health and disease

Ashley-ann Cooper Tue Mar 08 21:56:10 PST 2016

factors ensuring health
proper shelter, nutrition, exercise, adequate sleep, adequate rest, good hygiene, access to medical and
dental care
health
a state of complete mental, physical and social well-being. a person with good health has good physical
feeling, is able to adjust in society, and is able to undertake daily mental and physical tasks without great
difficulty.
disease
a disorder or malfunction of the body which results in a departure from good health
acute vs chronic
if symptoms appear quickly and suddenly, causing rapid changes then the disease is acuteif the
symptoms appear gradually over time, causing timely changes which last for a long time, the disease is
chronic
list the categories of disease
1. physical2. infectious3. non-infectious4. inherited5. deficiency6. degenerative7. social8. self-inflicted9.
mental
physical disease
a physical disease is one that involves some kind of damage to part or parts of the body. this includes all
diseases except those mental illnesses which have not yet been linked to any physical brain abnormalities
infectious disease
infectious diseases are caused by pathogens - other organisms that enter the body and reproduce there -
such as viruses, bacteria, fungi, and protoctists. they can be passed between persons and/or between
animals and people.
list the ways infectious diseases can be transmitted
airborne: pathogens are carried by droplets in the air or on dust eg. the fluwaterborne: pathogens are
carried by water that is contaminated by faeces eg. cholerafood borne: pathogens contaminate food as a
result of contact with faeces or human carriers by flies or rodents eg. typhoidinsect borne: pathogens
carried by insects eg. malariasexually transmitted: pathogens pass from person to person as a result of
sexual intercourse eg. herpesdirect contact: pathogens are spread by skin contact or saliva eg. chicken
pox
inherited disease
an inherited or genetic disease is one which results from the combination of alleles a person inherits from
their parents. they can result from genetic mutations (the sequence of bases in the DNA changes due to
substitution, deletion, inversion or insertion of nucleotides eg. sickle cell) or chromosomal mutations
(change in chromosome number eg. Down's syndrome, or change in chromosome structure eg. fragile X
syndrome).
deficiency disease
a deficiency disease is one that results from a lack of a certain nutrient in the diet e.g. lack of vitamin C
can lead to scurvy
degenerative diease
degenerative diseases are caused by a progressive destruction of specialized cells, resulting in a loss in
function in one or several tissues or organs. deficiency of nutrients can prevent the development of
tissues in childhood, resulting in degenerative diseases later in life. the 3 major types of degenerative
diseases are diseases of the skeletal, muscular and nervous systems (eg. arthritis), cardiovascular
diseases/CVDs (eg stroke) and cancers.
cardiovascular diseases
these affect the circulatory system and are caused by a gradual deterioration of the heart and blood
vessel tissues. when arteries lose their elasticity and become hardened, this is called arteriosclerosis and
can cause blood clotting. the blood clot is called a thrombus and can prevent blood flow to surrounding
tissues, resulting in death. coronary heart disease is a disease of the arteries that supply blood to the
heart muscles, resulting in malfunctioning of the heart. if blood flow to the brain is interrupted by clots or if
a blood vessel bursts, leaking blood into the brain, a stroke develops.
mental disease
a mental disease is one that affects the mind and may or may not be due to the degeneration of the brain
or change sin the structure or function of a particular part of the brain. the 2 groups of mental diseases
are neuroses and psychoses. neuroses and mild disorders not associated with physical malfunction of the
brain (eg. anxiety disorders) and psychoses are severe disorders which affect a persons ability to function
normally; psychoses are associated with physical damage or malfunction of the neurotransmitters in the
brain (eg. bipolar disorder)
social diseases
social diseases are ones that are strongly associated with the social setting in which a person spends
their life. social factors such as physical environment, sanitation, standards of housing, pollution, access
to recreational facilities, types of occupation etc. can redispose people to certain diseases (eg. unhygienic
conditions leading to infectious disease)
self inflicted disease
self inflicted diseases are those that can be considered to have been caused by a persons own lifestyle
choices (eg. smoking from a young age increases the risk of developing chronic bronchitis, emphysema,
