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https://www.readbyqxmd.com/read/28282539/increasing-podiatry-referrals-for-patients-with-inflammatory-arthritis-at-a-tertiary-hospital-in-singapore-a-quality-improvement-project
#1
K Carter, P P Cheung, K Rome, A Santosa, M Lahiri
BACKGROUND: Foot disease is highly prevalent in people with inflammatory arthritis and is often under-recognized. Podiatry intervention can significantly reduce foot pain and disability, with timely access being the key factor. The aim of this study was to plan and implement a quality improvement project to identify the barriers to, and improve, uptake of podiatry services among patients with inflammatory arthritis-related foot problems seen at a tertiary hospital in Singapore. METHOD: A 6-month quality improvement program was conducted by a team of key stakeholders using quality improvement tools to identify, implement and test several interventions designed to improve uptake of podiatry services...
December 28, 2016: Foot
https://www.readbyqxmd.com/read/28282061/hydroxychloroquine-retinopathy
#2
REVIEW
I H Yusuf, S Sharma, R Luqmani, S M Downes
Hydroxychloroquine (HCQ; Plaquenil) is used increasingly in the management of a variety of autoimmune disorders, with well established roles in dermatology and rheumatology and emerging roles in oncology. Hydroxychloroquine has demonstrated a survival benefit in patients with systemic lupus erythematosus; some clinicians advocate its use in all such patients. However, Hydroxychloroquine and chloroquine (CQ) have been associated with irreversible visual loss due to retinal toxicity. Hydroxychloroquine retinal toxicity is far more common than previously considered; an overall prevalence of 7...
March 10, 2017: Eye
https://www.readbyqxmd.com/read/28271158/physicians-perspectives-on-the-diagnosis-and-management-of-periodic-fever-aphthous-stomatitis-pharyngitis-and-cervical-adenitis-pfapa-syndrome
#3
Kalpana Manthiram, Suzanne C Li, Jonathan S Hausmann, Gil Amarilyo, Karyl Barron, Hanna Kim, Simona Nativ, Geraldina Lionetti, Andrew Zeft, Donald Goldsmith, David Kimberlin, Kathryn Edwards, Fatma Dedeoglu, Sivia Lapidus
To assess the practice patterns of pediatric rheumatology and infectious diseases subspecialists in the diagnosis and treatment of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome. An online survey assessing diagnostic and treatment approaches was sent to 424 members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) and 980 members of the Pediatric Infectious Disease Society (PIDS). 277 physicians (123 from CARRA and 154 from PIDS representing 21% of the total membership) completed the survey...
March 7, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28262590/the-implications-of-biologic-therapy-for-elective-foot-and-ankle-surgery-in-patients-with-rheumatoid-arthritis
#4
REVIEW
Ross Diaper, Ernest Wong, Stuart A Metcalfe
INTRODUCTION: Rheumatoid arthritis (RA) is one of a number of inflammatory arthropathies resulting in foot pain and deformity. Patients with this disease may require surgical intervention as part of their management. Many of these patients are now taking biologic agents which pose several risks to patients in the perioperative phase. The surgical team therefore need to be aware of these associated complications and how to manage these cases. AIM: This paper aims to review the current literature about perioperative needs (foot and ankle surgery) associated with patients with rheumatoid arthritis receiving biologic therapy...
January 27, 2017: Foot
https://www.readbyqxmd.com/read/28260595/a-danish-nationwide-questionnaire-study-of-hepatitis-b-virus-screening-before-immunosuppressive-therapy
#5
Kristine Ifigenia Bunyoz, Henrik Krarup, Nina Weis
INTRODUCTION: Difficulty in identifying patients who are at risk for hepatitis B virus (HBV) reactivation makes it import-ant to screen for HBV before initiating immunosuppressive therapy. The aim of this study was to investigate screening procedures for HBV infection before initiation of immunosuppressive therapy and to explore HBV treatment strategies. METHODS: All Danish units of haematology, oncology, dermatology, rheumatology and gastroenterology using immunosuppressive agents were invited to fill out a questionnaire for The Danish Database for Hepatitis B and C...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28228115/weight-loss-and-exercise-for-communities-with-arthritis-in-north-carolina-we-can-design-and-rationale-of-a-pragmatic-assessor-blinded-randomized-controlled-trial
#6
Stephen P Messier, Leigh F Callahan, Daniel P Beavers, Kate Queen, Shannon L Mihalko, Gary D Miller, Elena Losina, Jeffrey N Katz, Richard F Loeser, Sara A Quandt, Paul DeVita, David J Hunter, Mary F Lyles, Jovita Newman, Betsy Hackney, Joanne M Jordan
BACKGROUND: Recently, we determined that in a rigorously monitored environment an intensive diet-induced weight loss of 10% combined with exercise was significantly more effective at reducing pain in men and women with symptomatic knee osteoarthritis (OA) than either intervention alone. Compared to previous long-term weight loss and exercise trials of knee OA, our intensive diet-induced weight loss and exercise intervention was twice as effective at reducing pain intensity. Whether these results can be generalized to less intensively monitored cohorts is unknown...
February 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28223263/apps-for-people-with-rheumatoid-arthritis-to-monitor-their-disease-activity-a-review-of-apps-for-best-practice-and-quality
#7
Rebecca Grainger, Hermaleigh Townsley, Bonnie White, Tobias Langlotz, William J Taylor
BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory arthritis requiring long-term treatment with regular monitoring by a rheumatologist to achieve good health outcomes. Since people with RA may wish to monitor their own disease activity with a smartphone app, it is important to understand the functions and quality of apps for this purpose. OBJECTIVE: The aim of our study was to assess the features and quality of apps to assist people to monitor their RA disease activity by (1) summarizing the available apps, particularly the instruments used for measurement of RA disease activity; (2) comparing the app features with American College of Rheumatology and European League against Rheumatism (ACR and EULAR) guidelines for monitoring of RA disease activity; and (3) rating app quality with the Mobile App Rating Scale (MARS)...
February 21, 2017: JMIR MHealth and UHealth
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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)]...
February 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28088339/evidence-based-management-of-systemic-sclerosis-navigating-recommendations-and-guidelines
#18
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
#19
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
#20
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
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