Blog 13 Alzheimer Disease 3

Alzheimer's disease is a neurological disorder in which the death of brain cells causes memory loss and cognitive decline. A neurodegenerative type of dementia, the disease starts mild and gets progressively worse.

In the US, the most recent census has enabled researchers to give estimates of how many people have Alzheimer's disease. In 2010, some 4.7 million people of 65 years of age and older were living with Alzheimer's disease in the US.

The 2013 statistical report from the Alzheimer's Association gives a proportion of the population affected - just over a tenth of people in the over-65 age group have the disease in the US. In the over-85s, the proportion goes up to about a third.

As our dementia page outlines, there is a handful of different types, but Alzheimer's disease is the problem behind most cases of memory loss and cognitive decline.

Like all types of dementia, Alzheimer's is caused by brain cell death. It is a degenerative disease, which means there is progressive brain cell death that happens over a course of time.

The total brain size shrinks with Alzheimer's - the tissue has progressively fewer nerve cells and connections.

In the Alzheimer's disease process, progressing from the normal brain to increasing dementia changes, the Alzheimer's Association has produced a journey of 16 slides.

Some things are more commonly associated with Alzheimer's disease - not seen so often in people without the disorder. These factors may therefore have some direct connection. Some are preventable or modifiable factors (for example, reducing the risk of diabetes or heart disease may in turn cut the risk of dementia).

For doctors to make an initial diagnosis of Alzheimer's disease, they must first be satisfied that there is dementia - guidelines spell out what dementia consists of. It involves cognitive or behavioral symptoms that show a decline from previous levels of "functioning and performing" and interfere with ability "to function at work or at usual activities.

There is no known cure for Alzheimer's disease - the death of brain cells in the dementia cannot be halted or reversed.

There is, however, much backing for therapeutic interventions to help people live with Alzheimer's disease more ably.

Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear after age 65. Estimates vary, but experts suggest that as many as 5 million Americans age 65 and older may have Alzheimer’s disease.

Alzheimer’s disease is the most common cause of dementia among older people. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities, to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.Changes in the Brain in Alzheimer’s DiseaseSigns and Symptoms
Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear after age 65. Estimates vary, but experts suggest that as many as 5 million Americans age 65 and older may have Alzheimer’s disease.
Alzheimer’s disease is the most common cause of dementia among older people. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities, to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living.

Alzheimer’s disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary tangles). Plaques and tangles in the brain are two of the main features of Alzheimer’s disease. The third is the loss of connections between nerve cells (neurons) in the brain.

Alzheimer’s disease is complex, and it is unlikely that any one intervention will be found to delay, prevent, or cure it. That’s why current approaches in treatment and research focus on several different aspects, including helping people maintain mental function, managing behavioral symptoms, and slowing or delaying the symptoms of disease.

Blog 14 Digestion Excretion Center

The digestive system is a group of organs working together to convert food into energy and basic nutrients to feed the entire body. Food passes through a long tube inside the body known as the alimentary canal or the gastrointestinal tract (GI tract). The alimentary canal is made up of the oral cavity, pharynx, esophagus, stomach, small intestines, and large intestines. 

Excretion is  the process by which animals rid themselves of waste products and of the nitrogenous by-products of metabolism. Through excretion organisms control osmotic pressure—the balance between inorganic ions and water—and maintain acid-base balance. The process thus promotes homeostasis, the constancy of the organism’s internal environment.

Digestion time varies between individuals and between men and women. After you eat, it takes about six to eight hours for food to pass through your stomach and small intestine. Food then enters your large intestine (colon) for further digestion, absorption of water and, finally, elimination of undigested food.

In the 1980s, Mayo Clinic researchers measured digestion time in 21 healthy people. Total transit time, from eating to elimination in stool, averaged 53 hours (although that figure is a little overstated, because the markers used by the researchers passed more slowly through the stomach than actual food). The average transit time through just the large intestine (colon) was 40 hours, with significant difference between men and women: 33 hours for men, 47 hours for women.

