rheumatoid arthritis…

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ra, arthritis, rheumatoid, rheumatoid arthritis, chronic, long-term, inflammation, the joints, surrounding tissues, it can also affect other organs, rheumatoid arthritis, ra, considered autoimmune disease, the body's immune system, fights off foreign substances, like viruses, in an autoimmune disease, immune system confuses healthy tissue, foreign substances, body attacks, ra can occur at any age, occurs in people between 25, women, affected more often than men, course, severity, the illness, vary considerably, infection, genes, hormones, contribute, ra, affects joints on both sides, the body equally, wrists, fingers, knees, feet, ankles, the most commonly affected, begins gradually, fatigue, morning stiffness, lasting more than one hour, widespread muscle aches, loss of appetite, weakness, eventually, joint pain appears, joint is not used, become warm, tender, and stiff, lining, the joint, synovium, becomes inflamed, gives off more fluid, joint becomes swollen, joint pain, felt on both sides, effect the wrist, knees, elbows, fingers, toes, ankle, neck, additional symptoms, loss of appetite, low-grade fever, limited range of motion, deformities of hands, feet, round, painless nodules under the skin, a sign of more severe disease, inflammation, the lung, pleurisy, skin redness, inflammation, paleness, swollen glands, eye burning, itching, discharge, numbness, tingling, anemia, due to failure, the bone marrow to produce enough new red cells, joint destruction, 1-2 years, appearance, joint x-rays, rheumatoid factor test is positive in, 75% of people, erythrocyte sedimentation rate is elevated, cbc, low hematocrit, anemia, abnormal platelet counts, c-reactive protein a positive indication, patients, no detectable rheumatoid factor, synovial fluid analysis, ra, lifelong treatment, including medications, physical therapy, exercise, education, possibly surgery, aggressive treatment, ra, delay joint destruction, medications, once a diagnosis is confirmed, current standard of care, rest, strengthening exercises, anti-inflammatory drugs, aggressive therapy, disease-modifying anti-rheumatic drugs, dmards, methotrexate, rheumatrex, commonly used dmard, rheumatoid arthritis, others include leflunomide, arava, gold thiomalate, myochrysine, aurothioglucose, solganal, or auranofin, ridaura, anti-inflammatory agents, treat ra include aspirin, non-steroidal anti-inflammatory drugs, nsaids, ibuprofen, motrin, advil, fenoprofen, indomethacin, naproxen, naprosyn, nsaids, commonly used to relieve joint pain, inflammation, nsaids work well, long-term use, cause stomach problems, ulcers, bleeding, heart problems, in april 2005, drug manufacturers of nsaids to, warning label on their product that alerts users of an increased risk, cardiovascular events, gastrointestinal bleeding, cox-2 inhibitors block an inflammation-promoting enzyme, cox-2, this class of drugs was initially believed to work, traditional nsaids, fewer stomach problems, numerous reports of heart attacks, re-evaluate the risks, benefits, the cox-2s, rofecoxib, vioxx, valdecoxib, bextra, have been withdrawn, market following reports of heart attacks in patients taking the drugs, celecoxib, celebrex, still available, labeled, strong warnings, lowest possible dose, the shortest duration possible, the drug is appropriate, safe, antimalarial medications hydroxychloroquine, plaquenil, sulfasalazine, azulfidine, beneficial, in conjunction, methotrexate, it may be weeks, a patient sees any benefit from these medications, toxic side effects, patient must have frequent blood tests, tumor necrosis factor, tnf, inhibitors, a relatively new class of medications, treat autoimmune disease, etanercept, enbrel, infliximab, remicade, adalimumab, humira, adalimumab, etanercept, injectable medications, infliximab is given by iv, another relatively new medication is injectible anakinra, kineret, man-made protein, blocks the inflammatory protein interleukin-1, slow the progression, of moderate to severe active ra, patients over 18, not responded to one, the dmards, kineret, dmards, tnf inhibitors, drugs that suppress the immune system, azathioprine, imuran, cyclophosphamide, cytoxan, used, failed other therapies, medications, toxic side effects, reserved, severe cases of ra, corticosteroids have been, reduce inflammation in ra, more than 40 years, potential long-term side effects, corticosteroid use, limited to short courses, low doses where possible, side effects, bruising, psychosis, cataracts, weight gain, susceptibility to infections, diabetes, high blood pressure, thinning, the bones, osteoporosis, a number of medications, administered, steroids to minimize osteoporosis, consult a health care provider, using any medication, over-the-counter drugs, surgery, surgery is needed, severely affected joints, surgeries, relieve joint pain, correct deformities, modestly improve joint function, most successful surgeries, performed on the knees, hips, first surgical treatment, sysnovectomy, is the removal, the joint lining, synovium, a later alternative is total joint replacement, a joint prosthesis, in extreme cases, total knee, hip replacement, mean the difference, totally dependent on others, having an independent life at home, physical therapy, range-of-motion exercises, individualized exercise programs, prescribed by a physical therapist, delay the loss of joint function, joint protection techniques, heat, cold treatments, splints, orthotic devices to support, align joints, therapists, use special machines to apply deep heat, electrical stimulation to reduce pain, improve joint mobility, occupational therapists, construct splints, hand, wrist, teach how to best protect, use joints, arthritis, people how to better cope, day-to-day tasks at work, at home, despite limitations, ra, frequent rest periods between activities, 8 to 10 hours of sleep per night, prosorba column, prosorba column, the treatment of moderate to severe ra in adults, long-standing disease, not responded to dmards, device removes inflammatory antibodies, blood, procedure takes 2-3 hours, once a week, 12 weeks, studies have reported that ra slows, stops getting worse in, one third to one half, the people who receive this treatment, side effects include anemia, fatigue, fever, low blood pressure, nausea, have developed an infection, tube, remove the blood, flare-up of joint pain, several days, arthritis support group, regular blood, urine tests, determine how well medications are working, drugs, causing any side effects, course of ra differs, from person to person, rheumatoid factor, subcutaneous nodules, more severe form, people who develop ra at younger ages, a more rapidly progressive course, remission, likely to occur, in the first year, probability decreases over time, by 10 to 15 years from diagnosis, 20% of people have remission, 70%, patients, able to work full-time, after 15-20 years, 10% of patients, severely disabled, unable to do simple daily living tasks washing, dressing, eating, average life expectancy, ra shortened by 3 to 7 years, severe forms of ra, die 10-15 years earlier than expected, rheumatoid arthritis improves, severe disability, life-threatening complications, decreasing, rheumatoid arthritis, a disease of joint destruction, involve all organs, a life-threatening joint complication, the cervical spine becomes unstable, a result of ra, rheumatoid vasculitis, inflammation, the blood vessels, serious, potentially life-threatening complication of ra, lead to skin ulcerations and infections, bleeding stomach ulcers, nerve problems that cause pain, numbness, tingling, vasculitis, affect the brain, nerves, heart, cause stroke, heart attack, heart failure, ra may cause the the outer lining, the heart to swell, pericarditis, heart complications, inflammation of heart muscle, myocarditis, of these conditions, lead to congestive heart failure, treatments, ra, cause serious side effects, tell health care provider, better therapies, reducing the occurrence of these severe complications, symptoms of rheumatoid arthritis, rheumatoid arthritis has no known prevention, prevent further damage, the joints, proper early treatment, ra, eye complications, patients, have regular eye exams, us food, drug administration, fda announces series, class of marketed non-steroidal anti-inflammatory drugs, nsaids, national press office, april 7, press release p05-16, food, drug administration, fda issues public health advisory recommending limited use of cox-2 inhibitors, national press office, december 23, 2004. talk paper t04-61.