Abstract This paper proposes a study to review the efficacy of a disease management program for osteoarthritis (OA) in a primary care setting, based on preservation of joint function as well as adequate pain management. For the purposes of this study, the following question is asked: "How does a primary care based medical and educational management program effect the disease progression in patients with mild to moderate osteoarthritis as evidenced by a reduction in pain and progression of disease?" The author hypothesizes that it is insufficient to provide self-administered education programs for OA patients and that an interactive program containing education, pain management, hands on evaluation and frequent follow up will demonstrate patient reports of reduction in daily pain as well as objective demonstration of preservation of function, as evidenced by serial physical examination.
Outline:
Introduction
Statement of the Problem
Literature Review
Research Design
From the Paper "Conversely, a study published in the Journal of Rheumatology reports there was no significant improvement in patient function or pain related to implementation of the Arthritis Self Management Program (ASMP). Subjects were recruited for intervention and evaluated at baseline as well as four months after completion of the course or reading of the ASMP manual (This group functioned as the control for the study). No significant clinical benefits were noted at four months in patients who had been recruited from primary care practices, although the authors were able to note an improvement in other patient groups, such as those who had been referred for specialty care. "
Abstract The purpose of this paper is to introduce, discuss, and analyze the disease of arthritis. Specifically, the paper discusses the differences between osteoarthritis and rheumatoid arthritis, and their commonalities. The writer notes that, although there are many types of arthritis, these two are the most common. Both of these forms of arthritis can be debilitating and painful. The writer points out that they can also lead to other complications, such as surgery and continued medication for pain. Arthritis is serious because it cannot be cured, only treated, and because it affects so many Americans and their daily lives. The writer concludes that arthritis should be a top research priority in America, because curing or preventing the disease could make a real difference in so many people's lives. One of the source articles used is appended to the paper.
From the Paper "The symptoms of the disease include stiffness after remaining in one position for a long time (such as sitting or sleeping), a sound of bone rubbing on bone or crunching when the bone is used, swelling or pain in the joint, and tenderness in the joint. Anti-inflammatory drugs, along with mild exercise and even re-alignment of misaligned joints, can treat osteoarthritis. Topical treatments, such as creams and hot and cold packs can also be effective in many cases. X-rays are the most common way to confirm a diagnosis of osteoarthritis, but a doctor may order joint aspiration in cases that are more difficult to diagnose. Often, the most effective treatment for this form of arthritis is surgery to replace the damaged joints. It is the most common reason most Americans undergo hip and knee surgery, and most patients report success and far less pain in those joints after surgery."
"Rheumatoid arthritis does not have as many sufferers as osteoarthritis, and it has different symptoms and treatments. This form of the disease can actually affect other areas of the body, such as the blood supply and lungs, and it is actually causes by inflammation of the joint lining, which causes loss of movement, pain, and swelling."
Abstract The paper defines osteoarthritis as the most common form of arthritis, mostly affecting senior citizens progressively with age, though trauma-induced osteoarthritis is also observed in younger people. The paper looks at the results of osteoarthritis on the bones and cartilage. It shows how it affects different areas of the body, as well as the frequency and demographics of this ailment. Other issues covered in the paper are signs and symptoms, diagnosis and radiology, treatment and intervention, self-care and research.
From the Paper "There are two types of osteoarthritis which pathologically manifest similarly though for different reasons. The less common type"secondary osteoarthritis"occurs from stress on bones of the hand, hips and knees which are typically involved in manual or weight bearing operations. The secondary kind is often seen in younger people. The reasons for occurrence of the more common type"primary osteoarthritis"observed in seniors are ambiguous at best. There is no apparent initiation for primary osteoarthritis."
Abstract "Between 20 and 40 million Americans suffer from osteoarthritis, a condition in which the normally spongy cartilage between bones deteriorates so that bones rub together, causing stiffness, debilitating pain, fluid in the joints and inflammation.
From the Paper "Between 20 and 40 million Americans suffer from osteoarthritis, a condition in which the normally spongy cartilage between bones deteriorates so that bones rub together, causing stiffness, debilitating pain, fluid in the joints and inflammation. This paper will look at two new over-the-counter supplements, glucosamine sulfate and chondroitin sulfate, which are being used to treat different forms of arthritis.
