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From: The Rheumatologist, March 2012

Features

The Mystery of IVIg

Although initially given as replacement therapy for patients with primary and secondary immunodeficiency states, intravenous immunoglobulin (IVIg) has proven to be effective in the treatment of various autoimmune and inflammatory disorders. This success has led to a dramatic increase in the use of IVIg, with its use as an antiinflammatory agent now vastly surpassing its use in the treatment of immunodeficiencies. Even so, the basis for the antiinflammatory activity of IVIg remains unclear.

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From the College

Gout - Rheumatology's Royal Pain

Gout is a common rheumatic disease often characterized by swelling, redness, and intense pain in the big toe. Once thought to be an exclusive disease of the wealthy who overindulged in food and spirits, gout has become a royal pain for millions of Americans.

Patient Fact Sheet - Gout

Gout is a painful and potentially disabling form of arthritis that has been recognized since ancient times. Treatments are available to control most cases of gout, but diagnosing this disorder can be difficult, and treatment plans often have to be tailored for each person.

New Patient vs. Established Patient

Office visits are considered evaluation and management codes (E/M) in the Current Procedural Terminology (CPT) manual and are a fundamental part of a rheumatologist’s day. There are two types of office visits: new patient and established patient.

A Journey Begins with the First Step

The ACR Research and Education Foundation (REF) has launched the Action Alliance network, a program that calls on rheumatologists, investigators, and health professionals to join the REF in asking patients and families to be a part of the conversation. The Action Alliance consists of two programs working together: From the Field Speakers Bureau and Patients and Families for Progress.

Coding Corner - New Patient vs. Established Patient Quiz

Coding Corner Answer - New Patient vs. Established Patient Quiz

Magnify Rheumatology’s Legislative Impact this Month

Members of the ACR’s Executive, Government Affairs, and RheumPAC Committees, along with the Affiliate Society Council, attended 75 meetings with legislators and their staff. These meetings are critical to advancing awareness of rheumatology and the issues affecting your profession and patients.

ACR's Advocacy Toolkit

Ways to contact your member of Congress; tips for communicating with your member of Congress; ways to get patients involved; and donloadable briefs, posters, and brochures.

ACR Partners with Patient Organizations

The ACR met with representatives from 14 patient advocacy organizations in Washington, D.C., to discuss mutual advocacy and legislative objectives.

ARHP Members Earn Leadership Position, Award

Kamala Nola, PharmD, MS, was inducted as the 2011-2012 president-elect of the Tennessee Pharmacists Association; Danuta Bujak, PhD, FNP, an ARHP member, was honored as the recipient of the 2011 Yale School of Nursing Distinguished Alumna Award.

Optimize Patient Scheduling

Optimizing patient schedules is a continuous process that is critical to physician efficiency and satisfied patients. Taking inventory of the scheduling trends in your practice can have a positive influence on tackling appointment templates, which determines patient flow that affects your revenue.

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Departments

Confusion, Expressive Aphasia, Gait Instability

A 49-year-old man presented to the hospital with confusion, dysarthria, expressive aphasia, and progressive gait instability.

Information on New Drug Approvals and Medication Safety

Rheumatology-related drug safety, approvals, and what's in the pipeline.

How to Retire from Your Medical Practice

If you are a physician nearing retirement, it is important that you plan, discuss, and make contractual agreements that will allow you to accomplish your goals and changing needs.

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Columns

Maintenance of Certification Is Not Just for the Young

I certainly am relieved to know that I will never need to recertify with the American Board of Internal Medicine Maintenance of Certification, but this feeling is shadowed by a deep sense of shame. I decided to step up and take advantage of all the wonderful recertification programs the ACR has to offer.

Pain is a Tricky Thing to Treat, or Even Evaluate

Rheumatology is such a gratifying and emotionally rewarding medical specialty. There is no better feeling than helping patients with conditions whose proper diagnosis and management have eluded other practitioners. A patient with diffuse idiopathic skeletal hyperostosis (DISH) presents with pain, and a major clinical tenet of DISH has been its lack of association with pain.

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Meeting

First ARHP “Best of the Meeting” Highlights Sleep Research, Osteoporosis Screening, More

“The line between ACR and ARHP sessions has totally blurred,” said Donah Zack Crawford, MA, during the presentation, “Highlights from the 2011 ARHP Sessions,” here at the 2011 ACR/ARHP Annual Scientific Meeting held in Chicago in November 2011.

Biosimilar Drugs Face Challenges to Reach the U.S. Market

To date, the FDA has not approved a biosimilar product. In its own discussion of the merits and obstacles to biosimilar drugs, the ACR sponsored a panel session titled, “Biosimilar Products in the U.S. Market: Fact or Fiction?” at the 2011 ACR/ARHP Annual Scientific Meeting here in November.

Where Will Kinase Inhibitors Fit into the RA Treatment Mix?

Presenters at “Looking Ahead to Kinase Inhibition in Rheumatoid Arthritis,” a session here at the 2011 ACR/ARHP Annual Scientific Meeting, delved into some of the big questions that rheumatology faces with kinase inhibitor use.

Link between Autoimmunity and Environmental Exposure Needs Further Research

Rheumatology needs further cost-effective and validated methods to track the connection between environmental exposure and autoimmune diseases, including research on phenotypes, genotypes, the synergy between multiple infectious and noninfectious exposures, the timing of exposure, and the mechanisms involved, according to presenters of “Impact of Environmental Health on Autoimmunity,” a session here at the 2011 ACR/ARHP Annual Scientific Meeting held in Chicago in November 2011.

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