A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…
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Weakness, Fatigue Can Signal Underlying Rheumatologic Disease
As clinicians, we are familiar with pain, stiffness and soreness—subjective nouns that define our métier. These helpful words serve as signposts that direct us along the path to the proper diagnosis. Consider the young man with a stiff, sore back (a case of ankylosing spondylitis?) or the postpartum woman experiencing newly painful, stiff and sore…
Medical Paradoxes in Clinic, Lab Should Encourage Physicians to Reappraise Ideas about Health and Disease
Wash your hands. This most basic tenet of proper hygiene has been drummed into our heads for years. It’s an obvious infection prevention activity, yet for years, compliance among physicians and other caregivers has been lackluster. To rectify this matter, regulatory agencies began auditing hospital staff adherence to this axiom of infection prevention. Not only…
Gout Treatments Effective If Patients Maintain Lifelong Adherence to Therapies
Although gout is one of the most effectively treated of all rheumatic diseases, it is among the worst-managed diseases long term, as shown by many studies. “Treatments are excellent, yet are dramatically under-utilized,” says Theodore Fields, MD, FACP, rheumatologist, Hospital for Special Surgery (HSS), New York. “This is because some gout patients feel better between…
Rheumatology Drug Updates: Celecoxib and Cardiovascular Safety Trial Results Reviewed
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used therapeutically since the 1960s.1 Evidence of adverse cardiovascular outcomes led to the withdrawal of the selective COX-2 inhibitor rofecoxib in September 2004, when the question of cardiovascular safety of NSAIDs first came into the limelight.2 Valdecoxib (Bextra) was subsequently withdrawn from the market in April 2005 due to…
Celecoxib & Cardiovascular Death: NSAID Safety Under Review
A recent study showed that at moderate doses celecoxib may be noninferior with respect to cardiovascular safety compared with ibuprofen or naproxen…
Insight into Infectious Diseases Could Lead to Preventive Vaccines for Some Rheumatic Illnesses
CHICAGO—Medicine is in the middle of an infectious-disease “revolution” that seems almost destined to lead to prevention through immunization of many diseases, including rheumatic illnesses, that never were previously thought to involve transmissible agents, an infectious disease specialist said in a session at the ACR’s 2016 State-of-the-Art Clinical Symposium. An array of unlikely and fascinating…
Biochemical Insights into Progeria Syndrome Identify Bisphosphonates, Statins as Possible Candidate Drugs to Halt Aging
Can We Stay Forever Young? May your heart always be joyful And may your song always be sung May you stay forever young Forever Young —Bob Dylan Beneath the rubric of orphan diseases reside some rare conditions and others that are extraordinarily uncommon. These are the diseases that most physicians either never to get to…
Precision Medicine Latest Initiative in War on Autoimmunity, Rheumatic Illnesses
It’s been said that there is no greater bully pulpit than the American presidency. Linking the force of moral persuasion to this most powerful office—one that is capable of issuing executive orders and bypassing the wishes of Congress or rousing public opinion in favor of or against bills that are in the process of being…
Trying to Parse True Meaning of Pain Can Be Challenging for Rheumatologists
Discussing aching joints, sore muscles and tender limbs is all in our day’s work. We are rheumatologists; we deal in misery. But trying to parse the true meaning of these terms is among the most vexing of clinical challenges.
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