Interactions between an individual’s genetic background and their exposure to environmental factors are thought to result in a cascade of immune reactions, ultimately leading to the development of autoimmune diseases such as rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), systemic lupus erythematosus (SLE) and juvenile dermatomyositis.1,2 For example, an environmental factor that conclusively affects susceptibility…
My dear friends, we come to praise Caesar. As we march toward 2016, we ought to acknowledge the great Roman emperor’s role in creating a proper calendar. At the start of Caesar’s reign, the calendar year lasted 355 days, 10¼ days fewer than the time it took the earth to fully orbit the sun.1 Although…
Recognizing the need to provide guidance on the current disparate management of polymyalgia rheumatica (PMR), the American College of Rheumatology (ACR), in collaboration with the European League Against Rheumatism (EULAR), recently published the first international set of recommendations for the screening, treatment and management of PMR.1,2 Specifically, the recommendations offer guidance on the use of…
A recent trend to incorporate patient-reported outcomes (PROs) in clinical research, and ultimately clinical practice, is a response to the need to better measure and treat what patients truly care about, and adapt to the changing healthcare environment, which increasingly includes patient satisfaction as a key metric for overall quality of care, a metric tied…
To practice rheumatology, you’ve got to love a challenge and be prepared to navigate some twists and turns before arriving at the right diagnosis. Rheumatologist and avid kayaker William Truslow, MD, says the same qualities apply to running rivers. “The toughest part is the mental attitude—feeling that I can do this,” says Dr. Truslow, a…
When deciding where to locate a rheumatology practice, you need to do your homework. There are many factors to ponder, including accessibility, population demographics, competition, need, costs and whether a building meets your needs. First and foremost, it’s important that patients can easily get to and find your practice. Randy Eigen, first vice president, CBRE…
Despite a generation of advances in molecular biology, a huge gap exists between the Sjögren’s syndrome (SS) patient’s description of their symptoms and the objective findings. Current issues include: Many SS patients are misclassified as either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), even within rheumatology clinics. Frequently, the sickest SS patients with extraglandular…
I sometimes find myself mired in sticky clinical circumstances. I am facing a distraught patient who is seeking my opinion about a condition that, according to some, may not truly belong in the rheumatologist’s bailiwick. Case example: hearing loss. The Steroid Test Sudden sensorineural hearing loss (SSNHL) and its relative, autoimmune inner ear disease (AIED),…
I am a few weeks post-retirement. Having written thank you notes and completed urgent home projects, I swing in a hammock at our currently fire-threatened cabin north of Winthrop, Wash., and reflect. I feel like a young boy while freely flipping pages of a hand-scribed picture book, The Principles of Uncertainty, by Maira Kalman. She…
NIH Director Francis Collins, MD, PhD, is working to improve funding for research into new treatments for lupus and RA through the Accelerating Medicines Partnership, a coalition of private and public partners identifying and validating promising biological targets for therapeutics…