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Best of 2023: How Being a Patient Taught Me to Be a Better Doctor
When I was accepted into medical school, my Dad (a trauma surgeon) taught me that as a doctor I should not judge and do my best not to let my personal views interfere with how I manage and interact with my patients.
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ICYMI: Here at Last: Treatment Options for VEXAS
We have known about the VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome for nearly 3 years, but there has been relatively little to say about how to treat it. To date there have been over twice as many publications about VEXAS (263 publications) as there have been patients described with respect to treatment strategies (116 patients). One of the late breaking abstracts may finally have rectified this imbalance.
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Best of 2023: 2023 ACR/EULAR Criteria for Calcium Pyrophosphate Deposition Disease
The prevalence of radiographic chondrocalcinosis is estimated to be 4% to ≥10% in older adults, but the prevalence of symptomatic CPPD disease is unknown.
https://t.co/gsCtfHzn4Z https://t.co/lIaf36epZY
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Best of 2023: How Being a Patient Taught Me to Be a Better Doctor
Since I can remember, I always wanted to be a doctor. My dad was a trauma surgeon and my mom a nurse.
https://t.co/JE4QoJy4jp https://t.co/jrJoqRD30P
Dr. John Cush RheumNow ( View Tweet)
Best of 2023: LAVLI - A New Autoinflammatory Disorder
NIH researchers have have described a novel autoinflammatory disorder called "Lyn kinase-associated vasculopathy and liver fibrosis" (LAVLI), based on a mutation in the LYN gene.
https://t.co/5nzq6KvOpy https://t.co/Y2MCXkGck2
Dr. John Cush RheumNow ( View Tweet)
Does King Charles have Sausage Digits (dactylitis) or OA? https://t.co/HpOdaXAxff https://t.co/HpOdaXAxff https://t.co/IrjJcxUG9b
Links:
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Metanalysis of Steroids in hosp community-acquired pneumonia (CAP). 18 studies, 4661 pts. Corticosteroids reduced mortality in more severe CAP(RR 0.62; 0.45 to 0.85), but not less severe CAP(RR 1.08). Steroids lower need for mech ventilation, ICU https://t.co/1QbuCZRXze https://t.co/16qiqIatJq
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Denosumab Reduces Type II Diabetes Risk. The British Medical Journal has published a matched cohort analysis demonstrating that adults receiving denosumab had a lower risk of NIDDM compared with those taking oral bisphosphonates for osteoporosis. https://t.co/vZALPMU8lI https://t.co/yGvDLHIp5y
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Bimekizumab in Hidradenitis Supprativa (HS) - results of 2 phase III BE HEARD I & II trials show Week 16 50% HS Responses to be 48% and 52% (vs PBO 29% and 32%). >75% maintained response out to wk 48; at wk 48, a 75% HS response seen in 55%. https://t.co/vAMPWV1gKi
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QD Clinic - Great Rheum Meetings
What makes for a great Rheumatology CME meeting?
https://t.co/tdb2crz8XP https://t.co/ZnMIhZpejO
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Best of 2023: 25 Great Women in Rheumatology
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NEJM - Clinical Images. Sleeve Sign and Inverse Gottron’s Papules in Anti-MDA5 Dermatomyositis. Erythematous plaques/patches on lateral aspects upper arms &; red patches, papules, pustules on ventral palms https://t.co/UHKGePi6TK
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Livedo reticularis is a painless, cyanotic cutaneous mottling in a fishnet pattern, often on extremities > trunk & exaggerated by cold. NOT specific but may be assoc w/ fibromyalgia, Raynauds, atheromatous or autoimmune Dz, hyperviscosity, thrombotic Dz https://t.co/8tGz1hIDiA https://t.co/3mw2RwTEeL
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- High mortality risk predictors in patients with anti-MDA5 dermatomyositis include:
- rapidly progressive interstitial lung disease
- anti-Ro52 antibody
- age > 57 years
(based on study of 126 MDA-5+ DM pts)
https://t.co/8bw1zpEOIh https://t.co/LKXMYtr7hU
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Empathy is the hard part.
The rest is mechanics. We're not wired to walk in someone else's shoes, it's not our first instinct.
Showing up with empathy is difficult, hard to outsource and will wear you out. But it's precisely what we need from you. - Seth Godin… https://t.co/U8Ou3WwBmC https://t.co/C4aAVovHDH
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RHEUMATOLOGIST SURVEY QUESTION - Is TYK2 part of the Janus Kinase family?
Click here to answer >> https://t.co/7SgvYqFe1W
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Maryland specialty clinic eval 1395 Lyme pts & saw marked differences between blacks & whites. Black patients had 5 fold (OR 4.93) higher risk of disseminated LD & delay in Abx Rx. Dissem Dz also more likely in men (OR, 1.6) EM Rash harder to spot https://t.co/NL8yJ9CdvQ https://t.co/dUUXyWYbsT
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Programmed-cell-death 1 (PD-1) expression on T-cells is assoc w/ activation & exhaustion. The exhausted phenotype of PD-1+CD8+ T cells add to the pathogenesis of active idiopathic inflammatory myositis. https://t.co/xOYfEs16ou https://t.co/MzEPpUc7Eb
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Danish study compared 106K adults w/ major osteoporotic fracture (hip, vertebrae, wrist, humerus) vs 1+ mill controls & found Mortality highest 30d following 1st index hip Fx (HR 10.98 women; & HR 16.40 men). Pneumonia most common cause of mortality https://t.co/0D7ynN4f5L https://t.co/qX61cgq1SL
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Cardiology 101 for the Rheumatologist
Dr. Janet Pope reports on a cardiology session presented a 2023 ACR Convergence in San Diego, CA
https://t.co/0cS8JVneIG https://t.co/6SIPx6WmqX
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