Scoliosis is a problem with the spine where the spine is curved instead of straight, with the upper back being rounded and the lower back having a “swayback,” or inner curved problem, reports WebMD.

According to the Scoliosis Research Society, 85 percent of all scoliosis causes are idiopathic, meaning the cause is unknown. The remaining causes of scoliosis include birth defects, such as vertebrae that form abnormally before birth, and certain disorders such as cerebral palsy, Marfan’s syndrome, muscular dystrophy and Down syndrome. Infections and spinal fractures can also cause scoliosis.curvature of the spine during surgical correction of this condition. Screws and rods are placed in order to stabilize and straighten the spine.

What You Should Know About Adult Scoliosis

Scoliosis is defined as a curve of the spine of 10 degrees. Adult scoliosis is broadly defined as a curve in your spine of 10 degrees or greater in a person 18 years of age or older. Adult scoliosis is separated into 2 common categories:

• Adult Idiopathic Scoliosis patients have had scoliosis since childhood or as a teenager and have grown into adulthood.  We do not yet know the cause of idiopathic scoliosis, but there is a lot of genetic work going on in an attempt to answer this question.

• Adult “De Novo” or Degenerative Scoliosis develops in adulthood. Degenerative scoliosis develops as a result of disc degeneration. As the disc degenerates, it loses height. If one side of the disc degenerates more rapidly than the other, the disc begins to tilt. As it tilts, more pressure is placed on one side of your spine and gravity tends to cause the spine to bend and curve. The more discs that degenerate, the more the spine begins to curve.

Scoliosis is more common in girls than in boys, and the diagnosis is usually made after a child reaches 10 years of age. A doctor performs a physical examination and may take X-rays to definitively diagnose the disease. An X-ray tells if there is any growth left in the growth plates of the femur or humerus, and scoliosis can become worse if the patient has more growing to do, states MedicineNet. Serial X-rays are performed to track the changes of the spinal curve, which helps determine the best course of treatment.

Types of idiopathic scoliosis are categorized by both age at which the curve is detected and by the type and location of the curve.

When grouped by age, scoliosis usually is categorized into three age groups:

• Infantile scoliosis: from birth to 3 years old
• Juvenile scoliosis: from 3 to 9 years old
• Adolescent scoliosis: from 10 to 18 years old

This last category of scoliosis, adolescent scoliosis, occurs in children age 10 to 18 years old, and comprises approximately 80% of all cases of idiopathic scoliosis. This age range is when rapid growth typically occurs, which is why the detection of a curve at this stage should be monitored closely for progression as the child’s skeleton develops.

Terms Used to Describe Spinal Curvature

Scoliosis curves are often described based on the direction and location of the curve. Physicians have several detailed systems to classify specific curves, but here are some common terms used to describe scoliosis:

Terms that describe the direction of the curve:

• Dextroscoliosis describes a spinal curve to the right (“dextro” = right). Usually occurring in the thoracic spine, this is the most common type of curve. It can occur on its own (forming a “C” shape) or with another curve bending the opposite way in the lower spine (forming an “S”).

Severe scoliosis can lead to heart and lung problems if not treated, as the ribs press against the chest, making breathing more difficult, states Mayo Clinic. Adults who had scoliosis as a child may experience more back pain throughout their lives as compared to people without scoliosis.

Symptoms of scoliosis include an uneven waist, uneven shoulders, disjointed hip and a protruding shoulder blade, according to Mayo Clinic. The spine also curves or twists in acute cases, and the disease can cause one side of the ribs to protrude more than the other. Severe cases also induce labored breathing and back pain.

Diagnosis

Scoliosis can be recognized and diagnosed with a clinical exam, but xrays are necessary to fully evaluate the magnitude and type of scoliosis present. For a proper scoliosis evaluation, full length, whole spine xrays need to be performed. An MRI may also be recommended if there are symptoms of leg pain that may be associated with stenosis or if there is concern about possible spinal cord compression or abnormalities.

Treatment

The treatment of adult scoliosis is very individualized and based on the specific symptoms and age of the patient. Many patients have scoliosis and have very minor symptoms and live with it without treatment. Patients with predominant symptoms of back pain would typically be treated with physical therapy. Patients with back pain and leg pain may receive some benefit from injection treatment to help relieve the leg pain.  If lumbar stenosis (narrowing of the spinal canal) is present and is unresponsive to non-surgical treatment, then a decompression( removal of bone and ligaments pressing on the nerves) may be recommended. If the scoliosis is greater than 30 degrees, a fusion procedure will most likely be recommended along with the decompression. The fusion is recommended to prevent the curve from progressing when the spine is destabilized by the bone removal that is necessary to  decompress the nerves. Fusions are usually accompanied with metal rod and screw placement into the spine to help correct and stabilize the scoliosis and help the bone heal or fuse together. The length of the fusion, or the number of spine levels included, depends on the type of scoliosis and the area of the spine involved. The goal of adult scoliosis surgery is to first remove pressure on the nerves, and second to keep the scoliosis from progressing further.

