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Posted: January 3rd, 2023
Evelyn Dominguez
Evelyn Dominguez: Discussion 2
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Gestational diabetes mellitus (GDM) is a fatal illness for pregnant women and may lead to birth complications. This is a common phenomenon in women who have not been previously diagnosed with diabetes mellitus. The patients tend to develop hyperglycemia during the pregnancy period. Authors in this article state that hyperglycemia is caused by impaired glucose tolerance due to the dysfunction of pancreatic β-cell on the background of resistance for insulin (Plows et al., 2018). The authors also describe the risk factors for gestational diabetes mellitus which include overweight and obesity, genetic history and advanced maternal age. The authors also shed light on the consequences that come with this illness.
Some of the mentioned risks include maternal cardiovascular diseases, macrosomia, infant birth complications and type II diabetes. According to Plows et al., (2018), infants born by mothers with this illness are at risk of cardiovascular diseases, obesity and type II diabetes. The authors give statistics showing that 16.5% of all pregnancies globally are associated with gestational diabetes mellitus which has led to increased infant obesity (Plows et al., 2018). The reasons behind this, according to the authors, are poor lifestyles defined by poor nutrition and physical inactivity. This is due to the poor definition of underlying GDM molecules. The authors discuss what is known about the physiology of this illness and conclude that there are notable gaps in the literature and this warrants for further exploration.
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Reference
Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018). The pathophysiology of gestational diabetes mellitus. International journal of molecular sciences, 19(11), 3342.
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Discussion: Euclides Munoz Perez
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Plows et al., (2018) state that Gestational Diabetes Mellitus is a severe condition that affects pregnant women. Women who have never been diagnosed with diabetes develop persistent hyperglycemia when gestating. Overweight and obesity are the major risk factors for Gestational Diabetes Mellitus. Family history and advanced maternal age are also risk factors for this condition. Plows et al., (2018) state that this condition affects around 16.5% of pregnant ladies, and there is a probability that it will rise because of obesity cases. Insulin is one of a strategy used to manage GDM, but so far, no cure strategy has been discovered because of the poor molecular definition underlying GDM. The article outlines interventions that may be used to control GDM. The report provides future studies recommendations such as examining GDM incidences across the world. Healthcare professionals should prioritize such studies, and collect data from individuals across the globe and try to find out the correlation between gestational diabetes and several factors such as environment, social-economic factors like stress among others. These studies will allow health care practitioners to discover the best ways to prevent and control increasing GDM cases.
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Reference
Plows, J. F., Stanley, J. L., Baker, P. N., Reynolds, C. M., & Vickers, M. H. (2018). The pathophysiology of gestational diabetes mellitus. International journal of molecular sciences, 19(11), 3342.
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May-lee Perez: Discussion Forum 2
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Schizophrenia is a prolonged psychiatric disorder with neurobiological and diverse genetic backgrounds that influence the early development of the brain. It is characterized by psychotic symptoms such as disorganization, delusions, and hallucinations. Other symptoms include cognitive and motivational dysfunctions. According to Sass et al. (2018), the mean lifetime disorder is below 1 %. However, it involves elusive pathological changes in particular neural cell populations and in cell-cell interaction. Schizophrenia is more about how the mind processes information, as a behavioral and cognitive disorder. Schizophrenia is a complex condition that can be divided into cognitive, positive, and negative categories. The identification and diagnosis of the disorder is challenging, given that the onset of the disorder starts many years in the early face before its diagnosis is made. Many pharmacological drugs that are used to manage the condition do relieve psychotic symptoms, although they do not lead to considerable developments in cognitive, occupational, and social abilities.
The average lifetime incidence is narrowly defined, although Nguyen et al. (2018), reported that the standardized mortality rate was 3.0 with suicidal thoughts and actions being the primary contributors at onset on the disorder and cardiovascular disease and the significant risk factor in later years of the disorder. Management of Schizophrenia is made with psychological therapies in supporting psychosis through a variety of similar objectives such as understanding and insight, improving communication, facilitate knowledge, enhancing coping, reducing the impact of symptoms, and engagement in meaningful activities. Sass et al. (2018), assert that psychological treatments involve a range of interventions designed to help patients make the necessary changes and understand their emotions, thinking, and interpersonal relationships to improve mental functioning and emotional distress.
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References
Nguyen, T. T., Kosciolek, T., Eyler, L. T., Knight, R., & Jeste, D. V. (2018). Overview and systematic review of studies of microbiome in schizophrenia and bipolar disorder. Journal of psychiatric research, 99, 50-61.
Sass, L., Borda, J. P., Madeira, L., Pienkos, E., & Nelson, B. (2018). Varieties of self disorder: a bio-pheno-social model of schizophrenia. Schizophrenia bulletin, 44(4), 720-727.
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Dalia Salgado Discussion Forum#2
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Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease (AD) (Moore, Shpiner, & Luca, 2019). PD has been traditionally considered as a pure movement disorder secondary to focal degeneration of dopaminergic neurons in the substantia nigra, but, in recent years, the clinical phenotype has been better illuminated, showing that PD is a multisystem neurodegenerative disorder with motor and non-motor features. Among motor symptoms and signs, the cardinal ones (bradykinesia, rest tremor, and rigidity) are mainly the loss of dopaminergic neurons, but those involving posture, balance, and gait are largely secondary to degeneration of nondopaminergic pathways and significantly contribute to impairment and disability in advanced PD patients (Moore, Shpiner, & Luca, 2019). Nonmotor features result from multiple neurotransmitter deficiencies in the central and peripheral nervous system and include psychiatric such as: depression, apathy, hallucinations, and delusions. Autonomic includes constipation, orthostatic hypotension, and urinary and genital disturbances. Cognitive impairment such as: involvement of executive functions, memory, sleep disorders, olfactory dysfunction, and pain that together contribute to worsening the quality of life and patient’s disability (Moore, Shpiner, & Luca, 2019).
