Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Sunday, 2 February 2014

LES DATTES ET LES BIENFAITS



  
 Les dattes sont riches en nutriments, vitamines, minéraux et oligo-éléments. 
Mangez des dattes, votre santé vous remerciera, les dattes sont exemptes de cholestérol et très faibles en graisses. Les meilleures pour la santé sont les dattes fraiches (medjool bien grosse et pleines d'eau)  Les dattes sont riches en éléments nutritifs : Les dattes sont de très bonnes sources de fibres alimentaires (dattes sèches) et de protéines. Ces fruits sont riches en vitamine C (pour la datte fraîche), vitamine B1, B2, B3 et B5 et de vitamine A1. Il comporte 20 différents types d’acides aminés qui facilitent le processus de digestion. Les dattes sont riches en fibres solubles et insolubles (des substances d’origine végétale bénéfiques pour votre intestin). Nos besoins en fibres alimentaires sont de 25 à 35 grammes de fibres par jour. Étant un aliment laxatif, les dattes peuvent soulager les personnes qui souffrent de constipation. 2. Un fruit tonique pour notre corps : Les dattes sont considérées comme l’une des meilleures alimentations énergisantes. Elles contiennent 29 grammes de sucres naturels comme le glucose, le fructose et le saccharose. Elles contiennent également 31 grammes de glucides et 3 grammes de fibres alimentaires. L’ajout de dattes dans du lait peut être une collation très nutritive et vivifiante, particulièrement en période de convalescence, pour les enfants et même les adultes. 3. Les dattes sont faibles en calories : Les dattes possèdent un nombre très faible de calories, environ 23 calories pour une datte. Ce fruit est adapté pour les gens soucieux de leur poids et de leur santé. 4. Les dattes sont riches en potassium et faibles en sodium : Un des avantages clés des bienfaits des dattes sur notre santé réside dans sa capacité à réguler un système nerveux sain, grâce à la teneur riche en potassium (plus de 670 mg aux 100 g). La recherche recommande que l’apport élevé de potassium peut réduire de 40% le risque d’attaque. D’autres sels minéraux importants incluent le cuivre, le zinc, le fer (bénéfique pour ceux qui souffrent d’anémie), le magnésium, le manganèse et le phosphore. Ils ont aussi une forte concentration d’antioxydants phénoliques et d’autres nutriments. Un autre avantage clé des bienfaits des dattes sur notre santé réside dans sa capacité à abaisser le LDL-cholestérol. La datte est un fruit miraculeux. Les cancers et tumeurs sont rares dans les pays où la datte est l’aliment de base. Les scientifiques vous le confirmeront, la datte est un oligo-élément qui a un rôle préventif dans les maladies cancéreuses. La datte est un fruit exotique exceptionnel. La datte, entre autres fruits exotiques, est très riche en oligo-éléments, notamment en magnésium et en phosphore. La datte, riche en magnésium Une carence en magnésium peut être la cause de plusieurs symptômes et troubles comme la nervosité, la dépression, l’anxiété, l’insomnie, les troubles vasculaires et cardiaques, les problèmes respiratoires, la mauvaise circulation sanguine, etc. Quels sont les effets bénéfiques de la datte ? • elle tonifie vos muscles • elle retarde votre vieillissement • elle évite l’accumulation de déchets nutritionnels • elle vous protège des troubles nerveux, des névrites, des polynévrites • a une action bénéfique sur la prostate et les reins La datte, riche en phosphore Une carence en phosphore peut être la cause d’une déminéralisation du tissu osseux, mais aussi de troubles respiratoires, cardiaques et neurologiques. • elle fixe la cellule nerveuse • elle fixe la calcification des os • la datte est préconisée dans les névroses, les maladies nerveuses, l’asthénie, les névrites Le fer et le calcium, le potassium et le cuivre sont aussi des éléments qui composent ce petit fruit doté d’une énorme puissance énergétique et de vertus rajeunissantes. La datte, ce fruit merveilleux Elle est conseillée : • pour les personnes souvent atteintes de fatigue, d’anémie • pour les convalescents : personnes qui se remettent d’une maladie, pour les femmes enceintes et celle qui viennent d’accoucher • les décalcifiés : personnes qui manquent de calcium • les personnes âgées et déminéralisés : personnes au capital osseux fragilisé • pour les enfants et les sportifs.

