I glanced up from Amanda Wolf’s chart as the emergency department nurse, followed by the lab technician (tech), followed by the electrocardiogram (ECG) tech flowed into cubicle No. 5. John Benner, MD, pulled up a chair to review the case with me at the nursing station. “Here’s what we’ve got. Thirteen-year-old girl with a one-week…
NEW YORK (Reuters Health)—Heredity plays a substantially larger role than diet in determining serum urate levels, according to new findings in BMJ. Nearly 25% of the variation in serum urate is attributable to common genetic variants, while dietary pattern explained less than 1%, Dr. Tanya J. Major of the University of Otago in Dunedin, New…
AMSTERDAM—Newly proposed systemic lupus erythematosus (SLE) classification criteria and new findings on SLE pathogenesis are two ways in which researchers and clinicians are getting a better grasp on the heterogeneous disease. The criteria and findings were discussed this June in a session at EULAR: the Annual European Congress of Rheumatology. ‘Paradigm Shift’ Sindhu Johnson, MD,…
Immune checkpoint inhibitors (ICIs) are at the forefront of advances in cancer therapy and have shown promising results for progression-free survival. Checkpoint signaling pathways, such as cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death protein 1 (PD-1), normally regulate the immune response to promote self-tolerance and prevent tissue damage and inflammation. PD-1 is a…
Studies highlighting the large numbers of people affected by knee osteoarthritis (OA) point to what clinicians who treat knee OA have been seeing for the past few decades: a substantial increase in the prevalence of knee OA in the U.S. and globally. Roughly 250 million people are affected by knee OA worldwide, and about 14…
A 36-year-old woman presented at the Johns Hopkins Arthritis Center for a second opinion regarding a diagnosis of psoriatic arthritis (PsA). One year prior to our evaluation, she had developed pain and stiffness in her hands, feet, knees, ankles, elbows and shoulders. She had mild plaque psoriasis of the scalp and base of the neck,…
As rheumatology professionals, we focus on how to achieve better outcomes for our patients: lower disease activity, remission, milder symptoms and prevention of joint damage or serious complications, such as heart disease. Another outcome is just as important: good quality of life. What can we do to engage our current patients and those at risk…
Multiple studies show that hydroxychloroquine (HCQ) has many benefits in systemic lupus erythematosus (SLE), including cardiovascular benefits, such as reducing coronary artery and thrombosis risks. HCQ can prevent disease flares, including in renal and central nervous system lupus, and is the only drug shown to prolong survival in lupus. However, guidelines released in 2016 by…
A 55-year-old female patient with pain in multiple joints is referred to the office by her primary care physician. She complains of pain in both knees and both shoulders. She rates the pain at 7 on the pain scale. Her pain is worse at night after she gets off work. Soaking in her hot tub…
AMSTERDAM—A variety of factors lead to delays in patients seeking medical care for rheumatoid arthritis—from the nature of symptoms to coping tendencies—requiring more awareness from physicians when managing patients, researchers said at EULAR: the Annual European Congress of Rheumatology. Longer delays in treatment bring about more emotional distress to patients, missed chances to ease symptoms…