News for Patients

Fat Cell Transplants Boost Hand Function in SSc

Author: Rita Baron-Faust
Date Published: August-2014
Source: Rheumatology Network

Transplanted into their fingers, their own fat cells produce improvements in hand disability, pain, swelling and Raynaud’s phenomenon in as little as two months among patients with scleroderma, according to preliminary results from a small clinical trial in France. In the open-label, single-arm trial, autologous adipose-derived stromal/stem cells (ADSC) were aspirated from the abdomen, purified, and injected into the fingers of 12 women with systemic sclerosis (SSc), with no serious adverse consequences.


Joint and tendon involvement predict disease progression in systemic sclerosis: a EUSTAR prospective study

Author: J. Avouac, U. Walker, E. Hachulla, G. Riemekasten, G. Cuomo, et al
Date Published: August-2014
Source: Annals of the Rheumatic Diseases

Objective To determine whether joint synovitis and tendon friction rubs (TFRs) can predict the progression of systemic sclerosis (SSc) over time. Patients and methods We performed a prospective cohort study that included 1301 patients with SSc from the EUSTAR database with disease duration ≤3 years at inclusion and with a follow-up of at least 2 years. Presence or absence at clinical examination of synovitis and TFRs was extracted at baseline. Outcomes were skin, cardiovascular, renal and lung progression. Overall disease progression was defined according to the occurrence of at least one organ progression.


Sclerosis: Autologous Cell Transfers May Help Patients

Author: Jennifer Garcia
Date Published: August-2014
Source: Medscape Medical News

Injections of autologous stromal vascular fraction (SVF) may improve hand function and decrease pain among patients with systemic sclerosis (SSc), according to a new study published online August 11 in the Annals of the Rheumatic Diseases. The phase 1, open-label study enrolled 12 female patients with SSc and a Cochin Hand Function Scale score higher than 20/90. Patients receiving vasodilator or immunosuppressive therapy in the 3 months before or 6 months after enrollment were excluded from the study. Patients were administered subcutaneous injections of autologous SVF into each finger of both hands and were evaluated over the course of a 6-month period.


4 keys to appealing a rejected insurance claim

Author: Tom Murhpy
Date Published: August-2014
Source: Associated Press

Keep calm and take notes. Stay true to this principle and you can improve your odds of successfully fighting a health insurer's claim rejection. Experts who help with the appeals process say patients have a 50 percent chance or better of prevailing. They say a winning argument may require heavy doses of research and persistence, but the end result is a decision that can stave off thousands of dollars in medical bills.


Pharmacologic Therapy for Pulmonary Arterial Hypertension in Adults: CHEST Guideline and Expert Panel Report

Author: D. Taichman, MD, PhD, FCCP; J. Ornelas, MS; L., MD; J. Klinger, MD, FCCP; et al
Date Published: August-2014
Source: Chest

OBJECTIVE: Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS: This guideline was based on systematic reviews of English language evidence published between 1990 and November 2013, identified using the MEDLINE and Cochrane Library databases. The strength of available evidence was graded using the Grades of Recommendations, Assessment, Development, and Evaluation methodology. Guideline recommendations, or consensus statements when available evidence was insufficient to support recommendations, were developed using a modified Delphi technique to achieve consensus.


Low Blood Pressure Increases Risk of Death in Patients with Systemic Sclerosis-Associated Pulmonary Arterial Hypertension

Author: Lara C. Pullen, PhD
Date Published: July-2014
Source: The Rheumatologist

Patients with pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc-APAH) have a higher mortality rate than non-SSc-APAH patients with idiopathic disease as well as those with other connective tissue diseases (CTD-APAH). In a recent study, researchers pinpoint specific predictors that put patients with SSc-APAH at higher risk of death.


Pulmonary Arterial Hypertension Treatment Guidelines: New Answers and Even More Questions

Author: Anna R. Hemnes, MD
Date Published: August-2014
Source: Chest

I vividly remember my first patient with pulmonary arterial hypertension (PAH) during my internship in 1999. We admitted a young woman with pulmonary hypertension, clearly miserable from right-sided heart failure. Although she had been followed in our pulmonary hypertension clinic, there was little to offer her until she clearly required the only medication that was known to be efficacious in patients with PAH at that time: IV epoprostenol.1 Within a few days of starting therapy, she was a new person: walking through the hall, heart failure resolved, and ready to go home to her family.


