AN EXPLORE ON SARCOIDOSIS

 

 

 

 

 

 

 

 

AN EXPLORE ON SARCOIDOSIS

 

 

 

 

 

 

 

 

 

 

 

 

 

An Explore on Sarcoidosis

Medical experts have discovered that sarcoidosis is a sequential ailment whose cause remains a mystery yet it presents varied and numerous forms of conditions, consequences, severity, and needs for medical attention especially treatments (Liu et al., 2014). Bearing in mind that sarcoidosis ailment associated with the development of tiny chains of inflammatory cells mainly in the lungs and lymph nodes as well as eyes and skin, the presentation of this condition could be typical or in many cases, they remain non-specific hence could mislead the diagnostic outcomes. The most significant case which could present this condition is the one with the forefront of pulmonary manifestations (Alicia, 2014). Consequently, the diagnosis depends on three common criteria which are not clinically common.

The Rates of Morbidity courtesy of Sarcoidosis

Scientific researches affiliated to the Sarcoidosis deaths in the States: 1999 to 2016 courtesy of the journal Respiratory Medicine explored that, America loses about 16,665 people through sarcoidosis. The data also revealed that the mortality rates had increased from 2.1 to 3 per 1 million persons in 1999 to 2016 respectively (Blankstein et al., 2014). These rates seemed to have increased from 2.1 to 3.1 from 1999 to 2002 and remained stable in the progressing years. The data also shows that patients within the age brackets of 35 years and above died courtesy of sarcoidosis with those between 65 to 75 years recording the highest rates of 8.5 deaths per 1 million while those between 75 to 84 years reporting nine deaths per 1 million (Liu et al., 2014).  Either the rate of deaths among women patients increased by 32% (2.5 to 3.3 per 1 million patients while men morbidity increased by 73.3% (from 1.5 to 2.6 deaths per 1 million patients.

About a sarcoidosis case involving a 43-year-old, Coolie Cope, a university student taking masters in Hotel Management, he was diagnosed with various symptoms observed: pains in the joints, fever, fatigue, respiratory disorders, and deformed skin. Consequently, the patient underwent a three-week treatment plan which included medical as well as physical therapy through the outpatient medical plan as depicted in the last section of this paper (Blankstein et al., 2014). From the onset of the treatment, the client’s condition was severe; hence it took longer than anticipated to recuperate him. For instance,   the client was under strict timetable of medication and minor physical therapies for the first two weeks in order to eliminate joint pains, fever, and respiratory conditions to normalcy before being submitted to an exact timetable of physiotherapy. The session was guided by close and strict monitoring hence responding to the situation and recovering as expected. Both the medical and physiotherapies lasted for three weeks with an extra week for the final interventions at the time the client was able to return to his normal daily activities.

Etiology of Sarcoidosis

Although the cause of this ailment remains unknown, scientists have been able to establish the condition could emerge from the response between the one’s body immunity with an unknown substance (Liu et al., 2014). Some researchers have pinpointed that infectious agents, dust, chemicals and abnormal response to the body’s proteins otherwise called self-proteins could contribute to the formation of granulomas in the genetically predisposed patients (Alicia, 2014). Even though this ailment does not have a cure, the majority of the patients survive without treatment with some modest undergoing treatment. Some patients have experienced prolonged sarcoidosis while others said the condition vanished on its own.

Anatomy of Sarcoidosis

Accordingly, the anatomical structure of sarcoidosis depicts predominantly localized within the lymph nodes, lungs, and skin. Either, the severity of tuberculin energy is the basic and determining features of this condition. Consequently, there should be cautious while carrying out diagnostic tests from the history of the lymph node material. It can prevail, therefore, presumptively; not with the final certainty (Florence et al., 2016). Lung biopsy specimens could emerge with transbronchial biopsy or from the extrapulmonary sections like the pubic lymphatic system and the liver. According to pathological outcomes in sarcoidosis constitute of noncaseating granulomas with epithelioid cells the large multinucleated giant cells. Nevertheless, granulomas from the inflammatory activities exemplified by tuberculosis, fungal and histoplasmosis infections and the tumor-related sarcoid response should be isolated.

