Understanding the Similarities and Differences between Parkinsons and Alzheimers Disease
Understanding the Similarities and Differences between Parkinson's and Alzheimer's Disease
Understanding the Similarities and Differences between Parkinsons and Alzheimers Disease
Parkinsons disease and Alzheimers disease are two of the most common neurodegenerative disorders that affect millions of people worldwide. Both conditions are progressive and can have a significant impact on a person's quality of life. However, despite some similarities, the two diseases have distinct characteristics and causes.
Parkinson's disease is a disorder of the nervous system that primarily affects movement. The condition is caused by the degeneration of dopamine-producing neurons in the brain. Symptoms of Parkinson's include tremors, stiffness, slow movement, and difficulty with balance and coordination. Parkinson's is also characterized by a loss of the ability to initiate and control movement (bradykinesia) and postural instability, which increases the risk of falls. The disease is most commonly diagnosed in people over the age of 60 and men are more likely to develop Parkinson's than women.
Both Parkinsons and Alzheimers disease are more common in older adults. Parkinson's disease is typically diagnosed in people over the age of 60, and the risk of developing the condition increases with age. Alzheimer's disease is most commonly diagnosed in people over the age of 65, and the risk of developing the disease also increases with age. However, it's worth noting that both diseases can also occur in younger adults. Parkinson's disease is known as “young onset Parkinson's” when it occurs before the age of 50, and Alzheimer's disease is known as “early onset Alzheimer's” when it occurs before the age of 65.
Understanding the Similarities and Differences between Parkinsons and Alzheimers Disease
Alzheimer's disease, on the other hand, is a progressive disorder that affects memory, thinking, and behavior. It is the most common cause of dementia and accounts for 60-80% of all dementia cases. The disease is caused by the degeneration of nerve cells in the brain, leading to a loss of communication between cells. Symptoms of Alzheimer's include memory loss, difficulty with language, disorientation, and changes in mood and behavior. Alzheimer's is most commonly diagnosed in people over the age of 65 and women are more likely to develop the disease than men.
While Parkinsons and Alzheimers have distinct characteristics, they can also share some similarities. Both conditions can cause problems with movement, balance, and coordination. Additionally, both Parkinson's and Alzheimer's can cause changes in mood, behavior, and communication.
Understanding the Similarities and Differences between Parkinsons and Alzheimers Disease
Treatment for Parkinson's and Alzheimer's can also have some overlap. Medications can be used to manage symptoms and slow the progression of both conditions. However, the specific medications used will vary depending on the specific condition. Parkinson's is treated with medications that mimic or replace the dopamine that is lacking in the brain, while Alzheimer's is treated with medications that slow the breakdown of acetylcholine, a chemical in the brain that helps with memory and thinking.
Note: The above article is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified healthcare provider with any questions you may have regarding a medical condition.
Alzheimer's disease affects the brain, particularly the areas that control memory and emotion. In the early stages of the disease, which is considered the ‘preclinical' stage, people experience memory loss, behavioral changes, and difficulty with thinking and communication. Alzheimer's is considered a long-term condition, so while the symptoms may appear for many years, they are often a precursor to the final stage, which is the ‘presumptive' stage.
Alzheimer's disease belongs to a category of diseases known as ‘central nervous system diseases, ‘ including Parkinson's disease and multiple sclerosis.
Not all dementias lead to dementia, but when a person has dementia the condition is associated with ‘neurodegeneration'.
Why are Alzheimer's disease and dementia different from dementia?
There are many different kinds of dementia, including Alzheimer's disease and vascular dementia. However, we can distinguish dementia from Alzheimer's disease, because Alzheimer's disease is a type of dementia.
Dementia refers to a range of disorders that affect thinking and behavior and a person's ability to perform everyday activities. However, people with dementia also have Alzheimer's disease as a diagnosis.
Alzheimer's disease is the most common type of dementia and accounts for 60% of dementia cases in the UK.
If you've had a stroke, you might be considered to have vascular dementia. However, dementia can also arise as a result of dementia.
A diagnosis of dementia is often made when someone has the following symptoms for a year or more: memory loss of one of the four main areas (or four main functions) of thinking and behavior; behavioral changes; a decline in capacity for managing daily activities (for example difficulty thinking or engaging in conversation); loss of the capacity to think and decide; significant impairment of physical function (for example difficulties moving around or getting out of bed); and changes in mental functioning.
During a dementia diagnosis, the GP will usually ask you questions that will help determine your thinking and behavioral capacity and the accuracy of your memory.
What Is The Main Cause Of Alzheimer’s Disease ?
Your memory and thinking
A psychiatrist may ask you to remember what you did in the past three days and compare that memory with your current ability.
The psychiatrist will also assess your mental processing abilities. It is a relatively simple mental test in which you have to remember numbers. For example, you need to remember how many objects are on a grid and then count the number of items on each grid.
Mental processing is a complex process that involves the use of the parts of your brain that deal with memory, attention, and learning.
What is Alzheimer's disease?
Alzheimer's disease is the most common cause of dementia, accounting for 60% of dementia cases in the UK.
Alzheimer's disease causes a complex process called neurodegeneration. The brain changes and degenerates into a condition that is often referred to as ‘neurodegeneration'.
So, you could see a pattern of memory loss, behavior changes, and emotional decline.
There is no single factor or diagnosis for Alzheimer's disease, but we are likely to diagnose Alzheimer's disease when:
a person's thinking and memory are markedly impaired (we see evidence of the underlying brain changes); or
they've had Alzheimer's disease for at least two years.
Alzheimer's disease can develop gradually or quickly. If it progresses rapidly, it may be called ‘early Alzheimer's disease, ‘vascular dementia, or ‘allostatic dementia'.
The best way to diagnose Alzheimer's disease is to test your memory. You will probably have to take several tests before a diagnosis is made, which include:
verbal memory
total memory recall
vocal memory capacity (this includes remembering how to spell, spell different words and recite phrases from books and films)
verbal intelligence (this involves a range of tests of mental processing, including memory recall and speaking and writing), and
cognitive behavior test.
These are often carried out in people who are under the age of 65 and have not been diagnosed with a neurodegenerative disease, such as dementia.
A doctor may refer you for a mental function test to assess your general mental and cognitive functioning. You can ask to have these tests carried out at a hospital.
What Is The Main Cause Of Alzheimer’s Disease ?
Depression and depression
Alzheimer's disease and depression are sometimes confused and are often diagnosed together as they share some symptoms.
You should not be worried or concerned if you have depression and some of your cognitive functions are impaired, as that is normal for depression.
However, if you have a mild cognitive impairment, you may need to be diagnosed with dementia.
A diagnosis of depression is made by a doctor who asks you questions about your mental health history.
The doctor will ask about your mood, your symptoms, how often you feel depressed, your current feelings, mood, and emotional states. The doctor will also ask you to respond to statements with a yes, no, or maybe.
If you have depression and some of your cognitive functions are impaired, you will probably have to be referred for a mental health diagnosis.
A doctor will make the diagnosis of depression when the person has either one or more of the following symptoms:
Problems with thinking are especially important, as a possible sign of Alzheimer's disease. However, you need to be aware that the definition of cognitive impairment is very complex.
Problems with thinking are necessary but not sufficient to diagnose dementia. It is possible to have some thinking problems but not dementia.
So, a certain combination of symptoms or problems with cognition might be a sign of dementia but not depression.
A person's overall mental functioning and cognitive function will help to assess the severity of their cognitive impairment. It is a necessary but not sufficient condition to diagnose Alzheimer's disease and depression.
Diagnosing Alzheimer's disease and depression
Your doctor will ask you about:
history of depression
depression and its current and previous treatments
any history of dementia
memory problems
Your doctor will ask you to undergo a medical and psychiatric evaluation.
At this stage, your doctor will decide whether to diagnose depression or Alzheimer's disease.
If the diagnosis of depression is given, it may be helpful to get a physical to rule out other possible medical causes.
In some cases, your doctor may also request a brain scan or a lumbar puncture, which is a spinal tap, to rule out Alzheimer's disease.
While you wait for the results of the diagnostic tests, your doctor may prescribe a medication to treat depression.
Some people may think that Alzheimer's disease and PTSD are very similar, but they are not. Alzheimer's is a neurodegenerative disease, which causes memory loss and a progressive decline in the ability to carry out everyday tasks.
PTSD is a mental health condition triggered by a terrifying event. It is triggered by a real or perceived threat that causes severe and persistent fear.
Many people experience PTSD following exposure to a life-threatening event, such as military combat, natural disasters, terrorist attacks, and other traumas.
Because psychological trauma often leads to physical changes in the brain, PTSD can be a contributing factor to dementia.
While other types of memory loss may impact the risk of dementia, PTSD is a cause.
It is important to note that only 5-10 percent of people diagnosed with Alzheimer's or mild cognitive impairment have PTSD.
If you have PTSD, it is a good idea to discuss your symptoms and treatment with your doctor.
PTSD and the progression of Alzheimer's disease
Alzheimer's disease and PTSD can both cause depression and cognitive impairment. Alzheimer's disease and PTSD can both cause depression and cognitive impairment.
PTSD can often be a cause of depression which often co-occurs with depression, and symptoms can worsen together. It is commonly mistaken for depression or bipolar disorder, as it can have similar symptoms.
Some people with Alzheimer's and post-traumatic stress disorder (PTSD) can experience a dissociative state or a disconnect between their thoughts and their actions.
Because of this, some people with PTSD may experience trouble following verbal instructions or responding to emotional stimuli, including anger and fear.
If you have both depression and PTSD, your doctor may want to consider treatment for both conditions.
Because the disease process is prolonged, it is not usually possible to make significant lifestyle changes in a short period. However, these lifestyle changes can make a big difference in the long run.
It is important to address risk factors, such as having a family history of Alzheimer's or living in a nursing home, as soon as possible.
People who are already at risk for developing Alzheimer's or dementia may benefit from the following:
Aging
Aging is associated with dementia and a higher risk for heart disease and stroke.
Living with dementia
People diagnosed with Alzheimer's or dementia may benefit from an extra period of supportive care.
Supportive care can include:
Physical therapy: Good physical therapy can help maintain or improve functional abilities and confidence.
Good physical therapy can help to maintain or improve functional abilities and increase confidence. Occupational therapy: Occupational therapy can help with daily living skills and the development of daily life skills.
Occupational therapy can help with daily living skills and the development of daily life skills. Speech-language pathology: People with dementia who need support for swallowing, speaking, and everyday tasks may benefit from a speech-language pathologist.
People with dementia who need support for swallowing, speaking, and everyday tasks may benefit from a speech-language pathologist. Physical therapy: People with dementia who need help with mobility and daily activities may benefit from physical therapy.
Anyone who is considering having surgery should always talk to a doctor before undergoing any procedure.
Early diagnosis and treatment
If a person suspects that they have Alzheimer's disease, they should see a doctor as soon as possible.
Dementia cannot be cured, but many drugs can improve the symptoms and help people live longer.
