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  • Jul 10, 2020
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    For Jessica, an ICU nurse, 12-hour shifts were usually fast paced, challenging and productive. But the cadence and demands of work abruptly changed mid-March when COVID-19 came. Amongst her many ICU admissions she took care of Larry, who was instantly interesting and forever memorable. He had contracted the coronavirus less than a week before. He was a 60-ish yr. old man who tried to be humorous, but who was clearly distressed and worried. He was febrile, anxious, breathing hard and on the verge of being unstable. 
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ICYMI: Protective Benefit of Colchicine in COVID-19 Infection

Jul 10, 2020

Colchicine has been advocated as a potential anti-inflammatory intervention in patients with the coronavirus 2 infection and clinical trials have been developed to assess its effect in early COVID-2 infection.  JAMA has published a randomized clinical trial showing that low dose colchicine had less clinical deterioration without significant changes in biomarkers, such as high-sensitivity cardiac troponin and C-reactive protein.

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10 FALSE reasons for not wearing a mask - https://t.co/zOViN8n4Yw Please wear a mask out of concern and care for others !!

Dr. John Cush @RheumNow (  View Tweet)

Jul 10, 2020
Check my updated virtual video joint exam for rheumatologists - Video here> https://t.co/ZXEUKcw5mb or listen to the podcast>> https://t.co/XSHWuwxJ9L https://t.co/lBtG0lvAZM
Dr. John Cush @RheumNow (  View Tweet)
Jul 10, 2020
Open label, uncontrolled study shows that background use of azathioprine (2mg/kg) in Pegloticase treated refractory… https://t.co/uXQR8JE1he

Dr. John Cush @RheumNow (  View Tweet)

Jul 10, 2020
Skin is often involved w/ ANCA+ vasculitis - 1184 AAV pt study shows skin involvement in 34% GPA; 28% MPA & 47% EGPA. Common are petechiae/purpura pruritus, urticaria, and maculopapular rash.

Dr. John Cush @RheumNow (  View Tweet)

Jul 10, 2020
Great NY Times article on 30+ years of an adversarial friendship between Dr. Tony Fauci and AIDS activist Larry Kramer (who recently passed away). Keen that adversaries can still be on the same side, pushing for change differently https://t.co/lnfk6fXfF2

Dr. John Cush @RheumNow (  View Tweet)

Jul 10, 2020

ICYMI: Preventing COVID - Masks, Meters and Eyewear

Jul 09, 2020

A Lancet systematic review and meta-analysis provides the basis for physical distancing and the value of making as measures to prevent infection with coronavirus 2 (SARS-CoV-2) or COVID-19. The analysis included 172 observational studies, no randomised controlled trials and 44 relevant comparative studies involving 25 697 patients. 

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H2H UPA vs ABA RCT; UPA is clinically superior to ABA in DAS-CRP remission, ACR50, ACR70 at wk 12/24 (NOT diff in P… https://t.co/7lwVCSYjPu

Dr. John Cush @RheumNow (  View Tweet)

Jul 09, 2020
Avacopan is as effective as steroids in ANCA Assoc Vasculitis – 330 pt RCT AAV Rx w/ RTX or CTX but randomized to p… https://t.co/mxm5NAjZtL

Dr. John Cush @RheumNow (  View Tweet)

Jul 09, 2020
#EULAR2020 #op0201 nationwide cohort study: higher incidence of dementia in SLE (3.9/1000pys) vs non-SLE ( 2.73/1000pys). HR 1.43. SLE risk of Alzheimer’s 1.4x &risk of vascular dementia 1.6x Higher than non-SLE cohort.

Dr. John Cush @RheumNow (  View Tweet)

Jul 09, 2020

ICYMI: COVID-19 and Thrombotic Complications

Jul 08, 2020

Severe and fatal outcomes with coronavirus infection are often the result of the downstream damage that follows the viral infection. Rising high on the list of complications are the hematologic and vascular complications seen in severely affected patients, so much so that many centers are routinely anticoagulating hospitalized (but not ambulatory) COVID patients.

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AHRQ estimates that 40-80% of information a patient is told during an office visit is forgotten immediately, and that almost half of the information a patient does retain is actually incorrect https://t.co/XeGx2YXsOQ

Dr. John Cush @RheumNow (  View Tweet)

Jul 08, 2020
23 yoF with 1 mos digital ulcers, hair loss, sicca Sxs, dysphagia; No sclerodactyly but finger tips cyanotic w/ distal pitting scars, ischemic ulcers, periungual erythema & dilated nailfold capillaries (no hemorrhages). +tests for ANA, Ro52, Ro60 and Scl-70 Abs. How to treat?

Dr. John Cush @RheumNow (  View Tweet)

Jul 08, 2020
African-Americans with Ank Spondylitis have worse disease compared to whites. Study of 10,990 AS patients shows AA to have high frequency of anterior uveitis, hypertension, diabetes, depression, and heart disease and higher ESR and CRP levels.

Dr. John Cush @RheumNow (  View Tweet)

Jul 08, 2020

ICYMI: The Nine Lives of Hydroxychloroquine (Updated)

Jul 07, 2020

Hydroxychloroquine is one of many medications frequently used in rheumatology practice. Its remarkable versatility is attested by its routine use in lupus, in patients with an autoimmune coagulopathy, in patients with rheumatoid arthritis, as well as in those with a low-level inflammatory arthropathy.

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Rheumatology Round-Up from #EULAR2020 w/ Drs. Kavanaugh & Cush.

Dr. John Cush @RheumNow (  View Tweet)

Jul 07, 2020
#EULAR2020 #op0106 Cosentyx 150mg demonstrates clinical improvement in NrAxSpA Sx in Ph3 PREVENT @52wk. Significant improvement in ASAS40, BASDAI50& ASdAS-CRP ID.
Dr. John Cush @RheumNow (  View Tweet)
Jul 07, 2020
CDC guidelines for Rx of Latent Tuberculosis; Preferred: A) 3 months of once-weekly INH plus rifapentine (3HP); B) 4 months of daily rifampin (4R); C) 3 months of daily INH plus rifampin (3HR) - Shorter, safer, effective with higher completion rates.

Dr. John Cush @RheumNow (  View Tweet)

Jul 07, 2020
A msg from my nurse friend: “A blood clot from my pt yesterday. Covid lungs. I helped changed his code to DNR, talked to his son/ex wife/brother&sister to say goodbye. He asked if I would pray w/him. I prayed. He cried. Then I walked out & lost it.
k dao @KDAO2011 (  View Tweet)
Jul 06, 2020
Case Controlled Study of 482 RA patients with ILD vs 741 RA w/o IL found an inverse relationship Between MTX exposu… https://t.co/ljtaKO8pVZ

Dr. John Cush @RheumNow (  View Tweet)

Jul 06, 2020
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