A Mechanical Model Of Vocalization

A Mechanical Model Of Vocalization

When people speak, sing, or shout, they produce sound by pushing air over their vocal folds -- bits of muscle and tissue that manipulate the air flow and vibrate within it. When someone has polyps or some other problem with their vocal folds, the airflow can be altered, affecting the sound production.

"Voice disorders affect 30 percent of the general population and up to 60 percent of educators," says Plesniak. "The objective of our work is to develop a detailed understanding of the phonation process, which will enable the development of computational models."

Wanting to better characterize the physics of this process, George Washington University professor Michael Plesniak and his doctoral student Byron Erath teamed up with speech pathologists a few years ago, while Plesniak was at Purdue University, to investigate the velocity field and flow structures in the airflow that occur when a person speaks.

Plesniak and his students constructed a mechanical model of the vocal folds that had motorized, programmable components that can alter their shape and motion in various ways to mimic vocal folds. By placing this model in a wind tunnel, they examine normal vocalization and common pathologies like the formation of polyps and cysts.

An important feature of the model, says Plesniak, is that it is seven-and-a-half times larger than the actual physiology, which allows the dynamics to be studied in greater detail. The ultimate goal, he adds, is to create tools to help surgeons make preoperative assessments of how a vocal tract surgery will affect an individual's voice.

North Carolina Based Cromoz Inc. Launches Carbon Nanotechnology For Target Drug Delivery System In Cancer Treatment In Hyderabad, India

North Carolina Based Cromoz Inc. Launches Carbon Nanotechnology For Target Drug Delivery System In Cancer Treatment In Hyderabad, India

Cromoz Inc., located in Research Triangle Park, will initiate water-soluble carbon nanotube-based cancer drug delivery system in Hyderabad, India. The water-soluble carbon nanotubes, which have functional groups on the walls that allows for conjugation with cancer drugs, was developed in partnership with the Indian Institute of Kanpur (ITT). The conjugated carbon nanotubes serves as a drug delivery vehicle with the ability to target the cancer site which has the potential to increase the drug efficacy.

The target drug delivery reduces the amount of chemotherapeutic drugs used in cancer treatment and minimizes the side effects. The reduced dosage without compromising the drug efficacy will make the cancer treatment more potent and targeted to killing the cancer and more affordable and available to a larger community.

"Certain percentage of these carbon nanotubes are composed of smaller Quantum Carbon Dots," stated Iffat Allam, President & CEO of Cromoz Inc. "The nontoxic carbon quantum dots can be used as Fluorescent Probes for imaging living biological processes and to monitor cancer growth. These quantum dots are of assorted sizes, they absorb and emit light at different wavelengths. This results in multi-colored images which will be very useful to diagnose a specific organ and its function and the effect of drug delivery to specific cancer sites."

Cromoz has successfully conjugated cancer drugs such as Taxol and Gemcitabine and is currently working with Johns Hopkins Cancer Center in Maryland, USA. Early next year Cromoz will initiate a research and development (R&D) and manufacturing facility in Biotech Park in Hyderabad, India.

Cromoz Inc., is an advanced materials innovator and manufacturer focused on the development of carbon nanotechnology-enabled products primarily for the biomedical industry. These innovative products are based on two proprietary technologies, water-soluble carbon nanotubes and water-soluble fluorescent carbon quantum dots. The CNTs (Carbon Nano Tubes) are insoluble in water. Some have used a common technique to wrap the CNT with hydrophilic molecules to make them disperse in water. Cromoz have successfully derivatized the multi-wall of CNTs and Carbon Dots to make them water-soluble. These derivatized CNTs are bio-friendly, fluorescent and hence well suited for drug delivery.

Climate Change Could Boost Incidence Of Civil War In Africa

Climate change could increase the likelihood of civil war in sub-Saharan Africa by over 50 percent within the next two decades, according to a new study led by a team of researchers at University of California, Berkeley, and published in the online issue of the journal Proceedings of the National Academy of Sciences(PNAS).

The study, conducted by researchers at UC Berkeley as well as at Stanford University, New York University and Harvard University, provides the first quantitative evidence linking climate change and the risk of civil conflict. It concludes by urging accelerated support by African governments and foreign aid donors for new and/or expanded policies to assist with African adaptation to climate change.

"Despite recent high-level statements suggesting that climate change could worsen the risk of civil conflict, until now we had little quantitative evidence linking the two," said Marshall Burke, the study's lead author and a graduate student at UC Berkeley's Department of Agricultural and Resource Economics. "Unfortunately, our study finds that climate change could increase the risk of African civil war by over 50 percent in 2030 relative to 1990, with huge potential costs to human livelihoods."

"We were definitely surprised that the linkages between temperature and recent conflict were so strong," said Edward Miguel, professor of economics at UC Berkeley and faculty director of UC Berkeley's Center for Evaluation for Global Action. "But the result makes sense. The large majority of the poor in most African countries depend on agriculture for their livelihoods, and their crops are quite sensitive to small changes in temperature. So when temperatures rise, the livelihoods of many in Africa suffer greatly, and the disadvantaged become more likely to take up arms."

Understanding the causes and consequences of civil strife in much of the African continent has been a major focus of the social sciences for decades, said Miguel, as monumental suffering has resulted from it. In the case of the Democratic Republic of Congo's, the International Rescue Committee estimates that at least 5.4 million people have died from fighting, hunger and disease during that country's ongoing civil unrest over the past 10 years.

In the study, the researchers first combined historical data on civil wars in sub-Saharan Africa with rainfall and temperature records across the continent. They found that between 1980 and 2002, civil wars were significantly more likely in warmer-than-average years, with a 1 degree Celsius increase in temperature in a given year raising the incidence of conflict across the continent by nearly 50 percent.

Building on this historical relationship between temperature and conflict, the researchers then used projections of future temperature and precipitation change to quantify future changes in the likelihood of African civil war. Based on climate projections from 20 global climate models, the researchers found that the incidence of African civil war could increase 55 percent by 2030, resulting in an additional 390,000 battle deaths if future wars are as deadly as recent ones.

All climate models project rising temperatures in coming decades, said David Lobell, study co-author and an assistant professor of environmental earth systems science at Stanford.

"On average, the models suggest that temperatures over the African continent will increase by a little over 1 degree Celsius by 2030," he added. "Given the strong historical relationship between temperature rise and conflict, this expected future rise in temperature is enough to cause big increases in the likelihood of conflict."

To confirm that this projection was not the result of large effects in just a few countries or due to overreliance on a particular climate model, the researchers recalculated future conflict projections using alternate data. "No matter what we tried - different historical climate data, different climate model projections, different subsets of the conflict data - we still found the same basic result," said Lobell.

It's easy to think of climate change as a long way off, said the researchers, but their study shows how sensitive many human systems are to small increases in temperature, and how fast the negative impacts of climate change could be felt.

"Our findings provide strong impetus to ramp up investments in African adaptation to climate change by such steps as developing crop varieties less sensitive to extreme heat and promoting insurance plans to help protect farmers from adverse effects of the hotter climate

FDA Approves Agriflu Seasonal Influenza Vaccine

FDA Approves Agriflu Seasonal Influenza Vaccine

The U.S. Food and Drug Administration approved Agriflu for people ages 18 years and older to prevent disease caused by influenza virus subtypes A and B.

Agriflu, manufactured by Novartis Vaccines and Diagnostics in Siena, Italy, was approved using the FDA's accelerated approval pathway, which helps safe and effective medical products for serious or life-threatening diseases become available sooner. In this case, Novartis demonstrated that the vaccine induced levels of antibodies in the blood likely to be effective in preventing seasonal influenza.

