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Crush Syndrome
Crush syndrome (also traumatic rhabdomyolysis or Bywaters' syndrome) is a medical condition characterized by major shock and kidney failure after a crushing injury to skeletal muscle. It should not be confused with crush injury, which is the compression of the arms, legs, or other parts of the body that causes muscle swelling and/or neurological disturbances in the affected areas of the body, while crush syndrome is a localized crush injury with systemic manifestations. Cases occur commonly in catastrophes such as earthquakes, to individuals who have been trapped under fallen or moving masonry. People with crushing damage present some of the greatest challenges in field medicine, and may need a physician's attention on the site of their injury. Appropriate physiological preparation of the injured is mandatory. It may be possible to free the patient without amputation; however, field amputations may be necessary in drastic situations. Pathophysiology Seigo Minami, a Japanese ...
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Kidney Failure
Kidney failure, also known as renal failure or end-stage renal disease (ESRD), is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as either acute kidney failure, which develops rapidly and may resolve; and chronic kidney failure, which develops slowly and can often be irreversible. Symptoms may include leg swelling, feeling tired, vomiting, loss of appetite, and confusion. Complications of acute and chronic failure include uremia, hyperkalemia, and volume overload. Complications of chronic failure also include heart disease, high blood pressure, and anaemia. Causes of acute kidney failure include low blood pressure, blockage of the urinary tract, certain medications, muscle breakdown, and hemolytic uremic syndrome. Causes of chronic kidney failure include diabetes, high blood pressure, nephrotic syndrome, and polycystic kidney diseas ...
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The Blitz
The Blitz (English: "flash") was a Nazi Germany, German bombing campaign against the United Kingdom, for eight months, from 7 September 1940 to 11 May 1941, during the Second World War. Towards the end of the Battle of Britain in 1940, a contest for daylight air superiority over the United Kingdom between the and the Royal Air Force, Germany began conducting mass air attacks against British cities, beginning with London, in an attempt to draw the RAF Fighter Command into a battle of annihilation.Price 1990, p. 12. Adolf Hitler and Hermann Göring, commander-in-chief of the Luftwaffe, ordered the new policy on 6 September 1940. From 7 September 1940, London was systematically bombed by the Luftwaffe for 56 of the following 57 days and nights. Notable attacks included a large daylight attack against London on Battle of Britain Day, 15 September, a large raid on 29 December 1940 against London -- resulting in a firestorm known as the Second Great Fire of London,Hooton 1997, p. ...
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Compartment Syndrome
Compartment syndrome is a serious medical condition in which increased pressure within a Fascial compartment, body compartment compromises blood flow and tissue function, potentially leading to permanent damage if not promptly treated. There are two types: Acute (medicine), acute and Chronic condition, chronic. Acute compartment syndrome can lead to a loss of the affected limb due to tissue death. Symptoms of acute compartment syndrome (ACS) include severe pain, decreased blood flow, decreased movement, numbness, and a pale limb. It is most often due to Injury, physical trauma, like a bone fracture (up to 75% of cases) or a crush injury. It can also occur after Reperfusion injury, blood flow returns following a period of poor circulation. Diagnosis is Clinical diagnosis, clinical, based on symptoms, not a specific test. However, it may be supported by measuring the pressure inside the Fascial compartment, compartment. It is classically described by pain out of proportion to the in ...
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Creatine Kinase
Creatine kinase (CK), also known as creatine phosphokinase (CPK) or phosphocreatine kinase, is an enzyme () expressed by various tissues and cell types. CK catalyses the conversion of creatine and uses adenosine triphosphate (ATP) to create phosphocreatine (PCr) and adenosine diphosphate (ADP). This CK enzyme reaction is reversible and thus ATP can be generated from PCr and ADP. In tissues and cells that consume ATP rapidly, especially skeletal muscle, but also brain, photoreceptor cells of the retina, hair cells of the inner ear, spermatozoa and smooth muscle, PCr serves as an energy reservoir for the rapid buffering and regeneration of ATP ''in situ'', as well as for intracellular energy transport by the PCr shuttle or circuit. Thus creatine kinase is an important enzyme in such tissues. Clinically, creatine kinase is assayed in blood tests as a marker of damage of CK-rich tissue such as in myocardial infarction (heart attack), rhabdomyolysis (severe muscle breakdown), muscu ...
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Creatine
Creatine ( or ) is an organic compound with the nominal formula . It exists in various tautomers in solutions (among which are neutral form and various zwitterionic forms). Creatine is found in vertebrates, where it facilitates recycling of adenosine triphosphate (ATP), primarily in muscle and brain tissue. Recycling is achieved by converting adenosine diphosphate (ADP) back to ATP via donation of phosphate groups. Creatine also acts as a Buffer solution, buffer. History Creatine was first identified in 1832 when Michel Eugène Chevreul isolated it from the basified water-extract of skeletal muscle. He later named the crystallized precipitate after the Ancient Greek, Greek word for meat, ('). In 1928, creatine was shown to exist in Tautomer, equilibrium with creatinine. Studies in the 1920s showed that consumption of large amounts of creatine did not result in its excretion. This result pointed to the ability of the body to store creatine, which in turn suggested its use as ...
