Victor Pimentel-Quiroz

👇👇👇👇👇👇👇👇👇👇👇👇

Management of ANCA-Associated Alveolar Hemorrhage: A Bayesian Reanalysis of the PEXIVAS Trial jrheum.org/content/early/…

Inflammatory Myopathies | New England Journal of Medicine nejm.org/doi/full/10.10…

In ANCA-associated vasculitis, a person's antibody type can be used to predict lung damage and guide treatment, per a study using CT scans. buff.ly/Dq6gSrJ

Anti-neutrophil cytoplasmic antibody-associated vasculitis: biological insights and biomarker-guided disease management dlvr.it/TSVRfl

🦴 Rheumatoid Arthritis Treatment — EULAR 2025/2026 Update ⸻ 1️⃣ Methotrexate (MTX) Remains First-Line ➊ Start MTX immediately after diagnosis ➋ Escalate rapidly up to 25 mg/week + folic acid ➌ Aim for remission or low disease activity within 3–6 months ⸻ 2️⃣ Steroids = Short-Term “Bridge” Only ➊ Use the lowest dose possible ➋ Taper rapidly — ideally within 3 months ➌ Avoid chronic steroid use due to cumulative toxicity ⸻ 3️⃣ If MTX Fails → Reassess Risk ➊ Poor prognostic factors: • High RF/ACPA • Early erosions ➋ No poor factors → switch to another csDMARD ➌ Poor factors present → add bDMARD or tsDMARD ⸻ 4️⃣ Biologics vs JAK Inhibitors ➊ bDMARDs and tsDMARDs are now on similar footing after csDMARD failure ➋ Choice depends on: • Comorbidities • Safety profile • Patient preference ⚠️ JAK inhibitors require screening for: • VTE risk • Malignancy history • Major cardiovascular events (MACE) • Herpes zoster risk ⸻ 5️⃣ Combination Therapy Matters ➊ Combine biologics/JAK inhibitors with MTX when possible ➋ Improves efficacy and reduces immunogenicity 📌 If MTX contraindicated → IL-6 inhibitors or JAK inhibitors are preferred monotherapy options ⸻ 6️⃣ Sustained Remission Strategy ➊ Consider tapering only after >6 months stable remission ➋ Taper order: • Steroids first • Then biologics/JAKi • csDMARDs last 🚫 Avoid abrupt discontinuation to reduce flare risk ⸻ 7️⃣ Difficult-to-Treat (D2T) RA ➊ Defined as failure of ≥2 biologic classes ➋ Re-evaluate for fibromyalgia or non-inflammatory pain mimics ➌ Switch mechanism of action rather than cycling within the same class ⸻ 📚 Get our new Musculoskeletal Book —-focused revision notes for USMLE, PLAB, MRCP & NEET-PG 🦴✨ 🌐 Visit our website: mediconotes.com #Rheumatology #MedEd #USMLE #MedicalEducation #NEETPG

Wipe that ‘SMILE’ away! #hydroxychloroquine did NOT ❌ reduce onset of #SLE #lupus In people w 2 or 3 #criteria for lupus & +ANA Smile trial sad 😢 Dr Judith James #CCREast

Today #PANLAR2026 came to a close, I am proud of our team, we presented nine abstracts from our cohorts and we also participated in nine more collaborative efforts. One of them was an oral presentation, done by our first-year fellow Nadja Ludeña

Nice talk on management of #IgG4RD by @VictorioPQ @GEAS_Peru #PANLAR2026

Today #PANLAR2026 begins and @VictorioPQ will talk about the treatment of #IgG4RD

Depression among rheumatologists in Latin America😥 ☑️Moderate to severe depression: 15.8% ☑️More prevalent among: younger physician, fewer practice years, lower income, shorter vacation, experiencing burnout 📝Need to promote well-being and mental health journals.lww.com/jclinrheum/ful…

Mepolizumab (MEPO) spacing in EGPA. 🇯🇵 cohort study, 43 patients treated with MEPO, ☑️10 patients extended interval to every 5 to 6 weeks ☑️Flares: 7 during standard-interval period vs 1 during the spaced period🔥 📝No difference in the time to relapse journals.lww.com/jclinrheum/ful…

#Myositis mimics are a regular challenge encountered in clinics, and critically important for our patients. A real pleasure working with #neurology colleagues on this—highlighting practical #guidance that is especially useful for new consultants : lnkd.in/eupVTqze

#VEXAS syndrome | Nature Reviews Disease Primers share.google/aSbUCQcjPVnedL…

Seguro esto ya lo habían compartido, pero vale la pena ponerlo de nuevo. Clásicamente, para diferenciar el derrame pleural de tipo trasudado de exudado, se usan criterios de Light: 🔴Proteínas pleural/suero >0.5 🔴DHL pleural/suero >0.6 🔴DHL pleural >2/3 LSN Pero esta joya de Porcel (2026), logró la misma sensibilidad (99%) y AUC (0.84), usando SÓLO líquido pleural, cualquiera de: 🔴Proteínas e líquido pleural: >3 g/dL 🔴DHL en líquido pleural: >250 UI/L 🔴Colesterol en líquido pleural: >55 mg/dL Misma utilidad, menos muestras de sangre, más rapidez, menos costo. Codifiqué las reglas para Calculus, la pueden usar gratis acá (droliverioambriz.com/calculus/crite…).

⭐ Leflunomide in Lupus Nephritis

📌 Revised Approach to ANCA Testing in ANCA Associated Vasculitis 🧾 1999 Consensus Step 1: Screening •IIF (Indirect Immunofluorescence) Step 2: Confirmation (if IIF+) •PR3-ANCA •MPO-ANCA Concept •IIF first → ELISA second •Two-step mandatory approach 🧪 2017 Consensus (Revised Approach) Step 1: Initial Test •PR3-ANCA •MPO-ANCA Gating Strategy •ANCA+ → supports AAV •ANCA− + high suspicion → second assay 🔁 Second Testing (When Needed) •High clinical suspicion + negative ANCA → ↑ sensitivity •Low antibody levels / borderline → ↑ specificity ⚖️ Key Shift •IIF-first ❌ •Immunoassay-first ✅ Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis. Nature Reviews Rheumatology. 2017;13(11):683–692. #RheumattDoc #MedTwitter #RheumTwitter #Medicine #rheumatology @docakx @IhabFathiSulima @CelestinoGutirr @DurgaPrasannaM1

Long-term survival for EGPA patients has improved in Japan, likely due to multiple factors rather than a single disease therapy, per a study. buff.ly/f3xrsrG

@CesarAcunaP Igual no pasarás!

La incompetencia de la ONPE y de Piero Corvetto es criminal: dejar a miles de peruanos sin votar no es un simple error logístico, es un golpe directo a la voluntad popular. Exigimos: - Que la Fiscalía denuncie penalmente a Corvetto por omisión de funciones. - Que la JNJ proceda con su destitución inmediata por estas graves irregularidades. ¡El voto no se negocia! No permitiremos que la ineptitud administrativa anule la voz de miles de peruanos. #LaDemocraciaSeRespeta #Elecciones2026

الروابط الجديدة لموقع sci-hub لتحميل الابحاث العلمية المدفوعة 👇👇 1- sci-hub.ee 2- sci-hub.xin 3- sci-hub.ai 4- sci-hub.st 5- sci-hub.se 6- sci-hub.do

@cesarcombina @ONPE_oficial Por las...

No se puede votar en: Surco, San Borja, Magdalena, San Isidro, Lurin, Miraflores, San Miguel, SJM, VES y varios otros distritos por responsabilidad de la @ONPE_oficial ... Esto es FRAUDE