Alzheimer’s Disease and Dementia

Alzheimer’s disease is the most common cause of dementia. It is caused by a build up of protein in the brain to form plaques and tangles. Plaques are clusters of proteins called beta-amyloid that build up between nerve cells. Smaller clumps block signals between nerve cells which leads to damage within the brain. The inflammation caused can trigger the immune system to attack brain cells. Tangles are formed within dying cells and are twists of proteins known as tau. They disintegrate the transport system within cells therefore, depriving cells of their vital nutrients, leading to cell death. The plaques and tangles usually form in the cerebral cortex in areas associated with memory and language.  There is also damage to the hippocampus and it often shrinks with Alzheimer’s disease.

Symptoms include:

  • Memory problems.
  • Personality changes.
  • Disorientation.
  • Problems with speech and language.
  • Hallucination.
  • Depression.
  • Anxiety.

Usually, those over 65 are affected by Alzheimer’s, but early onset alzheimer’s can occur in people who are younger. It is very difficult to diagnose alzheimer’s due to the progressive nature of the disease.

There is no cause for Alzheimer’s disease, but symptoms can be treated with medication. In most cases, treatment is used to slow down progression of the disease. Psychological treatments such as cognitive stimulation therapy may be used. It is a life-limiting condition and can lead to other problems such as difficulty swallowing. In many cases, people survive 8-10 years after diagnoses but this can vary from person to person; most people require palliative care.

 

Dementia is caused by Alzheimer’s disease and is used to describe a wide range of progressive neurological disorders.

Symptoms include:

  • Memory problems.
  • Difficulty with concentrating.
  • Language problems.
  • Spatial Visualisation problems.
  • Difficulty reasoning.

Types of dementia:

  1. Alzheimer’s disease (see above)
  2. Vascular dementia – Due to a series of small strokes which cause pockets of cell damage in the brain. Memory is less affected, but instead language and speech problems ensue. It is possible to have Alzheimer’s as well as vascular dementia at the same time, this is mixed dementia.
  3. Frontotemporal dementia – Affects personality and behaviour more than memory. It is known as frontal lobe or Pick’s disease. It can be confused with depression and psychosis.
  4. Dementia with Lewy Bodies – Movement is affected including motor skills. Tremors are common, similar to those of Parkinson’s disease, in addition, tremors can also occur.
  5. Early Onset Dementia – Occurs in those below 65 and can be accompanied by depression and anxiety in younger people as well as familial stress.

Dementia can be treated via drug use and the most common form of treatment for Alzheimer’s are three drugs known as donepezil, rivastigmine or galantamine. Memantine can be used to treat a more progressive form of Parkinson’s disease.  Those with vascular dementia are treated in order to alleviate symptoms such as high blood pressure and cholesterol. Those with dementia with Lewy bodies are treated with the same drugs as alzheimer’s in order to treat hallucinations.

 

References:

https://www.dementiauk.org/understanding-dementia/about-dementia/

https://www.alzheimers.org.uk/info/20007/types_of_dementia/1/what_is_dementia

http://www.alz.org/what-is-dementia.asp

http://www.nhs.uk/Conditions/dementia-guide/Pages/about-dementia.aspx

https://www.alzheimers.org.uk/info/20007/types_of_dementia/2/alzheimers_disease

http://www.nhs.uk/Conditions/Alzheimers-disease/Pages/Introduction.aspx

 

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Breast Cancer

Cancer is caused by the uncontrollable division of cells and can come in two forms: benign and malignant. Malignant tumors invade surrounding body tissue and are able to metastasize and spread to other parts of the body, whereas benign tumors are relatively harmless.

Symptoms of breast cancer include:

  • Breast Lumps (90% are not cancerous)
  • Change in size/shape/feel of breast
  • Breast pain
  • Skin Changes
  • Changes in nipple position
  • Fluid from nipples

Risks include:

  • Age
  • Ethnicity
  • Substance Abuse
  • Diet/Exercise
  • Overweight/Obese Patients
  • Genetics – family with cancer
  • Cancer genes
  • Many more

The TNM staging system stands for Tumour, Node, Metastasis.

