TOPIC/MODULE #9: MATERNAL SUBSTANCE ABUSE, INFECTIOUS DISEASES, MALNUTRITION, DISEASES OF THE RESPIRATORY SYSTEM

MATERNAL SUBSTANCE ABUSE

→ consumption or substances that can have detrimental effects to health of women and development of fetus

→ can affect the health of the woman and baby

→ lead to various complications

TERATOGEN

Acts during embryonic or fetal development to produce a permanent alteration → permanent alteration of form or function to fetus which can cause harm

TERATOGEN Can be of many forms

Medication or any other chemical substance that the mother is consuming while pregnant

Physical or environmental factor  → e.g., heat, radiation (x-ray)

Maternal metabolite (e.g., diabetes)

Infection  → mother gets sick while being pregnant

TERATOGEN Many factors to consider

Genotype of the fetus and the mother

Developmental stage at exposure

Dose and duration of exposure

risk is highest at: EMBRYONIC PERIOD (week 3-8)

• When most organ systems are developing (organogenesis) 

CLEFT PALATE

→ can be induced in the blastocyst stage: increased risk of cleft palate as early: day 6 

→ during gastrulation: day 14 

→ early limb bud stage: 5th week 

→ palatal shelves are forming: 7th week

LICIT SUBSTANCES

→ readily available and easily acquired 

→ tobacco/nicotine 

→ alcohol 

→ caffeine

ILLICIT SUBSTANCE

→ illegal drugs 

→ heroin 

→ marijuana/cannabis

→ methampethamine

PRESCRIPTION DRUG USE OR MISUSE

→ legal, but not readily available: prescription needed

→ prescription opioids (fentanyl): pain killer

→ selective serotonin reuptake inhibitors: SSRI; type of antidepressant

FETAL ALCOHOL SPECTRUM DISORDER (FASD)

Umbrella term for disorders caused by alcohol exposure prior to birth

FETAL ALCOHOL SYNDROME

3 Major criteria/characteristics

CNS PROBLEMS

DYSMORPHIC FACIAL FEATURES

GROWTH DEFICITS

PARTIAL FETAL ALCOHOL SYNDROME (pFAS)

Did not meet full criteria for FAS

Some facial features and history of prenatal alcohol exposre

ALCOHOL-RELATED NEURODEVELOPMENTAL DISORDER (ARND)

May have intellectual disabilities

Behavorial difficulties

ALCOHOL-RELATED BIRTH DEFECTS (ARBD)

→ might have problems with heart, kidneys, bones, or with hearing or mix

NEUROBEHAVIORAL DISORDER ASSOCIATED WITH PRENATAL ALCOHOL EXPOSURE (ND-PAE)

Effects of alcohol exposure are more seen in behavior

For diagnosis: preganant mother must consumed more than 13 alcoholic beverages per month or more than 2 drinks in one sitting

NEONATAL OPIOID WITHDRAWAL SYNDROME (NOWS)

Formerly known as neonatal abstinence syndrome (NAS)

Withdrawal symptoms experienced by babies 

Children are born with drugs in their system

NOWS SYMPTOMS

Withdrawal symptoms

Gastrointestinal dysfunction

Autonomic nervous system (ANS) instability

CNS excitability

Long term complications

INFECTIOUS DISEASES

→ caused by pathogens (harmful organisms) → body from an infected person, animal, contaminated object

Infection: when microbes enter body and multiply

Disease: damaged due to infection

INFECTIOUS AGENTS

CELLULAR (LIVING)
PARASITES	PROTOZOA	FUNGI	BACTERIA
Helminths or parasitic worms Common:  TRICHINOSIS (from undercooked meat)  FOOTWORM	Common infectious diseases cause by protozoa:  Malaria, dessentry	Caused by fungi:  Ringworms, nail infections, vaginal yeast infections	Larger than viruses, single-celled organisms, can reproduce, multiply in the host  → uti, tuberculosis, strep throat

ACELLULAR (NON-LIVING)
VIRUSES	PRIONS
Packets of nucleic acid, cannot reproduce on its own, lack self-sufficiency → common colds, measles, influenza, COVID-19

CELLULAR (LIVING)

PARASITES

PROTOZOA

FUNGI

BACTERIA

ACELLULAR (NON-LIVING)

VIRUSES

PRIONS

PARASITES

Helminths or parasitic worms

Common: 

TRICHINOSIS (from undercooked meat) 

FOOTWORM

PROTOZOA

Common infectious diseases cause by protozoa: 