In healthy joints, cartilage makes a slippery, lubricating cushion between bones that allows for easy movement (Fraser 46). Injuries, overuse, or age can wear cartilage down, leaving bone grinding against bone. Half of all people over 65 have this version of arthritis known as osteoarthritis. Osteoarthritis is a wearing away of joint cartilage and a thickening of the lubricant-containing synovial tissues which insulate contact of ..."
Abstract The paper beings by looking at osteoarthritis, rheumatoid arthritis, tendinitis, and carpal tunnel syndrome. It then looks at actin and myosin and how they interact in muscle contraction. Next, the paper looks at the intestinal villi and specialized cells found there.
From the Paper "Osteoarthritis is a degenerative joint disease which is progressive and causes a gradual loss of cartilage resulting in the development of bony spurs and cysts on the joint margins. The name comes from the Greek words for bone joint and inflammation. Osteoarthritis causes disability because it limits movements of the joint. It results from deterioration or loss of cartilage from weight-bearing joints like the knees and hips and as the cartilage is worn away the bones rub together forming spurs which are areas of abnormal hardening...
Abstract The paper discusses the three types of arthritis, namely rheumatoid arthritis, osteoarthritis and psoriatic arthritis. The paper describes the problems associated with arthritis and the common misperceptions of the disease. It also discusses the important link between sports, exercise and arthritis and the social and economic cost of arthritis. A list of the treatments for arthritis is given. The paper presents which areas of research into arthritis could be extended.
Table of Contents
Problem Statement
Literature Review
Introduction
Types of Arthritis
Osteoarthritis Rheumatoid Arthritis
Psoriatic Arthritis
Causes of Arthritis
Treatments Available
Current Research
Arthritis and Athletic Activities
Research Needed
Learning Outcome
From the Paper "Arthritis is said to be the number one cause of disability in the United States, with more individuals disabled with arthritis than by both heart disease and strokes (Lewis 2000). Arthritis is also a disease that is plagued with misunderstanding. The Center for Disease Control warns that it is these misunderstandings that result in the disease doing so much harm (Lewis 2000)."
Abstract This paper looks at how 144,000 total hip arthroplasties are performed annually in the United States and how, of these, approximately 100,000 are due to osteoarthritis of the hip joint. It examines how candidates for total hip replacements most commonly present with pain and often with reduced range of motion and how a total hip arthroplasty is performed only when all other possible methods of treatment have failed. It shows how the main cause for choosing this treatment option is osteoarthritis, the degeneration of articular cartilage in the joint, and how other causes include rheumatoid arthritis, trauma, post traumatic arthritis, and congenital deformities.
From the Paper "The intraoperative problems associated with total hip arthroplasty are thrombophlebitis (a blood clot in the large veins of the leg), infection, nerve injury, vascular injury, cement reaction/fat embolus, and fracture/canal perforation3,4. During the surgery, the most difficult step is obtaining proper alignment and positioning of the acetabular cup. This is important because it will affect the range of motion and the loading of the joint, as well as directly affecting the life of the implant. A cup protector must be utilized to protect the acetabular cup from scratches from bone, instruments, and debris. It is also imperative to sufficiently ream the femoral canal and to apply an even cement mantle. Additional problems commonly seen postoperatively include stem subsidence, dislocation, aseptic loosening, wear that can lead to systemic effects, weakening of surrounding bone (bone resorption), instability, and fracture."
From the Paper " HIP OSTEOARTHRITIS
Introduction
Osteoarthritis is found to be the most common form of arthritis. Studies show that around five percent of the US population is affected with hip or knee osteoarthritis and over 70 percent of total hip and knee replacements are for osteoarthritis (5). Research demonstrates that most people over the age of 65 have evidence of osteoarthritis (OA), the most common joint disorder. Prevalence of hand, hip, and knee OA is found to increase with age and is higher in women than in men. OA causes disability in the elderly and impacts the cost of care for that population. Studies show that people with OA have higher rates of mortality than those without the disease. Radiographic evidence of the disease is focused on, however many.."