Agriflu is administered as a single injection in the upper arm and is available in single dose, pre-filled syringes that do not contain preservatives.

"The approval of the new seasonal influenza vaccine, Agriflu, is an important step in adding to the production capacity to enhance the supply of vaccine for the United States for future influenza seasons," said Karen Midthun, M.D., acting director of the FDA's Center for Biologics Evaluation and Research.

Common side effects in clinical studies included pain, swelling and redness at the injection site, headache, muscle aches and malaise. People with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated.

New Report Shows 97 Medicines And Vaccines Currently In Development For HIV/AIDS

America's pharmaceutical research and biotechnology companies are testing 97 medicines and vaccines to treat or prevent HIV/AIDS and related conditions, according to a new report released by the Pharmaceutical Research and Manufacturers of America (PhRMA). December 1 marks the 21st anniversary of "WorldAIDS Day" a global awareness campaign that originated at the 1988 World Summit of Ministers of Health on Programmes for AIDS Prevention.

"We are greatly encouraged by these critically important medicines and vaccines in development to treat and prevent HIV infection," says PhRMA President and CEO Billy Tauzin. "Pharmaceutical researchers are continuing their efforts to develop new therapies and vaccines to improve and lengthen the lives of HIV-infected patients."

The report found that the 97 products in development include 23 vaccines and 54 antivirals. These drugs are either in human clinical trials or awaiting approval by the U.S. Food and Drug Administration.

Thirty-one medicines to treat HIV/AIDS have been approved since scientists first identified the virus that causes AIDS more than 20 years ago. The first HIV/AIDS medicine was approved in 1987, just four years after the virus was identified.

Although the U.S. Centers for Disease Control and Prevention (CDC) estimate that more than 1 million Americans were living with HIV infection at the end of 2006, the increased availability and utilization of newer prescription medicines has helped to reduce the U.S. death rate from AIDS substantially in recent years, according to government statistics. In fact, the CDC estimates that since the introduction of highly active anti-retroviral therapy in 1995, the annual number of deaths in the U.S. due to AIDS has dropped by more than 70 percent.

Despite this progress, AIDS remains a devastating and growing health problem in developing countries, particularly in sub-Saharan Africa, China, India and the Russian Federation. According to the Joint United Nations Programme on HIV/AIDS, in 2007 an estimated 33 million people were living with HIV, 2.7 million were newly infected with HIV, and 2 million people died from the disease.

From 2000 to 2007, America's pharmaceutical research and biotechnology companies contributed more than $9.2 billion to improve health care in the developing world, according to the International Federation of Pharmaceutical Manufacturers & Associations.

The projects they supported included clinics to treat patients with HIV/AIDS, education and prevention programs, initiatives to prevent mother-to-child transmission of HIV, and donations of medicines for AIDS and related diseases. A number of companies also provide AIDS drugs at reduced prices in many countries.

"As a result of HIV/AIDS medicines, a disease that was once a virtual death sentence can now be controlled and treated as if it were a chronic disease," states Tauzin. "And the new medicines our scientists are working on right now bring hope for even more promising results in the future."

"While researchers are making exciting progress in the search for new treatments for HIV/AIDS, these efforts are wasted if the medicines that are developed don't get to the patients who need them," says PhRMA Senior Vice President Ken Johnson.

Help is available to patients in need through the Partnership for Prescription Assistance (PPA), a program sponsored by America's pharmaceutical research companies. To date, the PPA has helped more than 6 million patients nationwide. Since its launch in April 2005, the PPA bus tour has visited all 50 states and more than 3,000 cities.

Lupus and WomenLupus and Women

Lupus and Women

What Is Lupus?

Lupus is an autoimmune disease in which the body literally attacks itself, harming its own healthy cells and tissues. It can affect the joints, skin, kidneys, heart, lungs, blood vessels, and brain, causing inflammation and damage to tissues. For most people, lupus is a mild disease affecting only a few organs. For others, it can be disabling and cause serious and even life-threatening problems. One in five people with the disease are disabled, most commonly from fatigue and joint and muscle pain. Fifteen to 20 percent of all cases of lupus result in death, most commonly from kidney disease, infection, and cardiovascular disease. Currently, there is no cure for lupus. However, with early diagnosis and appropriate treatment, symptoms can usually be managed, and most people with the disease can lead active, healthy lives.

Who Has Lupus?

Lupus affects 1.4 million people in the United States (1 in 85). Ninety percent of lupus patients are women, striking most often between the ages of 15 and 44. Lupus is three times more common in black women than in white women and is also more common in women of Hispanic, Asian, and Native American descent. Researchers are trying to learn why these women are more susceptible.

What Are the Different Types of Lupus?

Systemic lupus erythematosus (SLE) is the form of the disease that most people are referring to when they say "lupus". SLE can affect many parts of the body and its symptoms can range from mild to serious. Although SLE usually develops in people between the ages of 15 and 45 years, it can occur in childhood or later in life as well.

Discoid lupus erythematosus (DLE) mainly affects the skin, causing a red, raised rash on the face, scalp, or other parts of the body. The rash may become thick and scaly and may last for days or years. A small percentage of people with DLE later develop SLE.

Drug-induced lupus is a rare adverse reaction to certain medications. Its symptoms are similar to those of SLE (arthritis, rash, fever, and chest pain, but not kidney disease) but they go away when the drug is stopped. Common medications that may cause drug-induced lupus include hydralazine (Apresoline_), procainamide (Procan_, Pronestyle_), methyldopa (Aldornet_), quinidine (Quinaglute_), isoniazid (INH_), and some anti-seizure medications such as phenytoin (Dilantin_) or carbamazepine (Tegretol_). However, not everyone who takes these drugs will develop drug-induced lupus. Only about 4 percent of the people who take these drugs will develop the antibodies suggestive of lupus. Of those 4 percent, only an extremely small number will develop drug-induced lupus.

Neonatal lupus can affect some newborn babies of women with SLE or certain other immune system disorders. Babies with neonatal lupus may have a serious heart defect. Other affected babies may have a skin rash, liver abnormalities, or low blood counts. Neonatal lupus is very rare, and most infants of mothers with SLE are entirely healthy.

What Causes Lupus?

Although the cause of lupus is unknown, it is likely a combination of genetic, environmental, and possibly hormonal factors. The exact cause may differ from one person to another. Research suggests that genetics plays an important role; and it appears that several genes may be responsible for increasing a person's susceptibility to the disease. Most cases of SLE occur sporadically, indicating that both genetic and environmental factors play a role in the development of the disease. Some of the factors that scientists are studying include sunlight, stress, certain drugs, and infectious agents such as viruses. Even though a virus might trigger the disease in susceptible individuals, a person cannot "catch" lupus from someone else.

What Are the Symptoms of Lupus?

Lupus is characterized by periods of illness (flares) and periods of wellness (remission). It is difficult to diagnose because it is often mistaken for other diseases. The following are some common symptoms of lupus:

• Extreme fatigue
  
  
• Painful or swollen joints (arthritis)
  
  
• Unexplained fever
  
  
• "Butterfly" rash across the nose and cheeks that is characteristic to lupus
  
  
• Skin rashes on other parts of the body
  
  
• Chest pain or pleurisy (inflammation of the pleura, the membrane that covers the lungs)
  
  
• Kidney problems
  
  
• Unusual loss of hair
  
  
• Pale or purple fingers from cold or stress
  
  
• Sensitivity to the sun
  
  
• Low red blood-cell count
  
  
• Seizures
  
  
• Mouth or nose ulcers
  
  
• Cardiovascular disease
  
  

Some people also experience headaches, dizziness, or depression. New symptoms may continue to appear years after the initial diagnosis, and different symptoms can occur at different times.

