New ulmonary arterial hypertension in rheumatic diseases 財團法人風濕病基金會台灣抗風濕病聯盟
This document summarizes a presentation on pulmonary artery hypertension (PAH) in rheumatic diseases. It begins with a case presentation of a patient diagnosed with limited systemic sclerosis and PAH who was treated with various medications. It then provides background on PAH classification and the pathophysiology of PAH in connective tissue diseases. Specifically, it discusses the prevalence of PAH in different rheumatic diseases like systemic sclerosis, the mechanisms involved in pathogenesis, and differences in phenotypes between SSc-PAH and non-SSc PAH. Treatment approaches are also summarized.
Current diagnosis and management of PAH from cardiologist point of view財團法人風濕病基金會台灣抗風濕病聯盟
1. Pulmonary arterial hypertension (PAH) is often misdiagnosed or diagnosed late due to non-specific symptoms. Right heart catheterization is the gold standard diagnostic test.
2. PAH can be classified into 5 groups, with Group 1 including idiopathic PAH and PAH associated with conditions like connective tissue diseases.
3. PAH progresses from a reversible stage of endothelial dysfunction and vasoconstriction to an irreversible stage involving structural changes to the pulmonary vasculature. This leads to increased pulmonary vascular resistance and pressures over time.
This document discusses pulmonary hypertension (PH) in patients with connective tissue diseases (CTD). It finds that treatment is less effective for CTD-associated PH (CTD-PAH) compared to idiopathic PAH, with less improvement in walking distance and higher rates of clinical worsening. Combination therapy may be more effective than monotherapy for CTD-PAH. The prognosis of CTD-PAH patients is better if they are short-term responders to treatment or were initially treated with glucocorticoids and immunosuppressants upon PAH and CTD diagnosis. However, treatment outcomes are worse if CTD-PAH patients also have interstitial lung disease. Right ventricular size measured
1. Rheumatoid arthritis (RA) is an autoimmune disease where the immune system mistakenly attacks the body's own tissues, causing inflammation in the joints.
2. If left uncontrolled, long-term inflammation from RA can cause joint deformity, disability, and loss of function.
3. RA occurs when cytokines that regulate inflammation become imbalanced, leading to excess production of pro-inflammatory cytokines like interleukin-6, interleukin-1, and tumor necrosis factor-alpha.
With your arm extended, parallel to the floor, position your palm face up. Using your opposite hand, grab hold of the fingers and pull the palm of the extended hand toward the floor. Hold for 30 seconds. Now, do the same exercise, except this time turn your palm face down. Using the opposite hand, push
the top of your extended fingers and hand down toward the floor. Hold for 30 seconds.
Keep Wrists Flexible
To do: This exercise is done sitting at a table or desk. With your left forearm on the table, let your left hand hang over the edge of the table. Using your right hand, grab the fingers of your left hand and bend your left hand at the wrist, slowly moving it up and then down as far as possible without pain. Repeat with the opposite hand. Increase up to 20 repetitions, twice daily.
Sit or lie on your back on the floor or on a bed, feet slightly apart. With your legs and knees straight, turn your knees in toward each other and touch the toes of your feet together, holding for 5 seconds. Now turn the legs and knees out, and hold for 5 seconds. Repeat this, gradually increasing up to five, 10, and then 20 repetitions, twice daily.
facing the wall, place palms flat on the wall, one foot forward, and one foot back. Leaving your heels on the floor, lean forward. As you do so, feel the pull in the calf of your back leg and the Achilles tendon at the back of the ankle. Hold for 30 seconds. Do three repetitions. Then reverse the position of your legs and repeat.
Isometric Shoulder Extension
To do: This isometric exercise is done standing with your back against a wall and your arms at your sides. With your elbows straight, push your arms back toward the wall. Hold for 5 seconds, and then rest. You can repeat this 10 times. If this exercise hurts your joints, ask a trainer to show you another isometric shoulder exercise.
等長運動，就是肌肉長度相等長，關節不移動,它的運動在於肌肉收縮而鼓起，避免關節的運動,它能夠減緩肌肉的萎縮退化
幫助血液循環及消除腫脹，便是靠著肌肉縮弛之間對循環的幫助。
High-impact exercises, such as jogging, running, or playing tennis on hard pavement, can put excess stress on your joints. Lifting heavy weights may also not be the best form of exercise for people with RA. Looking for a more intense workout? Talk with your doctor first to see if you can do more taxing exercises such as heavy weight lifting, tennis, basketball, or volleyball without risk of joint injury.
Swimming is a great way to increase conditioning for all your joints, as well as strengthen your back, without putting excess stress on your joints.
To do: Start slowly with just a few minutes in a heated pool. Use a kickboard when you first start to get used to moving in the water. Gradually build to a goal of swimming 30 minutes at a time. Increase physical activity with each exercise period until you reach your goal time.
Tai Chi Increases Flexibility
The ancient discipline of tai chi can help those with RA increase range of motion, boost flexibility, and tone muscles to provide better balance. The focus of tai chi is on breathing and creating an inner stillness, allowing participants to relax.
