After having had juvenile idiopathic arthritis (JIA) for 20 years, I had a moment in my journey when I realized something new: “Your arthritis doesn’t just affect you, you know,” my sister said. This statement stopped me in my achy tracks. For two decades, I had been operating under the assumption that JIA was my…
Systemic sclerosis (SSc), a subtype of scleroderma, is a rare, complex autoimmune disease characterized by widespread vasculopathy of the small arteries and fibroblast dysfunction.1,2 It has been described as a fibrosing microvascular disease, because vascular injury precedes and leads to tissue fibrosis.3 The resulting Raynaud’s phenomenon, pain, skin thickening and tightening, and multi-organ involvement have…
A study in mice provides insight into the maturation of the self-reactive B cell response, contextualizing the epitope spreading observed in autoimmune disease. Researchers found that clonal expansion of wild type B cells in autoreactive germinal centers appeared to be at the heart of epitope spreading and the consequent autoimmune response…
In Part 1 of this series, we covered the vital role of medical decision making in determining the final level to bill for a patient encounter. Medical decision making is the key component in coding because it reflects the intensity of the provider’s cognitive labor. This implies that there’s an unseen component involved in the…
A 22-year-old Indian male presented to the emergency department with hemoptysis. A month prior, he had presented to an urgent care center complaining of cough with occasional episodes of blood-tinged sputum in the morning. He was diagnosed with community-acquired pneumonia based on a chest X-ray without laboratory testing and was prescribed levofloxacin. A few days…
Steady hands, nerves of steel: The endoscopic transphenoidal hypophysectomy is a delicate neurosurgical procedure. Using a three-dimensional microscope and a powerful magnetic resonance imaging machine to guide them, the surgeon must meticulously dissect the throat tissues, navigate through the palate and the sinuses to reach the base of the skull where the pea-sized master gland,…
NEW YORK (Reuters Health)—Ibuprofen boosts blood pressure (BP) more than naproxen or celecoxib in patients who take non-steroidal anti-inflammatory drugs (NSAIDs) to treat arthritis, according to a new substudy from the PRECISION trial. “These drugs are different with regard to BP, and ibuprofen is the worst,” Dr. Frank Ruschitzka of University Hospital Zurich in Switzerland,…
In a recent clinical trial, tocilizumab helped sustain glucocorticoid-free remission in patients with giant cell arteritis. Patients also received a prednisone taper, and 50% of tocilizumab-treated patients achieved prednisone-free remission and were less likely to experience disease flare compared with placebo…
Elderly patients have unique requirements with regard to treatment for pain, rheumatic disease and other ailments. Collaboration between rheumatologists, geriatricians and primary care physicians is essential to avoid unnecessary interventions and improve care for this patient population…
For years, guidelines from various organizations have recommended osteoporosis screening in women and men starting at a specific age or based on specific risk factors. Among these guidelines are those developed by the U.S. Preventive Services Task Force (USPSTF) that recommend universal osteoporosis screening for women 65 years of age and older and for targeted…