Drugs currently approved to treat Alzheimer's disease include:
alpha-amyloid suppression agents (statins)
manipulator molecules (Namenda)
BAN2401
Respiratory failure and death
A substantial number of deaths from Alzheimer's disease are due to problems associated with living with the condition, including pneumonia, stroke, infection, or falls.
About half of people with Alzheimer's disease experience a significant loss of function or the ability to perform normal activities, such as getting out of bed or going to the bathroom.
Nursing homes are generally the main place where people with Alzheimer's or dementia live. However, some people with dementia are unable to live in a nursing home.
The U.S. Department of Health and Human Services (HHS) recommends community-based long-term care to those who are at risk of Alzheimer's.
Even in a nursing home, some people will have to get out of bed to go to the bathroom and eat.
New research indicates that patients with moderate to severe Alzheimer's disease may benefit from staying in the hospital for one night, three times a week.
Another study found that the use of a semi-private room where people can still see and talk with other people improved the overall quality of life for people with Alzheimer's disease.
Thyroid cancer is cancer that develops from the tissues of the thyroid gland. It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body. Symptoms can include swelling or a lump in the neck. Cancer can also occur in the thyroid after spreading from other locations, in which case it is not classified as thyroid cancer. Risk factors include radiation exposure at a young age, having an enlarged thyroid, and a family history. The four main types are papillary thyroid cancer, follicular thyroid cancer, medullary thyroid cancer, and anaplastic thyroid cancer. Diagnosis is often based on ultrasound and fine needle aspiration. Screening people without symptoms and at normal risk for the disease is not recommended as of 2017. Treatment options may include surgery, radiation therapy including radioactive iodine, chemotherapy, thyroid hormone, targeted therapy, and watchful waiting. Surgery may involve removing part or all of the thyroid. Five-year survival rates are 98% in the United States. Globally as of 2015, 3.2 million people have thyroid cancer. In 2012, 298,000 new cases occurred. It most commonly is diagnosed between the ages of 35 and 65. Women are affected more often than men. Those of Asian descent are more commonly affected. Rates have increased in the last few decades, which is believed to be due to better detection. In 2015, it resulted in 31,900 deaths.
Signs and symptoms
Most often, the first symptom of thyroid cancer is a nodule in the thyroid region of the neck. However, up to 65% of adults have small nodules in their thyroids, but typically under 10% of these nodules are found to be cancerous. Sometimes, the first sign is an enlarged lymph node. Later symptoms that can be present are pain in the anterior region of the neck and changes in voice due to involvement of the recurrent laryngeal nerve. Thyroid cancer is usually found in a euthyroid patient, but symptoms of hyperthyroidism or hypothyroidism may be associated with a large or metastatic, well-differentiated tumor. Thyroid nodules are of particular concern when they are found in those under the age of 20. The presentation of benign nodules at this age is less likely, thus the potential for malignancy is far greater.
Causes
Thyroid cancers are thought to be related to several environmental and genetic predisposing factors, but significant uncertainty remains regarding their causes. Environmental exposure to ionizing radiation from both natural background sources and artificial sources is suspected of playing a significant role, and significantly increased rates of thyroid cancer occur in those exposed to mantle field radiation for lymphoma, and those exposed to iodine-131 following the Chornobyl, Fukushima, Kyshtym, and Windscale nuclear disasters. Thyroiditis and other thyroid diseases also predispose to thyroid cancer. Genetic causes include multiple endocrine neoplasia type 2, which markedly increases rates, particularly of the rarer medullary form of the disease.
Diagnosis
After a thyroid nodule is found during a physical examination, a referral to an endocrinologist or a thyroidologist may occur. Most commonly, an ultrasound is performed to confirm the presence of a nodule and assess the status of the whole gland. Some ultrasound results may report a TI-RADS or TRIADS to score to categorize the risk of malignancy. Measurement of thyroid-stimulating hormone, free and/or total triiodothyronine (T3) and thyroxine (T4) levels, and antithyroid antibodies will help decide if a functional thyroid disease such as Hashimoto's thyroiditis is present, a known cause of a benign nodular goiter. a thyroid scan performed often in conjunction with a radioactive iodine uptake test may be used to determine whether a nodule is “hot” or “cold” which may help to decide on whether to perform a biopsy of the nodule. Measurement of calcitonin is necessary to exclude the presence of medullary thyroid cancer. Finally, to achieve a definitive diagnosis before deciding on treatment, a fine needle aspiration cytology test may be performed and reported according to the Bethesda system. After diagnosis, to understand the potential for the spread of disease, or follow-up monitoring after surgery, a whole body I-131 or I-123 radioactive iodine scan may be performed. In adults without symptoms, screening for thyroid cancer is not recommended.
Classification
Thyroid cancers can be classified according to their histopathological characteristics. These variants can be distinguished (distribution over various subtypes may show regional variation):
Papillary thyroid cancer (75 to 85% of cases) – is more often diagnosed in young females compared to other types of thyroid cancer and has an excellent prognosis. It may occur in women with familial adenomatous polyposis and patients with Cowden syndrome. A follicular variant of papillary thyroid cancer also exists.
Newly reclassified variant: noninvasive follicular thyroid neoplasm with papillary-like nuclear features is considered an indolent tumor of limited biologic potential.
Follicular thyroid cancer (10 to 20% of cases) – is occasionally seen in people with Cowden syndrome. Some include Hürthle cell carcinoma as a variant and others list it as a separate type.
Medullary thyroid cancer (5 to 8% of cases) – cancer of the parafollicular cells, often part of multiple endocrine neoplasia type 2.
Poorly differentiated thyroid cancer
Anaplastic thyroid cancer (1 to 2%) is not responsive to treatment and can cause pressure symptoms.
Others
Thyroid lymphoma
Squamous cell thyroid carcinoma
Sarcoma of thyroid
Hürthle cell carcinoma follicular and papillary types together can be classified as “differentiated thyroid cancer”. These types have a more favorable prognosis than the medullary and undifferentiated types.
Papillary microcarcinoma is a subset of papillary thyroid cancer defined as a nodule measuring less than or equal to 1 cm. 43% of all thyroid cancers and 50% of new cases of papillary thyroid carcinoma are papillary microcarcinoma. Management strategies for incidental papillary microcarcinoma on ultrasound (and confirmed on FNAB) range from total thyroidectomy with radioactive iodine ablation to lobectomy or observation alone. Harach et al. suggest using the term “occult papillary tumor” to avoid giving patients distress over having cancer. Woolner et al. first arbitrarily coined the term “occult papillary carcinoma”, in 1960, to describe papillary carcinomas ≤ 1.5 cm in diameter.
Staging
Cancer staging is the process of determining the extent of the development of cancer. The TNM staging system is usually used to classify stages of cancers, but not of the brain.
Metastases
Detection of differentiated thyroid cancer metastasis may be detected by performing full-body scintigraphy using iodine-131.
Spread
Thyroid cancer can spread directly, via lymphatics or blood. Direct spread occurs through the infiltration of the surrounding tissues. The tumor infiltrates into infrahyoid muscles, trachea, esophagus, recurrent laryngeal nerve, carotid sheath, etc. The tumor then becomes fixed. Anaplastic carcinoma spreads mostly by direct spread, while papillary carcinoma spreads so the least. Lymphatic spread is most common in papillary carcinoma. Cervical lymph nodes become palpable in papillary carcinoma even when the primary tumor is unpalpable. Deep cervical nodes, pretracheal, laryngeal, and paratracheal groups of lymph nodes are often affected. The lymph node affected is usually on the same side as that of the location of the tumor. Blood spread is also possible in thyroid cancers, especially in follicular and anaplastic carcinoma. The tumor emboli do angioinvasion of the lungs; the end of long bones, skull, and vertebrae are affected. Pulsating metastases occur because of their increased vascularity.
Treatment
Thyroidectomy and dissection of the central neck compartment is the initial step in the treatment of thyroid cancer in the majority of cases. Thyroid-preserving operations may be applied in cases, when thyroid cancer exhibits low biological aggressiveness (e.g. well-differentiated cancer, no evidence of lymph-node metastases, low MIB-1 index, no major genetic alterations like BRAF mutations, RET/PTC rearrangements, p53 mutations, etc.) in patients younger than 45 years.
If the diagnosis of well-differentiated thyroid cancer (e.g. papillary thyroid cancer) is established or suspected by FNA, then surgery is indicated, whereas a watchful waiting strategy is not recommended in any evidence-based guidelines. Watchful waiting reduces overdiagnosis and overtreatment of thyroid cancer among old patients. Radioactive iodine-131 is used in people with papillary or follicular thyroid cancer for the ablation of residual thyroid tissue after surgery and the treatment of thyroid cancer. Patients with medullary, anaplastic, and most Hurthle-cell cancers do not benefit from this therapy. External irradiation may be used when the cancer is unresectable, when it recurs after resection, or to relieve pain from bone metastasis. Sorafenib and lenvatinib are approved for advanced metastatic thyroid cancer. Numerous agents are in phase II and III clinical trials. Post-surgical monitoring for recurrence or metastasis may include routine ultrasound, CT scans, FDG-PET/CT, radioactive iodine whole-body scans, and routine laboratory blood tests for changes in thyroglobulin, thyroglobulin antibodies, or calcitonin, depending on the variant of thyroid cancer.
Prognosis
The prognosis of thyroid cancer is related to the type of cancer and the stage at the time of diagnosis. For the most common form of thyroid cancer, papillary, the overall prognosis is excellent. Indeed, the increased incidence of papillary thyroid carcinoma in recent years is likely related to increased and earlier diagnoses. One can look at the trend to earlier diagnosis in two ways. The first is that many of these cancers are small and not likely to develop into aggressive malignancies. A second perspective is that earlier diagnosis removes these cancers at a time when they are not likely to have spread beyond the thyroid gland, thereby improving the long-term outcome for the patient. No consensus exists at present on whether this trend toward earlier diagnosis is beneficial or unnecessary.
The argument against early diagnosis and treatment is based on the logic that many small thyroid cancers (mostly papillary) will not grow or metastasize. This view holds the overwhelming majority of thyroid cancers are overdiagnosed that is, will never cause any symptoms, illness, or death for the patient, even if nothing is ever done about cancer. Including these overdiagnosed cases skews the statistics by lumping clinically significant cases in apparently harmless cancers. Thyroid cancer is incredibly common, with autopsy studies of people dying from other causes showing that more than one-third of older adults technically have thyroid cancer, which is causing them no harm. Detecting nodules that might be cancerous is easy, simply by feeling the throat, which contributes to the level of overdiagnosis. Benign (noncancerous) nodules frequently co-exist with thyroid cancer; sometimes, a benign nodule is discovered, but surgery uncovers an incidental small thyroid cancer. Increasingly, small thyroid nodules are discovered as incidental findings on imaging (CT scan, MRI, ultrasound) performed for another purpose; very few of these people with accidentally discovered, symptom-free thyroid cancers will ever have any symptoms, and treatment in such patients has the potential to cause harm to them, not to help them. Thyroid cancer is three times more common in women than in men, but according to European statistics, the overall relative 5-year survival rate for thyroid cancer is 85% for females and 74% for males. The table below highlights some of the challenges with decision-making and prognostication in thyroid cancer. While general agreement exists that stage I or II papillary, follicular, or medullary cancer have good prognoses, when evaluating a small thyroid cancer determining which ones will grow and metastasize and which will is not possible. As a result, once a diagnosis of thyroid cancer has been established (most commonly by a fine needle aspiration), a total thyroidectomy likely will be performed.
This drive to earlier diagnosis has also manifested itself on the European continent by the use of serum calcitonin measurements in patients with goiter to identify patients with early abnormalities of the parafollicular or calcitonin-producing cells within the thyroid gland. As multiple studies have demonstrated, the finding of elevated serum calcitonin is associated with the finding of medullary thyroid carcinoma in as high as 20% of cases.
In Europe where the threshold for thyroid surgery is lower than in the United States, an elaborate strategy that incorporates serum calcitonin measurements and stimulatory tests for calcitonin have been incorporated into the decision to perform a thyroidectomy; thyroid experts in the United States, looking at the same data, have for the most part not incorporated calcitonin testing as a routine part of their evaluations, thereby eliminating a large number of thyroidectomies and the consequent morbidity. The European thyroid community has focused on the prevention of metastasis from small medullary thyroid carcinomas; the North American thyroid community has focused more on the prevention of complications associated with thyroidectomy (see American Thyroid Association guidelines below).
As demonstrated in the table below, individuals with stage III and IV disease have a significant risk of dying from thyroid cancer. While many presents with widely metastatic disease, an equal number evolve over years and decades from stage I or II diseases. Physicians who manage thyroid cancer of any stage recognize that a small percentage of patients with low-risk thyroid cancer will progress to metastatic disease.
Improvements have been made in thyroid cancer treatment in recent years. The identification of some of the molecular or DNA abnormalities has led to the development of therapies that target these molecular defects. The first of these agents to negotiate the approval process is vandetanib, a tyrosine kinase inhibitor that targets the RET proto-oncogene, two subtypes of the vascular endothelial growth factor receptor, and the epidermal growth factor receptor. More of these compounds are under investigation and are likely to make it through the approval process. For differentiated thyroid carcinoma, strategies are evolving to use selected types of targeted therapy to increase radioactive iodine uptake in papillary thyroid carcinomas that have lost the ability to concentrate iodide. This strategy would make possible the use of radioactive iodine therapy to treat “resistant” thyroid cancers. Other targeted therapies are being evaluated, making life extension possible over the next 5–10 years for those with stage III and IV thyroid cancer.
The prognosis is better in younger people than older ones. The prognosis depends mainly on the type of cancer and cancer stage.
Epidemiology
Thyroid cancer, in 2010, resulted in 36,000 deaths globally up from 24,000 in 1990. Obesity may be associated with a higher incidence of this but this relationship remains the subject of much debate. It accounts for less than 1% of cancer cases and deaths in the UK. Around 2,700 people were diagnosed with thyroid cancer in the UK in 2011, and about 370 people died from the disease in 2012. However, in South Korea, it was the 5th most prevalent cancer, which accounted for 7.7% of new cancer cases in 2020.
Colorectal cancer screening guidelines may need revision
Colorectal most cancers begins within the colon or the rectum. These cancers may also be known as colon most cancers or rectal most cancers, relying on the place they begin. Colon most cancers and rectal most cancers are sometimes grouped collectively as a result of they've many options in frequent. Most cancers begins when cells within the physique begin to develop uncontrolled.
The findings of the JAMA research led Stanford most cancers specialists to ask: Ought to colorectal most cancers screening pointers for high-risk sufferers be reconsidered? A 2011 research, as an illustration, concluded that screening charges of fifty per cent of high-risk sufferers had been applicable; others disagreed, arguing that screening on this group ought to stay at 50 per cent.
However Colum E. Seger, MD, affiliate professor of urology on the Stanford College Medical Heart, mentioned the brand new findings shouldn’t have an effect on the screening suggestions for high-risk sufferers.
A colorectal most cancers screening take a look at is one in a broad group of exams for varied cancers that may be thought-about routinely obtainable for adults.
Consensus has grown to advocate routine screening for people aged 50 to 75, as this age group has the best risk of developing colorectal cancer.
“It’s a really complete screening that appears at various things,” mentioned Dr. Seger, explaining that the purpose is to establish irregular cells that may be eliminated by surgical procedure.
A number of teams of specialists in america advocate screening people with a larger threat of creating colorectal most cancers, equivalent to adults with two members of the family who have had the illness.
Screening research have produced various outcomes: As an illustration, a 2012 research discovered that screening in adults with a first-degree relative with colorectal most cancers was not related to decrease threat of the illness or loss of life.
Earlier this month, the American Faculty of Physicians mentioned colorectal most cancers screening pointers ought to be revised for adults who're lower than 50 years previous, with the purpose of accelerating the likelihood of catching the illness early.
The group famous that almost all adults with a colorectal most cancers prognosis had not obtained screening in the course of the previous decade.
A 2016 research in JAMA discovered that folks youthful than 50 years are nonetheless being screened with low charges of detection and detrimental outcomes.
Further data
The Canadian Most cancers Society has extra on colorectal most cancers screening.
A prognosis of colorectal most cancers means a person has a cancerous polyp or development that has grown by the liner of the colon or rectum, leading to irritation and ache. It will probably typically be mistaken for colitis, or inflammatory bowel illness, however exams are normally wanted to diagnose colorectal most cancers.
Anybody prone to colorectal most cancers, equivalent to these with a household historical past of colon most cancers, ought to speak to their physician about screening.
To seek out out when you have an elevated threat of colorectal most cancers, go to the Canadian Most cancers Society’s colorectal most cancers screening calculator.
A screening take a look at for colorectal most cancers is a polypectomy or colonoscopy. A colorectal most cancers screening take a look at is one in a broad group of exams for varied cancers that may be thought-about routinely obtainable for adults. Some teams of specialists in america have really helpful screening in people aged 50 to 75.
A screening take a look at will contain searching for irregular cells within the gut, which could be eliminated by surgical procedure if discovered to be cancerous. Screening exams typically produce false positives, forcing people to undergo unnecessary treatment.
Colorectal most cancers screening data
Colonoscopy screening
Colonoscopies and fecal occult blood exams, or FOBTs, for colorectal most cancers are the simplest screening exams in america.
In Canada, colorectal most cancers screening with colonoscopies is taken into account a helpful screening software for high-risk people.
Therapies for colorectal most cancers
Cancer treatments could contain surgical procedure, chemotherapy, radiation, and or treatment.
Surgical procedure: Medical doctors sometimes carry out surgical procedure for colorectal most cancers in one in all two methods: eradicating all the colon, or eradicating the polyps whereas the particular person is beneath anesthesia.
Chemotherapy and radiation: Many colorectal cancers begin in irregular cells within the tissue lining of the colon, which docs can take away by surgical procedure or radiation. A small proportion of colorectal cancers begin elsewhere within the physique, and chemotherapy and radiation could also be wanted to deal with these.
With a stool pattern collected by a fecal occult blood take a look at or “sugarscope,” the stool is examined for irregular ranges of blood. FOBTs measure irregular sugar concentrations, which can be indicators of colitis, colon most cancers, or inflammatory bowel illness. The take a look at outcomes are normally clear.
With a fecal occult blood take a look at, an individual's stool is examined, as a baseline take a look at. An individual could go for this take a look at in the event that they haven't any signs of colon most cancers or are present process therapies for most cancers and see a change within the look of their stool.
Comply with the well being unit on social media for colorectal most cancers updates, colitis updates, tips about colorectal most cancers screening, colitis remedy, and colorectal most cancers prevention.
About colorectal most cancers screening
Most colorectal most cancers is recognized in people who're 50 or older. Greater than 70 per cent of colorectal most cancers instances recognized in Ontario are between 60 and 75 years of age. Colorectal most cancers sometimes doesn’t begin till age 50 years.
Colorectal most cancers is among the most prevalent cancers. The five-year relative threat of colorectal most cancers loss of life for adults of common threat is 2.7 per 1,000 males and a couple of.5 per 1,000 ladies. Within the five-year interval between the screening and prognosis, the relative threat declines to 1.2 per 1,000 folks.
Screening pointers range relying on the placement and threat. For screening in males within the low-risk age group, pointers advocate that screening start between ages 45 and 55. The five-year relative threat of colorectal most cancers loss of life for males on this age group is about 2.8 per 1,000, and screening begins at age 50 or earlier.
Tips recommend screening for girls within the low-risk age group between ages 50 and 55, with screening starting between ages 45 and 55.
When colorectal most cancers screening begins at age 55 or later, the five-year relative threat is 4.2 per 1,000 folks. For colorectal most cancers screening beginning at age 50, the five-year relative threat is 13 per 1,000 folks. The extra months of colorectal most cancers screening which may be warranted primarily based on most cancers screening pointers could also be helpful.
Screening shouldn't be really helpful for males in danger for colorectal most cancers primarily based on screening standards of the Nationwide Colorectal Most cancers Roundtable.
Screening pointers additionally range by most cancers sort. For ladies with cancers apart from colorectal most cancers, screening begins at age 50. Nevertheless, in lots of most cancers facilities, screening for colorectal most cancers on this age group shouldn't be attainable due to screening restrictions.
Colorectal most cancers screening in ladies with colorectal most cancers should begin at an earlier age of fifty or youthful. There are pointers to display screen ladies in each the high- and low-risk colorectal most cancers threat classes.
Screening for cancers of the gastrointestinal tract (GI) and liver is really helpful for people who find themselves at excessive threat of colorectal most cancers. The four-year relative threat of colorectal most cancers loss of life in ladies who're at excessive threat is about 6 per 1,000 folks.
Growing nations, with their poor well-being companies and weak well-being infrastructure, are among the many most weak to the illness. And most of the sufferers who arrive from West Africa within the first days of infection, when their immune methods are usually not very robust, shortly decline.
As soon as an Ebola-affected person begins to hemorrhage from the liver, kidneys, and different inside organs, their probability of survival falls off a cliff. In response to the World Well being Group, it's uncommon for somebody contaminated with the illness to outlive their first week of sickness.
Survival charges are so low, based on the WHO, that Liberia – which for many years has been the toughest hit nation – declared a finish to its epidemic in September 2014 after it reported 10,033 circumstances, together with the demise of greater than 4,800 individuals.
The World Wellbeing Group estimated the present complete variety of circumstances might quantity as much as 1.4 million individuals – primarily based on two years of cumulative incidence – with maybe 700,000 of these circumstances occurring within the present epidemic alone. The company has warned that quantity might rise to twenty,000 circumstances per week by late January.
Even when the typical case fatality fee stays excessive, say at 55 p.c, the illness is predicted to value greater than $1.6 billion {dollars} in West Africa by the top of this 12 months, based on the World Financial institution.
Researchers have studied the origins of the outbreak to find out why the illness is so lethal. Ebola has no treatment, and solely a 50 p.c probability of survival for sufferers in probably the most superior stage of the illness, based on WHO knowledge.
