Asthma
Aetiology
- A combination of factors, primarily environmental and genetic factors, are believed to cause asthma
- Allergens, which are airborne, cause the disease; they include pollen, mold and animal dander among others
- Irritants such as smoke and dust also cause the disease
- Tough stress and depression
- Physical activities and particular medications can induce asthma
- People with a genetic predisposition to utilize Th2 helper cell can contract the disease
Pathogenesis
- Fundamentally, asthma comes in as immunological
- Several factors obstruct the airway, injury of the epithelium, bronchospasm, edema, a higher rate of mucus secretions and cellular, mainly eosinophilic, infiltration of the airway walls (White & Campell, 2001)
- Chronic inflammation has a connection with eosinophil that has proteins that destruct the epithelium in the airway
- All the above factors result into narrowing of the airway, hence higher resistance to the flow of air
Clinical Manifestations
- A chronic asthma entails worsening shortness of breath and wheezing, with a little help from inhalers
- The airway is blocked up to a point where the victim is unable to make a complete sentence as the ribs make futile efforts to breath (Rother, 2007)
- Airway remodeling involves structural changes in the large and small airways
- The structural changes are epithelial changes, gland increase, enlarged smooth muscle mass and neovascularization
- The structural changes thicken the airway wall, hence narrowing it
Management
- Consumption of corticosteroid beta2 and agonist beta2 minimizes asthma symptoms avoids exacerbations and increases lung function
- Other drugs include using inhalers that have combinations of the two drugs, unlike when taken separately
Risk Factors
- Taking a diet that is likely to result into overweight is a risk factor for contracting asthma
- Foods that are likely to cause overweight include consuming large amounts of meat, seafood and chicken
Depression
Aetiology
- Depression is inheritable through genes
- However, a person does not inherit the disease directly but inherits susceptibility to depressive illness from the parents
- Several brain chemicals and hormones such norepinephrine, thyroid and dopamine may lead into the development of depression
- Low levels of the chemicals may cause depression
- In addition, changes in Limbic Hypothalamic Pituitary Adrenal (LHPA) and serotonin (5-HT) system cause mood-changing illness, depression
Pathogenesis
- The nucleus solitarii (NTS) coordinates the arterial baroflex control
- Activation of presynaptic metabolic glutamate autoreceptor in the baroflex control suppresses the further production of frequency-dependent manner (Fava, 2000)
- Failure to regulator the autoreceptor can cause depression disorders
- During clinical manifestation of depression, NTS fails to activate presynaptic metabolic glutamate autoreceptor, hence symptoms of depression
Clinical Manifestations
- Symptoms of depression include when a person is feeling sadness, frustration, sleeping for many hours, insomnia and stopping to have an interest in regular activities such as sex
- Signs of depression include drug addiction to dealing with depression, drug addiction as well as the motive to commit suicide
Management
- Selective serotonin inhibitors (SSRIs) and tricyclic antidepressants (TCAs) help in the treatment of depression disorders
- SSRIs are preferred to TCAs because of their tolerance and safety
- However, there exists a difference between the two in terms of efficacy barely
- Another treatment available is serotonin and norepinephrine reuptake inhibitors (SNRIs), antidepressant that combine levomilnacipran, venlafaxine, desvenlafaxine and duloxetine (Barbui, Guaiana & Hotopf, 2004)
Risk Factors
- Vegetables, poultry, fruits, low-fat cheese and whole grains form a diet that puts one in less risk of contracting depression disorders
- Processed meats, junk food and sugar, put a person into higher chances of depressive symptoms
Type II Diabetes Mellitus
Aetiology
- Genes abnormalities can lead to type II diabetes
- However, there are rare cases of a single gene abnormality causing the disease
- A combination of gene abnormalities is what causes type II diabetes mellitus
- Gene hereditary condition help transfer type II diabetes to the siblings from the parents
- Insulin resistance is a metabolic factor linked with accumulation fats on the waistline that causes type II diabetes
Pathogenesis
- When there is insulin resistance, higher blood sugar is maintained within the body resulting to diabetes
- An increasing blood sugar level in the body because of type II diabetes causes damage to the nerves leading to a condition known as neuropathy
- The nerve disorder makes the sensory nerves insensitive, especially those located underneath the skin
- It also affects nerves that control body organs and muscle
- Hyperinsulinemia happens when there is more than normal level of insulin in the body (Tolmunen, Hintikka, Ruusunen, Voutilainen, Tanskanen, Valkonen, Viinamäki, Kaplan & Salonen, 2004)
- It is associated with type II diabetes; insulin resistance, which causes type II diabetes, makes the pancreas to give out more insulin as a consequence of its effects wanting to compensate for the insulin resistance
Clinical Manifestations
- If type II diabetes mellitus becomes acute and chronic, it is likely to cause serious complications
- It can lead to stroke, heart attack-even four times, complete kidney failure up to three times, amputation and blindness
- In addition, if the diseases takes a long time, it can cause damage to blood vessels, body organs and tissues, eventually, leading to death (Ruusunen, Lehto,Tolmunen, Mursu, Kaplan & Voutilainen, 2010)
Management
- Oral hypoglycaemic drugs help manage type II diabetes
- In most cases, they administered to victims who have not responded to dietary regulation
- Insulin is recommended for patients that have not controlled diabetes despite receiving oral glycaemic therapy
Risk Factors
- Avoiding a fatty diet such as processed meats and junk foods can save one from diabetes
- In addition avoid foods with high-salt, high-sugar and low-fiber
References
Barbui C, Guaiana G, Hotopf M. (2004) “Amitriptyline for inpatients and SSRIs for outpatients with depression? Systematic review and meta-regression analysis”. Pharmacopsychiatry.37(3):93-7
Fava M. (2000). “Weight gain and antidepressants”. J Clin Psychiatry. 61(11):37-41
Tolmunen T, Hintikka J, Ruusunen A, Voutilainen S, Tanskanen A, Valkonen V-P, Viinamäki H, Kaplan GA, Salonen JT. (2004). “Dietary Folate And The Risk Of Depression In Finnish Middle-Aged Men. A Prospective Follow-Up Study”. Psychother Psychosom. 73:334-9
Rother KI (April 2007). "Diabetes treatment—bridging the divide". The New England Journal of Medicine 356 (15): 1499–501
Ruusunen A, Lehto S, Tolmunen T, Mursu J, Kaplan GA, Voutilainen S. (2010). “Coffee Consumption And The Risk Of Severe Depression In Middle-Aged Eastern Finnish Men”. Public Health Nutr. 13:1215-20.
White JR, Campbell RK (2001). “Recent Developments In The Pharmacological Reduction Of Blood Glucose In Patients With Type 2 Diabetes”. Clinical Diabetes 19:153–159, 2001
