Combination Biologic Therapy in PsA: The beginning of a new era?

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Without question, basic immunology is at the foundation of rheumatology as a discipline. Indeed, for many rheumatologists, it was the intricacies of the immune system that attracted us into the field. With each passing year, extraordinary advances in scientific methods begat tremendous gains in our understanding of the immune system. Excitingly, we may be entering a new era, driven by results in psoriatic arthritis and other related diseases.

Best of 2021: Steroid Poker

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It began as many cases do: an ill patient, in the ICU, with signs and symptoms across several body systems, yet no clear unifying diagnosis on admission. With things stabilizing, the internal medicine hospital team on which I was serving as hospitalist that week assumed care of the patient. As the case unfolded – pulmonary infiltrates that could be hemorrhagic, renal dysfunction with proteinuria – rheumatic diseases rose in the differential. When serologic studies and other data suggested GPA rather than glomerular basement membrane (GBM) disease or other possibilities such as infection, it seemed the right time to act. And that is when a game of what I call “steroid poker” began.

Best of 2021: Drug Safety Risk Communication- The 800 lb Gorilla Approach

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Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.

ICYMI: Steroid Poker

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It began as many cases do: an ill patient, in the ICU, with signs and symptoms across several body systems, yet no clear unifying diagnosis on admission. With things stabilizing, the internal medicine hospital team on which I was serving as hospitalist that week assumed care of the patient. As the case unfolded – pulmonary infiltrates that could be hemorrhagic, renal dysfunction with proteinuria – rheumatic diseases rose in the differential. When serologic studies and other data suggested GPA rather than glomerular basement membrane (GBM) disease or other possibilities such as infection, it seemed the right time to act. And that is when a game of what I call “steroid poker” began.

ICYMI: Drug Safety Risk Communication- The 800 lb Gorilla Approach

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Discussions on drug safety can be as treacherous as quicksand for the patient and physician. What the physician knows and what the patient perceives may not be in sync.

Three Healthcare Hashtags You Should Follow 

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I've sent more than 2,000 tweets since joining Twitter in July 2010. Even better, I've read (and sometimes shared) thousands of other educational, informative and sometimes humorous tweets from fellow rheumatologists, physicians, healthcare providers and others around the world. While following individuals and organizations relevant to you is important, so is following hashtags. Here are three I recommend.

Best of 2020: My Experience as a COVID19 Vaccine Trial Participant

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I have been an investigator for many clinical rheumatology studies over the past two decades but have never been a study subject until now. On October 31, 2020, I enrolled in the phase 3 trial of the Pfizer/BioNTech mRNA vaccine against SARS-CoV2 (protocol C4591001). Here's my experience.

Best of 2020: Steroid Poker

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It began as many cases do: an ill patient, in the ICU, with signs and symptoms across several body systems, yet no clear unifying diagnosis on admission. With things stabilizing, the internal medicine hospital team on which I was serving as hospitalist that week assumed care of the patient. As the case unfolded – pulmonary infiltrates that could be hemorrhagic, renal dysfunction with proteinuria – rheumatic diseases rose in the differential. When serologic studies and other data suggested GPA rather than glomerular basement membrane (GBM) disease or other possibilities such as infection, it seemed the right time to act. And that is when a game of what I call “steroid poker” began.

My Experience as a COVID19 Vaccine Trial Participant

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I have been an investigator for many clinical rheumatology studies over the past two decades but have never been a study subject until now. On October 31, 2020, I enrolled in the phase 3 trial of the Pfizer/BioNTech mRNA vaccine against SARS-CoV2 (protocol C4591001). Here's my experience.

Need for Pre-operative Hyperglycemia Testing Prior to Total Joint Replacement

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JAMA reports on a large Medicare cohort study showing that amongst patients undergoing total joint replacement (TJR), preoperative HbA1c testing was performed in 26% to 43% of patients with diabetes and in only 5% of those without diabetes. Importantly research has shown that an elevated HbA1c level is associated with postoperative complications.

Staying Abreast of COVID-19

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Dealing with unknowns is both difficult and frustrating, as the answer is often not within our reach. The current pandemic has created a tidal wave of unknowns, scaring patients and putting physicians in a difficult spot.

ACR20 Pearls Part 3: Pragmatic Applications for Managing Vasculitis

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While the ACR prepares to publish its new guidelines for the diagnosis and management of vasculitis in the Spring of 2020, Dr. John Stone presented his own perspectives on the practical management of vasculitis during the 2019 ACR meeting in Atlanta.  He acknowledged that what may be pearls one day, may be disproven with data in the future.