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guidelines rheumatology

Robert Battat, Marc Jhonson, Lorne Wiseblatt, Cruff Renard, Laura Habib, Manouchka Normil, Brian Remillard, Timothy F Brewer, Galit Sacajiu
BACKGROUND: Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti...
October 19, 2016: BMC Medical Education
Jordi Gratacos-Masmitja, Jesus Luelmo-Aguilar, Pedro Zarco-Montejo, Rafael Botella-Estrada, Ana Maria Carrizosa-Esquivel, Maria Luz Garcia-Vivar, Silvia Perez-Barrio, Jose Antonio Roman-Ivorra, Maria Dolores Ruiz-Montesino, Jose Luis Lopez-Estebaranz
INTRODUCTION: In numerous clinical practice guidelines, emphasis is placed on the need for coordinated care of psoriatic arthritis (PsA) between rheumatologists and the objective was to develop experience-based points to consider facilitating the implementation of multidisciplinary units (Dermatology/Rheumatology) for the management of patients with PsA. METHODS: A scientific committee of rheumatology and dermatology experts in the management of PsA, and with experience in joint care, discussed the critical aspects of multidisciplinary PsA Units...
October 18, 2016: Advances in Therapy
Robert Morlock, Pierre Chevalier, Laura Horne, Javier Nuevo, Chris Storgard, Lalitha Aiyer, Dionne M Hines, Xavier Ansolabehere, Fredrik Nyberg
INTRODUCTION: The present study aimed to assess disease control, health resource utilization (HRU), and healthcare costs, and their predictors in gout patients across the USA, UK, Germany, and France. METHODS: Data were extracted from the PharMetrics Plus (USA), Clinical Practice Research Datalink-Hospital Episode Statistics (UK), and Disease Analyzer databases (Germany and France) for adult gout patients over a 3-year period: 2009-2011 (all dates +1 year for France)...
June 2016: Rheumatol Ther
Alan G Wade, Gordon M Crawford, David Young, Joyce Leman, Neil Pumford
BACKGROUND: Scottish Intercollegiate Guidelines Network and National Institute of Health and Care Excellence guidelines stress the importance of assessing patients with psoriasis for psoriatic arthritis, comorbidities associated with severe disease and quality of life (QoL). The purpose of the study was to evaluate the primary care management of psoriasis in relation to disease severity and QoL from a patient's perspective. METHODS: A cross-sectional survey of adults (≥18 years) with psoriasis managed in primary care was conducted in Scotland over 1-year (2012-2013)...
October 14, 2016: BMC Family Practice
Mine Durusu Tanrıöver, Servet Akar, Nuran Türkçapar, Ömer Karadağ, İhsan Ertenli, Sedat Kiraz
Infectious diseases in any age group can be successfully prevented through immunization. Protection provided through immunization in childhood decreases over the years. Immunization in adulthood is important because of the growing elderly population, chronic diseases, and globalization. Recommendations on this subject are being constantly updated through scientific guidelines. Immunization in adulthood is also important in rheumatology. There is an increased risk not only of infection in rheumatic diseases but also of infections being more severe...
March 2016: Eur J Rheumatol
Ömer Karadağ, Timuçin Kaşifoğlu, Birol Özer, Sabahattin Kaymakoğlu, Yeşim Kuş, Murat İnanç, Gökhan Keser, Sedat Kiraz
Biological drugs (tumor necrosis factor inhibitors, rituximab, tocilizumab, abatacept, and tofacitinib) are important treatment alternatives in rheumatology, particularly for resistant patients. However, they may cause hepatitis B virus (HBV) and hepatitis C virus (HCV) reactivation; for instance, HBV reactivation may occur in a patient who is an inactive hepatitis B surface antigen (HBsAg) carrier or who has resolved HBV infection. Therefore, the screening of patients before biological treatment and the application of a prophylactic treatment, particularly with respect to latent HBV infections, are recommended when necessary...
March 2016: Eur J Rheumatol
James D Chambers, Colby L Wilkinson, Jordan E Anderson, Matthew D Chenoweth
BACKGROUND: Payers in the United States issue coverage determinations to guide how their enrolled beneficiaries use prescription drugs. Because payers create their own coverage policies, how they cover drugs can vary, which in turn can affect access to care by beneficiaries. OBJECTIVE: To examine how the largest private payers based on membership cover drugs indicated for rheumatoid arthritis and to determine what evidence the payers reported reviewing when formulating their coverage policies...
