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Carolina Jaime's Paper

Created By: Jessica De anda
Alzheimer's Cure
Q2: Report: (Required*) 
A2: "Alzheimer's...it is a barren disease, as empty and lifeless as a desert. It is a thief of hearts and souls and memories." This quote is written by Nicholas Sparks in The Notebook, and for those of you who haven't seen the movie, in the end, Allie, Noah's true love, dies from Alzheimer's. (Suggestion: This quote is written by Nicholas Sparks in The Notebook. For those of you who haven't seen the movie,  Allie, Noah's true love, dies from Alzheimer's in the end.) What a beautiful love story, with such a horrific ending, but what if this bad ending could turn into a good one? What if there can be a cure for Alzheimer's? Even though not all scientists may agree, I believe that there is hope as trial and error will eventually reveal a cure for Alzheimer's. In order to find a cure for this deadly disease, it is important to first go through the history, background, stages, and effects it has on patients and caregivers. Also, there are experiments being done to prove that there can be a happy ending to this movie, and for the lives of people afflicted by Alzheimer's. Good!!!! :)

Alzheimer's disease was first introduced on November 25, 1901 by Alois Alzheimer who is known to be "The Father of Alzheimer's Disease" (Ataman 2012, 13). This is the most common type of dementia that deteriorates brain cells and causes the brain to shrivel significantly (Stone 2013, 2). Dr. Alzheimer saw that this disease was abnormal and destroyed the brain, taking memories with it. When he first admitted Auguste D. as a patient, she shared her troubling experiences over the years, noting how she was beginning (use "began" instead of "was beginning" because you used "became" later in your sentence) to forget recollections of the past, became extremely frightened of people close to her, and was envious of her husband (Ataman 2012, 3). These types of symptoms were common because this disease leads to confusion about events, behavior and attitude changes, difficulty speaking, paranoia of people, and trouble walking (Stone 2013, 4). Using the staining method, a way to examine brain tissues in a microscope, Dr. Alzheimer noticed a large amount of amyloid plaques and neurofibrillary tangles in the nerve cells of the cerebral cortex. This amyloid protein usually stains blue when immersed in an iodine solution. Amyloid plaques are protein fragments that the brain produces normally; neurofibrillary tangles are consisted (use "consist" instead of "are consisted") of a protein called tau which is (made up of) insoluble twisted fibers inside the brain's cells (Ataman 2012, 4; Stone 2013, 3; Kim 2009, 2). He assumed that this mental disorder was inherited through genes and could be passed along to generations to come (Ataman 2012,5). 

One of the origins of Alzheimer's disease that many neuroscientists think is true is the accumulation of the amyloid beta, also known as AB or A-beta, in the brain. (This sentence is good :), but here's a suggestion: The most accepted belief among neuroscientists as to how Alzheimer's disease originated is the...) A-beta is a peptide processed by the amyloid precursor protein (APP) with non-pathological activity (Burica 2010, 1; Murray et. al 2013, 1). The amyloid precursor protein is found in many tissues of the brain and is focused in the synapses of neurons which later lead to plaque formation. Signs of this disease show ten to twenty years after changes in the brain have already occurred; so many doctors are aiming to find symptoms and trying to delay the progression of this fatal disease with drugs (LaPook 2012, 3). Approximately 5.4 million people in 2012 have been affected by Alzheimer's; if there is still no cure, studies have shown that this massive number is estimated to triple by 2050 (LaPook 2012, 1; Lloyd 2012,3). WOW! That's crazy! The government has been generous enough to donate about twenty-four million dollars in experimental trials to end the losses that many families are going through because of this horrendous illness; they have also outlined a plan to have a cure for this dementia 12 years from now (Lloyd 2012, 2). Alzheimer's has been around for 112 years, but new trials are underway to put an end to all of this misery. 

