Thursday, 21 Nov 2019

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RheumNow Podcast – Gout Spot Light (1.11.19)

Dr. Jack Cush discusses the highlights from the past week on

  1. Cluster analysis of 157 SAPHO pts shows 3 distinct patterns or types - spinal type (44.6%; spinal, sacral); costal type (33.1%; ribs) and sternoclavicular type (22.3%) disease course was longer in SC type than costal or spinal types (P < 0.001).
  2. Medicare claims analysis shows that older ankylosing spondylitis patients have a 2 fold increased risk of THA and TKA (RR 2.14, 95% CI 1.93–2.38).
  3. Obesity makes everything worse, including SLE! Study of 148 SLE pts; the 32% who were obese had worse disease activity, depression, pain and fatigue. 
  4. BMS Buyout of Celgene for $74 Billion  
  5. Only One-Third of Gout Patients Receive Urate-Lowering Drugs  
  6. January 11, 2019: Joint Meeting of the Arthritis Advisory Committee and the Drug Safety and Risk Management Advisory Committee Meeting Announcement   
  7. NEJM Review - Glucocorticoid-Induced Osteoporosis.
  8. RheumNow Live – March 22-24, 2019; Fort Worth, TX


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Rheumatologists' Comments

Jack-just a few random thoughts on your invitation "Do you have a quip or bit of advice for your peers and younger rheumatologists?" In regards to having a vision, I believe Jonathan Swift stated that vision is (I paraphrase) "The ability to see what others do not". A corollary might be "you see what you know!" My advice to fellows when they appear to be worn down or in a rut because of their clinical loads and medically complex patients with mundane rheumatic complaints whom they are consulted to see-Approach every patient as an opportunity to learn something your didn't know much about before by thinking out of the box no matter how routine the clinical complaints appear to be. Don't just think of Zebras, consider the unexpected (GC arthritis in 56 y/o Nun?) Above all-Critical thinking and intellectual honesty. Avoid the "diagnosis of convenience" (even though it satisfies the EHR program and insurance requirements for PA.

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