Nurs6531 Week 1 Case Study

Nurs6531 Week 1 Case Study
Discussion Week Four # 2 NURS6531, N–8 As a provider, one will care for many patients that have different types of anemia. Anemia is not so much
as a disease as a symptom of an underlying issue. Although there can be particular signs and symptoms associated with anemia, the basis of a
diagnosis is from laboratory data. For the purpose of this discussion, I will evaluate a case study and give a differential diagnosis. I will also assess
how patient history, physical exam, and lab reports support my diagnosis. I will explain the pathophysiology of the type of anemia and give causes
and treatment options available. My case study is that of a 28–year–old vegetarian female who presents for a routine physical. The patient has no
complaints... Show more content on Helpwriting.net ...
However, absorption cannot occur in the absence of IF. Once in the circulation B12 binds to a transport protein and is taken to the liver, bone marrow,
and other proliferating cells. Most individuals with normal absorption have no issue acquiring the needed daily amount. The cause of Malabsorption
of both folate and B12 is from lack of IF, gastric surgery, inflammatory bowel disease, celiac disease, and hyperthyroidism (Buttaro, Trybulski, Polgar
Bailey, Sandberg–Cook, 2013). Healthy adults may consider taking supplemental crystalline vitamin B12 (Stabler, 2013). However, treatment is not
necessary for asymptomatic anemia. Deficiency related to IF indicates a need for 1000 mcg of B12 intramuscular injections weekly for eight weeks
and then monthly for life. Treatment for macrocytic anemia resulting from folate insufficiency is 1 mg of folic acid PO daily until the patient achieves
an adequate hemoglobin level and indefinitely if patient has an underlying illness or an inadequate diet (Buttaro, Trybulski, Polgar Bailey,
Sandberg–Cook,
... Get more on HelpWriting.net ...

Celiac Disease
Celiac disease: an often missed diagnosis Commonly referred to as wheat allergy, celiac disease is not an allergic disorder; rather it is actually
intolerance to gluten, a protein in wheat. It is also known as celiac sprue, nontropical sprue and gluten–sensitive enteropathy. Celiac disease occurs in
people who have a genetic susceptibility. It was considered a north European disease initially but now it has a high prevalence in all the continents. In
north– India it affects 1 in 200–300 individuals, similar to its prevalence in Europe. Celiac disease is primarily a digestive condition triggered by
consumption of the protein gluten resulting in an immune reaction in the small intestine, which leads to inability to absorb certain... Show more content
on Helpwriting.net ...
Rye and barley are also prohibited. Thus gluten–free diet consists of maize, rice, rice flour, maize–flour, Soya–flour, besan and a mixture of these
flours. All vegetables, fruits, eggs and all meat products are permitted. Certain shops in big cities market gluten–free biscuits and snacks .Indeed it is
difficult for mothers to plan recipes for school–tiffin for their children. However a consultation with a dietician can easily solve this problem. Apart
from gluten–free diet, which has to be continued life long, patients with celiac disease need supplements like iron, Vitamin B, and calcium. If
adequately treated, patients with celiac disease will lead a healthy and normal

Early Childhood Celiac Disease
independent diagnostic criterion for severe acute malnutrition was necessary. A higher cut–off of 115 mm was recommended as it will identify more
infants and children as having severe acute malnutrition and still have a high specificity of more than 99% over the age range 6–60 months1. Celiac
disease (CD) is an immune–mediated chronic enteropathy triggered by the ingestion of gluten in genetically susceptible individuals. Gluten is a protein
component in wheat, a staple food for most populations in the world, and other cereals (rye and barley)22. The major CD–predisposing genes are
located in the HLA region, namely the HLA–DQ2 and/or DQ8 genotypes found in at least 98% of patients23. The first description of what has been
called celiac disease dates from the first and second centuries A.D. by Aretaeus the Cappadocian (Adams 1856)23.
In 1888, Samuel Gee, having drawn attention to the disorder in a lecture delivered on October 5, 1887, at the Hospital for Sick Children in London,
produced his classic paper, On the Coeliac Affection23,24.
Dr. Gee described celiac disease as follows:
"There is a kind of chronic indigestion which is met with in persons of all ages, yet is especially apt to affect children between one and five years old .
. . Signs of the disease are yielded by the faeces; being loose, not formed, but not watery; ... Show more content on Helpwriting.net ...
Children who suffer from it are not all weak in constitution. Errors in diet may perhaps be a cause, but what error? Why, out of a family of children
all brought up in much the same way, should one alone suffer? To regulate the food is the main part of treatment .The allowance of farinaceous food
must be small; highly starchy food, rice, sago, corn–flour are unfit"25.Despite his great clinical keen insight, Gee was not able to make the final link
between gluten ingestion and celiac disease because he concluded: "Malted food is better, also rusks or bread cut thin and well toasted on both

The Consequences Of Malabsorption Syndrome In...
Research Question: The Consequences of Malabsorption Syndrome in Post–Operative Gastric Bypass Patients
Rationale: Gastric bypass operative procedures are a group of techniques that divides the stomach into a small upper pouch and a much larger lower
pouch, then rearranges the small intestine so that it connects with both. There are a number of techniques to reconnect the intestine, but all lead to a
considerable reduction in the volume of the stomach, also accompanied by an altered physiological response to food. Despite media advertising, these
procedures are major surgeries that are usually only prescribed to treat morbid obesity, type–2 diabetes, serious hypertension or sleep apnea. Typically,
15% of patients have negative complications, and .5% dies within six months of surgery due to post–operative complications (USDHHS, 2009).
The surgery itself, regardless of the technique, typically reduces the stomach by about 90%. When the patient eats even a small amount of food, the
first response is stretching of the wall of the stomach pouch, which then stimulates nerves that tell the brain the stomach is full. The patient feels as if
they ate a large meal with only a tiny amount of food, also teaching the patient to eat slowly and many very small meals. Recent research shows that
changes in food intake are only partially responsible for weight loss, with no real evidence in most patients of significant malabsorption of calories.
Instead, the research shows that the surgery

Celiac Disease Case Study
Treatment. Patients with celiac disease should adhere to a gluten free diet for life. Grains with gluten are wheat, barley and rye. There is a question of
oats; they appear to be tolerated by the majority of patients with celiac disease. Other grains could contaminate oats. Patients should be monitored
closely. Patents should be referred to a dietitian who is knowledgeable about the disease, to receive a nutritional assessment with education on a gluten
free diet. Patients will also need to undergo additional testing for nutrient deficiencies to receive treatment. Some of these deficiencies include but are
not limited to, iron, folic acid, vitamin D, and vitamin B12. Low bone mineral density. (Rubio, Hill, Kelly, Calderwood, & Murray,

Surgical Weight Loss
The Brian Allgood Army Community Hospital (BAACH) is committed to your care. Surgical weight reduction is a major decision and should not be
taken lightly.
2. Surgery and Weight Loss:
Obesity surgery helps you lose weight by changing the way your body digests and absorbs food. Your body digests food to break down what you eat
into small pieces of nutrients. When the pieces are small enough, the cells of your body absorb the nutrients to give you energy.
Normally, digestion and absorption begin in the stomach, continue through the small intestine and end in the large intestine, which digests and absorbs
what it can and eliminates the rest as waste. Obesity surgery involves making changes to the stomach and/or small intestine.
3. There are two main types of obesity surgery;
1) ... Show more content on Helpwriting.net ...
A small stomach pouch is created, and a Y–shaped connection is made to the mid–small intestine (jejunum) for malabsorption. The longer the segment
of small intestine bypassed, the greater the malabsorption and the greater the weight loss.
Surgery time: 1.5–2 hours
Hospital stay: 2–3 days
Recovery time: approximately 3–4 weeks
Expect to lose 60–80% of excess body weight over 12–18 months
4. Possible side effects following bariatric surgery:
Nausea and vomiting
Obstruction of stomach or intestine
Acid reflux or ulcers
Malnutrition
Constipation
Hair loss
Dumping syndrome – in which food moves too quickly through the small intestine and can cause nausea, weakness, sweating, faintness, and sometimes
diarrhea after eating. There can be an inability to eat sweets without severe weakness and sweating.

