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Cutting-edge Rheumatology by Ihor Magun, M.D., F.A.C.P. One of the things I love about medicine is seeing firsthand the new medical developments and treatment strategies available to doctors and their patients. Amazing things have been happening and reshaping our scientific thinking. One day we hope for a new treatment to come along; the next day we marvel at the rapid advancement that has made it possible or will make it possible in the not too distant future. How extraordinary is that? One area of medicine that has been im pacted by this extraordinary trend is rheumatoid arthritis. This malady affects 1% of the population worldwide, with a female to male ratio of about five to one. (Not that equal ratios would be any better.) The disease affects people between the ages of 40 and 70. About 80% of patients afflicted with rheumatoid arthritis have some degree of disability after 20 years. The life expectancy of people with this condition is actually reduced by 3 to 18 years, a frightening statistic. Traditional therapy has been anti-inflammatory agents, but in the last few years, treatment has shifted to Disease Modifying Anti rheumatic Drugs (DMARDs). DMARDs use im munologic mechanisms to decrease the number of swollen and tender joints, slow radiographic disease progression, improve laboratory measurements of inflammation, and maintain patient's physical function. These medications have been available for some time, but our use and the timing of their introduction for treatment have dramatically changed. DMARDs work best for individuals who have early rheumatoid arthritis. They should be started within the first three to six months of the onset of the condition. Prompt early intervention prevents the major disability issues that are typical with rheumatoid arthritis. (Most common DMARDs are methotrexate, avara, azulfidine, and plaquenil.) Although DMARDs are quite helpful, many patients cannot tolerate this therapy or just do not respond as well as hoped for. An alternative therapy is biological DMARDs (examples include Enbrel, Remicade, Humia, Orencia and Rituxan). Dramatic responses have been seen in patients who have been given these agents early in the course of the disease. Primary use of these agents as first-line treatment is ongoing. One drawback to these agents is that biologic DMARDs are administered via injections and are costly, although covered by most insurance plans. We have come a long way in the man agement of rheumatoid arthritis. Make sure to ask your physician whether the new agents can become a part of your armamentarium in the management of this debilitating condition. Branch 97 of Buffalo, New York, is happy to announce that the third edition of our successful cookbook Recipes To Crow About is now available. This 183-page book contains 300 Ukrainian and American recipes in English. All proceeds benefit the UNWLA Branch 97 Scholarship Fund. For more information, please call 716-773-2117. To order, send check in the amount of $15 (includes shipping in the U.S.) payable to " UNWLA Branch 97" and mail to: UNWLA 97 Cookbook 118 Tracey Lane Grand Island, NY 14072-1920 Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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