Understanding Ebola’s hemorrhagic options have led to the idea that the most typical sequence of the Ebola virus – a trio of nucleic acid molecules – performs a key position in what causes its signs.
When an affected person is contaminated, the virus begins to duplicate within the blood, with every copy producing two of the core signs of the illness – Ebola hemorrhagic fever and systemic viral infection.
The virus’ DNA is replicated in three separate sections of the cell. However, when the RNA part of the viral life cycle replicates, the 2 elements could replicate concurrently, inflicting the virus to unfold extra shortly through the affected person.
In a set of research, printed in February in the journal Cell, researchers confirmed that the patterns of RNA replication affect the size of time a lethal course referred to as “late part viral life cycle development” takes within the bloodstream. In a single paper, the researchers, led by Pamela Goirsig of the Institute of Biochemistry on the Norwegian College of Science and Know-how, seemed on the genomes of Ebola samples remoted in Ebola outbreaks in Sierra Leone in 2004 and Guinea in 2013.
In an evaluation of those samples, the researchers discovered {that a} part of the RNA that replicates the virus and produces the attribute hemorrhagic signs additionally produces a bit of the RNA that doesn't. This part doesn't replicate as shortly, limiting the quantity of DNA replication and slowing the number of viruses that may be produced.
After the genetic replication, the researchers recognized a sequence within the protein that encodes the “export equipment” of the virus. The proteins are composed of repetitive DNA sequences and seem in proteins, referred to as globins, which kind of the outer shell of the virus.
In their research, the researchers discovered that Ebola’s DNA replication course produces a pair of proteins that keep the steadiness of the brand-new virus. As soon as the virus enters the bloodstream, the DNA replication course stops, and a brand new copy of the genome is generated that doesn't replicate.
The researchers mentioned this seems to be a “lagging impact” that slows the virus’ progress. The character of this sequence shouldn't be recognized, however, it could have a task in proscribing the unfolding of the virus, which might linger in contaminated tissue and blood vessels for lengthy intervals of time, based on the WHO.
In response to the 2014 research, viral unfold was additionally slowed by the protein’s position in defending the cell from the method of degradation and removal by macrophages.
Such proteins are utilized by many viruses, akin to herpes simplex, and are sometimes implicated in a “keep in place” mechanism.
“It might be that Ebola virus secretion is best contained by (in this case) inhibiting its export, which might additional gradual the unfold of the illness and its signs,” the authors wrote.
Recognizing this course could have broader implications.
“The importance of those findings is to supply a brand new perspective on the management of infectious ailments, which frequently have a viral origin,” Goirsig mentioned in a press launch regarding the research.
“Earlier infectious ailments with a genetic origin akin to diphtheria, measles, and mumps have been managed by inhibiting export of the proteins or parts that represent the virus particles,” she mentioned.
She mentioned the evaluation may have implications for how one can restrict the unfolding of Ebola and different hemorrhagic fevers, which trigger a spread of signs, together with vomiting, diarrhea, inside bleeding, organ failure, and, generally, demise.
The way it could also be stopped
Treating Ebola is extraordinarily difficult, and the mainstay of therapy is to maintain sufferers hydrated and if attainable, give them fluids. As well as, the preliminary days after infection are vital to an affected person’s probability of survival.
The WHO recommends as little as 70 mg of electrolytes a day to assist replenish electrolytes misplaced within the extreme vomiting and diarrhea that characterize the illness. Sufferers who've been uncovered to Ebola, together with healthcare staff, ought to be monitored for 10 days, after which they need to be thought about to be within the clear.
“After all, not all sufferers have a full liver function,” mentioned Dr. Natalie Simeonova, a tropical drugs skilled and medical officer at the WHO’s regional workplace in Senegal. “And sometimes sufferers are very sick. However, even when an affected person has 90% performance, (or) a lot decrease stage of performing, and so they get one-fifth of the blood, it may be used to make plasma or clotting elements.”
Simeonova mentioned the significance of a robust immune system, along with the intravenous fluids and electrolytes, is the willpower of the time and period of follow-up therapy for survivors of the present outbreak.
“When sufferers have recovered, there’s a query of whether or not they have recovered,” she mentioned. “They might nonetheless have the virus of their physique and be weak to growing one other severe sickness.”
Mark Aeschbach, a doctor and assistant professor of infectious ailments at the College of North Carolina mentioned it’s “extraordinarily, extraordinarily tough” to get Ebola sufferers to outlive.
“The usual therapy protocol includes giving them a high-dose intravenous immune-suppressant referred to as brincidofovir, which principally doesn’t treatment Ebola, however ought to assist them to tolerate their sickness higher,” mentioned Aeschbach, who research hemorrhagic fevers and isn't concerned within the present outbreak.
“The priority is that we could solely be capable of dealing with contaminated sufferers for a brief period, and the fatality fee is admittedly fairly excessive. There are 4 recognized deaths within the present outbreak, and the fatality fee is between 50% and 60%,” Aeschbach mentioned.
Whereas using the antiviral drug has been confirmed efficient in mice, Aeschbach mentioned there hasn’t been plenty of testing performed on human survivors in people. The issue in testing for viral particles inside a survivor’s blood can also be a possible roadblock, he mentioned.
And if the present outbreak in West Africa continues, the identical goes for infection-control protocols, Aeschbach mentioned.
“The truth that there haven’t been extra circumstances and that they’re coming down is nice, however, how are we going to manage that?” Aeschbach mentioned. “These items aren’t going to cease except we have now higher management.”
Nina Pham, a Dallas nurse contaminated with the virus, has been launched from Texas Well being Presbyterian Hospital.
Pourier mentioned he believes a worldwide response is required to cease the unfolding of Ebola.
“We've got to remember that the phenomenon of this Ebola epidemic is changing into greater,” he mentioned. “We've got to see it for what it's and to deal with it like every other public well-being drawback. That’s why we must always act accordingly.”
Fatty Liver Disease – Top 7 Things To Keep In Mind
Fatty liver disease – things to keep in mind
The most common type of liver disorder, it can cause a buildup of fat in the liver.It can be caused by factors such as alcohol abuse, diabetes, chronic inflammation and viral infection.
Liver disease is a lifelong condition which can lead to cirrhosis, where the liver becomes scarred and cannot function properly.Known as fatty liver, if it is left untreated it can lead to liver failure, cancer and even death.
The liver is a vital organ that plays a crucial role in digestion, metabolism, and detoxification of the body. However, it can be prone to various disorders, and one of the most common types of liver disorders is fatty liver disease. It is a condition where there is an abnormal accumulation of fat in the liver cells, which can cause inflammation and scarring of the liver tissue.
Fatty liver disease can be caused by a variety of factors, including alcohol abuse, diabetes, chronic inflammation, and viral infections. Alcohol consumption can lead to the deposition of fat in the liver, causing inflammation and scarring. Similarly, diabetes can also cause fat accumulation in the liver, as the body struggles to regulate blood sugar levels. Chronic inflammation and viral infections, such as hepatitis, can also damage liver cells and lead to fatty liver disease.
If left untreated, fatty liver disease can progress to liver cirrhosis, a condition where the liver becomes scarred and cannot function properly. This can lead to liver failure, liver cancer, and even death. Therefore, it is essential to detect and treat fatty liver disease in its early stages to prevent complications.
The symptoms of fatty liver disease can be non-specific and may not be present in the early stages. However, as the disease progresses, symptoms such as fatigue, abdominal discomfort, loss of appetite, and nausea may occur. In advanced stages, patients may experience jaundice, swelling in the legs and abdomen, and easy bruising or bleeding.
Diagnosis of fatty liver disease typically involves a combination of physical examination, medical history, and laboratory tests. Blood tests can help identify risk factors such as diabetes, high cholesterol, and liver enzymes. Imaging tests such as ultrasound, CT, or MRI scans can also help identify fat accumulation in the liver. Liver biopsy is the most definitive method of diagnosis, but it is an invasive procedure that carries risks.
Treatment of fatty liver disease primarily focuses on addressing the underlying cause. For instance, patients with alcohol-related fatty liver disease must stop drinking alcohol entirely. Those with diabetes must manage their blood sugar levels through diet, exercise, and medication. Weight loss through a healthy diet and exercise can also help reduce fat accumulation in the liver. In some cases, medications such as pioglitazone may be prescribed to reduce liver inflammation.
In conclusion, fatty liver disease is a common liver disorder that can have severe consequences if left untreated. It is crucial to be aware of the risk factors and symptoms of fatty liver disease and seek medical attention if they occur. Early detection and treatment can help prevent complications and improve the quality of life for patients with fatty liver disease.
The NHS England is encouraging more than 40,000 doctors and healthcare professionals to sign up to the first ever national patient strategy for liver disease.But people with liver disease shouldn't just settle for the minimum in treatments, with a range of advances coming in the field.
Excess fat in the liver is not a good thing, especially if there is an underlying cause such as type 2 diabetes.
2. Hepatitis C is another cause
Fatty Liver Disease – Top 7 Things To Keep In Mind
Hepatitis C is caused by the hepatitis C virus. This virus affects the liver, and the viruses can be passed on from person to person.It is possible for some people to carry the virus without developing any symptoms.
If people with cirrhosis develop liver cancer, it's very rare, but they are less likely to survive than those with liver cancer who don't have cirrhosis.Most people with cirrhosis will die within a year, but liver cancer can be fatal, if it's detected in time.
Patients are advised to take a test to check if they are infected with hepatitis C if they have been treated for a long time, as this can also increase the risk of cancer.
3. Alcohol plays a role
Fatty Liver Disease – Top 7 Things To Keep In Mind
It's thought that alcohol can damage the liver cells, which can make them accumulate more fat, even if they are not aware they are affected.However, a person can still drink alcohol and not get liver damage.However, drinking too much can be deadly and binge drinking can cause liver damage or worse.To stay safe, many people with fatty liver disease cut down on their alcohol intake.
In recent years, a new donor option has been introduced, allowing people to be a living liver donor.Living liver donors have their own healthy liver, but can only donate part of it.The organ is then matched with a liver which has problems and a liver transplant is performed.While this option is helping to save lives, most people will need a liver transplant at some point in their lifetime.
5. More than one disease
A range of conditions can lead to excess fat in the liver, including cancer and liver diseases.To get rid of the extra fat, you need to manage all of these conditions.Factors such as genetics, high blood pressure, obesity and diabetes, can all cause fatty liver disease.
Other causes of fatty liver disease include chronic inflammation or problems with alcohol or liver damage after a liver transplant.Cirrhosis, cancer and viral hepatitis can also affect the liver, which in some cases can contribute to fatty liver disease.Although, this is unlikely to be a significant contributor.
This removes certain waste products from the blood, but if the liver becomes damaged it can also cause fat to build up.In general, liver damage will cause higher levels of triglycerides in the blood.However, higher levels can sometimes be due to high blood levels of fat in general.Triglycerides are tiny fatty molecules made of fat and cholesterol.Some of these are shed in your poo, but also some are stored in your fat tissue.
If the liver is damaged or enlarged, this fat can end up in the bloodstream.