5. After Surgery:
Lifestyle adjustments – Lifelong use of nutritional supplements such as vitamins, vitamin B12, vitamin D, and calcium may be necessary.
Surgical follow–up: Physical, nutritional, and metabolic counseling are needed to prevent nutritional deficiencies.
6. Point of Contact for this information

Symptoms And Treatment Of Celiac Disease
Celiac disease (CD) is defined as a chronic autoimmune disorder characterized by small intestine mucosal damage in response to the ingestion of
dietary gluten (proteins found in wheat, barley, and rye) in genetically predisposed individuals that improves with strict adherence to a gluten–free diet
(Kelly, et al., 2015; Woodward, 2016; Meyer & Rosenblum, 2016; Isaac, et al. 2016; & Hill, 2016). Ludvigsson, et al. (2013) explain that while
the symptoms of celiac disease have been described in medical literature for over 100 years, it was not until the 1940s that Dutch physician Dicke
made the association of gluten exposure to the symptoms now associated with CD (p. 43). This paper will explore characteristics of the disease, as
well as the current treatments and role of the primary care provider in caring for afflicted children. Etiology According to James (2016) more than
95% of individuals diagnosed with CD express the characteristic HLA DQ2/DQ8 genes, but adds that approximately 30% of all Caucasians do as well
(p. 26). This suggests the existence of an environmental component in addition to the genetic component of the etiology of CD that is not fully
understood. In an individual genetically predisposed to developing CD (those with HLA DQ2/DQ8 and non–HLA genes), the enzyme tissue
transglutaminase modifies ingested gluten and an abnormal T–cell mediated response occurs in response, leading to initiation of an inflammatory
reaction, subsequent intestinal tissue

Essay On Chronic Pancreatitis
Chronic pancreatitis (CP) is a persistent inflammatory state of the pancreas. This disease is characterized by progressive damage to the pancreas that
leads to extensive fibrosis, loss of the lobular morphology, and changes in the arrangement and composition of the islets. This is an irreversible damage
that results in impairment of endocrine and exocrine functions. The incidence of chronic pancreatitis ranges from 3.5 to 10 cases per 10,000. (A.
Catharine Ross, Benjamin Caballero, Robert J. Cousins, Katherine L. Tucker, Thomas R. Ziegler, 2014). Risk factors of chronic pancreatitis are
associated with environment and genetic factors such as alcohol consumption, nicotine–consumption, hereditary factors, nutritional factors, and
immunological... Show more content on Helpwriting.net ...
The nutritional management changes through the different phases.
During the early chronic pancreatitis total abstinence from alcohol and smoking is recommended. Recommendations for macronutrient composition are
30% of calories as fat, and 1 to 1.5 g/kg of protein daily. It should be given frequent nutritionally balanced small meals (4–8 times a day), and a low fat
diet, also it may be required multivitamin– mineral supplement. It is recommended a low fiber diet. High consume of fiber may absorb enzymes and
delay the absorption of nutrients.
Late disease results in a decrease of lipase secretion. Medium chain triglycerides (MCT) may be administrated to the patient if steatorrhea persists
and weight gain is insufficient. MCT are rapidly absorbed via the portal vein, even in the absence of lipase, although doses higher than 50 g / d could
have secondary effects such as production of ketone bodies, cramps, diarrhea, and nausea. Fat soluble vitamins (A, D, E and K), vitamin B12, and
pancreatic enzyme should be

T. A Case Study
T.A. had an electrocardiogram to monitor his heart rhythms in case there are any changes due to his electrolyte imbalance. An electrocardiogram can
detect arrhythmias such as sinus bradycardia, sinus tachycardia, atrial flutter, atrial fibrillation, and other abnormal heart rhythms due to electrolyte
imbalances. Arrhythmias can lead to other complications like myocardial infarction, ventricular fibrillation, or heart failure. To prevent the patient from
developing further complications, the use of an electrocardiogram for T.A. would be appropriate.
A computerized axial tomography, or CT scan, was done to assess the severity of T.A.'s acute kidney injury. Davis's Comprehensive Handbook of
Laboratory Diagnostic Tests with Nursing Implications ... Show more content on Helpwriting.net ...
His abnormal results were: urine protein presence, blood urea nitrogen 37 mg/dL (high), creatinine 1.9 mg/dL (high), chloride level 110 mmol/L
(high), calcium level 8.3 mg/dL (low), total protein 5.6 g/dL (low), and albumin 2.7 g/dL (low). Normal levels of these results are: absence of protein
in urine, blood urea nitrogen 8–21 mg/dL, creatinine 0.61–1.21 mg/dL, chloride level 97–107 mmol/L, calcium level 8.2–10.2 mg/dL, total protein 6–8
g/dL, and albumin 3.4–4.8 g/dL (Bladh et al., 2013). These abnormal lab results can be caused by and related to many

Anti-Gliadin Case Studies
This study was conducted to confirm weather or not gluten sensitivity is a marker in patients with neurological illness. Anti–Gliadin antibodies are
produced to counter react gliadin, a protein commonly found in bread. These antibodies are also an indicator of untreated coeliac disease within some
patients that have been studied. Since neurological dysfunctions are usually directly associated with coeliac disease, the case study was conducted to
show that a gluten intolerance would be common in patients that have a neurological disorder of unknown cause. Data was obtained in patients with
known causes of neurological disorders, unknown causes of neurological disorders and healthy patients to see the difference of anti–gliadin antibody
count in blood samples. The study was conducted by taking samples from 147 ... Show more content on Helpwriting.net ...
Out of the 30 from group 1 that tested positive for antibodies, one patient had a IgA deficiency, another was anemic and one more had low vitamin
B12. All three of the patients tested positive for coeliac disease, however the other 27 patients had no issues with malabsorption. It was also found that
patients with neurological dysfunctions of unknown cause not only had a high frequency of anti–gliadin antibodies, but also had a higher frequency of
individuals who had coeliac disease. The results of antibody screening for group one was significantly higher than that of groups consisting of
neurological dysfunctions of known cause or the healthy control group. Another important aspect of the study was the alternative hypothesis, given that
anti–gliadin antibodies are directly involved in the neuropathological process and are indicators of autoimmune activity with unidentified antibody
presence to be toxic. From the information obtained in the experiment, the hypothesis that gluten sensitivity will be common in patients with
neurological diseases of unknown cause will be

Medical Case Study: Celiac Disease
6.A 35–year–old male presents to the clinic with a long history of gas and flatulence, diarrhea and nausea after consuming milk or dairy products.
Patient has a family history of celiac disease and therefore you advised the patient to be tested for Celiac disease. Which statement is correct regarding
celiac disease testing? A.IgG anti–gliadin antibody is the most sensitive for celiac disease B.IgG gliadin peptide is recommended for initial testing
C.IgA tissue transglutaminase is the most specific for celiac disease D.IgA tissue transglutaminase is recommended for initial testing E.IgA endomysial
antibody is recommended for initial testing Answer: D. Explanation: Answer A is incorrect as IgG anti
–gliadin antibody is not the most sensitive

