Clinical Guideline for the Diagnosis and Management of Early Rheumatoid Arthritis PDF Download
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Author:
Publisher:
ISBN: 9780869063002
Category :
Languages : en
Pages :
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Book Description
This guideline presents a comprehensive review of pharmacological and non-pharmacological management of early RA within the Australian health care context, based on the best available evidence available up to December 2006.
Author:
Publisher:
ISBN: 9780869063002
Category :
Languages : en
Pages :
Get Book Here
Book Description
This guideline presents a comprehensive review of pharmacological and non-pharmacological management of early RA within the Australian health care context, based on the best available evidence available up to December 2006.
Author: Scottish Intercollegiate Guidelines Network
Publisher:
ISBN: 9781905813704
Category : Rheumatoid arthritis
Languages : en
Pages : 27
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Book Description
Author: John J. Cush
Publisher: Professional Communications
ISBN: 1932610588
Category : Health & Fitness
Languages : en
Pages : 369
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Book Description
Emphasizes the importance of early intervention in RA with focus on pharmacologic treatments of RA. Detailed information on the various medications employed in treatment, including corticosteroids, NSAIDs, DMARDs, biologic agents, and combination therapy, is reviewed, including evidence-based data on efficacy, safety, side effects, and monitoring requirements. Clinical evaluation is presented, including lab findings, joint scoring, diagnostic criteria, and radiographic outcomes. Surgical options and the management of advanced RA are discussed.
Author: National Collaborating Centre for Chronic Conditions (Great Britain)
Publisher:
ISBN: 9781860163593
Category : Rheumatoid arthritis
Languages : en
Pages : 228
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Book Description
The guideline covers the management of people with rheumatoid arthritis all the way through the disease process - from early identification to sever disease.
Author: Paul Emery
Publisher:
ISBN: 9781416027676
Category : Rheumatoid arthritis
Languages : en
Pages : 0
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Book Description
This issue covers the latest developments in the understanding of rheumatoid arthritis at the early stage. Treatments such as with newer biologic agents and conventional disease-modifying antirheumatic drugs are reviewed. Also included are articles on imaging modalities as a means of identifying those in the early stages and monitoring response to treatment.
Author: Hani Almoallim
Publisher: Springer Nature
ISBN: 9811583234
Category : Medical
Languages : en
Pages : 562
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Book Description
This Open Access book presents practical approaches to managing patients affected by various rheumatological diseases, allowing readers to gain a better understanding of the various clinical expressions and problems experienced by these patients. Discussing rheumatology from an organ systems perspective, it highlights the importance ofdetailed musculoskeletal examinations when treating patients affected by rheumatological diseases. The book first explores the latest diagnostic approaches and offers key tips for accurate musculoskeletal examinations before addressing the various treatment modalities, with a particular focus on the most common joints involved in rheumatoid arthritis: the wrists and the metacarpophalangeal joints (2nd and 3rd). Featuring easy-to-understand flow diagrams and explaining the common medical problems associated with rheumatic disease, such as shortness of breath and anemia, it is not only a valuable resource to rheumatologists, but will also appeal to medical students, junior residents, and primary healthcare physicians.
Author: Ruben Tavares
Publisher:
ISBN: 9780494403518
Category :
Languages : en
Pages : 512
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Book Description
Rationale. Clinical guidelines for rheumatoid arthritis (RA) pharmacotherapy recommend initiating disease modifying anti-rheumatic drugs (DMARDs) within three months of established disease and three months of symptoms are required to establish a diagnosis with certainty. Unfortunately, data on delays to accessing DMARD therapy for early RA is lacking from Canada. These patients may not be receiving optimal treatment in a timely manner. Purpose. To determine the proportion of Canadian RA patients treated with DMARDs within six months of symptom onset; to determine the predictors and components of time to treatment; and, to characterize early pharmacotherapy and clinical management in usual care. Methods. A retrospective chart audit of 339 randomly selected adult patients, clinically diagnosed with RA between June 2001 and May 2003 from the practices of 18 rheumatology specialists. Time to DMARD treatment was determined using Kaplan-Meier analysis. Multivariable logistic regression (LR) and Cox modeling using Markov Chain Monte Carlo multiple imputed data was conducted to determine predictors of delay. Bootstrapping was used to validate LR models. Median component delays and frequency estimates of pharmacotherapies and clinical assessments utilized were determined. Results. Subjects were 50 +/- 14 years at symptom onset and 75.5% were female. At baseline, subjects had a median (interquartile range) of 10 (6,14) swollen and 13 (8,19) tender joints, an erythrocyte sedimentation rate (ESR) of 32 (20,46) mm/h, and C-reactive protein (CRP) of 29 (14,37) mg/L, 69.9% of subjects were rheumatoid factor positive (RF+), 40.4% had an arthritic comorbidity, 41.9% previously consulted another rheumatologist, and the majority (85.0%) were previously treated with non-steroidal anti-inflammatory drugs (NSAIDs). Within six months of symptom onset, 39.1% were treated with DMARDs. Multivariable predictors of increased time from