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arteriosclerosis-Osteoarthritis-Rheumatoid arthritis

Arteriosclerosis

Atherosclerosis is a condition caused by the formation of plaque in the arteries, that is, the blood vessels where the blood carries oxygen and nutrients, which causes its obstruction.


This plaque is a substance composed of fat, cholesterol, calcium and other substances found in the same blood and, over time, causes the arterial wall to harden to block the arteries, limiting the flow of blood. blood.


This procedure is the same that occurs in atherosclerosis, except that the latter is a type that is encompassed within atherosclerosis and is caused by an atherosclerotic plaque (cholesterol).

Causes
The main reason for atherosclerosis is the accumulation of lipids, especially cholesterol, and other substances. When an obstruction occurs, blood rich in nutrients and oxygen can not circulate, which is called ischemia.

Ischemia can end up producing, in the most serious cases, cell death (necrosis) and infarction. The latter can occur in the myocardium, which is the most frequent, but it is also possible to affect other parts of the body such as the brain or lower limbs.

One of the main causes of arteriosclerosis is poor nutrition, that is, one in which saturated fats or fast foods are abused, combined with a sedentary lifestyle and lacking physical activity. This statism prevents the body from burning the excess fats and reduces the constant flow of blood to the organs.

Suffering from hypertension or diabetes, in addition to smoking or drinking too much alcohol, are risk factors that generate more propensity to suffer from this disease. Aging can also lead to hardening of the arteries.

Another cause that can cause the emergence of atherosclerosis is fibrosis, caused by a chronic inflammation that eventually hardening blood vessels.
symptom
In general terms, the condition does not present symptoms until an artery narrows too much or completely.

When the severity of the disease is increasing, coronary blood flow is reduced considerably and this can lead to chest pain, also called angina pectoris, or difficulty breathing.

In addition to these symptoms, the condition can also cause damage to other organs, such as the intestines, kidneys, legs, or brain.

Prevention
To prevent atherosclerosis, it is important to reduce the consumption of saturated fats and replace it with an increase in the intake of fruits and vegetables. In addition, it is recommended to consume drinks or foods that contain antioxidants, which benefits the flow of blood.

Another of the necessary guidelines is to carry out exercise routinely, both to prevent atherosclerosis and atherosclerosis.

All this is concentrated in the framework of a healthy and healthy diet, such as the Mediterranean, which rejects smoking or abuse of other substances such as alcohol.

Types
Among the types of arteriosclerosis is:

Atherosclerosis: This type of arteriosclerosis also involves an accumulation of substances in the arteries that prevent the passage of blood but, in this case, is caused by an atherosclerotic plaque.

Monckeberg sclerosis: It is characterized by the presence of calcifications in medial arteries of muscular type. Although it can occur simultaneously to atherosclerosis, both are anatomically different.

This condition is uncommon before the age of 50 and usually affects the femoral, tibial, radial or cubital arteries.

Atherosclerosis: Contains the same characteristics as atherosclerosis but affects arterioles, ie small arteries.
Diagnosis
Since atherosclerosis is a condition that takes time to present symptoms, it is necessary an early diagnosis of the disease to prevent irreversible damage.

Periodic exams are needed, especially from 40-50 years and in those with a history of diseases such as atherosclerosis or atherosclerosis.

Treatments
Since medications can not purge arteries that have become blocked, other forms of treatment should be considered.

One of the options is percutaneous coronary angioplasty. This therapy consists of dilating one or more coronary arteries by using a catheter, the end of which has a device that inflates upon reaching the clogged area.

This increases the diameter of the artery and restores normal blood flow. This catheter is inserted through the femoral or radial artery, from where it leads to the obstruction.

Also, metallic devices called endoprostheses or stents can be introduced into the coronary arteries percutaneously to correct the narrowing caused by a thrombus or plaque. This procedure is usually used within angioplasty.

Another form of treatment is surgery in the coronary or carotid arteries. But even so, all options involve a change in lifestyle that will prevent a worsening of the disease.
Early detection of the condition is necessary to avoid, in this way, serious problems, such as:

Coronary artery disease, that is, those that transfer blood to the heart.

