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    Gloria was the charge nurse on 3 West when a “code” was called. Action, running, and commotion ensues as the crash cart, nurses, and respiratory therapist appear at the bedside. Two residents emerge as the patient is hooked up to the monitor. While everyone assumes their position and role, Gloria ensures the protocol and steers the people, pumping, intubating, monitoring and medicating. 
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Review of Toll-like Receptor Research

EurekAlert!

A new review on Toll-like receptors (TLRs) systematically summarizes forty years of discoveries in the TLR field, from the initial identification of Toll in Drosophila embryonic development to the current understanding of multilayered regulatory mechanisms that govern TLR signaling.

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More Comorbidity in Difficult-to-Treat RA A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA). https://t.co/guMm6mqJGr https://t.co/xiykw5tBlJ
Dr. John Cush @RheumNow (  View Tweet)
STEP Talk: Mitigating Surgical Risk with Dr. Susan Goodman Surgery is high stakes for rheum patients. Dr. Susan Goodman shares how to mitigate perioperative risk and optimize outcomes at #RheumNowLive 2026. Smart prep = better recovery. https://t.co/AM1N3SimiY #Rheumatology https://t.co/wk99ytXZKl
Dr. John Cush @RheumNow (  View Tweet)
Global trends in systemic sclerosis (SSc) mortality. Betw 2001-23, in 74 countries, 85,291 SSc deaths (79% females). While SSc-Crude mortality increased from 1.97 (2001) to 2.34 (2023), the age-standardized mortality decreased from 1.58 to 1.29. declining in Americas & Europe. https://t.co/lvHbF5HLPY
Dr. John Cush @RheumNow (  View Tweet)
Full read review of Preclinical Rheumatoid Arthritis: - Mucosal Origin Hypothesis - Gut Microbiota - Smoking & environment - Periodontitis - Immunosenescence - T cell abnormalities - Drug prevention https://t.co/UgqNBnKLMT https://t.co/2YZEiRCKNi
Dr. John Cush @RheumNow (  View Tweet)
HLA-B27 in PsA: assoc w/ earlier onset, axial Dz, enthesitis, systemic inflammation. Study of 333 CASPAR PsA pts - 12% HLA-B27 positive--earlier onset (43 v 49), axial (46 v 24%), enthesitis (33 v 18%). No signif differences in sex, dactylitis, uveitis, Rx responses, https://t.co/ALP6AnygSf
Dr. John Cush @RheumNow (  View Tweet)
Rheumatoid Factor as a Potential Marker of Cardiometabolic and Hepatic Risk. RF has been assoc w/ ASHD, MI, CAD, ischemic stroke, obesity, insulin resistance, type 2 diabetes, and metabolic syndrome -- all mediated via downstream inflammation. https://t.co/gQvqMJmyPw https://t.co/TmoodnuJTe
Dr. John Cush @RheumNow (  View Tweet)

A Patient’s Plea for a New Paradigm in Autoimmune Disease

A current article in Nature Reviews Rheumatology has a patient boldly asking why we rheumatologists aren't more like her oncologists?

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Breaking the Rules: Dual-Advanced Combinations in Rheumatology

For decades, the standard of care in rheumatology has been combination therapy - pairing methotrexate (MTX) with an advanced biologic or synthetic agent to achieve optimal outcomes. 

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24 systemic amyloidosis pts (AA type 46%, AL 29%); 62% joint pain & AM stiff, axial 37.5%, macroglossia (4 pts, 17%), carpal tunnel (12%), proteinuria > 1 gm 50%, CKD 21%, Cardiac amyloid 29%. Amyloid was secondary to Rheum Dx in 11/24. Better survival w/ AA than AL (91% vs https://t.co/pAEqYJIKaw
Dr. John Cush @RheumNow (  View Tweet)
Taiwan, real-world study 267 RA new DMARD starts w/ tofacitinib (145) or TNFi (122). Post adjustments; no significant difference in Efficacy, AEs, Serious AE (20 v 21%), MACE (0 v 0.8%), CA (2% vs 0.8%), deaths (1.4% vs 3.3), SIE (13% vs 8.2%) or H zoster (12% v 3%) https://t.co/XLsdfKyeGx
Dr. John Cush @RheumNow (  View Tweet)
French prospective study of pregnancy in 94 RA & 124 SpA pts. RA more likely to flare 1st 6 mos postpartum (62 v 43%), while SpA remained stable in preg & postpartum. bDMARD continuation during pregnancy was more frequent in SpA; 55-60%restarted bDMARD postpartum. https://t.co/usKHS4wYbN
Dr. John Cush @RheumNow (  View Tweet)
Great Lectures; Great Presentations Dr. Jack Cush lectures on giving a great presentation; based on 40 years of lecturing in Rheumatology. https://t.co/AvW8Z7bhkl https://t.co/LeI7oPDRan
Dr. John Cush @RheumNow (  View Tweet)

Metabolic Syndrome Predicts Cardiovascular Outcomes in Inflammatory Arthritis

Chronic inflammatory arthritis (CIA) is associated with elevated cardiovascular risk. While metabolic syndrome (MetS) is prevalent, how much it contributes to adverse clinical outcomes is unclear.

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More Comorbidity in Difficult to Treat RA

A systematic review demonstrated that smoking, obesity, fibromyalgia, and depression are significantly associated with difficult-to-treat rheumatoid arthritis (D2T-RA).

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JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/cq3CuIuMKX
Dr. John Cush @RheumNow (  View Tweet)
By @RheumattDoc #Psoriasis and nail changes #PsA #PsoriaticArthritis #enthesitis #dactylitis https://t.co/rxH2zrGBwC
Dr Gurdeep S Dulay @gurdeep_dulay (  View Tweet)
U.S. spending on prescription drugs in 2025 jumped 13% to $915 billion=projected to surpass $1 trillion in 2026, according to ASHP/USA today. One major reason– the popularity of the weight-loss and diabetes drugs tirzepatide and semaglutide. https://t.co/EQ9yFCCdBp https://t.co/cig1jNp6NF
Dr. John Cush @RheumNow (  View Tweet)
Steroids Corticosteroids remain a cornerstone of rheumatologic therapy — rapidly effective but chronically dangerous, as their power to suppress inflammation through inhibition of prostaglandins, lipoxygenase, pro-inflammatory cytokines, and proteases comes at the cost of a https://t.co/fKGgYF3yWA
Dr. John Cush @RheumNow (  View Tweet)
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