Rheumatology

Article Abstract:

Rheumatology is the field of medicine concerned with diseases affecting connective tissues, including arthritis, scleroderma, and lupus erythematosus. The most common form of arthritis is osteoarthritis, in which the cartilage at the joints slowly disintegrates. Often, there is new bone formation as well, adding to the pain and difficulty moving the affected joints. In some families, osteoarthritis is passed from generation to generation as an inherited trait. Genetic research now indicates that the gene responsible for this disorder is the gene for the important connective tissue protein procollagen II. Curiously, some rheumatic diseases seem to be the result of both an inherited factor and an environmental factor. Ankylosing spondylitis is a rheumatic disease which results in an immobile spine. The condition seems to result from infection with any one of several common types of bacteria. Not all people are equally affected by the bacteria, however; only those with the HLA type of B27 are likely to develop the disorder. The relationship of the B27 protein, which is expressed on the surface of many cells in the patients with this HLA type, to the infection and the development of the disease is currently not understood. Many researchers suspect that as more is learned about other rheumatic diseases similar relationships will emerge in them as well. In terms of therapies for rheumatological disorders, methotrexate is being increasingly used for rheumatoid arthritis, in conjunction with folic acid, which can reduce the toxic effects of methotrexate. The mechanism responsible for methotrexate's efficacy against rheumatoid arthritis is unclear. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Reports, Drug therapy, Connective tissue diseases, Joint diseases, Methotrexate

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Rheumatology

Article Abstract:

Topics such as rheumatoid arthritis (RA), silicon breast implants and certain classes of antibodies are receiving increased attention in the practice of rheumatology. The traditional approach to treating RA emphasizes beginning with the mildest drugs and bed rest first and then moving to increasingly stronger drugs if needed. This approach is being questioned because significant damage to the joints occurs early in the disease. The new approach being debated starts treatment with stronger drugs and then tapers down to the milder ones. Studies of the link between silicon breast implants and connective tissue diseases are often based on small sample populations and anecdotal evidence that makes it difficult to assess the magnitude of the relationship. For these reasons the decision to remove breast implants should be made on a case-by-case basis. Antineutrophil cytoplasmic antibodies (ANCA) are associated with certain diseases. A test to detect the presence of ANCA holds promise as a non-invasive method for diagnosing vasculitis, or inflammation of the blood vessels, which may indicate the presence of a systemic disorder.

Research

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Rheumatology

Article Abstract:

Several health assessment questionnaires are being used to evaluate patients with arthritis. Factors that would predict deterioration in patients with rheumatoid arthritis are being studied. New treatments for rheumatoid arthritis include oral antibiotics such as minocycline, oral type II collagen and biological products. Rheumatoid arthritis patients who had Chicken type II collagen in their diets did better than patients receiving a placebo. Clinical osteoarthritis may be genetically linked. Analgesics such as acetaminophen are preferred over anti-inflammatory drugs to control pain. Criteria have been set up to classify fibromyalgia, and better treatment is being investigated.

Genetic aspects, Osteoarthritis, Fibromyalgia

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