Disorders of urinary system.Who is most at risk of developing urinary disorders?

The urinary system rids your body of waste,so it is crucial that functions well.

The urinary system,also known as the urinary tract,consist of a pair of kidneys,the bladder,the ureters,which connect each kidney to the bladder and the urethra,through which urine leaves the body.
Most kidney diseases affects the filtration capacity of the kidneys,causing them to lose function.
Kidney disorders are broadly classified as acute (the sudden failure of the kidney,which may be fatal) or there may ba a gradual reduction in fucntion over months or years,in which case it is chronic.
Although the urinary system is structured in a way that help ward off infection,infections can occur.
They are caused by germs that get into the urethra,which can spread to the kidneys.

Urinary tract infections

Infections can occur if bacteria get into the body via the bloodstream or the urethra.Urinary tract infections (UTI's) are more common in women.
Despite containing fluids,salts and waste products,urine is sterile (free from germs such as bacteria).An infection occurs only when bacteria begin to grow.A woman's urethral opening lies near sources of bacteria from the anus and vagina.
Infections often start in the urethra.From there,the bacteria can move up into the bladder,causing an infection (cystitis).If the infection si not treated,it can spread to the kidneys,causing pyelonephritis,which is serious and can demage the kidneys.

Who is most at risk of developing urinary disorders?

Diet and lifestyle:
People who live n hot climates and who are susceptible to kindney stones are at increased risk if they do not drink enough fluids to replace that lost through perspiration.
Gender and age:
About 20% of women will contract a urinary tract infection (UTI) at some point in their life.The reason for this are not fully understood,although it may because a woman's urethra is short,allowing bacteria quick access to the bladder.Kidney stones are more common in Caucasians,in men and in those between the age of 20 and 40.
Family history:
You are more likly to develop a stone if someone in your family has had a kidney stone.Similarly,anyone who has a kidney stone is at increased risk of having an other .
Other factors:
Any abnormality of the urinary tract that obstruct the flow of urine (a kidney stone,for exemple) sets the stage for a urinary tract infection.
An enlarged prostate gland can also slow urine flow,thus increasing the risk of infection.Sexually,active woman or those who use a diaphragm for birth control may be more likly to have a UTI.
People with diabetes have a higher risk of a UTI because of changes in their immune system.
People with ulcerative colitis or Crohn's diseases,or who have had intestinal bypass surgery for weight loss,are at risk of developing oxalate kidney stones and those poeple may be prescribed preventive treatment.
People with diabetes or high blood pressure,or who have suffered repeated kidney infections are at greatest risk of developing kidney failure.

CANCER PREVENTION!Formation of Red Blood Cells.Importance of Diet in formation of Red Blood Cells

Red blood Cells production occurs in the bone marrow,starting with the stem cell and progressing through various intermediates.Normal development takes about 7-10 days.

Red Blood Cells are produced in the liver and spleen of the fetus.After birth the bone marrow is the site of formation of Red Blood Cells.Until adolescence the bone marrow of all bones produces Red Blood Cells.
By the age of 20,the marrow is in the cavities of long bones exept the upper humerous and femur becomes infiltrated with fat and produces more red cells.After the age of 20 the marrow of the flat bones is the only site of formation of Red Blood Cells.

Factors affecting the Formation of Red Blood Cells:

-Healthy bone marrow
-Healthy liver
-Hormones
-Diet :Proteins,Iron,Vitamins
-Tissue oxygenation.

1.Healthy Bone Marrow:
A healthy bone marrow is essential for the production of red cells.Bone marrow is destroyd by X-ray,atomic radiation,drugs as CHLORAMPHENICOL and by malignant tumours.

2.Healthy liver:
The liver is important for the formation of red blood cells because:
-it acts as a store of Vitamin B12
-it acts as a store of iron
-it is the site of formation of globin part of hemoglobin molecule.

3.Hormones:
Hormones regulate the metabolic processes in various tissues including the bone marrow.Thus,thyroid hormones,androgens and gluccorticoids stimulate formation of red cells.

4.Diet:
Because of the continuing need to replenish red blood cells,the cells of the bone marrow are among the most rapidly growing and reproducing cells of the entire body.Therefore,as would be expected,their maturation and rate of production is affected greatly by a person's nutritional status.
-Proteins: Proteins of high biological value are needed in the diet to build globin of hemoglobin.Defeciency of proteins in the diet leads to failure of formation of red blood cells.
-Iron: Iron is important for the formation of hemoglobin,myoglobin and other substances such as cytocromes,cytocromes oxydase,peroxidase and catalase enzyme.
-Vitamin B12: All vitamins are needed for formation of red blod cells,but vitamin B12 and folic acid are especcilay important for final maturation of the red cells.
Vitamin B12 contains COBALT and is important for DNA formation.

