Case report: A 60-year-old Hispanic male with poorly controlled hypertension was sent from the primary care clinic for evaluation of malignant hypertension with a systolic blood pressure above 200 mmHg. His symptoms at the time of presentation included episodic confusion, worsening vision and an unsteady gait. A head computed tomography (CT) scan showed a subacute…
I am a few weeks post-retirement. Having written thank you notes and completed urgent home projects, I swing in a hammock at our currently fire-threatened cabin north of Winthrop, Wash., and reflect. I feel like a young boy while freely flipping pages of a hand-scribed picture book, The Principles of Uncertainty, by Maira Kalman. She…
Recent updates to criteria used for diagnosing neuromyelitis optica (NMO) are aimed at helping physicians make the differential diagnosis of this disorder differentiating it from other inflammatory disorders—a diagnosis that can be difficult given the presenting symptoms that can mimic a number of other conditions, such as multiple sclerosis. Published in July 2015, the new…
Case report: A 78-year-old Caucasian female presented to our outpatient rheumatology clinic with pain in her bilateral shoulders, hands and knees that began suddenly one month earlier. She admitted to stiffness in her hands lasting several hours, and expressed an inability to extend her fingers. She denied fever, rashes, jaw claudication, headache or visual changes….
Temporal arteritis was first described by Sir Jonathan Hutchinson in 1890 in an elderly retired gentleman’s servant who developed red, painful streaks on his temples and was found to have bilaterally swollen temporal arteries with feeble pulses.1 Sir Hutchinson disputed the suggestion that the red streaks were caused by the man’s hat and, instead, called…
(Reuters Health)—Of all the ways for patients to receive their medical test results, one option—password-protected websites—appears to be preferred much of the time, a study suggests. U.S. researchers surveyed about 400 adults and found they were generally comfortable with web portals regardless of how sensitive the test results might be. This was among the most…
NEW YORK (Reuters Health)—Tocilizumab improves remission rates and slows disease progression in patients with early rheumatoid arthritis (RA), a new randomized controlled trial demonstrates. Tocilizumab was effective both on its own and when combined with methotrexate, Dr. Gerd R. Burmester of Charite Medical University of Berlin and his colleagues found. Tocilizumab, an interleukin-6 (IL-6) blocker,…
Michael Lockshin, MD, reminds medical professionals that patients suffering from antiphospholipid syndrome (APS) don’t respond to medications in the same way as patients with other clotting-related diseases. Insufficient evidence exists to determine whether the new wave of anticoagulant medications is safe for use in patients with APS…
NEW YORK (Reuters Health)—Exposure to probiotics in the first few weeks of life is associated with a reduced risk of islet autoimmunity, according to results from the TEDDY study. “Early supplementation of probiotics may be important but we need more research on this,” Dr. Ulla Uusitalo from University of South Florida in Tampa told Reuters…
NEW YORK (Reuters Health)—Although histomorphometry of iliac bone gives precise results, bone turnover markers provide a better reflection of the overall skeleton in untreated postmenopausal osteoporotic women, according to French researchers. Bone histomorphometry allows study of bone remodeling at the basic structural unit level, Dr. Pascale Chavassieux and colleagues at the University of Lyon note…