What struck me first as I walked by the exam room where Lynn P. sat was the swelling in her fingers and wrists. The bloated hands rested unnaturally on her thighs, palms up, fingers slightly flexed. Her strawberry-blond curls were offset by a high-neck, loose-fitting, burgundy sweater. Her pale skin matched her trim slacks. She had…
Antiphospholipid syndrome (APS) is an autoimmune condition characterized by hypercoagulability often manifested as recurrent thrombosis or pregnancy complications, with persistently circulating antiphospholipid (aPL) antibodies or lupus anticoagulant. Catastrophic APS (CAPS), also known as Asherson syndrome, occurs in less than 1% of cases of APS and involves occlusive microangiopathy in at least three organ systems.1 Case…
The Friday night press release: When a politician or any public figure needs to disclose unfavorable news, chances are they will release it sometime on a late Friday afternoon or evening, hoping that nobody is paying attention. In fact, this behavior was coined “the take out the trash day” on the television political drama, The…
About a year ago, I stuffed all my earthly belongings into my black Volkswagen Jetta and set out on a 10-hour interstate journey. I had just graduated from residency at the University of Kentucky and was headed westward, to Iowa City, for a fresh start as a rheumatology fellow. During the 10 hours I spent…
Pain can be reduced and functionality significantly improved for children with fibromyalgia without drug therapy, according to a study of 64 children in Philadelphia. Researchers combined intensive physical therapy and psychotherapy in individualized programs to treat the fibromyalgia patients…
(Reuters Health)—Knee replacement surgery may significantly ease pain and improve leg function and quality of life in patients with osteoarthritis or rheumatoid arthritis (RA), a new study suggests. While surgery doesn’t restore the same level of comfort and function patients had in their younger years, before they developed arthritis, the authors write in the journal…
CHICAGO—With the approval of the Jak inhibitors (i.e., jakinibs) tofacitinib and ruxolitinib—and others being investigated—rheumatologists need to arm themselves with an understanding of these drugs so they can think critically when evaluating them and deciding how to use them, said John O’Shea, MD, chief of the Molecular Immunology and Inflammation Branch of and scientific director…
After completing a 10-year clinical trial examining treatment strategies for rheumatoid arthritis, Dutch researchers used a questionnaire to determine the study conditions and individual motivators that kept 60% of patients participating long term…
Clinical Vignette A 45-year-old woman with long-standing asthma and chronic sinusitis has new-onset peripheral neuropathy, arthralgias, fatigue, progressive dyspnea and a nonproductive cough. She has never smoked and has no environmental exposures. Her medications include an albuterol metered-dose inhaler (which she uses daily); an inhaled corticosteroid, montelukast; and ibuprofen (which she takes occasionally). She is…
The beep of the cellphone text got me off the armchair. I had been feeling cozy and comfortable. Outside the window, it was a blissful winter wonderland—the one, I believe, Nat King Cole intended when recording “The Christmas Song.” But at the same time, I was anxious to hear whether my clinic would be canceled…