5.Tissue Oxygenation:
Any condition that cause the amont of oxygen transported to the tissue to decrease will increase the rateof red blood cells production.This can occur in the fallowing conditions:
-at high altitudes where the oxygen pressure is the atmospheric air is decreased thus decreasing oxygen supply to the tissue.
-various diseases as prolonged heart failure and lung diseases.
-increased demand for oxygen as in athletes and hard workers.

READ ALSO:
Importance of Iron in Diet in Formation of Red Blood Cells

Puberty Changes

Puberty is the period of life characterized by morphological and physiological changes which occur in the growing boy or girl as the gronads from their infantile to their adult state.
These changes involve nearly all organs and structures of the body.

The age of puberty varies according to genetic,racial,socioeconomic and nutritional factors.
Usually boys know the onset of puberty at age 9-14 years old and girls arround 8-13 years old.

The principle manifestations of puberty:

1.The adolescent growth spart:
This is an acceleration fallowed by deceleration of growth in most skeletal dimensions terminated by fusion of epiphysis and final adult height.
In girls the most rapid growth is 25 cm,it occurs early before the development of secondary sexual characters.In girls the first sign of puberty is increase in height velocity.
In boys the peak height velocity is 28 cm.It starts on the average 2 years after the average age of onset in girls.

During puberty the growth spurt is controled by hormons. (sex steroids,thyroid hormone).

2.Development of gonads:
In boys the first sign of puberty is the growth of the testes.

3.Development of secondary sexual characters:
In girls appears :

Breast development (controlled by estrogen) .
Breast development stages:
-stage 1:elevation of papilla only
-stage 2 (breast bug stage): elevation of breast and papilla as a small mound elargement of areolar diameters.
-stage 3: further enlargement of breast and areola with no separation of their contours
-stage 4: projection of areola and papilla to form a secondary mound above the level of the breats
-stage 5 (mature stage):projection of papilla only resulting from recession of the areola to the general contour of the breast.

Pubic hair:(contolled by adrenal androgen)
Axillary hair.
Other features: in girls increased size of ovaries and uterus.In boys: the growth of testes and penis,acne,voice change and facial hair that occurs late stage of puberty.

Diabetic Coma-Causes,Symptoms and Management

Diabetic Coma usually is caused by:

• Severe diabetes
• Interaption of insulin therapy
• Stress in conditions as:

         -infections and severe exertion
         -trauma and operations
         -pregnancy and labour
         -severe vomiting and diarrhoea
         -starvation or excess intake of fats.

Symptoms:

• Air hunger,abdominal pain and vomiting
• Acetone odour in breath and ketone bodies in urine
• Dry tongue,dry cold skin,sunken eyes and weak,rapid pulse
• Confusion,stupor and then coma.

Management:
Imediatlly this symptoms occurs is necessary the hospitalization for measures to care the comatosed patient or insulin replacement,fluids replecement,monitoring potassium plasmalevels and necessary treatment.


   

Complications of Diabetes-Signs

I.Skin Complications:
-pruritus (for exemple pruritus vulvae).
-infections: multiple furuncles and carbuncle.
-fungus infection (for exemple in ano-genital region and toes).
-necrobiosis diabeticorum (reddish painful papules appearing on the shins of tibia and later as ulcerate and heal by scar.
-carotinamia: yallow colouration over the palms due to excessive intake of vegetables.
-insulin lipodystrophy (small dent in the skin that forms when a person keeps performing injection in the same place).

II.Cardiovascular Complications:
-atheroclerosis: cerebral,coronary (infarction even sudden death),ischemia,gangrene.

III.Neurological Complications:
Cerebral:
-coma
-cerebral atherosclerosis and trombosis.
Spinal Cord:
-diabetic lateral sclerosis.
-transverse myelitis (disease caused by inflammatory process of the spinal cord).
-anterior or posterior spinal artery occlusion.
Neuropathy:
-senzory:deep and superficial.
-autonomic: urinary incontinence,impotence and diarrhoea,postural hypotension,increase sweating.
-cranial: optic neuritis (inflammation of the optic nerve that may cause a complete or partial loss of vision).

