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Speak Out Rheum

A History of the Science, Treatment of Rheumatologic Illnesses from Gold to Gene Therapy

Simon M. Helfgott, MD  |  December 17, 2017

Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…

Heated Gloves Provide Relief from Hand Pain, Dysfunction in Diffuse Systemic Sclerosis

Rosemarie A. Curley, MPT, DPT  |  November 10, 2017

Raynaud’s phenomenon in scleroderma or systemic sclerosis (SSc) is associated with significant discomfort and functional disability, especially in the presence of digital ulcers.1 Having lived with diffuse systemic sclerosis (dSSc) for nearly a decade, I can attest to this. It has been my experience that the hand pain and dysfunction in dSSc stems from Raynaud’s…

Unwise Choices: EHRs, PBMs, Drug Costs Are Leading to Physician Burnout

Simon M. Helfgott, MD  |  November 5, 2017

My dear electronic health records How do I dislike thee? Let me count the ways Adaptation of Sonnet 43 By Elizabeth Barrett Browning, 1806–1861 As my tenure as physician editor winds down, it’s worth reviewing some of the more nettlesome issues confronting clinicians that have been previously discussed in these pages and gauge their current…

Letter: Tips to Improve Osteoporosis Screening Rates

Timothy Harrington, MD  |  October 16, 2017

Osteoporosis Screening The aphorism, “Those who do not learn history are doomed to repeat it,” applies to The Rheumatologist August 2017 article that documents the continued low screening rates for those at high risk for osteoporosis-related fragility fractures, in particular people older than 65 and those who have suffered a fracture already. So here’s a…

The Legacy of Amyloid: Infiltration Linked to Dementia, Rheumatic Disease

Simon M. Helfgott, MD  |  October 16, 2017

An Unforgettable Story Her name was unforgettable. Not only did we share our given names—Simon and Simone, but her French-Canadian surname was based on this appellation, too. I was the junior resident working on our hospital’s nephrology service when she was admitted for evaluation of progressively worsening kidney disease and an overall failure to thrive….

When Is a Doctor Too Old to Practice?

Simon M. Helfgott, MD  |  September 18, 2017

Steady hands, nerves of steel: The endoscopic transphenoidal hypophysectomy is a delicate neurosurgical procedure. Using a three-dimensional microscope and a powerful magnetic resonance imaging machine to guide them, the surgeon must meticulously dissect the throat tissues, navigate through the palate and the sinuses to reach the base of the skull where the pea-sized master gland,…

Opinion: Help Bring Drug Prices Down

Maarten Boers, MSc, MD, PhD  |  August 22, 2017

I read with interest the articles in the June issue of The Rheumatologist pertaining to high drug costs. Simon Helfgott rheuminated on it, and Susan Bernstein, a medical journalist, wrote a two-page article titled “Concerns About Cost.” Both articles were thoughtful summaries of a complex issue, putting large question marks over both initial prices and…

What Do Diabetes, Islet Cells & Autoimmunity Have in Common?

Simon M. Helfgott, MD  |  August 15, 2017

“Man may be the captain of his fate, but he is also the victim of his blood sugar.” —Wilfrid Oakley, MB BChir, an early pioneer in diabetes care Perusing the list of the most notable medical achievements in the 20th century, a reader may conclude that the discovery of insulin should rank in a category…

How Global Geographic Disparities Affect Healthcare Outcomes

Simon M. Helfgott, MD  |  July 13, 2017

Your home & your health: Does geography impact medicine? Does it matter whether a region is surrounded by large bodies of water, encircled by towering mountain peaks or that its residents share a common ancestry? Consider Switzerland, a nation with a highly developed economy replete with advanced technological and medical infrastructure. Despite these advantages, less…

The Birth and Growth of Biotechnology, and the Impact of Biologic Drugs on Rheumatology

Simon M. Helfgott, MD  |  June 15, 2017

Here’s a trivia question: Where were the big ideas for the field of biotechnology first discussed? Answer: At a since-demolished delicatessen in Waikiki Beach, Hawaii. Go figure. The year was 1972, and Stanley Cohen, MD, professor of medicine at Stanford University in Palo Alto, Calif., and Herbert Boyer, PhD, a former professor and biochemist at the…

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