This paper is about rheumatoid arthritis, its symptoms and signs, and the existing methods of treatment. This library thesis is based on documentary analysis as the main method of investigation. The evaluation of the literature from different sources helps to get a clear picture of what researchers, journalists, and scientists know and think about rheumatoid arthritis and its effects on human life. In fact, rheumatoid arthritis is the problem of millions of people, and it is necessary to learn it from different aspects.
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The aim of this work is to clarify what has been already discovered about this disease and create a solid basis for further investigations in this field. Rheumatoid arthritis is a health problem. Still, it has a solution or even more than one solution. Therefore, this thesis is an attempt to prove why people should learn such topics as rheumatoid arthritis deep and follow the achievements made recently.
In this project, the goal is to investigate all peculiar features of rheumatoid arthritis and clarify if some new treatment methods or signs of RA have been offered during the last five years. It is expected to answer such questions as if the last five years were productive in terms of RA investigations if people have more complaints about the ways of how RA is treated, and if people with RA are satisfied with the options their governments offer them to treat RA. RA is a serious disease that bothers a number of people across the whole world, and it is important to discover the depths of this disease to help people and improve the health care systems of their countries.
Material and Methods
This section will provide the description and evaluation of the research methods and materials chosen in order to give answers to the questions posed in this study. In this library research, it is expected to base the findings on the available literature and research that have been done in the field of RA treatment. There are many approaches on how to investigate the chosen topic, and a documentary analysis is one of the most appropriate ideas that could help to cover various aspects of the disease.
A documentary analysis aims at obtaining various data and findings from the already offered documents and sources without communicating with people, who are directly involved in RA discussions. To succeed in documentary analysis, there is no need to observe people’s behavior or analysis of their actions. It is enough to plan personal time and think where it is possible to get access to credible and up-to-date information about RA.
In fact, a documentary analysis is one of the oldest and most effective methods of writing dissertations and research projects. In comparison to interviews and experiments, the documentary and literature analysis help to focus on such issues as the evaluation of the literature, current research, and investigations. Such a method is effective because of its possible scope and time-framing. Documents and literature help to reveal much information about people with RA and organizations that investigate and offer various treatments and to clarify the social context in which RA could emerge.
In this project, the literature search was done in several stages with each of them having clear goals and outcomes. First, it was necessary to set the goals that had to be achieved at this stage of writing a library thesis. The main tasks were about to clarify the main sources of information that were available at the moment of writing a project, to identify the ways of how the material could be gathered, establish the inclusion and exclusion criteria, and underline the main keywords that can be used in the search.
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Second, it was important to identify the time frames of this stage. It was expected to gather enough material in one working week plus spend two weekends during which it was possible to work on the project all day long. Finally, the evaluation of the material should be done in the next two days.
Nowadays, it is possible to find a number of places where information about rheumatoid arthritis could be found. The most evident are hospitals, libraries, and the Internet. In the beginning, the nearest hospital was visited in order to ask its workers to share several histories of patients with RA. Still, it was impossible to get the required portion of information because of the existing ethical norms, the privacy of patients’ information, and the inabilities to give clear and legal reasons for why this study deserved the right to ask for such kind of information. As a result, the search of the literature was reduced to the level of libraries and the Internet.
In both types of searches, it was necessary to clarify what sources were appropriate. Medical journals, sites with medical news, and books (that were no older than five years) were chosen for the analysis because of several reasons. First, medical journals could contain credible articles with investigations from different parts of the world. Second, news sites could be used to find out if there were the latest achievements in the sphere of RA treatment and diagnosis.
Finally, books could perform the functions of powerful theoretical grounds for the project as the sources with personal experiences and stories that could help to comprehend the essence of rheumatoid arthritis and its impact on human life.
The main keywords that were used in the search were the following: “rheumatoid arthritis” stood alone and in combination with one of such words as “history”, “diagnosis”, “symptoms”, “treatment”, “personal experience”, and “latest research”. Another important keyword used in the search was “living with rheumatoid arthritis”. Such keyword was chosen to find out what people, who had or observed how other people had RA, thought about that disease, how they fought against it, and if there was a hope that positive outcomes could be achieved. The main inclusive criterion was the years of publications. It was decided to use the date of the source from 2010 to 2016.
There was no need to use only peer-reviewed articles because it was important to identify the latest news and achievements. Online news magazines contain much information about rheumatoid arthritis and the latest ideas on how it can be diagnosed and treated. Therefore, this library thesis is based on the analysis of literature and documents that could be found in journals, documents, and books that are available online and in libraries.
In general, the sources varied considerably. No race, age, gender, or ethical differences were taken into consideration in order to clarify which groups of people were under a significant threat of having rheumatoid arthritis.
