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The field of medicine is advancing rapidly. Researchers are shedding new light on debilitating health problems, which create havoc in the daily lives of so many Americans. All too often, the terms and language used when discussing these problems is complex and confusing. The USSA Medical Library is intended to give our visitors "basic factual information" about variety problems and help "raise public awareness" about that particular problem. The USSA Library is NOT a complete listing of possible health problems nor is it intended to replace or contradict any Doctors opinions or those in the medical/research fields!
INDEX
I
Muscular Dystrophy [MD]
II
Multiple Sclerosis
III
Cerebral Palsy
IV
Lou Gehrig's Disease [ALS]
V
Cystic Fibrosis [CF]
VI
Cancer
VII
Spina Bifida
VIII
Down Syndrome
IX
Crohn's Disease
I. Muscular Dystrophy [MD]

Muscular Dystrophy is actually a group of a genetic disease family, characterized by a progressive weakening and degeneration of the skeletal muscles that control a person's movement. There are many types of MD, and they can appear at various times in a person's development. There are four predominant types of MD, and they are different in the: 1. How fast the disease progresses 2. Age the disease takes hold 3. How the type is inherited 4. How muscle weakness is distributed in the body.

MD Types:
1. Congenital MD:
Congenital MD is noticeable at the time of birth.

2. Duchene MD:Duchene MD: is the result of mutations in a gene that regulates a protein responsible for maintaining strong healthy muscle fibers. Young males are affected the most, and disease onset is usually between three to five years of age. Progression is usually quite rapid after onset, and most young men are unable to walk by their 12th birthday. By the end of their teens, most sufferers are unable to breath on their own and must use a respirator to breath.

3. Myotonic MD:Myotonic MD: is characterized by prolonged muscle spasms in the face and finger muscles. Additionally, heart problems, cataracts, hormonal problems and a floppy-foot gait often accompany the afflicted. People with Myotonic MD have droopy eyelids and long faces. Baldness often occurs in males as well.

4. Facioscapulohumeral MD: Facioscapulohumeral MD is characterized by a progressive weakening of the facial muscles. Certain muscles in the arms and legs can be affected as well. Disease progression is normally slow, and the outward symptoms can vary from mild to disabling.

Cure and Treatment: There is no known cure. Treatments are varied and there is not any one treatment that is the answer. Improving the quality of life is the best alternative with strategies such as, medications, physical therapy, orthopedic measures, pacemakers, and respirators.

Prognosis: Variable and depends on the type of MD and how far it's already progressed. Individuals with mild cases that are progressing slowly may live a normal life time. Severe cases often lead to immobility and artificial respiration. Duchene MD patients usually lose their battle in the early 20's.

Links:
Muscular Dystrophy Family Foundation
Parent Project Muscular Dystrophy

II. Multiple Sclerosis

MS is an inflammatory, auto-immune disease that affects the central nervous system, including the brain, spinal cord, and eyes. Fatty nerve insulation tissue (myelin) is destroyed in one or more areas, and scar tissue (sclerosis) forms. If the nerve tissue is damaged, critical impulses between the brain and the body are disrupted, which causes the various symptoms of MS. People with MS can expect one of four clinical courses of disease, each of which might be mild, moderate, or severe. MS is one of the most common neurological diseases affecting young adults. It is estimated that nearly one million Americans are living with MS in the U.S. today.

MS types:
1. Relapsing/Remitting MS: The vast majority of people presenting with Multiple Sclerosis are first diagnosed with relapsing/remitting. This is typically when they are in their twenties or thirties, around twice as many women as men are affected with this MS variety.

2. Secondary Progressive MS: Through out their lifetime, many people who have had relapsing/remitting MS will pass into a secondary progressive phase of the disease. This is characterized by a gradual worsening of the disease between relapse periods.

3. Progressive Relapsing MS: This type of MS follows a progressive course from clinical onset, punctuated by relapses. There is significant recovery immediately following a relapse but between relapses there is a gradual worsening of symptoms.

4. Primary Progressive MS: PPMS characterized by a gradual progression of the disease from its onset with no remission periods at all. There may be periods of a leveling off of clinical disease activity and, as with secondary progressive; there may be good and bad days or weeks.

