ASH is the largest organization of hypertension researchers and health care providers in the United States committed to preventing and treating hypertension and its consequences. The editors of ConsultantLive bring you updates from the 2013 ASH conference in San Francisco, CA. Read More
Prominent, pigmented polyangular scales on the extensor surfaces of the arms, legs, and trunk suggested recessive X-linked ichthyosis. More in this article.Read More
More than 1300 physicians of all specialties responded to the 2012 survey. Many of the respondents are primary care physicians. See how your colleagues responded and learn what concerns them most.Read more
Some patients with systemic lupus erythematosus or antiphospholipid syndrome may initially present with movement disorders, especially chorea. Physicians may not associate these symptoms with either disorder, thereby delaying diagnosis and effective treatment. More »
A series of studies using functional MRI have identified brain-signal patterns specific for pain that are attenuated by opioids: Also last week: top rheumatology findings of 2012, more on TNF inhibitors and cancer, and concerns about vitamin D. More »
The latest results from two late-stage, multicenter clinical trials of belimumab (Benlysta) show that, when given alongside standard therapy for systemic lupus erythematosus, the drug improves health-related quality of life (HRQOL) and fatigue. More »
New in the nonspecialty journals: Definitive evidence that glucocorticoids cause venous thromboembolism (not mere association), and a case study about Reynaud's. More »
An analysis of adverse events in 17 global clinical trials of adalimumab (Humira) confirms the drug’s safety profile over nearly a dozen years of use for rheumatoid arthritis and other inflammatory disorders. Serious infections were the most common side effect. More »
Evaluating fewer and more targeted foot and hand joints with B-mode and power Doppler ultrasound proves just as effective as the broader 44-joint assessment in detecting clinical remission. More »
A 56-year-old woman presents with a history of intermittent shoulder pain for the past six months. Early signs point to bursitis, but the plot thickens: She also has sarcoidosis and lymphoma. How would you proceed? More »
In lupus patients, urinary CD4 T cell counts correlate selectively and specifically with disease activity and renal involvement, well enough to be used to monitor the progress of treatment. More »
Iron-deficiency anemia appears to be a good indicator of rapid progression of erosive rheumatoid arthritis not seen using standard disease activity measures. More »
(AUDIO) Intensive analysis of protein pathways inside joints is showing strong activity among messengers involved in wound healing. In this podcast, learn about the new research that backs the vision of arthritis as a chronic wound, and the implications for management. More »
. Search The CDC. Note: Javascript is disabled or is not supported by your browser. For this reason, some items on this page will be unavailable. For more information about this message, please visit this page: Add this to. Prepared by. Amanda C.
To develop evidence-based recommendations on the use of imaging of the joints in the clinical management of rheumatoid arthritis (RA).
Methods
The task force comprised an expert group of rheumatologists, radiologists, methodologists and experienced rheumatology practitioners from 13 countries. Thirteen key questions on the role of imaging in RA were generated using a process of discussion and consensus. Imaging modalities included were conventional radiog
Anticitrullinated protein antibodies (ACPA) are a major risk factor for bone loss in rheumatoid arthritis (RA). We have recently shown that ACPA directly induce bone loss by stimulating osteoclast differentiation. As ACPA precede the clinical onset of RA by years, we hypothesised that ACPA positive healthy individuals may already show skeletal changes.
Methods
We performed a comparative micro-CT analysis of the bone microstructure in the metacarpophalange
To identify predictors of sick leave and disability pension in patients with early rheumatoid arthritis (RA).
