How does rheumatoid arthritis affect life expectancy. What are the main complications of RA that can impact longevity. Can you improve your life expectancy with rheumatoid arthritis. What are the key factors influencing prognosis in RA patients.

The Impact of Rheumatoid Arthritis on Life Expectancy

Rheumatoid arthritis (RA) is an autoimmune disorder that can have significant implications for a person’s overall health and longevity. While advances in treatment have improved outcomes, RA still has the potential to reduce life expectancy by 10 to 15 years compared to individuals without the condition.

Why does RA affect life expectancy? The chronic inflammation associated with RA can damage various body systems over time, leading to complications that may shorten lifespan. However, it’s crucial to understand that modern treatments and lifestyle modifications can substantially mitigate these risks.

Understanding Disease Activity and Its Relation to Longevity

Disease activity is a key factor in determining the long-term prognosis for individuals with RA. High disease activity, particularly when sustained over time, is associated with a greater risk of complications and reduced life expectancy.

How is disease activity measured? Rheumatologists use a combination of blood tests and physical examinations to assess disease activity. Regular monitoring allows for timely adjustments to treatment plans, helping to maintain low disease activity and improve long-term outcomes.

The Role of Medications in Managing Disease Activity

Modern RA medications play a crucial role in controlling inflammation and reducing disease activity. By effectively managing these aspects of RA, patients can significantly lower their risk of serious health complications and potentially extend their life expectancy.

Major Complications of Rheumatoid Arthritis Affecting Life Expectancy

While RA primarily affects the joints, its systemic nature can lead to various complications that may impact life expectancy. Understanding these potential issues is crucial for both patients and healthcare providers.

• Cardiovascular disease
• Lung problems
• Increased risk of certain cancers
• Susceptibility to infections
• Digestive system complications

Cardiovascular Complications in RA

Cardiovascular disease is a significant concern for RA patients. The chronic inflammation associated with RA can stress the heart and blood vessels, leading to an increased risk of heart attacks, strokes, and atherosclerosis. In fact, individuals with RA have approximately twice the risk of developing these cardiovascular issues compared to the general population.

Respiratory Complications

RA can affect the lungs, leading to conditions such as interstitial lung disease or pulmonary fibrosis. These respiratory complications can significantly impact quality of life and overall life expectancy if not properly managed.

Cancer Risk in RA Patients

Studies have shown that individuals with RA may have a higher risk of developing certain types of cancer, particularly lymphoma and lung cancer. While the exact mechanisms are not fully understood, chronic inflammation and certain RA medications may play a role in this increased risk.

Predictors of Life Expectancy in Rheumatoid Arthritis

Several factors can help predict life expectancy in individuals with RA. By understanding these predictors, patients and healthcare providers can work together to develop targeted strategies for improving long-term outcomes.

1. Age at RA onset
2. Type of RA (seropositive vs. seronegative)
3. Smoking status
4. Presence of extra-articular manifestations
5. Comorbidities
6. Socioeconomic factors

The Impact of Early-Onset RA

Individuals diagnosed with RA at a younger age may face a more significant impact on life expectancy. Early-onset RA is often associated with more severe symptoms and a longer duration of disease exposure, potentially leading to more complications over time.

Seropositive vs. Seronegative RA

Seropositive RA, characterized by the presence of specific antibodies in the blood (rheumatoid factor or anti-cyclic citrullinated peptide), may be associated with a higher risk of certain complications. Some research suggests that individuals with seropositive RA are more likely to develop lung disease, which can impact overall life expectancy.

Strategies to Improve Life Expectancy with Rheumatoid Arthritis

While RA can pose challenges to longevity, there are numerous strategies that patients can employ to improve their life expectancy and overall quality of life.

Early Diagnosis and Treatment

Why is early diagnosis crucial in RA management? Initiating treatment as soon as possible after symptom onset can help prevent joint damage, reduce inflammation, and lower the risk of long-term complications. Patients who see a rheumatologist early in the disease course tend to have better outcomes in the long term.

Adherence to Treatment Plans

Consistently following prescribed treatment regimens is essential for maintaining low disease activity and preventing complications. Regular check-ups with a rheumatologist allow for monitoring of progress and timely adjustments to treatment plans as needed.

Lifestyle Modifications

Adopting a healthy lifestyle can significantly impact life expectancy for individuals with RA. Key areas to focus on include:

• Maintaining a healthy weight
• Engaging in regular exercise
• Quitting smoking
• Managing stress
• Following a balanced, anti-inflammatory diet

The Importance of Smoking Cessation in RA Management

Smoking is a modifiable risk factor that can have a significant impact on RA prognosis and life expectancy. Smokers with RA are more likely to experience aggressive disease progression and lung inflammation. Quitting smoking can add years to one’s life expectancy, with the greatest benefits seen when cessation occurs before age 40.

How does smoking affect RA? Smoking can exacerbate inflammation, increase disease activity, and potentially reduce the effectiveness of certain RA medications. By quitting smoking, patients can improve their overall health and potentially extend their life expectancy by up to 10 years.

Monitoring and Managing Comorbidities in RA

Given the systemic nature of RA, it’s crucial for patients to be vigilant about potential comorbidities and complications. Regular check-ups and open communication with healthcare providers can help identify and address issues early on.

Cardiovascular Health in RA Patients

How can RA patients protect their heart health? Regular cardiovascular screenings, maintaining a healthy lifestyle, and working with healthcare providers to manage traditional risk factors (such as high blood pressure and cholesterol) are essential. In some cases, additional preventive measures may be recommended to address the increased cardiovascular risk associated with RA.

Bone Health and Osteoporosis Prevention

RA patients are at an increased risk of osteoporosis due to both the disease itself and certain medications used in its treatment. Regular bone density screenings, adequate calcium and vitamin D intake, and weight-bearing exercises can help maintain bone health and prevent fractures.

The Role of Biologic Therapies in Improving RA Outcomes

Biologic medications have revolutionized the treatment of RA, offering new hope for patients in terms of disease control and quality of life. These targeted therapies can help reduce inflammation, slow disease progression, and potentially improve long-term outcomes.

How do biologic therapies impact life expectancy in RA? While more long-term studies are needed, early evidence suggests that effective use of biologic therapies may help reduce mortality risk in RA patients. By controlling inflammation and reducing disease activity, these medications may help mitigate the systemic effects of RA that can impact life expectancy.

Weighing the Benefits and Risks of Biologic Therapies

While biologic therapies offer significant benefits, they also come with potential risks, including an increased susceptibility to infections. Patients and healthcare providers must carefully weigh these factors when considering treatment options, taking into account individual risk factors and overall health status.

The Importance of Mental Health in RA Management

Living with a chronic condition like RA can take a toll on mental health, potentially impacting overall well-being and life expectancy. Depression and anxiety are common among RA patients and can affect treatment adherence, lifestyle choices, and overall quality of life.

How can RA patients protect their mental health? Strategies may include:

• Seeking support from mental health professionals
• Joining support groups or patient organizations
• Practicing stress-reduction techniques like mindfulness or meditation
• Maintaining social connections and engaging in enjoyable activities
• Communicating openly with healthcare providers about emotional well-being

The Mind-Body Connection in RA

Research has shown that psychological stress can exacerbate RA symptoms and potentially impact disease activity. By addressing mental health concerns and developing effective coping strategies, patients may be able to improve both their quality of life and overall health outcomes.

Nutrition and Diet in RA Management

While there is no specific “RA diet,” nutrition plays a crucial role in managing the condition and potentially improving long-term outcomes. A balanced, anti-inflammatory diet can help support overall health, maintain a healthy weight, and potentially complement medical treatments.

What dietary approaches may benefit RA patients? Some strategies to consider include:

• Incorporating omega-3 fatty acids from sources like fish or flaxseed
• Consuming a variety of fruits and vegetables rich in antioxidants
• Limiting processed foods and added sugars
• Considering the Mediterranean diet, which has shown potential benefits for RA patients
• Staying hydrated and limiting alcohol consumption

The Potential Role of Dietary Supplements

Some RA patients may benefit from certain dietary supplements, such as vitamin D or omega-3 fatty acids. However, it’s crucial to consult with a healthcare provider before starting any supplement regimen, as some may interact with RA medications or have unintended effects.