How Is Lupus Diagnosed?

Early diagnosis and treatment are needed to improve health and reduce tissue damage. Diagnosing lupus can be difficult, however, because it may take months or even years for doctors to piece together the symptoms to make an accurate diagnosis. Giving the doctor a complete, accurate medical history is critical to the process of diagnosis. This information, along with a physical examination and the results of laboratory tests, helps the doctor rule out other diseases that may mimic lupus. Reaching a diagnosis may take time and occur gradually as new symptoms appear.

What Are the Treatments for Lupus?

Because each person's symptoms are different, doctors treat lupus on an individual basis. Once lupus has been diagnosed, the doctor will develop a treatment plan based on the patient's age, gender, health, symptoms, and lifestyle. Tailored to the individual's needs, this plan may change over time. In developing a treatment plan, the doctor has several goals: to prevent flares, to effectively treat them when they do occur, and to minimize complications. The doctor and patient should reevaluate the plan regularly to ensure that it is as effective as possible.

Treatment for lupus includes physical and emotional rest, protection from direct sunlight, a healthful diet, exercise, prompt treatment of infections, avoidance of known allergens and aggravating factors, and medication when necessary. The medication the doctor chooses is based on the patient's individual symptoms and needs. For people with joint pain, fever, and swelling, drugs that decrease inflammationCnonsteroidal anti-inflammatory drugs (NSAIDs)Care often used. Antimalarials are another type of drug commonly used to treat lupus. They may be used alone or in combination with other drugs to treat fatigue, joint pain, skin rashes, and inflammation of the lungs. Corticosteroid hormones are the mainstay of lupus treatment. Related to cortisol, which is a natural anti-inflammatory hormone, corticosteroids work by rapidly suppressing inflammation. Because they are potent drugs, the doctor will seek the lowest dose with the greatest benefit.

Working closely with the doctor helps ensure that treatments for lupus are as successful as possible. Because some treatments may cause harmful side effects, it is important to promptly report any new symptoms to the doctor.

It is also important not to stop or change treatments without talking to the doctor first. With early diagnosis and the correct treatment and medication, most people with lupus can maintain an overall high quality of life.

SOURCES: National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH Publication No. 93-3219; Lupus Foundation of America.

Department of Health and Human Services Activities on Lupus

Office on Women's Health (OWH) within the Department of Health and Human Services (DHHS) is the Federal government's focal point for women's health issues. OWH works to improve women's health by coordinating women's health research, health care services, policy, and public and health care professional education across the agencies of the DHHS; and collaborating with other government organizations, and consumer and health care professional groups.
Phone: (202) 690-7650;
Web: http://www.4woman.gov/owh/about/index.htm

National Women's Health Information Center (NWHIC), a service of OWH, is a national resource for information on women's health. Through NWHIC, the public and health professionals can access the vast array of Federal and other sources of women's health information.
Phone: 1-800-994-WOMAN (1-800-994-9662);
Web: http://www.4woman.gov/

National Institutes of Health (NIH) is the Federal focal point for biomedical research in the United States. The goal of NIH is to acquire new knowledge to help prevent, detect, diagnose, and treat disease and disability. Within NIH, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the National Institute of Nursing Research (NINR) conduct and support research on lupus.
Phone: (301) 496-4000;
E-mail: nihinfo@od.nih.gov;
Web: http://www.nih.gov//

NIAMS of the NIH leads the Federal medical research effort in arthritis and musculoskeletal and skin diseases. NIAMS supports research and research training throughout the United States as well as on the NIH campus in Bethesda, MD. The National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse (NAMSIC) is a public service sponsored by NIAMS that provides health information.
Phone: (301) 495-4484; TTY: (301) 565-2966;
Web: http://www.nih.gov/niams/

NIAMS has recently produced a manual entitled LUPUS: A Patient Care Guide for Nurses and Other Health Professionals to help health professionals who work with lupus patients to improve their care and quality of life. The guide covers symptoms and diagnosis, advances in lupus research, lab tests for diagnosis and evaluation, lupus medications, health care interventions for general and system-specific manifestations of lupus, psychosocial aspects, and information resources.

Saliva Proteins Change As Women Age

In a step toward using human saliva to tell whether those stiff joints, memory lapses, and other telltale signs of aging are normal or red flags for disease, scientists are describing how the protein content of women's saliva change with advancing age. The discovery could lead to a simple, noninvasive test for better diagnosing and treating certain age-related diseases in women, they suggest in a report in ACS' Journal of Proteome Research, a monthly publication. These diseases include lupus, Sjögrens syndrome (associated with dry mouth and dry eye), and other immune-related disorders that affect millions of women worldwide, often at higher rates than in men.

John Yates and colleagues note that human saliva contains many different proteins involved in digestion, disease fighting, and other functions. Scientists are seeking ways to use the proteins as molecular "fingerprints" to develop quick diagnostic tests that provide an alternative to the needle sticks currently needed for blood tests. To do that, they need detailed information on how normal aging affects these proteins.

The scientists analyzed saliva proteins in healthy women aged 20-30 and 55-65. They identified 293 proteins differed between the two age groups. Most were involved in the immune system's defenses against infection. Older women had almost twice as many immune-related proteins than younger women. The results suggest that "it is critical to take into consideration these normal differences in protein expression when searching for clinically relevant, disease specific biomarkers

What is Lupus?

photo © St Thomas' Lupus Trust

Lupus is an autoimmune disease where the body's immune system becomes hyperactive and attacks normal, healthy tissue. This results in symptoms such as inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs.

Under normal function, the immune system makes proteins called antibodies in order to protect and fight against antigens such as viruses and bacteria. Lupus makes the immune system unable to differentiate between antigens and healthy tissue. This leads the immune system to direct antibodies against the healthy tissue - not just antigens - causing swelling, pain, and tissue damage.
(* An antigen is a substance capable of inducing a specific immune response.)

What are the different types of lupus?

Several different kinds of lupus have been identified, but the type that we refer to simply as lupus is known as systemic lupus erythematosus or SLE. Other types include discoid (cutaneous), drug-induced, and neonatal.

photo © St Thomas' Lupus Trust

Patients with discoid lupus have a version of the disease that is limited to the skin. It is characterized by a rash that appears on the face, neck, and scalp, and it does not affect internal organs. Less than 10% of patients with discoid lupus progress into the systemic form of the disease, but there is no way to predict or prevent the path of the disease.

SLE is more severe than discoid lupus because it can affect any of the body's organs or organ systems. Some people may present inflammation or other problems with only skin and joints, while other SLE sufferers will see joints, lungs, kidneys, blood, and/or the heart affected. This type of lupus is also often characterized by periods of flare (when the disease is active) and periods of remission (when the disease is dormant).

Drug-induced lupus is caused by a reaction with certain prescription drugs and causes symptoms very similar to SLE. The drugs most commonly associated with this form of lupus are a hypertension medication called hydralazine and a heart arrhythmia medication called procainamide, but there are some 400 other drugs that can also cause the condition. Drug-induced lupus is known to subside after the patient stops taking the triggering medication.

A rare condition, neonatal lupus occurs when a mother passes autoantibodies to a fetus. The unborn and newborn child can have skin rashes and other complications with the heart and blood. Usually a rash appears but eventually fades within the first six months of the child's life.

Who is affected by lupus?

According to the Lupus Foundation of America (LFA), 1.5 to 2 million Americans have some form of lupus. The prevalence is about 40 cases per 100,000 persons among Northern Europeans and 200 per 100,000 persons among blacks. Although the disease affects both males and females, women are diagnosed 9 times more often than men, usually between the ages of 15 and 45. African-American women suffer from more severe symptoms and a higher mortality rate.

