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Archive for April, 2010

Americans fear Alzheimer’s disease more than any illness other than cancer-and for older people, concerns about Alzheimer’s outrank even cancer. More than a third of all Americans know a family member or friend who has Alzheimer’s, and nearly two-thirds of Americans believe they will have to provide care someday for someone with Alzheimer’s.

These are just some of the results from a January 2006 MetLife Foundation/Harris Interactive poll of American adults. The survey, found in “MetLife Foundation Alzheimer’s Survey: What America Thinks,” included questions about how people view Alzheimer’s disease, what they know about it and what they are doing to plan for a future that may include the deadly illness.

A progressive brain disorder that science has yet to defeat, Alzheimer’s gradually destroys a person’s memory and ability to reason, communicate and function. Currently, 4.5 million Americans have Alzheimer’s disease, and the Alzheimer’s Association estimates that these numbers will grow to as many as 16 million Americans by 2050. Increasing age is the greatest risk factor for Alzheimer’s. One in 10 individuals over 65 and nearly half of those over 85 are affected. The Alzheimer’s Association and the National Institute on Aging estimate that direct and indirect costs of current care are at least $100 billion annually.

The survey results underscore not only the fears that people have about this illness, but also the disturbing fact that few are prepared to face a future that may include Alzheimer’s.

Key findings from the poll, which was commissioned by MetLife Foundation, are summarized in a report available at www.metlife.org. They include:

• Americans fear Alzheimer’s disease. When people are asked to name the disease they are most afraid of getting from a list of illnesses, one out of five picks Alzheimer’s, while only 14 percent worry about heart disease and 13 percent are concerned about stroke. Only cancer tops Alzheimer’s. In fact, adults aged 55 and older fear getting Alzheimer’s even more than cancer.

• Americans know little or nothing about Alzheimer’s. While virtually all of those surveyed are aware of the disease (93 percent), almost three-quarters (74 percent) say they know only a little or nothing at all about Alzheimer’s.

• One-third of Americans say they have direct experience with Alzheimer’s disease. One in three Americans (35 percent) has a family member and/or friend with Alzheimer’s.

• Most Americans are concerned that they will be responsible at some point for caring for someone with Alzheimer’s disease. More than three out of five people worry that they will have to eventually provide or care for someone with the disease.

Most Americans recognize the need to create a plan to address the possibility of Alzheimer’s disease, but very few have taken steps to do so. More than eight out of 10 Americans think it is important to plan ahead for the possibility of getting Alzheimer’s disease. However, despite the overwhelming agreement that planning is important, almost no one has taken action. Nearly nine out of 10 Americans say they have made no comprehensive plans. The survey shows that Americans know enough about Alzheimer’s disease to fear its onset, but have not taken any steps to provide for the possibility of developing the disease.

Americans’ fears of Alzheimer’s are justified, given its increasing presence among a population that will live longer. As the population ages, it is essential to learn as much as possible about the disease and plan for the future.

Type 1 diabetes
Results from the body’s failure to produce insulin, the hormone that unlocks the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.

Having type 1 diabetes increases your risk for many serious complications. Some complications of type 1 diabetes include: heart disease (cardiovascular disease), blindness (retinopathy), nerve damage (neuropathy), and kidney damage (nephropathy).

Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.

Having type 2 diabetes increases your risk for many serious complications. Some complications of type 2 diabetes include: heart disease (cardiovascular disease), blindness (retinopathy), nerve damage (neuropathy), and kidney damage (nephropathy). Learn more about these complications and how to cope with them.

Gestational diabetes
Gestational diabetes affects about 4% of all pregnant women – about 135,000 cases in the United States each year.

Because gestational diabetes can hurt you and your baby, you need to start treatment quickly. Treatment for gestational diabetes aims to keep blood glucose levels equal to those of pregnant women who don’t have gestational diabetes. Treatment for gestational diabetes always includes special meal plans and scheduled physical activity. It may also include daily blood glucose testing and insulin injections. You will need help from your doctor, nurse educator, and other members of your health care team so that your treatment for gestational diabetes can be changed as needed.

For the mother-to-be, treatment for gestational diabetes helps lower the risk of a cesarean section birth that very large babies may require. Sticking with your treatment for gestational diabetes will give you a healthy pregnancy and birth, and may help your baby avoid future poor health. (see Diabetes Symptoms)

Pre-diabetes
Pre-diabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 41 million Americans who have pre-diabetes, in addition to the 20.8 million with diabetes.

