Impact of COVID-19 pandemic on social isolation and loneliness among minority populations.

Background: The impact of social isolation and loneliness (SIL) was heightened during the COVID-19 pandemic. Although the pandemic disproportionately affected racial/ ethnic minorities, no studies have investigated the ramifications of the pandemic on SIL among these populations. This study aimed to determine the prevalence and pervasiveness of SIL during the COVID-19 pandemic on minority communities.

Dendritic cell-specific transmembrane protein is required for synovitis and bone resorption in inflammatory arthritis.

Objective: Dendritic Cell-Specific Transmembrane Protein (DC-STAMP) is essential for the formation of fully functional multinucleated osteoclasts. DC-STAMP deficient mice, under physiological conditions, exhibit osteopetrosis and develop systemic autoimmunity with age. However, the function of DC-STAMP in inflammation is currently unknown.

Adopting the Quadruple Aim: The University of Rochester Medical Center Experience: Moving from Physician Burnout to Physician Resilience.

Background: The high rates of burnout among medical professionals in the United States are well documented. The reasons for burnout and the factors that contribute to physician resilience among health care providers in academic centers, however, are less well studied.

Methods: Health care providers at a large academic center were surveyed to measure their degree of burnout and callousness and identify associated factors.

Decreased influenza-specific B cell responses in rheumatoid arthritis patients treated with anti-tumor necrosis factor.

Introduction: As a group, rheumatoid arthritis (RA) patients exhibit increased risk of infection, and those treated with anti-tumor necrosis factor (TNF) therapy are at further risk. This increased susceptibility may result from a compromised humoral immune response. Therefore, we asked if short-term effector (d5-d10) and memory (1 month or later) B cell responses to antigen were compromised in RA patients treated with anti-TNF therapy.

Comparative analysis of disease activity measures, use of biologic agents, body mass index, radiographic features, and bone density in psoriatic arthritis and rheumatoid arthritis patients followed in a large U.S. disease registry.

Objective: To compare disease activity, radiographic features, and bone density in psoriatic arthritis (PsA) and rheumatoid arthritis (RA) matched cohorts.

Methods: Disease activity and radiographic data in the Consortium of Rheumatology Researchers of North America database from 2001 to 2008 were compared for 2481 patients with PsA and 17,107 patients with RA subsequently matched for age, gender, and disease duration. Radiographic outcomes included presence of erosions, and joint deformity.

The diagnosis and treatment of early psoriatic arthritis.

Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disorder associated with a heterogeneous disease presentation, varied disease expression and an unpredictable but often chronically destructive clinical course. Joint damage can occur early in the disease; indeed, several imaging modalities have demonstrated subclinical joint involvement in psoriasis patients without musculoskeletal signs or symptoms. Efforts are underway to validate questionnaires that will enable dermatologists to screen patients with psoriasis for the presence of musculoskeletal disease.

Bone loss in the spondyloarthropathies: role of osteoclast, RANKL, RANK and OPG in the spondyloarthropathies.

Bone loss is a common finding in the spondyloarthropathies. It may be localized and present as erosions or be generalized and cause osteoporosis. The pathogenesis of bone loss in the spondyloarthropathies is yet to be fully understood.

Role of RANKL in bone diseases.

Bone remodeling is a tightly regulated process of osteoclast-mediated bone resorption, balanced by osteoblast-mediated bone formation. Disruption of this balance can lead to increased bone turnover, resulting in excessive bone loss or extra bone formation and consequent skeletal disease. The receptor activator of nuclear factor kappaB ligand (RANKL) (along with its receptor), the receptor activator of nuclear factor kappaB and its natural decoy receptor, osteoprotegerin, are the final effector proteins of osteoclastic bone resorption.

Anti-RANKL therapy for inflammatory bone disorders: Mechanisms and potential clinical applications.

Focal bone loss around inflamed joints in patients with autoimmune disease, such as rheumatoid arthritis, remains a serious clinical problem. The recent elucidation of the RANK/RANK-ligand/OPG pathway and its role as the final effector of osteoclastogenesis and bone resorption has brought a tremendous understanding of the pathophysiology of inflammatory bone loss, and has heightened expectation of a novel intervention. Here, we review the etiology of inflammatory bone loss, the RANK/RANK-ligand/OPG pathway, and the clinical development of anti-RANK-ligand therapy.

Treatment update on spondyloarthropathy. From NSAIDs and DMARDs to anti-TNF-alpha agents.

Traditionally, nonsteroidal anti-inflammatory drugs (NSAIDs) and disease-modifying antirheumatic agents (DMARDs) have been used to control the symptoms of spondyloarthropathy. With the advent of anti-tumor necrosis factor alpha (anti-TNF-alpha) agents, however, it is now possible to slow disease progression, improve overall function, and provide symptomatic relief of arthritis, skin lesions, and bowel inflammation associated with these disorders. Here, Drs Anandarajah and Ritchlin explore the effectiveness of conventional therapies as well as biologic agents that are currently available or under development.

Pathogenesis of psoriatic arthritis.

Purpose Of Review: Psoriatic arthritis is an inflammatory arthritis associated with psoriasis that is more common and severe than initially appreciated. The success of biologic agents in psoriatic arthritis has sparked great interest in this disorder, although the disease pathogenesis is poorly understood. This review focuses on recent advances in the genetic factors and immune pathways that have been implicated in susceptibility to disease.

Etanercept in psoriatic arthritis.

Psoriatic arthritis (PsA), an inflammatory arthritis associated with psoriasis, can lead to disability from progressive joint destruction and bony fusion. To date, conventional disease modifying antirheumatic drugs (DMARDS) have not convincingly lessened joint pain and inflammation in PsA and there is very little data on the limitation of radiographic progression with these agents. The biological agent etanercept (Enbrel, Amgen, Inc, Thousand Oaks, California, USA) is a soluble TNF receptor fusion protein with proven efficacy in the treatment of rheumatoid arthritis (RA).