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June 6, 2011

Anti-CCP not too helpful in HIV patients

HIV infected patients can present with a variety of rheumatic manifestations, including spondyloarthropathies, polyarthritis resembling Rheumatoid Arthritis and Sjogren’s like-syndrome. False positive results for ANA, RF, and ANCA have been documented in patients with HIV infection. But how about anti-CCP?

A study in the Journal of Rheumatology (J Rheumatol June 2011 38:1055-1060) investigate the usefulness of anti-CCP in HIV/AIDS patients. Sixty patients with AIDS without arthritis were studied. Investigators assessed anti-CCP levels  before and 6 months after antiretroviral therapy (HAART). Results were compared to 26 healthy controls. Patients were followed for one year for the development of RA.

Posted By: Bruno Oliveira  

May 18, 2011

May 11, 2011

The effects of Lupus on male genitalia

The Lupus journal from April of 2011 brought an intriguing study on Systemic Lupus Erythematosus and its effects on penile anthropometry. The authors analyzed several aspect of the male reproductive system, including: testicular size, penis length and circumference, hormonal levels, pubertal milestones, and spe...

Posted By: Bruno Oliveira  

April 5, 2011

Picking on Bisphosphonates

Very few drugs have been more in the media spotlight than bisphosphonates. Anytime a new study finds something remotely negative about bisphosphonates, a media onslaught is unleashed. Unfortunately, good news don’t get the same amount of airtime. More on that in a minute.

The most noticeable media attacks took place following studies on osteonecrosis of the jaw (

Posted By: Bruno Oliveira  

March 28, 2011

Sarcoidosis in Rheum

From time to time, I get involved in the evaluation and treatment of patients with Sarcoidosis. The typical scenario is of a refractory sarcoid patient seeking additional treatment options.

Despite the treatment refractory patient, I have had several interesting cases of Sarcoidosis as well. One patient had lytic lesions in his lumbar spine, which failed to methotrexate and corticos...

Posted By: Bruno Oliveira  

March 13, 2011

Nitroglycerin for Osteoporosis

Nobody knows how this really works, but there is growing evidence suggesting that Nitroglycerin in the form of ointment works for Osteoporosis. A study in JAMA showed additional data supporting this claim. 

Not only Nitroglycerin worked, but it appeared to affect both arms of Osteoporosis pathogen...

Posted By: Bruno Oliveira  

March 1, 2011

Activity level and the risk for Osteoarthritis

A study in the Journal of Rheumatology (February/2011 issue) tried to answer the eternal question of whether physical activity is a risk factor for Osteoarthritis. Investigators in Australia prospectively followed 39,023 subjects from 1990 through 2005. More specifically, they linked their cohort with the National Registry of joint replacement (knees and hips). Physical activity was measured by...

Posted By: Bruno Oliveira  

February 13, 2011

No Pegloticase for you!!

By now you probably heard that Pegloticase (Krystexxa) is not for the faint of heart. Due to direct-to-consumer advertisement, patients may already be asking you about it. I suppose this is go...

Posted By: Bruno Oliveira  

February 6, 2011

An Afternoon Without EMR

Last week, one of the main servers for the Electronic Medical Records broke down. All of a sudden, everybody lost access to all patient data. It was an extraordinary system crash. It took the whole afternoon for the IT department to fix it.

It was rather interesting to see patients the whole afternoon without EMR. I wasn't sure about patient's medication, allergy history, and ...

Posted By: Bruno Oliveira  

December 27, 2010

Undifferentiated Peripheral Inflammatory Arthritis

We have discussed the topic of Seronegative Polyarthritis in this Blog previously. I was surprised (actually upset) when I started private practice and was introduced to the world of undifferentiated peripheral inflammatory arthritis (UPIA) for the first time. Training at University settings “protects” Rheumatology fellows from interacting with this common entity.

A paper...

Posted By: Bruno Oliveira  

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About This Blog

Dr. Bruno Oliveira, a young rheumatologist in Montana, shares his practice experiences, computer tools, and productivity tips for Rheumatology practice.

Dr. Bruno Oliveira assumes no responsibility for comments made by readers, none of which are moderated prior to publication. Reader comments are subject to Medscape's community code of conduct. Individuals seeking specific information about a drug's efficacy, indication, dose, or safety profile should consult an appropriate drug information resource.

Disclosure: Bruno S. Oliveira, MD, has disclosed no relevant financial relationships.

  • Bruno Oliveira

    I am a Rheumatologist working at Billings Clinic in Billings, Montana. You heard it, Montana!

The content of this blog does not necessarily reflect the viewpoints of Medscape.
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