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Fed Up with Rising Costs, Big U.S. Firms Dig Into Healthcare

Caroline Humer  |  

SAN JOSE, Calif., (Reuters)—At its Silicon Valley headquarters, network gear maker Cisco Systems Inc. is going to unusual lengths to take control of the relentless increase in its U.S. healthcare costs. The company is among a handful of large American employers who are getting more deeply involved in managing their workers’ health instead of looking…

Prenatal TNF Inhibitor Exposure Not Linked to Serious Infections

Anne Harding  |  

NEW YORK (Reuters Health)—Children of women with rheumatoid arthritis (RA) who are exposed to tumor necrosis factor-alpha inhibitors (TNFis) in the womb are not at markedly increased risk of serious infections, new findings suggest. “It’s reassuring for mothers who need to take these medications during pregnancy,” Evelyne Vinet, MD, of McGill University Health Center in…

HCV-Associated Cryoglobulinemic Vasculitis Resolves after Virologic Cure

Will Boggs MD  |  

NEW YORK (Reuters Health)—Cryoglobulinemic vasculitis associated with hepatitis C virus (HCV) infection resolves after effective treatment with direct-acting antivirals (DAAs), with most patients remaining in remission for two or more years, researchers from Spain report. “Most clinical manifestations of the disease improve over time, but some patients may have a clinical recurrence of their disease…

Improved Family Planning Counseling Needed

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In the U.S. today, approximately 45% of pregnancies are unintended or unplanned.1 Although this rate is considerably lower than in the past, women with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or inflammatory myopathies tend to have better pregnancy outcomes if their disease is well controlled when they conceive. In addition, women taking certain medications…

5 Ways to Unlock the Power of Consultation

Eli M. Miloslavsky, MD, & Jakob I. McSparron, MD  |  

Think back to your time as a trainee. Do you remember an interaction with a consultant in which you learned something, felt your opinion was heard, were empowered to collaborate with the consulting team and knew you were pro­viding outstanding care? We suspect a number of examples come to mind, regardless of the amount of…

Case Report: Refractory Calciphylaxis in Lupus

Joey Kim, MD, Navneet Kaur, MD, Phillip Zhang, MD, & Irene Blanco, MD, MS  |  

Calciphylaxis is a poorly understood and life-threatening ischemic vasculopathy characterized by calcification of the small- and medium-size arteries in the skin, subcutaneous tissue and internal organs, which leads to thrombosis, tissue necrosis and painful skin ulcerations that won’t heal. The disease has a 50–80% mortality rate. Although affected patients typically have end-stage renal disease (ESRD)…

3 Ways to Improve How You Work with Doctors from Other Specialties

James T. Rosenbaum, MD  |  

Many trainees tell me they’re attracted to rheumatology because it demands becoming a complete physician. We need knowledge of the brain, eye, lung, kidney, liver, skin, bones and vascular system to be effective rheumatologists. And because our diseases are frequently multisystem diseases, rheumatologists must be the quintessential collaborators. For more than 30 years, I’ve directed…

IgG4-Related Kidney Disease: Diagnostics, Manifestations, & More

IgG4-Related Kidney Disease: Diagnostics, Manifestations & More

Despina Michailidou, MD, PhD, & Paul Cohen, MD   |  

Immunoglobin G4-related disease (IgG4-RD) is a rare fibro-inflammatory disease of unknown etiology that has been recently recognized. It can cause fibro-inflammatory masses in almost every organ of the body and is associated with dense lymphoplasmacytic infiltration of IgG4-postitive plasma cells, storiform fibrosis and elevated levels of serum IgG4.1 IgG4-RD is a systemic disease that may…

Report Shows Rituximab May Help Treat MCTD-Associated PAH

Josna Haritha, MD, MPH, Huzaefah Syed, MD, Abhishek Nandan, MD, & Daniel Grinnan, MD  |  

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…

How & Why Attending Physicians Should Teach in Patient Rooms

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No matter where you practice, rheumatology clinics are extremely busy. And in that hustle and bustle we find an uncomfortable jostling of priorities between delivering optimal care for as many patients as possible and upholding education for teachers and learners at all levels. Because salary usually comes from seeing more and more patients, teaching is…