IV.Urinary Complications:
-infections: cydtitis.
-kidney stones.

V.Ocular Complications:
-infections:conjunctivitis.
-diabetic retinophatyin juvenil and long standing cases.
-diabetic cataract.
-nervous complications of the eye.

VI.Respiratory Complications:
-pulmonary inferctions,tuberculosis
-acetone odour during ketosis.

VII.Gastro-intestinal Complications:
-beefy tongue
-gingivitis and dental caries are common
-dyspepsia
-nausea,vomiting and abdominal pain during ketosis
-diarrhoea
-fatty liver
-gall stones.

VIII.Genital Complications:
-in males impotence
-in females: menorrhagia (abnormally heavy and prolonged menstrual period),sterility,pruritus vulvae and skin infections,abortion,premature labour,delivery of big babies.

Acromegaly-Features

Acromegaly-is a syndrom resulted when the pituitary gland produces excess growth hormone after epiphyseal plate closure at puberty.

Acromegaly most commonly affects adults in middle age(20-40 years) evolves gradual,has a course slowly progressive and can result in severe disfigurements at the level of:

1.Head and Face
-big skull with enlogated face
-big ears,big nose,lips and tongue
-prominent frontal bosses and prominent supraprbital ridge.

2.Hands:
-big hands with blunt fingers

3.Skeletal Affection:
-osteoarthritis may occur

4.Skin Affection:
-thick
-wrinkled
-greasy

5.Internal Organs Enlargement

Neurological Manifestation:
-peripherial neuropathy
-parasthesias in hands and feet may occur
-pressure manifestations

The true about the daily requirement of water

Water forms about 70% of body weight.The water represents a necessity of life,being a constituent of all body cells,that is needed for body functioning.
About the daily requirement we hear recomandations like 2 liters ,that is necessary for a good hydration and a healthy function body.
Is true the water helps you eliminate the toxins of the body,keeps your body cells hydrated but we have to fix our water quantity according to many factors.
The daily water requirement varies with factors as climate,physical activity,age.
An adult in temperate climate need about 2-2,5 liters of water a day,obtained from potable water and water from ingested fluids and foods (fresh fruits and vegetables).
Atention,a healthy individual takes as much water as he needs for a satisfying feeling of thirst.
Consume more water (more that your body feels to consume) whit an increased activity,hot environment (more sweating) and conditions associated with excessive fluid loss,otherwise in certain conditions (dietary or healthy) you can create water retantion.

What are Free Radicals and other Oxidants?

The man is at the risk of of degenerative diseases that involve different parts of the body under the action of the oxidants.The elderly are the main high risk group exposed to morbidity hazard of aging.
The aging process is not fully clear yet and a number of theories is suggested to explain aging changes and associated hazardsas:
-Defective synthesis of protein
-Faulty repair of DNA
-Accelerated wear and tear (may play a role)
-Free radicals theory.

Free Radicals are hightly reactive chemicals that must be inactivated by different defence systems of the body,otherwise their reactivity can involve and damage the body cells.Are those implicated in the etiology of different degenerative diseases.
Free radicals are externally introduced (exogenous) or internally produces (endogenous) sources.

Externally introduced sources of free radicals:
-exposure to radiation (the ultraviolet)
-some drugs,specially when exist an abuse of it
-inhalation of certain air pollutants,including pesticides
-exposure to ozone
-cigareete smoking.

Internally produced sources of free radicals:
-some metabolic processes of the body that produce reactive oxygen species (oxidantive metabolic process)
-inflammatory and ischemic processes and others.

Free radicals and other oxidants are cell oxidizers described as cell destroyers.The molecules of oxidants are not readily metabolized in the body and so accumulate leading to irreversible cell damage.
Antioxidant defensive mechanism of the body protects the cells against their destroying effect.But,formation of free radicals and oxidants,together with impaired antioxidant defences,predispose to cell deterioration and degenerative diseases,specially of elderly.

Harmful oxidative effect involves proteins,carbohydrates,lipids and DNA,and plays an important role in pathogenesis of degenerative  of degenerative diseases of aging for exemple:
-artherosclerosis and associated cardiovascular and cerebrovascular disease.
-cancer
-cataract
-neurodegenerative process (Alzheimer's disease).

Can appear the Oxidative Strees:
Is the adverse condition that results from imbalance between high exposure to sources of oxidants and antioxidants defence of the body.

