Clean dish strategy for treatment of gout

Allopurinol may be discontinued after five years of treatment as long as certain conditions are met. These are: (1) allopurinol is given for at least 5 years after resolution of tophi OR for 5 years in those without tophi, (2) serum uric acid levels are maintained at less than 6mg/dL during allopurinol treatment and (3) serum uric acid levels are maintained at less than 7mg/dL after withdrawal of allopurinol.

 Fernando Perez-Ruiz, MD, PhD, from Hospital Universitario Cruces in Vizcaya, Spain, and colleagues tested the hypothesis that a less stringent target is necessary for long-term treatment of gout once urate crystal dissolution is achieved.
 

http://onlinelibrary.wiley.com/doi/10.1002/art.30649/abstract

Great advice for medical clerks

downloaded from md.utoronto.ca 2011Dec28

This student gives great advice on being a medical clerk. I wish I read this back when I was one.

https://abnormalfacies.wordpress.com/2011/11/28/clerkship-advice-internal-medicine/

Funny?

 Or NOT.

http://gruntdoc.com/2005/04/dilberts-doc-meets-a-drug-rep.html

Christmas with HHC

Try HHC services for your home care and geriatric care needs.

Have merry HHC Christmas!

rayuma-tologist

photo downloaded from healthmetz.com 2011Dec28

A rheumatologist is an internist who specializes in the treatment of patients with arthritis, gout, osteoporosis, fibromyalgia, SLE or other autoimmune diseases.

I have joint pain (or back pain) and I was referred by my doctor to the orthopedic surgeon, rehab doctor and a rheumatologist. What do I do?

Some would recommend you see the rheumatologist first. All three specialists see patients with arthritis or musculoskeletal problems but have different focus of treatment. The rheumatologist will refer you to the others if your case needs specialized treatments (physical therapy or surgery) .

My doctor thinks I have kidney disease due to lupus and told me to see a nephrologist and a rheumatologist. Do I need to see both?

You may need to, eventually. It is a good idea to see the rheumatologist first who can check if you have lupus in other parts of your body.

 I have been having pains that do not go away. Do I have gout or arthritis?

It is best to see the rheumatologist with your complaints. 

A geri-who?

downloaded from filipinolifeinpictures.wordpress.com 2011Dec28

A geriatrician is an internist or family physician who specializes in the care of the older person. 

Who needs a geriatrician? 

The older person does. Kids see a pediatrician. People with heart problems see a cardiologist. The older person should see a geriatrician.

But I (or my lolo or my lola) already see/s a cardiologist/diabetologist/etc?
Yes. The geriatrician can (and will) still help in the overall care of the older person.

What about if I (my lola/lola) am/is well?
The geriatrician can still help in two ways. First, in preventing disease or disability by suggesting personalized yet simple ways to do so. Second, by identifying "quiet" conditions that may lead to progressive disability or disease if not treated early.

First Post

Hello! I am an internist-geriatrician-rheumatologist. This is my first attempt at doing a health blog on common conditions in the older person or persons with arthritis, rheumatism and autoimmune disease.