t    

September is National Sickle Cell Awareness Month, a time to recognize the perseverance of patients living with sickle cell disease (SCD) and to recommit ourselves to improving the quality of life and health outcomes for all individuals living with SCD.

Mount Sinai Health System is reminding the community of the importance of newborn screening performed soon after birth with a blood test, education for families with this inherited condition and comprehensive care for children and adults including regular visits with a specialist can reduce complications of this illness.

SCD is the most commonly inherited blood disorder in the United States, affecting 100,000 people, and millions more worldwide. The disease primarily affects people of African, Hispanic, Mediterranean, Middle Eastern and South Asian ancestry.

What is sickle cell disease (SCD) actually?

The term sickle cell disease (SCD) describes a group of inherited red blood cell disorders. People with SCD have abnormal hemoglobin, called hemoglobin S or sickle hemoglobin, in their red blood cells.

Hemoglobin is a protein in red blood cells that carries oxygen throughout the body.

“Inherited” means that the disease is passed by genes from parents to their children. SCD is not contagious. A person cannot catch it, like a cold or infection, from someone else.

People who have SCD inherit two abnormal hemoglobin genes, one from each parent. In all forms of SCD, at least one of the two abnormal genes causes a person’s body to make hemoglobin S. When a person has two hemoglobin S genes, Hemoglobin SS, the disease is called sickle cell anemia. This is the most common and often most severe kind of SCD.

Hemoglobin SC disease and hemoglobin Sβ thalassemia (thal-uh-SEE-me-uh) are two other common forms of SCD.

Cells in tissues need a steady supply of oxygen to work well. Normally, hemoglobin in red blood cells takes up oxygen in the lungs and carries it to all the tissues of the body.

Red blood cells that contain normal hemoglobin are disc shaped (like a doughnut without a hole). This shape allows the cells to be flexible so that they can move through large and small blood vessels to deliver oxygen.

Sickle hemoglobin is not like normal hemoglobin. It can form stiff rods within the red cell, changing it into a crescent, or sickle shape.

Sickle-shaped cells are not flexible and can stick to vessel walls, causing a blockage that slows or stops the flow of blood. When this happens, oxygen can’t reach nearby tissues.

The lack of tissue oxygen can cause attacks of sudden, severe pain, called pain crisis. These pain attacks can occur without warning, and a person often needs to go to the hospital for effective treatment.

Most children with SCD are pain free between painful crises, but adolescents and adults may also suffer with chronic ongoing pain.

The red cell sickling and poor oxygen delivery can also cause organ damage. Over a lifetime, SCD can harm a person’s spleen, brain, eyes, lungs, liver, heart, kidneys, penis, joints, bones, or skin.

Sickle cells can’t change shape easily, so they tend to burst apart or hemolyze. Normal red blood cells live about 90 to 120 days, but sickle cells last only 10 to 20 days.

The body is always making new red blood cells to replace the old cells; however, in SCD the body may have trouble keeping up with how fast the cells are being destroyed. Because of this, the number of red blood cells is usually lower than normal. This condition, called anemia, can make a person have less energy.  Anemia ending line is lack of oxygen to the tissue body parts all over.

“Sickle cell disease is devastating for patients and their families,” said Jeffrey Glassberg, MD, MA, Assistant Professor of Emergency Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai. “It’s a chronic disorder causing pain in the extremities and back, infections, organ failure and other tissue damage, skin infections, loss of eyesight, severe blood clots and strokes. Patients learn to function in a constant state of pain and when that pain becomes debilitating, they often end up in the emergency room,” said Dr. Glassberg, also Associate Director of the Comprehensive Sickle Cell Program at The Mount Sinai Hospital.

“Patients with SCD are more likely to live full lives if they undergo regular checkups, prevent infections and develop healthy habits,” said Jena Simon, MS, FNP-BC, RN, also of the Comprehensive Sickle Cell Program.

Tips to Staying Healthy for SCD patients:

• Get regular checkups. Regular health checkups can help prevent some serious problems.
• Prevent infections. Common illnesses, like influenza quickly can become dangerous for both children and adults with SCD. The best defense is to get a flu shot every fall and to stay up-to-date on other immunizations.
• People with SCD should drink 8 to 10 glasses of water every day and eat healthy food. They also should try not to get too hot, too cold, or too tired.
• Look for clinical studies. New clinical research studies are beginning all the time at Mount Sinai and elsewhere, with the goal of finding better treatments for SCD. Study participants gain early access to experimental medicines and treatments.
• Get support. People with SCD should find a patient support group or other organization in the community that can provide information, assistance, and support.

