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Burnout or Retire (4.12.2024)
Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. Is it time to worry about burnout and those who are leaving healthcare?
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Of 375 #Gout pts D/C pegloticase after a median of 8 infusions (taken 112days (max 1,240d). Only 73% had SUA < 6 during pegloticase. After D/C 84% went on ULT (63% allopurinol; 34% febuxostat; after mean 92d); after ≥ 30 days), 51% achieved SUA < 6 https://t.co/unkvt1whrs https://t.co/DgVpBgKXcm
Dr. John Cush RheumNow ( View Tweet)
Mental health in 1150 adolescents & young adults w/ juvenile idiopathic arthritis (age 15.6 yrs; Dz duration 7.2 yrs, 43% oligo-, 26% polyarthritis): 30% reported suicidal thoughts, 19% mod-severe depressive/anxious Sxs (moreso in Females OR 2.33) https://t.co/THW1IMqZpa https://t.co/IU2Kr3efYj
Dr. John Cush RheumNow ( View Tweet)
ICYMI: Top 5 Clinical Pearls in RA Management
https://t.co/zWRXzHTtIo https://t.co/rbitB9oWQG
Dr. John Cush RheumNow ( View Tweet)
Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005) https://t.co/ieHeXvgj3n https://t.co/MEMA1nrUpy
Links:
Dr. John Cush RheumNow ( View Tweet)
Join us 4/16 for Tuesday Night Rheumatology at 6:30pm ET. This week we'll be focusing on Vasculitis Mavens with:
Vasculitis & Pregnancy - Catherine Sims, MD
GPA Management in 2024 - Anisha Dua, MD, MPH
Treat to Target in Vasculitis - Philip Seo, MD
https://t.co/6IaCdCodGf https://t.co/HlZ8OiZWc4
Links:
Dr. John Cush RheumNow ( View Tweet)
JAMA: SLE Review
Drs.Siegel & Sammaritano (from HSS in NYC) published an impressive overview of SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.
https://t.co/byr1hRA6rV https://t.co/wZeIdfTlH0
Links:
Dr. John Cush RheumNow ( View Tweet)
Pearl: Patients with persistent TMJ pain are more likely to have fibromyalgia than inflammatory or degenerative arthritis (as the underlying cause of their chronic pain) https://t.co/G43rxKVHus https://t.co/4mCu7b0PGn
Dr. John Cush RheumNow ( View Tweet)
IL-1 recept accessory protein (IL1RAP) shown to block mediators (IL-1, IL33, IL36) that may drive systemic sclerosis. In vitro, IL1RAP inhibited fibroblasts and endothelial cells; in mouse models of SSc anti-IL1RAP decr dermal & pulmonary fibrosis. https://t.co/6YE02P4rjR https://t.co/mzw7t88Jzl
Dr. John Cush RheumNow ( View Tweet)
SLE in JAMA (authored by Drs Siegel & Sammaritano at HSS), impressive, full-read review, Covers:
- Presentations: skin, Jts, brain, heme, etc
- Treatments
- Prognosis
- Complications: CV, infx, CA
- FAQs
https://t.co/7WHYK3DgIf https://t.co/pC2MSCpn52
Links:
Dr. John Cush RheumNow ( View Tweet)
Polycyclic Aromatic Hydrocarbons Increase Lupus Risk
A case-controlled study shows environmental exposure to polycyclic aromatic hydrocarbons (PAH) may increase the risk of developing systemic lupus erythematosus (SLE).
https://t.co/AuYazGtamr https://t.co/S96LAuGtba
Dr. John Cush RheumNow ( View Tweet)
Join us 4/16 for Tuesday Night Rheumatology at 6:30pm ET. This week we'll be focusing on Vasculitis Mavens with:
Vasculitis & Pregnancy - Catherine Sims, MD
GPA Management in 2024 - Anisha Dua, MD, MPH
Treat to Target in Vasculitis - Philip Seo, MD
https://t.co/5tvMJ5P2FC https://t.co/sk8Te3iEIy
Links:
Dr. John Cush RheumNow ( View Tweet)
Best Imaging in Giant Cell Arteritis - US, PET, MRI?
Imaging is often instrumental in diagnosing and staging patients diagnosed with giant cell arteritis (GCA).
https://t.co/LXVB6cHDfO https://t.co/ArLNdEPuVx
Dr. John Cush RheumNow ( View Tweet)
This study examined the risk of neuroinflammatory disease after initiation of b/tsDMARDs
Overall risk of neuroinflammatory events among new users of TNF inhibitors did not differ substantially as compared to new users of other b/tsDMARDs
In AC&R
https://t.co/8rGgZmpq9c https://t.co/5gxuWBctBL
Links:
ACR_Journals ACR_Journals ( View Tweet)
Korean National Insurance claims study (2010-18) of NSAID use and CV events found among 19,775 RA pts (F/U 98290 PYs); there were 1663 cases of CV evens. Increasing NSAID doses incr incident CVD(adjHR 1.10); including CVA (aHR 1.09). CHF (aHR 1.12) https://t.co/mdRKYMQq1s https://t.co/36i2KT4j5A
Dr. John Cush RheumNow ( View Tweet)
LEGISLATION: In the USA, betw 2019-2023, 13 policies introduced in 7 different states to encourage nonpharmatologic measures for pain management (PT, CBT, acupuncture, chiropractic, etc). Only 2 were enacted, 3 in progress, 1 vetoed, 7 failed https://t.co/hYK3pRHG5D https://t.co/28PHVUiTD3
Dr. John Cush RheumNow ( View Tweet)
And of course, this https://t.co/fOWfnoHRrZ
Dr. Glaucomflecken DGlaucomflecken ( View Tweet)
I’m seeing some “free market” simps defending Nature’s 12k open access fees. Guess it’s time to bring this back around. https://t.co/sPW2qHN5m8
Dr. Glaucomflecken DGlaucomflecken ( View Tweet)
Tuesday Night Rheumatology- Psoriatic Arthritis - Hot Topics
Missed this past week's TNR? We've got you covered.
https://t.co/uXUnKFdp9o https://t.co/TJcycELCPg
Dr. John Cush RheumNow ( View Tweet)
JAMA: SLE Review
Drs.Siegel & Sammaritano (from HSS in NYC) published an impressive overview of SLE) in JAMA. This timely, well-written review covers the many complexities of this multi-organ disorder that affects nearly 3.4 million people worldwide.
https://t.co/H9M3KPDkhf https://t.co/WBMjKZzziX
Links:
Dr. John Cush RheumNow ( View Tweet)