Search results for: liver

HCV-Associated Cryoglobulinemic Vasculitis Resolves after Virologic Cure

Will Boggs MD | May 18, 2018

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

Susan Bernstein | May 18, 2018

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 | May 18, 2018

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 | May 17, 2018

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 | May 17, 2018

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…

Report Shows Rituximab May Help Treat MCTD-Associated PAH

Josna Haritha, MD, MPH, Huzaefah Syed, MD, Abhishek Nandan, MD, & Daniel Grinnan, MD | April 26, 2018

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

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS | April 26, 2018

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…

Kussmaul, Meier & Polyarteritis Nodosa

Ruth Jessen Hickman, MD | April 26, 2018

In 1866, Adolf Kussmaul, an internist, and Rudolf Maier, a pathologist, published the classic characterization of what eventually became known as polyarteritis nodosa.1 It was the first scientific clinical characterization of a noninfectious vasculitis. As such, it became a paradigmatic point of contrast to other types of vasculitides that were later described. Their description also…

Patient Satisfaction Scores—Do They Matter?

Zineb Aouhab, MD, RhMSUS | April 26, 2018

You see a patient for the first time to establish care for Sjögren’s disease. She complains of dry eyes, dry mouth and diffuse arthralgias. You do not appreciate any synovitis on physical exam. Of note, you are the fourth rheumatologist she has seen during the past year. Toward the end of the clinic visit, she…