Exam 1

Neuron Structure


Synapse

Tiny gap between neurons, signals cross the synapse to communicate and send signals to other neurons


Semipermeable membrane

The neuron's outer surface, allowing for smaller molecules and molecules with no charge to pass through, stopping larger or charged molecules


Soma

Cell body, where the nucleus of the neuron is located, maintains the cell and keeps the neuron functioning efficiently


Dendrites

Branches of the soma, where signals are received from other neurons and transmit electrical signals to the axon


Axon

Major extension of the soma, carries signals away from the soma, includes myelin sheath, nodes of ranvier


Axon terminals

Located at the end of the neuron, responsible for transmitting signals to other neurons. Contain neurotransmitter vesicles (sacs that store neurotransmitters, making them available for when signal transportation is necessary)


Neurotransmitters

The chemical messengers of the nervous system


Myelin sheath

Acts as insulator of the axon and increases speed of the signal transfers


Nodes of Ranvier

Gaps in the myelin sheath, signals can jump across the Ranvier, which further speeds up the transmission process









The Nervous System

Send messages from various parts of your body to your brain, and from your brain to your body for directions. Regulate your thoughts, memory, learning, feelings, movements, senses, healing, sleep, heartbeat and breathing patterns, response to stressful situations, digestion, body processes, etc. 


Central nervous system

Comprises of the brain and spinal cord, read signals from nerves to regulate how you think, move, and feel


Peripheral nervous system

Contains sensory and motor nerve cells, relays information from your brain and spinal cord to your organs, arms, legs, fingers, toes, etc. Composed of your somatic nervous system and autonomic nervous system.


Somatic nervous system

Focuses on the voluntary movement of the body. Delivers information from your senses to your brain, also carries commands from brain to muscles, works mainly with sensory input and movement control. 


Autonomic nervous system

Regulate activities you do without thinking about them, involved mostly with your internal organs. Composed of the sympathetic nervous system, the parasympathetic nervous system, and the enteric nervous system. 


Sympathetic nervous system

Activates body processes that help you in times of stress or danger, including fight-or-flight response. Increases heart rate and breathing, dilates pupils, inhibits digestion, more sweating, shuts down parasympathetic responses in order to utilize more energy in the fight-or-flight response.


Parasympathetic nervous system

Responsible for the rest-and-digest body processes, works to maintain long-term health and a healthy balance across all the body's functions. Slows your heart rate, dilates blood vessels, enhances digestion, more relaxed muscles, etc. 


Enteric nervous system

A network of nerve cells in the digestive system that controls digestion and other functions, the largest and most complex unit of the peripheral nervous system






Organelles/Cellular Structure


Endoplasmic Reticulum

Produces proteins and lipids for the rest of the cell to function on. Contains the rough endoplasmic reticulum and the smooth endoplasmic reticulum. "Scaffolding for ribosomes". 


Rough endoplasmic reticulum

Covered in ribosomes, which creates the rough appearance, which produce proteins.

Smooth endoplasmic reticulum

Produces and stores lipids and hormones.


Mitochondria

Known as the powerhouse of the cell, it produces energy (ATP). Properly maintained energy levels provide necessary energy for learning, memory, brain health, etc. 


Golgi Apparatus

Processes and packages proteins and lipids for transport within and outside the cell. Used to modify and direct neurotransmitters to the right locations. Collecting and packaging center for export out of the cell. 


Nucleus

Contains the cell's genetic material and controls cell functions. Synthesis of neurotransmitters as well. Can cause things like Huntington's disease, which affects motor control, mood regulation, and cognition due to abnormalities in the nucleus.


Lysosomes

Break down waste and cellular debris. Dysfunction is related to Alzheimer's and Parkinson's. Degrades debris and contains hydrolytic enzymes (enzymes that help break down complex molecules).


Vesicles

Found in neurons, store neurotransmitters and release them into the synapse during neural communication. Focused on transport.


Vacuoles

Help with the removal of waste products and store neurotransmitters, waste products, ions, etc. Focused on storage. 


Cellular Membrane

Essential to neural communication given their electrical charge, they also house receptors that bind to neurotransmitters, which play a central role in mood regulation, learning, and memory. A lipid bilayer, semi permeable, hydrophobic.



Ribosomes

Form proteins, are typically associated with rough endoplasmic reticulum, but also freely float throughout the cytoplasm


Cytoplasm

Jelly-like substance inside a cell, provides a medium for chemical reactions and supports the movement of materials inside the cell such as ribosomes. 


Cytoskeleton

A network of protein fibers and filaments inside a cell that provides structural support, helps maintain the cell's shape, and facilitates movement.


Microtubules

One of the main components of the cytoskeleton. Long, hollow tubes that provide structural support. Helps make up the cytoskeleton, particularly of the structure of axons.






