Two British doctors studied digestion time in children. They fed 35 children juice containing a red marker and asked the children's mothers to note when the stool first turned red. The mean time of transit from mouth to anus for the group was 33 hours (meaning half the children had digestion times slower than this and half had digestion times greater than this).

Blog 13 Digestion/Excretion Disease

Digestion is the breaking down of food in the body, into a form that can be absorbed and used or excreted. It is also the process by which the body breaks down food into smaller components that can be absorbed by the blood stream. In order to use the food we eat, our body has to break the food down into smaller molecules that it can process; it also has to excrete waste.

The digestive process begins in the mouth.

Food is partly broken down by the process of chewing and by the chemical action of salivary enzymes (these enzymes are produced by the salivary glands and break down starches into smaller molecules).

The digestive system is made up of the digestive tract, a series of hollow organs joined in a long, twisting tube from the mouth to the anus, and other organs that help the body break down and absorb food.

Organs that make up the digestive tract are the mouth, esophagus, stomach, small intestine, large intestine, also called the colon, rectum, and anus. Inside these hollow organs is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food. The digestive tract also contains a layer of smooth muscle that helps break down food and move it along the tract.

Two solid digestive organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes called ducts. The gallbladder stores the liver’s digestive juices until they are needed in the intestine. Parts of the nervous and circulatory systems also play major roles in the digestive system.

Mechanical and chemical digestion begin in the mouth where food is chewed, and mixed with saliva to break down starches. The stomach continues to break food down mechanically and chemically through the churning of the stomach and mixing with enzymes. Absorption occurs in the stomach and gastrointestinal tract, and the process finishes with excretion.

The stomach is a small,'C'-shaped pouch with walls made of thick, elastic muscles, which stores and helps break down food. Food enters the stomach through the cardiac orifice where it is further broken apart and thoroughly mixed with gastric acid, pepsin and other digestive enzymes to break down proteins.

The enzymes in the stomach also have an optimum, meaning that they work at a specific pH and temperature better than any others. The acid itself does not break down food molecules, rather it provides an optimum pH for the reaction of the enzyme pepsin and kills many microorganisms that are ingested with the food. It can also denature proteins. This is the process of reducing polypeptide bonds and disrupting salt bridges which in turn causes a loss of secondary, tertiary or quaternary protein structure. The parietal cells of the stomach also secrete a glycoprotein called intrinsic factor which enables the absorption of vitamin B-12. Other small molecules such as alcohol are absorbed in the stomach, passing through the membrane of the stomach and entering the circulatory system directly. Food in the stomach is in semi-liquid form, which upon completion is known as chyme.

Blog 12 Diseases 2 Nephrotic Syndrome

Nephrotic syndrome may occur when the filtering units of the kidney are damaged. This damage allows protein normally kept in the plasma to leak into the urine in large amounts, which reduces the amount of protein in your blood. Since the protein in the blood helps keep fluid in the bloodstream, some of this fluid leaks out of the bloodstream into your tissues, causing swelling, called edema. The swelling may be most noticeable in your legs after you have been standing and around your eyes when you first get up in the morning. Eventually, the swelling in your legs may be there all the time, and it may also occur in other parts of your body. You may notice that your urine foams more than usual because of the amount of protein in it.

A urine test can check for the amount of protein, blood and other things to indicate kidney damage. A blood test can indicate how well your kidneys are working. Your doctor will also check for other diseases that may be causing the nephrotic syndrome. Diagnosis may also require a kidney biopsy.

Nephrotic syndrome is not a specific kidney disease. It can occur in any kidney disease that damages the filtering units in a certain way that allows them to leak protein into the urine. Some of the diseases that cause nephrotic syndrome, such as nephritis, affect only the kidney. Other diseases that cause nephrotic syndrome, such as diabetes and lupus, affect other parts of the body as well.