Other risk factors include exposure to sunlight, certain prescription medications, infection with Epstein-Barr virus, and exposure to certain chemicals.

What causes lupus?

Although doctors are do not know exactly what causes lupus and other autoimmune diseases, most believe that lupus results from both genetic and environmental stimuli.

Since lupus is known to occur within families, doctors believe that it is possible to inherit a genetic predisposition to lupus. There are no known genes, however, that directly cause the illness. It is probable that having an inherited predisposition for lupus makes the disease more likely only after coming into contact with some environmental trigger.

The higher number of lupus cases in females than in males may indicate that the disease can be triggered by certain hormones. Physicians believe that hormones such as estrogen regulate the progression of the disease because symptoms tend to flare before menstrual periods and/or during pregnancy.

Certain environmental factors have been known to cause lupus symptoms. These include:

• Extreme stress
• Exposure to ultraviolet light, usually from sunlight
• Smoking
• Some medications and antibiotics, especially those in the sulfa and penicillin groups
• Some infections, such as cytomegalovirus (CMV), parvovirus (such as fifth disease), hepatitis C infections, and the Epstein-Barr virus (in children)
• Chemical exposure to compounds such as trichloroethylene in well water and dust

What are the symptoms of lupus?

Since no two cases of lupus are exactly alike, there is a wide range of symptoms that are known to affect many parts of the body. Sometimes symptoms develop slowly or appear suddenly; they can be mild, severe, temporary, or permanent. Most people with lupus experience symptoms in only a few organs, but more serious cases can lead to problems with kidneys, the heart, the lungs, blood, or the nervous system.

Lupus episodes, or flares, are usually noted by a worsening of some of the following symptoms:

• Achy joints (arthralgia), arthritis, and swollen joints, especially in wrists, small joints of the hands, elbows, knees, and ankles
• Swelling of the hands and feet due to kidney problems
• Fever of more than 100 degrees F (38 degrees C)
• Prolonged or extreme fatigue
• Skin lesions or rashes, especially on the arms, hands, face, neck, or back
• Butterfly-shaped rash (malar rash) across the cheeks and nose
• Anemia (oxygen carrying deficiency of red blood cells)
• Pain in the chest on deep breathing or shortness of breath
• Sun or light sensitivity (photosensitivity)
• Hair loss or alopecia
• Abnormal blood clotting problems
• Raynaud's phenomenon: fingers turn white and/or blue or red in the cold
• Seizures
• Mouth or nose ulcers
• Weight loss or gain
• Dry eyes
• Easy bruising
• Anxiety, depression, headaches, and memory loss

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Lupus can also lead to complications in several areas of the body. These include:

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• Kidneys - serious kidney damage is a primary cause of death for lupus sufferers.
• Central nervous system - lupus can cause headaches, dizziness, memory problems, seizures, and behavioral changes.
• Blood and vessels - lupus causes an increased risk of anemia, bleeding, blood clotting, and vessel inflammation
• Lungs - noninfectious pneumonia and difficulty breathing due to inflammation of the chest cavity are more likely with lupus
• Heart - heart muscle and artery inflammation are more likely with the disease, and lupus increases the chances of cardiovascular disease and heart attacks.
• Infection - lupus treatments tend to depress the immune system making your body more vulnerable to infection.
• Cancer - lupus increases the risk of cancer, especially of non-Hodgkin's lymphoma, lung cancer, and liver cancer
• Bone tissue death - a lower blood supply to bone tissue leads to tiny breaks and eventual death of bone. This is most common in the hip bone.
• Pregnancy - lupus increases the risk of miscarriage, hypertension during pregnancy, and preterm birth.

What is Lupus? - Video

A short video by Expert Village explaining a bit about what Lupus is.

How is lupus diagnosed?

As signs and symptoms vary considerably from person to person, there is no single diagnostic test that can confirm lupus. In addition, signs and symptoms tend to change over time and are similar to those of other disorders and diseases. These fluctuations in disease activity make lupus extremely challenging to diagnose.

Currently, doctors use guidelines established by The American College of Rheumatology (ACR) to diagnose lupus (SLE). The guidelines focus on eleven abnormalities that, when combined, suggest that the patient has lupus. To be classified as having SLE, a patient must meet 4 of the following 11 symptoms at any time since the onset of the disease:

1. Serositis - inflammation of the membrane around the lungs (pleuritis) or the heart (pericarditis)
2. Mucosal ulcers - small sores found in the lining of the mouth and nose
3. Arthritis - nonerosive arthritis (tenderness, swelling, pain) of two or more peripheral joints
4. Photosensitivity - skin rash or other symptoms caused by exposure to ultraviolet light
5. Blood disorder - hemolytic anemia (low red blood cell count), leucopenia and lymphopenia (low white blood cell count), or thrombocytopenia (low platelet count)
6. Renal (kidney) disorder - high protein count in urine
7. Antinuclear antibody test positive
8. Immunologic disorder - positives on anti-Smith, anti-ds DNA, antiphospholipid antibody tests.
9. Neurologic disorder - seizures or psychosis
10. Malar rash - rash on cheeks
11. Discoid rash - red, scaly patches on skin that cause scarring

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In addition to the above tests, doctors will often conduct a variety of blood tests such as:

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• Complete blood count (CBC) to detect anemia, low platelet count, and low white blood cell count
• Erythrocyte sedimentation rate (ESR) to determine the rate at which red blood cells settle to the bottom of a tube in an hour. Rates faster than normal may indicate lupus or another systemic disease, inflammatory condition, or infection.
• Kidney and liver assessment to look for certain enzymes and albumin
• Urinalysis to measure protein levels or red blood cells in the urine
• Syphilis test to determine if anti-phospholipid antibodies are in the blood.

How is lupus treated?

There is currently no cure for lupus, nor has there been a new drug to treat the disease in the last 50 years, although there are a number of new drugs currently being researched or in clinical trials. However, early diagnosis and proper medical treatment can significantly help control the disease and its symptoms. Treating lupus effectively consists of minimizing symptoms, reducing inflammation and pain, helping maintain normal function, and preventing serious complications.

Since the disease affects each person differently, treatments are usually tailored to the specific problems that arise in each person. Medications and dosages will also vary depending on the severity of the disease.

When lupus presents with mild or moderate symptoms, the following medications are commonly used in treatment:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen sodium (Aleve), and ibuprofen (Advil, Motrin, others). Common side effects of NSAIDs include stomach bleeding and an increased risk of heart problems.
• Antimalarial drugs such as Hydroxychloroquine (Plaquenil). There is no known relationship between lupus and malaria, but malaria medicines have been useful in treating lupus symptoms and haven prevented flares of the disease. Side effects include vision problems and muscle weakness.
• Corticosteroids to counter inflammation. Serious long-term side effects include weight gain, easy bruising, osteoporosis, hypertension, diabetes, and increased risk of infection. The risk of osteoporosis can be reduced by taking calcium and vitamin D supplements.

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When lupus presents with severe or aggressive symptoms, the following treatments are commonly used:

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• High-dose corticosteroids. These may be taken intravenously or orally to control dangerous signs or symptoms of lupus. However, serious side effects have been observed such as infections, mood swings, hypertension and osteoporosis. Doctors tend to administer the lowest dose possible that will control symptoms, reducing the dosage over time.
• Immunosuppressive drugs such as cyclophosphamide (Cytoxan) and azathioprine (Imuran). These drugs suppress the immune system and may be helpful in serious lupus cases. They also carry a risk of serious side effects such as an increased risk of infection, liver damage, infertility and an increased risk of cancer.

