Introduction to Human Diseases

Chapter 1:

Introduction to Human
Neighbors and Tannehill-Jones

Diseases.
Pete LeRoy, PhD

Department of Exercise and Sport Studies New Mexico Highlands University

A Few Learning Objectives

1.
2. 3. 4. 5. 6. 7. 8.

Define Basic Terminology used in the study of Human Diseases Discuss the Pathogenesis of Disease Describe the Standard Precaution Guidelines for Disease Prevention Identify Predisposing Factors to Human Disease Explain the differences between Diagnosis and Prognosis of a Disease. Differentiate between Infectious Diseases and Chronic Diseases Discuss the role of Medicine and the role of Education as they pertain to disease Explain why the Infectious Diseases no longer pose the major challenge and why they have been replaced by

Chronic Diseases

Overview
The study of Human Diseases is important so that we can better prevent and treat diseases. It is always better to prevent a disease, when possible, then to wait for the disease to occur and have to depend upon treatment. Some diseases affect only one part of the body or a particular body system, whereas other diseases affect several body parts or body systems at the same time. There are many factors that influence the bodys ability to remain healthy or predispose it to the diseases process. Many of these factors are controllable while some are non-controllable (heredity).

Some of the Terms we will Examine

Disease Disorder Syndrome Homeostasis Pathology Pathogens Pathogenesis Etiology Acute Chronic Idiopathic Iatrogenesis Nosocomial Diagnosis Prognosis Palliative Remission Exacerbation Morbidity Mortality

But first, some Basic Biology

The Cell
Mitochondria
Every cell has 3parts: Membrane, Nucleus, Cytoplasm. The Nucleus contains the Chromosomes (carries the genes) and the Nucleolus which directs cytoplasmic activity. The Cytoplasm contains a variety of Organelles e.g., mitochondrion.

Cell Membrane Nucleolus

Nucleus
Cytoplasm

Chromosomes

Disease & Disorder

These terms are often used synonymously. Disease is a change in in structure or function considered to be abnormal (unhealthy). A disease state means there is pathology (structural & functional changes in tissue and organs). In a disease state, homeostasis (the bodys maintenance of normalcy) is disrupted. Disorder is defined as a derangement of function not related to pathology. A nutritional disorder, for example might be related to a vitamin deficiency. In practice, the terms are often used interchangeably.

Pathology
Broadly defined, the word pathology means the study of disease. (patho=disease, ology=study). More precisely defined, it means that

branch of medicine which treats of the essential nature of disease, especially the structural and functional changes in tissues and organs of the body caused by disease.

Pathologists

1. 2. 3. 4.

A pathologist is one who studies disease. There are different types of pathologists: Experimental research Academic teaching Anatomic clinical examinations (autopsies, biopsies) Clinical laboratory examinations (hematology, immunology, microbiology) Pathogenesis is a description of how a disease progresses. For example, the common cold.

Pathogens

1. 2. 3. 4. 5.

Pathogens are microorganisms that cause disease. Pathogens can be: Bacteria single-celled microscopic organisms Viruses infectious agents much smaller than bacteria. They can only replicate within a living host cell. Fungi microscopic plant-like organisms (yeast and molds) Protozoans single-celled microscopic parasites Helminthes - worms

Pathogens produce a structural and functional change in tissue and organs.

Etiology & Idiopathic

The cause of a disease is the etiology of the a disease. For example, the primary etiology of lung cancer is cigarette smoking. When the etiology is unknown, the disease is said to be idiopathic. For example, the cause of most hypertension (~90%) is idiopathic. This type of hypertension is called primary hypertension.

Different Categories of Diseases:

Infectious versus Chronic
Infectious Diseases (also called Communicable Diseases) are caused by microscopic pathogens such as bacteria and viruses. These diseases can be transmitted from one person to another. Chronic diseases are NOT caused by pathogens. They are, for the most part, caused by behaviors such as smoking, sedentary lifestyles, inappropriate eating, and obesity. Chronic diseases are not transmittable, i.e., they are not communicable. Most of the diseases confronting the industrialized
Worldwide, infectious diseases still kill more people than do the chronic diseases.

nations (U.S., England, France, Germany, Australia, etc.) are Chronic diseases.

Where have the Infectious Diseases Gone?

The Infectious Diseases continue to kill more people than the Chronic Diseases on a Worldwide basis. But, in the Industrialized Nations (e.g., U.S. & Europe) the Chronic Diseases are the major killers. In the U.S. we have been successful in control of the Infectious Diseases through Public Health Efforts (increased sanitation measures and personal hygiene, control of refuge, potable drinking water and inoculation) In the Developing Nations (e.g., Africa & Bangladesh) Public Health efforts lag behind resulting in more deaths from the infectious diseases.

Predisposing Factors
Factors which predispose a person (increase the chances) for disease are called risk factors. Risk factors do not cause the disease, per se, but they increase the odds of the disease occurring. Risk factors are divided into 5-categories: Age Sex Environment Lifestyle Heredity Risk factors are subdivided into controllable and non-controllable factors.

1. 2. 3. 4. 5.

