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By X. Benito. Transylvania University.

An iron deficiency inhibits Hb synthesis pamelor 25mg anxiety issues, With the aid of heme oxygenase cheap pamelor 25 mg otc anxiety zen, Fe in mucosal leading to hypochromic microcytic anemia: cells cleaves from heme and oxidizes to Fe(III). The Thetriferricformeitherremainsinthemucosa primary causes are: as a ferritin-Fe(III) complex and returns to the! If pH is important since it (a) increases the H+ the iron supply bypasses the intestinal tract (iron in- gradient that drives Fe2+ via DCT1 into the cell jection), the transferrin capacity can be exceeded and (b) frees dietary iron from complexes. The and the resulting quantities of free iron can induce absorption of iron into the bloodstream is iron poisoning. When an B12 vitamin (cobalamins) and folic acid are also iron deficiency exists, aconitase (an iron-regu- required for erythropoiesis (! Deficiencies lating protein) in the cytosol binds with fer- lead to hyperchromic anemia (decreased RCC, ritin-mRNA, thereby inhibiting mucosal fer- increased MCH). As a result, larger quantities intrinsicfactor(requiredforcobalaminresorp- of absorbed Fe(II) can enter the bloodstream. Because of the large apotransferrin, a protein responsible for iron stores available, decreased cobalamin absorp- transport in plasma (! Transferrin tion does not lead to symptoms of deficiency (=apotransferrin loaded with 2Fe(III)), is until many years later, whereas folic acid defi- 90 takenupbyendocytosisintoerythroblastsand ciency leads to symptoms within a few cells of the liver, placenta, etc. Iron intake and metabolism 1 Iron intake 2 Fe absorption Mucosal cells Normal Fe intake: Heme- (duodenum) 10–20 mg/day FeII 5–10 mg/day Heme Fe Fe absorption: Fe2+ FeIII Mucosal 3–15% of FR transferrin Fe intake HCI Fe Fe2+ Ferritin Fe Stomach + H FeIII Lyso- Liver some Cell FeIIIFeIII III turnover Fe Non-absorbed Fe in feces: Normally 85–97% of intake 3 Fe storage and Fe recycling Transferrin Fe Bone marrow Liver Systemic blood Ferritin Hemo-Heme Fe Ferritin Fe pexin Hemo- siderin Hapto- Hemo- globin Hb siderin Fe stores Erythrocytes Already in bone marrow Macrophages in spleen, liver and bone marrow (extravascular) B. Folic acid and vitamin B12 (cobalamins) NADP NADPH +H+ Folic acid Other organs Dihydrofolate 0. The sum of the concentrations of these parti- Viscosity (η) = 1/fluidity = shearing force cles yields a plasma osmolality of 290mOsm/ (τ)/shearing action (γ) [Pa·s]. The most abundant blood rises with increasing hematocrit and cationinplasmaisNa,andthemostabundant+ decreasing flow velocity. Although plasma major organelles and, therefore, are highly de- proteins carry a number of anionic net charges formable. Because of the low viscosity of their ("C),theirosmoticefficacyissmallerbecause contents, the liquid film-like characteristics of the number of particles, not the ionic valency, their membrane, and their high surface/ is the determining factor. The composition of in- twice as high as the viscosity of plasma (ηplasma terstitial fluid therefore differs significantly = 2 RU; water: 1 RU = 0. A completely different RBCs normally have no problem passing compositionisfoundinthecytosol,whereK+is through capillaries or pores in the splenic ves- the prevailing cation, and where phosphates, sels (see p. Blood viscosity is only slightly 378), and they provide a protein reserve in higher than plasma viscosity in arterioles times of protein deficiency. A critical increase in blood viscos- (apolipoproteins), hemoglobin (haptoglobin), itycanoccura)ifbloodflowbecomestooslug- iron (apotransferrin), cortisol (transcortin), gish and/or b) if the fluidity of red cells and cobalamins (transcobalamin). Most decreases due to hyperosmolality (resulting in plasma factors for coagulation and fibrinolysis crenation), cell inclusion, hemoglobin malfor- are also proteins. IgG, the most abundant immuno- dergo aggregation (rouleaux formation), in- globulin (7–15 g/L), can cross the placental creasing the blood viscosity tremendously (up barrier(maternofetaltransmission;"D). This can quickly lead to the cessa- Igconsistsoftwogroup-specific,heavyprotein tion of blood flow in small vessels ("p. Plasmaproteins Albumin Globulins 8 Blood α1 α2 β γ 60% 4% 8% 12% 16% 6 4 Plasma 2 Water 1 0 1 5 10 50 100 500 1000 Vessel inside diameter (µm) Electrophoretic protein fractions C. Ion composition of body fluids Interstitium Cytosol Cations Anions Cations Anions Cl– Proteins– + K+ Na – Inorganic HCO3 phosphate 2+ K+ Na+ HCO – Ca,Mg2+ Proteins,phosphates, 2+ 2+ 3 etc. The specific im- defenses linked with specific (acquired) im- mune system, with its T-killer cells (! C3), responds slowly: viruses, fungi, parasites and foreign (non-self) primary immune response or sensitization. The virus is quickly eliminated, phocytes differentiate into plasma cells that and the disease does not develop a second secrete antigen-specific antibodies (immuno- time. It can be achieved andopsonizeantigensandtoactivatethecom- by vaccinating the individual with a specific plement system (! Passive im- ensure that the respective antigen is specifi- munization can be achieved by administering cally recognized, then eliminated by relatively ready-made Ig (immune serum). Nonspecific Immunity Precursor lymphocytes without an antigen- Lysozyme and complement factors dissolved in binding receptor are preprocessed within the plasma(! These organs cells) and phagocytes, especially neutrophils produce up to 108 monospecific T or B cells, and macrophages that arise from monocytes each of which is directed against a specific an- that migrate into the tissues (!

