Complement can deposit in various tissues, and previous studies have associated complement deposition with an increased risk for all-cause mortality and stroke. Now, new research underscores the relationship between rheumatic disease, the complement system and cardiovascular disease. In particular, inflammatory rheumatic disease status appears to be uniquely associated with mononuclear cell infiltrates in the vascular…
Prospects for Treating Patients with Arthritis in African Countries with Few Rheumatologists
At present, the U.S. has approximately 5,000 full-time adult rheumatologists. By the year 2025, that number will decline to roughly 3,600.1 Sounds dire, right? Hold that thought. Question: What country has 99 million people and no adult rheumatologists? Answer: Ethiopia.2 The Nigerian Story And then there is Africa’s most populous country, Nigeria, with roughly 170…
Tips to Help Physicians Understand, Cope, Manage Burnout
Years ago, the Mayo Clinic was exploring effective ways to minimize burnout among the more than 3,000 doctors employed at its three medical and research facilities in Rochester, Minn., Scottsdale, Ariz., and Jacksonville, Fla. One strategy involved inviting physicians to participate in small groups to discuss topics that were fairly ubiquitous among doctors, from medical…
Dr. Peter Schur Discusses Lupus Treatment, Management Advances in Past 50 Years
Although systemic lupus erythematosus still does not have a definite cause or cure, rheumatologists and researchers over the past 50 years have witnessed and contributed to a great deal of progress that helps patients, says Peter H. Schur, MD, director emeritus of the Lupus Center, Brigham and Women’s Hospital, and professor, Harvard Medical School, Boston. Dr. Schur’s…
Infection Rates for Patients with SLE on Immunosuppressive Drugs
A comparison study of the serious infection burden among patients with lupus found no major differences in patients treated with three separate immunosuppressive drug regimens. Given that serious infections are among the leading causes of hospitalizations and death in patients with systemic lupus erythematosus (SLE), researchers investigated whether the incident rates differed in patients who…
Advantages, Disadvantages of Private Practice Ownership for Rheumatologists
When he worked for a multi-specialty practice, Jonathan M. Greer, MD, FACR, FACP, president, Arthritis and Rheumatology Associates of Palm Beach, and affiliate clinical professor of medicine, Nova Southeastern University, Boynton Beach, Fla., found that there were too many restrictions and controls and no way to enhance the revenue stream for rheumatologists. So he moved on…
Psoriasis May Itch as Intensely as Atopic Dermatitis
NEW YORK (Reuters Health)—Itch intensity in moderate to severe plaque psoriasis can be substantial, and may be on a par with the notoriously itchy skin condition atopic dermatitis, new research suggests. “Both conventional wisdom and some of our classic dermatologic textbooks have stated that psoriasis is not particularly itchy,” corresponding author Dr. Alexa B. Kimball…
U.S. Supreme Court Speeds Copycat Biologic Drugs to Market
WASHINGTON (Reuters)—The U.S. Supreme Court on Monday cut the time it will take for copycat versions of biologic drugs to get to the market in a pivotal ruling about an expensive class of medicines that can yield billions of dollars in sales for drug companies. The justices, in a 9–0 ruling, overturned a lower court…
Documentation Guidelines for Proper Medical Decision Making
The Medical Decision Making (MDM) of an evaluation and management (E/M) visit is one of the three components of determining the level of a patient’s visit. But the MDM can sometimes be the most difficult component, as this is where the provider’s thought process is quantified in deciding the correct level of E/M service. In the…
Rheumatology Coding Corner Answer: Infusion Services for Skilled Nursing Facility Patient
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…
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