Journal of Endocrinology and Metabolism - MyAssignmenthelp.com

Question: Discuss about the Journal of Endocrinology and Metabolism. Answer: Introduction: Cardiovascular system of the body is complex framework consisting of heart, blood vessels and blood. Heart here pumps the blood throughout the body, which is circulated via the blood vessels. The blood vessels can have further subdivision, arteries, veins and capillaries. Arteries transport the blood away from the heart. Veins has opposite functions with-respect to arteries, it transport the blood towards the heart from different parts of the body. Capillaries are regarded as the connection between the arteries and the veins. They can also be termed as small blood vessels (Stanfield, 2012). The main function of the cardiovascular system is to deliver the transport blood to different parts of the body and in turn bring away the deoxygenated blood from the organs or the organs system to lungs where purification occurs. Blood contains dissolved oxygen and this oxygenated blood when reaches to every cell of the organs, it helps in the breakdown of ATP to release energy. Blood also contains nutrients that help in nourishing the body (Stanfield, 2012). There are three main parts of the respiratory system and these include a pair of lungs, airways and the muscles. Here the airways consists of mouth, a pair of nose, larynx, pharynx, trachea, bronchi and bodys exterior part. The pair of lungs act as the main functional unit of the respiratory system. It performs exchange of oxygen and carbon dioxide between the body and the exterior environment. The muscles of the respiration are diaphragm and inter-coastal muscles. They act together to aid lungs in pumping and pushing the air both inside and outside of the body via inflation and deflation (Stanfield, 2012). The bodys oxygen transport system carries the oxygenated blood throughout the body via the circulatory system. This circulatory system in exchange of the oxygenated blood, brings out the deoxygenated blood from the organs to the lungs or the respiratory system. While at lungs, the deoxygenated blood gets purified via the exchanging carbon dioxide with oxygen. This exchange is done via respiratory system (Stanfield, 2012). Respiratory system undergoes several physiological, anatomical and immunological changes. The structural change includes change in the structure of the cell wall along with the thoracic deformity that impairs the overall breathing process leading to laboured breathing. The parenchyma cell of the lungs also loses its structure with the decrease in muscle strength, leading to dilation of air spaces. Aging is also associated with a degenerative change in the cardiovascular system. Aging causes a progressive increase hypertonic increase in the thickness in the wall of the left ventricle. This increases cardiac overload followed by age-associated arterial dilation and gradual loss of vascular compliance and peripheral resistance (Stanfield, 2012). Angina pectoris is disease of heart caused by the myocardial ischemia resulting out of imbalance between oxygen demand and myocardial blood supply. The main symptoms include retrosternal discomfort in chest characterised by pressure, heaviness, burning and chocking sensation. The pain is localised mainly in the back, neck, shoulders and jaws. Emphysema is defined as an abnormal enlargement of the air spaces which are situated at the distal side of the terminal bronchioles. The condition also causes destruction of the alveolar walls. Emphysema is also popularly known as Chronic Obstructive Pulmonary Disease. The main symptoms of COPD are recurrent respiratory infection along with shortness of breath, fatigue and tightness in chest (Candamourty et al., 2012). The common risk factors of emphysema are cigarette smoking which is associated with the reduction in the association rate constant of the alpha-1 antitrypsin of the lungs for neutrophil elastase. The risk factors of angina is more or less similar to emphysema and include, chewing of tobacco, active and passive smoking that causes damage of the interior walls of the arteries. Other risk factor includes high cholesterol in blood (Candamourty et al., 2012). The immediate assessment in case of John is fever control, external supply of oxygen in order improve shortness of breath along with a chest X-ray to ascertain the degree of sputum congesting the heart. The rate of the external oxygen supply will be determined only after calculation the respiratory rate and degree of oxygen saturation (Dossey et al., 2012). Other health professionals which may be involved in Johns case is a physiotherapist who will help John to excrete