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Newsletter

January 2008

Volume 2, No 1

                    Use The Person That Physicians Rely On - A RN -    

 
Exactly What Is Cancer?

"Cancer is a renegade system of growth that originates within a patient's biosystem, more commonly known as the human body. There are many different types of cancers, but all share one hallmark characteristic: unchecked growth that progresses toward limitless expansion.

Because cancer is so prevalent, people have many questions about its biology, detection, diagnosis, possible causes, and strategies for prevention.

Different Kinds of Cancer:

1.  Carcinomas: the most common types of cancer, arise from the cells that cover external and internal body surfaces. Lung, breast, and colon are the most frequent cancers of this type in the United States.

2.  Sarcomas: are cancers arising from cells found in the supporting tissues of the body such as bone, cartilage, fat, connective tissue, and muscle.

3.  Lymphomas: are cancers that arise in the lymph nodes and tissues of the body's immune system.

4. Leukemias:  are cancers of the immature blood cells that grow in the bone marrow and tend to accumulate in large numbers in the bloodstream.

Naming Cancers:

Scientists use a variety of technical names to distinguish the many different types of carcinomas, sarcomas, lymphomas, and leukemias.
In general, these names are created by using different Latin prefixes that stand for the location where the cancer began its unchecked growth. For example, the prefix "osteo" means bone, so a cancer arising in bone is called an osteosarcoma. Similarly, the prefix "adeno" means gland, so a cancer of gland cells is called adenocarcinoma--for example, a breast adenocarcinoma.

Loss of Normal Growth Control:

Cancer arises from a loss of normal growth control. In normal tissues, the rates of new cell growth and old cell death are kept in balance. In cancer, this balance is disrupted. This disruption can result from uncontrolled cell growth or loss of a cell's ability to undergo cell suicide by a process called" apoptosis." Apoptosis, or "cell suicide," is the mechanism by which old or damaged cells normally self-destruct. "

To learn much more and see diagrams on this interesting subject:

Source:  Cancer.gov

Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections (CA-MRSA)

MRSA remains a major human pathogen. Traditionally, MRSA infections occurred exclusively in hospitals and were limited to immunocompromised patients or individuals with predisposing risk factors.

However, recently there has been an alarming epidemic of CA-MRSA strains that can cause a spectrum of disease ranging from uncomplicated skin infections to severe infections that can result in necrotizing soft-tissue infections and necrotizing pneumonia and death in otherwise healthy humans outside of the healthcare setting. The emerging potential danger associated with CA-MRSA invasive infections was demonstrated by the deaths of 4 healthy children in Minnesota and North Dakota between 1997 and 1999.

The US Centers for Disease Control and Prevention (CDC) has defined CA-MRSA as having no healthcare risk factors. Persons with MRSA infections that meet all of the following criteria likely have CA-MRSA infections:

  • Diagnosis of MRSA was made in the outpatient setting or by a culture positive for MRSA within 48 hours after admission to the hospital

     
  • No medical history of MRSA infection or colonization
     
  • No medical history in the past year of
     
    • Hospitalization, dialysis, or surgery
       
    • Admission to a nursing home, skilled nursing facility, or hospice
  • No permanent indwelling catheters or medical devices that pass through the skin into the body
CA-MRSA strains can be highly virulent (actively poisonous) and have been documented to cause life-threatening necrotizing (causing death of tissue, such as skin) infections. Many strains of CA-MRSA encode for the PVL toxin, a pore-forming cytotoxin (a substance that has a toxic effect on certain cells) associated with necrotic lesions or abscess formation. More rarely, CA-MRSA infection can lead to cases of serious, life-threatening diseases, such as necrotizing pneumonia, necrotizing soft-tissue infections, -- which may prove fatal.

CA-MRSA is an important public health problem. CA-MRSA infections are on the rise in epidemic proportion.

Close contacts of persons with CA-MRSA skin or pulmonary infections have a higher likelihood of acquiring an infection, so infection control issues are extremely important. It is critically important to address prevention of transmission of CA-MRSA infections by advocating for hand hygiene.

Source:  Medscape.com
For more information: see

http://www.medscape.com
/viewarticle/566787?src=mp

Dementia and Alzheimer's
There is a Distinct Difference

For this entry, let me just state that there is often confusion and misunderstanding with the terms Alzheimer's disease and dementia, but there is a distinct difference.

The term dementia refers to a set of symptoms, not the disease itself. These symptoms might include language difficulty, loss of recent memory or poor judgment. In other words, when an individual is said to have dementia they are exhibiting certain symptoms. With a thorough screening including blood tests (to rule out other causes of dementia such as vitamin deficiency), a mental status evaluation, neuropsychological testing, and sometimes a brain scan, doctors can accurately diagnose the cause of the dementia symptoms in 90 percent of the cases. (It is true however, that Alzheimer's can be diagnosed with complete accuracy only after death, using a microscopic examination of brain tissue, which checks for plaques and tangles).

Although Alzheimer's disease accounts for 60-70 percent of cases of dementia, other disorders that cause dementia include: Vascular dementia, Parkinson's disease, dementia with Lewy Bodies and Frontotemporal dementia.

In the early stages of a disease, there can be some clear differences between the diseases. For example, in dementia with Lewy Bodies (the second most common cause of dementia) early symptoms of the disease may not be so much forgetfulness, but lowered attention span, recurrent visual hallucinations, and a fluctuation between periods of lucidity (or clear thinking) followed by periods of confusion. However, as the specific disease advances, more parts of the brain become affected, and the differences from one cause of dementia to another are subtle.

No two persons are similar in how the disease impacts them.

Source:  The Mayo Clinic

What is Restless Legs Syndrome?

