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The Match Game (4.14.2023)
Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com, including Rheumatology success in the NRMP MATCH, Cocaine vasculitis and worrisome safety risks with Biologics and tsDMARDs.
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Doctor’s Contracts: Pitfalls and Traps
I have signed a few employment contracts in my career. Signing a legal document always makes me nervous. Did I forget to add something, was there something in the fine print I missed, should I have clarified a clause, what happens if I break a clause or cannot fulfill the contract obligations?
I spoke with Andrea Liberatore, JD, to navigate these questions and explain what to look for in a contract.
Pain and Opioid Updates
Today, the CDC and FDA provided new updates on the scope of pain in the USA and guidance on the use of opioids.
MMWR April 14, 2023
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Probiotic strain Ligilactobacillus salivarius studied in gout (as it metabolizes purines). 30 pts w/ hyperuricemia & recurrent gout were given L. salivarius or allopurinol for 6 mos. Probiotic group had less gout attacks (5/15) than controls (13/15). https://t.co/YYq4zHEPoB https://t.co/aitjaTgx8B
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Dr. John Cush RheumNow ( View Tweet)
This past Tuesday Night Rheumatology was focused on contracts and contract negotiations.
This highly informative discussion featured:
Gwenesta B. Melton, MD, FACR ( @gwenesta_melton )
Andrea Liberatore, JD
Kathryn H. Dao, MD ( @KDAO2011 )
https://t.co/fK7JkQQzRZ https://t.co/aDHA5COq2V
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Dr. John Cush RheumNow ( View Tweet)
RA Patients on Biologics and tsDMARDs are still High Risk
A new Swedish ARTIS registry study of key safety outcomes in RA patients receiving either targeted synthetic or b/ts DMARDs, including JAKi, has been updated and affirms previously held risks.
https://t.co/mqfP4deGJv https://t.co/m43GSRlrct
Links:
Dr. John Cush RheumNow ( View Tweet)
Best Treatments for Immune Checkpoint Inhibitor-associated Arthritis
A retrospective study of cancer patients who developed ICI-IA shows that biologic DMARDs were more effective than csDMARDs in rapid control of arthritis.
https://t.co/O5bMpwwM8Z https://t.co/H27RSA3oMt
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Dr. John Cush RheumNow ( View Tweet)
Mentoring is Personal
Dr. Una Makris ( @UnaMakris ) shares a few lessons learned about being both a mentor and mentee.
https://t.co/6UyHlre0hL https://t.co/iGS4LDcnO0
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Dr. John Cush RheumNow ( View Tweet)
Clinical Profile of RA-associated Interstitial Lung Disease
A prospective, cross-sectional analysis of patients with rheumatoid arthritis (RA) shows those with interstitial lung disease (ILD) tend to be older, obese and have a smoking history.
https://t.co/Khe9jV1jGa https://t.co/WejiaxolQP
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Dr. John Cush RheumNow ( View Tweet)
Join us April 18 for: Private Practice & Academia
In this session, our panelists will address the big questions of: "How do I choose between private practice and academia?" and "How do I advance in my career?".
https://t.co/BrWG57mRRG https://t.co/A0pzEvJ3cu
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Dr. John Cush RheumNow ( View Tweet)
Industry Payments to Rheums Dropped During COVID
Having their clinics shut down and patients staying away during the COVID-19 pandemic was bad enough for physicians' finances, but now a new study finds that payments from industry dried up as well.
https://t.co/jsxw23tTyY https://t.co/5PiaRpiSa4
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Dr. John Cush RheumNow ( View Tweet)
COVID had a significant effect on mental health of inflammatory rheumatic Dz (IRDs) pts. UK NHS survey of 639 IRD (70% RA, 16% PsA) saw 40% w/ mod/severe pandemic impact on physical & mental health; 29% w/ depression, 22% anxiety; affecting Women>males https://t.co/odUCjScMBZ https://t.co/Eb1E2In5z1
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Dr. John Cush RheumNow ( View Tweet)
Rheumatology Workforce: Is it a Women’s Issue?
Dr. Rachel Tate weighs in.
https://t.co/wcAtnbMu5C
@uptoTate https://t.co/RU5sYABGol
Links:
Dr. John Cush RheumNow ( View Tweet)
Retrospective of 28,360 #PsA pts saw more comorbidities by race - AAs had signif. more HTN (59% vs 52%), DM (31% vs 23%), obesity (47% vs 30%) & gout (12% vs 8%); but whites more cancer (20% vs 16%), anxiety (28% vs 23%), OP(14% vs 12%), more biologic use https://t.co/YwGjVowO3G https://t.co/3BUXFX11rh
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Dr. John Cush RheumNow ( View Tweet)
Pooled analysis of 5 RCTs of tocilizumab vs DMARDs in 4474 female #RA pts- 63% postmenopausal, 23% premenopausal, 9% perimenopausal. Perimenopausal F had less remission (HR 0.78); but exogenous Sex hormone use had higher remission (HR 1.20) https://t.co/zmvpzFlBRQ https://t.co/lUbGKr4akR
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Dr. John Cush RheumNow ( View Tweet)
Olmstead Co. population study: Clinically Isolated Aortitis (CIA) saw 8 cases over 20 yrs; incidence of 8.9 per 1,000,000over age 50 yrs. 6 of 8 were female, mean age 76yrs; all Dx @ ascending aortic aneurysm repair. Having CIA did not affect mortality. https://t.co/ruxOX4Pxg9 https://t.co/NlpF5uXWNV
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Dr. John Cush RheumNow ( View Tweet)
We developed a list of shared decision making resources that can help health care care providers and patients learn more about the process, available patient decision aids, decision coaching, and more! You can access these resources on our website here. https://t.co/t5Wua8olVA https://t.co/WdVQI72pcV
Karine Toupin April toupinak ( View Tweet)
Predictors of RA-ILD include smoking, Dz activity, steroid use and obesity. @jeffsparks @UTSW_Rheum https://t.co/VRQc9igHWW
Dr. John Cush RheumNow ( View Tweet)
Methotrexate-induced pneumonitis (0.3% risk) is different than RA-ILD. MTX does not increase odds of RA-ILD. @jeffsparks @UTSW_Rheum https://t.co/JV1CcB0sLP
Dr. John Cush RheumNow ( View Tweet)
Japanese cohort study shows Lung cancer is more common in males w/ elder-onset dermatomyositis - risk increased by Smoking, anti-TIF1-γ-Abs and elevated MLR (monocyte to lymphocyte ratio) https://t.co/LlTkiWp7pb https://t.co/Bu9atnI8je
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Dr. John Cush RheumNow ( View Tweet)