Need ONE Response Per Each Discussion Total 6 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion
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discusion1Wanda.docxDUARDO SOTO QUINONES
Eduardo Soto Quinones Discussion # 1. CAP
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The article by Cillóniz, Cardoza, and García-Vidal (2018) of the Annals of Research Hospitals titled, “Epidemiology, pathophysiology, and microbiology of community-acquired pneumonia” is a review article that discusses the epidemiology, pathophysiology and microbiology of the main cause of death from infectious disease globally. The rates of community-acquired pneumonia (CAP) are especially high in Europe. Streptococcus pneumoniae (pneumococcus) is the most frequent cause of CAP.
CAP is usually acquired through inhalation, aspiration or, rarely, through blood contamination. The acquisition of the microorganisms that cause CAP is combined with the decrease in local defense mechanisms and an increase in fluid in the lungs. It is caused by the pathogen but risk factors for pneumonia include sex, age and comorbidties. People spread CAP by not covering their cough. They spread the virus into the air through their cough and others inhale or aspirate it into their lungs, and depending upon the risk factors and their overall general health, can develop CAP. However, the incidence of the disease is decreasing in the United States and Canada because of a pneumonia vaccination.
The fact that the pneumonia vaccine can reduce the incidence of CAP is a good thing especially since there are now strains of pneumonia that have become antibiotic resistant (Cillóniz, Cardoza, & García-Vidal, 2018, p. 4). The article goes on to list various types of pneumonia that are resistant to antibiotics. The resistant rates vary from 5% to 40% with the highest being for macrolied used to treat S. pneumoniae (Cillóniz, Cardoza, & García-Vidal, 2018, p. 5). The Center for Disease Control and Prevention (CDC) (2017) says, “Until 2000, pneumococcal infections caused 60,000 cases of invasive disease each year. Up to 40% of these infections were caused by pneumococcal bacteria that were resistant to at least one antibiotic” (CDC, 2017). This has decreased because of the pneumonia vaccine.
The article also talks about the advances in the study of lung microbiomes in recent years. It concludes by reiterating that CAP is still a significant cause of morbidity, mortality, and health costs globally even with the vaccine and advances in knowledge. CAP is especially prevalent in Europe due to an aging population and greater numbers of comorbidities. Prevention strategies may affect this trend.
References
CDC. (2017, September 6). Drug Resistance. Retrieved from Center for Disease Control and Prevention: https://www.cdc.gov/pneumococcal/drug-resistance.html
Cillóniz, C., Cardoza, C., & García-Vidal, C. (2018). Epidemiology, pathophysiology, and microbiology of community-acquired pneumonia. Annals of Research Hospitals, 2(1), 1-11. Retrieved from http://arh.amegroups.com/article/view/3921/4658
Lizandra Alvarez
Discussion Forum #1
Advanced Pathophysiology
Heart failure is the final result in a heart unable to compensate for a cardiac injury. The heart is a very powerful organ that demands lots of energy, or ATP. This energy is usually available from the mitochondria. The metabolic process of the mitochondria is the energy house of the heart. Heart failure has always been related to mitochondrial breakdown. New research now suggests that the mitochondria might have a bigger responsibility in heart failure. According to research, the heart does not go into failure all at once. The process is seen as a chain reaction from not been able to adapt to energy stress. This maladaptive behavior leads to more damage. Some of the other dysfunctions of the mitochondria that lead to heart failure include excessive actyl-CoAs, dysregulation of Ca2+, and electron leakage (Zhou & Tian, 2018). The failure to keep homeostasis in the heart’s energy use is what leads to overall heart failure. Understanding what happens to our heart and how energy is used allow us to understand its disease process. That’s why it’s important to maintain the balance in our bodies in order to prevent heart failure. A healthy weight, reduction of fat in our diet, no smoking, and stress reduction can impact our heart health tremendously. As providers, we need to be aware of how metabolic functions affect our hearts in order to better care for our patients.
Reference
Zhou, B., & Tian, R. (2018). Mitochondrial dysfunction in pathophysiology of heart failure. Journal of Clinical Investigation, 128(9), 3716-3726. doi:http://dx.doi.org/10.1172/JCI120849
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Rosie Jean Louis
According to Afable and Karingula (2016), the effects of diabetes are significantly adverse as related to the development of health complications such as cardiovascular disease, amputations, renal disease, and blindness. In the worst cases, diabetes leads to premature death (Afable & Karingula, 2016). This health condition disproportionately affects individuals in low and middle-income countries. In this regard, India and China have the leading number of diabetes cases in the world, adults living in China are estimated to be 98.4 million, whereas in India 65.1 million individuals living with diabetes (Afable & Karingula, 2016). Nevertheless, Afable and Karingula (2016) attribute the growth of diabetes globally to shifting lifestyle trends associated with urbanization and social mobility. Individuals immigrating from rural to urban areas may take up sedentary jobs, which are significantly different compared to the previous labor-intensive work they undertook in rural areas. Moreover, the shift may lead to the adoption of a relatively unhealthy diet associated with the consumption of processed and high-calorie food and engagement in minimal physical activities. These situations increase the risks of developing type 2 diabetes.
However, Afable and Karingula (2016) illustrate the effectiveness of the adoption of lifestyle intervention programs, which involve the engagement in physical activities and the adoption of healthy diets to reduce the prevalence of type 2 diabetes. Afable and Karingula (2016) achieve this aspect by reviewing previous studies that have been conducted to illustrate this concept. As such, Afable and Karingula (2016) explain that most research studies report positive findings on the adoption of an active lifestyle and healthy eating to reduced risks of developing type 2 diabetes. These findings imply that health interventions involved in the prevention and management of diabetes should aim towards promoting the importance of a healthy diet and engagement in physical activities among individuals in order to achieve positive health outcomes.
