(Reuters Health)—Doctors who were asked about causes of inappropriate care at the end of life didn’t have to look far to place blame. They blamed themselves. Australian researchers interviewed 96 physicians from 10 medical specialties and asked them to describe situations when patients received end of life care that the doctors felt was inappropriate. Futile…
Opinion: More Tests Needed to Diagnose Fever of Unknown Origin
I’m writing in regard to the article, “Fever of Unknown Origin” (TR, March 2016), by Charles Radis, DO. In regard to the non-caseating granulomas, there was no mention of epithelioid or giant cells. In addition, it was mainly [complement] C4 in the center of the granulomas, which is often found in sarcoidosis. Moreover, whether these…
Rheumatoid Arthritis & Autoimmune Glomerulonephritis
Rheumatoid arthritis (RA) is rarely associated with renal manifestations, but secondary amyloidosis due to chronic inflammation is reported to be the etiology of renal dysfunction in many cases of RA.1,2 The discovery of biologic therapy, with TNF-alpha inhibitors in particular, made a huge difference in the disease course and prognosis of RA patients. However, TNF-alpha…
Diagnostic Tests, Tips for Gluten-Induced Celiac Disease
CHICAGO—Celiac disease—the gluten-induced illness that can be seen alongside rheumatic diseases—has been seen much more commonly over the past 20 years than it was previously, but the illness can come with questions that are not always straightforward, an expert said at the ACR’s State-of-the-Art Clinical Symposium. The disease, in which the small intestine becomes inflamed…
Treatments for Scleroderma with Gastrointestinal Involvement Address Symptoms
CHICAGO—Nine out of 10 scleroderma cases include clinical signs of gastrointestinal (GI) involvement, with severe involvement associated with high mortality rates, but the pathology of this is not very well understood, a GI expert said at the ACR’s State-of-the-Art Clinical Symposium. That has left clinicians with a slate of treatments—anti-reflux, antimicrobials and prokinetics—that address only…
Tips on Vaccinating Patients with Rheumatic Diseases
CHICAGO—In October of last year, a 52-year-old woman came to see Kevin Winthrop, MD, MPH, associate professor in infectious diseases, public health and preventive medicine at the Oregon Health & Sciences University. She had rheumatoid arthritis and was taking methotrexate and prednisone. She had had little change in her RA disease severity and was considering…
Pitfalls of Potential Lupus Diagnosis
Spotting the signs of autoimmunity as early as possible is often viewed as a positive goal for rheumatologic research. The premise: Patients may begin treatment years before their disease is active and destroying joints and tissue. Although much progress has been made in identifying early stages of rheumatoid arthritis pathogenesis, the clues are not as…
Email Remains Dominant Communications Method in Medicine
Forty-five years ago, a computer engineer in Boston sent an electronic message between two computers some 10 feet apart. It took another 10 years or so before the electronic mail message was dubbed email—a term now, perhaps, more ubiquitous than any other in the lexicon of modern communications. Despite the seemingly definitive place email communication…
How Rheumatologists Can Plan for Extended Work Absences
Sometimes, life calls for you to be out of the office for a length of time. Whether the absence is planned or not, it’s important to consider the best actions to take given the circumstances to ensure patients are cared for during your absence. Alexa Meara, MD, clinical instructor and rheumatologist, The Ohio State University…
How Rheumatologists Can Engage Congress Locally, Advance Rheumatology
With limited time to spend away from your practice, you can still have an impact on issues important to Advancing Rheumatology! Below are several ways to have your voice heard, without ever leaving town. Set Up a Local Meeting with Your Elected Officials Every member of Congress has at least one local office in the…
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