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Thromboplastin
Thromboplastin (TPL) is derived from cell membranes and is a mixture of both phospholipids and tissue factor, neither of which are enzymes. Thromboplastin acts on and accelerates the activity of Factor Xa, also known as thrombokinase, aiding blood coagulation through catalyzing the conversion of prothrombin to thrombin. Thromboplastin is found in brain, lung, and other tissues and especially in blood platelets. Thromboplastin is sometimes used as a synonym for the protein tissue factor (with its official name "Coagulation factor III hromboplastin, tissue factor). Historically, thromboplastin was a lab reagent, usually derived from placental sources, used to assay prothrombin times (PT). When manipulated in the laboratory, a derivative could be created called partial thromboplastin. Partial thromboplastin was used to measure the intrinsic pathway. This test is called the aPTT, or activated partial thromboplastin time. It was not until much later that the subcomponents of thrombop ...
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Phosphate
Phosphates are the naturally occurring form of the element phosphorus. In chemistry, a phosphate is an anion, salt, functional group or ester derived from a phosphoric acid. It most commonly means orthophosphate, a derivative of orthophosphoric acid, phosphoric acid . The phosphate or orthophosphate ion is derived from phosphoric acid by the removal of three protons . Removal of one proton gives the dihydrogen phosphate ion while removal of two protons gives the hydrogen phosphate ion . These names are also used for salts of those anions, such as ammonium dihydrogen phosphate and trisodium phosphate. File:3-phosphoric-acid-3D-balls.png, Phosphoricacid File:2-dihydrogenphosphate-3D-balls.png, Dihydrogenphosphate File:1-hydrogenphosphate-3D-balls.png, Hydrogenphosphate File:0-phosphate-3D-balls.png, Phosphate or orthophosphate In organic chemistry, phosphate or orthophosphate is an organophosphate, an ester of orthophosphoric acid of the form where one ...
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Metabolite
In biochemistry, a metabolite is an intermediate or end product of metabolism. The term is usually used for small molecules. Metabolites have various functions, including fuel, structure, signaling, stimulatory and inhibitory effects on enzymes, catalytic activity of their own (usually as a cofactor to an enzyme), defense, and interactions with other organisms (e.g. pigments, odorants, and pheromones). A primary metabolite is directly involved in normal "growth", development, and reproduction. Ethylene exemplifies a primary metabolite produced large-scale by industrial microbiology. A secondary metabolite is not directly involved in those processes, but usually has an important ecological function. Examples include antibiotics and pigments such as resins and terpenes etc. Some antibiotics use primary metabolites as precursors, such as actinomycin, which is created from the primary metabolite tryptophan. Some sugars are metabolites, such as fructose or glucose, which ar ...
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Nephrotoxicity
Nephrotoxicity is toxicity in the kidneys. It is a poisonous effect of some substances, both toxic chemicals and medications, on kidney function. There are various forms, and some drugs may affect kidney function in more than one way. Nephrotoxins are substances displaying nephrotoxicity. Nephrotoxicity should not be confused with some medications predominantly excreted by the kidneys needing their dose adjusted for the decreased kidney function (e.g., heparin, lithium). Types of toxicity Cardiovascular * General: diuretics, β-blockers, vasodilator agents * Local: ACE inhibitors, ciclosporin, tacrolimus. Direct tubular effect * Proximal convoluted tubule: Aminoglycoside antibiotics (e.g., gentamicin), amphotericin B, cisplatin, radiocontrast media, immunoglobulins, mannitol * Distal tubule: NSAIDs (e.g. aspirin, ibuprofen, diclofenac), ACE inhibitors, ciclosporin, lithium salts, cyclophosphamide, amphotericin B * Tubular obstruction: sulphonamides, methotr ...
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Kidney
In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organ (anatomy), organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal artery, renal arteries; blood exits into the paired renal veins. Each kidney is attached to a ureter, a tube that carries excreted urine to the urinary bladder, bladder. The kidney participates in the control of the volume of various body fluids, fluid osmolality, Acid-base homeostasis, acid-base balance, various electrolyte concentrations, and removal of toxins. Filtration occurs in the glomerulus (kidney), glomerulus: one-fifth of the blood volume that enters the kidneys is filtered. Examples of substances reabsorbed are solute-free water, sodium, bicarbonate, glucose, and amino acids. Examples of substances secreted are hy ...
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Ischemia
Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue, i.e., hypoxia and microvascular dysfunction. It also implies local hypoxia in a part of a body resulting from constriction (such as vasoconstriction, thrombosis, or embolism). Ischemia causes not only insufficiency of oxygen but also reduced availability of nutrients and inadequate removal of metabolic wastes. Ischemia can be partial (poor perfusion) or total blockage. The inadequate delivery of oxygenated blood to the organs must be resolved either by treating the cause of the inadequate delivery or reducing the oxygen demand of the system that needs it. For example, patients with myocardial ischemia have a decreased blood flow to the heart and are prescribe ...
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Phosphorus
Phosphorus is a chemical element; it has Chemical symbol, symbol P and atomic number 15. All elemental forms of phosphorus are highly Reactivity (chemistry), reactive and are therefore never found in nature. They can nevertheless be prepared artificially, the two most common allotropes being white phosphorus and red phosphorus. With as its only stable isotope, phosphorus has an occurrence in Earth's crust of about 0.1%, generally as phosphate rock. A member of the pnictogen family, phosphorus readily forms a wide variety of organic compound, organic and inorganic compound, inorganic compounds, with as its main oxidation states +5, +3 and −3. The isolation of white phosphorus in 1669 by Hennig Brand marked the scientific community's first discovery since Antiquity of an element. The name phosphorus is a reference to the Phosphorus (morning star), god of the Morning star in Greek mythology, inspired by the faint glow of white phosphorus when exposed to oxygen. This property is ...
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