The Future of RA Treatment and Life Expectancy

As research in rheumatology continues to advance, new treatments and management strategies are emerging that may further improve outcomes for RA patients. Personalized medicine approaches, based on individual genetic and clinical factors, hold promise for optimizing treatment efficacy and minimizing side effects.

What emerging therapies show promise for RA? Areas of ongoing research include:

• New biologic targets and small molecule inhibitors
• Gene therapy approaches
• Stem cell treatments
• Improved drug delivery methods
• Precision medicine strategies for tailoring treatments to individual patients

The Role of Patient Empowerment in Improving Outcomes

As treatment options expand and become more complex, patient education and empowerment play an increasingly important role in RA management. By actively participating in their care, staying informed about new developments, and working closely with their healthcare team, patients can take a proactive approach to managing their condition and potentially improving their long-term outcomes.

In conclusion, while rheumatoid arthritis can impact life expectancy, advances in treatment and management strategies offer hope for improved outcomes. By understanding the factors that influence prognosis, adhering to treatment plans, adopting healthy lifestyle habits, and staying engaged in their care, individuals with RA can take significant steps towards optimizing their health and longevity. As research continues to progress, the future looks increasingly bright for those living with this challenging condition.

How to Improve Your Life Expectancy

Could rheumatoid arthritis make you live a shorter life than other people?

People with RA don’t live as long as other people on average. Life expectancy, or how long you may expect to live, is influenced by many things, like your genes, age, medical history, and lifestyle. RA can shorten your life expectancy by as much as 10 to 15 years compared to people who don’t have the disease.

But people with RA are living longer than ever before. Though the disease may still affect life expectancy, it doesn’t have as much impact as it did in the past. Newer, better RA medications that treat inflammation, lower disease activity, and control your disease are a main reason.

Disease Activity and Life Expectancy

Disease activity tells you how well your RA is controlled. The doctor measures it with blood tests and physical exams at your regular appointments. High disease activity means your RA is poorly controlled. High disease activity that stays high over time shortens your life expectancy.

But RA medications can help you lower your disease activity. If it stays low, your risk of serious health conditions and a shorter life span go down, too.

Complications Play a Role

RA doesn’t directly shorten your life. But it does raise your odds of getting some serious health conditions (your doctor will call them complications) that could affect your health and life expectancy:

Heart disease. RA makes you more likely to develop cardiovascular disease. Chronic inflammation stresses your heart and blood vessels over time. People with RA have twice the risk of heart attacks, strokes, and atherosclerosis.

Diabetes. RA makes you more likely to get type 1 and type 2.

Lung and stomach problems. RA also raises your risk of lung and digestive diseases that affect life expectancy.

Cancer. People with RA have a higher risk of some types of cancer, such as lymphoma and lung cancer.

Infections. Some drugs used to treat RA may make you more likely to get infections.

Can You Predict Life Expectancy With RA?

How do you know if RA will affect your life expectancy? Research shows these things can predict a shortened life span:

Other things might also play a role:

Age when your RA started. People diagnosed with RA at a younger age may have a shorter life expectancy. Young adults with RA often have more severe symptoms.

The type of RA you have. People with seropositive RA have one of two antibodies in their blood: rheumatoid factor or anti-cyclic citrullinated peptide (anti-CCP). Some research suggests that if you have seropositive RA, you’re more likely to develop lung disease.

Smoking . This is a something you can control. Smokers with RA are more likely to have lung inflammation and more aggressive RA. Smoking, with or without RA, can shorten your life expectancy by 10 years. Quit smoking or get help to quit. Stop smoking before age 40 to get the most benefit.

Can You Change Your Risk?

Your life doesn’t have be shorter if you have RA. You can raise your life expectancy by getting your disease activity under control. If you lower your disease activity and keep it low, you’ll have a better quality of life and may live longer, too.

Take these steps:

• Start treatment as early as possible. People who see a rheumatologist for diagnosis and treatment soon after they notice symptoms do better in the long term. The sooner you start treatment, the less damage RA can do.
• Follow your treatment plan. See your doctor regularly to watch for complications and keep an eye on your progress.

Other positive things you can do include:

• Stay at a healthy weight.
• Exercise regularly.
• Don’t smoke.
• If you notice any unusual symptoms, tell your doctor right away. They may be early signs of complications that need to be treated.

How RA Can Become Life-Threatening

When rock music legend Glenn Frey died at age 67 due to complications from rheumatoid arthritis (RA), many people expressed shock. After all isn’t arthritis mainly a nuisance condition, causing stiff and painful joints? How can arthritis cause someone to die?

As an autoimmune disorder, RA can affect the health and function of many body systems and individual organs. Here are a few ways rheumatoid arthritis can turn life-threatening.

RA is different from osteoarthritis.

When you hear the word “arthritis,” you may initially think of osteoarthritis. This common condition causes pain and stiffness in the fingers, knees and other joints. Because osteoarthritis is caused by wear-and-tear to the lining of your joints, many people develop osteoarthritis as they age. Doctors generally treat this type of arthritis with anti-inflammatory medications like ibuprofen. Severe osteoarthritis in a major joint like the knee might be treated with joint replacement surgery, but as a rule osteoarthritis is not considering a life-threatening condition.

Rheumatoid arthritis, on the other hand, does not result from wear-and-tear to the joints. As an autoimmune disorder, RA occurs when your body’s immune system mistakenly attacks its own healthy tissue. RA is an incurable disease that can threaten a person’s life through heart and lung damage.

Rheumatoid arthritis can cause life-threatening complications.

At its core, RA is an inflammatory disease process. It is considered “systemic,” which means the inflammation affects all of your body’s systems in some way. The first symptoms of RA might be painful finger joints, but other effects of the disease can include:

• Anemia: low red blood cell count
• Atherosclerosis: hardening of the arteries
• Osteoporosis: thinning of the bone tissue
• Pericarditis: inflammation of the heart lining
• Rheumatoid lung: inflammation and scarring of the lungs
• Scleritis: inflammation and/or scarring of the whites of the eyes
• Skin nodules and rashes: bumps or change in skin texture or color
• Vasculitis: inflammation of small and medium-sized blood vessels throughout the body

When RA causes serious complications, they can quickly turn life-threatening. For example, scarring of the lung tissue can make it impossible for the body to take in enough oxygen or expel enough carbon dioxide to survive. And if a person develops multiple RA complications, the results can be dire.

But there are ways to stay healthy with RA.

Fortunately, not everyone who has rheumatoid arthritis will develop serious complications. Many people with RA live active, productive lives. While the condition is not yet curable, you can take many steps to stay as healthy as possible when you have RA:

• Apply heat and cold to relieve joint pain.
• Eat healthfully, including a diet rich in omega-3 fatty acids like the kind you get from eating salmon.
• Relax through meditation, walking or another technique to reduce stress and improve your quality of life.
• Stay physically active to preserve joint function and keep your muscles strong.
• Stop smoking, as tobacco use seems to worsen RA symptoms.
• Work closely with an experienced rheumatologist to explore the best treatment options for you.

As you can see, rheumatoid arthritis is a condition that goes well beyond the nuisance of swollen joints. This inflammatory autoimmune disease affects many body systems and can even turn life-threatening when its complications affect the lungs or heart. But with careful management and healthy lifestyle choices, you can continue to live well even in the face of RA.

Rheumatoid Arthritis Can be Deadly

20 Aug Rheumatoid Arthritis Can Cause Deadly Complications if Left Untreated

Posted at 05:00h
in Joint Pain
by Kim Smith

Rheumatoid arthritis can be very painful, and it’s one of the most common types of arthritis that Dr. Nikesh Seth treats. However, did you know that it can be deadly if it’s not treated correctly? Rheumatoid arthritis, or RA, is a chronic type of arthritis that increases your odds of lung and heart disease. The actual risk depends on many factors, including how RA progresses, the patient’s lifestyle, and their age. Although there is no cure for RA, there are a variety of treatments available to slow down the progression and ultimately minimize complications.