Reference
Afable, A., & Karingula, N. (2016). Evidence based review of type 2 diabetes prevention and management in low and middle income countries. World Journal of Diabetes, 7(10), 209-229. Doi: 10.4239/wjd.v7.i10.209
Pathophysiology Discussion 1
Marie Germain
Diabetes type 2 is a chronic disease that is highly prevalent in the United States of America. Several factors have been suggested as possibly link to insulin resistance and beta-cell dysfunction in the pathogenesis of type 2 diabetes. The evidence-based research article entitled Diabetes risk increased between spouses by Chaput (2014) demonstrates that biologically related family members tend to have a higher risk of having diabetes if there is a history of the disease within the family. The research also illustrates that socio-environmental elements can lead to a reduction of the diabetes prevalence among couples. The study demonstrated that if one of the couples becomes obese, the other partner has a 37% chance of being obese (Chaput, 2014). The study monitored spousal diabetes and concluded that couples that know that they have a shared diabetes risk tend to form greater support and collaboration in order to identify and implement preventive measures. These couples can educate each other on healthy eating habits and equally engage in continuous physical activities that would restore their health and decrease the impact of diabetes type 2 in their lives.
Diabetes is a chronic disease that affect approximately 25.6 million individuals, that impact the overall aspect of the healthcare base on treatment and complications of the disease (Clark & Utz 2014). Due to the complications of the disease, the implications on healthcare are profound. According to Clark & Utz, (2014), the cost of diabetes in the United states was estimated at 245 billion dollars. To decrease the impact of Diabetes on healthcare, education is the main aspect to improve the crippling effects. Educating patient of ways to manage the disease, which will lower or prevent the complications that can derive from this disease, such as heart disease, stroke, retinopathy, poor circulation, kidney disease and poor wound healing, will prevent readmission in the hospital, thus decrease the overall implication on the healthcare. As nurses and future Family Nurse Practitioners (FNP), it is crucial that we educate our patients on lifestyle modifications, for instance, stop smoking, exercises, eating food high of fiber, and decrease fat intake (Clark & Utz 2014).
References
Chaput, J. (2014). Diabetes risk increased between spouses. Evidence Based Nursing, 18(1), 28-28.
Clark, L. M., Utz, S. (2014). Social determinants of type 2 diabetes and health in the
United States. World Journal of Diabetes 5(3): 296–304.
Dalia Salgado Discussion Forum#1
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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).
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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Guillermo Carabeo
Hypertension
Hypertension is body condition that affects the normal pressure of the blood. It’s the elevated force of blood that travels through the vessels from the heart to other parts of the body. The increased blood pressure has effect on the blood cells. The condition can worsen over a long period of time where complications or even death occurs when treatment is not sought on time. The main implications discussed here are the ones affecting the body itself, to other diseases, and implications to the economy.
120/80 mmHg is the average normal blood pressure for an adult. Any figure above this average one is always considered high BP. The damage to the artery walls is a consequence of the increase in the blood pressure. A small tear is the onset of the damages to the arteries which escalates to bad cholesterol flowing through blood where the arteries become narrow. Little blood flows through the arteries gives the heart an extra task to pump blood. Consequently the left ventricle enlarges and puts an individual at a higher risk of heart attack (Dragu et.al, 2015). Hypertension impacts the cardiovascular diseases directly hence increased mortality on the cardiovascular diseases.
A study on the Chinese famine showed that extend of exposure famine in childhood affected the rate at which hypertension was contracted in adulthood. The improvement on the nutrition and the health environment to pregnant mothers controls the disease in adulthood. The health condition of babies like overweight and starvation implicates the hypertension in adulthood, another study revealed. An increase in the waist circumference over transition from childhood to adulthood causes an increase in the hypertension occurrence in adulthood.
Dietary foods like salt also cause elevated hypertension. An average consumption of salt per day should be 5g per person per day. However, an increase in intake especially in adults, leads to an increase in one contracting hypertension. A study on the Indian adults revealed. Other foods that are processed like lunch meats also causes higher chances. An American Heart Association has a recommendation on alcohol consumption where men should take two drinks and women a single drink in a day. Increased alcohol intake leads to increased rates of hypertension.
As a major contributor of cardiovascular diseases, hypertension if not treated leads to more deaths relating to cardiovascular infections (Kjeldsen et al, 2015). It’s a growing public concern where on an instance hypertension caused $ 51.2 billion shillings to U.S between 2012 and 2013. This is an economic threat where the disease needs to be lowered through preventive measures or pharmacological treatment measures that are cheaper.
Dragu, R., Rispler, S., Habib, M., Sholy, H., Hammerman, H., Galie, N., & Aronson, D. (2015). Pulmonary arterial capacitance in patients with heart failure and reactive pulmonary hypertension. European journal of heart failure, 17(1), 74-80. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.192
Kjeldsen, S. E., Lund-Johansen, P., Nilsson, P. M., & Mancia, G. (2016). Unattended blood pressure measurements in the systolic blood pressure intervention trial: implications for entry and achieved blood pressure values compared with other trials. Hypertension, 67(5),808-812.retrievedhttps://www.ahajournals.org/doi/abs/10.1161/hypertensionaha.116.07257
