Example of antecedents from pregnancy and triggers from foods
Listens by first asking him how he believed his condition should be treated and what he believed would help his condition hears about spirituality or religious beliefs. explains to him that religious participation alone was not adequate to protect him from cardiovascular events in the future, citing the most recent evidencethe literature demonstrates a positive link between religious behaviours among teens and positive health behaviours, including abstinence from alcohol, drugs, and later sexual debut. The physician congratulates Pt on not smoking and being motivated to stay healthy. She expresses understanding of his perspective and acknowledges the culture of food as a "social glue" in Pt’s belief system. She then recommends that Pt and his wife consider some alternative ingredients for their cooking recipes to incorporate heart-healthy components.negotiateswith Pt to add family activities around Sunday church attendance that involves brisk walking. Aks if Pt is willing to start a heart-healthy social interest group at his church to encourage others to attend to their lifestyle goals, including weight loss. Offers to be a future speaker at such a group. Pt is delighted and agrees to pursue the idea.
The x shape is not only attractive to us, but has become so partly due to evolutionary defences that we have learned to associate this shape with increased longevity – albeit not a universal approach.
I said to the Gym instructor: “Can you teach me to do the splits?” He said: “How flexible are you?” I said: “I can't make Tuesdays.”
The diagram shows the way in which triiodothyronine increases cardiac output by affecting tissue oxygen consumption (thermogenesis), vascular resistance, blood volume, cardiac contractility, and heart rateKlein I, Levey GS. The cardiovascular system in thyrotoxicosis. In: Braverman LE, Utiger RD, eds. Werner & Ingbar's the thyroid: a fundamental and clinical text. 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2000:596-604
Experiencing a stressful situation, as perceived by the brain, results in the stimulation of the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic–adrenal–medullary (SAM) axis. The production of adrenocorticotropic hormone by the pituitary gland results in the production of glucocorticoid hormones. The SAM axis can be activated by stimulation of the adrenal medulla to produce the catecholamines adrenaline and noradrenaline, as well as by 'hard-wiring', through sympathetic-nervous-system innervation of lymphoid organs. Leukocytes have receptors for stress hormones that are produced by the pituitary and adrenal glands and can be modulated by the binding of these hormones to their respective receptors. In addition, noradrenaline produced at nerve endings can also modulate immune-cell function by binding its receptor at the surface of cells within lymphoid organs. These interactions are bidirectional in that cytokines produced by immune cells can modulate the activity of the hypothalamus. APC, antigen-presenting cell; IL-1, interleukin-1; NK, natural killer.
Immunoglobulin (Ig)A-mediated retrotransport of luminal antigens. IgA is a protective mucosal immunoglobulin secreted in the intestinal lumen through polymeric IgR (pIgR) in the form of secretory IgA (SIgA). Whereas the major role of SIgA is to contain microbial and food antigens in the intestinal lumen, in some pathological situations, an abnormal retrotransport of SIgA immune complexes can allow bacterial or food antigens entry in the intestinal mucosa, with various outcomes. Indeed, SIgA can mediate the intestinal entry of SIgA/Shigella flexneri immune complexes through M cells and interact with dendritic cells, inducing an inflammatory response aimed at improving bacterial clearance and the restoration of intestinal homeostasis. In celiac disease, however, SIgA allows the protected transcytosis of gliadin peptides, a mechanism more likely to trigger exacerbated adaptive and innate immune responses in view of the constant flow of gluten in the gut and to precipitate mucosal lesions. Indeed, whereas in healthy individuals, undigested gliadin peptides are taken up by nonspecific endocytosis in enterocytes and entirely degraded/detoxified during transepithelial transport, in contrast, in active celiac disease, the ectopic expression of CD71 (the transferrin receptor also known as IgA receptor) at the apical membrane of epithelial cells, favors the retrotransport of IgA immune complexes and inappropriate immune responses.
Products or structural components of the gut microbiota, such as short-chain fatty acids (SCFA) and peptidoglycan (PG), could cross the intestinal epithelium to activate receptors, for example GPR43 and NOD1, of innate immune cells. Moreover, gut microbiota modulate circulating levels of lipopolysaccharides (LPS), possibly contributing to obesity-associated inflammation through TLR4. Vijay-Kumar et al.2 now add another layer of complexity to this picture by showing that, in the absence of TLR5, the crosstalk between the innate immune system and the gut microbiota alters the specific composition of the microbiota, which in turn contributes to inflammation by signalling back to the innate immune system through as-yet-unidentified pattern-recognition receptors (PRRs) or another cascade, resulting in metabolic syndrome.
Atherosclerosis is the most common pathological process leadingto cardiovascular disease. The development of endothelial dysfunction,the earliest stage of atherosclerosis, involves genetic andhaemodynamic factors as well as other acquired and modifiablerisk factors, including smoking, hypercholesterolaemia, diabetesmellitus and hypertension. In addition, it has become clearthat innate and adaptive immune systems are involved in theinitiation and progression of atherogenesis
Forcing through opinion even when the evidence is against you should not put you off questioning and researching to find out the truths.
If you think our general medicines approach to health care is criminal join me in trying to change the situation by visiting ....