This is what worries researchers about using wearables in clinical trials

Author: Stephanie Baum
Date Published: July-2014
Source: MEDCITY News

As the technology behind wearables for healthcare evolves in its sophistication, there’s a lot of interest in applications for remote monitoring, including for clinical trials. Wearables offer the potential to reduce the cost of these trials and drug development. There’s plenty of skepticism about the execution, particularly when it comes to issues like ensuring the accuracy of the data. That hasn’t deterred healthcare companies from studying these devices.


15 Tips for Seeing a New Rheumatologist- Your First Visit

Author: Emily Bradley
Date Published: July-2014
Source: MEDCITY News

I have written before about finding a new rheumatologist, but what about your first visit to your new rheumatologist? Here are 15 tips for when you’re done doctor shopping and ready to try them on: Keep in mind that every doctor works differently and each person presents their disease differently.


Lungs, joints and immunity against citrullinated proteins in rheumatoid arthritis

Author: A. Catrina, A. Ytterberg, G. Reynisdottir, V. Malmström & L. Klareskog
Date Published: July-2014
Source: Nature Reviews Rheumatology

Rheumatoid arthritis (RA) is a prototype for a criterion-defined inflammatory disease, for which the aetiology and initial molecular pathogenesis has been elusive for a long time. We describe in this Review how studies on the interplay between specific immunity, alongside genetic and environmental predisposing factors, provide new tools to understand the molecular basis of distinct subsets of the disease. A particular emphasis is on the possibility that pathogenic immune reactions might be initiated at other sites than the joints, and that the lungs could harbour such sites.


When Chronic Illness Makes You World Weary: An honest, compassion account about life with lupus and other chronic illnesses

Author: Theresa Johnson
Date Published: July-2014
Source: Psychology Today

This may be the worst possible time for me to try and write about chronic illness. I'm feeling worse than usual. I'm tired and I am completely overwhelmed by everything "disability.” Where do I even begin is an understatement. First, let me be honest. This is not going to be one of my more typical positive pieces. At least not at the beginning. Knowing my nature, I'll find something good in all of this by the end, if you can make it that far. You may just want to bail out now.


Accenture report: Private insurance exchanges experiencing ‘hyper growth’

Author: Dan Verel
Date Published: July-2014
Source: MEDCITY News

While considerable attention has been heaped on the public health insurance exchanges over the year, private health insurance exchanges “are experiencing hyper-growth” and enrollment could exceed that of public exchanges by 2017, “if not sooner,” according to Accenture. In a recent report, Accenture said employers, consumers and carriers alike are expressing enthusiasm for private exchanges, which are undergoing “an earlier-than-expected growth spurt.” More than 3 million individuals could enroll in health plans through private exchanges just during the 2014 benefit year, Accenture estimates.


Stem cell transplant prolongs systemic sclerosis survival

Author: Nicholas J. Bernard
Date Published: July-2014
Source: Nature Reviews Rheumatology

12-year multicentre clinical trial data now reported in JAMA show haematopoietic stem cell transplantation (HSCT) has long-term survival benefits compared with pulsed cyclophosphamide for treating systemic sclerosis (SSc). “No therapy has previously been shown to improve long-term survival,” say corresponding authors of the study, Jaap van Laar and Dominique Farge-Bancel,…


Severity of Systemic Sclerosis-Associated Pulmonary Arterial Hypertension in African Americans

Author: Blanco, I. MD, PhD; Mathai, S. MD, MHS; Shafiq, M. MD; et al
Date Published: July-2014
Source: Medicine

African Americans (AA) with systemic sclerosis (SSc) have a worse prognosis compared to Americans of European descent (EA). We conducted the current study to test the hypothesis that AA patients with SSc have more severe disease and poorer outcomes compared to EA patients when afflicted with pulmonary arterial hypertension (PAH). We studied 160 consecutive SSc patients with PAH diagnosed by right heart catheterization, comparing demographics, hemodynamics, and outcomes between AA and EA patients.


