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RheumNow Weekly Podcast – 3 Wiseguy Rheumatologists (11.9.18)

Dr Jack Cush reviews the News and Journal reports from the past week on  Be sure to check out our upcoming meeting in March 2019 - RheumNow Live.

  1. What works in Dactylitis? Literature review suggests ustekinumab, ixekizumab, adalimumab, and apremilast are efficient. Secukinumab, clazakizumab, abatacept, and tofacitinib were promising. Brodalumab was ineffective
  2. Analysis of Natl Inpatient Sample database (1998-2014) compared outcomes in 87605 SLE pregnancies vs matched cohort: found SLE had more C-section, IU fetal death, Pre-eclampsia, VTE, CKD, HTN, longer stays Presented by Dr. Bella Mehta #ACR18 Abst 1852
  3. Durkan Test for CTS is when the Examiner presses the thumbs over carpal tunnel and holds pressure for 30 seconds. The onset of pain or paresthesia in the median nerve distribution within 30 seconds is a positive result .
  4. Study of 512 pts shows when testing for Carpal Tunnel syndrome Thenar atrophy & sensory loss were highly specific, but thenar atrophy had lowest sensitivity (22%) & Durkan test highest (96%). Tinel had lowest specificity 40.9% and NPV 59.1%.
  5. Korean claims data analysis shows intestinal Behcets disease is associated with a 24-34 fold increased risk of hematologic malignancy (esp leukemia, myelodysplasia) vs population. BD Women not men) have an overall higher cancer risk (SIR 4.27)
  6. JAMA Metanalysis shows there is limited evidence showing the benefit of reduced dietary salt intake in heart failure patients.
  7. DEA report says 2017 was a record year for Opioid Overdose deaths - 72,000 or ~ 200 deaths per day; lead by Heroin, fentanyl, other opioids, methamphetamine and cocaine.
  8. Should Immunoglobulins be Monitored with Rituximab Use   
  9. Low Short-Term Risks of NSAIDs in High Risk Patients  
  10. Controversial New Super Opioid Approved by FDA  
  11. Frankincense is derived from Boswellia plants. Boswellia serrata is an Ayurvedic purported to be anti-inflammatory; inhibits 5-lipoxygenase & possibly prostaglandins, Pilot studies in OA have shown significant pain relief and improved physical function
  12. Do you know who patients perceive to be a "great doctor"? Just listen - it’s always someone who shows they care and/or someone with a personality. Dispassionate, know-it-all service isn’t well received!


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