Cure / Treatment
Although there is still no cure for MS, there are various strategies available to help improve the quality of life of those suffering from the disease. Modifying the disease course through drug treatments has proved beneficial. Rehabilitation programs such as physical and occupational therapy can often help maintain or reverse the effects of MS.

Links:
Youth Against Multiple Sclerosis
National MS Society
Multiple Sclerosis Foundation

III. Cerebral Palsy

CP is a simply broad term used to describe a group of non- progressive, chronic neurological disorders that impair the ability to control physical movement. Cerebral palsy may be congenital or acquired after birth. Signs of cerebral palsy usually occur early in life before three years of age. Clinical symptoms generally do not worsen over time. CP disorders are caused by faulty development of or damage to the motor areas of the brain, which intern disrupts the brain's ability to control movement and physical posture. Symptoms of cerebral palsy include difficulty performing fine motor skill tasks, involuntary spasmodic type movements and/or difficulty walking and maintaining balance. Some of the common causes of CP are: German measles [rubella], jaundice, and head injuries. CP is non-infectious or contagious.

Treatment: With each CP patient suffering a different degree of neurological disorder, there is no standard therapy that works for all patients. Mechanical aids and braces help overcome physical impairments and drug treatments can be used to control seizures and muscle spasms. Physical, speech, and occupational therapy has had a great impact on the quality of life. Counseling for the more distraught can also be effective, as can surgery.

Links:
Children's Neurobiological Solutions
http://www.ndsaonline.org
United Cerebral Palsy

IV. Lou Gehrig's Disease [ALS]

Lou Gehrig's disease, also called Amyotrophic lateral sclerosis (ALS), is a progressive neuromuscular disease that weakens and eventually destroys the body's motor neurons (components of the nervous system that connect the brain with the skeletal muscles), responsible for controlling voluntary muscles. A person with ALS usually has significant problems with gait and dexterity which results from muscle weakness. Difficulty speaking or swallowing is another telltale sign of the diseases presence. As a general rule, people with ALS die from respiratory failure, usually within three to five years from the onset of symptoms. Approximately ten percent of the individuals with ALS can survive for 10 or more years. The cause of ALS is not definitively known.

Incidence and Prevalence of ALS: ALS is most commonly diagnosed in middle aged adults between the ages of 40 - 70, and affects men more often than women although this disease can strike anyone; it is very uncommon among adults and extremely rare in children. It is estimated that only two out of every 100,000 people will get Lou Gehrig's disease. Approximately 30,000 patients in the United States are currently known to have ALS. The disease has no known socioeconomic, racial, or ethnic boundaries! Because ALS is not contagious, it is impossible to catch ALS from someone who has the disease.

ALS Types
1. Familial ALS:
Constitutes 5% to 10% of all ALS cases in the United States. Familial ALS IS inherited and can appear more prevalently in certain family trees.

2. Sporadic ALS: Constitutes roughly 95% of all ALS cases in the United States. Sporadic ALS is NOT inherited.

Treatment and cures: There is no known cure for ALS! Drug therapy helps with swallowing problems and pain management. Counseling and support groups help with the patient's outlook. The power of Prayer remains foremost in combating this dreaded disease.

Links:
Kids Health
ALS Association

V. Cystic Fibrosis [CF]

Cystic fibrosis (CF) is an inherited "multi-system" disease, meaning that it affects many body organs. CF can have many different symptoms which can affect different parts of the body, particularly the lungs and digestive system. In a healthy person, there is a constant flow of mucus over the surfaces of the air passages in the lungs. This removes debris and bacteria. In someone with CF, this mucus is excessively sticky and cannot perform this role properly. In fact, the sticky mucus provides an ideal environment for bacterial growth. People with CF are at greater risk of bacterial chest infections.

CF is the most commonly inherited disease in Caucasian people, affecting about 1 in every 2,500 children born. It can strike people of African or Asian descent, but the incidence is far rarer than with Caucasian. There are several different types of genetic mutation which are associated with different degrees of severity of the disease.

Treatment and Cure: There is currently no cure for CF. A lot of new research is under way to try to find a cure for CF lung disease manifestation through gene therapy techniques. We know children born with CF do not have a normal life expectancy, though it is improving all the time! The average survival is now more than 30 years of age. With the best treatment, children today with CF have a greater than 80% chance of living into their late forties.