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Other common treatments for specific signs and symptoms include:

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• Staying out of the sun and wearing sun block to prevent skin rashes. Indoor fluorescent lighting can also trigger skin rashes in some people with lupus. Topical corticoid steroids may be used to treat skin rashes in addition to oral steroids and antimalarial drugs.
• Medication to treat fatigue. Difficulty sleeping, depression and poorly controlled pain are all potential causes of fatigue, and doctors will treat these underlying causes. Medications such as corticosteroids and antimalarial drugs may be used if the cause of fatigue cannot be determined.
• NSAIDs, antimalarial drugs or corticosteroids to treat swelling around the heart and lungs that causes chest pain.

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In addition to medications, physicians recommend that lupus patients take good care of themselves. Patients may see a reduction in the frequency and severity of flares if they make healthy lifestyle choices such as:

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• Regular exercise.
• Becoming educated about lupus.
• Not smoking.
• Eating a healthful, balanced diet.
• Surrounding oneself with a support system of family, friends, and health professionals.

Living with lupus

Although there is no cure for lupus, there are several measures that patients can take to cope with the disease.

• Sun care - Use sunscreen with an SPF of at least 15 that can block both UVA and IVB rays.
• Diet - Eat a nutritious and well-balanced diet with limited sugar and salt intake if on corticosteroids. There is some evidence that fish has anti-inflammatory properties, but alfalfa sprouts may increase inflammation.
• Pain management - Apply moist heat to painful joints or soak in a hot tub or Jacuzzi.
• Exercise - Low-impact walking, swimming, aerobics, and bicycling may help prevent muscle atrophy and lower the risk of osteoporosis.
• Rehabilitation - Physical, occupational, and vocational therapists can help you to strengthen muscles, exercise, lower stress, recommend assistive devices, train for a job that does not exacerbate symptoms
• Don't smoke. Quit if you are a smoker.
• Climate - Changes in pressure can exacerbate symptoms. Try to live somewhere with minimal changes in climate and pressure.
• Fatigue - Control fatigue by remaining active and resting for an appropriate amount of time.
• Relationships - Maintain good relationships with the physicians that are helping you to manage lupus. Keep appointments, be honest, take medicines, and respect their time.
• Pregnancy - Keep aware and consult with a doctor about risks associated with pregnancy for you and your child.
• Cognitive function - A psychologist or cognitive therapists may be helpful if lupus leads to cognitive dysfunction or memory loss.

This is Lupus? - Video

A video from the Lupus Foundation. Individuals whoase lives have been greatly affected by lupus describe the suffering caused by disease and offer ways that you can help find a cure.

Lupus news

Medical News Today is a leading resource for the latest headlines on lupus. So, check out our lupus news section. You can also sign up to daily lupus news alerts or our weekly digest newsletters to ensure that you stay up-to-date with the latest news.a

International Sports Star Undergoes Surgery, Regains Sight At UAB After Training Disaster

Baljit Singh was looking forward to 2010. The premier event in professional field hockey, the World Cup, is to be hosted in his native India next year. And Singh, 28, was the goalie on the Indian National Team. He was considered the best goalie in Asia, ranked fourth in the world. Until a practice incident on July 17 changed everything.

Singh and the team were practicing in Bundi, in northwestern India. It was a common drill, the coach hitting a golf ball at Singh, trying to keep the ball low. A field hockey ball is about the size of a baseball, and by trying to stop the much smaller and faster moving golf ball, it was thought a goalie could improve his reflexes and timing. Only this time the coach hit the ball too high.

The ball struck Singh directly on the right eye, breaking through his protective mask. The impact caused four fractures in the bones of the eye socket and did extensive damage to the eye itself.

He was rushed to a Delhi hospital and had the first surgery to save his eye within 24 hours. Ophthalmologists there told Singh the optic nerve and his center vision, the macula, were damaged. He was told there was nothing to be done and any further procedures would only cause more damage.

But Singh and his family refused to accept that outcome. They did some research on the Internet and one name kept popping up. Robert Morris, M.D., associate professor of ophthalmology at the Callahan Eye Foundation Hospital at the University of Alabama at Birmingham (UAB) and president of the International Society of Ocular Trauma. Morris and his colleagues Doug Witherspoon, M.D., and Ferenc Kuhn, M.D., are renowned for their ability to repair damaged eyes after severe trauma. They have pioneered new techniques and instruments that allow them to gain access to and operate on the back of the eye. And they have shown that even injured eyes with no light perception (NLP) can sometimes be returned to useful vision.

Singh arrived in Birmingham on Aug. 7. Upon examination, Morris discovered that his damaged eye was smaller than normal and shrinking. He had minimal light perception.

"Mr. Singh understood that reconstructing the eye after this sort of trauma is like opening a surprise package," said Morris. "We could not assure him that it would be possible to restore any useful vision. He also understood that fine detail vision was unlikely. None the less, he wanted us to try."

"Dr. Morris was my last hope," said Singh. "I did not want to give up, so I told him to go for it, and we'd hope for the best."

On Aug. 11, Morris operated for the first time. Blood was drained from the eye and the retina re-attached. Silicon oil was injected into the eye to stop the shrinking and give the eye shape. More importantly, Morris discovered that Singh's optic nerve and macula were not destroyed, although the macula had been detached due to bleeding for the three weeks since the original injury.

"He began to see colors again, which was a good sign that the macula was beginning to recover," said Morris. "The macula and optic nerve looked normal although much of the rest of the eye has been badly injured."

In a follow up visit in mid-September, Morris fitted Singh with a contact lens. His vision improved to 20/200, which is the top line of the eye chart. Morris said there is potential to regain greater vision over time, but this was a significant improvement over the bare light perception prior to surgery. A final determination of how much vision Singh will regain won't be possible until early in 2010.

Singh, who returned home in early October, said he is focused on recovering his vision, not playing field hockey.

"I realize that my vision might not come back to the extent that I can play again at the level I did before," Singh said. "I must deal with reality, with both the negative and the positive. I'm thankful for the improvement thus far."

Singh said his teammates and coaches called every day while he was in Birmingham, offering encouragement and support. The Indian news media followed his progress. And he says the team no longer uses the golf ball drill in practice.

"I'm hopeful to regain full vision, but whatever will be, will be," Singh said. "I have full faith in Dr. Morris. He is a famous man in India now."

High Blood Pressure Easy To Miss In Children With Kidney Disease

Spot blood pressure readings in children with chronic kidney disease often fail to detect hypertension even during doctor's office visits increasing a child's risk for serious heart problems, according to research from Johns Hopkins Children's Center and other institutions. A report of the findings appears online in the Journal of American Society of Nephrology.

Researchers compared blood pressure measurements obtained during regular doctor visits to readings obtained via a special device the children wore at home that automatically recorded their blood pressure every 20 minutes.

Of the 198 children in the study, nearly 40 percent had "masked" hypertension, meaning their blood pressure was normal at the doctor's office, but spiked outside of it.

An even more disturbing finding: Children with masked hypertension were four times more likely to have a form of hypertension-related heart damage called left ventricular hypertrophy (LVH) than children with normal blood pressure, researchers report. LVH is a common consequence of untreated hypertension that results in a thickening of the left chamber of the heart and that over time can lead to heart failure and heart rhythm disturbances.

"Taking blood pressure at the doctor's office clearly misses many cases of masked hypertension," says Susan Furth, M.D., Ph.D., a pediatric nephrologist at Hopkins Children's and one of the study's principal investigators. "This means children with chronic kidney disease should have their blood pressure taken at home several times a day and regularly reported to their doctors." An overnight monitor, like the one used in the study, that automatically takes a child's blood pressure every 20 minutes is great, but some insurance companies won't pay for it, investigators say.

