Managementul pacienţilor cu poliartrită reumatoidă în practica medicului de familie (I).

The General Practitioner's role in diagnosing and monitoring the pacients with rheumatoid arthritis (RA) is not very well established in Romania. RA, a chronic inflammatory disease with a progressive evolution, systemic symptoms and severe disfunctions, decreases the quality of life, leading to early retiring and the descrease of life expectancy with 5 to 10 years. Establishing PRE-RA (Personalized Risk Estimator for Rheumatoid Arthritis) for first degree relatives of the RA affected patients, according to age, gender, family history and risk behavior, allows the prevention and the delay of the disese. Some preventing measures are the following: giving up smoking, mediteranean diet, weigh control, statines therapy in order to descrese the cardiovascular risk, oral hygiene. RA begins with a prolonged asymptomatic period, characterized by the presence of asymptomatic smallairway disease, certain infections and inflammatory disease (gut, periodontium, genitourinary tract) or dysbiosis. We can find increased circulating disease specific autoantibodies or increased levels of cytokines and chemokines. A good knowledge of the first symptoms is very important for the general practitioner (GP) and could also help the rheumatologist to start the treatment immediately after the occuring of the disease. The GP could have a very important role together with the rheumatologist and the hole team in surveying the disease evolution and also the associated comorbidities, complications and possible opposite reactions to the treatment. The GP is also involved in the pacients' and their families' counciling, and his presence in the multidiscipinary teams increases the adherence, compliance and persistence to the therapy. [ABSTRACT FROM AUTHOR]