STROKE

Stroke (United Kingdom: stroke, cerebrovascular accident, CVA) is a condition that occurs when the blood supply to a part of the brain is suddenly interrupted. In brain tissue, the lack of blood flow causes a series of biochemical reactions, which can damage or shut down the nerve cells in the brain. The death of brain tissue can lead to loss of function which is controlled by that network. Stroke is the third leading cause of death in the United States and many other industrialized countries in Europe (Jauch, 2005). If it can be saved, sometimes patients experience paralysis of limbs, loss of a portion of memory or the ability of speech. In recent years more and more popular the term brain attack. The term is in accord with the terms that are already widely known, ' heart attack '.

A Stroke occurs because blood vessel branch hampered by emboli. Cholesterol Emboli can be or the air.

Classification

Strokes are divided into two types, ischemic strokes and stroke hemorragik. A prognosis results of a study in Korea stated that, 75,2% ischemic strokes suffered by men with the prevalence of hypertension, smoking and alcohol consumption. Based on the system of the TOAST, the composition is divided into 20.8% 17.4% of LAAS, LAC, 18,1% 16.8% CEI, UDE and 26.8% ODE.

Stroke Hemorragik

In a stroke, blood vessel rupture hemorragik so that impedes normal blood flow and blood seeping into an area in the brain and ruin it. Bleeding can occur in all parts of the brain such as the caudate putamen; talamus; the hippocampus; frontal, parietal, and occipital cortex; the hypothalamus; area suprakiasmatik; cerebellum; pons; and midbrain.Nearly 70 percent of cases of stroke hemorrhagik attack sufferers of hypertension. Stroke hemorragik divided into subtypes of intracerebral bleeding (ICH), subarachnoid space bleeding (legitimate), cerebral venous thrombosis, stroke and spinal cord. ICH is further divided into parenchymal hemorrhagic infarction, bleeding, and punctate bleeding.

In Ischemic Stroke

Ischemic strokes blockage can happen along the blood vessels arteries leading to the brain. Blood to the brain is supplied by two international and two arteria karotis artery of vertebral fracture. This artery-artery is a branch of the aortic arch (arcus aorta), heart failure.

Handling

Acute stroke patients are usually given BC-20302, or microplasmin, oxygen infusions, mounted to enter food substances, liquids and then given manitol or corticosteroid to reduce swelling and pressure on the brain, due to infiltration of white blood cells. A recent study shows that other symptoms of paralysis and could have been prevented or recovered if recombinan tissue plasminogen motivator for (rtPA) or streptokinase that function destroys the emboli are given in a time of 3 hours, [61] after the onset of a stroke. Trombolisis with proven beneficial in the management of rtPA stroke acute, although it can increase the risk of bleeding of the brain, especially in the area of brain blood barrier open.

Some compounds are given in conjunction with the rtPA to reduce risk include batimastat (BB-94) and marimastat (BB-2555), which inhibits the enzyme MMP, the spin trap agent compounds such as α-phenyl-N-t-butylnitrone (PBN) and disodium-[tert-butylimino) methyl] benzene-1,3-N-oxide disulfonate (NXY-059), and the compound of anti-ICAM-1. Method of treatment of hemodilusi with the use of albumin is still controversial, however research by The Amsterdam Stroke Study gives the prognosis in the form of a decrease in the death rate of 27% to 16%, increased self-reliance activities of 35% to 48%, at 3 months since going on the attack of acute stroke.

Recovery

Stroke related to limitations of pulihnya brain function, though the area of fairy-neuroplastik myocardial becomes more acidic, allowing improvements to sensorimotorik functions do the mapping in the area of the brain that is damaged. Cellular level, going on two processes of regeneration in the cortex of the fairies-myocardial, Axon will experience changes in the phenotype of the neurotransmitter into the status of the regenerative, and poked the stem to make a new connection under the influence of trombospondin, laminin, and NGF secretion cells Schwann, results and cell migration occurred into the cortex neuron progenitor peri-myocardial. Almost all 1 month since going on the attack, stroke-fairy area will experience decreased myocardial molecular barrier to growth. In this span of time, neuron will activate genes that stimulate the growth, in the undulating rhythms. Neurogenesis intertwined with angiogenesis is also going on a bumpy beginning with the migration of GFAP expression with neuroblas, which is in a zone subventrikular into the cortex of the fairies-myocardial. This migration is mediated by several compounds, among others, of erythropoietin, stromal-derived factor-1 (SDF-1) and angiopoietin-1, to generate migration neuroblas with mileage and longer time span shorter cytokinesis.