When being diagnosed with Alzheimer's, it is life-changing for both, (take out comma) the patient and family (Anonymous 2013b, 5). There are three stages for this type of dementia: early, middle, and last-stage caregiving. Patients in the early-stage are still able to operate alone; they can continue to do their daily activities such as driving and working, with little or no problem. Because each patient is affected differently, the amount of caregiver support varies (Anonymous 2013b, 13). An issue most people tend to face is discussing the diagnosis of Alzheimer's; it is helpful to make the person not feel anxious as it can cause tension in the atmosphere (Anonymous 2013b, 4). (Suggestion: it is helpful to avoid making the person feel anxious as...) This stage can last up to several years, and others may not even be able to see this dementia until symptoms become recognizable (Anonymous 2013b, 2). Family members or care partners need to give emotional support, including love and camaraderie, as it is critical for the patients to feel lighthearted (Anonymous 2013b, 3).Mood changes will begin to occur, (actually, idk if you need this comma or not... ) making the person sense ("sense" sounds a bit awkward here, maybe change it to "feel")  as if they are losing control and (are) unaware of what they are feeling (if you changed "sense to "feel, change "unaware of what they are feeling" to "unaware of the varied emotions they are experiencing" so its not repetitive). These kinds of responses are normal for Alzheimer's disease (Anonymous 2013, 8; Carlsson et. al. 2013, 7). It is important to start planning for the future as symptoms will gradually worsen (Anonymous 2013b, 5).  

The middle-stage of Alzheimer's requires more time spent with the patient as the disease grows, and is usually the longest of the three stages. The role of being a caregiver will definitely come into play as the responsibility will become more demanding and help will be needed daily. Caregivers are recommended to take time for themselves, even if it's just a few moments (Carlsson et. al. 2013, 9). There will be good days and there will be bad days, but it's during these times that connections and bonds grow deeper (Anonymous 2013b, 6). Damages to the brain makes communication and thoughts rougher to express, so (Suggestion: use "thus" or "therefore" instead of "so") when communicating with a patient, caretakers must speak slowly and repeat their words for the patient to fully understand (Anonymous 2013, 7). Safety concerns such as supervision will be needed because patients begin to wander around (Anonymous 2013b, 10; Carlsson et al. 2013, 8). Memories will start to fade or modify from what they originally were; places will become a mystery (Anonymous 2013, 5).  

There is no way to predict when an Alzheimer's patient will die, but the last stage of this disease can last from numerous weeks to years. This is the time when caregivers spend all day and night with their patients; some patients even need to move to a facility because their home cannot provide the essential needs (use "necessities" instead of needs) (Anonymous 2013b, 9). Alzheimer's disease makes the patient handicapped where they can't do anything themselves. Families have a challenging time when thinking about the quality care they wish their family member to receive, either hospice of ("or" instead of "of"?) a convalescent home. A few important caregiving tasks include helping with personal care, eating, and walking (Anonymous 2013b, 1112). Because patients cannot walk or move, they are vulnerable and open to getting an infection. Caregivers try to save the patient's pride and self-respect by showing their love through their senses; even though the (Suggestion: use "their loved one's" instead of "the") brain is rotting away and losing its function, they should try to make it as enjoyable as possible because their heart still remains with them even if their brain doesn't (Anonymous 2013b, 1014). 

A new study at Harvard University proposes the idea that the main cause of Alzheimer's disease--the accumulation of amyloid beta--may be what can protect the brain (Burica 2010, 1). This protein looks similar to the LL-37, which is known to fight off infections in animals. In an experiment, A-beta killed over 60% of bacteria, making it effective (Burica 2010, 2). Neuroscientists studying this case believe that Alzheimer's disease is just caused by too much of the amyloid beta protein. Laura Vogel, a professor of immunology, states that this can be a possible explanation since the majority of people believe that destroying A-beta will treat Alzheimer's. If a patient needs the amyloid beta protein to protect themselves from contagion, disposing away of this protein may not be such a good idea. A professor of biology by the name of H. Tak Cheung believes that controlling the cause of the A-beta protein, which is a bacteria-based infection, may result in a cure for dementia (Burica 2010, 3).