Diseases of the carotid arteries, which are those that carry the blood to the brain.

Peripheral arterial disease, which includes arteries found in the arms, legs and pelvis. When they become blocked, numbness, pain and even secondary infections can occur.
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Rheumatoid arthritis

Rheumatoid arthritis is a chronic and degenerative disease characterized by inflammation of the synovial membrane (membrane that feeds, protects and covers the cartilage) of the joints and surrounding tissues. Sometimes arthritis can have extra-articular behavior and damage organs and systems such as the heart, kidney, and lung. For this reason it is a systemic disease.

The inflammation of this membrane is responsible for pain, clearly visible swelling, the sensation of stiffness that patients can feel in the morning and loss of joint mobility.

It affects more strongly joints than others, especially the more mobile ones such as hands and feet, elbows, shoulders, hips, knees and ankles. There are some that are never affected.

If the inflammation remains in a maintained and uncontrolled way, it can end up damaging the bones, ligaments and tendons around the joint. This can lead to progressive deformity of the joints and loss of ability to perform daily movements and tasks. All this has repercussions on the quality of life of patients.

Incidence
According to the Episer study on the impact and prevalence of rheumatic diseases, carried out by the Spanish Society of Rheumatology (SER), it is estimated that worldwide this pathology affects between 0.5 and 0.8 percent of the population , Or approximately five people per thousand worldwide. However, there are still many people who are not diagnosed.

According to SER, in Spain there are more than 200,000 people with rheumatoid arthritis and each year 20,000 new cases are diagnosed. "This is a remarkable figure because rheumatoid arthritis is the most disabling of rheumatic diseases," they explain from society.

Its incidence is higher in women than in men. In fact, for every 3 diagnoses in women only one is done in men. Although it can affect anyone and appear at any age, it is most often manifested in women 30 to 50 years.

Within the same geographic area there is a trend towards greater occurrence in urban versus rural municipalities.
Causes
The cause of the onset of this disease is unknown. Infectious agents such as bacteria or viruses have been studied and, although suggestive data have been found in some cases, there is still no evidence to confirm its implication.

Specialists believe that it may have a genetic origin since the immune system itself attacks the joints because it does not recognize them as their own and therefore they become inflamed. What is known as autoimmune disease. It is also believed that certain proteins that are transmitted in hereditary form could predispose to the disease.

Differences in the frequency of the disease make the specialists also suggest that there are environmental factors involved in the onset of the disease.
As indicated by the Spanish Society of Rheumatology, the disease begins slowly and insidiously with general manifestations of other diseases, such as fever or asthenia.

However, the main symptom of this disease is the involvement of the diarthrodial joints. Initially there is an inflammation that is visible to the naked eye and causes pain in the individual who suffers. Along with inflammation, other manifestations may appear, such as increased volume, stiffness after nocturnal rest that gradually disappears as the patient exercises his daily activity, muscle weakness and limitation of mobility.

Hard lumps (rheumatoid nodules) may also appear on areas of skin rubbing such as the elbows, backs of the fingers and toes, which may also be localized inside the body.

If the disease is in an advanced stage, the patient may have some deformity due to the progressive deterioration of the affected joints. In addition, it can evolve and affect vital organs like the kidney or the lung.

It often causes dryness of the skin and mucous membranes. This causes inflammation and subsequent atrophy of the glands that generate tears, saliva, digestive juices or vaginal discharge (Sjögren's syndrome).

It can also produce some fever and, occasionally, inflammation of the blood vessels (vasculitis), which causes nerve damage or sores in the legs (ulcers). Other symptoms are inflammation of the membranes lining the lungs (pleuritis) or heart wrap (pericarditis), or inflammation and scarring of the lungs can produce chest pain, shortness of breath and abnormal heart function.

"In the long term, the consequences of the disease left to its evolution are the limitation and inability to perform, initially, the work activities and, later, the daily life of the subject who suffers from it.

Prevention
At present there is no measure that helps prevent the onset of rheumatoid arthritis. However, experts recommend doing physical activity on a regular basis to encourage the use of all joints.

