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Managing JDM with Calcinosis

d Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis.

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Insomnia,Sleep,bed,night

Melatonin Use Growing, Inappropriate & Potentially Unsafe

d Jack Cush, MD

With nearly one-third of adults, adolescents and children having sleep difficulties, many resort to using melatonin. JAMA reports substantial increases in the use of over-the-counter (OTC) melatonin, in all age groups. But is it effective, safe and warranted?

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PSS.scleroderma.arthritis.contractures

Rituximab Efficacy in Systemic Sclerosis

d Jack Cush, MD

The DESIRES trial studied rituximab (RTX) in patients with systemic sclerosis (SSc) and showed clinically significant improvement in skin and lung outcomes after a subsequent 24-week open-label extension phase.

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Malar,rash,SLE, Lupus

Low Dose IL-2 Therapy in SLE

d Jack Cush, MD

A multicentre, proof-of-concept trial of suggests that low-dose IL-2 therapy may be effective in moderate-to-severe systemic lupus erythematosus (SLE).

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SCLE,DIL,PPI

Drug-Induced Lupus from Proton Pump Inhibitors

d Jack Cush, MD

A wide range of therapies have been implicated in causing drug-induced lupus erythematosus (DIL); now it appears that proton pump inhibitors (PPIs) can be added to the list of causative drugs.

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Urine-soluble CD163 as a biomarker in #SLE: usCD163 significantly higher w/ active lupus nephritis & correlates w/ UPCR, disease activity, anti-dsDNA Ab levels and a higher chronic kidney disease stage. https://t.co/gbSn0ZcFEK https://t.co/qjOSNvkIPC

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Dr. John Cush RheumNow ( View Tweet)
Managing JDM with Calcinosis Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis. https://t.co/6tvK90Yngc https://t.co/hyXtOdP65H

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Dr. John Cush RheumNow ( View Tweet)
Melatonin Use Growing, Inappropriate & Potentially Unsafe With nearly 1/3 of adults, adolescents and children having sleep difficulties, many resort to using melatonin. But is it effective, safe and warranted? https://t.co/JrvfN1Awy3 https://t.co/NbVKAuUT1u

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Dr. John Cush RheumNow ( View Tweet)
Rituximab Efficacy in Systemic Sclerosis The DESIRES trial studied rituximab (RTX) in patients with systemic sclerosis (SSc) and showed clinically significant improvement in skin and lung outcomes after a subsequent 24-week open-label extension phase. https://t.co/0GvUYrBJLs https://t.co/rhhihBY03Z

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Dr. John Cush RheumNow ( View Tweet)
No benefit to social networking (SN) in RA. 210 #RA pts randomized to RA website +/- guided discussion/sessions; most were facebook familiar. @3 & 6 mos knowledge & self efficacy improved in both groups; w/ more satisfaction in FB grp (p≤0.04) https://t.co/TQtsRyse59 https://t.co/rY2DBTFjp0

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Dr. John Cush RheumNow ( View Tweet)
CDC report of fungal infx in US 2019 - coccidioidomycosis (20,061), histoplasmosis (1,124) & blastomycosis (240). Most Cocci cases (97%) AZ & CA; most Blasto (75%) in MN &WI; most Histo in IL (26%), but also MN, MI, WI, IN, LA, AR. https://t.co/XjZ9NX9nkM https://t.co/fA71SI4RK3

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Dr. John Cush RheumNow ( View Tweet)
Worldwide there are 484,213 #SLE cases in 2017 (7MM), with 54% in the USA (259,474 cases), the rest in the EU and Japan. Next most prevalent was UK (62,852) followed by Italy. Spain has lowest prevalence of SLE https://t.co/anRCYwrLoM https://t.co/nHbLzC0mSd

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Dr. John Cush RheumNow ( View Tweet)
Medicare study of 10,868 Hospitalized lupus pts. Looking at age groups. 30 d rehospitalization higher in young adult LE (36%) - 40% higher than those without LE, 85% higher older LE. Rehospitalization higher with Longer hosp stay & higher comorbidity. https://t.co/Ul91DX6H8r https://t.co/t3plpQQ8qn

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Dr. John Cush RheumNow ( View Tweet)
MSK US in Gout? 71 gout pts on ULT followed x 1yr, 42% had at least one flare (median=2). Baseline US showing MSU deposits & inflammation significantly assoc w/ with # Flares (MSU score RR 1.17; power Doppler score RR 1.29) https://t.co/6IQo4JWtK0 https://t.co/Slm0fOvbnt

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Dr. John Cush RheumNow ( View Tweet)
Gout T2T: Rheumatology societies target urate <5 mg/dl (0.30 mmol/l) or <6 mg/dl (<0.36 mmol/l) - below point of urate saturation -->MSU crystal dissolution. Achieving target reduces flares & tophi; but these clinical benefits take time. https://t.co/qfFSpGCJZp https://t.co/ILMAX3jj50

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Dr. John Cush RheumNow ( View Tweet)
Rheums! Do you have a rheumatology 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/cvmbzknQqA https://t.co/6mX5eRUNuU

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Dr. John Cush RheumNow ( View Tweet)
Survey of 3357 retired Olympians (45 yrs) shows same OA rates as 1735 gen population (41yrs) - #OA in 23% (knee 7.4%, hip, ankle). OA from Injury, age, obesity. Prior knee/hip injury increased OA rates significantly (aOR 1.51/4.03) https://t.co/yZAHA8MYly https://t.co/W1StoLYjkl

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Dr. John Cush RheumNow ( View Tweet)
NEJM Clinical Images: 74-yoF with psoriatic arthritis has swelling of the fifth finger; found to have nontender, subcutaneous nodules in the hypothenar region and over the fifth finger. https://t.co/leVXN4WNXx https://t.co/5S5nD8ZgcQ

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Dr. John Cush RheumNow ( View Tweet)
Study of 209 Early RA (<1yr) pts found 23 (11%) with Drug Free Remission (DFR) after 74 mos of F/U; DFR maintained x 48 mo (18–82). DFR was assoc w/ early persistence on Therapy (HR 3.84). Adhering to prescribed treatment may lead to DFR https://t.co/oO8wKOKfxE https://t.co/DPX9JudplX

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Dr. John Cush RheumNow ( View Tweet)
Popeye sign (=biceps tendon rupture) #MedTwitter https://t.co/vES4juLCUp
Avraham Z. Cooper, MD AvrahamCooperMD ( View Tweet)

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