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Infection

Predicting Infection in Lupus Nephritis

Machine learning (ML) models were applied to 3 cohorts of lupus nephritis (LN) patients and established algorithms to predict co-infection in LN. 

This study analyzed 111 non-infected LN patients, 72 infected LN patients, and 206 healthy controls (HCs), looking at patient

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Chikungunya arthritis Metanalysis & good full-read review - 8 studies showing chronic arthritis (CCA) in minority of infected;, polyarticular, looks like RA, few seropositive, few w/ erosions on imaging. CCA may be progressive w/ irreversible damage https://t.co/8NdBCGTfxF https://t.co/SLt5COmKVf
Dr. John Cush @RheumNow( View Tweet )

Canary in a Coal Mine (4.19.2024)

Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.

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RA-ILD at Higher Risk for Serious Infection and Death

A prospective, multicenter study from Spain has demonstrated higher rates of mortality and serious infection in rheumatoid arthritis–associated interstitial lung disease (RA-ILD) patients.

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Burnout or Retire (4.12.2024)

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?

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Seasonal Pathogens and Henoch-Schönlein Purpura

Epidemiologic studies of Henoch-Schönlein purpura (HSP) have suggested seasonal variation in occurrence rates (higher from September-April, lower in June-August), suggesting a role for infectious triggers. The importance of infection was recently shown with nonpharmaceutical interventions (

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1/600 Falls May Die (4.5.2024)

Dr. Jack Cush reviews the news and Journal reports from this past week on RheumNow.com -  including problems w/ falls, pain and treatment of Dupuytren’s contractures.

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7 Updates on Prosthetic Joint Infections

These are excerpts and takeaway summaries from several literature reports addressing the diagnosis and outcomes of prosthetic joint infections (PJI).

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Naysayers & Disrupters (3.22.2024)

Dr. Jack Cush reviews the news and journal reports from the past week - including a few contrary reports on infection, seropositivity and plasmapheresis.

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French claims data study of Serious infections in 12K #PsA pts Rx w/ biologics (2015-2020) found 367 (3%) w/serious infxn (17/1000Pys). Compared to adalimumab, a signif. lower SIE risk was seen w/ ETN (HR 0.72), & ustekinumab (HR 0.57) https://t.co/oVomnKuYGJ https://t.co/y5DQatFoCa
Dr. John Cush @RheumNow( View Tweet )

Infection and Rituximab-linked Immunoglobulin Deficiency

A minority of immune-mediated inflammatory disease (IMID) patients treated with rituximab (RTX) are expected to develop and depressed immunoglobulin (Ig) levels.  A recent cohort analysis suggests that RTX-induced Ig deficiency was not associated with an increased risk of severe

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Insights on Postinfectious ME/CFS

The medical community is challenged by myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS - its origins, pathogenesis outcomes and treatment.  JAMA has reviewed a recent Nature paper wherein an NIH led team of multidisciplinary experts performed an inpatient study of

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Ides of March (3.15.2024)

Dr. Jack Cush has advice for Caesar and the superstitious, and covers pregnancy, platelets, dialysis and vaccinations in Lupus.





  1. Dutch study of 586 RA pts on bDMARDs found more nonserious infections (NSIE) (77/100PYs) than serious infx (SIE)(1.3/100Pys). Upper respiratory

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MMWR: Vaccination and Multisystem Inflammatory Syndrome in Children

CDC

Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition typically occurring 2–6 weeks after SARS-CoV-2 infection and characterized by fever and multiorgan involvement.  The current MMWR report shows that MIS-C case numbers have decreased by 98% since 2021.

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Depression and RA (3.8.2024)

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week.

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Lyme Disease 2022

The CDC has updated its Lyme disease surveillance report based on a new case definition. Compared to 2017–2019, the number of cases in 2022 rose by 69%.

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Can Mycophenolate be Stopped in Stable SLE?

In patients with clinicall stable systemic lupus erythematosus (SLE) and lupus nephritis, the withdrawal of mycophenolate mofetil was not significantly inferior to mycophenolate maintenance, but MMF withdrawal had numerically more reactivations, while MMF maintenance had more infections.

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COVIDs Extended Risk for Rheumatic Disease

EurekAlert!

Annals of Internal Medicine reports a large, binational study finding SARS-CoV-2 infection was associated with an increased risk for autoimmune inflammatory rheumatic diseases (AIRDs) that extends up to 12 months after

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Sniffles & Arthritis (3.1.2024)

Dr. Jack Cush reviews the news and journal reports from the past week on RheumNow.com. Are these associations with infection, biomarkers and weather real or imaginary? Linked or luck? Causal or casual?  You decide....





  1. No clear link between weather & MSK symptoms

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Sinusitis Linked to 40% Heightened Risk of Rheumatic Disease

EurekAlert!

The common inflammatory condition sinusitis is linked to a 40% heightened risk of a subsequent diagnosis of rheumatic disease, particularly in the 5 to 10 years preceding the start of symptoms, finds research published in the open access journal RMD Open.

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Immunosuppression Increasing (2.23.2024)

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks on RheumNow.com; but begins with a discussion of what constitutes "immunosuppression" and how it applies to our patients.





  1. 2021 NHIS Survey data suggests the prevalence of immunosuppression in the USA

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PJP prophylaxis in GPA. Always a trade off but these things are not created equal. PJP or sepsis are much worse on average than the AEs @anisha_dua @RheumNow #RNL2024 https://t.co/9sECd7fSRk
Richard Conway @RichardPAConway( View Tweet )
Dr. Winthrop avoid JAKi and TNFi in pts with chronic lung infections like MAI. #RNL2024 @rheumnow https://t.co/TfMa7hktL9
TheDaoIndex @KDAO2011( View Tweet )
For pts on JAKi needing vaccines; to avoid diminishing vaccine efficacy, Dr. Winthrop noted he treats a JAKi like he would MTX in that he holds the JAKi a week after vaccinating. #RNL2024 @rheumnow

TheDaoIndex @KDAO2011( View Tweet )

#RNL2024 @RheumNow Winthrop on Shingrix: Good data at 10 yrs Diminished response in immunocompromised (chemo) Very limited data with autoimmune patients https://t.co/cJitGOWZQt
Eric Dein @ericdeinmd( View Tweet )