his green thick cough via doing special physiotherapy message over his back side of the chest. This message will help in the easy excretion of the cough and thereby clearing his chest and promoting improved breathing. Since his diet is poor, he needs a proper diet chart that can only be supplied via a nutritionist who will help John to maintain a low cholesterol diet, required for patients of COPD (Dossey et al., 2012). Artificially acquired immunity is obtained via vaccines. The process involves immunization with the help of antigen. In response to this artificially injected antigen, body will develop antibodies along with memory B-cells to fight against the recurrent infection (Owen, Punt Stranford, 2013). The endocrine structure is made up of endocrine glands. The endocrine glands secrete hormones directly into the body fluid that is blood other than through ducts. like hypothalamus, pituitary, parathyroid, reproductive organs (testes and ovaries), adrenal glands and pineal gland. Pancreas though not a gland is also included with within the endocrine system. This organ helps in secretion of hormone like insulin (Stanfield, 2012). The glands of the endocrine system produce hormones, which are regarded as the chemical messenger the control and co-ordinated the activity of the cells and the organs along with promotion of sexual development. Other functions of hormones include metabolism and growth (Stanfield, 2012). Position of the Pituitary Gland Name of the hormones Function of the hormones Anterior Pituitary Somatotropic Hormone (STH) It is an anabolic hormone that promotes muscle and skeletal growth Thyroid Stimulating Hormone (TSH) It promotes growth and development of the thyroid gland Adrenocorticotropic hormone Stimulates adrenal cortex to release cortico steroid hormones Gonadotrophic hormone (Follicle Stimulating Hormone and Luteinizing Hormone) Regulates the growth and the function of the sexual organs or gonads Prolactin Promotes production of milk Posterior Pituitary Oxytocin Promotes uterine contraction that trigger labour pain during pregnancy, at the time of child birth Antidiuretic hormone Helps in renal reabsorption Table: Classification of Pituitary Hormones (Source: Stanfield, 2012) 3.Graves disease is the major outcome of the hyperthyroidism. It occurs mostly in the genetically predisposed population. Autoimmune problem is the driving force behind the disease. The Immunoglobulin of the patients who are suffering from graves disease show increase in the number of the thyroid-targeted activities that increases in the thyroid stimulating hormone (TSH). This increases stimulation of TSH is related to the interaction of immunoglobulin G (IgG) with the TSH receptors. This constant secretion of TSH increases the level of thyroid hormone in blood (T3 T4) leading to hyperthyroidism or Graves disease (Owen, Punt Stranford, 2013). The risk factor of Graves disease include genetic pre-disposition, family history of auto-immune disease, increased intake of iodine, increase level of stress, unwanted use of sex steroid hormones and uncontrolled smoking (Stanfield, 2012). Isabella is suffering from Hypothyroidism or graves disease. Isabellas blood produces auto-antibodies which binds to the receptor of TSH while mimicking the function of TSH. This activates adenylate cyclise and results in unregulated synthesis of thyroid hormones, thyroxine (T4) and triiodothyronine (T3). It is due to this condition that Isabellas TSH concentration is within the normal limit while high concentration of T3 and T4. Unlike TSH, auto-antibodies are not regulated via negative feedback mechanism and thus they continuously stimulate thyroid hormone (Stanfield, 2012). Hence they are also known as long-acting thyroid stimulating antibodies (LATS) (Owen, Punt Stranford, 2013). The main structure of the digestive system includes stomach, gall bladder, pancreas, liver, large intestine (colon), small intestine. Other associated structures include salivary glands, pharynx, esophagus, rectum and mouth (Stanfield, 2012). The alimentary canal or the digestive system functions via channelizing food through the gastrointestinal (GI) tract. The process of digestion starts in mouth with the help f the salivary glands and chewing and ends in the small intestine. Food during its passage through the GI tract, gets mixed with the digestive juices, helping the large food molecules to break down into smaller counter parts (Stanfield, 2012). Immune system is a versatile defence system that protects animals from the invading micro-organisms that are pathogenic in nature. Immune system is divided into two parts, innate and adaptive immunity. Innate immunity provides