Friday, 15 Feb 2019

Today's Headlines

Stopping Biologics Before Joint Surgery: Is Earlier Better?

Withholding intravenous abatacept (Orencia) for longer than a month before hip or knee arthroplasty among patients with rheumatoid arthritis (RA) did not lower the risk for postoperative infection, a retrospective claims-based analysis found.

Mortality and Hospitalization with Pulmonary Hypertension in Systemic Sclerosis

PHAROS is a prospective cohort studying the natural history of pulmonary hypertension (PH) in systemic sclerosis (SSc). They have shown that risk factors for poor outcomes in this cohort included male sex, DLCO < 50%, exercise oxygen desaturation, and pericardial effusions. 

Noninfectious Proximal Aortitis Needs Serial Follow-ups

A Cleveland Clinic review of patients undergoing thoracic aortic surgery (1996‐2012) identified 196 patients with histopathology‐proven non‐infectious aortitis. The majority of these patients had a recognized systemic disorder, and serial assessments and imaging is crucial to an accurate diagnosis.

No Added Benefit to MRI-Guided Therapy in Rheumatoid Arthritis

A treat-to-target (T2T) strategy to manage rheumatoid arthritis hinges on clinical metrics to optimize therapy. But investigators from Denmark have shown that using magnetic resonance imaging–guided T2T failed to improve disease activity remission rates or reduce radiographic progression.

Differing Effects of Smoking and HLA-DRB1 in Seropositive Rheumatoids

Analyses from the Swedish EIRA incident rheumatoid arthritis cohort study shows that smoking and HLA-DRB1 exert differential effects on serologically defined RA subsets - but that the strongest influence was seen in double positive (CCP+, RF+) individuals.

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He would have died. About 4 weeks ago, my 74 year old father-in-law, “Pops” was admitted to a small community hospital for delirium and worsening congestive heart failure. He was seen by a caring hospitalist and a local cardiologist who was deemed good by all the locals, but they could not get him better. Despite the delirium, Pops pleaded he wanted to live to see my 8 year old son graduate high school. My husband, who is an internist, respected the other doctors’ decision and did not want to interfere with his dad’s medical care. With tears in his eyes, he whispered, “I wish we could do more.” My heart was heavy as I did not want to go against my in-law’s wishes to get a second opinion. Trying to make the right decision, I talked to my colleagues, I talked to my patients, and I talked to my own family: what should I do? Go against my in-law’s wishes and transfer him to Dallas for a full evaluation or be complicit in the Do Not Resuscitate Order?
This “How to Use RheumNow” blog is intended to help those of you who would like to get better use and quick hints on consuming RheumNow content. This is also a good opportunity to get some feedback from you on what we could do better or how we could serve your interests and online education. What keeps you up at night? We would really like to know.
It’s hard work wearing a crown. The dermatologists have been dethroned as Medscape’s happiest specialty after years at the top. While studies only detail that we are the most satisfied outside of work, I argue we are the happiest working, too. With an N of 1, here are my 10 observations.
Resolutions are about the new and better you. Yet most people discard resolutions, largely because they are satisfied with the status quo or are afraid of change. Here's are some suggestions for being the best version of yourself in 2019.
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