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What Caught Our Eye

What Caught My Eye: Trauma and SLE: Continuing the Discussion on a link between Adverse Experiences and Autoimmune Disease

By: CARRA | October 12, 2017 |

By Tamar Rubinstein, MD. Back in July, Jim Jarvis wrote in “What Caught Our Eye” about an association between Adverse Childhood Experiences (ACEs) and autoimmune disease. He pointed out that over the past decade, evidence has amassed linking ACEs (which include trauma, neglect, parental incarceration, food insecurity, and racial discrimination) to poor health and the development of chronic disease.

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What Caught My Eye: Breaking the Seal on P Values

By: CARRA | September 15, 2017 |

By Jay Mehta, MD, MS, The Children's Hospital of Philadelphia. When I was in medical school, there was a saying: “P = M.D.” In this case, “P” referred to a passing grade and this was usually said late at night while studying for a major test. The point was that all we needed to do was pass the test and we’d be ok in our quest to graduate from medical school. A passing grade was sufficient. There was no need to aim higher than that.

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What Caught our Eye: Kawasaki Disease...Incomplete, or...not?

By: CARRA | August 10, 2017 | What Caught Our Eye

By Brian Feldman, MD, MSc, FRCPC University of Toronto – The Hospital for Sick Children I know that the rheumatology service isn’t involved in the treatment of most Kawasaki Disease patients at many centres. At SickKids, though, we are. Our team sees somewhere around 150 patients with KD a year...

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Adverse Childhood Experiences and Autoimmune Disease — Is There a Link?

By: CARRA | July 24, 2017 | What Caught Our Eye

By Jim Jarvis, MD Dept of Pediatrics and Genetics, Genomics, & Bioinformatics Program, University at Buffalo Jacobs School of Medicine & Biomedical Sciences Have you ever wondered, even if just a little bit, why it is that for every complex genetic trait,...

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What Caught My Eye… and Provoked My Paranoia and Propensity to Rant

By: CARRA | April 19, 2017 | What Caught Our Eye

By Kenneth N. Schikler, MD Chief, Divisions of Pediatric Rheumatology & Adolescent Medicine University of Louisville School of Medicine Kosair Children's Hospital In the January 2017 issue of Journal of Pediatrics, Morris et al report on their findings in...

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Doctors Facing Borders

By: CARRA | February 28, 2017 | What Caught Our Eye

A couple weeks ago, our administrator received an email that sent our division into panic. The title of the email was “URGENT,” in all caps, followed by three exclamation points. It was a warning of a possible draft of a new executive order that would limit entry into...

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You’re Asking ME??!?

By: CARRA | February 2, 2017 | What Caught Our Eye

"Isn't there something natural or a diet we can use instead of these poisons?" This is a question all of us hear on a regular basis. And while we may believe we are recommending treatments utilizing the best evidence, that may not be the perception of some families....

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Does Depression Cause Arthritis In Teenagers?

By: CARRA | January 1, 2017 | What Caught Our Eye

Mental illness is certainly an important aspect of many of our patients’ struggles, and I hope I’ve made the case earlier that it’s something pediatric rheumatologists should be paying attention to… There is a lot of good literature to show that patients with chronic...

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Chicken Or Egg? The Relationship Between Sleep And Pain In Our Patients

By: CARRA | December 8, 2016 | What Caught Our Eye

Teenagers are notorious for poor sleeping habits. (And probably pediatric rheumatologists aren't much better, at least not the ones I know.) The average teenager gets about 7 hours of sleep each night, but needs about 9 hours or more. I've had a personal interest in...

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What Caught My Eye

By: CARRA | October 31, 2016 | What Caught Our Eye

It is not unusual for pediatric rheumatologists to be asked to see a child with persistent fever, without arthritis, who may or may not have had rash. Usually by the time the rheumatologist is called, the child has often been treated with antibiotics, and bacterial cultures have been done and were negative, and serologic or PCR studies for tick related illnesses and other infectious etiologies are in process or negative. Viral studies are done, and how specific/ disease related is the finding of a positive recovery of a respiratory pathogen from a nasal swab?

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Some breast milk a day keeps the IVIG away?

By: CARRA | September 13, 2016 | What Caught Our Eye

Perhaps you missed the New York Times article published in October 2015, “Overselling Breast Feeding” or the firestorm that erupted afterwards. I didn’t. I was up nursing my newborn on our first week home and reading resultant Facebook posts, emails, and even an...

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Are we doing enough sharing with our caring?

