Themed Issue On Comorbidities In Rheumatic Diseases

This book explores comorbidity in patients with rheumatic diseases and details both care and treatment options in standard clinical practice. Patients with rheumatic diseases are clinically complex, and the interplay of their disease activity with associated conditions may lead to increased morbidity and mortality. Recently there have been major advances in the management of rheumatic diseases, however, without addressing the potential comorbid conditions, including cardiovascular disease; pulmonary disease; and depression; outcomes remain poor. ​​​ With its 19 chapters, covering the management of major rheumatic diseases (e.g. rheumatoid arthritis, systemic lupus erythematosus , and osteoarthritis), potential comorbidities and treatment recommendations, as well as possible interactions between conditions; this book addresses the gap between textbook medicine and day to day patients' care. Authors also discuss the new hot issue of the comorbidity index, comparing the standard tools to the recently developed indices and how they can assist the rheumatologists in determining disease burden, prognosis, and comorbidity probability. This book is an ideal clinical guide and reference that enables rheumatologists, internal medicine physicians, and residents to address the full clinical expression of these rheumatic diseases with views towards prevention or early management of comorbid conditions.

This Open Access book presents practical approaches to managing patients affected by various rheumatological diseases, allowing readers to gain a better understanding of the various clinical expressions and problems experienced by these patients. Discussing rheumatology from an organ systems perspective, it highlights the importance ofdetailed musculoskeletal examinations when treating patients affected by rheumatological diseases. The book first explores the latest diagnostic approaches and offers key tips for accurate musculoskeletal examinations before addressing the various treatment modalities, with a particular focus on the most common joints involved in rheumatoid arthritis: the wrists and the metacarpophalangeal joints (2nd and 3rd). Featuring easy-to-understand flow diagrams and explaining the common medical problems associated with rheumatic disease, such as shortness of breath and anemia, it is not only a valuable resource to rheumatologists, but will also appeal to medical students, junior residents, and primary healthcare physicians.

The Social Security Administration (SSA) administers two programs that provide disability benefits: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. SSDI provides disability benefits to people (under the full retirement age) who are no longer able to work because of a disabling medical condition. SSI provides income assistance for disabled, blind, and aged people who have limited income and resources regardless of their prior participation in the labor force. Both programs share a common disability determination process administered by SSA and state agencies as well as a common definition of disability for adults: "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." Disabled workers might receive either SSDI benefits or SSI payments, or both, depending on their recent work history and current income and assets. Disabled workers might also receive benefits from other public programs such as workers' compensation, which insures against work-related illness or injuries occurring on the job, but those other programs have their own definitions and eligibility criteria. Selected Health Conditions and Likelihood of Improvement with Treatment identifies and defines the professionally accepted, standard measurements of outcomes improvement for medical conditions. This report also identifies specific, long-lasting medical conditions for adults in the categories of mental health disorders, cancers, and musculoskeletal disorders. Specifically, these conditions are disabling for a length of time, but typically don't result in permanently disabling limitations; are responsive to treatment; and after a specific length of time of treatment, improve to the point at which the conditions are no longer disabling.

Interstitial lung disease (ILD) is a broad category of lung diseases that includes more than 150 disorders characterized by scarring or fibrosis of the lungs. In Pulmonary Arterial Hypertension and Interstitial Lung Disease: A Clinical Guide, renowned experts provide a state-of-the-art overview of the problems seen by physicians in the clinical management of ILDs. Divided into two sections, the first part provides and update on general issues and introduces both interstitial lung disease and associated pulmonary hypertension. A detailed analysis of the pathology of the various interstitial lung diseases is also provided. The second part addresses specific categories of disease. Bronchiolitis, hypersensitivity pneumonitis, and other conditions are covered, and the use of inspiratory and expiratory high resolution CT scan is discussed as well. This important new text is an invaluable resource for the practicing physician who must be aware of the broad and troubling manifestations of interstitial lung disease.

Market forces are driving a radical restructuring of health care delivery in the United States. At the same time, more and more people are living comparatively long lives with a variety of severe chronic health conditions. Many such people are concerned about the trend toward the creation of managed care systems because their need for frequent, often complex, medical services conflicts with managed care's desires to contain costs. The fear is that people with serious chronic disorders will be excluded from or underserved by the integrated health care delivery networks now emerging. Responding to a request from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, this book reflects the results of a workshop that focused on the following questions: Does the model of managed care or an integrated delivery system influence the types of interventions provided to patients with chronic conditions and the clinical and health status outcomes resulting from those interventions? If so, are these effects quantitatively and clinically significant, as compared to the effects that other variables (e.g., income, education, ethnicity) have on patient outcomes? If the type of health care delivery system appears to be related to patient care and outcomes, can specific organizational, financial, or other variables be identified that account for the relationships? If not, what type of research should be pursued to provide the information needed about the relationship between types of health care systems and the processes and outcomes of care provided to people with serious chronic conditions?

A comprehensive textbook for health-care professionsl and students covering the rheumatic diseases, including arthritis, lupus, osteoporosis, fibromyalgia and more.

This issue of Rheumatic Disease Clinics, guest edited by Drs. James Katz and Brian Walitt with the NIH, will cover several key aspects of diagnosing and treating Rheumatic Diseases in Older Adults. The Consulting Editor for the series is Dr. Michael Weisman. The topics discussed in the issue will include: Pharmacotherapy Pearls for the Geriatrician, Pathogenesis and Management of Sarcopenia, A Review of Osteoporosis in the Older Adult, Regional Rheumatic Disorders and Rehabilitation in Older Adults, Rheumatologic Manifestations of Malignancy, Sjögren Syndrome and Other Causes of Sicca in Older Adults, Cardiovascular Disease Risk in Patients with Rheumatic Diseases, Update on Crystal-Induced Arthritides, Immune dysregulation in aging with a focus on B cells and their potential clinical consequence, and Spinal Stenosis, among others.

The first book dedicated explicitly to the care of elderly patients with rheumatic diseases, this comprehensive resource is a practical guide for navigating the medical concerns of these complex patients. While patients over 65 years of age comprise roughly 15% of the population, they consume about 50% of rheumatology resources. This book presents current clinical practices with an eye toward achieving economically sustainable models of care. The world’s leading authorities have come together to cover the full spectrum of rheumatic diseases, the immune system in aging, and ultrasound evaluation and arthrocentesis. The book also addresses the milieu of co-morbidities that the clinician may encounter with an older patient, as well as the accompanying concerns about multiple pharmacologic therapies and drug interactions. Bringing in experts from a wide array of subspecialties, the editors present the essentials of multidisciplinary care, an approach which is the hallmark of geriatrics and which naturally translates into the field of gerontorheumatology. Designed for primary care physicians and rheumatology consultants, Geriatric Rheumatology is an invaluable guide to caring for this rapidly growing patient population.

A strong clinical emphasis is present throughout this volume from the first section of commonly presenting problems through to the section addressing problems shared with a range of other clinical sub-specialties.