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Diagnostic Delay in Axial Spondyloarthritis (2.25.2022)

Feb 25, 2022 2:33 am

Dr. Jack Cush reviews the news and journal reports from the past week on This week, rheumatologic problems incited by respiratory infections, air pollution and how you live, now where you live.

  1. Diagnostic delay in axial spondyloarthritis? Systematic review shows Dx delay ranged 0.67 to 8 years (>75% =,2-6 yrs). Only 1/3 had median delay ~ 2 yrs. Gender and +FamHx did not influence Dx Delay.

  2. SLE mortality rates (ASMR) nearly doubled since 1998 & remain high (vs non-SLE mortality) w/ significant sex & regional disparities. Data from 11449 SLE deaths, ASMR signif increased 1998 to 2009, down 2009 to 2013 and increased thereafter

  3. Single center study of 957 plaque psoriasis pts and the effect of air pollutants. Overall 39% experience a PSO flare and that concentrations of all pollutants were significantly higher in the 60 days before psoriasis flare

  4. Korean study of 53 424 kids with Kawasaki disease (KD) showed that outbreaks of rhinovirus, respiratory syncytial virus and varicella were significantly correlated with KD at 1 to 3 months before KD outbreaks

  5. Prevent NSAID GI bleeding or perforation? Korean study (n=92K) shows (vs non-prophylaxis) PPI and COX-2 inhibitors associated with 64% and 74% reduced risk. COX2 = PPI +nsNSAID. H2-receptor antag. did not reduce the risk

  6. 144 SLE pts from the SLICC cohort were studied showing that a majority (61.2%) scores consistent with depression over 4 yrs; also an inconsistent association between disease activity and depression in multivariate analysis

  7. CSF aptamer (short nucleic acid sequences) discovery of neuropsychiatric lupus pts finds increase in few CSF proteins that are discriminatory -- CSF Lipocalin-2, M-CSF, IgM and complement C3, the latter assoc w/ acute confusional state.

  8. Using whole gut scintigraphy & gastric emptying studies on 97 systemic sclerosis pts, researchers found 35% had gastroparesis, and these pts also had abnormal transit thru out the GI tract. High anti-CENP-B titers assoc w/ slower gastric emptying

  9. Where you live doesn't alter your risk for RA. Systematic review of 54 articles, 11 studies shows that rural/remote populations had no greater #RA risk. But Rural/remote pts have >barriers to care which increases the risk for inequities in outcomes.

  10. Increased Odds of Arthritis with Social Risk Factors

  11. Positive Results from the DOA (Duloxetine in OsteoArthritis) Study

  12. Medscape: Physician Burnout Report 2022

  13. MMWR - NFL Study on When to Be Released if COVID(+)

  14. #ASK CUSH ANYTHING – Dr. Walaliyada - TNF inhibition with RA Lung Disease (see Dr. Jeffs Sparks lecture

  15. March 19-20th -- a great medical meeting for Rheumatologists

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