Prevent Raynaud’s Pain, Numbness and Tingling

Author: Brenda Goodman
Date Published: July-2014
Source: Arthritis Foundation

If you’re among the estimated 20 to 30 percent of people with inflammatory arthritis who also have Raynaud’s syndrome, or Raynaud’s phenomenon, a condition that affects blood flow to the extremities and causes pain, numbness and tingling, the fall and spring – months when temperatures are constantly shifting – can be especially challenging. A sudden chill may cause blood vessels to spasm, shutting off circulation and turning affected parts a ghostly shade of white or blue. Fingers, toes, hands, feet, lips and the tongue are most commonly afflicted, and they may become painfully cold, tingling or numb.


Investigating the Causes of Chronic Itch: New Advances Could Bring Relief

Author: Kirstie Saltsman, Ph.D
Date Published: June-2014
Source: NIAMS

Chronic itch, which occurs in many medical conditions and in response to certain drugs, affects millions of Americans, yet its causes are poorly understood. Now, investigators funded in part by the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases have uncovered previously unknown pathways that trigger chronic itch, painting a clearer picture of the condition and suggesting novel therapeutic strategies. Itch was once thought to be sensed through the body’s pain pathways, but research over the past few decades has revealed that it uses its own dedicated nerves, molecules and receptors. While itch is ultimately conveyed through nerves to the brain, the most well-understood itch pathway initiates with immune molecules called histamines. Histamines normally serve a protective immune function by helping combat invading pathogens, but they also trigger the itchiness caused by a mosquito bite or a bout of hives by acting on sensory nerves in the skin.


Emerging role of epigenetics in systemic sclerosis pathogenesis

Author: M. Ciechomska, J. M. van Laar and S. O'Reilly
Date Published: June-2014
Source: Nature Genes & Immunity

Systemic sclerosis is a connective tissue disease of unknown aetiology characterised by autoimmunity, inflammation, vascular abnormalities and ultimately fibrosis. Although great advances have been made in determining the molecular mechanisms of disease pathogenesis over the last decade, aided by new genetic screens, no current specific disease-modifying treatment is yet available. Epigenetics is defined as heritable changes that are not due to changes in DNA sequence, and there is at present intense research effort to understand the basic mechanisms of epigenetic regulation and how these impact diseases.


Health Insurance Claim Denied? Appeal!

Author: Chris Kissell
Date Published: June-2014
Source: Fox Business

Few things are scarier than racking up medical bills and then learning that your health insurance company won't pay. It's a nightmare that could panic any policyholder. But before you worry about sinking into a black hole of medical debt, know that federal law offers a way to appeal. "When a claim is denied, consumers should not view that as the end of the story," says Katherine Vukadin, an assistant professor at Texas Southern University's Thurgood Marshall School of Law in Houston.


Sun Protection and Connective Tissue Disease

Author: Isabela Wieczorek, MD and Horatio F. Wildman, MD
Date Published: July-2014
Source: Hospital for Special Surgery

After a long winter, summer is finally here. As we spend more time outdoors, it is important to protect against the strong summer rays. Sunlight contains harmful ultraviolet rays that increase the risk of skin cancer, accelerate aging of the skin, and flare connective tissue disease. Sunlight that reaches the Earth’s surface contains two types of ultraviolet (UV) light, both A and B. UVB light is more damaging, causing sunburns and altering DNA in the body’s cells. Sunlight contains about 10-20 times more UVA light, which penetrates the skin more deeply. Both forms of UV radiation cause skin cancer and premature aging of the skin. Tanning beds also produce UVA and UVB radiation, often at much higher levels than the sun.


Should I Refer to a Rheumatologist? Early Warning Signs of Inflammatory Rheumatic Diseases

Author: ACR
Date Published: July-2014
Source: ACR Simple Tasks

Over 11 million Americans suffer from inflammatory rheumatic diseases, and that number jumps to over 50 million when you include osteoarthritis. With numbers this large, prioritizing referrals can become difficult. Signs of a rheumatic disease can be symptomatic of different disorders and can be difficult to identify. To help you prioritize your referrals, here are some red flags to watch out for: