Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com. 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 https://t.co/Ls6p060mFB
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) https://buff.ly/43XLa2t
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 https://t.co/VfFZ03yZYL
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) https://t.co/gCEm8A3RAT
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) https://t.co/2YFosInpGs
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% https://t.co/hjaPnTbE0E
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) https://t.co/tuIigaswDK
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) https://t.co/tDiFqixbLV
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 https://t.co/OvCDJYAsoS @NatureHumBehav @j_packheiser @helenahhartmann @FredericMichon @GazzolaValeria @sbl_nin https://t.co/YuAiKtq87p https://t.co/Sxj1LfO5ZG

10. Seasonal Pathogens and Henoch-Schönlein Purpura  

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