October 2016: Journal of Managed Care & Specialty Pharmacy
Yolanda Braun-Moscovici, Marius Braun, Tarek Saadi, Doron Markovits, Menahem A Nahir, Alexandra Balbir-Gurman
BACKGROUND: Immunosuppressive agents may induce hepatitis B flares. The minimal corticosteroid dose and duration of therapy leading to HBV reactivation is unknown. OBJECTIVE: To assess whether short-term corticosteroid therapy for rheumatologic diseases induces HBV reactivation. METHODS: The records of all HBsAg or HBcore antibodies positive, anti-HBs negative patients who were hospitalized in the rheumatology department during 2001-2014 and treated with corticosteroids were reviewed...
October 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Jasvinder A Singh, Alomgir Hossain, Ahmed Kotb, George Wells
BACKGROUND: To perform a systematic review and network meta-analysis (NMA) to compare the risk of serious infections with immunosuppressive medications and glucocorticoids in lupus nephritis. METHODS: A trained librarian performed two searches: (1) PubMed for all lupus nephritis trials from the end dates for the systematic review for the 2012 American College of Rheumatology (ACR) lupus nephritis treatment guidelines and the 2012 Cochrane Systematic Review on treatments for lupus nephritis, to September 2013; and (2) PubMed and SCOPUS for all lupus trials (excluding lupus nephritis) from inception to February 2014, to obtain additional trials for harms data in any lupus patient...
2016: BMC Medicine
Emma Dures, Isobel Fraser, Celia Almeida, Alice Peterson, Judy Caesley, Jon Pollock, Nicholas Ambler, Marianne Morris, Sarah Hewlett
OBJECTIVES: Psychological support for inflammatory arthritis is recommended in rheumatology treatment guidelines. Previous research found that high numbers of patients would access such support but that provision is often inconsistent and inadequate. The present study explored patients' perspectives on the nature of the psychological impact of inflammatory arthritis and how to meet the associated support needs. METHODS: A cross-sectional survey was conducted, using questionnaires which included three open-ended questions about helpful and unhelpful psychological support...
September 8, 2016: Musculoskeletal Care
Karine Toupin April, Tamara Rader, Gillian A Hawker, Dawn Stacey, Annette M O'Connor, Vivian Welch, Anne Lyddiatt, Jessie McGowan, J Carter Thorne, Carol Bennett, Jordi Pardo Pardo, George A Wells, Peter Tugwell
OBJECTIVE: To develop an innovative stepped patient decision aid (StDA) comparing the benefits and harms of 13 nonsurgical treatment options for managing osteoarthritis (OA) and to evaluate its acceptability and effects on informed decision making. METHODS: Guided by the Ottawa Decision Support Framework and the International Patient Decision Aid Standards, the process involved (1) developing a decision aid with evidence on 13 nonsurgical treatments from the 2012 American College of Rheumatology OA clinical practice guidelines; and (2) interviewing patients with OA and healthcare providers to test its acceptability and effects on knowledge and decisional conflict...
October 2016: Journal of Rheumatology
David J Odgers, Natalie Tellis, Heather Hall, Michel Dumontier
Rheumatoid arthritis (RA) accounts for one-fifth of the deaths due to arthritis, the leading cause of disability in the United States. Finding effective treatments for managing arthritis symptoms are a major challenge, since the mechanisms of autoimmune disorders are not fully understood and disease presentation differs for each patient. The American College of Rheumatology clinical guidelines for treatment consider the severity of the disease when deciding treatment, but do not include any prediction of drug efficacy...
2016: AMIA Summits on Translational Science Proceedings
Melinda Zsuzsanna Szabó, Emese Kiss
The authors present the latest guideline for the treatment of lupus nephritis and their own single-centre results with mycofenolate mofetil treated lupus nephritis. Lupus nephritis and mainly its proliferative form is a frequent and potentially life-threatening manifestation of systemic lupus erythematosus that can lead to end-stage renal disease. The treatment of lupus nephritis greatly improved in the last decades; mycofenolate mofetil has become an alternative of cyclophosphamide both in remission induction and as a maintenance regimen as well in the treatment of Class III and IV glomerulonephritis...
