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Burnout or Retire (4.12.2024)

Dr. Jack Cush reviews the news and journal reports from this past week on Is it time to worry about burnout and those who are leaving healthcare?

  1. Cross-sectional study of 7887 NY & IL nurses: between 2018-21 top reasons for 2287 leaving nursing were planned retiring (39%), burnout (26%), insufficient staffing (21%), family obligations (18%) & COVID (17%)-- all addressable by health care employers
  2. Korean National Insurance claims study (2010-18) of NSAID use and CV events found among 19,775 RA pts (F/U 98290 PYs); there were 1663 cases of CV evens. Increasing NSAID doses incr incident CVD(adjHR 1.10); including CVA (aHR 1.09). CHF (aHR 1.12)
  3. In RA, previously affected Jts more likely to flare ("joint-specific memory") ?mediated by synovial resident memory T cells, predominantly CD8+ T cells, with a restricted TCR repertoire, responding to specific Ags by releasing chemokines & cytokines
  4. Pearl: Patients with persistent TMJ pain are more likely to have fibromyalgia than inflammatory or degenerative arthritis (as the underlying cause of their chronic pain)
  5. Pearl: Three "S" Rule (Smoking, Seropositivity, Sex/Male): if present the risk of RA-UIP (ILD) goes up nearly 13 fold (ACR23 Abstract 1269)
  6. Staph. aureus bacteremia (SAB) is assoc w/ poor outcomes & Osteoarticular infection. Danish study of 18 274 SAB pt (367 w RA). 90d SAB risk in RA was 23% vs 12.5% in non-RA (HR 1.93). Higher w/ Jt implants (29%) & TNFi use (42%). 90d Mortality was 35%
  7. Canadian OBRI study in 692 RA pts shows pts treated w/ triple DMARD (MSH) stayed on Rx longer (15 mos) compared to MTX+LEF (9.6 mos); not significant but MTX/SSZ/HCQ had signif lower DAS28 @ 6 mos (3.4 vs 3.9) & at 12 mos (3.2 vs 3.5, p=0.0005)
  8. Primary care pop. study pts shows poor health literacy in gout pts assoc. w/ more gout flares. Study of 551pts; 30% w/ 2+ flares in 12 mos; 9.4% w/ poor health literacy. pts had more flares (OR 4.1) & hx of oligo/polyarticular flares (OR 1.93)
  9. Human touch. A systematic review that underscores the physical and mental health benefits. The essence of medicine that will not be provided by #AI @NatureHumBehav @j_packheiser @helenahhartmann @FredericMichon @GazzolaValeria @sbl_nin
  10. Seasonal Pathogens and Henoch-Schönlein Purpura  

  11. Neuropsychiatric SLE - 2/3 Improved at 12 Months  
  12. ILD Onset in MDA-5 Dermatomyositis 


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The author has no conflicts of interest to disclose related to this subject