The new recommendations are based on research indicating that early exposure is more likely to protect babies from developing peanut allergies than to harm them. As with any such topic, it is important that parents discuss the matter with their healthcare provider. View a news story that helps explain the guidelines, and which includes an interview in which Dr. Kim provides helpful perspectives for parents: http://www.wral.com/giving-peanut-based-foods-to-babies-early-prevents-allergies/16401974/
Dr. Amanda Nelson awarded grant to evaluate feasibility and reliability of using ultrasound technology for study of knee osteoarthritis; also assumes leadership role in national rheumatology association
While X-rays are frequently used to assess OA for clinical and research purposes, the technology does not correlate well with symptoms, or changes over time.
Ultrasound provides numerous potential advantages for the assessment of OA, as it is cost-effective, widely available, reliable, and can identify OA changes earlier when intervention may be more effective. The results of the study could assist in planning future studies of knee OA, and will provide insights that may be useful for clinical practice.
Titled “Sonography of OA by Rheumatologists (SOAR),” the study will be integrated into the Johnston County Osteoarthritis Project (JoCoOA), which is a large, population-based research program evaluating the determinants and societal implications of OA. The JoCoOA Project is managed by the UNC Thurston Arthritis Research Center, and has been continuously funded for over 25 years.
In other ultrasound-related news, Dr. Nelson has been appointed to the American College of Rheumatology’s Oversight Committee for Musculoskeletal Ultrasound Certification (RhMSUS). In this role she will be actively involved in all aspects of the RhMSUS certification program, with a particular focus on examination development.
As a nationally recognized leader in musculoskeletal ultrasound imaging, Dr. Nelson and a former Thurston Arthritis Research Center Rheumatology fellow, Dr. Jake Ritt, recently co-authored the chapter “Ultrasound of the Knee,” in the book “Musculoskeletal Ultrasound in Rheumatology Review.” Their chapter focuses on imaging technique, normal joint imaging, and knee pathology visible using ultrasound.
The book is available for physicians who would like to learn more about the use of musculoskeletal ultrasound for rheumatologic conditions.
A few highlights from the meeting:
- Richard Loeser, MD, served as Chair of the Annual Meeting Planning Committee – which oversees the planning of over 450 sessions that included more than 1,000 expert speakers – and was quoted as an official representative for the meeting. In his capacity as Chair, Dr. Loeser worked with the ACR staff and played a central role in helping to coordinate the activities of the planning committee responsible for selecting topics to be covered at the meeting, as well as the faculty best able to speak on those topics. The committee was also responsible for reviewing close to 4,000 abstracts that were submitted for presentation under 28 basic and clinical research categories.
- Kelli Allen, PhD, received the prestigious “Distinguished Scholar” award from the ARHP – which is a division of the ACR. The award is presented annually to a member who demonstrates exceptional achievements in scholarly activities related to arthritis and rheumatic diseases. Dr. Allen received the honor for her innovative research focused on improving the lives of people with osteoarthritis through impactful and practical behavioral – as well as health-system – interventions.
- TARC experts led six separate scientific presentations and workshops, and presented at 10 poster sessions with topics ranging from functional genomic screening, to social influences in rheumatic disease and many points in-between.
- Thurston researchers and clinicians have a long history of leadership roles with ACR, including TARC director Joanne Jordan, MD, MPH, who serves on the Board of Directors. TARC researchers and clinicians who served on key committees for the ACR/ARHP meeting included; Leigh Callahan, PhD; Richard Loeser, MD; Kelli Allen, PhD; Beth Jonas, MD; Becki Cleveland, PhD; and Yvonne Golightly, PhD, PT. Joanne Jordan, MD, MPH, is Director of the Thurston Arthritis Research Center and a member of the ACR Board of Directors.
Dr. Saira Sheikh and Dr. Mildred Kwan Address Under-Utilization of Critical Immunizations for Patients with Inflammatory Diseases
According to the CDC, the most significant barrier to achieving optimal vaccination rates for patients with chronic inflammatory diseases is lack of awareness about vaccines among adult patients and providers. Vaccine guidelines can be particularly complex, and must be altered and customized for different types of patients based on their health history, vaccination history, risk factors, age and other variables.
To address the problem head on, Dr. Saira Sheikh, an allergist/immunologist and rheumatologist, and Dr. Mildred Kwan, an allergist/immunologist, have developed a number of specialized educational tools that will be distributed directly to all board certified allergists, immunologists and rheumatologists throughout the country. Because of their educational value, the materials will also be provided to fellows-in-training for both subspecialties.
The two UNC Thurston Arthritis Research Center physicians developed the materials in partnership with the American Academy of Allergy, Asthma and Immunology, which is posting the items on its website. To further enhance readership among physicians, the materials will count toward CME (Continuing Medical Education). Dr. Sheikh’s and Dr. Kwan’s work on the educational materials is supported by a Junior Faculty Development Award and the UNC Thurston Arthritis Research Center.
At the conclusion of the program, data gathered to measure its success will be analyzed with the hope that it can be fine-tuned, and expanded for use in primary care and other sub-specialties.
Thurston Arthritis Research Center and Osteoarthritis Action Alliance Participate in First "Rheumatologic Disease Awareness Month" Initiatives
Raising disease awareness and supporting patients and their families are core goals for the UNC Thurston Arthritis Research Center (TARC) and the Osteoarthritis Action Alliance (which is managed by TARC). For that reason, these organizations are participating in the American College of Rheumatology’s (ACR) first annual Rheumatic Disease Awareness Month, which is shedding much-needed light on a broad range of more than 100 diseases, including arthritis, lupus, Sjogren’s syndrome, gout, and many others.