Pheochromocytoma is an important cause of secondary Hypertension. We have adnenal gland located at upper portion of each kidney. It is divided into adrenal cortex and adrenal medulla. Pheochromocytoma is a tumor of Adrenal Medulla. Normal function of adrenal medulla is to produce epinephrine or adrenaline. Which is responsible for controlling blood pressure and to help cope with stressful situations.
So majority of symptoms of pheochromocytoma are due to excess secretion of adrenaline from adrenal medulla. Most patients of pheochromocytoma have recurrent episodes of headache, sweating and a feeling of high anxiety. The following symptoms are listed from the most common to the least common
Headaches (severe)
sweating Episodes (generalized)
heart palpitations (tachycardia and palpitations)
Anxiety
nervousness (feelings of impending death)
tremors
Pain in the lower chest or upper abdomen
Nausea (with or without nausea)
Weight loss
Heat intolerance

These symptoms may come by situations which causes pressure over tumor like physical activity, exercise, defecation, anesthesia, or change in body position.

Who should be examined for Pheochromocytoma
Those who have uncontrolled hypertension
Those who have age between 40 and 60
Those who are already taking 4 antihypertensive drugs but blood pressure is not controllable.
Those who have episodes of above symptoms

Cause of pheochromocytoma is unknown, however some forms of this tumor runs in families like,
a-Multiple endocrine neoplasia, type II (MEN-II). In addition to a pheochromocytoma, people with MEN-II also have thyroid cancer. Other forms of MEN-II include pheochromocytoma with thyroid cancer and hyperparathyroidism (MEN-IIA), and pheochromocytoma with thyroid cancer and tumors of nerves in the eyes lips, mouth and digestive tract (MEN-IIB).
b-Neurofibromatosis 1 (NF1). Pheochromocytomas can occur in a small percentage of people with NF1, a syndrome that includes multiple tumors in the skin (neurofibromas), pigmented skin spots, tumors of the optic nerve of the eye, and bone diseases.
c-Von Hippel-Lindau (VHL) disease. People with this rare multi system disorder are at high risk of pheochromocytoma brain eye and kidney tumors.

Most pheochromocytomas are benign tumors and they don’t spread to other parts of body however some forms do show metastasis (spread) to other parts of body like lungs, bones and brains. Usually only one gland is involved however this tumor can be present in both adrenal glands.

Investigations:
Blood and Urine tests: We perform blood and urine tests to diagnose pheochromocytoma. 24 hr urine collection is tested for epinephrine, norepinephrine and dopamine. This test is called VMA. Idea is just to check level of epinephrine and its metabolites in urine. If these are detected in urine in excess quantity, then tumor is diagnosed.

Abdominal scan.
Now you have diagnosed tumor by blood and urine tests, after that to find out location of tumor, do Ultrasound, CT scan of abdomen.

Complications:
If high blood pressure remained uncontrolled it may lead to complications of heart failure, infarction, cerebrovascular accident, vision damage and kidney failure.

Treatment:
First treatment is to control high blood pressure with medication like Alpha Blockers and Beta Blockers. When epinephrine is secreted by this tumor it acts on alpha and beta receptors present on heart and blood vessels, result is vasoconstriction and increase heart rate. Now if if we take drugs like alpha blocker and beta blocker, epinephrine will be blocked by these drugs to act on these receptors so result is vasodilation and slow heart rate. Common Alpha blockers are Prazosin (Minipress), Terazosin (Hytrin) Phenoxybenzamine( Dibenzaline). Common Beta Blockers are Atenolol(Tenormin), Carvedilol(Carveda), Metoprolol(Mepressor), Inderal.

Treatment of choice for this tumor is Surgery. After removal of this gland by surgery, blood pressure becomes normal with a day. There are two types of surgeries. General and Laproscopic surgery. However Surgery is not an option for those tumors which show metastasis to other parts of body. For that we use chemotherapy and radiations.

Whenever you have high blood pressure with any symptom, don’t ignore it, you may be the patient of Pheochromocytoma. Always contact your Doctor.

If you want to know more about Pheochromocytoma, visit our site highbloodpressuremed.com