Technology is taking medicine and the Cleveland Clinic and Mayo Clinic to unexpected places. The famed institutions are testing a new way to deliver medical care, with walk-in kiosks mobilized to reach patients who may be too far away, too short on time or facing other challenges that keep them from a traditional doctor’s office…
ROME, Italy—The European League Against Rheumatism (EULAR) annual congress (EULAR 2015) was a much-anticipated event, with more than 14,000 delegates attending from far and wide. The Health Professional Standing Committee was particularly delighted to have planned a program that provided the latest in research terms but also an eclectic mix of valuable topics for health…
In diagnosing and treating a disease that is rapidly gaining recognition worldwide since it was first recognized in Japan in 2003, 42 experts from 10 different countries recently collaborated to discuss and review the current experience and data on IgG4-related disease. The result is the “International Consensus Guidance Statement on the Management and Treatment of…
When the local hospital approaches you about selling your practice and converting it to a provider-based outpatient department, you may want to hear them out. There are many benefits to becoming a department of the hospital, but what would it mean for you and the practice you worked tirelessly to build? What Does It Mean…
Every day, rheumatology patients live with the realities of having a chronic disease that requires a lifetime of treatment. This knowledge can be an emotional burden, and some people deal with it better than others. Emerging research is showing that those patients who exhibit emotional control are better able to cope and ultimately experience a…
A 35-year-old female with a history of systemic lupus erythematosus (SLE) without kidney involvement was admitted to our hospital with low-grade fevers, headache, increasing lower extremity edema and elevated blood pressure. History She was first diagnosed with SLE as a teenager when she developed oral ulcers and pleuritic chest pain and tested positive for anti-Smith…
“Love is the bone and sinew of my curse.” —Sylvia Plath Cutting the Cord Here’s the problem: No one grows up wanting to seek the cure for bursitis—or tendonitis or just about any of the other seemingly mundane maladies afflicting our body’s scaffolding. Meniscal tears, fasciitis, tendinopathies—the list is endless. Chances are, your college essay…
The transition to ICD-10 is not just another yearly diagnosis codes update; it is a complete overhaul. This not only will affect providers, but also all payers, vendors and stakeholders are being affected by the expanded ICD-10 code sets through medical coding operations, software systems, reporting, administration, registration and more. With approximately 20 days before…
Teresa Fama: Rheumatologist to Chair Public Advisory Council Teresa Fama, MD, is the new chair of the New England Comparative Effectiveness Public Advisory Council (CEPAC). A rheumatologist who practices in Berlin, Vt., Dr. Fama has previous experience in public policy, specifically health policy. Before she began her second career as a physician, Dr. Fama was…
A presentation given during FOCIS 2015, the 15th annual meeting of the Federation of Clinical Immunity Societies in June 2015 in San Diego, focused on advances in stem cell research related to treatment of cancer and the function that particular enzymes play in disease. Anjana Rao, PhD, professor at the La Jolla Institute for Allergy…
The controversy over vitamin D is hearty enough to confuse even seasoned rheumatologists, says Nathan Wei, MD, The Arthritis Treatment Center, Frederick, Md. “It’s like what you hear with coffee. One week, [a study finds] coffee is … good for you; the next week, there’s a study saying it’s bad for you,” he says. Vitamin…
Summer is a season for travel, so if your immunocompromised patients plan to journey to regions where there are outbreaks of infections, such as chikungunya, tuberculosis, typhoid, yellow fever or other diseases, communication and preparation may prevent serious health events. “The world teems with disease-causing organisms, and almost every infection is more serious in the…
Systemic sclerosis (SSc) is an acquired, sporadic, autoimmune, connective tissue disease with two subsets: limited cutaneous scleroderma (lcSSc) and diffuse cutaneous scleroderma (dcSSc). In the U.S., the annual incidence is about 20 cases per 1 million adults, with a prevalence of about 240 cases per 1 million adults.1 As with other connective tissue disorders, SSc…
It takes a great deal of time and money to produce clinical practice guidelines for rheumatic diseases. No matter how well a treatment inhibits inflammatory cytokines, it won’t lower disease activity without one essential factor: patient compliance. “You can’t propose a treatment algorithm in your research that no patient would actually use,” says Veena Ranganath,…
People diagnosed with osteoporosis have almost twice the risk of developing hearing loss as those without the bone-fragile skeletal disease, according to results from a large retrospective study in Taiwan. The study looked at the risk of sudden sensorineural hearing loss (SSHL) using data collected from Taiwan’s National Health Insurance claims and is believed to…
If Stephen Soloway, MD, FACP, FACR, CCD, wants to thank someone for his impressive baseball card collection, he may want to start with his mother. Recalling her taking him for baseball cards regularly, he went on to become the rare owner of every set of famed Topps, not to mention a few individual cards with…
Observation and research have confirmed that patients with rheumatoid arthritis (RA) are at greater risk of cardiovascular disease than their peers of similar age and gender, and that traditional risk factors and chronic inflammation associated with RA apparently play a significant role in that risk. However, predicting which patients with rheumatoid arthritis are at greater…
Guselkumab Studied to Treat RA & Plaque Psoriasis Guselkumab (GUS) is a subcutaneously administered monoclonal antibody that targets interleukin (IL) 23.1 It is being investigated in a Phase 2 study to treat rheumatoid arthritis (RA) and moderate to severe plaque psoriasis (PsA). On June 11, 2015, at the 2015 meeting of the European League Against…
ROME, Italy—When it comes to thinking about disease modification—a main goal in the treatment of axial spondyloarthritis (axial SpA) and other inflammatory diseases—it’s time to reconsider the concept, an expert said at EULAR 2015, the annual congress of the European League Against Rheumatism (EULAR). The traditional way of assessing disease modification, inhibiting radiographic progression, is…
