The Phone Call A phone call in the middle of the night can rattle one’s nerves. The rush of adrenaline sets the heart pounding as our ears brace for what we are about to hear next. A distress call from an elderly parent or a child away at college? Is everyone safe? Or may this…
Environmental Factors in Pediatric Systemic Autoimmune Diseases
Systemic autoimmune diseases are thought to result from immune dysregulation in genetically susceptible individuals who were exposed to environmental risk factors. Many studies have identified genetic risk factors for these diseases, but concordance rates among monozygotic twins are 25–40%, suggesting that nonheritable environmental factors play a more prominent role.1,2 Through carefully conducted epidemiologic and other…
Metagenomic Deep Sequencing for Uveitis Enhances Traditional Diagnostic Testing
Throughout their training and practice, physicians become adept at pattern recognition as a means to efficiently connect and synthesize seemingly disparate laboratory, physical exam, and radiologic and historical findings into a coherent theory for what likely ails the patient sitting in front of them. This inductive method of reasoning is necessary because, based on these…
On the Road in Rajasthan: Vehicular-Caused Bone, Joint Damage in India
In the good old days, physicians routinely made house calls. The decision to visit the literal bedside of a patient was practical: hospital services were primitive and often offered too little benefit to justify an emergency journey by the patient. These physicians carried leather bags, sometimes called Gladstones, that were filled with instruments for eventualities…
High Cost of Rheumatoid Arthritis Medications Burdens Patients in Saudi Arabia
In the past 15 years, rheumatoid arthritis (RA) has posed an economic burden on patients in Saudi Arabia due to the high cost of the medications used to treat the condition. As a rheumatology consultant, I’ve observed the economic impact on patients in one clinic in a private hospital in Riyadh. RA is a chronic,…
Undercoding Is Not an Audit-Proof Strategy in Medical Documentation
Overcoding is a common term used when discussing fraud and abuse in reporting procedures and services not supported by the actual work performed. Alternatively, undercoding—or failing to report the full extent of services or procedures provided—is an equally unsound practice and a compliance risk. In the world of quality reporting, undercoding can have damaging effects…
New NICE Guidance for Low Back Pain
If left untreated, low back pain can cause long-term disability. To aid its diagnosis and management, the National Institute for Health and Care Excellence has released revised guidance. Recommendations include the use of risk stratification tools for diagnosis, as well as physical activity or a comprehensive program that addresses biomechanical, aerobic and/or psychological needs…
Scant Consumer Information in Local TV Coverage of Obamacare
(Reuters Health)—Local TV news coverage of the Affordable Care Act (ACA), often called Obamacare, generally focused more on politics than on information consumers can use to help choose insurance, a recent study suggests. Overall, less than half of ACA-related news coverage focused on health insurance products, while much of the rest of the spots concentrated…
Not Much Saving Going on in Health Savings Accounts
NEW YORK (Reuters)—Health savings accounts (HSAs) feature prominently in the new healthcare bill being considered by the U.S. House of Representatives, with a variety of changes in store. But research shows not many participants are actually saving money beyond the initial tax break. More than 20 million Americans currently have these accounts, which allow people…
Paternal Methotrexate Exposure Not Tied to Adverse Pregnancy Outcomes
NEW YORK (Reuters Health)—A father’s exposure to methotrexate 90 days or less before conception “should not be of major concern,” researchers say. Prepregnancy paternal methotrexate exposure appears to confer no increased risk of major or minor congenital malformation, stillbirth or preterm birth in his offspring, their study found. Methotrexate is a first-line therapy for rheumatoid…
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