Rheumatoid Arthritis
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Rheumatoid Arthritis
There have been developments in the management and treatment of rheumatoid arthritis all over the world. The new inventions and treatments for rheumatoid informed the decision on the choice of this topic since the developments has made remission possible and becoming a central focus of clinical trials and studies. Rheumatoid arthritis is a systemic chronic inflammatory disorder with ability to affect the whole body. It manifests itself on various body joints (Cdc.gov, 2015). The disease is autoimmune where the immune system of a person attacks the tissues of the joint and other body parts with unknown reasons. Rheumatoid arthritis is capable of affecting the body function and cause permanent disability.
According to CDC (2015), the inflammation affects membrane lining the joints leading to erosion of the cartilage and bones, extending to joint deformity at one point. The condition is attributed to fault in immune system, even though the actual cause is not yet established. No specific age the condition can start, but mostly it occurs at late adulthood. There is no proper treatment for the condition but some effective drugs continually available to treat the disease in their combination and prevent joint deformity (McInnes & Schett, 2011). Other practices, surgery, education and health promotion and personal discipline can also reduce pain and prevent disability resulting from the condition.
Rheumatoid arthritis can affect five or more joints at the same time with different possible disease causes. A large number of people diagnosed with the condition experience remission within five years (Cdc.gov, 2015). The disease is common in men than women and peaks among those of old age than other groups of people. The condition affects almost one in every five people of old age and attributes to a larger percentage of people in the developed world than those of the developing countries (Nras.org.uk, 2015).
Signs and Symptoms of the Disease
A person with rheumatoid arthritis may experience pain, and a feeling of being sick, fatigue and feverish. It also causes joints pain on different body parts, swelling and redness of joints. The disease has three possible courses. It can occur in an episode after diagnosis and does not manifest again ('Guidelines for the management of rheumatoid arthritis: 2008 Update', 2008). In the second instance, the level of the disease fluctuates throughout the period of the condition and finally the condition severities increase without remitting. Joint tenderness, warmth, and stiffness of joints with several joints affected are also common symptoms of the condition. The stiffness can be common in the morning lasting for several hours where fine tissue bumps on the skin and weight loss can be experienced. As the disease progress, the symptoms spread to other parts, occurring on both sides of the body.
Causes
The condition is ordinarily because of immune system error, where the immune system inflames the joint tissues. The trigger of the immune system attacking itself is not yet known. However, it has been established that the immune system makes antibodies that are sent to attack the lining on joints (Cdc.gov, 2015). The membrane lining the joints is then inflamed and become sore, and thickens causing damage to the nearby bones, cartilage, tendons and ligaments. If the condition is not treated, the joints loose shape, swell at the end causing complete destruction of the joint (Nras.org.uk, 2015). It is not yet established whether there is a viral, bacterial or fungal cause of the disorder. Even though it is suspected that other factors contribute to the trigger of immune system, the argument is still center of sharp focus. Some people who experience the condition may have inherited them due to genetic predisposition. Lymphocytes are activated and chemicals are released to the sites with inflammation. Exposure to silica, chronic periodontal disease is one of the factors attributed to the condition (Budoff, Filopoulos, Kennish, Labitigan, McCracken, Swearingen, & Yazici, 2012).
Diagnosis
Rheumatoid arthritis is possibly diagnosed within six months of onset of symptoms. Treatment can therefore be initiated earlier to halt the progress of the condition (Budoff et al., 2012). The symptoms of the disorder are not specific in early stages and can really bring challenge in the diagnosis, as they may at times be symptoms of other conditions. The condition is diagnosed clinically with proper standards and criteria established for the diagnosis and study (Cdc.gov, 2015). So far, rheumatoid arthritis has no definite test and many conditions that are causative factors may be symptoms. A practitioner assesses all symptoms to establish the possibility of the condition over which when confirmed, a specialist is brought in to handle the case. Blood tests can be conducted to show the possible indication of arthritis. Erythrocyte sedimentation rate is tested through observing how fast the red blood cells fall down the tube to the bottom. A faster falling rate of the cells to the bottom of the tube is an indication of inflammatory condition.
Reactive protein presence in the blood is also a basis for establishing presence of an inflammatory infection in the body, and more presence is a possible indication of an inflammatory disorder ('Guidelines for the management of rheumatoid arthritis: 2008 Update', 2008). Lack of red blood cell that is a symptom of anemia can also be used to diagnose rheumatoid arthritis since persons with arthritis commonly experience anemia too. Imaging is also an important factor for establishing any form of abnormality, aiding in establishing different types of arthritis and monitoring the progress of the condition (McInnes & Schett, 2011).
Prognosis
Rheumatoid arthritis can cause general complications, progressive disability, mortality and socioeconomic impacts (McInnes & Schett, 2011). The therapy of the condition is escalated in order to pursue clinical remission on those people affected. The conventional or biological therapies available for modifying disease only rendered partial as reliable therapeutic responses are lacking. To achieve sustainable remission, continued pharmacology therapy and reliable bio-prediction is necessary (McInnes & Schett, 2011). Patients with the condition exhibit higher mortality rate than the population with other systemic conditions and cardiovascular disease remaining a major challenge for such patients (Nras.org.uk, 2015). There is a major progress in pathogenic mechanisms that control and perpetuate rheumatoid arthritis.