Abstract This paper explains that, although many patients first turn to pain-reducing medications, the patients soon find that they are either eventually ineffective or that the risks associated with their continued use outweigh their benefits; thereby, a total hip replacement is indicated. The author points out that, although in previous years the actual hip replacement procedure was quite invasive, leaving a long scar from above the hip to mid thigh, today, new instrumentation and techniques are less invasive, completing the entire procedure through a single three to four-inch incision, resulting in faster recovery times. The paper reveals that, of all the complications possible during or following surgery, many patients are surprised to learn that the newly transplanted joint is more prone to dislocation than a normal joint; therefore, the patient is instructed to avoid sitting "low" or crossing his or her legs for some time following the procedure.
Table of Contents
Introduction?Overview of Total Hip Replacement
Preoperative Care
Recommended Procedures
Necessary Pre-Op Arrangements
Instrumentation
Old Method
New Minimally Invasive Method
Basic Procedure
Postoperative Care
Sedation
In the Hospital
Discharge
Possible Complications
Conclusion
From the Paper "The actual process leading to degenerative hip disease can be attributed to many factors. Foremost among these possible factors is osteoarthritis, or ?wear and tear arthritis,? meaning, much like a part in a car, the hip joint basically wears out. Further, although there does seem to be a strong genetic component involved in one's propensity to develop osteoarthritis, it can still occur in virtually anyone. In addition, vascular problems can also lead to the degeneration of the hip, causing the femoral head, or the "ball" of the hip to die from a lack of blood. Eventually, the dead femoral head collapses, leading to the degeneration of the joint. The risk factors leading to this condition include patient histories of alcoholism, cortisone treatment, as well as injury of the hip from falls or other accidents. Finally, anatomic abnormalities can also lead to hip degeneration. These abnormalities can also be a result of an injury, or even a deformity existing from birth."
An analysis of the way the giant pharmaceutical manufacturer Merck handled the problem where one of its pain medications was shown to increase the risk of heart attack and stroke in patients.
Abstract This paper examines the way in which Merck dealt with the public relations nightmare that it found itself in after a study in the "New England Journal of Medicine" revealed that there was an increased risk of heart attack and stroke in patients who were using Merck's popular pain relief medicine, VIOXX. The paper considers whether Merck knew that VIOXX posed as a significant cardiovascular risk and, if it did, what were the public relations implications of not removing the drug from the market in a more timely manner.
From the Paper "When Merck removed VIOXX, it's popular and lucrative COX-2 inhibitor from worldwide distribution in September of 2004, the chief executive of the company stated that Merck was primarily concerned with putting the safety of consumers first (Wilde-Mathews and Martinez, 2004). A large scale prospective study of the effects of drugs like VIOXX called the Vigor study performed at the Cleveland Clinic had found that COX-2 inhibitors - the popular painkillers celecoxib (Celebrex - Pharmacia; Pfizer) and rofecoxib (VIOXX - Merck) - may cause a slight increase in a patient's risk of stroke, heart attack or even death. The findings from this study were originally published in the August 22nd issue of the Journal of the American Medical Association."
Abstract This paper traces the roots of hypnosis to the 18th century when it was first used by Austrian Dr. Franz Anton Mesmer. This paper analyzes the various uses for hypnosis in curing and/or treating numerous disorders and conditions including convulsions, weight loss and even schizophrenia. This paper delves into the training and methods used in successful hypnosis. This paper details the benefits of hypnosis including cessation of smoking and dealing with diverse types of phobias. This paper examines the published research results pertaining to the effectiveness of hypnosis in managing physical pain such as osteoarthritis. This paper also discusses the morally negative aspects of hypnosis which can be both dangerous and highly unethical if not used as initially intended.
Table of Contents:
History
Methods and Training
Benefits of Hypnosis
Contraindications with Schizophrenia
The Research
Conclusion
References
From the Paper "Eye fixation is a method most commonly seen being practiced in movies where the hypnotist takes out a pocket-watch and swings it like a pendulum in front of the patient. This method is not very effective and a large number of people or patients do not get hypnotized using this method. However the concept is to get the patient to focus on the moving object with such a concentration that they disregard any other external stimuli. While the patient focuses on the object, the doctor, using a low soft tone talks to the patient. "The hypnotist says to his subject, 'Let your eyes focus oil some point on the wall. As you continue to stare, your eyelids could become heavy, so heavy that they may close, and you might feel more relaxed about going into trance whenever you are ready, either now or in a few moments'" (Don J. Feeney Jr., p.75). This puts the patient in a relaxed state. This method has now become obsolete but was used widely in the early days."
