Rheumatology Medicine Research Articles

What is in the Myopathy Literature?

This update begins with muscle manifestations of coronavirus 2019. They may include myalgias and elevations in serum creatine kinase. It is unknown whether there is direct muscle invasion and how often the critically ill have muscle sequelae. Regarding autoimmune myopathies, a retrospective study of statin-induced necrotizing myopathy is covered. A relatively large proportion of patients had normal strength at presentation. Examples of dermatomyositis associated with immune checkpoint inhibitors are provided including one with cytokine storm. A report of juvenile dermatomyositis with severe abdominal complications is noteworthy. Two articles address unusual associations with inclusion body myositis, namely, spinocerebellar ataxias and granuloma myositis. In the category of muscular dystrophies, a relatively large single center study of the outcome of scapulothoracic arthrodesis for facioscapulohumeral muscular dystrophy is discussed and a article on anoctaminopathies with pauci- or asymptomatic hyperCKemia.

Addressing Home Healthcare Staffing Challenges Through Geo-Intelligent Scheduling.

Industries that face challenges in staffing and scheduling have successfully addressed these issues through the implementation of intraday staffing automation. Home healthcare, however, introduces an additional dimension: location-specifically, efficiently scheduling the appropriate healthcare worker based on their projected location at a given time with the location of a patient who needs care. Geo-Intelligent Scheduling has the potential to effectively address the unique staffing/scheduling challenges in home healthcare: the ability to get the right clinician to the right patient at the right location at the right time by taking into account the real-time location of the patient and clinician throughout the day. Geo-Intelligent Scheduling also has the potential to automatically create route-optimized intraday schedules for clinicians and increase effective staffing capacity by over 16% with no additional labor cost. Finally, Geo-Intelligent Scheduling can potentially improve appointment-time adherence, automate Electronic Visit Verification compliance, enhance patient/clinician communication, and improve employee retention through self-scheduling empowerment.

Art and Pediatric Orthopaedics: The Master of Alkmaar and an Act of Mercy.

The painting, "The First Act of Mercy" shows a subject with complex lower limb anomalies. The probable diagnosis is discussed.

Advanced Practice Provider-Led Strategies to Improve Patient Discharge Timeliness.

Hospitals are under increased pressure to address both financial and capacity constraints to improve their clinical operations. Effective capacity management programs have become a key driver of clinical operations for managing the flow of patients into and out of the hospital. Many high-functioning medical centers have developed capacity management programs to strategically address patient throughput. Discharging patients from the hospital is one fundamental, but complex, patient flow initiative for efficient patient throughput. Despite advances in optimizing patient flow, there is a lack of understanding associated with the structure and processes to efficiently discharge patients. This article outlines a discharge timeliness project where advanced practice providers are principal leaders of designing a safe and efficient patient discharge prototype. Design thinking was used to develop a patient discharge prototype that included 6 key areas that led to improved discharge times on a cardiac surgery step-down unit. High tech solutions were incorporated into the electronic medical record system to enhance communication across phases of care and inform the interdisciplinary team of patient progress.

Abridged Abstracts From the Medical Literature.