Another study using radiation on mice was found for a possible treatment of Alzheimer's disease. Brian Marples, one of Beaumont's Radiation Biologists, discovered that taking genetically bred mice with injected proteins, relating to Alzheimer's, and giving them radiation over a couple of weeks could lead to a possible cure (Larson 2012, 12). The amyloid beta plaque reduced by 80% when giving low amounts of radiation over time; when patients take drugs to lower their symptoms, the drug has to get into the blood brain-barrier, which are cells that make up the walls of brain capillaries and prevent fluids in the blood to diffuse freely into the brain; however, when using radiation, neuroscientists don't have to cross that barrier (Larson 2012,3). These mice were very cooperative when doing the radiation. Dr. Marples will begin a human study to see if high or low radiation will reduce amyloid deposits and whether it has a benefit on a patient's memory (Larson 2012, 4). 

The modulation of the ADAM10 gene, or A Disintegrin and Metalloproteinase, could perhaps be a target for the cure and prevention of Alzheimer's disease (Kim 2009, 6). Disintegrin and metalloproteinase cut off transmembrane proteins; these proteins go from one side of the cell membrane to the other. There is indication that the ADAM10, as well as two other mutations, Q170H and RI81G, are associated with this dementia; about 70% of these mutations were found in seven Alzheimer's families (Kim 2009, 15). The Q170H and R181G mutations significantly lower a-secretase activity of ADAM10. A-secretase are seen on the surfaces of cells and are attached in the cell membrane. The place where these two mutations are on the ADAM10 gene suggest that the amount of activity through the prodomain, a specific function or interaction with other proteins, could signify the advancement for a treatment and avoidance of Alzheimer's (Kim 2009, 6). Good!!!! :)

Ketoacids, also called ketone bodies, are medium chain triglycerides (MCT oil) that have been experimented to cure and prevent this type of dementia. Ketone bodies are chemicals that the body makes when there is not enough insulin in the blood and must break down fat, instead of glucose, for energy; they help the brain recover oxygen after it has been lost in babies through adults (Newport 2008, 34). The liver converts all MCTs as ketone bodies to use as energy. This MCT oil produces hyperketonemia, which are then available to the brain, even in the presence of glucose; hyperketonemia is the concentration of ketone bodies in blood, and result in an increase of cerebral blood flow, and mental dysfunction. Brain cells, precisely neurons, are limited to the type of energy they can use to work and survive. We, humans, don't have these ketone bodies flowing and open to the brain (Newport 2008, 56). Before symptoms begin to show in Alzheimer's disease, neurons in certain parts of the brain slowly die off because they are unable to take in glucose, due to the insulin resistance. These neurons could ("would" instead of "could"? bc you used "were" later on in this sentence... i really dont think its a big deal though :)) stay alive and function if ketone bodies were accessible. When sugar is not available in the body, beta-hydroxybutyrate is used to protect neurons; consuming more of this beta can result in higher levels of ketone bodies (Newport 2008, 10). In order to have ketone bodies circulating the blood all day, 7 teaspoons of coconut oil should be taken once a day. After about 50 days of using coconut oil, the patient definitely saw (since you used "should" in the previous sentence, maybe you should change "the patient definitely saw" to "the patient should definitely see") some improvement in their memory (Newport 2008, 913). 

Genentech crenezumab and an insulin nasal spray vaccine are two studies that scientists are undergoing to stop Alzheimer's from spreading, which may eventually lead to a cure. Crenezumab is an experimental antibody drug given to an extended family of 300 in Colombia showing no signs or symptoms of this dementia, but unfortunately having the disease in their gene (Anonymous 2012, 7). Its mission is to stop amyloid beta from forming in the brain, and prevent it from into going to people who are predestined to have Alzheimer's (Lloyd 2012, 5; Anonymous 2012, 23). Scientists are aiming to see if this antibody can sustain memory and cognitive skills (Callaway 2012, 5). The second study is an insulin nasal spray vaccine that will test if insulin sent to the brain will help people with mild memory problems. Not only will this spray help manage Alzheimer's, but it can also help prevent strokes (Anonymous 2011, 1). By using the body's own immune system, damages in the brain tissue will be repaired through attacking the amyloid-beta protein. The reason scientists are using insulin for the vaccine is because brain cells need glucose, which is a form of fuel for the brain (Lloyd 2012, 6). This vaccine could be given to people are at risk or show symptoms of Alzheimer's, or those who have had strokes in the past (Anonymous 2011, 4).