Genetic And Environmental Factors Of Crohn 's Disease
After researching for hours and viewing so many different diseases, I came across a disease I am familiar with and have actually learned about
during this online course. Crohn's disease which affects millions of people around the world is a type of disease that has had research done on it for
years and with all of the research that has been done, there still has not been a finding on the exact triggers of this disease. First of all, Crohn's disease
usually involves the small intestine and it may lead to nutrient malabsorption. One thing that has been figured out by researchers is, genetic and
environmental factors definitely contribute to the development of Crohn's disease. This disease can really occur in any region of the Gastrointestinal
Tract (GI Tract) but, for most cases it will affect the ileum, and the large intestine. Patients who suffer from Crohn's disease will likely develop Lesions
in different areas in the intestine, and eventually normal tissue separating the affected areas. Inflammation of the intestine can extend deeply into
intestinal tissue and this usually is caused by ulcerations, fistulas, or fissures. Fistulas are normally the main cause out of those three, this is where
abnormal passages between the organs or tissues allow the passage of fluids or secretions. With scar tissue resulting from Fistulas, the tissue eventually
thickens, and this narrows the lumen and it sometimes causes strictures and/or obstructions. We know that having Crohn's disease

Consequences of Malabsorption Syndrome
Malabsorption syndrome: Its consequences and the usefulness of evidence–based practice Gastric bypass surgery has been found to be profoundly
helpful for some morbidly obese individuals who have struggled to reach a healthy weight using the tools of diet and exercise alone. However, the
surgery is a serious undertaking and should not be regarded as a 'quick fix.' One of the most common complications of gastric bypass surgery is
malabsorption syndrome. To some extent, the purpose of the surgery is interrelated with this unpleasant 'side effect.' Through the surgery, "the food
stream is rerouted so that approximately 60% of the small intestine (the primary site for the absorption of nutrients) is bypassed" (Bariatric Surgery,
2013, ASMB). Because food is in contact with the small intestine for a shorter period of time than in normal individuals, fewer nutrients can be used
by the body. On one hand, this has a positive effect in the sense that fewer calories and carbohydrates are available. On the other hand, this also means
that fewer vital nutrients can be extracted to support vital life functions. Patients must often consume nutritional supplements to counteract this effect
of the surgery. Secondly, "by virtue of this food rerouting, there is less mixing with bile and pancreatic enzymes. Contact with bile is necessary for
absorption of fat, and pancreatic enzymes are necessary to break down proteins, fats and complex carbohydrates for absorption. The mixing of

Celiac Disease
Celiac disease: an often missed diagnosis Commonly referred to as wheat allergy, celiac disease is not an allergic disorder; rather it is actually
intolerance to gluten, a protein in wheat. It is also known as celiac sprue, nontropical sprue and gluten–sensitive enteropathy. Celiac disease occurs in
people who have a genetic susceptibility. It was considered a north European disease initially but now it has a high prevalence in all the continents. In
north– India it affects 1 in 200–300 individuals, similar to its prevalence in Europe. Celiac disease is primarily a digestive condition triggered by
consumption of the protein gluten resulting in an immune reaction in the small intestine, which leads to inability to absorb certain... Show more content
on Helpwriting.net ...
In fact half of the adult celiac disease patients coming to PGI do not have any abdominal symptoms. The most common non –gastrointestinal symptom
is iron deficiency anemia followed by weight loss. Celiac disease symptoms can also mimic those of other conditions, such as irritable bowel
syndrome, gastric ulcers, parasite infections, skin disorders or bone disease. Celiac disease may also present itself in less obvious ways, including
irritability or depression, joint pains, muscle cramps, mouth sores, dental and bone disorders (such as osteoporosis), and tingling in the legs and
feet (neuropathy). When to seek medical advice If you notice or experience any of the signs or symptoms common to celiac disease, see your
doctor. If someone in your family is known to have celiac disease, you may need to be tested. Starting the process will help you avoid complications
associated with the disease, such as osteoporosis, anemia and certain types of cancer. Seek medical attention for a child who is pale, irritable, fails to
grow and who has foul smelling stools. Many other conditions can cause these same signs and symptoms, so it's important to talk to your doctor before
trying a gluten–free diet. Left untreated, celiac disease can lead to several complications: п‚§Malnutrition. Untreated celiac disease can lead to
malabsorption, which in turn can lead to malnutrition. This occurs in spite of what appears to be an adequate diet. Because vital nutrients are lost in

Malabsorption Syndrome in Postoperative Gastric Bypass...
Mal–Absorption Syndrome in Post Operative Gastric Bypass Patients Mal–absorption There seem to be an increasing application of Roen–en–Y gastric
bypass today by some surgeons. This is a restrictive procedure that has minimal mal–absorption issues and it makes part of an array of bariatric
surgeries. However, the most commonly used procedure is biliopancreatic diversion or Scopinaro, which have been used for more than two decades
and are popular in with many surgeons more so in the developing countries. This process is intended to inhibit absorption of fat in a bid to trigger
massive weight loss in patients who are morbidly obese. It restricts gastric thereby diverting bile and pancreatic fluids to the distal ileum (Consensus
Development Conference Panel, 1991). This procedure therefore exposes a limited area of small bowel for the absorption of nutrients that need biliary
and pancreatic fluids. The procedure and its variations are still common as indicated above including; biliopancreatic diversion with duodenal switch,
which also result in malabsorption. It is however noted that most patients who undergo this procedure also experience severe protein and fat related
malabsorption problems. Protein deficiency following gastric bypass is caused by patients' limited stomach size as well as intolerance to meat and
related products. According to Stamm (2011), protein supplementation is critical however unclear their effects on the metabolic and hormonal changes
resulting

HUN4446 Study Guide Essay
HUN 4446 Exam 2 Study Guide
Lactose Mal Digestion/ Malabsorption
1. What are the products of lactose digestion? –The products of lactose digestion are glucose and galactose.
2. What is lactase deficiency? –Lactase deficiency is a deficiency in the enzyme that breaks down lactose. The causes of lactase deficiency include
congenital defects, secondary lactase deficiency, and primary (acquired).
3. Define lactose maldigestion, identify the potential etiologies of lactose maldigestion, and describe the metabolic/physiologic effects of lactose
maldigestion. –Lactose Maldigestion: reduced digestion of lactose due to low lactase activity that subsequently results in MALABSORBTION of
lactose; it may be asymptomatic. – The ... Show more content on Helpwriting.net ...
1. Crohn's Disease 2. Ulcerative Colitis
3. Describe the factors that are believed to contribute to the etiology of Crohn's disease. – You need to be genetically susceptible to the disease, and
then something in the environment triggers it. [also, something about microbiota and an inflammatory immune response].
4. Describe the symptoms/ clinical manifestations of Crohn's disease. – Signs and symptoms of Crohn's disease are: в—¦diarrhea, abdominal pain and
tenderness в—¦blood/mucus in the stool (less likely than Ulcerative colitis, though) в—¦tenesmus (strong urge to relieve your bowels) в—¦weight loss
в—¦fever в—¦anorexia в—¦delayed growth in pre–pubescent patients в—¦perianal fistula в—¦в†‘ inflammatory markers: ESR (erythrocyte
sedimentation rate – how fast RBCs fall); C–reactive protein
5. Describe the tests and procedures used to diagnose Crohn's disease. –The tests used to diagnose Crohn's disease include an endoscopy/colonoscopy,
or a capsule endoscopy, where you swallow a little pill that takes pictures. –Small bowel x–ray/ barium enema – CT scan – ASCA (antisaccharomyces
Ab) [tests for yeast antibodies because people with IBD are more susceptible to yeast infections, so they would be more likely to have anto–yeast
antibodies.] –biopsy *There is no single test to detect Crohn's disease
6. What are the potential complications for Crohn's disease? –Potential complications of Crohn's disease are: в—¦obstruction or

