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  • 1
    Online Resource
    Online Resource
    Gout
    CMA Impact Inc. ; 2021
    In:  Canadian Medical Association Journal Vol. 193, No. 5 ( 2021-02-01), p. E171-E171
    Details
    In: Canadian Medical Association Journal, CMA Impact Inc., Vol. 193, No. 5 ( 2021-02-01), p. E171-E171
    Type of Medium: Online Resource
    ISSN: 0820-3946 , 1488-2329
    URL: Article
    DOI: 10.1503/cmaj.201392
    Language: English
    Publisher: CMA Impact Inc.
    Publication Date: 2021
    detail.hit.zdb_id: 2028772-0
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  • 2
    Online Resource
    Online Resource
    La goutte
    CMA Impact Inc. ; 2021
    In:  Canadian Medical Association Journal Vol. 193, No. 15 ( 2021-04-12), p. E536-E537
    Details
    In: Canadian Medical Association Journal, CMA Impact Inc., Vol. 193, No. 15 ( 2021-04-12), p. E536-E537
    Type of Medium: Online Resource
    ISSN: 0820-3946 , 1488-2329
    URL: Article
    DOI: 10.1503/cmaj.201392-f
    Language: English
    Publisher: CMA Impact Inc.
    Publication Date: 2021
    detail.hit.zdb_id: 2028772-0
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  • 3
    Online Resource
    Online Resource
    Transient Osteoporosis of the Hip in a Middle-Aged Male Construction Worker
    The Journal of Rheumatology ; 2017
    In:  The Journal of Rheumatology Vol. 44, No. 2 ( 2017-02), p. 258-258
    Details
    In: The Journal of Rheumatology, The Journal of Rheumatology, Vol. 44, No. 2 ( 2017-02), p. 258-258
    Type of Medium: Online Resource
    ISSN: 0315-162X , 1499-2752
    URL: Article
    DOI: 10.3899/jrheum.160934
    RVK:
    XA 10000
    Language: English
    Publisher: The Journal of Rheumatology
    Publication Date: 2017
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  • 4
    Online Resource
    Online Resource
    Rat Bite Erosion of the Knee
    The Journal of Rheumatology ; 2023
    In:  The Journal of Rheumatology Vol. 50, No. 8 ( 2023-08), p. 1087-1087
    Details
    In: The Journal of Rheumatology, The Journal of Rheumatology, Vol. 50, No. 8 ( 2023-08), p. 1087-1087
    Type of Medium: Online Resource
    ISSN: 0315-162X , 1499-2752
    URL: Article
    DOI: 10.3899/jrheum.221171
    RVK:
    XA 10000
    Language: English
    Publisher: The Journal of Rheumatology
    Publication Date: 2023
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  • 5
    Online Resource
    Online Resource
    Musculoskeletal Surgery in Psoriatic Arthritis: Prevalence and Risk Factors
    The Journal of Rheumatology ; 2023
    In:  The Journal of Rheumatology Vol. 50, No. 4 ( 2023-04), p. 497-503
    Details
    In: The Journal of Rheumatology, The Journal of Rheumatology, Vol. 50, No. 4 ( 2023-04), p. 497-503
    Abstract: Despite medical therapy, damage occurs in patients with psoriatic arthritis (PsA) requiring musculoskeletal (MSK) surgery. We aimed to describe MSK surgery in patients with PsA and identify risk factors for undergoing first MSK surgery attributable to PsA. Methods A single-center cohort identified patients with PsA fulfilling Classification Criteria for Psoriatic Arthritis who had MSK surgery between January 1978 and December 2019 inclusive. Charts were reviewed to confirm surgeries were MSK-related and attributable to PsA. Descriptive statistics determined MSK surgery prevalence and types. Cox proportional hazards models evaluated clinical variables for undergoing first MSK surgery using time-dependent covariates. Using a dataset with 1-to-1 matching on markers of PsA disease severity, a Cox proportional hazards model evaluated the effect of targeted therapies, namely biologics on time to first MSK surgery. Results Of 1574 patients, 185 patients had 379 MSK surgeries related to PsA. The total number of damaged joints (hazard ratio [HR] 1.03, P 〈 0.001), tender/swollen joints (HR 1.04, P = 0.01), presence of nail lesions (HR 2.08, P 〈 0.01), higher Health Assessment Questionnaire scores (HR 2.01, P 〈 0.001), elevated erythrocyte sedimentation rate (HR 2.37, P = 0.02), and HLA-B27 positivity (HR 2.22, P = 0.048) were associated with increased risk of surgery, whereas higher Psoriasis Area Severity Index (HR 0.88, P 〈 0.002) conferred a protective effect in a multivariate model. The effect of biologics did not reach statistical significance. Conclusion MSK surgery attributable to PsA is not rare, affecting 11.8% of patients. Markers of cumulative disease activity and damage are associated with a greater risk of requiring surgery.
