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Cytomegalovirus Increases Thromboembolism Risk in ANCA-associated Vasculitis
Infection may play an important role in the genesis of vasculitis and ANCA seropositivity; this report suggests that past cytomegalovirus infection may be a risk in the occurrence of venous thromboembolism (VTE) in patients with anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis.
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Rheums! Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/1aSrRsLkel https://t.co/gmh155ty6w
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Systematic review of Telemedicine in Rheumatology - 36 reports: 27 observational studies, 7 RCTs , 2 controlled trials - most on general rheum. Most show TM as good as usual / in-person care (Dzactivity, pt satisfaction, costs, & feasibility). TM Works https://t.co/04QW8UiB8j https://t.co/846sqKbnX1
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Study of 497 pts referred by general practitioners to rheumatologist (2018-19) showed:
- GP Dx changed by Rheum in 58%
- Low complexity Dx (FM, OA) acct for 50% referrals
- 46% of referrals inappropriate
- GP correlations w/ Rheum Dx poor (κ < 0.5) https://t.co/q592iHQZbq https://t.co/XyPdtpHQGK
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OPTION-DM study of 140 diabetic neuropathy pts Rx for 16 weeks w/ one agent (& if no response) an add-on agent. At wk 16, all 3 regimens lowered nerve pain score from 6.6 to 3.3 w/ no difference between Elavil+Lyrica, Lyrica+Elavil, o Cymbalta+Lyrica) https://t.co/rijJyq1DYL https://t.co/NwHF6xuF0j
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Dr. John Cush RheumNow ( View Tweet)
Life expectancy for Americans is the lowest it's been since 1996. Read about the decline from @sheridan_kate https://t.co/QwkOmOt2Tp https://t.co/wavGjOv6q5
STAT statnews ( View Tweet)
Prospective study of 124 adults hospitalized w/ acute MSK trauma saw good outcomes in 23% @6 mos & 61% @12 mos. Worse outcomes assoc w/ posttraumatic stress Sxs (OR 2.09), pain intensity (2.87), # fractures (2.79)& pain extent (4.67) https://t.co/ubuyWCBFgU https://t.co/ZfNGUQ1i0e
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Influenza Vaccination Recommendations
The CDC has published an update to the recommendations from the Advisory Committee on Immunization Practices (ACIP) on the use of seasonal influenza vaccines in the United States for the 2022-23 season.
https://t.co/6V21XZUsqX https://t.co/ln9bqta6UT
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Dr. John Cush RheumNow ( View Tweet)
The prospective CARDIA cohort study studied 2110 adults (38 - 50 yrs) for 10+ yrs and showed those taking >7000 steps/day had a 50% to 70% lower risk of mortality (vs those taking <7000 steps/day). https://t.co/lE152z8vTw https://t.co/hjfnCN4bno
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Charcot (neuropathic) arthropathy of elbow due to Syringomyelia - review of 50 pts. Median age 45 yrs, 2/3 isolated elbow arthritis; other joints: shoulder > wrist > MCPs/IPs. 2/3 had Chiari malformations, sensory/motor deficits, or ulnar neuropathy https://t.co/2hEArpbL8p https://t.co/MK4VTzSSRB
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Cochrane review of Stem cell transplantation in systemic sclerosis (3RCTs w/ 125 pts). Non‐myeloablative & myeloablative selective HSCT had moderate evidence for improved survival, skin thickness & function. But these had high Serious AE rates. https://t.co/sGzWYLwcAZ https://t.co/7JiR0fe3GY
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HIgher mortality in thos with lower serum uric acid levels, is partly explained by low SUA assoc w/ sarcopenia and weight loss. NHANES study (1999-2006) of 13,979 people shows low SUA assoc w/ low lean mass, underweight BMI, & weight loss https://t.co/YC2a6eXqCb https://t.co/aZ18jbCcn4
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Melatonin Use Growing, Inappropriate & Potentially Unsafe
With nearly 1/3 of adults, adolescents and children having sleep difficulties, many resort to using melatonin. But is it effective, safe and warranted?
https://t.co/JrvfN1Awy3 https://t.co/NbVKAuUT1u
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No benefit to social networking (SN) in RA. 210 #RA pts randomized to RA website +/- guided discussion/sessions; most were facebook familiar. @3 & 6 mos knowledge & self efficacy improved in both groups; w/ more satisfaction in FB grp (p≤0.04) https://t.co/TQtsRyse59 https://t.co/rY2DBTFjp0
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CDC report of fungal infx in US 2019 - coccidioidomycosis (20,061), histoplasmosis (1,124) & blastomycosis (240). Most Cocci cases (97%) AZ & CA; most Blasto (75%) in MN &WI; most Histo in IL (26%), but also MN, MI, WI, IN, LA, AR. https://t.co/XjZ9NX9nkM https://t.co/fA71SI4RK3
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Dr. John Cush RheumNow ( View Tweet)
Rheums! Do you have a rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
https://t.co/cvmbzknQqA https://t.co/6mX5eRUNuU
Links:
Dr. John Cush RheumNow ( View Tweet)
Has insurance moved to a new tactic to intimidate doctors from appeals? I was expecting to do a peer to peer to get #Xeljanz approved, they put me on the phone with a courtroom judge to make me swear I am telling the truth about why the medicine is needed for the patient.
TheDaoIndex KDAO2011 ( View Tweet)
Amgen and ChemoCentryx, (maker of newly approved Avacopan)have entered into a definitive agreement wherein Amgen will acquire ChemoCentryx for ~$3.7 billion ($52 per share). https://t.co/8quO9ET8vH https://t.co/AphPizgKo8
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Dr. John Cush RheumNow ( View Tweet)
Private insurance claims data suggests that in the last 5 yrs Lyme disease has increased 19% (urban) to 60% (rural areas). Prevalence highest in June & July. Top 5 states - NJ, Maine, VT, Rhode Island, Conn. https://t.co/QHnhiWLOk3 https://t.co/7fYWQe0nBh https://t.co/GYKekF4Enf
Dr. John Cush RheumNow ( View Tweet)
JAMA overview of Patient Reported Outcomes (PROs) - how generated, validated, used and limitations.https://t.co/572KxUO59s https://t.co/5c6xQfZqzu
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Dr. John Cush RheumNow ( View Tweet)
