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Is Acetaminophen Potentially Hazardous in Pregnancy?

Jack Cush, MD

A consensus report from a multinational group of 91 scientists, clinicians and public health professionals alarmed the medical world last week as they suggest the use of acetaminophen (paracetamol) during pregnancy may have hazardous developmental effects on the fetus.

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RheumNow Podcast – I Wanna New Drug.V2 (9.24.2021)

Jack Cush, MD

Almost three years ago to the day, I did a podcast entitled, "I wanna new drug." As I go over this week's podcast, I want to say it again. I want a new drug safe enough to use during pregnancy, for PMR, for GVHD, and more. I'm going to cover these, and other topics including lupus, COVID breakthrough infections, and statin use and the risk of RA, as I review the news and journal articles from the past week on RheumNow.

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RheumNow Podcast – JAK Inhibitor Warnings from the FDA

Jack Cush, MD

FDA JAK inhibitor warnings and what it means (also: what do you think?); other news released this week; and, two questions submitted from listeners. Dr. Cush discusses this and more in this week's podcast.

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RheumNow Podcast – Driving in Pain (8.20.2021)

Jack Cush, MD

You know, I'm a very good driver. We all think we're great drivers - but consider what it's like to drive in pain: would you be a good driver? Also, I want you to consider the diagnosis of calcium pyrophosphate dihydrate disease (CPPD). But first, let's look at a study out of Scotland, looking at military service and greater risk of hip and knee replacement.

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Lumbar Spine Decompression Alone is Superior to Decompression with Fusion

Jack Cush, MD

The NEJM has published a multicenter study wherein patients with surgical lumbar spinal stenosis and degenerative spondylolisthesis were found to fair equally well (noninferior if treated with decompression surgery alone compared to decompression with instrumented fusion.

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Fatigue, FM, fibromyalgia

Fibromyalgianess Influences Steroid Persistence

Jack Cush, MD

"Fibromyalgianess" is highlighted as a risk factor for undue, extended glucocorticoid use in rheumatoid arthritis (RA) patients, according to Wallace and colleagues in Rheumatology.

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The #1 question I get from new consults: “How did I get arthritis?” Here is my list of 11 drugs (or drug classes) known to cause arthritis or rheumatic disorders (as an unintended consequence). #RheumNow https://t.co/GsV0Qj9ENr https://t.co/IrTkY5yFdY

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Breakthrough infections from UK QResarch database: Among 6.95 million vaccinated, 74.1% recv two vaccine doses, there were 2031 covid-19 deaths & 1929 hosp admissions; ~4.0% deaths & admissions were >14 days after 2nd dose https://t.co/bbDsb1zLhX

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Musculoskeletal sequelae/complications in adults following ICU admission studied by metanalysis of 32 studies. Muscle problems, pain (shoulder pain) predominated. Weakness in 29%, Chronic pain 34%, neuromuscular impairment 51%. https://t.co/FpqDvRDtVq

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FORWARD prospective registry showed Obesity to be associated with a substantially higher risk of incident chronic opioid use (HR adj 1.74). Approximately 1 in 4 cases of incident strong opioid use can be attributable to obesity ((HRadj 2.11) https://t.co/R0KhH4b05g https://t.co/HGHeqh4B0c

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JCI paper showing IgG fibromyalgia pts given to mice leads to passive transfer of FM symptoms leads to sensory hypersensitivity; increased sensitivity to noxious mechanical & cold stimulation, & nociceptive fibers in skin-nerve preparations.WHAT? https://t.co/af24a9BzzW

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Among pregnant women, receipt of the BNT162b2 vaccine was associated with a 78% lower risk of incident SARS-CoV-2 infection. Cohort study tincluded 15 060 pregnant women in Israel. No adverse pregnancy outcome difference in Vax Pts https://t.co/jXUjaKIfUV

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Dr. John Cush RheumNow ( View Tweet)

Rheums--have a question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/wzNmOzH4VE https://t.co/QJn6Uo3lbM

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New podcast available for download wherever you get your podcasts! We review the big stories on RheumNow this week. https://t.co/dbX9RN8ji5 https://t.co/WEf7yCR9km

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Acupuncture (AP) studied in 440 men w/ chronic prostatitis/chronic pelvic pain syndrome (AP vs Sham). Responders were higher in the AP group at wk 8 and week 32 (61.5% vs 38.3%; adjusted odds ratio, 2.6) https://t.co/TOtUBE3Wvu

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Using data from Framingham Study, 347 pt w/ Widespread Pain (WP) compared to 2117 without. WP was associated with an increased risk of all-cause dementia (HR: 1.43), Alzheimer's (HR: 1.47) and stroke risk (HR: 1.29). https://t.co/S1CS01zNkJ

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ICYMI: Can you manage FM without opioids? Study of 698 Fibromyalgia pts from a tertiary center finds 27.1% taking opioids. Opioid associated with longer Sx duration (>3 yrs), increased age, worse functional impairment & pain catastrophizing https://t.co/N1G4ZtkUE5

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Can you manage FM without opioids? Study of 698 Fibromyalgia pts from a tertiary center finds 27.1% taking opioids. Opioid associated with longer Sx duration (>3 yrs), increased age, worse functional impairment & pain catastrophizing https://t.co/N1G4ZtkUE5

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Dr. John Cush RheumNow ( View Tweet)

"Fibromyalgianess" is highlighted as a risk factor for undue, extended glucocorticoid use in rheumatoid arthritis (RA) patients, according to Wallace and colleagues in Rheumatology. https://t.co/uv19GSZsBV https://t.co/aSFlV9zeGt

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Dr. John Cush RheumNow ( View Tweet)
Pain Persists in RA, Even Without Inflammation One-third of patients with rheumatoid arthritis had unacceptably high levels of pain 5 years after diagnosis, often despite low levels of inflammation, Swedish researchers found. https://t.co/K8zf1pE9jM https://t.co/aEBu7jVHft

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