 
Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described by people as burning, creeping, tugging, or like insects crawling inside the legs. Often called paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), the sensations range in severity from uncomfortable to irritating to painful.

The most distinctive or unusual aspect of the condition is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes exhaustion and daytime fatigue. Many people with RLS report that their job, personal relations, and activities of daily living are strongly affected as a result of their exhaustion. They are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks.

RLS occurs in both genders, although the incidence may be slightly higher in women. Although the syndrome may begin at any age, even as early as infancy, most patients who are severely affected are middle-aged or older. In addition, the severity of the disorder appears to increase with age. Older patients experience symptoms more frequently and for longer periods of time.

As described above, people with RLS feel uncomfortable sensations in their legs, especially when sitting or lying down, accompanied by an irresistible urge to move about. These sensations usually occur deep inside the leg, between the knee and ankle; more rarely, they occur in the feet, thighs, arms, and hands. Although the sensations can occur on just one side of the body, they most often affect both sides.

Because moving the legs (or other affected parts of the body) relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations. They may pace the floor, constantly move their legs while sitting, and toss and turn in bed.

Most people find the symptoms to be less noticeable during the day and more pronounced in the evening or at night, especially during the onset of sleep. For many people, the symptoms disappear by early morning, allowing for more refreshing sleep at that time. Other triggering situations are periods of inactivity such as long car trips, sitting in a movie theater, long-distance flights, immobilization in a cast, or relaxation exercises.

The symptoms of RLS vary in severity and duration from person to person. Mild RLS occurs episodically, with only mild disruption of sleep onset, and causes little distress. In moderately severe cases, symptoms occur only once or twice a week but result in significant delay of sleep onset, with some disruption of daytime function. In severe cases of RLS, the symptoms occur more than twice a week and result in burdensome interruption of sleep and impairment of daytime function.

What Causes RLS?

In most cases, the cause of RLS is unknown (referred to as idiopathic). A family history of the condition is seen in approximately 50 percent of such cases, suggesting a genetic form of the disorder. People with familial RLS tend to be younger when symptoms start and have a slower progression of the condition.

In other cases, RLS appears to be related to the following factors or conditions, although researchers do not yet know if these factors actually cause RLS.

1.  People with low iron levels or anemia may be prone to developing RLS. Once iron levels or anemia is corrected, patients may see a reduction in symptoms.

2.  Chronic diseases such as kidney failure, diabetes, Parkinson's disease, and peripheral neuropathy are associated with RLS. Treating the underlying condition often provides relief from RLS symptoms.  (Continued below)

      
3.  Some pregnant women experience RLS, especially in their last trimester. For most of these women, symptoms usually disappear within 4 weeks after delivery.

4.  Certain medications-such as antinausea drugs (prochlorperazine or metoclopramide), antiseizure drugs (phenytoin or droperidol), antipsychotic drugs (haloperidol or phenothiazine derivatives), and some cold and allergy medications-may aggravate symptoms. Patients can talk with their physicians about the possibility of changing medications.

Researchers also have found that caffeine, alcohol, and tobacco may aggravate or trigger symptoms in patients who are predisposed to develop RLS. Some studies have shown that a reduction or complete elimination of such substances may relieve symptoms, although it remains unclear whether elimination of such substances can prevent RLS symptoms from occurring at all.

How is RLS Diagnosed?

Currently, there is no single diagnostic test for RLS. The disorder is diagnosed clinically by evaluating the patient's history and symptoms. Despite a clear description of clinical features, the condition is often misdiagnosed or underdiagnosed.

Despite these efforts to establish standard criteria, the clinical diagnosis of RLS is difficult to make. Physicians must rely largely on patients' descriptions of symptoms and information from their medical history, including past medical problems, family history, and current medications.

If a patient's history is suggestive of RLS, laboratory tests may be performed to rule out other conditions and support the diagnosis of RLS. Blood tests to exclude anemia, decreased iron stores, diabetes, and renal dysfunction should be performed. Electromyography and nerve conduction studies may also be recommended to measure electrical activity in muscles and nerves, and Doppler sonography may be used accompanying damage or disease in nerves and nerve roots (such as peripheral neuropathy and radiculopathy) or other leg-related movement disorders. Negative results from tests may indicate that the diagnosis is RLS. In some cases, sleep studies such as polysomnography (a test that records the patient's brain waves, heartbeat, and breathing during an entire night) are undertaken to identify the presence of PLMD.

For those with mild to moderate symptoms, prevention is key, and many physicians suggest certain lifestyle changes and activities to reduce or eliminate symptoms. Decreased use of caffeine, alcohol, and tobacco may provide some relief. Physicians may suggest that certain individuals take supplements to correct deficiencies in iron, folate, and magnesium.

Studies also have shown that maintaining a regular sleep pattern can reduce symptoms. Some individuals, finding that RLS symptoms are minimized in the early morning, change their sleep patterns. Others have found that a program of regular moderate exercise helps them sleep better; on the other hand, excessive exercise has been reported by some patients to aggravate RLS symptoms. Taking a hot bath, massaging the legs, or using a heating pad or ice pack can help relieve symptoms in some patients. Although many patients find some relief with such measures, rarely do these efforts completely eliminate symptoms.

What is The Prognosis?

RLS is generally a lifelong condition for which there is no cure. Symptoms may gradually worsen with age, though more slowly for those with the idiopathic form of RLS than for patients who also suffer from an associated medical condition. Nevertheless, current therapies can control the disorder, minimizing symptoms and increasing periods of restful sleep. In addition, some patients have remissions, periods in which symptoms decrease or disappear for days, weeks, or months, although symptoms usually eventually reappear. A diagnosis of RLS does not indicate the onset of another neurological disease. 

Source: National Institute of Neurological Disorders and Stroke

 

                     

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