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Academic Medicine Acute Care Nursing Addiction Medicine Administration Advanced Practice Nursing Allergy & Immunology Allied Health Alternative & Complementary Medicine Anesthesiology Anesthesiology Nursing Audiology & Ear and Hearing Basic Science Cardiology Cardiothoracic Surgery Cardiovascular Nursing Cardiovascular Surgery Child Neurology Child Psychiatry Chiropractics Clinical Sciences Colorectal Surgery Community Health Critical Care Critical Care Nursing Dentistry Dermatology Emergency Medicine Emergency Nursing Endocrinology Endoncrinology Forensic Medicine Gastroenterology General Surgery Genetics Geriatrics Gynecologic Oncology Hand Surgery Head & Neck Surgery Hematology/Oncology Hospice & Palliative Care Hospital Medicine Infectious Disease Infusion Nursing Internal/General Medicine Internal/General Medicine Residency Library Sciences Maternal Child Nursing Medical Oncology Medical Research Neonatal/Perinatal Neonatal/Perinatal Nursing Nephrology Neurology Neurosurgery Nursing-administrative Nursing-all Specialties Nursing-education Nutrition & Dietetics Obstetrics & Gynecology Obstetrics & Gynecology Nursing Occupational & Environmental Medicine Oncology Nursing Oncology Surgery Ophthalmology/Optometry Oral & Maxillofacial Surgery Orthopedic Nursing Orthopedics/Spine/Sports Medicine Surgery Otolaryngology Pain Medicine Pathology Pediatric Surgery Pediatrics Pharmacology Pharmacy Physical Medicine & Rehabilitation Physical Therapy & Womens Health Physical Therapy Plastic Surgery Podiatary-general Podiatry-general Primary Care/Family Medicine/General Practice Psychiatric Nursing Psychiatry Psychology Public Health Pulmonology Radiation Oncology/Therapy Radiology Rheumatology Skills & Procedures Sleep Medicine Sport & Exercise/Training/Fitness Sports Medicine Surgical Nursing Transitional Care Transplant Surgery Trauma Nursing Trauma Surgery Urology Womens Health Wound Care Other What's your speciality? Addiction Medicine Allergy & Clinical Immunology Anesthesiology Audiology & Speech-Language Pathology Cardiology Cardiothoracic Surgery Critical Care Medicine Dentistry, Oral Surgery & Medicine Dermatology Dermatologic Surgery Emergency Medicine Endocrinology & Metabolism Family or General Practice Gastroenterology & Hepatology Genetic Medicine Geriatrics & Gerontology Hematology Hospitalist Immunology Infectious Diseases Internal Medicine Legal/Forensic Medicine Nephrology Neurology Neurosurgery Nursing Nutrition & Dietetics Obstetrics & Gynecology Oncology Ophthalmology Orthopedics Otorhinolaryngology Pain Management Pathology Pediatrics Plastic/ Reconstructive Sugery Pharmacology & Pharmacy Physiology Psychiatry Psychology Public, Environmental & Occupational Health Radiology, Nuclear Medicine & Medical Imaging Physical Medicine and Rehabilitation Respiratory/Pulmonary Medicine Rheumatology Sport Medicine/Science Surgery (General) Trauma Surgery Toxicology Transplantation Surgery Urology Vascular Surgery Virology I don't have a medical specialty What's your work setting? 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Human leukocyte antigen-genotyping according to sex in extrapulmonary tuberculosis patients in Iraq

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Academic Medicine Acute Care Nursing Addiction Medicine Administration Advanced Practice Nursing Allergy & Immunology Allied Health Alternative & Complementary Medicine Anesthesiology Anesthesiology Nursing Audiology & Ear and Hearing Basic Science Cardiology Cardiothoracic Surgery Cardiovascular Nursing Cardiovascular Surgery Child Neurology Child Psychiatry Chiropractics Clinical Sciences Colorectal Surgery Community Health Critical Care Critical Care Nursing Dentistry Dermatology Emergency Medicine Emergency Nursing Endocrinology Endoncrinology Forensic Medicine Gastroenterology General Surgery Genetics Geriatrics Gynecologic Oncology Hand Surgery Head & Neck Surgery Hematology/Oncology Hospice & Palliative Care Hospital Medicine Infectious Disease Infusion Nursing Internal/General Medicine Internal/General Medicine Residency Library Sciences Maternal Child Nursing Medical Oncology Medical Research Neonatal/Perinatal Neonatal/Perinatal Nursing Nephrology Neurology Neurosurgery Nursing-administrative Nursing-all Specialties Nursing-education Nutrition & Dietetics Obstetrics & Gynecology Obstetrics & Gynecology Nursing Occupational & Environmental Medicine Oncology Nursing Oncology Surgery Ophthalmology/Optometry Oral & Maxillofacial Surgery Orthopedic Nursing Orthopedics/Spine/Sports Medicine Surgery Otolaryngology Pain Medicine Pathology Pediatric Surgery Pediatrics Pharmacology Pharmacy Physical Medicine & Rehabilitation Physical Therapy & Womens Health Physical Therapy Plastic Surgery Podiatary-general Podiatry-general Primary Care/Family Medicine/General Practice Psychiatric Nursing Psychiatry Psychology Public Health Pulmonology Radiation Oncology/Therapy Radiology Rheumatology Skills & Procedures Sleep Medicine Sport & Exercise/Training/Fitness Sports Medicine Surgical Nursing Transitional Care Transplant Surgery Trauma Nursing Trauma Surgery Urology Womens Health Wound Care Other What's your speciality? Addiction Medicine Allergy & Clinical Immunology Anesthesiology Audiology & Speech-Language Pathology Cardiology Cardiothoracic Surgery Critical Care Medicine Dentistry, Oral Surgery & Medicine Dermatology Dermatologic Surgery Emergency Medicine Endocrinology & Metabolism Family or General Practice Gastroenterology & Hepatology Genetic Medicine Geriatrics & Gerontology Hematology Hospitalist Immunology Infectious Diseases Internal Medicine Legal/Forensic Medicine Nephrology Neurology Neurosurgery Nursing Nutrition & Dietetics Obstetrics & Gynecology Oncology Ophthalmology Orthopedics Otorhinolaryngology Pain Management Pathology Pediatrics Plastic/ Reconstructive Sugery Pharmacology & Pharmacy Physiology Psychiatry Psychology Public, Environmental & Occupational Health Radiology, Nuclear Medicine & Medical Imaging Physical Medicine and Rehabilitation Respiratory/Pulmonary Medicine Rheumatology Sport Medicine/Science Surgery (General) Trauma Surgery Toxicology Transplantation Surgery Urology Vascular Surgery Virology I don't have a medical specialty What's your work setting? 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Abridged Abstracts From the Medical Literature.

