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Sally wakes up on a Monday morning, and following her daily routine searches for a new outfit, reaches for a cup of coffee, and squats down to tie her shoes. However, Sally has arthritis and even the simplest of such tasks is a bitter reminder of her chronological disease, which to her seems more like a warrant of pain.
Arthritis is defined as joint inflammation — derived from the Greek arthron meaning joint and supplemented by the suffix "itis" meaning inflammation. There are many types of arthritis; in its most forms, arthritis is a chronic or lifelong disease. One of the most common forms of arthritis is rheumatoid arthritis (RA), which is an autoimmune disease that involves inflammation in the membrane lining of the joints and/or internal organs. The inflamed joint lining, called the synovium, can attack and damage — by the release of a class of degradatory/digestive enzymes from the inflammatory cells — bone and cartilage. The joint involved can lose its shape and alignment, resulting in pain and partial loss of movement (1).
It is rather important to diagnose arthritis in its early stages. This assures an immediate start on treatment. A few of the symptoms include:
•     Swelling of joints
•     Difficulty moving accompanied by acute pain
•     Loss of appetite
•     Fever
•     Loss of energy
•     Anemia (a decreased amount of oxygen-carrying substance (hemoglobin) found in red blood cells through a number of means— results in weakness)
•     Rheumatoid nodules, which are lumps of tissue under the skin in areas that receive pressure (2)
Though the cause of rheumatoid arthritis is not quite known yet, experts have been able to come up with a few potential theories. A probable cause of RA is that glycosaminoglycans (GAGs), which are self-antigenic carbohydrates, cause autoimmune dysfunctions that involve the expansion of GAG-binding cells which travel to anatomical sites rich in GAGs. The GAG-binding cells may promote the inflammation and pathology seen in RA patients (3).
RA is an exceptionally common illness. In fact, 2.1 million people — near one percent of all American adults — are diagnosed with RA (4). Who’s at risk for RA can be determined by three factors: age, gender, and heredity. Usually, those who get arthritis are in their twenties or thirties. In addition, there is some bad news for the women. About two to three times as many women as men suffer from RA. Many people with RA have a certain genetic marker called HLA-DR4 (5). Therefore, researchers suspect that visrus-like agents may "trigger" RA in some people who have an inherited tendency for the disease. Furthermore, researchers suspect other genes that influence the development of RA.
Obviously RA is an unpleasant condition, but many misinterpret the effects and pains of this chronic illness. In the beginning stages of the disease, the patient will notice fatigue, soreness, stiffness, and aching. As time progresses, the disease become more painful, because the swelling may increase. RA usually affects the feet, wrist, and hands, but usually not the joints that are closest to the fingernails (except the thumb). After a while, the inflammation may increase onto other joints such as the elbows, shoulders, neck, knees, hip, and ankles. Inflammation tends to expand over an extended period, and over time other joints such as the elbows, shoulders, neck, knees, hip, and ankles may swell. Swollen joints may continue to become more damaged, and unfortunately cause more pain. However, the severity varies from person to person, and even from day to day. In some people, only a few joints are affected and the impact may be small. In other people, the entire body system may be affected.
Though rheumatoid arthritis is a chronic disease, treatments can’t still help relieve the pain and suffering. When the common cold strikes, a few pills and a possible syrupy medicine is prescribed to ease the patient through the healing process; arthritis is no exception! Medications are categorized into two groups. Symptomatic medications (symptom targeted), such as Nonsteroidal anti-inflammatory drugs (NSAIDS), asprin, analgesics, fibromyalgia and gout medications, and glucocorticoids help reduce the characteristic stiffness, swelling, soreness, and joint pain. The other type of medications are disease-modifying medications (disease targeted), which include methotrexate, leflunomomide, D-pinicillamine, sulfasalazine, minocucline, azathioprine, disease-modifying anti-rheumatic drugs (DMARD), and hydroxycloroquine (6).
Other than drugs, treatments range from surgery to, believe it or not, environmental change. Surgery is rare, but certain forms of therapy may help. Even though exercised seems like the worst thing for an RA patient, the two actually go hand in hand. Now suppose your physician told you to move to a more suitable place because you had RA, would you be confused? Of course, anyone would be. However, an area with a dry, hot climate, such as southwest America, has been proven to reduce the symptoms of arthritis. And unlike the "Rest it and it will heal" motherly advice, RA is not a disease to "wait out." Resting will help in that the joint is not being overworked, however, no matter how long one rests, RA will never be completely treated (7).
Though treatments have come a long way, there is always room for improvement. The hopes for the future are to have better treatments that will have a greater effect in reducing pain. Also, new research focuses on different types of arthritis individually and focuses on gene therapy, vaccines, and biologic response modifiers.
Gene therapy, of course, is a treatment for genetically linked disease where a defective gene makes one with the genetic marker more susceptible to a disease. However, there are drawbacks to this solution that is why it is not in use today. One disadvantage is that this may not work in people with early signs of certain types of arthritis. Much research remains to be done. Vaccines are being investigated as RA is thought to be caused by a virus or bacterium in persons with a predisposition for the disease. If researchers are able to identify what the exact cause is, they will be able to develop a vaccine as a treatment. Research is hopeful and ongoing to find biologic response modifiers that target tumor necrosis factor (TNF), a protein that causes inflammation.
An overview of arthritis (in particular rheumatoid arthritis) depicts a glimpse into the discipline of scientific research. It is with the implementation of a broad range of experiments and the individual talent of scientists which make the worldwide effort to alleviate disease hopeful. Perhaps even more importantly, the importance of science education, worldwide communication between scientists, and marriage of various scientific disciplines is well represented in this fight against arthritis.
The point to site different works is to site EVERY argument you have. So when you talk about "people misinterpret the effects and pains" paragraoh, you need to site some paper that you get that argument from.

Also, stop using Which and That so much and find clever ways to fix up verbs and adjectives to alleviate the use of which and that.

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