CHICAGO—The pre-clinical rheumatology curriculum at the University of North Carolina (UNC) School of Medicine, Chapel Hill, used to consist mainly of portions of a musculoskeletal course, with up to only three instructional hours, and not always with a rheumatologist in the room with students. Systemic autoimmune diseases were never fully discussed in any of the…
Tom Collins is a freelance writer in South Florida, who has written about medical topics from nasty infections to ethical dilemmas, runaway tumors to tornado-chasing doctors. He travels the globe gathering conference health news and lives in West Palm Beach.
Articles by Thomas R. Collins
The Latest Data on Cancer Immunotherapy’s Interaction with Autoimmunity
CHICAGO—The body of literature on immunosuppressive drugs used to treat cancer and autoimmune diseases is growing, helping bring some clarity to their effects on the immune system and how well they work in patients. This has helped refine the questions that further research must answer, said an expert at the 2018 ACR/ARHP Annual Meeting. The…
7 Insights into Methotrexate Administration, Drug Resistance & Toxicity
CHICAGO—Once methotrexate enters a cell through the reduced folate carrier (RFC), which thinks it is picking up folate, the drug is polyglutamated. It is this polyglutamate methotrexate that provides the actual clinical effect. These methotrexate polyglutamate “species” are added and lost over time, but it’s a slow process. What difference does it make whether a…
Learn to Lead: Tips for Diagnosing & Resolving Conflict
CHICAGO—Resolving conflict doesn’t start with clever strategizing, but with understanding the bigger picture and the factors that led to conflict in the first place, from cultural differences to resistance to change, an expert said at the 2018 ACR/ARHP Annual Meeting in a session about how to be a better leader. “To me, what’s often missing…
Diagnosing & Managing Pulmonary & Kidney Manifestations in Lupus
CHICAGO—In systemic lupus erythematosus (SLE), most types of severe pulmonary manifestations are relatively rare, but it’s crucial they be caught because of the potentially dire consequences, said Richard Silver, MD, professor in the Rheumatology Division at the Medical University of South Carolina, Charleston, at the 2018 ACR/ARHP Annual Meeting. Pulmonary Manifestations Parenchymal disease—seen in the…
The Tortured Path to the Cortisone Discovery
CHICAGO—The path to the discovery of cortisone—a top-selling, important drug, with dozens of indications—was complicated by failure, false moves, desperation and obsession. The tale, recounted in the Philip Hench, MD, Memorial Lecture: Crossroads of History & Hope: Discovery & First Use of Cortisone for RA at the 2018 ACR/ARHP Annual Meeting in October, is an…
These 3 Tough Cases from the 2018 Thieves Market Underscore Need for Clinical Diligence
CHICAGO—In the Thieves Market session at the 2018 ACR/ARHP Annual Meeting, rheumatologists from around the country presented a slate of challenging cases that emphasized the importance of clinical persistence and attention to detail, and the need to consider diagnoses that might not be common or obvious. Three of them are summarized below. (Look for more…
Social & Psychological Elements Are Vital to Rheumatology Care
CHICAGO—To drive home the importance of how social determinants can make or break a person’s health, Jillian Rose, LCSW, MPH, the director of community, engagement, diversity and research at the Hospital for Special Surgery in New York City, told a story about a gardener planting flowers at the 2018 ACR/ARHP Annual Meeting. In the story,…
Rheumatoid Arthritis Prevention, Remission & Treatment De-Escalation
CHICAGO—With an ever-strengthening foundation beneath the pathophysiology and prediction of rheumatoid arthritis (RA), the field may soon focus more intently on prevention, an expert said at the 2018 ACR/ARHP Annual Meeting. The session also covered the latest in remission targets and therapy de-escalation. RA Prevention Kevin Deane, MD, PhD, associate professor of medicine and principal…
How to Teach in the Inpatient Setting
CHICAGO—Teaching in the inpatient setting can be a tall task, hindered by a lack of time, an unpredictable environment and a variety of learners encountered at different levels. But a few techniques—based mainly on understanding who your students are and how they prefer to learn—can make a big difference, an expert said at the 2018…
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