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https://www.readbyqxmd.com/read/28153440/adherence-to-hydroxychloroquine-dosing-guidelines-by-rheumatologists-an-electronic-medical-record-based-study-in-an-integrated-health-care-system
#1
Rebekah A Braslow, Mira Shiloach, Marian S Macsai
PURPOSE: To study the adherence of rheumatologists to the hydroxychloroquine (HCQ) dosing guidelines established by the American Academy of Ophthalmology in 2011 and 2016. DESIGN: Retrospective review of electronic medical records (EMRs) in an integrated health care system. PARTICIPANTS: All rheumatology patients started on HCQ who were seen by a NorthShore ophthalmologist between the years 2009 and 2016. METHODS: Data on patient weights, height, gender, and HCQ dosage were extracted from the EMR...
January 30, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28145658/frequency-and-clinical-characteristics-of-hydroxychloroquine-retinopathy-in-korean-patients-with-rheumatologic-diseases
#2
Doo Ri Eo, Min Gyu Lee, Don Il Ham, Se Woong Kang, Jaejoon Lee, Hoon Suk Cha, Eunmi Koh, Sang Jin Kim
This study aimed to evaluate the frequency and clinical characteristics of hydroxychloroquine (HCQ) retinopathy in Korean patients with rheumatologic diseases. We retrospectively reviewed medical records of 310 patients taking HCQ. Ophthalmic examinations included spectral-domain optical coherence tomography (SD-OCT), automated visual field test, and fundus autofluorescence. The severity of retinopathy was categorized as early, moderate, or severe, and the location was categorized as parafoveal, pericentral, or mixed pattern...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28138915/evaluation-of-internet-based-patient-education-materials-from-internal-medicine-subspecialty-organizations-will-patients-understand-them
#3
David R Hansberry, Nitin Agarwal, Elizabeth S John, Ann M John, Prateek Agarwal, James C Reynolds, Stephen R Baker
The majority of Americans use the Internet daily, if not more often, and many search online for health information to better understand a diagnosis they have been given or to research treatment options. The average American reads at an eighth-grade level. The purpose of this study is to evaluate the readability of online patient education materials on the websites of 14 professional organizations representing the major internal medicine subspecialties. We used ten well-established quantitative readability scales to assess written text from patient education materials published on the websites of the major professional organizations representing the following subspecialty groups: allergy and immunology, cardiology, endocrinology, gastroenterology, geriatrics, hematology, hospice and palliative care, infectious disease, nephrology, oncology, pulmonology and critical care, rheumatology, sleep medicine, and sports medicine...
January 30, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28134086/the-spectrum-of-early-rheumatoid-arthritis-practice-across-the-globe-results-from-a-multinational-cross-sectional-survey
#4
Elena Nikiphorou, James Galloway, Piet van Riel, Yusuf Yazici, Glenn Haugeberg, Andrew Ostor, Feride Gogus, Markku Kauppi, Tuulikki Sokka
OBJECTIVES: To explore patterns of real-world early RA (ERA) care across countries. METHODS: An online survey was disseminated to practising rheumatologists across Europe and the US, also made accessible on social media between April and May 2015. Survey questions (n=38) assessed the structure and setting of ERA clinics, times to diagnosis and treatment, patient monitoring, guideline use and data recording. RESULTS: A total of 212 rheumatologists from 39 countries (76% European) completed the survey...
January 27, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28134084/pneumocystis-jiroveci-pneumonia-in-rheumatic-disease-a-20-year-single-centre-experience
#5
Christopher A Mecoli, Deanna Saylor, Allan C Gelber, Lisa Christopher-Stine
OBJECTIVES: Pneumocystis jiroveci pneumonia (PJP) is an opportunistic infection with high mortality among patients with underlying rheumatologic conditions. Given the paucity of prospective data to guide treatment, clinical guidelines to initiate PJP prophylaxis are based on expert opinion and identify patients on ≥20 mg daily prednisone for ≥4 weeks duration for treatment. Herein we describe the PJP experience in rheumatic disease over a 20-year period at a single academic medical centre to investigate this 20 mg threshold and risk associated with lymphocyte counts, co-existing lung disease and immunosuppressive medications...
