Daniel Morganstein

@graham74GC DPP-4 is expressed in lymphocytes. Is this really SGLT-2 being protective or an impact of inhibiting DPP-4 on lymphocytes behaviour?

Interesting & surprising! Lee et al - pts taking SGLT2 inhibitors signif less likely to develop lymphoma (e.g. FL, HL). Based on large propensity matched database analysis. #ASH23 #lymsm

Opportunity for a Pan-London Cancer Research Fellowship to study the impact of steroid induced hyperglycaemia during chemotherapy - with me, @Lennae13 and @PinkieChambers rmpartners.nhs.uk/applications-o…

Yesterday we launched the updated acute care toolkit 7. A must-read for all physicians caring for patients with cancer who are admitted to acute care: ow.ly/3KwR50Q2Y58 @acutemedicine

'Diagnostic criteria and proposed management of immune-related endocrinopathies following immune checkpoint inhibitor therapy for cancer' - a recently published review by Ruth Percik et al. Read it now: ow.ly/2E6j50OJU2g

NETs for Newcomers 2023 - Programme now LIVE on our website: ukinets.org/education/ Please register now!

Type 2 diabetes mellitus may influence efficacy outcomes from immune checkpoint blockade in patients with cancer 🔥 - proud to publish our experience with @ACortelliniMD @A_DAlessioMD @ImperialSandC @ImperialBRC @UniAvogadro @AACR @myESMO @ASCO aacrjournals.org/clincancerres/…

NETs for Newcomers Thursday 18th May 2023 Birmingham, UK. Full details here: neuroendocrinecancer.org.uk/nets-for-newco… #NeuroendocrineCancer #NETs @RoyalFreeNHS @ImperialNHS @TheChristieNHS @LeedsHospitals @SheffieldHosp @NHSScotAcademy

Please to share our paper in @DiabeticMed mapping diabetes and hyperglycaemia after immune checkpoint inhibitor therapy. @EndoLWBC @DrSanjayPopat Hyperglycaemia following immune checkpoint inhibitor therapy—Incidence, aetiology and assessment onlinelibrary.wiley.com/doi/10.1111/dm…

A big thank you to everyone that came along to our first #CWInnovation New Horizons event today. It was great to hear from @sadiahasnain, Dr Rachael Jones, Dr Sara Day and @DanielMorganst2 about Virtual Wards and Remote Monitoring @ChelwestFT.

@hormone_doc @pash22 @ProfRobHoward @barttels2 @AlbertoEspay @MadhavThambiset @LonSchneiderMD @nvillain_alz @MemoryDoc The mechanisms differ. Almetuzumab is essentially an immunosuppressive drug and the thyroiditis is postulated to be part of an immune reconstitution syndrome. The checkpoint inhibitors ( Ipi, Pembro etc) activate and induce something resembling natural autoimmune conditions.

@ShivaniM_KC Agree. I think a point of care test has to involve taking a sample and analysing it. If you were to use CGM in an inpatient setting more comparable to an O2 sats monitor ( not POCT) vs an ABG ( is POCT).

Is CGM a point-of-care test? I say NO: 1) CGM continuously senses whereas POC = interrupted / serial 2) POC = a test done in the lab, taken outside of the lab, but the lab can't 'do CGM' 3) delivery of POC needs quality assurance but CGM doesn't have any What do you think?

👉 53% of diabetic NSCLC patients receiving immunotherapy ➡️ hyperglycaemia. 👉 6% non-diabetic NSCLC pts ➡️ hyperglycaemia 👉 Does not affect survival 👍 Great collaboration between @ChelwestFT and @royalmarsdenNHS

@graham74GC How relavent is the grade system to endocrine side effects here - much like post immunotherapy need active screening and prompt hormone replacement.

At median of 8y, 98% of lymphoma pts who had an auto SCT had mod or severe late effect. 47% had mod or severe late effect in > 3 organ systems. Assoc with ⬇️ QoL. * Sobering * #lymsm Smeland et al haematologica.org/article/view/h…

For Health Care Professionals (HCPs) only: @NHSEngland @NHSScotland @NHSWalesDU @UKINETS @CardiffGastro @FrontGastro_BMJ @BTOGORG @M4RareDiseases @BMJMasterclass @drphiliplee1 @Medic_Russell

UK recommendations for #SDHA germline genetic testing and surveillance in clinical practice #OpenAccess: bit.ly/3CtX7zw #Cancer #GCChat #Paraganglioma #Phaeo @UKCGG @McVeighTerri @De1Diana @tischkowitz @ER_Woodward @clare__turnbull

@DrNicolaDavis Definitely highlight immunotherapy toxicity - as presents very differently from other oncology treatment effects - and probably more likely to present to primary care. Fatigue for example may not raise much concern in a patient receiving chemo or radiotherapy but red flag in ICPI

Have any of my oncology colleagues done teaching on treatment related side effects for GPs? I’m putting together a talk but would be good to hear what others have done?

@hugorifkind 2/2 But a lateral flow will miss some cases so if you have symptoms should not be using them and go direct to a PCR which is more accurate.

I'm confused. If they're scrapping PCRs for people who test LF positive with no symptoms, where's the sense in keeping them for people who DO have symptoms?

@hugorifkind It’s simple: Lateral Flow less accurate - but if used regularly in those without symptoms will pick up many who are most infectious. Despite being less accurate when there is this much COVID around a positive lateral flow is almost certainly a true positive. 1/2

@Maherjane @KathrynBanfill @Existential_Doc @hormone_doc Agree - the cumulative steroid doses used to treat some IRAE are eye watering, largely due to the prolonged courses. They need glucose monitoring and bone protection like any other long term steroid group.

@KathrynBanfill @Existential_Doc Similar discussion re immunotherapy toxicity @hormone_doc

I've never found the evidence behind why we give 8mg bd of dexamethasone in oncology for brain mets, MSCC, SVCO etc (it was 6mg bd one place I worked). Does the dose even need to be this high?