2/1/2010

Environmental and Nutritional

Diseases

Air pollution
Toxic exposure
Air
Water
Work/domestic
S
Sun light
li h and
d radiation
di i
Trauma
Self induced
Tobacco
Drugs

Indoor vs. Outdoor

Indoor
Radon
East Coast
Tobacco
Off-gassing
Outdoor
Gasses
Particulates
Increased UV

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Air Pollution Dealing with the Agent

Great scale Filtration
In door Mucus
Out door Cough reflex
Ozone
If too small
Chemicals
Cant remove
10,000 20,000 liters Scarring and
Particle size alveolar damage
5-10 microns bronchi
1-2 microns alveoli

Emphysema Lung Changes of Emphysema

Proteolytic damage
Activation of
inflammatory enzymes
Decreased inhibition
Small airways
Alveoli
Loss of surface area
for gas exchange

Asthma Hypersensitivity Pneumonitis

Hypersensitivity type I Interstitial tissue

Air passages Molds and chemicals
Bronchoconstriction Injury to alveolar
Permanent small lining cells
airway narrowing Fibrosis
Many allergens
Pollens
Mold spores
Dander

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Pneumoconiosis Lung Cancer

Scarring secondary to Tobacco smoke

inhaled particulates Secondhand tobacco
Coal Industrial agents
Silica
Radon
Cotton fibers

Tobacco Smoke Tobacco related tumors

Firsthand
Secondhand Squamous cell
Types of injury carcinoma of lung
Carcinogens Bladder cancer
Cell irritants & damage
Poisons Gastric cancer
Drug related Pancreatic cancer
Diseases
Multiple cancers
Atherosclerosis
Penile dysfunction
Emphysema
Bronchitis

Lead Silicates and other Particulates

Paint Silica
Industrial Industrial
Absorption variable Sand on the streets
Scarring
Organs
Brain & peripheral n.
Bone marrow
Kidney tubules
Long bone growth
centers in children

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Silica Scar

Alcohol Related Metabolism of ethanol

Ethanol & others
May help lipid metab.
Cellular toxin
Acute & Chronic
CNS depressant
Depresses inhibitions
Liver cell injury
Acute fatty liver
Cirrhosis
Fat soluble vitamins

Drug Abuse Cocaine

Crack Cocaine Inhibits uptake of

Arrhythmia transmitter
Dissecting aorta Stimulatory
IV drugs
g Hypertension
yp
Respiratory death Arrhythmia
Endocarditis MI
Social and economic Stroke
HIV Dissection of aorta

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Aortic Dissection Pulmonary Edema

Pulmonary Edema Endocarditis

Physical Agents Ecchymosis

Mechanical injury
Abrasions
Contusions
Lacerations
Incised wounds
Penetrating wounds

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Thermal Injury

Nutritional Diseases
Too little nutrient
Isolated deficiency is rare
Too much nutrient
With
With French Fries?
Fries?
How did it come to happen
Dietary related
Refined out of diet
Absorption problem
Utilization

Protein deficit, Kwashiorkor Marasmus

Second child Lack of calories

Edema Stunting
CNS Loss of
Skin and hair subcutaneous fat
Muscular atrophy

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Obesity

Hypertension
6 miles of capillaries
Insulin resistance
DM type II
High serum lipids
Atherosclerosis
Gallstones
Osteoarthritis

Vitamin A
Specific Vitamin Deficiencies
Fat soluble vitamins
K, A, D, & E
Problems of absorption
Pancreatic insufficiency
Liver disease
Multiple deficiencies
Water soluble vitamins
B-complex
C
Dietary absence
GI related

Bitots Spot

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Keratomalacia Epithelial Changes

Epithelial Changes Night Blindness

Vitamin D Vitamin D Deficincy

Skin in most adults

Renal and liver steps
Fish oils
Rickets in children
Osteomalacia in adults
Fractures
Excess leads to
hypercalcemia
Renal stones

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Vitamin K Deficiency B Complex

Water soluble
Green vegetables
Cereals
Deficiency states
Starvation
Refinement of food
Alcoholics

Thiamine Deficiency, Beri Beri Thiamine Deficiency, CNS

Alcoholism
Wernickes
encphalopathy
Physical
y abn.
Mamillary body
necrosis
Korsakoffs
Psychiatric
Confabulation

Niacin, Pellagra Commercial Message

3 Ds of Pellagra
In keeping with fat soluble vitamins.
Dermatitis
Diarrhea Fish oil supplements and the like.
Dementia The John West Red Salmon Company p y

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Vitamin C Vitamin C deficiency

Citrus and vegies

Function
Water soluble free radical scavenger
Helps
H l absorb
b bF Fe and dCCu (i
(in reduced
d d state)
t t )
Collagen metabolism
Hydroxylation of lysine and proline
Scurvy

Vitamin C deficiency Vitamin C deficiency

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