What is Rheumatology?

Rheumatology represents a subspecialty in internal medicine and pediatrics, which is devoted to adequate diagnosis and therapy of rheumatic diseases (including clinical problems in joints, soft tissues, heritable connective tissue disorders, vasculitis and autoimmune diseases). This field is multidisciplinary in nature, which means it relies on close relationships with other medical specialties.

The specialty of rheumatology has undergone a myriad of noteworthy advances in recent years, especially if we consider the development of state-of-the-art biological drugs with novel targets, made possible by rapid advances in the basic science of musculoskeletal diseases and improved imaging techniques.

Rheumatology is a broad discipline that covers the non-surgical management of disorders involving the musculoskeletal system. A myriad of different pathophysiological processes (such as abnormalities in biochemical pathways, degeneration, trauma, autoimmunity and inflammation) underpin the diseases of this system.

There are more than 200 specific rheumatic diseases known today which span from various types of arthritis to osteoporosis, and on to systemic connective tissue diseases. As per AMRI hospital‘s specialist the first disorders to be defined were rheumatoid arthritis, gout and osteoarthritis.

Rheumatoid arthritis
Rheumatoid arthritis represents a common autoimmune disorder associated with progressive disability, potential systemic complications, early death, and concomitant socioeconomic costs. It has been reported that this disease affects up to 1% of the adult population of developed regions around the world.

Akin to many autoimmune diseases, the etiology of rheumatoid arthritis is multifactorial. The disease is characterized by inflammatory pathways and overproduction of proinflammatory cytokines that cause proliferation of synovial cells in joints. Ensuing pannus formation often leads to underlying cartilage destruction and bony erosions.

Patients with this disease typically present with stiffness and pain in multiple joints. Commonly involved structures are wrists, as well as proximal interphalangeal and metacarpophalangeal joints. Patients often present with morning stiffness and systemic symptoms of fatigue, low-grade fever and weight loss. Increased mortality is due to accelerated cardiovascular disease, particularly in patients with high disease activity and chronic inflammation.

Gout
Gout is a specific type of inflammatory arthritis triggered by the deposition of monosodium urate crystals in synovial fluid and other tissues. This rheumatologic condition is often associated with hyperuricemia, serious comorbidity and increased risk of cardiovascular disease. The definitive diagnosis of gout demands microscopic identification of monosodium urate crystals.

Two clinical phases of gout are commonly observed. Intermittent acute gout is one of the most painful forms of arthritis, characterized by the abrupt onset of severe joint pain (classically the first metatarsophalangeal joint), swelling and erythema, with asymptomatic periods between attacks. If hyperuricemia is not treated satisfactorily, transition to the second phase which manifests as chronic tophaceous gout can ensue.

Recognized triggers for recurrent flares are alcohol intake, diuretic use, hospitalization and surgery. The patient should understand that sugar-sweetened drinks and large amount of meat or seafood may contribute to elevated urate levels, therefore such episodes should be minimized. Management should be tailored to the stage of disease and eventual coexisting illnesses.

Other diseases
Systemic lupus erythematosus (SLE) represents chronic and potentially debilitating autoimmune inflammatory disease that is commonly encountered in women of childbearing age. Although any organ system can be affected, clinical symptoms are usually musculoskeletal, dermatologic, renal and hematologic. The disease can be mild or life-threatening, depending on the organs involved.

Osteoarthritis is the most common chronic condition of the joints, with an associated risk of mobility disability for patients with affected knees being greater than that due to any other medical condition in people aged 65 years of age or older. The societal burden of this rheumatologic disorder is expected to increase as obesity level soars and the community becomes increasingly older.

The inflammatory myopathies represent a heterogeneous group of subacute, chronic or acute acquired diseases of striated muscle. On the basis of unique clinical, immunological, histopathological and demographic features, they are differentiated into three major subsets: dermatomyositis, polymiositis and inclusion body myositis.

Arthritis is also the most frequent, but least specific manifestation of rheumatic fever. Other diseases in rheumatology include spondyloarthropathies, Sjögren’s syndrome, systemic sclerosis, various forms of vasculitis, and a plethora of congenital and familial disorders that affect different joints.

How Air Pollution Contributes to Lung Disease

When we breathe in dirty air, we bring air pollutants deep into our lungs, so it’s no surprise that air pollution causes serious damage to the respiratory tract. Air pollution exposure can trigger new cases of asthma, exacerbate (worsen) a previously-existing respiratory illness, and provoke development or progression of chronic illnesses including lung cancer, chronic obstructive pulmonary disease, and emphysema. Air pollutants also negatively and significantly harm lung development, creating an additional risk factor for developing lung diseases later in life.

