...Non-Alcoholic Fatty Liver Disease: A Case Study Introduction The case study involves Andrew Lincoln who is a overweight 23 year old caucasian male, who has returned home over winter break after being away at college. While at school Mr. Lincoln works part-time at a pizza parlor to decrease his financial burden. During his free time while at college Andrew is minimally active and prefers to play video games over doing strenuous physical activities. Mr. Lincoln presents to his primary provider for an physical after a 4 years hiatus while being away at college. He has no significant past medical history and was only was hospitalized when he fell and broke his leg as a child. He currently has no physical complaints but has noticed over the last year his stool has become yellow tinged and his flatulence has become very...
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...Case Study BSHS/325 December 8, 2014 Maria Perrotta Case Study Human services provide help to many in need. Human service professionals need to be able to be provided with general information, the case information, about an individual, and understand the needs of the client. This case study involves Michael and his relationships, his roles, and the effects of his unhealthy habits. Michael’s Basic Information and Relationships Michael is a single 45 year old male with no children and he is a practicing attorney. He volunteers for a youth mentoring program for male youths. He is currently dating Tina, whom he is considering marrying. Tina has three adult children. He seems to be unable to confront Tina about whether or not she loves him and would accept an offer of engagement. Michael is 200 pounds overweight, eats high-fat and high calorie foods, and is currently on high blood pressure medication. His recent visit to his physician has encouraged slight and immediate changes to his diet. Michael has no desire to go to the gym or to exercise. Exercising would allow him to feel better and may help with the psychological problems of not talking with Tina or Taylor, his sister. He lives with his sister, who is HIV positive. They are very close. Taylor does not work, although she is physically capable of working. She does help Michael with cooking and cleaning. Michael and Taylor no longer discuss each other’s health issues because of the problems it...
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...Apple peel compound boosts calorie burning, reduces obesity in mice Obesity and its associated problems such as diabetes and fatty liver disease are increasingly common global health concerns. A new study by University of Iowa researchers shows that a natural substance found in apple peel can partially protect mice from obesity and some of its harmful effects. The findings suggest that the substance known as ursolic acid reduces obesity and its associated health problems by increasing the amount of muscle and brown fat, two tissues recognized for their calorie-burning properties. The study, which was published June 20 in the journal PLoS ONE, was led by Christopher Adams, M.D., Ph.D., UI associate professor of internal medicine and a Faculty Scholar at the Fraternal Order of Eagles Diabetes Research Center at the UI. “From previous work, we knew that ursolic acid increases muscle mass and strength in healthy mice, which is important because it might suggest a potential therapy for muscle wasting," Adams says. "In this study, we tested ursolic acid in mice on a high-fat diet -- a mouse model of obesity and metabolic syndrome. Once again, ursolic acid increased skeletal muscle. Interestingly, it also reduced obesity, pre-diabetes and fatty liver disease. "Since muscle is very good at burning calories, the increased muscle in ursolic acid-treated mice may be sufficient to explain how ursolic acid reduces obesity. However, we were surprised to find that ursolic acid...
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...Nunn, Brandon English Brooks English 1010 4 October 2015 Mark Bittman’s “The Food Industry’s Solution to Obesity” For decades, obesity has been a major problem in American society. Some attribute this to the laziness or lack of ambition of Americans. Others blame the marketing strategies of big name food companies. Mark Bittman attributes it to big name food companies not distributing “healthy” food to the public. He insists that they instead distribute food that is terrible for you. Loaded down with excess amounts of sugar, calories, and fats, the food companies have begun to appear to be selling “better” food to society. In his article, “Parasites, Killing Their Hosts: The Food Industry’s Solution to Obesity,” he dives deeper into the corrupted world of public health versus company profit. Published in the New York Times on June 17, 2014, his article covers the world of obesity and how the food industry contributes to this dystopia we’re working towards. Mark Bittman is an American food journalist, columnist for the New York Times, and author of 14 books and cookbooks. One of these books was awarded the James Beard Award for General Cooking. Working for the New York Times since 1996, Bittman has slowly worked his way up to the current lead food writer for the paper. He has been featured on NPR, The Today Show, and PBS’s 2008 American food and travel series “Spain…on the Road Again." As Bittman writes his article he begins to analyze how little the food industry really...