Sunday, 12 January 2014

Self-Certificates

You do not normally need a doctor’s certificate for the first seven days of illness.
The Statutory Sick Pay Regulations state that employers are required to accept self-certification notes (filled in by you) for the first seven days of illness.
These are available from the Surgery and your employer may also hold some.
Alternatively, you can download and print off a copy yourself from the link below.
All employers must comply with these regulations
You do not require any form of certification during the first FOUR DAYS off work.
If you take up to SEVEN DAYS because you are not well enough to attend work, then you must fill in a self-certificate.Self-Certificate – click here to download
Anything OVER SEVEN DAYS means you will need a doctor’s certificate and will need to visit a Doctor to acquire this.
Some employers or insurance schemes may ask you to provide a sick note.
There will be a fee if you require a private note for the first seven days of your illness.
The Surgery will be able to advise of the current fee and it would normally be expected that your employer cover this cost for you as doctor’s notes are not normally required for the first week of any illness.
Self-Certificate – click here to download

Friday, 10 January 2014

Medical vocabulary


Macrocyte

Red blood cells of large diameter.

Macula

The macula is a small yellow depression located on the retina where the optic axis leads .

Manus

Manus is the Latin word for hand.

Nevus pigmentary

· Nevi nevi or moles

· The melanocytic nevus ( mole ) is developing a patch to the skin and whose size is variable, ranging from a few millimeters to a few centimeters in diameter.
Its color also varies , ranging from pale yellow to dark brown.
Its thickness is variable. It can be covered with scabs and / or sometimes surmounted by a hair.
· Most nevi are benign , but their presence requires regular dermatological surveillance to detect their possible evolution (change of shape, color ... ) and prevent the risk of degeneration into a skin cancer , melanoma .

Nostrils

Nostrils The nostrils are the openings of the nose.
The choanal nostrils and are of communication ports of the nasal cavity , the two cavities located in the middle of the face .
Previous orifices , nostrils, open to the front face of the form and communicate with the nasal cavity outside , while the rear openings , the choanal , open in the nasopharynx.
The choanal are smaller because they are constricted by the mucosal lining and which contributes to the air filter .

Natriuresis
Or natriuresis . Sodium content in the urine

Obese

· The World Health Organization defined obesity as an index of over 30 body weight, while overweight is defined by a ratio of greater than 25 body mass.
- The body mass index is calculated by dividing weight (in kg) and height squared ( in meters ): Weight ( kg)
Size (2) ( m) - Many diseases or organ dysfunction may be associated with obesity : -> The pseudohypoparathyroïdies - > Diabetes type II -> Cushing's Disease - > The hyperlipidemia - > in myxedema of hypothyroidism -> Prader -Willi ..

Obst

Obst . stands for obstetrics is the branch of medicine that deals with pregnancy and childbirth .

Obtuseness

Disturbance of consciousness manifested by slow intellectual and sensory functions and a lack of attention.

PAF

Abbreviation of platelet activating factor , that is to say, platelet activating factor .
Factor ( phospholipid ) released during certain allergic reactions , causing , in addition to its role in bringing in heaps of blood platelets , bronchial constriction ( in asthma ) , decreased blood pressure and promotes tissue infiltration by a fluid ( edema ) .

Palilalie

Speech disorder in which the subject repeats the same idea or unintentionally the same word.
Q.i.d.

Q.i.d. : Medical abbreviation Quater in Die ( four times daily ) . Rather used in Anglo-Saxon . In France , the abbreviation is : 4 x / d

Quadriplegia
Medical term meaning paralysis of four limbs due to central or peripheral nerve damage.

Quinine
Alkaloid extracted from cinchona bark , has the property to reduce fever and whose derivatives are used in the treatment of malaria.

Fifth
Access successive cough.

Rabic
Which relates to rabies.

Spine

Spine .hypophosphatemic rickets

· Rickets , as osteomalacia are characterized by defective bone mineralization and cartilage bone growth ( in children) .
· Rickets is clinically manifested by bone pain associated with bone deformities ( bowing of long bones, frontal bossing , depressed chest ... ) , fractures and disorders of growth.
· In early childhood , other symptoms may be present such as apathy , irritability , muscle weakness may interfere with the independence movement .
· The causes of rickets are multiple: -
>Vitamin D deficiency : lack of capital, lack of sun exposure , digestive malabsorption , abnormal metabolism of vitamin D , hypophosphatemia
... - > Target organ resistance to the action of vitamin D -
 > chronic renal failure -
> regulation disorders of phosphate or calcium -
 > metabolic acidosis , certain medications or poisoning (lead, cadmium , aluminum ... ) ...

