This probably explains why my #Covid_19 patient today was desaturating on BiPAP, but got better on CPAP #medregoncall

We had a discussion at RheumNow Live with an ID expert. There is no compelling reason to stop biologics or immunosuppressives because of COVID19. There is research on the potential benefits of Plaquenil, baricitinib and IL-6 inhibitors in Rxing COVID19

To become a brain-surgeon, bridge-designer, airline pilot, ship’s captain, you need rigorously examined qualifications, fitting the serious responsibility. To lead a major country with nukes & a trillion-scale budget … er … let me see, what are your qualifications?

Hi @MedtronicUK Sending things as signed for post to anyone who works means they need to take time out of their day to go pick them up. You sent 2x copy of letter that needed signed for, one of which accidentally had no postage on it so I had to pay to pick it up. Now this:

A really informative review on ’Osteosarcopenia’ by @DrGustavoDuque et al. Reiterates the importance of muscle and bone groups working together to combat falls/fractures with aging!

This is excellent and will make you smile all the way through to the footnotes.

🚗Happy Birthday to the #M6 motorway! 60 years old today! 🚗🎂🎈🎉

Prof Mason: Carotid changes in Takayasu's can be imaged by ultrasound! Also PET, CT angio - needed instead of US if no carotid involvement but PET access limited in some areas.

Nice slide discussing the different and important role of imaging modalities in Takayasu Arteritis c/o Prof Justin Mason #vasculitiseducationday #ManchesterRheumatology

Why did the man with sarcopenia cross the road? Because physical activity elicits muscle protein synthesis through the mTOR pathway via release of phosphatidic acid and focal adhesion kinases when coupled with appropriate resistance training thereby improving quality of life.

Consider more than inflammatory markers in possible vasculitis - microcytic anaemia, thrombocytosis, low albumin and slightly elevated IgG also point to chronic inflammation - Prof Justin Mason #vasculitisstudyday

Prof Moots: Bio Behçets trial currently recruiting in Liverpool if you have patients with Behçets who are needing biological therapy - they are looking for more participants.

People with Behçets may present repeatedly to primary care (in case described, for 10years) prior to underlying issue being identified in multisystem disorder - rare (800pts in England) so difficult to think of it in primary care, decide where to refer etc

How to treat vascular Behcet’s syndrome: * Control inflammation with high dose pulsed steroids * Immunosuppressants: steroids, (transplant drugs), biologics, (autologous peripherals stem cell transplant) * Avoid anticoagulants! Prof Rob Moots #vasculitiseducationday #wythenshawe

Avoid anticoagulation in Vascular #Behçet���s Disease. - Prof Rob Moots #vasculitisstudyday #universityofmanchester

New Behçets guidelines highlighted by Prof Moots are here:

Behcet’s disease diagnostic criteria - Prof Rob Moots #vasculitiseducationday #wythenshawehospital

Pathergy test can be positive in Behcet’s disease but also in other conditions (e.g. Sweet’s syndrome). Negative pathergy test doesn’t rule out BD - Prof Rob Moots #vasculitiseducationday #wythenshawehospital

Reminder to LOOK at the mouth ulcers your patients with possible behcets report - get them to take pictures at home and do consider a differential incl oral manifestations of IBD (Prof Moots)