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Pre-Diabetes Associated Risk for Arthritis, Obesity and Physical Inactivity

d Jack Cush, MD

The current MMWR reports that arthritis is seen in nearly one-third of adults with prediabetes and that more than half of such patients are obese and not engaged in regular physical activity.

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MMWR: Death by Firearms

d Jack Cush, MD

The CDC's Morbidity and Mortality Weekly Report (MMWR) reports that during 2015–2016 there was a total of 27,394 firearm homicides and 44,955 firearm suicides among US residents, with 12% and 5% of events occuring in children 10–19 years.

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CIRT Trial - Methotrexate Fails at Cardiovascular Prevention

d Jack Cush, MD

Methotrexate has been shown to reduce cardiovascular (CV) deaths in rheumatoid arthritis (RA) patients. Given that inflammation underlies the pathogenesis of atherothrombosis, Dr. Paul Ridker and colleagues studied the value of low dose methotrexate (MTX) in preventing cardiovascular events.

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RheumNow Weekly Podcast – 3 Wiseguy Rheumatologists (11.9.18)

d Jack Cush, MD

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

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Intensive Patient Education Does Not Improve Low Back Pain Care

d Jack Cush, MD

JAMA reports on a randomized clinical trial of 202 adults with acute low back pain showing the addition of intensive patient education failed to improve pain outcomes.

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E/M Guidelines: Right Road, Wrong Direction

d RheumNow

Last July, the Centers for Medicare & Medicaid Services (CMS) proposed new E/M guidelines for office visits with physicians. It issued the final guidelines on November 1, with a few tweaks.

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Metanalysis of 28 studies, 52,520 psoriasis cases shows high prevalence of sexual dysfunction (40-56%) and erectile dysfunction (34-81%), with strong associations with anxiety, depression, genital psoriasis and increasing age. https://t.co/2myhgWEW1a

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Dr. John Cush RheumNow ( View Tweet)

Anticoagulation (AC) advice from #ACR18 - Stony Brook study of Temp artery bx found 20/27 pts on AC prior to procedure - Data from 16pts showed continuing AC found only 3/16 with minor bleeding adverse events - Abst #2782 https://t.co/TDsdfO27J9.

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Dr. John Cush RheumNow ( View Tweet)

NEJM publishes the CIRT trial - Methotrexate given to stable atherosclerosis patients for nearly 3 years was equal to placebo in the prevention of cardiovascular outcomes (MI, CVA, death, unstable angina). Story covered on RheumNow https://t.co/YCdwzKD9Da

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Dr. John Cush RheumNow ( View Tweet)

Connecticuts medical marijuana program has 31 approved medical conditions and just approved medical marijuana for use in intractable headaches, rheumatoid arthritis, degenerative spinal disorders, muscular dystrophy & osteogenesis imperfecta. https://t.co/iuyyWrCQOE

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Dr. John Cush RheumNow ( View Tweet)

Physicians and NRA square off in a twitter war regarding CDC reports and ACP position papers on the epidemiology of firearm violence and the need for gun control in the USA. https://t.co/EbwAOLNlvU

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Dr. John Cush RheumNow ( View Tweet)

Metanalysis of 10 studies and 204 RA patients suggests that during pregnancy disease activity improved in 60% of patients but flared post-partum in nearly half (47%). https://t.co/DHeY4rgKu1

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Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - 3 Wiseguy Rheumatologists. Watch it here https://t.co/WudWQPRtXl or listen on iTunes or here https://t.co/OOJ0e2IG0L

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Dr. John Cush RheumNow ( View Tweet)

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 https://t.co/OPxal73aIF

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Dr. John Cush RheumNow ( View Tweet)

BMJ metanalysis of toxicity w/ checkpoint inhibitors shows risks w/ atezolizumab (hypothyroid, N/V) , pembrolizumab (arthralgia, pneumonitis, hepatic tox), ipilimumab (skin/GI/renal), nivolumab (milder, endocrine); Nivolumab (best safety w/ lung CA) https://t.co/qzcehpLe4S

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Dr. John Cush RheumNow ( View Tweet)

What works in Dactylitis? Literature review suggests ustekinumab, ixekizumab, adalimumab, and apremilast are efficient. Secukinumab, clazakizumab, abatacept, and tofacitinib were promising. Brodalumab was ineffective https://t.co/SLPcjBaNAv

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Dr. John Cush RheumNow ( View Tweet)

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 https://t.co/iYicIbOlxP

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Dr. John Cush RheumNow ( View Tweet)

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 . https://t.co/1wlJWzX68H
Dr. John Cush RheumNow ( View Tweet)
Do you know who patients perceive to be a "great doctor"? Just listen - its always someone who shows they care and/or someone with a personality. Dispassionate, know-it-all service isnt well received!

Dr. John Cush RheumNow ( View Tweet)

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%. https://t.co/Wi8qxNSxIg

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Dr. John Cush RheumNow ( View Tweet)

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