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Rheumatic Diseases Clinics of North America

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https://www.readbyqxmd.com/read/30001792/rheumatic-diseases-in-older-adults
#1
EDITORIAL
James D Katz, Brian Walitt
No abstract text is available yet for this article.
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001791/rheumatic-diseases-in-older-adults
#2
EDITORIAL
Michael H Weisman
No abstract text is available yet for this article.
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001790/nonsurgical-management-of-osteoarthritis-knee-pain-in-the-older-adult-an-update
#3
REVIEW
Nora Taylor
Symptomatic knee osteoarthritis is a common complaint of many elderly patients in primary care offices. For those unable or unwilling to undergo knee replacement, the primary practitioners' understanding of the strengths and weaknesses of the available treatment modalities for pain relief is critical to successful in-office counseling and expectation management. Treatment requires a multimodal approach of nonpharmacologic and pharmacologic therapies to achieve a maximal clinical benefit. The focus of this review is on the nonsurgical options for treatment of knee osteoarthritis in patients aged 65 and older...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001789/lumbar-spinal-stenosis-in-older-adults
#4
REVIEW
Anna M Lafian, Karina D Torralba
Lumbar spinal stenosis (LSS) is a frequent cause of low back pain among adults, caused by a narrowing impinging on the spinal cord or nerve roots. Several conditions cause LSS, including disc herniation, spondylolisthesis, tumor, fractures, and other degenerative changes. Back pain is frequently experienced. MRI is the radiologic modality of choice. Radiographic evidence of LSS may not correlate well with symptoms. An increase in utilization of surgery has been noted. However, surgery has no significant benefit over more conservative options...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001788/crystal-induced-arthritides-in-the-elderly-an-update
#5
REVIEW
Hossam El-Zawawy, Brian F Mandell
The prevalence of gout increases with age. After the serum concentration of urate exceeds the saturation or solubility point, it deposits in and around the joints. Presentation in the elderly is often atypical and challenging to diagnose. Treatment depends on disease stage, health status, and comorbidities. Elderly patients often have several confounding issues; treatment decisions can be complicated and therapeutic options limited. To prevent recurrence, serum concentration of urate should be maintained well below the saturation threshold of 6...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001787/update-on-cardiovascular-disease-risk-in-patients-with-rheumatic-diseases
#6
REVIEW
Rachel H Mackey, Lewis H Kuller, Larry W Moreland
Cardiovascular disease (CVD) risk is 1.5-fold higher in rheumatoid arthritis (RA), partly due to subclinical atherosclerosis that develops before the diagnosis of RA. Dyslipidemia in RA is better quantified by lipoproteins and apolipoproteins than by cholesterol levels. Current risk factors likely underestimate CVD risk by underestimating prior risk factor levels. Some of the 2-fold higher risk of heart failure and total mortality in RA may be due to myocardial disease caused by inflammation. Per recent recommendations, to reduce CVD risk in RA, control disease activity, reduce inflammation, and aggressively treat CVD risk factors...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001786/regional-rheumatic-disorders-and-rehabilitation-in-older-adults-an-update
#7
REVIEW
Katharine E Alter, Ana T Acevedo, Adrienne Jackson
Musculoskeletal problems are the most frequently reported complaints among older adults living in the community. The impact of the aging process on skeletal muscles and joints can have a profound effect on the ability of individuals to function. This article reviews the rehabilitation medicine approach to the evaluation of older adults with regional rheumatic disorders and the rehabilitation medicine considerations for clinical intervention. Future research is required to gain a greater understanding of the subject matter and its impact on the provision of care and patients' quality of life...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001785/a-review-of-osteoporosis-in-the-older-adult-an-update
#8
REVIEW
Paloma Alejandro, Florina Constantinescu
Osteoporosis in the elderly population is common. It results in more than 1.5 million fractures per year in the United States. The goal of managing osteoporosis is to prevent fractures. In men, osteoporosis is underrecognized and undertreated. More men than women die every year as a consequence of hip fractures. Bisphosphonates are the first-line treatment of men and women. In the past several years, advances in bone biology have resulted in major therapeutic advances. A review of diagnosis and treatment of osteoporosis is described...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001784/update-on-sj%C3%A3-gren-syndrome-and-other-causes-of-sicca-in-older-adults
#9
REVIEW
Alan N Baer, Brian Walitt
Dry eye and dry mouth symptoms are each reported by up to 30% of persons more than 65 years of age, particularly in women. Medication side effects are the most common contributing factors. The evaluation of these symptoms requires measures of ocular and oral dryness. Sjögren syndrome is the prototypical disease associated with dryness of the eyes and mouth and predominantly affects women in their perimenopausal and postmenopausal years. In addition to topical treatment of the mucosal dryness, patients with Sjögren syndrome may require treatment with systemic immunomodulatory and immunosuppressive agents to manage a variety of extraglandular manifestations...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001783/the-relationship-between-rheumatologic-disorders-and-malignancies
#10
REVIEW
Mandana Hashefi
A variety of conditions mimicking rheumatologic syndromes may be associated with an underlying malignancy. Therefore, distinguishing these syndromes from more common, nonparaneoplastic rheumatologic conditions can be perplexing. Some autoimmune conditions and the medications used for their management can be associated with increased future risk of malignancy. Some cancers can directly involve the musculoskeletal structures, whereas others present with systemic manifestations at sites away from the tumor and its metastases...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001782/sarcopenia-a-rheumatic-disease
#11
REVIEW
Sarthak Gupta, Robinder J S Dhillon, Sarfaraz Hasni
Sarcopenia refers to the age-related loss of muscle mass, muscle strength, and physical function. With an increase in the number and proportion of elderly in the population, sarcopenia is a growing global health concern due to its impact on morbidity, mortality, and health care expenditure. Despite its clinical importance, sarcopenia remains underrecognized and poorly managed in routine clinical practice. This is, in part, due to a lack of available diagnostic testing and uniform diagnostic criteria. This article provides the general practitioner or rheumatologist an overview of the pathophysiology, diagnosis, and management of this complex and critical entity...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/30001781/pharmacotherapy-pearls-in-rheumatology-for-the-care-of-older-adult-patients-focus-on-oral-disease-modifying-antirheumatic-drugs-and-the-newest-small-molecule-inhibitors
#12
REVIEW
Blas Y Betancourt, Ann Biehl, James D Katz, Ananta Subedi
Providing safe and effective pharmacotherapy to geriatric patients with rheumatologic disorders is challenging. Multidisciplinary care involving rheumatologists, primary care physicians, and other specialties can optimize benefit and reduce adverse outcomes. Oral disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the small molecule inhibitors tofacitinib and apremilast have distinctive monitoring requirements and specific adverse reaction profiles...