The evaluation of the literature available online and in libraries helped to gather much information on the chosen topic and comprehend that rheumatoid arthritis had been a crucial problem for many people since decades ago. In order to comprehend what people could do today to get the best treatment for rheumatoid arthritis, it was suggested to look at the history of the disease. It was discovered that European explorers and settlers transmitted the disease from the New World to the Old World more than 1000 years ago (Weisman, 2011).
Such a conclusion was based on several paleopathological studies. At the same time, some researchers admitted that this disease was observed even in 1500 BC. Though it was not termed as rheumatoid arthritis, the signs were similar to that disease. In fact, Garrod was the first, who coined the term rheumatoid arthritis in 1858 (Joshi, 2012). Treatment of RA differed with time. Mandal (2013) informed that in the olden days, people with RA could be treated by means of bloodletting and leeching. In several decades, people tried such approaches as acupuncture and acupressure. Still, the majority of attempts were failed. The conditions of the patients were not improved.
Certain success was achieved to reduce the level of pain. Still, continuous investigations and new methods were required. People were in need of changes, and new treatments were discovered. The following table is the findings on the treatment of RA during different periods of time.
|1895||Payne suggested quinine as one of the possible medications to treat rheumatic diseases (Mandal, 2013).|
|1940||Sulphasalazine was introduced as one of the possible anti-inflammatory medications.|
|1957||Bagnall offered to use chloroquine (daily dosages should not exceed 250mg) and hydroxychloroquine (daily dosages should not exceed 400 mg) (Fineman & Ho, 2012).|
|1980’s||Methotrexate was offered to treat RA as a part of disease-modifying antirheumatic drugs (DMARDs). Earlier, in the 1950s, this medication was synthesized to treat patients with leukemia only (Mandal, 2013).|
|1993||Tumor necrosis factor (TNF) was identified as a crucial inflammation of a human organism (Shlotzhauer, 2014). It was decided to develop anti-TNF antibodies to provide patients with RA with effective treatment (Mandal, 2013).|
|1990’s||Steroids and biologics revolutionized in the field of treatment offered to patients with RA (Joshi, 2012).|
Modern RA Treatment
Nowadays, people also make use of such non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium (that can be offered in dosages of 250, 375, and 500 mg) in order to reduce pain that is caused by RA and treat the main challenges and negative outcomes of the disease (Shlotzhauer, 2014).
Recently, research on modern treatment methods was offered by Waffle. The author underlined that gluten-free diet could be used to treat RA. Waffle (2016) introduced the story of a 29-year-old woman, who had RA during the last three years. It had been already offered to use gluten-free diets to treat celiac disease (the condition when the small intestine turns out to be hypersensitive to gluten and leads to problematic food digesting).
That woman did not have the diagnosis of celiac disease. Still, she decided to try that diet even before testing for celiac disease. The results were impressive. Her diet decreased pain connected with RA and made her stop using any medications for her RA. Waffle (2016) said that RA was similar to celiac disease autoimmune disorder.
Still, the center of the disease was not intestines but joints. The diet included such products as extra-virgin olive oil, nuts, herbs and spices, grains, legumes, and fruit/vegetables and excluded such things as red meat, milk, processed food, and fruit juices (Waffle, 2016). Though no clear explanations and approvals had been given, it was concluded that such diet could be a new investment to the investigations of patients with RA and possible treatments.
Signs and Symptoms
In addition to the investigations made in the field of treatment of patients with RA, literature search helped to clarify the main symptoms and signs of RA in order to diagnose it at the early stages and help people to avoid complications. Well-known signs of RA are usually tender, swollen joints and joint stiffness that could be worsening in the mornings. Still, Shlotzhauer (2014) underlined that RA was a disease that could affect more than one part of the body, and some symptoms could not be related to joints at all. For example, people with RA could experience fatigue, the decrease in appetite, or fever.
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RA is a kind of inflammation, and it is easy to get confused with the symptoms. Therefore, it is suggested to address doctor as soon as some abnormalities are observed in an organism. Baker et al. (2015) developed research within the frames of which it was proved that weight loss and the obesity paradox were also inherent to the patients with RA. Besides, they concluded that if the patients with RA suffered from weight loss, it could be a serious predictor of death in some cases. Therefore, RA should be considered as the disease that required constant observations and evaluations conducted by professionals in different spheres of health care. BMI loss was determined as a crucial factor that could never be neglected in RA cases.
The results observed in after literature search was conducted prove that the topic of rheumatoid arthritis is still open and needs more explanations and examinations. Nowadays, people are under a threat of having RA in combination with a number of other dangerous diseases. In addition to the fact that in America, more than 2 million people have been diagnosed with RA during the last several years, the actual numbers of how many people with RA could be hard to find.