January 27, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28101833/gout-treatment-survey-of-brazilian-rheumatology-residents
#6
REVIEW
Rodrigo Balbino Chaves Amorim, Ana Beatriz Vargas-Santos, Leticia Rocha Pereira, Evandro Silva Freire Coutinho, Geraldo da Rocha Castelar-Pinheiro
To assess the current practices in gout management among Brazilian rheumatology residents. We performed a cross-sectional online survey among all the rheumatology residents and those rheumatologists who had just completed their training (post-residency (PR)) regarding their approach to gout management. Results were compared with the 2012 American College of Rheumatology (ACR) gout guidelines and with the responses of a previous survey with a representative sample of practicing Brazilian rheumatologists (RHE)...
January 19, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28099214/rheumatoid-arthritis-selecting-monotherapy-versus-combination-therapy
#7
Nimish Mehta, Lynne Kolton Schneider, Emilie McCardell
The overall goal of therapy for patients with rheumatoid arthritis (RA) is to achieve low disease activity or remission and to prevent or control joint damage, prevent loss of function, and decrease pain. However, many patients with RA do not have the disease adequately controlled, and only a minority attain consistent remission. To successfully treat to target, rheumatologists need practical guidance to select monotherapy and combination therapy regimens based on available data. Differences in study design, dosing regimens, and data from defined and specific patient populations pose challenges to clinicians who treat patients with diverse characteristics and needs...
January 18, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28094753/quantifying-cutaneous-adverse-effects-of-systemic-glucocorticoids-in-patients-with-rheumatoid-arthritis-a-cross-sectional-cohort-study
#8
Jonna Amann, Anne-Marie Wessels, Friederike Breitenfeldt, Dörte Huscher, Johannes W J Bijlsma, Johannes W G Jacobs, Frank Buttgereit
OBJECTIVES: EULAR guidelines state that adverse effects (AEs) of glucocorticoid (GC) therapy should be considered and discussed with the patient before treatment is initiated. However, reliable quantitative data, especially on cutaneous AEs of low-to-medium dose GCs are lacking. We performed a study assessing the occurrence of cutaneous AEs of GCs and its association with current and cumulative GC doses in patients with rheumatoid arthritis (RA). METHODS: In a cross-sectional study performed in 2 outpatient rheumatology centres, 381 RA patients were enrolled...
January 15, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28093417/cardiovascular-risk-of-patients-with-gout-seen-at-rheumatology-clinics-following-a-structured-assessment
#9
Mariano Andrés, José Antonio Bernal, Francisca Sivera, Neus Quilis, Loreto Carmona, Paloma Vela, Eliseo Pascual
OBJECTIVES: Gout-associated cardiovascular (CV) risk relates to comorbidities and crystal-led inflammation. The aim was to estimate the CV risk by prediction tools in new patients with gout and to assess whether ultrasonographic carotid changes are present in patients without high CV risk. METHODS: Cross-sectional study. Consecutive new patients with crystal-proven gout underwent a structured CV consultation, including CV events, risk factors and two risk prediction tools-the Systematic COronary Evaluation (SCORE) and the Framingham Heart Study (FHS)...
January 16, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28089200/limitations-of-the-current-standards-of-care-for-treating-gout-and-crystal-deposition-in-the-primary-care-setting-a-review
#10
Robert T Keenan
PURPOSE: This article outlines several important issues regarding the management of patients with gout. The topics discussed include best practices for gout based on the most current guidelines, opportunities for improving gout management, and current and emerging therapies for gout. METHODS: [PubMed and Google Scholar databases] were search for all articles and trials published before 2016, using the key terms [hyperuricemia, gout, tophi, joint erosion, joint damage, treatment guidelines, American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), flare, comorbidity, epidemiology, adherence, serum uric acid (sUA), monosodium urate (MSU), <6 mg/dL, MSU crystal formation, as well as individual drug names and classes of treatments of interest (allopurinol, febuxostat, colchicine, non-steroidal anti-inflammatories (NSAIDs)]...
