Pathophysiology
Chronic Obstructive Pulmonary Disease (COPD) is a disease that affects the lungs and leads to massive inflammation of the tissues that make up the lungs (Barnes, 2000). Generally, this disease condition results in the blockage of the air passages in the pulmonary compartments. It has been noted that the major cause of this disease is chronic cigarette smoking. However, smoke that comes from other sources is also associated with the development of this disease (Gross, 2003). It has been defined that the disease mainly occurs in coal mines, cotton ginneries, and grain stores.
It has been noted that smoke and dust or other irritants make blood cells (neutrophils and T-lymphocytes) accumulate and cause blockages in the pulmonary airways (Copstead & Banasik, 2009). An inflammatory response is triggered by this phenomenon. In this attempt, an influx of inflammatory mediators moves into these sites to destroy the inhaled debris. Repeated exposure to such irritants triggers the inflammatory response which seems to progress. This leads to the massive destruction of the airways. They narrow and constrict a condition that leads to excessive mucus production which reduces the functioning of the cilia. This makes clearance of the airways difficult, and patients develop persistent coughs and general dyspnea (Gross, 2003). The mucus layer that forms on the airways creates an attractive environment for bacteria that live and multiply in a warm and moist setting. Such bacteria colonize the region and increase in number which results in the development of diverticula and bacterial infection (Copstead & Banasik, 2009).
Treatment
Upon diagnosis of a patient with COPD, special attention should be given to the reduction of the risk factors and amelioration of signs and symptoms through pharmacological and non-pharmacological procedures to optimize the patient’s functional status and longevity. Focus on risk reduction helps to control the induced inflammatory reactions that continuously damage the airways. This is the first step in managing and treating COPD. Smoking cessation plays a great role in the cure of this disease.
The use of bronchodilators also makes up a basis in the treatment of COPD (Gross, 2003). Some of the most commonly used types include anticholinergics, beta-adrenergic agonists, and methylxanthines (Barnes, 2000). These bronchodilators cause smooth muscle relaxation which enhances effective lung deflation. It also helps to minimize dynamic hyperinflation. Improved thoracic exercise enhances inspiration capacity and helps to remove mucus exudates from the airways. Bronchodilators, therefore, enhance the capacity of regular exercises in COPD patients and consequently improve their condition.
Phosphodiesterase-4 inhibitors are also widely used to fight against COPD. These have been shown to improve the condition by stable exacerbations. The use of corticosteroids has helped as well to cure and improve conditions of COPD patients. It has been observed that inhaled corticosteroids are effective in managing exacerbations (Gross, 2003). Prophylactic immunizations against influenza have been made available to people and have been associated with reduced incidences of COPD (CDC, 1999). It has been recommended that the 23-polyvalent pneumococcal vaccine should be administered to patients with COPD. Antibiotics such as macrolides are effective in fighting bacterial colonies which inhabit the airways. They, therefore, have found expansive applicability in COPD treatment plans. Mucokinetic agents together with corticosteroids have also been used to reduce the levels of exacerbations and auger in the management of COPD (Barnes, 2000).
In conclusion, it should be stated that priority in treating COPD has to be given to the change of lifestyle by avoidance of the irritants that trigger an inflammatory response. It is vital to avoid smoking and dust in the workplace.
References
Barnes, J. (2000). Chronic Obstructive Pulmonary Disease. N Engl J Med, 343(4), 269-80.
Centers for Disease Control and Prevention (CDC). (1999). Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep, 48, 1-28.
Copstead, C., & Banasik, L. (2009). Pathophysiology. St. Louis: Saunders.
Gross, N. J. (2003). Outcome Measures in COPD. Are We Schizophrenic? Chest, 123(5), 1325-1327.
Significance Of Multifactorial Traits
Introduction
Multifactorial traits refer to distinguishing human attributes that involve several factors or causes, especially about a condition or disease resulting from the interaction of many genes (Cummings, 2015). The environment contributes a lot to the development of human traits. Research has established that most traits exhibited by human beings belong to this category. Attributes such as height, hair color, and skin complexion belong to this category because they tend to vary from one person to another (Brown, 2007). This is also the case for certain diseases such as cancer, diabetes, heart conditions, and defects. Although human characteristics are often passed through subsequent generations, research has established that genes and the immediate environment of an individual have a lot of influence on the way they are expressed. Research has established that traits expressed by human beings have similar characteristics, but not the same (Brown, 2007). This phenomenon is attributed to human genetic variations; whereby people tend to have certain common traits albeit with a certain level of inconsistency. Multifactorial traits are often influenced by a combination of genes from both parents, as well as several environmental factors (Cummings, 2015). Multifactorial traits play a very important role in understanding human genetic variation. The traits that people exhibit depend a lot on the kind of distribution the genes from both parents will have from the time of conception (Rosenberg, 2012). This explains the reason why some people are taller than others, more intelligent than others, and have different skin colors.