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...I. Understanding the Disease and Pathophysiology 1. The liver is an extremely complex organ that has a particularly important role in nutrient metabolism. Identify three functions of the liver for each of the following: • Carbohydrate Metabolism Glucogensis, gluconeogensis, oxidation via TCA cycle, glycogenolysis, glycolysis • Protein Metabolism Synthesis of serum proteins, synthesis of prothrombin, globin of hemoglobin, apoferritin, nucleoproteins and serum mucoprotein, degradation of some proteins to peptides and amino acids, synthesis of urea • Lipid Metabolism Lipogensis, lipolysis, saturation/desaturation, ketogenesis, esterification of fatty acids, fatty acid oxidation, uptake/formation/breakdown/esterification/excretion of cholesterol. Formation of lipoproteins • Vitamin and Mineral Metabolism Formation of acetyl CoA from pantothenic acid, hydroxylation of vitamin D to 25‐OH D3, formation of 5‐methyl tetrahydrofolic acid, methylation of niacinamide, phosphorylation of pyridoxine, dephospsorylation of thiamin, formation of coenzyme B12 2. The CT scan and liver biopsy confirm the diagnosis of cirrhosis. What is cirrhosis? • Cirrhosis is any pathological condition where fibrous connective tissue replaces healthy tissue in an organ, usually as a consequence of inflammation or other injury. 3. The most common cause of cirrhosis is alcohol ingestion. What are additional causes of cirrhosis? What is the cause of this patient’s cirrhosis? • Other causes of cirrhosis...
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...by the stomach, these digestive actions are not significant, as almost no real breakdown of fat occurs until the fats reach the duodenum in the form of gastric chyme. Fat Breakdown In The Small Intestine Fat digestion and absorption requires that the complex fat molecules be broken down into smaller more manageable molecules. This is done by mixing the fat with the digestive enzyme lipase, which enters the duodenum from the pancreas - the main source of enzymes for digesting fats and proteins. Lipase chops up lipid molecules into fatty acid molecules and glycerol molecules. However, because fat does not dissolve in water, the fat molecules enter the duodenum in a congealed mass, which makes it impossible for the pancreatic lipase enzymes to attack them, since lipase is a water soluble enzyme and can only attack the surface of the fat molecules. To overcome this problem the digestive system uses a substance called bile, produced in the liver but stored in the gallbladder, which enters the duodenum via the bile duct. Bile emulsifies fats - meaning, it disperses them into small droplets which then become suspended in the watery contents of the digestive tract. Emulsification allows lipase to gain...
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...Trace of the Bolus MOUTH The mouth, also referred to as the oral or buccal cavity, is formed by the cheeks, hard and soft palates, and tongue. Forming the lateral walls of the oral cavity are the cheeks—muscular structures covered externally by skin and internally by non-keratinized stratified squamous epithelium. The anterior portions of the cheeks end at the lips. The lips or labia are fleshly folds surrounding the opening of the mouth. They are covered externally by skin and internally by a mucous membrane. There is a transition zone where the two kinds of covering tissue meet. This portion of the lips is non-keratinized, and the color of the blood in the underlying blood vessels is visible through the transparent surface layer. The inner surface of each lip is attached to its corresponding gum by a midline fold or mucous membrane called the labial frenulum. The orbicularis oris muscle and connective tissue lie between the skin and the mucous membrane of the oral cavity. During chewing, contraction of the buccinators muscles in the cheeks and orbicularis oris muscle in the lips helps keep food between the upper and lower teeth. These muscles also assist in speech. The vestibule of the oral cavity is a space bounded externally by the cheeks and lips and internally by the gums and teeth. The oral cavity proper is a space that extends from the gums and teeth to the fauces, the opening between the oral cavity and the pharynx or throat. The hard palate—the anterior...
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...GI and Diabetes Exam Study Guide Tube Feeding – (enteral nutrition) refers to the administration of a nutritional balanced liquefied food or formula through a tube inserted into the stomach, duodenum, jejunum. It is used to provide nutrients via the GI tract either alone or as a supplement to oral or parenteral nutrition. - Nasogastric (NG) Tube – is most commonly used for short-term feeding problems. Other means of feeding are; esophagostomy, gastrostomy or jejunostomy. Transpyloric tube placement or placement into the jejunum is used when physiologic condition warrant feeding the pt below the pyloric sphincter. Special Indications – anorexia, orofacial fractures, head and neck cancer, neurologic or psychiatric conditions that prevent oral intake, extensive burns and those who are receiving chemotherapy or radiation therapy. Procedure for tube feeding 1. Patient position – 30-45 degrees position. Head remain elevated for 30-60 mins 2. Patency of tube – Tube should be irrigated with water before and after each feeing to ensure patency. 3. Tube Position – Placement of tube is checked before each feeing or every 8 hours with continuous feeings. Checking methods; aspiration and pH. 4. Formula 5. Administration of feeding – feeing are given either by gravity drip method or by feeding pump. 6. General Nursing Considerations – daily weight, accurate I’s and O’s. Blood glucose check. Complication Related To tube and feeding - Vomiting and or Aspiration -...