The disease is characterized by inflammation of joint membranes and swelling with antibody activation, destruction of joints, together with other disorders. The condition involves several complex factors ranging from environmental, genotype among the rest. New effective therapies introduced help advance clinical outcomes of the condition (McInnes & Schett, 2011). Other conditions and causative factors related to rheumatoid arthritis have since reduced due to the introduction of new therapies rendering remission possible in patients with the condition. Curative and preventive therapies should be developed to transform the condition from being chronic (McInnes & Schett, 2011).
Treatments
Developments and improvements over the past years have advanced the understanding of genetics, immune system and general biology making it possible for scientists to design treatment for rheumatoid arthritis in conventional ways that were not previously possible (Cdc.gov, 2015). In the past, the treatment was undertaken using non-steroidal anti-inflammatory drugs progressing through to disease modifying anti-rheumatic drugs (DMARDs). There are progressive approaches with increasing biological DMARDs availed that are able to halt the disease progress and prevent deformity (Cdc.gov, 2015). There are different medical guidelines recommended including the biological and non-biological therapies together with non-medical interventions.
Early treatment that include medical and lifestyle interventions with supportive surgery and support are necessary. The focus of the treatment is usually to halt the progress of the condition and reduce disability related to rheumatoid arthritis. The biological treatments and DMARDs are commonly used to prevent the condition from worsening or halt any possible progress of the disease (Cdc.gov, 2015). The DMARDs in their combination help as part of treatment, easing the symptoms and preventing further development of the disease. The drugs have ability to prevent the activity of chemicals released from the trigger of the immune system preventing any further damage of the surrounding cells and tissues (Budoff et al., 2012).
The drugs used in patients to manage the condition have possible side effects and reactions, while other people tolerate it. There must be compatibility test conducted to aid in choice of the drug that will be used to treat the condition. The medication should be continuously taken even if it takes longer to notice any change. There are also newer biological treatments developed for rheumatoid arthritis and are used in combination with DMARDs at a time to achieve better results. The medical treatments are injected thus preventing any emissions that stop chemical in the body from triggering the immune system to attack the joint membranes (Cdc.gov, 2015). The side effects of any biological method are very mild though at some points some patients get risk of more serious problems.
The systems and organs affected by rheumatoid arthritis include the skin, eye, the heart and blood vessels together with lungs and personal emotions (Nras.org.uk, 2015). It is important that the problems are identified earlier and managed to help avoid any further complications in a person. A person is able to develop further complications in lifetime related to these factors making the conditions and other complexities in the body hard to manage. It is important that a person express any problem to a practitioner in the event of managing the condition to aid in care.
The life expectancy of a person with the disease is lower than that of other people without similar conditions due to complexities the patients face. However, awareness of the risk factors, personal management and change in lifestyle are some aspects that can refute the possible differences in terms of life expectancy of persons with arthritis. Onset of the condition at a younger age, longer prognosis together with other critical health complexities can affect the lifespan of a person (Nras.org.uk, 2015). Those who receive earlier attention to their condition may achieve better outcome as any progress and complications are managed and halted.
The latest research being conducted concerning rheumatoid disease is on the treatment and understanding the causative factors of the condition (Chu, Khan, & Ng, 2013). Scientists and researchers continue to explore new means of establishing the actual cause of the disease and progress of means of treating and managing the disease from its earlier stages to its advanced levels. It is possible to achieve advancements for a cure for the disease and possible management to full recovery through increased research and trials.
References
Budoff, S., Filopoulos, M., Kennish, L., Labitigan, M., McCracken, W., Swearingen, C., & Yazici, Y. (2012). Utility of the new rheumatoid arthritis 2010 ACR/EULAR classification criteria in routine clinical care.BMJ Open, 2(5), e001117-e001117. doi:10.1136/bmjopen-2012-001117
Cdc.gov,. (2015). CDC - Arthritis - Basics - Definition - Rheumatoid Arthritis. Retrieved 12 April 2015, from http://www.cdc.gov/arthritis/basics/rheumatoid.htm
Chu, A., & Khan, M., & Ng, B. (2013). A retrospective cohort study: 10-year trend of disease-modifying ant rheumatic drugs and biological agents use in patients with rheumatoid arthritis at Veteran Affairs Medical Centers. BMJ Open, 3(4), e002468-e002468. doi: 10.1136/bmjopen-2012-002468
Guidelines for the management of rheumatoid arthritis: 2008 Update. (2008). Arthritis & Rheumatism, 46(2), 328-346. doi:10.1002/art.101
McInnes, I., & Schett, G. (2011).The Pathogenesis of Rheumatoid Arthritis. New England Journal of Medicine, 365(23), 2205-2219. doi: 10.1056/nejmra1004965
Nras.org.uk,. (2015). NRAS - National Rheumatoid Arthritis Society. Retrieved 12 April 2015, from http://www.nras.org.uk