News Article | December 22, 2016
The Center for Rheumatology, LLP in Albany, New York has partnered with TSI Healthcare, a national leader in the sales and support of customized NextGen® Practice Management and Electronic Health Record solutions. TSI Healthcare will be the sole provider and support center for The Center for Rheumatology’s Practice Management (PM) software, rheumatology specific Electronic Health Record (EHR) software, and Cloud ASP Hosting services. With more than 28 years in practice, The Center for Rheumatology is the second largest rheumatology practice in the country. As the practice’s patient and provider network grew, it realized its current EHR system could not adequately meet basic workflow, federal policy, and service demands. In need of a system that would help the practice achieve its goals, The Center for Rheumatology began searching for a comprehensive vendor that would propel it to the next level of patient care. TSI Healthcare’s rheumatology specific EHR content, Stevie Award winning customer service, and 1-on-1 guided federal policy assistance were the perfect fit. The Center for Rheumatology will incorporate TSI Healthcare’s 500+ rheumatology specific enhancements into their practice workflow. These enhancements include a rheumatology specific ScoreCard™, outcomes tracking comparing disease activity scores against daily treatments, and a joint exam featuring color-coded homunculus diagrams. As The Center for Rheumatology prepares for MACRA in 2017, it will rely on TSI Healthcare’s Government Affairs team to help it achieve new levels of success through services such as Quality Program Services, set to launch in full in January 2017. “We were seeking new ways to survive the ever-evolving healthcare landscape and continue growing our practice. We needed an integrated PM and EHR system and support team that provided both rheumatology specific content and federal policy guidance,” said Marc Miranda, The Center for Rheumatology’s business manager. “We are confident that TSI Healthcare will exceed our EHR needs; in fact, during our search process TSI Healthcare was the only company to receive 100% positive feedback from their clients.” “With nearly 20 years in healthcare IT, we remain dedicated to partnering with rheumatologists across the nation to further their goal of remaining independent,” says David M. Dickson, Jr., TSI Healthcare’s founder, president, and CEO. “This partnership reinforces our continued commitment to helping rheumatology practices like The Center for Rheumatology expand their service offerings by providing them with the best tools and the best service in the industry.” About TSI Healthcare TSI Healthcare, founded in 1997, is a national leader in the sales and support of customized NextGen® Practice Management and Electronic Health Record solutions. TSI Healthcare’s solutions are designed to meet the unique needs of rheumatology practices through rheumatology specific EHR content, top ranked service, and award winning software. In addition to core products powered by NextGen®, TSI Healthcare also offers Patient Portal, Population Health Management, Revenue Cycle Management, Cloud ASP Hosting and more. TSI Healthcare’s support and service teams include NextGen Certified Professionals, clinicians, and former practice administrators and physicians. TSI Healthcare has approximately 150 employees and services more than 2,000 providers nationwide. For more information, visit http://www.tsihealthcare.com/rheumatology or call 800-354-4205. About The Center For Rheumatology, LLP The Center for Rheumatology, LLP is the largest rheumatology practice in Upstate New York and employs the second largest number of rheumatologists in the nation for the diagnosis and care of individuals with arthritis, osteoporosis, autoimmune and musculoskeletal disease, and for investigation of new treatments for these disorders. As the major regional center in this rapidly evolving field, The Center For Rheumatology strives to be a center of excellence in the diagnosis and care of individuals with rheumatic diseases, in the development of new treatments, and a resource for the education of our patients, the medical community, and the public at large.
Borie D.,Genentech |
Kremer J.M.,The Center for Rheumatology
Seminars in Arthritis and Rheumatism | Year: 2015
Objective: The John Cunningham virus (JCV) is a generally benign and asymptomatic polyomavirus. Due to an association of the anti-integrin agent natalizumab with progressive multifocal leukoencephalopathy (PML) in patients with multiple sclerosis (MS), a newly developed anti-JCV antibody assay has been implemented as a risk-stratification tool for natalizumab-treated patients with MS. This viewpoint offers insight and perspective regarding the potential unapproved use of the anti-JCV antibody assay in rheumatoid arthritis (RA) and examines how rheumatologists can best assist patients. Methods: A primary literature search was conducted to identify articles on the number of cases of PML associated with natalizumab in patients with MS, the number of cases of PML associated with patients with rheumatic disease, PML incidence in the general population, serum-based assays to detect JCV exposure, and clinical PML presentation and treatment methods. Results: Risk of PML in patients with RA receiving biologics appears orders of magnitude lower than that expected in natalizumab-treated patients with MS (1 in 1000). If patients with RA are risk stratified assuming an anti-JCV antibody seropositivity of 60%, theoretically 23,400 anti-JCV antibody-positive patients would have to receive rituximab before potentially observing 1 PML case. Conclusions: Data currently indicate that rheumatologists should not order the anti-JCV antibody assay for patients requiring biologics. Monitoring relevant symptoms indicative of emerging PML might provide greater value to patients, thus prompting interventional measures that could affect prognosis. © 2015 The Authors. Published by Elsevier HS Journals ,Inc.