Iron Deficiency Anemia From Poor Dietary Intake And Or...
Iron deficiency anemia from poor dietary intake and/ or absorption of iron causes approximately 50% of global anemia. The relationship between
HIV and anemia is not known though at times it is a side effect of some ARVs (Kenyan National Guidelines on Nutrition and HIV/AIDS, 2007).
Persons with HIV who are anemic progress faster to AIDS than those without. 2.4.1 Weight loss and wasting in HIV/AIDS
The relationship between nutrition and HIV/AIDS is best understood by considering the effect of the disease on body size and composition and the
immune system. Body size and composition are used as indicators of protein–energy status, and are commonly expressed in terms of body weight and
height (Piwoz and Preble, 2000).
Wasting syndrome found in adult patients in Africa is the severe nutritional manifestation of the disease. Wasting is usually precede by changes in
appetite, repeated infections, weight fluctuations and subtler changes in body composition, such as changes in lean body mass and body cell mass
(Babameto and Kotler, 1997).
Weight loss and wasting in PLWHA develop as a result of three overlapping processes (Piwoz and Preble, 2000):
a)Reductions in food intake
This may be due to painful sores in the mouth, pharynx, and/or esophagus. Fatigue, depression, changes in mental state, and other psychosocial factors
may also play a role by affecting appetite and interest in food. Economic factors affect food availability and the nutritional quality of the diet. Side

Environmental and Genetic Factors that Causes Celiac Disease
Celiac Disease (CD) is a digestive disease triggered and continued by the ingestion of gluten in the diet. Individuals with celiac disease have an
irreversible intolerance to gluten. Celiac disease is also known as celiac sprue, nontropical sprue, and gluten–sensitive enteropathy. CD is considered an
autoimmune disease. It is activated by eating gluten–containing foods. People who are genetically susceptible can experience varying degrees of lesions
in the small bowel mucosa. The lesions can range from "mild intraepithelial lymphocytosis to severe mononuclear infiltration which can result in total
villous atrophy". (GarcГa–Manzanares,).
People at high risk for developing CD have the human leukocyte antigens (HLA) HLA DQ2 or HLA DQ8 ( Pietzak). That genetic background
combined with exposure to a group of proteins called prolamins can activate CD. The prolamins are gliadin in wheat, secalins in rye, and hordeins in
barley. Gluten in wheat is broken down to the peptide gliadin which causes the reaction. These dietary gliadins trigger the immune system which causes
the typical CD response. (Harris)
Celiac disease is one of the most common genetic diseases and it results from both environmental and genetic factors. CD effects approximately
0.5%–1% of the population in different parts of the world. People with diabetes, Down syndrome, Williams syndrome, Turner syndrome, cystic fibrosis
and autoimmune disorders have a higher risk for development of CD. Individuals related to

Consequences Of Malabsorption Syndrome In Postoperative...
The Consequences of Malabsorption Syndrome in Post Operative Gastric Bypass Patients Literature Review Matrix Part I: PICO Analysis of
Research Topic P: The patient (population) in this particular study is the post operative gastric bypass patient. I: The anticipated intervention
would be to treat malabsorption syndrome in that population. C: The comparison group would be those who do not have the syndrome. O: The
outcome desired would be to successfully treat the malabsorption syndrome. Part II: Search Strategy Step 1: Identify the resources you will utilize,
or utilized, to find articles that pertain to your topic Electronic Databases Research or Professional Organizations Experts in the field to consult
Books, encyclopedias, handbooks Walden Library Journal of Surgical Research John Morton, MD Life After Gastric Bypass ERIC American
Journal of Surgery Denis Halmi, MD Gastric Bypass Surgery Google Scholar Jrnl of Plastic & Reconstructive Srgy. Amir Moazzez, MD Weight
Loss Surgery for Dummies GoPubMed Obesity Surgery Matthew Fitzer, MD Ready, Set, Shrink! HubMed Eplasty Hazem Elariny, MD Exodus
from Obesity Academic Search Journal of the American Society of Bariatric Surgery Osvaldo Anez, MD Is it Worth the Weight? CHBD Urology Dr.
Nilesh Patel Eating Well after Weight Loss Surgery FreeFullPDF Gastro Endoscopy John Cameron I Want to Live JSTOR Jrnl of Gastro Surgery
David Chang Culinary Classics Step

Folate-Deficiency Anemia
FOLATE–DEFICIENCY ANEMIA– (Chapter 28, Module 4) Folate (folic acid) is a B vitamin essential for normal production and synthesis of
DNA and RNA within a maturing erythrocyte (red blood cell). Folate deficiency is the lack of folic acid in the blood which can cause megaloblastic
anemia (Folate–deficiency anemia) in which the red blood cells are abnormally large and the inner contents not completely developed. The absorption
of folate occurs primarily in the upper small intestine and is then circulated through the liver for storage. The daily requirement of 50 to 200 mcg of
Folate per day must be met through dietary intake. This amount that increases for women who are pregnant or lactating in order to meet the additional
demands of the... Show more content on Helpwriting.net ...
Clinical management & Treatment "Evaluation of folate deficiency is based on measurement of serum folate levels and symptoms" (McCance, 2010).
Treatment is determined based on patient age; overall health; medical history; extent of disease; patient tolerance for specific medications, procedures,
or therapies; expectations for course of disease; and patient opinion or preference of treatment. It may include vitamin and mineral supplements, a
change in diet including decreasing or eliminating alcohol intake, medication, and treatment of the causative disease. Once the deficiency is corrected,
typically long–term treatment is unnecessary as long as an appropriate diet is maintained (McCance, 2010). Works Cited Alterations in Erythrocyte
Function. (2010). In K. L. McCance & S. E. Huether (Eds.), Pathophysiology: The biologic basis for disease in adults and children (7th ed., pp. 989).
Mosby. Finke, A., RN, BSN (Ed.). (n.d.). Anemia of Folate Deficiency. Retrieved July 1, 2015, from University of Rochester Medical Center Health
Encyclopedia

Celiac Disease And Celiacs Disease
Celiacs disease (gluten–sensitive enteropathy) is a condition where in some people, gluten cannot be digested and causes an immune response. Gluten
is a protein found in wheat, barley, oats, and rye. In some people who take in and ingest gluten, an enzyme named transglutaminase transforms the
gluten into a chemical that triggers an immune reaction, causing irritation and inflammation of the lining of the small intestine (Wedro, 2016). The
microvilli that make up the inside surface of the intestine are destroyed, causing nutirents to pass without being, like our body needs from our diet.
This can cause damage to other organs in the body due to malabsorption. (Wedro, 2016) Organs that depends the most on nutrients to function properly
consist of the liver, bones and the brain. This is crucial especially in children because malnutrition can lead to abnormal growth and development.
(Wedro, 2016) Celiacs disease can also be known byCoeliac Disease. Roughly 8,000 years after its first appearence, celiacs disease was identified and
named. A Greek physician named Aretaeus of Cappadocia who lived in the first century AD, wrote about "The Coeliac Affection." Also, he called it
"koiliakos" after the Greek word "koelia" meaning abdomen. (Guandalini, 2007) Another 17 centuries passed, and in the early 19th century Dr. Mathew
Baillie, presumably unaware of Aretaeus, published his observations on a chronic diarrheal disorder regarding adults, causing malnutrition and
characterized by a

