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…
Early Consults, Timely Patient Histories Aid Rheumatologists Treating Patients in the ICU
CHICAGO—When it comes to treating patients with rheumatic diseases who are in the intensive care unit (ICU), there are so many complications and considerations that few rules exist as a guide. But Paul Dellaripa, MD, associate professor at Harvard Medical School, said at the ACR’s State-of-the-Art Clinical Symposium that there are basic steps a rheumatologist…
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…
University of Alabama at Birmingham’s Division of Clinical Immunology & Rheumatology Recognized for Excellence
An interdisciplinary and collaborative environment is a critical factor for the advancement of basic science and clinical research in the academic environment, says William J. Koopman, MD, former director of the University of Alabama at Birmingham’s (UAB’s) Division of Clinical Immunology and Rheumatology. And in 1977, when he was being recruited by Division Director J….
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…
Protein Phosphatase 2A and Regulatory T Cell Function Researched
The serine-threonine protein phosphatase 2A (PP2A) enzyme is critical for regulatory T cells to function—without it, they don’t have the ability to suppress effector T cells and can’t protect against autoimmunity, according to new research published in Nature Immunology. Researchers found that conditional knockout mice—in which PP2A expression is knocked out only in regulatory T cells—developed…
Find Your Mentor in Medicine
Medicine has traditionally been an apprenticeship model. The most elemental and constructive method of passing on knowledge is the mentor–mentee relational experience. Mentorship encompasses not only the role of teacher, but also that of coach, role model, advisor and confidante. Matthew J. Koster, MD, rheumatology fellow and instructor in medicine, Mayo Clinic, Rochester, Minn., can…
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…
Rheumatology Coding Corner Answer: Office Visit with DEXA Scan
Take the challenge. CPT: 99213-25, 77085 ICD-10: Diagnosis M81.0, Z79.52 The encounter is coded as 9913 as follows: History—The history of the present illness was extended. The review of systems was complete, and the past medical history was documented. This makes the history detailed. Examination—The examination was expanded problem focused. Medical decision making—The diagnosis was…
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