heart disease, lung cancer, hypertension and gangrene)
incidence
the number of new cases of a disease that arise within a population in a given time period, usually a year
prevalence
the total number of persons within a population with a particular disease at a specific time
mortality
the number of persons that die from a disease each year
cancer
cancer is a disease in which the normal control of cell division breaks down. the timing of mitosis is
controlled by a number of different genes within a cell. if these genes are altered then the cell may begin
to divide uncontrollably. these continuously dividing cells may eventually form a lump called a tumour. the
continuous division of cells places a huge demand on the body, as the rapid division of cells requires
nutrients.
benign vs cancerous tumours
if the tumour stays in one place and does not grow too much, it may not be harmful and s said to be
benign. benign tumours can however cause compression or displacement of surrounding tissues, eg.
ovarian cysts. if the tumour invades tissues around it or spreads around the body, this is dangerous and it
is a cancer.
secondary growth & metastasis
if cells break off and spread to other parts of the body by blood or lymph it is called secondary growth;
when cancer spreads this way it is described as metastasis. secondary cancers are most dangerous
because they cannot be found and removed. tumours may grow and block intestines, lungs or blood
vessels.
classifications of cancer
sarcoma: malignant tumour of non-epithelial (connective) tissue (eg. bone cancer) melanoma: tumour of
melanin forming cells (eg. skin cancer) lymphoma: cancer of lymph nodes; this affects the immune
system. papilloma: small growth derived from epidermis. most times they are benign, carcinoma: cancer
arising in the epithelial tissue of the skin or the lining of internal organs (eg. breast cancer)
what causes cancer?
our cells contain many genes which regulate cell division; some of these genes called proto-oncogenes
can mutate to form oncogenes. oncogenes can cause cancer bc they allow the cell to divide
uncontrollably. cells also contain repressor genes which normally inhibit cell division. they can mutate so
that they lose their function, thereby allowing uncontrollable division to take place. several mutations are
usually needed before cancer develops. some alleles of the genes are more susceptible to mutations and
so some persons are at greater risk of developing cancer. mutated cells are usually inoperable and die
early or the immune system gets rid of them. cancerous cells seem to escape both fates and form a
tumour.
carcinogens
any mutagen that causes the development of cancer is a carcinogen. these include:
ionizing radiation
ultraviolet light
chemicals
virus infection
hereditary predisposition
weakened immune system
ionizing radiation and cancer
ionizing radiation includes particles from the decay of radioactive elements, x-rays, alpha and beta
radiation. ionizing radiation forms damaging ions that can break DNA strands. cells seem more vulnerable
to ionizing radiation during late interphase.
ultraviolet light and cancer
ultraviolet light is electromagnetic radiation that has wavelengths shorter than what our eyes can detect,
and has less energy than ionizing radiation. consequently, they cannot penetrate the skin but can cause
skin cancer. ultraviolet rays do not form damaging ions, however they can damage DNA strands. early
inerphase is the time when cells are most susceptible to UV radiation.
chemicals and cancer
many different chemicals, including dyes, and food additives like the sweeteners cyclamate and saccharin
are carcinogenic. carcinogens in tobacco smoke are responsible for approx 25% of all cancer deaths in
developed countries. these chemicals damage DNA molecules.
viral infections and cancer
some viruses cause cancer, such as HPV which causes cervical cancer, and viruses which cause some
leukaemias. the HPV that causes cervical cancer carries a code for a protein that interacts with a region
of our DNA coding for a protein called p53. Alteration of p53 causes many cancers.
hereditary predisposition to cancer
some cancers seem to be caused by the inheritance of a single faulty gene, eg. retinoblastoma is caused
by an error on chromosome 13; women with the faulty version of BRCA1 gene have a 60% risk of
developing breast cancer before age 90.
weakened immune systems and cancer
many of our cells are potentially cancerous, but our immune systems normally identify abnormal cells and
destroy them. if a person's immune system is badly impaired then it may not be able to protect from the
development of cancer. eg. a weakened immune system causes the development of Kaposi's sarcoma.

