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Diabolical Negativism

Our inner thoughts are usually negative, critical or pessimistic. Negative thinking is ubiquitous, and may be responsible for indecision or ill-choices.  How to identify it and deal with it in patient care is an unsavory challenge often left undone.

The Week in Review - 13 February 2016

Video highlights from last week's reports, news and tweets on RheumNow.com

Methotrexate: Where it All Began

It’s somewhat bizarre that a designer drug from over 65 years ago would become the cornerstone of treatment for rheumatoid arthritis in the 21st century. When Sidney Farber designed a molecule that would interfere with folate metabolism in the middle of the 20th century, he was looking for a ubiquitous antimetabolite to treat cancer. Farber was actually quite concerned with the potential side effects of a drug that competitively inhibits folate metabolism. That is part of the reason he combined the “met” for metabolism with an “x”. The x was found on poison bottles and he thought it wise to include it in the name of this agent.

 

The Week in Review: 5 February 2016

Dr. Cush reviews highlights from last week's news and research in rheumatology.

It Took Me 30 Years to Learn This About Rheumatoid Arthritis

I’m alot better at RA in the last 10 years than I was when I started to practice 30 years ago. RA has not changed, but tools, knowledge and treatments have progressed admirably. Decades have taught me that many aspects of RA were wrongly taught, misunderstood or not apparent when I first started in rheumatology in 1984. Here are 10 things I've learned.

Patients Believe Lab Tests More Than Doctors

Patients believe that a lab result is a numeric true representation their biology and a pivotal arbiter of wellness, yet physicians often dismiss such results as hanging chads in a meaningless election. Why do patients believe their labs moreso than their doctor? 

How to Handle Latex Allergies and Biologics

What to do when a patient has a latex allergy and you prescribe an injectable biologic (many having latex allergy as a contraintication)?

TIPS for Arthritis Travelers (Best of 2015: #3)

Travel can be challenging for arthritis patients. Here are some useful tips to travel smoothly and pain free.

5 Things To Know About Antimalarials for Lupus (Best of 2015: #5)

Here are five things every rheumatologist should know about antimalarial medications for lupus. 

11 Pearls for Pregnancy Management in Rheumatoid Arthritis (Best of 2015: #6)

Rheumatoid arthritis affects women in their child-bearing years and many will face the issue of pregnancy and RA management at some point. Here are11 considerations for those managing RA patients who wish to become pregnant.

5 Things To Know About Antimalarials for Lupus

Here are five things every rheumatologist should know about antimalarial medications for lupus. 

The Born Again Rheumatoid

While there are currently 9 biologic agents approved and marketed for the treatment of RA, and although each has a valued place in our arsenal, I would propose none has been as influential or dramatic as TNF inhibitors. The “born again” rheumatoid feeling is not well captured by any of the usual metrics or measures. It’s not found in the HAQ, DAS28, SF36 (either mental or physical), fatigue score, or any lab parameter. I believe it’s best described by my patient RH who wrote me a letter soon after starting etanercept.

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