American College of Rheumatology/Association of Rheumatology Health Professionals Annual Meeting
Philadelphia, PA; October 17-21, 2009

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Sustained Response in Early Rheumatoid Arthritis with Abatacept

Philadelphia, PA—Two-year data from the AGREE (Abatacept Study to Gauge Remission and Joint Damage Progression in Methotrexate-Naïve Patients with Early Erosive Rheumatoid Arthritis) trial show that patients treated with abatacept in combination with methotrexate (MTX) achieved sustained low disease activity scores at 24 months. Results of

I was recently asked to consult on a 93-year-old man, Mr. M, who had fallen and broken his left femur and right humerus. He had underlying dementia and several chronic medical conditions. The patient’s initial liver function tests (LFTs) demonstrated a slightly increased total bilirubin of 2.1 mg/dL, but the rest were all within normal limits: aspartate aminotransferase (AST), 41 IU/L; alkaline phosphatase (ALP), 42 IU/L; and gamma glutamyl transpeptidase (GGT), 14 IU/L. He had a large hematoma in his thigh and upper arm, and a broken left 10th rib. Mr. M was treated acutely for his fracture

Introduction

Deficiency of vitamin A is rare in the United States, yet many people take supplemental vitamins that contain vitamin A to prophylactically manage what potentially may ail them. Vitamin A has received much attention, both in the scientific and lay press, that is established in fact, assumption, misinformation, as well as hype. Recent findings on the nutritional and metabolic differences between young and old persons have raised the concern of vitamin A toxicity. Therefore, healthcare professionals should be cognizant of the physiology of retinol, and the benefits and

This article is the second in a continuing series on trauma care and the older adult. The first article of the series, “Trauma in the Elderly: Causes and Prevention,” was published in the January 2010 issue. This series will discuss the growing problem of trauma in the elderly, including its causes and possible ways to prevent it, care in the acute stages, and manifestations and treatment strategies when trauma involves the torso, spine, brain, and hip. Authors include skilled experts in the trauma field representing various specialties at the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center and the University of Maryland School of Medicine.

Introduction

Most biologic capabilities decline with age, although the extent of the decrements are usually modest and vary by function. Cross-sectional studies show that strength declines by approximately 30% from the third through eighth decades and that sensory changes, while difficult to measure, are comparable.1 The effects of disease are superimposed on age-related decreases often resulting in significant functional impairment. Many neuromuscular diseases are uncommon in older persons. This two-part article will focus on the conditions that occur with regularity in older persons or have a striking effect on their lives. Part I discusses cervical spondylotic radiculomyelopathy, lumbar spondylosis, amyotrophic lateral sclerosis (ALS), Guillain-Barré syndrome (GBS), and acquired demyelinating polyneuropathies. Part II, which will be published in the next issue of the Journal, will focus on myasthenia gravis, inclusion body myositis, polymyositis, and polymyalgia rheumatica.