Dementia and Emergency Department Use in Older Adults With Systemic Lupus Erythematosus: An Administrative Claims Data Analysis of Medicare Beneficiaries.

Background/objective: Systemic lupus erythematosus (SLE) is associated with increased dementia risk. Whether this association is present among older adults with SLE is unclear. Further, whether individuals with concomitant SLE and dementia are at increased risk of emergency department (ED) use has not been explored.

Psychometric Evaluation of the Scleroderma Skin Questionnaire: A Novel Patient Reported Outcome for Skin Disease in Patients with Systemic Sclerosis.

Objective: To evaluate the psychometric properties of the Scleroderma Skin Questionnaire (SSQ), a novel patient-reported outcome (PRO) to assess systemic sclerosis (SSc) related skin symptoms.

Methods: The SSQ was administered to 799 adults (mean age 52.7; 82% female) enrolled in the SSc Collaborative National Quality and Efficacy Registry (CONQUER).

Self-Perceptions of Aging and Physical Activity in Older Adults with Arthritis: Impact of General Health.

How negative self-perceptions of aging relate to physical activity (PA) in older adults with arthritis is unclear. We examined whether general health mediated the relationship between Awareness of Age-Related change (AARC) losses and PA. We analyzed baseline data from a randomized controlled trial of a PA intervention for adults ≥60 years who self-reported PA, AARC, general health, pain, and social support.

Frailty in older adults with systemic lupus erythematosus and emergency department utilization: an administrative claims data analysis of Medicare beneficiaries.

Introduction / Objectives: While presence of concomitant SLE and frailty has been associated with greater emergency department (ED) use than SLE alone in young/mid-aged adults, whether frailty increases ED use in older adults with SLE remains unknown. In a nationally representative United States administrative claims dataset, we investigated the association of frailty duration with use of ED services in the SLE population compared with individuals without systemic rheumatic disease (SRD).

Method: We identified Medicare beneficiaries ≥ 65 years with SLE and matched them (1:4) by age and gender with non-SRD comparators with osteoarthritis.

Flares of Systemic Autoimmune Rheumatic Disease Following Coronavirus Disease 2019 Vaccination: A Narrative Review.

This narrative review summarizes current evidence on the risk of systemic autoimmune rheumatic disease (SARD) flare following coronavirus disease 2019 vaccination. The authors detail key studies in the literature employing diverse methodologies, including cross-sectional surveys, prospective and retrospective cohorts, case-crossover designs, self-controlled case series, and systematic reviews. Data are reassuring, suggesting that vaccination is unlikely to increase the risk of flares across a range of SARD.

Training of Peer Coaches to Assist Individuals with Knee Osteoarthritis Prepare and Recover From Total Knee Replacement.

Objective: The objective of this study is to outline the training of peer coaches in the Moving Well intervention, which was designed to reduce anxiety, depression, and pain catastrophizing in patients before and after total knee replacement (TKR).

Methods: Selected peer coaches had a history of knee osteoarthritis (KOA), a TKR of 12 months or more before training, and were 60 or older. Training was primarily conducted virtually, with a later addition of one in-person session.

Social support and physical activity: does general health matter?

Background: Physical activity levels remain suboptimal in older adults. Exploration of potentially modifiable factors such as social support is needed to inform the development and implementation of patient-oriented physical activity interventions for older adults. The impact of general health on the relationship between social support and physical activity is not well understood.

Is Preoperative Weight Reduction in Patients Who Have Body Mass Index ≥ 40 Associated With Lower Complication Rates After Primary Total Hip Arthroplasty?

Background: Given the heightened risk of postoperative complications associated with obesity, delaying total hip arthroplasty (THA) in patients who have a body mass index (BMI) > 40 to maximize preoperative weight loss has been advocated by professional societies and orthopaedic surgeons. While the benefits of this strategy are not well-understood, previous studies have suggested that a 5% reduction in weight or BMI may be associated with reduced complications after THA.

Methods: We identified 613 patients who underwent primary THA in a single institution during a 7-year period and who had a BMI >40 recorded from 9 to 12 months prior to surgery.

Substantial Weight Loss May Not Improve Early Outcomes of Total Knee Arthroplasty in the Morbidly Obese.

Background: Body mass index (BMI) cutoffs for morbidly obese patients otherwise indicated for total knee arthroplasty (TKA) have been widely proposed and implemented, though they remain controversial. Previous studies suggested that a 5% reduction in BMI may be associated with fewer postoperative complications. Thus, the purpose of this study was to determine whether a substantial reduction in preoperative BMI in morbidly obese patients improved 90-day outcomes after TKA.

Rheumatology: What You May Have Missed in 2023.

Many patients with rheumatologic conditions receive care from physicians other than rheumatologists. Here we note key findings from 6 studies in rheumatology published in 2023 that offer valuable insights for internal medicine specialists and subspecialists outside of rheumatology. The first study investigated the effect of low-dose glucocorticoids on patients with rheumatoid arthritis (RA) over 2 years and challenged existing perceptions about the risks of glucocorticoids in this setting.

Association of phenotypic frailty and hand grip strength with telomere length in SLE.

Objective: Frailty and objective hand grip strength (one of the components of the frailty phenotype) are both risk factors for worse health outcomes in SLE. Whether telomere length, an established cellular senescence marker, is a biologic correlate of the frailty phenotype and hand grip strength in patients with SLE is not clear. First, we aimed to evaluate differences in telomere length between frail and non-frail women with SLE and then assessed whether frailty or hand grip strength is differentially associated with telomere length after adjusting for relevant confounders.

Obesity Severity Does Not Associate With Rate, Timing, or Invasiveness of Early Reinterventions After Total Knee Arthroplasty.