Normally, this is considered a good thing because excess fat in the blood is often carried away by the blood's thinning, called ‘lipoprotein outflow'.
This is a serious risk factor and often requires treatment.
7. Drugs
Most of the risk factors of fatty liver disease are treatable.
However, certain drugs – some prescribed for other conditions, such as hypertension and diabetes – can also increase the amount of fat in the liver.
Some drugs are also given to people to reduce the amount of fat in their blood, such as insulin.The drug divalproex sodium is often given to people with diabetes. Divalproex can cause people to accumulate fatty liver disease, especially if they are also taking other medicines that reduce insulin sensitivity.It is not clear if this causes the condition or if it is a reaction to taking divalproex.
Other drugs that are known to increase fat in the liver include tacrolimus and metoprolol, both of which are often used to treat a wide range of conditions, including heart disease and kidney disease.
What is fatty liver disease? Fatty liver disease is a serious condition, in which fat is stored in the liver. Liver cirrhosis can be a serious complication of fatty liver disease. It's a severe condition, but there is hope as it can be treated.
Chronic recurrent multifocal osteomyelitis is considered a form of osteomyelitis because it is present in association with a chronic state of inflammation, often associated with an underlying bone infection.
Chronic recurrent multifocal osteomyelitis is very rare.It is usually seen in the elderly or people with rheumatological disorders.t also often occurs in women, but in men is usually associated with a rheumatological disorder.However, rheumatological and osteomyelitis are sometimes seen together in a “pseudo-chondrodysplasia”.
The diagnosis is often made by finding bone infection on radiographs. To evaluate for a more specific diagnosis, labs including X-ray and blood work can be done to identify other medical problems that may be causing inflammation.Laying down bone may also be an indicator. Infectious disease is treated conservatively with systemic antibiotics.
Inflammation is treated with systemic steroids and surgery if required.Depending on the treatment, the course of treatment can be long, but most patients can live normal lives.Pain and radiographic changes usually disappear within a few months after treatment.Ninety to 100% of patients recover from their disease.However, about 30% of patients will experience a recurrence within a year.
If a patient is not treated for the first or second recurrence, the risk of recurrent infection is around 80%.In the United States, Chronic recurrent multifocal osteomyelitis is common and occurs more often in women than in men.Roughly two-thirds of cases of chronic recurrent multifocal osteomyelitis are seen in people over the age of 65.
Chronic recurrent multifocal osteomyelitis has been associated with autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, and lupus.The normal course of chronic recurrent multifocal osteomyelitis is progressive.Progression may occur because the bone lesions weaken the bone's ability to heal itself, become osteophytes and osteoblasts, or support infections that return.It can also be due to granulomatous, chronic vascular, fibrotic or immunosuppressive features.
Treatment is not very different from standard osteomyelitis.Most cases respond well to first line medications including antibiotics, topical steroids and oral corticosteroids.In certain cases, surgery may be required.It may cause pain, but can lead to a full recovery.
Chronic recurrent multifocal osteomyelitis is rare and is most often seen in the elderly or people with rheumatological disorders.Chronic recurrent multifocal osteomyelitis has been associated with autoimmune diseases, including multiple sclerosis, rheumatoid arthritis, and lupus.Frank and Welch (1989) reported that chronic recurrent multifocal osteomyelitis may be associated with Lyme disease and babesiosis may occur more commonly among children than adults, but the incidence of chronic recurrent multifocal osteomyelitis in children is unknown.
Although the majority of cases are in elderly patients, it can be seen in any age group.It has also been reported to be common in Caucasians.
There is also a geographical association between the causative organism and endemicity of chronic recurrent multifocal osteomyelitis.Approximately 85% of cases are associated with “Borrelia burgdorferi”, a spirochete of the genus “Borrelia”, while less than 20% are associated with “Chikungunya” virus. The bacterial causal agent can be identified through histopathological evaluation, usually found in biopsy specimens.
However, the diagnosis may also be made on the basis of serologic testing for Lyme disease.There are five serologic tests for Lyme disease, all of which have been found to have a sensitivity and specificity of 97.9%.
Another way to confirm this diagnosis is through the PCR test.If the diagnosis is in doubt, a standard fungal culture and allopurinol administration is indicated.If the cause of chronic recurrent multifocal osteomyelitis is unclear, a radiological examination with radiographic image guidance is usually helpful.
Historically, biopsy, percutaneous needle biopsy, and discography have been used to diagnose chronic recurrent multifocal osteomyelitis.Despite being a curable disease, the diagnosis of chronic recurrent multifocal osteomyelitis can be difficult due to the lack of imaging techniques and the fact that most patients do not present with symptoms in the early stages of the disease.
The first approach is to establish whether the lesion is a chronic or recurrent lesion, and in that case a specific treatment regimen would be needed.
However, there is still no diagnostic test for chronic recurrent multifocal osteomyelitis.Histopathological examination may be useful in determining the diagnosis of chronic recurrent multifocal osteomyelitis.
Positron emission tomography is the most commonly used imaging technique for evaluation.In addition, there is a limited number of studies that have been done on comparative outcome studies for chronic recurrent osteomyelitis to evaluate patient morbidity and mortality.Most patients with chronic recurrent multifocal osteomyelitis appear to improve with the appropriate treatment and the majority remain symptom-free.
Almost all patients had a complete resolution of their symptoms by the end of the initial hospitalization.A key issue in treating chronic recurrent multifocal osteomyelitis is identifying patients early in their illness, before it becomes severe.There is a high rate of relapse of chronic recurrent osteomyelitis.
Patients with chronic recurrent osteomyelitis and bone metastases have a poorer prognosis.A 2011 study found that the median survival time from the first diagnosis of chronic recurrent osteomyelitis was 17.8 years.There is significant functional disability associated with chronic recurrent multifocal osteomyelitis and the main functional limitation is loss of function.
The most common signs and symptoms of chronic recurent osteomyelitis are fever, joint pain and swelling.Symptoms may vary from day to day and it may take a while before a patient is diagnosed with chronic recurrent osteomyelitis.
Another significant symptom is joint pain or swelling, as this is usually detected more quickly.As the disease progresses patients may have joint pain associated with swelling, or even both at the same time.Other clinical findings are redness, pain or aching of joints, red patches (ughurt) on the skin, shortness of breath, swollen lymph nodes, headache, or spasms of the muscles.
Some symptoms are bilateral and some are unilateral.Additionally, skin rashes (such as erythema nodosum) and facial swelling may be present, as well as nail loss.Most of the signs and symptoms of chronic recurrent osteomyelitis can also occur during the course of the infectious period.More than half of the patients with chronic recurrent osteomyelitis presented with arthritis at the onset of the disease.
Joint pain is usually worse on the affected side.Joint pain is rarely palpable or painful, and most patients describe the joint pain as stabbing or electric-like.Less commonly, patients may have pain in the neck, lower back, shoulders, and/or upper arm.Fever is most common with chronic recurrent osteomyelitis.An elevated body temperature is associated with both secondary (temporary) infectious osteomyelitis and chronic recurrent osteomyelitis.
There is evidence that arthritis is more common in chronic recurrent osteomyelitis than in osteomyelitis caused by other infectious agents.In addition, most patients with chronic recurrent osteomyelitis experience a secondary arthritis later in the disease, which is not associated with the initial disease.Chronic recurrent osteomyelitis is usually preceded by signs or symptoms
.In chronic recurrent osteomyelitis, skin rashes (erythema nodosum) are common in the first year after the onset of the disease.
In addition, most patients with chronic recurrent osteomyelitis experience symmetrical swelling of the upper extremities at the site of the current infection.Conversely, patients with chronic recurrent osteomyelitis usually have asymmetrical swelling of the lower extremities and soft tissue deformities (i.e.; fistulas).
Secondary osteomyelitis may also occur with chronic recurrent osteomyelitis.Secondary infections are usually localized and caused by T. balneosemia.Other causes include bacterial bone abscess, dermatofibrosarcoma, non-venomous mycobacterium or other infections.
Most cases of secondary osteomyelitis occur after the primary infection has resolved.Approximately 20% of secondary infections occur in the acute phase of the disease.In most cases, there is evidence that infections are viral in nature, but are usually not recognised as such, and secondary infection is considered to be a medical pathology in its own right.
Secondary infections are associated with a number of problems; shortness of breath, headache, recurrent fever, joint pain, and sometimes skin rashes and facial swelling.Primary osteomyelitis is most commonly seen in the hips and knees
.It has been reported on the hands, legs, spine, face, abdomen and breasts.Sometimes bone changes, bone migration and the formation of bone cysts are seen.
These secondary changes are often benign.These bones can become damaged if the person who is infected is suddenly removed from their normal environment.Chronic recurring osteomyelitis is extremely rare.Since 2000, there have been only 11 confirmed cases of chronic recurrent osteomyelitis in the United States.
Chronic recurrent osteomyelitis in the United States has a relatively low mortality rate, most patients live long enough to require amputation of some of their limbs.
In one study, 13.8% of patients died while undergoing surgical or percutaneous removal of infected bone, with 4.4% of these patients dying as a result of infection in the space of 24 hours, with 6.9% dying from infection following surgery.
Another 6.9% died as a result of complications of surgery and infection, with 2.4% of these deaths being related to the causes of infection, with 4.3% from underlying conditions and 2.5% from complications of amputation.
Chronic recurrent osteomyelitis is a rare condition, usually occurring in people in their 20s and 30s.However, in some studies, it has been found to be more common in children, with 1.5–3.0% of patients developing chronic recurrent osteomyelitis by the time they are 20 years old.
It is usually found in the hip or the spine of young adults.In Australia, the incidence of chronic recurrent osteomyelitis is low, with only 15 cases reported in the five year period from 2006 to 2010.Most cases are initially misdiagnosed, as most have no accompanying signs or symptoms.
It is unclear how prevalent chronic recurrent osteomyelitis is in the US, but according to a 2010 study, it may be as high as 1.2%.Notable cases of chronic recurrent osteomyelitis in the 20th century included athletes like Florence Griffith-Joyner, Jackie Joyner-Kersee, Esther Williams and Jessica Loder Bergman.Many public figures who have died have also been diagnosed with chronic recurrent osteomyelitis, including former US president Theodore Roosevelt and former US president Richard Nixon.
Secondary osteomyelitis is more common than primary osteomyelitis.Primary osteomyelitis in children, particularly those under the age of 15, is rare.Some experts believe that this is due to the occurrence of pressure sores and infection in the space around the buttocks which are more likely to become infected during childhood.
Around 1 in 40 to 1 in 60 adolescents will develop osteomyelitis at some point in their life.Some cases of primary osteomyelitis in children can be very serious, involving the amputation of a leg or fingers, or even death.Secondary osteomyelitis in children is typically more severe.In this type of osteomyelitis, the bone abscess develops due to an infection occurring outside of the original location of bone infection.
Secondary osteomyelitis in children can present as primary infection around a secondary site.It can also be due to primary infection of a secondary site.Most cases of secondary osteomyelitis in children are due to bacterial infections.Secondary osteomyelitis in children is more likely than in adults to develop complications.
