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RheumNow Podcast – Why Do We Love Rheumatology Fellows? (8.7.20)

Jack Cush, MD

Dr. Jack Cush reviews why we all love our rheumatology fellows and our best advice for them stemming from these articles.

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More Rheumatology Fellow Advice from the Mentors

Jack Cush, MD

If you’re looking for some great advice to consider or rebuke, here is the generous guidance of nearly two dozen leaders in rheumatology who sincerely offer you their wisdom and best wishes.

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ACR Advice on Reopening Strategies

The American College of Rheumatology (ACR) has issued a guidance document for rheumatologists and rheumatology health professionals to consider as practices, business and patient care begins to reopen in this next phase of the COVID-19 pandemic.

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RECOVERY Trial: Dexamethasone in COVID-19

Jack Cush, MD

Inflammatory events following infection with SARS-CoV-2 can often worsen the morbid or mortal outcomes with COVID, yet it has been unclear if glucocorticoids may modulate inflammation-mediated damage and lung injury.  The RECOVERY trial reports that dexamethasone (DEX) use lowered 28-day mortality among COVID-19 patients requiring respiratory support.

The RECOVERY trial was performed in the UK and enrolled hospitalized COVID-19 patients who were randomly assigned patients to usual care alone or the addition of oral or intravenous dexamethasone (at a dose of 6 mg once daily) for up to 10 days. The primary outcome was 28-day mortality. 

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RheumNow Podcast – LTF – Listen to Fauci (7.17.20)

Jack Cush, MD

Dr. Jack Cush reviews the news, tweets and journal articles from the past week on RheumNow. Let's dig into this week's 14 highlights.

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ACR Position Statement on Telemedicine

Jack Cush, MD

The American College of Rheumatology (ACR) has released an official position statement supporting the role of telemedicine as a tool with the potential to increase access and improve care for patients with rheumatic diseases.

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RheumNow Podcast - Why we Love Rheumatology Fellows (8.7.20) Watch it here>> https://t.co/ftrycqoWRR or Listen to the podcast on iTunes or on SoundCloud>> https://t.co/gi5hO0HaIl

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Dr. John Cush RheumNow ( View Tweet)

Analysis of PPI use from the Nurses Health Study shows regular PPI use was associated with increased risk of RA in women, higher with a longer duration of PPI use. With 1.7 million PY F/U, Regular PPI users had a 44% higher RA risk (adjHR 1.44; 1.10–1.89) https://t.co/pmBf88zGKH

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Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #5: The worst/most ineffective Virtual visits done with the Patient (or MD) driving in their CAR for the virtual visit!! Amazingly I have had a half dozen of these & requested the patient pull over so I could deliver a rheum Citation.

Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #5: Its easier to see gouty Tophi and rheumatoid nodules than nail changes of PsA or subtle rashes. For Rashes and oral lesions its BEST to have the patient take multiple pix with the cell phone and send them in by EMR or Email.

Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #4: Professor Paul Emery was right! THe MCP squeeze (done by the patient) and MTP squeeze is fairly predictive of RA/inflammatory arthritis AND outperforms the "Finger" (distal hand) squeeze. Hence the MCP/MTP is my main squeeze!

Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #3: Despite cam setups designed to do upper extremity exams, patients can easily move cams and limbs to examine spinal movt, gait, knee, ankle and foot problems with great accuracy.

Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #2 : Despite being in my video on the Virtual joint exam; asking the patient to show you their fist (AKA fist bump the camera) to see potential MCP swelling has thus far been a largely useless maneuver...but it looks good on cam...

Dr. John Cush RheumNow ( View Tweet)

Virtual Video Joint Exam Pearl #1: pain elicited by cervical lateral bending (in someone w/ otherwise normal Cx ROM) is highly correlated with Tender trigger points in the neck region (hence #FM)

Dr. John Cush RheumNow ( View Tweet)

The RheumNow Podcast is up - Top 13 Rheumatology Centers in the US; anakinra & colchicine in COVID, unload the loading dose, CB2 in Scleroderma. Watch it here>> https://t.co/5LIIi7Pwg1 or listen to the podcast here>> https://t.co/5LIIi7Pwg1

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Dr. John Cush RheumNow ( View Tweet)

Safety & efficacy of rituximab in Older RA (>65; n=97) vs younger (<65yrs; n=276) showed no difference in drug survival over 2 yrs (72% vs 74%)or SDAI activity. BUT.. there were more SIE (14.2 vs 6.6/100 PY) & pneumonia (10.7 vs 5.1/100 PY) in older pts https://t.co/dxqPg2fOlV

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Dr. John Cush RheumNow ( View Tweet)

Analysis of administrative health data (1984‐2016) on 12984 #RA pts shows RA w/ psychiatric comorbidities (depression, anxiety, bipolar, schizophrenia) had more additive visits (10.9), hospitalizations, hospital days (3.6), more drugs (7.3) & FP visits https://t.co/5py0i2tWqL

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Dr. John Cush RheumNow ( View Tweet)

RheumNow Podcast is Up! Listen to Fauci! Watch it here>> https://t.co/dHq3fP85Ip or Listen to the Podcast>> https://t.co/LdHO7fKUCp

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Dr. John Cush RheumNow ( View Tweet)

Registry of COVID CNS complications reports 125 pts; 77 (62%) w/ Cerbrovascular event (57 ischemic CVA), 9 intracerebral hemorrhage, 1 CNS vasculitis. 39 w/ AMS, 9 encephalopathy & 7 encephalitis. 10 new-onset psychosis, 6 dementia, 4 affective Dz https://t.co/mXyTHIFBIE

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Dr. John Cush RheumNow ( View Tweet)

Main factors influencing #physicalactivity in inflammatory #arthritis patients are psychological ➡️Main factor related to knowledge of benefits of #exercise & symptoms ➡️Modifiable ➡️Health professional support key FRI0642-HPR #EULAR2020 👉🏽https://t.co/Vdc7rjnC6Y by @DavergneT https://t.co/aMUHA5IMrn

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Dr Ai Lyn Tan DrAiLynTan ( View Tweet)
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