A growing understanding of the immunomodulatory effect of the autonomic nervous system (ANS) is edging closer to having clinical applications that could one day benefit patients with rheumatoid arthritis (RA). Researchers pursuing this as an alternative path to biomarkers are investigating whether autonomic status can be used to predict response to therapy. Seattle-area rheumatologist and…
Over the years, cell phones have evolved from purse-size behemoths to the size of a wristwatch. In addition, they have moved from basically a portable telephone to the smartphones of today. Both the changes in size and the added functions have resulted in new concerns for physicians. “We had a family meeting about two years…
A healthy 30-year-old Indian male was performing his routine workout in the gym when he developed giddiness and transient blackouts. He thought it was due to exercising excessively. Over the next month, he developed a low-grade fever and started feeling lethargic, to the extent that he was unable to exercise or work. He was admitted…
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by hypercoagulability often manifested as recurrent thrombosis or pregnancy complications, with persistently circulating antiphospholipid (aPL) antibodies or lupus anticoagulant. Catastrophic APS (CAPS), also known as Asherson syndrome, occurs in less than 1% of cases of APS and involves occlusive microangiopathy in at least three organ systems.1 Case…
In the past decade, there has been a clear demand for and a significant increase in online learning. This was clearly documented in the 2013 report, Changing Course: Ten Years of Tracking Online Education in the United States.1 The report finding demonstrated that 6.7 million students were taking at least one online course, a marked…
All practices share a basic need for infrastructure and governance, because this has direct implications on success. Regardless of the type of practice or location, there should be processes in place to monitor the execution of the entire business operation. Although not everyone in the practice will need to be proficient in this area, it’s…
CPT code: 99214 Diagnosis: ICD-9 274.02 **ICD-10: M1A.0720 History—The history of present illness was extended. The review of systems was extended (six systems were reviewed), and two of the three elements for past family social history were documented. This makes the history level detailed. Examination—Three systems were examined. This makes the exam expanded problem focused….
Each year in August, lawmakers return home for the summer recess and convene district workweeks. That means you have the opportunity to meet with members in their local offices, attend fund-raisers nearby or participate in a town hall. This is where our strength as a membership organization can benefit us most. We have real physicians…
Turn your great idea into a great meeting! Submit your session or study group proposal for the 2016 ACR/ARHP Annual Meeting, to be held Nov. 11–16, 2016, in Washington, D.C. We are looking for ideas that reflect clinical innovation and cutting-edge research, convey best practices, present evidence-based medicine and stimulate discussion to challenge mindsets. When developing your…
We all know that completely different medical conditions can create the same effects on our patients’ work lives. That is, from the employer’s purely administrative standpoint, an absence is an absence regardless of its cause. Even medical care professionals react differently to similar effects rendered by completely different circumstances. A Personnel Crisis Let me give…