...Thank you for referring Mario Stefanile, a 64-uyear-old gentleman who is a retired maintenance worker. Mario reports a history of asbestos exposure between 1975 and 2015. He was only wearing protective masks since 2010. He is an ex-smoker of less than ten pack-years and keeps two pet dogs that he has had for a number of years. As you are aware, Mario has a history of ischemic heart disease and I note has had three coronary artery stents inserted, the most recent of which was in 2004. He continues to report exertional chest pain, although I gather an echocardiogram from late last year was unremarkable. The last stress test appears to have been in 2015, the results of which I am uncertain of. There is also a history of rheumatoid arthritis diagnosed three years ago and this is polyarticular in nature. Mario is not aware of any extra-articular manifestations. Under the care of Lionel Schachna, he is currently medicated with methotrexate 20mg weekly, prednisolone 10mg daily and sulfasalazine. Other regular medications include Zoloft, Tazac??, Plavix, Coversyl, Caduet, Plaquenil, Minax??, Panadol Osteo, Nexium, Minitran patches and Lyrica....
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...Human NutritionProfessor Chitra Wendakoon | Rheumatoid Arthritis | By Daniel Schramm | Schramm 2/24/2013 | What is Rheumatoid Arthritis? Rheumatoid Arthritis is an autoimmune disease that we do not get from a virus or human contact. The disease is our own body’s immune system turned against its self. Your immune system is an assembly of cells and organs intended to safeguard your body from external intruders. Your structure comprises the spleen, lymph nodes, tonsils, bone marrow and white blood cells. All these work collectively to fight off germs and infections that can harm you or make you sick. When your immune system is not working properly, it sees your own body as an enemy which it attacks, therefore generating a potential illness with an auto immune disease such as Rheumatoid Arthritis (RA). There are several types of auto immune diseases that can upset the body; more notably, the heart, lungs kidneys, brain as well as the joints. Since the 1930′s researchers have been exploring the link between diet and arthritis. We continue to hear claims that special diets, foods and supplements may help to cure or alleviate symptoms of arthritis, but most claims are unproven. Many experts speculate that claims of nutritional remedies and cures with food or dietary supplements are related to the “placebo affect”. The placebo effect is the patient’s perception of improved symptoms and well-being, resulting from new therapy, regardless of evidence for actual...
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...Introduction to Rheumatoid Arthritis Treatment Rheumatoid arthritis is a chronic condition that can change a course of a person’s life. During the last decade there has been significant changes and progress that has been made to treat rheumatoid arthritis. These treatment advances have played a major role in slowing the progression of the disease, and improving quality of life. It is a progressive and painful condition in which the body’s immune system attacks its own tissues, especially a thin membrane that lines the joints called the synovium. It is disease that can have a devastating effect on a person, and it is really necessary for health care workers to recognize its symptoms, provide education and give treatment to slow down the progression of this distressing disease. The article Nursing Considerations for Infusions Therapy in Rheumatoid Arthritis Verus Malignancy by Nicole Furfaro and Philip J. Mease was published in 2008 in the Journal of Infusion Nursing. The article is about the different treatment available for rheumatoid arthritis especially the drug rituximab. It discusses the effects of the medication and important factors infusion nurses need to monitor and be aware of while administering this drug. Another article Treatment of Early Rheumatoid Arthritis by Karim Raza, Mike Salmon and Christopher Buckley was published in 2005 in the Journal Therapy. This article discusses the importance of early treatment of rheumatoid arthritis and compares different studies relating...
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...Instructions: 1. Download and Save this file with your name in the file name. (ex: Skeletal System Case Study-CharlieBrown) 2. Type your name in the header of this document. 3. Read the following case study. 4. Answer all the questions that follow by typing in your answer directly underneath each question. Be sure to answer each question completely. 5. When you finish, be sure to save the entire document for submission to your instructor. 6. Submit your document by the due date listed in your syllabus. Submission should be through the ASUN Portal. Upload your completed document—make sure the file you upload and mark as final has your answers typed in it! Note: You must UPLOAD the document and MARK AS FINAL for it to be properly “turned in” through the Portal. 7. Participate in the Class Discussions of this Case Study—this will be completed on the Discussion Forums page within the ASUN Portal. 8. Email me if you have any questions. The Skeletal System - Aging and Disease The skeletal system is required for nearly every body movement. It also supports the body at rest, protects vital organs, and produces blood cells. However, like any other system, it is susceptible to disease. Different diseases become more (or less) likely as the body ages. A few common diseases include scoliosis, arthritis, and osteoporosis Scoliosis Scoliosis is defined as an “s” or “c” shaped spinal curvature. It is most often diagnosed during adolescence...