symptom onset to treatment included the existence of an arthritic comorbidity, female gender, and younger age at symptom onset. Previously consulting another rheumatologist and seeing an academic investigator were associated with decreased time to treatment. The major delays occurred prior to rheumatology referral (78%), of which, 27% occurred prior to NSAID therapy. Therapy with DMARDs was initiated a median of 70 days prior diagnosis confirmation. The most common first DMARDs were hydroxychloroquine (HCQ, 55.5%) and methotrexate (MTX, 40.1%). At DMARD initiation, 47.2% were prescribed a combination therapy, including multiple DMARDs for 16.5% and DMARD-corticosteroid combinations for 30.7%. Laboratory assessments frequently accompanied referral letters (81.0%). Joint examination (40.7%), pain (50.2%), function (28.9%), and radiographs (49.7%) were infrequently included in referral letters. Except for radiography (55.5%), all other assessments noted above were conducted at a frequency of greater than 80% at baseline and follow-up by the investigator. Formal assessments of disease activity (DAS, 0.3%; DAS28, 8.6%), functional (HAQ, 34.6%; MHAQ, 16.0%), and pain (VAS, 43.6%) were infrequently collected over follow-up. Conclusions. Almost 40% of RA patients are treated with DMARDs within six months of symptom onset. The largest components of delays to treatment precede referral to rheumatologic care. On average, patients are treated with DMARDs prior to the confirmation of a diagnosis. Attention should be given to the development of RA symptoms in patients with arthritic comorbidities, lesser age, and females, as these variables predict increased time to treatment. Underlying characteristics of subjects who consult a single rheumatologist leading up to diagnosis and those referred to nonacademic specialists need to be explored as they also predict increased time to treatment. In light of patients being started on DMARDs in advance of a confirmed diagnosis, as well as the low proportion of patients with high disease activity early in the disease course, the initial DMARD care provided may be considered aggressive with nearly 50% receiving either multiple DMARDs or single-DMARD-corticosteroid combinations at this time point. The potential improvement in rheumatologic care achievable with tight monitoring of patients should be met with increased frequency of formal disease activity, function, pain and radiography assessments over the course of care.
Author: Scottish Intercollegiate Guidelines Network
Publisher:
ISBN: 9781899893379
Category : Arthritis, Rheumatoid
Languages : en
Pages : 44
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Book Description
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309670950
Category : Medical
Languages : en
Pages : 319
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Book Description
The Social Security Administration (SSA) administers two programs that provide disability benefits: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. SSDI provides disability benefits to people (under the full retirement age) who are no longer able to work because of a disabling medical condition. SSI provides income assistance for disabled, blind, and aged people who have limited income and resources regardless of their prior participation in the labor force. Both programs share a common disability determination process administered by SSA and state agencies as well as a common definition of disability for adults: "the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months." Disabled workers might receive either SSDI benefits or SSI payments, or both, depending on their recent work history and current income and assets. Disabled workers might also receive benefits from other public programs such as workers' compensation, which insures against work-related illness or injuries occurring on the job, but those other programs have their own definitions and eligibility criteria. Selected Health Conditions and Likelihood of Improvement with Treatment identifies and defines the professionally accepted, standard measurements of outcomes improvement for medical conditions. This report also identifies specific, long-lasting medical conditions for adults in the categories of mental health disorders, cancers, and musculoskeletal disorders. Specifically, these conditions are disabling for a length of time, but typically don't result in permanently disabling limitations; are responsive to treatment; and after a specific length of time of treatment, improve to the point at which the conditions are no longer disabling.
Author: Jozef Rovensky
Publisher: Springer Science & Business Media
ISBN: 3211993592
Category : Medical
Languages : en
Pages : 93
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Book Description
In the present monograph, we offer current insights into polymyalgia rheumatica and giant cell arthritis. Both diseases are typical for advanced age, and their incidences increase with aging. Both diseases are a center point of interest not only for rheu- tologists, gerontologists, ophthalmologists or neurologists, but also for general prac- tioners. Early diagnosis and rapid treatment, mainly with glucocorticoids can save one of the most precious senses-vision. Damage to other organs (heart, aorta, co- nary arteries, liver, lungs, kidneys), which are supplied by the arteries affected by ischemic syndrome in the setting of giant cell arthritis, has serious consequences as well. Late diagnosis of giant cell arthritis can have fatal consequences for affected patients. It is a matter of fact that the human population is aging. Therefore, more attention has to be paid not only to diagnosis, clinical course and treatment of rheumatic d- eases in elderly, but also to their genetic, immunologic, endocrinologic, chronobiologic mechanisms, and state-of-the-art diagnostic modalities. I am convinced that the int- disciplinary research of the diseases will allow us to diagnose and treat the rheumatic diseases even faster and more effectively in the future.