    Type of Medium: Online Resource
    ISSN: 0315-162X , 1499-2752
    URL: Article
    DOI: 10.3899/jrheum.220908
    RVK:
    XA 10000
    Language: English
    Publisher: The Journal of Rheumatology
    Publication Date: 2023
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  • 6
    Online Resource
    Online Resource
    An Overview of Reviews to Inform Organization-Level Interventions to Address Burnout in Rheumatologists
    The Journal of Rheumatology ; 2023
    In:  The Journal of Rheumatology
    Details
    In: The Journal of Rheumatology, The Journal of Rheumatology
    Abstract: To identify organization-directed strategies that could be implemented to prevent burnout among rheumatologists. Methods A search of English language articles published 2011 or later was conducted on Cochrane Database of Systematic Reviews, Embase, Medline, and PsycInfo on January 25, 2022. Included reviews had ≥ 1 primary studies with ≥ 10% of participants who were physicians, recorded burnout as an outcome, and described an organization-directed intervention to prevent burnout. Overlap of primary studies across reviews was assessed. The final review inclusion was determined by study quality, minimization of overlap, and maximization of intervention breadth. The A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 tool was used for quality assessment. Included studies and interventions were assessed by rheumatologists for their applicability to rheumatology. Results A total of 17 reviews, including 15 systematic reviews, 1 realist review, and 1 umbrella review were included. AMSTAR 2 quality ratings classified 5 systematic reviews as low quality, 1 as moderate, and 9 as critically low. There was significant heterogeneity between and within reviews. Six conducted a metaanalysis and 11 provided a qualitative summary of findings. The following intervention types were identified as having possible applicability to rheumatology: physician workflow and organizational strategies; peer support and formal communication training; leadership support; and addressing stress, mental health, and mindfulness. Across interventions, mindfulness had the highest quality of evidence to support its effectiveness. Conclusion Although the quality of evidence for interventions to prevent burnout in physicians is low, promising strategies such as mindfulness have been identified.
    Type of Medium: Online Resource
    ISSN: 0315-162X , 1499-2752 , 0315-162X
    URL: Article
    DOI: 10.3899/jrheum.2023-0437
    RVK:
    XA 10000
    Language: English
    Publisher: The Journal of Rheumatology
    Publication Date: 2023
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  • 7
    Online Resource
    Online Resource
    Adherence and Treat to Target Benchmarks in Older Adults with Gout Initiating Urate Lowering Therapy in Ontario, Canada: A Population‐based Study
    Wiley ; 2024
    In:  Arthritis Care & Research
    Details
    In: Arthritis Care & Research, Wiley
    Abstract: We sought to evaluate urate lowering therapy (ULT) adherence and treatment‐to‐target (T2T) serum uric acid (SUA) levels amongst older adults with gout starting ULT. Methods We performed a population‐based retrospective cohort study in Ontario, Canada in patients with gout aged ≥66 years newly dispensed ULT between 2010 and 2019. We defined successful T2T as patients having SUA levels 〈 360 μmol/L (6 mg/dL) within 12‐months after ULT dispensation. We also assessed adherence to ULT. Multi‐level logistic regression clustered by ULT prescriber evaluated patient, physician and prescription factors associated with reaching target SUA levels. Results Among 44,438 patients (mean (SD) age 76.0±7.3 years; 64.4% male), 30,057 (67.6%) patients had ≥1 SUA test completed. Overall, 52.3% patients reached SUA target within 12‐months, improving from 45.2% in 2010 to 61.2% in 2019 ( p 〈 0.0001). ULT adherence was 55.3% overall and improved annually. Key factors associated with achieving T2T included febuxostat use (OR 11.40, 95% CI 