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...is a chronic liver disease that is characterized by normal liver cells being replaced by scar tissue. This affects the normal functioning of the liver and usually occurs from years of damage to the liver, resulting in inflammation, scarring and thickening of the fibrous tissues. It is most often a result of chronic hepatitis C or alcoholism, however there are other causes which will be discussed throughout this paper. Why is the liver important? More often than not, a person is born with a healthy, normally functioning liver. The liver is an extremely important organ and plays a vital role in maintaining homeostasis in the human body. Among the most important functions of the liver are: processing nutrients from food, removing toxins from the body, helping to store sugar and releasing it into the blood as needed to maintain glucose levels, and producing bile for digestive purposes. The liver also plays a role in producing proteins, fat metabolism for producing energy, breaking down old damaged cells, and blood clotting. It is obvious to see that the liver has many important functions that a person’s body depends on. Cirrhosis of the liver can affect the normal functions of the liver, as well as the body’s normal homeostatic state. This can result in many problems, including death....
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...Alcohols effects on Liver Fatty Liver * Fatty liver is reversible, and is present in a high % of heavy drinkers. * Caused by fat droplets from adipose tissue, can lead to higher BP, hypertension - stroke Hepatitis * Reversible with complete absence of alcohol in the system for a long period of time, but 75-85% turns chronic. * Causes inflammation/necrosis of the liver tissue * Centre for disease control (CDC) 2007 stated hepatitis kills more patients than HIV/Aids. * 15,100 deaths in hepatitis patients, 12,700 HIV deaths Cirrhosis * Excess fibrosis and hardening of blood vessels impairs liver function. * Blood flow from GI tract & spleen through portal vein to liver can cause variceal haemorrhages - intense bleeding due to the hypertensive blood flow Gamma - Glutamyl Transferase * Marker of alcohol intake leading to liver dysfunction * Counteracts oxidative stress - breaking down extracellular glutathione (antioxidant/protective) - making its component amino acids available to cells. * BUT: high alcohol intake causes free radical production - depletes the glutathione - so less amino acids available - less repair of liver cells showing necrosis. Metabolism * Alcohol metabolised by oxidation reactions * Alcohol dehydrogenase oxidises ethanol to acetaldehyde - hepatotoxic so is then oxidised by aldehyde dehydrogenase to acetate * NAD+ oxidised to NADH - increases lactate conc - slows down krebs cycle - less ATP made ...
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...Protein digestion Protein metabolism denotes the various biochemical processes responsible for the synthesis of proteins and amino acids, and the breakdown of proteins (and other large molecules, too) by catabolism.Dietary proteins are first broken down to individual amino acids by various enzymes and hydrochloric acid present in the gastro-intestinal tract.[1] These amino acids are further broken down to α-keto acids which can be recycled in the body for generation of energy, and production of glucose or fat or other amino acids. This break-down of amino acids to α-keto acids occurs in the liver by a process known as transamination Protein digestion occurs in the stomach and duodenum in which 3 main enzymes, pepsin secreted by the stomach and trypsin and chymotrypsin secreted by the pancreas, break down food proteins into polypeptides that are then broken down by various exopeptidases and dipeptidases into amino acids. The digestive enzymes however are mostly secreted as their inactive precursors, the zymogens. For example, trypsin is secreted by pancreas in the form of trypsinogen, which is activated in the duodenum by enterokinase to form trypsin. Trypsin then cleaves proteins to smaller polypeptides. Protein metabolism is dependent on a vast number of endogenous mediators. These mediators define the balance between anabolic and catabolic processes. Insulin is the major anabolic hormone and also has an important role in amino acid and protein homeostasis. During injury and...
