Glucocorticoid-Induced Osteoporosis Program (GIOP): a novel, comprehensive, and highly successful care program with improved outcomes at 1 year.

Introduction: Patients who take chronic glucocorticoids (GC) are at increased risk of osteoporosis and fracture. Only a minority of patients who take chronic GC receive optimal osteoporosis prevention, diagnosis, and/or treatment.

Methods: An organized program of care--GIOP (Glucocorticoid-Induced Osteoporosis Program)--was designed and implemented.

Real-world effectiveness of select biologic and DMARD monotherapy and combination therapy in the treatment of rheumatoid arthritis: results from the RADIUS observational registry.

Objective: To evaluate the effectiveness of select biologics, methotrexate (MTX), and other disease-modifying anti-rheumatic drugs (DMARDs) in the management of adult rheumatoid arthritis (RA) in routine clinical practice.

Research Design And Methods: RADIUS (Rheumatoid Arthritis DMARD Intervention and Utilization Study) comprises two prospective, 5-year, observational registries of over 10 000 patients. Over 4600 patients who initiated MTX or a biologic regimen (etanercept [ETN], infliximab [INF], ETN + MTX, and INF + MTX) and who had at least one on-regimen, follow-up evaluation, were included in this analysis.

"The rheumatologist can see you now": Successful implementation of an advanced access model in a rheumatology practice.

Objective: To provide rheumatologic care to patients in a timely and patient-centered manner.

Methods: We developed and implemented processes to measure and help eliminate backlog, created access time for same-day patients, and retooled the appointments process to be more efficient and patient focused. In addition, we developed a protocol to be used by our primary care colleagues to care for osteoarthritis of the knee in a standardized manner.

Using mobile DXA to improve access to osteoporosis care: unit design, program development, implementation, and outcomes.

Osteoporosis diagnosis and monitoring is best accomplished with dual X-ray absorptiometry (DXA), but technology availability can hinder access to care. We designed a mobile DXA program incorporating a Hologic Delphi-C trade mark bone densitometer housed in a specially configured 30-ft Winnebago trade mark. The mobile DXA program provided osteoporosis testing and education at the convenience of the patient's primary care site within our rural health care system.

Pyomyositis: clinical features and predisposing conditions.

Objective: To describe the manifestations of nontropical pyomyositis and associated comorbid conditions that may predispose to pyomyositis.

Methods: A retrospective review of 13 patients with pyomyositis seen at our center including one illustrative case report. Reports of tropical and nontropical pyomyositis were found by review of Index Medicus, Medline, and references from published cases and clinical review papers.

The arthritis of primary biliary cirrhosis: clinical features and associated immune processes.

We have performed a survey to determine the percentage of patients with primary biliary cirrhosis (PBC) and arthritis followed at Geisinger Clinic, a rural tertiary care center. We have assessed the clinical features of the arthritis, delineated any signs that suggest the diagnosis of asymptomatic PBC in patients with arthritis, and explored coexisting immune diseases.From January 1988 through November 1993, 36 patients with PBC were identified from a computer search of the Geisinger Gastroenterology Clinic database.

Sulfasalazine therapy in psoriatic arthritis: clinical and immunologic response.

Sulfasalazine therapy has been shown effective in rheumatoid arthritis and ankylosing spondylitis. We treated 10 patients with active polyarticular psoriatic arthritis with 2 g/day of sulfasalazine for 16 weeks. Significant improvement was seen in joint count score, morning stiffness, and patient/physician assessment of disease activity.

Pneumocystis carinii pneumonia complicating low dose methotrexate treatment for rheumatoid arthritis.

Low dose methotrexate has been used effectively for various rheumatic and non-rheumatic diseases. Three cases of Pneumocystis carinii pneumonia occurring during treatment of rheumatoid arthritis with low dose methotrexate are presented. Several mechanisms might contribute to impaired immunity and the rare development of opportunist lung infection with methotrexate.

Aortic arch arteritis in the elderly. An important manifestation of giant cell arteritis.

Five elderly patients with aortic arch syndrome secondary to large-vessel vasculitis all presented with upper-extremity claudication and absence of blood pressure and pulses in the affected extremity. Diagnosis was suspected by a markedly elevated erythrocyte sedimentation rate associated with constitutional symptoms and angiograms showing changes consistent with arteritis of the aortic arch vessels. Treatment with high-dose corticosteroids resulted in rapid resolution of constitutional symptoms and improved functional use of the upper extremity.

Sarcoid arthritis in a North American Caucasian population.

Thirty-two of 150 Caucasian patients (21%) with sarcoidosis studied had articular symptoms. Twenty-one had acute sarcoid arthritis with bilateral ankle arthritis/periarthritis. Joint symptoms resolved within 4 months and none developed chronic arthropathy or progressive systemic sarcoidosis.