Sickle Cell Disease Facts & Figures:

• SCD is an inherited blood disorder that can cause severe pain and permanent damage to the brain, heart, lungs, kidneys, liver, bones and spleen.
• SCD is most common in Africans and African-Americans. It is also found in other ethnic and racial groups, including people from South and Central America, the Caribbean, Mediterranean countries, and India.
• More than 2 million people carry the sickle cell gene that allows them potentially to pass the disease on to their children. People of African, Hispanic, Mediterranean, Middle Eastern, and Indian descent may want to be tested for the gene before having children. You can carry the gene and not have any signs or symptoms of SCD. Both parents have to have the gene to have a child with SCD.

DIAGNOSIS & TREATMENT for SCD:

Minnesota Department of Health states the following about treatment:

“Sickle cell disease is usually diagnosed at birth through a blood spot test, which is part of the Newborn Screening Program. A blood test can also be performed at any time for those not screened at birth.

Treatment can help relieve symptoms and complications of SCD, which vary and can range from mild to severe. Treatment will be different for each person based on what symptoms they have. The goals of treating SCD are to prevent and relieve SCD complications, including pain, infections, organ damage, and strokes. Treatments can include:

• Receiving blood transfusions
• Drinking lots of water (8 to 10 glasses of water each day)
• Receiving IV (intravenous) therapy (fluids given into a vein)
• Taking pain relievers
• Taking an FDA-approved medication, such as hydroxyurea, crizalizumah, L-glutamine, or voxeletor

Currently, the only known cure for SCD is a blood or marrow transplant (BMT). A blood or marrow transplant is a procedure that takes healthy stem cells from a donor and puts them into someone else. These healthy stem cells cause the bone marrow to make new cells that are not in the sickle shape. Many people do well after a BMT and experience significant improvement in their quality of life. However, there are risks associated with transplants. Discuss eligibility for transplant and associated risks and benefits with a transplant doctor.”.

Having several health topics and one of those topics covers awareness on elder’s well being. Why some may even not realizing how significantly important this is to address in thinking should this even be addressed?

Obviously, YES is the answer to anyone in this world who thinks that question and here is the reason why. This was developed in 1963 for the purpose of professional development opportunities for community, hospital and residential services. Its focus is on those resources that are specifically concerned with older people’s mental health and wellbeing and those resources that are generally accessible on a statewide basis. The government even is involved that developed a program called a “Wellbeing in Later Life” with one major aspect on covering 1.)the understanding of anxiety and depression 2.) strategies to help manage core symptoms 3.)practical skills to practice each week to help recovery 4.) stories about how others have applied the skills to help them recover; which is one small area of what this covers with much more.

Regarding the global trend in particular on elders with health promoting their age it is predicted the amount of elders is considerably increasing from decades back.

With facts check this out:

The global population is ageing at a rapid rate. In 1950, just over five percent of the world’s population was 65 years or older. By 2006, that number had jumped to eight percent. By 2030, experts anticipate that older adults will comprise 13 percent of the total population—one in eight people will be 65 or older. While developing countries will experience the most rapid growth in ageing, with increases of up to 140 percent, developed countries will experience increases averaging 51 percent. (Women, who tend to outlive men, will comprise the bulk of the older adult population.) Simultaneously, overall population is declining in many countries due to low fertility rates, HIV/AIDS, and international migration. The United Nations estimates that the number of adults 60 years and older will outnumber children under the age of 15—an historical first—by 2045.

Not only is the world ageing, but it is also ageing differently. Life expectancy is increasing, with people 85 years and older—especially women—comprising the fa stest growing segment of the population in many countries. Notable exceptions include South Africa, where life expectancy dropped from 60 to 43 years in the last decade, primarily due to HIV/AIDS. Globally, more people are dying from non-communicable diseases and chronic, degenerative conditions than from infectious and parasitic diseases, a trend expected to grow in the next couple of decades. (Whether increased life expectancy will be associated with increases or decreases in disability status remains an open question.) At the same time, communicable diseases—especially HIV/AIDS—remain prevalent, particularly in low- and middle-income countries. In considering the benefits and consequences of population ageing, therefore, it is essential to consider not only longevity but also healthy life expectancy, or expected years of life free of illness, disease, and disability.

Looking at older adults (elders 65 and older)-Although older adults serve as essential resources to their communities, they face a great risk of marginalization. Older adults often experience both social de-evaluation and poverty upon leaving the labor market; financial market fluctuations contribute to income and social insecurity regardless of employment history, especially in countries with developing and transitioning economies. Groups particularly vulnerable to poverty and social devaluation in old age, due to cultural and institutional biases which affect people throughout the lifespan, include women, people with disabilities, people with a migration background, and people who do not belong to the majority racial or ethnic group of any given society. Moreover, older adults seeking support to maintain independence and quality of life frequently encounter either a lack of social services, especially in rural and remote areas, or services that are poor in quality or unresponsive to linguistic and cultural diversity.