Antioxidant Defence of the Body:
They combate the harmful effect of free radicals and other oxidants.
1.Enzyme-are antioxidants that react with the oxidizing chemicals and diminish the concentration of harmful oxidants in the body and protect the body against their damaging effect.
2.Antioxidants vitamins: vitamin A,C and E.This protect the cells by binding electrically unbalanced free radicals and prevent deposition of cholesterol in arterial walls and so protect the heart and limit progression of degenerative disease and premature aging.

Megaloblastic Anemia Definition

Megaloblastic Anemia is that anemia in which there is impaired DNA synthesis due to deficiency of Vitamin B12 or/and folic acid leading.
Vitamin B12 deficiency is more common in the case of lack diet of animal products,vegetarian individuals.
Specific for this type of anemia is the  Vitamin B12  malabsorbtion.
An increased demand it is found in infancy,pregnancy,malignancy and chronic hemolysis.
The folic acid deficiency is more common in case of lack diet of vegetables and excessive alcohol intake.
An increased demand it is found in infancy,pregnancy,malignancy and chronic hemolysis.

Vitamin B12 and folic acid deficiency are essential for DNA synthesis,so their deficiency will lead to deficient DNA synthesis in the dividing cells.This way in the bone marrow a delayed division will result in the production of megaloblasts instead of the normaloblasts.Since the megaloblasts are abnormal cells,they will be destroyed in the bone marrow.

Megaloblasts that are formed in the bone marrow will lose their nuclei and reach the peripheral blood as macrocytes (which are large cells whit reduced hemoglobin).Many of this macrocytes are taken by the spleen and destroyed.

Symptoms of Megaloblastic Anemia:
-Manifestation due to infections and bleeding.
-Red glazed tongue
-Dyspepsia,anorexia,nausea,vomiting
-Abdominal pain,diarrhoea,malabsorbtion.
-Neurological manifestations (only in B12 deficiency)

Anaemias-Definition,Classification and Manifestations

The anaemia is defined as reduction in number of red blood cells and haemoglobin content of blood with a corresponding reduction in the oxygen carrying capacity of blood.

Classification:

I.Aetiological Calssification:
1.Dyshaemopoietic anaemia:due to deficiency of factors essential for erythropoiesis.
-iron deficiency anaemia
-megaloblastic anaemia:due to B12 or folic deficiency
-anaemia of renal disease:due to erythropoietin deficiency
-anaemia of endocrinal disease:due to pituitary thyroid or suprarenal deficiency
-vitamin C and pyroidoxine deficiency anaemia(very rare0
2.Aplastic anaemia:due of failure of Bore marrow to carry on erythropoiesis.
3.Haemolytic:due to excessive of distruction of red blood cells.
4.Haemorrhagic anaemia:
-acute haemorrhagic anemia:occurs after severe hemorrhage and gives the characteristic of shock
-chronic hemorrhagic aneamia:occurs after repeated slight bleeding and gives the characteristic of iron deficiency anaemia.

II.Morphological Classification;
1.Microcytic-hypochronic anaemia
-iron deficiency anaemia
-anaemia not caused by iron deficiency(sideroblastic anaemia,thalassemia,chronic lead poisoning).
2.Nermocytic-nonmochromic anaemia:
-aplastic anaemia
-hemolytic anaemia
-hemolytic anaemia
-acute hemorrhagic anaemia
-anaemia associated with infection and chronic systemic diseases.
3.Macrocytic-nonchromic anaemia;
-megaloblastic anaemia
-non-megaloblastic anaemia.

General manifestations of anaemia:
1.Skeletal:tiredness,lassitude and easy fatiguability
2.Neurological:lack of concentration,drowziness and may be faintness,headache,tinnitus and black spots before the eyes,may be numbness and tingling in feet and hands.
3.Pallor;this is the most prominent and characteristic sign.It is seen in the face,palm of hand,nail bed and mucus membranes of mouth and conjunctiva.
4.Cardio-vascular:dyspnoea of exertion,palpitation and may be angina,manifestation of hyperdynamic circulation,heart failure may occur in severe cases and sligh oedema of lower limb may occur without heart failure due to increased capillary permeability.
5.Gastro-intestinal:anorexia,flatulence and may be constipation of diarrhea.
6.Genital;menstrual disturbance.
7.renal:slight proteinuria may occur.

