Weekly Health and Fitness Corner

"...following a stroke there are several complications to be aware of the patient may have brain edema or increased intracranial pressure which can have a detrimental effect on the outcome of that patient this occurs due to Cellular swelling breakdown of the blood-brain barrier leaking of cerebrospinal fluid from the ependymal lining as well as from cellular debris causing an increased osmolality in that affected region this then causes movement of water into the affected space symptoms include headache dizziness nausea and vomiting and you may have signs such as papilledema and a gradual loss of consciousness because of the increased pressure there is also a risk of obstructive hydrocephalus who Nation Mannitol was previously used to reduce intracranial pressure in these patients however a recent study has shown that this may even increase the in-hospital mortality other potential therapies include hyperventilation and diuretics and some sources also specify steroids although the evidence is contradictory surgery involving a craniotomy with a skull is temporarily lifted can also help to reduce the intracranial pressure ischemic Strokes can give rise to a hemorrhagic transformation especially after thrombolytic treatment in the case of hemorrhagic stroke secondary to a subarachnoid hemorrhage the maybe vasospasm following the initial bleed which can then generate infarction which is essentially a secondary stroke to counter this a calcium channel blocker such as numata peen may be given and in the acute setting the patient may be given a cute volume expansion and vasopressin has in an attempt to increase cerebral blood flow infections are another complication of stroke pneumonia can be due to post stroke paralysis with a patient is not able to move well and can suffer atelectasis which is a collapse of part along this generates an environment that Mike I'm growing leading to pneumonia additionally due to swallowing difficulty the patient may be more prone to aspiration and therefore aspiration pneumonia urinary tract infections are also common especially in patients who have an indwelling catheter placed this is because patients with stroke have an increased risk from suppression bladder dysfunction and of course the use of the catheter itself Additionally the fever and systemic inflammatory response associated with the urinary tract infection May impair stroke recovery..."

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"...seizures are defined as a transient occurrence of signs and symptoms due to abnormally excessive or synchronous neuronal activity in the brain they are classified into several types the first thing to consider is where the seizure originated in the brain generalized seizures begin involving both hemispheres of the brain previously they were known as primary General seizures on the other hand focal seizures originate from an area on one hemisphere if seizures begin on one Hemisphere and then involve both they known as focal to bilateral seizures this was previously called secondarily generalized seizures the next factor is whether or not the patient keeps their awareness the seizure generalized seizures are automatically considered to affect awareness, therefore, this distinction only applies to focal seizures meaning you either have focal away previously known as simple partial or focal impaired awareness previously complex partial then we have motor or non-motor seizures motor implies the involvement of movement during The Siege generalized seizures May feature stiffening and jerking while focal seizures can have movements such as twitching jerking and stiffening too but they may also feature automatic movements like licking lips or rubbing hands in focal seizures initially one group of muscles may be affected but this abnormal movement can later spread or move to other muscle this occurs due to the abnormal neuronal activity in the brain also moving to a different area this is known as the Jacksonian March generalized non-motor seizures and mostly known as absence seizures were primarily individuals will have changes in awareness and stay focal know look to seizures typically have other symptoms that happen first previously known as an aura this could be changes in sensation in Emotion thinking or there are six main types of generalized seizure the most well-known is the tonic clonic seizure previously known as grand mal here the seizures present contraction of the limbs followed by limb extension and arching of the back usually lasting 10 to 30 seconds at this stage you may also hear what is known as the it cry which is a sound produced due to the contraction of the chest muscles following this the limbs May begin shaking and in total a tonic-clonic would last around two to three minutes atonic seizures as the name suggests present with increased tonicity meaning a sustained contraction similar to the start of the tonic-clonic..."

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...the descending Pathways carry motor signals down the spinal cord and a generally divided into pyramidal or extrapyramidal tracts the pyramidal fibers travel through the medullary pyramids of the medulla oblongata which is why they are termed pyramidal these fibers originate in the cerebral cortex and are responsible for the voluntary control of the muscles of the body and the face there are two different tracks that make up the pyramidal tracts these are the corticospinal and corticobulbar tract the corticospinal tract responsible for the control of the body the cell bodies are found within the cerebral cortex with axons converging and passing through the internal capsule followed by the crus cerebri in the midbrain the pons and subsequently arriving into the medulla oblongata at this level around 75% the fibers will it to the other side of the spinal cord and continue down to sign ups with a lower motor neuron in the ventral horns at each level these fibers are known as the lateral corticospinal the other 25% of the fibers that remain on the ipsilateral side will continue as the anterior corticospinal tract and they will continue down ipsilateral e until the cervical and highest thoracic levels where they will decussate and sign ups with their motor neurons as for the corticobulbar tract this is the tract responsible for the voluntary control of the head the face and the neck similarly to the corticospinal tract they originated from the cerebral cortex and pass through the internal capsule however rather than descend into the spinal cord these neurons have their axons sign up sing to the lower motor neurons in the brain stem specifically on to the cranial nerve nuclei...