Participation of older adults in societal development enhances the well-being both of older adults and of communities as a whole and depends on multiple factors.

Accordingly, the rising proportion of older people is placing upward concerns & pressure on overall health care spending in the developed world, although other factors such as income growth and advances in the technological capabilities of medicine generally play a much larger role.

Relatively little is known about aging and health care costs in the developing world. Many developing nations are just now establishing baseline estimates of the prevalence and incidence of various diseases and conditions. Initial findings from the WHO SAGE project, which provides data on blood pressure among women in six developing countries, show an upward trend by age in the percentage of women with moderate or severe hypertension, although the patterns and age-specific levels of hypertension vary among the countries. If rising hypertension rates in those populations are not adequately addressed, the resulting high rates of cerebrovascular (CVA-stroke) and cardiovascular disease are likely to require costly medical treatments that might have been avoided with antihypertensive therapies costing just a few cents per day per patient. Early detection and effective management of risk factors such as hypertension—and other important conditions such as diabetes, which can greatly complicate the treatment of cardiovascular disease—in developing countries can be inexpensive and effective ways of controlling future health care costs.

In high-income countries, heart disease, stroke, and cancer have long been the leading contributors to the overall disease burden. The burden from these and other chronic and non-communicable diseases is increasing in middle- and low-income countries as well.

To gauge the economic impact of shifting disease profiles in developing countries, the World Health Organization (WHO) estimated the loss of economic output associated with chronic disease in 23 low- and middle-income nations, which together account for about 80 percent of the total chronic disease mortality in the developing world.

Largely because of global aging, the incidence of cancer is expected to accelerate in coming decades. The annual number of new cancer cases is projected to rise to 17 million by 2020, and reach 27 million by 2030. A growing proportion of the global total will be found in the less developed world, and by 2020, almost half of the world’s new cases will occur in Asia.

So regarding anyone who may have questioned today or at another time why is elder health important I think after reading this you would see why. The more unhealthy an elder person is in large populations the higher the population of unhealthy elders will be in society besides putting the cost of health living in communities higher. So if people stay healthy from childhood to geriatric age the less health problems we will have. National elder well being is a prime concern to be addressed and dealt with just like neonate, pediatric and adult to mid adult.  Every age in important and every age bracket has rights with vitally importance to address in there health!

“Much has changed in the United States over the past 100 years. Medicine has evolved as much as any field, with dramatic advances in diagnosis and treatment. Changing, too, is the American lifestyle, with its new emphasis on healthier diets and regular exercise and its declining dependence on tobacco. As a result of these developments, life expectancy is also changing, rising slowly but steadily year after year (see Table 1). One thing, though, has not changed — the gender gap. People of both sexes are living longer, but decade after decade, women continue to outpace men. In fact, the gap is wider now than it was a century ago.

The longevity gap is responsible for the striking demographic characteristics of older Americans. More than half of all women older than 65 are widows, and widows outnumber widowers by at least three to one. At age 65, for every 100 American women, there are only 77 men. At age 85, the disparity is even greater, with women outnumbering men by 2.6 to 1. And the longevity gap persists even into very old age, long after hormones have passed their peak; among centenarians, there are four females for every male.

The gender gap is not unique to America. In fact, every country with reliable health statistics reports that women live longer than men. The longevity gap is present both in industrialized societies and in developing countries. It’s a universal observation that suggests a basic difference between the health of men and women.”

Harvard Health Publishing – Harvard Medical School (https://www.health.harvard.edu/newsletter_article/mars-vs-venus-the-gender-gap-in-health)

More males than females are born in America each year. Still regarding health to both genders through research and just living the experience of being an RN over a quarter of a century in numerous fields (primarily of adults to geriatrics) it shows women are more healthier than men (even starting from infancy).

Out of the 15 leading causes of death, men lead women in all of them except Alzheimer’s disease, which many men don’t live long enough to develop in many cases.  Although the gender gap is closing, men still die five years earlier than their wives, on average.

Through WebMD experts have told them the reason for this is that they are partly biological, and men’s approach to their health plays a role too, of course. “Men put their health last,” says Demetrius Porche, DNS, RN, editor in chief of the American Journal of Men’s Health. “Most men’s thinking is, if they can live up to their roles in society, then they’re health.” Not always the case especially when age keeps creeping up on a male with his priorities of life changing with new love or even peeps that come on board in a man’s lifetime. In most cases living healthy normally happens when are age is younger but then due to work to families to expectations leaves little room for healthier habits in the week but even 30 minutes a day could make a tremendous change to all systems of the human body preventing certain diseases/illnesses, especially those due to poor diet, eating habits and overall health habits (Ex. as simple as getting 8 hours for sleep a day).

