Archive for 'Medical'

Understanding Parkinson’s Disease

Parkinson’s disease (PD) is a degenerative disorder of the central nervous system.  It was first described in 1817 by James Parkinson, a British physician who published a paper on what he called “the shaking palsy.” In this paper, he set forth the major symptoms of the disease that would later bear his name.


Early symptoms of PD are subtle and occur gradually. Affected people may feel mild tremors or have difficulty getting out of a chair.  They may notice that they speak too softly or that their handwriting is slow and looks cramped or small. They may lose track of a word or thought, or they may feel tired, irritable, or depressed for no apparent reason. This very early period may last a long time before the more classic and obvious symptoms appear.

  • Tremor. The tremor associated with PD has a characteristic appearance. Typically, the tremor takes the form of a rhythmic back-and-forth motion at a rate of 4-6 beats per second. It may involve the thumb and forefinger and appear as a “pill rolling” tremor.  Tremor often begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress.
  • Rigidity. Rigidity, or a resistance to movement, affects most people with PD. A major principle of body movement is that all muscles have an opposing muscle. Movement is possible not just because one muscle becomes more active, but because the opposing muscle relaxes. In PD, rigidity comes about when, in response to signals from the brain, the delicate balance of opposing muscles is disturbed.
  • Bradykinesia. Bradykinesia, or the slowing down and loss of spontaneous and automatic movement, is particularly frustrating because it may make simple tasks somewhat difficult
  • Postural instability. Postural instability, or impaired balance, causes patients to fall easily.  A number of other symptoms may accompany
  • PD. Some are minor; others are not. Many can be treated with medication or physical therapy. No one can predict which symptoms will affect an individual patient, and the intensity of the symptoms varies from person to person.
  • Depression. This is a common problem and may appear early in the course of the disease, even before other symptoms are noticed. Fortunately, depression usually can be successfully treated with antidepressant medications.
  • Emotional changes. Some people with PD become fearful and insecure.
  • Difficulty with swallowing and chewing. Muscles used in swallowing may work less efficiently in later stages of the disease.
  • Speech changes. About half of all PD patients have problems with speech.Urinary problems or constipation. In some patients, bladder and bowel problems can occur due to the improper functioning of the autonomic nervous system, which is responsible for regulating smooth muscle activity.
  • Sleep problems. Sleep problems common in PD include difficulty staying asleep at night, restless sleep, nightmares and emotional dreams, and drowsiness or sudden sleep onset during the day.  Patients with PD should never take over-the-counter sleep aids without consulting their physicians.
  • Dementia or other cognitive problems. Some, but not all, people with PD may develop memory problems and slow thinking.  In some of these cases, cognitive problems become more severe, leading to a condition called Parkinson’s dementia late in the course of the disease.  This dementia may affect memory, social judgment, language, reasoning, or other mental skillsOrthostatic hypotension. Orthostatic hypotension is a sudden drop in blood pressure when a person stands up from a lying-down position.  This may cause dizziness, lightheadedness, and, in extreme cases, loss of balance or fainting.
  • Muscle cramps and dystonia. The rigidity and lack of normal movement associated with PD often causes muscle cramps, especially in the legs and toes.  Massage, stretching, and applying heat may help with these cramps.
  • Pain. Many people with PD develop aching muscles and joints because of the rigidity and abnormal postures often associated with the disease
  • Fatigue and loss of energy. The unusual demands of living with PD often lead to problems with fatigue, especially late in the day.  Fatigue may be associated with depression or sleep disorders, but it also may result from muscle stress or from overdoing activity when the person feels well.

Coping wit PD:

While PD usually progresses slowly, eventually the most basic daily routines may be affected — from socializing with friends and enjoying normal relationships with family members to earning a living and taking care of a home.  These changes can be difficult to accept.  Support groups can help people cope with the disease emotionally.  These groups can also provide valuable information, advice, and experience to help people with PD, their families, and their caregivers deal with a wide range of issues, including locating doctors familiar with the disease and coping with physical limitations. A list of national organizations that can help patients locate support groups in their communities appears at the end of this brochure.  Individual or family counseling also may help people find ways to cope with PD.

People with PD also can benefit from being proactive and finding out as much as possible about the disease in order to alleviate fear of the unknown and to take a positive role in maintaining their health.  Many people with PD continue to work either full- or part-time, although eventually they may need to adjust their schedule and working environment to cope with the disease.

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Editor’s Note- We have many families affected with PD who we take care of via Boca Home Care Services and Boca Home Care. We recommend family members learn about the diease, join a Parkinson’s Organization to stay abrest of all new developments in treatment, and be part of the national or local community. There is a lot of support out there to be made use of.

Macular degeneration may be on the decline

A disabling eye condition that typically strikes in older age may be less common than in the past, suggests a large new study.

Researchers estimate that macular degeneration — which involves damage to the center of the retina, making it difficult to see fine details — affects less than seven percent of the U.S. population aged 40 and older.

A study from the early 1990s had put that number at more than nine percent.