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Health and Disease

Health
can be defined as a person's
physical, mental
and
social
condition.
Good health is more than being free from disease; it is having a positive outlook on life and
feeling good physically. To enjoy good health, a person needs
proper shelter, nutrition,
exercise, sleep and rest. Good hygiene and the access to medical and social care are also
important.
Disease
is a
disorder
or
malfunction
of the
mind
or
body
, which destroys good health.
Disease may have a single cause
-
for example, malaria or be multifactorial, such as heart
disease. Diseases have characteristic symptoms, which may be physical, mental or both. Those
that have a sudden onset with rapid changes, but only last for a short t
ime are called
acute
,
while the effects of
chronic
disease may continue for months or years.
Categories of disease
There are
nine main categories of disease
but some diseases are more difficult to classify and fit into more than
one of them.
Physical
disease
These diseases involve
temporary or permanent damage to the body
and include all the other categories
except mental disease where there is no sign of physical damage to the brain. An example would be
leprosy.
Infectious disease
Pathogens
are organi
sms living in or on our bodies, causing disease. Infectious diseases are caused by pathogens
such as
viruses, bacteria, fungi, protoctists, worms
and
insects
, which can be transmitted from person to
person. This may be via normal social contact
-
for examp
le,
chicken pox
, or via food and water, sexual contact or
an animal bite.
Carriers are people who can transmit the pathogen but do not have the disease symptoms.
Non
-
infectious diseases
These are all diseases, which are
not
caused by pathogens and
cannot
be passed on by physical contact. An
example would be
sickle cell anaemia.
Deficiency diseases
These are
nutritional
diseases caused by an inadequate or unbalanced diet. One or more essential nutrient is
missing or in short supply
-
for example, a shortage
of Vitamin C causes
scurvy.
Inherited diseases
These diseases are caused by
genes
and can therefore be passed from parent to child. They are also sometimes
called
genetic diseases
or
disorders.
In Britain, the most common inherited disease is
cystic
fibrosis
, which is characterised by a build
-
up of sticky
mucus. This makes breathing difficult and can act as a breeding ground for bacteria, so sufferers need daily
physiotherapy to remove the mucus.
It is caused by a recessive faulty allele and so parent
s may be carriers for the disease without having any symptoms.
As yet, genetic diseases may be treated but not cured because we cannot replace the faulty gene (gene therapy).
The
Human Genome Project
involves scientists in many countries and began in 1990.
It aims to:

Determine the sequence of the bases throughout all the DNA in human cells.

Identify the estimated 1000, 000 genes formed by the bases.

Find the location of the genes on the 23 human chromosomes.

Store all this information for research.

Consider the ethical, legal and social issues arising from this information.
The findings have already had a major impact, such as the devising of diagnostic tests to see if parents are carriers
for a particular disease. In the future, drugs that act again
st the faulty gene causing a disease may be developed,
which will have fewer side effects and be more effective.
The replacement of faulty genes or gene therapy may become commonplace.
Many people are concerned about the implications of genetic testing. In
many cases there may be no treatment for a
disease that we can test for. There are also risks of discrimination by employers, insurance companies and others if
they discover an individual has a positive test for a faulty gene.
How reliable will the test b
e?
How will they be made available to the world's poorest nations?
Degenerative diseases
These diseases are characterised by a
gradual loss of function
, in one or several organs or tissues. In old age, this
is often the result of the failure of the
bodies repair mechanisms
-
for example, loss of mobility due to worn joints.
However, degenerative diseases can strike in ones youth or middle age. They may be the result of poor nutrition in
childhood or due to the immune system attacking the bodies, own
cells.
There are three main categories:

Diseases of skeletal, muscular and nervous tissues

-
for example,
osteoarthritis.

Cardiovascular diseases of the circulatory system

-
for example,
coronary heart disease.