preliminary line of defence against infection. It is regarded as inborn immunity that is majorly acquired from the maternal antibodies. Adaptive immunity develops during the course of life and is stronger than innate immunity as it has memory response to combat recurrent infection (Owen, Punt Stranford, 2013). Myasthenia gravis is an autoimmune disease that is mediated by a class of blocking auto antibodies. A patient suffering from Myasthenia gravis produces auto-antibodies that bind with the acetylcholine receptors. This trigger complement mediated lyses of the cells. Cell lyses weakens the skeletal muscles. In extreme cases the auto antibodies destroys the cell bearing those receptors resulting in complete loss of the signalling (Owen, Punt Stranford, 2013). Interventions Rationale Administration of thyroid hormone antagonist It will help to prepare patients for the surgery Administration of non-selective beta blockers (propranolol) Helps in the reduction of the thyrotoxic effects and also blocks the synthesis of thyroid hormones and also blocks the peripheral conversion of T4 to T3. Table: Nursing plan for Hyperthyroidism (Source: Smallridge et al., 2014) Dietician: Isabella since running on high thyroid hormones and loos in weight, she needs a diabetic chart from better management of the insulin hormone secretion and regulation of thyroid hormones (American Diabetes Association, 2013). Ophthalmologist: High thyroid hormones (T3 and T4) in the blood affect the eye, creating vision problem and hence a thorough check up of ophthalmologist is must (American Diabetes Association, 2013). Nephrologists: Increase in the concentration of the thyroid hormones in blood affects the renal development and physiology negatively. Thyroid hormones are attributed to have a pre-renal and intrinsic renal affect and this increase the renal blood flow along with the glomerular filtration rate. Hence, multidisciplinary health care team of Isebella must contain a nephrologist in order to side-pass associated renal complications (Basu Mohapatra, 2012). Nervous system has three basic function and these are sensory function, interpretative function and motor function. The role of sensory function is to gather information from both the internal and external environment. The collected information is then transported by the nerves into the central nervous system (CNS). The motor nerves collect in the information from the muscle cells and convey the information to the CNS (Stanfield, 2012). Multiple sclerosis is an inflammatory disease mediated by immune response that attacks the central nervous system via destroying the myelin sheet and the axon terminal. Pathological hallmark of Multiple Sclerosis (MS) inflammatory plaques arising out of the demyelination with in the Central Nervous System (CNS). The inflammation in the MS is not restricted to the white matter of the CNS. It also occurs in the region, which has high synaptic density like cerebral cortex (Owen, Punt Stranford, 2013). Inflammation arising out of the MS contributes to visual loss as and this goes in sync with the symptoms of Daisy who reports blurred vision. Inflammation also contributes towards the neurological deficit via modifying the characteristics of the gilial cells like microglia and astrocytes. Here the astrocytes are believed to be important in regulating several factors in brain. The modification in the astrocytes affects the memory function and leading to frequent loss of memory in case of Daisy. Demyelination of neurons causes loss of the signal transduction from the neurons and this loss of the transmission of the nerve impulses from one axon terminal to another leads to a burning sensation, which ultimately creates numbness in leg. Here Daisy is experiencing bilateral numbness in both of her leg, arising out of the demyelination of MS (Goldenberg, 2012). The main structural parts of the urinary system include a pair of kidneys, ureter, bladder and urethra. Kidneys are bean-shaped organs that are located on the back side of the abdominal wall, just behind the peritoneum. The right hand side kidney is located slightly lower than the left hand side kidney in order to accommodate liver. Ureters are long and thin tube shaped organs, which are made up of smooth muscles. Contraction of smooth muscles, push the urine down the ureters and the bladder. The female urethra is shorter than the male urethra (Stanfield, 2012). In the domain of anatomy and medicine, the special senses are defined as those senses that have some specialized organs devoted for them like vision (a pair of eyes), hearing and maintenance of body balance (a pair of ears), smell or odorant sense (nose) taste (tongue). The information from the special senses is carried via special somatic afferents and visceral afferents. Touch is also a special sense also known as somatic sense but it does not have specialized organ, apart from skin (Stanfield, 2012). Vision: Vision is the first sign of the disease manifestation in MS. It occurs due to the inflammation occurring in the optic nerves, a condition known as optic neuritis. Hearing: Problem with hearing is pretty much rare in case of patient with MS. Problem generally arise from the inflammation or scarring centering the auditory nerves as it enters inside the brain stem. Taste: MS significantly affects the taste buds. The lesions that appears in large section on the frontal side of the brain and on the temporal lobe of the brain cause loss of taste in the taste buds. Smell: 45% of the patient suffering from MS, witness the symptom of loss of smell. It occurs due to the reduction of the olfactory bulb (the region specific in the brain that is responsible for detecting smell) and grey matter. This reduction in grey matter then leads to loss in memory. Touch: The symptoms affecting the touch senses may be mild or severe. The symptoms are exacerbated via fatigue or heat (Stanfield, 2012). A person who has lost his or her teeth either partially or completely is known as edentulous or edentate. Organisms that are completely devoid of teeth are also classified under edentulous like sloths and anteaters. Organisms who have not lost any teeth is known as dentate (Pettersson et al., 2012). Multiple sclerosis and periodontal disease both have inflammatory origin and thus is inter-related. In case of MS, due to difficulty in nerves, patients fail to observe through dental hygiene, which further aggravates the dental problem (Elemek Almas, 2013). In case of Daisy, problem in the nerve endings arising out of the MS, is resulting in jaw pain. Nature of complications Assessment Interventions Difficulty in walking Manual test of the muscle 6 minutes walk Gait analysis along with functional gait assessment and dynamic gait assessment Proper gait assistive device and gait training Behavioral and environmental modifications Poor body balance with a risk of fall Manual test of the muscle Strength training along with behavioral modification The treatment of the dental problems as experienced by Daisy should be done by a professional dental hygienists or a dentist. Here the dentist will take care of Daisy's jaw pain via assisting her in maintaining proper dental hygiene and thereby preventing periodontal disease (Elemek Almas, 2013). Daisy also needs a daily assistance from a trained registered nurse in order to carry out her daily activities. She is experiencing bilateral numbness in both her feet along with blurred vision and here a constant assistance of a nurse is must for her. References American Diabetes Association. (2013). Executive summary: Standards of medical care in diabetes2013.Diabetes care,36(Supplement 1), S4-S10. Basu, G., Mohapatra, A. (2012). Interactions between thyroid disorders and kidney disease.Indian journal of endocrinology and metabolism,16(2), 204. Candamourty, R., Venkatachalam, S., Babu, M. R., Kumar, G. S. (2012). Ludwig's AnginaAn emergency: A case report with literature review.Journal of natural science, biology, and medicine,3(2), 206. Dossey, B. M., Certificate, C. D. I. N. C., Keegan, L., Co-Director International Nurse Coach Association. (2012).Holistic nursing. Jones Bartlett Publishers. Elemek, E., Almas, K. (2013). Multiple sclerosis and oral health: an update.The New York state dental journal,79(3), 16-21. Goldenberg, M. M. (2012). Multiple sclerosis review.Pharmacy and Therapeutics,37(3), 175. Karampampa, K., Gustavsson, A., Miltenburger, C., Kindundu, C. M., Selchen, D. H. (2012). Treatment experience, burden, and unmet needs (TRIBUNE) in multiple sclerosis study: the costs and utilities of MS patients in Canada.J Popul Ther Clin Pharmacol,19(1), 11-25. Kravets, I. (2016). Hyperthyroidism: Diagnosis and Treatment.American family physician,93(5). Owen, J. A., Punt, J., Stranford, S. A. (2013).Kuby immunology(pp. 427-444). New York: WH Freeman. Pettersson, A., Komiyama, A., Hultin, M., Nsstrm, K., Klinge, B. (2012). Accuracy of virtually planned and template guided implant surgery on edentate patients.Clinical implant dentistry and related research,14(4), 527-537. Smallridge, R. C., Ain, K. B., Asa, S. L., Bible, K. C., Brierley, J. D., Burman, K. D., ... Shah, M. H. (2012). American Thyroid Association guidelines for management of patients with anaplastic thyroid cancer.Thyroid,22(11), 1104-1139. Stanfield, C. L. (2012).Principles of human physiology. Pearson Higher Ed.