Introduction Throughout this essay I shall critique the available evidence regarding rheumatoid arthritis (RA); particularly concerning the conclusions on its aetiology, diagnosis techniques, pharmacological management, physical therapeutics and surgical treatment interventions. I shall explore the expected prognosis and the key developments we can expect in the future. Aetiology and Prevalence RA is a chronic, systemic and inflammatory disease that progressively impacts peripheral joints (Panayi 2011).The damage that occurs is predominantly symmetrical and polyarthropathic (Rindfleisch & Muller 2005). It affects the host’s joint synovial membranes, tendon sheaths and bursae and causes stiffness, pain and swelling to the joints …show more content…
Genetics influence a high percentage of cases; according to de De Vries (2011), 50-60% of sero-positive and 30-50% of sero-negative cases are influenced by hereditary factors. A greater understanding of this area could bring new found appreciation of RA pathogenesis and treatment methods (Mikuls 2012). Relationship of increase RA incidence with smoking is reported widespread in literature (Fisher 2012, Klareskog 2008, Sugiyama 2010, Mahdi 2009). Interaction occurs between two copies of HLA-DR SE specific genes and smoking; specific citrullinated protein antigens are induced by cigarette smoke which increases likelihood of RA. This causes a 21-flod increase risk of RA in comparison to non-smokers (Klareskog 2006). Furthermore, literature dictates that peripheral vascular disease (PVD), steroid therapy and prednisone use have consistent supportive evidence that shows increased risk of RA (Firth et al.2008a, Maradit‐Kremers 2007, Wegner 2010). There is little evidence to dictate a common infectious cause of RA, however some pathogenic organisms such as periodontitus, B19 parvovirus or Epstein-Barr virus (EBV) virus may stimulate the disease by activating the B cells to presence antibodies (Wegner 2010). There is inconclusive evidence to suggest that the diet or breast implants play a role in the aetiology of RA (Tugwell et al 2001, Pattison 2006). Pathogenesis In RA, the immune system cannot differentiate Major
Mary Surratt was sentenced to death by hanging for aiding in the president's assassins. She helped John Wilkes Booth and his associates kill president Lincoln and attempt to kill vice president Seward. I think Mary Surratt was guilty of aiding the president's assassins and attempting to help kidnap the president and i will tell you why.
Rheumatoid arthritis is an autoimmune inflammatory disease which causes inflammation on joints leading to disability. The deterioration is caused by constant attack in the synovium leading to synovial cells to a rough and grainy tissue eventually allowing the bones to crumble away. The disease currently has no cure and scientists are thriving to find a target specifically aiming at the bones.
Around 70% of arthritis sufferers in the UK have rheumatoid arthritis (RA). Women are also more likely to develop RA than men, and commonly affects adults between ages 50 and 60. This condition is characterised by an insidious onset of pain, swelling of joints and morning stiffness. Arthritis is caused by inflammation of the synovial tissue of the joints, supposedly triggered by the presence of autobodies such as rheumatoid factors. The first line treatment for RA is a combination of disease modifying anti-rheumatic drug (DMARD). These slow down the progression of RA and treatment typically includes methotrexate in combination with another DMARD (e.g. sulphasalazine). Short term glucocorticoids are also used with DMARDS to manage flares of inflammation. Anti-TNF drugs
Rheumatoid Arthritis (RA) is a systemic inflammatory autoimmune disease associated with swelling and pain in multiple joints. First joint tissue to be affected is the synovial membrane, which lines joint cavity. Multiple immune-regulatory cytokines (such as B-cells and interleukins) contribute to joint damage. Eventually, inflammation may spread to articular cartilage, fibrous joint capsule, and surrounding ligaments and tendons, causing pain, joint deformity, and loss of function.
Unfortunately, we have a little evidence for the treatment of ILD associated with RA,due to the lack
Nick Carraway, the storyteller of The Great Gatsby, has created a story to show The Great Gatsby is a story told by Nick Carraway, who was once Gatsby's neighbor, and is here to tell us that he tells the story sometime after 1922 sometime, when the incidents that fill the book take place. As the story opens and shows the dramatic changes throughout the story line. Nick has just moved from the Midwest to West Egg, Long Island, seeking his fortune as a bond salesman and to get his love from Daisy but, does that truly work? Do he actually get his love with Daisy and get the chance to be with her?