5.10–25.43) (was only dispensed in 88 patients), ULT adherence (OR 5.17, 95% CI 4.89–5.47) allopurinol starting doses 〉 50 mg (OR 2.53, 95% CI: 2.14–2.99), colchicine/oral corticosteroids co‐prescription (OR 1.24, 95% CI: 1.14–1.34) and ULT prescription from a rheumatologist. Conclusions Only 52.3% of patients achieved an optimal SUA level within 1 year of ULT initiation. ULT adherence was suboptimal though improving over time. ULT adherence and higher allopurinol starting doses had the strongest associations of achieving a target SUA level. This study highlights room for improvement in gout management and potential strategies to address care gaps.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    URL: Article
    DOI: 10.1002/acr.25380
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2016713-1
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  • 8
    Online Resource
    Online Resource
    Disequilibrium
    Springer Science and Business Media LLC ; 2020
    In:  Journal of Medical Humanities Vol. 41, No. 3 ( 2020-09), p. 451-451
    Details
    In: Journal of Medical Humanities, Springer Science and Business Media LLC, Vol. 41, No. 3 ( 2020-09), p. 451-451
    Type of Medium: Online Resource
    ISSN: 1041-3545 , 1573-3645
    URL: Article
    DOI: 10.1007/s10912-019-09576-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2017000-2
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  • 9
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    Online Resource
    The Evaluation of an Osteoporosis Clinic in a Community Hospital Setting: a Retrospective Chart Review and Telephone Survey
    Canadian Geriatrics Society ; 2019
    In:  Canadian Geriatrics Journal Vol. 22, No. 3 ( 2019-08-30), p. 143-147
    Details
    In: Canadian Geriatrics Journal, Canadian Geriatrics Society, Vol. 22, No. 3 ( 2019-08-30), p. 143-147
    Abstract: BackgroundPatients who have suffered fragility fractures are at an in-creased risk for subsequent fractures. The Osteoporosis (OP) Clinic at Markham Stouffville Hospital (MSH) was set up in July 2015 to screen, diagnose, and treat patients with fragility fractures. The goal of this study was to identify differences in OP screening and treatment initiation between patients seen in the OP clinic versus usual care.MethodsA retrospective cohort study and telephone interview was conducted on 40 patients who had sustained a hip fragility fracture between September 2015 and July 2016. 20 of those patients were referred to the OP clinic, while the remaining patients received usual care. ResultsAt the end of the intervention, 16/20 patients in the OP clinic group were appropriately placed on a bisphosphonate/RANKL inhibitor versus only 6/20 patients in the usual care group (p 〈 .01).ConclusionsA significant care gap exists in secondary fracture prevention between the osteoporosis clinic and usual care groups. Better screening and subsequent intervention are needed for patients with fragility fractures. This study highlights the efficacy of an outpatient OP clinic in a community hospital setting.
    Type of Medium: Online Resource
    ISSN: 1925-8348
    URL: Article
    DOI: 10.5770/cgj.22.359
    Language: Unknown
    Publisher: Canadian Geriatrics Society
    Publication Date: 2019
    detail.hit.zdb_id: 3053637-6
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  • 10
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    Online Resource
    Vaccination in adults with autoimmune rheumatic diseases
    CMA Impact Inc. ; 2019
    In:  Canadian Medical Association Journal Vol. 191, No. 36 ( 2019-09-09), p. E1005-E1005
    Details
    In: Canadian Medical Association Journal, CMA Impact Inc., Vol. 191, No. 36 ( 2019-09-09), p. E1005-E1005
    Type of Medium: Online Resource
    ISSN: 0820-3946 , 1488-2329
    URL: Article
    DOI: 10.1503/cmaj.190345
    Language: English
    Publisher: CMA Impact Inc.
    Publication Date: 2019
    detail.hit.zdb_id: 2028772-0
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