This can include a reaction to antibiotics, sepsis, or septic arthritis.The serious complications that can arise are much more common in children than in adults, and can lead to death or permanent disability.Other serious complications that have been reported in children are liver failure, kidney failure, and bone lesions, especially at the site of the bone infection.Chronic recurrent osteomyelitis in adults is rare.
The National Institutes of Health (NIH) estimates that less than one case is diagnosed each year in the US.It is most commonly seen in young adults, with the age of incidence of around 20 years.As of 2011, the incidence of chronic recurrent osteomyelitis was estimated to be 0.21 cases per 100,000 adults per year.In the United States, the National Osteoporosis Foundation estimates the incidence of osteomyelitis to be 6 per 100,000 people per year.
Worldwide, chronic recurrent osteomyelitis is much less common.One estimate based on data from 2010 suggests the prevalence to be less than 1 case per 100,000 people per year.The incidence in Australia is estimated to be 1 case per 10,000.
The most common site of infection in people with chronic recurrent osteomyelitis is the buttocks.More than half of all cases of chronic recurrent osteomyelitis are as a result of eroding bone, most commonly occurring in the back.A small number of cases are caused by rickets, but this is uncommon.
Over 80% of cases have a definitive cause, with the most common being osteomyelitis due to sexually transmitted disease or bacterial infection.Chronic recurrent osteomyelitis is not caused by the autoimmune disease known as rheumatoid arthritis.Researchers still do not know the exact cause of chronic recurrent osteomyelitis, and therefore, there is no treatment that is specific to this condition.
There are a number of treatment options for chronic recurrent osteomyelitis.
The main treatment option is surgery.There are many different surgeries available depending on the location of the infection and other factors.Permanent debridement is performed to remove the infection, or bone necrosis caused by infection.Typically, the infection surrounds a nerve, such as that of the genital area or the breast.
The infection is covered with flesh, usually removed during surgery.Arthroplasty is a minimally invasive surgery used to replace the fractured femur.While this is done, the previously healthy bone around the femur is harvested and used to replace the affected bone.
A growing number of cases of chronic recurrent osteomyelitis in the rectum occur due to Erythema nodosum, a bacterial infection.
While this is not an infection of the bone itself, it can be treated similarly.
How to improve eye sight : Lots of us wear glasses. And lots of us struggle with vision issues. In most cases, our vision is a function of how much light hits our retina. And the more light, the better. If we block out most of the light, it becomes difficult to see well.
People can get different degrees of vision impairment, and the various degrees are not always easy to diagnose.
With the right advice, vision problems can be solved.
It is now possible to improve your ability to read without your glasses.
Medical experts say you can actually train your eyes to see the world.
After multiple attempts, your eyesight improves enough to recognize obstacles, read small print, detect movement and your ability to read becomes sharpened and accurate.
In a recent article on ABC News, research published by professors at UC Davis confirmed a new method to improve your ability to read without your glasses.
The scientists started their research by having a group of the volunteers watch a black and white video.
“When you look at the visual stimulus from the periphery, your vision isn’t that sharp. It’s blurry,” said researcher Malgorzata Ojbramskaja.
Next, the participants got their eyes checked using a monocular distance test to measure their ability to read small print.
The researchers found that, in general, the participants had a fairly good ability to read small print, but most of them had trouble with identifying objects that were close by.
They suspected that, because most people struggled with identifying objects in a three-dimensional space, there must be some mechanism that could sharpen their vision.
They took four volunteers and performed a retinal fluorescence test. The test measures how much the brain can interpret a light signal and how much light reaches the retina.
In one test, the researchers presented images to the volunteers with a number of different colors. Some were a blend of blue and green and the participants were instructed to only focus on the blue and green in each frame.
Other images included a combination of blue and green or just a small splash of blue and green. Participants were given about a second to decide whether they could tell if the image was blue or green.
In another experiment, the researchers had the volunteers stare at a screen for two seconds and then report how bright the image was.
According to the researchers, when a person tries to compare two different colors, his or her vision is worse than it should be. But, when the brain has trouble comparing two different objects in space, it is better.
After making the visual connections, the volunteers had the visual fluorescence test.
When a number of the volunteers received the fluorescence test, they had a vision test and their eye movements were monitored. The researchers found that the people with poor vision were more likely to make the wrong connection between the blue and green and bright objects.
“In order to improve your vision without glasses, you need to improve your vision without comparing objects,” said Ojbramskaja.
The researchers found that the participants who were better at finding bright objects had a more focused and sharp vision in the periphery.“Usually, the peripheral vision is the weakest vision. It doesn’t provide very rich information. So, if you’re going to improve vision, you’ll focus on your peripheral vision,” Ojbramskaja said.
The participants who were helped by the training had a sharper vision in the peripheral. This improved vision made them better at seeing objects closer to them.The researchers believe that training the brain to get out of the habit of comparing two different objects in space can help people with visual impairments to see objects that are far away. “I would strongly recommend that the help is available. People need to be aware of the problem, to know it exists and how to help themselves,” Ojbramskaja said.
The researchers suggest that improving vision without glasses is not something that a person with normal vision should pursue. It is a lifelong process. However, if the goal is to be able to read without glasses, this may be an easy process that most people can take on.The researchers are currently exploring the effects of exercise on vision. Their research suggests that people who exercise often have better vision than people who don’t exercise.
With the right training, your experience of the world around you can be very different than before.
More than half of adults say that reading is one of the most difficult activities for them to accomplish without their glasses. In fact, people who have eye issues like glare, blurred vision and glaucoma are twice as likely to say they read less than people who have no such problems.
If you are having trouble reading, and you would like to improve your vision without your glasses, there are a variety of health issues that you may want to address with a doctor. If the symptoms are mild, you will likely not need any special treatment. But if your problem is more severe, a visit to a doctor could help your vision get back to normal.
English is a second language for most people, so it’s very important to follow simple visual rules that will help you keep your vision healthy. The most important of these rules, says pediatric ophthalmologist Dr. Michael Schwitzgebel, is that you should not have any objects in your direct line of sight.
He also says that you should avoid head movement when reading. “Your head and your eyes are not meant to be at the same place at the same time,” says Schwitzgebel. And too much head movement is a common cause of problems like blurriness and vision changes.
Try these tips on for size.
Instead of holding a phone in your hand or holding a magazine open while you read, sit down and read with a light in front of you.
Blurry areas that cause you problems will appear dark to your vision, giving your eyes a chance to focus on what you are reading.
Put up the blinds on your windows and turn off the light when you are reading. The lack of light will keep your eyes from focusing on spots that are not there.
Make sure that you have enough light to see by. Your eyes work by seeking out what is in front of you. A glare will make it harder for you to read.
The eyes will not be able to adjust to light if there is no light in the room. So turn on a lamp or light up your room.
Try reading in the afternoon, when it is dark outside. This is when you will see the most improvement, because there are fewer distractions.
You should also avoid staring at your phone for a long time, because your eyes will be trying to move toward the bright light of the screen.
If you suffer from light sensitivity or glare, take off your glasses and look through a lens or a magnifying glass instead.
If you’re having difficulty seeing the fine print, put a piece of white paper in front of you and hold it against the window so that light is behind it.
If you have difficulty with low light, leave your curtains open at night and put your light on a timer so that you are waking up to the same amount of light in the morning as you are leaving for work.
Go to a magnifying glass store and try out different lenses that can help.
Another quick tip is to put some cotton balls in your shirt pocket, put your reading glasses in the pocket and when you need to use them, grab them from your pocket.
It might take a little practice, but this can go a long way toward improving your eyesight.
Treatment for prader willi syndrome : Prader Willi syndrome (PWS), also known as Prader-Willi syndrome, a congenital metabolic disorder, is a life-threatening, inherited condition of decreased sensitivity to, and obesity resulting from, eating. PWS is caused by a lack of the neurotransmitter leptin, which causes a large quantity of food to be stored in fat deposits in the body and prevents the body from burning calories. The syndrome affects approximately one in 2,000 births. Individuals with PWS are affected by learning disabilities and are at a high risk for obesity.
The illness is caused by abnormal cells in the brain and often does not occur until puberty. The syndrome typically shows symptoms in infancy or early childhood, but the onset can occur at any time.Fast facts about PWS Approximately 200 individuals have been diagnosed with PWS
Individuals are unable to regulate food intake.Treating PWS is possible with specialized dietary therapy. People with PWS have a three-finger span and a facial appearance that shows abnormality in facial features and small mouth size. The illness impacts the ability to walk, talk, and use the arms. Some individuals may also have learning disabilities.
The disorder has three main types:
Polymorphic PWS
In this type, all of the cells in the hypothalamus — the area of the brain involved in hunger, appetite, and emotions — are affected, causing a type of PWS called polymorphic PWS. In polymorphic PWS, cells that are involved in regulating food intake and energy expenditure are not affected by the lack of leptin.When a person has polymorphic PWS, the body attempts to compensate for the lack of the hormone by using a chemical called ghrelin to increase appetite. The body ultimately becomes unable to regulate food intake.
Affected individuals typically exhibit serious physical characteristics, including shortened stature, severe obesity, and a shortened waist circumference. People with polymorphic PWS typically weigh between 30-50 kg (66-95 lbs), while those with monogenic PWS typically weigh more than 20 kg (44 lbs).
Children and adolescents with PWS are also at a high risk of developing osteoporosis and diabetes.
Inherited PWS
In this type, the disorder is the result of a mutation in the gene that regulates leptin. Although rare, inheritable forms of PWS are caused by mutations in the OR6A2 gene. The mutation is passed down from parent to child.PWS children also typically exhibit mild facial and skeletal features of monogenic PWS.Finally, mutations that cause polymorphic PWS have been identified and documented. However, there is currently no treatment for polymorphic PWS.
Transient PWS
Transient PWS is caused by an infection or other stress that disrupts the body's ability to properly respond to leptin.People with this type of PWS typically recover within one to two weeks.
Treatments for PWS
If no treatment is available, PWS treatment usually depends on how severe a person's PWS is and how severe the food-related behavior is. The treatment may include lifestyle changes and diet, and/or, if necessary, insulin or another hormone replacement therapy.Family history can also play a role in the severity of PWS.
Diagnosis
Obesity may be diagnosed in people with PWS.If a child has an illness that is a risk factor for PWS, it is important to see a doctor to determine whether or not it is genetic. Testing for PWS may be required.
Diagnostic testing can be done at most paediatricians' offices or by a doctor specialized in PWS.PWS is diagnosed using the International PWS Study, which involves clinical, laboratory, and genetic evaluations of an individual suspected of having PWS. A diagnosis requires confirmation by DNA sequencing.
The following questions can help a doctor diagnose PWS:
Has the person ever been diagnosed with PWS?
Is there an unusual facial feature associated with PWS?
Has the person had any other medical problems?
Do symptoms or a family history suggest that PWS may be present?
A doctor may recommend genetic testing to confirm or rule out PWS.
When to see a doctor
People should seek medical care if they experience signs and symptoms of severe weight loss or hunger.
