A recent study found that the varicella zoster virus downregulates expression of programmed death ligand 1 and major histocompatibility complex 1 in brain fibroblasts, perineurial cells and lung fibroblasts. These effects may lead to persistent inflammation in the vessels and lungs, as well as promote subsequent infection of T cells and the spread of the virus…
Rheumatologists Reflect: What Drew Them to the Profession & How They Can Attract Others
Each rheumatologist’s path to the specialty is unique. Here, three practicing rheumatologists share what inspired them to become rheumatologists, what brings them fulfillment and how to bring others into the specialty…
Reinitiating TNF Blockers after Tuberculosis Treatment
A retrospective study showed that patients who have rheumatic disease and develop tuberculosis may be able to resume anti-TNF therapy and other biologic agents…
Transfer of Certolizumab in Breast Milk Not a Concern
NEW YORK (Reuters Health)—There is minimal to no transfer of the tumor necrosis factor (TNF) inhibitor certolizumab (Cimzia) from plasma to breast milk, according to a new study. “These findings are reassuring” and imply that continuing certolizumab treatment is compatible with breastfeeding, Dr. Megan Clowse of Duke University School of Medicine in Durham, North Carolina,…
TNF Inhibitor Tied to Lower Cardiovascular Risk in Psoriasis
NEW YORK (Reuters Health)—Psoriasis patients treated with tumor necrosis factor-alpha (TNF) inhibitors may have a lower risk of major cardiovascular (CV) events than those treated with methotrexate (MTX), according to a new study. “The findings do not surprise me. TNF inhibitors control inflammation better than methotrexate,” lead author Dr. Jashin J. Wu of Kaiser Permanente…
Patients with Parkinson’s Disease Are at Risk for Carpal Tunnel Syndrome
Patients with Parkinson’s disease may be at risk of carpal tunnel syndrome (CTS). New research examined why patients with Parkinson’s have a higher incidence of CTS than that of the general population. The study found that those patients who underwent subthalamic nucleus deep brain stimulation to monitor them for neuropathy may develop CTS…
Myocardial Inflammation Elevated in Active RA, Eases with DMARD Therapy
NEW YORK (Reuters Health)—Patients with active rheumatoid arthritis (RA) and no known heart disease may have subclinical myocardial inflammation, which improves with disease-modifying therapy, new research shows. “We know that patients with RA have higher risk of cardiovascular events, including heart failure and we really don’t know why. Maybe myocardial inflammation is one of the…
Telemedicine: One Rheumatologist’s Experience
Once the barriers to telemedicine are overcome, this modern approach to the practice of medicine solves patient access issues and increases physician productivity, says Daniel Albert, MD, a pediatric rheumatologist at the Center for Telehealth at Dartmouth-Hitchcock Medical Center…
Employee Non-Compete Agreements in Physician Practices
You started a medical practice and, through the years, have developed policies, procedures, strategies, work products, client relationships and confidential information that are specific to your practice and its success. As your practice grows, you know you will need to hire more employees. You also understand, however, that any potential employee may pose a risk…
Rheumatologists Should Discuss with Patients Use of Immunomodulatory Agents During Pregnancy
The decision to continue or discontinue immunomodulatory medications during pregnancy is a difficult one for both patients and physicians. On the one hand, when left untreated, rheumatic conditions can cause harm to an unborn child, as well as to the pregnant mother. On the other hand, medications can be harmful to a developing fetus. In…
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