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…
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…
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….
The Friday night press release: When a politician or any public figure needs to disclose unfavorable news, chances are they will release it sometime on a late Friday afternoon or evening, hoping that nobody is paying attention. In fact, this behavior was coined “the take out the trash day” on the television political drama, The…
The Lupus Initiative (TLI) has been an emergent creation inside the American College of Rheumatology (ACR) for the past six years. In 2009, the Office of Minority Health and Office of Women’s Health (now called the Office of Health Disparities) solicited an application from the ACR to develop resources for educating non-rheumatologists, both in training…
Follow-up Visit with Time A 62-year-old male patient returns to the office for a follow-up visit for chronic idiopathic gout without tophi. The patient’s present uric acid level is 4.0, and he is now taking allopurinol 450 mg per day. Previously, he was taken off indapamide due to an increase in his uric acid. He…
Pain can be reduced and functionality significantly improved for children with fibromyalgia without drug therapy, according to a study of 64 children in Philadelphia. Researchers combined intensive physical therapy and psychotherapy in individualized programs to treat the fibromyalgia patients…
(Reuters Health)—Knee replacement surgery may significantly ease pain and improve leg function and quality of life in patients with osteoarthritis or rheumatoid arthritis (RA), a new study suggests. While surgery doesn’t restore the same level of comfort and function patients had in their younger years, before they developed arthritis, the authors write in the journal…
A new study has examined how ACPA may originate at the molecular level. The researchers propose that numerous environmental factors may trigger the generation of ACPAs that then cross-react with various citrullinated human autoantigens through molecular mimicry to induce RA…