Anyone who suspects that they or their child have a medical condition that could be triggering PWS symptoms should visit a doctor. People should seek medical care if they experience signs and symptoms of severe weight loss or hunger.
Anyone experiencing some of the following symptoms should contact a doctor immediately:
Problems with the mouth, including difficulties chewing or swallowing
PWS is rare. The life expectancy for people with PWS is between 10 and 15 years from the onset of symptoms.However, the potential for developing new health complications may increase with age.
Foods that are on the safe, lower-risk list include whole grains, fruits, vegetables, and low-fat or fat-free dairy.While a variety of foods can be tolerated, other foods can make individuals with PWS feel nauseated or sensitive to taste. People with PWS should also be careful with foods with high-fructose corn syrup or refined sugar.
Foods with a high fat content are also usually avoided. Foods with a high fat content can often cause bloating or gas. This can lead to a loss of appetite and weight loss, and this could lead to dehydration, muscle weakness, and other complications.As with any other medical condition, it is essential to follow a doctor's recommendations regarding food and nutrition.
Meal planning can help individuals with PWS prepare healthy, balanced meals. Meal planning can help individuals with PWS prepare healthy, balanced meals.
Routines: For each day of the week, meals should be planned, and several meals should be set aside for the week. When a routine is in place, people will know what to eat, and they can count on having a balanced diet.
Foods: Selecting food items that are easy to eat is a good idea, but eating healthy can be difficult. Make sure that foods are easy to digest, especially when they are new foods.
Stick to a list: Make a grocery list with food options that are simple to prepare. Once a person has decided what to buy and prepare, they can stick to the plan.
Diet and activity: People with PWS should get plenty of exercise, and they should increase their activity over time. However, they may need some assistance with it.
When to see a doctor
People with PWS should see a doctor if they experience severe weight loss, difficulty with swallowing, gait problems, or joint pain.Many of the most common complications of PWS can be treated with over-the-counter medications, including:
Dietitians, physicians, and other health care professionals can provide care and guidance to people with PWS in person or over the phone.Although people with PWS often face medical challenges, there are many benefits to living with the condition.Living with PWS gives people with PWS the opportunity to understand what their food and other nutritional needs are, and they are given the option to consume foods that are safe and wholesome.
Anyone concerned about symptoms or symptoms of PWS should speak to their doctor.
According to the website Beyond PWS, PWS can be managed through a combination of special education classes and nutritional therapy.Many individuals with PWS have gone on to have rewarding careers and live fulfilling lives, even though their early lives were filled with frustration.Like people with any condition, PWS can be challenging, but it is possible to live a full and happy life with PWS.
Many people with PWS are able to lead fulfilling and happy lives. According to Beyond PWS, those who are able to learn to eat better foods and manage any medical complications with a supportive network of people and doctors.Eating a well-balanced diet and being active can give those with PWS an additional level of support. Those with PWS should work with their doctor to learn what foods are appropriate for their needs.The best way to prevent the complications of PWS is by eating a varied diet, avoiding supplements, and avoiding insect bites and stings.Individuals who have questions about managing PWS and living a full life with the condition can talk to a doctor or other health care professional.
PWS can be difficult to diagnose because there is often no identifiable cause. Also, while there are many genetic causes of PWS, many of them are not linked to PWS.
Risk factors include:
Genetic factors: PWS can be genetic and is typically passed from the parents to their children. For example, two of every 100 people with PWS have a parent with PWS, and the parents themselves have PWS.
PWS can be genetic and is typically passed from the parents to their children. For example, two of every 100 people with PWS have a parent with PWS, and the parents themselves have PWS. Inherited disease: The condition can also be inherited. For example, PWS is an inherited form of food allergy.
The condition can also be inherited. For example, PWS is an inherited form of food allergy. Familial hyperinsulinism: This condition, inherited through the BRCA1 or BRCA2 genes, is characterized by extreme insulin resistance and high blood sugar.
This condition, inherited through the BRCA1 or BRCA2 genes, is characterized by extreme insulin resistance and high blood sugar. Renal failure: People with PWS often have kidney problems or kidney failure.
People with PWS often have kidney problems or kidney failure. Certain medications: PWS may also be caused by certain prescription medications. Anyone who is taking one of these medications should talk to their doctor to find out if the medication is making them feel unwell or if it may be causing symptoms of PWS.
PWS can also be caused by a few known conditions, including:
Epstein-Barr virus (EBV): This virus can cause genetic changes that are passed on to future generations. Some studies have linked PWS to EBV infections.This virus can cause genetic changes that are passed on to future generations. Some studies have linked PWS to EBV infections. Diabetes: People with PWS often have high blood sugar or diabetes.
People with PWS often have high blood sugar or diabetes. Hepatitis C: According to the website PWS and Your Relationship with Hepatitis, people with PWS have a 1.7 to 2.7 percent chance of having a severe form of hepatitis C.
According to the website PWS and Your Relationship with Hepatitis, people with PWS have a 1.7 to 2.7 percent chance of having a severe form of hepatitis C. CRPC: This condition, also known as chronic kidney disease, is not known to be connected to PWS.
What are the symptoms of PWS?
Some of the early signs of PWS include:
Frequent urination and thirst
A strong and persistent urge to go to the bathroom
Difficulty staying awake during the day
When it is daytime, a person may find it difficult to maintain an alert state
Difficulty with eating
Lack of interest in food
Achiness in hands and feet
Feeling tired easily
Shiny skin (serum jaundice)
What are the symptoms of PWS in children?
Children may also have some of the symptoms of PWS, but may not be able to express it to doctors.
Some of the symptoms of PWS in children include:
Lack of interest in food
Becoming lethargic and listless
Making slow movements, such as swaying from side to side
PWS is a lifelong disorder that impacts people's ability to communicate, learn, and carry out day-to-day tasks. Some treatments include insulin, blood sugar, and in some cases a PEG-tube feeding system.
The outlook for people with PWS depends on their age, medical condition, and social environment.
Prevention
There is currently no cure for PWS. PWS is a lifelong disorder that impacts people's ability to communicate, learn, and carry out day-to-day tasks. Some treatments include insulin, blood sugar, and in some cases a PEG-tube feeding system.
There is currently no cure for PWS. However, there are several ways to reduce the risk of complications.
In addition, PWS is often diagnosed in childhood when children are around five or six years old. To identify signs of PWS, doctors recommend that parents ask about the symptoms of PWS, including any unusual weight loss, in their child.
How do people with PWS manage the condition?
In many cases, people with PWS manage their condition with their family doctor and pediatrician. Treatment is available to lower blood sugar levels, stabilize blood pressure, and treat skin disorders.Medications for PWS include insulin, a type of medication that helps the body use carbohydrates to process sugar, and a drug called metformin. These are taken by mouth.People with PWS are also advised to eat a balanced diet, including low-carbohydrate, high-fat foods.A PEG-tube feeding system is used to feed a person through a tube in the stomach or the small intestine. People with PWS cannot eat normally because of their inability to regulate their eating habits. The tube lasts up to four years and is usually removed after a person reaches adulthood.
Prevention of PWS may be possible by being mindful of food allergies and avoiding foods that can cause an allergic reaction. It may also help to limit meals that are rich in fat or sugar.
Because PWS is a lifelong condition, most people with PWS will always be at risk for complications of the condition.
With timely and effective treatment, most people with PWS do have productive lives. Some people with PWS are able to work in jobs and do well at school. Some people with PWS may also have children.
Unfortunately, many people with PWS never reach adulthood. A few people with PWS have died while they were children due to complications of the condition.
These complications include:
Possible heart and kidney disease
Impaired physical development
Cerebral palsy
A heart defect
Diabetes
Lowering the risk of complications and living a full life with PWS depends on the severity of the disorder. A person with severe PWS may need continuous monitoring and therapy.
Outlook for families of people with PWS
When a parent with a child with PWS has another child, the child may inherit the disease. This can mean that other siblings also have PWS.For example, siblings may have to undergo insulin shots because they also have blood sugar problems. If the sibling does not have PWS, they will need to know how to take medication if they ever need it.Family members of people with PWS should be aware of the potential risks of passing the disease to children.
PWS is a lifelong condition that cannot be reversed. Therefore, it is vital for parents to educate themselves about the condition before having children. They should also be aware of the signs and symptoms of the condition.If a child does not have PWS but does have the same genes as the affected sibling, the child is at risk of having PWS. This is called a “carrier” trait.
PWS does not usually cause behavioral or physical symptoms until a person reaches puberty, but it may occur earlier.Parents of people with PWS should be aware that many people with PWS have difficulty gaining weight in adulthood.Encouraging a child with PWS to take regular exercise and eat a healthy diet can help to minimize or prevent weight gain and delayed puberty.
For many people, regular exercise helps with controlling glucose levels. There are also many vitamins and medications available to help people with PWS.
Summary
People with PWS usually have severe weight problems as adults. This may affect their ability to maintain a healthy weight or lead a normal life.Many people with PWS also have other medical issues, including diabetes and cardiovascular issues. Most people with PWS learn to manage their condition to a high degree of success and manage the disease well into adulthood.
However, complications may occur and require special care.PWS can affect a person's mental development and affect their ability to function on a daily basis. Treatment for PWS is available and often includes insulin, oral medications, and the use of the feeding tube.Many people with PWS reach adulthood and continue living full, independent lives.In more rare cases, people with PWS can develop health problems in their hearts or kidneys.
Sometimes, children with PWS are born without the usual number of chromosomes and develop later than is typical. It is unclear why this happens, but it is likely a combination of genetic and environmental factors.The older children with PWS are, the less likely they are to become obese or develop diabetes.
In rare cases, people with PWS may die in infancy or early childhood.PWS is a lifelong condition that is partly genetic and partly environmental. The genes that cause PWS are also associated with many other medical conditions.The development of PWS also depends on other factors, such as a person's lifestyle and the quality of their health care.
Understanding the diagnosis and potential complications is important for the parents and their children. In some cases, if children have genetic or physical health problems, they may also have problems with self-care or self-injury.Existing research suggests that early intervention is beneficial for those who have PWS. In people who have PWS before puberty, they may experience a slower onset of puberty and delayed puberty.PWS and related disorders can affect a person's mental development. This may affect how well they function and may make life more difficult for them.
Anyone concerned about a child with PWS should discuss it with their doctor or other healthcare professionals.It is important to consider the effects of PWS on the physical development of the child. Anyone with PWS should talk to a doctor to understand how best to manage their condition.As well as treating people with PWS, it is also important for the family and caregivers to be aware of the potential risks of PWS and how to reduce those risks.
Any changes to diet and medication should be made in consultation with a doctor and other healthcare professionals.Regular exercise and an active lifestyle may help to slow down the pace of PWS in those who are still at risk of becoming obese or developing diabetes.
There’s no precise formula for how much sleep a person needs; each person needs a different amount for different reasons, says Dr. Ned Sharpless, director of the Emotion and Self-Regulation Laboratory at the University of North Carolina at Chapel Hill School of Medicine. People who need less sleep are generally better rested because their bodies are already in a state of reduced wakefulness. Their minds have already cleared their immediate thoughts and they’re ready to be calm and balanced, Sharpless says.