Saccharin

succédané chemical sugar, flavored with it ( sweetness ), but not its nutritional value.

Sacrum
Triangular bone located between the fifth lumbar vertebra and the coccyx, the last bone of the spine .
The sacrum is the part of the spine between the lumbar spine and the coccyx .
It consists of five fused vertebrae to each other which form a single bone structure .
The sacrum has a median sacral crest (located along the posterior surface of the sacrum ) resulting from the fusion of the spinous processes of the vertebrae component .
Under this sacral crest is the sacral canal , a tunnel from the top of the sacrum to a hiatus ( opening ) near its base.
Four pairs of holes ( sacred hole) pierce the sacrum on each side of the midline ( center) where the intermediate sacral crest formed by the fusion of the articular processes of the vertebrae that compose it.
On each side of the middle sacral crest is a lateral sacral crest formed by the fusion of the transverse processes of the vertebrae.
Thus , unlike the upper vertebrae of the spine , there is no inter - transversaires ligaments in the sacrum they are replaced by merging the apophyses .
Peaks do not appear on the front of the sacrum , but the sacred holes are clearly visible.

Blood

The blood is placed in an organic liquid movement ( sucked and discharged ) by the heart and circulates in all the arteries , veins and capillaries.
It consists of plasma , white cells (leukocytes ) , red blood cells (erythrocytes ) and platelets (thrombocytes ) .
Blood is one of three main body fluids ( the other two are located around the liquid and within the cells) .
It carries oxygen , nutrients and hormonal messengers to every cell of the body and waste from them.
It also has a role in defending the body against foreign bodies .
An adult has about 3.1019 blood cells. Each cubic millimeter of blood contains 4.5 to 5.5 million red blood cells and 7,500 white blood cells on average .
Blood is made up of four main components : red blood cells , white blood cells , platelets and plasma. Red and white blood cells are destroyed and the body continually produces new times. About 2.5 million red blood cells die every second and about 2.5 million new cells are produced at the same time .

T.i.d.
T.i.d. : Medical abbreviation Ter in die ( three times daily ) . Used mainly in Anglo- Saxon countries. In France we prefer the abbreviation : 3 x / day

T3 lowered

· T3 or tri- thyroxine or T4 and iodithyronine are thyroid hormone whose synthesis by the thyroid gland is under the control of TSH and requires an adequate intake of iodine.
· The synthesis of thyroid hormones and thus their blood levels , will therefore depend on several factors which are , in particular , the amount of iodine taken up by the thyroid, the functional state of the thyroid gland , stimulating his or her freination TSH or other products.
· Hyperthyroidism is associated with an increase of T4 , a high or a normal T3 and TSH usually low .
· Hypothyroidism usually see a low T4, normal T3 and lowered ( its dosage is not required for diagnosis ) and high or low depending on the cause of hypothyroidism TSH .
· Some diseases or drug taken (such as amiodarone , carbamazepine ... ) may be accompanied by an increase in T4, T3 with a low or high normal TSH .

Taenia

Or tapeworm or tapeworm .
Flatworm segmented the order of tapeworms , intestinal parasite .

Ulceration

Loss of substance of the skin or mucous membrane , which heal with difficulty.
ulcer
An ulcer is a break in the skin or mucous membrane caused by an inflammatory , infectious or malignant process . Ulcers often contains pus.

Ulite

Or gingivitis . Inflammation of the gums .

Hives

Hives
Urticaria (from the Latin urtica : nettle) is made ​​of a rash erythematous papules , sometimes white opal center and outskirts, sharply defined contours , whose size can vary from a few millimeters to several centimeters , or coalesce into large plaques .
This papular rash is itchy and fleeting (see pruritus) .
The angioedema or angioedema is a variety of urticaria , subcutaneous , non-itchy .
It is potentially serious in its localization to the upper airways ( glottis , larynx ... ) with risk of asphyxiation
Urticaria is particularly common , it is estimated that 20 % of patients will present an urticarial episode in their lives.
There are: - acute urticaria , the duration does not exceed three weeks , and represent 75% of the hives . Their cause is usually found in general food , drug or contact ( animals, plants, chemicals ...) - recurrent hives is urticaria which pushed succeed in life. They have the same difficulties as chronic urticaria etiological diagnosis. - Chronic urticaria whose duration exceeds 6 weeks ( up to 3 months according to some authors ) . They represent, in general population, 15-25 % of hives . Often , the cause does not appear so obvious and requires an assessment .
Chronic urticaria can be original : - Physical : Mechanical ( dermographisme , vibration , pressure) , cholinergic , warm , cold , water , solar , adrenergic receptors. - Contact allergic or not: animals , plants, drugs ... may have an occupational cause . - Common : food cause, drug , infectious , or due to environmental allergens ... - Systemic : urticarial vasculitis , connective tissue ( lupus erythematosus ) ... - Other causes polycythemia vera , hyperthyroidism ... - Genetic : angioneurotic edema hereditary ... - It is not uncommon that at the end of the balance sheet , no origin is found . These hives , tell chronic idiopathic urticaria are actually waiting for a diagnosis.