Impaired function of the GABA in ekstrasinaptik absorbent fairies-by myocardial dysfunction occurs due to GABA transporter GAT GAT-3/-4, in the rat, an animal can be recovered by administering benzodiazepina.

Prevention

In humans without risk factors stroke with aged under 65 years, the risk of the occurrence of stroke in 1 year revolves around the figure of 1%. After the mild stroke or TIA, the use of anti-coagulant compounds such as warfarin, a drug used for people with atrial fibrillation, would lower the risk of stroke from 12% to 4% in one year. Whereas the use of anti-platelet compounds such as aspirin, typically on a daily dose of 30 mg or more, will only provide protection with a 10.4% reduction in risk. A combination of aspirin and dipyridamole provide protection even further with a decreased risk of annual be 9.3%.

The best way to prevent the occurrence of stroke is to identify people who are high risk and control risk factors stroke as much as possible, such as smoking, hypertension, and spinal stenosis in the carotid vessels, set a healthy diet and avoid foods that contain bad cholesterol (LDL), and olaraga on a regular basis. Spinal Stenosis is vasodilation effect (edrf) is generally caused by a decrease in the secretion of NO by endothelial cells, the cells can be muted Ascorbic acid that increases the secretion of NO by endothelial cells through cell pathways NO synthase or siklase nitrita be guanilat, reduce and inhibit LDL oxidation of NO in the trajectory of atherosclerosis.

Some health institutions such as the American Heart Association or the American Stroke Association Council, the Council on Cardiovascular Radiology and Intervention provides a guide to prevention starts with careful handling of the various diseases that can be caused by atherosclerosis, the use of a compound of anti-trombotik for kardioembolisme and anti-platelet compounds for cases of non-kardioembolisme, followed by the control of risk factors such as arterial dissection, patent foramina ovale, hiperhomosisteinemia, hypercoagulable states, sickle cell disease; cerebral venous sinus thrombosis; stroke, stroke during pregnancy hormones resulting from the use of post menopause, use of anti-coagulant compounds after the occurrence of cerebral bleeding; hypertension, hypertension, smoking, diabetes, atrial fibrillation, carotid stenosis, Dyslipidemia, obesity, metabolic syndrome, excessive alcohol consumption, excessive consumption of drugs, consumption of drugs, birth control, migraines, enhancement of snoring lipoprotein and phospholipase.

Source: www.wikipedia.com

DIABETICS MELLITUS

Diabetes mellitus, DM (Greece: & amp; # 948; & amp; amp; # 953; & amp; amp; # 945; & amp; amp; # 946; & amp; amp; # 945; & amp; amp; # 943; & amp; amp; # 957; & amp; amp; # 949; & amp; amp; # 953; & amp; amp; # 957;, diaba nein, translucent or shower) (Latin: mellitus, sweetness), also known in Indonesia as the disease of the urinary sugar is a disorder caused by metabolis many factors, with the symptom of chronic hiperglisemia and disorders of the metabolism of carbohydrates, fats and proteins, as a result of:

- deficiency of the hormone insulin secretion, insulin activity, or both.[2] 

- the glucose transporter deficiency.

Various disease, syndrome and symptom can be triggered by diabetes mellitus, among others: ataxia-telangiectasia, Alzheimer 's, Down syndrome, Huntington's disease, mitochondrial disorders, muscular dystrophy, Parkinson's disease, miotonis syndrome, Prader-Willi syndrome, Werner's syndrome, Wolfram [3] leukoaraiosis, dementia, [4] hypothyroidism, hyperthyroidism, hipogonadisme, [5] and others.

Classification

The World Health Organization (WHO) classifies forms of diabetes mellitus and treatments based on symptom: [2] 

Type 1 Diabetes, which include symptom in diabetic to destruction of pancreatic beta cells inside caused or causes autoimmunity, and idiopathic. Diabetes mellitus with pathogenesis is clear, such as cystic fibrosis or mitochondrial deficiency, not included in this classification. 

