The pathophysiology of diabetes
Janet Titchener in Diabetes Management, 2020
Diabetes is a group of metabolic diseases characterised by hyperglycaemia secondary to one or more pathologies. While type 1 and type 2 diabetes are the most common types of diabetes, there are many other types – some rare and some not so rare. This chapter reviews the pathophysiology of each type of diabetes, but emphasises the need to recognise that people with the same type of diabetes do not necessarily share the same pathologies, while people with different types of diabetes can share the same pathologies. Furthermore, diabetes, regardless of type, is a progressive disease and the pathologies contributing to its expression can change over time. The take-home message is that each person with diabetes has a unique set of underlying pathologies contributing to their disease. This sets the stage for the need to individualise diabetes management.
Body fluids and electrolytes
Peate Ian, Dutton Helen in Acute Nursing Care, 2020
Understanding the principal pathophysiology and factors compromising fluid and electrolyte balance, as well as the essential nursing assessment and management required to prevent further deterioration in a medical emergency can help to improve care outcomes. The chapter focus is on body fluids and electrolytes. The fluid compartments of the body are explained along with an outline of the transport mechanisms of water and solutes and movement between compartments. Mechanisms that help to regulate body fluid balance are discussed, and the nursing assessment of the patient with an acute fluid and/or electrolyte imbalance, using an ABCDE approach, is outlined as well as the nursing management and treatment of a patient with a fluid and/or electrolyte imbalance. The reasons for choosing intravenous fluid therapy based on individual fluid and electrolyte requirements are provided.
Acute mountain sickness
Andrew M. Luks, Philip N. Ainslie, Justin S. Lawley, Robert C. Roach, Tatum S. Simonson in Ward, Milledge and West's High Altitude Medicine and Physiology, 2021
This chapter marks the transition in this book from a detailed review of high altitude physiology to consideration of these illnesses and other clinical problems that affect people traveling at high altitude and focuses in detail on the first and most common of the problems described by Ravenhill, acute mountain sickness (AMS). After considering the scope of the problem, risk factors for its development, and the current understanding of AMS pathophysiology, it provides a detailed review of the clinical aspects of AMS including the clinical presentation, diagnostic approach, and strategies for prevention and treatment. Although the general principles are the same regardless of the setting, the diagnosis of AMS varies to some extent depending on whether diagnosis is being made in a clinical or research setting. Given that headache is the primary symptom of AMS, the discussion of AMS pathophysiology must begin by considering the mechanisms behind the development of headache.
The possible role of gastrointestinal endocrine cells in the pathophysiology of irritable bowel syndrome
Published in Expert Review of Gastroenterology & Hepatology, 2017
Magdy El-Salhy, Trygve Hausken, Odd Helge Gilja, Jan Gunnar Hatlebakk
Introduction: The etiology of irritable bowel syndrome (IBS) is unknown, but several factors appear to play a role in its pathophysiology, including abnormalities of the gastrointestinal endocrine cells. The present review illuminates the possible role of gastrointestinal hormones in the pathophysiology of IBS and the possibility of utilizing the current knowledge in treating the disease. Areas covered: Research into the intestinal endocrine cells and their possible role in the pathophysiology of IBS is discussed. Furthermore, the mechanisms underlying the abnormalities in the gastrointestinal endocrine cells in IBS patients are revealed. Expert commentary: The abnormalities observed in the gastrointestinal endocrine cells in IBS patients explains their visceral hypersensitivity, gastrointestinal dysmotility, and abnormal intestinal secretion, as well as the interchangeability of symptoms over time. Clarifying the role of the intestinal stem cells in the pathophysiology of IBS may lead to new treatment methods for IBS.
The proteome of sickle cell disease: insights from exploratory proteomic profiling
Published in Expert Review of Proteomics, 2010
Susan Yuditskaya, Anthony F Suffredini, Gregory J Kato
The expanding realm of exploratory proteomics has added a unique dimension to the study of the complex pathophysiology involved in sickle cell disease. A review of proteomic studies published on sickle cell erythrocytes and plasma shows trends of upregulation of antioxidant proteins, an increase in cytoskeletal defects, an increase in protein repair and turnover components, a decrease in lipid raft proteins and apolipoprotein dysregulation. Many of these findings are consistent with the pathophysiology of sickle cell disease, including high oxidant burden, resulting in damage to cytoskeletal and other proteins, and erythrocyte rigidity. More unexpected findings, such as a decrease in lipid raft components and apolipoprotein dysregulation, offer previously unexplored targets for future investigation and potential therapeutic intervention. Exploratory proteomic profiling is a valuable source of hypothesis generation for the cellular and molecular pathophysiology of sickle cell disease.
An update: emerging drugs for tinnitus
Published in Expert Opinion on Emerging Drugs, 2018
Christopher R. Cederroth, Jonas Dyhrfjeld-Johnsen, Berthold Langguth
Introduction: During the last decade, a number of candidate drugs for the treatment of tinnitus have emerged with the hope of alleviating the burden of millions of sufferers with a persisting ringing in their ears. Knowledge of the pathophysiologic mechanisms has progressed remarkably in the recent years, which has led to the identification of potential new drug targets for the treatment of tinnitus. However, pharmacologic interventions are still limited. Areas covered: In this editorial results from recent Phase 3 and Phase 2a trials investigating the NMDA receptor antagonist AM-101 from Auris Medical, the AMPA receptor antagonist BGG492 from Novartis and the Kv3 modulator AUT00063 from Autifony Therapeutics will be discussed. In this context, we will reevaluate the translational development approach from animal models to clinical trials and seize this opportunity to debate and improve future R&D in tinnitus pipeline. Expert opinion: In spite of huge advances in pathophysiologic knowledge and research methodology in the last decades, pharmaceutical research in tinnitus still represents a high-risk field. Important research directions include the identification of potential therapeutic targets and the development of objective outcome measurements to facilitate translational research.
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