Vaccine

A vaccine is a preparation containing microorganisms that are either inactivated bacteria or germs killed. This preparation is administered in order to immunize the body against infectious diseases.

Vacuole

Cavity of the vibrant and organized around the nucleus ( cytoplasm ) substance.
ship
Body's natural channel in which circulates the blood or lymph (liquid fluid , clear and slightly yellow in color , which bathes the tissues). One distinguishes arteries, veins and capillaries .

Valve

Membranous fold preventing liquid from flowing back into the ducts and vessels of the body.

Western Blot

The Western Blot is a blood test to look for certain antigens .

Willebrand factor -von
Protein normally present in the blood , which is essential to platelet aggregation during coagulation . Its absence causes von Willebrand disease .

Wormien
Wormien says each small supernumerary bones meshed in the sutures of the skull.

Xanthodermie
Yellowing of the skin.
This term also refers to a mild jaundice (or jaundice, yellowing of the skin and mucous membranes due to the accumulation of bile pigment - bilirubin - secreted by the liver ) in the feet , hands and nose, occurring during the Gilbert's syndrome ( or Gilbert's syndrome), a disease characterized by abnormal conversion of the bile pigments .

Xerosis

Xerosis : transformation of the surface layer of the skin which gradually dries up and withers .

Xerostomia
Xerostomia Xerostomia :
-reduction or depletion of salivary secretions with a dry mouth as in Sjogren's syndrome .

Yersin ( bacillus )
Bacterial agent of plague (epidemic bacterial disease characterized by the appearance of buboes ( bubonic plague ) or signs of pulmonary inflammation ( pneumonic plague ) .

Eyes

The eyeball is set in adipose tissue inside the eye sockets ( two bony notches ) located in the skull, above and laterally from the center .
 Of all the senses, sight is the one that is often considered the most important.
Estimated four-fifths of all our knowledge enter the brain through the eyes.
Eyes transmit constant flow to the brain images , in the form of electrical signals .
Eyes receive information transmitted by the light rays .
These are absorbed or reflected .
Objects that absorb all the light rays appear black , while those who think all appear white . Colored objects absorb parts of the light spectrum and reflect others.
When you look at something , light rays reflected from the object enters the eye.
The light is refracted by the cornea and passes through the aqueous humor and the transparent pupil to reach the lens .
The iris control the light intensity entering the eye.
The lens focuses the light passing through the vitreous to the retina to reach , thus forming an inverted image and in reverse.
The photosensitive cells of the retina transmit this image to the brain by means of electrical signals . The brain "sees " the image area.

Yoga

This discipline provides an immediate sensation of well-being and in the long term , contribute to the harmonious development of personality.
This quest for harmony between body, mind and spirit could not be more soothing.

Lisp

Trouble pronunciation in which the " j " and " g " are replaced by a soft "z" .

Shingles

Shingles is a viral infection caused by a type of herpes virus ( VZV ), which after chickenpox , moved so latent in the sensory ganglia .
It is common in adults and its frequency increases with age.
Once reactivated, the virus will spread along the sensory nerve (most often it reaches the dorsal nerves , lumbar and the ophthalmic branch of the trigeminal nerve) .
It is responsible , in the territory of the nerve and considered unilaterally manifestations of sensory nerve ( decreased sensitivity , pain, itching , tingling ... ) above a few days the skin lesions ( macules , papules, vesicles, pustules and crusts ) .
Eye location shingles exposed to acute lesions ( keratitis, iritis , retinal disease ) and their sequelae.
Painful sequelae of herpes zoster occur especially as the subject is elderly or immunocompromised .
Complications of shingles can be drive ( paralysis that most often regress ) , reaching the spinal cord, diffuse and focal encephalitis , cerebral vasculitis . These complications are much more frequent than the subject is immunocompromised .

