3 Page Paper Due @ 6pm on 7/23/20

Written Assignment BIOL 2110 Anatomy and Physiology 1

· You may write about ANY disease of your choice

· Please cover these 10 aspects of the disease in your paper. Five points each for total of 50 points.

1. Background about the disease

2. Pathophysiology and causes (i.e. the disease is brought about by eating raw sushi, parasites, bacteria, virus, etc.)

3. Risk Factors (i.e. smoking, lack of exercise, being obese, age, family history, etc.)

4. Epidemiology (i.e. baby or senior citizen is more likely to have the disease)

5. Signs and symptoms (i.e. skin falls off, headache, heartache, hairloss, hair growth, etc.)

6. Diagnosis tests (i.e. blood test, MRI, CXR, etc.)

7. Treatments and drugs (1-2 drugs is sufficient)

8. Complication (i.e. if disease is left untreated; then…) and Prognosis (i.e. 1% of dying from the disease or surviving the disease)

9. Recommended lifestyle change, prevention, or home remedies or alternative medicine (i.e. stop smoking, eat more healthy, low-sodium diet, supplemental diet: omega-3, kale, garlic, etc.)

10. References:

· Please use PRIMARY literatures for citation, minimum of ONE.

· APA style references (minimum of 3). Cannot just copy and paste URL address. Explanation and example of APA Style citation, please see the link below: https://owl.english.purdue.edu/owl/resource/560/06/

· One points deduction for NOT using at least one primary literature

· Two points deduction for citing less than 3 references.

· Three points deduction for not using APA style of reference

· Four points deduction for bare URL-only references

· Five points deduction if there was no citation.

· Please use of third-person narrative. Five points deduction for using first or second-person narrative, meaning no usage of “I” or “you” in your paper. This is considered a science paper.

· Minimum of 2-pages. Double or single space.

· You may write in bullet points or in essay style.

· NO PLAGIARISM: use your own words.

· Please submitting only in either Microsoft Word document or .pdf file format. The D2L does NOT support .pages format. It will NOT be readable for grading and will NOT be considered as submission. Please check your format as soon as you upload your paper or come talk to me if you have any issue.

· Deadline is 11:59 PM on the final Exam day. I am accepting submission beginning on the first day of class. You may turn the paper in by uploading to the D2L Dropbox ONLY. Any late submission past the midnight (the morning after) would result in zero point.

· Examples of Primary literature sources: CDC.gov, National Institute of Health (NIH), Academy of family medicine journal, New England Journal of Medicine, American Heart Association, American Academy of Dermatology, US Preventive Services Task Force, American Cancer Society, NATURE, Science journal

· Examples of Secondary literature sources: Mayoclinic.org, WebMD.com, Clevelandclinic.org, Time magazine

· Examples of tertiary literature sources: Anatomy and Physiology Textbook, Encyclopedias, Britannica

Please see example papers below and use a disease other than these ones.

Example Paper #1

Ebola Hemorrhagic Fever (Ebola Virus Disease)

1. Background about the disease:

a. The Ebola Hemorrhagic Fever (EVD) is caused by different strains of the Ebola Virus, it was first experienced by humans in 1976 and the first outbreak happened along the Ebola River, which is where it got it’s name from.

b. Humans have never been infected by any animal in the United States, only brought into the United States from people who traveled to areas known for having the Ebola Virus strains.

c. There are 5 strains of the EVD. The following 4 are the most deadly: Zaire, Sudan, Tai Forest, and Bundibugyo virus (Zaire Ebola virus the most deadly).

d. EVD is one of the most life threatening viral infections. Total of 13,308 known deaths since 1976.

2. Pathophysiology and causes:

a. Caused by Ebola Virus strains that cause symptoms that are listed below. “That leads to damaged vascular cells that form blood vessels. As the massive viremia continues, coagulation factors are compromised and the microvascular endothelial cells are damaged or destroyed, resulting in diffuse bleeding internally and externally. This uncontrolled bleeding leads to blood and fluid loss and can cause hypotensive shock that causes death in many Ebola-infected patients” (Davis, C).

3. Risk Factors:

a. The main risk factor of contracting the Ebola Virus in traveling to areas with reported EVD infections, as well as, working with and or eating animals in those areas.

4. Epidemiology:

a. EVD affects everyone the same, granted if you have a weaker immune system (elderly, young children, and preexisting complications), it becomes more difficult to overcome and survive. b. Those at a higher risk are healthcare workers who do not follow proper infection control and procedures.