Toledo A.E.,Steffens Scleroderma Center |
Toledo A.E.,The Center for Rheumatology |
Shapiro L.S.,Steffens Scleroderma Center |
Shapiro L.S.,The Center for Rheumatology |
And 6 more authors.
BMC Gastroenterology | Year: 2015
Background: The malignant form of atrophic papulosis (Köhlmeier-Degos disease) is a rare thrombo-occlusive vasculopathy that can affect multiple organ systems. Patients typically present with distinctive skin lesions reflective of vascular drop out. The small bowel is the most common internal organ involved, resulting in considerable morbidity and mortality attributable to ischemic microperforations. Determination of the presence of gastrointestinal lesions is critical in distinguishing systemic from the benign, cutaneous only disease and in identifying candidates for treatment. Case presentation: We describe an 18 year old male who first presented with cutaneous atrophic papulosis but became critically ill from small bowel microperforations. He had an almost immediate and dramatic response to treatment. Prior to his presentation with acute abdomen he had upper and lower endoscopy showing areas of nonspecific patchy erythema. At laparotomy, innumerable characteristic lesions with central pearly hue and erythematous border were seen. PubMed was used for a literature search using the keywords malignant atrophic papulosis, Degos disease, endoscopy, laparoscopy and laparotomy. This search yielded 200 articles which were further analyzed for diagnostic procedures and findings. Among the 200 articles we identified only 11 cases in which endoscopy was performed. Results of endoscopy and laparotomy in our patient with malignant atrophic papulosis were compared to those in the literature. Endoscopy of the gastrointestinal tract has shown gastritis and non-specific inflammation whereas laparoscopy shows white plaques with red borders on the serosal surface of the small bowel and the peritoneum. From personal communications with other physicians worldwide, we identified three additional unpublished cases in which endoscopy revealed only minimal changes while laparoscopy showed dramatic lesions. From our experience the endoscopic findings are often subtle and nonspecific, whereas laparascopy or laparotomy will reveal pathognomic lesions on the serosal surface of the intestine. Conclusion: Our report contrasts the endoscopic and laparoscopic findings in malignant atrophic papulosis which suggest laparoscopy is the more powerful means of detecting gastrointestinal involvement. Imaging studies may serve as a key indicator of systemic progression. Based on our experience, laparoscopy should be performed when there is a high index of suspicion for gastrointestinal malignant atrophic papulosis, even if endoscopic examination is non-diagnostic or normal. © 2015 Toledo et al.
Dervieux T.,Cypress Bioscience |
Zablocki R.,Cypress Bioscience |
Kremer J.,The Center for Rheumatology
Rheumatology | Year: 2010
Objective: MTX is a prodrug producing anti-arthritic effects through a folylpolyglutamate synthasemediated activation to MTX polyglutamates (MTXPGs). Our objective was to characterize the pharmacokinetics of intracellular MTXPGs and the factors associated with their accumulation in adult RA patients treated with MTX weekly. Methods: MTX pharmacokinetics were evaluated in 47 MTX-naïve patients enrolled in an MTX doseescalation study for an average of 20 weeks and 223 patients enrolled in a cross-sectional study under long-term MTX therapy. Short-chain (MTXPG1-2), long-chain (MTXPG3) and very long-chain (MTXPG4-5) concentrations were measured in circulating red blood cells using liquid chromatography. Statistical analyses consisted of non-linear mixed models, multivariate regression analyses and Wilcoxon signed-rank test. Results: The accumulation of MTXPG1-5 was sigmoidal and steady-state concentrations were achieved after 7 weeks of therapy. However, additional exposure and MTX dosage escalation produced a selective redistribution towards longer chain MTXPGs at the expense of shorter chain MTXPGs. Age, glomerular filtration rate and route of MTX administration were the most important predictors of MTXPG accumulation. In 10 patients, a switch from oral to parenteral MTX was associated with a 37% increase in longchain MTXPGs, a 132% increase in very long-chain MTXPGs and a concomitant 31% reduction in disease activity (P<0.02). Conclusion: The selective emergence of long-chain MTXPGs is function of dose, time of exposure and hence dosage intensity. Switching from oral to parenteral MTX produces a selective accumulation of longer chain MTXPGs that are known to be more potent inhibitors of de novo purine biosynthesis than shorter chain MTXPGs. © The Author 2010. All rights reserved.