Thoracic involvement

Bearing in mind that pulmonary involves hugely in the majority of the sarcoidosis cases, CT outcomes is critical in diagnosing and presenting this ailment. There are some radiologic steps of intrathoracic transformation: normal radiograph step followed by the stage of lymphadenopathy only and the lymphadenopathy which comes with the infiltration of the parenchyma. Either, the stage of parenchymal disorder only and the pulmonary fibrosis stage are also crucial in this scenario (Alicia, 2014). About a half the number of sarcoidosis patients are victims of the first stage of the disease.

Meditational lymph nodes: The left paratracheal and aortic-pulmonary window nodes become enlarged, yet they are not readily visible on a poster anterior chest radiographs. Either calcification, which is usually amorphous, egg-like and punctuates, happens within the affected lymph nodes (Blankstein et al., 2014). Either its closeness to the duration of the ailment help to identify the severity of the condition.

            Lungs: Researches have also stated that sarcoid granulomas in the lungs are within the lymphatic vessels whose activities collate with the interstitial tissues found in the bronchovascular bundles as well as the perilobular and the open sections of the subpleural.  The pattern of distribution as depicted by the High-resolution CT shows that the upper lung predominantly and coexistence of meditational lymphadenopathy strongly shows the presence of sarcoidosis (Liu et al., 2014). This scenario helps to differentiate the condition from the other nodular lesions namely military tuberculosis, eosinophilic granuloma, and metastasis. Heart: According to the outcomes of the autopsy series, patients could remain asymptomatic with one prevailing condition; abnormal electrocardiographic outcomes and clinical symptoms of myocardial involvement. Nevertheless, the involvement of the conduction pathway could lead to sudden cardiac arrest, heart blockage, arrhythmia, and congestive heart failure.

Sarcoidosis Recovery Time

According to Alicia (2014), almost 60% of patients suffering from this disease will heal own their own without any intervention. The recovery time for Sarcoidosis varies based on severity and the stage of the disease.  Acute sarcoidosis normally takes a few weeks to months from the onset the symptoms. A patient suffering from a chronic one may takes years to return to normal action after full recovery.

Prevention measures for Sarcoidosis

Although sarcoidosis ailment is mysterious in terms of how it infects or treated, the ailment could be prevented through engaging in a healthy lifestyle hence avoiding the excess taking of alcohol and cigarette smoking as well as limiting exposure to toxic inhalants, gases, and fumes (Blankstein et al., 2014). PTA Interventions:  The absence of a cure for sarcoidosis prompted scientific remedies towards suppressing the ailment through medical and PTA interventions depending on its stage

            Acute stage: during this period, patients under short-term admissions due to sarcoidosis ailment, surgery or recovery from the same are submitted to physical therapy to enhance his/her medical stability and safety thus speeding up discharging. Patients involved in a guided program of physical exercises within a recommended period in order to improve one’s mood, reduce fatigue and strengthen body muscles hence promoting wellness. Functional stage: This stage is where sarcoidosis symptoms cannot be referred to any measurable lesions or change of structure as opposed to ailment stages where the organ is damaged (Blankstein et al., 2014). Apart from undergoing frequent testing and monitoring, encouraging patients to take their prescribed medicine, physical therapists would also take them through flexible chains of physical activities

Out of PTA, a scope suggested interventions

When offering treatment to sarcoidosis patients, it is clear that there is no cure for this ailment and the treatment offered depends on the severity of the condition. Among the offered out of therapy, interventions include giving medication, surgery, consistency monitoring as well as offering other treatments.

