DorlandHealth

A behind-the-scenes look at the nebulous sect of autoimmune diseases, with a spotlight on MS

Autoimmune diseases are highly complex and not completely understood. For many autoimmune diseases there is little in the way of treatments. Often the complete etiology of the disease is unknown, thus treatments, when available, are often incomplete, leaving the individual with symptoms related to the disease. As autoimmune diseases are exceedingly complex, our inquiry must begin with a basic understanding of the normally functioning immune system. The immune system exists to defend against pathogens. These pathogens include viruses, bacteria, parasites, allergens, malignant cells and harmful chemical agents. The immune system has three important characteristics:

1. Diversity and specificity. This is the ability to recognize a wide variety of pathogens with both a general and specific response.
2. Memory. This is the ability to rapidly recognize a previously encountered pathogen.
3. The ability to distinguish self from non-self. This prevents autoimmue responses.

The immune system defends on several levels. The first is through system barriers, like the walls of a castle. The skin, the mucous membranes and the cornea of the eye provide a barrier to invading pathogens. Yet these barriers are inadequate for all pathogens; the immune system also has complex mechanisms of defense at the cellular level.

A Controversy That Care Managers Should Know About

PART I

This is the first of a two-part series about cardiovascular risk, identifying people with those risks, and helping them lower it — and importantly, what role care managers can play in that effort. In part one, we present the statistics on cardiovascular risk and define an actor — metabolic syndrome — that started an ongoing controversy in the medical community. In part two, we will describe how different areas of the medical community have disagreed with the definition and focus of the condition, and how this lack of consensus may be affecting a concerted effort to decrease cardiovascular risk. We also focus on how care managers can respond to the needs of the patient in the face of the controversy — helping them identify and decrease their cardiovascular risks and improve quality of life while, at the same time, the medical community clarifies the evidence.

Look around. In malls, on bleachers at ball games, in offices, at family dinners. Every place you go, you will find us. We are young and old, male and female, from every ethnic group, and we look like a cross-section of America. We are busy living our lives, going to work, taking care of our families. We feel well, and many of us consider ourselves healthy. But the truth is there are those among us who are “walking cardiovascular time-bombs.” And in many cases, we don’t even know it — until it’s too late.

The statistics on cardiovascular disease in America aren’t pretty. Coronary heart disease (CHD) is the largest major killer of both American males and females, causing one in five deaths in the U.S. Every 25 seconds an American suffers a coronary event, and every minute one of us dies from it, according to statistics from the American Heart Association (AHA). This year, approximately 785,000 Americans will experience a new coronary attack, 470,000 will have a recurrent one, and an additional 195,000 will have a silent event.