The increase in cardiovascular disease (CVD) risk in rheumatoid arthritis (RA) is well known; however, appropriate management of this elevated risk in rheumatology clinics is less clear. Purpose of Review By critically reviewing literature published within the past five years, we aim to clarify current knowledge and gaps regarding CVD risk management in RA. Recent Findings We examine recent guidelines, recommendations, and evidence, and discuss three approaches: (1) RA-specific management including treat-to-target and medication management, (2) assessment of comprehensive individual risk, and (3) targeting traditional CVD risk factors (hypertension, smoking, hyperlipidemia, diabetes, obesity and physical inactivity) at a population level. Considering that 75% of US RA visits occur in specialty clinics, further research is needed regarding evidence-based strategies to manage and reduce CVD risk in RA. Summary This review highlights clinical updates including US cardiology and international professional society guidelines, successful evidence-based population approaches from primary care, and novel opportunities in rheumatology care to reduce CVD risk in RA.

Objectives/Hypothesis Digital kymography (DKG) can provide objective, quantitative data about vocal fold vibration which may help distinguish normal from pathological vocal folds as well as nodules from polyps. Study Design Case-control study. Methods 87 subjects were separated into three groups: control, nodules, and unilateral polyps, and examined using a high-speed camera attached to an endoscope. Videos were analyzed using a custom MATLAB program, and three DKG line-scan positions (25%, 50% and 75% of vocal fold length) were used in statistical analyses to compare vocal fold vibrational frequency, amplitude symmetry index (ASI), amplitude order, and vertical and lateral phase difference (VPD and LPD, respectively). Results Significant differences among groups were found in all vibrational parameters except frequency. Polyps and nodules groups exhibited greater ASI values (less amplitude symmetry) than the control group. While the control group consistently showed its largest amplitudes at the midline, the polyps group showed larger amplitudes toward the posterior end of the vocal folds. A significant anterior-posterior pattern in amplitude was not found in the nodules group. LPD values were usually largest (most symmetrical) in the control group, followed by nodules and polyps. LPD at the 25% position allowed for differentiation between polyp and nodule groups. The largest VPD (more pronounced mucosal wave) values were usually found in the control group. Conclusion Vibratory characteristics of normal and pathological vocal folds were quantitatively examined and compared using multi-line DKG. These findings may allow for better characterization of pathologies and eventually assist in improving the clinical utility of DKG.

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Indirect CT-LG may be useful for differentiating metastatic from nonmetastatic lymph nodes.