“At every stage of life, men are encouraged to consider three equally important aspects of their health—physical health, mental health and social connection. Men’s Health Month in the United States is observed every June. This month aims to raise awareness of the same health concerns of Men’s Health Week but lasts the whole month. It is different from November, which is held in November and focuses on men’s mental health as well as prostate cancer. During the month of June, men are encouraged to set goals for their own health and wellness and begin to create a roadmap for achieving those goals.  This is for men to address medical or health problems that may be starting or already there or hopefully cleared as healthy and to continue yearly to make sure its cleared healthy or if not address before the issue gets severe.”

Lifespan / Miriam Hospital (https://www.lifespan.org/lifespan-living/importance-mens-health-month)

Men in this age range are encouraged to discuss the health concerns below with their doctors. These discussions can be part of a yearly annual wellness visit. While you may think you don’t need some of these tests, establishing a base line can be useful for continued health monitoring as you age, or as more acute health concerns arise.

• Physical exam: check blood pressure, screen for obesity and assess body composition (waist circumference). Testicular exam and testicular self-exam are important at this age.
• Metabolic screening: fasting blood sugar and fasting lipid profile based on risk and family history.
• Vaccines: influenza, COVID-19, Hepatitis A/B, HPV, Tdap and MMR should be considered.
• STI screening: HIV, Hepatitis B/C, syphilis, gonorrhea and chlamydia screening should be considered, and pre-exposure prophylaxis for HIV (PreP) should be discussed.
• Assessment of risky behaviors: discuss any use of tobacco, alcohol, recreational drugs, anabolic steroids, as well as use of seatbelts and helmets and gun safety.
• Family planning: “pre-conception” counseling to educate men that adopting a healthy lifestyle—exercising, eating healthy foods, and avoiding substances—at an early age improves the chances of conceiving and having a healthy pregnancy and a healthy child.

Recommended screenings for adult men over 40

These screenings are similar to those recommended for younger men but start to look at health concerns that most often appear in middle age.

• Physical exam: check blood pressure, screen for obesity, measure body composition and consider prostate exam (in some cases).
• Metabolic screening: fasting blood sugar and fasting lipid profile and estimation of cardiovascular risk.
• Vaccines: influenza, covid-19, Hepatitis A/B, HPV (through age 45), Tdap and MMR. Shingles vaccine is recommended for adults over 50.
• STI screening: HIV, Hepatitis B/C, syphilis, gonorrhea and chlamydia screening should be considered, and pre-exposure prophylaxis for HIV (PreP) should be discussed.
• Cardiovascular screening: based on risk and symptoms (may include stress testing or coronary artery calcium score).
• Cancer screening: based on family history and personal risks. May include prostate, colon and lung cancer screening as well as skin exam.
• Eye exam.

Recommended screenings for adult men over 65

Older men should continue to evaluate their health and make lifestyle changes based on conversations with their doctors to ensure they are able to live life to the fullest.

• Physical exam: blood pressure, height and weight, waist circumference and prostate exam.
• Metabolic screening: fasting blood sugar, fasting lipid profile, thyroid function (in some cases).
• Vaccines: influenza, covid-19, Hepatitis A/B, Tdap, Pneumovax/Prevnar and Shingles.
• STI screening: based on risk.
• Cardiovascular screening: abdominal ultrasound, coronary artery calcium score and stress testing based on risk and symptoms.
• Cancer screening: prostate, colon and lung as well as skin exam.
• Osteoporosis: screening should be considered in men over 70, men who lose height over time or have a low impact fracture. Fall risk assessment should be completed.
• Eye exam.

Mental health is an important determinant of overall health and quality of life at every age. Although men are more likely to suffer “deaths of despair” including alcoholism, overdose and suicide, they are far less likely than women to seek out mental health services. Undiagnosed and untreated mood disorders in young men are associated with impaired learning, risk-taking behaviors, use of substances and violence. Adult men with chronic diseases like diabetes and cardiovascular disease have worse outcomes when they also suffer from depression, and depression is associated with decreased longevity in older men.  Men are less likely to get treated than a women in screening or when signs or symptoms arise until they get in the way or regarding mental health do men make a move and help yourself since no one may do it for you.  Help yourself its June make a change for the best in your health!

“Cataracts affect more than 20.5 million Americans age 40 and older, and 6.1 million Americans have had cataract surgery.  Prevalence of Age Related Macular Degeneration-AMD increases with age. For people age 80 and older, approximately 3 in 10 Americans have early AMD and 1 in 10 have late AMD.”