People with CF need daily chest therapy which involves vigorous massage to help loosen the sticky mucus. Parents of a child with CF are taught by hospital staff how to do this. Older children and adults with CF can be taught to do this for themselves as well. People with CF are at high risk, and they need to have any chest infection treated quickly with antibiotics. Daily medications, prayer, and occasional counseling can also help improve their quality of life.

Links:
Keep Kids Healthy
Kids Health
About Pediatrics

VI. Cancer

Youth Brain Cancers : Childhood brain tumors are a diverse group of diseases characterized by the abnormal growth of tissue contained within the skull. Brain tumors can be benign (without cancer cells) or malignant (contains cancer cells). Brain tumors are the most common type of cancer that occurs in youths. Brain tumors can occur in both children and adults however the treatment may be different for adults than for children. Surgery is usually required to determine whether a brain tumor exists and whether the tumor is malignant or not (called a Biopsy).

Symptoms
Seizures
Mood swings
Changes in learning ability
Headaches
Loss of appetite
Vomiting

Treatment
Surgery:

IF the tumor is in a location that operation is possible! Radiation and chemo therapy recommendations depend on the grade, type, and whether the cancer is spread or remains in the body.

Prognosis
Also depends on the type, grade, and location of the tumor and whether cancer cells remain after surgery and/or have spread to other parts of the brain.

VII. Spina Bifida

Spina bifida is the most common type of a category of "birth defects" called neural tube defects [NTDs]. Spina Bifida is commonly called "Open Spine" and affects the backbone and also the spinal cord nerves of newborns. In the United States, Spina bifida is one of the most common types of severe birth defects, and approximately 1750 infants per year are affected [about 1 in 2000 births]. Around 95 percent of babies with spina bifida are born to parents with no family history of SB .Whites and Hispanics are affected more frequently; while African, Asian, and Hebrew populations are less likely to experience SB occurrence. Even though Spina bifida appears to run in certain families, it does not seem to follow any particular inheritance pattern.

There are three forms of spina bifida:
1. Occulta:

Occulta SB is the least severe form, and clinical symptoms can be negligible. Occulta is characterized by a small defect or gap in one or more of the vertebrae of the spine. The spinal cord and nerves are usually normal, and most affected individuals have no problem living normal lives.

2. Meningocele:
Meningocele SB is the rarest form. A Cyst-like "membrane lump" surrounds the spinal cord and pokes through an opening in the spine. These membrane cysts vary in size and can be removed surgically. After successful surgery, patients often develop normally!

3. Myelomeningocele:
The most severe form of SB is Myelomeningocele SB. A cyst holds BOTH the spinal cord membranes AND the nerve roots; and sometimes the spinal cord its self. In addition, there may be NO cyst at all, but only an exposed section of the spinal cord and its associated nerves. Spinal fluid may indeed leak out, increasing the risk of infection. Surgery is essential to close the opening, but varying degrees of leg paralysis, bladder, and bowel control may persist. The severity of paralyses is determined by which spinal nerves are involved. The higher on the back the cyst is located, the greater the likely hood of problems. About 80 percent of spina bifida cysts are in the lower back's lumbar and sacral regions.

Treatment
Surgery to remove the cysts in Meningocele SB is common and effective. Myelomeningocele SB requires surgery to remove cysts and/or close up spinal openings. Antibiotics are also important, due to the high risk of infection with an open spine.

Links:
Children and Adults with Spina Bifida
Center for Cerebral Palsy
Kids Health from Nemours, Spina Bifida
Spina Bifida Association
National Dissemination Center for Children with Disabilities

VIII. Down Syndrome

Down syndrome is one of the most common birth defects in America. Down syndrome is a chromosomal disorder that can includes a variety of birth defects. These problems may include, a degree of mental retardation, characteristic facial features, heart defects, vision and heart problems, and increased likelihood of infections. The severity of all of these problems varies greatly among affected individuals. The National Down Syndrome Society believes there are about 350,000 individuals with Down syndrome in this country. Each year in the United States, approximately one in every 800 to 1,000 newborns has Down syndrome. This translates to approximately 5,000 children. Life expectancy among adults with Down syndrome is about 55 years; and will vary with the severity of their medical condition.

