Stage two of progression is marked by a significant
decline in memory function and the beginnings of a personality change. There is difficulty in remembering the names of new acquaintances, difficulty in remembering items which have been read, and difficulties in organizing and planning. Towards the end of this stage, the symptoms become more and more evident to others around the individual. A small proportion of individuals are diagnosed with Alzheimer’s at this stage.
By stage three of the disease, individuals are
unable to function without assistance. There is great difficulty in remembering information such as their address and phone number, and sometimes even the date, day of the week or month. While they may be able to remember the names of people near to them, they forget the names of those they see on a less regular basis. They may often not recognize their surroundings. By this stage, a significant proportion of patients will be diagnosed.
In stage four, patients will require help with most
of their daily functions. Personality changes also become evident and there may be expressions of inappropriate emotions. Patients can still distinguish between familiar and unfamiliar faces, but have difficulty in identification. They can wander off and get lost, if not kept under observation. Frequently, they may need help with their bodily functions and can become doubly incontinent. They appear lost and confused for most of the time, though there may be periods of lucidity.
The final stage of the disease is characterised by a
catatonic-like state, which means that patients are unable to speak or respond to others, though they may occasionally utter words. Their muscles become rigid and they are unable to sit up, smile, swallow or hold their heads up. Death eventually intervenes, typically around eight years after the initial diagnosis of Alzheimer’s.
Transcript ≤1.9 Lecture 4
The problem that Dr Snow faced was that he did not know what was causing the disease. At this time, the dominant theory regarding the transmission of disease was that it came from breathing foul air or ‘miasma’ which contained harmful particles. Dr Snow, on the other hand, felt that the water which people drank might be making them ill. However, he was unable to describe the mechanism which caused it, because the micro-organism theory of disease would not be fully formulated until 1875.
24
He had a number of scientific tools at his disposal
to help identify the cause of the problem. He took samples of the water from all the pumps in the area and investigated them using a microscope and chemical analysis. However, this did not reveal anything of significance. His next step was to identify where the people who died of cholera had lived and he created a spot map to show this. The results of the spot map showed that most of the people who died lived very close to one of the public water pumps, on Broad Street. Another, smaller cluster was close to another public water pump.
Snow followed this up by talking to the residents
who lived near the second pump. He found that people who had died there drank water from the Broad Street pump, as they preferred the taste. As a result of this he concluded that the water from the Broad Street pump was a common factor in all the deaths. He took his results to the local authorities, and as a result of his investigations the handle was taken off the pump, so that no more water could be taken from that source. The outbreak came to an end shortly afterwards.
Even though he was unable to identify the
mechanism which caused the disease, Dr Snow was successful in preventing it. This investigation laid the foundations of the science of epidemiology, the study of the transmission of diseases in populations. The science still relies on many of the techniques pioneered by Dr Snow, particularly the use of statistics to identify the spread of a disease among a population, and hence its likely sources. It has also given rise to the branch of medicine known as public health medicine, which has delivered many of the enormous gains in life expectancy and quality of life experienced over the last century.
Transcript ≤1.10 Lecture 5
These hormones control how quickly the body metabolizes energy. They also have direct effects on most organs, including the heart, which beats faster and harder under the influence of thyroid hormones. Essentially all cells in the body will respond to increases in thyroid hormone with an increase in the rate at which they conduct their business.
In healthy people, the thyroid makes just the right
amounts of T4 and T3. However, in a relatively small number of people there can be an imbalance of the hormones. Hyperthyroidism is the condition which is caused by the effects of too much of the thyroid hormones on tissues of the body.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140 |
Page 141 |
Page 142 |
Page 143 |
Page 144 |
Page 145 |
Page 146 |
Page 147 |
Page 148 |
Page 149 |
Page 150 |
Page 151 |
Page 152 |
Page 153 |
Page 154 |
Page 155 |
Page 156 |
Page 157 |
Page 158 |
Page 159 |
Page 160 |
Page 161 |
Page 162 |
Page 163 |
Page 164 |
Page 165 |
Page 166 |
Page 167 |
Page 168 |
Page 169 |
Page 170 |
Page 171 |
Page 172 |
Page 173 |
Page 174 |
Page 175 |
Page 176 |
Page 177 |
Page 178 |
Page 179 |
Page 180 |
Page 181 |
Page 182 |
Page 183 |
Page 184 |
Page 185 |
Page 186 |
Page 187 |
Page 188 |
Page 189 |
Page 190 |
Page 191 |
Page 192 |
Page 193 |
Page 194 |
Page 195 |
Page 196 |
Page 197 |
Page 198 |
Page 199 |
Page 200 |
Page 201 |
Page 202 |
Page 203 |
Page 204 |
Page 205 |
Page 206 |
Page 207 |
Page 208 |
Page 209 |
Page 210 |
Page 211 |
Page 212 |
Page 213 |
Page 214 |
Page 215 |
Page 216 |
Page 217 |
Page 218 |
Page 219 |
Page 220 |
Page 221 |
Page 222 |
Page 223 |
Page 224 |
Page 225 |
Page 226 |
Page 227 |
Page 228 |
Page 229 |
Page 230 |
Page 231 |
Page 232 |
Page 233 |
Page 234 |
Page 235 |
Page 236 |
Page 237 |
Page 238 |
Page 239 |
Page 240 |
Page 241 |
Page 242 |
Page 243 |
Page 244 |
Page 245 |
Page 246 |
Page 247 |
Page 248 |
Page 249 |
Page 250 |
Page 251 |
Page 252 |
Page 253 |
Page 254 |
Page 255 |
Page 256 |
Page 257 |
Page 258 |
Page 259 |
Page 260 |
Page 261 |
Page 262 |
Page 263 |
Page 264 |
Page 265
