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CellCept drug for the treatment of kidney complications could be a boon to lupus patients (Chang, 2005). A small study showed that the drug delivered better results than standard chemotherapy, which could cause infertility and other medical problems. A recent experiment compared the effects of CellCept and the older treatment, cyclophosphamide, in patients for 6 months. Those taking CellCept reported fewer side effects. The researchers were led by Dr. Ellen Ginzler of the SUNY Downstate Medical Center. The disease develops mostly in women of childbearing age. The immune system attacks its own organs and tissue. The cause is still unknown. But in a third of patients, the most common symptom is inflammation of the kidney. This can, in turn, lead to kidney failure (Chang).
Chemotherapy has been the standard treatment for lupus for the past 30 or more years (Chang, 2005). But it produces unpleasant side effects, which include hair loss, nausea and infertility. These side effects discourage many patients to discontinue treatment. CellCept is an FDA-approved drug, manufactured by Hoffman-La Roche, Inc. It is used primarily to prevent organ rejection in transplant patients. But it is recommended to lupus patients who cannot endure chemotherapy. A study was conducted on 140 lupus patients who received daily doses either of CellCept or cyclophosphemide intravenously. Findings showed that 23% of those on CellCept had complete remission and 30% had partial remission. These figures were compared with 25% of those who received chemotherapy. Those patients who received the drug also had fewer infections and hospitalizations, although they experienced more bouts of diarrhea. Dr. W. Joseph McCune of the University of Michigan Medical Center commented that it would be reasonable for doctors to prescribe the drug to patients who were concerned about fertility (Chang).
Short and midterm survival among SLE patients was said to have significantly improved in the last three decades (Jancin, 2006). Survival beyond 15 years, however, remained low or poor, especially if the disease was severe. Five-year survival three decades ago increased to 15 years today, according to Dr. Doria, a rheumatologist at the University of Padova. Forty-four percent of these tested patients had severe SLE and whose survival rate for the first 10-15 years compared with those with mild SLE. Mortality figures sharply decreased too (Jancin).
Psychosocial/Social Work Implications
When the disease is in mild form, it often produces confusing or non-specific symptoms (Meadows, 2006). The person may feel tired or achy in the afternoons. His symptoms may be mistaken for depression or a virus. Feeling sick is one of the most frustrating realities about lupus. Other people misconstrue him to lazy or crazy while looking healthy and nice. Childbearing women had higher rates of pregnancy loss on account of lupus. They also had unexplained rashes, anemia, leg and arm pain, urinary tract infections, kidney infections, fevers, mouth sores and overwhelming fatigue. Dr. Isenberg and his team conducted a study in 1999 and discovered that fatigue was their major complaint. Fatigue got them worrying throughout the night and remained tired throughout the day. Some patients reported falling into deep depression and flu symptoms, joint and chest pains (Meadows).
SLE is an autoimmune disease, which is still hardly understood. The immune system attacks the body it is supposed to protect. The cause is still unknown and diagnosis is performed only on symptoms. Types are SLE, discoid lupus erythematosus or DLA, neonatal lupus, and drug-induced lupus.
There have been significant strides with medications, which have only increased survival. It is much more common among childbearing age. Chemotherapy has been its standard treatment until the introduction of new drugs, which hold promise for cure.
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Podiatry Now (2008). Doorway to possible new lupus treatment. Society of Chiropodists and Podiatrists: Gale, Cengage Learning. Retrieved on February 13, 2009 at http://findarticles.com/p/articles/mi_6857/is_4_11/ai_n28557695?tag=content;col1
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It is also a population that often has limited resources and one that seeks to find others to help comfort and educate them. Modern technology has certainly improved both the diagnosis and treatment of the illness, but there are so many options that the patient is often left bewildered and frightened (Guadalupe). A proactive and professional nursing approach to this illness takes Mishel's theory and uses it in four ways: To