Discover and read the best of Twitter Threads about #Rheumatoid
Most recents (7)
😣Patient: "All my joints are painful & swollen!"😣
👩⚕️But when you examine the patient, you don't find any joint swelling
How to approach this scenario? 🤷
#MedTwitter #RheumTwitter #MedEd 🧵🧵🧵
(1/10)
👩⚕️But when you examine the patient, you don't find any joint swelling
How to approach this scenario? 🤷
#MedTwitter #RheumTwitter #MedEd 🧵🧵🧵
(1/10)
Now there are two possibilities
1️⃣ There was a joint swelling which is no longer there
OR
2️⃣ There was no joint swelling to begin with
(2/10)
1️⃣ There was a joint swelling which is no longer there
OR
2️⃣ There was no joint swelling to begin with
(2/10)
Let's start with the first one– there was indeed joint swelling which is no longer there
That means we are dealing with
☝️ An episodic inflammatory disease
✌️ Drug modified disease
(3/10)
That means we are dealing with
☝️ An episodic inflammatory disease
✌️ Drug modified disease
(3/10)
#Methotrexate is the nr1⃣drug of choice for Rheumatoid #Arthritis.
MTX's history is eventful, and deserves a 🧵
🔹It started with childhood leukeamia
🔹Sleeping Beauty in the 1960-70's
🔹Awakened by Hoffmeister
🔹FDA👍1988 and 🔝 in the 1990's
1/🧵 #RheumTwitter #MedTwitter
MTX's history is eventful, and deserves a 🧵
🔹It started with childhood leukeamia
🔹Sleeping Beauty in the 1960-70's
🔹Awakened by Hoffmeister
🔹FDA👍1988 and 🔝 in the 1990's
1/🧵 #RheumTwitter #MedTwitter
The start:
🔹1948, Dr Farber treated 5 children with #leukemia with Aminopterin, an anti-folate & precursor of #MTX, with outstanding results
🔹1951, first positive results of Aminopterin in #RA & #Psoriasis pts
Despite this, Aminopterin was aborted in RA
2/🧵 #RheumTwitter
🔹1948, Dr Farber treated 5 children with #leukemia with Aminopterin, an anti-folate & precursor of #MTX, with outstanding results
🔹1951, first positive results of Aminopterin in #RA & #Psoriasis pts
Despite this, Aminopterin was aborted in RA
2/🧵 #RheumTwitter
MTX enters:
Due to difficulties in manufacturing, Aminopterin was modified and MTX was created.
🔹1962, positive results with MTX in both RA and #PSA
🔹Next 10 years: MTX was extensively studied in #psoriasis but halted in #RA
🔹In RA, MTX becomes the Sleeping Beauty👸💤
3/🧵
Due to difficulties in manufacturing, Aminopterin was modified and MTX was created.
🔹1962, positive results with MTX in both RA and #PSA
🔹Next 10 years: MTX was extensively studied in #psoriasis but halted in #RA
🔹In RA, MTX becomes the Sleeping Beauty👸💤
3/🧵
💭When we think of #Rheumatoid #Arthritis , a mental image of this comes up 👇
But does it have to get to this🤔???
🙅NO! Definitely, NO! 🙅
#MedTwitter #MedEd #RheumTwitter #Rheumatology
@MedTweetorials
(1/8)
But does it have to get to this🤔???
🙅NO! Definitely, NO! 🙅
#MedTwitter #MedEd #RheumTwitter #Rheumatology
@MedTweetorials
(1/8)
🪜The first step is early diagnosis, do not wait until the deformities to form!
💬Think of RA when a patient presents with
🔸Peripheral
🔸Symmetric
🔸Arthritis
🔸Morning stiffness>30 minutes
#MedTwitter
(2/8)
💬Think of RA when a patient presents with
🔸Peripheral
🔸Symmetric
🔸Arthritis
🔸Morning stiffness>30 minutes
#MedTwitter
(2/8)
🧪👨🔬A positive Rheumatoid factor is seen in ~70% of cases and anti-CCP in ~75% cases, so about 1/5th of the cases may be seronegative!!
So a good history and clinical examination is the king 👑
(3/8)
So a good history and clinical examination is the king 👑
(3/8)
The Gut #Microbiome is implicated in the pathogenesis of inflammatory arthritides & other health conditions
Gut dysbiosis is a broad term relating to an 'imbalance' of gut microbiota associated with an unhealthy outcome
I find this an interesting topic with several unknowns
🧵
Gut dysbiosis is a broad term relating to an 'imbalance' of gut microbiota associated with an unhealthy outcome
I find this an interesting topic with several unknowns
🧵
"Gut inflammation is strongly associated with #Spondyloarthritis (SpA), as exemplified by the high prevalence of inflammatory bowel disease (IBD) and the even higher occurrence of subclinical gut inflammation in patients with #SpA."
nature.com/articles/s4158…
nature.com/articles/s4158…
"Gut #Microbiome composition differs across regions and ethnicities, changes over time, and can be influenced by multiple factors, including, among others, diet, lifestyle, hormonal cycles, disease, comorbidity..."