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Some practitioners say it is superior to eye- wandering sally order pamelor 25 mg amex anxiety symptoms dry lips, creeping charlie generic pamelor 25mg free shipping anxiety 9 year old, and creeping john. It is recommended as a treat- leaves are smooth, and it is a leafy trailing plant. It has small It can also be used as an antiseptic gargle to cure bright yellow flowers that will last all summer if condi- throat infections and is said to be good for quinsy, which tions are right. Looses- Like yellow and purple loosestrife, it is known as a trife has astringent properties, and has been used in the deterrent to vermin and insects when burned. It is said to be useful for the treatment of whooping It may be used as a decoction, ointment, or as a cough when boiled with wine or honey. Preparations Irish folklore The dried herb may be used as an infusion or decoc- tion. It used to be The various species of lysimachia are common to commonly made up into an ointment for the treatment of the British Isles, and are well known to folk medicine. It was be- To make a useful gargle or eyewash, mix half a tea- lieved that its use would discourage bad feeling and dis- spoon of salt into two cups of boiling water, adding 1-2 cord between the inhabitants of a house. The mix- ture should be kept covered if used as an eyewash, to It is an effective antidote to diarrhea and has also avoid contamination. Other medicinal uses include Precautions leucorrhea, tuberculosis, fevers, liver disease, and even Purple loosestrife may be taken up to three times cholera and typhoid. Since the virus can cause cold sores, canker sores, and genital sores, L-lysine supplements increase the ratio Lysimachia tends to have a high tannin content, and of lysine to arginine in the body, curing the outbreak of as such should not be used as a remedy over long periods the virus. Avoiding foods with arginine and eating foods of time, as it may lead to deficiencies in valuable minerals. Interactions Foods containing arginine: Lysimachia is not known for its toxicity, and no • gelatin records of any interaction have been found. It slows the damage Lysine to the eye caused by diabetes, and it may help cure ath- Description erosclerosis. Since it is used to slow the herpes simplex virus, its antiviral properties may help treat chronic fa- Lysine is an amino acid not produced by the body, tigue syndrome, hepatitis, and HIV. It is necessary for tissue repair and growth, and for producing antibodies, enzymes, and hormones. Lysine is Preparations found in other protein sources, such as red meats, chick- L-lysine is best taken as a single supplement and not en, and turkey. Such combina- of lysine; however lysine levels may be low in vegetari- tions are touted as nutritional supplements that build ans and low-fat dieters. Without enough lysine or any more muscle and are often used by athletes and body- other of the eight essential amino acids, the body cannot builders. However, too much protein strains the func- build protein to sustain muscle tissue. The single supplement should be taken on an General use empty stomach because larger amounts of the amino acid can build up in the blood and brain, enhancing its The body only uses L-lysine to build protein. Supplements are best used by individuals amino acid molecules are asymmetrical, each amino acid suffering from a herpes outbreak or by vegetarians and exists as both a right- and left-handed form, distin- low-fat dieters. L-lysine is used to treat the herpes simplex virus, help prevent osteoporosis and cataracts, and boost the im- mune system. Precautions Supplemental combinations of amino acids are not Herpes simplex virus remedy recommended to build muscle. In the 1950s, scientists discovered that foods con- taining certain amino acids could encourage or discour- Some consumers are sensitive or allergic to soy- age the growth of the herpes virus. When added to the beans, a popular food used by vegetarians to replace the herpes virus, the amino acid arginine increases the natural supply of lysine found in many meats. Lysine, on the other hand, suppress- in 2002, researchers announced progress in creating soy- GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 1259 beans that could be tolerated by consumers with those Duke, James A. Emmaus, PA: Rodale sensitivities by shutting off a gene in soybean seeds be- Press, 1997. Odle 1260 GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 M Ma huang see Ephedra have shown that a diet of this type can significantly re- duce the risk of diabetes, heart disease, stroke, and var- Mace see Nutmeg ious cancers. The macrobiotic diet is rich in vitamins, high in dietary fiber, and low in fatty foods.