Men go to the doctor less than women and are more likely to have a serious condition when they do go, research shows. “As long as they’re working and feeling productive, most men aren’t considering the risks to their health,” says Porche. Like a lot of men say “I don’t have to time to think about it.”.   But even if you’re feeling healthy, a little planning can help you stay that way. One is through preventions measures before secondary have to start, meaning ending line your now with a disease or illness, that may have been prevented completely if you lived a healthier life. One way of preventing disease and illness is good eating or diet, with balancing out the 4 food groups (to get all nutrients from minerals to vitamins to enzymes to proteins and more). The top threats to men’s health aren’t secrets: they are commonly known and often preventable.

WebMD consulted the experts that came up with for you this list of the top health threats to men, and how to avoid them.

— “Heart disease and stroke are the first and second leading causes of death worldwide, in both men and women,” says Darwin Labarthe, MD, MPH, PhD, director of the Division for Heart Disease and Stroke Prevention at the CDC. “It’s a huge global public health problem, and in the U.S. we have some of the highest rates.” In cardiovascular disease, cholesterol plaques gradually block the arteries in the heart and brain. If a plaque becomes unstable, a blood clot forms, blocking the artery and causing a heart attack or stroke.

One in five men and women will die from cardiovascular disease, according to Labarthe.  For unclear reasons, though, men’s arteries develop atherosclerosis earlier than women’s. “Men’s average age for death from cardiovascular disease is under 65,” he says; women catch up about six years later.

Even in adolescence, girls’ arteries look healthier than boys’. Experts believe women’s naturally higher levels of good cholesterol (HDL) are partly responsible. Men have to work harder to reduce their risk for heart disease and stroke. How do you go about this? Take a guess. Yes, again through your diet, eating, the 4 food groups in your diet, activity or exercise (at least 30 minutes a day or 1 hour every other day) and practicing daily good health habits.

—Lung cancer is a terrible disease: ugly, aggressive, and almost always metastatic (spreads somewhere in the body). Lung cancer spreads early, usually before it grows large enough to cause symptoms or even show up on an X-ray. By the time it’s found, lung cancer is often advanced and difficult to cure. Less than half of men are alive a year later. So … are you still SMOKING?

Tobacco smoke causes 90% of all lung cancers. Thanks to falling smoking rates in the U.S., fewer men than ever are dying of lung cancer. But lung cancer is still the leading cancer killer in men: Again due to many still practicing poor habits which could have prevented many of the lung cancer cases. Anyone who QUITS smoking at any age reduces the risk for lung cancer. Few preventive measures are as effective as stopping smoking and nothing is as challenging, like any addiction (whether mental or physical)

–Prostate Cancer: A Leading Cancer for Men

This is one health problem men can lay full claim to — after all, women don’t have prostates. A walnut-sized gland behind the penis that secretes fluids important for ejaculation, the prostate is prone to problems as men age.

Prostate cancer is the most common cancer in men other than skin cancer. Close to 200,000 men will develop prostate cancer this year in the U.S.

But while one in six men will be diagnosed with prostate cancer in his lifetime, only one in 35 will die from it. “Many prostate cancers are slow-growing and unlikely to spread, while others are aggressive,” says Djenaba Joseph, MD, medical officer for cancer prevention at the CDC. “The problem is, we don’t have effective tests for identifying which cancers are more dangerous.”

Screening for prostate cancer requires a digital rectal exam (the infamous gloved finger) and a blood test for prostate specific antigen (PSA).

But in fact, “Screening has never definitively been shown to reduce the chances of dying from prostate cancer,” according to Joseph. That’s because screening finds many cancers that would never be fatal, even if undetected. Testing then leads to aggressive treatment of relatively harmless cancers, which causes problems like impotence and incontinence.

Should you get screened for prostate cancer? Some experts say yes, but “the best solution is to see your doctor regularly and talk about your overall risk,” says Joseph. “All men should understand the risks and benefits of each approach, whichever you choose.”

–Depression and Suicide: Men Are at Risk 

Depression isn’t just a bad mood, a rough patch, or the blues. It’s an emotional disturbance that affects your whole body and overall health. In effect, depression proves the mind-body connection. Brain chemicals and stress hormones are out of balance. Sleep, appetite, and energy level are disturbed. Research even suggests men with depression are more likely to develop heart disease.

The results can be tragic. Women attempt suicide more often, but men are more successful at completing it. Suicide is the eighth leading cause of death among all men; for young men it’s higher.

–Diabetes: The Silent Health Threat for Men

Diabetes usually begins silently, without symptoms. Over years, blood sugar levels creep higher, eventually spilling into the urine. The resulting frequent urination and thirst are what finally bring many men to the doctor.

The high sugar of diabetes is anything but sweet. Excess glucose acts like a slow poison on blood vessels and nerves everywhere in the body. Heart attacks, strokes, blindness, kidney failure, and amputations are the fallout for thousands of men.

