Rheumatology

The recent discovery of the protein, HVCN1, may provide some insight into the mechanics of autoimmune diseases, including rheumatoid arthritis, lupus and certain types of cancer.

Patients with advanced knee arthritis tend to experience successful pain relief and improved function with total knee replacement surgery, according to the results of a study presented at the 2010 Annual Meeting of the American Academy of Orthapaedic Surgeons.

The market for retail health clinics is expected to expand more than 30 percent by 2014, signaling a major opportunity for physicians. Here are three ways in which you can take advantage of this growth trend.

Rep. Paul Ryan (R-Wis.) and Chris Jennings discussed the state of health care reform.

Last month, results from a study that compared the prevalence of arthritis and arthritis-attributable activity limitations in the US and Canada were released. Upon review, study authors found that there was a "higher prevalence of arthritis and AAL to a greater level of obesity and physical inactivity in Americans, particularly women."

While the changes President Obama and Democratic leaders in Congress are proposing are considerable (they could reduce the deficit within two decades), they aren't a government takeover.

ABSTRACT: No new drug was FDA-approved for gout for close to 45 years, but new drugs are on the market now and others are in development. Established treatments often are effective, but each has limitations. In 2009, the FDA approved a nongeneric colchicine for acute gout.

Last week, BioTrends Research Group released topline findings from LaunchTrends®: ACTEMRA, Wave 1, highlighting the market uptake of the product at one month post launch.

I think I'm rather opinionated, ok, very opinionated and also think that medicine, as noble a profession as it is, is in dire trouble. I offer my viewpoints and hope that others will read and agree with me, although I guess you get more popular if people disagree.

ABSTRACT: Evidence of ongoing juvenile idiopathic arthritis (JIA) into adulthood has led to a shift in the treatment paradigm. Most physicians now pursue an approach of early, aggressive combination therapy.

This article describes a study of the prevalence of lateral epicondylitis or tennis elbow among patients with neck or arm pain, reviews the prevalence of concomitant cervical radiculopathy, and proposes a management plan for cases in which the conditions coincide.

ABSTRACT: A 36-year-old woman presented with Raynaud phenomenon, arthralgia, photosensitive rash, proteinuria, dry eyes and dry mouth, and alopecia.

A 45-year-old woman presented to the emergency department with a 3-day history of an acutely painful, swollen, and erythematous thumb. Ordinary x-ray was central to the correct diagnosis.

Ted Eytan, MD, and Holly Potter, discussed the power of health IT and social media to improve the quality of healthcare.

The CDC and the Arthritis Foundation (AF) are spearheading a new initiative designed to reduce the effect of osteoarthritis (OA) on Americans. In response to the recommendations outlined in this action plan, the AF also is cooperating with the Ad Council and the American College of Rheumatology in sponsoring a national public awareness campaign for OA management and prevention.

Kathryn Kern-Stout, MD, MBA, discussed some of the challenges her institution had to overcome during the EHR selection and implementation process.

More than 261,000 persons visited an emergency department in 2007 because they had a distal radius fracture, according to the American Academy of Orthopaedic Surgeons (AAOS). To improve patient care for those who sustain this injury, the AAOS released an evidence-based clinical practice guideline, The Treatment of Distal Radius Fractures.

There are significant associations between the increased numbers of telangiectases in patients with scleroderma and the presence of pulmonary arterial hypertension (PAH). Cutaneous telangiectases may be a manifestation of the vasculopathy of scleroderma that could serve as a clinical biomarker for pulmonary vascular disease.

For girls who play soccer, participation in a multifaceted injury prevention program that combines education, proper motion patterns, strength, and balance may reduce the incidence of acute knee injuries significantly. It also may lessen the severity of injuries that do occur.

The prevalence of obesity in the United States remains high, exceeding 30% in most sex and age groups. However, the prevalence may not be continuing at as high a level as in earlier periods, especially in women and perhaps in men.

Although sleep often is disturbed in persons with chronic fatigue syndrome (CFS), activity-related exacerbation of symptoms is not related to poor sleep. In fact, persons with CFS often sleep better after engaging in exercise.

Late-onset systemic lupus erythematosus (SLE), often considered to have a benign disease course, actually involves greater disease activity and comorbidities than early-onset SLE. Differences in disease activity may be associated with an interaction between the SLE and age.

Neither preterm birth nor being breastfed is significantly associated with the incidence of rheumatoid arthritis (RA). These findings are consistent with those of previous investigations for a null association between RA and gestational age, but the previously reported protective effect of being breastfed was not confirmed.

Mrunal Shah, MD, ABFM, discussed his large integrated health system's experiences with implementing a system-wide electronic record.

Use of a treadmill may help infants who have prenatal complications or were injured at birth walk earlier and better, according to researchers at the School of Kinesiology, University of Michigan, in Ann Arbor. Angulo-Barroso and associates1 studied developmental changes in treadmill stepping and physical activity in 15 infants at risk for neuromotor delay and explored these changes by diagnosis of cerebral palsy.

A healthy gait pattern is based on an array of biomechanical features orchestrated by the CNS for economy and stability, according to investigators in the departments of mechanical engineering and biomedical engineering at the University of Michigan in Ann Arbor. Injuries and pathologies may alter these features and result in substantial gait deficits, often with detrimental consequences for energy expenditure and balance. Therefore, an understanding of the role of biomechanics in the generation of healthy gait may provide insight into these deficits that may be applied to clinical gait pathologies.

Prolonged standing on a sloped surface rather than on a level surface results in decreased subjective low back pain (LBP) and associated biomechanical changes, according to researchers at the Regis University School of Physical Therapy in Denver. Nelson-Wong and Callaghan1 noted that occupations that require prolonged periods of standing have been associated with increased reports of musculoskeletal disorders, including LBP.

The chronic inflammation of rheumatoid arthritis (RA) leads to impairment of bone biomechanics in terms of stiffness, ductility, and ultimate strength (fracture), according to researchers at the Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, in Portugal. The direct effect of inflammation on bone is difficult to study in patients with RA, they noted, because the skeleton also is affected by corticosteroids and other drugs, as well as aging and menopause, which contribute to bone fragility.

Plantar pressures measurement, frequently used in rehabilitation and related research, is highly reliable in evaluating patients with rheumatoid arthritis (RA), according to researchers at the University Rehabilitation Institute, Republic of Slovenia, in Ljubljana. On the basis of their findings, they concluded that such measurement is suitable for clinical practice, as well as for research, and recommended taking several measurements and using the average.

This course features a discussion between rheuamtologist Leonard Calabrese, MD, and hepatologist Nizar Zein on the "hepatic effects of biologic agents in the treatment of rheumatoid arthritis and their potential for the treatment of viral hepatitis."