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It is also possible that generic pamelor 25 mg mastercard anxiety 1 mg, for genetic reasons generic pamelor 25 mg online anxiety symptoms and treatment, some people are simply born with fewer cells in their substan- Substantia nigra—One of the movement control tia nigra than others, and they develop PD as a conse- centers of the brain. Symptoms • In most cases, there is a “masked face,” with little facial expression and decreased eye-blinking. The identifying symptoms of PD include: In addition, a wide range of other symptoms may • Tremors, usually beginning in the hands, often occuring often be seen, some beginning earlier than others: on one side before the other. The classic tremor of PD is called a “pill-rolling tremor,” because the movement • Depression resembles rolling a pill between the thumb and forefin- • Speech changes, including rapid speech without inflec- ger. This across the page (micrographia) may lead to a rapid, shuffling gait (festination) to pre- • Progressive problems with intellectual function vent falling. The diagnosis of Parkinson disease involves a care- ful medical history and a neurological exam to look for Drugs characteristic symptoms. There are no definitive tests for PD, although a variety of lab tests may be done to rule The pharmacological treatment of Parkinson dis- out other causes of symptoms, especially if only some of ease is complex. Tests for other drugs that can be effective, their effectiveness varies causes of parkinsonism may include brain scans, blood with the patient, disease progression, and the length of tests, lumbar puncture, and x rays. Dose-related side effects may preclude using the most effective dose, or require the introduction of a new drug to counteract them. Treatment and management There are five classes of drugs currently used to treat There is no cure for Parkinson disease. L-dopa is a derivative of dopamine, and is converted into Exercise, nutrition, and physical therapy dopamine by the brain. It may be started when symptoms Regular, moderate exercise has been shown to begin, or when they become serious enough to interfere improve motor function without an increase in medica- with work or daily living. Exercise helps maintain range L-dopa therapy usually remains effective for five of motion in stiff muscles, improve circulation, and stim- years or longer. An exercise program designed by a physi- motor fluctuations, including peak-dose “dyskinesias” cal therapist has the best chance of meeting the specific (abnormal movements such as tics, twisting, or restless- needs of the person with PD. A physical therapist may ness), rapid loss of response after dosing (known as the also suggest strategies for balance compensation and “on-off” phenomenon), and unpredictable drug response. In addition, side effects of L- Good nutrition is important to maintenance of gen- dopa include nausea and vomiting, and low blood pres- eral health. A person with PD may lose some interest in sure upon standing (orthostatic hypotension), which can food, especially if depressed, and may have nausea from cause dizziness. These effects usually lessen after several the disease or from medications, especially those known weeks of therapy. Slow movements may make it dif- ENZYME INHIBITORS Dopamine is broken down by ficult to eat quickly, and delayed gastric emptying may several enzyme systems in the brain and elsewhere in the lead to a feeling of fullness without having eaten much. The two most commonly soft foods can reduce the amount of needed chewing, prescribed forms of L-dopa contain a drug to inhibit the and a prokinetic drug such as cisapride (Propulsid) can amino acid decarboxylase (an AADC inhibitor), one type increase the movement of food through the digestive of enzyme that breaks down dopamine. The main drug used to treat PD, L- formulations also aid in prolonging the effective interval dopa, is an amino acid, and is absorbed by the digestive of an L-dopa dose. Limiting inhibitor selegiline may be given as add-on therapy for L- protein, under the direction of the physician or a nutri- dopa. Research indicates selegiline may have a neuropro- tionist, can improve the absorption of L-dopa. Entacapone and tolcapone, two antioxidants used to date have shown promise as a treat- inhibitors of another enzyme system called catechol-O- ment except for selegiline, an MAO-B inhibitor. A large, methyltransferase (COMT), may soon reach the market 886 GALE ENCYCLOPEDIA OF GENETIC DISORDERS as early studies suggest that they effectively treat PD A third procedure, transplant of fetal nigral cells, is symptoms with fewer motor fluctuations and decreased still highly experimental. DOPAMINE AGONISTS Dopamine works by stimulat- ing receptors on the surface of corpus striatum cells. Drugs that also stimulate these cells are called dopamine Alternative treatment agonists, or DAs. DAs may be used before L-dopa ther- Currently, the best treatments for PD involve the use apy, or added on to avoid requirements for higher L-dopa of conventional drugs such as levodopa.

