NEW YORK (Reuters)—Medicare, the government-run health insurance program for elderly and disabled Americans, paid physicians $90 billion in 2013, up 17% from $77 billion in 2012, U.S. healthcare officials reported on Monday. Physician payments accounted for less than one-fifth of Medicare’s 2013 net outlays of $492 billion, which rose from $466 billion in 2012. Payments to…
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Better Evidence Supports Slightly Revised Treat-to-Target Recommendations for RA
NEW YORK (Reuters Health)—A number of recent studies support last year’s update of 2010 treat-to-target recommendations for rheumatoid arthritis (RA), according to the international task force that revised them. Dr. Josef S. Smolen from Medical University of Vienna, Austria, and colleagues updated their 2010 advice based on systematic literature reviews and expert opinion. They left…
Anti-TNF Agents May Improve Clinical Symptoms of Ankylosing Spondylitis
Ankylosing spondylitis primarily affects the joints and ligaments of the spine, but may also have an impact on other joints. Patients experience pain and stiffness that limit mobility in the back and other affected joints. Symptoms can come and go, last for long periods of time and be severe. Anti-tumor necrosis factor (anti-TNF) drugs are…
Bone Microarchitecture Impaired in Active Celiac Disease
Bone microarchitecture is impaired in premenopausal women with active celiac disease, a new study from Argentina shows. “This report helps us to understand how bone is affected in celiac disease: increasing bone resorption and thinning trabeculae, even losing some number of them,” Dr. María Belén Zanchetta from Instituto de Diagnóstico e Investigaciones Metabólicas in Buenos…
FDA Issues Safety Alerts for Bisphosphonates & SGLT2 Inhibitors
Safety The Food and Drug Administration (FDA) has updated the Warnings and Precautions sections of prescribing information for the bisphosphonate agents, including risedronate sodium tablets and combinations with calcium (Actonel/Atelvia), alendronate and combinations with vitamin D (Binosto/Fosamax), ibandronate (Boniva), etidronate (Didronel) and the RANK-ligand inhibitor denosumab (Prolia/Xgeva).1 This information relates to an increased risk for…
Pediatric to Adult Care Transition Challenging for Patients with JIA
Dr. Sheffield is an adult rheumatologist who received the following referral request from a family doctor: “Please see this 22-year-old male with a history of juvenile arthritis for ongoing care. I have only seen him once, and have no previous medical records.” Dr. Sheffield meets with Paul, who reports that he has had arthritis since…
Physicians as Targets of Medical Workplace Violence
Tuesday, Jan. 20, a busy morning lay ahead for the staff of the cardiovascular surgery clinic. There were several new patients to see. No doubt, many of them were anxious to hear whether the skills of the surgeons they were going to meet could help them live another day. There were countless follow-up visits and…
Rheumatologist Recalls Personal Experience with RA
In late March 2012, I awoke with pain in my left hand. I had difficulty moving my metacarpophalangeal (MCP) joints. They did not move smoothly, but clunked. As I repeatedly attempted to open and close my hand, I realized that I had morning stiffness. As the pain and stiffness gradually improved over the next hour,…
Melioidosis: What Rheumatologists Need to Know
Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia.1 In recent years, the incidence of melioidosis has increased worldwide. Septic arthritis is a rare, but well-recognized, manifestation of melioidosis. Case Report A 49-year-old woman with known diabetes was admitted elsewhere with uncontrolled diabetes and fever. She was found to…
Rheumatologists Expand Reach Through Telemedicine
What started out as a way to bring specialty medicine to rural areas around 40 years ago has evolved from sharing imaging and laboratory results to seeing and interacting with patients remotely. Telemedicine is beginning to evolve from its traditional urban–rural linkage, and rheumatologists are following along. “Telemedicine covers a variety of services, but it…
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