Monday, 27 Jun 2016

Today's Headlines

Family History Doesn't Influence Rheumatoid Arthritis

To assess whether family history of rheumatoid arthritis (RA), among the strongest risk factors for developing RA, also carries information on the clin
METHODS:
Researchers at the Karolinska Institute have studied their prospective Swedish Rheumatology register the role of a family history of rheumatoid arthritis (RA) on clinical presentation or treatment responses.  

AS Diagnosis Linked to CVD Risk

Prevalent patients with ankylosing spondylitis (AS) face a 30–50% increased risk of acute coronary, cerebrovascular, and thromboembolic events compared with the general population.

But although an AS diagnosis appears to increase relative risk for cardiovascular events, that increase is not as great as the relative risk observed among patients with rheumatoid arthritis (RA).

Infection Risk Increased in Giant Cell Arteritis

French researchers recruited 486 patients with giant cell arteritis (GCA) from over 40 centers throughout France, and compared their outcomes to age and sex matched individuals randomly selected from the general population. Both groups were followed for 5 years and assessed for the risk of serious infections.

Hypogonadism Ups the Risk of Autoimmunity

In a variety of models, testosterone has been shown to be immunosuppressive and deficiency of testosterone has been linked with autoimmune disease and increases in C-reactive protein (CRP), tumor necrosis factor, and interleukin-6 (IL-6). There have been no studies to examine the association between low levels of testosterone and autoimmunity.

Predictors of Progression in Early Inflammatory Polyarthritis

A substantial, but unclear, percentage of patients presenting with new onset inflammatory polyarthritis (IP) will spontaneously remit, while others may persist and develop rheumatoid arthritis (RA).

Researchers with the Norfolk Arthritis Register (NOAR) assessed the frequency of remission in IP patients assessed at baseline and years 1, 2, 3 and 5. Remission was defined as no tender or swollen joints.

New EULAR Guidelines on Behçet's

At the EULAR 2016 meeting, new EULAR recommendations for the management of Behçet's disease (BD) were presented (http://buff.ly/28OxkGQ).  These were developed by a multidisciplinary expert committee that reviewed the evidence from the medical literature and developed final set of 9 recommendations:

A $20 Drug Company Meal Yields 2-5 Times More Prescriptions

Accepting a single pharmaceutical industry-sponsored meal was associated with higher rates of prescribing certain drugs to Medicare patients by physicians, with more, and costlier, meals associated with greater increases in prescribing, according to an article published online by JAMA Internal Medicine.

BLOG

It was at the end of the visit with the patient I've only seen three or four times for her osteoa

I recognized the tone in his voice. I recognized the clipped words and the unmistakable undertone of bother and dismay. I recognized them because I have had the same tone, the same clipped speech and latent frustration in my voice: and now I was on the receiving end of this undercurrent of impatience. It took my recent stint as a patient to make me realize how important the call from the patient can be.

After several months’ hiatus, I am back and writing about my recent trip to London. My past blogs centered on wine from my rheumatology-related trips and experiences. Moving forward I'm adding a culinary dimension; hence, it will be Wine, Food and the Rheumatologist. My bone fides? Well, I like to eat, that is for sure - but more than that, I like to cook. 

Rheumatologists distinguish themselves from their medical colleagues in several ways: exceptional joint exam and joint injection skills, interpretation of complex immunologic findings and cost-efficient ways of managing common musculoskeletal disorders. But what’s the one trait, skill or question that defines the acumen of the rheumatologist? Please don’t say morning stiffness. 

I had a 20-minute visit scheduled with Mrs. Goldstein yesterday. She is a thin, foreign-born, older woman with rheumatoid arthritis, recently complicated by lymphoma. As I sat, I asked “where is your husband this morning”, as he usually attends her medical visits. I had already turned to the computer and started to bring up her file, meds, etc. There was a long pause before she finally answered.   

Spending almost half of the year traveling, I am privileged to get to read lots of books. I rarely read a book twice. This book was an exception.  

What do you call it when you say one thing and the listener hears something else?

EULAR 2016 Round-Up - Dr. Jack Cush
/vef/load/1411e3e62055ae95f576d5006d8f5035?width=640&height=365

Daily Download

Scope of Infections Associated with Biologic Use

Biologics and Tofacitinib have common and uncommon infections associated with the st

Survey

What is the most important study to come out of EULAR 2016?