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Pain in the Neck (7.28.2023)

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. This week COVID persists, mortality from misdiagnosis, and cervical pain is more than a pain in the neck.

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IL-23 Inhibitor Performance in Psoriatic Disease

d Jack Cush, MD

IL-23 inhibitors are approved for the treatment of psoriasis and psoriatic arthritis; a single center real-world observational study shows three commercially available IL-23 inhibitors have high and similar drug survival and effectiveness in difficult-to-treat psoriasis and PsA.

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2023 ACR/EULAR Criteria for Calcium Pyrophosphate Deposition Disease

d Jack Cush, MD

The prevalence of radiographic chondrocalcinosis is estimated to be 4% to ≥10% in older adults, but the prevalence of symptomatic calcium pyrophosphate deposition (CPPD) disease is unknown. To advance our understanding of CPPD, the American College of Rheumatology and EULAR have published validated classification criteria for symptomatic CPPD disease.

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Unrecognized Mental Health Problems in Autoimmune Diseases

d Jack Cush, MD

More than half of patients with auto-immune conditions experience mental health conditions such as depression or anxiety, yet the majority are rarely or never asked in clinic about mental health symptoms, according to new research from the University of Cambridge and King’s College London.

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Unrecognized Mental Health Problems in Autoimmune Diseases More than half of patients with auto-immune conditions experience mental health conditions such as depression or anxiety, yet most are rarely asked in clinic about mental health symptoms. https://t.co/wxuGmuPh7D https://t.co/jMZkH1SIcS

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EULAR/ACR Guidance on HLH/MAS A EULAR/ACR task force has established evidence based, up-to-date guidance, and expert opinion on the evaluation, management and monitoring of patients with HLH and MAS. https://t.co/rZkxuaCsSf https://t.co/c0kHKmZbyt

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Dr. John Cush RheumNow ( View Tweet)
Rheumatoid vasculitis (RV) metanalysis: RV decreased sincefrom 9.1 (1988-2000) to 3.9 (2001-2010) per million. RV risk increased w/ smoking, disease duration, seropositivity, males, HLA-DRB104, HLA-C3. Common: skin (65–88%), CNS(35–63%), cardiac (33%) https://t.co/VADI7DbKSc https://t.co/UwJQmzpmkZ

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While COVID rates are near historic lows & far less dangerous, hospitalizations are up 10.3%, ER visits up 7%, pos. tests rose to 6.3% from 5.8% in the last week https://t.co/TFAt4p24au

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UK-NiCE Guidelines on Gout: Treat to Target to Prevent Irreparable Joint Damage Indications for Urate-lowering Rx: - Multiple/troublesome flares - CKD 3 to 5 - Diuretic Rx - Tophi - Chronic gouty arthritis https://t.co/eUqQpn7QUI https://t.co/eAGTRShYlf

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Dr. John Cush RheumNow ( View Tweet)
IL-1β inhibitors can be effective in #Gout. Based on metanalysis of 14 studies(10 RCTs), 4367 gout pts (Rx w/ anakinra, canakinumab rilonacept) Shows CAN, RIL better than active comparator at pain; CAN/RIL reduced gout flares https://t.co/57JSFtLLJD https://t.co/RueDE01jHj

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Link Between Vitamin D and Psoriasis Severity More than 8M people in the US experience psoriasis-a person’s vitamin D levels could play an important role in psoriasis severity, according to one of the largest studies to date. https://t.co/IMvFS0Vp4v https://t.co/cmQAIQ0U4p

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Dr. John Cush RheumNow ( View Tweet)
Dr. Joseph Flood (1952-2023) - Past ACR President Dr Joseph Flood, a past president of the American College of Rheumatology, passed away on July 13, 2023 at age 70 due to complications of liver disease, diabetes and liver cancer. https://t.co/G0elIbTsGg https://t.co/TaxCBxpOpo

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Dr. John Cush RheumNow ( View Tweet)
What is your effective treatment for rheumatoid Nodules?

Dr. John Cush RheumNow ( View Tweet)

Chronic neck pain is associated with increased mortality in individuals with osteoarthritis. NHANES study of 5965 adults, OA in 8.2% and 5.9% had neck pain. Neck pain assoc w/ 2 fold risk OA. OA pts w/ chr neck pain higher all-cause mortality risk (OR ~3) https://t.co/MLzJUa3AnY https://t.co/WB8lhvUOjw

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Dr. John Cush RheumNow ( View Tweet)
Ignaz Semmelweis (1818-65) a Hungarian physician whose work demonstrated that hand-washing could drastically reduce the number of women dying after childbirth. For this reason he is known as the ‘saviour of mothers’. #historyofmedicine #handwashing #obstetrics #antisepsis https://t.co/qt1kbPamXK
Past Medical History PastMedHistory ( View Tweet)
When you're the boss, "reasons don't matter...success or failure is totally within your control" - Steve Jobs https://t.co/5rDanu7Oj4
Dr. John Cush RheumNow ( View Tweet)
Estimated 795 000 Americans are misdiagnosed annually (371,000 pts die; 424,000 permanently disabled). Just 15 diseases account for about half of all serious harms & top 5 (Stroke, Sepsis, Pneumonia, VTE, Lung CA) account for 39% https://t.co/3pvgGLLHbs https://t.co/94ij9txIyK

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Structured interviews from 462 pts from Michigan SLE clinic. 22% admit to cost-related non-adherence (CRNA) over 12 mos. CRNA associated signif. higher levels SLE disease activity & more lupus damage. Worse scores in those with Fibromyalgia https://t.co/NHIIqmWVqJ https://t.co/zX4gTFTcW7

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Adding Trabecular Bone Score (TBS) to FRAX and BMD enhances Fx risk prediction in osteoporosis. TBS is validated index of bone microarchitecture from LS spine DEXA. TBS is good at fragility Fx risk and monitoring response to OP Rx https://t.co/T7EStHyDBq https://t.co/sct79nTzBO

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Dr. John Cush RheumNow ( View Tweet)
CMS billing data shows female MDs are 25% more likely than male MDs to leave academia (OR 1.25; 1.23-1.28); at all stages of their careers. At 5 yrs, attrition rate from academia was 34.2% (38.3% for females and 32.4% for male physicians). https://t.co/5wZKuYrdoB https://t.co/wNPGOCDSJ4

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Dr. John Cush RheumNow ( View Tweet)

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