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Academic Medicine Acute Care Nursing Addiction Medicine Administration Advanced Practice Nursing Allergy & Immunology Allied Health Alternative & Complementary Medicine Anesthesiology Anesthesiology Nursing Audiology & Ear and Hearing Basic Science Cardiology Cardiothoracic Surgery Cardiovascular Nursing Cardiovascular Surgery Child Neurology Child Psychiatry Chiropractics Clinical Sciences Colorectal Surgery Community Health Critical Care Critical Care Nursing Dentistry Dermatology Emergency Medicine Emergency Nursing Endocrinology Endoncrinology Forensic Medicine Gastroenterology General Surgery Genetics Geriatrics Gynecologic Oncology Hand Surgery Head & Neck Surgery Hematology/Oncology Hospice & Palliative Care Hospital Medicine Infectious Disease Infusion Nursing Internal/General Medicine Internal/General Medicine Residency Library Sciences Maternal Child Nursing Medical Oncology Medical Research Neonatal/Perinatal Neonatal/Perinatal Nursing Nephrology Neurology Neurosurgery Nursing-administrative Nursing-all Specialties Nursing-education Nutrition & Dietetics Obstetrics & Gynecology Obstetrics & Gynecology Nursing Occupational & Environmental Medicine Oncology Nursing Oncology Surgery Ophthalmology/Optometry Oral & Maxillofacial Surgery Orthopedic Nursing Orthopedics/Spine/Sports Medicine Surgery Otolaryngology Pain Medicine Pathology Pediatric Surgery Pediatrics Pharmacology Pharmacy Physical Medicine & Rehabilitation Physical Therapy & Womens Health Physical Therapy Plastic Surgery Podiatary-general Podiatry-general Primary Care/Family Medicine/General Practice Psychiatric Nursing Psychiatry Psychology Public Health Pulmonology Radiation Oncology/Therapy Radiology Rheumatology Skills & Procedures Sleep Medicine Sport & Exercise/Training/Fitness Sports Medicine Surgical Nursing Transitional Care Transplant Surgery Trauma Nursing Trauma Surgery Urology Womens Health Wound Care Other What's your speciality? Addiction Medicine Allergy & Clinical Immunology Anesthesiology Audiology & Speech-Language Pathology Cardiology Cardiothoracic Surgery Critical Care Medicine Dentistry, Oral Surgery & Medicine Dermatology Dermatologic Surgery Emergency Medicine Endocrinology & Metabolism Family or General Practice Gastroenterology & Hepatology Genetic Medicine Geriatrics & Gerontology Hematology Hospitalist Immunology Infectious Diseases Internal Medicine Legal/Forensic Medicine Nephrology Neurology Neurosurgery Nursing Nutrition & Dietetics Obstetrics & Gynecology Oncology Ophthalmology Orthopedics Otorhinolaryngology Pain Management Pathology Pediatrics Plastic/ Reconstructive Sugery Pharmacology & Pharmacy Physiology Psychiatry Psychology Public, Environmental & Occupational Health Radiology, Nuclear Medicine & Medical Imaging Physical Medicine and Rehabilitation Respiratory/Pulmonary Medicine Rheumatology Sport Medicine/Science Surgery (General) Trauma Surgery Toxicology Transplantation Surgery Urology Vascular Surgery Virology I don't have a medical specialty What's your work setting? Hospital Under 250 Beds Hospital Over 250 Beds Eldercare or Hospice Facility Psychiatric or Rehabilitative Facility Private Practice Group Practice Corporation (Pharmaceutical, Biotechnology, Engineering, etc.) Doctoral University or Medical School Masters or 4-Year Academic University Community College Government Other I have read & acknowledge the End User License Agreement. I have read & accept the terms of the Privacy Policy. Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. 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Antibiotics May Not Be Necessary for Some Patients with Diverticulitis.