People have complaints of constant pain, stiffness, and swelling. Many people experience warmth in their joints and observe pink skin around the problematic part of the body. Besides, people, who have guesses about the possibilities of having RA, add such symptoms as fever, fatigue, and sudden weight of loss in order to create a more or less clear picture of their conditions. Therefore, ordinary people and even some professional doctors are not always able to classify the presence of health problems in patients.
In some countries, people are eager to unite the health care systems of their countries with politics and governments in order to make sure that the required portion of support could be provided. For example, the investigation shows that Scottish citizens are not satisfied with the health care offered to patients with RA in their country (“Health service top priority for people with arthritis”, 2016). Even Scottish Parliamentary Elections was based on the questions of health care. The majority of Scottish population paid attention to the candidates, who were going to fight for development of health services and the improvement of care quality for people, who had to live with constant pain (“Health service top priority for people with arthritis”, 2016).
In addition to the governmental support, it was discovered that people wanted to get some scientific guarantees that RA could be treated effectively with time. For example, the latest achievements of the American company Pfizer helped to introduce tofacitinib as one of the best alternatives to methotrexate in patients with rheumatoid arthritis. Though methotrexate was defined as one of the predominant first-line treatment methods for patients with RA (Lee et al., 2014), the researchers offered various dosages of tofacitinib (5 mg or 10 mg twice a day) and proved that the treating period could be shortened with a minimum of negative outcomes.
Such achievements in the sphere of health care explain that people do not want to stop investigating RA and try to help people, who have to suffer from joints pain day by day. At the same time, the analysis of the literature shows that not many researchers and scientists pay enough attention to the history of the disease, its origins, and complications. Scientists and medical workers are bothered with the current state of affairs and consider the recent methods and opportunities. Still, it is possible to investigate what previous research offered, what methods were used, and what reasons for why people could think the offered treatment could be effective for patients with RA.
Today, people with RA have access to a number of treatment methods. For example, they can use some alternative medicine and try various types of fish or plant oils (that help to reduce RA pain but lead to the development of new health problems such as nausea or diarrhea) or tai chi (the movement therapy with the elements of stretching and breathing) (Shlotzhauer, 2014). If people do not trust the alternatives, they can use some NSAIDs or DMARDs that can be prescribed by doctors.
Some patients use steroids in order to reduce inflammation and joint damage. Still, all patients should understand that any kind of treatment even the one that has been proved by professional doctors could have its side effects. Therefore, patients should be informed about the possible cases of nausea, bone thinning, or even diabetes (the outcome for patients on steroids). Very often, doctors offer their RA patients to combine several types of treatment in order to achieve effective results.
In general, people with RA want to believe that they have some guarantees in case they ask medical workers and specialists for help. Rheumatoid arthritis is the disease that came from the old times. It has developed new symptoms. At the same time, new treatment methods have been invented. Though it is not easy to live with rheumatoid arthritis, people have all chances to understand the reasons for their pain and find the most appropriate solutions to their problem.
The only piece of advice that could be given is not to treat independently but to find some time and address a professional for help in order to avoid complications and negative outcomes. Rheumatoid arthritis is not the problem without a solution. In cases of emergency, people could also think about surgery as the possible method of treatment.
Baker, J. F., Billig, E., Michaud, K., Ibrahim, S., Caplan, L., Cannon, G. W.,… & Mikuls, T. R. (2015). Weight loss, the obesity paradox, and the risk of death in rheumatoid arthritis. Arthritis & Rheumatology, 67(7), 1711-1717.
Fineman, M.S. & Ho, A.C. (2013). Color atlas and synopsis of clinical ophthalmology: Wills Eye Institute: Retina. Philadelphia, PA: Lippincott Williams & Wilkins.
Health service top priority for people with arthritis living in Scotland, according to new poll. (2016). Arthritis Research UK. Web.
Joshi, V.R. (2012). Rheumatology, past, present and future. The Journal of the Association of Physicians of India, 60, 21-24.
Lee, E. B., Fleischmann, R., Hall, S., Wilkinson, B., Bradley, J. D., Gruben, D.,… & Zwillich, S. H. (2014). Tofacitinib versus methotrexate in rheumatoid arthritis. New England Journal of Medicine, 370(25), 2377-2386.
Mandal, A. (2013). Rheumatoid arthritis history. News Medical. Web.
Shlotzhauer, T.L. (2014). Living with rheumatoid arthritis. Baltimore, MA: Johns Hopkins University Press.
Waffle, V. (2016). Can the gluten-free diet treat more than celiac disease? Gluten-Free Living. Web.
Weisman, M.H. (2011). Rheumatoid arthritis. New York, NY: Oxford University Press.