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What to do with "no-shows"
A current Medscape article on patient "no shows" in private medical practice examines the cause and approach to the problem.
The most common reason for no shows is lack of knowledge about the scheduled appointment. Here are other common causes of no-shows, and how to address the problem.
Cochrane review of Stem cell transplantation in systemic sclerosis (3RCTs w/ 125 pts). Non‐myeloablative & myeloablative selective HSCT had moderate evidence for improved survival, skin thickness & function. But these had high Serious AE rates. https://t.co/sGzWYLwcAZ https://t.co/7JiR0fe3GY
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JAK-pot study of 19 registries, 31,846 RA pts Rx w/ new drugs shows equal CDAI efficacy for TNFi (54%), ABA (50%), IL-6i (55%), & JAKi (56%). Most D/C for LOE. Compared to TNFi, JAKi and IL-6i were d/c more for adverse events, less for ineffectiveness https://t.co/FlqPUVdWaC https://t.co/BZnpwtB8SY
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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/WAX6RWhToU https://t.co/ChlbHDDKCZ
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Dr. John Cush RheumNow ( View Tweet)
Favorable Pregnancy Outcomes in Spondyloarthritis
Pregnancy often occurs in women with axial spondyloarthritis (axSpA), and a recent cohort study suggests outcomes are generally better than what had been reported in the literature.
https://t.co/piAjx1Ugsu https://t.co/N6SGYOM6F1
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Dr. John Cush RheumNow ( View Tweet)
Cluster analysis of 649 #GPA patients (age 60 yrs) finds 3 clusters:
1)Limited dz w/ ENT + cough(n=426) - many evovle to gen dz @ yr 1
2) Generalised non-renal Dz (176) )
3) Renal dominant Dz(47)
Mortality in #1, signif lower than mortality in #2 & #3 https://t.co/XgZVt9b73n
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Dr. John Cush RheumNow ( View Tweet)
HIgher mortality in thos with lower serum uric acid levels, is partly explained by low SUA assoc w/ sarcopenia and weight loss. NHANES study (1999-2006) of 13,979 people shows low SUA assoc w/ low lean mass, underweight BMI, & weight loss https://t.co/YC2a6eXqCb https://t.co/aZ18jbCcn4
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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/8wWrt8GQ5v https://t.co/CIQKUyngN5
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Dr. John Cush RheumNow ( View Tweet)
Low Dose IL-2 Therapy in SLE
A multicentre, proof-of-concept trial of suggests that low-dose IL-2 therapy may be effective in moderate-to-severe SLE.
https://t.co/PNOp3Zdc8M https://t.co/B8DmUs5iuH
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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/bR0vh01mvP https://t.co/JFJ1EWAhoF
Dr. John Cush RheumNow ( View Tweet)
Drug-Induced Lupus from Proton Pump Inhibitors
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.
https://t.co/72w2dp9tfc https://t.co/dALeVbzOwo
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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/9fJ6Ci1rDm https://t.co/IkAKBtPRJ3
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Dr. John Cush RheumNow ( View Tweet)
JUNIPERA Study - Secukinumab in Juvenile PsA & ERA
JUNIPERA study evaluated SEC in children with ERA and JPsA and was found to be safe and effective in patients with active ERA and JPsA who previous failed to respond to conventional therapy. https://t.co/ncvG8ZIcdE
Dr. John Cush RheumNow ( View Tweet)
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Dr. John Cush RheumNow ( View Tweet)
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
Links:
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)