Discussion
Research has established that the environment has a lot of influence on the way human beings exhibit certain traits (Brown, 2007). For example, people with albinism are very vulnerable to excess heat, thus do not have very many hours of contact with direct sunlight. Other conditions such as body weight can be influenced by the ability of individuals to engage in physical activities in their places of work or residence. One of the main features of multifactorial traits is the fact that they occur again in families (Rosenberg, 2012). This means that closely related family members have a high chance of exhibiting the same condition or physical feature. The main reason for this is the fact that multifactorial traits do not exhibit Mendelian ratios (Cummings, 2015). Some of the traits that closely related people have a higher chance of sharing include fingerprint patterns, height, eye color, and skin complexion. Fingerprints are often used as a means for knowing the identity of a person, as well as distinguishing between different people (Brown, 2007). As a multifactorial trait, the pattern of fingerprints can be slightly different, especially in the case of identical twins due to the effect of environmental factors.
According to experts, the prevailing environmental factors when a woman is pregnant, or the period from conception to birth can lead to dermatoglyphic changes (Rosenberg, 2012). Over the years, fingerprints have been used by law enforcement authorities to track down criminals (Rosenberg, 2012).
Height is also a very important multifactorial trait that helps in identifying and distinguishing people. Height varies a lot across all populations because we have short, tall, and medium height people. According to experts, some of the notable environmental factors that influence the variability of this trait across populations are health and dietary choices (Rosenberg, 2012). People tend to have a height measuring in between that of their parents. People who do not have any health conditions at birth or during their childhood tend to develop normally, thus their height is never compromised. On the other hand, people born with certain health conditions tend to experience stunted growth, which affects their ability to reach their maximum height (Paterson, 2010). Nutrition also influences the ability of human beings to grow to their maximum height. Good dietary choices are very important for the strong development of bones and other body organs. Over the years, height has been used as an element for describing, categorizing, and distinguishing people. Height plays a vital role in the life of human beings because it also defines roles for certain people, especially in sports and law enforcement-related duties (Cummings, 2015).
Eye and skin color is also important multifactorial trait among human beings. Research has established that eye color is an inheritable character that is controlled by several genes at once (Brown, 2007). The same case applies to skin color because its main influencing factor is melanin, an insoluble pigment that accounts for the color of an individual’s skin. Variations in the level of distribution account for the differences in people’s skin colors (Paterson, 2010). One of the environmental factors that have the most impact on skin color is sunlight. Research has established that exposure to sunlight for prolonged periods can make the color of the skin lighten or deepen (Brown, 2007). Although skin color has been widely used to predict the ethnicity of people in various parts of the world, scientists argue that it cannot be used to tell the genetic history of an individual (Cummings, 2015). The main significances of skin color are identification, distinction, and relation. Psychologists argue that people living in highly diverse communities tend to develop relations more easily with people of the same skin color because they believe in common ethnicity (Rosenberg, 2012). However, it is important to note that skin color is one of the multifactorial traits that have been abused the most across the world, as very many people have been subjected to racism in different parts of the world.
Bodyweight is also a multifactorial trait that has grown in significance over the years. For example, obesity has been a growing challenge in the United States of America, despite numerous campaigns sensitizing people about healthy life choices (Paterson, 2010). Research has established that bodyweight is a trait that depends a lot on one’s genes and a few environmental factors. Bodyweight is controlled by a hormone called Leptin, whose main role is in regulating appetite and the metabolic rate within the body (Paterson, 2010). People whose bodies produce this hormone in abnormal quantities often have issues with managing their body weight. High levels of Leptin increase someone’s appetite and decrease the rate of metabolism, thus leading to obesity. Research has established that the environment also controls body weight (Brown, 2007). Some weather conditions motivate people to engage in vigorous physical activities, while others limit people from being active. Physical activity is very important in the management of body weight. Bodyweight is very significant concerning the concept of human development because it influences the ability of the body to carry out its other functions. For example, obese people are very vulnerable to various heart conditions due to the high concentration of fat within the body. In addition, maintaining a good body weight is very important for healthy development, especially among children (Cummings, 2015). Research has established that obese parents often have a higher chance of having children with the same condition, a phenomenon that shows the effect of interaction between several genes (Brown, 2007).
