Dr. Jack Cush reviews the appproach to evaluating fever in adults suspected of having a rheumatic disease, Stills disease or autoinflammatory conditions. Presentations, fever duration, disease criteria and genetic testing are discussed.
Dr. Jack Cush reviews the news, journal articles and new ACR COVID-19 guidelines from the past week on RheumNow.com.
COVID-19 is not going to suddenly end on June 1st. This is a long haul change and you need to be prepared for the aftershocks and fallout. It’s time to be be a Marine and ”Improvise, Adapt, and Overcome”.
Treatment options for painful knee osteoarthritis (OA) are numerous, but comparative outcomes are seldom available. A NEJM report shows that physical therapy is superior to intraarticular glucocorticoids injections assessing the outcomes 12 months after the intervention.
The presentations of the COVID-19 infection have been clearly chronicled with the worrisome onset of sore throat, dry cough, loss of smell and taste with fevers, myalgias, fatigue and the worrisome progression of pulmonary involvement in a minority. Lab findings may include a leukocytosis, lymphopenia, and elevated LDH and hepatic enzymes.
Nevertheless there are several other organ systems that can be involved.
The Journal of Rheumatology reports a retrospective, single center, analysis of 17 rheumatoid vasculitis patients who responded well to intravenous rituximab (RTX) therapy.They identified 17 patients treated with RTX for systemic rheumatoid vasculitis from 2000 to 2017. At RV diagnosis, mean age was 59 years, 59% were female, 94% were white, and 82% had positive rheumatoid factor.
On April 11th, the ACR Board of Directors approved a COVID-19 guidance document written by an ACR task force charged with updating and clarifying recommendations for rheumatologists and rheumatic disease patient management during the current COVID-19 crisis.
The 9/11/01 terrorist attach on the World Trade Center (WTC) resulted in at least 2,977 fatalities, over 25,000 injuries, and caused at least $10 billion in infrastructure and property damage. Arthritis & Rheumatology reports that dust cloud exposure among responders and PTSD among community members was associated with a significant increased risk of new‐onset systemic autoimmune disease.
The monoclonal antibody guselkumab (Tremfya), which binds the interleukin (IL)-23 p19 subunit, was effective for psoriatic arthritis in two large clinical trials, providing comprehensive benefits for this heterogeneous disorder, investigators reported in The Lancet.
The Annals of Rheumatic Disease reports that rheumatoid arthritis patients on biologic therapies do not have a greater risk of postoperative infection after hip fracture, abdominopelvic or cardiac surgery compared (compared with those on methotrexate alone) and that glucocorticoids were associated with a dose-dependent increase risk for postoperative infections.
Dr Jack Cush reviews the news and journal reports from the past week on RheumNow.com
The New England Journal of Medicine has featured a report of three COVID infected patients, who developed peripheral and central infarcts with a antiphospholipid antibodies.
All patients, who were hospitalized in Wuhan, China, had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that was confirmed by PCR assay or serologic testing.
Our practice standards have been flipped. The physician’s best clinical tool has become the webcam or telephone. The nagging question is: “who needs to be seen in clinic or in the hospital with a F2F evaluation?” It basically boils down to urgency.
On Tuesday, April 7th, RheumNow hosted its first Tuesday Nite Rheumatology webinar - kicking off a two-month series of Rheumatology Grand Rounds lectures. The first session featured Jack Cush, MD (UT Southwestern) who lectured on "The Safety of Biologics and Newer Agents".
The incubation period for coronavirus disease 2019 (COVID-19) has important implications for surveillance and control activities. The Annals of Internal Medicine reports a pooled analysis of confirmed COVID-19 cases January 4, 2020 and February 24, 2020. The analyzed confirmed SARS-CoV-2 infection outside Hubei province, China.