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Academic Medicine Acute Care Nursing Addiction Medicine Administration Advanced Practice Nursing Allergy & Immunology Allied Health Alternative & Complementary Medicine Anesthesiology Anesthesiology Nursing Audiology & Ear and Hearing Basic Science Cardiology Cardiothoracic Surgery Cardiovascular Nursing Cardiovascular Surgery Child Neurology Child Psychiatry Chiropractics Clinical Sciences Colorectal Surgery Community Health Critical Care Critical Care Nursing Dentistry Dermatology Emergency Medicine Emergency Nursing Endocrinology Endoncrinology Forensic Medicine Gastroenterology General Surgery Genetics Geriatrics Gynecologic Oncology Hand Surgery Head & Neck Surgery Hematology/Oncology Hospice & Palliative Care Hospital Medicine Infectious Disease Infusion Nursing Internal/General Medicine Internal/General Medicine Residency Library Sciences Maternal Child Nursing Medical Oncology Medical Research Neonatal/Perinatal Neonatal/Perinatal Nursing Nephrology Neurology Neurosurgery Nursing-administrative Nursing-all Specialties Nursing-education Nutrition & Dietetics Obstetrics & Gynecology Obstetrics & Gynecology Nursing Occupational & Environmental Medicine Oncology Nursing Oncology Surgery Ophthalmology/Optometry Oral & Maxillofacial Surgery Orthopedic Nursing Orthopedics/Spine/Sports Medicine Surgery Otolaryngology Pain Medicine Pathology Pediatric Surgery Pediatrics Pharmacology Pharmacy Physical Medicine & Rehabilitation Physical Therapy & Womens Health Physical Therapy Plastic Surgery Podiatary-general Podiatry-general Primary Care/Family Medicine/General Practice Psychiatric Nursing Psychiatry Psychology Public Health Pulmonology Radiation Oncology/Therapy Radiology Rheumatology Skills & Procedures Sleep Medicine Sport & Exercise/Training/Fitness Sports Medicine Surgical Nursing Transitional Care Transplant Surgery Trauma Nursing Trauma Surgery Urology Womens Health Wound Care Other What's your speciality? Addiction Medicine Allergy & Clinical Immunology Anesthesiology Audiology & Speech-Language Pathology Cardiology Cardiothoracic Surgery Critical Care Medicine Dentistry, Oral Surgery & Medicine Dermatology Dermatologic Surgery Emergency Medicine Endocrinology & Metabolism Family or General Practice Gastroenterology & Hepatology Genetic Medicine Geriatrics & Gerontology Hematology Hospitalist Immunology Infectious Diseases Internal Medicine Legal/Forensic Medicine Nephrology Neurology Neurosurgery Nursing Nutrition & Dietetics Obstetrics & Gynecology Oncology Ophthalmology Orthopedics Otorhinolaryngology Pain Management Pathology Pediatrics Plastic/ Reconstructive Sugery Pharmacology & Pharmacy Physiology Psychiatry Psychology Public, Environmental & Occupational Health Radiology, Nuclear Medicine & Medical Imaging Physical Medicine and Rehabilitation Respiratory/Pulmonary Medicine Rheumatology Sport Medicine/Science Surgery (General) Trauma Surgery Toxicology Transplantation Surgery Urology Vascular Surgery Virology I don't have a medical specialty What's your work setting? 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Rehabilitation Medicine in Rheumatology

