Best of 2018: Rheumatology Dead Word Cemetery 2019

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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?

Best of 2018: Advance Practice Clinicians Proliferating in Specialty Practices

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An analysis of SK&A outpatient provider files, covering 90% of physician practices in the United States, shows that between 2008 to 2016, there was a 22% increase in the employment of advanced practice clinicians (APCs) by specialty practices.  By 2016, 28% of all specialty practices employed APCs.

Best of 2018: 5 Mistakes When Diagnosing Adult-Onset Still’s Disease

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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 2018: Hydroxychloroquine Being Over-Dosed with New Guidelines?

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Hydroxychloroquine retinopathy prevention guidelines have revised from ideal body weight-based dosing to actual body weight-based dosing; the question remains whether these have been adopted in clinical practice. A database of nearly 21,000 new HCQ users from a UK general population database studied HCQ dosing and use between 2007 and 2016. Specifically they examined whether users were subjected to excess HCQ dosing per ophthalmology guidelines (defined by exceeding 6.5 mg/kg of IBW and 5.0 mg/kg of ABW).

Best of 2018: U.S. News 2018-19 Rheumatology Rankings

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The Annual U.S. News and World Report Rankings of Hospitals has listed the top contenders in the field of rheumatology. The U.S. News Review rates hospitals nationwide in 16 specialties – including rheumatology. Of the 4,500 hospitals covered by U.S.

Best of 2018: Dealing with Drug Reps - Dead or Alive

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Several years ago, long before promotional lectures, I traveled for a series of lectures. I flew north for 4 days and 4 lectures, 2 at major university programs and 2 dinner lectures to local rheumatologists.The first lecture went well but the weather turned bad, with a snow storm in the overnight forecast.  Hence my host, a local drug rep, suggested we drive at night to beat the snow and get to the next city for the 10 am University lecture the following morning.The one-hour drive felt like a week in Cleveland. 

Best of 2018: Patients May Not Fill Your Prescription

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A new study linking administrative claims and electronic health records (EHRs) shows that nearly 40% of patients fill and take newly prescribed methotrexate (MTX), tofacitinib or biologics. Kan et al set out to estimate the extent and predictors of primary nonadherence in rheumatoid arthritis (RA) patients who received new prescriptions for methotrexate, biologics or tofacitinib.

Best of 2018: Death of the Dinner Meeting

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Best of 2018: Ustekinumab May be Effective in Lupus

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Ronald F van Vollenhoven and colleagues have reported in Lancet that ustekinumab (UST), an interleukin-12 and -23 inhibitor, when added to usual therapy in systemic lupus erythematosus (SLE) patients, was shown to be superior to placebo at improving clinical efficacy and laboratory param

Best of 2018: Unproven But Profitable Stem Cell Clinics

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Stem cell clinics are popular and proliferating as they are largely a cash business and fall outside of FDA regulatory control. In lieu of scientific proof, most advocates use patient testimonials and the placebo effect to back up their claims.