RA increases inflammation in the body’s tissue

RA increases inflammation in the body’s tissue. Although RA itself isn’t deadly, the resulting inflammation can be life-threatening. The Rheumatoid Arthritis Support Network reports that RA patients have lifespans 10 – 15 years shorter than the average population. However, if you have RA, you can beat those odds by getting the right treatment as quickly as possible. When a person with RA controls their symptoms, their life spans are the same as everyone else.

Inflammation can lead to permanent organ damage

Inflammation can lead to permanent organ damage over time. However, recent reports have found that mortality rates in those with RA have been decreasing in recent years. This is likely due to improved treatment, earlier diagnoses, and patients being more informed about how lifestyle changes can increase their lifespan with RA.

Nobody knows exactly what causes RA, and there’s no one size fits all treatment. However, trying different approaches with the guidance of a skilled pain expert can help you slow down the progression of RA and minimize pain. One of the most common symptoms of RA is back pain, which happens when your body’s immune system attacks the spine’s synovial lining. Compression of the spinal cord can happen in advanced stages of RA.

Schedule your checkup with IPC today to discuss treatment options for Rheumatoid arthritis

If you have arthritis or suffer from any type of pain, an early diagnosis is critical. Call Integrated Pain Consultants at 480-626-2552 and get on the fast track to management.

What kills patients with rheumatoid arthritis? | Rheumatology

Patients with rheumatoid arthritis (RA) die at a younger age than their peers in most hospital series [ 1 ], while an increase in standardized mortality rate (SMR) has not been a consistent feature in recent studies of RA patients from date of diagnosis (inception cohorts) [ 2 ]. The reasons for this apparent discrepancy are likely to be the presence of more severe disease in hospital-based series and the advent of earlier and more effective treatment in recent years. However, an increased mortality from vascular disease in RA has been consistently reported in both established and inception studies [ 1 , 3 ], and an increased SMR for respiratory disease and lymphoreticular cancers has also been recognized in most series.

A detailed study in this month’s issue addresses the important question of whether patients with RA treated early and actively with disease-modifying anti-rheumatic drugs (DMARDs) still have increased mortality rates [ 4 ]. The study assesses the effect of modern out-patient intervention on all-cause mortality in a large inception cohort over the first 7 yrs of their disease, and examines whether this relates to disease severity or duration. Detailed assessment of the causes of death offers new insights into the relevance of both cardiovascular and respiratory contributions to mortality and attempts to identify risk factor profiles.

Although increasing age and male gender have been recognized as predictors for an earlier death in RA, few other clues as to an individual’s risk of premature death have been identified. However, recent work has shown direct links between rheumatoid disease activity, increased comorbidity and early death [ 5 , 6 ]. The Early Rheumatoid Arthritis Study (ERAS) group [ 4 ] reports on 1429 patients recruited within 2 yrs of diagnosis over the 11 yrs from 1986. Although 84% received therapy with DMARDs, the all-cause SMR was significantly raised. After increased age, the odds ratios for death were most elevated in those patients with extra-articular disease and in those with established comorbidity.

Early death was most often due to cardiovascular disease or interstitial pulmonary fibrosis, although other vascular and respiratory causes were also over-represented. Cardiovascular disease accounted for 31% of all deaths while pulmonary problems (including respiratory infection and lung cancer) were responsible for almost 29%.

Ischaemic heart disease (IHD) accounted for a quarter of all deaths and carried an SMR of 1.49. It was also the most common cause of death at a young age and had a worse prognosis than in patients without RA. There was a relationship between disease activity as assessed by erythrocyte sedimentation rate (ESR) and probability of death from IHD, a finding consistent with previous reports linking increased markers of inflammation with coronary artery disease [ 7 ]. This suggests that DMARD therapy should protect RA patients from developing IHD, and reinforces the need for such therapy to be commenced early in the disease and used aggressively where possible, aiming for remission within the first year of disease.

The link between cardiac disease and other therapeutic agents is less clear. Oral steroids did not have any clear effect on cardiovascular mortality but high-dose or long-term therapy might be expected to adversely affect the traditional risk factor profile by increasing blood pressure and body mass index and worsening the lipid profile. The influence of non-steroidal anti-inflammatory drugs (NSAIDs) on cardiovascular health has been much debated lately. COX-2 drugs especially have been linked with an increase in vascular events (in the order of one additional event per 100 patient years), with the data leading to the ultimate withdrawal of rofecoxib. However, a recent major meta analysis of the data on all NSAIDs report that many non-selective agents such as ibuprofen and diclofenac are also associated with an increased risk of adverse cardiovascular events, although it was unclear as to whether this effect was linked to dose or duration of treatment [ 8 ].

Perhaps the most striking aspect of the ERAS report is the high mortality resulting from interstitial pulmonary fibrosis (IPF). This accounted for 6% of all deaths and exceeded the combined number of deaths from all other extra-articular features of RA. It especially affected those patients with a younger age at onset of RA. Given that features of IPF can be shown using high-resolution computed tomography (HRCT) in up to 20% of RA patients [ 9 ], this is a significant finding. Although there is some evidence that the natural history of IPF in RA is better than that in cryptogenic fibrosis [ 10 ], there is a paucity of data in the literature on this condition. Recent concern has been expressed that the natural history is worse in patients on biological agents following reports linking death from accelerated IPF in patients receiving etanercept, infliximab or adalimumab. Indeed the BSRBR confirms that deaths from IPF are increased nearly 3-fold in patients on anti-tumor necrosis factor (anti-TNF) agents when compared with controls on methotrexate. Methotrexate itself has not been shown to cause deterioration in lung function in large series of patients, but nor does it appear to have any beneficial effect on IPF. Its ability to cause pneumonitis places patients with reduced respiratory reserve at increased risk, and is a cogent argument for the assessment of pulmonary function prior to its use, with patients demonstrating a restrictive defect requiring greater definition using HRCT to identify those patients with significant underlying lung disease [ 11 ]. Perhaps the choice of DMARD in patients with proven IPF should be driven by consideration of the lung disease as much as by the degree of articular involvement?

Drug-related deaths were reported in the ERAS report, and these related largely to the use of NSAIDs which were responsible for eight fatalities resulting from upper gastrointestinal haemorrhage or perforation. Most of these patients had been on long-term therapy with NSAIDs but some had only recently commenced these agents. There is good evidence to implicate Helicobacter pylori infection in upper gastrointestinal ulceration, and recent work has shown that the presence of this bacterial agent together with NSAID exposure in RA patients greatly increases their risk of having an endoscopically visualized peptic ulcer [ 12 ]. Drugs may also have contributed to the greatly increased SMR (350) recorded for renal failure in the study, given the propensity of NSAIDs to precipitate renal failure in patients with reduced glomerular filtration rates. Taking these findings together with those linking NSAIDs with increased cardiovascular mortality, it is time for rheumatologists and primary care practitioners to reduce dependence on NSAIDs, particularly in patients with a high 10-yr risk of cardiovascular disease, a history of dyspepsia or evidence of reduced renal function.

The risk of death as a result of infection is increased in patients with RA and this is reflected in the ERAS report. Septicaemia had an SMR of nearly 700, and chest infections were the most common respiratory cause of death. The link between infection and RA has been established for over half a century and chronic infection such as bronchiectasis may predate RA, and has been proposed to precipitate it through the formation of immune complexes. The prevalence of bronchiectasis in RA has been shown to be as high as 20% in some studies using HRCT; although there is little information in the literature as to how to manage this in RA patients. Many other infectious processes and organisms have been putatively linked with the subsequent development of RA and certain antibiotics are reported to have disease-modifying potential. However, the reasons for the increased prevalence of infection in RA are not entirely clear. Drugs have been cited as a contributory factor and the use of anti-TNF agents is contraindicated in patients with chronic infection. However, the ERAS group did not find evidence to implicate DMARDs, although oral steroids were not entirely exonerated. The evidence suggests that active RA is itself associated with a reduced response to infection and that patients failing to mount an adequate leucocyte response to sepsis are at greatest risk of succumbing to it. This is may be further compounded by the lack of normal clinical signs of infection, which in turn may result in delays in treatment. This reinforces the need to ensure that all patients with RA are advised to have immunization against influenza annually, and pneumococcal vaccination should be considered 5-yearly (especially for patients on methotrexate who have been shown to have a suboptimal response to vaccination) [ 13 ]. Those patients who do develop infection require early assessment and intervention as the risk of atypical infection and adverse outcome is high. Guidelines for ‘surviving sepsis’ [ 14 ] and managing pneumonia [ 15 ] are proven to reduce mortality and are recommended for use in these settings.