There are two group divisions of cytokines interactions: Pro-inflammatory and anti-inflammatory cytokines (Lubberts & Berg, 2003). Managing the balances and interaction of these two groups is important for therapeutical reasons (Lubberts & Berg, 2003). One of the most important therapeutic applications has been on how to balance the pathway in the pro-inflammation part of the cytokine interaction in RA. In essence, cytokines like interleukin-1 (IL-1) and Tumor Necrosis Factor Alpha (TNF-a) control RA pro-inflammation (Lubberts & Berg, 2003). IL-1 is a group of 11 cytokines whom central role is to mediate and regulate the inflammation process, and TNF-a is also an essential protein involve in the systemic inflammation process. In 1992, the Kennedy Institute of
Rheumatoid arthritis is one of the incurable diseases and turns chronic with progressive inflammatory of the synovial lining of peripheral joins. It is characterized by symmetric, chronic, and deforming polyatrhitis that causes long term joint disability when not controlled early. Considering there is no cure for this disease, management focuses on pain and inflammation reduction in order to prevent destruction of joints while at the same time preserving and improving on the functionality of the patient (Varatharajan et al, 2009).
Most evidence today support the concept that the pathology of rheumatoid arthritis has its bases in an inflammatory response involving the immune system. Other theory of causation include genetic factors, infectious agents and an antigen-antibody response. It is unlikely that a single factor is responsible for all cases of rheumatoid arthritis.
Rheumatoid arthritis (RA) is a complex disorder characterized by inflammation of the synovium (the thin lining of a joint). RA is a chronic disease in which genetic and environmental factors contribute to the breakdown of tolerance to self antigens.
RA is a mediated inflammatory process that triggers an autoimmune response. The result is in the production of antibodies and inflammatory cytokines that over time destroys bone, cartilage, tendons, ligaments and blood vessels (Dewing, Setter, & Slusher, 2012). Although joints are the primary areas of destruction, the inflammatory process can also affect various organs, such as heart tissue including the heart values, visceral layers of the lung and brain, spleen, sclera and larynx (Dunphy, Windland-Brown, Porter, & Thomas 2011). If RA is not treated promptly or if the patient does not respond to treatment, irrevocable bone deformity, bone erosion and immobility is often the sequelae.
The process involves an inflammatory response of the capsule around the joints (synovium) secondary to swelling (hyperplasia) of synovial cells, excess synovial fluid, and the development of fibrous tissue (pannus) in the synovium (Gerd et al.,2014). RA is more prevalent among women than men, and usually develops in the fourth and fifth decades of life, with 80% of the total cases occurring between ages 35 and 50 (Kavanaugh and Lipsky 1996).RA reduces lifespan on average from three to twelve years. RA is associated with decreased physical function, disability, under employment, and overall diminished quality of life. (Maclean C H et al., 2000). When it occurs in children it is called Juvenile Rheumatoid Arthritis. The incidence and prevalence of RA differs significantly over time and between continents. The prevalence in developing countries ranges between 0.1 and 0.5% (Akar et al., 2004). Rheumatoid arthritis (RA) is a chronic systemic inflammatory illness with prevalence of approximately 0.75% in India (Ausaf et al.,
Rheumatoid Arthritis, what is it? The word Rheumatoid comes from the greek word referring to rheumatism, which means any painful disorder from the joints. Arthritis means inflammation of the joint. (William Collins Sons & Co. Ltd. 1979). Putting these two words together Rheumatoid Arthritis creates a disorder. The pathophysiology of RA is that it is a chronic, systemic, inflammatory autoimmune disease which means that this disorder is attacking your own body (Silvestri, 2013, p. 851 ). This usually happens at the joints where two bones meet that create movement of body parts. This disorder is systemic and usually if it happens one side,
Description: Kaiser Wilhelm depicted in the centre of the cartoon, with a smoking shell billowing the image of the devil’s face. Also pictured is a conical flask on top of a piece of parchment title, “The Hague Convention”. An eagle sits on the globe on the right hand side of the image with a rattle snake labelled distinctly as the “kultur” pertaining to a German civilization and culture (sometimes used in a derogatory sense to suggest elements of racism, authoritarianism, or militarism). A soldier’s skeleton also hangs in the background accompanied by a baby nailed to the wall. Leonard Raven-Hill: Often viewed a a strong advocate of British imperialism and a strong supporter of the conservative party. Encouraged men to join the amred forces
Rheumatoid Arthritis (RA) is a common autoimmune disease. The chronic inflammation they induced lead to severe joint swelling and damage2. It is more likely to strike on aged people and females3. In Australia, 400,000 people are suffering from it with different extent3-4. The mechanisms of the disease are well-studied. The synovium is the primary target of immune system for RA patients. With white blood cell migrated in, the synovium membrane become thick and inflamed, which leads to undesired tissue growth3. Various chemical substances are released from the inflamed site and starts affecting surrounding tissues, such as cartilages and ligaments. In severe cases, they might even result in whole-body disorder2-4.