January 11, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28088339/evidence-based-management-of-systemic-sclerosis-navigating-recommendations-and-guidelines
#11
REVIEW
Russell Edward Pellar, Janet Elizabeth Pope
OBJECTIVES: Systemic sclerosis (SSc) is a rare heterogeneous connective tissue disease. Recommendations addressing the major issues in the management of SSc including screening and treatment of organ complications are needed. METHODS: The updated European League Against Rheumatism/European Scleroderma Trial and Research (EULAR/EUSTAR) and the British Society of Rheumatology (BSR) and British Health Professionals in Rheumatology (BHPR) guidelines were compared and contrasted...
December 9, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28078432/-evidence-based-recommendations-for-diagnostics-and-treatment-of-gouty-arthritis-in-the-specialist-sector-s2e-guidelines-of-the-german-society-of-rheumatology-in-cooperation-with-the-awmf
#12
REVIEW
U Kiltz, R Alten, M Fleck, K Krüger, B Manger, U Müller-Ladner, H Nüsslein, M Reuss-Borst, A Schwarting, H Schulze-Koops, A K Tausche, J Braun
Due to the increasing prevalence of gout, particularly in old age, the disease is becoming of increasing importance in Germany. Gout is one of the most common forms of recurrent inflammatory arthritis and is induced by the deposition of monosodium urate crystals in synovial fluid and other tissues. The principal goals of therapy in chronic gout are the symptomatic treatment of the acute joint inflammation and the causal treatment of the underlying metabolic cause, the hyperuricemia. Only a consistent and permanent reduction of the serum uric acid level ultimately results in an efficient avoidance of further gout attacks and therefore the prevention of structural damage...
January 11, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28042124/improvement-in-herpes-zoster-vaccination-in-patients-with-rheumatoid-arthritis-a-quality-improvement-project
#13
Heena Sheth, Larry Moreland, Hilary Peterson, Rohit Aggarwal
OBJECTIVE: To improve herpes zoster (HZ) vaccination rates in high-risk patients with rheumatoid arthritis (RA) being treated with immunosuppressive therapy. METHODS: This quality improvement project was based on the pre- and post-intervention design. The project targeted all patients with RA over the age of 60 years while being treated with immunosuppressive therapy (not with biologics) seen in 13 rheumatology outpatient clinics. The study period was from July 2012 to June 2013 for the pre-intervention and February 2014 to January 2015 for the post-intervention phase...
January 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28012023/oral-to-subcutaneous-methotrexate-dose-conversion-strategy-in-the-treatment-of-rheumatoid-arthritis
#14
Michael H Schiff, Peter Sadowski
Both the American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) guidelines recommend the use of methotrexate (MTX) for the treatment of rheumatoid arthritis (RA) when there is no contraindication. While MTX is the foundation of RA therapy (Singh et al. in Arthritis Care Res 64:625-639,2012), absorption saturation compromises its oral bioavailability (BA). Differences in the relative BA of oral versus subcutaneous (SC) MTX demonstrate the need for guidance on successful dose-conversion strategies...
February 2017: Rheumatology International
https://www.readbyqxmd.com/read/27980014/stiffness-is-the-cardinal-symptom-of-inflammatory-musculoskeletal-diseases-yet-still-variably-measured-report-from-the-omeract-2016-stiffness-special-interest-group
#15
Serena Halls, Premarani Sinnathurai, Sarah Hewlett, Sarah L Mackie, Lyn March, Susan J Bartlett, Clifton O Bingham, Rieke Alten, Ina Campbell, Catherine L Hill, Robert J Holt, Rod Hughes, John R Kirwan, Amye L Leong, Ying Ying Leung, Anne Lyddiatt, Lorna Neill, Ana-Maria Orbai
OBJECTIVE: The objectives of the Outcome Measures in Rheumatology (OMERACT) Stiffness special interest group (SIG) are to characterize stiffness as an outcome in rheumatic disease and to identify and validate a stiffness patient-reported outcome (PRO) in rheumatology. METHODS: At OMERACT 2016, international groups presented and discussed results of several concurrent research projects on stiffness: a literature review of rheumatoid arthritis (RA) stiffness PRO measures, a qualitative investigation into the RA and polymyalgia rheumatica patient perspective of stiffness, data-driven stiffness conceptual model development, development and testing of an RA stiffness PRO measure, and a quantitative work testing stiffness items in patients with RA and psoriatic arthritis...
