Rheumatoid Arthritis Essay Example for Free

Rheumatoid Arthritis Essay Rheumatoid arthritis (RA) belongs to a class of autoimmune disorders that cause chronic joint inflammation as well as inflammation of the tissues surrounding the joints (Goronzy Weyand, 2001, p. 55). Other organs in the body are also affected when the cells fail to differentiate self from non-self. The failure of the immune cells to differentiate the body’s own cells from the foreign or intruding cells leads to autoimmunity where the immune cells attack the body’s own cells. Usually, the immune system is organized in a way that it seeks and destroys the body’s invaders particular the pathogens. The antibodies in patients with autoimmune diseases always target the body’s own tissues and cause inflammation. The effects resulting from the self-attack spreads to multiple body organs and this condition is commonly referred to as rheumatic arthritis (Arthritis Foundation, 2010). Epidemiology Rheumatoid arthritis is perhaps the commonest of all rheumatoid diseases and it affects about 1. 3 million people in the U. S alone (Arthritis Foundation, 2010). Women are three times as riskier than men to be afflicted by the disease although the disease is common among all races in equal magnitude (Clair, Pisetsky, Haynes, 2001, p. 1). The numbers of women suffering from rheumatoid arthritis are currently on the increase despite the recorded decline in numbers a few decades ago. The use of contraceptive pills containing insufficient estrogen as birth control measures has been blamed for the reduced immunity among women thus the increased cases of RA (Clair, Pisetsky, Haynes, 2001, p. 5). Environmental factors such as cigarette smoking are also to blame for the increase in disease cases among women. Although the general smoking rates have declined in the United States, the rates of women smokers, separately considered, have not declined though. While genetic factors such as the role of human leukocyte antigen (HLA) DRB1 alleles have for long been suspected to cause aberrations in proteins in immune cells, this has not been proved yet (Clair, Pisetsky, Haynes, 2001, p. 5). The risk among women has also been linked to the deficiency of vitamin D. Rheumatoid arthritis usually afflicts individuals of a wide range of ages although it is commonly begins after one has attained the age of 40 although it is rare beyond the age of 60 (Silman Pearson, 2002, p. 267). It has also been shown that rheumatoid arthritis can occur in multiple members of the same family. This observation suggests the propensity that the disease is inheritable (Goronzy Weyand, 2001, p. 55). A specific gene is suspected to be the underlying reason for the strange behavior of the immune cells attacking the body’s own cells. Pathophysiology and Pathogenesis Arthritis refers to some form of inflammation that occurs at the joints. Joints are points where two bones join each other and are critical for locomotion process. Rheumatoid arthritis results to the inflammation of the joint which is accompanied with severe pain, swelling, redness and stiffness in the joints. Rheumatoid arthritis can also lead to severe inflammation in tissues surrounding the joints such as ligaments, tendons and muscles. Chronic inflammation in some patients with rheumatoid arthritis can result into complete destruction of the bones, cartilage and ligaments thus leading to serious joint deformities. Usually, destruction of the joints can occur in early stages if development but gets worse as one advances in age (Arthritis Foundation, 2010). The main cause of RA is not well known although bacteria, viruses and fungi have for long been in the suspect list without any of the biological agents been proved. As for this reason, intensive research efforts are being invested in the identification of the causal agents for RA. Genetic causes and environmental infectious agents have been associated with the deranged immune system which goes out of control and attacks the body’s own cells (Goronzy Weyand, 2001, p. 55). The deranged immune system results into massive joint and organ inflammation which leads to rheumatoid arthritis. The common organs affected include the eyes and the lungs. Specifically, the activation of lymphocytes marks the start of the process of inflammation. In the inflamed cells, a number of chemical messengers are expressed including the interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor (TNF) (Gupta Fomberstein, 2002, p. 3). Symptoms of Rheumatoid Arthritis Patients suffering from rheumatoid arthritis experience episodic inflammatory symptoms depending on the extent of individual tissue inflammation. The disease is overly active following extensive tissue inflammation and becomes inactive after inflammation has subsided. The condition undergoes remission following treatment or spontaneously and this can last for several days to years. In remission stage, patients feel well again until the conditions flares (return of symptoms and course of the disease). Active symptoms of RA include energy loss, lack of appetite, fatigue, joint and muscle pain, stiffness and low-grade fever. The reddening and swelling of the joints at the point of inflammation is indicative of RA. The joints also become tender and overly painful and the synovium, which is the tissue lining the joints, gets inflamed leading to overproduction of joint fluids or synovial fluid (Clair, Pisetsky, Haynes, 2001, p. 26). The inflammation of the synovium (synovitis) results mainly from its thickening. A number of organs and other body parts are affected in rheumatoid arthritis because the disease is a systemic condition. Specifically, the disease affects several body joints which are inflamed in a symmetrical manner mainly involving the small joints of the wrist and the hands (Clair, Pisetsky, Haynes, 2001, p. 12). The wrists and the hands are affected and the patients afflicted by the disease get it difficult to even open jars and turn door knobs. RA also affects a number of small joints of the feet. However, when a single joint is affected, the arthritis presents as joint infection or gout. Damage to tissues, bones and cartilages results from chromic inflammation and this can eventually lead to a complete cartilage loss and bone and muscle weaknesses and erosion. Joints will become deformed, destroyed or may completely lose function. The vocal cords can be affected to a level of influencing the voice tone. The effect to the cricoarytenoid joint has been suggested to influence the voice tone and cause voice hoarseness of the afflicted individuals. Inflammation of the glands located in the mouth and eyes often cause dryness, a condition known as Sjogren’s syndrome. Chest pain associated with shortness of breath, deep breathing or coughing results from pleuritis or the inflammation of the linings of the lungs (Clair, Pisetsky, Haynes, 2001, p. 18). Lungs tissues may become scarred, inflamed or rheumatoid nodules may form in the lungs. The pericardium or the tissues that surround the heart may become inflamed (pericarditis) and lead to massive chest pain especially when afflicted individuals lean forward or lie down (Clair, Pisetsky, Haynes, 2001, p. 19). The total erythrocytes and leucocytes count immensely reduces and a reduction in red blood cells leads to anemia while a decrease in leucocytes results to the enlargement of the spleen, a condition known as the Felty’s syndrome (Clair, Pisetsky, Haynes, 2001, p. 17). The region around the fingers and elbows may experience firm lumps known as the rheumatoid nodules (Clair, Pisetsky, Haynes, 2001, p. 16). While rheumatoid nodules do not lead to any significant symptoms, they can be infected occasionally. In RA patients, the nerves may become pinched around the wrist area and result to carpal tunnel syndrome. While it is rare for patients to suffer from vasculitis, the condition is one of the serious complications associated with RA and can totally impair the supply of blood to the tissues and lead to necrosis or tissue death. In vasculitis, tiny black spots around the beds of nails or ulcerations of the legs are commonly visible. Treatments To date, there is no specific known treatment for rheumatoid arthritis. However, modern interventions have been directed towards reducing pain and inflammation of the joints and maximizing the functioning of the joints. With proper management such as X-ray monitoring, the damage to joints and improvement of joint functions can be achieved. A combination of medication, sufficient rest, joint protection, patient education and exercise to strengthen the joints has been proved effective (Clair, Pisetsky, Haynes, 2001, p. 146). The treatment plan is not uniform among all patients but depends on the disease activity, general health of the patient, the age and occupation of the patient and the type of joints affected by RA. In all the treatment plans, there should be total cooperation between the patient, doctor and the family members. There are two main classes of drugs used in the management of RA: the first-line drugs or the fast-acting drugs and the second-line or the slow acting drugs. Among the first-line drugs include aspirin and corticosteroids such as cortisone which are used in the management of joint inflation and pain. Second-line or slow acting medications, also known as disease-modifying antirheumatic drugs (DMARDs) include agents such as methotrexate, hydroxycholoroquine and gold (Arthritis Foundation, 2010). These agents increase the chances for disease remission and prevent any progressive destruction of the joints but do not act as anti-inflammatory agents (Arthritis Foundation, 2010). Since the level of destructiveness from RA varies with individuals, treatment options also differ among individuals. For instance, patients with less destructive forms of RA can be advised to have sufficient rest or given analgesic or anti-inflammatory drugs to manage the condition. Second-line medications can be administered in a timely manner to improve the function and minimize joint destruction and disability within a short period following disease diagnosis. However, a great percentage of individuals suffering from aggressive form of RA require second-line drugs like methotrexate as well as the anti-inflammatory drugs. Different second-line drugs can also be given in combination regiment. In severe deformities of the joints, surgical procedure may be recommended to correct the deformities (Arthritis Foundation, 2010).

