Although most systemic juvenile idiopathic arthritis patients don’t develop macrophage activation syndrome (MAS), the approximately 10% who do have this serious complication can experience widespread, massive inflammation, debilitating symptoms and even death. To improve understanding of MAS among physicians and advance efforts to develop effective therapies to treat it, a panel of 28 international pediatric…
The American College of Rheumatology (ACR) recognized the 50th anniversary of the Association of Rheumatology Health Professionals (ARHP) during the ACR/ARHP Annual Meeting this past November in San Francisco. The University of Arizona Arthritis Center followed up with a reception in Tucson to honor past presidents of the ARHP. The Tucson area has the highest…
An interdisciplinary and collaborative environment is a critical factor for the advancement of basic science and clinical research in the academic environment, says William J. Koopman, MD, former director of the University of Alabama at Birmingham’s (UAB’s) Division of Clinical Immunology and Rheumatology. And in 1977, when he was being recruited by Division Director J….
Medicare and other third-party payers have started predicating reimbursement on adherence to standards of care. Post hoc chart reviews have resulted in substantial take-backs for failure to adhere to those values in cardiology, pulmonology and expanding to other areas. Outpatient medicine is also being subjected to such scrutiny. The question of standards and who sets…
Value is the ratio of quality to cost. The delivery and measurement of healthcare quality, however, is complex. “We first need to understand and define the health outcomes that are important to patients. Then we need to put into place care pathways that will lead to those outcomes, and finally we need mechanisms to measure…
SAN FRANCISCO—A 40-year-old woman shows up in the clinic with scarring alopecia, with an area of hyperpigmentation on the rim of her scalp, extending from just behind the temple to behind her ears. An examination with a dermatoscope shows hyperkeratotic follicular plugging. The case—in this example, the discoid form of cutaneous lupus erythematosus (DLE)—is one…
The Case A 41-year-old woman was referred to the dermatology clinic for a three-month history of tender lesions on her elbows and around the joints of her hands. Her medical history was notable for seropositive, non-erosive rheumatoid arthritis (RA), which was being treated with 5 mg prednisone daily, 10 mg methotrexate weekly by mouth, 200…
Teresa Fama: Rheumatologist to Chair Public Advisory Council Teresa Fama, MD, is the new chair of the New England Comparative Effectiveness Public Advisory Council (CEPAC). A rheumatologist who practices in Berlin, Vt., Dr. Fama has previous experience in public policy, specifically health policy. Before she began her second career as a physician, Dr. Fama was…
It takes a great deal of time and money to produce clinical practice guidelines for rheumatic diseases. No matter how well a treatment inhibits inflammatory cytokines, it won’t lower disease activity without one essential factor: patient compliance. “You can’t propose a treatment algorithm in your research that no patient would actually use,” says Veena Ranganath,…
ROME, Italy—The medical environment is increasingly adapting to the possibilities of optimizing care by individualizing medical treatment and tailoring treatment to disease phenotypes. Data suggest that individualizing exercise therapy, an important treatment modality for rheumatic and musculoskeletal diseases, can help control disease, maximize function, minimize functional barriers and decrease the risk of co-morbidity.1,2,3 Personalizing exercise…