薬物治療の進歩とともに関節リウマチ（RA）を含むリウマチ性疾患のリハビリテーション診療はよくも悪くも大きく変化した．挙児希望（WoCBA）RA患者への対応や高齢RA・高齢発症RA患者の併存疾患，重複障害の問題，生活期の療養場面でのRA治療，介護場面での需給ミスマッチなど解決すべきことは山ほどある．そのような状況下でも治療効果を最大化するためには，患者自らの主体的なかかわり（アドヒアランス）を高めることが大切であり，SARAHが大きなヒントになる．そして，主体的なかかわりが困難な状況に陥ったとしても，RA患者を「生活しにくさをもつ人」として捉え，必要な医療や援助が適切に受けられる地域包括RAケアシステムの構築を期待したい．

Surprise Medical Bills: Are We Any Nearer to a Federal Fix?

The pandemic is shaking up health care delivery and markets. And it's an election year.

American Surgical Association Statement of Solidarity on Condemning and Eliminating Racism

The American Surgical Association Council prepared the submitted statement in response to the George Floyd killing and our responsibility as leaders in academic surgery to condemn and eliminate racism.

DECIDE: A Decision-Making Model for More Effective Decision Making by Health Care Managers.

The purpose of this article is to describe a step-by-step process for decision making, and a model is developed to aid health care managers in making more quality decisions, which ultimately determines the success of organizations. The DECIDE model is the acronym of 6 particular activities needed in the decision-making process: (1) D = define the problem, (2) E = establish the criteria, (3) C = consider all the alternatives, (4) I = identify the best alternative, (5) D = develop and implement a plan of action, and (6) E = evaluate and monitor the solution and feedback when necessary. The DECIDE model is intended as a resource for health care managers when applying the crucial components of decision making, and it enables managers to improve their decision-making skills, which leads to more effective decisions.

Standing up to stigma in epilepsy.

This article explores the nature of stigma and discusses how stigma negatively affects both adults and children with epilepsy.

Acceptance Was the Key

A psychiatric nurse confronts the stigma of his own depression.

Ultrasound-Guided Interventions During the COVID-19 Pandemic—A New Challenge

Ultrasound-Guided Interventions During the COVID-19 Pandemic—A New Challenge

Autologous Facial Fat Transfer: Soft Tissue Augmentation and Regnenerative Therapy.

Soft-tissue contour deficiencies depend on various origins including esthetics, congenital and post trauma asymmetries, post tumor defects, and chronic wound sequelae. Reconstructions or repairs are still a challenge today. Fat grafting is an old reconstructive technique dating back to 1893, but it has only recently become popular, especially among plastic surgeons. Being generally disregarded by medical practitioners for many years, adipose tissue has come into the spotlight because it is omnipresent and easily obtainable in substantial quantities with little patient discomfort and no relevant donor-site morbidity. Particularly, adipose tissue contains more multipotent cells per cc than bone marrow does. For example, 1 g of adipose tissue yields ∼5 × 10 stem cells, that is, 100-fold higher than the number of mesenchymal stem cells in 1 g of bone marrow. In reconstructive surgery, both adipose tissue aspiration and fat transfer have become typical surgical procedures. It is quite easy to harvest an abundant volume of tissue, obtaining a large amount of isolated stem and therapeutically active cells without needing cell expansion in tissue culture facilities. This procedure will likely mark the beginning of a new era in both regenerative medicine and facial-craniofacial reconstructions.

Adjuvant chemotherapy in rectal cancer: state of the art and future perspectives.

The value of adjuvant chemotherapy in rectal cancer is controversial with opinions varying from 'not be used' since randomized trials have not shown significant gains to 'be used as in colon cancer' as the need is the same and colon and rectal cancers are quite similar. This review will look upon data critically and with open eyes. With the exception of one randomized phase II trial (ADORE) revealing a significant gain in disease-free survival using one more effective regimen (mFOLFOX) than bolus 5-fluorouracil leucovorin, no new data have been presented. However, bringing up aspects in previous trials, either considered irrelevant for the present situation or overall negative, of what adjuvant treatment can achieve, a small reduction (hazard ratio about 0.8) in the risk of recurrence is present. This reduction is not fundamentally different from that in colon cancer considering that adjuvant treatment for rectal cancer cannot be initiated as rapidly as it can after a colon cancer diagnosis. Adjuvant chemotherapy after rectal cancer surgery reduces recurrence risks but the benefit is limited and for most patients not clinically relevant. Neoadjuvant therapy can be more effective but results from randomized trials are not yet available.