Conclusion
Multifactorial traits play a very significant role in understanding human development and genetic variations witnessed in people. Experts argue that all human beings share the same traits, albeit with several variations. Height is a good example of such a trait since there are short and tall people. The same case applies to intelligence, whereby some people have a better ability to understand and profit from an experience more than others. Over the years, multifactorial traits have been used as a basis for identification, differentiation, and classification. Traits such as height, skin color, and body weight are often to describe someone. However, it is important to note that the variability in these traits has made them very desirable to the extent of causing harm. A good example is people who suffer from conditions such as skin cancer through tanning. Some tanning effects happen from exposure to sunlight, while others seek medical assistance to achieve the same. People need to accept the variability in the traits that define them because every human being is unique in their way.
References
Brown, J.R. (2007). Comparative Genomics: Basic and Applied Research. New York: CRC Press.
Cummings, M. (2015). Human Heredity: Principles and Issues. New York: Cengage Learning.
Paterson, A.H. (2010). Molecular Dissection of Complex Traits. New York: CRC Press.
Rosenberg, L.E. (2012). Human Genes and Genomes: Science, Health, Society. California: Academic Press.
Cardiac Disease During Pregnancy
Heart related diseases are caused by many factors and they are becoming common in pregnant women. The presence of cardiac disease during pregnancy poses a challenging clinical situation to medical doctors because they are also supposed to concentrate on the wellbeing of the unborn baby (Perry etal. 2011). During this time when the mother is pregnant, profound changes occur in the blood circulation, which may adversely affect the health of the mother and that of the unborn baby (Perry etal. 2011). This situation may even get worse if there is presence of underlying heart conditions in the mother. The prevalence of cardiovascular complications among pregnant women has been estimated to be 4 percent, and according to recent research, maternal heart diseases and other heart complications are among the main causes of death in pregnant women. Research has also shown that patients who have undiagnosed heart diseases are likely to have complications or even die during the pregnancy period.
Diagnosis of heart diseases
During pregnancy, there is an increased demand of blood in the body for the mother and unborn child (Sahni, 2012). The increased demand puts a lot of pressure on the heart and circulatory system making pregnant women prone to cardiovascular diseases. The blood demand during pregnancy is 50 percent compared to 30 percent for people who are not expectant (Sahni, 2012). Therefore, the heart has to work extra hard to meet the required demand in the body, which affects the cardiovascular system.
The cardiovascular system is vital because it keeps body organs supplied with oxygen for proper functioning (Sahni, 2012). However, because of some reasons some of the arteries and veins may become impaired making them unable to perform their functions as expected. This impairment leads to cardiovascular diseases, which are different and vary in the way they affect the heart. The impairment can be caused by poor lifestyle, alcohol and tobacco use, obesity, physical inactivity and poor eating habits (Perry etal. 2011). One of the diseases that occur because of cardiovascular system impairment is called coronary heart disease. This condition can be fatal during pregnancy because it causes high blood pressure that causes many maternal deaths.
Diagnosis of heart diseases during pregnancy can be done through checking patient’s medical history, physical examination, and chest examination (Sahni, 2012). Carrying out tests during pregnancy remains the best way to detect a heart disease. In addition, tests can be used to check the general function of the heart (Sahni, 2012). However, it is good to note that x-rays should not be used to get chest films because they can affect the development of the fetus. Nevertheless, an electrocardiogram (ultrasound) is efficient in identifying any irregularities in the heart rate, arrhythmias and detects any past heart problems (Northwestern Memorial Hospital, 2012).
In addition, Cardiac Event Monitors are used on women who have palpitations to determine any abnormality in the heart. The use of Cardiac Monitors enable doctors to check any changes taking place in the heart by monitoring the heart beat in hours or days (Ignarro, Balestrieri, and Napoli, 2007). This helps to detect heart condition, which occurs infrequently and can go undetected if doctors are not keen during this period. Another form of checking the heart during pregnancy is based on ultrasound that has no negative effects on unborn babies (Sahni, 2012). The ultrasound can be combined with a Doppler to determine functioning of the valve throughout the pregnancy period (Northwestern Memorial Hospital, 2012). Other problems that are checked during pregnancy that are associated with the heart include heart infection, blood clots among others. These kinds of problems are only seen through a (TEE) transesophageal echocardiogram (Sahni, 2012). It has been discovered that most heart attacks are a result of blockage in the blood vessels.
