Evidence-based management for polymyalgia rheumatica for rheumatology practitioners, nurses and physiotherapists.

Evidence-based practice is an increasingly popular term, used in a variety of clinical settings and situations. Practitioners are encouraged to use best evidence as part of clinical decision-making when caring for individual patients. This evidence, combined with practitioner expertise and knowledge, aims to inform practice, ensuring that accurate, effective and safe treatment options are utilized.

Bcl-x(L) expression in vivo in rheumatoid synovium.

To examine the expression of the apoptosis regulatory protein, Bcl-x(L), in the synovium of patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Immunohistochemistry for Bcl-x(L) was carried out on synovial samples from patients with RA and OA. Reverse transcriptase polymerase chain reaction (RT-PCR) and Western blot analysis were performed to qualitatively examine the expression of Bcl-x(L).

Myocarditis as a prognostic indicator in systemic lupus erythematosus.

Lupus myocarditis is a life threatening complication of systemic lupus erythematosus (SLE). A case of left ventricular failure secondary to myocarditis occurring in a patient with SLE is reported. Despite resolution of the cardiac failure with pulsed cyclophosphamide and steroids, she eventually died of non-cardiac complications 18 months later.

Gastric antral vascular ectasia--a cause of refractory anaemia in systemic sclerosis.

Recurrent gastrointestinal haemorrhage is an uncommon manifestation of systemic sclerosis. We report a case of gastrointestinal bleeding due to gastric antral vascular ectasia (GAVE) in a patient with systemic sclerosis. Failure to recognise the condition as a cause of gastrointestinal bleeding may delay the instigation of appropriate treatment.

The challenges of implementing quality improvement in small rural hospitals.

In the five years since launching its QI initiative, Mason General Hospital has dealt with many of the challenges that commonly arise in healthcare organizations during TQM implementation, including involving physicians and training staff. It also had to address a host of issues common to small rural organizations. At first glance, one might suspect that the move toward QI would be easier in a small organization because there are fewer leaders to orient, fewer people involved in work processes, and fewer levels of management.