Cardinal motor features of Parkinson’s disease (PD) include bradykinesia, rest tremor, and rigidity, which appear in the early stages of the disease and largely depend on dopaminergic nigrostriatal denervation (Moore, Shpiner, & Luca, 2019). Intermediate and advanced PD stages are characterized by motor fluctuations and dyskinesia, which depend on complex mechanisms secondary to severe nigrostriatal loss and to the problems related to oral levodopa absorption, and motor and nonmotor symptoms and signs that are secondary to marked dopaminergic loss and multisystem neurodegeneration with damage to nondopaminergic pathways (Moore, Shpiner, & Luca, 2019). Nondopaminergic dysfunction results in motor problems, including posture, balance and gait disturbances, and fatigue, and nonmotor problems, encompassing depression, apathy, cognitive impairment, sleep disturbances, pain, and autonomic dysfunction. There are a number of symptomatic drugs for PD motor signs, but the pharmacological resources for nonmotor signs and symptoms are limited, and rehabilitation may contribute to their treatment (Moore, Shpiner, & Luca, 2019).
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Pharmacological therapy is based on levodopa and dopamine agonists and is very successful in the early stages of the disease, when dopaminergic symptoms and signs are predominant and long term motor complications still have not developed, but other treatment strategies are necessary as time passes (Hajj, 2018). Long term levodopa-induced motor complications include motor fluctuations and dyskinesia and affect almost all PD patients at some point during the disease course, with relevant implications in global health status (Hajj, 2018). Despite various pharmacological approaches, as well as more invasive strategies including devices and functional neurosurgery, being available to manage such complications, many patients remain significantly disabled, and a fully satisfying management of motor complications is still an unmet need of PD therapy. Nonmotor symptoms and signs are integral to PD at onset and throughout the disease course, but to date their treatment is largely unsatisfactory (Hajj, 2018).
References
Hajj, R. (2018). Parkinson Disease Therapies and Drugs. Pathology, Prevention and Therapeutics of Neurodegenerative Disease, 151–158. doi: 10.1007/978-981-13-0944-1_13
Moore, H., Shpiner, D. S., & Luca, C. C. (2019). Management of Motor Features in Advanced Parkinson Disease. Clinics in Geriatric Medicine. doi: 10.1016/j.cger.2019.09.010
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Lizandra Alvarez
Discussion Forum #2
Advanced Pathophysiology
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With the raising number of adults with hypertension worldwide, research continues to investigate its pathogenesis. The immune system has been linked with hypertension. Immunosuppressant drugs and inhibition of cytokines prevent hypertension. Many studies conducted have shown that lymphocytes are important in developing hypertension. Also, immunity seems to be a factor causing hypertension in autoimmune diseases. Permeation of immune cells, oxidative stress, and stimulation of the angiotensin system are prompted by stimulating the innate and adaptive immunity. High blood pressure occurs from inflammation in the natriuresis, dysfunctional vascular relaxation, and overactivity of the sympathetic nervous system. Disparities in the inflammatory responses and anti-inflammatory response of T cells determines the gravity of inflammation. Research in this topic of immune reactivity in hypertension may allow for new treatment modalities of the disease. Evaluating the use of immune suppression in combination with anti-hypertensive medications can potentially offer great results in the research of hypertension and immunity. This idea can open new doors moving forward in researching the pathophysiology of hypertension. From a nursing point of view, hypertension is the leading cause of many fatal diseases. With this in mind health care providers can use the available information to continue investigating hypertension in relation to immunity.
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Reference
Beevers, G., Lip, G. Y., & O'Brien, E. (2001). ABC of hypertension: The pathophysiology of hypertension. BMJ (Clinical research ed.), 322(7291), 912–916. doi:10.1136/bmj.322.7291.912
Robert Alonso
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Pathophysiology is a vital discipline in medicine and is generally useful for diagnosis and patient care. The disease-related to pathophysiology is heart failure. Wright and Thomas (2015) explain that pathophysiology in the management of heart failure ensures that patients are optimized on a maximum tolerated dose of medicine to treat heart failure with reduced ejection fraction. Heart failure is a complex clinical syndrome whereby the heart is not able to attain the metabolic demands of the body. The reasons underlying the mismatch can be multifactorial. However, the various pathological conditions make the treatments and management of the condition to be complex. Therefore, pathophysiology is essential in minimizing the burden on the condition. Heart failure is on the increase for the past decade leading to the heightening of the adult population to around 1% to 2%. The male population is the greatest affected gender, with an estimated 33% of men above 55 years old having the condition as compared to the 28% in women (Farmakis et al., 2015). Pathophysiology seeks to redress the balance through initiating contemporary measures. However, the measures have become damaging to the diseases and can lead to worsening cardiac output that can result in additional stress to a failing heart.
References
Farmakis, D., Parissis, J., & Filippatos, G. (2015). Acute heart failure: epidemiology, classification, and pathophysiology. Oxford Medicine Online, 2(1), 2-10. doi:10.1093/med/9780199687039.003.0051
Wright, P., & Thomas, M. (2018). Pathophysiology and management of heart failure. Clinical Pharmacist, 2(1), 1. doi:10.1211/cp.2018.20205742
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