Course Evaluation Scheme. Pathology and Nutrition. Texts. Part 1: General Pathology. exclusive use by CSNN Ottawa students. Recommended Resources

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1 Course Evaluation Scheme Pathology and Nutrition Instructor: Andrea Bartels NNCP, RNT Session #1 Quiz #1: (15%) Session 2 (covers session 1) Quiz #2: (15%)Session 4 (on session 2+3) Quiz #3: (15%) Session 6 (on session 4+5) Quiz #4: (15%) Session 8 (on session 6+7) 2 Menus (15 % each = 30%) Problem-Solving Assignment (TBA): 10% Texts Recommended Resources Required: Nutritional Pathology 2 nd ed. -by Brenda Lessard-Rhead, ND for CSNN The Merck Manual of Medical Information Home edition Essentials of Anatomy and Physiology (E. Marieb) Getting Comfortable with Medical Terminology Part 1: General Pathology Important terms to know Etiology = cause of disease Pathogenesis = the path of disease progression, from start to end Morphological changes = structural changes Clinical presentation = signs and symptoms 1

2 Risk Factors vs. Complications Risk Factor = what conditions/habits increase susceptibility to the disease? For ex.: i.e. smoking is a risk factor for lung cancer Complications = what scenarios or pathologies may result from the condition if it is left untreated/unmanaged? For ex.: anemia is a complicationof menorrhagia (heavy/prolonged menstrual periods) Terminology cont d How pathologies are named Tip: cut the word into pieces that sound familiar e.g. dysbiosis:the condition of having an imbalance in the number of healthy and unhealthy gut flora. dys = bad, out of balance bio = living osis = the presence of See Chapter 1 / page 1 for other important terms Disease begins with Cellular Injury Causes of Cellular Injury 1. Toxic (for ex. organic or inorganic poisons) 2. Deficit (for ex. hypothermia, dehydration, nutrient deficiencies) 3. Physical (for ex. electric shock, impact) 4. Infectious (for ex. Virus, bacteria, parasite, yeast, etc.) Disease Starts When Cells Have Become Injured What organisms, chemical imbalances and circumstances have damaged the cell? E.g.: virus, poison, physical trauma, etc. What are the mechanisms or processes that produce the cellular damage? -E.g.: fever, inflammation, oxidative stress, Cell injury may be reversible or irreversible Cellular Adaptations/Changes Atrophy: shrinkage of cells Hypertrophy: enlargement of cells Hyperplasia: increased number of cells Part 2: Immune System Pathologies Dysplasia: deranged maturation of cells, affecting appearance, size and shape of cells Neoplasia: new, abnormal cells forming a tumour (benign or malignant) 2

3 Immune System Anatomy and Physiology: Review Job description: to correctly identify, label, attack and eliminate threats to the physical body Organs, cells and tissues involved in immune defense: Swelling Inflammation: Signs and Symptoms Heat (And sometimes, itching) Redness Pain Functions of Acute Inflammation Seals off area to prevent spread of damage Concentrates wbcs and antibodies to fight the infection/injurious agent Decreases mobility of injured part to prevent further injury Inflammation is protectiveand beneficial as long as it is not chronic or severe Disorders of Immunity under-active immunity infections cancer over-active immunity hypersensitivity auto-immune Under-active immunity---> Infection = Invasion and multiplication of micro-organisms which excites the immune system into attack infectious agents include bacteria, viruses, protozoa, helminths, flukes, nematodes, yeasts, and fungi Infection always creates an inflammatory response but the degree of inflammation depends on the condition of the host Infectious Agent rhinovirus e.g. H1N1 virus candida albicans bacteria HIV virus Pathologies Involving Under-active Immunity Resulting Pathology common cold influenza candidiasis cellulitis AIDS infection results from an inadequate/underfunctioning immune system 3

4 HIV / AIDS Etiology: viral Risk Factors: needle-sharing, sex Pathogenesis: HIV infection leads to progressive degeneration of the immune system by reduction in T cell count until eventually complications kill the victim. Complications: systemic candidiasis, cancer, etc. Exercise: Common Cold Etiology: Clinical Aspect: Risk Factors: Pathogenesis: Complications: Under-activity ---> Cancer Cancer: is characterized by a group of abnormal cells which replicate unchecked by the immune system and compete with the body for nourishment Cancerous tumours consist of malignant cells that by definition of their behaviour are life-threatening Cancer cont d Requirements for Cancer Development: cellular injury in which DNA is injured an inadequate, under-active immune system Cancer Prevention and Management Emphasis on alkalizing diet Vegetable based Reduced starch and sugars Organic foods, esp. animal products Fermented foods Brassica vegetables Spices: turmeric, garlic Tea: green tea with measured levels of EGCG Supplements Be very careful recommending supplements to cancer patients undergoing conventional sick care. Contraindications exist! Work with the attending oncologist or Naturopath. 4