In conclusion, many people who are battling Alzheimer's disease have already suffered a tremendous amount of misery and deserve to believe in hope for a brighter future, hope that someday there will be a cure. They should be able to see their children, even grandchildren, and be able to recognize them with opening arms and love. This disease has ripped families apart and taken away memories that should have never been forgotten. Alzheimer's disease goes way back to the 1900s and has a plethora of background; it contains three stages which effect not only the patients, but caregivers as well. Multiple experiments such as radiation, the ingestion of coconut oil, usage of insulin nasal sprays and many other methods will soon prove that there will be a cure for Alzheimer's. Hope and patience is what one needs in this battle to end the epidemic of Alzheimer's.  

Your report is really good!!!!! :) LOVE the conclusion!!!!!
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Mariela Dagio's Paper

Created By: Jessica De anda
A1: Bipoloar Disorder: The Whole Story
Q2: Report:(Required*) 
A2: About 5.7 million people 18 and older are affected by bipolar disorder a year. That's about 2.6% of the U.S population. After researching bipolar disorder, its symptoms, treatments, who it affects, role of genes, looking at journals of neuroimaging, and seeing what happens in the brains of patients with bipolar disorder I can say I have learned a lot and would like to share that knowledge on how I believe bipolar disorder is caused and what happens in the brain. (Suggestion: After researching bipolar disorder's symptoms, treatments, susceptibility rates, and the role of genes, along with looking at journals of neuroimaging, and observing the abnormal brain functions of patients, I would like to explain this information within my report. I believe bipolar disorder is caused by... and *this* happens in the brain.)

Bipolar disorder equally affects both women and men, as well as equally affects every race, age social class, and ethnic group (Anonymous 2013, 2; Bressert 2 2013, 3). Although it affects both genders equally, women have been proven to experience 3x more rapid cycling, which is experiencing four or more mania or depression episodes inside of a year. Mania episodes are when the patient starts experiencing rapid thoughts and loses all clarity due to overwhelming confusion, they start to think everything is funny and suddenly go to the worst where they are irritable, frightened, angry, and uncontrollable (Anonymous 2 2013, 2). This is one of the main symptoms of bipolar disorder along with other symptoms occurring daily such as sudden moodswings, racing thoughts, fast talking, making impulsive decisions, restlessness, increased energy, an inflated self-esteem, and high sex drive (Anonynous 2 2013, 1).
   
There are many questions on what causes bipolar disorder. The cause isn't entirely known though. There are beliefs that genetic, neurochemical, and environmental factors play a part in the onset and progression of bipolar disorder (Bressert 2013, 1). There are many thoughts bipolar disorder is a biological disorder that occurs in a specific part of the brain, and is due to malfunction of the neurotransmitters in the brain. Being a biological disorder means it may always be there active or not and caused to be active by being triggered by stressors (Bressert 2013, 14). (Suggestion :) - As a biological disorder, bipolar disorder will always be part of a person, whether it is active or not; Stressors are known to trigger bipolar activeness within one.)
    
There are studies done on patients with bipolar disorder (to see) if there is a connection between brain abnormalities such as an underdeveloped prefrontal cortex, which is the site where your emotions, personality, and decision making happen (Strakowki 2004, 4). Bipolar disorder is related to structural brain abnormalities (McIntosh et al. 2005, 1). There are studies on identical twins when (maybe use "where" instead of "when" but i dont think it really makes a difference :)) only one of them has bipolar disorder. Since they are identical twins they share 100% of their genes. Which means if it was relied on genes alone then both of them would get bipolar disorder but they only have a 28-96% of coordance which means it happens to both (Phillips 2005, 2). (Suggestion: This means that if the disorder relied on genes alone, then both of them would get bipolar disorder. Surprisingly, they only have a 28-96% of coordance, which means it happens to both) So the question remains, what causes bipolar disorder? 