Zoose

Parasitic disease whose agent is transmitted to humans by animals .

Zygote
A zygote is an egg resulting from the fertilization of an ovum by a spermatozoon

BIOMEDECINE THEORIQUE: LA VOIE GERNEZ

André Gernez
Physician
  • André Gernez was a French non-conventional physician. Gernez explained diseases such as cancer or neurodegenerations through a theory of mitosis and differentiation. Wikipedia

  • Born: January 25, 1923, Avesnes-les-Aubert
     
     
  • Died: http://www.jacques-lacaze.com/pages/LES_TEXTES_DU_DOCTEUR_ANDRE_GERNEZ_EN_LIGNE-2058486.htmlJanuary 8, 2014
     
    Un site a été créé pour mettre en ligne progressivement les textes du Docteur André Gernez. Ce site est en construction, mais déja les 4 livres sont publiés:
    - Néopostulats biologiques et pathogéniques
    - La carcinogénèse
    - Le cancer. Dynamique et éradication
    - Lois et règles de la cancérisation
    La brochure de La Vie Claire: "Campagne 73 " est aussi publiée sur ce site
    Adresse du sitelink

    Friday, 3 January 2014

    Une plante chinoise contre la douleur

    La médecine moderne dispose de peu de moyens pour traiter les douleurs chroniques, qui concernent pourtant 15 à 25 % de la population. L'analyse d'une plante de la pharma­copée traditionnelle chinoise a révélé une molécule prometteuse qui pourrait venir renforcer l'arsenal thérapeutique.

    La découverte est le fruit des recherches de l'équipe du Pr Xinmiao, de l'Institut de chimie physique de Dalian, à l'origine du projet Herbalome, en collaboration avec l'Université de Californie. Lancée en 2008, l'initiative a déjà permis d'identifier les composés actifs et toxiques de centaines de plantes utilisées dans la médecine traditionnelle chinoise. La nouvelle molécule antidouleur, ­présentée jeudi dans la revue Current Biology, provient d'une plante à fleurs appelée corydale. Depuis des siècles, ce végétal qui pousse principalement dans le centre-est de la Chine se consomme bouilli dans du vinaigre pour traiter maux de dos et de tête.

    Pas d'effet d'accoutumance


    Les chercheurs ont montré que le principe actif, la déhydrocorybulbine (DHCB), était efficace contre les trois principaux types de douleur: aiguë, inflammatoire et chronique. Or, si l'on dispose de traitements efficaces contre les douleurs aiguës (codéine, morphine) et inflammatoires (ibuprofène, aspirine), les douleurs chroniques (persistant un mois au-delà de la durée attendue) sont difficiles à soulager. Autre propriété intéressante de la DHCB: elle n'entraîne pas d'effet d'accoutumance, contrairement aux opiacés comme la morphine.

    Le Pr Julien Nizard, directeur du centre de traitement de la douleur au CHU de Nantes, voit cette découverte d'un bon œil: «On soigne de plus en plus la douleur en combinant plusieurs molécules aux modes d'action distincts. L'élargissement des options possibles est donc intéressant.» Les extraits naturels ont aussi l'avantage de présenter moins d'effets secondaires, souligne-t-il.

    Bien que l'on puisse trouver des extraits naturels de corydale en vente sur Internet, le Dr Olivier Civelli, coauteur de l'étude, rappelle que de plus amples recherches en toxicité doivent encore être conduites avant la mise sur le marché d'un médicament à base de DHCB dans une dizaine d'années.
                                          La corydale pourrait soulager les douleurs chroniques

    Wednesday, 1 January 2014

    Toxic Effects




    Toxic Effects

    Toxicity is complex with many influencing factors; dosage is the most important. Xenobiotics, or chemicals foreign to the body, cause many types of toxicity by a variety of mechanisms. Some chemicals are themselves toxic and are sometimes referred to as "parent" compounds. Others must be metabolized (chemically changed within the body) before they cause toxicity.
    Many xenobiotics distribute in the body and often affect only specific target organs. Others, however, can damage any cell or tissue that they contact. The target organs that are affected may vary depending on dosage and route of exposure. For example, the target for a chemical after acute exposure may be the nervous system, but after chronic exposure the liver.
    Toxicity can result from adverse cellular, biochemical, or macromolecular changes. Examples are:
    • cell replacement, such as fibrosis
    • damage to an enzyme system
    • disruption of protein synthesis
    • production of reactive chemicals in cells
    • DNA damage
    Some xenobiotics may also act indirectly by:
    • modification of an essential biochemical function
    • interference with nutrition
    • alteration of a physiological mechanism