In addition, once rheumatoid arthritis has been diagnosed, they recommend to properly follow the treatment to prevent the progression of the disease.
Diagnosis
Although there is no specific evidence, the diagnosis of this pathology is relatively simple if the patient visits the rheumatologist on suspicion of having some of the symptoms described above.

If the disease is in an early stage, the diagnosis can be more complicated since all the symptoms may not appear in the laboratory tests, since the assessment of the disease is mainly clinical. "It is done in the presence of a series of signs and symptoms in the joints in the form of polyarthritis (multiple joint arthritis) of a symmetrical nature), chronic course (more than 6 weeks) and almost constant involvement of joints," specify From the Spanish Society of Rheumatology.

The problem at diagnosis is that there are other rheumatic diseases, such as lupus or psoriatic arthritis, which in the early stages may be confused with rheumatoid arthritis.

During the evaluation the rheumatologist can perform a series of complementary examinations to facilitate the diagnosis:

Blood test.

Rheumatoid factor tests.

Test to detect antibodies against citrullinated peptides. These antibodies are present in two thirds of patients with this pathology.

X-rays to detect the presence of erosions.
Treatments
Rheumatoid arthritis is a chronic disease that currently has no treatment to cure the disease. However, pharmacological therapies and treatment strategies are very effective and allow good control of the disease.

The treatment of rheumatoid arthritis includes two types of drugs: those used to relieve pain (anti-inflammatories and corticosteroids), and those used to modify the disease in the long term. The latter can be effective weeks and even months after treatment. They are not effective in one hundred percent of patients, according to the Spanish Society of Rheumatology, so the doctor usually prescribes several sequentially until finding the one that is more effective and better tolerated by the patient.

The mainstay of therapy is disease-modifying antirheumatic drugs (Fames). Among them, the most used is methotrexate. Other medicines would be sulfasalazine, leflunomide or gold salts (nowadays in disuse).

According to SER, the early prescription of these treatments is essential to minimize joint inflammation and disease progression.

In cases where Fames do not function properly the specialists treat the pathology with biological therapies. These are drugs designed with complex formulas that include TNF antagonists (etanercept, adalimumab and infliximab), abatacept and rituximab. These drugs have proven to be very effective in improving pain and inflammation and in preventing joint destruction.

Both biological therapies and Fames can have side effects, but in general they are quite safe and patients tolerate them well.

If the disease is very advanced, the patient may need surgery.

Other data
Relationship with tobacco
Numerous studies have shown that there is an association between smoking and the development of the disease. However, from the Spanish Society of Rheumatology indicate that the causal relationship between tobacco and the development of pathology is complex.

On the other hand, studies have also shown that patients who smoke suffer the disease more severely than those who are not smokers.

Forecast
The prognosis of the disease is very variable, since in some cases there are benign diseases that can be controlled with a simple treatment and others in which the disease evolves very quickly and the prognosis is fatal in a short time.

From SER, they emphasize that if arthritis is not adequately treated, it is common for the disease to evolve towards irreversible joint destruction with impaired pulmonary capacity. This prognosis varies if treated with optimal treatment.

In addition, there are risk factors that worsen the prognosis: the onset of the disease at young ages, smoking, the existence of citrullinated anti-protein antibodies or rheumatoid factor or the involvement of other organs, for example.

Living with the disease
The first step that a person diagnosed with rheumatoid arthritis should take to adapt to their illness is to avoid leading a hectic life, jerky movements and trying to sleep for an average of 10 hours.

In addition, it is convenient that these patients avoid those jobs that require intense physical exercise. During the working day, they should maintain a straight position in the seat and avoid staying with the neck or back flexed for a long time.
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Osteoarthritis

Osteoarthritis is a chronic disease that affects the joints. It is usually located on the hands, knees, hip or spine. Osteoarthritis causes pain, inflammation and prevents normal movements such as closing your hand, climbing stairs or walking.
The joints are the components of the skeleton that allow the connection between two bones (such as elbow, knee, hip, etc.) and, therefore, movement. Cartilage is the tissue in charge of coating the ends of these bones and is indispensable for the proper functioning of the joint since it acts as a shock absorber.

