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…
My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…
“Burnout? In rheumatology fellowship? You’re kidding me, right?” That was the response of one of my very good friends from residency who is now a cardiology fellow, when I told him that I was concerned that one of my co-fellows, at another institution, was on the verge of burning out. Stepping back, I could understand…
Which came first? The infectious microorganism or a host’s immune resistance against it? Through the millennia, a raging battle has pitted the hordes of infectious agents surrounding us against, arguably, the most complex biologic structure ever created, the finely tuned human immune system. The stakes are high for both sides. For the infectious agent, an…
In 2014, the American College of Rheumatology (ACR) was one of 25 healthcare associations invited to participate in an initiative by the American Medical Association (AMA) to reduce the public health epidemic posed by the abuse of prescription opioids.1 The AMA initiative is based on the belief that physicians are professionally obligated to participate in…
During an interactive, case-based course at the 2016 ACR/ARHP Annual Meeting, participants will develop strategies to help patients manage unique barriers to access to care and adherence…
Are too many patients diagnosed with fibromyalgia? The co-authors of one new study believe that close to 75% of patients who have received a clinical fibromyalgia diagnosis do not meet the 2010 Preliminary American College of Rheumatology (ACR) Criteria for Fibromyalgia.1 They say these patients are false-positive and may be taking treatments they don’t need….
(Reuters)—Johnson & Johnson says on Monday that the U.S. Food and Drug Administration approved the company’s psoriasis drug, ustekinumab (Stelara), for use in adults with Crohn’s disease. The drug is approved in the U.S. to treat plaque psoriasis and a type of arthritis associated with psoriasis. Crohn’s is a chronic inflammatory condition in the gastrointestinal…
LONDON—Josef Smolen, MD, chair of rheumatology at the University of Vienna and former president of the European League Against Rheumatism (EULAR), expressed a “personal disappointment” in the development of useful biomarkers in the treatment of rheumatoid arthritis (RA). Even though a good portion of his life’s work has been researching biomarkers to help with targeting…
LONDON—From optimizing responses to methotrexate, to the efficacy of biologics, to the need for imaging in assessing remission, the literature, as ever, has been lively with explorations of pressing topics in the treatment and management of rheumatoid arthritis. Josef Smolen, MD, chair of rheumatology at the Medical University of Vienna, reviewed many of the highlights…