American Academy of Ophthalmology (https://www.aao.org/newsroom/eye-health-statistics)

Medications that can cause Cataracts:

Certain medications are well-known causes of cataracts, and some drugs can also accelerate their development. Steroid medications – whether pills, injections, or eye drops – are most frequently associated with cataract formation. If you are taking steroid medications to manage a long-term condition, it is important to note any visual changes and to have your ocular health managed by a qualified ophthalmologist. The medications that can cause cataracts include:  Corticosteroids, Eye drops containing steroids, Glaucoma medications, Certain antipsychotics and antidepressants, Certain medications for autoimmune conditions, and Medication to control heart arrhythmia

Signs and Symptoms of Cataracts:

You may not have any symptoms at first, when cataracts are mild. But as cataracts grow, they can cause changes in your vision. For example, you may notice that:

• Your vision is cloudy or blurry
• Colors look faded
• You can’t see well at night
• Lamps, sunlight, or headlights seem too bright
• You see a halo around lights
• You see double (this sometimes goes away as the cataract gets bigger)
• You have to change the prescription for your glasses often

These symptoms can be a sign of other eye problems, too. Be sure to talk to your eye doctor if you have any of these problems.

HOW YOU CAN PREVENT CATARACTS:

Maintaining healthy eating habits can help to prevent cataracts in two ways. First, a good diet will control your weight, thus eliminating one of the significant risk factors. Second, increasing your antioxidant intake can also inhibit the oxidation process. In a 2013 Swedish, researchers observed 30,000 women over age 49, and found that those who consumed the highest amounts of antioxidants had a 13 percent lower chance of developing cataracts than those who consumed the least amounts.

To reduce your risk for cataracts, be sure to eat plenty of foods high in antioxidants.

TREATMENTS FOR CATARACTS:

“June is Cataracts Awareness Month. As the year nears its midpoint, aging adults are advised to pause and learn more about a vision-worsening condition that occurs around age 40 when proteins in the eye lens begin to break down, clump and form a cloudy area over time. Cataracts affect 70 percent of adults by age 75, and recent CDC data* indicate more than 17% of adults above age 40 have a cataract in one or both eyes.

Risk factors linked to early development and quicker progression of cataracts include excessive sunlight exposure, smoking, and long-term use of steroid medication. Medical conditions linked to higher risk include diabetes, obesity, high blood pressure, and prior eye surgery or eye injuries. Aging adults should discuss their health behaviors and history with their eye specialist to evaluate risk for developing cataracts and other age-related eye diseases to prevent blindness.”

UNC school of medicine / school of medicine ophthalmology (https://www.med.unc.edu/ophth/2023/06/june-is-cataracts-awareness-month/)

A cataract is a cloudy area in the lens of your eye. Cataracts are very common as you get older. In fact, more than half of all Americans age 80 or older either have cataracts or have had surgery to get rid of cataracts.

At first, you may not notice that you have a cataract. But over time, cataracts can make your vision blurry, hazy, or less colorful. You may have trouble reading or doing other everyday activities.

There are 3 types of Cataracts:

1-Nuclear cataracts, which form in the lens’ nucleus, are the most common type of cataracts. Because opacity develops in the center of the lens, known as the central nucleus, nuclear cataracts interfere with a person’s ability to see objects in the distance. Usually the result of advancing age, nuclear cataracts can take years to develop and often give the nucleus a yellow tint.

2=Cortical cataracts begin at the outer rim of the lens and gradually work toward the central core. Thus, this type of cataract resembles spokes of a wheel. Patients with cortical cataracts often notice problems with glare, or a “halo” effect around lights. They may also experience a disruption of both near and distance vision.

3-Subcapsular cataracts progress the most rapidly. While nuclear cataracts take years to develop, subcapsular cataracts reach an advanced stage within a matter of months. Posterior subcapsular cataracts affect the back of the lens, causing glare and blurriness. This type of cataract is usually seen in patients who suffer from diabetes, extreme nearsightedness or retinitus pigmentosa, as well as among those who take steroid medication.

Obesity is most commonly linked to the development of posterior subcapsular cataracts. According to researchers at Harvard University, individuals with a BMI of 33 had at least a 30 percent greater likelihood of developing cataracts, compared to subjects with a BMI of 23 or below.

**Congenital cataracts exist and refer to cataracts that are present from birth, as well as to those that develop in early childhood. These cataracts can be nuclear, cortical, or subcapsular. Congenital cataracts may be linked to an infection contracted by the mother during pregnancy or to a genetic condition such as Fabry disease, Alport syndrome, or galactosemia. Because clear vision is essential to the development of the child’s eyes and brain, it is important to diagnose congenital cataracts as early as possible.