August 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29622304/advanced-epidemiologic-methods-for-the-study-of-rheumatic-and-musculoskeletal-diseases
#13
EDITORIAL
Sindhu R Johnson
No abstract text is available yet for this article.
May 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29622303/the-brave-new-world-of-rheumatic-disease-research-today
#14
EDITORIAL
Michael H Weisman
No abstract text is available yet for this article.
May 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29622302/applied-bayesian-methods-in-the-rheumatic-diseases
#15
REVIEW
Sindhu R Johnson, George A Tomlinson, John T Granton, Gillian A Hawker, Brian M Feldman
The use of applied Bayesian methods is increasing in rheumatology. Using the Bayes theorem, past evidence is updated with new data. Preexisting data are expressed as a prior probability distribution or prior. New observations are expressed as a likelihood. Through explicit incorporation of preexisting data and new data, this process informs how this new information should change the way we think. In this article, the authors highlight the use of applied Bayesian methods in the study of rheumatic diseases.
May 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29622301/cluster-and-multiple-correspondence-analyses-in-rheumatology-paths-to-uncovering-relationships-in-a-sea-of-data
#16
REVIEW
Lu Han, Susanne M Benseler, Pascal N Tyrrell
Rheumatic diseases encompass a wide range of conditions caused by inflammation and dysregulation of the immune system resulting in organ damage. Research in these heterogeneous diseases benefits from multivariate methods. The aim of this review was to describe and evaluate current literature in rheumatology regarding cluster analysis and correspondence analysis. A systematic review showed an increase in studies making use of these 2 methods. However, standardization in how these methods are applied and reported is needed...
May 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29622300/measuring-patient-preferences-an-overview-of-methods-with-a-focus-on-discrete-choice-experiments
#17
REVIEW
Glen S Hazlewood
There is increasing recognition of the importance of patient preferences and methodologies to measure them. In this article, methods to quantify patient preferences are reviewed, with a focus on discrete choice experiments. In a discrete choice experiment, patients are asked to choose between 2 or more treatments. The results can be used to quantify the relative importance of treatment outcomes and/or other considerations relevant to medical decision making. Conducting and interpreting a discrete choice experiment requires multiple steps and an understanding of the potential biases that can arise, which we review in this article with examples in rheumatic diseases...
May 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29622299/use-of-administrative-databases-to-assess-reproductive-health-issues-in-rheumatic-diseases
#18
REVIEW
Evelyne Vinet, Eliza F Chakravarty, Julia F Simard, Megan Clowse
Administrative databases, registers, and other sources of big data can be interesting sources to address important research questions on reproduction in women with rheumatic diseases. There are many different types of administrative datasets worldwide, and it is important to understand the type of data present and unavailable in each dataset, validity and potential misclassification of data, and the ability to link maternal data with infant data. This article discusses the advantages and methodologic issues associated with administrative database use for the conduct of observational studies on reproductive issues in women with rheumatic diseases...
May 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29622298/strategies-for-dealing-with-missing-accelerometer-data
#19
REVIEW
Samantha Stephens, Joseph Beyene, Mark S Tremblay, Guy Faulkner, Eleanor Pullnayegum, Brian M Feldman
Missing data is a universal research problem that can affect studies examining the relationship between physical activity measured with accelerometers and health outcomes. Statistical techniques are available to deal with missing data; however, available techniques have not been synthesized. A scoping review was conducted to summarize the advantages and disadvantages of identified methods of dealing with missing data from accelerometers. Missing data poses a threat to the validity and interpretation of trials using physical activity data from accelerometry...
May 2018: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/29622297/-big-data-in-rheumatology-intelligent-data-modeling-improves-the-quality-of-imaging-data
#20
REVIEW
Robert B M Landewé, Désirée van der Heijde
Analysis of imaging data in rheumatology is a challenge. Reliability of scores is an issue for several reasons. Signal-to-noise ratio of most imaging techniques is rather unfavorable (too little signal in relation to too much noise). Optimal use of all available data may help to increase credibility of imaging data, but knowledge of complicated statistical methodology and the help of skilled statisticians are required. Clinicians should appreciate the merits of sophisticated data modeling and liaise with statisticians to increase the quality of imaging results, as proper imaging studies in rheumatology imply more than a supersensitive imaging technique alone...
May 2018: Rheumatic Diseases Clinics of North America
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