Causes:
There are 3 types of Down Syndrome;

1. Trisomy 21 (Nondisjunction)
Individuals with this most common form of Down syndrome, have an extra [3 total] 21st chromosome, caused by an error in cell division. Experts are not exactly sure why this chromosomal error occurs, but it does appear to be related to the age of the mother. Trisomy occurs prior to or at conception. This faulty cell division is responsible for 95 percent of all cases of Down syndrome.

2. Mosaicism
Mosaicism occurs when nondisjunction of the 21st chromosome takes place in one of the initial cell divisions after fertilization. Research has shown that individuals with mosaic Down syndrome are less affected than those with trisomy 21. Mosaicism is rare, being responsible for only one to two percent of all cases of Down syndrome in America.

3. Translocation
Translocation occurs when part of the number 21 chromosome breaks- off during cell division and attaches to another chromosome. Translocation occurs either prior to, or at conception as well. Unlike nondisjunction, maternal age is not linked to the risk of translocation. Most cases are sporadic, chance events. However, in about one-third of cases, one parent is a carrier of a translocated chromosome.

Cure or treatment
There is no cure for Down Syndrome. Treatments generally vary as to what degree the individual is affected. Generally, a multidimensional approach works well, with careful medical monitoring of central importance. Physical, and occupational therapy often helps Down individuals be integrated back into society, attend special education, and hold down jobs.

Links:
Down Syndrome for New Parents
Kids Health from Nemours, Down Syndrome
National Down Syndrome Society
Downsyndrome.com

IX Crohn's Disease

Crohn's disease is a chronic disorder that results in varying degrees of inflammation in the digestive or gastrointestinal tract. Crohn's disease can affect any area of the GI tract from the mouth to the anus, but it most commonly affects the end of the small intestine (the ileum) and the beginning of the large intestine. CD is marked by an abnormal response by the body's immune system. Our immune system is made up of various kinds of cells and proteins; which protect the body from infection. The body's immune system reacts inappropriately, in people with Crohn's disease. The immune system mistakes microbes, such as bacteria that are normally found in healthy intestines, for foreign or invading substances, and the launches a "defensive" attack. During this process, the body sends white blood cells into the lining of the intestines, where they produce chronic inflammation.

There is no single test that can establish the diagnosis of Crohn's disease with certainty. Symptoms may range from mild to severe. Patients will go through periods in which the disease flares up; followed by times of remission.

Causes
Studies indicate that the inflammation in Crohn's disease probably involves a complex interaction of factors:

1. The immune system
2. Environmental factors of trigger.
3. Inherited genetic make-up

Environmental foreign substances (antigens) may be the direct cause of the inflammation, or they may stimulate the body's defenses to produce an inflammation that continues on without control. Researchers believe that once the CD patient's immune system is "turned on," it does not know how to properly "turn off" at the right biological time.

Distribution
It is estimated that as many as 500,000 Americans have CD. Crohn's disease can occur in people of all ages, but it is primarily a disease of young adults and adolescents, primarily affecting people between 15 and 35 but can manifest itself in people over 70. Males and females appear to be equally affected. An estimated 100,000 youngsters under the age of 18 make up 10% of all people affected with CD. Crohn's disease affects certain ethnic groups more than others. People of Jewish decent descent are four to five times more likely to develop CD than the general population; while CD prevalence rates among Hispanics and Asians are lower than those for whites and African Americans. CD tends to run in families, and we know that genes definitely play a role. Studies have shown that about 20 to 25 percent of patients may have a close relative with CD. In a breakthrough study the first gene for Crohn's disease was recently identified. Crohn's disease is reported to be more common in urban than in rural areas, and in northern than in southern climates of the developed world.

Treatment
There is no cure for CD. Two-thirds to three-quarters of patients with Crohn's disease will require surgery at some point during their lives. Surgery becomes necessary in Crohn's disease when medications can no longer control the symptoms.

Links:
US and Chrohn's a site for teens
Crohn's and Colitis Foundation of America, Chapters
Crohn's and Colitis Foundation of America, Camp Oasis


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