"Our findings are a sobering reminder of something we have long known: Blood pressure changes constantly throughout the day," says study lead author Mark Mitsnefes, M.D., M.S., from the Division of Nephrology and Hypertension at Cincinnati Children's. "We really can't rely on a single measurement as a valid indicator."

Investigators recommend that all children with chronic kidney disease get regular at-home readings of their blood pressure in addition to those taken during their visits to the doctor. Even though they used a different device in the study, researchers say many blood pressure monitors sold at drug stores are reliable but urge parents to talk to a doctor before choosing one.

Children who have repeated episodes of high blood pressure, researchers say, should also get a baseline echocardiogram, an ultrasound picture of the heart to evaluate heart muscle and function, and to get them every year thereafter.

This study was part of an ongoing NIH-funded research of chronic kidney disease in children, the largest to date, and involving more than 500 patients from 57centers. Hopkins Children's is one of two clinical coordinating sites, along with the Children's Hospital at the University of Missouri-Kansas City. The Johns Hopkins Bloomberg School of Public Health is the study's data coordinating center.

Kidney disease in children tends to start and evolve silently. More than one-third (37 percent) of kidney transplant patients in 2001 were between the ages of 20 and 44, and the majority of them likely developed the disease in childhood, researchers say. Researchers estimate that 650,000 Americans will develop end-stage renal disease by 2010, costing the health care system $28 billion a year.

WPI Researchers Take Aim At Hard-To-Treat Fungal Infections

A team of researchers at the Worcester Polytechnic Institute (WPI) Life Sciences and Bioengineering Center at Gateway Park has developed a new model system to study fungal infections. The system can be a powerful tool for screening potential drug targets for conditions like thrush, athlete's foot and vaginal yeast infections, which affect millions of people each year but are difficult to treat with existing medications. Using the new model, the researchers also identified a gene that may be a promising target for a new anti-fungal drug.

The WPI research team led by Reeta Prusty Rao, PhD, assistant professor of biology and biotechnology, developed the new model using the microscopic soil worm Ceanorhaditis elegans (C. elegans) as a test host which is then infected with the fungus Saccharomyces cerevisiae (S. cerevisiae). Commonly known as baker's yeast or brewer's yeast, S. cerevisae doesn't cause disease in humans, but the WPI team found that it can infect, and if left untreated, kill the worm. Since S.cerveisiae has many genes in common with fungi that do cause human disease, the genetic and molecular analysis now possible with this new testing model can be used to identify targets that could prevent or treat fungal infections in people.

"The beauty of this new model is that we can study both sides of the equation: the processes of fungal infection and the host's response to try and fight off that infection," said Prusty Rao.

Fungal infections are persistent and are not easily cleared by the handful of drugs currently available to treat them. As a result, the infections often reoccur. Typically, common fungal infections like athlete's foot and vaginal yeast infections do not cause serious harm. However, when an infection spreads to the bloodstream, it can be deadly. Hospitalized patients with catheters or central intravenous lines are at risk, as the fungi can grow on those devices and enter the body. Because of the lack of an effective treatment, the mortality rate for some systemic fungal infections is nearly 45 percent.

In their recently published study, Prusty Rao's team, working in collaboration with Samuel Politz, PhD, associate professor of biology and biotechnology at WPI, used a range of available genetic tools to monitor the infection process and observe how the worm tried to defend itself against the infection. They also studied which genes in the yeast were involved in trying to fight back against the worm's defense mechanisms. The team reported their findings in the paper "A Pathogenesis Assay Using Saccharomyces cerevisiae and Caenorhabditis elegans Reveals Novel Roles for Yeast AP-1, Yap1, and Host Dual Oxidase BLI-3 in Fungal Pathogenesis" published by the journal Eukaryotic Cell.

The work showed that the worms produce hydrogen peroxide and other so-called reactive oxygen species (ROS) to try and kill the invading fungus, while certain genes in the yeast produce other chemicals that can ward off the hydrogen peroxide attack. One gene in particular, called Yap 1, was found to be essential for the yeast's ability to neutralize the ROS attack. When they removed Yap 1 from the yeast's genome, infection was prevented. This was an important finding because Yap 1 is found only in fungi, not people. If a drug can be developed to target only that gene, it should not have any side-effects in people.

"The challenge has been to find therapeutic agents that can kill the fungus, but not harm the surrounding tissue; that's proven to be very difficult," Prusty Rao said. "In this study, we show that the gene Yap 1 is essential for infection, and it is only found in yeast, including the strains that do cause disease in people. So this is a promising target for further study."

Women Can Quit Smoking And Control Weight Gain

Many women don't quit smoking because they are afraid of gaining weight. That's because nicotine suppresses the appetite and boosts a smoker's metabolism.

But a new meta-analysis (results of several studies) shows that women who quit smoking while receiving treatment for weight control are better able to control their weight gain and are more successful at quitting cigarettes.

The finding disproves current clinical guidelines that say trying to diet and quit smoking at the same time will sabotage efforts to ditch cigarettes.

"Women who smoke often feel caught between a rock and hard place, because they're concerned about their health but also concerned about their appearance," said Bonnie Spring, lead author of the study and a professor of preventive medicine at the Northwestern University Feinberg School of Medicine. "Now they don't have to choose between the two."

Previously, it was assumed that a person could only change one health risk behavior at a time. "But these findings show that, at least in the case of smoking and eating, you actually get an added benefit when you try to change a couple of behaviors at once," Spring said.

Recently published in the journal Addiction, Spring's paper examined the results from 2,233 smokers in 10 studies from 1991 to 2007.

The study showed that women whose treatment addressed both smoking and weight control were 29 percent more likely to quit smoking in the short term (at three months) and 23 percent in the long term (from six to 14 months) than those whose treatment addressed only smoking. Women whose treatment included smoking and weight control also gained less weight than those whose treatment included only smoking. They gained an average of 2.1 pounds less in the short term and 2.5 pounds less in the long term.

Spring hopes the study results will change doctors' attitudes and current clinical guidelines about combining weight control and smoking cessation. "Perhaps this news also will encourage more women to quit," she added, noting that cigarette smoking kills an estimated 178,000 women in the U.S. each year. About 17.4 percent of women in the U.S. smoke.

Her meta-analysis looked at different kinds of approaches to weight control.

"Some worked better than others, " she said. "Now we need different investigators to test out those most promising treatments to see if they get the same good results."

More studies also are needed that offer longer-term intervention for weight and smoking cessation. The literature on weight control shows patients lose the benefit when they stop treatment, Spring pointed out.

What Is Cartilage Damage? What Is Articular Cartilage Damage?

Cartilage structures and functions can relatively easily be harmed, often resulting in damage. Cartilage is a tough, flexible connective tissue that is found in many areas of the body. This fine, rubbery tissue mainly functions as a cushion for bones at joints. The English word "cartilage" comes from the Latin word cartilage, which means "cartilage" or "gristle".

Cartilage has several functions:

• Shock absorber: Cartilage covers the surface of joints, allowing bones to slide over one another. It reduces any friction, prevents any damage and helps to support weight when moving, bending, stretching or running.


• Acts as a mould: the tough, flexible cartilage tissue forms specially shaped and curved body parts that would otherwise have no support from the bones. For instance, the outside of the ears and most of the nose are made up of cartilage.

However, cartilage unlike other types of tissue does not have a blood supply. Blood cells help repair tissue damage. As a result, unlike damaged skin or muscles that can heal, damaged cartilage will not heal quickly.

