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Loss of Good Sleep Linked to All-Cause Mortality
A US study shows that nearly two-thirds of the population had suboptimal 5-year sleep duration trajectories with a resultant 29% increase in risk of all-cause mortality.
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"Never take the advice of someone who has not had your kind of trouble"
- Sidney J. Harris https://t.co/xdB6u6OiPq
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Ankle Fusion or Total Replacement?
In a large study of British patients needing surgical treatment for advanced arthritis in the ankle, fusion appeared to be a better option than total ankle replacement.
https://t.co/ZFbd2VinpP https://t.co/QCqMkxNLoQ
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Diagnoses via Immune ‘Fingerprints’
Science and researchers at Stanford Medicine have reported the use of Mal-ID (machine learning for immunological diagnosis) to analyze B and T cell receptors (BCRs and TCRs) sequences from human blood, showing the ability to predict health… https://t.co/nqyf4iaD10 https://t.co/wt5V6uxLYf
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JAMA Case: A Woman With Painful Digital Ulcers - What would you order next?
- chest CT w/ myositis-specific autoAb panel
- dsDNA
- SCL-70 & Centromere Abs
- muscle biopsy https://t.co/t0WCIMtZg2 https://t.co/M1jBhnclLl
Dr. John Cush RheumNow ( View Tweet)
Diagnoses via Immune ‘Fingerprints’
Science and researchers at Stanford Medicine have reported the use of Mal-ID (machine learning for immunological diagnosis) to analyze B and T cell receptors (BCRs and TCRs) sequences from human blood, showing the ability to predict health… https://t.co/ni09ssCYSv https://t.co/4HWui3XxfE
Dr. John Cush RheumNow ( View Tweet)
Cross-trait study of >300K patients’ electronic health records at UCSF and Stanford. Autoimmune conditions associate with greater Alzheimer’s risk (ORs 1.4–1.7). Women with autoimmune disorders have higher risk than men with autoimmune disorders https://t.co/bwtGhyNBs6 https://t.co/FNUdRNozCw
Dr. John Cush RheumNow ( View Tweet)
Do infections lead to Kawasaki Dz (KD)? Swedish registry study of 1774 KD vs 17 731 controls. +Hx of Infx incr risk of KD (OR 2.3; 2.0 to 2.5) - mostly Resp, skin, GU & GI Infx. Infxns usually clustered before KD Dx (OR 5.1 15–28d; OR 1.3 6-12 mos prior KD. More infx = more KD… https://t.co/V9zbcmJdKv https://t.co/Evl3rtCxUO
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Optimal Management of Rheumatoid Arthritis Patients and Liver Disease
https://t.co/4JfUueF55o https://t.co/hBkgYU1Mye
Dr. John Cush RheumNow ( View Tweet)
Medicare study of 2.3 million shows high Telemedicine use was assoc w/ slight increase in visits (F2F & telemed), modestly lower use of 7 of 20 low-value screen tests for cervical CA, ECG, CMP, CBC, TFTs, & imaging for uncomplicated LBP (with less costs too)… https://t.co/lrG9NJ20B7 https://t.co/rLkGdBqWmr
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National Statistics analysis (2020-22)of 3.6 million US workers shows MDs & HCP had lower age/sex adjusted mortality rates vs non-HCPs. In nonHCPs, mortality is lower in females (HR 0.55), but in MD/HCP females its equal (HR 0.97; more CA +respt) & MD/HCP Black higher than whites… https://t.co/gmPJEN4xs0 https://t.co/7QpTZko8GP
Dr. John Cush RheumNow ( View Tweet)
JAMA Case: A Woman With Painful Digital Ulcers - What would you order next?
- chest CT w/ myositis-specific autoAb panel
- dsDNA
- SCL-70 & Centromere Abs
- muscle biopsy https://t.co/9T8mNDdJTs https://t.co/pTphzcuZKF
Dr. John Cush RheumNow ( View Tweet)
AI-assisted diagnosis for immunological disease
A novel machine learning framework – Mal-ID – can decipher an individual’s immune system’s record of past infections and diseases, according to a new study, providing a powerful tool with the potential for diagnosing autoimmune… https://t.co/gAViSbzreI https://t.co/IFXObUZe2s
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CRP and Hidradenitis Supprativa
A post hoc analysis of 2 phase 3 randomized clinical trials (PIONEER I and II) of adalimumab vs Placebo in patients with active Hidradenitis suppurativa (HS) demonstrated more severe HS that was associated with elevated CRP had a higher BMI.… https://t.co/VxFRjt3cRw https://t.co/rdNIvzMaP8
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Eric Dein @ericdeinmd
Active Morphea: - MTX +/- steroids. If not effective, MMF/RTX/ABA - Topicals for circumscribed - Phototherapy Most pts achieve remission in active in 1 year Inactive morphea - Can address with PT, pain rx, psychological support, plastic surgery fat… https://t.co/wEnlo6vtAB https://t.co/4uJYC9HaS1
Dr. John Cush RheumNow ( View Tweet)
Full read, comprehensive review of Hidradenitis Supprativa in Lancet Feb 1, 2025
Common assn; DM, IBD, Smoking, Obesity, metabolic syndr, NASH, SpA, RA
FDA approved Rx: Adalimumab, Secukinumab, Bimekizumab https://t.co/9er7TkNXpK https://t.co/N6sal9URv3
Links:
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Three B-cell targeting anti-CD20 mAbs in clinical use:
- Rituximab (1997) for RA, GPA, CLL, NHL, Pemphigus Vulgaris
- Ofatumumab (2020) for relapsing MS
- Obinutuzumab (2013) for Follicular lymphoma & CLL
OFA & OBIN may be better than RTX in membranous GN pts w/ anti-RTX Abs… https://t.co/ZhUbXFXjSR https://t.co/vUHkS76PK7
Dr. John Cush RheumNow ( View Tweet)
Optimal Management of Rheumatoid Arthritis Patients and Liver Disease
https://t.co/KpdY1MEM1w https://t.co/vETGMJgHf3
Dr. John Cush RheumNow ( View Tweet)
JAMA Review on Dx & Rx of Monoclonal Gammopathy of Undetermined Significance. MGUS has NO Sxs or organ damage. MGUS & Dz associations (OP, Autoimmune) were likely overestimated; M protein testing should be done if malignancy or MGCS is suspected. Risk of progression to malignancy… https://t.co/Jikc5q3BJL https://t.co/hxhcD4bJ2X
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That's not my problem - or is it? Multimorbidity in RA
RA can look so easy on the television commercials where patients appear young, healthy, and vibrant on the advertised treatment.
https://t.co/4lSVKeRtyx https://t.co/Xa1UGbJigy
Dr. John Cush RheumNow ( View Tweet)