Hypothyroidism

Hypothyroidism is presented in two modes:cretinism(during infancy and myxoedema after puberty).

Causes of CRETINISM:
-congenital absence or hypoplasia of thyroid gland
-congenital defect in the enzymes converting iodide into nascent iodine or entering into formation of di-ioothyroisine
-endemic cretinism(due to iodine deficiency)
-an amount use of antithyroid drugs or rasioactive iodine during pregnancy.

Characteristics:
1.General features:
Face:
-puffness of eye lids and depressed nasal bridge
-big lips and large protruding tongue
-delayed dentition and teeth are small
Hands:
-square sharped whit short tapering fingers
-dorsal pad of fat
Disproportionate dwarfsm(the height is more than the span).
Walking is delayed and the gait is waddling due to dysgenesis of the femur head and muscle weakness.
Subnormal body temperature.
2.Skin manifestation;
-dry,rough,scaly.cold skin
-hair is scanty,coarse and britte
-deposition of subcutaneus myxoedematous tissue,particularly on the dorsum of hands,face and suclavian region
3.Nervous Manifestations:
-mental retardation
-slow speaking and thinking and hoarse cry
4.Cardiovascular Manifestations:bradycardia and electrocardiogramma shows low voltage
5.Muscle weakness:together with constipation lead to pot belly abdomen and the umbelical hernia is common.

The treatment in case of hypothyroidism should be started before the elapse of the first year of life to prevent mental retardation.And after the medical prescription Thyroxin is started by 0,025mg/day and gradually increase up to 0.2 mg/day for life.

Hyperprolactinaemia

Hyperprolactinaemia is the presence of abnormally hight levels of prolactin in the blood.Prolactine is a peptide hoemone produced by the anterior pituitary gland primarily associated with lactation and plays a vital role on breast developement during pregnancy.
Hyperprolactinaemia may cause prodaction and spontaneous flow of breast milk and disruption on the normal menstrual period in woman and hypogonadism,infertility and erectile dysfunction on men.
causes:
1.Physiological;
-sleep
-pregnancy,suckling and nipple stimulation
-coitus
-stress
2.Phatological:
-prolactinomasacromegaly(benign tumour to the gland that produce the prolactin hormon) and hypotalamo-hypophyseal tumour
-primary myxedema(dermal edema)
-renal failure
-opiates(narcotic opioid found in opium plant)
3.Drugs
-oestrogens
-metocopramide and cimetidine
-methyl dopa and reserpine
opiates
Characteristics:
-Galactorrhea:spontaneous flow of milk brom the breast unassociated with childbirth or nursering.
-Oligomenorrhea or amenorrea:the absence of the menstrual period in a woman in reproductive age.
-Decreased libido,deacreased potency and subfertility
-Delayed puberty in the peripubertal patient
The medical investigation has to view the prolactin level,realize a visual field,X-ray skull,C.T and MRI for pituitary tumours.
Treatment:
Bromocriptine wil decrease prolactinaemia and the pituitary tumour removed surgical or by irradiation.

Diabetes symptoms

Diabetes represents hight glucose (sugar) level in the blood and can be caused by two factors: the body don't produce enought insulin or the body cells don't respond properly to the insulin produced.
The insulin is a hormon produced in pancreas that enable body cells to absorb glucose,wich is transformed in energy.If the body cells not absorb the glucose,the glucose accumulates in the blood(hyperglycemia).
Exist two types of diabetes:
Type 1-the body don't produce properly insulin and the person need to inject it.This type depends of the genetic side.
Type 2-the cells don't use insulin properly.This type is known as determinated by the lifestyle.
One other particular form is gestional diabetes when the pregnent women even haven't had diabetes before,during the pregnancy the glucose reach hight level.
Predisposition to diabetes is gived by family history,the lifestyle(sedentarism,obesety,unhealthy diet,smoking,alcohol).
The hight level of glucose is a worry sign,but a repeted blood test can confirm your health status.The symptoms of diabetes can be often confused,can have even the aspect of a normal condition,so the blood test is imperative.
Most commun diabetes symptoms are:
-excesive thirst
-dry mouth
-frequent urination
-constant hunger
-unexplained weight loss
-fatique.
The symptoms can develop rapidly in weeks or months,and the diabetes type 2 develop slowly and symptoms can even be absent.
In case of juvenil diabetes the symptoms are similar:increased urination,constantly hunger no matter of the quantaty of food eated,weight loss.