Boys born in 2000 have an alarming one-in-three chance of developing diabetes in their lifetimes. Overweight and obesity are likely feeding the diabetes epidemic. “The combination of diabetes and obesity may be erasing some of the reductions in heart disease risk we’ve had over the last few decades,” warns Labarthe.

Exercise, combined with a healthy diet, can prevent type 2 diabetes. Moderate weight loss — for those who are overweight — and 30 minutes a day of physical activity reduced the chance of diabetes by more than 50% in men at high risk in one major study.

—Erectile Dysfunction: A Common Health Problem in Men                          

Erectile dysfunction may not be life threatening, but it’s still signals an important health problem. Two-thirds of men older than 70 and up to 39% of 40-year-old men have problems with erectile dysfunction. Men with ED report less enjoyment in life and are more likely to be depressed.

Erectile dysfunction is most often caused by atherosclerosis — the same process that causes heart attacks and strokes. In fact, having ED frequently means that blood vessels throughout the body are in less-than-perfect health. Doctors consider erectile dysfunction an early warning sign for cardiovascular disease.

You’ve probably heard more about the numerous effective treatments for ED than you ever cared to just by watching the evening news. Treatments make a fulfilling sex life possible despite ED, but they don’t cure the condition. If you have erectile dysfunction, see your doctor, and ask if more than your sex life is at risk.

So what’s the key to decreasing these diseases or illnesses in men live a healthier life so men in America can decrease the chances of developing these diseases or if with one of these diagnoses already it will surely help decrease the impact of the disease or illness compared to living an unhealthy life.   

Various lifestyle factors have been associated with increasing the risk of stroke. These include lack of exercise, alcohol, diet, obesity, smoking, drug use, and stress. Guidelines endorsed by the Centers for Disease Control and Prevention and the National Institutes of Health recommend that Americans should exercise for at least 30 minutes of moderately intense physical activity on most, and preferably all, days of the week. Recent epidemiologic studies have shown a U-shaped curve for alcohol consumption and coronary heart disease mortality, with low-to-moderate alcohol consumption associated with lower overall mortality. High daily dietary intake of fat is associated with obesity and may act as an independent risk factor or may affect other stroke risk factors such as hypertension, diabetes, hyperlipidemia, and cardiac disease. Homocysteine is another important dietary component associated with stroke risk, while other dietary stroke risk factors are thought to be mediated through the daily intake of several vitamins and antioxidants. Smoking, especially current smoking, is a crucial and extremely modifiable independent determinant of stroke. Despite the obstacles to the modification of lifestyle factors, health professionals should be encouraged to continue to identify such factors and help improve our ability to prevent stroke, decrease cancers caused by smoking, decrease coronary artery disease which decreases your chance with Obesity, ED, stroke, & hypertension and more.  

Learn healthy habits or healthier habits, broaden your knowledge on the 4 food groups in what is lean or leaner or leanest with each group, increase your activity 30 minutes a day and learn what a healthy diet actually is.  There are many books out in the world for giving guidance like through Dr. Wayne Scott Anderson’s book “Dr. A’s habits of health” for example and even if you need to lose weight the book can show you the way to do it healthy. It’s not a diet for 3 months or even 6 months to a year but it is learning how to get to your body mass index in the ideal weight range for your height and you decide how low you want to go.  There are many books out in the world that do this or even access through the internet.  Just research if you need it and want it.

Join many others trying to get America healthier and in time decrease our population in diseases or illnesses primarily impacted by health habits, diet, and weight. Wouldn’t you and the future want to get better in mind and body to impact our health care system that includes our insurance and most importantly lives of citizens in the USA in how they live (which would be more active).  It just takes discipline and the drive to want to stay healthy or get in a better state of heath.   We can do this without changing your environment upside down and killing cattle, or living on insects but you could eat healthier foods like not fast food and lean meats with definitely vegetables, fruit and low fat foods.  You can treat yourself now and than.  Hope I have helped someone out there in broadening your knowledge regarding how to keep or reach a healthier life.

“Aphasia is a disorder that affects how you communicate. It can impact your speech, as well as the way you write and understand both spoken and written language.

Aphasia usually happens suddenly after a stroke or a head injury. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent damage (degenerative). The severity of aphasia depends on a number of things, including the cause and the extent of the brain damage.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518)

What is aphasia?

Aphasia is a disorder that results from damage to portions of the brain that are responsible for language. For most people, these areas are on the left side of the brain. Aphasia usually occurs suddenly, often following a stroke or head injury, but it may also develop slowly, as the result of a brain tumor or a progressive neurological disease. The disorder impairs the expression and understanding of language as well as reading and writing. Aphasia may co-occur with speech disorders, such as dysarthria or apraxia of speech, which also result from brain damage.

Who can acquire aphasia?

