Preconception planning is essential to help women with autoimmune disease have optimal pregnancy outcomes. Unplanned pregnancy can also negatively impact disease course in some patients. Yet many rheumatologic patients of childbearing age do not receive adequate contraception or prepregnancy education and counseling. Rheumatologists must work collaboratively with other healthcare providers to make sure rheumatic patients…
My dear electronic health records How do I dislike thee? Let me count the ways Adaptation of Sonnet 43 By Elizabeth Barrett Browning, 1806–1861 As my tenure as physician editor winds down, it’s worth reviewing some of the more nettlesome issues confronting clinicians that have been previously discussed in these pages and gauge their current…
Research has shown that anticonvulsants are teratogens and pose a risk for fetal malformations. Meadow was the first to note a possible link between congenital abnormalities and maternal use of anticonvulsive drug in 1968.1 In 1974, Barr et al noted hypoplasia and irregular ossification of the digital distal phalanges with nail dystrophy in children born to…
It seems like yesterday I was asked to write my first presidential column, and here I am penning my last. It’s incredible how fast the time goes and yet how much gets done. That progress is made possible by the dedicated and talented group of ACR volunteers and staff. This year, the College has had…
Raynaud’s phenomenon in scleroderma or systemic sclerosis (SSc) is associated with significant discomfort and functional disability, especially in the presence of digital ulcers.1 Having lived with diffuse systemic sclerosis (dSSc) for nearly a decade, I can attest to this. It has been my experience that the hand pain and dysfunction in dSSc stems from Raynaud’s…
While medical advances in rheumatoid arthritis (RA) have led to improvements in disease control and quality of life for patients worldwide, the rate for stable remission remains low.1 Management of RA symptoms is traditionally accomplished through a combination of medications and nonpharmacological interventions.2 This approach can prevent the development of secondary adverse health outcomes. Two…
Almost one year into my term on the ACR’s Political Action Committee, RheumPAC, I’m looking back and reflecting on what led me here. My early career was focused on learning the basics of clinical practice and building relationships with healthcare providers. Shortly after I completed my fellowship, I established goals to improve access to care…
You may say the 30 million Americans with osteoarthritis (OA) are walking around with a Band-aid—or so it seems.1 That’s because there’s no actual cure for this disabling condition. However, an international group of scientists is making headway on a method of eliminating aging—senescent—cells as a way to prevent or even reverse OA. Cartilage Disappears,…
During the two or three short years of a rheumatology fellowship, there is so much to learn: the subtle art of the musculoskeletal examination, the intricacies of the immune system and the indications for a dizzyingly increasing array of new medications, to name just a few topics. One topic that you rarely hear about, but…
Systemic sclerosis (SSc) is a disease characterized by immunologic abnormalities, microvascular involvement and tissue fibrosis. In previous studies, 10-year survival rates ranged from 50–84%. However, there are concerns that these studies, using prevalent cohorts, are underestimating mortality. “While the prognosis of many rheumatic diseases has improved with the availability of more effective and targeted therapies,…
Tubulointerstitial nephritis and uveitis (TINU) syndrome, also known as Dobrin syndrome, is a rare oculo-renal inflammatory disease. It was first described in 1975 by American physician Robert Dobrin, MD.1 It manifests as acute interstitial nephritis and bilateral uveitis. In addition, patients often experience nonspecific systemic findings, such as fever, weight loss, malaise, myalgia and arthralgia. TINU…
A 57-year-old Ghanaian woman was referred to our rheumatology practice with acute, left elbow swelling and pain. The referring oncologist suspected gout, because the patient had hyperuricemia. Six months before, the patient was diagnosed with stage IV human T-lymphotropic virus type 1 (HTLV-1)-associated adult T cell lymphoma (ATLL). Her initial oncologic manifestations included multiple thoracic,…
Every day, more than 5 million records are lost or stolen. That’s more than 217,000 records per hour, 3,600 records per minute and 60 records every second. Due to increasingly sophisticated hacking tactics and ransomware, it’s anticipated that the number of reported breaches will continue to rise at an accelerated rate. In August, the list…
The Rheumatology Research Foundation is now offering the Rheumatology Future Physician-Scientist Award to enhance the training of promising MD/PhD or DO/PhD students who intend to become physician-scientists. As part of the Foundation’s work to recruit and train the next generation of rheumatology professionals, the award supports the nation’s top emerging physician-scientists. S. Louis Bridges Jr., MD,…
History A 25-year-old female patient is seen in the office after her primary care physician requested a consultation for a possible diagnosis of systemic lupus erythematosus (SLE). The patient presents today with muscle pain in both legs, she rates the pain at an 8 on a scale of 10. She states she experiences throbbing, usually…
Take the challenge. CPT codes: 99245/99205 ICD-10: M79.1, R21, R53.83, L65.9, K13.79, R00.0 This visit can be billed out as a 99245 only if the insurance carrier allows the billing of consultation codes. If the carrier does not allow consult codes, then this visit must be billed as a new patient visit. Because many outpatient…
Roughly 15 years ago, Steven K. Magid, MD, rheumatologist and chief medical information officer at the Hospital for Special Surgery (HSS) in N.Y., attended a social event for hospital employees. While chatting with other physicians, nurses, and lab techs, he watched one of his colleagues slaughter her opponents at Ping-Pong. “She was very skilled,” recalls Dr. Magid,…
Medications for serious or life-threatening conditions may receive accelerated approval from the U.S. Food and Drug Administration (FDA) by showing an effect on surrogate measures that are reasonably likely to predict a treatment’s clinical benefit. Post-approval confirmatory drug trials are then required to determine whether or not these effects translate into clinical improvements. In recent…
RETRACTED Editor’s note: The study this article reported on was retracted by the researchers. Key aspects could not be replicated, and they said, “Most importantly, the findings from behaviour studies and sequencing of microglia isolated from 564Igi autoimmune mice as shown in Figs. 1a, b, d and 3a, b are not substantiated upon further analysis…
Dr. Sherine Gabriel Joins Board of Trustees In July, ACR Past President Sherine E. Gabriel, MD, MSc, joined the New York Academy of Medicine Board of Trustees. Dr. Gabriel is a distinguished professor and dean of Rutgers Robert Wood Johnson Medical School. As dean emerita of Mayo Medical School, Dr. Gabriel developed successful clinical research training and career development…
This month, the ACR ushers in its new president, David Daikh, MD, PhD. Dr. Daikh serves as the director of the Rheumatology Fellowship Training Program at the University of California, San Francisco (UCSF) and as chief of the Rheumatology Division at the SFVA Medical Center, where he directs the Rheumatology Clinic. He graduated from the Oregon…