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"...the definition of syncope is a reversible loss of consciousness that occurs due to an inadequate blood flow to the brain usually their fast onset short duration and a spontaneous recovery so first things first what's the difference between a transient loss of consciousness and sinker beep well a syncope is a form of transient loss of consciousness which can be divided into loss of consciousness due to head trauma or non-traumatic causes under which comes along with syncope do other non-traumatic causes of a transient loss of consciousness include epileptic seizures psychogenic causes and rear causes like the problem clinically with syncope is Discerning the really serious and by that I mean potentially lethal causes of syncope so the causes are divided into Exxon knurled mediated syncope orthostatic hypotension and cardiac causes under reflex mediated we have vasovagal syncope which can be due to author's death that happens when the patient experiences fear phobias such as seeing blood or even pain next we have situational underneath reflex mediated syncope which includes losing Consciousness after death coughing finally for reflux syncope we have carotid sinus syndrome which is where the Carotid baroreceptors react too strongly to detecting an increased pressure leading to an excessive drop in blood pressure and therefore syncope an example is when people put their Ties on too tightly we take this few seconds off to inform you are valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic classic functional medicine Back to Basics health tips and special updates from the best doctors in the United States of America check out this health and wellness podcast shows explore Health talk healthy lifestyle matters excellent Health digest healthy and free daily and last but not least weekly health and fitness Corner also check out nasty Boise see the truest story never told for that real life on the go experience with the 27 year old Golden Boy Who made our guest invite number one list he tells us about his story as it happens in real time and in real life it's nasty boy CC the truest story never told go get a load of that happiness because happiness is healthy as we know it join us every week as..."

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"...Parkinson's disease is a neurodegenerative condition affecting dopaminergic neurons in the brain leading to Associated motor symptoms neurodegeneration means a progressive irreversible loss of neurons and in Parkinson's disease it is mostly the dopamine-producing neurons in the substantia nigra that's a lost for us to move signals are generated by the cerebral cortex that then pass through the motor pathways and lead to with our muscles and ultimately movement however this process needs to be regulated which is primarily the job of the basal ganglia the substantia nigra is a part of the basal ganglia which are a group of nuclei in the brain all normally there are two main Pathways the direct and indirect pathway the direct pathway is an excitatory pathway that facilitates movement the motor cortex sends excitatory signals via glutamate to the striatum the striatum sends inhibitory signals to the Globus pallidus internus substantia nigra pars reticulata via Gaba these two both release Gaba which normally inhibits Thalamus so in this path there is inhibition of the inhibition on the thalamus giving an overall increased activity of the thalamus which promotes movement the indirect pathway is instead an inhibitory pathway that's purpose is to terminate movement in this case there is an inhibitory Gaba signal from the striatum to the Globus pallidus external Tunis the Globus pallidus external is normally inhibits the subthalamic nucleus which normally stimulates the Globus pallidus internal this means that the indirect pathway increases the inhibitory effect of the Globus pallidus internus on the thalamus and so there is less signal from the thalamus and so there is less move in Parkinson's there is a gradual degeneration of neurons within the substantia nigra pars compacta these neurons release dopamine to the striatum in the striatum there are direct pathway neurons that have D1 dopamine receptors and are excited by dopamine and indirect pathway neurons that have dopamine D2 receptors and that inhibited by dopamine overall this means dopamine released from the past compactor..."