Some of the kidney diseases that cause nephrotic syndrome are treatable with medicine. Some may get better on their own, but others get worse and may lead to kidney failure no matter what treatment is used. Unfortunately, many diseases that cause nephrotic syndrome have no treatment. Only your doctor can find out what specific disease is causing you to have it.

If your nephrotic syndrome is caused by a disease that has no specific treatment, help may still be available. Controlling your blood pressure is important. Reducing salt in your diet can help to control blood pressure and swelling. Your doctor may also prescribe diuretics, which are prescribed for high blood pressure and can also help with swelling. The doctor may also prescribe the use of other blood pressure medicines that can also help reduce the protein in your urine.

Although the syndrome is caused by the loss of protein into your urine, eating a high-protein diet does not help and may actually make matters worse. Nephrotic syndrome may also cause an increase in fat in your blood. If the level of fats in your blood is too high, your doctor may recommend treatments to lower the levels of fat in your blood.

Blog 11 NS Disease 2

Noonan syndrome is a condition that affects many areas of the body. It is characterized by mildly unusual facial characteristics, short stature, heart defects, bleeding problems, skeletal malformations, and many other signs and symptoms.

People with Noonan syndrome have distinctive facial features such as a deep groove in the area between the nose and mouth (philtrum), widely spaced eyes that are usually pale blue or blue-green in color, and low-set ears that are rotated backward. Affected individuals may have a high arch in the roof of the mouth (high-arched palate), poor alignment of the teeth, and a small lower jaw (micrognathia). Many children with Noonan syndrome have a short neck and both children and adults may have excess neck skin (also called webbing) and a low hairline at the back of the neck.

Approximately 50 to 70 percent of individuals with Noonan syndrome have short stature. At birth, they are usually of normal length and weight, but growth slows over time. Abnormal levels of growth hormone may contribute to the slow growth.

Individuals with Noonan syndrome often have either a sunken chest (pectus excavatum) or a protruding chest (pectus carinatum). Some affected people may also have an abnormal side-to-side curvature of the spine (scoliosis).

Most people with Noonan syndrome have a heart defect. The most common heart defect is a narrowing of the valve that controls blood flow from the heart to the lungs (pulmonary valve stenosis). Some affected individuals have hypertrophic cardiomyopathy, which is a thickening of the heart muscle that forces the heart to work harder to pump blood.

A variety of bleeding disorders have been associated with Noonan syndrome. Some people may have excessive bruising, nosebleeds, or prolonged bleeding following injury or surgery. Women with a bleeding disorder typically have excessive bleeding during menstruation (menorrhagia) or childbirth.

Adolescent males with Noonan syndrome typically experience delayed puberty. Affected individuals go through puberty starting at age 13 or 14 and have a reduced pubertal growth spurt. Most males with Noonan syndrome have undescended testicles (cryptorchidism), which may be related to delayed puberty or to infertility (inability to father a child) later in life. Females with Noonan syndrome typically have normal puberty and fertility.

Noonan syndrome can cause a variety of other signs and symptoms. Most children diagnosed with Noonan syndrome have normal intelligence, but a small percentage has special educational needs, and some have intellectual disability. Some affected individuals have vision or hearing problems. Infants with Noonan syndrome may be born with puffy hands and feet caused by a buildup of fluid (lymphedema), which can go away on its own. Affected infants may also have feeding problems, which typically get better by age 1 or 2. Older individuals can also develop lymphedema, usually in the ankles and lower legs.

Noonan syndrome occurs in approximately 1 in 1,000 to 2,500 people.

This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder.

In some cases, an affected person inherits the mutation from one affected parent. Other cases result from new mutations in the gene and occur in people with no history of the disorder in their family.

Blog 10 NS Disease 1

Congenital means present at birth. Congenital heart defects are heart conditions that a baby’s born with. These conditions can affect the heart’s shape or how it works, or both.

