Blogs
Changing the Conversation with Patients: Lupus
Dr. Megan Clowse from Duke University talks about changing how she talks to patients with lupus, exploring and treating two types of lupus.
A Shortage of Trust
I wanted to complain about patients who complain, but guilt and common sense took over. I intended to declare the problem to primarily belong to the doctor, rather than the patient. To me, the solution to the patient’s consternation should begin and end with the source: me (you). My introspection, reasonings, and commandments were fine, but I kept running into the enigma of “Trust” – which can either be a speed-bump or chasm in our physician-patient relationships.
Best of 2022: Freeze Tag
A beloved childhood game I enjoyed was Freeze Tag. Players would run to avoid being tagged by the person who was “It”. If you were tagged, you had to “freeze” in your spot until someone was brave enough to come un-tag you. The game ends when everyone is frozen or if people quit. For over 2 years, I have been living in a real-life “Freeze Tag” game and able to dodge COVID19, until now. Sitting in my room symptomatic and frozen in isolation, I ruminated about my patients who had COVID19 and their experiences. I wanted to share with you three stories of three variants.
Best of 2022: Five Mistakes When Diagnosing Still’s Disease
Adult-onset Still's presents an interesting and diagnostic challenge when encountered. Here are 5 tips to improve your diagnostic acumen for this febrile disorder.
Best of 2022: Methotrexate in PsA
Until the publication of the SEAM trial, evidence in the medical literature for the efficacy of the most commonly used drug for psoriatic arthritis worldwide, methotrexate, has been lukewarm at best. Yet we all employ it commonly, either as monotherapy or in combination with biologic or targeted synthetic DMARD treatment. It is inexpensive and widely available, and only modestly toxic.
The Best Prescription
The craziest question that you can ask any doctor is “what is your best therapy for __?”. Crazy, because there are exponential answers, with factored layers that make each decision unique to that doctor. Each doctor has her own cha-cha-cha algorithm to a particular problem. The problem is, we each dance to a different cha-cha-cha tune in the practice of medicine.
From the Archives: Rheumatology Dead Word Cemetery
I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine. How did we decide which words should perish? And by what criteria? Who has the final say?
Still's disease: paediatrics to adults, a continuum or not?
Dr. Ilenia Di Cola and Dr. Piero Ruscitti
The Still’s Continua
The concept of a “Still’s disease continuum” that encompasses both sJIA and AOSD is based on the many common clinical, genetic and laboratory features shared by both sJIA and AOSD.
AOSD: complicated disease or a disease with complications?
Many clinicians may not have seen a case of AOSD during training, which overall leads to several delays in referrals and appropriate diagnosis for AOSD patients. AOSD is an autoinflammatory disease where innate immunity plays a primary role and is characterized by seemingly unprovoked inflammation, but without the high-titer autoantibodies or antigen specific T cells seen in autoimmune diseases.