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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

New Insights into Cartilage & Tendon Differentiation

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By examining the phenotypic plasticity of cartilage and tendon cells, researchers found that oxidative stress and P13K signaling pathways are key modulators of the phenotype of musculoskeletal cells. Using monolayer and three-dimensional cultures, the experiments confirmed that dedifferentiation occurs via reductions in expression of genes for cartilage (Col2a1, Agcn) and tendon (Tnmd, Serpinf1)…

Statin Use Tied to Attenuation of Tocilizumab-Mediated Lipid Increases

Reuters Staff  |  

NEW YORK (Reuters Health)—Statin treatment is associated with an attenuation of the increases in serum lipids experienced by rheumatoid arthritis patients on tocilizumab, according to a post-hoc analysis of clinical trials. Treatment with the interleukin-6 receptor-alpha inhibitor tocilizumab is known to raise total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride levels. To explore the possible effect of…

CMS Cancels Medicare Part B Demonstration Project

From the College  |  

When the controversial Medicare Part B Drug Payment Model final rule was not released by the Centers for Medicare & Medicaid Services (CMS) as expected before Nov. 21, it signaled an increasing likelihood of defeat for the proposed rule—a signal proved true on Dec. 15. A spokesperson for the CMS said, “After considering comments, CMS…

When Chronic Pain Is Personal

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Opening up to patients about a medical condition is a personal choice for physicians. But for Richard Brasington, MD, who has chronic back pain and arthritis, it helps him communicate with and connect to some of his patients. In an interview, he provides insights into his experiences managing pain on the job…

The Future of Pediatric Rheumatology Grounded in Evolution of Childhood Arthritis and Rheumatology Research Alliance

Yukiko Kimura, MD, & Laura E. Schanberg, MD  |  

Pediatric rheumatology was formally recognized as a specialty in 1991 by the American Board of Pediatrics. Prior to this time, children with rheumatic diseases were treated by a hodgepodge of providers. In addition to providers who had training as pediatric rheumatologists, general pediatricians, adult rheumatologists, allergist-immunologists, orthopedists, pediatric infectious disease specialists and others treated children…

Rheumatology Case Report: Systemic Capillary Leak Syndrome and Rheumatoid Arthritis

Alexis Smith, MD, & Angus Worthing, MD, FACP, FACR  |  

Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…

How Hospital Design Can Promote Better Patient Outcomes

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A storm has been brewing down the street from my office. It is a David & Goliath dispute, pitting young children and their families against a renowned pediatric institution, Boston Children’s Hospital. It concerns the fate of a half-acre swath of green space, the Prouty Garden, replete with meandering paths, fountains and a towering redwood…

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Assessing Autoimmune Disease Symptoms in Silicone Breast Implant Recipients

Charles Radis, DO  |  

My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…