Osteoarthritis causes deterioration of the articular cartilage causing bones to wear out and pain appear. As the cartilage disappears, the bone reacts and grows on the sides (osteophytes) causing the deformation of the joint.

Incidence
Osteoarthritis is the most common joint disease in Spain, according to data from the Spanish Society of Rheumatology, which estimates that more than 7 million Spaniards over 20 years of age have osteoarthritis of the knee, hand or spine. In addition, this disease is more common in women, 52 percent, compared to 29 percent in men.

"From the radiological point of view, the population segment between the ages of 50 and 64 has 70 percent of osteoarthritis in the hands, 40 percent in the feet, 10 percent in the knees and 3 percent in The hips, "they say.

In addition, according to the World Health Organization, about 28 percent of the world's population over 60 years of age has osteoarthritis and 80 percent of it has movement limitations. The increase in life expectancy and the aging of the population will make osteoarthritis become the fourth cause of disability in the year 2020.
Causes
To date, the causes of osteoarthritis are not exactly known, but there are some risk factors associated with its appearance:

Age increases exponentially after age 50.

Gender: affects mainly women older than 50-55 years.

Genetics: may also be a hereditary disease. Specifically, genetic inheritance in the development of osteoarthritis can be as high as 65 percent.

Work activity: repetition of joint movements can lead, in the long term, to joint overload. Therefore, certain work activities (hairdressers, masons, etc.), can cause the appearance of osteoarthritis.

High physical activity: Elite athletes are at increased risk of developing the disease.

Menopause: the decrease in estrogen levels that occurs with the advent of menopause is one of the risk factors for its development.

Obesity: does not seem to participate in the development of osteoarthritis, but it can aggravate it in certain joints such as knees.

Injuries: Fractures and injuries can be a triggering factor.
Evaluate your symptoms
symptom
The manifestations of osteoarthritis are very varied, progressive and appear dilated in time.

The most frequent symptoms are joint pain, limitation of movements, creaking and, in some cases, joint effusion. In addition, some people may have stiffness and joint deformity.

The symptom that most worries people with osteoarthritis is pain. In a first stage, it is triggered when the joint is moved or exerted. This pain usually ceases with rest. Subsequently, aggravation of osteoarthritis will cause the pain to appear with both movement and rest.

One of the good points of arthritic pain is that it is not always constant, so patients can stay for long periods of time without suffering pain, which does not mean that osteoarthritis does not follow its evolution.

Prevention
The main measure that groups of risk have to take into account to prevent the development of the disease is to lead a healthy and balanced diet, such as the Mediterranean diet, to perform moderate physical activity, activities that are according to age and state Physique of the person and avoid obesity.

It is also advisable to limit heavy physical effort, such as carrying heavy objects or labor activities involving overexertion.

On the other hand, experts recommend that people be careful when practicing contact sports, such as football or rugby, as they are not recommended for patients with osteoarthritis. The reason is that these sports are one of the factors that can trigger the disease. In fact, many footballers suffer from osteoarthritis of the knee due to the injuries that they have suffered in the meniscus.

In case of having the disease they must avoid the movements that produce pain, without getting to immobilize the zone.

Types
At present osteoarthritis manifests itself mainly in four areas:



Knee osteoarthritis
Osteoarthritis of the knee is the most common type of osteoarthritis. In fact, in Spain is suffered by 10 percent of Spaniards. One can distinguish between two types of knee osteoarthritis:
Secondary knee osteoarthritis is usually caused by a previous injury, such as a fracture or a ligament injury. It usually affects athletes and obese people, since the overexertion they require to their knees is high.
In this case the disease affects the internal and / or frontal part of the knee causing pain when an effort is made. As a consequence of this pain and the degenerative evolution of the disease the patient may have lameness if the disease progresses to an advanced stage. In this type of osteoarthritis the movement of the joint usually causes clicks.