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

Number staging ranges from 1-4 and relate to size of tumor and its spread.

Early, locally advanced and secondary breast cancer.

Early: The cancer has not spread to areas outside the breast.

Locally Advanced: Cancer has not spread but the tumor is 5cm or larger, growing in chest skin/muscle or present in the lymph nodes in the armpits.

Secondary: Also known as stage 4 is when the cancer has spread to other parts of the body.

Grading is also used:

  • low grade – grade 1 (slow growing)
  • intermediate grade – grade 2
  • high grade – grade 3 (faster growing)

 

Diagnosis involves attending screenings, visiting a GP and then undertaking MRI and possibly CT scans to show the size and position of the tumor.

Treatment varies depending on the grading systems mentioned previously. Surgery, chemotherapy, radiotherapy, hormone therapy, biological therapy and clinical trials. Surgery is usually used for the lower grade cancers that are positioned in such a way that they can be easily removed. Types include:

  • Lumpectomy – removal of the cancerous tumor
  • Mastectomy – removal of the breast
  • Breast Reconstruction
  • Lymph Node Removal

 

For many patients and their families, breast cancer can be incredibly scary and difficult to deal with. It is important to learn as much as you can about breast cancer and to make an informed position. Breast cancer is not only hard on the person who has it, but also their friends and family. It can be difficult to adjust but it is vital to support one another and to ensure mental health does not deteriorate rapidly.

References:

http://www.cancerresearchuk.org/about-cancer/breast-cancer

http://www.nhs.uk/conditions/Cancer-of-the-breast-female/pages/symptoms.aspx

https://www.breastcancercare.org.uk/

Parkinson’s Explored

Parkinson’s disease is a neurological condition that affects one in 500 people. Parkinson’s disease is caused by a loss of nerve cells in a part of the brain known as the substantia nigra. These nerve cells are responsible for the production of dopamine. Dopamine acts as a messenger between the parts of the brain and nervous system that help control and coordinate body movements.

A reduction in dopamine levels is responsible for many of the symptoms of Parkinson’s disease. However, the majority of symptoms occur after around 80% of nerve cells have been lost. The exact cause of the loss of nerve cells is unknown but lead researcher’s believe that it is caused by a combination of genetic and environmental factors.

 

Parkinson’s disease accompanies a wide variety of symptoms including loss of movement, rigidity, tremors, insomnia and depression. Everyone who has Parkinson’s experiences these symptoms in a different way and to different degrees.

Parkinsonism is the umbrella term which describes conditions that share the same symptoms as Parkinson’s disease. Idiopathic parkinson’s, or Parkinson’s Disease, is the most common type of parkinson’s. There is no known cause for this type of parkinson’s. It is usually diagnosed by measuring response to medication, if symptoms alleviate and decrease in severity, then it can be said that the patient does suffer from idiopathic parkinson’s disease.

Vascular Parkinsonism occurs when blood supply to the brain is restricted. This atypical form of Parkinson’s usually affects older people with diabetes and those who have suffered from a stroke. Symptoms include a difficulty speaking and swallowing and in making facial expressions. Cognitive problems and memory loss also accompany this form of Parkinson’s disease.

Drug induced Parkinsonism occurs through use of neuroleptic drugs that are used to treat schizophrenia and other psychotic disorders. These drugs block dopamine and are thought to be the biggest cause of drug-induced parkinsonism. In this type of Parkinson’s recovery can occur at a much faster rate than that of others.

Dementia with Lewy Bodies is similar to Parkinson’s and Alzheimer’s. Symptoms include problems with memory and concentration, attention, language and the ability to carry out simple actions. Yet again, dementia with lewy bodies is a progressive condition which worsens with time.

