It's Nurses Week and time to reaffirm our reverence for nurses. Dr. Jack Cush gives a video testimonial to the dedication, dependability and excellence Nurses bring to patient care. God Bless our Nurses! 

MMWR reports that after attending a 2.5 hr choir practice with one COVID+ symptomatic person, 87% of the choir developed COVID 19; 3 were hospitalized, and two died. 

The ACR has published the 2020 guidelines on the management of gout that includes strong recommendations favoring treat‐to‐target management and starting urate lowering therapy (ULT) for patients with frequent flares, radiographic damage or tophi due to gout.

The EXCEED study was a head-to-head trial of secukinumab (SEC) versus adalimumab (ADA) as first-line monotherapy in psoriatic arthritis (PsA) patients; this 52 week trial showed that while SEC failed to achieve clinical superiority over ADA, SEC treated patients demonstrated higher

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com.

Severe and fatal outcomes with coronavirus infection are often the result of the downstream damage that follows the viral infection.

Modifiable lifestyle choices can impact long term health.  A recent study shows that usual and increased physical activity can results in less hospitalization amongst the the general population.

Dr. Len Calabrese from the Cleveland Clinic delivers this week's Tuesday Nite Rheumatology Grand Rounds, entitled "IL-6 in Health and Disease: Where Rheumatology Meets COVID-19".

Dr. Calabrese provides a comprehensive review of IL-6 biology, and discusses IL-6 signaling, IL-6 roles in health, exercise, infection, innate and adaptive immunity as pertains to both rheumatology and the management of coronavirus infection.

Hydroxychloroquine has been a dominant news item since the start of the COVID-19 crisis, with a great deal of misconceptions by those who don't know or use or take the drug. HCQ leaped to the headlines on March 19th when President Trump endorsed the drug as being “approved” by FDA. Of course at that time, it was still only approved for SLE, RA and malaria and it wasn't until 2 weeks later (March 31st) that the FDA issued an "emergency use authorization" allowing the use of either chloroquine or HCQ for treatment of severe, hospitalized patients with COVID-19.

To provide clarity and evidence - here are some of the facts you need to know.

On April 26, 2020 the American College of Rheumatology (ACR) published a guidance paper to assist rheumatologists and rheumatology health professionals in assessing the need for urgent or face-to-face medical care versus virtual or telehealth patient care.  The driving principals being

JAMA Internal Medicine has reported that cigarette smoking associated with an increased odds of having antineutrophil cytoplasmic antibody–associated vasculitis (AAV) (especially MPO positive AAV) and is thereby a modifiable risk factor for AAV.

Many patients with rheumatoid arthritis (RA) who achieved remission or low disease activity on biologic treatment were able to reduce the dose of their biologic, particularly if they were also on methotrexate, a retrospective study found.

JAMA Cardiology reports the risk of QT (QTc) prolongation when hydroxychloroquine (HCQ) was given to hospitalized patients with coronavirus disease 2019 (COVID-19), especially when given with azithromycin. 

The oral cannabinoid receptor type 2 (CB2) agonist lenabasum showed promising results for systemic sclerosis (SSc) in a phase II study.

The Annals of Rheumatic Disease has published the preliminary recommendations of the German Society of Rheumatology for the management of Inflammatory rheumatic diseases patients during the SARS-CoV-2/Covid-19 pandemic.

These preliminary recommendations are based on an expert consensus from 17 experienced German rheumatologists.

The world has been turned upside down in the last 6 weeks. Medicine and rheumatology have certainly changed – a frightening experience for Chicken Little, a disaster for the pessimist, a challenge for the pragmatist and an opportunity for the optimists amongst us. Last week I asked our audience to tell me their “upside or downside of COVID-19”. Read on to see how your peers have operating or thinking.

Pediatricians are asking the question - could this be a rare manifestation of COVID-19 in children?

In the last few days there have been encouraging "preliminary" reports that IL-6 inhibition by either tocilizumab or sarilumab may be efficacious in patients with severe coronavirus infections.