Osteoarthritis of hands
Osteoarthritis of the hands is the second most common type of osteoarthritis. In Spain is suffered by 6 percent of citizens. It is usually closely linked to the female gender and genetic inheritance of the patient. Osteoarthrosis of the hands originates in a joint and can subsequently be extended to the rest of the hand.

It is very visible, since it often deforms the fingers and comes to affect the day to day of patients in daily tasks such as writing. During the process the pain accompanies the evolution of the disease being stronger at the beginning and mitigating itself as the nodules appear. The discomfort tends to decrease when the deformation is complete. The functionality of the hand may be affected and the joint may be slightly flexed or deflected.

Hip arthrosis
Hip osteoarthritis is one that affects the upper leg. This type of osteoarthritis is quite common, although not as much as osteoarthritis of the knee or hand. In general, it is typical of older people, but may appear before age 50, being exceptional in young people.

The main symptom is pain, which is located in the groin area and the inner thigh area. However, sometimes pain can be reflected in the knee.

At the beginning of the illness, pain only appears when walking and when going up or down stairs. You also feel pain after a period of rest, until the joint becomes warm, and then reappears after a long walk or prolonged exercise, because the joint is overloaded. Progressively, such elementary actions as crossing or flexing legs, or walking are difficult. In advanced stages the pain may appear at night, due to the position of rest and, over time, it is normal for lameness to appear when walking.

Spine osteoarthritis
The spine is made up of many joints. This causes osteoarthritis to develop in this area, often in the lumbar and cervical areas.

This type of osteoarthritis may be asymptomatic and, in many cases, it is not diagnosed and is accidentally located when performing an X-ray for another reason.

The pain can appear when performing mechanical activities, such as movements and overloads in the affected area. In addition, changes in time and pressure often aggravate the pain.

Diagnosis
As explained by the Spanish Society of Rheumatology (SER), the diagnosis of pathology is made through a clinical interview.

There are some tests that help the specialist complete the study. The doctor can distinguish osteophytes, cartilage clipping, subchondral grooves, and asymmetric decrease in joint space by clear symptoms of osteoarthritis.

Other tests that can be used in exceptional cases are CT and MRI when the doctor has doubts about the origin of the process or is studying in a complementary way other problems, such as a discus extrusion in a spondyloarthrosis or meniscal rupture in a gonarthrosis.

Finally, high resolution ultrasound has been incorporated as a very effective diagnostic tool because it reveals the soft parts surrounding the joint as well as whether there is inflammation or injury in any of them and distinguish if the bone profile is being altered.

Treatments
The main goal of treatment in osteoarthritis is to improve pain and functional disability without causing side effects.

To achieve this, from the SER insist that the first step that specialists must give is to teach patients to avoid anything that contributes to injury to joints such as being overweight, repetitive movements, inappropriate attitudes at work, shoes, Kitchen utensils, furniture, etc.

Secondly, it is advised that each patient has a customized and adapted exercise chart that must be performed under the supervision of the physiotherapist to improve the course of the disease.

Finally, from the SER indicate that the rheumatologist will decide the appropriate pharmacological treatment for each case:

Anti-inflammatories and / or analgesics
In the most acute phase, the pain increases greatly because of the inflammation of the affected area. At this point, it may be necessary
Forecast
Although this disease is not very serious, it significantly reduces the quality of life of patients. In fact, its prognosis differs greatly depending on the joint that is affected and the evolution of the pathology.

In addition, factors such as early diagnosis and joint prevention measures may contribute to slow the development of osteoarthritis.

In general terms, SER explains that the evolution of pathology is slow and progressive.

How does it affect the patient's life?
Pain and lack of mobility are the main factors that affect and decrease the quality of life of patients.

Since the disease affects mainly patients over 60 years of age, functional limitation can increase sedentary life in these population groups. This can promote obesity, and thereby increase the risk of increased cholesterol levels, diabetes, hypertension, or other risk factors for cardiovascular disease.

Contact your doctor for more information. The information provided on (what the health) is of a general nature and for purely disclosure purposes can in no way replace the advice of a physician (or a legally qualified person) or, in specific cases, of other operators health.


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