A 68-year-old female Medicare patient with a diagnosis of primary osteoarthritis of the left knee returns to a practice for her third injection in a series of knee injections. She reports being able to resume her after-dinner walks, which last for 30–40 minutes at least twice weekly. She denies fevers or any rashes. She has…
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When Immunodeficiency & Autoimmunity Coexist
CHICAGO—Although rare, when a patient has both primary immune deficiency and autoimmune disease, the combination can lead to life-threatening complications requiring careful, long-term therapy. In When Immune Deficiency and Autoimmunity Coexist, a session at the 2018 ACR/ARHP Annual Meeting, M. Eric Gershwin, MD, the Jack and Donald Chia professor of Medicine and chief of Rheumatology,…

Case Report: Lymphocytic Vasculitis of the Central Nervous System
Vasculitis is a group of chronic inflammatory diseases in which the blood vessel is the target of an immune reaction. They can be secondary to connective tissue disease, idiopathic or due to infection, neoplasm or drugs.1 Primary angiitis of the central nervous system (PACNS) is a rare syndrome characterized by inflammatory cell infiltration and necrosis…

Tofacitinib Shows Early Potential for Treating Dermatomyositis
A proof-of-concept study including 10 patients treated for dermatomyositis with tofacitinib, an FDA-approved drug for RA and psoriatic arthritis, shows strong clinical efficacy…
Updated ACP Ethics Manual Provides 6-Step Approach to Dilemmas
NEW YORK (Reuters Health)—The 2019 edition of the American College of Physicians (ACP) ethics manual provides a six-step approach to resolving ethical dilemmas and adds or expands sections that address emerging issues in 21st century medicine.1 “The Manual provides succinct guidance on issues that affect the patient-physician relationship, and also issues that have to do…

Intensive Patient Education May Not Be Helpful for Acute Low Back Pain
Education with recommended first-line care may not improve pain outcomes in patients with acute low back pain. When comparing patients who received education with those who received professional consultation without information or advice, researchers found patient education was no more effective than placebo at reducing depression or incidence of chronic low back pain…

Ethics Forum: Is a Conflict-of-Interest Slide Enough?
We have all been to numerous lectures, grand rounds and other continuing medical education activities where the speaker, prepared and poised at the podium, begins his lecture with a title slide. Soon after, we see the ubiquitous conflicts of interest slide, which lists the invited speaker’s research funding, his consulting activities and his board memberships—all…

Jessica Farrell, PharmD, in the Spotlight: Why the ARP Is for Me
It was never in the plan for Jessica Farrell, PharmD, to enter rheumatology. In fact, when she applied for one of two pharmacist positions at Albany College of Pharmacy and Health Sciences in 2008, she made it clear she was only interested in the family practice position. “I was offered an interview for the family…

How to Teach in the Inpatient Setting
CHICAGO—Teaching in the inpatient setting can be a tall task, hindered by a lack of time, an unpredictable environment and a variety of learners encountered at different levels. But a few techniques—based mainly on understanding who your students are and how they prefer to learn—can make a big difference, an expert said at the 2018…

When Immunodeficiency & Autoimmunity Coexist
When a patient has both primary immune deficiency and autoimmune disease, the combination can lead to life-threatening complications. Here are some insights into the challenges of diagnosing and treating this rare subset of patients…
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