Thursday, 22 Mar 2018

Today's Headlines

Novel Approach to Knee Osteoarthritis Pain

Geniculate artery embolization was found to dampen knee pain arising from osteoarthritis, according to interim study results presented at the 2018 annual meeting of the Society of Interventional Radiology.

One month after the catheter-based procedure, patients reported having less intense knee pain on a visual analog scale (VAS; baseline 75 mm, average decrease of 53 mm, P<0.01).

Time to Rethink Gout as a Chronic Disease

The current issue of JAMA has a perspective article on Gout’s bad rap as dietary disease rather than the complex, chronic inflammatory disorder that is ineffectively treated in many. 

The author and experts interviewed believe that the pipeline of new drugs for gout will fuel the future of evidence-based care and more informed lifestyle instruction.

Using Synovial Tissue Biopsies to Develop Precision Medicine for Rheumatoid Arthritis

Researchers at Northwestern University have used ultrasound-guided tissue biopsy from the joints to analyze the genes of tissue macrophages with the hope that transcriptional profiling of synovial macrophages may be correlated with clinical parameters or drug responsiveness in rheumatoid arthritis (RA) patients.(Citation source: 

MMWR: Arthritis Prevalence Increases and Varies Widely

MMWR reports that In 2015, the number of adults with arthritis continued to increase; with marked geographic variability in arthritis estimates with gaps in arthritis management.

The CDC estimates that physician-diagnosed arthritis affects 54 million of adults in the United States with an annual cost of approximately $300 billion annually.

Repeat Malignancy Unlikely with Biologic Therapy

Research from the Danish biologics registry shows that the use of a biologic in patients with a history of a primary cancer does not increase the risk of a second malignant neoplasm (SMN) or mortality in rheumatoid arthritis (RA) patients.

They analyzed 15,286 RA patients in the DANBIO Register between 2000–2011 and found 1678 with a primary cancer.  The majority (1203) did not use biologics after. 

The RheumNow Week in Review - 16 March 2018

Dr. Jack Cush reviews the highlights from the news, journals and major meetings. Bigtime rheumatologic lessons with tales from intestinal crypts, the friendly skies & the hips of hockey players. Also the microbiome and lupus, benefits of ENT findings with GPA and rare risk of opportunistic infections with biologics.


I’m a firm believer that your desk space is a window to your soul, if not your neuroses. 

My first year fellow and colleague kept his desk meticulously sterile. It was so sparsely decorated and clean, he could be the poster child for minimalism. This was in drastic contrast to our program director, who had papers and books strewn about and multiple half-filled coffee cups surrounding his desk. His chair was typically found in the middle of the room with his white coat thrown about like a kindergartener’s art project. 

Here are my observations from the natural habitats and home-base of rheumatologists.  

A 3rd year medical student started his rotation with me this past week and the rotation was a challenge for us both.

Several years ago, long before promotional lectures, I traveled for a series of lectures. I flew north for 4 days and 4 lectures, 2 at major university programs and 2 dinner lectures to local rheumatologists.

The first lecture went well but the weather turned bad, with a snow storm in the overnight forecast.  Hence my host, a local drug rep, suggested we drive at night to beat the snow and get to the next city for the 10 am University lecture the following morning.

The one-hour drive felt like a week in Cleveland. 

“It’s unbelievable how much you don’t know about the game you’ve been playing all your life.” - Mickey Mantle.

What I know and learned is often the subject of blogs on RheumNow. Yet, I’ve always been challenged and irked by what I don’t know.

Angie is my last patient before lunch. I've known her since her RA diagnosis at age 17 years. And for the last 7 years, she’s matured into a fabulous young woman who has adeptly grown her professional life, her dating life and developed her independence, despite her severely active rheumatoid arthritis. But today I see she has a troubled and anxious look as I greet her. 

Dr. Jack Cush: The Hot Seat Cases
Dr. Jack Cush discusses his presentation on "Hot Seat Cases", and highlights three of the cases that were discussed at the 2018 RWCS Meeting in Maui.


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