Infliximab Research Paper

TERMINOLOGY CLINICAL CLARIFICATION • Overwhelming, deleterious host immune response to an infection due to release of chemicals to fight the infection 2• 1 • Immune chemicals cause widespread inflammation, leading to blood clots and reduced blood flow 2• 1 • Systemic and can quickly become life-threatening with organ failure, including reduced blood pressure and heart failure

3. Would it be appropriate to consider treating this patient with tissue plasminogen activator (tPA, alteplase)? How does this drug work?

He underwent an interlaminar injection in May 2015 which improved his lower extremity pain by 99%. This has lasted him up until 1 month when he has had recrudescences of pain emanating from the low back radiating intermittently into the left lower extremity in a sharp shooting fashion, average pain 5/10, and worse pain 81/0. The pain is frequent and is associated with numbness and tingling. There is some difficulty with walking. Over the past 1 month, the pain has been severe. Home exercises and nonsteroidal anti-inflammatory medications (NSAIDS) have not been effective in reducing his pain and the pain is severe at times and limiting his ability to lift and sit. Walking, exercise and standing increased the pain. Lying down reduce the

Onset: 2 hours ago Location: Right leg Duration: Steady consistent pain Characteristics: Associated with altered gait, edema, limited weight bearing, and range of motion. Aggravating Factors: Applying pressure on the right leg when walking. Relieving Factors: At rest pain decreases to 4 out of 10. Treatment: Wrapped leg in ace bandage. Current Medications: Hydrochlorothiazide 25 mg, orally once a day, for hypertension. Acetaminophen 500 mg, 2 capsules every 6 hours, while symptoms last, for leg pain Allergies: Penicillin, Sulfa PMHx: Last immunization was tetanus on 6/2014 No influenza immunization was taken. Childhood immunization for DTaP, MMR, meningitis, varicella, Hep B, Hib B, OVP, Surgery include tonsillectomy at year 8. Social Hx: Patient is a high school counselor. He participates in physical activities by running 2 to 3 times a week, playing golf, and volunteering at a nursing home. The patient is married with one daughter and one son. He does not use tobacco and periodically drinks at

This condition can be treated at anytime by an antibiotic like penicillin. Since this condition can damage the organs, it is better to get it treated sooner than later. It is also important to keep going back to the doctors to get blood work done repeatedly to make sure that the infection is totally cleared up.

The patient is a 72 year old female. She has been experiencing progressively worse pain and stiffness in her joints. She is reports that she is having decreased range of motion, redness, and swelling in her joints. She is reports symptoms occur in the same joints on both sides of her body. She is also reporting the symptoms are worse when she first wakes up in the morning.

Laboratory: CK 41, aldose 5.7, CCP 5, rheumatoid factor 10.8, ANA negative, ANCA is less than 1:20, P-ANCA less than 1:20, hypersensitivity pneumonitis panel is negative, anti-Jo-1 is less than 0.2, scleroderma antibody is less than 0.2, IDE total 5. CBC within normal limits.

CLC Home Visit with Sallie Mae Fisher Patient Sallie Mae Fisher was released from the hospital last Saturday. This patient is eighty two years old and lives alone as her daughter lives too far away to be helpful. Her medical history includes chronic congestive

2. What treatment options should be discussed with the patient? Provide a rationale for each potential treatment and how each is thought to impact the disease processes.

As stated previously, this type of disease affects the digestive system. As this Firstly, doctors provide drugs to help prevent your intestines from further inflammation and to relieve symptoms. These drugs also help to stop the symptoms from appearing. Many use Aminosalicylates, which treat the mild stages of the disease and they help to control the level of inflammation. Antibiotics, another common medication helps to treat and heal infections and symptoms. Corticosteroids are very powerful and are used during the late stages, and are very effective as they are fast-acting, but can cause major side effects. Besides medications, surgery is also an option, where parts of your digestive tract will be removed and repositioned, connecting it to healthy parts. Surgery may be considered generally in the severe stages to close up opened tissue, drain out waste or to widen the narrowed intestines. In addition, you may also consider taking nutrient therapy, where nutrients are injected into your veins to relieve your bowel, or you would be asked to follow a low-fiber diet in order to reduce the risk of blocking your

TREATMENT Once diagnosed, you and your doctor will come up with a treatment based on your age and your symptoms to try to reduce inflammation and joint pain, and to weaken your overactive immune system. There will be a fairly strict treatment plan set in place and regular checkups.

As a child, Artemis asked her father, Zeus, to grant her six wishes on her third birthday. Zeus, being the father he was, happily agreed. She wished to be allowed to live her life chaste, without the complications of marriage, to have a bow and arrow like her brother, Apollo’s, a hunting costume, the job of bringing light into the world, sixty nymphs to be her companions, and all the mountains on the earth to live on.

Diagnosis and Treatment The bacteria are identified using a selective media and under specific atmospheric conditions. Normally the disease self-resolves, but erythromycin can be prescribed to shorten the length of the illness.

Clinical Manifestations. The initial signs and symptoms of CD are lower right The lifelong prognosis of CD includes periods of remission and exacerbation but unfortunately, there is no known cure (Farrell & Dempsey, 2014, p. 917). Management involves adhering to corticosteroid medication in controlling the inflammation process (Bullock & Hales, 2013, p. 825). Relief from diarrhoea and abdominal pain can be treated with relevant medication (Bullock & Hales, 2013, p. 826).

EMG/NCV study obtained on 06/01/11 showed evidence of a positive right L4-5 radiculopathy. Per the AME report dated 07/08/15, the patient was deemed P & S with regard to her right knee and lumbar spine as of this date. Future medical care includes ongoing exercise program, occasional orthopedic visits, brief periods of PT, anti-inflammatory medications for flares, prescription medications and periodic injections.