http://www.angirx.com/blog/rheumatic-heart-disease-epidemiology/
rheumatic heart disease epidemiology
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I suffer from rheumatoid arthritis. What are my chances of becoming disabled and can not do something?
Rheumatoid arthritis (RA) is a chronic, progressive inflammatory autoimmune disease that affects more than 2 million Americans. It is a condition that is associated with a mortality increased (death rate) as a result of cancer (lymphoma), cardiovascular events (myocardial infarction and stroke) and significant disability.
The purpose of this paper is to discuss the state of the art in terms of disability.
It is clear that the maintenance of disease activity leads to joint damage leading to disability. Although the disease a patient has active disease, which is poorly controlled, who have a certain degree of deterioration in performance. With the onset of permanent joint damage, however, the disability becomes a major problem.
How serious is the risk of disability in RA? A number of epidemiological studies showed that about 20 per cent of RA patients with disability in the year, between 32 and 50 per cent of patients aged 10 years and up to 90 percent after 30 years.
The most disturbing statistic is the potential degree of disability in the first year. Handicap This scale has a huge impact physical, social, psychological and economic.
Basic research has shown that tumor necrosis factor (TNF) is an important contribution to the joint damage that results from the AR. TNF stimulates cells called osteoclasts, "chew" in cartilage and bone. This process eventually causes the chewing of irreversible joint damage.
Although current therapies, such as combination of methotrexate, TNF-inhibitors (Examples include Enbrel, Humira and Remicade) are very effective against rheumatoid arthritis early there was little evidence of their ultimate impact on the results of work.
Recent studies have however shown that early intervention with methotrexate and anti-TNF therapy is effective in reducing work disability. The best current study (presented at the European League against Rheumatism 2007), is the study PROWD assess the effects of a combination of methotrexate with adalimumab (Humira). The study showed that patients treated with methotrexate and adalimumab was better than the loss of work and working time lost compared to patients treated methotrexate alone.
All studies evaluating new therapies seem to agree on one point: Because of the consequences resulting from irreversible joint damage, early aggressive intervention only prevents irreversible disability.
Therefore, disability prevention and restoration of function should be an important goal of therapy. Both persistent disease activity and joint damage help disability. Using a combination of methotrexate and inhibition of TNF reduces inflammation early and control joint damage. Is this the limitation of damages joints which helps preserve physical function and reduce disability from work.
About the Author
Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info:
Arthritis Treatment
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