December 15, 2016: Journal of Rheumatology
https://www.readbyqxmd.com/read/27906921/rheumatologists-fail-to-advise-people-with-ra-to-get-immunised-which-matters-if-you-are-under-65-an-audit-in-a-new-zealand-rheumatology-service
#16
Brendan Ng, Lynn McBain, Rebecca Grainger
AIM: To assess if yearly-influenza and five-yearly pneumococcal vaccines are recommended to people with rheumatoid arthritis (RA) in a New Zealand rheumatology service in accordance with guidelines and determine patient immunisation status for these respiratory pathogens. METHODS: Retrospective review of electronic health records of all outpatients with RA attending a regional rheumatology centre in New Zealand over a one-month period immediately after the release of the 2015 influenza vaccination...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27904996/-methodological-approaches-in-the-development-of-clinical-guidelines
#17
REVIEW
K Albrecht
Practical guidelines assist the clinical decision-making process in modern medicine. In rheumatology the number of practical guidelines dealing with diagnostics and therapy of rheumatic diseases is also constantly increasing. Methodological standards for guidelines ensure adequate development under consideration of precisely defined structures. Expert recommendations for action (S1) are distinguished from consensus (S2k) or evidence-based (S2e) as well as consensus and evidence-based (S3) guidelines. Levels of evidence categorize available studies by study design...
November 30, 2016: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/27896522/tapering-biologics-in-rheumatoid-arthritis-a-pragmatic-approach-for-clinical-practice
#18
Aleksander Lenert, Petar Lenert
Optimal rheumatoid arthritis (RA) therapy in daily clinical practice is based on the treat-to-target strategy. Quicker escalation of therapy and earlier introduction of biological disease-modifying anti-rheumatic drugs have led to improved outcomes in RA. However, chronic immunosuppressive therapy is associated with adverse events and higher costs. In addition, our patients frequently express a desire for lower dosing and drug holidays. Current clinical practice guidelines from the American College of Rheumatology and European League Against Rheumatism suggest that rheumatologists consider tapering treatment after achieving remission...
January 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/27888342/putting-recommendations-into-practice-australian-rheumatologists-opinions-on-leflunomide-use-in-rheumatoid-arthritis
#19
Ashley M Hopkins, Michael D Wiese, Catherine E O'Doherty, Susanna M Proudman
Leflunomide is the most recently introduced conventional disease-modifying anti-rheumatic drugs in Australia. It has several unique methods for initiation, unique monitoring recommendations and a distinctive cessation protocol in the event of serious toxicity. The aim of this study was to evaluate initiation and monitoring practices of Australian rheumatologists using leflunomide. A survey was emailed twice, approximately 3 months apart to 332 rheumatologist members of the Australian Rheumatology Association...
November 25, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27882408/-evidence-based-recommendations-on-diagnostics-and-therapy-of-axial-spondyloarthritis-s3-guidelines-of-the-german-society-of-rheumatology-dgrh-in-cooperation-with-the-association-of-the-scientific-medical-societies-in-germany-awmf
#20
REVIEW
U Kiltz, M Rudwaleit, J Sieper, J Braun
The clinical course of axial spondyloarthritis (SpA) is variable and characterized by chronic back pain and extraspinal manifestations, such as asymmetrical arthritis, dactylitis and enthesitis. Extra-articular manifestations in the eyes (anterior uveitis), skin (psoriasis) and intestines (chronic inflammatory bowel disease) are also frequent manifestations in patients with SpA. Due to the heterogeneity of disease manifestations and the partial concentration on structural alterations in the sacroiliac joints visible in X‑ray images, the diagnosis is often delayed for many years...
November 23, 2016: Zeitschrift Für Rheumatologie
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