Malaria, dessentry

FUNGI

Caused by fungi: 

Ringworms, nail infections, vaginal yeast infections

BACTERIA

Larger than viruses, single-celled organisms, can reproduce, multiply in the host 

→ uti, tuberculosis, strep throat

VIRUSES

Packets of nucleic acid, cannot reproduce on its own, lack self-sufficiency

→ common colds, measles, influenza, COVID-19

MODES OF TRANSMISSION

DIRECT
Mother to unborn child	Person to person	Animal to person
Through placenta or breast milk	Touch, kiss, exhange of bodily fluids  Cough or sneeze to someone: 1. DROPLET TRANSMISSION: transmission to new host over the distance of 1m or less 2. AIRBONE TRANSMISSION: distance >1m, type of indirect already	Being bitten or scratch, handling animal waste

INDIRECT
Suspended air particles	Inanimate objects	Vectors

INSECT BITES
Infected mosquitoe bite uninfected person	Infection speads through body and through RBCs	Second mosquito bites infected person, mosquito may now transmit infection to another person

FOOD CONTAMINATION
Fly pick up pathogen from fecal matter and carries it on its body	Fly transfers pathogen to food	Parson eats contaminated food and gets sick

DIRECT

Mother to unborn child

Person to person

Animal to person

INDIRECT

Suspended air particles

Inanimate objects

Vectors

INSECT BITES

Infected mosquitoe bite uninfected person

Infection speads through body and through RBCs

Second mosquito bites infected person, mosquito may now transmit infection to another person

FOOD CONTAMINATION

Fly pick up pathogen from fecal matter and carries it on its body

Fly transfers pathogen to food

Parson eats contaminated food and gets sick

INFECTIOUS DISEASES THAT AFFECT THE BRAIN

Affect cognition, speech, language, and motor skills

MENINGITIS

inflammation of the meninges: protective membranes surrounding brain and spinal cord

ETIOLOGY

COMMON SYMPTOMS

MANAGEMENT

→ multiple infectious agents  → most common dangerous type: bacterial meningitis  → can be caught by direct transmission from person to person (human nose, gut, or vagina)  BACTERIA AND MOST AT RISK Neisseria meningitidis (meningngococcus) Streptococcus pneumoniae Haemophilus influenzae  Streptococcus afalactiae  Grp B streptococcus Young children, adolescents, young adults  Young children, elderly  Young children  Newborn babies

→ lack of energy  → lack of appetite → petechiae: small round spots that look like rashes → for babies Vomiting, fussy, difficult to wake up → less frequent  Seizures, coma, neurological deficits

Prevention → vaccination for bacterial meningitis  Treatment depends on cause → treat it as medical emergency Post illness complications → hearing loss, seizures, limb weaknesss → (-)  vision, speech, language, memory, and communication Depending on cause, disease course, brain involvement, and systemic complications

ENCEPHALITIS

Inflammation, swelling of the brain itself

ETIOLOGY

COMMON SYMPTOMS

MANAGEMENT

→ caused by infection or autoimmune response → can result from viruses carried by mosquitoes and ticks → mosquitos → lead to encephalitis  Zika virus West nile virus Chikungunya  → can also be from herpes, rabies

→ fatigue,  headache, high fever, neck stiffness,  confusion, drowsiness, memory issues, loss of consciousness, nausea, speech issues, personality changes, weakness in parts of body, seizure  For babies → bulging fontanelle, vomiting, stiffness, poor feeding, irritable

→ prevention through vaccinations  → treatment depends on cause  → post illness complications (fatigue, irritability, impaired concentration, seizures, hearing loss, memory loss, blindness) → recovery may take months or years  → intensive rehabilitation

BRAIN ABSCESS

Accumulation of pus and dead cells in the brain causing brain to swell

Detrimental to cognitive function 

Can keep blood from flowing from other parts of the brain

ETIOLOGY

COMMON SYMPTOMS

MANAGEMENT

20-50% are d/t infections from other parts of the body (heart, lung)  Can be d/t bacterial induction Fungal infection  Youn children: congenital heart disease

Headache, changes in mental status (lethargy), nuchal rigidity, fever, seizures, comitting, focal neurologic deficit (specific anatomic site)  For babies → bulging fontanelle, limb spasticity, vomiting, high-pitched crying

→ treatment depnds on cause of the infection  → usually surgery to drain or remove abscess Post illness complications → depdends on early diagnosis and medical treatment that will follow → depends on where brain abscess is and how function is affected

