Rheumatology Physician Burnout and Depression

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The 2018 Medscape Physician Burnout and Depression report shows that 42% of physician respondents report "burnout" and up to 15% experience some sort of depression. In a survey of 15,543 doctors from 29 specialties, they found highest burnout rates in critical care and neurologists (48%), family medicine (47%), ob/gyns and internists (46%). Lowest rates were seen in pathology and dermatology (32%), and plastic surgery (23%). 

What did rheumatologists report?

IL-1 and IL-6 Inhibition Preferred in Systemic JIA

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Since 2000, the German Biologics register (BiKeR) has prospectively enrolled children with juvenile idiopathic arthritis to assess outcomes with biologic therapies.  A new report evaluates the efficacy and safety of etanercept (ETA), tocilizumab (TOC) and the interleukin-1 inhibitors (anakin

Salt Drives Gut-Brain Connection via IL-17

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A study from Nature Neuroscience shows that a high salt diet may mediate neurovascular disease by altering microbiome and the expansion of TH17 cells in the small intestine, thereby increasing plasma interleukin-17 (IL-17) and its subsequent effects on endothelium in the brain.

Laparoscopic Gastric Sleeve Compared to Bypass Bariatric Surgery

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JAMA reports the results of a 5 year Finnish study comparing the results of laparoscopic sleeve gastrectomy vs Roux-en-Y gastric bypass and shows that gastric bypass yielded greater weight loss at 5 years, the difference was not statistically significant, in patients with morbid obesity. 

New Rise in Hip Fractures Amongst Women

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Reuters reports that the incidence of hip fractures in older women in the U.S. is rising after more than a decade of decline, according to a large new study of Medicare recipients.

Stroke Risk Confirmed in SLE

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The most common cerebrovascular events (CVEs) seen among a large cohort of patients with systemic lupus erythematosus (SLE) were stroke and transient ischemia, and the majority of these events were attributable to the disease itself, a multinational study determined.

The RheumNow Week in Review - 12 January 2018

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Dr. Jack Cush reviews a dozen highlights from the past week on RheumNow.com.

B Cell Changes Predict Autoimmunity with Checkpoint Inhibitors

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The Journal of Clinical Investigation reports results of a study showing that increases in CD21lo B cells and plasmablasts following that combination checkpoint blockade preceded the onset of immune-related adverse events.

While some have postulated that IRAEs are thought to be T cell mediated, B cells have also been implicated. Investigators studied 39 melanoma patients undergoing treatment with either anti-CTLA4 or anti-PD1, or combination CCB therapy. They analyzed changes in circulating B cells before and after the first cycle of therapy of immune checkpoint blockade (23 received combination therapy, 8 received anti-CTLA4, and 8 received anti-PD1).

Ibuprofen’s Anti-androgenic Effect May Result in Hypogonadism in Males

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PNAS reports use of ibuprofen by males may result in antiandrogen effects that may contribute to adult male reproductive problems.

40% of Arthritis Patients Fail to Receive Exercise Guidance

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The latest issue of CDC’s MMWR reports that exercise counseling among arthritis patients increased from 52% to 61% (2002 to 2014); hence ~40% do not receive health care provider counseling, suggesting the need for provider education and training in exercise counseling, and improved electroni

Increasing Adverse Events Seen with Higher Disease Activity in Early RA

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Researchers in the NEO-RACo Study Group studied adverse events (AEs) in relation to disease activity in patients with early rheumatoid arthritis (RA).

Small Joint Surgeries Drop Among RA Patients

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The rate of small - but not large - joint surgery has dropped among patients with rheumatoid arthritis since 1995, a retrospective review of orthopedic surgeries found. By 2015, less than 1% of patients per year underwent small joint surgery, reported Ashima Makol, MD, of the Mayo Clinic in Rochester, Minnesota, and colleagues in Arthritis Care & Research.