People who have genes that are prone to Parkinson’s may be more likely to develop the condition when combined with other factors, such as environmental toxins or viruses.

Treatment of Parkinson’s disease varies, however drug treatment is the main form of treatment used. Drug treatments aim to increase the level of dopamine that reaches the brain and stimulate the parts of the brain where dopamine works. Examples of drugs used in treatment include:

Levodopa which is a chemical building-block that your body converts into dopamine. It replaces the dopamine that is lost in

Dopamine agonists which act like dopamine to stimulate your nerve cells.

 

However, these drugs can have side effects, one example is dyskinesia which is where those who have Parkinson’s suffer from involuntary movements that are uncontrollable. Another side effect is impulsive and compulsive behaviour. This affects people who are taking dopamine agonists, which act in a similar manner to dopamine within the body.

Therapies that are used in treatment include physiotherapy, occupational therapy, speech and language therapy, seeing a dietician and complementary therapies.

Surgery is also used in treatment despite medication being the main sort of treatment. The main procedure carried out is:

Deep Brain Stimulation, which is used to minimise symptoms. Deep brain stimulation involves implanting very fine wires with electrodes at their tips into the brain.These are connected to extensions that are placed under the skin behind the ear and down the neck. They are connected to a pulse generator (a device like a pacemaker), which is placed under the skin around the chest or stomach area. High frequency stimulation is targeted onto a small area, this changes some of the electrical signals responsible for the symptoms of Parkinson’s.

Lesioning: can also be used which involves making selective damage (a lesion) to cells in a target area of the brain. The target site is found using a brain scan. An electrode is then inserted into the site and an electric current is passed through the tip. The current is used to target some of the cells that control movement.

In our day and age, Parkinson’s disease and its symptoms are both manageable and treatable and with advances in modern medicine, the process is becoming increasingly streamlined, improving the quality of life for those with Parkinson’s worldwide.

Emphysema

Emphysema is a type of COPD, and leads to a shortness of breath. Emphysema affects lung tissue and lung elasticity in a number of ways, but mainly by damaging the alveoli and bronchioles. When the alveoli are damaged they can no longer support the bronchioles, so they collapse. Due to there being less alveoli, less oxygen will enter the bloodstream.

Cigarette smoking is one of the largest causes of emphysema, and also adds to damage as it leads to inflammation as well as alveolar damage, and increased mucus production. Symptoms include:

  • Shortness of breath.
  • Wheezing
  • Fatigue
  • Mucus production

A preliminary test for emphysema is using a stethoscope to listen for a hollow sound in the chest. Other tests include: Spirometer tests, X-rays, Electrocardiogram, Pulse Oximetry.

For smokers, the first treatment is to cease smoking. Medication is also used to relax muscles around the airways and anti inflammatory medication, to increase airway diameter. Oxygen therapy is also used to provide a more rapid recovery, however this is not to be used in the long-term.

References:

https://medlineplus.gov/emphysema.html

http://www.webmd.boots.com/smoking-cessation/emphysema

http://my.clevelandclinic.org/health/articles/emphysema

 

Regeneration of the Pancreas

US researchers have discovered that the pancreas can be stimulated to regenerate if a fasting diet is taken up. The diet mimics periods of feast and famine. It was tested on mice and highlighted that beta cells were regenerated through the fasting. The beta cells detect the blood glucose level and stimulate the release of insulin which is used to control blood sugar along with glycogen and glucagon.

However this diet did lead to low blood sugar and a decrease in a hormone called IGF-1. Doctors have discouraged people from attempting to start a crash diet as it is important to see a physician first to ensure that the body is able to cope with such a varied diet.

Those who took part lost up to 4kg but put this back on in the feasting period of the diet.

This type of treatment reduces the need for drugs and can be seen to have fewer side effects than the traditional medication used in both type 1 and type 2 diabetes.

References:

http://www.bbc.co.uk/news/health-39070183

http://www.cell.com/cell/fulltext/S0092-8674(17)30130-7