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)…
A recent study found that the varicella zoster virus downregulates expression of programmed death ligand 1 and major histocompatibility complex 1 in brain fibroblasts, perineurial cells and lung fibroblasts. These effects may lead to persistent inflammation in the vessels and lungs, as well as promote subsequent infection of T cells and the spread of the virus…
In May, the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) published its recommendations for the treatment of psoriatic arthritis (PsA).1 The updated recommendations represent advances in drug development and availability since previous recommendations published in 2009, as well changes in treatment paradigms and the importance of associated aspects of the disease.2…
Depending on stage, severity and rate of progression of disease, systemic corticosteroids are commonly used to treat pulmonary sarcoidosis. However, a review of the literature suggests they have limited usefulness in advanced stage IV pulmonary sarcoidosis. Once sarcoidosis has advanced to this degree, steroid use may unnecessarily expose a patient to life-threatening complications, as demonstrated…
Oral health is not frequently considered within the sphere of a rheumatologist’s practice. However, recent results published by the Canadian Scleroderma Research Group (CSRG) point out the importance of assessing oral health in patients with systemic sclerosis (SSc). Result of 3-Year Grant Between 2008 and 2011, 163 patients with SSc and 231 controls were entered…
Otulipenia is a recently discovered autoinflammatory disease caused by germline mutations, which results in dysregulated ubiquitination in patients. In a small-scale study, researchers used exome sequencing and candidate gene screening to identify three different loss-of-function mutations in the OTULIN/FAM105B gene in patients…
We read the case report by Dr. Diana Girnita and colleagues (“Severe Refractory Gout: What options are left when pegloticase fails?” The Rheumatologist, August 2016) with interest. A case is reported of a subject with 20 years of chronic refractory gout who failed to respond to pegloticase therapy, and the potential roles of anti-drug antibodies or…
CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established outpatient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…
A 55-year-old female patient returns to the office with complaints of gout pain. She is complaining of swelling and a burning pain in her left toe. She has been taking an over-the-counter NSAID to treat the pain, but this has done little to alleviate it. This is her second flare this year. The patient denies…
NEW YORK (Reuters Health)—Anti-TNF drugs are more likely to improve growth in children with inflammatory bowel disease (IBD) if they’re given in the earlier stages of puberty, new findings show.¹ Children who achieve remission are also more likely to have satisfactory growth, the research team reported online on Sept. 21 in the Journal of Pediatric…