Here's my wikipedia list of organ systems:
- Circulatory system: pumping and channeling blood to and from the body and lungs with heart, blood and blood vessels.
- Integumentary system: skin, hair, fat, and nails.
- Skeletal system: structural support and protection with bones, cartilage, ligaments and tendons.
- Reproductive system: the sex organs, such as ovaries, fallopian tubes, uterus, vagina, mammary glands, testes, vas deferens, seminal vesicles and prostate
- Digestive system: digestion and processing food with salivary glands, esophagus, stomach, liver, gallbladder, pancreas, intestines,rectum and anus.
- Urinary system: kidneys, ureters, bladder and urethra involved in fluid balance, electrolyte balance and excretion of urine.
- Respiratory system: the organs used for breathing, the pharynx, larynx, bronchi, lungs and diaphragm.
- Endocrine system: communication within the body using hormones made by endocrine glands such as the hypothalamus, pituitarygland, pineal body or pineal gland, thyroid, parathyroid and adrenals, i.e., adrenal glands.
- Lymphatic system: structures involved in the transfer of lymph between tissues and the blood stream; includes the lymph and the nodes and vessels. The lymphatic system includes functions including immune responses and development of antibodies.
- Muscular system: allows for manipulation of the environment, provides locomotion, maintains posture, and produces heat. Includes skeletal muscles, smooth muscles and cardiac muscle.
- Nervous system: collecting, transferring and processing information with brain, spinal cord and peripheral nervous system.
I'm starting with the nervous system... I'm skipping the anatomy/ physiology part for right now (I'll come back to it) because I found this cool article to read instead.
Article: The Search For Effective Alzheimer's Therapies: A Work In Progress (Bor, 2014-- Health Affairs)
- Basically Alzheimer's sucks. It strips away the elements of life that make life meaningful-- memories, ability to take care of oneself, ability to carry-on a conversation with someone-- but it does so pretty slowly.
- Places a large burden on caretakers, who are often family-members, creating additional pain and suffering for both the patient and caretaker
- About 5 million people have Alzheimer's in the US, prevalence is expected to increase as more people age (to the tune of tripling the # of people with Alzheimer's)
- Costs: In 2010 the average annual cost of caring for a patient with dementia was estimated to be $41,000–$56,000, for a total cost of $157–$215 billion each year in the United States.
- The goal is to manage Alzheimer's like any other chronic disease (diabetes, HIV/AIDs)-- where, if you adhere to the medication/ lifestyle protocol, you will delay the onset of further complications
- We aren't there yet... HHS set of moon-shot goal saying we should get there by 2025.. but but I'm not sure we're going to meet that goal
- Two types
- Early onset-- can happen as early as 30s-- usually end stage by 40s
- Late onset-- happens at age 60+
- This quote from the article gives a great description of Alzheimer's brain compared to a healthy brain:
- We're not sure what causes Alzheimer's...
- Two proteins are the focus of much of the research. They are present in both healthy brain function, and in patient's with Alzheimer's:
- Beta amyloid-- form "plaques" on the brain
- Tau-- form "tangles" in brain cells
- Research-- we haven't cracked the code yet... still searching
- Some drug trials have been conducted to address the build-up of plaque (targeting amyloid) (drug: bapineuzumab)-- while it reduced plaque, it didn't reduce clinical symptoms of Alzheimer's-- IE-- people took the drugs, but they didn't get noticeably better
- Assessment of National Institute on Aging:
- “The interventions did not work, which in concept means that amyloid is not an appropriate target, that it wasn’t appropriately targeted by these interventions, or that the time of intervention when symptomatic disease had already developed was too late in the course of cell damage to have an impact.”
- The thinking is now that treatments will need to target both plaque and tangles-- and will need to be delivered as early as possible (maybe even before symptoms start)
- We're still looking for the perfect biomarker-- the thing that identifies you're either going to get Alzheimer's-- or you're at a higher risk for contracting it.
- Some promising prospects from
- John's Hopkins--cerebrospinal fluid (spinal tap) showing
- Georgetown-- blood test
- Prospective trial going on with 1000 asymptomatic patients
- Current treatment options:
- 5 Drugs exist right now to treat the symptoms of Alzheimer's but do nothing to address the actual disease process (like taking a pain killer after surgery-- it dulls the symptom of pain... but it doesn't close up the surgical incision to stop the pain permanently).
- Aricept, Cognex, Razadyne, Namenda, and Exelon
- No evidence exists directly linking lifestyle factors (diet/ exercise) to Alzheimer's... sure there are "brain-healthy" diets-- but we can't say at this time that poor diet = Alzheimer's.
- How we're treating the disease right now:
- 5 drugs above
- Aware that patients with dementia are more likely to admit to the hospital with ambulatory-sensitive conditions
- Opportunity to have a clinic for these people? Are these frequent-flyers in the ED? Do they affect the 30-day readmissions rates? Why do they keep coming into the ED for things that can be treated in a PCPs office?
- Treat neuropsychiatric/ behavioral symptoms (agitation, depression, etc.)
- Be in communication with/ support family members or caregivers:
- If you can educate them and make sure they can get the patient to the doctor as needed, adhere to the medication schedule, and have safe living arrangement that can delay the need to have the patient in a nursing home for up to 9 months.