Most people who have aphasia are middle-aged or older, but anyone can acquire it, including young children. About 1 million people in the United States currently have aphasia, and nearly 180,000 Americans acquire it each year, according to the National Aphasia Association.

What causes aphasia?

Aphasia is caused by damage to one or more of the language areas of the brain. Most often, the cause of the brain injury is a stroke. A stroke occurs when a blood clot or a leaking or burst vessel cuts off blood flow to part of the brain. Brain cells die when they do not receive their normal supply of blood, which carries oxygen and important nutrients. Other causes of brain injury are severe blows to the head, brain tumors, gunshot wounds, brain infections, and progressive neurological disorders, such as Alzheimer’s disease.

What types of aphasia are there?

There are two broad categories of aphasia: 1-fluent and 2-nonfluent, but know there are several types within these groups.  So the 2 main groups of aphasia are as follows:

1- Fluent aphasia

There is damage to the posterior temporal lobe of the brain.

This may result in Wernicke’s aphasia (see figure above), the most common type of fluent aphasia. People with Wernicke’s aphasia may speak in long, complete sentences that have no meaning, adding unnecessary words and even creating made-up words.

For example, someone with Wernicke’s aphasia may say, “You know that smoodle pinkered and that I want to get him round and take care of him like you want before.”

As a result, it is often difficult to follow what the person is trying to say. People with Wernicke’s aphasia are often unaware of their spoken mistakes. Another hallmark of this type of aphasia is difficulty understanding speech.

2- Nonfluent aphasia

The most common type of nonfluent aphasia is Broca’s aphasia (see figure above).

People with Broca’s aphasia have damage that primarily affects the frontal lobe of the brain.  Damage to a discrete part of the brain in the left frontal lobe (Broca’s area) of the language-dominant hemisphere has been shown to significantly affect the use of spontaneous speech and motor speech control. Words may be uttered very slowly and poorly articulated.

They often have right-sided weakness or paralysis of the arm and leg because the frontal lobe is also important for motor movements. People with Broca’s aphasia may understand speech and know what they want to say, but they frequently speak in short phrases that are produced with great effort. They often omit small words, such as “is,” “and” and “the.”

For example, a person with Broca’s aphasia may say, “Walk dog,” meaning, “I will take the dog for a walk,” or “book book two table,” for “There are two books on the table.” People with Broca’s aphasia typically understand the speech of others fairly well. Because of this, they are often aware of their difficulties and can become easily frustrated.

OTHER TYPES OF APHASIA:

– Global aphasia, results from damage to extensive portions of the language areas of the brain. Individuals with global aphasia have severe communication difficulties and may be extremely limited in their ability to speak or comprehend language.  Damage to the language processing centers in the left hemisphere of your brain, including Wernicke’s and Broca’s areas, can cause global aphasia. These two areas are critical for the production and understanding of language.

This is the most severe form of aphasia. It usually involves the following features.

• Loss of fluency. People with global aphasia struggle with the physical act of speaking. People with the most severe forms of this might only make small or isolated sounds, or they might not make any sounds at all (mutism). They also may repeat words or simple phrases over and over (this is a problem with fluency, as they’ll still have trouble repeating back words or phrases you say to them).
• Problems with understanding. People with this struggle to understand what others are saying. They might understand very simple sentences, but the more complex the sentence or phrase, the harder it is to understand.
• Struggle with repetition. Global aphasia affects repetition, meaning a person with it might struggle to repeat back words or phrases you say to them.
• Other symptoms: This kind of aphasia happens with conditions that cause severe brain damage, such as major strokes or head injuries. The damage is usually severe and affects multiple parts of the brain, causing other serious symptoms like one-sided paralysis, blindness and more.

Other forms of aphasia

• Transcortical motor aphasia: This is similar to Broca’s aphasia but usually not as severe. A key difference is that people with this don’t have a problem repeating back phrases or sentences you say to them.
• Transcortical sensory aphasia: This type is similar to Wernicke’s aphasia but usually not as severe. Like with transcortical motor aphasia above, people with this type don’t have a problem repeating back what you say. This type of aphasia is common with degenerative brain conditions like Alzheimer’s disease.
• Conduction aphasia: This type of aphasia affects fluency but not understanding. People with this struggle to pronounce words, especially when trying to repeat something you say to them.
• Mixed transcortical aphasia: This aphasia is like global aphasia, except that people with this can still repeat what people say to them.
• Anomic aphasia: People with this kind of aphasia struggle to find words, especially names of objects or words that describe actions. To get around this problem, they often use several words to explain what they mean or non-specific words like “thing” instead.