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...Rheumatoid Arthritis (RA) is a musculoskeletal and autoimmune disease, which causes the body’s immune system to target and attack primarily its own joints and joint linings (Brodwin, Tellez, & Brodwin, 2009, p. 124). Since RA is a systematic disease, it affects the body as a whole, and is not limited only to joints. The inflammation and pain can spread from the joints, into the cartilage, connective tissue, and ultimately into adjacent organs (Cush, Kavanaugh, & Stein, 2005, p. 323). After the initial diagnosis of RA, there are three classifications that RA can develop into. The first is called Monocyclic RA, which means that an individual is afflicted with a single episode of inflammation, lasting up to five years, and then enters remission....
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...Rheumatoid Arthritis A Review of The Literature Mechanisms of Human Pathology Charles Childers Rheumatoid Arthritis Rheumatoid Arthritis (RA) is a chronic, autoimmune systemic inflammatory process that primarily attacks synovial joints as well as other tissues and organs of the body. This disorder is characterized by hyperplasia of synovial cells leading to an inflammatory response of the synovium that may ultimately cause destruction of articular cartilage. In cases of severe comprehensive damage joints can become ankylosed. RA is usually known to affect the wrist and hands bilaterally and symmetrically, but may be seen in any of the other synovial joints. The destruction can be progressive leading to joint deformations and disabilities.1 RA can also bring inflammation of the lungs, pleura, sclera of the eye, and pericardium. Nodules have been seen in the extensor tendons subcutaneously especially over the olecranon process. As has been reported,1 mechanistic paths to synovitis leading to this articular damage have shown tumor necrosis factor alpha (TNF-α) to take a significant part in joint inflammation responsible for the destruction. Therapies have developed to target TNF-α bringing a substantial impact on patient care. The exact etiology remains unclear in this autoimmune progressive disorder, but much is being looked at in search of an autoantigen or another triggering agent. According to Robinson,2 the importance of early diagnosis and...
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...Autoimmune Diseases Your body's immune system protects you from disease and infection. But if you have an autoimmune disease, your immune system attacks healthy cells in your body by mistake. Autoimmune diseases can affect many parts of the body. These diseases tend to run in families. Women - particularly African-American, Hispanic-American, and Native-American women - have a higher risk for some autoimmune diseases. The diseases may also have flare-ups, when they get worse, and remissions, when they all but disappear. The diseases do not usually go away, but symptoms can be treated. Multiple Sclerosis Is a disease affecting nerves in the brain and spinal cord, causing problems with muscle movement,balance and vision. Every nrve fibre in the brain and spinal cord is surrounded by a layer of protein called myelin which protects the nerve and helps electrical signals from the brain travel to the rest of the body. In MS, the myelin becomes damaged. This disrupts the transfer the transfer of these nerve signals,causing a wide range of potential symptoms such as: * numbness and tingling * blurring of vision * problems with mobility and balance * muscle weakness and tightness * MS can damage nerve fibres in your brain and spinal cord, which can cause muscles to contract tightly and painfully (spasm). Your muscles may also become stiff and resistant to movement, which is known as spasticity. * Neuropathic pain – caused by damage to the nerve fibres in...
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...Evaluate the importance of regular exercise in maintaining a healthy body and mind; to what extent should the state play a role in ensuring that its citizens exercise regularly? Refer to at least two countries in your answer. Abstract Recent years have witnessed a dramatic increase in physical activity and fitness around the world. This essay will focus on the benefits of exercise for both physical and mental health. It is obvious that exercise helps people prevent a variety of diseases such as diabetes, cardiovascular, depression and Parkinson’s. This also raises an argument on whether government should play an important role in promoting physical activity. This essay will clarify that it is reasonable for the state to take responsibilities in order to make sure that social health would be improved in the following years. 1/ Introduction A healthy lifestyle and longer lives are always the target that everyone wants to achieve, specifically; it is obvious that one of the most effective ways to do this is through exercise. Exercise generally means physical activity that makes your body strong and healthy. In addition, exercise also benefits mental health, especially in stressful work conditions which can affect individuals who lead busy lives. Therefore, in my opinion, it will be reasonable for the government (the state) to be responsible for ensuring regular exercise of all citizens. This essay consists of three main parts which will discuss the reasons why physical...