Another area highlighted in the study published in this month’s issue relates to the inadequate recording of RA as a contributory or causative factor on death certificates. In spite of a very high retrieval rate of certification, the presence of RA was recorded only in 18% of all deaths occurring in patients with the disease. This observation has been reported for 20 yrs [ 16 ], and the lack of progress over this time highlights the need for all primary and secondary care physicians to recognize the systemic and potentially severe nature of the disorder. Similar issues have been reported with the under-recording of diabetes as a contributory factor in deaths in patients with this condition. Indeed, RA has been compared with diabetes through its association with premature demise as a result of accelerated atherosclerosis, high incidence of renal failure and increased risk of infection, several of the factors confirmed as contributing to death in the ERAS report.

Perhaps rheumatologists should consider revising the approach adopted in the routine assessment of RA patients by using an annual review form to include the systemic aspects of the disease in addition to its articular manifestations. This could be roughly analogous to the approach taken by diabetologists for decades, which has helped to reduce mortality through regularly recording of predictors such as blood lipid profiles, blood pressure, hepatic and renal function, together with a global measurement of disease activity. In diabetes this is usually HbA1c, but with the advent of the Disease Activity Score (DAS), which is now in common use in rheumatology clinics for the identification and assessment of patients who may qualify for anti-TNF treatment, we have the opportunity to use this as our own analogous global measurement of severity in all patients with RA. This approach might go some way to identifying and protecting those RA patients at greatest risk of premature death through reversible causes, and reinforces the need for RA patients to have ongoing specialist input––in contrast to the Government’s latest edict suggesting care for such patients could be undertaken in the community. Much progress has already been made lately in the management of RA but with greater attention to detail, combined with improved partnerships with patients, primary care physicians and secondary care colleagues; the next decade may bring further reductions in mortality.

The authors have declared no conflicts of interest.

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Rheumatoid arthritis – Complications – NHS

Rheumatoid arthritis can put you at a higher risk of developing other conditions, particularly if it’s not well controlled.

Some of these conditions are described below.

Carpal tunnel syndrome

Carpal tunnel syndrome is a common condition in people with rheumatoid arthritis.

It’s caused by compression of the nerve that controls sensation and movement in the hands (median nerve) and has symptoms such as:

• aching
• numbness
• tingling in your thumb, fingers and part of the hand

Symptoms of carpal tunnel syndrome can sometimes be controlled with wrist splints or steroid injections, although surgery to release the pressure on the median nerve may be needed in severe cases.

Find out more about treatment for carpal tunnel syndrome.

Widespread inflammation

Rheumatoid arthritis is an inflammatory condition which can cause inflammation to develop in other parts of your body, such as the:

• lungs – inflammation of the lungs or lung lining can lead to pleurisy or pulmonary fibrosis, which can cause chest pain, a persistent cough and shortness of breath
• heart – inflammation of the tissue around the heart can lead to pericarditis, which causes chest pain
• eyes – inflammation of the eyes can lead to scleritis or Sjögren’s syndrome. Scleritis can cause eye redness and pain, whereas Sjögren’s syndrome can cause dry eyes
• blood vessels – inflammation of the blood vessels, known as vasculitis, is the thickening, weakening, narrowing and scarring of blood vessel walls. In serious cases, it can affect blood flow to your body’s organs and tissues and can be life threatening

However, with early treatment, inflammation in other parts of the body from rheumatoid arthritis is less likely.

Joint damage

If rheumatoid arthritis is not treated early or is not well controlled, the inflammation in your joints could lead to significant and permanent damage.

Problems that can affect the joints include:

• damage to nearby bone and cartilage (a tough, flexible material that covers the surface of joints)
• damage to nearby tendons (flexible tissue that attach muscle to bone), which could cause them to break (rupture)
• joint deformities

These problems sometimes need to be treated with surgery to prevent loss of function in the affected joints.

Cardiovascular disease

If you have rheumatoid arthritis, you’re at a higher risk of developing cardiovascular disease (CVD).

CVD is a general term that describes conditions affecting the heart or blood vessels, and it includes life-threatening problems such as heart attack and stroke.

It’s not clear exactly why people with rheumatoid arthritis are at an increased risk of these problems. You can reduce your risk by ensuring your arthritis is well controlled and by:

• stopping smoking
• eating a healthy, balanced diet
• exercising regularly

Find out more about preventing CVD.

Cervical myelopathy

If you’ve had rheumatoid arthritis for some time, you’re at increased risk of developing a problem at the top of your spine known as cervical myelopathy.

Your may need a special assessment of your neck before any operation where you’re given general anaesthetic.

This condition leads to dislocation of joints at the top of the spine, which puts pressure on the spinal cord. Although uncommon, it’s a serious condition that can greatly affect your mobility and lead to permanent spinal cord damage if not treated quickly with surgery.

Want to know more?

Page last reviewed: 28 August 2019
Next review due: 28 August 2022

Cardiovascular case fatality in rheumatoid arthritis is decreasing; first prospective analysis of a current low disease activity rheumatoid arthritis cohort and review of the literature | BMC Musculoskeletal Disorders

Juvenile Rheumatoid Arthritis | Johns Hopkins Medicine

What is juvenile idiopathic
arthritis?

Juvenile idiopathic arthritis (JIA) is a form of arthritis in children. Arthritis
causes joint swelling (inflammation) and joint stiffness. JIA is arthritis that
affects one or more joints for at least 6 weeks in a child age 16 or younger.

Unlike adult rheumatoid arthritis, which is ongoing (chronic) and lasts a lifetime,
children often outgrow JIA. But the disease can affect bone development in a growing
child.

There are several types of JIA:

Systemic onset
JIA. This type affects one or more joints. There is often a high
fever and a skin rash. It may also cause inflammation of internal organs, including
the heart, liver, spleen, and lymph nodes. It is the least common type. It affects 1
in 10 to about 1 in 7 children with JIA.

Oligoarticular
JIA. This type affects 1 to 4 joints in the first 6 months of
disease. If no more joints are affected after 6 months, this type is called
persistent. If more joints are affected after 6 months, it is called extended.

Polyarticular
JIA. This type affects 5 or more joints in the first 6 months of
disease. Blood tests for rheumatoid factor (RF) will show if this type is
RF-positive or RF-negative.

Enthesitis-related
JIA. With this type, a child has arthritis as well as enthesitis.
This is a swelling of the tissue where bone meets a tendon or ligament. It often
affects the hips, knees, and feet.

Psoriatic
arthritis. With this type, a child may have both arthritis and a
red, scaly skin disease called psoriasis. Or a child may have arthritis and 2 or
more of the following:

• Inflammation of a finger or toe
• Pits
  or ridges in fingernails
• A
  first-degree relative with psoriasis

Undifferentiated
arthritis. This is arthritis that has symptoms of 2 or more JIA
types above. Or the symptoms might not match any type of JIA.

What causes juvenile idiopathic
arthritis?

Like adult rheumatoid arthritis, JIA is an autoimmune disease. This means the
body’s immune system attacks its own healthy cells and tissues. JIA is caused by
several things. These include genes and the environment. This means the disease can
run in families, but can also be triggered by exposure to certain things. JIA is
linked to part of a gene called HLA antigen DR4. A person with this antigen may be
more likely to have the disease.

What are the symptoms of
juvenile idiopathic arthritis?

Symptoms may appear during episodes (flare-ups). Or they may be ongoing (chronic).
Each child’s symptoms can vary. Symptoms may include:

• Swollen, stiff, and painful joints in the knees, hands, feet, ankles,
  shoulders, elbows, or other joints, often in the morning or after a nap
• Eye
  inflammation
• Warmth and redness in a joint
• Less
  ability to use one or more joints
• Fatigue
• Decreased appetite, poor weight gain, and slow growth
• High fever and rash (in systemic JIA)
• Swollen lymph nodes (in systemic JIA)

These symptoms can seem like other health conditions. Make sure your child sees his
or her healthcare provider for a diagnosis.