After researching the causes of bipolar disorder I believe that bipolar disorder is caused by environmental and genetic factors. A person who has a long line of generations in their family with at least one family (member?) with bipolar disorder they (maybe take out "they") are (at a) higher risk of (developing) bipolar disorder than someone who does not have history of the disorder in their family. A life altering event in a negative way can trigger a mood episode in someone who has genetic depositor, bipolar disorder running the family, to bipolar disorder (Bressert 2013, 8). Also having excessive bad habits that lead to any psychological problems such as alcohol and/or drug abuse, hormonal problems, and illegal substance use can trigger a mania episode even in someone who does not have history of the disorder in the family (Bressert 2013, 9). 

Bipolar disorder is highly likely to be misdiagnosed in women as depression and in men as schizophrenia, (maybe change the comma to a ; and add "in other words,") it is a gender bias in diagnosis (Anonymous 2013,11). When being misdiagnosed and given medicine for that, such as anti depressants, it can trigger a medication-triggered mania (Bressert 2013, 12). Also having an effect on your brain when having bipolar disorder is a decrease in frontal cortex grey matter which is the regions of the brain involved in muscle control, sensory perception such as seeing and hearing, memory, emotions, and speech (Van Der Schot et al., 2010, 3).

Bipolar disorder affects everyone from adolescents to adults. It affects many families and it is the sixth leading cause of disability in the U.S (Anonymous 2013, 4; Asher 2010, 2). It also is one of the leading causes of suicide along with paranoid schizophrenia. Bipolar disorder has no cure but there are treatments to help keep the mania and depression episodes under control. There is no one medication that works for everyone, so many medications have to (be) tried out before having a rountine medication (Anonymous 3 2013, 1). Many medications are tries (use "tried" instead of "tries") out such as mood stabilizers, which are usually the first ones to be prescribed. Mood stabilizers usually stay in the rountine medication along with lithium ( Anonymous 3 2013, 2). Lithium is a medication used to prevent mania and depression episodes and controlling the symptoms of those episodes (Anonymous 3 2013, 3). Valproic acid is an alternative to lithium for treating mania and is usually as effective as lithium (Anonymous 3 2013, 4). Patients with bipolar disorder usually have thyroid gland problems, lithium may cause low thyroid function with the treatment (Anonymous 3 2013, 5). It causes hypothyroidism, which is when your thyroid makes too much thyroid hormone which can cause you to lose weight quickly, have a fast heartbeat, sweat a lot, or feel nervous and moody (Anonymous 4 2013, 1; 2). Good!!!!! (not the disease haha)
    
There are four basic types of bipolar disorder. Bipolar 1 disorder is mainly mania and depression episodes for at least seven days, or maniac symptoms that require hospital care (Anonymous 5 2013, 1). Bipolar 2 disorder is having a pattern of depressive episodes, and going back back and forth from hypomanic episodes but never going into full blown maniac or mixed episodes (Anonymous 5 2013, 2). Bipolar Disorder Not Otherwise Specified (BP-NOS) is when the patient has the symptoms of bipolar disorder but does not meet the full criteria od (of) bipolar disorder 1 or 2. The symptoms do not last long enough or do not have enough symptoms to be bipolar 1 or 2. You can tell that the characteristics of the behavior is not the person's normal personality (Anonymous 5 2013, 3). Cyclothymic disorder is a more mild sort of bipolar disorder. The patient experiences mild depression episodes along with hypomania but to meet the diagnostic requirements for bipolar disorder (Anonymous 5 2013, 4). If bipolar disorder is not treated it may get worse, and over a long period of time the patient starts suffering from more severe and frequent episodes (Anonymous 5 2013, 5). 
    