MALNUTRITION

Refers to deficiencies or excess in nutrient intake imbalance of essential nutrients or impaired nutrient utilization; Double burden

Undernutrition, overnutrition

OVERNUTRITION

→ imbalance of energy intake and energy expenditure 

OVERWEIGHT: excessive fat depositis

OBESITY: chronic complex disease, defined by fat depositis but multifactorial disease 

FACTORS OF OBESITY: obesogenic environment, psychosocial factors, genetic variants

CAN LEAD TO HIGHER RISK OF: type 2 diabetes, heart disease, certain cancers 

→ affect bone and reproduction 

→ associated to NCDs → lifestyle disease

OVERWEIGHT

excessive fat depositis

OBESITY

chronic complex disease, defined by fat depositis but multifactorial disease

FACTORS OF OBESITY

obesogenic environment, psychosocial factors, genetic variants

UNDERNUTRITION

UNDERWEIGHT	STUNTING
Low weight for age, can be waster, stunted or both	Low height for age, chronic, long term problem that starts from 1000 days of conception , prevents person from reaching full physical, cognitive potential
WASTING	MICRONUTRIENT DEFICIENCIES
Low weight for height, recent and severe weight loss	Lack of vitamins and minerals 1. Iron d: cause anemia 2. Vit A: cause blindness 3. Vit D: cause soft bones and prevent bone growth 4. Iodine: thyroid problems  5. Foliate: affect fetal development of the child

UNDERWEIGHT

Low weight for age, can be waster, stunted or both

STUNTING

Low height for age, chronic, long term problem that starts from 1000 days of conception , prevents person from reaching full physical, cognitive potential

WASTING

Low weight for height, recent and severe weight loss

MICRONUTRIENT DEFICIENCIES

Lack of vitamins and minerals

1. Iron d: cause anemia

2. Vit A: cause blindness

3. Vit D: cause soft bones and prevent bone growth

4. Iodine: thyroid problems 

5. Foliate: affect fetal development of the child

NUTRITION CARE ALGORITHM

developed to address patients from underwight to overweight upon administration to a hospital

BRONCHITIS 

Inflammation of the lining of the bronchial tubes → leads to coughing with thickened mucuos

ETIOLOGY

COMMON SYMPTOMS

MANAGEMENT

ACUTE BRONCHITIS: develops from cold or respiratory infection  CHRONIC BRONCHITIS: long term, constant irritation/inflammation, mainly due to smoking

Coughing, wheezing, dyspnea, fever, runny nose, fatigue

→ over-the-counter medications → reduce your risk factor → pulmonary rehabilitation and oxygen therapy

PNEUMONIA

Inflammation of the lung tissue that could lead to fluid or pus build up in lungs

ETIOLOGY

COMMON SYMPTOMS

MANAGEMENT

→ Bacteria: bacterial pneumonia more common and severe, streptococcus pneumoniae, hameophilus influenza, chlamydia pneumoniae, legionella  → virus: viral pneumonia, influenza, common cold, COVID-19, respiratory synccytial virus (RSV) → fungi: fungal pneumonia, candida albnicians, aspergillus → high risk populations: adults >65, children <2, immunocompromised CLASSIFICATIONS  Community-acquired pneumonia: anywhere you contract pathogen for pneumonia  Hospital-acquired pnuemonia: impatient for certain disease and acquire pneumonia as you stay in the hospital Health care-associated pneumonia: involve long term care facilities or outpatient clinics Ventilator-associated pneumonia Aspiration pneumonia: when bolus goes does trachea and into lungs → lungs can be infected

High fever, cough, tiredness, rapid breathing, shortness of breath, sweating or chills, chest or abdominal pain, loss of appetite, bluish skin,lips, or nails, confusion or altered mental state

→ prevention through vaccination  → treatment depends on cause  → SLPs: help in improvement of voice (difficulty breathing → more efficient breathing when talking) → improvement of swallowing  Safe swallow Rehabilitation: how to swallow, speak, use their

Community-acquired pneumonia

anywhere you contract pathogen for pneumonia 

Hospital-acquired pnuemonia:

 impatient for certain disease and acquire pneumonia as you stay in the hospital

Health care-associated pneumonia:

involve long term care facilities or outpatient clinics

Aspiration pneumonia:

when bolus goes does trachea and into lungs → lungs can be infected

 Iron d deficiency

cause anemia

 Vit A deficiency

cause blindness

Vit d defienciency

cause soft bones and prevent bone growth

Iodine deficiency

thyroid problems

foliate deficiency

affect fetal development of the child