Spotting the signs of autoimmunity as early as possible is often viewed as a positive goal for rheumatologic research. The premise: Patients may begin treatment years before their disease is active and destroying joints and tissue. Although much progress has been made in identifying early stages of rheumatoid arthritis pathogenesis, the clues are not as…
The serine-threonine protein phosphatase 2A (PP2A) enzyme is critical for regulatory T cells to function—without it, they don’t have the ability to suppress effector T cells and can’t protect against autoimmunity, according to new research published in Nature Immunology. Researchers found that conditional knockout mice—in which PP2A expression is knocked out only in regulatory T cells—developed…
Medicine has traditionally been an apprenticeship model. The most elemental and constructive method of passing on knowledge is the mentor–mentee relational experience. Mentorship encompasses not only the role of teacher, but also that of coach, role model, advisor and confidante. Matthew J. Koster, MD, rheumatology fellow and instructor in medicine, Mayo Clinic, Rochester, Minn., can…
Forty-five years ago, a computer engineer in Boston sent an electronic message between two computers some 10 feet apart. It took another 10 years or so before the electronic mail message was dubbed email—a term now, perhaps, more ubiquitous than any other in the lexicon of modern communications. Despite the seemingly definitive place email communication…
Sometimes, life calls for you to be out of the office for a length of time. Whether the absence is planned or not, it’s important to consider the best actions to take given the circumstances to ensure patients are cared for during your absence. Alexa Meara, MD, clinical instructor and rheumatologist, The Ohio State University…
Take the challenge. CPT: 99213-25, 77085 ICD-10: Diagnosis M81.0, Z79.52 The encounter is coded as 9913 as follows: History—The history of the present illness was extended. The review of systems was complete, and the past medical history was documented. This makes the history detailed. Examination—The examination was expanded problem focused. Medical decision making—The diagnosis was…
It is no secret that payers and providers have conflict as it relates to reimbursement rates for medical services, and there is another stakeholder, the patient, that plays an important role in the financial impact of healthcare reimbursement. Usually, patients are faced with unforeseen bills from their providers due to an unpaid portion of a…
A 67-year-old female patient with Medicare returns to the office for a follow-up of her age-related osteoporosis. She states she has an achy pain in her left hip that lasts for 30–40 minutes in the morning. Currently, she has taken ibandronate sodium and alendronate sodium for the past year, and her pain level is a…
New research investigates the role of autophagy, specifically the cell digestion process called LC3-associated phagocytosis (LAP), in inflammation and the pathology of systemic lupus erythematosus (SLE). Researchers found that defects in this process result in failure to digest dying cells, which increases inflammatory cytokine production and results in SLE-like disease in mice. Further exposure to dying cells accelerated disease development…
With limited time to spend away from your practice, you can still have an impact on issues important to Advancing Rheumatology! Below are several ways to have your voice heard, without ever leaving town. Set Up a Local Meeting with Your Elected Officials Every member of Congress has at least one local office in the…