I was methodically signing off on stack of refill requests, until I find one I don’t recognize. The patient is mine but the prescription (under my name) is not. It’s for a specialty compounded cream...
Sleep disruption is a core feature of fibromyalgia. People with fibromyalgia exhibit sleep brain wave patterns often disrupted by brain waves that correspond to wakefulness.
Rheumatoid arthritis patients are often said to have no or a low risk of cancer. But numerous studies have shown there is an imbalance of risk - as some cancers are more prevalent (lymphoma, lung, skin), while others are seen less frequently (colon, breast) in RA patients compared to the general population.
Dr. Steven Katz describes how NIAMS sets priorities for investing congressionally-appropriated funds. NIAMS's mission includes supporting research into causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; training of basic and clinical scientists to conduct that research; and disseminating information on research progress in those diseases.
Dr. Marty Bergman (see prior article) writes to remind rheumatologists that the October 1 deadline is for the date of service. If you see the patient on September 30th, but don't bill it until October 4th, you need to use ICD-9 codes. Also, most carriers (such as my local Blue Cross) don't want to see mixed codes on the same transmission form.
Travel can be challenging for arthritis patients. Here are some useful tips to travel smoothly and pain free.
Smoking is a well-known inciting or exacerbating factor in many inflammatory diseases, including rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, Crohn's disease and ulcerative colitis.
Rituximab has been used for years with good efficacy, but with several safety concerns. Van Vollenhoven and colleagues have published the cumulative clinical trial safety experience of RTX wherein 3595 patients 1–20 (average - 4) courses over 11 years [14,816 patient-years (PY)]. Nearly one-third of patients had more than 5 years of followup.
A cross-sectional survey of 309 Brazilan rheumatologists was performed to assess their compliance with the 2012 ACR guidelines on gout. Specifically, they assess their use of colchicine, prophylaxis with urate-lowering therapy (ULT), not interrupting ULT during acute gout, targetting SUA < 6.0 mg/dl, and allopurinol dosing regiment (e.g., starting at 100 mg qd).
Behcet's disease is difficult to treat and often has an over-reliance on corticosteroid use. Alemtuzumab (previously known as Campath-1H) has been studed in patients with Behcet's. Alemtuzumab is a humanized anti-CD52 monoclonal antibody that has been used in GVHD, lymphoproliferative disorders, and inclusion body myositis; but notably failed in RA.
Your patient with Crohn’s or ulcerative colitis has a musculoskeletal problem that needs treatment. You consider a nonsteroidal anti-inflammatory drug, but are reminded that “NSAIDs are to be avoided as these drugs will worsen inflammatory bowel disease (IBD)”.
Different Phenotypes for Osteoarthritis of the Foot. Osteoarthritis is often characterized as either a symmetric polyarticular (often involving DIPs, PIPs and CMC1), asymmetric oligoarticular or monarticular (knee or hip OA), but OA may also affect the foot. A recent study sheds light on different phenotypes of OA of the foot – MTP1 OA or more extensive joint involvement that may include the midfoot.
The current JAMA issue examines the process and potential flaws of society clinical practice guidelines -a timely commentary as we await the 2015 ACR RA treatment guidelines first presented at the 2014 ACR meeting in Boston and slated for upcoming publication in Arthritis & Rheumatology.
The CDC has released data from the NHANES (National Health and Nutrition Examination Survey) analysis of 2005-2010 data regarding the population frequency of osteoporosis and osteopenia. Bone density proven osteoporosis of the spine and hip was found in 16% of all American seniors -- 25% of women and nearly 6% of men. (Citation source http://buff.ly/1EqzhP7)
I was recently offered a project that paid a lot less than what I feel my time is worth. My research on compensation suggests a male colleague would have been offered at least 2-3 times as much for the same project. At first I was insulted, but then I took a deep breath and said to myself, I need to negotiate for a higher price. Why not?
