HIV and AIDS

HIV is the human immunodeficiency virus and leads to AIDS, acquired immune deficiency syndrome.

The virus works by destroying the bodies T cells which are used to destroy pathogens. HIV attaches to a protein called CD4 on a T Helper cell. Upon doing so, it then enters the T cell were it converts viral RNA into DNA using an enzyme called reverse transcriptase. The new DNA is then taken into the nucleus of the T cell where it is then inserted and used to produce messenger RNA. The mRNA then utilises the cell’s protein synthesis mechanisms to produce the viral components which are taken to the cell surface and then expelled producing a replica of a virus.

In  using T cells this way, T cells are then unable to stimulate phagocytes, produce memory cells, produce cytotoxic T cells and stimulate B cells to divide. In this way the body becomes unable to protect itself from disease. This eventually  leads to the formation of AIDS. Most sufferers do not die from the HIV or AIDS but instead from secondary diseases such a pneumonia and even the common cold. As the immune system is so weak, it can not even protect itself from even the relatively less dangerous diseases.

HIV is found in body fluid and is transmitted this way. It can be transplanted from, mother to fetus, through sharing needles, blood transfusion and through unsafe sexual intercourse.

Eventually as symptoms worsen it can lead to:

  • weight loss
  • chronic diarrhoea
  • night sweats
  • skin problems
  • recurrent infections
  • serious life-threatening illnesses

Diagnosis in recent times usually involves a blood test which is double checked to confirm whether a person is HIV positive.  Treatment can include:

  • Emergency HIV pills
  • Antiretroviral drugs
  • Post-exposure prophylaxis (PEP)

The aim of the treatment is to reduce the level of HIV in the blood, allow the immune system to repair itself and prevent any HIV-related illnesses.

References:

http://www.nhs.uk/Conditions/HIV/Pages/Treatmentpg.aspx

http://www.medicalnewstoday.com/articles/17131.php?page=3

https://www.aids.gov/hiv-aids-basics/

 

Hyperglycaemia and Hypoglycaemia

Hyperglycaemia is the term  given to high blood sugar, which usually develops over a period of hour or days. Hyperglycaemia can result in a diabetic coma, also known as ketoacidosis.

Recognition:

  • Warm/dry skin
  • Rapid pulse
  • Excessive thirst
  • Drowsiness
  • Frequent urination

Exercising frequently aids the effects of hyperglycaemia.

Hypoglycaemia occurs when blood sugar levels fall below normal. It usually develops if the insulin-sugar balance in the body is incorrect, and is common among those who have recently be diagnosed with diabetes. It can develop following an epileptic seizure.

Recognition:

  • History of diabetes
  • Faitness/hunger
  • Confusion
  • Sweating – cool/clammy skin
  • Palpitations/ muscle tremors

Treatment revolves around attempting to increase glucose levels, usually by drinking fruit juice, fizzy drinks or sweets to raise blood glucose quickly and safely.

References:

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hyperglycemia.html?referrer=https://www.google.co.uk/

http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html

 

Angina and Heart Attack

Angina occurs when coronary arteries that supply the heart muscle with blood become narrowed and cannot carry sufficient blood to the heart and around the body. Most cases of angina are brought about by atherosclerosis, which is where arteries are narrowed due to a build up of fatty deposits and plaque, reducing blood supply.

heart attack occurs when there is an obstruction of the blood supply to part of the heart muscle. There is usually a complete lack of blood supply which can lead to the heart ceasing from beating. Aspirin, a blood thinner, can be used to try to restrict the size of the clot.

As the heart becomes deprived of oxygen and other nutrients carried by the blood, muscle contraction slows down or stops, which can lead to death.

First aiders are trained to treat angina as a heart attack if they are unable to differentiate between the two.

Recognition of angina:

  • Shortness of breath
  • Vice like central pain
  • Tiredness
  • Anxiety
  • Pain that eases with rest

Recognition of heart attack:

  • Persistent vice like central chest pain, which spreads to jaw or arms.
  • Breathlessness
  • Discomfort, like indigestion
  • Faintness/dizziness
  • Sense of impending doom.
  • Ashen skin, blue lips
  • Rapid, weak or irregular pulse
  • Profuse sweating

In first aid, you would usually attempt to treat these symptoms as a heart attack, so after calling an ambulance, easing stress and comforting the casualty is vital. Typically, the casualty would be asked to sit in a W shape, they can be further supported by blankets and pillows. In some cases, the casualty may carry aspirin with them or angina medication, so these would be administered. With most cases of first aid it is vital to record and monitor vital signs as they aid diagnosis and paramedics.

Typically, causes include poor diet which leads to obesity, smoking, high blood pressure, high cholesterol. Those who have suffered an attack usually attempt to live a healthier lifestyle to prevent it from occurring again and many spend their lives taking a variety of medications.

References:

http://www.webmd.com/heart-disease/heart-disease-angina

http://www.nhs.uk/conditions/Angina/Pages/Introduction.aspx

https://www.bhf.org.uk/heart-health/conditions/angina

St John First Aid Manual, 10th Edition.

Chronic Kidney Disease

Kidney disease is usually picked up by blood and urine tests and is when the kidney function deteriorates, which can lead to kidney failure.