August 2016: Orvosi Hetilap
Jinoos Yazdany, Mark Robbins, Gabriela Schmajuk, Sonali Desai, Diane Lacaille, Tuhina Neogi, Jasvinder A Singh, Mark Genovese, Rachel Myslinski, Natalie Fisk, Melissa Francisco, Eric Newman
BACKGROUND: Electronic clinical quality measures (eCQMs) rely on computer algorithms to extract data from electronic health records (EHRs). On behalf of the American College of Rheumatology (ACR), we sought to develop and test eCQMs for rheumatoid arthritis (RA). METHODS: Drawing from published ACR guidelines, a working group developed candidate RA process measures and subsequently assessed face validity through an interdisciplinary panel of health care stakeholders...
August 26, 2016: Arthritis Care & Research
G Candelas, V Villaverde, S García, M Guerra, M J León, J D Cañete
The aim of this study was to systematically review the literature available about the benefit of health education by a training nurse in patients with axial and/or peripheral psoriatic arthritis in the framework of the drawing up of the axial spondyloarthritis and psoriatic arthritis guidelines of the "Spanish Society of Rheumatology". Electronic databases (Cochrane Central Register of Controlled Trials, EMBASE, Medline/PubMed, CINAHL) were systematically searched from inception to 2014 using medical subject headings and keywords...
November 2016: Rheumatology International
Nabil Zeineddine, Lara El Khoury, Joseph Mosak
Systemic sclerosis (SSc) is associated with increased risk of malignancy. The organ systems most commonly affected are the lungs, the breasts and the hematological system. Risk factors predisposing a SSc patient for development of malignancy are not well defined, and the pathogenic basis of the association is yet to be explained. The incidence of malignancies in SSc patients is variable from one report to another, but most importantly, questions regarding the role of immunosuppressive therapies and the effect of autoantibodies have weak or sometimes contradictory answers in most of the currently available literature and physicians have no available guidelines to screen their SSc patients for malignancies...
September 2016: Journal of Clinical Medicine Research
Chris Paget
BACKGROUND: Cytokine modulators (adalimumab, infliximab, etanercept, anakinra, canakinumab, rituximab, tocilizumab and abatacept) are high-cost biologics used primarily in paediatrics to treat patients with juvenile idiopathic arthritis.1 Funding mechanisms are unreliable and inconsistent hence appropriate dose rounding is a key cost-saving measure.2 However, there is a lack of evidence-based guidance for dose rounding in paediatrics.3 AIMS AND OBJECTIVES: Determine if 100% of inpatient cytokine modulator prescriptions in rheumatology are dose rounded up or down to the nearest whole vial, pen or syringe if within 5 or 10% of the dose for patients less or more than 10 kg respectively...
September 2016: Archives of Disease in Childhood
Andrew Schreiner, Kit Simpson
BACKGROUND: Primary care referrals to specialty physicians play an integral role in patient care and health care costs. Multiple factors play into the primary care physician's decision to refer, including comfort managing particular conditions. As the burden of chronic disease climbs, the relationship between patients, primary care physicians and specialists in accurately diagnosing, managing and treating chronic conditions needs clarity. The objective of this study is to assess the relationship between specialty physician involvement and the care of three chronic conditions: diabetes mellitus (DM), chronic kidney disease (CKD) and systemic lupus erythematosus (SLE)...
August 15, 2016: Journal of Evaluation in Clinical Practice
Felicitas Bellutti Enders, Brigitte Bader-Meunier, Eileen Baildam, Tamas Constantin, Pavla Dolezalova, Brian M Feldman, Pekka Lahdenne, Bo Magnusson, Kiran Nistala, Seza Ozen, Clarissa Pilkington, Angelo Ravelli, Ricardo Russo, Yosef Uziel, Marco van Brussel, Janjaap van der Net, Sebastiaan Vastert, Lucy R Wedderburn, Nicolaas Wulffraat, Liza J McCann, Annet van Royen-Kerkhof
BACKGROUND: In 2012, a European initiative called Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile dermatomyositis (JDM) is a rare disease within the group of paediatric rheumatic diseases (PRDs) and can lead to significant morbidity. Evidence-based guidelines are sparse and management is mostly based on physicians' experience...
August 11, 2016: Annals of the Rheumatic Diseases
Krzysztof Bonek, Piotr Głuszko
The current methods of cardiovascular (CV) risk assessment in the course of inflammatory connective tissue diseases are a subject of considerable controversy. Comparing different methods of CV risk assessment in current rheumatoid arthritis (RA) guidelines, only a few of them recommend the use of formal risk calculators. These are the EULAR guidelines suggesting the use of SCORE and the British Society for Rheumatology guidelines performed in collaboration with NICE preferring the use of QRISK-2. Analyzing the latest American and British reports, two main concepts could be identified...
2016: Reumatologia
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