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...systemic effects is the central nervous system followed by skin, blood circulation system, liver, lungs and kidneys. Muscle and bones as well as the male and female reproductive systems often suffer debilitating impacts from many substances. Target organs can also refer to an organ is targeted to receive a therapeutic dose of irradiation. An example would be beaming gamma rays to the renal area of a kidney for the treatment of a tumor. Another example of a target organ is the thyroid gland, when the anterior pituitary gland secretes a thyroid stimulating hormone (Silbergeld, 2011). Target organ toxicity is when a toxins adverse effects or disease states manifest in specific organs in the body. The higher the cardiac output, the higher the exposure. Organs each have specialized tissues and cells with differentiated cellular processes and receptors while some toxicants and metabolites may have specific reactive pathways. As pointed out previously, toxicants do not always affect all organs to the same extent. There could be several sites of action and target organs for a particular toxicant. The same organ could be targeted by more than one toxicant. The target organ may not even be where the toxicant is stored. The degree of toxic concentrations in target organs is determined by the toxicokinetic processes (Silbergeld, 2011). One of the most important organs in the body is the liver. The liver plays a key role when it comes to detoxifying foreign substances or...
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...systemic effects is the central nervous system followed by skin, blood circulation system, liver, lungs and kidneys. Muscle and bones as well as the male and female reproductive systems often suffer debilitating impacts from many substances. Target organs can also refer to an organ is targeted to receive a therapeutic dose of irradiation. An example would be beaming gamma rays to the renal area of a kidney for the treatment of a tumor. Another example of a target organ is the thyroid gland, when the anterior pituitary gland secretes a thyroid stimulating hormone (Silbergeld, 2011). Target organ toxicity is when a toxins adverse effects or disease states manifest in specific organs in the body. The higher the cardiac output, the higher the exposure. Organs each have specialized tissues and cells with differentiated cellular processes and receptors while some toxicants and metabolites may have specific reactive pathways. As pointed out previously, toxicants do not always affect all organs to the same extent. There could be several sites of action and target organs for a particular toxicant. The same organ could be targeted by more than one toxicant. The target organ may not even be where the toxicant is stored. The degree of toxic concentrations in target organs is determined by the toxicokinetic processes (Silbergeld, 2011). One of the most important organs in the body is the liver. The liver plays a key role when it comes to detoxifying foreign substances or toxins. Through...
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...The Liver Section A: Describe the cause and effect of alcohol toxicity on the structure and function of the liver. The liver is the largest internal organ and the largest gland in the body. Glands produce hormones that other parts of the body use to function. The liver is divided into two major sections; the right side is bigger while the left is smaller. Sixty percent of the liver is made up of liver cells called hepatocytes; these cells take in nutrients, destroy and remove harmful substances from the blood. The liver is important for survival, it has many functions, and according to the British Liver Trust (2007) it has over five hundred functions. Here is a brief summary of some of the functions of the liver. It processes digested food from the intestine, it controls the levels of fats, amino acids and glucose in the blood, fights infections, produces bile, breaks down food and turns it into energy as well as produces quick energy. It produces, breaks down and controls most hormones in the body, it also makes enzymes and proteins, and these are responsible for most chemical reactions in the body, British Liver Trust (2007). There are many conditions that can affect the functions of the liver. One of these is alcohol abuse. Alcohol is developed from the fermentation of sugar by yeast. It is a drug. The liver cannot store alcohol so it breaks down the alcohol into water, carbon dioxide and fat, then processes about ninety percent of the alcohol and removes around five...
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...The gallbladder can be best described as a small pear shaped organ, roughly 3 to 4 inches long and about 1 inch wide), that is connected to the liver by the hepatic duct. The gall bladder stores and concentrates bile. The primary function of the gallbladder is to store bile and concentrate. Bile is a digestive liquid that is secreted by the liver continually. The bile neutralizes acids in partly digested food and it also emulsifies fats. The bile flows from the gallbladder into the cystic duct when the muscular valve in the common bile duct opens. It then falls from the gallbladder into the cystic duct, along the common bile duct, and into the duodenum, which is part of the small intestine. Gallstones are small, pebble like substances that develop in the gallbladder. Gallstones are created when liquid that is stored in the gallbladder hardens into pieces of rock like material. Gallstones can interrupt the normal flow of bile if they move from the gallbladder and settle in any of the ducts that carry bile from the liver to the small intestine. Gallstones are usually discovered during tests for other health issues. Gallstones attacks are very similar to those of heart attacks, appendicitis, ulcers, irritable bowel syndrome, hiatel hernia, pancreatitis, or hepatitis. This is why an accurate diagnosis is very important, and if the physician suspects that the cause of the patient’s complaints to be gallstones they are most likely to order an ultrasound examination...
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