Graduation Speech: In Memory of Those Who Did Not Make It :: Graduation Speech, Commencement Address

Good evening and welcome parents, family, community members, friends, the School Board, faculty, and seniors to the County High School Class of 2012 commencement ceremony. It is a great honor to be able to welcome you here today. Class of 2012, you have worked hard for 12 years; tonight we celebrate your achievements - this night is yours. Congratulations! I have heard that some faculty members have coined the term "survivors" with reference to our graduating class. Indeed, we are survivors and I cannot think of a better term to describe us. Throughout the past year, our class has been subjected to several devastating tragedies. The deaths of three of our family members at County High: Joy M., Serik P., and George F. These three members of our family at County High School were each amazing and loving individuals. Their spirit of love lives on and was clearly exhibited by the manner in which the students and faculty pulled together to comfort each other and mourn their deaths. Their families will remain in our thoughts and prayers. As you graduate tonight, I would ask you to remember their love and strive to make it an integral part of your lives. The great Mahatma Gandhi called the love that I believe these three held in their hearts "all embracing ... [a love that] transforms all it touches ... [with] no limit to its power." And, most definitely, their love transformed people's lives. They certainly have inspired me. A wise man simply known to us as Paul wrote of this love as the "most excellent way." Paul wrote, "Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps no record of wrongs.

