A slim, yoga bending, middle aged school teacher seeks a rheumatology consultation to determine the cause and cure for her left lateral heel pain for the past 6 months. No trauma, no crazy footwear and no systemic symptoms, uveitis, or peripheral/axial arthritis.
Hydroxychloroquine is one of many medications frequently used in rheumatology practice.
A famous quote from Verna Wright, MD,states, “Clinicians may all too easily spend years writing“doing well” in the notes of a patient who has become progressively crippled before their eyes".
There’s a certain comfort to work that is rote, mechanistic and almost automatic.
Reactivation of hepatitis B virus infection can have devastating consequences, especially amongst those patients receiving immunosuppressive therapy.
The spread of the viral infection Chikungunya continues with the CDC issuing a travel advisory for those traveling to Mexico, where over 7000 cases of the viral infection have been reported.
What are your rules on methotrexate and alcohol use? How about casual, social or occasional alcohol use? If one alcoholic beverage is ok, what about 2, 3 or six while taking MTX?
The disease activity score (DAS28) has been developed as a dynamic assessment tool and a therapeutic response measure for use in clinical trials and practice.
Barry Waters, MD*: I have a 21 yr old lupus nephritis patient on mycophenolate, hydroxychloroquine and prednisone 40 mg per day.
Researchers at Stanford University analyzed 2013 Medicare Part D prescription drug coverage claims for narcotic painkillers containing hydrocodone, oxycodone, codeine and other opioids. (Citation source http://buff.ly/1JgR2Tr)
I am often asked the question: When is the right time to taper a patient off opioids?
My view is that a patient should be tapered any time the risks exceed the benefits, or when treatment goals are not being met.
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