Basic Principles


Health care, education, etc. are only as strong as their weakest link.


Early life exposures matter, good or bad.

  • The nervous system changes rapidly during early life

  • Infancy and childhood are a time of great sensitivity to environmental factors

    • Peanut allergies have increased 55% in the last five years in the USA, because parents were told not to expose their children to it, which then didn't build up the children's immune system to it

      • Exposure to peanuts in early childhood decreases the likelihood of developing an allergy for it

    • Doctors were once advised against breastfeeding, but breast milk actually contains large amounts of antibodies and other essential nutrients for the baby

      • The FDA also found lots of dangerous things such as BPA's in baby bottles, which can be very harmful to a baby

    • Fetal alcohol syndrome develops as the baby is exposed to alcohol while in the womb, most susceptible during the first and second trimester of a woman's pregnancy

    • Perfect pitch is also developed in early childhood

      • Perfect pitch - the ability of a person to identify or re-create a given musical note without the benefit of a reference tone

    • Cat litter is dangerous for pregnant women because there are things such as teratogens, which can cause birth defects among other things, in embryos/fetuses

    • Thalidomide was once a nausea treatment for pregnant women, but it was discovered that it actually creates strong birth defects in children 

    • Zika virus causes microcephaly and other birth defects

      • Microcephaly - a birth defect where a baby's head is smaller than expected

Most disease, particularly chronic disease, is an exacerbation of normal changes. In other words, disease is not a threshold event but rather a continuum change. 

  • High prevalence of coronary atherosclerosis in asymptomatic teenagers and young adults

    • Coronary atherosclerosis - A condition caused by the buildup of fats, cholesterol and other substances in and on the walls of the heart arteries

  • This is why biomarkers are so valuable to science and medicine

    • Biomarkers - Measurable characteristics that can indicate a person's health or risk of disease

      • E.g: OCT machine, Actigraphy, Coronary calcium score, blood pressure and heart rate

        • Optical coherence tomography (OCT) - a non-invasive imaging test that uses light waves to take cross-section pictures of your retina, tests for macular degeneration, glaucoma, etc. 

          • Macular degeneration - an eye disease that can cause blurred or lost central vision, can be tested for by an OCT machine

          • Glaucoma - a group of eye diseases that can damage the optic nerve and lead to vision loss or blindness, can be tested for by an OCT machine

        • Actigraphy - a non-invasive method that measures a person's activity and rest cycles over a period of time, can detect sleep disorder of patterns in your sleep-wake cycle that affect your health

        • Coronary calcium score - a measurement of calcium in the coronary arteries, which can help indicate the risk of health disease

Nearly all biological traits can be described as a normal curve.

  • E.g: IQ scores, human skin color distribution, susceptibility of disease

    • CoV - coefficient of variation - measures relative event dispersion, commonly used in comparing relative risk

Most age-related decline is heterogeneous, and can be described as a heteroscedastic function.

  • Heterogeneous - Derived from another source or species

  • Heteroscedastic - A statistical term that describes when the variance of errors (when there is variability of scores caused by factors other than the IV) is not constant across observations

    • Diastolic blood pressure - the pressure in your arteries when your heart relaxes and fills with blood between heartbeats - increases with age

      • Some older people retain young levels others show increase

  • Homoscedasticity - a statistic assumption of equal or similar variance in different groups being compared

    • Some variables do not spread with age, such as presbyopia

      • Presbyopia - Loss of your eyes' ability to focus on nearby objects

Bodily systems are not autonomous. 

  • The gut-brain axis - Consists of bidirectional communication between the central and the enteric nervous system, linking emotional and cognitive centers of the brain with peripheral intestinal functions

    • IBS is an example of the disruption of this relationship

  • Psychoneuroimmunology - A term used to describe the interactions between the emotional state, nervous system function, and the immune system

    • E.g: function of the nervous system, as you go into stress and your body activates the sympathetic nervous system, digestion and all the functions of the parasympathetic nervous system turn off, which work towards long-term health. So, if your body is in stress too much, your sympathetic nervous system is always activated and you lack the benefits of the parasympathetic nervous system, which can in term affect the immune system function

  • Drug side effects - one chemical can affect many things

    • Iatrogenesis - any harm or illness caused unintentionally by medical treatment or diagnostic procedures

      • E.g: Adverse drug reaction (ADR) - any noxious, unintended, and undesired effect of a drug, which occurs at doses used in humans for prophylaxis, diagnosis, or therapy

        • Prophylaxis - Preventative care, action taken to prevent disease, especially by specified means or against a specified disease

    • Prospective study - Develop and conduct studies on subjects before they develop outcomes, follow a group of people over time, looking at the future

    • Retrospective study - Look back at data collected from previous studies/patients to investigate outcomes that have already occurred, looking at the past

  • Sensory input affects cognitive output

    • Taking care of your hearing and vision slows cognitive decline by 50-75%

Biology is plastic (mutable).