Cancers.
Mental disorders
These disorders
affect a person's mind
, but may be accompanied by
physical symptoms.
Emotions, thoughts,
memories and personal and social behaviour can be affected.
Some mental diseases are caused by degeneration of brain tissue
-
for example,
Alzheimer's
-
a progressive
deterioration in memory is followed by a general decline in all mental faculties (dementia). Other mental disorders
seem to be accompanied by changes in the blood flow to the brain
-
for example,
Schizophrenia.
Social diseases
This is a very wide category
that can include almost all infectious diseases and multifactorial diseases, which are
influenced by people's
living conditions
and
their personal behaviour.
For example, deficiency diseases may be
the result of lack of choice of food, due to shortage of m
oney.
Self
-
inflicted diseases
These diseases are caused by damage to a person's health by their
own decisions
and behaviour. Included in this
category would be the choice to
smoke
or
misusing drugs, sunbathing
or eating a
high fat diet.
Deliberate
self
-
harm, such as attempted suicide, could also be placed here although it is often an indication of poor
mental health.
Terms used to describe diseases
An
infectious
disease, which is always present in a
population,
is called
endemic.
An
epidemic
occurs
when a disease suddenly
spreads rapidly
and
affects many people.
If a disease spreads
over a continent or even the world it will be termed
pandemic.
Health Statistics
Epidemiology
is the study of patterns of diseases and the factors affecting its spread.
Incidence, prevalence and mortality for a disease may be determined. Collecting information on
the distribution of disease helps to identify the underlying causes and if it turns out to be
infectious, may point to how it is transmitted.
Other causes such
as the links between smoking and lung cancer may also be determined. The
data on
morbidity
(numbers ill) and
mortality
(numbers who have died) for a disease when
expressed in certain ways enables comparisons across cities or countries to be made.
Statistics
can be used to monitor the effectiveness of health provisions by both governments
and the
World Health Organisation (WHO).
Global patterns of disease
Data collected by
WHO
shows that in developing countries, the main cause of death is infectious diseases, while in
developed countries, very few deaths are caused by pathogens.
The reasons for this is that the incidence of infectious disease is low in developed countries due to
vaccination, good
standards of hygiene and nutrition, and the availability of antibiotics if they do contract one.
Although globally health is improving, there are still many poor people in the world and poverty is responsible for the
highest death rates
in some countries. In the richer countries, degenerative diseases are the biggest killers. This is
mainly due to lifestyles that put people at risk of heart disease and cancers.
Smoking and Disease
Tobacco companies do not declare the ingredients in cigar
ettes, but upon analysis, they contain
over 4000 different chemicals, many of which are toxic.
There are three main ingredients, which damage the
gaseous exchange system
or
the
cardiovascular system.
Chemicals found in cigarettes
Tar
This is a mixture of
aromatic substances, which settles on the
airway linings
and stimulates changes that may lead
to obstructive
lung disease
and
lung cancer.
Carbon monoxide
This gas diffuses across the alveoli into the blood and onto the red blood cells, combining with hae
moglobin to
form
carboxyhaemoglobin.
This stops the haemoglobin from becoming fully saturated and so it carries 5
-
10% less
oxygen.
This places a strain on the heart as the heart muscle receives less oxygen and carbon monoxide can damage directly,
the
linings of arteries.
Nicotine
This drug is absorbed readily into the blood and stimulates the nervous system to reduce the diameter of arterioles
and the adrenal glands to release adrenaline. This
increases heart rate and blood pressure
and
decreases the
b
lood supply
to the extremities
-
for example, the hands and feet.
Another effect is that platelets become stickier which, can lead to an increased risk of
blood clots
forming.
Diseases
Lung disease
Chronic bronchitis
Tar stimulates
goblet cells
and
mucus
glands
to enlarge, producing more mucus. It destroys the
cilia
inhibiting
the cleaning of the airways and mucus (containing dirt, bacteria and viruses) builds up blocking the smallest
bronchioles.
A
smoker's cough
is the attempt to move the mucus but it da
mages the
epithelia
resulting in
scar tissue
, which
narrows the airways and makes breathing difficult.
Infections
like pneumonia may further inflame the linings resulting in a very severe cough and large quantities of
phlegm.
Emphysema
Due to constant infe
ction,
phagocytes
are attracted to the lungs where they release
elastase
-
an enzyme that
breaks down the
elastin
in the alveoli walls, to enable them to reach the surface where the bacteria are. Without
adequate elastin, the alveoli cannot stretch, so
they recoil and many burst.
Large air spaces appear, reducing the surface area for gas exchange and making sufferers breath more rapidly. As it
progresses, patients become
breathless
and
wheezy
-
they may need a constant supply of oxygen to stay alive.
C
hronic obstructive pulmonary disease
This very disabling disease is the result of
chronic bronchitis and emphysema occurring together
.
Troublesome breathlessness often only occurs once half of the lung tissue has been destroyed, which can only rarely
be
reversed. Britain has the highest death rate from this disease in the world.
Lung cancer
Tar contains
carcinogens,
which react with the DNA in epithelial cells and cause
mutations,
which can lead
to
tumours.
Although it takes twenty to thirty years to devel
op, most growth of the tumour occurs prior to any symptoms, which
include
coughing up blood
due to tissue damage. Once discovered, it's usually well advanced and requires surgery
to remove it, followed up by chemotherapy or radiotherapy.
Links Between
Smoking and Disease
These can be put into two groups:
Epidemiological evidence
looks for patterns in the diseases, which smokers suffer from. It only shows an
association and not a causal link.
Experimental evidence
attempts to prove a causal link.
Chroni
c obstructive pulmonary disease is very rare in non
-
smokers and 90% of deaths from it can be attributed to
smoking. 98% of people with emphysema smoke and 20% of smokers suffer from it. Deaths from pneumonia and
influenza are twice as high among smokers.
L
ung cancer is eighteen times more likely in smokers and one third of all cancer deaths can be attributed to smoking.
25% of smokers die from lung cancer and the risks are higher if they inhale, start young, smoke a large number of
cigarettes a day and smok
e over a long period of time.
The risks of developing lung cancer fall as soon as smoking stops but it takes ten years for the risks to fall to that of
a non
-
smoker.
Experimental evidence includes the development of tumours in animals exposed to smoke and
the identification of
carcinogens in tar. Both lung cancer and chronic obstructive lung disease have been observed in dogs and tar has
caused cancerous growths in the skin of mice.
The cardiovascular system
Cardiovascular
diseases are degenerative diseases of the heart and circulatory system. They are responsible for
50% of deaths in developed countries and are multifactorial
-
smoking being one risk factor.
Atherosclerosis
This is caused by a
build
-
up of fatty material in
artery walls,
which reduces the flow of blood and therefore
oxygen to the tissues. An
atheroma
is a build up of cholesterol, fibres, dead muscle cells and platelets and is more
likely to develop upon damage to the artery wall by high blood pressure, carbon
monoxide or nicotine.
Blood clots (thrombosis)
become more likely and if one develops in the coronary artery a
heart attack
may be
the result, while if it occurs in an artery supplying the brain, a
stroke
may result.
Coronary heart disease
This is a
disease of the
coronary arteries,
which branch from the
aorta,
to supply the heart muscle.
If
atherosclerosis,
of these vessels occurs, then the heart has to work harder and
blood pressure rises.
This makes it
difficult for the heart to receive the extra
nutrients and oxygen it requires during exercise.
Three forms exist:

Angina
is severe chest pains upon exercising caused by a shortage of blood to the heart muscle but causes no death
of heart tissue and stops upon resting.

Heart attacks
occur upon the
blocking of a moderate branch of the coronary artery by a blood clot and cause
starvation and death of heart tissue.

Heart failure
is when the coronary artery starts to block up and results in a gradual weakening of the heart.
Stroke
These occur if an
artery
in the
brain bursts
and
blood leaks
into the brain tissue or when an artery supplying the
brain becomes blocked. The brain tissue becomes starved of oxygen and dies. Strokes can be fatal or very mild and
may
affect speech, memory and control of the
body.
Links between smoking and cardiovascular disease
Smoking
increases the concentration of blood cholesterol,
which is a risk factor, so smokers increase the risk
of having heart disease or a stroke. The risks of developing the disease
increases with ag
e
and
men are more at
risk
than women.
Being
overweight
increases the risk as does eating a
diet high in saturated fat and salt.
Diets with more
antioxidants (vitamins) and soluble fibre
decrease the risk as does taking regular exercise. Having diabetes raises the
risks and high alcohol intake is another contributory factor.
This is a disease associated with affluence and is avoidable by a change in lifestyle.
Treatments involve:

Drugs
to
lower blood pressure, decrease risks of clots, reduce retention of fluids and decrease blood cholesterol.

Coronary by
-
pass
surgery
involves the use of blood vessels from
-
for example, a leg to replace a diseased vessel
and carry blood from the aorta to a
place beyond the blockage.

Heart
transplants
are very expensive and it is difficult to obtain matching tissue from donors.
Better than treatment is obviously prevention.
This can be achieved via education highlighting the risk factors
and by screening for
those most at risk. Unfortunately, bad eating and smoking are hard habits to kick.