Type 2 Diabetes, which is caused by a deficiency of insulin secretion, often accompanied by insulin resistance syndrome. 

Type 3 Gestasional, which include Diabetes, gestational impaired glucose tolerance, diabetes mellitus and gestational GIGT, GDM.

and according to clinical stage of pathogenesis, without any consideration being made:

1 Insulin-requiring diabetes for survival, as in the case of C-peptide deficiency.

2 Requiring Insulin for control of diabetes. At this stage, the insulin secretion is insufficient to reach the endogenus symptom normoglicemia, if not accompanied by additional hormones from outside the body. 

3 Not insulin-requiring diabetes.

Fourth grade at the clinical stage classification similar to IDDM (United Kingdom: insulin-dependent diabetes mellitus), were fifth and sixth stages are members of NIDDM classification (United Kingdom: non insulin-dependent diabetes mellitus). IDDM and NIDDM is a classification that is listed in the International Nomenclature of Diseases in 1991 and the tenth revision of the International Classification of Diseases in 1992.

Malnutrion classification-related diabetes mellitus, MRDM, is no longer used because, although the malnutrition can affect the expression of several types of diabetes, until now, has not found evidence that malnutrition or protein deficiency can cause diabetes. MRDM Subtypes; Protein-deficient pancreatic diabetes mellitus, PDPDM, PDPD, PDDM, still considered a form of malnutrition induced by diabetes mellitus and requires further research. While the other subtypes, pancreatic diabetes, Fibrocalculous, classified as a disease of the FCPD pancreatic exocrine fibrocalculous path pancreatopathy that induces diabetes mellitus.

Classification of Impaired Glucose Tolerance, IGT, is now defined as the stage of the defective regulation of glucose, as can be observed in all types of hiperglisemis disorders. But are no longer considered diabetes. 

Classification of Impaired Fasting Glycaemia, IFG, introduced as a medical condition where the ratio of fasting blood sugar is higher than the upper limit range is normally, but still below the ratio defined as the basis for a diagnosis of diabetes.

Type 1 Diabetes Mellitus

Type 1 Diabetes mellitus, diabetic children (United Kingdom: childhood-onset diabetes, juvenile diabetes, insulin-dependent diabetes mellitus, IDDM) is a diabetes that occurs due to a decreased ratio of insulin in the blood circulation due to the loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas. IDDM can be suffered by children as well as adults. 

Up to this point can not be prevented and IDDM cannot be cured, even with diet and exercise. Most people with type 1 diabetes have weight and health good when the disease started he suffered. In addition, the sensitivity and the body's response to insulin generally normal on this type of diabetics, especially at an early stage.

The cause of most of the beta cell loss in diabetes type 1 is a mistake that destroyed the cell reaction Autoimmunity beta pancreas. The reaction can be triggered by Autoimmunity is the presence of infection in the body.

Currently, the only type 1 diabetes can be treated with the use of insulin, with careful monitoring of blood glucose levels through blood testing monitors. The basic treatment of type 1 diabetes, even for the earliest stage though, is the replacement of insulin. Without insulin to ketosis and ketoacidosis, diabetic coma can cause even could lead to death. Emphasis is also given on lifestyle adjustments (diet and exercise). Apart from administering injections in General, it is also possible the granting of insulin through a pump, which allows for the grant of the inputs of insulin 24 hours a day at the rate prescribed dose, dosing is also possible (a bolus) of insulin which is required at the time of eating. As well as possible also for administering insulin through the entries ' and inhaled powder '.

Type 1 diabetes treatment should be continued. The treatment will not affect normal activities if sufficient awareness, proper care, and discipline in the examination and treatment is executed. The average Glucose level for patients with type 1 diabetes should be as close as possible to a normal number (80-120 mg/dl, 4–6 mmol/l).[citation needed?] Some doctors recommend up to 140-150 mg/dl (7-7.5 mmol/l) for those who are troubled with lower numbers, such as ' frequent hypoglycemic events '.[citation needed?] Numbers above 200 mg/dl (11 mmol/l) is often accompanied by a sense of discomfort and pee too often causing dehydration.[citation needed] Numbers above 300 mg/dl (16 mmol/l) usually require treatment as soon as possible and can lead to Ketoacidosis.[citation needed?] Low blood glucose levels, called hipoglisemia, can cause loss of consciousness.

