Management of Digital Ulcers in Scleroderma

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Currently there are no FDA-approved medications for the treatment of digital ulcerations in the United States.  Digital ulcers are a common, unfortunate and difficult to manage consequence of the vascular obliteration and fibrosis that accompanies systemic sclerosis.

ACP Backs Supreme Court Decision on Obamacare

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ACP has endorsed the Supreme Court ruling that the premium subsidies created by the Affordable Care Act, essential to making coverage affordable to millions, will continue to be available in states where the federal government manages their health insurance marketplaces.

Drug Shortages - June 2015

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RheumNow is committed to reporting safety issues in our monthly Drug Safety Bulletins. Each month we will update you with reports of new, ongoing and resolved Drug Shortages that will affect the practicing rheumatologist.

Fibromyalgia Update: Genes, Hyperbaric Therapy & Conflicts of Interest

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An Israeli crossover trial analyzed the efficacy of hyperbaric oxygen therapy (HBOT) in 60 patients with fibromyalgia.

IM Residents Concerned about Cost, But Don't Have Access to Cost of Care Numbers

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A large ACP survey of over 18,000 US internal medicine residents shows they often incorporate cost of care in discussions and decisions, but may not know the data (citation source http://buff.ly/1KeLq0D).

Doctors are Unaware How Opioids are Abused

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A survey of internists and family practitioners shows that half of physicians are unaware of how opioids are abused.

Adherence to Lupus Meds Linked to Increased Acute Hospitalizations

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Using Medicaid data from 2000-2006, 9,600 hydroxychloroquine new users were compared to 3,829 new users of immunosuppressive agents (IS) in patients with SLE. They assessed adherence using the MPR - the medication possession ratio.

Adherence to ETN/MTX is Greater Than Triple DMARD Therapy

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Rheumatoid management hinges on choosing your best therapies first.

Right Knee Pain - What's Your Dx?

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A 36 year-old white male butcher has right knee pain for 3 weeks. He noted a similar episode 5 years earlier and admits to a traumatic fall on that knee years ago. He denies fever, redness, warmth, other joints or other past medical problems. He only takes OTC ibuprofen prn. 

Australia Allows Pharmacy Substitution with Biosimilars Without Notice

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Biosimilars are copies of the biologic medicines used to treat inflammatory and immunologic conditions such as rheumatoid arthritis, multiple sclerosis and cancer- potentially at lower costs.

Chikungunya Infection in Rheumatoid Arthritis Patients

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Inflammatory Ocular Disease in US Veterans

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A retrospective review of 1285 US male veterans showed the prevalence of inflammatory eye disease to be 2%. Uveitis was most common (most being anterior uveitis), followed by keratitis, scleritis, episcleritis, and acute ischemic optic neuropathy.

The History of Citrullination

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1998 marked the introduction of citrulline as a unique target in the pathogenesis of rheumatoid arthritis. The hallmark article by Schellekens et al in the Journal of Clinical Investigation has since been cited over 500 times.  Dr.

NICE Judges Apremilast Less Cost Effective than TNF Inhibitors

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The National Institute for Heath and Care Excellence has turned down Otezla for coverage under the U.K. healthcare system for psoriatic arthritis.

High Lupus Flare and Complication Rates in Lupus Pregnancy

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An incident cohort study from Denmark showed that 84 SLE pregnancies resulted in 62 live births.  Lupus disease activity strongly influenced maternal complications seen in half and fetal complications were observed in one-third of cases.

Conservative Equals Surgical Management of Lumbar Spinal Stenosis

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A randomized controlled trial of compared the outcomes of  surgical decompression or physical therapy in 169 lumbar spinal stenosis patients.  After two years, intention-to-treat analyses revealed no difference between groups.

Psoriatic Arthritis Occurs in 10-15% of Psoriasis Patients

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Estimates on the prevalence of psoriatic arthritis among psoriasis patients has varied widely, ranging from 5-40%.  A systematic review of the literature shows that prevalence of undiagnosed PsA was 15.5% when all studies were considered and 10.1% when only epidemiological studies were consi

Brain Natriuretic Peptide Measurement in Rheumatoid Arthritis

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Cardiovascular (CV) risk and adverse cardiac outcomes are common in rheumatoid arthritis (RA). It has been presumed that chronic systemic inflammation has a deleterious effect on the myocardium and vasculature, thereby leading to higher rates of MI, CHF and CV death.

Intraarticular Hip Injection of Ketorolac Equals Steroid Responses

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Using ultrasound guided intraarticular injection of the hip, 98 OA of the hip patients were randomized to receive IA ketorolac or triamcinolone. At, 1, 3, and 6 mos pain scale and Harris hip scores were improved equally in both groups with no statistical differences.

Thiazide Diuretics May Reduce Osteoporotic Fracture Risk

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A large Swedish cohort study of hypertensive men and women presented at the 25th Scientific Meeting of the European Society of Hypertension, identitied a protective effect on osteoporotic fractures among current users of thiazide diuretic drugs independent of blood pressure level.  This retr