    Factors Influencing Toxicity

    The toxicity of a substance depends on the following:
    • form and innate chemical activity
    • dosage, especially dose-time relationship
    • exposure route
    • species
    • age
    • sex
    • ability to be absorbed
    • metabolism
    • distribution within the body
    • excretion
    • presence of other chemicals
    The form of a substance may have a profound impact on its toxicity especially for metallic elements. For example, the toxicity of mercury vapor differs greatly from methyl mercury. Another example is chromium(Cr). Cr3+ is relatively nontoxic whereas Cr6+ causes skin or nasal corrosion and lung cancer.
    The innate chemical activity of substances also varies greatly. Some can quickly damage cells causing immediate cell death. Others slowly interfere only with a cell's function. For example:
    • hydrogen cyanide binds to cytochrome oxidase resulting in cellular hypoxia and rapid death
    • nicotine binds to cholinergic receptors in the central nervous system (CNS) altering nerve conduction and inducing gradual onset of paralysis
    The dosage is the most important and critical factor in determining if a substance will be an acute or a chronic toxicant. Virtually all chemicals can be acute toxicants if sufficiently large doses are administered. Often the toxic mechanisms and target organs are different for acute and chronic toxicity.
    Exposure route is important in determining toxicity. Some chemicals may be highly toxic by one route but not by others. Two major reasons are differences in absorption and distribution within the body. For example:
    • ingested chemicals, when absorbed from the intestine, distribute first to the liver and may be immediately detoxified
    • inhaled toxicants immediately enter the general blood circulation and can distribute throughout the body prior to being detoxified by the liver
    Frequently there are different target organs for different routes of exposure.
    Toxic responses can vary substantially depending on the species. Most species differences are attributable to differences in metabolism. Others may be due to anatomical or physiological differences. For example, rats cannot vomit and expel toxicants before they are absorbed or cause severe irritation, whereas humans and dogs are capable of vomiting.
    Selective toxicity refers to species differences in toxicity between two species simultaneously exposed. This is the basis for the effectiveness of pesticides and drugs. Examples are:
    • an insecticide is lethal to insects but relatively nontoxic to animals
    • antibiotics are selectively toxic to microorganisms while virtually nontoxic to humans
    Age may be important in determining the response to toxicants. Some chemicals are more toxic to infants or the elderly than to young adults. For example:
    • parathion is more toxic to young animals
    • nitrosamines are more carcinogenic to newborn or young animals
    Although uncommon, toxic responses can vary depending on sex. Examples are:
    • male rats are 10 times more sensitive than females to liver damage from DDT
    • female rats are twice as sensitive to parathion as male rats
    The ability to be absorbed is essential for systemic toxicity to occur. Some chemicals are readily absorbed and others poorly absorbed. For example, nearly all alcohols are readily absorbed when ingested, whereas there is virtually no absorption for most polymers. The rates and extent of absorption may vary greatly depending on the form of the chemical and the route of exposure. For example:
    • ethanol is readily absorbed from the gastrointestinal tract but poorly absorbed through the skin
    • organic mercury is readily absorbed from the gastrointestinal tract; inorganic lead sulfate is not
    Metabolism, also known as biotransformation, is a major factor in determining toxicity. The products of metabolism are known as metabolites. There are two types of metabolism - detoxification and bioactivation. Detoxification is the process by which a xenobiotic is converted to a less toxic form. This is a natural defense mechanism of the organism. Generally the detoxification process converts lipid-soluble compounds to polar compounds. Bioactivation is the process by which a xenobiotic may be converted to more reactive or toxic forms.
    The distribution of toxicants and toxic metabolites throughout the body ultimately determines the sites where toxicity occurs. A major determinant of whether or not a toxicant will damage cells is its lipid solubility. If a toxicant is lipid-soluble it readily penetrates cell membranes. Many toxicants are stored in the body. Fat tissue, liver, kidney, and bone are the most common storage depots. Blood serves as the main avenue for distribution. Lymph also distributes some materials.
    The site and rate of excretion is another major factor affecting the toxicity of a xenobiotic. The kidney is the primary excretory organ, followed by the gastrointestinal tract, and the lungs (for gases). Xenobiotics may also be excreted in sweat, tears, and milk.
    A large volume of blood serum is filtered through the kidney. Lipid-soluble toxicants are reabsorbed and concentrated in kidney cells. Impaired kidney function causes slower elimination of toxicants and increases their toxic potential.
    The presence of other chemicals may decrease toxicity (antagonism), add to toxicity (additivity), or increase toxicity (synergism or potentiation) of some xenobiotics. For example:
    • alcohol may enhance the effect of many antihistamines and sedatives
    • antidotes function by antagonizing the toxicity of a poison (atropine counteracts poisoning by organophosphate insecticides)