How is juvenile idiopathic
arthritis diagnosed?

Diagnosing JIA may be difficult. There is no single test to confirm the disease.
Your child’s healthcare provider will take your child’s health history and do a
physical exam. Your child’s provider will ask about your child’s symptoms, and any
recent illness. JIA is based on symptoms of inflammation that have occurred for 6
weeks or more.

Tests may also be done. These include blood tests such as:

• Antinuclear antibody (ANA) and other antibody tests. These tests
  measure blood levels of antibodies that are often seen in people with rheumatic
  disease.
• Complete blood count (CBC). This test checks for low counts of red
  blood cells, white blood cells, and platelets.
• Complement test. This test is done to measure the level of complement.
  This is a group of proteins in the blood that help destroy foreign substances.
  Low levels of complement in the blood are linked to immune disorders.
• Erythrocyte sedimentation rate (ESR or sed rate). This test looks at
  how quickly red blood cells fall to the bottom of a test tube. When swelling and
  inflammation are present, the blood’s proteins clump together and become heavier
  than normal. They fall and settle faster at the bottom of the test tube. The
  faster the blood cells fall, the more severe the inflammation.
• C-reactive protein (CRP). This protein shows up when inflammation is
  found in the body. ESR and CRP show similar amounts of inflammation. But one may
  be high when the other is not. This test may be repeated to check a child’s
  response to medicine.
• Creatinine. This is a blood test to check for kidney disease.
• Hematocrit. This measures the number of red blood cells in a blood
  sample. Low levels of red blood cells (anemia) are common in people with
  inflammatory arthritis and rheumatic diseases.
• Rheumatoid factor (RF). This test checks to see if RF is in the blood.
  This is an antibody found in the blood of most people who have rheumatoid
  arthritis and other rheumatic diseases.
• White
  blood cell count. This measures the number of white blood cells in the
  blood. Higher levels of white blood cells may mean an infection. Lower levels
  may be a sign of some rheumatic diseases or a reaction to medicine.

Your child may also have imaging tests. These can show how much damage the bones
have. The tests may include:

• X-rays. This test uses a small amount of radiation to make images of
  organs, bones, and other tissues.
• CT
  scan. This uses a series of X-rays and a computer to make detailed
  images of bones, muscles, fat, and organs. CT scans are more detailed than
  regular X-rays.
• MRI. This test uses large magnets and a computer to make detailed
  pictures of organs and structures in the body.
• Bone
  scan. This uses a small amount of radiation to highlight the bones in a
  scanner.

Other tests may include:

• Urine
  tests. These look for blood or protein in the urine. This can mean the
  kidneys are not working normally.
• Joint
  aspiration (arthrocentesis). A small sample of the synovial fluid is
  taken from a joint. It’s tested to see if crystals, bacteria, or viruses are
  present.
• Full eye exam done by an ophthalmologist

How is juvenile idiopathic
arthritis treated?

The goal of treatment is to reduce pain and stiffness, and help your child keep as
normal a lifestyle as possible.

Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.

Treatment may include medicines such as:

• Nonsteroidal anti-inflammatory medicines (NSAIDs), to reduce pain and
  inflammation
• Disease-modifying antirheumatic medicines (DMARDs), such as methotrexate, to
  ease inflammation and control JIA
• Corticosteroid medicines, to reduce inflammation and severe symptoms
• Medicines called biologics that interfere with the body’s inflammatory
  response. They are used if other treatment isn’t working.

Talk with your child’s healthcare provider about the risks, benefits, and possible
side effects of all medicines.

Other treatments and lifestyle changes may include:

• Physical therapy, to improve and maintain muscle and joint function
• Occupational therapy, to improve ability to do activities of daily living
• Nutrition counseling
• Regular eye exams to find early eye changes from inflammation
• Regular exercise and weight control
• Getting enough rest
• Learning to use large joints instead of small joints to move or carry
  things

What are the complications of
juvenile idiopathic arthritis?

Nearly half of all children with JIA recover fully. Others may have symptoms for
years. Some will have rashes and fever. Others may have arthritis that gets worse.
Problems may include slow growth and thinning bones (osteoporosis). In rare cases,
there may be problems with the kidneys, heart, or endocrine system.

Helping your child live with
juvenile idiopathic arthritis

Help your child manage his or her symptoms by sticking to the treatment plan. This
includes getting enough sleep. Encourage exercise and physical therapy and find ways
to make it fun. Work with your child’s school to make sure your child has help as
needed. Work with other caregivers to help your child take part as much possible in
school, social, and physical activities. Your child may also qualify for special
help under Section 504 of the Rehabilitation Act of 1973. You can also help your
child find a support group to be around with other children with JIA.

When should I call my child’s
healthcare provider?

Tell the provider if your child’s symptoms get worse or there are new symptoms.

Key points about juvenile
idiopathic arthritis

• JIA is a form of arthritis in children ages 16 or younger. It causes joint
  inflammation and stiffness for more than 6 weeks.
• The
  disease may affect a few joints or many joints. It may cause symptoms all over
  the body.
• The
  most common symptoms include swollen, stiff, warm, red, and painful joints.
• Treatment options include medicines, physical therapy, healthy eating and
  exercise, eye exams, and rest.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At
  the visit, write down the name of a new diagnosis, and any new medicines,
  treatments, or tests. Also write down any new instructions your provider gives
  you for your child.
• Know
  why a new medicine or treatment is prescribed and how it will help your child.
  Also know what the side effects are.
• Ask
  if your child’s condition can be treated in other ways.
• Know
  why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test
  or procedure.
• If
  your child has a follow-up appointment, write down the date, time, and purpose
  for that visit.
• Know how you can contact your child’s provider after office hours. This is
  important if your child becomes ill and you have questions or need advice.

90,000 What chronic diseases are especially dangerous during the coronavirus | World Events – Estimates and Forecasts from Germany and Europe | DW

The SARS-CoV-2 coronavirus epidemic continues to spread around the world – the total death toll from COVID-19 pneumonia has exceeded 42,000. Whole countries are quarantined, epidemiologists and virologists do not stop calling for self-isolation of those at risk: people older 65 years old and patients with chronic diseases and weakened immunity.Who needs to be extra careful and what diseases cause the immune system to malfunction?

Asthma and chronic lung diseases

Bronchial asthma is a chronic disease characterized by repeated attacks of suffocation and wheezing. The frequency of attacks can vary from several times a day to several times a week. The WHO estimates that 235 million people worldwide suffer from asthma. It is also the most common chronic illness in children.

During an asthma attack, the mucous membrane of the bronchi swells, the airways spasm and narrow, which causes less air to enter the lungs. It becomes difficult for asthmatics to inhale and especially exhale. Attacks are accompanied by coughing, wheezing, increased shortness of breath. The body tries its best to counteract them, and this struggle significantly weakens it.

According to WHO estimates, 235 million people suffer from asthma

Asthma attacks can provoke allergens and respiratory tract infections.In this case, the immune system has to fight not only with asthma, but also with other diseases. Sometimes she is unable to cope with her task, and in the most unfavorable cases this can lead to irreversible consequences.

Another disease of the respiratory system is chronic obstructive pulmonary disease (COPD). It is believed that tobacco smoke is one of the main causes of COPD, and both active and passive smokers are at risk. The immune system of people with COPD, which has to fight other diseases as well, is doubly stressed.The lungs of COPD patients are severely damaged and viruses have much fewer barriers to entry.

Diabetes mellitus

Diabetes occurs when the pancreas does not produce enough insulin or when the body cannot efficiently use the insulin it produces. This leads to a chronic high blood sugar – hyperglycemia.

There are two types of diabetes. The first type, also called insulin-dependent, is characterized by a lack of insulin production.Mostly children are exposed to it. Type 2 diabetes affects about 90 percent of those who have the disease. It develops as a result of the body being unable to efficiently use the insulin it produces.