There are three types of cartilage:

• Elastic cartilage is the most springy and supple type of cartilage. This type of cartilage makes up the outside of the ears, some of the nose, and also the epiglottis.


• Fibrocartilage is the toughest type of cartilage, and it is able to withstand a great deal of weight. It is found between the discs and vertebrae of the spine and between the bones in the hips and pelvis.


• Hyaline cartilage is both springy and tough. It is found between the ribs, around the windpipe, and between the joints. The cartilage between the joints is known as articular cartilage.

Types of cartilage damage

All three types of cartilage can be damaged. A blow to the ear can damage the elastic cartilage, causing the ear to appear deformed. Or, the fibro cartilage between the discs of the back can become damaged, resulting in a slipped disc.

One of the most common and potentially serious types of cartilage damage occurs in the articular cartilage that lies in between a joint, usually the knee joint. This can cause pain, swelling, and some loss of mobility. Articular cartilage damage is not life threatening, but does strongly affect the quality of life. This damage is often the cause of severe pain, swellings, handicapped mobility and severe restrictions to the patient's activities.

What are the signs and symptoms of cartilage damage?

A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor notice. For example, pain may be a symptom while a rash may be a sign.

The symptoms of articular cartilage damage include:

• decreased range of movement in the affected joint
• joint pain
• stiffness
• swelling

If the damage is particularly severe, a piece of cartilage can break off and become loose. In this case, the loose piece of cartilage may affect the movement of the joint. This can cause a feeling of the joint 'locking' or catching. Sometimes, the joint may also give way.

What are the causes of cartilage damage?

• Direct blow: Articular cartilage damage can occur as a result of a sudden, direct blow to the cartilage. This can happen, for example, when falling directly onto the knees. This is why cartilage damage is often a problem for people who play sports that involve physical contact,such as football, rugby, and some martial arts.


• 'Wear and tear': Cartilage can also become damaged gradually, over time. There is an increased risk of developing this type of cartilage damage for overweight individuals, or for people with a problem with the structure of the joint. This type of long-term damage to the cartilage is known as osteoarthritis.


• Immobility: Being immobile for a long period can also damage the cartilage. It requires regular movement in order for it to function properly.

Articular cartilage has a very limited capacity for self repair. Small damage does not repair itself and can often get worse over time.

How is cartilage damage diagnosed?

Diagnosing articular cartilage damage can be difficult. The diagnosis cannot be confirmed through physical examination. In addition, the symptoms are similar to the ones of other types of knee injuries, such as a sprain or a damaged ligament.

• Magnetic resonance imaging (MRI): MRI scans use strong magnetic fields and radio waves to produce detailed images of the inside of the body. It can often detect cartilage damage.


• Arthroscopy: This is a form of 'keyhole surgery' where the surgeon makes a small incision into the joint. An arthroscope (a small, flexible tube with a camera) is used to look inside the joint.
  
  Arthroscopies can be carried out under local anesthetic and there is no need for an overnight stay at the hospital.


• Grading of cartilage damage
  
  After an arthroscopy, the extent of the damage can be determined. Cartilage damage is measured in grades from zero to four:
  
  
  • Grade 0 - the cartilage is healthy, undamaged and intact.
  
  
  • Grade 1 - the cartilage has some blistering and soft spots.
  
  
  • Grade 2 - there is a minor defect (less than 50 percent) in the cartilage. There are minor tears in the surface of the cartilage.
  • Grade 3 - there is a deeper defect (more than 50 percent), deep crevices in the cartilage.
  
  
  • Grade 4 - the cartilage has lost all of its thickness, leaving the bones of the joint exposed.
  
  
  The grading does not always correspond to the level of pain. For example, one person may have severe pain as a result of grade-one damage, while another person who has sustained extensive damage may experience very little pain. Pain is not a good indicator of the extent of the damage. Also, the size of each defect will be measured as well as its location.

What is the treatment for cartilage damage?

There are a number of non-surgical treatments that can help to relieve the symptoms of damaged articular cartilage:

• Physiotherapy: A set of exercises that strengthen the muscles surrounding or supporting the joint. This may help to reduce the pressure on the joint, and reduce pain.


• Painkillers: non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, can help to reduce swelling and pain. Avoid taking ibuprofen if there is history of stomach problems, such as a peptic ulcer.


• Supportive devices: for example, a cane, or a leg brace.


• Lifestyle changes: for example, reducing activity that involves the affected joint.

Non-surgical treatment may only provide short-term relief and surgery may be required in more severe cases.

Surgical treatment

• Arthroscopic lavage and debridement: It is a technique that is used when pieces of cartilage have become loose in the joint, causing the joint to lock up. An arthroscope (a flexible tube with a camera on the end) is used to enter the joint, before literally 'washing out' the joint using a saline solution.
  
  The technique cannot repair the damaged cartilage, but it can help to reduce the pain and increase mobility.


• Marrow stimulation: It is a procedure that involves drilling tiny holes (micro fractures) into the bone underneath the damaged cartilage. This exposes the blood vessels inside the bone. As a result, it leads to the formation of a blood clot within the damaged cartilage. The blood cells then begin to stimulate the production of new cartilage. The disadvantage to the procedure is that the newly generated cartilage is fibro cartilage rather than hyaline cartilage. Fibro cartilage is not as supple as hyaline cartilage. Therefore, there is a risk that it can wear away after a few years in some cases. Further surgery may be required.


• Mosaicplasty: It is a new technique that involves removing healthy cartilage from the non-weight bearing areas of a joint, such as the side of the knee. It is then used to replace the damaged cartilage.
  
  Mosaicplasty appears to be successful in most people. However, there is not enough available evidence to determine what the possible long-term advantages and drawbacks of the technique may be.
  
  As it is a new procedure, the possible risks and benefits of the technique should be fully discussed with the surgeon.


• Autologous chondrocyte implantation (ACI) : It is another new technique where a small sample of cartilage cells is taken from the edge of the knee.
  
  The cells are then sent to a laboratory and placed in an incubator, where they are given nutrients. This encourages them to divide and produce new cells. After a few weeks, the number of cartilage cells will have increased by 50 times from their original number. The new cartilage will be used to replace the damaged cartilage.
  
  The National Institute for Health and Clinical Excellence (NICE), UK, has studied ACI and determined that there is not enough evidence about its long-term effects or safety. It is only available as part of a clinical trial or in a number of private clinics. The possible risks and benefits should be fully discussed with the surgeon before choosing to have the procedure.

Rehabilitation

Rehabilitation following any articular cartilage repair procedure is essential for the success of any articular cartilage resurfacing technique. The rehabilitation is often long and demanding. Mainly because it takes a long time for the cartilage cells to adapt and mature into repair tissue. Cartilage is a slow adapting substance.

Current research

There are a number of research projects that are currently investigating additional efficient and effective ways of repairing cartilage.

• Hybrid cartilage: created by combining human cells with synthetic fibers.


• Stem cells: Another project is looking at ways of using special cells, known as stem cells, to generate new cartilage.

These projects are still in their initial stages. But, researchers are confident that they will in time lead to new kinds of treatment.

Parkinson's Disease And Its Effects On The Mind And Emotions

Parkinson's Disease And Its Effects On The Mind And Emotions

When the phrase "Parkinson's disease" is mentioned the majority of people will automatically think about the physical symptoms associated with the condition such as the tremors, the loss of mobility and other motor impairments. However coping with Parkinson's disease also take a tremendous toll on the emotional well being of the sufferer; something that many people don't consider.