Sleep also boosts the body’s physical processes, such as the liver’s production of hormones that regulate blood sugar. “Without that extra sleep, that would not be happening,” says Kelli Miner, an associate professor at the Harvard School of Public Health. That said, healthy adults require eight hours of sleep a night.
Miner cites three major behavioral and medical conditions that can affect a person’s sleep: depression, sleep apnea and insomnia. “Some people have a real hard time when they’re depressed or have insomnia,” Miner says. “If someone is depressed and can’t sleep, they may not even want to get out of bed, because it would mean they would have to do something about their feelings.” For those with insomnia, suppressing that urge to sleep can be the key to avoiding the feelings that can become so overwhelming that people can’t deal with them in any other way. “They can become withdrawn, depressed,” Miner says.
Why Do Some People Need Less Sleep
Trying to beat insomnia by avoiding going to sleep on a nightly basis and then trying to sleep at night is a big mistake, Miner says. “That can cause the problem to get worse,” she says. “If you’re able to rest at night and go to sleep, that doesn’t necessarily mean you’re less sleepy. You may just be able to fall asleep on time because you’re so well rested.”
About half of American adults are affected by sleep apnea, says Ramani Durvasula, a neuroscientist and assistant professor of psychology at Stanford University. But only about a third of them have been diagnosed, she says.
Sleep apnea is a serious disorder that prevents people from breathing at least 30 seconds at a time during sleep. People who suffer from sleep apnea can wake up several times a night gasping for air. The disorder is linked to a variety of health problems, including cardiovascular disease, high blood pressure, diabetes and a greater likelihood of having a stroke. Many of these health problems can be fatal.
“These people become tired, they have blood sugar problems, they have metabolic problems and depression,” Durvasula says. “Those kinds of things come along with this reduction in oxygen.” In addition, a person with sleep apnea may have a difficult time thinking clearly.
Like many types of depression, sleep apnea is more common in people who have higher levels of depression or anxiety, Miner says. In fact, she says, people with depression tend to be more at risk for sleep apnea. “A lot of it is linked to depression,” Miner says. “If you have a lot of depression, you may not be getting enough sleep and therefore not feeling well rested.”
In the study that provides the most accurate estimate of sleep apnea in the general population, those between 18 and 45 had an average of 18 apnea events per hour (a typical sleep episode for a person without sleep apnea is four or five per hour).
Why Do Some People Need Less Sleep
“The larger this percentage of people who have sleep apnea is, the more acute the problem becomes,” Miner says. “If you have only one person with sleep apnea in the same room as you, you may not notice it, but multiply that by a thousand people, and you’re suddenly at risk for pretty serious problems.”
Doctors and psychologists can often detect sleep apnea simply by asking a patient to complete a questionnaire about his or her sleep habits, Durvasula says. People who are overweight and not very active may not notice that they are breathing less than their peers.
Obstructive sleep apnea usually shows up during sleep when the throat relaxes and the airway becomes partially blocked. The most common form of sleep apnea is obstructive, which occurs when tissue that separates the two top nasal passages or two lower airways narrows. When the nose is blocked, air cannot flow through the airway, which prevents a person from breathing. The most common reason for obstructive sleep apnea is a congenital defect in the brain’s softening, shearing or softening mechanisms.
“Even though we know that sleep apnea is associated with cardiovascular problems, there is not a lot of research showing that it’s linked to depression,” Durvasula says. “We know that [sleep apnea] can be part of depression, but now we’re starting to understand more about why that is.”
In addition to causing fatigue and depression, obstructive sleep apnea can cause an increased risk of hypertension, high blood sugar, insulin resistance and cardiovascular problems. More than 50,000 U.S. deaths are caused by cardiovascular disease each year, but untreated sleep apnea is one of the most common causes of cardiovascular problems, according to a recent report from the American Academy of Sleep Medicine.
Approximately one-quarter of people with sleep apnea are obese, which adds to the severity of the problem, Durvasula says. “Obesity can affect the body’s way of reacting to oxygen, so that can cause a more severe form of the condition.”
For some people with sleep apnea, there is no cure. A general treatment is to wear a continuous positive airway pressure (CPAP) machine that will keep air flowing through the airway, Durvasula says. “The good news is that patients can use the machine themselves and get a sense of what it feels like and adjust accordingly,” she says.
A CPAP machine will cost around $600 to $700, depending on how many filters and accessories are needed. “In some ways, it’s similar to oxygen tank therapy in that people will have to see a doctor and get fitted,” Durvasula says. “But you do the sleep study and the doctor starts you out with a machine to see how well you do. You can really get back to the most basic life with a CPAP machine.”
In this study, people who were prescribed an inexpensive continuous positive airway pressure device had significantly improved quality of life compared to people who were simply told they had sleep apnea, Durvasula says. “CPAP really has a number of effects, including improving a patient’s ability to get and stay asleep, decreasing daytime sleepiness and sleepiness,” she says.
Doctors and researchers have identified a variety of physiological mechanisms underlying the effects of sleep apnea, and some of the causes are tied to genetics. Durvasula says the role of sleep apnea in people with mood disorders has been a hot topic of research in the last decade. “Maybe some of the [sleep disorder] symptoms are caused by a combination of the sleep disorders and a history of depression,” she says. “I think it’s important that we do more research to see if the symptoms can be directly linked.”
Sleep also boosts the body’s physical processes, such as the liver’s production of hormones that regulate blood sugar. “Without that extra sleep, that would not be happening,” says Kelli Miner, an associate professor at the Harvard School of Public Health. That said, healthy adults require eight hours of sleep a night.
Miner cites three major behavioral and medical conditions that can affect a person’s sleep: depression, sleep apnea and insomnia. “Some people have a real hard time when they’re depressed or have insomnia,” Miner says. “If someone is depressed and can’t sleep, they may not even want to get out of bed, because it would mean they would have to do something about their feelings.” For those with insomnia, suppressing that urge to sleep can be the key to avoiding the feelings that can become so overwhelming that people can’t deal with them in any other way. “They can become withdrawn, depressed,” Miner says.
Trying to beat insomnia by avoiding going to sleep on a nightly basis and then trying to sleep at night is a big mistake, Miner says. “That can cause the problem to get worse,” she says. “If you’re able to rest at night and go to sleep, that doesn’t necessarily mean you’re less sleepy. You may just be able to fall asleep on time because you’re so well rested.”
About half of American adults are affected by sleep apnea, says Ramani Durvasula, a neuroscientist and assistant professor of psychology at Stanford University. But only about a third of them have been diagnosed, she says.
Sleep apnea is a serious disorder that prevents people from breathing at least 30 seconds at a time during sleep. People who suffer from sleep apnea can wake up several times a night gasping for air. The disorder is linked to a variety of health problems, including cardiovascular disease, high blood pressure, diabetes and a greater likelihood of having a stroke. Many of these health problems can be fatal.
“These people become tired, they have blood sugar problems, they have metabolic problems and depression,” Durvasula says. “Those kinds of things come along with this reduction in oxygen.” In addition, a person with sleep apnea may have a difficult time thinking clearly.
Like many types of depression, sleep apnea is more common in people who have higher levels of depression or anxiety, Miner says. In fact, she says, people with depression tend to be more at risk for sleep apnea. “A lot of it is linked to depression,” Miner says. “If you have a lot of depression, you may not be getting enough sleep and therefore not feeling well rested.”
In the study that provides the most accurate estimate of sleep apnea in the general population, those between 18 and 45 had an average of 18 apnea events per hour (a typical sleep episode for a person without sleep apnea is four or five per hour).
“The larger this percentage of people who have sleep apnea is, the more acute the problem becomes,” Miner says. “If you have only one person with sleep apnea in the same room as you, you may not notice it, but multiply that by a thousand people, and you’re suddenly at risk for pretty serious problems.”
People with sleep apnea are at a greater risk of having heart attacks and strokes, Durvasula says, which can be a life-threatening problem. But she and other sleep apnea researchers point out that stroke risk is reduced by the fact that the lack of oxygen in the blood carries a mild wake-up feeling that prevents people from suddenly becoming aggressive and not wanting to wake up to a medical emergency. “If you can get a good night’s sleep and wake up feeling clearheaded, then you may not have the need to use the phone or the 911 emergency number for your heart to be palpitating,” Durvasula says.
Doctors and psychologists can often detect sleep apnea simply by asking a patient to complete a questionnaire about his or her sleep habits, Durvasula says. People who are overweight and not very active may not notice that they are breathing less than their peers.
Obstructive sleep apnea usually shows up during sleep when the throat relaxes and the airway becomes partially blocked. The most common form of sleep apnea is obstructive, which occurs when tissue that separates the two top nasal passages or two lower airways narrows. When the nose is blocked, air cannot flow through the airway, which prevents a person from breathing. The most common reason for obstructive sleep apnea is a congenital defect in the brain’s softening, shearing or softening mechanisms.
“Even though we know that sleep apnea is associated with cardiovascular problems, there is not a lot of research showing that it’s linked to depression,” Durvasula says. “We know that [sleep apnea] can be part of depression, but now we’re starting to understand more about why that is.”
In addition to causing fatigue and depression, obstructive sleep apnea can cause an increased risk of hypertension, high blood sugar, insulin resistance and cardiovascular problems. More than 50,000 U.S. deaths are caused by cardiovascular disease each year, but untreated sleep apnea is one of the most common causes of cardiovascular problems, according to a recent report from the American Academy of Sleep Medicine.
Approximately one-quarter of people with sleep apnea are obese, which adds to the severity of the problem, Durvasula says. “Obesity can affect the body’s way of reacting to oxygen, so that can cause a more severe form of the condition.”
For some people with sleep apnea, there is no cure. A general treatment is to wear a continuous positive airway pressure (CPAP) machine that will keep air flowing through the airway, Durvasula says. “The good news is that patients can use the machine themselves and get a sense of what it feels like and adjust accordingly,” she says.
A CPAP machine will cost around $600 to $700, depending on how many filters and accessories are needed. “In some ways, it’s similar to oxygen tank therapy in that people will have to see a doctor and get fitted,” Durvasula says. “But you do the sleep study and the doctor starts you out with a machine to see how well you do. You can really get back to the most basic life with a CPAP machine.”
In this study, people who were prescribed an inexpensive continuous positive airway pressure device had significantly improved quality of life compared to people who were simply told they had sleep apnea, Durvasula says. “CPAP really has a number of effects, including improving a patient’s ability to get and stay asleep, decreasing daytime sleepiness and sleepiness,” she says.
Doctors and researchers have identified a variety of physiological mechanisms underlying the effects of sleep apnea, and some of the causes are tied to genetics. Durvasula says the role of sleep apnea in people with mood disorders has been a hot topic of research in the last decade. “Maybe some of the [sleep disorder] symptoms are caused by a combination of the sleep disorders and a history of depression,” she says. “I think it’s important that we do more research to see if the symptoms can be directly linked.”
Weight Loss and Wellness: Your Ultimate Guide to Fitness and Nutrition