Lactose Intolerance Syndrome
Module four discussed lactose intolerance and dumping syndrome in great detail, then briefly explained other disorders of the GI tract and
pancreases. Lactose intolerance occurs when the body can no longer efficiently digest lactose result in bloating, cramping, and sever diarrhea. Lactose
is not directly absorbed by the body, so lactase has to break it down into glucose and galactose. The breakdown of lactose occurs in the last part of the
small intestine, but if this does not occur then lactose will move to the colon causing an osmotic effect. The osmotic effect will causes water to diffuse
into the colon through capillaries of the intestinal tissue. Colonic bacteria will start to metabolize lactose, and produce gases such as carbon dioxide,
methane and hydrogen gas. ... Show more content on Helpwriting.net ...
Lactose intolerance can be tested for by measuring the amount of hydrogen gas that is present when the person exhales. Dumping syndrome occurs
when a person has had gastric surgery involving stomach staples or removal of a section of the stomach. Stomach contents are emptied too quickly into
the duodenum, where they mix with pancreatic and intestinal juice which causes rapid digestion of carbohydrates resulting in glucose. There are two
problems that arise from rapid digestion of carbohydrates. The first problem occurs because glucose is absorbed rapidly, which causes a spike
blood glucose levels leading to a rise in insulin, resulting in blood glucose levels to drop; otherwise known as hypoglycemia. The second problem
arises because glucose digestion occurs at a faster rate than absorption, leading to a buildup of glucose in the small intestine. An osmotic effect occurs
where water enters the intestines resulting in sever diarrhea. An abundance of water is lost from the body due to the diarrhea causing a decrease in blood

Small Intestinal Failure
CSBS is a rare, complex clinical disorder of the newborn with extreme mortality rate. This feature is characterized by malabsorption and diarrhea as a
result of shortened small intestine with mean length of 50cm compared to normal length of 190–280 cm (Siebert et al., 1980; Reiquam et al., 1965). In
several cases, colon was affected too (Sabharwal et al., 2003; Sarimurat et al., 1998; Iwai et al., 1985). Malabsorption may develop nutrient
deficiencies. SBS is defined as a condition in which poor growth, fatty stools, malnutrition, abdominal pain and dehydration occurs (Hamilton et al.,
1969). Developmental defect can cause malrotation of the intestine which is always present in these patients. They usually have normal mental ability
(Ordonez et al., 2006; Schalamon et al., 1999). CSBS patients are born with functional or anatomical loss of adequate small bowel length that is a
consequence of surgical resection or congenital disease of an important part of the small intestine (Erez et al., 2001). Behind them, receiving parenteral
nutrition (PN) is required for patients with intestinal failure as a life–saving therapy. Also, it should be continued for the first two years of life (Dorney
et al., 1986; ... Show more content on Helpwriting.net ...
As time passes, length and absorption capacity of small intestine improves causing better absorption of nutrients. In spite of significant efforts to
dealing with the disease, great number of patients die of starvation in early stage of life.
Regarding genetics studies for basis of disease have shown CSBS was frequently observed in consanguine families. In previous studies CLMP and
FLNA were suspected to be involved in the pathogenesis of the recessive and x–linked form of CSBS, respectively (Van der Werf et al., 2012, 2013).
This work have been done in division of medical genetics in Tabriz children's hospital and this study reports the first case of short bowel syndrome in

Barriat Research Paper
Introduction Bariatric is the field of medicine that manages obesity and the disease that accompanies it. Obesity is a chronic disease associated with
the three leading causes of death in the United States: cardiovascular disease, type 2 diabetes mellitus, and cancer. (McCance 1477). Successful
interventions fare needed to help improve obesity, which affects more than one–third (34.9% or 78.6 million) of US adults. (CDC 1). Drug therapy and
bariatric surgery are used as adjuncts to diet and exercise in the treatment for obese patients with a BMI greater than 30. (Burchum 998).
Drug Therapy Drug therapy can promote weight loss by suppressing the appetite, reducing absorption of nutrients, or increasing the metabolic rate.
(Burchum ... Show more content on Helpwriting.net ...
Twenty to thirty percent of patients experience oily rectal leakage, flatulence, fecal urgency, and fatty or oily stools while ten percent may experience
increased defecation. (Burchum 998). Nevertheless, these side effects diminished once the patient learned to restrain from eating high–fat meals whilst
taking the drug. (Bray 3). There have been rare cases of liver damage with symptoms ranging from itching and vomiting to jaundice and anorexia
(Burchum 998–999); however, at a time when 40 million patients in the United States took Orlistat, only one case occurred. (Bray

Final Essay
individual's diet during recovery. Conversely, severe deficiency in relevant nutrients would also decrease resistance to infections. Scientific studies have
proven that nutritional deficiencies decrease immune function and frequently result in severe infections and in certain cases lead to death in children.
In this regard, protein–energy malnutrition and Iron deficiency attract the greatest health concern. Protein–energy malnutrition leads to a reduction in
phagocytic cells, secretory immunoglobulin A antibody response plus number and functions of T–cells. In developing world, protein deficiency in
humans majorly contributes to mortality resulting from infectious diseases (35).
Furthermore, epidemiological studies have revealed that ... Show more content on Helpwriting.net ...
The relationship between HIV/AIDS and nutrition has sparked scientific interest for a number of reasons. First, diet is an essential factor of human
health. Second, there is abundance of scientific evidence associating function of the immune system to nutrition. Third, diet options affords people with
HIVIAIDS the opportunity to have an opinion in their treatment. Documentation shows that CD4+ T–lymphocytes are essential in the origination and
development of acquired immunodeficiency syndrome (AIDS) (39). The advancing immunosuppressive feature of AIDS and its predisposition to
tumors and infectious organisms (Toxoplasma, Haemophilius influenza, Mycobacterium tuberculosis, and Pneumocystis carinii is attributable to a
gradual reduction in CD4+ T–lymphocytes (40). Investigators suggest that the process through which CD4+ cells are destroyed may be linked to
apoptosis, autoimmunity, and replication of human immunodeficiency virus (HIV) infection (39–42).
HIV and AIDS are characterized by the following immunological abnormalities; hypergammaglobulinaemia, impaired killing of intra–cellular
pathogens, decrease in humoral response to primary immunisation, cytotoxicity for virally infected cells, DTH responses, IL–2, IFN–gamma and MAF
production, proliferative response to T and B cell mitogens, decrease in CD4+ count (40).
In an