Type 2 Diabetes Mellitus

Diabetes mellitus type 2 (adult-onset of United Kingdom: diabetes, obesity-related diabetes, non-insulin-dependent diabetes mellitus, NIDDM) is a type of diabetes mellitus that occurs is not caused by a ratio of insulin in the blood circulation, but rather is a metabolic disorder caused by mutations in many genes, [6] including those expressing cell dysfunction & amp; # 946 hormone secretion disorders;, insulin, resistance of the cells to insulin [9] caused by dysfunction GLUT10 [8] with the hormone resistin cofactors that causes cell network, especially in the liver become less sensitive to insulin [9] as well as RBP4 that suppress absorption of glucose by muscle striated but increases the secretion of blood sugar by heart.[9] Gene Mutations that often occurs on chromosome 7 which is the most populous chromosomes that are found in humans.[10]

On the expression of SGLT1 NIDDM found on high, [11] and the hormone resistin RBP4 ratio is high, [9] increased metabolic rate glikogenolisis and gluconeogenesis in the liver, [9] decrease in the rate of oxidation and increased the rate of esterification in the heart.[12]

NIDDM can also be induced by Dyslipidemia [13], lipodystrophy, [9] and the insulin resistance syndrome.

In the early stages of the disorder that arises is the reduced sensitivity to insulin, which is characterized by increased levels of insulin in the blood.[citation needed] Hiperglisemia can be coped with diabetes drugs that can increase sensitivity to insulin or reduce the production of glucose from hepar, but getting worse disease, insulin secretion is also reduced, and therapy with insulin is sometimes required.[citation needed?] There are several theories that mention the exact cause and mechanism of the onset of resistance, but the Central obesity predisposition factor known as the occurrence of resistance to insulin, in regard to the expenditure of adipokines (its a hormone) that impair glucose tolerance.[citation needed?] Obesity is found in approximately 90% of patients developed world with diagnosis of diabetes type 2.[citation needed?] Other factors include the brood and family history, although in the last decade has been steadily began to affect teenagers and children.[citation needed?].

Type 2 Diabetes can occur without any symptoms before the results of the diagnosis. Type 2 Diabetes is usually treated with initially, how changes in physical activity (sports), diet (general reduction of the intake of carbohydrates), and through weight reduction. It can restore hormone insulin sensitivity back, even when the load is weight loss/humble, for example, around 5 kg (10 to 15 lb), most especially when it is in the abdominal fat deposit. The next step, if necessary, treatment with oral antidiabetic drugs [[. [As/when/Because] production of the hormone insulin treatment is hindered, initially an oral (often used in combination) can be used to increase the production of the hormone insulin (e.g., sulfonylureas) and set the release/release is not appropriate of glucose by the liver (and insulin hormones retaliation thinning to a certain extent (e.g., metformin), and in fact thinned insulin hormones retaliation (e.g., thiazolidinediones). If this fails, the insulin hormone medicine will be needed to maintain normal or near normal glucose levels. A way of life that orderly about blood glucose checks are recommended in most cases, most notably and need when taking most medications.

A bearer of dipeptidyl peptidase 4 substances called sitagliptin, recently allowed for use as a treatment for diabetes mellitus type 2.[14] such as dipeptidyl peptidase 4 substances brominated, sitagliptin will open up opportunities for the development of tumor cells as well as cancer.[15][16]

A phenotype is typically indicated by a human is a deficiency of NIDDM in oxidative metabolism in the mitochondria [19] on the striated muscles.[18][19] in contrast, tri-iodotironina hormone induces mitochondrial biogenesis, and increasing the synthesis of ATP synthase in complex V, improve the activity of cytochrome c oxidase at complex IV, lower reactive oxygen, reduces oxidative stress, [21] is the hormone melatonin will increase the production of ATP inside mitochondria and increases the activity of the respiratory chain, especially in complex I, III and IV.[9] along with insulin, the hormone is formed the third cycle regulating mitochondrial oxidative phosphorylation in skeletal muscle.[22] on the other hand, metalotionein that inhibits the activity of GSK-3beta will reduce the risk of heart muscle deficiency in diabetics.[23][24][25]

