Pulmonary arterial hypertension (PAH) in connective tissue disease (CTD) features significant morbidity and mortality. Standard therapies with endothelin receptor antagonists and phosphodiesterase-5 inhibitors have shown some clinical improvement in patients, but these clinical improvements have proved modest when compared with other types of PAH. As our case below suggests, rituximab may show promise as a…
When Paul Sufka, MD, a rheumatologist with HealthPartners Medical Group and Regions Hospital in St. Paul, Minn., wants to connect with his colleagues or keep abreast of the latest rheumatology journal articles, he turns to Twitter. Dr. Sufka is one of many rheumatologists who have found effective ways to incorporate social media into their medical…
There is an old adage that there are two types of people—lumpers and splitters. For some, people are easily categorized into liberal vs. conservative, Democrat vs. Republican, Donald Trump supporter vs. Hillary Clinton supporter. For others, everyone is a snowflake, and what makes us different is much more important than what makes us the same….
The year was 1978. I was a newly married, 25-year-old registered nurse working on a medical unit at Mercy Medical Center in Oshkosh, Wis. I began to notice morning stiffness, increasing fatigue, and bilateral heel and ankle pain. Every step hurt as I walked down the halls to care for my patients. My diagnosis was…
A 58-year-old African American woman with a past medical history of hypertension (HTN), hyperlipidemia, severe gastroesophageal reflux disease (GERD) and limited cutaneous systemic sclerosis (lcSSc) presented to the emergency department with shortness of breath (SOB) and progressive bilateral lower extremity swelling for three weeks. She denied any chest pain, but endorsed generalized fatigue and dyspnea…
A recent study examined how often patients exceed the dosing limits of nonsteroidal anti-inflammatory drugs and identified the characteristics of the patients most likely to exceed recommended doses…
In this review, the authors address the key pathophysiologic mechanisms that drive acute and chronic chikungunya arthritis, arguably the most incapacitating sequela among long-lasting chikungunya virus disease manifestations, based on recent animal experimental disease models and epidemiologic studies. They explore the latest findings in therapeutic development aimed at limiting viral spread and at immune and…
SAN DIEGO—To manage patients with systemic lupus erythematous (SLE), rheumatologists must be aware of potentially serious complications affecting many organ systems. On Nov. 7 at the 2017 ACR/ARHP Annual Meeting, two experts offered insights on cardiovascular and hematological complications of lupus. Myocardial Disease in Lupus Lupus patients are at increased risk for heart-related complications, especially…
Patient-centered care requires increased communication and a proactive patient. But how does it benefit a rheumatology practice? According to Stanford Shoor, MD, patient-centered care offers a team-based approach that can improve satisfaction in care and positively affect RA-specific outcomes…
4 Patients in 4 Weeks Baltimore is a little over two hours away from Richmond, Va., by car. I know this now because I recently drove to Richmond to attend a memorial service. I drove in silence. Music made me sleepy, and I could not bear to listen to another iteration of how we are…