Clinical Interventions and Treatment: Experts explores that clinical practices, prognosis, and the normal trends show some variation with the trend to wine and wax hence the likelihood that the course and prognosis may correlate with the mode of onset and the prevailing state of the ailment (Alicia, 2014).Chronic onset with asymptomatic bilateral hilar lymphadenopathy or erythema nodosum usually portends a self-disadvantaging course with the spontaneous decision, while the insidious onset as exemplified by the involvement of the lung or many extrapulmonary lesions followed by consistent fibrosis of the lungs as well as other body organs (Liu et al., 2014). According to researches, corticosteroids are useful in the treatment of sarcoidosis with some patients responding well while others needed prolonged therapy. In some cases with a vigorous ailment or frequently the recurring condition, immunosuppressive drugs namely cyclophosphamide and methotrexate could be needed.

Samples Treatment Plan

Recipient Information Provider’s Information
Medicaid Number: 25950966 Medicaid Number: 5555675
DOB: 09/12/1976 Treatment Plan Date: 07/01/2019
 
Other Agencies Involved Plan to Coordinate activities  
 Coolie Cope, MD. Medical Practitioner Telephone communication during the first week of treatment, as required but at least once in every month.
University of Wells Request the lecturer  to fill the necessary form, one during the initial week of treatment to facilitate constant phone communication as per the requirement
 
Medication Dose Frequency Indication
Methotrexate, leflunomide  or azathioprine 1 One in one week for three weeks Inability to work: fever, fatigue, joint pains, respiratory disorder, affected the skin
 
 
1.     Problem/ syndrome Inability to involve in  normal chores  as manifested through joint pains, fever, fatigue, respiratory disorders, and disfigured skin
Long Term Objective The symptoms of respiratory disorders, skin deformation, fever and fatigue, and joint pains would be mitigated not to interfere with Coolie Cope’s ability to work

 

Short Team Objectives Starting Date  Date of Completion  Date Achieved
1.     Coolie developed a wellness plan courtesy of a guide from a medical and physiotherapists

2.     Coolie had  to involve in minor physical activities  and an additional sport

3.     Coolie had frequent visits to the hospital for three weeks

4.      Coolie accessed problem-solving guidelines on coping with visible symptoms especially on joint pains and skin deformation.

5.     He also receives essential guidance on how to identify further symptoms and how to act.

07/01/2019

 

08/01/2019

09/01/2019

 

17/01/2019

21/01/2019

 

07/01/2019

 

09/01/2019

11/01/2019

 

17/01/2019

27/01/2019

 

07/01/2019

 

09/01/2019

16/01/2019

 

17/01/2019

27/01/2019

 

 

 

 

 

Intervention/Action: Conducting an individual physical and medical therapies and developing skills that would help identify different syndromes and the suitable ways of neutralizing them through any of the two approaches.

He received guidelines in developing medical and physical therapy plan towards neutralizing the symptoms such as joint pains, fatigue, fever and skin deformations hence encouraging Coolie to learn how to rely less on people for vigorous wellness. Coolie was under a strict schedule of taking medicine under the facilitation of medical practitioner or out of hospital assistants such as relatives. Follow up activities be used to review and monitor his healing state.

 

 

 

References

Alicia K. Gerke (2014): Morbidity and Mortality in Sarcoidosis. Published in final edited form as Curr Opin Pulm Med. 2014 Sep; 20(5): 472–478. Doi: 10.1097/MCP/000080

Blankstein R, Osborne M., & Naya M. (2014): Cardiac positron emission tomography enhances prognostic assessments of patients with suspected cardiac sarcoidosis. J Am Coll Cardiol. 2014; 63(4):329–36.

Florence Jeny, Diane Bouvry, Olivia Freynet, Michael Soussan, Michel Brauner, Carole Planes, Hilario Nunes & Dominique Valeyre (2016): Management of sarcoidosis in clinical practice. European Respiratory Review 25: 141-150; DOI: 10.1183/16000617.0013.

Liu Y., Su L, & Jiang SJ. (2014): Client-related clinical vulnerability factors for primary graft dysfunction during the post lung transplantation: a systematic review and meta-analysis. PloS one. 2014; 9(3):e92773.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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