The symptom occurs in NIDDM can be reduced with dramatic, followed by a reduction in body weight, after intestinal bypass surgery. This is known as a result of an increase in the secretion of the hormone inkretin, but experts have not been able to determine whether this method can provide healing for NIDDM with changes in glucose homeostasis.[26] 

In the traditional therapy, flavonoid compounds containing naringin, hesperidin and is known to cause: [27]

- increase in mRNA expression of GLUT4 glukokinase, 

- an increase of the liver tissue and absorbent peroxisome proliferator gamma enhancement

- increased the ratio of plasma hormones insulin and leptin, a protein C [28] 

- decrease in the expression of GLUT2 in liver 

- decrease in the ratio of plasma fatty acid and triglyceride levels in the liver and plasma ratio

- decrease cholesterol levels in the liver, among others by pressing the 3-hydroxy-3-methylglutaryl-coenzyme reductase, and acyl-Coa acyltransferase, cholesterol reduction

- in fatty acid oxidation in the liver and the activity of carnitine palmitoil, among other things by reducing the synthesis of glucose-6-Phosphatase dehydrogenase and phosphatidic fosfohidrolase Glycolysis rate

- increase and/or decrease the rate of gluconeogenesis pathway

Naringin are themselves, lowering of mRNA transcription fosfoenolpiruvat karboksikinase and glucose-6-Phosphatase in the liver. Hesperidin is an organic compound found in many types of fruit are oranges, many found in the fruit of naringin types of wine.

Course: www.wikipedia.com

HEART

Heart (Latin, cor) is a cavity, the cavity of the muscular organ pump blood through the blood vessels by repeated rhythmic contraction. The term cardiac means related to the heart, from the word Greece cardia for the heart. The heart is one of the organs of the human role in the circulatory system.

The Surface of the Heart

The human heart is more or less the size of fists. The heart is a muscle that consists of a single layer of endothelium. The heart is located in the torakik cavity, behind the sternum. The structure of the heart to turn down and slightly to the left. The heart is almost completely enveloped by the lungs, but covered by a double membrane called the pericardium, which is tacked on the diaphragm. The first layer is very closely attached to the heart, while the outer layers are more loose and watery, so as to avoid friction between the organs in the body that occurs due to the constant movement of the pumping of the heart. The heart is kept in place by vessels-blood vessels covering the area of the heart that evenly/flat, as in the base and on the side. Two lines pembelah (formed from the muscle) on the outer layer of the heart wall shows where the separator between the Foyer & amp; the Chamber of the heart.

The Internal Structure of the Heart

Internally, the heart muscle layers are separated by a dividing into two parts, from top to bottom, into two pumps. Both of these pumps since birth has never connected. This hemisphere consists of two cavities separated by the wall of the heart. Then it can be inferred that the heart consists of four cavities, the porch right & amp; the left and right side of booth & amp; left. The walls of the porch are much thinner than the walls of the Chamber because the booth must fight against the gravitational force of the Earth to pump from the bottom up and require greater force to supply large blood circulation, especially vessels aorta, to pump to all parts of the body that has the blood vessels. Each porch and a booth at each of the hemispheres are connected by a heart valve. The valve between the right and the right of the porch room called trikuspidalis valve or valve three-leaved. While the valve is between the left and the left of the porch room called the valve or the valve bikuspidalis mitralis (two-leaf valve).

In the Manner of Work of the Heart

At the time of each heart pulsating space slack off and filled in the blood (called diastol). Then the heart is contracting and pumping blood out of the heart space (called sistol). Second porch loosens and contracts simultaneously, and both Chambers also loosens and contracts simultaneously. The blood ran out of oxygen and contain a lot of carbon dioxide (dirty blood) from the rest of the body flows through the two great vein (vena cava) headed into the right atrium. After right atrial blood filled, it will push blood into the right ventricle through the valve trikuspidalis. Blood from the right ventricle to be pumped through the pulmoner valve to the inside of the arteries pulmonalis leads to the lungs. Blood will flow through a very small vessels (capillaries) that surround the pockets of air in the lungs, absorbing carbon dioxide and releasing oxygen, then piped back into the heart.