Etiology of cardiac disease during pregnancy
Complication of the heart during pregnancy is common and it is therefore, important for pregnant women to understand the risks involved. The pregnancy itself is a source of stress to the heart and the circulatory system (Northwestern Memorial Hospital, 2012). Because of this kind of stress, complications are most likely to occur during this delicate period. Even though, a big number of pregnant women who have heart problems deliver hale and hearty babies. However, in the majority of underdeveloped countries and developing countries, rheumatic disease is one of the major causes of maternal heart diseases (Sahni, 2012).
There are several reasons why cardiac diseases are common in pregnant women. One of the reasons is improved or better health care. Because of better and improved care in the hospitals, women who have heart-related problems are living a healthy life and they survive up to reproductive age (Ignarro, Balestrieri, and Napoli, 2007). It is only during the pregnancy that these complications emerge with full force. The second cause of cardiac disease in pregnant women is changes in demography, which have caused an increase of prevalence in regions with large number of immigrants (Ignarro, Balestrieri, and Napoli, 2007). The third reason why cardiac diseases are common among pregnant women is the tendency to delay motherhood until the third decade (Northwestern Memorial Hospital, 2012). Poor lifestyle, especially unbalanced diet and lack of exercise is another cause of cardiac disease in pregnant women. It has been proved that unbalanced diet may cause obesity, which is a major risk factor for cardiac disease. Other major causes include aortic dissection and myocardial infarction, which makes the heart vulnerable.
Signs, Symptoms, and Causes of the Disease/Disorder
There are different types of heart diseases, which may affect individuals. Pregnant women also suffer a number of heart related problems (Ignarro, Balestrieri, and Napoli, 2007). Current research findings reveal that approximately 90 percent of pregnant women with heart related problems had rheumatic heart disease (Northwestern Memorial Hospital, 2012). The main causes of rheumatic diseases are injuries to the heart and valves, which is brought by rheumatic fever (Northwestern Memorial Hospital, 2012). According to medical experts, rheumatic fever is not a common condition, although it is a serious clinical condition that can cause serious damages. It is caused by bacteria known as streptococcus, which can be treated using antibiotics. Because medical doctors are able to address the problem of rheumatic fever, the percentage of pregnant women with heart disease caused by rheumatic fever is relatively low, especially in the last 10 years (Ignarro, Balestrieri, and Napoli, 2007). Today, the major causes of cardiac diseases among pregnant women are congenital heart conditions and cardiovascular disease. These conditions are more prevalent and are evident in every 1 out of three woman with heart diseases.
There are several symptoms of heart conditions. Some of most common include difficulty in breathing, feeling dizziness and constant chest pains (Northwestern Memorial Hospital, 2012). Other patients may experience dizziness and lightheadedness combined with constant fainting. The presence of these symptoms varies according to level of defects. For instance, less serious congenital heart deficiencies are not easily detected at early stages. In most cases, these defects are only diagnosed at later stages (adulthood). Pregnant women with these defects have symptoms like short breath/ breathing problems, they get tired even after performing simple activities, and they swell in the hands and feet.
On the other hand, a cardiac disease is also another problem experienced by pregnant women. There are varies symptoms that may occur during the pregnancy period; some of the most common include constant fainting, chest pains, shortness of breath, feeling weak (fatigue), having breathing difficulties when sleeping, and constant shivering may also occur. Fainting may occur constantly due to high blood pressure and change of blood volume during the pregnancy. Difficulties in breathing and shortness in breathing may be caused by enlarging uterus as the pregnancy advances (Perry etal. 2011). Palpitations during pregnancy may be caused by change in position of the diaphragm as the fetus grows. Because of change in the blood volume, most pregnant women may develop problems in the heart beat, which can be indentified through cardiac testing (Ignarro, Balestrieri, and Napoli, 2007). Although most women develop swelling of feet and hands during this delicate stage, it is not entirely caused by heart complications (Perry etal. 2011). Because of the fact that heart diseases are many, the doctor should diagnose the patient to know which type of disease his/her patient is suffering from.