Methods
Individuals aged 19–59 years diagnosed with early RA (≤12 months symptom duration) were identified in the Swedish Rheumatology Quality Register (1999–2007; n=3029). We retrieved days of sick leave and disability pension from the Swedish Social Insurance Agency and baseline predictors of total work days lost during
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the pathology of Rheumatoid Arthritis (RA), particularly as vulnerable personality types are exposed to chronic stress. Emotions are powerful modulators of stress responses. However, little is known about whether patients with RA process emotions differently to matched controls. In this study we: 1) assessed whether the trait emotional intelligence (trait EI) scores of patients with RA differ from healthy controls at the
Because of the changing dietary habits of an aging population, hyperuricemia is frequently found in combination with other metabolic disorders. Longstanding elevation of the serum uric acid level can lead to the deposition of monosodium urate crystals, causing gout (arthritis, urate nephropathy, tophi). In Germany, the prevalence of gouty arthritis is estimated at 1.4%, higher than that of rheumatoid arthritis. There are no German guidelines to date for the treatment of gout. Its current treatment is based largely on expert opinion.|Selective literature review on the diagnosis and treatment of gout.|Asymptomatic hyperuricemia is generally not an indication for pharmacological intervention to lower the uric acid level. When gout is clinically manifest, however, acute treatment of gouty arthritis should be followed by determination of the cause of hyperuricemia, and long-term treatment to lower the uric acid level is usually necessary. The goal of treatment is to diminish the body's
Nitric oxide (NO), which is produced from L-arginine by the nitric oxide synthase (NOS) family of enzymes, is an important second-messenger molecule that regulates several physiological functions. In endothelial cells, it relaxes smooth muscle, which decreases blood pressure. Macrophage cells produce NO as an immune defense system to destroy pathogens and microorganisms. In neuronal cells, NO controls the release of neurotransmitters and is involved in synaptogenesis, synaptic plasticity, memory function, and neuroendocrine secretion. NO is a free radical that is commonly thought to contribute to oxidative damage and molecule and tissue destruction, and thus it is somewhat surprising that it has so many significant beneficial physiological effects. However, the cell is generally protected from NO's toxic effects, except under certain pathological conditions in which excessive NO is produced. In that case, tissue damage and oxidative stress can result, leading to a wide variety of
Calcium pyrophosphate dihydrate and basic calcium phosphate crystals are the two most common calcium-containing crystals involved in rheumatic diseases. Recent literature concerning their role in the pathogenesis of osteoarthritis is reviewed.|In some instances, these calcium crystals might worsen osteoarthritis cartilage destruction. Laboratory investigations have identified determinants of cartilage calcification, especially a better characterization of matrix vesicle content and a better understanding of the regulation of inorganic pyrophosphate and phosphate concentration. In-vitro studies have highlighted new pathogenic mechanisms of calcium crystal-induced cell activation. Several intracellular signalling pathways are activated by calcium crystals. Recent studies suggested the implication of the inflammasome complex and a pivotal role for IL-1 in pseudogout attacks and chondrocyte apoptosis in basic calcium phosphate crystal-related arthropathies.|Animal models of osteoarthritis
Rheumatoid arthritis (RA) causes pain and serious functional impacts and substantially affects patients' daily lives, including their ability to work.|This review examines recent studies of patients with RA treated with TNF antagonists and the impacts these therapies have on the workplace.|A total of 133 articles and 14 poster abstracts were reviewed that matched specific criteria.|The results of early studies of TNF antagonists varied regarding their effects on patients with RA in the workplace. However, recent studies of adalimumab showed positive impacts across a range of workplace burdens. Treatments such as adalimumab may help employees with RA to remain in the workforce and lead to reduced workplace costs to the employers and employees.
In recent years, pharmaceutical companies have increasingly focused on phosphoinositide 3-kinases delta (PI3Kdelta) and gamma (PI3Kgamma) as therapeutic targets for the treatment of inflammatory and autoimmune diseases. All class 1 PI3-kinases (alpha/beta/gamma/delta) generate phospholipid second messengers that help govern cellular processes such as migration, proliferation, and apoptosis. PI3K delta/ gamma lipid kinases are mainly restricted to the hematopoetic system whereas PI3K alpha/beta are ubiquitously expressed, thus raising potential toxicity concerns for chronic indications such as asthma and rheumatoid arthritis. Therefore, the challenge in developing a small molecule inhibitor of PI3K is to define and attain the appropriate isoform selectivity profile. Significant advances in the design of such compounds have been achieved by utilizing x-ray crystal structures of various inhibitors bound to PI3Kgamma in conjunction with pharmacophore modeling and high-throughput screening.
Primary Care Can't Thrive Without Nurse Practitioners Courtney H. Lyder, ND, May 17, 2013 With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.
