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Goofy But True

Jack Cush, MD

Dr. Jack Cush discusses declining survival rates in the USA, FDA approvals of new COVID subvariant boosters and other odd and possibly true new research reports from the past week on

  1. After historic drop in 2020 (COVID), life expectancy in USA dropped again, this time a full year to 76.1 years. The lowest since 1996 and the biggest 2-year decline in a century (dropping >2.5 yrs). To date, there have been 1,044,937 COVID deaths in USA

  2. ANA Increasing? Part of the NHANES survey, ANA (IIF on HEp-2 cells) was performed on 13,519 in 3 periods: 1988-1991, 1999-2004, and 2011-2012. ANA+ was 11% 1988-1991 11.4% 1999-2004 16.1% 2011-2012 (P <0.0001) Meaning ~22.3, ~26.6, &~41.5 mil had +ANAs

  3. SURPRISED? Psoriasis pts have a known increased risk of CV disease. But did you know several papers & metanalyses show increased risk of abdominal aortic aneurysm in PSO (HR 1.30), worse w/ dz activity; lost w/ age, female, DM?

  4. Statin Myalgias? Lancet metanalysis of 19 PCTs, >80K pts, @ 1yr, Statin caused a 7% increase in muscle pain or weakness (1·07; 1·04–1·10); thus 1 in 15 had myalgia due to statin (1/10 w/ high dose). After year 1, no signif excess in statin related myalgia

  5. Head Scratcher? Study of UK Biobank cohort (n=380,380) shows those taking Rx Folate had increased risk of COVID-19 Dx (OR 1.51; 1.42–1.61) and Death (OR 2.64; 2.15–3.24). MTX use (+/- folate) had no increase in COVID or COVID death(1.07;0.57–1.98)

  6. Influenza Vaccination Recommendations The CDC has published an update to the recommendations from the Advisory Committee on Immunization Practices (ACIP) on the use of seasonal influenza vaccines in the United States for the 2022-23 season.

  7. New data at today’s CDC/ACIP meeting on vaccine effectiveness vs BA.5 wave hospitalizations, all adults protection for both 3rd and 4th dose vaccines compared with the prior wave (BA.2, BA.2.12)

  8. Longitudinal study of 411 adult fibromyalgia pts showed that 73.2% had depression at enrollment. Higher depression scores at baseline predicted poorer functional outcomes. Effectively treated depression resulted in improved functioning at follow-up.

  9. Drugs causing Scleroderma (DASSc) – Anticancer rx made up 42% DASSc & 62.3% case reports. Included: taxane-based agents, bleomycin, vinblastine, imatinib, dacarbazine, pembrolizumab pemetrexed; also HRT romiplostim & eculizumab

  10. Risk of TNFi-related psoriasis in 5088 TNFi Rx children w/ IBD, JIA, or CNO. Compared to non-TNFi exposed, kids on TNFi had an increased PSO risk w/ ADA (IRR 2.70; 1.53-4.75), infliximab (2.34) or etanercept (2.21) & not incr w/ DMARD use

  11. Tapering biologics in Still’s/Systemic JIA? 4 studies suggests after sustained inactive disease achieved, options include QOD (anakinra) dosing or dose reduction or interval prolongation (CAN & TCZ). KEY: early biologic starts

  12. Study of Adult-onset Still’s in Western Australia. Incidence = 0.22/100 000, prevalence = 2.4/100 000. AOSD had higher risk of previous liver disease (OR 2.67), serious infx (OR 4.36), joint replacement (OR 45.5), mortality not increased @ 1 & 5 yrs

  13. Review of cGAS/STING – enzyme cyclic GMP-AMP synthase. self genomic & mitochondrial DNA stimulates cGAS–>dimerizes & binds to the endoplasmic reticulum protein stimulator of IFN genes (STING), unleashing an inflammatory response

  14. The prospective CARDIA cohort study studied 2110 adults (38 – 50 yrs) for 10+ yrs and showed those taking >7000 steps/day had a 50% to 70% lower risk of mortality (vs those taking <7000 steps/day).

  15. ALL-HEART study presented in Barcelona at ESC Congress 2022 showed that allopurinol given to 5,721 older adults without gout, failed to reduce # nonfatal myocardial infarction, nonfatal stroke or cardiovascular death in ischaemic heart Dz pts

  16. Prevalent Sleep Problems in Rheumatoid Arthritis  


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