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Obesity, Surgery, and Optimizing Patient Care

Eric Dein, MD

Rheumatologic care involves multidisciplinary approaches and collaboration with specialties to treat complex, systemic diseases. While many Pods at RheumNow Live are disease specific, the Pod II focused on Advancing Practice on important and emerging areas affecting rheumatologic patients. This session focused on two major areas of need: obesity and peri-operative management.

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RT @richardPAconway Dr Sparks shows risk factors for RA-ILD. Important for diagnosis (and screening?) Focus interventions on the modifiable ones! #RNL26 https://t.co/lE9Mkbq8oh
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RT @richardPAconway UIP is predominant radiologic pattern in RA-ILD. Contrast with our other diseases. But by no means exclusive - up to 50% of RA-ILD have a more inflammatory pattern. Important treatment implications! #RNL26 https://t.co/HmW1mz429i
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RT @ericdeinmd Mucosal Hypothesis RA #RNL26 Demoruelle Mucosal origins of RA? Key sites of immune-environment interaction initiate local inflamm, becomes systemic Link of lung inflamm/immune dysregulation - ass w/ smoking, ILD NETs in lung drive RA path? Gut/oral microbes drive
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RT @ericdeinmd Mucosal Hypothesis RA #RNL26 Demoruelle ACPA can predate RA development Nam et al: non-specific jt pain: 42% developed RA in 12 mos Circiumaro et al: MSK complaints 38% devel RA in 36 mo APIPPRA: 29% at 12 mo, 37% at 24 mo, StopRA 18% in 12 mo, 33% at 36 mo https://t.co/DxGhhFL1gO
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RT @richardPAconway Dr Sparks. RA-ILD is common. Pooled prevalence of 11% from recent meta-analysis. Less common than SSc or IIM, but more frequent than we think! #RNL26 https://t.co/mJSmMakSBM
Dr. John Cush Tweet
RheumNow
RT @ericdeinMD Mucosal Hypothesis RA #RNL26 Demoruelle ACPA can predate RA development Nam et al: non-specific jt pain: 42% developed RA in 12 mos Circiumaro et al: MSK complaints 38% devel RA in 36 mo APIPPRA: 29% at 12 mo, 37% at 24 mo, StopRA 18% in 12 mo, 33% at 36 mo https://t.co/JYiWmn0N0g
Dr. John Cush Tweet
RheumNow
RT @richardPAconway Dr Sparks. RA-ILD is common. Pooled prevalence of 11% from recent meta-analysis. Less common than SSc or IIM, but more frequent than we think! #RNL26 https://t.co/TCsDfeQjZC
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RT @ericdeinmd Mortality risk in RA #RNL26 Myasoedova Most common mortality: 1.5-1.6x increase risk CVD 2-3x increase risk ILD +ACPA increases risk in both https://t.co/Luwyy6UFg6
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RT @ericdeinmd Mortality risk in RA #RNL26 Myasoedova Premature deaths in up to 1/4 of pts Decline in mortality in RA after year 2000 Full siblings of RA also high mortality (shared genetic or environ factors affect risk?) Risks: Seropositivity, esp ACPA, CRP, extra-artic https://t.co/ytm6odmtgR
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Always on exams, but I've never seen a case! JAMA Dermatology reviews Multicentric Reticulohistiocytosis - pt w/ multiple nodules on hands & pain in shoulders, elbows, MCPs, IPs. Erythema over face, chest, & back & bead like Perionychial papules. Rx w/ MTX + Pred https://t.co/QgS5VBOB51
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ALTO: Long-Term Abatacept Outcomes in At-Risk RA Lancet Rheumatology has published the ALTO results - long term outcomes of the APIPPRA trial, demonstrating that treatment with abatacept (ABA) in at risk patients can delay progression to rheumatoid arthritis (RA) for up to 4 https://t.co/Lb8md9cYbG
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