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In this Advanced Practice Rheum, Dr. Jack Cush reviews steroids.
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Dr. Jack Cush follows the money and all the news that fits the Rheumatology Gab for this past week.
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Dr. Jack Cush reviews the news and journal reports from RheumNow.com this week - including his top four favorite subjects.
Dr. John Cush
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PTPN22 1858C>T allele, seen in 5-15% NAmerica, often assoc. w/ autoimmune dz risk. BUT...PNAS shows Ptpn22 augments innate immunity and enhances NK activity against coronavirus infection https://t.co/1AMTuOXtoT https://t.co/9f3JdimJsG
Dr. John Cush
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Parvovirus B19 Infection - Images from JAMA Dermatology. 40yoM 2-days asymptomatic rash w/ fever to 39°C, w/ arthralgias, Rash on BL cheeks, inguinal, flanks, axilla. WBC =2K, CRP 1.24 mg/dl. Dx by PCR for parvovirus B19 DNA https://t.co/LGGnabvFvA https://t.co/yyBF9pEGls
Dr. John Cush
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JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/SgVyk9fSCd
Dr. John Cush
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Supposedly there's a shortage of Infectious Dz specialists & Fellowship applic are down. Survey of 380 Int. Med residents (41 prgs) shows ID interest signif assoc w/ exposure to ID in Yr 1 & 2, outpt clinics, ID- research. https://t.co/AUkiIvsuaV https://t.co/pOqkBhy93U
Dr. John Cush
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Full read review of Preclinical Rheumatoid Arthritis:
- Mucosal Origin Hypothesis
- Gut Microbiota
- Smoking & environment
- Periodontitis
- Immunosenescence
- T cell abnormalities
- Drug prevention https://t.co/UgqNBnKLMT https://t.co/2YZEiRCKNi
Dr. John Cush
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JAMA Review of acute and chronic Hepatitis B infection. "All ...on immunosuppressive Rx should be tested for HBsAg, HBsAb, and HBc Ab. HBV DNA measured in HBsAg+ & those w/ isolated Ab HBcAg https://t.co/LTecQlSMX3 https://t.co/cq3CuIuMKX
Dr. John Cush
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COVID Virus Persistence with DMARD Use
Drugs commonly used to treat systemic autoimmune rheumatic diseases (SARDs) may prolong SARS-CoV-2 circulation after COVID-19 infection in patients with these conditions, with researchers documenting substantially increased viral antigen https://t.co/szeILIbmjF
Dr. John Cush
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Smoking is most established environmental risk factor for RA- Dz risk, severity, & RA-ILD. Role of other airborne pollutants is mixed: particulate matter & nitrogen dioxide show inconsistent associations w/ RA https://t.co/Fkemc5hAUB
Dr. John Cush
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Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/rS69epQiif
Dr. John Cush
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Retrospective study of 374 newly diagnosed microscopic polyangiitis (MPA) pts - 97 (26%) had severe infections w/in 6 mos - signif higher risk w/ high dose prednisone & chronic lung Dz. most common: bacterial (43%) & lung infx https://t.co/XXAxUZw7kx https://t.co/atK8Ob9zyQ
Dr. John Cush
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Retrospective clinicopathologic review of 170 AORTIC surgical pathology cases (2009-16) - showed 87% w/ atherosclerosis, 13% aortitis/periaortitis and 2.4% atherosclerosis w/ excessive inflammation. Lymphoplasmacytic inflammation was most common w/ aortitis/periaortitis. https://t.co/CuP30dqRQU
Dr. John Cush
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Retrospective observational study of IPAF (ILD w/ autoimmune) pts - from Mt Sinai ILD registry 791 - 14 Rx w/ rituximab vs 19 not. Betw group outcomes same: PFTs, O2 use, Infx, Resp admissions, mortality. RTX group recv more immunosuppressives. https://t.co/sle4a0JOFL https://t.co/SyhK12KhHY
Dr. John Cush
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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/0JRd1k0R2R
Dr. John Cush
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5 yr Italian study of hospitalized autoimmune pts(2018-23) 4,896 IMID pts compared to 301,126 non-IMIM. IMID had signif higher risk cancer (adj OR 1.32) highest 1st yr. Decreased from 1.83 @ yr 1 to 1.2 @5+ yrs. IMID had more lung & bladder CA, leukemia lymphoma & melanoma https://t.co/UXqDHQtzv0
Dr. John Cush
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Claims data 2,751 #AAV patients - 6.2% developed #PJP infx. w/ predictors: age, max GC dose, rituximab, CTX, & PJP prophylaxis had Good concordance (0.70) @2mos & 0.66@1yrs. W/ monthly risk of 1.0%, prophylaxis yielded 34 potentially preventable PJP cases https://t.co/c2ObDnmfYp https://t.co/Ljr5maHZcr
Dr. John Cush
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Korean Insurance claims nested case–control study of 27,410 RA pts - 5482 w/ > comorbid Dsx Vs 21,928 w/ < 10 comorbd Dz. Having >10 signif incr Serious infx (OR 1.44), opportunistic (21.9)& Hzoster (1.18); mainly skin & soft tissue infx - NOT fatal infx. https://t.co/qDrU3BXYzd
Dr. John Cush
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Myocarditis causes 17,000 deaths/Yr worldwide. Causes include A) iatrogenic/autoimmune: checkpoint inhibitors & gene therapy; B) High income countries: parvo B19, herpesvirus 6; C) low income: dengue, HIV, malaria and Trypanosoma cruzi (Chagas disease) https://t.co/0FjPyXygpz https://t.co/04J23AiqtK
