Benign skin lesions can arise in the outer ear as easily as in any other body part frequently exposed to the sun. Seborrheic keratosis may mimic malignant melanoma but is innocuous. Actinic keratosis is premalignant and should be excised, biopsied, and the site of excision monitored vigilantly.
These innocuous lesions of the outer ear may arise spontaneously or after trauma or surgery. Both auricular seroma and pyogenic granuloma usually resolve satisfactorily after minor surgery, though they may recur.
Diagnostic challenge: Two case reports of easily treated and innocuous causes of lesions in the outer ear. Chondrodermatitis nodularis helicis is associated with long cellphone use. Verruca vulgaris is caused, like all other warts, by human papillomavirus.
A 92-year-old woman presented with a 6-month history of progressively worsening fatigue, weight loss, generalized bone pain, and dyspnea on exertion. Click here for the laboratory results. Read more
A middle-age man presents to the ED with intermittent right shoulder pain. A check of his finger strength reveals abnormal looking fingernails. Click here to see how chronic shoulder pain and recent onset of fingernail clubbing relate.Read More
The effectiveness and safety of adalimumab in patients with active ankylosing spondylitis (AS) were maintained through 5 years in a study that was reported recently in Annals of the Rheumatic Diseases. More »
Interleukin-6 (IL-6) inhibition with tocilizumab (TCZ) plus methotrexate (MTX) retards joint damage progression independently of its impact on disease activity in patients with rheumatoid arthritis (RA). More »
The original antiphospholipid syndrome (APS) classification criteria (the Sapporo criteria), published in 1999, helped galvanize research in this disorder.1 New clinical, laboratory, and experimental insights gained since then were addressed at the Eleventh International Congress on Antiphospholipid... More »
More than half of women who have rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) have fewer children than desired, according to a new study. More »
Topics and dates for an expanded nationwide education series, Lupus: Learn from the Experts, were announced by the Lupus Foundation of America (LFA). More »
Ofatumumab significantly improved rheumatoid arthritis symptoms without triggering any more serious response than mild infusion reactions during 24 weeks. More »
A 61-year-old man with arthritis and an 80-pack-year smoking history presented with fever, dyspnea, and productive cough of a week’s duration that did not respond to outpatient treatment with levofloxacin. More »
Quantitative assessment of joint swelling and tenderness, essential for rheumatoid arthritis (RA) clinical research, also improves outcomes in routine clinical patient care. Both old and new RA classification criteria involve careful joint assessment, and the results of several studies indicate that... More »
An international peer-reviewed journal for health professionals and researchers in the rheumatic diseases. ... Adalimumab: long-term safety in 23 458 patients from global clinical trials in rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing
Conventional combination treatment versus biological treatment in methotrexate-refractory early rheumatoid arthritis: 2 year follow-up of the randomised, non-blinded, parallel-group Swefot trial. B...
PLoS ONE: an inclusive, peer-reviewed, open-access resource from the PUBLIC LIBRARY OF SCIENCE. Reports of well-performed scientific studies from all disciplines freely available to the whole world.
Archives of Internal Medicine, a bi-monthly professional medical journal published by the American Medical Association, publishes original peer-reviewed research articles on internal medicine topics
Growth of the mandibular condylar cartilage (MCC) is reviewed as a function of genetic and epigenetic factors. The growth centers around the differential spatial concentration of the chondrocytes, influence of growth factors like TGF- and heterogeneity in the number of IGF receptors, control the action of IGF. Besides these factors, growth of the mandibular condyle is influenced by differential response of chondrocytes as a function of their source/ageing, which in turn is regulated by TGF-, BMPs and IGFs. While IGF-1 promotes proteoglycan synthesis and survival of the chondrocytes to maintain cartilage homeostasis, TGF- synergistically catalysed the effect of IGF-1, while BMPs catalysed proteolysis as and when physiologically needed. To understand these processes, role of IGF-1 and its six receptors is at the center to a number of physiological processes being regulated by its mode of application for the growth and differentiation. Probing deeper, biological functions of IGFs
Rheumatologic diseases are often associated with ophthalmic findings. Familiarity with and recognition of these ophthalmic presentations are important in the management of both the systemic and ocular manifestations of the disease. Identification of ocular signs and symptoms of rheumatologic disease will allow a more comprehensive approach to treatment of patients with rheumatic conditions.
Many blood tests used in the evaluation of rheumatic diseases are non-specific and should not be ordered and interpreted in isolation. False positive results can lead to inappropriate therapies with serious adverse events while false negatives may steer the provider to incorrect diagnoses. Relying on blood tests alone without considering the clinical context should be avoided.
There are no reports of atraumatic hip subluxation and dislocation in the adult patient with rheumatoid arthritis (RA). This rare phenomenon is most prevalent in patients with congenital hip dislocation, von Recklinghausen disease, tumor infiltration, connective tissue disorders, and juvenile rheumatoid arthritis. We report an acute atraumatic dislocation of the hip in an adult patient with RA. We believe that two factors contributed to the patient's atraumatic dislocation: a shallow but appropriately positioned acetabulum and erosive RA with substantiate panus formation. Similar to previous reports, there was a rent or capsular defect that may have contributed to the mechanism of dislocation. Physicians should be aware that, although rare, a de novo atraumatic hip dislocation is a possibility in a patient with a long-standing history of RA and hip pain. Distinguishing features of this case include the acuteness of the dislocation, the absence of previous symptoms, and adult-onset RA.
22393135 2012 03 06 2012 04 16 1539-3704 156 5 Mar 6 Ann. Intern. Med. 390-1 Kirwan John Richard JR eng Comment Editorial United States Ann Intern Med 0372351 0003-4819 0 Antirheumatic Agents 0 Glucocorticoids 53-03-2 Prednisone 59-05-2 Methotrexate
Physician Performance Goals Are Great, But Balance Is More Realistic Jennifer Frank, MD, May 15, 2012 Performance measurements for physicians are well-intentioned and get me to rethink how I practice. But in the end I won't make the goals, so I'll have to go with balance over perfection.
Designing the Perfect Business Card for Your Medical Practice C. Noel Henley, MD, May 11, 2012 Does your business card say anything substantive about the valuable work you do in your practice? Here’s how to re-design your next business card for maximum impact and engagement.
Registered Nurses an Ideal Fit for Primary Care Practices Audrey "Christie" McLaughlin, RN, May 10, 2012 Here are four good reasons to hire a registered nurse for your primary care practice …maybe even instead of a medical assistant.
The Five Biggest Medical Practice Marketing Mistakes James Doulgeris, May 10, 2012 There are best practices to marketing your practice, but often, success is more about knowing what not to do. Here are the five most common pitfalls …and how to avoid them.
Can You Practice Medicine and Manage Your Practice? Rosemarie Nelson, May 9, 2012 Whether you practice alone, or in a group, if you're trying to see patients in this pay-for-volume environment and also run the business of your practice, you may be missing out on important opportunities.