Congenital heart defects are the most common types of birth defects. Birth defects are health conditions that a baby’s born with that change the shape or function of one or more parts of the body. They can cause problems in overall health, how the body develops, or in how the body works.

Critical congenital heart disease (also called CCHD) is group of the seven most severe congenital heart defects. They may affect the shape of a baby’s heart, the way it works, or both. Babies with CCHD need treatment within the first few hours, days or months of life. Without treatment, CCHD can be deadly.

Nearly 1 in 100 babies (about 1 percent or 40,000 babies) is born with a heart defect in the United States each year. About 4,800 babies each year are born with CCHD. Many heart defects don’t need treatment or can be fixed easily. But some, like CCHD, can cause serious health problems or death.

If your baby’s health care provider thinks your baby has a congenital heart defect or CCHD, she can refer you to a pediatric cardiologist. This is a doctor who treats babies and children with heart problems.

A congenital heart defect is a problem with the structure of the heart. It is present at birth. Congenital heart defects are the most common type of birth defect. The defects can involve the walls of the heart, the valves of the heart, and the arteries and veins near the heart. They can disrupt the normal flow of blood through the heart. The blood flow can slow down, go in the wrong direction or to the wrong place, or be blocked completely.

Doctors use a physical exam and special heart tests to diagnose congenital heart defects. They often find severe defects during pregnancy or soon after birth. Signs and symptoms of severe defects in newborns include, Rapid breathing, Cyanosis - a bluish tint to the skin, lips, and fingernails, Fatigue, Poor blood circulation.

Many congenital heart defects cause few or no signs and symptoms. They are often not diagnosed until children are older.

Many children with congenital heart defects don't need treatment, but others do. Treatment can include medicines, catheter procedures, surgery, and heart transplants. The treatment depends on the type of the defect, how severe it is, and a child's age, size, and general health.

Blog 9 NS Career 3 Neurosurgeon

A neurosurgeon is a physician who specializes in the diagnosis and surgical treatment of disorders of the central and peripheral nervous system including congenital anomalies, trauma, tumors, vascular disorders, infections of the brain or spine, stroke, or degenerative diseases of the spine.

Neurologists treat patients with complex disorders of the nervous system such as stroke, multiple sclerosis, Parkinson's disease, Alzheimer's disease, Lou Gehrig's disease, epilepsy, headache disorders, infections of the brain and peripheral nervous system. Neurologists often work closely with neurosurgeons, but do not perform surgery.

Neuromedicine describes a practice at Highland Hospital where neurosurgeons, neurologists, and other medical professionals work together to provide comprehensive inpatient care for patients with complex neurological disorders.

After four years of medical school and an internship program, the doctor enters a neurosurgical residency program of five to seven years. While in the program, neurosurgical residents are trained in all aspects of neurosurgery, including cerebrovascular, pediatrics, spine, trauma and tumor. The resident program is long and difficult, due to the extreme complexity of the nervous system and the advanced techniques used in neurosurgical operations. Some neurosurgeons opt to do an additional fellowship in a particular area of study following their residency. Following residency training and several years in practice, the neurological surgeon may take the American Board of Neurological Surgery examination - a thorough assessment of the neurosurgeon's skill, judgment and depth of knowledge. The successful completion of this examination brings a board certification. While the neurological surgeon has a vast knowledge after medical school and residency training, there are continual changes in this specialty that require ongoing study throughout the neurological surgeon's professional career. Monthly scientific journals, annual meetings, specialized symposia and other educational opportunities help the neurosurgeon keep pace with rapid changes and developments in neurosurgery.

Neurosurgeons are more than just brain surgeons. These medical specialists are trained to help patients with head and spine trauma; cerebrovascular disorders, like aneurysms of the brain and clogged arteries in the neck that can lead to strokes; chronic low back pain; birth defects; brain and spinal tumors; and abnormalities of the peripheral nerves.