Anais Cerci Forceps: A Novel Instrument for Shaping the Nasal Dome Before Transdomal Suture Placement.

One of the most important components of an attractive nasal tip is the cephalocaudally conical form of the dome at the sagittal plane. With respect to this fact, the author tried to design a new forceps which holds the dome in a convex shape on a transverse plane and cephalocaudally conical in shape on the sagittal plane. Before grasping the dome in the desired position with Anais Cerci forceps, some degree of lateral steal is suggested and can be performed to increase the tip rotation and projection. With the help of its specific shape and template forming function, this novel instrument may also help to prevent the excess strain of transdomal suture which is crucially important to prevent the formation of pinching. This newly designed forceps can also help to provide the opportunity of the required acute angle between two domes. Slight oblique grasping of the dome reciprocally provides nice acute angle between 2 domes. Additionally, this forceps may also help to provide formation of symmetrically and reciprocally designed dome curvatures. In several secondary rhinoplasty cases with highly destroyed lower lateral cartilages, septal, auricular or costal cartilages are used for alar reconstruction. Mimicking the lower lateral cartilage anatomy from a straight cartilage graft piece is not an easy way of restoration. In such cases, Anais Cerci forceps may facilitate reshaping of the dome from an amorphous cartilage graft.

Do micronutrient deficiencies contribute to mitochondrial failure in critical illness?

Mitochondrial dysfunction seems to be the common denominator of several critical care conditions and particularly of sepsis. Faced with relative failure, and limited progress of sepsis therapies aiming at blocking some oxidative and/or inflammatory pathways, the question of antioxidants micronutrient therapy, particularly of selenium, ascorbic acid and thiamine remains open. The rationale for the essentiality of numerous micronutrients within the mitochondria is well established. Many studies have tested single micronutrients in animal and in-vitro models and provide positive evidences in favor of reduction of organ failure (cardiac and renal mainly). In clinical settings, high-dose selenium administration in sepsis has been disappointing. The most recent high dose, short-term ascorbic acid trial in sepsis is promising though, with an associated reduction of mortality, but analysis of the impact of this intervention on the various organs remains to be conducted. Results from animal and human studies indicate that there are indeed intervention options at the level of the mitochondria, but neither the optimal dose nor the optimal combination of micronutrients is yet identified.

High prolidase levels in patients with Familial Mediterranean Fever (FMF).

Familial Mediterranean Fever (FMF) is an autoinflammatory disease. Prolidase is a specific imidodipeptidase that plays a role in collagen degradation, and an important role in inflammation and wound healing. Hypoxia-inducible factor-1α (HIF-1) is an important protein in the regulation of immunological response, hemostasis, vascularization. The aim of the study was to compare serum prolidase and HIF-1α levels in patients with FMF in attack-free period and healthy control group. Between August 2017 and December 2017, sixty patients diagnosed with FMF according to the criteria of the Tel-hashomer and admitted to Sivas Cumhuriyet University Medical Faculty, Internal Medicine Rheumatology Department and sixty healthy volunteers were enrolled in the study. Median serum prolidase levels were 72.1 (25.1-114.9) ng/ml in FMF group and 30.7 (21.3-86.2) ng/mL in healthy control (HC) group (p = 0.018). ROC analysis showed that the sensitivity was 65% and the specificity was 68.3% at serum prolidase levels 54.03 ng/mL (p < 0.05). The median serum levels of HIF-1α in the FMF group was 482.0 (292.0-3967.0) pg/mL and 632.0 (362.0-927.0) pg/mL in the HC group (p > 0.05). There was no significant correlation between laboratory findings, sex, age, and prolidase (p > 0.05). Serum prolidase enzyme levels in FMF patients with attack-free period were significantly higher than in the HC group. However, the role of prolidase and HIF1-α in the FMF disease needs to be clarified with more extensive and comprehensive studies.