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...& Toys for 4 – 5 Year Olds * Health * Newborn Babies * Skin Problems * Illness * Eyes, Ears, Mouth and Nose * Teen Health * Chronic Conditions * Arthritis * Fibromyalgia * Cholesterol * Diabetes * Depression * Cardiovascular Disease * Adult Health * Allergies * Anaphylaxis * Diagnosis * Newly Diagnosed * Allergy Gear & Fundraising * Allergy Friendly Recipes * Cakes * Muffins * Breads * Pancakes * Cookies & Bars * Meals * Contact Us | Home > Health > Chronic Conditions > Arthritis Arthritis What is ARTHRITIS? Arthritis is a general term for more than 100 diseases and conditions that affect the joints of the bones. It is a degenerative bone disease. Many people with arthritis do not have any symptoms in the early stages. Later, as it progresses, arthritis symptoms may include joint pain, swelling, and stiffness. Swelling may cause the skin to look tight, smooth or shiny. The muscles surrounding the joint may be sore, too. Some common forms of arthritis are osteoarthritis, gouty arthritis (a.k.a. gout), rheumatoid arthritis, psoriatic arthritis and fibromyalgia. While not all of the causes of arthritis are known, several factors that may contribute to a person’s risk of developing the condition have been identified, including… Heredity: A person’s family history may determine the shape of...
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...Case Study 1: In late September a woman brings her 14 yr old daughter to the family physician. The doctor examines the back of the daughter’s thigh where there are pale red, non-raise discolorations. The rash covers a wide area of the thigh and seems to be roughly circular. The center of the circular area appears normal. There are no other symptoms, but the rash has been present for over three weeks and it seems to be growing. The doctor questions about possible exposures. Has she worn any new pants lately? Has she been in the woods? Do her joints hurt? She tells him that she spent the month of August at summer camp in the mountains of Pennsylvania. She’s been wearing mostly shorts and bathing suits for the past two months, none of them new. She doesn’t remember any bites on her thigh. 1. On the basis of the oral history, what is the most likely diagnosis? What would the causative agent look like with gram stain? Lyme Disease is the most likely diagnosis (3). Borrelia burgdorferi will show up pink with gram stain because it is gram – (1). 2. How did she most likely acquire her infection? She most likely acquired the infection from an Ixodes tick bit (deer tick) at summer camp (1). 3. Would the diagnosis be any different if she had attended camp in Arizona? Explain. She may have still gotten a tick bite, but not by the same type of tick (4). In Pennsylvania, it was more than likely by a deer tick, resulting in Lyme Disease (1). In Arizona, she could...
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...of taking dietary supplements, some risks from taking dietary supplements, the government regulations surrounding dietary supplements, I will be discussing Rheumatoid arthritis and the use of an herbal supplement to treat it called cat’s claw. What are Dietary Supplements? Dietary supplements in the United States are classified as substances that you consume by the way of eating or drinking them. Dietary supplements can be herbal, vitamins, minerals, or amino acids, or even a part of all of these substances. Some benefits of taking these dietary supplements are boosting energy, losing weight, stress, heart health, liver health, and even to reduce wrinkles. These are just a few benefits of taking supplements, there are experts that say that there are places in our diet that has a definite need for supplements, but there primary goal is to fill in the gaps that we lose as nutrients. There are risks that are involved with taking dietary supplements and people need to pay close attention when taking to many supplements. Like all drugs there are side effects, Exposures to supplements (such as vitamins, herbs, protein powders, and botanicals) accounted for more than 35,000 calls to US poison control centers in 2011. Of these calls, more than 4,000 people were reportedly treated in health care facilities. More than 800 cases were described as having moderate to severe outcomes, with 4 deaths reported to poison control centers. (Dietary Supplements: What Is Safe?, n.d.) The government...