There was a recent study done where they found a genetic hotspot where depression and bipolar disorder are connected in a way. One gene that codes for a part that tells the gene when to turn on or off. It is over expressed in the brains of bipolar disorder patients (Asher 2010, 1). The gene they suspect is called PBRM1, (use ; instead of ,) it is in charge of coding for a protein that is very important for chromatin remodeling, which is a key process in regulating gene expression (Asher 2010, 3). The gene PBRM1 was found more in the prefrontal cortex of the brain, which is in charge of making decisions and controlling emotions, of patients of bipolar disorder than those without (Asher 2010, 4). Since bipolar disorder is most likely something to do with altered gene expression during brain development that makes PBRM1 a good explanation for the possible cause of mood disorders (Asher 2010, 5). 

The story behind bipolar disorder traces back to Ancient Greeks to a philosopher and physician of that time named Aretaeus of Cappadocia (Burton 2012,1). He described a group of people who were happy, dancing, and play all night and day. Then suddenly go to dull and sorrowful at other times (Burton 2012,12). The understanding we have now started in 1854, Jules Baillarger and Jean-Pierre Falret both presented independently descriptions of bipolar disorder to the Academie de Medicine in Paris (Burton 2012, 3). Baillarger called it dual-form insanity, while Falret called it circular insanity (Burton 2012, 5). Later in the early 1900s a German psychiatrist named Emil Kraepelin found a distinction from schizophrenia and the disorder, while leaving bipolar disorder untreated there were symptom free periods (Burton 2012, 67). Only recently was there a distinction between people with both manic and depressive episodes and people with depressive episodes with psychotic symptoms, which would be those with schizophrenia (Burton 2012, 7;8). Even though the most common term used for the disorder is bipolar disorder many people and psychiatrists still use manic-depressive illness because they feel it is a more accurate name for what it is (Burton 2012, 11). 

Even though bipolar disorder does not have a definite answer for why it happens scientists know there are many factors that contribute to it. Genetic factors seem to be the ones that pop out the most at scientists. It can run in the family and affect every person, and it might not. As I wrote earlier, even though identical twins share the exact same genes, not both of them always got the disorder. (Suggestion: As I wrote earlier, even though identical twins share the exact same genes, both did not always get the disorder.) There are also environmental factors such as stress, alcohol abuse, drug abuse, and  a life altering occurrence. There are also neurochemical factors with bipolar disorder such as the neurotransmitters not functioning properly with the chemicals (Bressert 2013, 7). And as said previously also medication-induced episodes are a factor in what cause bipolar disorder. 

There are many people bipolar disorder affects every year. It may hit a family hard when there are young adults with bipolar disorder that (who) take their own lives to to their condition. Bipolar disorder is highly connected to suicide (KR 2006, 1). 25- 50% of patients with bipolar disorder have tried to kill themselves at least once (KR 2006, 2). Lithium is also an effective treatment for suicide, because its mood-altering effects (KR 2006, 3). Suicide is a result of some form of mental illness (KR 2006, 4). Medication must be taken to prevent thought of suicide. If it is not the thoughts are always there. A boy by the name of Steven Hrabovsky-Kleine took his life after the third time of attempting suicide. He never took his medication. He hard a hard life and just wanted to go to Heaven with his grandmother who died when he was four.. After he dies his mother found eleven bottles of unopened bottles of medication. :'(
   
Many questions are asked when it comes to bipolar disorder that cannot be answered. Such as why people get it. Its a question that is asked for every mental illness. The main reason every scientist seems to come up with is that its in your genetics. There is no way to avoid it. It has to do with brain abnormalities as well (Van Der Schot et al. 2010, 1). Structural damages can also cause you to be diagnosed with bipolar disorder. There are many factors that cause the illness and there is not an exact way to know where it comes from. It's research is much like the illness; it has many ups and downs. 

Bipolar disorder is a very well known illness. It affects everyday people all the time. Being aware that you have bipolar disorder is a way too (to) make sure you keep it under control. Having bipolar disorder does not neccesarily (necessarily) make you disabled. You can live a normal life along with taking your medication. This was a very interesting topic and I am glad I chose to do a report on it. Not only did I learn a lot about mental illness, I also learned of the origin of bipolar disorder. That is the whole story of bipolar disorder.

Nice report!! :) 
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