5. Signs and symptoms:

a. Symptoms tend to appear 2 to 23 days after contraction.

b. Typically symptoms present as “dry” symptoms then become “wet” symptoms.

c. Main symptoms includes fever, fatigue, muscle pain, headache, sore throat, cough

6. Diagnosis tests:

a. Because early symptoms of EVD are not specific to EVD, it is difficult to accurately diagnose EVD. It’s early symptoms, fever, headache, and tiredness, are common for many other diseases like malaria and typhoid fever.

b. It is important to first determine if the patient could have come in contact with EVD in the past 21 days by being exposed to blood or body fluids from a person sick with or who died from EVD, objects contaminated with blood or body fluids of a person sick with or who died from EVD, infected fruit bats and nonhuman primates, or semen from a man who has recovered from EVD.

c. Polymerase chain reaction is the most common test because it allows low levels of EVD in the patients blood to be recognized.

d. It is critical that the doctor notifies the public health departments so that investigations can get started to trace the footsteps of the patient.

7. Treatments and drugs:

a. The FDA has approved an Ebola vaccine (rVSV-ZEBOV), also known as Ervebo. One dose is needed to help prevent the contraction of EVD. It has been 100% effective thus far.

b. For people not vaccinated, if they contract EVD, regeneron (REGN-EB3) and mAb114 help increase survival rates.

c. It is also important to provide fluids and electrolytes through infusion into the vein, offer oxygen therapy to maintain oxygen status, using medication to support blood pressure, reduce vomiting and diarrhea and to manage fever and pain, and treating other infections, if they occur.

8. Complication and Prognosis:

a. EVD can cause severe bleeding, organ failure, jaundice, delirium, shock, seizures, coma, and/or death.

b. Complications can occur after a patient has survived: hair loss, fatigue, hepatitis, inflammation of organs, sensory changes, and the virus can linger in semen for up to six months.

c. The prognosis for death ranges from 25% to 100%. It is estimated there has been a total 31,133 and 13,308 deaths. Which makes the death rate roughly 43%.

9. Recommended lifestyle change, prevention, or home remedies or alternative medicine:

a. Since this is a virus passed from animal then to human, following basic hygiene is the best preventive measure: 1. Wash hands often 2. Avoid close contact 3. Cover coughs and sneezes 4. Clean and disinfect often

References:

Center for Disease Control and Protection. (2019, November 5). Transmission | Ebola Hemorrhagic Fever | CDC. Retrieved March 19, 2020, from https://www.cdc.gov/vhf/ ebola/transmission/index.html Davis, C. (2019, July 19).

Ebola Virus Vaccine, Causes, Symptoms, Treatment, Contagious. Retrieved March 19, 2020, from https://www.medicinenet.com/ebola_hemorrhagic_ fever_ebola_hf/article.htm Bean, M. (2018, December 4).

Timeline of global Ebola outbreaks, 1976-present: West Africa’s Ebola outbreak sparked international concern in 2014, killing more than 11,310 people and infecting more than 28,000. The outbreak is now the most fatal and widespread ever recorded, with the CDC confirming the first travel-associated Ebola case in the U.S. in September 2014. Retrieved March 20, 2020, from https://www.beckershospitalreview.com/quality/timelineof-global-ebola-outbreaks-1976-present.html

Example Paper #2

Necrotizing Fasciitis

Background:

Also known as “flesh-eating disease,” necrotizing fasciitis is an infection by which invading bacteria secrete enzymes and toxins that destroy the tissues of the body. Its first recorded occurrence is most likely that of Hippocrates, who wrote in Of Epidemics of erysipelas “from some obvious cause, such as an accident, and sometimes from even a very small wound…great inflammation took place, and the erysipelas quickly spread all over. In the most of them abscessed ended in suppurations, and there were great fallings off (sloughing) of the flesh, tendons, and bones; and the defluxion which seated in the partwas not like pus, but a sort of putrefaction”

Pathophysiology and causes:

While necrotizing fasciitis can be caused by multiple bacterial species, Streptococcus pyogenes (a group A streptococcus) has been found to be the most common culprit, according to public health experts at the Centers for Disease Control and Prevention. Often found on the throat and skin, S. pyogenes infections (pharyngitis, or “strep throat,” being the most common) are usually mild and easily treated. However, in cases of necrotizing fasciitis, bacteria can spread quickly along fascia, inflicting damage to these connective tissues and the tissues nearby. Probably the most culpable of S. pyogenes’ virulence factors is the presence of a surface protein (M protein) that triggers a series of events ending in increased vascular permeability and plasma leakage into tissues. This protein also has antiphagocytic factors, which affect the ability of our immune system to get rid of the bacteria. Other examples of S. pyogenes virulence factors include: enzymes that break down blood clots and hyaluronic acid, allowing bacteria to spread, and erythrogenic toxins that stimulate the immune system to release chemicals, causing fever, rash, and shock.