Symptoms include:

  • Tiredness
  • Blood in urine
  • Shortness of breath
  • Swollen ankles
  • Weight loss
  • Itchy skin
  • Headaches

Chronic Kidney disease has a variety of causes which include:

  • High Blood pressure
  • High cholesterol
  • Diabetes
  • Kidney infections
  • Glomerulonephritis
  • Long term, regular use of certain medicines

There is no cure for chronic kidney disease, but sufferers can alleviate symptoms by changing their lifestyle, taking medication, undergoing dialysis or having a kidney transplant. The disease can leave sufferers to live a perfectly normal life with very few symptoms or can result in kidney disease. Those with kidney disease are at a higher rate of developing cardiovascular diseases.

 

References:

http://www.nhs.uk/conditions/Kidney-disease-chronic/Pages/Introduction.aspx

http://www.nhs.uk/Conditions/Kidney-disease-chronic/Pages/Symptoms.aspx

http://www.medicinenet.com/kidney_failure/article.htm

Prostate Cancer and MRI Scanning

One of the biggest advances in cancer diagnosis occurred this week, in regards to the detection of prostate cancer using MRI scanning techniques, which eliminates the need for a biopsy. Prostate cancer is the most common type of cancer in men and affects millions of families each year.

The Prostate MRI Imaging Study (Promis), led by researchers at University College London (UCL), also showed that more than a quarter (27%) of all men with suspected cancer could avoid a biopsy altogether.

After the trial on 576 men, results showed that more than a quarter of them could be spared from invasive biopsies that often lead to side effects.  The trial, showed 27% of the men did not need a biopsy at all. 11 British hospitals took part in the trial. 93% of aggressive cancer’s were detected using an MRI compared to only 48% using biopsies.

However overall 40% of results could be interpreted as incorrect as in some cases the MRI shows up and gives an all clear when in fact there is a cancerous element to the prostate.

More extensive testing needs to be done until this type of treatment is used on a wider scale worldwide.

References

http://www.bbc.co.uk/news/health-38665618

http://press.thelancet.com/promisAPPX.pdf

http://www.nhs.uk/news/2017/01January/Pages/MRI-scans-could-spare-25-per-cent-of-men-from-prostate-biopsies.aspx

https://www.theguardian.com/society/2017/jan/19/mri-biopsy-prostate-cancer-diagnosis-research-nhs

Coronary Heart Disease

Coronary heart disease or ischaemic heart disease, is known as a disease of affluence and is one of the top 10 deadliest diseases in the world, at present. 1 in 6 men and 1 in 10 women die from the disease each year, which is over 73,000 deaths in the UK each year.

Coronary heart disease occurs when the blood vessels leading to the heart, become blocked or interrupted by a build up of fatty tissues made of cholesterol and other cellular waste products. This restricts blood flow to the heart, and therefore restricts the amount of oxygen in the blood. This process is known as atherosclerosis. If the deposit ruptures, platelets will clump at the site to repair the artery, this blocks the artery and can lead to a heart attack.

Causes include:

  • Smoking
  • High blood pressure (Hypertension)
  • High cholesterol
  • Diabetes or insulin resistance
  • Sedentary lifestyle

There are also a number of risk factors:

  • As above.
  • Sex, men.
  • Family History
  • Age, over 50s.
  • Being overweight
  • High stress

Coronary heart disease leads to a large number of complications:

  1. Angina, Chest Pain.

The lack of blood flow to the heart results in chest pain and a shortness of breath.

2. Heart Attack

The complete reduction in blood flow to the heart, results in a heart attack as there is a lack of oxygen which affects the heart muscles.

3. Heart Failure

The heart becomes too weak to pump blood due to the reduction of nutrients and oxygen to the heart, as a result of the lack of blood flow.

4. Arrhythmia, Irregular Heart Beat

Inadequate blood supply interferes with the heart’s electrical impulse, causing irregular heart beats.

Treatment of coronary heart disease often involves the use of biological and mechanical stents, which are used to open up arteries and to widen them, to increase blood supply to the heart. This is known as coronary angioplasty. A complete heart transplant can also be used, however it is only used if other treatments are ineffective. By far, the easiest method is to change your lifestyle, by exercising regularly and maintaining a healthy diet.

Coronary artery bypass surgery is also used. A blood vessel is inserted between the aorta and the coronary artery beyond the point where the blockage resides. This means that some of the blood flow is diverted to one of the heart arteries, the blood bypasses the blocked blood vessels.

Medicines used to combat the effects and complications of coronary heart disease include:

  • Anti-platelets which act as blood thinners and reduce the risk of a heart attack.
  • Statins block the formation of cholesterol by increasing the number of LDL receptors in the liver, which aids in the increased removal of cholesterol.
  • Beta Blockers, slow heart beat and improve blood flow.
  • Vasodilators or Nitrates, widen blood vessels.

 

References:

http://www.healthline.com/health/top-10-deadliest-diseases

http://www.nhs.uk/Conditions/Coronary-heart-disease/Pages/Treatment.aspx

http://www.mayoclinic.org/diseases-conditions/coronary-artery-disease/symptoms-causes/dxc-20165314

https://www.bhf.org.uk/heart-health/conditions/coronary-heart-disease