If left untreated, low back pain can cause long-term disability. To aid its diagnosis and management, the National Institute for Health and Care Excellence has released revised guidance. Recommendations include the use of risk stratification tools for diagnosis, as well as physical activity or a comprehensive program that addresses biomechanical, aerobic and/or psychological needs…
NEW YORK (Reuters Health)—Fluctuations in the gut microbiome over time could underlie inflammatory bowel disease (IBD), including Crohn’s and ulcerative colitis, researchers suggest. “Both the state and the dynamics of the human gut microbiome in healthy individuals are highly personalized. Although cross-sectional studies have revealed dysbiosis of the gut microbiome in IBD, little is known…
WASHINGTON, D.C.—Despite the value of guidelines, they often “are not read,” said N. Lawrence Edwards, MD, professor of medicine specializing in rheumatology at the University of Florida, at the 2016 ACR/ARHP Annual Meeting talk titled, New & Emerging Therapies for Gout, as part of the ACR Review Course. Or if they are read, they aren’t…
In 1982, my wife (also a rheumatologist) and I attended our first American Rheumatism Association (now the ACR) national meeting. After the meeting we stayed with a friend in a suburb of Boston, where we also had the opportunity to meet our hostess’ in-laws, a retired general practitioner and his wife. When her father-in-law shook…
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…
Current guidelines for the long-term management of gout recommend a combination of lifestyle management and/or pharmacotherapy to lower serum UA levels to <6.0 mg/dL in most patients or <5.0 mg/dL in patients with more severe disease. Allopurinol is the most widely used xanthine oxidase inhibitor and is recommended in treatment guidelines as a first-line urate-lowering…
NEW YORK (Reuters Health)—A new test provides rapid infliximab drug concentrations that enable immediate dosing adjustments, researchers from Belgium report. “With this rapid test, our biggest wish is to persuade physicians to now perform and use infliximab measurements also in their own daily clinical practice, as many practical and organizational issues that went along with…
Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…
A retrospective study showed that patients who have rheumatic disease and develop tuberculosis may be able to resume anti-TNF therapy and other biologic agents…
The decision to continue or discontinue immunomodulatory medications during pregnancy is a difficult one for both patients and physicians. On the one hand, when left untreated, rheumatic conditions can cause harm to an unborn child, as well as to the pregnant mother. On the other hand, medications can be harmful to a developing fetus. In…