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"...stroke is characterized by having poor blood flow to part of the brain leading to cell death they are grossly divided into ischemic and hemorrhagic with around 15 to 20 percent of Strokes being hemorrhagic a hemorrhagic stroke results from the rupture of a blood vessel leading to bleeding compared ischemic stroke that have a sudden occlusion of a blood vessel within hemorrhagic Strokes there are two main types intracerebral meaning bleeding within the brain itself which can be intraparenchymal Hemorrhage weather is bleeding within the brain tissue or an intraventricular Hemorrhage where there is bleeding within the ventricular system of the brain around one intracerebral hemorrhage into the ventricles intracerebral Hemorrhage is most commonly caused by hypertension and age-related cerebral amyloid angiopathy which is where deposition of Lloyd Peter peptide in the vessels leads to a weaker vessel structure which is then therefore more likely to bleed the other main type is a subarachnoid with the bleed occurs between the arachnoid Mater and the Pia Mater subarachnoid hemorrhages can be due to trauma or can be spontaneous in 85% of cases in taneous subarachnoid hemorrhage is caused by rupture of a cerebral aneurysm with the most common locations being the anterior communicating artery in 35 percent of cases internal carotid artery in 30% and middle cerebral artery in 22% in 30% of cases there are multiple aneurysms the remaining maybe caused by rupture of an arteriovenous malformation coagulopathy or extension of an intraparenchymal bleed note that both of these types of hemorrhagic I considered intracranial bleeds however other types of intracranial bleeds such as epidural and subdural hemorrhages are not considered hemorrhagic stroke we take this few seconds off to inform you are valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic classic functional medicine Back to Basics health tips and special updates from the best doctors in the United States of America check out this health and wellness podcast shows explore Health talk healthy lifestyle matters excellent Health digest healthy and free daily and last but not least weekly health and fitness Corner also check out nasty Boise see the truest story never told Fiction podcast for that real life on the go experience with the 27 year old Golden boy..."

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"Hepatorenal syndrome is a life-threatening condition characterized by rapidly Progressive kidney failure that is seen in people with Advanced liver disease the prognosis is very Bleak and is usually fatal without the transplant there are two types type 1 has a median survival of two weeks and features a rapidly increasing creatinine level type 1 happens commonly in taneous bacterial peritonitis type 2 is a slightly more moderate form with a median survival of 10 weeks and a steadier creatinine here patients typically have a site that is resistant to DirectX approximately 18% of cirrhotic patients who have ascites will develop hepatorenal syndrome within one year so what exactly that makes this condition so bad the Hallmark is a renal basic constriction in the setting of vasodilation in splanchnic breasts those are the intestines spleen liver and pancreas the main branches of the aorta that make it up at the Celiac artery as well as the superior and inferior mesenteric arteries the underfill theory is that as liver disease progresses and portal hypertension follows possibly also generating ascites there is a splash so dilation because of release of vasodilatory mediators like nitric oxide and prostaglandins this vasodilation leads to more blood being directed into the splanchnic vessels which ends up draining into the portal circulation which causes the juxtaglomerular apparatus of the kidney to activate the renin-angiotensin-aldosterone system leading to vasoconstriction and in particular in the kidneys but the splanchnic vasculature is resistant to vasoconstriction due to the production of local vasodilators like nitric oxide and so remains vasodilate it the cycle leading to this vicious cycle of the renal vasoconstriction and splanchnic vasodilation ultimately leading to renal failure the activation of the renin-angiotensin-aldosterone is thought to be an important step in the formation of ascites in patients with cirrhosis to the extent that ascites and hepatorenal syndrome may be considered a splanchnic vasodilation determined the resistance of ascites to diuretics as is seen in type 2 hepatorenal syndrome as well as the onset of kidney vasoconstriction that leads to the initial onset of hepatorenal syndrome it is important to remember that having a cirrhotic patient with an AK I does not mean that the patient has HRS they may have the Aki for other reasons and so hepatorenal..."

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"diarrhea is defined as having stools that occur more than three times a day and a looser than usual specifically 200 grams 24 hours is considered diagnostic but as you can imagine trying to measure the weight of stools in everyone referring to diarrhea would be a mess literally so first off the call divide them into acute and chronic causes for start acute diarrhea is defined as lasting less than four weeks and is often caused by infections that they usually eat a viral or toxin-mediated typically they will resolve spontaneously I see cases lasting more than four weeks need to be divided into either organic or functional causes and the difference between them is that organic causes can be detected or Quantified through testing while functional causes cannot samples of organic causes include celiacs disease inflammatory bowel disease like ulcerative colitis or Crohn's disease we can also have bacterial and parasitic infections pain and of course intestinal neoplasms on the other hand functional causes of chronic diarrhea include irritable bowel syndrome lactose intolerance food alcohol how then can we begin to narrow down the causes when we encounter a patient with diarrhea let's first tackle how to distinguish functional from organic diarrhea firstly the duration of secondly the volume of organic diarrhea is usually larger than in functional next we look for the presence or absence of blood functional will never have blood while organic often does we can also ask about the naming organic doesn't have any specific pattern but may wake the patient up at night well functional is usually in the morning and will not wake the patient up this is also closely tied to stress where organic diarrhea doesn't have much Association to stress but functional diarrhea often coincides with we take this few seconds our valued loyal listener about the best health and fitness podcast shows from the Nez pod Studios join us as we give you the best of the best health and wellness updates you can rely on for the treatment of chronic classic functional medicine Back to Basics health tips and special updates from the best doctors in the United States of America check out this health and wellness podcast shows explore Health talk weekly healthy lifestyle matters excellent Health digest healthy and free daily and last but not least weekly Health and Fitness also check out nasty boy CC the truest story never told Fiction podcast for that real-life on-the-go experience with the 27 year old Golden Boy Who made our guest he tells us about his story as it happens in real time and in real life it's nasty boy CC the truest story never told go get a load of that happiness because happiness is healthy as we know it join us every week as we continue to provide you the best of health and fitness Wellness updates from around the globe enjoy the show"