Feelings of anxiety, frustration, embarrassment at not being able to do every day things and often depression can have a huge effect on Parkinson's patients. These psychological symptoms occur as a result of the physical symptoms and can have a very negative effect on a person. Depressive episodes are seen in an average of 50% of patients and these episodes often alternate with anxiety attacks so that the patient has the symptoms of a manic-depressive. Alternating emotional outbursts of depression and anxiety are common in around 80% of cases.

Partial memory loss can also add to the psychological stresses felt by a Parkinson's sufferer. As the disease progresses, patients can begin to forget dates, names and faces which can be quite traumatic, especially when the sufferer knows that a person is a loved one but they can not recall their name or what relation they are to them.

However with a loving support system of friends and family and all the information that can possibly be known about Parkinson's disease, many of the emotional symptoms of the disease can be kept under control i.e. depressive episodes and feelings of frustration. It is very helpful to a sufferer if they can join a local support group as well so that they can talk about their emotions with people who understand exactly what they are going through. Simply having someone who is experiencing the same feelings and frustrations can prove to be a very positive influence.

It is also helpful for a Parkinson's sufferer to participate in activities that hold their interest, be they physical activities or mental activities. Having happy experiences can quickly fend off any depressive feelings and mental exercises will help to keep the brains functioning normal for longer. Any activity can be enjoyed with the support of a loved one so for example daily exercises can be made fun if they are performed to music with a partner. They can even become a bit of a competition with a reward for the winner.

For the Parkinson's sufferer, work can be both a burden and a release. Explaining the situation to management can mean that allowances are often made so that stress levels and physical labor are kept to a minimum. People in general are very understanding when it comes to long term illness in the workplace and a good boss will help in any way they can. This means that a Parkinson's disease sufferer can remain active and with the people they know for much of the day, thus leaving less time to sit and contemplate their condition. Research has shown that the most emotionally stable Parkinson's disease patients are those who can make a joke out of their symptoms and who don't let the condition get them down, under any circumstances.

Parkinson's Disease - Definition, Causes, Symptoms and Treatment

Parkinson's Disease - Definition, Causes, Symptoms and Treatment

Parkinson's disease is a degenerative disorder of the central nervous system.

Parkinson's disease occurs when nerve cells, or neurons, in an area of the brain known as the substantia nigra die or become impaired. Normally, these neurons produce an important brain chemical known as dopamine. At least 500,000 people in the United States currently have PD. Parkinson's disease belongs to a group of conditions called movement disorders. Parkinson's disease is progressive, meaning the signs and symptoms become worse over time. But although Parkinson's disease may eventually be disabling, the disease often progresses gradually. Parkinson disease affects movement (motor symptoms). Typical other symptoms include disorders of mood, behavior, thinking, and sensation (non-motor symptoms). Individual patients' symptoms may be quite dissimilar and progression of the disease is also distinctly individual. Parkinson's usually begins around age 60. It is more common in men than in women. Symptoms of Parkinson's disease often start on one side of the body first and then affect both sides.

There are many secondary symptoms associated with Parkinson's disease.

Parkinson's disease patients may notice that they are weaker or more tired. Symptoms include disorders of mood, behavior, thinking, and sensation. Poor balance is due to the impairment or loss of the reflexes that adjust posture in order to maintain balance. Falls are common in people with Parkinson's. Shaking (muscle tremor). This is one of the first symptoms in three-quarters of people, and affects most people with Parkinson's disease. Bradykinesia is the phenomenon of a person experiencing slow movements. In addition to slow movements, a person with bradykinesia will probably also have incomplete movement, difficulty initiating movements and sudden stopping of ongoing movement. The progressive loss of voluntary and involuntary muscle control produces a number of secondary symptoms associated with Parkinson's. Postural instability, or impaired balance and coordination, causes patients to develop a forward or backward lean and to fall easily.

Parkinson's disease requires broad-based management including patient and family education, support group services, general wellness maintenance, exercise, and nutrition.

Medications can help manage problems with walking, movement and tremor by increasing the brain's supply of dopamine. Amantadine may also be added to carbidopa-levodopa therapy for people in the latter stages of Parkinson's disease. Catechol-O-methyl-transferase (COMT) inhibitors drugs prolong the effect of carbidopa-levodopa therapy by blocking an enzyme that breaks down dopamine. Tolcapone (Tasmar) is a potent COMT inhibitor that easily crosses the blood-brain barrier. A medicine called levodopa is often given to people who have Parkinson's disease. Called "L-dopa," this medicine increases the amount of dopamine in the body and has been shown to improve a person's ability to walk and move around. Thalamotomy involves the destruction of small amounts of tissue in the thalamus - a major brain center for relaying messages and transmitting sensations.

Parkinson's Disease Treatment

• Carbidopa and benserazide are dopa decarboxylase inhibitors.
• Tolcapone inhibits the COMT enzyme, thereby prolonging the effects of L-dopa, and so has been used to complement L-dopa.
• Selegiline and rasagiline reduce the symptoms by inhibiting monoamine oxidase-B (MAO-B).
• An antiviral drug, amantadine, can help reduce symptoms of PD and levodopa-induced dyskinesia.
• COMT (catechol-O-methyl-transferase) inhibitors are a new class of drugs that stop the breakdown of dopamine.
• Other therapies that are important for managing and coping with Parkinson's disease include physiotherapy, speech therapy, and occupational therapy.
• Amantadine acts like a dopamine replacement drug but works on different sites in the brain.

The Primary Cause of Parkinson Disease

The Primary Cause of Parkinson Disease

Parkinson's disease is a degenerative illness caused fundamentally by the gradual breakdown of a specific part of the brain. While this is the primary cause of Parkinson disease, there can be a number of reasons why this degeneration occurs.

The vast of majority of people suffering from Parkinson disease have been told that the cause is unspecific; meaning that there's no way of knowing why it has happened. Others, on the other hand may have developed Parkinson disease because of the genetics they've inherited from parents or grandparents; if someone's mother or father had Parkinson disease then they are also prone to it. Scientists have confirmed that there are 9 possible genes in human Dna that can be responsible for the onset of this disease. Various traumas (specifically to the head) can be to blame, as can exposure to certain toxins such as pesticides. While each of these causes is starkly different they all share one thing in common: they cause degeneration of the brain's Substantia Nigra and as a result we can call this the primary cause of Parkinson disease.

The Substantia Nigra is the part of the brain that is responsible for dopamine production. Dopamine is a neurotransmitter that allows messages to be passed through the brain and ultimately control movement. When there is a loss of dopamine carrying out intended actions can be difficult, which we see quite clearly in people with Parkinson's disease who take longer than average to answer a question, or who find something as simple as picking up a cup takes well over 10 seconds. The symptoms of Parkinson's disease can vary widely depending on the severity of the condition and the individual differences of the person affected. Alongside the fact that the cause of Parkinson disease can vary widely too, care can be completely different from one patient to the next.

So we know exactly what causes the Parkinson's disease to develop: the degeneration of the Substantia Nigra, yet what causes this to happen remains unclear. At present scientists and medical experts are researching the production of dopamine to see how the death of dopamine producing cells can be prevented. If this can be done then Parkinson's disease could be prevented when it's caught early. If scientists manage to find a way or reversing this kind of cell death then a cure for the cause of Parkinson disease will have been found.

If you, or a family member, have recently been diagnosed with Parkinson's disease then it's important to understand that while the causes have been narrowed down to genetics, trauma or exposure to toxins these may not be the only causes that exist. The most important thing fo you to do now is seek a long term routine of care, treatment and preventative measures so that quality of life is preserved for as long as possible. Parkinson's disease is a very unfortunate, debilitating and cruel disease but with the right network of doctors and friends to help you seek treatment as early on in the illness as possible you could slow down its progression considerably.