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Amyotrophic Lateral Sclerosis (ALS) – Reading & Sharing

Definition, Etiology, and Incidence


Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig disease after the famous New York Yankees baseball player, is a devastating neurologic disorder that selectively affects motor function with an unknown origin, characterized by progressive muscle atrophy with hyperreflexia that results from denervation, and results in muscle weakness, disability, respiratory insufficiency, and eventually death.

ALS is a rare, debilitating, and incurable neurologic disease, has an annual incidence of 0.5-2 per 100,000 population, is primarily a disorder of middle to late adulthood, affecting people most frequently in their fifties, with men developing the disease nearly twice as often as women. The median survival duration for patient is approximately 3 years, yet approximately 20% of patients survive greater than 5 years, and 10% will survive for greater than 10 years.

As the main area of involvement is the motor neurons of the brain and spinal cord, ALS affects motor neurons in three locations as follows: the anterior horn cells (lower motor neurons – LMNs) of the spinal cord; the motor nuclei of the brain stem, particularly the hypoglossal nuclei; and the upper motor neurons (UMNs) of the cerebral cortex. The death of the LMNs leads to denervation, with subsequent shrinkage of musculature and muscle fiber atrophy. It is this fiber atrophy, called amyotrophy, which appears in the name of the disease. The loss of nerve fibers in lateral columns of the white matter of the spinal cord, along with fibrillary gliosis, imparts a firmness or sclerosis to this CNS tissue. The term lateral sclerosis designates these changes.

A remarkable feature of the disease is that the entire sensory system, the regulatory mechanisms of control and coordination of movement, and the intellect remain intact.

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COPD (Reading & Sharing)

COPD is or chronic obstructive airway disease is actually an umbrella term for a group of diseases that cause airway blockage and breathing problems in general. According to Higginson and Parry (2018), “COPD is a progressive obstructive lung disease that adversely affects the patient’s ability to both breathe and exchange gases between the alveoli and circulation due to loss of lung tissue” (p. 12). Those diseases included are emphysema, chronic bronchitis and asthma. According to the CDC, almost 15.7 million Americans or 6.4% reported having COPD (CDC, 2018). The rate of COPD was higher in people aged 65 and older, American Indians and Alaskan Natives, current or former smokers, and those with a history of asthma (CDC, 2018).

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Atopic dermatitis (Reading & Sharing)

Atopic dermatitis is a common inflammatory skin disease that mostly occurs in children and E (IgE) is secreted in response to environmental or food allergens. Typically dermatitis and eczema are used interchangeably when the patient has an acute flare-up. The condition is non-contagious and is characterized by dry, itchy skin, but in chronic or severe cases it can cause thick plaques, slightly raised, watery exudate to form or become infected which can affect the patient’s quality of life. So, therefore, because eczema is a common skin disorder seen in primary care the discussion will include the incidence, prevalence of the disease and pathophysiology from the primary provider perspective. As well as the physical assessment and exam, treatment plan, patient education, follow up and evaluation.

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