The oxygen-rich blood flow within the vein pulmonalis leads to left atrial. Circulation of the right heart, lung and circulation called left atrial blood flowed into the pulmoner because the lungs. Blood in the left atrium to the left ventricle will be encouraged through the mitral valve bikuspidalis valve/, which will pump clean blood is passed through the aortic valve into the aorta (the largest artery in the body). The oxygen-rich blood is circulated throughout the body, except the lungs. and so on.

The Health of the Heart

The heart is one of the most important organs of the body, the heart may be at risk of abnormality in death. Problems in the heart the heart organ failure due to shared is often almost into two parts, viz. heart disease and heart attacks.

Heart Disease

Heart disease is a condition that causes the heart can not do their job properly. These things, among others:

a). Heart muscle is weak. This is a congenital disorder since birth. A weak heart muscle makes sufferers unable to do excessive activity, because the imposition of excessive cardiac performance will cause pain in the chest, and sometimes can cause the body to appear bluish. People with a weak heart muscle is easily collapsed.

b). The existence of a gap between the right and left of the porch, is therefore not completing the formation of a layer that separates between the porch when the patient still inside the content. This causes the blood clean and dirty blood mixed. This disease also makes sufferers unable to perform activities that are heavy, due to heavy activity almost certainly will make the sufferer's body becomes blue and shortness of breath, even though it does not cause pain in the chest. There is also a variation of the disease, the sufferer actually has only one fruit of the porch.

Heart Attack

A heart attack is a condition that causes the heart at all does not work. This condition usually happens spur of the moment, and is often called heart failure. Causes of heart failure are varied, but the main cause is usually terhambatnya blood supply to the heart muscles, veins-veins which normally drain blood to the heart muscles are clogged or hardened, either due to the fat and cholesterol, or due to chemical substances such as excessive use of drugs containing Phenols Propano Alanin (ppa) which many found in medicines such as Decolgen, and nicotine. 

Lately also sudden cardiac arrest is often found when someone is engaging in activities, like attacking some of the top athletes in the world's most famous football club in the middle of the field of football [1]. Usually it is caused by the heart activity exceeds the impositions thresholds, or the lack of warming up before doing sports. Food is also a major cause of heart attacks, especially fast food (junk food). The penelti of McMaster University in Canada, found the results that people who consume a lot of fried foods, salt, and the meat so you have the risk of a heart attack more than 35 percent larger compared to people who consume little or no consumption[2].

Countermeasures

There is no better countermeasures to prevent disease and heart attacks, in addition to a healthy lifestyle (such as wake up more often in the morning, don't often sleep too late at night, and avoid cigarettes and alcoholic beverages), patterns of healthy food (eating fibrous food and multiply bersayur, as well as not too many eating fatty foods and high-berkolesterol), and a regular sport and don't overdo it. However, there are some substances that are believed to be able to zoom out or zoom in on the risk of disease and heart attacks, among others:

- Some researchers suggest that allicin in garlic turns can help maintain heart health. The study showed that the efficacy by allicin, the tension of the blood vessels is reduced 75% [3]. However, some other researchers have also stated that there is no relationship between the garlic with heart health. In a study conducted on smokers-body fat, 90 researchers found that additional European garlic powder for 3 months not show changes in their cholesterol levels or some other sign of heart disease risk [4].

- Studies prove that reducing smoking did not reduce the risk of heart disease. To really reduce the risk of heart disease, someone should really quit smoking [5].

- The discovery published in the Journal of the American College of Cardiology reveals the consumption of supplements of Vitamin C can reduce the risk of heart disease [6].

- Research indicates, subtract salt consumption can reduce the risk of heart disease. The consumption of salt can increase blood pressure. On the experiment of low salt diet reveals the risk of heart disease by 25% and the risk of heart attack by up to 20%. 

- Consumption of food-food that can keep your heart health such as Salmon, tomatoes, olive oil, wheat, almonds, and apples, habatussauda and other herbal remedies.

Notes and References

^ a list of sudden death in the football pitch , pikiran-rakyat.com , taken 2007-08-11

 ^ heart healthy , avoid junk food

 ^ key a secret efficacy of garlic , bbc.com taken 2007-11-08 . 

^ garlic no impact on heart disease taken 2007-11-08 .

^ how to reduce the risk of heart disease , taken 2007-11-08 .

 ^ vitamin c reduce the risk of heart disease in women , indonesian heart foundation , taken 2007-11-08 .

Source : www.wikipedia.com