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...Individual Case Study Database Patient Profile D.K. is 78 year old female who is quite pleasant. D.K. was admitted into Healthsouth on November 3, 2008. D.K.’s admitting diagnoses are Debility, Rheumatoid Arthritis, Triple Arthrodesis on the right hind foot, GERD, Constipation, Hypertension, and Osteoporosis. I was the student nurse assigned to care for D.K. on clinical day November 10, 2008. Communication D.K.’s primary language is English, her speech is within normal limits and she had no difficulty communicating. The therapeutic communication techniques I used in communicating with the client were touch, eye contact, and open ended questions. The touch communication technique was very effective because it showed the client compassion towards the vulnerability the client was experiencing in the hospital. The client had excoriated skin located on her pubis, the primary nurse wanted the client to leave her undergarments off in order to let the skin to heal through air. The client was extremely vulnerable and a simple touch to the client’s hand gave the client a sense of compassion. I also used eye contact, maintaining eye-contact during conversation shows respect and willingness to listen. (Potter, P.A. & Perry, A.G., 2009, p. 345). This technique gave the client a feeling of comfort that someone was listening to her which prompted the to client open up and spoke to me about her life and her family. Using eye-contact with the client gave her a sense of trust in sharing...
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...Name: Institution: Osteoarthritis is a disorder that is characterized y a progressive deterioration of the articular cartilage. This is the most common of all joint diseases and it affects more than 80% of people who reach the age of 70 years and above. Though the suffix of the disease indicate otherwise, osteoarthritis is not characterized by a situation of excessive joint inflammation a s is the case with rheumatoid arthritis. This disease is asymptomatic, especially in the early years of its development. As the disease progresses, the pain, stiffness and also a limitation of movement may develop and grow to something that will become serious with time. The common sites where discomfort is experienced around the vertebrae area, the hips and the knees, or is simple terms, joints that bear much of the weight of the body. The cause of this disorder is not completely clear, but biomechanical forces that usually place stress on joints are thought to interact with biochemical and genetic factors that contribute to osteoarthritis. In the early stages of the disorder, there is roughening and softening of the cartilage, and eventually, they wear away. The bone is deprived of its protective cover and it regenerates the destroyed tissue. The action results to an even remodeling of the surface...
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...1 Introduction to Clinical Applications Objectives In this chapter we will study • various approaches to the study of disease; • the role of the Centers for Disease Control and Prevention; • common causes of disease; • the distinction between signs and symptoms of disease; • terms used to describe the time course of a disease; and • common abbreviations for medical specialists and specialties. Homeostasis and Disease The body’s tendency to maintain internal stability is called homeostasis. Examples include the body’s relatively stable temperature, blood glucose concentration, hormone levels, acid-base balance, and electrolyte balance. When physiological variables deviate too much from their set point, the body activates negative feedback loops that tend to restore stability and maintain health. In some cases, such as the stoppage of bleeding, positive feedback loops are activated to bring about rapid change. If the attempt to regain homeostasis fails, disease results. There is a strong emphasis in medicine today on promoting wellness through prevention. However, this manual focuses on what happens when prevention fails, homeostasis is disrupted, and disease occurs. The Study of Disease Disease (illness) is any deviation from normal that interferes with correct, life-sustaining bodily function. Literally, the word means dis-ease, the opposite of ease (comfort and normal function). Disease may have underlying structural foundations, such as a broken bone, and its...
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... Geriatrics Learning Objectives: The following case pertains to questions 2 and 3. J.T. is an 82-year-old community-dwelling woman with a history of stage III Parkinson disease, hypertension, and urinary incontinence (UI). She is receiving carbidopa/levodopa, pramipexole, selegiline, tolterodine, diazepam, metoprolol, and hydrochlorothiazide. When she comes to your pharmacy to get her prescriptions, she walks slowly with a cane, and she is stooped over. 1. Identify age-related pharmacokinetic and pharmacodynamic changes in older people. 2. Evaluate the pharmacotherapy regimens of older people to support the maintenance of optimal physical and mental function. 3. Identify inappropriate medication prescribing in older people. 4. Recommend appropriate pharmacotherapy for patients with dementia. 5. Evaluate the risks and benefits of the use of antipsychotics (APs) (including atypical APs) in older patients with dementia. 6. Recommend appropriate interventions for patients suffering from behavioral symptoms related to dementia. 7. Identify the types of urinary incontinence and recommend appropriate treatments. 8. Given a patient’s American Urology Association Symptom Index for benign prostatic hyperplasia, recommend appropriate therapy. 9. Recommend appropriate analgesic therapy for older patients with osteoarthritis. 10. Discuss risks and benefits of medication classes used to treat rheumatoid arthritis. 2. Which of the following is the single...
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