Abstract This paper takes a look at the history of Pilates, an exercise that was developed at the turn of the 20th century. Pilates has become a very popular form of exercise, especially in knee and hip injury rehabilitation or for sufferers of repetitive strain injuries, and for anyone wanting to prevent the onset of osteoporosis.
Contents:
Principles of Pilates
Cruciate Ligament
Osteoarthritis Rheumatoid Arthritis
Miniscal Damage
Knee Replacement
Hip Replacement
Pilates Mat work Exercises
Exercises Using the Swiss Ball
Case Studies
From the Paper "This is not "mindless exercise" but rather requires someone--in the case of rehabilitation, the therapist--to put some thought into the proper exercises and the proper order of exercises to accomplish the rehabilitation sought. Importantly, Pilates recognizes, in several of its principles, the fact that the torso ultimately controls actions of the extremities; therefore, the Pilates concentration on torso control and improvement cannot help but improve the use and function of muscles of the hip and knee in rehabilitation.
In addition, while most people think of hard, fast movements as being needed for building strength, Pilates movements are slow and methodical but through them, Robinson and Thomson note, strength is regained (2002, Positive Health Web site), a prime intention in almost any rehabilitation program."
Abstract The paper explains that although dance does not directly cause arthritis, improper techniques in dance can cause injuries that result in arthritis. The paper relates, however, that dance can also serve as a means of physical therapy for arthritic sufferers by increasing their range of motion, muscle strength and overall physical and mental health. More specifically, the paper discusses the relationship of dance at a young age to the development of arthritis as well as dance's therapeutic effect on arthritic sufferers.
From the Paper "Many dancers experience aches and pains though out their dancing careers. Despite the cause of the pain, many find it commonplace, and therefore ignore it. Others choose pain-dulling drugs to overcome the pain. However, pain and "discomfort should not be considered a normal result of dancing. If an ache or pain recurs after a few hours of rest or a good night's sleep, it must be confronted and the source examined." (Horosco, Cures and Myths about Arthritis 108) The causes of these pains are too many to number, but one that many do not realize may be linked to arthritis."
Abstract The paper discusses stem cells in human development, a specialized topic in developmental biology, focusing on potential cures for fetal malformations, via stem cell therapies and stem cells characteristics in general. The paper notes that the most promising use of stem cells is their ability to serve as a potential source of replacement cells to treat numerous diseases, such as Parkinson''s disease, Alzheimer's disease, ALS (amyotrophic lateral sclerosis), cancer, and heart disease. The paper further notes that any disease in which there is tissue degeneration can be a potential candidate for stem cell therapies, including spinal cord injury, stroke, burns, heart disease, osteoarthritis, rheumatoid arthritis, muscular dystrophy and liver disease. The paper includes photographs.
Outline:
Abstract
What are Stem Cells?
Types of Stem Cells
Embryonic Germ Layers From Which Differentiated Tissues Develop,
Mechanisms of Action:
Characteristics and Potential Uses
Hematopoietic and Stromal Stem Cell Differentiation
Human Embryonic Germ Cells
Human Adult Stem Cells
Summary of Animal Experiments
Mouse Embryonic Stem Cells
Bovine Embryonic Stem Cells' Studies
Primate Embryonic Stem Cells' Studies
Miscellaneous Animal Studies
Migration of Transplanted Human Cells
Survival of hCNS-derived neurospheres in the ischemic brain.
In Utero Stem Cell Therapy - Stem Cell Transplantation in the Fetus
Ontogeny of Hematopoiesis in Humans
In Utero Stem Cell Therapy in the Mouse
Conclusions
From the Paper "Embryonic stem cells are difficult to control, as they behave in an unstable manner resulting in unexpected results as they divide, or even cancerous growths. They are indeed more difficult to maintain and expand in culture (Van Blerkom, 1994). ES differ substantially from the stem cells found within the fully developed adult where they can be totally quiescent. Human ES cells may cause an immune reaction when transplanted into people, which means cells used in treatment may be rapidly destroyed unless they are protected by giving medication to suppress the immune system. It appears though that if stem cells were someday to be used for the treatment of disease, there would be greater advantage in using ES cells. "