Treatment and Prognosis of heart disease among pregnant women
Most heart diseases are easier to treat and manage, especially if they are detected early enough (Perry etal. 2011). Therefore, pregnant women who feel as if they have heart problems, whether judging from the general symptoms and signs; they should consult professionals immediately. In addition to this, it is highly advisable that all expectant mothers should go for regular health check ups during the whole period of pregnancy. In fact, pregnant women are advised to talk to their doctors in regard to any concerns one has about their heart and general health. If a patient does not have an already existing heart condition, she should see the doctor immediately, especially if one continues to experience breathing difficulties, shortness in breathing, constant chest pains and fatigue (which are the most common indicators of heart problems). In addition to this, women who have family members that have been diagnosed with heart related problems should also visit hospitals to be evaluated on a regular basis. This is because history of heart disease in family/ relatives is an important factor that should be put in consideration during the pregnancy.
Because of complications related to heart diseases, pregnant mothers should have frequent prenatal visits (Perry etal. 2011). This is extremely important because good patient cooperation and doctors’ care can help. In case of cardiovascular problems, medical therapy should only be conducted by trained specialists (cardiologist, obstetricians, and anesthesia care providers). During the pregnancy, the classification of the heart disease may advance from level 1 to level 4, which increase chances of miscarriage or complication at the time of birth.
Preconception counseling is also important part of the treatment. This is because some heart diseases, especially those that are congenital can result in congenital lesions to babies. Management of the cardiovascular diseases is important and it mainly focuses on “preventing hypotension and increased heart beat” (Perry etal. 2011). At the second stage, the disease should be managed through operative vaginal delivery (Perry etal. 2011). It is important to note that caesarian section should only be performed for women with obstetric issues.
In addition to this form treatment, there is a need to provide nursing care management for pregnant women so that they can recover quickly. When providing this kind of care, the doctors should combine routine peripartum care with special interest in cardiac analysis. This is essential to know the progress. The management of this problem can be addressed by strategizing on how to minimize stress on the heart. It is important to understand that the heart is more stressed between 28 and 32 weeks of pregnancy. It is therefore, significant to treat the pregnant mother against anemia, emotional stress, hypertension, and obesity, which are the main causes of stress to the heart (Ignarro, Balestrieri, and Napoli, 2007). The doctor should also encourage the pregnant mother to take a balanced diet containing high levels of iron. The mother should also be provided with folic acid (as a supplement) calories, and adequate proteins, which will help the patient to gain weight (Perry etal. 2011). The doctor should also recommend the patient to take more water. When providing cardiac medications, the doctor should also consider the wellbeing of the unborn baby. After prescribing drugs, the doctor should monitor the patient on regular basis to determine whether the drugs are affecting the fetus.
Conclusion
There are different types of heart disease, which may affect individuals. Pregnant women also suffer a number of heart-related problems and the most common one is cardiovascular disease. Heart related diseases are becoming more common in pregnant women due to several risk factors. Today, improved health care, postponing motherhood until third decade, and poor lifestyle are among the reasons why cardiac disease is common in pregnant women. The presence of cardiac disease during pregnancy poses a challenging clinical situation to medical doctors because they are also supposed to concentrate on the wellbeing of the unborn baby. Because complications of the heart during pregnancy are common, it is extremely important for pregnant women to understand the risks involved. Since the pregnancy is a source of stress to the heart and the circulatory system, doctors should strive to manage this stress. There are several symptoms of heart conditions and some of most common include difficulty in breathing, feeling dizziness and constant chest pains. Other patients may experience dizziness and lightheadedness combined with fainting (Perry etal. 2011). The presence of these symptoms varies according to level of defects. It is also worthy noting that most heart diseases are easier to treat and manage if they are detected early enough. Therefore, pregnant women who feel as if they have heart problems, whether judging from the general symptoms and signs; they should consult health professionals immediately. As part of treatment, the doctor should encourage the pregnant mother to take a balanced diet containing iron. The pregnant mother should also be provided with folic acid, calories, and adequate proteins. The doctor should also advice the patient to take more water. When providing cardiac medications, the doctor should also consider the wellbeing of the unborn baby. After prescribing drugs, the doctor should monitor the pregnant mother on a regular basis to determine whether the drugs are affecting the fetus.
References
Ignarro, L. J,. Balestrieri, M. L., Napoli, C. (2007). Nutrition, physical activity, and cardiovascular disease: an update. Cardiovascular research, 73 (2): 326–40.
Northwestern Memorial Hospital (2012). Cardiac signs & symptom during pregnancy. Web.
Perry, S. E., Hockenberry, D., Mariln, J., & Lodwermilk, L. (2011). Maternal Child Nursing Care, (4th edn.). Maryland: Mosby Inc.
Sahni. G. (2012). Cardiovascular Disease in Pregnancy, An Issue of Cardiology Clinics. Philadelphia: Elsevier Health Sciences.