There are too many topics for this article to represent a comprehensive and thorough review of rheumatology. Instead, this paper will focus on advances which would be of interest to a general medical audience. Highlighted are the more commonly encountered rheumatic diseases as well as uncommon disorders that are of significant interest as they expand our understanding of biologic mechanisms of disease. We will take a tour from rheumatoid arthritis to a fascinating new entity called VEXAS. The purpose of this review is to broaden knowledge of mechanistic and therapeutic advances in rheumatology and foster a greater appreciation of current management principles related to autoimmune rheumatic disease.
{"title":"Recent Advances in Rheumatology.","authors":"Kent Kwas Huston","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are too many topics for this article to represent a comprehensive and thorough review of rheumatology. Instead, this paper will focus on advances which would be of interest to a general medical audience. Highlighted are the more commonly encountered rheumatic diseases as well as uncommon disorders that are of significant interest as they expand our understanding of biologic mechanisms of disease. We will take a tour from rheumatoid arthritis to a fascinating new entity called VEXAS. The purpose of this review is to broaden knowledge of mechanistic and therapeutic advances in rheumatology and foster a greater appreciation of current management principles related to autoimmune rheumatic disease.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 5","pages":"433-439"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12543342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maternal mortality in the state of Missouri remains among the highest in the nation. Recognizing that the burden of making corrective actions does not rest solely with obstetric providers, it is time to consider how pregnancy affects our patients before, during, and after childbirth. Reviewing pregnancy history and pregnancy intention can be a chance to address modifiable risk factors to improve patient outcomes when providing medical care.
{"title":"Pregnant for Nine Months, Postpartum for Life: Long-term Implications of Pregnancy Related Conditions.","authors":"Helen Suzanne Hill, Kelly Jo Sandri","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Maternal mortality in the state of Missouri remains among the highest in the nation. Recognizing that the burden of making corrective actions does not rest solely with obstetric providers, it is time to consider how pregnancy affects our patients before, during, and after childbirth. Reviewing pregnancy history and pregnancy intention can be a chance to address modifiable risk factors to improve patient outcomes when providing medical care.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 5","pages":"389-395"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12543352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Changing Health Care for Good: Building Resilience to Tackle Burnout and Suicide for Physicians and Students.","authors":"Marc B Hahn","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 5","pages":"357-358"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12543353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Judicious use of intravenous fluids in hospitalized patients can improve outcomes and prevent adverse events. For many clinical scenarios, balanced crystalloids have some advantages over normal saline, though the differences in outcomes are small. Excessive administration of normal saline can cause metabolic acidosis and kidney injury. For conditions with sodium and/or chloride deficits, normal saline is preferred. Hypertonic saline is used to rapidly correct severe acute hyponatremia, and hypotonic fluids are indicated for replacement of free water deficits. Intravenous albumin is indicated in only specific scenarios in the setting of cirrhosis and does not seem to have significant advantages for routine volume resuscitation over crystalloids. When intravenous fluids are administered, patient response should be closely monitored to guide subsequent therapy.
{"title":"Intravenous Fluids in Hospitalized Patients: A Review of Best Practices.","authors":"J Lane Wilson, Matthew Decker, Chelsie Cain","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Judicious use of intravenous fluids in hospitalized patients can improve outcomes and prevent adverse events. For many clinical scenarios, balanced crystalloids have some advantages over normal saline, though the differences in outcomes are small. Excessive administration of normal saline can cause metabolic acidosis and kidney injury. For conditions with sodium and/or chloride deficits, normal saline is preferred. Hypertonic saline is used to rapidly correct severe acute hyponatremia, and hypotonic fluids are indicated for replacement of free water deficits. Intravenous albumin is indicated in only specific scenarios in the setting of cirrhosis and does not seem to have significant advantages for routine volume resuscitation over crystalloids. When intravenous fluids are administered, patient response should be closely monitored to guide subsequent therapy.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 5","pages":"396-402"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12543346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evan S Schwarz, Frank Dicker, Emilie Lothet, Hannah Spungen, Michael Levine
The illicit opioid supply is increasingly adulterated with novel synthetic opioids such as nitazenes. Nitazenes are very potent opioids and are increasingly associated with opioid overdoses and deaths. Despite their potency, nitazenes are reversed by naloxone. Given the high risk of overdose associated with these agents, improvements in the delivery of addiction care and naloxone distribution are needed to prevent morbidity and mortality from nitazenes and other novel opioids.
{"title":"Nitazenes: An Old Drug Class Causing New Problems.","authors":"Evan S Schwarz, Frank Dicker, Emilie Lothet, Hannah Spungen, Michael Levine","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The illicit opioid supply is increasingly adulterated with novel synthetic opioids such as nitazenes. Nitazenes are very potent opioids and are increasingly associated with opioid overdoses and deaths. Despite their potency, nitazenes are reversed by naloxone. Given the high risk of overdose associated with these agents, improvements in the delivery of addiction care and naloxone distribution are needed to prevent morbidity and mortality from nitazenes and other novel opioids.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 4","pages":"329-333"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Community Health: Health Forward Foundation, REACH Healthcare Foundation, and Missouri Foundation for Health.","authors":"Charles W Van Way","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 4","pages":"266-269"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary Elizabeth Sutherland, Kristine Jennings, Gerrit Seymour, Daniel Armounfelder
{"title":"Sex Industry Patients: A Primary Care Perspective.","authors":"Mary Elizabeth Sutherland, Kristine Jennings, Gerrit Seymour, Daniel Armounfelder","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 4","pages":"255-258"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号