Most cataracts form as a result of advancing age. Other possible causes of cataracts include environmental factors and certain medications, such as antidepressants. If your medical history or lifestyle increases your risk of developing cataracts, it is important to have your eye health monitored regularly by a qualified ophthalmologist.

Over 50 percent of Americans over the age of 80 have cataracts

RISK FACTORS:

1 Age

Age is the main reason cataracts form. According to the American Academy of Ophthalmology, the eye disease appears in over 22 million Americans over the age of 40. Over 50 percent of Americans over the age of 80 have cataracts. In fact, if we live long enough, nearly all of us will eventually develop this condition. Because the lens of the eye cannot shed old cells naturally, protein that accumulates on the lens gradually builds up over time, progressively obscuring vision by preventing light from reaching the retina.

2 History of Cataracts in the family

3 Ultraviolet Radiation (UVA or UVB)

According to the U.S. Environmental Protection Agency, long-term exposure to ultraviolet radiation, especially UVB rays, can cause changes in pigment that lead to the formation of cataracts. This is especially common in tropical climates, where high concentrations of UV exposure occur year-round. To protect the eyes from sun damage, it is important to wear sunglasses with a high level of UVA/UVB protection.

4 Trauma to the eye

Injury or trauma to the eye increases a patient’s risk of developing cataracts. Individuals who have experienced inflammation in the eye, either post-operatively or as the result of another eye disease, are also more likely to eventually develop cataracts. For instance, iritis is an ocular condition that causes chronic inflammation inside the eye, and is commonly linked to early and rapid cataract formation.

5 Have certain health problems, like diabetes

6 Smoking and Alcohol

Lifestyle habits such as smoking or consuming alcohol are often considered causes of cataracts.

7 Medications

Certain medications are well-known causes of cataracts, and some drugs can also accelerate their development. Steroid medications – whether pills, injections, or eye drops – are most frequently associated with cataract formation. If you are taking steroid medications to manage a long-term condition, it is important to note any visual changes and to have your ocular health managed by a qualified ophthalmologist.

Most cataracts are caused by normal changes in your eyes as you get older.

When you’re young, the lens in your eye is clear. Around age 40, the proteins in t he lens of your eye start to break down and clump together. This clump makes a cloudy area on your lens — or a cataract. Over time, the cataract gets more severe and clouds more of the lens.

“Actinic Keratosis a rough, scaly patches of skin that are considered precancerous and are due to sun exposure. Prevention is to cut sun exposure and wear sunscreen. Treatments include performing cryosurgery (freezing with liquid nitrogen), cutting the keratoses away, burning them, putting 5-fluorouracil on them, and using photodynamic therapy (injecting into the bloodstream a chemical that collects in actinic keratoses and makes them more sensitive to destruction by a specialized form of light).

Keratoacanthoma this is a harmless, hard nodule that appears on the skin, most commonly on the face or arm of elderly people. The nodule may grow to up to 2 centimeters in diameter over about 8 weeks before gradually disappearing. However, the unsightly nodule is often surgically removed. The cause of keratoacanthoma is unknown, although exposure to sunlight appears to be a factor.”

Medicine Net (https://www.medicinenet.com/image-collection/actinic_keratosis_solar_keratosis_picture/picture.htm)

Continuation of Types of skin cancer:

5-Akinetic Keratosis:

Actinic keratosis (AK) is a skin disorder that causes rough, scaly patches of skin. Another name for AK is solar keratosis. AK is a type of precancer, which means that if you don’t treat the condition, it could turn into cancer. Without treatment, AK can lead to a type of skin cancer called squamous cell carcinoma.

The risk factors of Keratocanthoma (KA):

“Most of the cells on the skin’s surface are flat, scale-like squamous cells. Squamous cell carcinomas are the second most common type of skin cancer, accounting for about 20 percent of all diagnoses. These cancers also are slowing growing, but squamous cell carcinomas can spread to lymph nodes and even internal organs. Research indicates that the metastasis rate of squamous cell carcinoma of the skin is less than 10 percent within two years of diagnosis.

More than 150 years ago, a German scientist named Friedrich Merkel documented what he identified as tastzellen, German for “touch cells.” They would later be named Merkel cells. These cells are found below the epidermis, where they interact with nerve cells and help the skin feel light touch, textures and fine details.

Merkel cell carcinomas may appear as bumps or nodules—often red in color—on sun-exposed skin. This is a rare cancer, but it is often aggressive and may metastasize.  About 2,000 to 3,000 cases of Merkel cell carcinoma are diagnosed in the United States every year, according to the American Cancer Society, and the numbers are on the rise. The disease is rarely diagnosed in patients under 50 years old and is mostly found in white men older than 70.”

Cancer Center/ City of Hope (https://www.cancercenter.com/community/blog/2023/10/skin-cells-merkel-basal-squamous#Q2)