Type 2 diabetes affects about 90 percent of patients with this disease

High blood sugar weakens the body’s resistance. Infectious diseases, especially those with fever, can dramatically worsen the condition of diabetics – even those whose disease is well controlled with medication.

But with diabetes mellitus, not only carbohydrate metabolism is disturbed. The disease can affect blood vessels and affect the state of internal organs, subjecting them to additional stress. And then it becomes much more difficult for the immune system to protect the body from foreign and harmful interference.

Cardio – vascular disease

More people die each year from cardiovascular disease (CVD) than from any other disease.According to the WHO, in 2016 they caused the death of almost 18 million people, which is one third of all deaths in the world. In 85 percent, death was from a heart attack (heart attack) or stroke. CVDs include coronary artery disease, in which the blood vessels are unable to supply blood to the heart muscle, and disease of the vessels that supply blood to the brain.

Any infectious disease for people with similar problems can be fatal. The same applies to those who suffer from dysfunction of the heart valves: viral infections can destabilize the functioning of the entire body.

Hypertension

Hypertension or hypertension characterized by high blood pressure is a widespread disease. In Germany alone, there are 20-30 million hypertensive patients, and their number in the world is 1.13 billion people.

Only in Germany alone 20-30 million hypertensive patients

Hypertension is considered one of the leading causes of death on our planet. It also increases the risk of developing diseases of the cardiovascular system, brain and other diseases.

High blood pressure leads to damage to arterial vessels and affects the work of the heart, which is forced to be in a state of overload. This can lead to the development of severe cardiovascular diseases and, as a result, weaken the body’s resistance to viruses and other infections.

Cancer

Patients with cancer are also at risk. Cancer is the second leading cause of death in the world.According to the WHO, 9.6 million people died from them in 2018.

Cancer cell division

Chemotherapy is one of the most common methods of cancer treatment. In this case, cytostatics are used – anticancer drugs that disrupt the growth, development and division of malignant cells. But cytostatics attack not only cancer cells – healthy tissues also suffer from them, this damages the immune system, and the body becomes more susceptible to pathogenic microorganisms.

The degree of detrimental effect on immunity in the treatment of cancer depends on various factors, including the type of cancer and the general condition of the patient. In any case, people undergoing chemotherapy or radiation sessions should be extremely careful. Even a relatively harmless cold can become extremely dangerous for them, therefore, during an exacerbation of respiratory diseases, cancer patients should, if possible, avoid contact with those who cough and sneeze.

Autoimmune diseases

Autoimmune diseases increase the risk of contracting not only coronavirus, but also other infections. They arise when the immune system fails for an unknown reason, and it begins to attack not foreign viruses and pathogens, but tissues and internal organs of its own body. There are many autoimmune diseases – some of which are rare and more common, such as rheumatoid arthritis, psoriasis, multiple sclerosis, or Crohn’s disease (chronic inflammation of the intestines).

For patients with autoimmune diseases, doctors prescribe immunosuppressants that suppress the activity of the immune system. People with HIV also take immunosuppressants. The defense mechanisms of a weakened immune system fail, and the body becomes an easy victim of infections. Therefore, those who are forced to take immunosuppressive drugs need to be extremely careful.

And, finally, do not forget that some pathogens of infectious diseases are dangerous for people without any chronic diseases.Therefore, everyone, without exception, should be careful not to neglect the rules of hygiene.

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How a bee attack saved the life of a dying woman

• Christy Wilcox
• BBC Future

April 15, 2015

Photo author, SPL

Ellie Lobel was preparing for death. But then she was bitten by bees – and everything changed. Correspondent

BBC Future found out how bee venom can save humans.

Ellie Lobel, 27, was bitten by a tick and contracted Lyme disease. Years later, the woman, tired of dealing with the dire consequences of her illness, decided to give up.

Lyme disease is caused by bacteria Borrelia burgdorferi , which enter the body through tick bites. About 300,000 new infections are reported in the United States each year. Almost none of the sick die, and most of them recover with timely medical care.Antibiotic treatment kills bacteria before they can infect the heart, joints, and nervous system.

But in the spring of 1996, Ellie did not suspect that it was necessary to pay attention to the characteristic reaction in the form of a rash – the woman thought that she had been bitten by a spider. After that, for three months, she suffered from flu-like symptoms and terrible pains that migrated to various parts of the body. Ellie, a healthy, active mother of three, did not know how to recover from this strange disease. She became disabled.“I could hardly lift my head off the pillow on my own,” the woman recalls.

The first doctor she went to diagnosed a viral disease and reassured her that it would go away by itself. The second doctor said the same. As time went on, Ellie went to the doctors, and each time she was given a new diagnosis – multiple sclerosis, lupus, rheumatoid arthritis, fibromyalgia. No one guessed that the woman’s body was infected with bacteria Borrelia . The correct diagnosis could only be made more than a year after infection, but by that time it was already too late.

“I went through a variety of treatments one after the other,” says Ellie. Her condition was steadily deteriorating. She could not get out of bed on her own, was forced to use a wheelchair, noticed a loss of short-term memory and a decrease in intelligence: “Sometimes I felt better for a short time, but then I again plunged into this nightmare – and with each time the relapses became more and more cruel. ”

After 15 years of this life, Ellie gave up. “Nothing worked for me anymore, and no one could advise me anything,” she says.- I didn’t care if I lived to see my next birthday. I decided that I had had enough. I just wanted to end this torment. “

Ellie moved to California to die there. And almost died.

Less than a week after moving, she was attacked by a swarm of Africanized bees – hybrid bees that are large and particularly aggressive.

Rescue Bees

Ellie had only been in California for three days prior to this incident.“I wanted to breathe fresh air at last, put my face in the sun and hear the birds singing,” she says. “I knew that I would die bedridden in three or four months.

By that time, Ellie was already struggling to stand on her feet without assistance. She hired a male nurse to help her navigate the country roads near her new home in Wildomare, which was to be her final resting place.

Photo author, Thinkstock

Photo caption,

Prior to this incident, Ellie was mortally afraid of bees

Ellie stopped at a destroyed wall when the first bee appeared. The insect, according to her recollections, bit her right in the head. “And all of a sudden, a whole swarm of bees swooped in,” she says.

Her companion has escaped. But Ellie could neither run nor even walk on her own: “The bees were entangled in my hair, I heard nothing but their buzzing. And then I thought – now I am going to die, right here.”

Ellie belongs to a relatively small group of people – according to various estimates, from 1% to 7% of the world’s population – with a very strong allergy to bee venom. When she was two years old, she developed anaphylaxis from a bee sting – a violent reaction of the immune system, which can manifest itself in swelling, nausea and a narrowing of the airways. Then Ellie almost died – she had a respiratory arrest and had to be revived with a defibrillator. After that incident, Ellie’s mother instilled in her the fear of bees, so that she would never again find herself in such life-threatening situations.

Potent poison

Bees, as well as some other species of insects of the order Hymenoptera, such as ants and wasps, possess a powerful weapon – a multicomponent venom. Perhaps the most important of these components is a tiny 26 amino acid peptide known as melitin, which causes the stinging sensation of a bee sting.

When the body is exposed to high temperatures, cells release inflammatory compounds that activate special channels in receptor neurons known as TRPV1 receptors.As a result, neurons send a signal to the brain that its owner is on fire. Melitin acts on other enzymes in the body, which, acting in the same way as inflammatory compounds, also activate TRPV1 receptors.

“I still managed to feel the first five to ten bites,” Ellie recalls. “All I heard was their deafening buzz; I felt them sting my head, face, neck.”

She continues: “I went limp, raised my hands and covered my face with them, because I didn’t want the bees to sting my eyes … And then the bees disappeared.”

Photo author, Thinkstock

Photo caption,

Ellie is sure that the bee venom saved her life

When the swarm finally flew away, the man who looked after Ellie tried to take her to the hospital, but she refused. “It was God who finally decided to relieve me of my torment,” she told him. “I’ll just accept his gift.”

“I locked myself in my room and asked him to come the next morning to pick up my body.”

But Ellie didn’t die – not that day, not four months later.

“I can’t believe what happened three years ago, I can’t believe my recovery,” she says. “But all the tests confirm this, and I feel so healthy!”

Ellie is sure that the bee venom saved her life.