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A third theory is that people of tissues and production of excess mucus in res- with the ACHOO syndrome are very sensitive to seeing piratory system generic 25mg pamelor amex anxiety symptoms guilt. The sneeze reflex of the syndrome can then Antibody—A protein produced by the mature B be thought of as an involuntary defense reaction against cells of the immune system that attach to invading bright light; when the person sneezes order pamelor 25mg line anxiety symptoms legs, they automatically microorganisms and target them for destruction by close their eyes. Antigen—A substance or organism that is foreign Diagnosis to the body and stimulates a response from the The ACHOO syndrome is diagnosed simply by immune system. Immune system—A major system of the body that produces specialized cells and substances that interact with and destroy foreign antigens that Treatment and management invade the body. Common measures, such as wearing sun- glasses, can help people who are severely affected. Therefore, it is sometimes assumed that medica- drome have a hypersensitive reaction to light, just like tions that are used for allergies, such as antihistamines, some people have a sensitivity to cat hairs or pollen. These stores of glycogen are then broken down strated that the syndrome is relieved by this type of med- into sugars, as the muscles require them. Alternative medicine, including homeopathy and the chemical substance that regulates the amount of herbal medicine, recommend a wide range of remedies glycogen stored in muscle cells. When too much glyco- for nasal allergies, these may accordingly also be helpful gen begins to accumulate in a muscle cell, acid maltase is for the ACHOO syndrome. Prognosis Individuals affected with acid maltase deficiency have People with the ACHOO syndrome generally have either a complete inability or a severely limited ability to the condition for life. This excess glycogen in Resources the muscle cells causes a progressive degeneration of the BOOKS muscle tissues. As a result, enzymes are not used up in chemical PERIODICALS reactions, but rather recycled. Rosick, DO, MPH, MS ous reactions of human life are produced within the body by genes. Genetic enzyme deficiency disorders, such as acid maltase deficiency, result from only one cause: the affected individual cannot produce enough of the neces- sary enzyme because the gene designed to make the enzyme is faulty. Enzymes are not used up in chemical reactions, but they do eventually wear out, or accidentally IAcid maltase deficiency get expelled. Also, as an individual grows, they may Definition require greater quantities of an enzyme. Therefore, most enzyme deficiency disorders will have a time component Acid maltase deficiency, also called Pompe disease, to them. Individuals with no ability to produce a particu- is a non-sex linked recessive genetic disorder that is the lar enzyme may show effects of this deficiency at birth or most serious of the glycogen storage diseases affecting shortly thereafter. It is one of several known congenital to produce a particular enzyme may not show the effects (present at birth) muscular diseases (myopathies), as dis- of this deficiency until their need for the enzyme, because tinct from a muscular dystrophy, which is a family of of growth or maturation, has outpaced their ability to pro- muscle disorders arising from faulty nutrition. Pompe first described this genetic disor- The level of ability of individuals with acid maltase der in 1932. Some of the sugars and deficiency usually begins to produce observable symp- starches from the diet that are not immediately put to use toms in affected individuals between the ages of two and are converted into glycogen and then stored in the mus- five months. Type b, or childhood, acid maltase defi- GALE ENCYCLOPEDIA OF GENETIC DISORDERS 23 ciency usually begins to produce observable symptoms in prevent the production of acid maltase and lead to infan- affected individuals in early childhood. Type c, or adult, acid maltase defi- the adult (type c) and the remainder of the childhood ciency generally begins to produce observable symptoms (type b) acid maltase deficiency cases have not yet been in affected individuals in the third or fourth decades of determined. Demographics Genetic profile Acid maltase deficiency is observed in approxi- mately 1 in every 100,000 live births. In 2000, it was esti- The locus of the gene responsible for acid maltase mated that between 5,000 and 10,000 people were living deficiency has been localized to 17q23. The severity of somewhere in the developed world with a diagnosed case the associated symptoms and the age of onset in affected of acid maltase deficiency. It is observed in equal num- individuals have been closely tied to the particular muta- bers of males and females and across all ethnic subpopu- tion at this locus. Since acid maltase deficiency is a recessive disorder, Each of these is associated with varying symptoms. In the case of carrier parents A gene is a particular segment of a particular chro- with one child affected by acid maltase deficiency, there mosome. However, within the segment containing a par- is a 25% likelihood that their next child will also be ticular gene there are two types of areas: introns and affected with the disorder. Introns are sections of the segment that do not (adult) acid maltase deficiency generally does not show actively participate in the functioning of the gene. Exons symptoms in the affected individual until that individual are those sections that do actively participate in gene is past 30, it is possible for an affected individual to par- function.

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