Age-related macular degeneration (AMD) is the leading cause of severe visual impairment in persons over 65 years of age, a group that is growing in numbers because of increased life expectancy,” lead researcher Dr. Ronald Klein of the University of Wisconsin in Madison, told Reuters Health in an e-mail.

To gauge AMD’s current impact, Klein and his colleagues looked at high-resolution pictures of the eyes of 5,553 U.S. adults, aged 40 or older, who participated in the 2005-2008 National Health and Nutrition Examination Survey.

Based on the digital photographs taken of both eyes, the researchers found that 6.5 percent of the participants had signs of some level of AMD, including tiny yellow or white deposits in the retina, pigment changes and deterioration of the retina and surrounding tissue.

Less than one percent had late disease, the advanced stage in which eyesight is more severely affected.

These figures translate to an estimate of 7.2 million people in the U.S. having any degree of AMD and 890,000 of those with advanced disease, report the researchers in the Archives of Ophthalmology.

In contrast, the 1988-1994 Third National Health and Nutrition Examination Survey estimated that 9.4 percent of people in this same age group had some level of AMD.

If that rate was correct and remained unchanged, it would mean some 18 million Americans should be showing signs of AMD today. The new estimates therefore represent a reduction of more than 30 percent in rates of AMD, the authors note.

The reason for the apparent decline is not completely clear.

“It may reflect changes over time in smoking behavior, diet, the use of antioxidant vitamins and zinc, and other factors associated with AMD,” Klein said.

The researchers did find that current rates of the condition increased with age and also differed by race, with African Americans at a lower risk for AMD than whites.

These racial differences, too, are not well understood. However, the authors point to the potential influence of harmful and protective genes that are more or less common in different racial and ethnic groups. Rates of smoking, high blood pressure, exercise and other relevant risk factors also vary in different populations.

A better understanding of why AMD’s frequency is falling in the older population, and doing so differentially, he said, could help inform new prevention strategies that could lead to further reductions.

It may also clarify whether current public health programs designed to increase awareness of the relationships between exposures and the disease are working.

“While AMD prevalence is declining, it is still a common condition in the population,” Klein added.

SOURCE: Archives of Ophthalmology, online January 10, 2011.

Possible Blood Test for Alzheimer’s Disease

Researchers may be closer to developing a new blood test that screens the blood for markers of Alzheimer’s disease, according to a new study.

Unlike previous attempts at making blood tests for the disease, which mainly used tiny protein molecules called peptides, this test uses peptoids, which are synthetic molecules that can bind to human antibodies (proteins that the body produces to ward off disease).

“I think that looking at natural peptides is probably not a great place to look for things that will bind these disease-specific antibodies,” said study researcher Thomas Kodadek, a professor of chemistry and cancer biology at The Scripps Research Institute in Florida.  “[Peptoids] don’t occur in the body.  They have different shapes, properties, chemistry than peptides do.”

How the test works

The researchers took blood samples from 18 study participants, ages 62 to 91, including six patients diagnosed with Alzheimer’s disease, six healthy people and six patients diagnosed with Parkinson’s disease.

They screened the blood, looking for peptoids that would bind to antibodies in people with Alzheimer’s disease, but would not bind to antibodies in people who didn’t have the condition.

They found three peptoids that distinguished the Alzheimer’s patients from the healthy participants. These peptoids were three times more likely to bind to antibodies from the Alzheimer’s patients than antibodies from the healthy people or Parkinson’s patients.

The researchers confirmed their finding by testing the blood of 38 participants, including 16 with Alzheimer’s disease, 16 healthy people and six patients with lupus. They found that by screening the blood samples with the three peptoids, they could  distinguish between the Alzheimer’s patients, 14 of the healthy subjects and the six lupus patients.

The test could be beneficial to pharmaceutical companies recruiting Alzheimer’s patients for clinical trials, Kodadek said, and that may lead to better treatmentsfor the condition.

“I think that the problem that they are having right now — and there have been a lot of high-profile failures in Alzheimer’s trials — is they are getting people that are too far gone,” Kodadek told MyHealthNewsDaily. Once there is a therapy in place, then this blood test could be used as a screening tool for catching the disease in its early stages, he said.

The future treatment of Alzheimer’s disease

Though there are advantages to such a screening tool for Alzheimer’s disease, some physicians urged caution in reviewing the study’s findings.

Small studies like this one tend to report better results for predicting and diagnosing the disease than those done in the general population, where there are more shades of grey across a wider spectrum of cognitive abilities, said Joe Verghese, a professor of neurology at Albert Einstein College of Medicine.

“The diagnostic ability would have to be established in the general population,” Verghese said.

Further studies will measure biomarkers in patients with mild cognitive impairment (MCI) — a condition that can be precursor to Alzheimer’s disease — and different types of cancers, the researchers said.

This test could become a commonly used in patients over age 50, Kodadek said.  “I really see no reason why, in the future, this couldn’t be a completely broad-based blood test that you can get in the doctor’s office whenever you go for your annual physical,” he said.

Approximately 5.1 million Americans may have Alzheimer’s disease, according to the National Institute on Aging.

The study was published Jan. 7 in the journal Cell.

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