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Arthritis Made Simple!
Wheatmark, February 15, 2007
Trim: 7.5 x 9.25
Health & Fitness
People with arthritis frequently struggle with confusing medical terminology and information overload as they try to manage their symptoms. Arthritis Made Simple! is an invaluable resource for anybody who wishes to take control of the process, providing easy-to-understand information about all aspects of the disease:
- The major warning signs of arthritis
- The most common forms of arthritis and related problems
- Prescription drug therapy
- Risks and benefits of various treatments
Equipped with a better understanding of arthritis and its treatment, readers of Dr. Malin Prupas’s comprehensive book will possess the vocabulary required to communicate with healthcare workers, the ability to make informed choices, and the confidence to proceed.
About the Author
Malin Prupas, MD, FACP, is a board-certified rheumatologist and medical internist. As a Fellow of the American College of Physicians and Rheumatology, Dr. Prupas has over twenty-five years of experience caring for patients. Currently, Dr. Prupas is an associate clinical professor of medicine at the University of Nevada, School of Medicine. He is a consultant for several major pharmaceutical companies and has been a principle investigator of more than three hundred clinical drug trials. Many of these investigational medications are now recognized therapies for the treatment of rheumatoid arthritis, osteoarthritis, osteoporosis, and gout. As the medical director of the Arthritis Center of Reno, he has helped thousands of patients with arthritis.
The withdrawal of successful painkillers like Vioxx (rofecoxib) and Bextra (valdecoxib) from the market has added to the confusion about the treatment of arthritis. Even so, there are several new therapies on the horizon. There is a lack of practical information available about arthritis and its treatment for health professionals and patients. This book is intended to be a simple explanation of a difficult subject.
Arthritis is a chronic disease. Arthritis affects everyone in the family. Millions of Americans have some form of arthritis, and one in three families is touched by it. As the American population gets older, musculoskeletal problems will become more important and frequent. The social and economical impact will be significant. Health care providers are preparing for this now. In recognition of the importance of promoting bone health and preventing fractures, the president of the United States declared 2002–2011 as the Decade of the Bone and Joint. Thus, the nation has committed resources to accelerate progress in a variety of areas related to the musculoskeletal system, including bone disease and arthritis.
The immune system normally makes proteins (antibodies) that protect the body against viruses, bacteria, and other foreign materials (antigens). However, in an autoimmune disorder, such as lupus, the immune system loses its ability to tell the difference between foreign cells and its own cells and tissues (self). As a result, the immune system incorrectly makes antibodies directed against itself. These autoantibodies react with the self-antigens to form immune complexes. The immune complexes deposit in various tissues and create inflammation, injury to tissues, and pain. More than 70 percent of people with systemic lupus have these antibodies deposited in different parts of the body. Several types of arthritis are characterized by specific autoantibodies and the immune complexes they form. These antibody markers are not foolproof, but serve as markers distinguishing diseases and the activity of disease.
This immunological mechanism is the body’s defense and is characterized by redness, warmth, swelling, and pain at the site of inflammation. The inflammation at a wound site will bring more blood, including specialized white cells to defend against infection, to the area. Healing begins as the inflammation subsides. Inflammation at the cellular level may not be visible, as is a sore on the skin. Chronic inflammation may be deleterious to good health. The inflammatory response of the body is measured by the C-reactive protein (CRP) in the blood. The inflammation measured by the CRP may contribute to the progression of heart disease. Reduction of inflammation in heart patients has been shown to reduce the progression of atherosclerosis linked to heart attacks and death.
Inflammation may be the link between increased risk of cardiovascular disease and early death in rheumatoid arthritis. Researchers have known that patients with rheumatoid arthritis have a higher mortality rate from heart disease than those individuals without rheumatoid arthritis. The exact mechanism—and whether the CRP measures the actual mechanism that causes plaques in the arteries or is just a sign of it—is unknown. While researchers unravel this complex issue, it is important that physicians pay more attention to the cardiovascular status of patients with arthritis.
Rheumatology is an internal medicine subspecialty providing care to persons with arthritis and related conditions. Rheumatism is a generic term describing all forms of arthritis. Rheumatic illnesses are primarily diseases of the immune system and other disorders that cause pain and inflammation of the joints, muscles, and bones. Osteoarthritis, rheumatoid arthritis, gout, systemic lupus erythematosis, bursitis, and osteoporosis represent some of the many forms of arthritis. Arthritis involves much more than just the joints. When arthritis affects multiple other organ systems of the body, it becomes a systemic illness. Arthritis patients obtain their care from rheumatologists, primary care physicians, and other allied health professionals.
Timely consultation with a rheumatologist can help ensure a positive outcome after a prompt and accurate diagnosis and initiation of appropriate therapy. Coordinated management by the primary care physician, specialist, and therapist is desirable. A rheumatologist can often diagnose and treat arthritis less expensively than doctors not specifically trained in arthritis management.
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