'Gut microbiome in #Rheumatic diseases'
ard.bmj.com/content/80/11/…
'Gut microbiome in #Rheumatic diseases'
ard.bmj.com/content/80/11/…
1/
Another #immunosuppression #tweetorial...spotlight today on #belatacept today
How do you say it? @Babybel @MedTweetorials
Another #immunosuppression #tweetorial...spotlight today on #belatacept today
How do you say it? @Babybel @MedTweetorials
2/
Belatacept is the FUSION protein that has been the @NKOTB in #kidneytransplant - having been approved for use in 2011.
What's fused?
1. Human IgG1 Fc fragment
2. Extracellular domain of cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4)
pubmed.ncbi.nlm.nih.gov/25416857/
Belatacept is the FUSION protein that has been the @NKOTB in #kidneytransplant - having been approved for use in 2011.
What's fused?
1. Human IgG1 Fc fragment
2. Extracellular domain of cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4)
pubmed.ncbi.nlm.nih.gov/25416857/
3/
The goal of this fusion protein? Disrupt Signal 2⃣ of the 3⃣-Signal T-cell activation pathway
Signal 2 = Binding of CD28 (on T-cell) to B7-1/B7-2 (on APC)
This important step is called co-stimulation and is necessary for T-cell activation
nejm.org/doi/full/10.10…
The goal of this fusion protein? Disrupt Signal 2⃣ of the 3⃣-Signal T-cell activation pathway
Signal 2 = Binding of CD28 (on T-cell) to B7-1/B7-2 (on APC)
This important step is called co-stimulation and is necessary for T-cell activation
nejm.org/doi/full/10.10…
Our foundation needs your input. I am writing about Microdrop's "imaware" home #celiac test and #rheumatoid #arthritis tests. Reply, DM or send an email to me at jiscol@celiaccommunity with your experience. Your name will not be published without your permission. RTs helpful.
We would like to hear about your Microdrop @imaware_health #celiac or #rheumatoid #arthritis test experience, positive or negative, whether adults or children were tested, whether you acted on the results, whether you looked into it and haven't purchased one, etc.
If you used an @imaware_health home #celiac or #rheumatoid #arthritis test in LATE APRIL, MAY or JUNE, we have an extra interest in hearing from you.
If you are an influencer paid to promote the company or received a free test, please disclose.
Qs are welcome - thanks!
If you are an influencer paid to promote the company or received a free test, please disclose.
Qs are welcome - thanks!
📆El 12 de Octubre se celebra #WorldArthritisDay 📆
🗣️Hablamos de la #ArtritisReumatoide 🗣️
📌"The extra-articular impacts of #Rheumatoid Arthritis: moving towards holistic care"👌
🔸Dolor
🔸Fatiga
🔸Ansiedad/Depresión
🔸Caquexia
🔓🔓⤵️⤵️#EULAR
ncbi.nlm.nih.gov/pubmed/30886982
🗣️Hablamos de la #ArtritisReumatoide 🗣️
📌"The extra-articular impacts of #Rheumatoid Arthritis: moving towards holistic care"👌
🔸Dolor
🔸Fatiga
🔸Ansiedad/Depresión
🔸Caquexia
🔓🔓⤵️⤵️#EULAR
ncbi.nlm.nih.gov/pubmed/30886982
1⃣ Dolor
🔸No todas las Causas son articulares
🔸Es el #síntoma que más preocupa a los pacientes.
🔸Es muy frecuente el Tto #Farmacológico 💊, y no tanto #Ejercicio 🏋️♂️🏊♂️#Fisioterapia 🖐️🧠 #Psicológico
👇👇👇
🔸No todas las Causas son articulares
🔸Es el #síntoma que más preocupa a los pacientes.
🔸Es muy frecuente el Tto #Farmacológico 💊, y no tanto #Ejercicio 🏋️♂️🏊♂️#Fisioterapia 🖐️🧠 #Psicológico
👇👇👇
2⃣ Ansiedad y Depresión😰😧
🔸Aparece con bastante frecuencia 📊
🔸Diferentes causas de aparición
🔸Vuelve a aparecer tendencia a Tto Farmacológico pero apenas #Psicológico 🧠🗣️➡️Escasez de medios
🔸Guía NICE para manejo 📖📚
🔸Aparece con bastante frecuencia 📊
🔸Diferentes causas de aparición
🔸Vuelve a aparecer tendencia a Tto Farmacológico pero apenas #Psicológico 🧠🗣️➡️Escasez de medios
🔸Guía NICE para manejo 📖📚