Bariatric Surgery
Bariatric Surgery is derived from the Greek words "weight" and "treatment". Bariatric Surgeries are major gastrointestinal operations that seal off most
of the stomach to reduce the amount of food one can eat and they rearrange the small intestine to reduce the calories the bodies can absorb. Weight loss
operations fall into three categories. The first category is the Restrictive procedures make the stomach smaller to limit the amount of food intake. The
second category is the Malabsorptive techniques reduce the amount of intestine that comes in contact with food so that the body absorbs fewer calories
and the third category is a combination of the operations that employ both restriction and malabsorption.
There are several different types ... Show more content on Helpwriting.net ...
A circular window is made through the stomach a few inches below the esophagus. A surgical stapler is used to create a small vertical pouch by
putting a row of staples from window toward the esophagus. The pouch is carefully measured at the time of the surgery and will hold about one
tablespoon of solid food. The next step involves a polypropylene band being placed through the window around the outlet of the pouch and it is
secured to itself with stitches. The band controls the size of the outlet and keeps it from stretching. VBG limits the amount of food a patient can eat at
one time. It works solely by restricting the amount a patient can eat, unlike the Roux–en–Y Gastric Bypass. The procedure is performed under general
anesthesia and requires four or five days in the hospital.
The Roux–en–Y Gastric Bypass is the most common Gastric Bypass Surgery. The stomach is made smaller by creating a small pouch at the top of
the stomach using surgical staples or a plastic band. The smaller stomach is connected directly to the middle of the portion of small intestine,
bypassing the rest of the stomach and upper portion of the small intestine. This procedure requires a four to six day stay in the hospital or two to three
days for the laparoscopic procedure. It is possible to return to normal activity three to five weeks after the

Lactase Intolerance
A lot of evidence on lactose intolerance emanating from lactase non–persistence has mainly been observational and anecdotal. Consequently, there is
also the problem of intolerance to A1 beta casein against A2 beta casein that presents almost similar effects to the gastro–intestinal system. The
rationale for this section of the paper is the considerable amount of literature that is linking childhood constipation to milk which, in some case, has
been misinterpreted to be intolerance to lactose while in other cases it has been mistaken as being intolerance to A1 and A2 beta caseins. Jianqin et al
(2016) carried out a study to establish and hence differentiate the impact of A1 casein against A2 casein proteins on gastro–intestinal physiology and...
Show more content on Helpwriting.net ...
The researchers, therefore, concluded that consumption of milk having A1 ОІ–casein was linked to higher gastrointestinal inflammation which was
linked to worse PD3 symptoms and a decrease in speed of cognitive processing. These findings provided insights on the symptoms of lactose
intolerance or lactase non–persistence and the fact that they might also be triggering inflammation. Therefore, it may be advisable that rather than
completely ignoring milk and other dairy products on the basis of lactose intolerance, one can consider consuming milk that only contains A2 type of
beta casein to see if indeed his or her problem is due to lactase non–persistence. Misselwitz et al (2013) also consent that there is no point in totally
excluding people who have reported lactose intolerance from consuming milk and other dairy products. Misselwitz et al (2013), in this study, sought to
establish the most appropriate technique for diagnosing lactose malabsorption and intolerance. According to the researchers, the most notable methods
such as self–reporting and duodenal biopsies are not only invasive, but are also limited by the patchy expression of lactose. The authors present four
main tests used for lactose malabsorption and tolerance and these include the H2–breath test, the lactose tolerance test, and the genetic test of

Case Study Of Osteomalacia
Introduction : Bone at the tissue level undergoes remodeling: it is continuously being resorbed and rebuilt (or formed). A negative balance between
bone resorption and formation, frequently due to excessive resorption, is the basis of many bone diseases. Definition of Osteomalacia : Osteomalacia
is a metabolic bone disease characterized by inadequate mineralization of bone. As a result of faulty mineralization, there is softening and weakening of
the skeleton. (Brunner and Suddarths Textbook of Medical–Surgical Nursin 12th edition) Pathophysiology of Osteomalacia : The major defect in
Osteomalacia is a deficiency of activated vitamin D , which promotes calcium absorption from the gastrointestinal tract and facilitates mineralization of
bone.... Show more content on Helpwriting.net ...
Severe renal insufficiency because result for bone demineralization of bone by increase of phosphate and decrease of calcium , cause of loss of
vitamin D Hyperparathyroidism increased bone resorption Prolong use of anti–seizure medication It cause deficiency of vitamin D Malnutrition
Insufficient vitamin D . Clinical manifestations : Osteomalacia may be asymptomatic and present radiologically as osteopenia. It can also produce
characteristic symptoms, independently of the underlying cause, including diffuse bone and joint pain, muscle weakness, and difficulty walking . Bone
pain and tenderness Muscle weakness Pathologic fracture Difficulty walking and waddling gait in four Skeletal deformities (spinal kyphosis and
bowed legs ) , often compression of vertebrae , shorting patient's trunk Weakness and unsteadiness , presenting risk of falls and fracture Muscle spasms,
cramps, a positive Chvostek's sign, tingling/numbness due to decrease calcium level.. Assessment and diagnostic findings : TestExpected result X–ray
generalized demineralization of bone is

Short Bowel Syndrome Case Study
Short bowel syndrome (SBS) is a heterogeneous, malabsorptive disorder that occurs after an extensive small bowel resection surgery (2). Conditions
of the small bowel which may warrant this type of surgery include Crohn's disease, post–radiation enteritis, ischemia/other vascular issues of the bowel,
malignancy, trauma, tumors, and complications from previous abdominal or gastric bypass surgery (1, 2). Once the bowel has been resected, the
normal processes involved in absorption of nutrients, electrolytes, and fluids are altered (1). A variety of long–term complications related to SBS exists
and is dependent upon which sections of the bowel remain, the amount of remaining bowel, and the functional and structural adaptations that occur
post–surgery... Show more content on Helpwriting.net ...
For example, the jejunum only has the ability to adapt functionally, but the ileum has the ability to adapt functionally and structurally (3). Therefore,
the more ileum remaining after a resection, the better the outcome. The severity of SBS symptoms is largely based on the type of small bowel
resection surgery that has been performed. Three distinct bowel resections are known to result in SBS: jejuno–ileal anastomosis, jejuno–colic
anastomosis, and end–jejunostomy (3). The adverse symptoms created by SBS vary based on the type of resection that has occurred, the phase of
post–resection in which the patient is, and the extent of adaptation of the bowel that occurs. FUNCTIONAL/STRUCTUAL ADAPTATION HERE
–4
STAGES

Bariatric Surgery Essay
Bariatric Surgery Patient care involves many aspects of healthcare and actions. One major intervention is teaching the patient how to follow their diet
after a certain diagnosis or procedure. After a bariatric surgery, diet plays a major role with patients' wellbeing. As nurses we help patients to be
coherent with doctors orders and overall improve their health. Bariatric surgery approach is performed after other medical treatments for loosing
weight have been tried with no success (Nix, 2017). Bariatric surgeries include the adjustable gastric band, gastric bypass, sleeve gastrectomy,
biliopancreatic diversion with duodenal switch. The overall concept of these surgeries is to make the stomach smaller or induce malabsorption. If the
stomach is smaller, less amount of food is being consumed and with malabsorption, most nutrients are not being absorbed (American Society for
Metabolic and Bariatric Surgery, 2018).... Show more content on Helpwriting.net ...
Changes in dietary diet may include a liquid diet for a period of time after surgery. We would slowly move on to pureed foods, and eventually
introduce regular–textured food. Patient should also limit foods high in sugar and refined carbohydrates like pastas, crackers and white breads (Henry,
2016). Due to the alteration of food absorption, nutrients have to prescribed to the patient. The most common prescribed nutrients are: calcium, iron,
vitamin D, and vitamin b 12. Staying active will help the patient to be successful with their surgery. Even though the weight is lost, continuous diet
adherence and exercise is needed. Patient should start slow and gradually increase exercise activity. Exercise should be about 60 minutes per day, 5
days out of the week. If a routine not established for diet and exercise, weight gain can return.