It has long been known that the harmful toxins in animal poisons can also be used for treatment. In Asia, bee venom has been used for medicinal purposes for centuries. In traditional Chinese medicine, scorpion venom is considered a powerful drug and is used to treat a wide range of conditions, from eczema to epilepsy.It is said that the Pontic king Mithridates VI, a powerful enemy of the Roman Empire (also known for studying poisonous plants from childhood), escaped death from serious injury on the battlefield by stopping the bleeding with the poison of a steppe viper.

“Over millions of years of evolution, insects, these tiny chemical engineers, have created an infinite number of molecules that act on different parts of our nervous system,” says Ken Winkel, director of poison research at the University of Melbourne. systems using these powerful neurotoxins have been circulating for a long time.But so far we do not have enough knowledge to do this effectively and safely for the patient. “

Photo author, Getty

Photo caption,

According to Ellie, in order to collect one gram of poison, it is necessary for 10,000 bees to pass over the plate

Despite the abundance of historical evidence for the use of animal poisons for medicinal purposes, their use in modern medical therapy remained minimal until the early 21st century, says researcher Glenn King of the University of Queensland in Brisbane, Australia.In 1997, while Ellie was rushing around the doctors, King decomposed the poison of the deadly Australian funnel spider into components. Now he is one of the leaders in research on the pharmacological properties of animal poisons.

King’s team was the first to decompose spider venom into its components using high performance liquid chromatography. “I was overwhelmed by the results,” King says. “No one before us seriously paid attention to this pharmacological gold mine.We were able to decompose the poison into hundreds of individual peptides. ”

During the 20th century, the medical literature periodically suggested the use of animal poisons in the treatment of various diseases. Tests have shown that such poisons help fight cancer, kill bacteria and even serve as powerful pain relievers – however, many experiments were limited to experimental animals.At the time of this writing, only six drugs based on animal poisons have been approved for medical use by the US Food and Drug Administration (another drug is Baltrodibin, created on the basis of spearhead snake venom – does not have such permission, but is sold outside the United States as a hemostatic agent during surgery).

The more we learn about poisons that cause terrible harm to human health, the more we understand how useful they can be from a medical point of view – for example, as in the case of melitin in bee venom.

Action at the molecular level

Melitin can not only cause pain. When dosed correctly, it punches holes in the protective membranes of cells, causing them to explode. In small doses, melitin binds to membranes, activating enzymes that break down lipids.These enzymes mimic the inflammatory process caused by exposure to high temperatures. But at a higher concentration and under certain conditions, melitin molecules are grouped into rings. They create wide pores in cell membranes, weakening the cell’s protective barrier and causing the entire cell to swell and burst like a balloon.

Photo by Victoria Jenkins

Caption,

Melitin easily copes with various bacteria and fungi

Due to this property, Melitin acts as a powerful antimicrobial agent, easily coping with a variety of bacteria and fungi.However, scientists believe that the beneficial qualities of melitin are not limited to this. They hope it will help fight diseases such as HIV, cancer, arthritis and multiple sclerosis.

For example, researchers at the Washington University School of Medicine in St. Louis, Missouri have found that melitin can destroy the protective membrane of the human immunodeficiency virus without damaging the cells in the body. At the same time, the virus has no chance to develop resistance to this threat.”Melitine destroys the inherent physical property of HIV,” Joshua Hood, the lead author of the work on this topic, told the press. At first, the drug, which is being worked on in Missouri, was developed as a prophylactic vaginal gel, but now scientists hope that nanoparticles, “charged” with melitin, can in the future be injected into the bloodstream of patients, thus clearing the body of infection.

Killer of bacteria

But did bee venom really cure Ellie of Lyme disease? The woman agrees that her story does not sound entirely believable. “If someone asked me to try bee stings to get well, I would think that person is crazy,” says Ellie. However, now she has no doubt that it was the poison that helped her to heal.

After she was bitten, Ellie looked at her watch, expecting the onset of symptoms of anaphylaxis, but they still did not appear.Instead, three hours later, excruciating pains began throughout the body. Even before her illness, Ellie received a science education. She believes her pain was not caused by an allergic reaction to bee venom, but by an allergic process to the toxins of dying bacteria known as the Jarisch-Hexheimer reaction. A similar syndrome is observed during the treatment of severe syphilis. There is a version that certain types of bacteria, dying, release toxic substances, which, in turn, cause fever, rash and other symptoms.

Ellie suffered from pain for three days. And then the pain disappeared.

“All these years, I have lived in a permanent state of semi-coma due to brain inflammation caused by Lyme disease,” she says. “But suddenly the fog in my head cleared. I realized that I could think clearly again – for the first time in many years.”

Photo author, Thinkstock

Caption,

Ellie used apitherapy for some time – treatment with live bees

Now that her mind cleared, Ellie wondered what happened to her.She did what anyone in her place would do – she began to search for information on the net. To her disappointment, the search yielded no significant results. However, she was able to find a link to a small study carried out in 1997 by scientists at Rocky Mountain Laboratories in Montana, who found that melitin killed the bacteria Borrelia . The researchers exposed cell cultures to pure melitin and concluded that the substance completely blocks the growth of Borrelia .After conducting a more detailed study, they found that soon after contact with melitin, the bacterium actually paralyzes – it loses its ability to move, and at this time the peptide acts on its outer membrane. After a while, the membrane begins to disintegrate, and the bacterium dies.

Inspired by her own experience and the findings of the researchers, Ellie decided to try apitherapy, a treatment using live bees and bee products. It was the living bees that interested her.

Ellie has set up a special house for bees in her apartment. She doesn’t grow them herself – she orders a batch by mail once a week. Ellie takes the bee with tweezers and gently presses it to one or another part of the body. “Sometimes you have to tap them lightly on the sting, but usually they sting willingly,” she says.

Ellie started with 10 bee stings a day, three times a week – Mondays, Wednesdays and Fridays. Three years have passed, and after countless bites, Ellie appears to have fully recovered.She is gradually reducing the number of stings and the frequency of the procedure – over the past eight months, she has caused bees to sting herself only three times (and once – in an attempt to reduce the swelling caused by the fracture, and not because of the symptoms caused by Lyme disease). Ellie still keeps bees at home just in case, but in the past year, mostly without their help.

New Research

Rare cases like Ellie’s are reminders of the powerful potential that animal poisons have.However, translating word-of-mouth healing legends into real pharmaceuticals can be a lengthy and challenging process. “It sometimes takes up to 10 years between the discovery of the pharmacological properties of a substance and the receipt of a patent for a medicine based on it,” King says. “And for every success, there are a dozen failures.”

After a 1997 study, no one had studied bee venom in depth as a possible remedy for Lyme disease — until Ellie did.

Photo author, Victoria Jenkins

Caption,

Bee venom is “more expensive than gold”

She has agreed to cooperate with a beekeeping farm that collects bee venom using an electrified glass plate placed at the entrance to the hives – bees pass over the plate on the way from the hive and back, and electric currents that are harmless to them stimulate the secretion of poison from the abdomen. Tiny droplets of poison settle on the glass, which are then collected. Ellie says that it takes 10,000 bees to pass through the plate to collect one gram of venom (according to other sources, such as the Food and Agriculture Organization of the United Nations, one gram of venom is found in 1 million bee stings).She emphasizes that this collection method does not harm the health of the bees.

Ellie ships some of the poison she bought – which she says is “more expensive than gold” due to the high cost of a humane collection method – to Eva Sapi, assistant professor of biology and environmental research at the University of New Haven, who studies Lyme disease.

Sapi’s work on the effects of bee venom on Lyme bacteria is ongoing and the results have not yet been published, although she says the preliminary findings by one of her students are “very encouraging.”Borellia bacteria can change shape in the body, which is why they are so difficult to kill. Sapi found that traditional antibiotics don’t actually kill bacteria, but simply force them to mutate into a more latent form. Once the patient stops taking antibiotics, the bacteria become active again. In his laboratory, Sapi tests various bee venoms in all forms that the bacteria can take, and so far research shows that melitin is effective in all cases.