Antibody-like molecules that can bind to more than one target—with the goal of having a more powerful effect than if those targets were treated separately in a combination of therapies—could become part of treatment regimens in rheumatic diseases over the next several years, an expert said here in a session at EULAR 2015, the annual…
ROME, Italy—In what researchers say is the first study evaluating cardiac magnetic resonance (CMR) findings in early rheumatoid arthritis (ERA) patients, cardiovascular abnormalities were significantly worse in patients with ERA than in matched, healthy controls. The study results were presented at EULAR 2015, the annual congress of the European League Against Rheumatism (EULAR). Cardiovascular Concerns…
ROME, Italy—The role of ACPA positivity in osteoarthritis is coming more into focus, with results from recent studies by researchers in Germany showing that ACPA positivity apparently works in concert with rheumatoid factor positivity to enhance bone erosion and that ACPA-positive patients show signs of bone erosion before they have clinical signs of arthritis. The…
ROME, Italy—The traditional approach to trials to assess new biomarkers and related treatments has largely been inefficient, and a better strategy is needed to make stratified treatment available for patients more quickly, an expert said at EULAR 2015, the annual congress of the European League Against Rheumatism (EULAR). Mahesh Parmar, PhD, director of the Medical…
ROME, Italy—The medical environment is increasingly adapting to the possibilities of optimizing care by individualizing medical treatment and tailoring treatment to disease phenotypes. Data suggest that individualizing exercise therapy, an important treatment modality for rheumatic and musculoskeletal diseases, can help control disease, maximize function, minimize functional barriers and decrease the risk of co-morbidity.1,2,3 Personalizing exercise…
ROME, Italy—The explosion of imaging technology has made it more important than ever to establish a standardized way in which imaging can and should be used in clinical practice, an expert said in a session at EULAR 2015, the annual congress of the European League Against Rheumatism (EULAR). Marie-Antonietta d’Agostino, MD, PhD, professor of rheumatology…
Dr. Simon Helfgott’s essay, “Barking at the Moon,” in the July 2015 issue of The Rheumatologist, about the unintended consequences of EHRs (electronic health records) prompted me to share my experience regarding the newly recognized KeMo disease. Keyboarding and mouse-clicking (KeMo) activity now consumes about 50% of the medical clinician’s day, as the modern EHRs…
As the rheumatology fellowship program director at the University of Mississippi Medical Center in Jackson, Miss., Vikas Majithia, MD, MPH, trains the next generation of rheumatologists. With the help of funding from the Rheumatology Research Foundation, he has not only expanded the training spots for rheumatology fellows at his institution, he also provides patients with…
The meeting with something for everyone! Below is a sneak peek at some of the 2015 ACR/ARHP Annual Meeting’s scientific sessions and content specific to each educational track. Basic Science Track Our knowledge of autoimmunity, bone pathology and other aspects of rheumatic disease is expanding rapidly due to the important research data produced by scientists…
Over the past few years, the ARHP and the European League Against Rheumatism (EULAR) health professional (HP) leaders have met informally at the EULAR Congress and the ACR/ARHP Annual Meeting to identify a mutually beneficial project to be pursued. At the 2013 EULAR Congress, ARHP and EULAR leaders agreed to formally organize a meeting of…
We’re in this together for rheumatology and our patients. Those who know me appreciate my devotion to Duke Basketball and my pride in their recent NCAA championship. Coach K (Krzyzewski), a firmly established leader in the world of college basketball, makes the analogy that a basketball team is like five fingers on a hand, and…
Level 3 Visit with Primary Diagnosis of Osteoarthritis A 36-year-old patient presents with unilateral primary osteoarthritis of the left hip. She reports her groin pain as 7 on a scale of 1–10. When she tries to straighten her left leg, she experiences increased groin pain. She is currently taking over-the-counter medication to relieve the pain,…
One parent wishes that she could have consulted a crystal ball at the beginning of her daughter’s illness to have “some kind of idea of what we were in for. There are so many stages of letting go of the idea of what your little kid is in for in life, what they are going…
CPT codes: 99213 Diagnosis Codes: ICD-9: 715.15, 278.01 ICD-10: M16.12, E66.01, Z68.41 This encounter is coded as 99213 as follows: History—The history of present illness was extended. The review of systems was comprehensive, and no past family social history was documented. This makes the history level expanded problem focused. Examination—There were eight systems examined. This…
Rheumatologists who have not been members of the American Medical Association (AMA), or have let their membership lapse, should strongly consider joining now for 2015 so rheumatology can remain involved in steering the direction of the AMA. Call the AMA at 800-262-3211 and specify that you want to join for 2015, or contact ACR staff…
Want to hear about the latest advances in rheumatoid arthritis (RA), osteoarthritis (OA), systemic lupus erythematosus (SLE) and polymyositis/dermatomyositis and how best to implement interprofessional care for your patients? The Association of Rheumatology Health Professionals (ARHP) Clinical Focus Course (CFC) is the course for you. The CFC is a full-day course titled, Clinical Advances in…
Ankle arthritis is a debilitating condition that leaves many patients in severe pain and greatly limits their activities. Until recently, the standard treatment for bone-on-bone ankle pain has been ankle fusion, or arthrodesis, in which surgeons literally fuse the bones of the ankle joint together. However, in the past few years, total ankle replacement surgery,…
How are Annie and Abby? That’s a question some patients ask J. Michelle Kahlenberg, MD, PhD, a rheumatologist and assistant professor in the school of medicine at the University of Michigan, who also runs a lupus research lab at the University of Michigan Health System. Patients aren’t asking about her children, but family members of…