Risk Factors and/or Prevention:

While necrotizing fasciitis is rare and not usually communicable, keeping even minor wounds and breaks in the skin clean and dry until healed is the number one way to prevent most bacterial skin infections. Additionally, if you have any open wounds or skin infections, the Centers for Disease Control and Prevention recommends refraining from spending time in communal and natural bodies of water (hot tubs, pools, rivers, oceans).

Epidemiology:

While the disease can be associated with the elderly and immunocompromised, infection is usually indiscriminate via a minor break in the skin on a young and healthy patient. It is not usually a communicable disease.

Signs and symptoms:

Unfortunately, signs and symptoms for this disease can initially be overlooked as a part of the original injury, causing a delay in treatment. Within the first 24 hours, there is pain that may feel akin to a pulled muscle around the site of injury and flu-like symptoms will begin to develop. Medical treatment should be sought immediately if you are wounded and have these symptoms (specifically fever, chills, and vomiting). Advanced signs and symptoms (3-4 days into infection) include pain, swelling, blistering, erythema, and necrosis. Critical signs and symptoms are a severe drop in blood pressure, septic shock, and unconsciousness.

Diagnostic tests:

Diagnosis can be difficult and may rely on lab cultures. This includes Gram stain resulting in short chains or pairs of Gram-positive bacteria and the sample being β-hemolytic on blood agar. Rapid antigen tests may also be done.

Treatments and drugs:

Treatment involves the use of IV antibiotics (ampicillin, clindamycin, cephalosporins, et al). Additionally, surgical removal of necrotic (dead) tissue may be required to stop the infection from spreading in areas too damaged for the antibiotics to reach.

Complications and Prognosis:

Prompt diagnosis and treatment are critical to a patient’s survival of this infection. Left untreated there is little to no chance of survival. With treatment, mortality rate for this infection by Streptococcus pyogenes is 43.2%.

Recommended lifestyle change or home remedies or alternative medicine:

This disease remains very low risk, especially with the maintenance of a healthy immune system and good hygiene practices.

Resources:

Centers for Disease Control and Prevention. (2017). Necrotizing Fasciitis. Retrieved from https://www.cdc.gov/features/necrotizingfasciitis/index.html

Hippocrates. Of Epidemics. (Francis Adams, Trans.). Retrieved from http://classics.mit.edu/Hippocrates/epidemics.2.ii.html

Khamnuan, P., Chongruksut, W., Jearwattanakanok, K., Patumanond, J., Yodluangfun, S., & Tantraworasin, A. (2015). Necrotizing fasciitis: risk factors of mortality. Risk Management and Healthcare Policy, 8, 1–7. http://doi.org/10.2147/RMHP.S77691

Misiakos, E. P., Bagias, G., Patapis, P., Sotiropoulos, D., Kanavidis, P., & Machairas, A. (2014). Current Concepts in the Management of Necrotizing Fasciitis. Frontiers in Surgery, 1, 36. http://doi.org/10.3389/fsurg.2014.00036

Taviloglu, K., & Yanar, H. (2007). Necrotizing fasciitis: strategies for diagnosis and management. World Journal of Emergency Surgery : WJES, 2, 19. http://doi.org/10.1186/1749-7922-2-19

Example Paper #3

Necrotizing Fasciitis

Abstract: Anti-NMDA receptor encephalitis is a serious life- threatening autoimmune disease that has been misunderstood throughout history. This disease can attack the body causing “demonic possession” like symptoms. These symptoms can include seizures, hallucinations, psychotic behavior and even catatonia. Anti-NMDA receptor encephalitis forms without known cause and acts in the lives of varied individuals. Josep Dalmau, who is the director and founder of Penn Center Autoimmune Neurology, claims that the “brain is on fire.” The disease causes the body to attack itself by forcing antibodies against the NMDA receptors in differing hemispheres of the brain, preventing the body from defending itself. This autoimmune disease is still being investigated to discover why it occurs and to whom it effects. Further research on Anti-NMDA receptor encephalitis would benefit the discipline and the medical community greatly.