    Systemic Toxic Effects

    Toxic effects are generally categorized according to the site of the toxic effect. In some cases, the effect may occur at only one site. This site is referred to as the specific target organ. In other cases, toxic effects may occur at multiple sites. This is referred as systemic toxicity. Following are types of systemic toxicity:
    • Acute Toxicity
    • Subchronic Toxicity
    • Chronic Toxicity
    • Carcinogenicity
    • Developmental Toxicity
    • Genetic Toxicity (somatic cells)

    Acute Toxicity

    Acute toxicity occurs almost immediately (hours/days) after an exposure. An acute exposure is usually a single dose or a series of doses received within a 24 hour period. Death is a major concern in cases of acute exposures. Examples are:
    • In 1989, 5,000 people died and 30,000 were permanently disabled due to exposure to methyl isocyanate from an industrial accident in Bhopal, India.
    • Many people die each year from inhaling carbon monoxide from faulty heaters.
    Non-lethal acute effects may also occur, e.g., convulsions and respiratory irritation.

    Subchronic Toxicity

    Subchronic toxicity results from repeated exposure for several weeks or months. This is a common human exposure pattern for some pharmaceuticals and environmental agents. Examples are:
    • Ingestion of coumadin tablets (blood thinners) for several weeks as a treatment for venous thrombosis can cause internal bleeding.
    • Workplace exposure to lead over a period of several weeks can result in anemia.

    Chronic Toxicity

    Chronic toxicity represents cumulative damage to specific organ systems and takes many months or years to become a recognizable clinical disease. Damage due to subclinical individual exposures may go unnoticed. With repeated exposures or long-term continual exposure, the damage from these subclinical exposures slowly builds-up (cumulative damage) until the damage exceeds the threshold for chronic toxicity. Ultimately, the damage becomes so severe that the organ can no longer function normally and a variety of chronic toxic effects may result.
    Examples of chronic toxic affects are:
    • cirrhosis in alcoholics who have ingested ethanol for several years
    • chronic kidney disease in workmen with several years exposure to lead
    • chronic bronchitis in long-term cigarette smokers
    • pulmonary fibrosis in coal miners (black lung disease)

    Carcinogenicity

    Carcinogenicity is a complex multistage process of abnormal cell growth and differentiation which can lead to cancer. At least two stages are recognized; initiation in which a normal cell undergoes irreversible changes; and promotion in which initiated cells are stimulated to progress to cancer. Chemicals can act as initiators or promoters of tumors.
    The initial neoplastic transformation results from the mutation of the cellular genes that control normal cell functions. The mutation may lead to abnormal cell growth. It may involve loss of suppresser genes that usually restrict abnormal cell growth. Many other factors are involved (e.g., growth factors, immune suppression, and hormones).
    A tumor (neoplasm) is simply an uncontrolled growth of cells. Benign tumors grow at the site of origin; do not invade adjacent tissues or metastasize; and generally are treatable. Malignant tumors (cancer) invade adjacent tissues or migrate to distant sites (metastasis). They are more difficult to treat and often cause death.

    Developmental Toxicity

    Developmental Toxicity pertains to adverse toxic effects to the developing embryo or fetus. This can result from toxicant exposure to either parent before conception or to the mother and her developing embryo-fetus. The three basic types of developmental toxicity are:
    Chemicals cause developmental toxicity by two methods. They can act directly on cells of the embryo causing cell death or cell damage, leading to abnormal organ development. A chemical might also induce a mutation in a parent's germ cell which is transmitted to the fertilized ovum. Some mutated fertilized ova develop into abnormal embryos.

