“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…
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TNF Stabilizes Inflammatory RNA in Synoviocytes
A recent study has helped researchers gain insight into the genome-wide regulation of mRNA stability in RA fibroblast-like synoviocytes (FLS). Chronic exposure of FLS to tumor necrosis factor appears to increase mRNA stability, enhancing the expression of inflammatory genes and the perpetuation of synovitis…
Anti-TNF-Alpha Agents May Improve Endothelial Function Patients with RA
A systematic review has found that anti-tumor necrosis factor alpha treatment may improve endothelial function in RA patients. Despite the heterogeneity of the included studies, a random-effects model showed a significant improvement in endothelial function in this patient population after receiving infliximab, adalimumab or etanercept…
What Rheumatologists Are Paid
A 2017 survey showed that rheumatologists’ pay has plateaued. And according to Anne Bass, MD, many cognitive fields, such as pediatrics and endocrinology, remain underpaid due to the current reimbursement structure…
Rheumatology Drug Updates: Uncertain Future for Romosozumab, Plus FDA Approves Tocilizumab for GCA
Romosozumab’s Future Is Uncertain Romosozumab, which has the possible U.S. brand name Evenity, is awaiting approval from the FDA.1 The treatment is an investigational, injectable biologic for treating osteoporosis. It increases bone formation and bone density, reducing a patient’s risk of fractures. The manufacturer no longer expects the FDA to approve the drug this year…
How to Document a Patient’s Medical History
The levels of service within an evaluation and management (E/M) visit are based on the documentation of key components, which include history, physical examination and medical decision making. The history component is comparable to telling a story and should include a beginning and some form of development to adequately describe the patient’s presenting problem. To…
The Walk from the Waiting Room
For a rheumatology practice, rooming time can be leveraged to improve efficiency and patient care. Christie Bartels, MD, MS, and colleagues have studied this time frame and developed data-based tips and tools to decrease variation among staff and streamline practices…
Rheumatologists Treating Patients with HIV Face Treatment, Diagnostic Challenges
Rheumatologists treating HIV patients in 2017 must think through many important factors as this population ages. As we continue to learn, rheumatologists must consider important drug–drug interactions, relatively uncommon rheumatological presentations of HIV, as well as specific diagnostic challenges. Working closely with infectious disease specialists is the best way to achieve optimum care for this…
Rheumatologists Concerned High Healthcare Costs May Encourage Patients to Forgo, Delay Treatment
While members of Congress debate healthcare legislation, rheumatologists say many of their patients struggle to afford everything from generic drugs to insurance copayments for physical therapy. “It’s a mess. The cost of prescriptions and the rationale for those rising costs in the U.S. right now—it’s just a mess,” says James R. O’Dell, MD, Stokes-Shackleford Professor of…
Plasma Complement Activation in Rheumatic Diseases May Accelerate Coronary Artery Disease
Complement can deposit in various tissues, and previous studies have associated complement deposition with an increased risk for all-cause mortality and stroke. Now, new research underscores the relationship between rheumatic disease, the complement system and cardiovascular disease. In particular, inflammatory rheumatic disease status appears to be uniquely associated with mononuclear cell infiltrates in the vascular…
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