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Nephrotic syndrome is a collection of signs and symptoms that result from damage to the kidneys and is often confused with nephritic syndrome in fatigue syndrome there is a substantial amount of protein being lost through the kidneys in the urine defined as more than 3.5 grams per day this leads to hypoalbuminemia a low level of albumin in the blood as albumin is the most abundant protein normally in the blood these two are defining features in nephrotic syndrome nephritic syndrome is different in that there is less proteinuria but also the presence of hematuria and red blood cell or white blood cell casts in the urine hypertension and oliguria which is a reduced urine output typically between 80 and 400 ml per day the unit of the kidney is the nephron and normally in the glomerulus of the Nephron there is a specialized membrane that forms the filter made up of a fenestrated endothelium the Maryland basement membrane and the foot processes of podocytes which are cells that wrap around the capillary giving this additional filtration layer all together these structures normally act as a filter and prevent large molecules from passing through into the Bowman's capsule and renal tubules they have a net negative charge which may mean that they can repel other negatively charged molecules albumin is negatively charged in the fatigue syndrome there is sufficient injury to these structures to change the permeability and allow albumin and other molecules to pass into the urine leading to hypoalbuminemia the signs and symptoms linked to hypoalbuminemia which includes peripheral edema and fluid overload particularly in children this can be evident as facial swelling but can also occur in adults particularly around the eyes fluid overload can mean weight gain peripheral edema and even the development of ascites or pleural effusion which can manifest as shortness of breath known as this near the reduction in the blood levels of albumin causes the oncotic pressure of the blood 24 meaning fluid will more readily leak into the surrounding tissues causing edema this is sensed as hypovolemia because less fluid is in the vessels which then triggers the renin-angiotensin-aldosterone system causing retention of salt and water this is known as the underfill hypothesis while another is the

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a sudden deterioration in the function of the kidneys is known as an acute kidney injury sometimes also called acute renal failure to measure this reduction in kidney function glomerular filtration rate or GFR is normally used which is a measurement of how well the kidneys are filtering the blood the functional unit of the kidney that actually does this is the Nephron made up of the glomerulus which is a modified capillary and as blood passes through it the waste is filtered into the Bowman's capsule GFR is the volume filtered through the glomerulus into the Bowman's capsule and through the Nephron in a given unit of time the filtrate passes along through the proximal convoluted tubule Loop of henle distal convoluted tubule and the distal collecting duct undergoing secretion and reabsorptionas it travels ultimately it forms urine and collects into the renal pelvis and passes into the bladder through the ureter to directly measure this process is difficult we instead use creatinine clearance to estimate the GFR creatinine is a normal breakdown product of creatine released from muscle tissue and this is freely filtered by the glomerulus and is not reabsorbed so fits the kind of substance we need however creatinine is secreted into the filtrate by the peritubular capillaries so it does tend to overestimate the GFR slightly the cockcroft and Gault formula is a famous formula used to estimate the creatinine clearance and therefore GF are taking into account age Mass gender and the serum creatinine as it travels ultimately it forms urine and collects into the renal pelvis and passes into the bladder through the ureter to directly measure this process is difficult we instead use creatinine clearance to estimate the GFR creatinine is a normal breakdown product of creatine released from muscle tissue and this is freely filtered by the glomerulus and is not reabsorbed so fits the kind of substance we need however creatinine is secreted into the filtrate by the peritubular capillaries so it does tend to overestimate the GFR slightly the cockcroft and Gault formula is a famous formula used to estimate the creatinine clearance and therefore GF are taking into account age Mass gender and the serum creatinine

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