Hereditary Fructose Intolerance: A Case Study
What is hereditary fructose intolerance (HFI)? What happens to the enzyme glycogen phosphorylase in patients who are diagnosed with HFI? Why?
Hereditary Fructose Intolerance (HFI) is a recessive disorder pertaining to those who lack the functional enzyme Aldolase B. It affects the kidneys,
small intestine and the liver (Wong, 2005). Our bodies require the glycolyticenzyme Aldolase B to metabolize fructose–1–phosphate in the liver during
digestion, and without this enzyme it is not possible to do. The consequences of eating honey, fruit and some vegetables that contain fructose result in
the accumulation of fructose–1–phosphate, which then inhibits glycogen phosphorylase (Coffee, 2002). In patients who are diagnosed with HFI, the
enzyme glycogen phosphorylase gets broken down into glucose–6–phosphate which is required to metabolize glycogen into glucose–6 phosphate.
Therefore glucose cannot be released into the blood from the liver. The outcome results in the blood glucose levels drop leading to hypoglycemia.
Sarah is a 30 year old woman who continuously experiences episodes of dizziness and tiredness. At a very young age she was diagnosed with HFI,
given her diagnosis what is ... Show more content on Helpwriting.net ...
Subsequently glycogen cannot be metabolized into glucose–6–phostphate, which results in glucose not being released into the blood from the liver in
order; which ultimately keeps her blood sugar levels stable. The lack of glucose in the blood causes the sugar levels to drop leading to
hypoglycemia. The outcome of low blood glucose levels are dizziness, sweating and weakness. People consume approximately 100g of fructose daily,
so it is understandable for those who suffer with HFI to feel nauseous, dizzy and drained for energy due to the malabsorption of the fructose in their
bodies during digestion (Coffee,

Gastric Bypass Case Study
Gastric surgery is used in the treatment of clinically severe obesity and more than 100000 surgeries are performed in the United States annually. The
two most common surgical procedures are Gastric bypass and gastric banding. There is also gastric sleeve. I learned that "Gastric bypass" is
irreversible and give the best result according to the video. The surgeon constructs a small stomach pouch and creates an outlet directly to the small
intestine. An average patients can lose anywhere from 90–120lbs. As the stomach become smaller the person can feel full with less food, but the
patient may have vitamin deficiency in the long run. In Gastric bypass there is no foreign object in the abdomen or need for adjustment. It's effective,
reliable... Show more content on Helpwriting.net ...
The surgeon use a gastric silicone band to create a small stomach pouch. The size of the opening can be adjusted by inflating or deflating the band. In
this procedure the patient eats slowly and feels less hungry between meals. The average patients can lose 30–60 pounds. The gastric banding procedure
is more flexible, less invasive and safer. It doesn't produce malabsorption. In Gastric Sleeve the surgeon cuts about 15% of the size of the stomach and
remove the excess. This procedure increase weight loos and doesn't produce malabsorption. The average person loses 60–90 pounds of their excess
weight. Patient with this type of surgery tend to be at risk of leakage and heartburn. There is little time of recovery and no need for adjustment. By
making better food choice and eating heathy diet you can prevent obesity. As strategy, all it is all about daily physical activities and lower energy
and food intake. If I had to choose between the three surgeries, I think I would probably choose the Gastric Bypass for the simple reason that it gives
the best result and there is no need for adjustment. I would not have to keep going back for a for more adjustment from time to time which could me
at risk for

Why Do People Become Intolerant To Gluten?
Gluten is a protein that can be naturally found in food, and it can also be added to enhance the gluten content of certain foods for example in bread to
add elasticity, thus making the bread look spongy. Gluten is found in wheat, barley, and rye among others, if we are talking about raw ingredients, but
it can also be found in ready to eat products from the supermarket shelf, and this can even go unnoticed since the FDA does not required for food labels
to mention its gluten content because it is considered a safe ingredient. This protein is the causative of celiac disease, gluten intolerance and/or gluten
insensitivity.
The reason why people become intolerant to gluten is still unknown for the most part. Some studies point to the possibility of inheritance, some others
to the acquisition of it because of external factors that combined can trigger either of both. In an article by Moises Velasquez from the New York
Times, in which he ... Show more content on Helpwriting.net ...
Because the body immune system response to gluten, the body lack of the capacity of breaking up the gluten protein's chemical bonds, therefore, the
inappropriate digestion of it. Gluten reaches the small intestine in still bound proteins, the amino acid chains are still present, thus damaging the villi of
the small intestine and not allowing the absorption of the amino acids. The damage caused by the inappropriately processed gluten also affects the
absorption of other nutrients; therefore it creates a chain reaction of other health issues. On the other hand, with gluten intolerance or sensitivity the
effects are not as serious as with celiac disease. Gluten intolerance does not cause damage to the small intestine as celiac disease does. Although there
is also some malabsorption of nutrients because of the indigestion it causes. Celiac disease and gluten intolerance share symptoms such as diarrhea,
bloating, cramps, and

Introlyte Levels : Case Study
In the current study, a recorded significant decrease in the electrolyte level ( Na , K, ca and cl) among infected lambs as compared to the non infected
ones. In this respect Barkas et al. (2013) attested that the mucosal inflammation of the intestine and the consequential impairment in electrolytes
secretion and absorption often lead to acid, base and electrolyte imbalance which may cause diverse complications in body. So, the recorded change in
the electrolyte balance could be attributed to the intestinal inflammation produced due to the activity Giardia trophozoites, and this may also interpret
the recorded cases of diarrhea which were noticed during the experiment. This aforesaid results came in agreement with other reports... Show more
content on Helpwriting.net ...
In our opinion, this elevation may be created as a result of the increase of nitrogen metabolism in Giardia infection. The high level of MDA among
infected lambs is an indication of the oxidative stress produced in the infected tissues (KД±lД±Г§ 2003) due to Giardia. The decreased activity of the
defense mechanism for protecting the tissues from the damage produced by the free radicals might be one of the reasons of elevation the level of
MDA among infected lambs (references).
As regard, the significant decrease in the level of serum Nitric Oxide among infected lambs was consistent with other report (Ragbetli.,2014). Nitric
oxide formation has been encountered in many parasitic infections including Giardia (Fernandes and Assreuy, 1997; Bayraktar., 2005). It is
considered as only part of an immunopathological series against infection (Nahrevanian, 2009). The low NO level may be credited to the release of
arginine deiminase by Giardia trophozoites which consumes all the local arginine ( precursor of nitric acid formation). Moreover, flavohemoglobins
released by Giardia decrease the levels of NO (Imran 2013).
The malnutrition effect of Gaardia among infected lambs was associated with a low AP level. Since, the hepatobiliary integrity is measured by the
serum AP (Brash et al. 2009), so this low level of AP accuses the indirect negative effect of Gaardia onliver tissues and bile duct