By: Jay Mehta, MD | July 15, 2016 | What Caught Our Eye

As the parent of a 4-year-old, and the resident of a major metropolitan area, the word share (and its various constructions) is a daily part of my lexicon. I’m constantly reminding my daughter the importance of “sharing” (which she thinks is giving her friends the toy that she doesn’t want to play with). The other day I took an Uber, and on my last vacation, I stayed in a house I found on AirBnB, both of which are parts of the “sharing economy.” And yesterday, I “shared” with my Twitter followers an interesting article on medical education.

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Of Mice and Men…and Maybe Muscle

By: Kenneth Schikler, MD | July 1, 2016 | What Caught Our Eye

As I am sure occasionally happens to us periodically, a young toddler was referred to me by gastroenterology after being evaluated for hepatopathy regarding elevated “liver enzymes.” This young boy ended up having muscle disease, and genetic testing confirmed Duchenne Dystrophinopathy. While he has been sent on to our MDA clinic for his future care, I was interested in looking into what was new in Muscular Dystrophy.

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What Caught Our Eye

By: Brian M. Feldman, MD, MSc, FRCPC | June 17, 2016 | What Caught Our Eye

We often hear of the glass ceiling that prevents the rise of women in academic medicine. In 2016, there is still much gender inequality in the world, as the UN clearly pointed out late last year. I’m old enough to remember the iconic “bra-burning” episodes in the 1960s; while much has been achieved, it’s remarkable how far we still have to go.

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What is our role in tackling mental health disparities in kids with rheumatologic diseases?

By: Tamar Rubinstein, MD, MS | June 3, 2016 | What Caught Our Eye

A month ago, the CDC came out with a report about a recent increase in suicides in the United States. The most disturbing trend was an increase of 200% among girls age 10-14 from 1999 to 2014. This statistic was quickly picked up by news outlets across the country. I heard it on NPR on my morning drive to work. But what about our kids? Are we sufficiently treating our patients in pediatric rheumatology for depression and anxiety? Are we sufficiently identifying them in the first place?

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By: Brian M. Feldman, MD, MSc, FRCPC | May 3, 2016 | What Caught Our Eye

Point-of-care ultrasound – with its clever acronym POCUS – has become a big thing in rheumatology, and in peds rheum. As someone who hasn’t received ultrasonography training, I find it highly mystifying, and I’m not sure on which side I fall.

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More on the Mind

By: Ken Schikler, MD | April 20, 2016 | What Caught Our Eye

After Rob Fuhlbrigge’s previous entry regarding the “power of the mind” and physiologic symptoms, I thought it timely to bring up a somewhat related paper. As CARRA members, we are involved in clinical trials that assess the safety and efficacy of an “active intervention” as compared to a “sham” or Placebo intervention.

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A Question of Mind over Immunity

By: Robert Fuhlbrigge, MD, PhD | April 14, 2016 | What Caught Our Eye

As pediatric rheumatologists, we are familiar with issues of anticipatory nausea in patients taking methotrexate and potent placebo effects that influence the interpretation of clinical trials in our field. The power of the mind to influence physiologic symptoms is impressive. But what if we could harness this power for good? What if you could teach your patients to respond as if they were exposed to a medicine even if they were not?

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Antibiotic Exposure, Infection and the Development of Pediatric Psoriasis

By: Kenneth Schikler, MD | April 7, 2016 | What Caught Our Eye

After Daniel Horton and his collaborators reported on the results of their nested case-controlled study regarding antibiotic exposure and JIA in Pediatrics (2015 vol 136 issue 2), the same group of data-miners did a similar, nested case-control study from UK’s Health Improvement Network data on children aged 1-15 years with newly diagnosed psoriasis, excluding those children with “juvenile arthritis”, immunodeficiency, or inflammatory bowel disease.

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Fish Oil: RA Prevention…or Just a Load of Carp?

By: Jay Mehta, MD | March 24, 2016 | What Caught Our Eye

“What about dietary changes?” I’m sure I’m not alone in getting this question more and more frequently with each passing year. It’s interesting that as our drugs get more effective at treating patients, families seem to be more interested in trying to treat with non-pharmacologic means.

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By: Brian Feldman | March 12, 2016 | What Caught Our Eye

What’s old is new, right? We used to have the patient history – now we have “patient reported outcome measures“. We used to have the physical exam, and other signs (like, say, lab tests or Xrays) – now we have “biomarkers“. It’s kind of cool how we can spin all that old fashioned stuff into… well… new-fashioned stuff.

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Anti-IL-1 Therapy and Long-term Cardiovascular Risk

By: CARRA | February 18, 2016 | What Caught Our Eye

With newer biologics allowing us to more effectively treat JIA and put many more kids into remission, it’s worth taking a moment to think about whether there could be some innocent bystanders from our targeted attacks on the immune system. With that in mind, we were...

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The Microbiome and JIA

By: Brian Feldman | February 9, 2016 | What Caught Our Eye

In case you missed it, the microbiome is really hot news these days.

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