Background: The use of body mass index (BMI) cutoff values has been suggested for proceeding with total knee arthroplasty (TKA) in obese patients. However, the relationship between obesity severity and early reoperations after TKA is poorly defined. This study evaluated whether increased World Health Organization (WHO) obesity class was associated with risk, severity, and timing of reintervention within one year after TKA.

The gut microbiome regulates the clinical efficacy of sulfasalazine therapy for IBD-associated spondyloarthritis.

Sulfasalazine is a prodrug known to be effective for the treatment of inflammatory bowel disease (IBD)-associated peripheral spondyloarthritis (pSpA), but the mechanistic role for the gut microbiome in regulating its clinical efficacy is not well understood. Here, treatment of 22 IBD-pSpA subjects with sulfasalazine identifies clinical responders with a gut microbiome enriched in Faecalibacterium prausnitzii and the capacity for butyrate production. Sulfapyridine promotes butyrate production and transcription of the butyrate synthesis gene but in F.

The Effect of Social Isolation on 1-Year Outcomes After Surgical Repair of Low-Energy Hip Fracture.

Objectives: To evaluate whether social isolation or loneliness is associated with outcomes 1 year after low-energy hip fracture.

Design: Prospective inception cohort study.

Setting: Academic level I trauma center.

Combined genicular artery embolization and genicular nerve block to treat chronic pain following total knee arthroplasty.

Background: Chronic knee pain after total knee arthroplasty (TKA) is a common complication that is difficult to treat. This report aims to highlight the benefit of combining embolotherapy and neurolysis intervention for symptomatic relief of post-TKA pain in a patient with long-standing pain refractory to conservative management.

Case Presentation: A 77-year-old man who had previously undergone left knee arthroplasty has been grappling with worsening knee effusion and debilitating pain, resulting in limited mobility and progressive musculature deconditioning over a 20-year period.

Association of COVID-19 Vaccinations With Flares of Systemic Rheumatic Disease: A Case-Crossover Study.

Objective: We aimed to determine the association of COVID-19 vaccination with flares of systemic rheumatic disease (SRD).

Methods: Adults with systemic rheumatic disease (SRD) in a single-center COVID-19 Rheumatology Registry were invited to enroll in a study of flares. COVID-19 vaccine information from March 5, 2021, to September 6, 2022, was obtained from chart review and self-report.

An Online Program for Primary Care Practitioners to Enhance Confidence in Ability to Care for Patients With or at Risk of Painful Knee Osteoarthritis.

Objective: Primary care practitioners (PCPs) care for the majority of patients with knee osteoarthritis (KOA). Despite the existing evidence-based guidelines, PCPs often feel unequipped to evaluate and effectively treat patients with KOA. To address this need, we designed and implemented a free internet-based program focusing on the diagnosis and treatment of KOA.

Factors Associated With COVID-19 Vaccine Hesitancy in Rheumatology Outpatients in New York City.

Objective: The aim of this study was to measure COVID-19 vaccine hesitancy among rheumatology outpatients from an early COVID-19 "hotspot" during the initial period of vaccine availability.

Methods: In March 2021, a Web-based survey was sent to 7505 adults seen at a Rheumatology Division in New York City. We evaluated characteristics associated with 3 categories of COVID-19 vaccination status: declined, undecided, and willing/already received.

Causal relationships between pain, medical treatments, and knee osteoarthritis: A graphical causal model to guide analyses.

Objective: Randomized controlled trials (RCTs) are a gold standard for estimating the benefits of clinical interventions, but their decision-making utility can be limited by relatively short follow-up time. Longer-term follow-up of RCT participants is essential to support treatment decisions. However, as time from randomization accrues, loss to follow-up and competing events can introduce biases and require covariate adjustment even for intention-to-treat effects.

Affine transformations accelerate the training of physics-informed neural networks of a one-dimensional consolidation problem.

Physics-informed neural networks (PINNs) leverage data and knowledge about a problem. They provide a nonnumerical pathway to solving partial differential equations by expressing the field solution as an artificial neural network. This approach has been applied successfully to various types of differential equations.

Comparison of two frailty definitions in women with systemic lupus erythematosus.

Objectives: Frailty is a risk factor for adverse health in SLE. The Fried phenotype (FP) and the SLICC Frailty Index (SLICC-FI) are common frailty metrics reflecting distinct approaches to frailty assessment. We aimed to (1) compare frailty prevalence according to both metrics in women with SLE and describe differences between frail and non-frail participants using each method and (2) evaluate for cross-sectional associations between each metric and self-reported disability.

Frailty and emergency department utilisation in adults with systemic lupus erythematosus ≤65 years of age: an administrative claims data analysis of Medicaid beneficiaries.

Objective: Frailty is a risk factor for adverse health in adults with SLE, including those <65 years. Emergency department (ED) utilisation is high in adults with SLE, but to our knowledge, whether frailty is associated with ED use is unknown. In a large administrative claims dataset, we assessed risk of ED utilisation among frail adults with SLE ≤65 years of age relative to non-frail adults ≤65 years of age with SLE.

Association of Baseline Frailty with Patient-Reported Outcomes in Systemic Lupus Erythematosus at 1 Year.

The relationship of baseline frailty with subsequent patient-reported outcomes in systemic lupus erythematosus (SLE) remains unclear. We assessed these associations in a pilot prospective cohort study. Frailty based on the FRAIL scale and the Fried phenotype and patient-reported outcomes, namely Patient Reported Outcomes Measurement Information System computerized adaptive tests and Valued Life Activities disability, were measured at baseline and 1 year among women aged 18-70 years with SLE enrolled at a single center.