Zollinger-Ellison Syndrome
Zollinger–Ellison syndrome, is known as the gastrinoma syndrome caused by gastrin–secreting tumors of the pancreas, which stimulate maximum acid
secretions and lead to ulcerations. ZES is connected with diarrhea, malabsorption, gastric reflux, severe ulcerations and ulcerations in the duodenum
and the proximal jejunum. There are a few types of ZES that exist in different forms, including benign, sporadic, metastatic, and part of multiple
endocrine neoplasia type 1 (MEN 1). Most gastrinomas are sporadic and sporadic tumors are a cancer that occurs in people who do not have a family
history of that cancer. Sporadic gastrinomas are located at the gastrinoma triangle, which is located in the junction between the cystic and bile duct,
portions of the duodenum, and the pancreas. While solitary tumors can... Show more content on Helpwriting.net ...
The large amounts of acid produced by gastrin lead to gastrointestinal mucosal ulcerations. Also this leads to symptoms of diarrhea and
malabsorption by the stomach. Malabsorption in ZES is caused by mucosal damage, the inactivation of pancreatic enzymes, and the deposit of bile
salts. ZES is sporadic in majority of patients while in certain cases, ZES is associated with MEN 1. MEN 1 is an autosomal dominant condition
categorized by pancreatic tumors, pituitary tumors, and hyperparathyroidism (Perry, 2013). The MEN1 gene is programmed for making a protein
called menin and this protein is a tumor suppressor that is involved in a couple of significant cell functions. Menin may play a role in the replication
of DNA, repair of DNA and regulation of apoptosis. The menin protein can be found in the nucleus of different types of cells and is active in all
stages of growth. In addition, menin can interact with other proteins like transcription factors. Transcription factors bind to areas of DNA and help
control certain genes by turning certain genes on or off. (Yvan,

Papers On Celiac Disease
Celiac disease is an autoimmune disorder that affects approximately 1 in every 141 people. While the actual act in which Celiacs was first discovered
is unknown, it was first mentioned in 250 A.D. Aretaeus of Cappodocia mentioned details of an "unnamed disease" where his patients were
experiencing "koiliakos" or "suffering in the bowls." He wrote: "If the stomach be irretentive of the food and if it pass through undigested and crude,
and nothing ascends into the body, we call such persons coeliacs." Later in 1856, Francis Adams translated the observations from the original Greek to
English, and giving the disease the name "Cleliacs."
Celiac disease affects all people; adults and children. According to studies, Celiac actually has a 4–8 times ... Show more content on Helpwriting.net ...
These symptoms also differ in children and adults. Being more prevalent in children, they can experience symptoms such as abdominal bloating,
chronic diarrhea, vomiting, constipation, weight loss, fatigue, irritability, dental enamel defects, delayed growth and puberty, short stature, ADHD, etc.
Adults, on the other hand, are less likely to experience any digestive symptoms, only one third of adult patients experience diarrhea. As opposed to
digestive symptoms, adults are more likely to experience unexplained iron–deficiency anemia, fatigue, bone/joint pain, arthritis, osteoporosis, liver and
biliary tract disorders, depression or anxiety, peripheral neuropathy, seizures, migraines, missed menstrual periods, infertility or recurrent miscarriages,
canker sores inside the mouth, and dermatitis herpetiformis.
There are three different classifications of celiac disease. There is classical, non–classical, and silent celiac disease. Classical celiac disease patients
have the signs and symptoms of malabsorption, and weight loss/failure to grow in children. Non–classical celiac disease patients have mild
gastrointestinal symptoms, and the signs of malabsorption are not as clear, or the patient might show seemingly unrelated symptoms. Lastly, silent
celiac disease is also known as asymptomatic celiac disease. Patients don't complain of any symptoms, but the body will be taking

Weight Accident Anaplasty Research Paper
Weight accident anaplasty as a endure resort can auspiciously advice acutely ample or adipose humans lose balance weight. There are several altered
types of weight accident surgeries to accept from. Consult your bloom affliction provider to altercate whether or not you accomplish a acceptable
applicant for weight accident surgery, which action would plan best for you and whether accustomed options like Slimirex adeptness be safer and
added effective.
How Does Weight Accident Anaplasty Work?
There are two basal types of weight accident anaplasty that are currently acclimated for weight reduction. Akin procedures plan by abbreviating aliment
intake. Malabsorptive procedures, on the added hand, adapt digestion, and could cause aliment to be ... Show more content on Helpwriting.net ...
It aswell involves the conception of a abdomen pouch, but it is a beyond accessory than one created in a akin weight accident surgery. Biliopancreatic
aberration alters the analysis of the baby civil to alter the acerbity and pancreatic juices so they accommodated the ingested aliment afterpiece to the
average or the end of the baby intestine. Patients address a greater bulk of achievement with this action than with akin weight accident surgery, because
they are able to eat beyond meals. And this anaplasty provides the greatest bulk of malabsorption, it aswell allows for the greatest bulk of weight loss.
But as with akin weight accident surgery, abiding success is abased aloft the patient's adeptness to attach to a dietary, supplement, exercise and
behavioral

Pathophysiology Of Celiac Disease Of Gluten, Wheat,...
PATHOPHYSIOLOGY Celiac disease is an enteropathy mediated by an autoimmune response to gluten, a protein complex found in the endosperm of
wheat, barley, and rye.1 The immune response is triggered by both environmental and genetic factors in individuals susceptible to the disease resulting
in elevated levels of immunoglobulin A (IgA) antibodies to tissue transglutaminase (tTG), duodenal mucosal villi atrophy, and the inability of tight
junctions to properly act as a barrier between the gastrointestinal tract and the systemic portion of the body.1 Environmental Factors Consumption of
gluten is the root cause of the autoimmune response that initiates the cascade of reactions in the body. Gluten proteins can be fractionated into gliadin
and glutenin, which are the environmental factors that trigger the immune response in the small intestine.2 These protein molecule complexes are
normally unable to permeate the intestinal epithelial. However, with celiac disease, the integrity of tight junctions is compromised, allowing the
protein complex to breach the intestinal lining. The regulatory intestinal peptide zonulin is thought to be responsible for the weakened state of tight
junctions.2 Genetic Factors Human leukocyte antigens (HLA) class II genes are recognized as the primary genetic predisposition for celiac disease.3
Patients who are carriers of the HLA–DQ2 allele account for 95% of confirmed celiac disease cases.4 The majority of the remaining population with
the disease are

The Pathophysiology Of Celiac Disease
Celiac disease is a T–cell–mediated, autoimmune, genetic illness that targets the small intestine in which the absorption of nutrients, particularly fats,
is impaired. The disease has been described as "a permanent intolerance to ingested gluten that damages the small intestine, characteristically inducing
crypt hyperplasia and villous atrophy, and typically resolves with removal of gluten from the diet." (AJN 34). Celiac disease appears to be more
prevalent in women than in men. Genetic and immune factors are known to play a role in its development. People that have a family member with
celiac disease and people that have autoimmune disorders are at higher risk to develop celiac disease. This paper outlines the pathophysiology of celiac
disease, discusses signs and symptoms, the four disease types, describes testing, treatment, addresses the differences between gluten–free diet and a diet
containing gluten, the use of dietary supplements, and vitamin D status.
Most absorption of nutrients occurs in the small intestine. The mucosa of the small intestine is arranged in microscopic folds, which in turn contain
even smaller finger–like projections called villi. The cells of the villi are covered with microscopic hairs, microvilli, projecting from the cell
membrane. The folds, villi, and microvilli of the intestinal mucosa provide a huge surface area for nutrient absorption. Cells of the intestines are
specialized to absorb different nutrients. Readily digested nutrients are

Nurs6531 Week 1 Case Study

Recommended

Recommended

More Related Content

Similar to Nurs6531 Week 1 Case Study

Similar to Nurs6531 Week 1 Case Study (17)

More from Diana Walker

More from Diana Walker (20)

Recently uploaded

Recently uploaded (20)

Nurs6531 Week 1 Case Study