    Genetic Toxicity

    Genetic Toxicity results from damage to DNA and altered genetic expression. This process is known as mutagenesis. The genetic change is referred to as a mutation and the agent causing the change as a mutagen. There are three types of genetic change:
    If the mutation occurs in a germ cell, the effect is heritable. There is no effect on the exposed person; rather the effect is passed on to future generations. If the mutation occurs in a somatic cell, it can cause altered cell growth (e.g., cancer) or cell death (e.g., teratogenesis) in the exposed person.

    Organ Specific Toxic Effects

    Blood and Cardiovascular Toxicity

    Blood and Cardiovascular Toxicity results from xenobiotics acting directly on cells in circulating blood, bone marrow, and heart. Examples of blood and cardiovascular toxicity are:
    • hypoxia due to carbon monoxide binding of hemoglobin preventing transport of oxygen
    • decrease in circulating leukocytes due to chloramphenicol damage to bone marrow cells
    • leukemia due to benzene damage of bone marrow cells
    • arteriosclerosis due to cholesterol accumulation in arteries and veins

    Dermal Toxicity

    Dermal Toxicity may result from direct contact or internal distribution to the skin. Effects range from mild irritation to severe changes, such as corrosivity, hypersensitivity, and skin cancer. Examples of dermal toxicity are:
    • dermal irritation due to skin exposure to gasoline
    • dermal corrosion due to skin exposure to sodium hydroxide (lye)
    • dermal hypersensitivity due to skin exposure to poison ivy
    • skin cancer due to ingestion of arsenic or skin exposure to UV light

    Eye Toxicity

    Eye Toxicity results from direct contact or internal distribution to the eye. The cornea and conjunctiva are directly exposed to toxicants. Thus, conjunctivitis and corneal erosion may be observed following occupational exposure to chemicals. Many household items can cause conjunctivitis. Chemicals in the circulatory system can distribute to the eye and cause corneal opacity, cataracts, retinal and optic nerve damage. For example:
    • acids and strong alkalis may cause severe corneal corrosion
    • corticosteroids may cause cataracts
    • methanol (wood alcohol) may damage the optic nerve

    Hepatotoxicity

    Hepatotoxicity is toxicity to the liver, bile duct, and gall bladder. The liver is particularly susceptible to xenobiotics due to a large blood supply and its role in metabolism. Thus it is exposed to high doses of the toxicant or its toxic metabolites. The primary forms of hepatotoxicity are:

    Immunotoxicity

    Immunotoxicity is toxicity of the immune system. It can take several forms: hypersensitivity (allergy and autoimmunity), immunodeficiency, and uncontrolled proliferation (leukemia and lymphoma). The normal function of the immune system is to recognize and defend against foreign invaders. This is accomplished by production of cells that engulf and destroy the invaders or by antibodies that inactivate foreign material. Examples are:
    • contact dermatitis due to exposure to poison ivy
    • systemic lupus erythematosus in workers exposed to hydrazine
    • immunosuppression by cocaine
    • leukemia induced by benzene

    Nephrotoxicity

    The kidney is highly susceptible to toxicants for two reasons. A high volume of blood flows through it and it filtrates large amounts of toxins which can concentrate in the kidney tubules. Nephrotoxicity is toxicity to the kidneys. It can result in systemic toxicity causing:
    • decreased ability to excrete body wastes
    • inability to maintain body fluid and electrolyte balance
    • decreased synthesis of essential hormones (e.g., erythropoietin)

    Neurotoxicity

    Neurotoxicity represents toxicant damage to cells of the central nervous system (brain and spinal cord) and the peripheral nervous system (nerves outside the CNS). The primary types of neurotoxicity are:
    • neuronopathies (neuron injury)
    • axonopathies (axon injury)
    • demyelination (loss of axon insulation)
    • interference with neurotransmission

    Reproductive Toxicity

    Reproductive Toxicity involves toxicant damage to either the male or female reproductive system. Toxic effects may cause:
    • decreased libido and impotence
    • infertility
    • interrupted pregnancy (abortion, fetal death, or premature delivery)
    • infant death or childhood morbidity
    • altered sex ratio and multiple births
    • chromosome abnormalities and birth defects
    • childhood cancer
    • delayed puberty

    Respiratory Toxicity

    Respiratory Toxicity relates to effects on the upper respiratory system (nose, pharynx, larynx, and trachea) and the lower respiratory system (bronchi, bronchioles, and lung alveoli). The primary types of respiratory toxicity are:
    • pulmonary irritation
    • asthma/bronchitis
    • reactive airway disease
    • emphysema
    • allergic alveolitis
    • fibrotic lung disease
    • pneumoconiosis
    • lung cancer