Uncontrollable Risk Factors: Age, Sex, Heredity

Age: The older we become, the higher our risk for disease especially the Chronic Diseases (a.k.a., Lifestyle Diseases) Sex: Some diseases are more prevalent (common) in one gender or the other. Men can contract prostate cancer, women cannot. Women are more likely to get breast cancer than men. Heredity: Some disease run in families. Some of these are clearly a genetic disorder others are referred to as heredofamilial.

Partly Controllable to NonControllable: Environment

The environment includes such things as the quality of the water we drink, the quality of the air we breathe, and sanitation. Included in this list are environmental stressors such as noise levels and over-crowding conditions.

Lifestyle - Controllable
Lifestyle plays a role in all diseases but especially chronic diseases. Ones lifestyle is the sum total of their usual behaviors. How one lives implies behavioral choices. Whether or not one smokes, exercises, eats a healthy diet and maintains a healthy body weight are examples of behavioral choices. Lifestyle risk factors are controllable.

The Role of Risk Factors for Chronic Diseases

MEDICAL CARE: 10%

HEREDITY: 16%

LIFESTYLE: 53% exercise, smoking, diet

ENVIRONMENT: 21%

Infectious versus Chronic

INFECTIOUS DISEASES
Cause: (Single causative) Microorganisms Onset: Abrupt, Sudden Duration: Finite, Predictable Recovery following Treatment: Rapid

CHRONIC DISEASES
Cause: (Multicausative) Lifestyle, environment, genetics Onset: Gradual, Insidious Duration: Indefinite, Often for a Lifetime Recovery following treatment: Ill-defined

The Role of Medicine versus Education

Medicine Drugs & Surgery Death Symptoms Signs

Education to reduce Risk Factors High-Level Health

No Smoking, Healthy Diet, Exercise, Weight Control

No Discernible Illness

The Medical System is a Passive System It is activated by a sick person. Education (pro-active) seeks to prevent Illness in the first

place.

Signs & Symptoms

Signs of disease states are objective. They can be measured. For example, blood pressure is measured with a sphygmomanometer (blood pressure cuff). Blood pressure is quantified as millimeters of mercury (mm/Hg). Symptoms are feeling a person has as reported to the physician. For example, headaches. Sometimes a symptom can also be a sign. For example, a runny nose.

Diagnosis & Prognosis

The identifying and naming of a disease is the diagnosis of a disease. Before any disease can be treated, the disease must be identified. Prognosis is the predicted or expected outcome of the disease. For example, the prognosis of the common cold is complete recovery within 7 to 10 days. The prognosis of lung cancer is not good. Most who are diagnosed with lung cancer will not survive 5-years.

Diagnosis Three Parts

Diagnosis is made by: 1. A complete Medical History of the sick person 2. A Physical Examination of the sick person 3. Data collected in Laboratory Tests.

Remission & Exacerbation

If a disease goes into remission, the symptoms are significantly diminished or temporary resolved. Exacerbation refers to a time when symptoms flare up or become worse. Complications are said to occur when a second disease occurs in an already diseased person. For example, a person with a broken arm may suffer from bone infection.

Iatrogenesis & Nosocomial

Iatrogenic problems stem from the medical treatment. For example, chemotherapy can cause anemia; mammography may increase the risk of breast cancer. Nosocomial means the disease was acquired in a hospital environment. Septicemia (infection) is a leading cause of death in the U.S.

Morbidity & Mortality

Mortality refers to death. Mortality rates express the number of fatalities for a particular disease. Morbidity refers to sickness (illness) rates.

Treatment
Once a disease has been diagnosed (given a name) treatment interventions can be decided upon. Treatment may include medications (drugs), surgery, physical therapy, exercise, dietary modifications, and education. The concept of treatment should be holistic, i.e., treatment of the person and not just the disease. Palliative treatment seeks to prevent pain and discomfort but does not seek a cure.

Ethical Issues
Ethics concerns itself with moral issues the rightness or wrongness of decisions. A major issue confronting us today is the rightness or wrongness of Euthanasia. Do you think Mercy Killing is good or bad and why? Do you want Heroic Measures implemented to save your life? How about the life of a loved one? Why do we consider putting our pets asleep a humane measure but dont think its humane to put a human out of misery? Who should make Life-or-Death decisions? You? Doctors? Courts?

Questions to Ponder
Why do you think it is important to study human diseases? What are the major diseases (categories) challenging people living in West Virginia and the United States? How important is it for us to control risk factors? Why do we refer to the medical-care system as a passive system? Why is Education called Pro-Active? What are the major risk factors for lifestyle diseases? Differentiate between Infectious Diseases and Chronic Diseases in terms of: Cause, Onset, Duration, and Recovery after Treatment. What is the percent contribution of Lifestyle to the Chronic Diseases? What are the three parts of a medical diagnosis and which is most important to the physician? Do you think its important that we set-an-example for our children and loved ones in the fight against chronic illness? Is it important that teachers who teach health be role models?

Terms
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

Do you Understand them?

What do the following terms mean? Disease Disorder Symptoms Signs Syndrome Homeostasis Pathology Etiology Chronic Infectious Idiopathic Diagnosis Prognosis Morbidity Mortality Passive versus pro-active