Chronic pathophysiology

The increasingly accepted hypothesis that acetaldehyde may be the causative agent in initiating the multitude of acute pharmacological and chronic pathophysiological effects of alcohol prompted Nagasawa et al. to seek methods to reduce its blood levels. One possibility would be the administration of (S)-penicillamine (4), a compound related to cysteine. The condensation of this amino acid with acetaldehyde produced 2,5,5-trimethylthiazolidine-4-carboxylic acid 242). The chirality of this compound was deducted by NMR analysis to be 72% 2S, 4S and 28% 2R, 4S. Thus, this result is consistent with the configuration found previously for the thiazolidines formed from (R)-cysteine and aldehydes 241 ... 

Most, if not all, of the tissues and organs in the body are adversely affected by chronic ingestion of excessive amounts of alcohol, including the liver, pancreas, heart, reproductive organs, central nervous system, and the fetus. Some of the effects of alcohol ingestion, such as the psychotropic effects on the brain or inhibition of vitamin transport, are direct effects caused by ethanol itself. However, many of the acute and chronic pathophysiologic effects of alcohol relate to the pathways of ethanol metabolism (see Chapter 25). 

In broad terms, pain can be divided into two categories, acute and chronic, which differ in their aetiology, mechanisms and pathophysiology. Acute pain and its associated responses are provoked by noxious stimulation and/or disease, or by abnormal function of muscle or viscerae which does not involve actual tissue damage. Although acute pain conditions may last for a length of time if not treated effectively, many cases of acute... 

Differentiate between the pathophysiology of chronic stable angina and acute coronary syndromes. 

Describe the pathophysiology of chronic obstructive pulmonary disease (COPD). 

Sethi S, Murphy TF. Acute exacerbations of chronic bronchitis new developments concerning microbiology and pathophysiology— impact on approaches to risk stratification and therapy. Infect Dis Clin North Am 2004 18 861-882. 

FIGURE 23-1. Proposed mechanisms for progression of renal disease. (From Joy MS, Kshirsagar A, Paparello J. Chronic kidney disease Progression-modifying therapies. In DiPiro JT, Talbert RL, Yee GC, et al, (eds.) Pharmacotherapy A Pathophysiologic Approach. 6th ed. New York McGraw-Hill 2005 803, with permission.)... 

Ciampolini J, Harding KG. Pathophysiology of chronic bacterial osteomyelitis. Why do antibiotics fail so often Postgrad Med J 2000 76 479M83. 

Explain the role of the Philadelphia chromosome in the pathophysiology of chronic myelogenous leukemia (CML). 

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