“The human brain has 86 billion neurons, give or take — on the same order as the number of stars in the Milky Way. If you look at the synapses, the connections between neurons, the numbers start to get beyond comprehension pretty quickly. The number of synapses in the human brain is estimated to be nearly a quadrillion, or 1,000,000,000,000,000. And each individual synapse contains different molecular switches. If you want to think about the brain in terms of an electrical system, a single synapse is not equivalent to a transistor — it would be more like a thousand transistors.

To make things more complicated, not all neurons are created equal. Scientists still don’t know how many different kinds of neurons we have, but it’s likely in the hundreds. Synapses themselves aren’t all the same either. And that’s not even taking into account all the other cells in our brain. Besides neurons, our brains contain lots of blood vessels and a third class of brain cells known collectively as glia — many of which are even more poorly understood than neurons.

Scientists are making progress breaking those numbers down into something more comprehensible. At the level of individual brain cells, research teams at the Allen Institute and elsewhere are making headway into sorting the cells into different categories, defined as “cell types,” as well as being able to record electrical activity from living human neurons using creative new techniques.

Many neuroscientists study the brain of the lab mouse, in part with the hopes of understanding basic principles of the mammalian brain that could apply to our brains too.

The mammal the octopus (cephalopods related to squid and cuttlefish-The octopus is classified as one branch of mollusks. — and its brain — are fascinating. For an animal with a brain, they’re about as different from humans as it gets. Octopuses have about half a billion neurons, more than five times as many as the lab mouse. But unlike in our nervous systems, more than half of those neurons are in the octopus’ arms. The animals have incredible autonomous control over their limbs — similar in some ways to our own spinal cords that send messages to out body to move.  Understanding the octopus brain isn’t just interesting in its own right, it could also help us understand broad general principles of large brains and animals who can learn and remember complicated behaviors — like us.”

The human brain is probably one of the most, if not the most, complicated brains in any living species.”

Allen Institute (https://alleninstitute.org/news/why-is-the-human-brain-so-difficult-to-understand-we-asked-4-neuroscientists/)

QUOTE 2 – “The human brain can be subdivided according to various criteria. It can be explained in terms of evolution, as, like all vertebrates, it consists of an end brain, interbrain, midbrain, hindbrain and medullary brain. Anatomically, the areas known as the cerebrum, interbrain and cerebellum, as well as the brain stem, are particularly noticeable. Particularly striking is the cerebral cortex, which forms part of the end brain. During evolution, it has grown so strongly that it surrounds almost the entire brain. With its ridges and coils, the cortex gives the brain its walnut-like look.”

MAX-PLANCK-GESELLSCHAFT (https://www.mpg.de/brain)

IIlustration body part,human brain left and right functions

The brain is like a committee of experts. All the parts of the brain work together, but each part has its own special properties. The brain can be divided into three basic units: 1 the forebrain, 2 the midbrain, and 3 the hindbrain.

1-THE CEREBRUM (The Forebrain) AND ITS FUNCTIONS:  Knowing what part of the cerebrum, if the brain injury is their, can explain the reasons for the symptoms the individual is having.

1-The forebrain is the largest and most highly developed part of the human brain: it consists primarily of the cerebrum and the structures hidden beneath it, which is the inner brain.

THE REGIONS (The 4 LOBES) THAT MAKE UP THE CEREBRUM:

The cerebrum, the large, outer part of the brain, controls reading, thinking, learning, speech, emotions and planned muscle movements like walking. It also controls vision, hearing and other senses. The cerebrum is divided two cerebral hemispheres (halves): left and right. The right half controls the left side of the body. The left half controls the right side of the body.

Each hemisphere has four sections, called lobes: frontal, parietal, temporal and occipital.  A lobe simply means a part of an organ (earlobe for example).  Each lobe controls specific functions. For example, the frontal lobe controls personality, decision-making and reasoning, while the temporal lobe controls, memory, speech, and sense of smell.

–The frontal lobe is the largest lobe of the brain.  The frontal lobe are the last parts of the brain develop as a person ages and the part of the human brain that is most different from other mammals and primates.  The last part to mature is the prefrontal lobe. This happens during adolescence. Many things affect brain development including genetics, individual and environmental factors.  We learn to become adults in our frontal lobes.   You choose between good and bad actions; override and suppress socially unacceptable responses; and determine similarities and differences between objects or situations. The frontal lobe is considered to be the moral center of the brain because it is responsible for advanced decision making processes. It also plays an important role in retaining emotional memories derived from the limbic system, and modifying those emotions to fit socially accepted norms.  The frontal lobes are considered our emotional control center and home to our personality. There is no other part of the brain where lesions can cause such a wide variety of symptoms (Kolb & Wishaw, 1990). The frontal lobes are involved in motor function, problem solving, spontaneity, memory, language, initiation, judgment, impulse control, and social and sexual behavior. Frontal lobe damage effects one or more of these areas depending on the severity of the damage.  The frontal lobes are extremely vulnerable to injury due to their location at the front of the cranium, proximity to the sphenoid wing and their large size. MRI studies have shown that the frontal area is the most common region of injury following mild to moderate traumatic brain injury.