Next, it will be necessary to find out whether it is melitin that has such an effect on bacteria, or whether the bee venom contains other substances involved in this process. “In addition, we want to see with high-resolution images exactly what happens when the bee venom comes in contact with Borellia ” , says the researcher.

Author of the photo, SPL

Caption to the photo,

It is still not known for certain whether the poison killed the bacteria of the disease or simply stimulated the immune system. collect more data.”Before we start researching on humans, we need to do some animal testing,” she says. “It’s still about poison.” In addition, it is still not reliably known why exactly the bee venom helped Ellie, including due to the fact that the etiology of the symptoms that she experienced during the cure remains unclear. “Was the bee venom effective in her case because it killed Borellia , or because it stimulated her immune system?” Sapi asks. There is no answer to this question yet.

Be that as it may, animal poisons can be excellent sources of medicines for the treatment of severe neurological diseases, since many of them act on the victim’s nervous system. “In this area, we do not yet have effective drugs, – says Winkel. – Meanwhile, tiny living factories live next to us producing an infinite number of amazing substances …”

No one knows exactly how many poisonous animal species live on Earth. But it is known about the existence of poisonous jellyfish, snails, insects and even primates.”When asked to provide the most compelling argument for conservation, my answer is that trying to appeal to its beauty and virginity is the most unsuccessful option,” says Dr. Brian Fry of the University of Queensland. Instead, he said, it should be emphasized that wildlife has a gigantic – and not yet fully explored – potential that can be useful to humanity: “We are talking about a resource, about money. Therefore, protecting nature through its commercialization is the only reasonable approach.” …

Ellie fully shares this idea. “We still have a lot of research to do with natural poisons,” she says. “We need to see what else nature has to offer to help us.”

Doctors talked about the treatment of coronavirus in people with autoimmune diseases

Head of the All-Russian Public Organization of Disabled People with Multiple Sclerosis, Doctor of Medical Sciences Yan Vlasov and rheumatologist, Doctor of Medical Sciences Dmitry Karateev told RT about the treatment of coronavirus in people with autoimmune diseases.

“Our patients tolerate the disease in the same way as the population average, despite the presence of such a severe chronic disease. Somehow the body can withstand this kind of viral load, ”said Vlasov.

The specialist emphasized that if we talk about the prescription of drugs that change the course of multiple sclerosis, then “no one recommends stopping, you need to continue treatment.”

“In the event of an exacerbation of the disease, it is necessary to receive appropriate medical assistance in the form of treatment of the exacerbation of the disease itself, despite the presence of coronavirus.If, of course, a person develops decompensation and pulmonary disorders with tissue damage, it is clear that all forces are thrown into a threatening condition, while immunomodulatory agents can be canceled, the underlying disease is being treated, ”the interlocutor of RT added.

In turn, Dmitry Karateev explained to RT that rheumatoid arthritis and coronavirus are not interrelated in any way. As the expert emphasized, there are European recommendations, which state that it is necessary to continue treatment as usual.

“There is no evidence that there are high risks for patients with rheumatoid arthritis. If a person becomes ill with a coronavirus infection and he has a severe course, it will not depend on whether he is sick with rheumatoid arthritis or another disease. I know such patients who have had a coronavirus infection, and, thank God, they have had a normal illness, ”he concluded.

At the same time, Associate Professor of the Department of Endocrinology of the Faculty of General Medicine of the Russian National Research Medical University named after V.I.N.I. Pirogov, candidate of medical sciences Yuri Poteshkin said in an interview with RT that diabetes mellitus is a risk factor for a severe course of coronavirus infection.

“People with diabetes are more likely to be seriously ill with coronavirus … In diabetes, in principle, there are higher other inflammations, and the coronavirus is just associated with inflammation, that is, it will increase significantly in diabetes,” Poteshkin said.

He clarified that in this case it is impossible to refuse therapy, it will rather need to be intensified, and in some cases – to switch to insulin.

“There are also cases when the course of the disease occurs, when the work of some organs is disrupted, and then pills or drugs are contraindicated,” Poteshkin summed up.

Earlier, Russian Deputy Prime Minister Tatyana Golikova said that people with diabetes and hypertension have a twofold increase in the risk of COVID-19 coronavirus infection.

News

The rhythm of modern life is very, very high. Our life is such that there is practically no time left for a person to rest.

A similar problem affects absolutely all age categories, from kindergarten kids to retirees.

As a result of such a rhythm of life, a person develops a syndrome of chronic fatigue, especially among residents of large cities, ecologically unfavorable regions. And if you do not take the necessary preventive measures and treatment, serious diseases may occur.

Symptoms of chronic fatigue

Doctors distinguish several main symptoms that appear when a person has chronic fatigue syndrome: as well as after reducing the load;

As a rule, people suffering from chronic fatigue syndrome are diagnosed with either a neurotic reaction or a banal vegetative-vascular dystonia. The treatment, which is usually prescribed in such cases, does not bring absolutely any positive result, the condition of the sick person is rapidly deteriorating, significant changes in memory and psyche, and even changes in the electrocardiogram, may occur.

Factors provoking the onset of chronic fatigue syndrome:

• Overwork may be associated with taking certain medications, such as medicines for colds, coughs and motion sickness, antihistamines and antiallergic drugs, sleeping pills, muscle relaxants; contraceptives and antihypertensive drugs;
• often occurs a month after a viral infection, and can also be an early symptom of some serious diseases (hepatitis, cancer, diabetes, anemia, heart disease, hypoglycemia, obesity, hypothyroidism, mononucleosis, rheumatoid arthritis, myasthenia gravis, alcoholism, sleep disturbances) …
• Non-observance of the rules of a healthy lifestyle: violation of work, rest, sleep, inappropriate nutrition, frequent stressful situations, constant conflicts at work, in the family, etc.

Prevention of chronic fatigue syndrome:

1. Organize the correct daily routine. Get up earlier so you don’t have to start the day rushed and tired. Learn to delegate something to others, especially when you already have enough responsibilities and tasks in your life.
2. Be physically active. Try to get at least 30 minutes a day to exercise. Do not exercise before bed, it can disrupt sleep, and you will feel tired in the morning. Sleep for the optimal amount of time. Most people need 6-8 hours to get enough sleep. If you feel the strength and desire to work, then you have slept enough. It is good if you manage to get some sleep during the day. This can be especially useful for teens with their hectic pace of life and the elderly who sleep less deeply.Avoid daytime sleep, however, if you will not be able to sleep at night after it.
3. Do not smoke. Smoking disrupts the supply of oxygen to your body, replacing oxygen with the deadly carbon monoxide. If you smoke for a long time, then it will not be easy to give up this bad habit. But still, try to at least reduce the number of cigarettes you smoke.
4. Drink as little caffeine and alcohol as possible. Alcohol acts as a depressant, it only brings fatigue, without adding strength.Caffeine will give a temporary rapid rise in activity, followed by sharp fatigue.
5. Choose an appropriate diet: some people work better after a light snack, while others can only work with a heavy meal. Avoid fatty foods as fats are processed more slowly than carbohydrates and this can reduce your activity.
6. Take short breaks from work throughout the day.
7. Go on vacation, or at least turn off your phone and relax at home.
8. Watch TV as little as possible. If you watch it to relax, sooner or later you may find yourself in a sluggish and sluggish state. Try to relax more actively, such as walking or reading. Find a way to calm yourself down.
9. A person suffering from chronic fatigue syndrome must take mandatory walks in the fresh air, and their duration should not be less than two hours a day.A sick person should try to choose as clean places for a walk as possible, preferably in green spaces, where the air is much cleaner than in the industrial zones of the city. However, if this is for some reason impossible, even a simple walk on the way home from work can be of great benefit.
10. Therapeutic physical training is also an irreplaceable aid in the treatment of chronic fatigue syndrome. A set of exercises for physical therapy should be selected by a specially trained medical worker.Such exercises allow you to maintain good physical shape, but spare the body without overloading it.

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Why shouldn’t women abuse green tea? Let’s figure it out.In this video we will talk with you about the health benefits and dangers of green tea, whether green tea helps with weight loss, how much green tea can you drink per day. We will debunk popular myths about green tea. And as a bonus, I’ll show you how to use green tea infuser in your garden and vegetable garden.

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