5 Nutritional Protocol #1: Under-active Immune System BUILD and fortify with nutrients: -A, C, E, Se, Zn, D, EFAs, protein BOOST with phyto-chemicals*: -echinacea -astragalus -mushroom extracts (contain beta 1,3 glucan) -panax quinquefolium (a ginseng) -cat s claw *limit to 10 days in a row, then break and repeat. Under-active Immune Protocol cont d USE anti-microbial agents if infection is present: -garlic, oil of oregano, grapefruit seed extract, etc. Restore/maintain gut flora in form of probiotics Minimize all types of stress Under-Active Immune Protocol cont d Reduce non-nutrients: Sugar, caffeine, alcohol, synthetic additives, trans fats Maintain hydration Augment fresh, whole foods Over-active Immune system involves unnecessary or exaggerated inflammatory response symptoms depend on tissue affected Types of Overactivity Allergy and hypersensitivity reactions Auto-immune diseases Chronic Inflammation In response to chronic stressor(s): -dietary -habitual -sport/vocation Chronic stress triggers cortisol production in effort to combat inflammation 5

6 Overactive Immunity Hypersensitivity/Classic Allergy: = inflammatory response to a particular foreign substance when it comes in contact with body tissues Auto-immune Disorders = inflammatory response to a particular type of body tissue or hormone. = incorrect labeling of self as non-self Pathologies Involving Over-active Immunity allergic rhinitis (hayfever) anaphylaxis* multiple sclerosis rheumatoid arthritis eczema systemic lupus erethymatosus (SLE) scleroderma Systemic Lupus Erythematosus Etiology: unknown Pathogenesis: antibodies made against high levels of circulating DNA, forming immune complexes that deposit and cause inflammation in a variety of tissue types including joints, heart, muscle, kidney and skin. Risk factors: female (90% of cases) SLE cont d Clinical presentation Arthritis / arthralgia Anemia Pleurisy (fluid in the lungs) Photosensitivity (eyes, skin sensitive to light) Fever Skin rashes, such as the butterfly rash Hair loss Weight loss Fatigue and weakness Complications of SLE Impaired kidney function Mental illness (depression, anxiety) Thrombosis and other vascular problems Scleroderma Pathogenesis: profuse collagen fibre formation in the dermis, both inside and outside of the body leading to reduced mobility and function of the tissues affected Clinical presentation (in well established cases) Mask-like countenance Spider-like/claw-like hands May co-exist with Raynaud s disease of the blood capillaries of the hands 6

7 Complications of Scleroderma Limited mobility due to joint binding Limited use of hands Dysphagia (difficulty swallowing) Asphyxia (choking) Auto-immunity defined Autoimmunity can be defined as a breakdown of mechanisms responsible for self-tolerance and induction of an immune response against components of the self. Protocol #2: Nutritional Support for Over-active Immunity support organs/tissues affected assume hypersensitivities are present reduce stressors reduce inflammation (SHARP) DO NOT BOOST the immune system Anti-inflammatory diet (avoid common allergens) Emphasize: What to Eat on an Anti-Inflammatory Diet Raw/steamed vegetables EFAs (fish and flax oils, most nuts) Other Basics Organic/wild/lean meats Gluten-free grains Low-sugar fruits (local fruits) legumes Milk products Red meats Eggs Saturated Fats Sugar Gluten Corn Anti-Inflammatory Diet AVOID List Yeast Mushrooms Nightshade vegetables* *removal only necessary in joint disorders Anti-Inflammatory Phytochemicals Curcumin (turmeric) Boswellin (boswellia)* Ginger Devil s claw* Sterols and sterolins (= plant waxes) Omega-3 fatty acids 7

8 About Prescription Anti-Inflammatories Synthetic cortico-steroids: Prednisone, hydrocortisone, Pulmicort, etc. Documented side effects: suppressed immune response water retention / edema (for ex. moon-face ) high blood sugar central obesity skin thinning bone density loss Helping You Study the Pathologies Is it systemic or localized? Is it acute or chronic? Is inflammation involved? Under-activity or over-activity? Is it degenerative? Who is at risk (risk factors)? What happens if left untreated (complications)? Is it a medical emergency? 8