Child Observation Essay

I observed the teacher and what instructional theory she used and the five students in her classroom. Her students consisted of three four girls and one boy from what was shown in the video. Instructional Theory used: The instructional theory that was used by the teacher was that of Vygotsky’s Cognitive Development Theory. Description of the lesson observed: The teacher started out with clear instructions informing the students that they would be doing about learning new words. She started out asking the students ‘Where is Squawker? † she followed up her answer by guiding the answer. Once the students were aware of the question, they answered by saying that Squawker was under the umbrella. The teacher cheered them on and gave positive feedback at that fact that the children answered correctly. She then reiterated the question and the answer and had the students repeat after her. She then asked one student in particular to go and get squawker, who would be her handheld helper for the lesson, from under the umbrella. Her name was Page. The teacher then told the children that they would be learning some new words that were in the word box. She again asked Page to be her word helper for that lesson. She gave the students clear expectations of the lesson. She told them that she would say the word, which she did by spelling it out completely first then saying in in a clear, crisp tone. She asked Page to select the first word and hold it up for everyone to see. The children then repeated the spelling of the first word, lungs, and then they also said the word clearly. *I had to note, that Page did not spell out the word lungs with the other students. She kind of just mumbled the word. * She, the teacher, made sure to also say to the children to â€Å"Look† closely at the word card. The next word Page pulled out of the word box was the word chest. The teacher again modeled how to pronounce each letter of the word and to say the word. She had the students model after her the same exact way. Again I noticed how Page did not pronounce the word like the other students. The teacher then proceeded to ask Page to place the word chest on her chest so that everyone could see the word. Page did as she was told, signifying she knew what the word was. The teacher also at that time emphasized the action â€Å"Do†. The teacher then had page pull out the picture of the lungs from the word box and place it on her chest. The teacher then engage the students and ask them how do we use our lungs, and elicit responses to see if the children had any knowledge of the content they were engaging in. The children showed readiness and ability to move forward with the questioning. She asked what is in the lungs and one child answered air. The teacher made connections to the environment by asking the children what else is full of air, and one child responded by answering â€Å"a balloon†. The teacher applauded and gave each child praise when answering the questions. The teacher also emphasized during this portion of the lesson â€Å"Say† as she wanted to know that the children knew what they were saying as well. She had Squawker, her hand helper, to ask follow up questions to see if the students comprehended the meanings or the usage of the word lungs, and chest all of which each of the five children responded with clear meaning of the text. The teaching technique the teacher used was in line with Lev Vygotsky’s theory of cognitive development. Vygotsky’s theory actively involves children in his or her own learning process. His theory also implies that learning occurs before development. It was clear that the children had a base knowledge of the content that the teacher taught them, she just deepened their understanding of the material and the vocabulary. Vygotsky’s theory also implies that development is driven by the children’s enjoyment from learning and interaction with their peers. This interaction with peers and adults play a critical role in their cognitive development. The teacher actively engaged the children. She assisted in their learning by modeling the content, and she also used role play by allowing a hand puppet to be a part of the class as a helper.

Socrates s Theory Of Knowledge - 1130 Words

In Socrates’ work, Phaedo, transcribed by Plato, Socrates is in jail after loosing his trial. He has been sentenced to death, and is now awaiting to be put to death. On the day of his death, Socrates is visited by a few of his followers who have been loyal for a long time. Fearing his death, they have a last conversation with Socrates trying to get some of the last philosophical knowledge out of him that they can get. In this conversation, Socrates tells his interlocutors a lot about life and virtue. During his final conversation, Socrates mentions that knowledge is a process of recollection, knowledge is present in the soul of the body, and that when knowledge is present, it allows us to make choices to ensure that there is right amounts of moderation in our life to lead a virtuous life. Before getting into his account of knowledge, Socrates has to first get his followers to agree with an underlying principle that must be true in order for his definition of knowledge to work. This is the fact that there are two parts of a human: the body, and the soul. While the body dies, the soul does not. The soul can live on forever. Socrates proves this theory while talking with Cebes. Cebes is not too sure about his thought that the soul is alive before the body. Socrates brings out the argument of opposites. He claims that for everything has an opposite, and there is a special process that exists that transforms it from one state to another (Phaedo 71a-d). He then carries on thisShow MoreRelatedSocrates s Theory Of Knowledge895 Words   |  4 PagesIn Phaedo, Socrates argued that knowledge is not learned, but recollected. Socrates used the example of sticks and stones, proving that our perception of the stones change. The stones may look equal from one angle, but different from another angle. This proves that we understand Equality, but Equality does not exist in the real world because it cannot be a real object. 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