Keywords: Auto-immune disease, Anti-NMDA, antibodies

Background Research: Anti-NMDA receptor encephalitis is a rare neurological autoimmune disease that can attack the brain. It is suggested that this disease could be the explanation behind historic claimsof “demonic possession” (NPR, 2012). However, due to Josep Dalmau’s hard work, there is a better understanding of why this disease is referred to as “brain on fire.” Anti-NMDA receptor encephalitis, an auto-immune disease, forms without known cause and acts in the lives of varied individuals, creating a range of hallucinogenic effects. Due to a study performed at the University of Pennsylvania, it has been proven that this disease occurs “when antibodies, produced by the body’s own immune system, attack NMDA receptors in the brain” (Anti-NMDA Foundation, 2020). This is quite the opposite of what antibodies are supposed to do. According to the Anti-NMDA foundation (2020), “antibodies are an important part of the body’s defense system. All healthy individuals produce antibodies against viruses, bacteria or tumors.” Antibodies are not doing their job because they are fighting against what they are supposed to be defending, NMDA receptors. The body creates antibodies against NMDA receptors in the brain. This is dangerous because according to Josep Dalmau, “NMDA receptors control memory and behavior. These antibodies disrupt normal brain signaling and cause psychosis, severe memory problems and other neurologic symptoms” (Penn Medicine, 2020). They control electrical impulses in the brain. In fact, these electrical impulses allow for “judgement, perception of reality, human interaction, the formation and retrieval of memory, and autonomic functions like swallowing and breathing” (Anti-NMDA Foundation, 2020).

Pathophysiology: Anti- NMDA receptor encephalitis may be associated with a tumor

Risk Factors: There are no risk factors because it is still unknown who or why people end up with anti-NMDA receptor encephalitis. Research is still being done.

Epidemiology: Anti-NMDA receptor encephalitis affects four times more women than men. In particularly, the majority of cases occur in young adults and children as well as young women who become sick during their childbearing years. If found in men, it is usually found in the testes. Anti- NMDA receptor encephalitis has been associated with lung cancer, breast cancer, thyroid tumors, neuroblastoma, and cancer of the colon.

Signs and Symptoms:

• Flu-like symptoms

• Memory deficits, including loss of short-term memory

• Sleep disorders

• Speech dysfunction- the patient is no longer able to produce coherent language or may be completely unable to communicate

• Cognitive and behavioral disturbances- confused thinking, hallucinations, delusional thinking, disinhibited behaviors

• Seizures

• Vision and/or hearing may be impaired

• Central hypoventilation- the patient may stop breathing, and may require a mechanical breathing machine

• Autonomic dysfunction- erratic breathing, heartbeat and blood pressure; loss of bladder control and bowel movements

• Movement Disorders- usually of the arms, legs, mouth, and tongue, but may include full body spasms. These are very common in Anti- NMDA receptor encephalitis and the patient is unable to control them.

Diagnosis Test: The diagnosis test requires antibodies to be detected in the body fluids of someone through either blood or spinal fluid test. Tests on the spinal fluid are more accurate than those on the blood (Anti-NMDA Foundation, 2020). Both tests should be tested before concluding the patient does not have anti-NMDA receptor encephalitis. Another important test is imaging, CT or MRI, to look at the body for any tumors. Women should receive an ultrasound of the ovaries while men should receive an ultrasound of the testes.

Treatment and Drugs: Every patient diagnosed with anti-NMDA encephalitis will have different experiences and symptoms and should be admitted to the hospital to be monitored by health professionals. Most are treated with medications that reduce the levels of antibodies in the blood and spinal fluid, according to the Anti-NMDA Foundation (2020). These medications includes corticosteroids, intravenous Immunoglobin, plasmapheresis. In order to eliminate the antibodies, more powerful drugs are needed. These includes Rituximab and Cyclophosphamide 9. Many other medications may be required to control blood pressure, stop seizures, ease anxiety, improve sleep, and treat hallucinations or abnormal behaviors.

Complication and Prognosis: If anti-NMDA receptor encephalitis is left untreated, patients can have seizures, abnormal movements, and several other symptoms which can potentially lead to death. It is very important to receive prompt diagnosis and treatment to make full recoveries. It is predicted that even after a full recovery, there is a possibility of a twenty five percent relapse of patients (Anti-NMDA Foundation, 2020). This is why even after recoveries; patients receive routine medical checks.

Recommended Lifestyle Change: There are no recommended lifestyle changes yet. According to the anti- NMDA foundation, there is no evidence to suggest this disease is hereditary or contagious. Anti-NMDA receptor encephalitis is usually associated with a tumor but not always. That being said, it is not known what causes this autoimmune disease.

Works Cited:

A Young Reporter Chronicles Her 'Brain On Fire'. (2012, November 14). Retrieved from https://www.npr.org/2012/11/14/165115921/a-young-reporter-chronicles-her-brain-on-firePenn Medicine's Josep

Dalmau, MD, PhD, Named Recipient of 2016 Cotzias Lecture and Award from American Academy of Neurology – PR News. (2020). Retrieved from https://www.pennmedicine.org/news/news-releases/2016/april/penn-medicines-josep-dalmau-md

What is Anti-NMDA Receptor Encephalitis? (In English, French, Spanish & Italian). (2020). Retrieved from https://www.antinmdafoundation.org/the-illness/what-is-anti-nmda-receptor-encephalitis/