Unfortunately, the symptoms and treatment of rheumatologic diseases can sometimes be complex and difficult to understand. The public awareness month addresses these issues via ACR’s ongoing campaign called, “Hundreds of Diseases. One Voice,” which provides educational content, as well as a variety of tools and resources.
Patients and their families who wish to learn more about osteoarthritis – both now and throughout the year – may access the Osteoarthritis Action Alliance’s website to participate in Twitter chats, listen to experts during free Lunch & Learn sessions, receive informative and inspirational emails, and subscribe to educational newsletters. Meanwhile, the Thurston Arthritis Research Center continues to leverage advanced research to investigate the causes and consequences of arthritis, autoimmune diseases and allergies, as well as care for patients while training tomorrow’s leading healthcare practitioners.
Dr. Kate Queen has received the UNC Medical Alumni Distinguished Faculty Award, which honors excellence in teaching, contributions to medicine in the state of North Carolina, and leadership in the continuing education of practicing physicians. The award also recognizes healthcare leaders who have improved communication between UNC faculty, alumni, and residents of the state.
An Adjunct Associate Professor in the Department of Family Medicine, Dr. Queen has a long association with the Thurston Arthritis Research Center (TARC) and has been involved with the Center in many different capacities. She is a former member of the TARC Board of Advisors, and has maintained numerous research relationships with TARC investigators for over 15 years. Her research projects have reflected what she is most passionate about, including the study of; osteoporosis prevention, genetics of generalized osteoarthritis, physical activity, and health literacy. She also serves on the External Advisory Board of the Thurston Multidisciplinary Clinical Research Center (MCRC), where she contributes valuable insights as a physician and researcher. She is currently collaborating with TARC on a trial known as “WE-CAN” (Weight Loss and Exercise for Communities with Arthritis in NC), which is evaluating the role of diet and exercise in the management of osteoarthritis.
“Throughout her career, Dr. Queen has demonstrated a remarkable depth of clinical expertise, combined with research acumen, and a passion for helping ensure patients have access to care,” said Dr. Joanne Jordan, Director of TARC, and Chief of the Division of Rheumatology, Allergy and Immunology. Dr. Jordan nominated Dr. Queen for the award and adds that she and her colleagues at TARC look forward to continuing their partnership with Dr. Queen in order to further advance the field of arthritis research.
Thurston Arthritis Research Center scientists shed new light on a specific mechanism involved with lupus
Researchers at the Thurston Arthritis Research Center (TARC) at UNC have obtained critical new insights into some of the biological mechanisms that cause lupus. And now, funding received from the Lupus Research Institute promises to help them continue advancing basic and clinical research that may help enable the development of new drugs in the future.
Lupus, an often debilitating autoimmune disease, results from the human body mistakenly attacking healthy cells and thereby damaging patients’ tissues and organs. Exactly how this happens is not well understood, but one key aspect of this process is now clearer, thanks to the work of researchers at TARC.
“In all individuals, cells and tissues naturally die off and need to be removed from the body,” says Barbara Vilen, PhD, and Associate Professor of Microbiology & Immunology. “This clearing process is performed by a biological structure within the cell called a lysosome. We have learned that in people with lupus, the activity of the lysosomes may be impaired in very specific ways. As a consequence the person’s body accumulates cellular waste that is not properly removed, causing their immune systems to produce auto-antibodies (proteins that attack the body’s cells), which leads to damage of healthy tissues.” In essence, the body mistakes the remaining cellular waste as foreign invaders and goes on the attack.
Jennifer Rogers, MD, a rheumatologist and assistant professor of medicine, adds that extensive laboratory research performed at TARC is now being validated in human patients, and it is shedding new light on what’s happening with patients who have lupus. The research center has begun enrolling patients for a cross-sectional and longitudinal clinical trial to gain additional insights among people with high and low levels of disease activity.
“What impedes drug development for the effective treatment of lupus is the ability to identify the underlying pathways that lead to improper activation of the immune system,” says Vilen. “Our research has now identified one of the key pathways involved with the body’s inability to degrade and clear cellular debris, which helps us better understand what mechanisms activate the immune system. This is the first research to clearly identify and illuminate this specific mechanism of action.”
While the research being performed at TARC is just one piece of the puzzle when it comes to finding ways to combat lupus, it’s a good example of how the research center is combining strong laboratory and clinical expertise to provide the greatest opportunity to find ways to help patients in the future.
Researchers Sheikh and Kwan awarded funding to conduct study evaluating means of increasing vaccination rates via physician education
Patients with chronic inflammatory disease such as asthma, rheumatoid arthritis and lupus are at a higher risk of infections compared to the general population. Despite the risks, too often these patients do not receive the proper vaccinations. The most significant barrier to achieving optimal vaccinations rates, according to the CDC, is the need for increased awareness about vaccines among patients and providers. Two researchers at the UNC Thurston Arthritis Research Center feel the situation can be improved.
Saira Sheikh, MD, an allergist/rheumatologist and assistant professor of medicine, and Mildred Kwan, MD, PhD, an allergist/immunologist and clinical assistant professor of medicine, have received funding for a research project that will address this pressing issue by developing a program designed to increase the rate of influenza and pneumococcal vaccination rates in high risk patient populations.
The program, which will be funded by an IBM Junior Faculty Development Award, will involve physician education via a Continuing Medical Education (CME) module regarding immunization guidelines, as well as wall posters, educational pamphlets, and individual educational pocket cards with immunization algorithms to further assist doctors in determining when vaccinations are indicated for various patient types. At its conclusion, data evaluating the success of the program will be analyzed with the hope that it can be fine-tuned, and expanded for use in primary care and other specialties.
Dr. Allen lead author in study published in Annals of Internal Medicine, examining effectiveness of combined patient-provider interventions for improving osteoarthritis outcomes.