Asthma Over 20 million people, including six million children now gasp for breath due to asthma. Asthma, a chronic disease of the lungs characterized by inflammation and narrowing of the airways, causes a sensation of tightness in the chest, shortness of breath, wheezing, and coughing. If untreated, asthma episodes can be near fatal or even fatal. Asthma is not currently curable, and damage that is done to lung tissue during asthma attacks may lead to permanent damage. Nearly 1.8 million emergency room visits were attributed to asthma in 2005, for treatment visit AMRI hospital, best onco hospital in kolktata

There are many triggers to asthma attacks, including dust, smoke, pollen, and volatile organic compounds. Common outdoor pollutant triggers include ozone, carbon monoxide, sulphur dioxide and nitrogen oxides. The Asthma-Ozone Connection Ozone, one of the most widespread air pollutants , is formed when volatile organic compounds react with nitrogen oxides in the presence of sunlight. Ozone irritates the lungs at concentrations which are fairly common in urban settings, particularly in summer months. Increases in ozone are linked to asthma and other lung diseases. For those with severe asthma, symptoms increase even when ambient ozone levels fall under the thresholds set by the EPA. Elevated ozone levels also aggravate pre-existing heart problems, like angina. Chronic Obstructive Pulmonary Disease (COPD), chronic bronchitis and emphysema Chronic Obstructive Pulmonary Disease (COPD) is another condition characterized by narrowing of the airways, but these changes are permanent rather than reversible.

COPD is caused by exposure to pollutants that produce inflammation, an immunological response. In larger airways, the inflammatory response is referred to as chronic bronchitis. In the tiny air cells at the end of the lung’s smallest passageways, it leads to destruction of tissue, or emphysema. Although current and ex-smokers account for most patients with COPD, exposure to air pollutants plays an important role in the development of COPD and the origin and development of acute exacerbations. Lung Cancer Lung cancer, the leading cancer killer in both men and women, is often (and accurately) associated with smoking tobacco. While that’s true, there are multiple other risk factors for developing lung cancer, including air pollution. Particulate matter and ozone in particular may affect mortality due to lung cancer.

Children are Especially Vulnerable Children are particularly susceptible to the effects of air pollution. They breathe through their mouths, bypassing the filtering effects of the nasal passages and allowing pollutants to travel deeper into the lungs. They have a large lung surface area relative to their weight and inhale relatively more air, compared to adults. They also spend more time out of doors, particularly in the afternoons and during the summer months when ozone and other pollutant levels are at their highest. And, children may ignore early symptoms of air pollution effects, such as an asthma exacerbation, leading to attacks of increased severity.

Combine those factors with the adverse impact of some pollutants on lung development and the immaturity of children’s enzyme and immune systems that detoxify pollutants, and you have a series of factors that contribute to children’s increased sensitivity to air pollutants.

Consult AMRI Hospitals, best hospital in Kolkata

Rheumatology and Rheumatic Diseases - AMRI Hospital

Rheumatic diseases affect your joints tendons, ligaments, bones, and muscles. Among them are many types of arthritis, a term used for conditions that affect your joints.
Sometimes they’re called musculoskeletal diseases. Common symptoms include:

Joint pain
Loss of motion in a joint or joints
Inflammation — swelling, redness, and warmth in a joint or affected area
The medical field that studies these types of conditions is called rheumatology. If your regular doctor thinks you have a rheumatic disease, he’ll probably send you to a rheumatologist — a doctor who’s specially trained to treat them.

Your rheumatologist will examine you to diagnose your condition, then oversee a treatment plan for you that will likely include medications, regular exercise, a healthy diet, stress management, and rest.

Common Rheumatic Disorders
Years ago, conditions like this fell under the broad heading of rheumatism. Now there are more than 200 distinct rheumatic diseases. Among the most common ones are:

Osteoarthritis
Rheumatoid arthritis (RA)
Lupus
Spondyloarthropathies — ankylosing spondylitis (AS) and psoriatic arthritis (PsA)
Sjogren’s syndrome
Gout
Scleroderma
Infectious arthritis
Juvenile idiopathic arthritis
Polymyalgia rheumatica

SOURCE: webmd.com