–The parietal lobes can be divided into two functional regions. One involves sensation and perception and the other is concerned with integrating sensory input, primarily with the visual system. The first function integrates sensory information to form a single perception (cognition).  The parietal lobes have an important role in integrating our senses. In most people the left side parietal lobe is thought of as dominant because of the way it structures information to allow us to read & write, make calculations, perceive objects normally and produce language. Damage to the dominant parietal lobe can lead to Gerstmann’s syndrome (e.g. can’t tell left from right, can’t point to named fingers), apraxia and sensory impairment (e.g. touch, pain). Damage to the non-dominant lobe, usually the right side of the brain, will result in different problems. This non-dominant lobe receives information from the occipital lobe and helps provide us with a ‘picture’ of the world around us. Damage may result in an inability to recognize faces, surroundings or objects (visual agnosia). So, someone may recognize your voice, but not your appearance (you sound like my daughter, but you’re not her). Damage to the parietal lobe depends on severity and location of the area. Because this lobe also has a role in helping us locate objects in our personal space, any damage can lead to problems in skilled movements (constructional apraxia) leading to difficulties in drawing or picking objects up.

–The temporal lobes they are in the section of the brain located on the sides of the head behind the temples and cheekbones.   It’s responsible for processing auditory information from the ears (hearing).   The temporal lobes play an important role in organizing sensory input, auditory perception, language and speech production, as well as short term memory association and formation. The Temporal Lobe mainly revolves around hearing and selective listening. It receives sensory information such as sounds and speech from the ears. It is also the key to being able to comprehend, or understand meaningful speech. In fact, we would not be able to understand someone talking to us, if it wasn’t for the temporal lobe. This lobe is special because it makes sense of the all the different sounds and pitches (different types of sound) being transmitted from the sensory receptors of the ears. Temporal Lobes Kolb & Wishaw (1990) have identified eight principle symptoms of temporal lobe damage: 1) disturbance of auditory sensation and perception, 2) disturbance of selective attention of auditory and visual input, 3) disorders of visual perception, 4) impaired organization and categorization of verbal material, 5) disturbance of language comprehension, 6) impaired long-term memory, 7) altered personality and affective behavior, 8) altered sexual behavior. These can be due to tumors on the right or left side of the temporal lobe, due to seizures in the temporal lobe and if seizures regularly happen to this individual in the temporal region, which causes lack of oxygen to that area of that area of the brain it will effect one or more of the functions of that lobe which we discussed earlier, listed above.

-The last region or lobe that makes up the cerebrum is the occipital lobe. The occipital lobe is important to being able to correctly understand what our eyes are seeing. These lobes have to be very fast to process the rapid information that our eyes are sending. This is similar to how the temporal lobe makes sense of auditory information, the occipital lobe makes sense of visual information so that we are able to understand it. If our occipital lobe was impaired or injured we would not be able to correctly process visual signals, thus visual confusion would result.

2-Midbrain – The uppermost part of the brainstem is the midbrain, which controls some reflex actions and is part of the circuit involved in the control of eye movements and other voluntary movements.

3-The hindbrain includes the upper part of the spinal cord, the brain stem, and a wrinkled ball of tissue called the cerebellum. The hindbrain controls the body’s vital functions such as respiration and heart rate. The cerebellum coordinates movement and is involved in learned rote movements. Rote means “mechanical or habitual repetition of something to be learned.”. Rote learning is flashcards, times tables, any kind of memorization-based learning. Rote movement applies to activities we do in a mechanical, repetitive way. Running, for example.  When you play the piano or hit a tennis ball you are activating the cerebellum= balance/coordination.

Knowing how the brain functions to understand this month’s awareness Aphasia (which we will discuss tomorrow).

“While people are accustomed to dealing with runny noses and scratchy throats in the fall and winter, many are experiencing the same symptoms this summer.

This could be due to a number of reasons, according to Dr. Judy Tung, section chief of Adult Internal Medicine at NewYork-Presbyterian/Weill Cornell Medical Center. Cold and flu viruses are continuing to circulate — in fact, in late April and early May, New York state saw an unusual spike in influenza — coinciding with summer allergies, not to mention an uptick in COVID-19 cases due to the rise of Omicron subvariants.

Summer cold symptoms are common and confusing this year not only because of COVID but also because of the late flu peak.  Remember Influenza activity is usually is from October to May but can be all year.

So remember colds are not unusual to have in the summer.”

Dr.  Tung from New York Presbyterian/Weill Cornell Medical Center  (https://healthmatters.nyp.org/what-to-know-about-the-surge-in-summer-colds/)