  • The brain is adaptable, we have more receptors in our brain than are necessary, so when we lose some due to things like strokes, our brain can adapt and use the ones we still have to carry out functions

  • Parkinson's disease and intensive exercise therapy - people with PD can undergo intensive exercise therapy and relearn how to do things that their brain lost the ability to, such as certain motor functions. This is because the brain is adaptable

  • Learning new things and new skills is a great way to prevent brain function loss

    • Short-term piano training influences verbal memory, executive functioning, and pre-attentive processing of sounds in older adults for the better

  • Use it or lose it…

    • If you want to retain balance, you must practice balance, if you want to retain a range of motion, you must regularly assume a range of motions, etc. 

      • An older adults falls every second of every day

      • One in four older adults reported a fall in 2014

      • Falls are the #1 cause of hip fractures

Many systems in the body are bicameral. 

  • E.g: parasympathetic nervous system and sympathetic nervous system balance each other out and are dependent on each other (the enteric nervous system can work independently of the two)

    • The body is at homeostasis when the sympathetic and parasympathetic nervous systems' balance each other out, but small stressors keep the sympathetic system active, minimizing parasympathetic (maintenance, repair, etc. ) activation
      Homeostasis


Unhealthy nervous system activation progression

  • Opponent processing of color

    • Perception of color is controlled by three opposing pairs of vs. green, blue vs. yellow, black vs, white

    • The activation of one inhibits the perception of the other

      • E.g: If you look at something blue, the blue channel is activated, while the yellow channel is suppressed

        • So, you cannot see a bluish-yellow

        • Also explains afterimages - If you stare at a yellow object for a long time and then look away, you might see a blue afterimage because the yellow channel gets fatigued, allowing the blue channel to briefly dominate

    • You can have a slightly dominate color, which explains why you might see certain colors in images such as this dress

Modern life is often inconsistent with our evolved biology 

  • Human biology evolved over hundreds of thousands of years

    • E.g: The "thrifty gene" hypothesis

      • There is a certain group of Indigenous Americans, The Pimas, who historically lived in the deserts of the Arizona area and developed the ability to survive on the "desert diet" which mostly consisted of plants and lived a very active lifestyle. As civilization evolved and diets changed, this group lives with the highest prevalence of diabetes, due to this gene evolution (their body is wired to live off the "desert diet", not the modern diet)

    • The pandemic of myopia (nearsightedness), "new" and mostly due to modern lifestyles

      • "Keep myopia away, go outdoors and play"

      • Endemic - A disease regularly found in a certain area or population

        • E.g: malaria in certain tropical regions due to its consistent presence year-round

      • Epidemic - Sudden increase in cases in a particular area or population

        • E.g: Sudden increase in flu in one city during the winter

      • Pandemic - Global outbreak of a disease across multiple regions or continents (epidemic spread)

        • E.g: COVID when it spread across the world

      • Emmetropization - eye lengthens according to growth signals (near a device for example, or far, like in the real world)

    • Presbycusis (also "new") - Loss of high frequency hearing with age

      • This did not exist before, because we did not have the stark loud noises before, such as alarms, headphones, etc. 

  • Cancer is largely a disease of the Western lifestyle

  • Older skeletons do not show similar joint degradation despite massive "wear and tear"

  • Modern food products differ from the single ingredient foods that our bodies had evolved to digest

  • Modern thinking is also incompatible with our evolutionary biology

    • Mobile telephone use is associated with changes in cognitive function in young adolescents

    • Much of the human brain is dedicated to vision and movement, making encoding visual-motor improves retention

      • Frontal lobe - responsible for thinking, movement, memory, etc. also controls personality and emotions

      • Parietal lobe - Helps interpret sensory information, also helps with attention, language, and visuospatial processing

      • Temporal lobe - Helps process information from the senses

      • Occipital lobe - processes images from the eyes and connects them to stored images in memory, allowing for image recognition

Human biology (including susceptibility to disease) evolved.

  • Mechanisms of natural selection

    • Pesticides and herbicide encourage the evolution of pest/herbicidal resistance

    • Antibodies promote evolution of more resistant microorganisms

    • Percentage of salmonella-poisoning cases studied in which bacteria were resistant to five commonly used antibiotics

    • Sickle cell anemia evolved as a defense against malaria

      • Sickle cell anemia - A blood disorder that affects the shape and function of red blood cells

      • The sickle cells kill the malaria parasite

    • Hemochromatosis evolved as a defense against the bubonic plague

      • Hemochromatosis - An inherited metabolic disorder causing iron overload in tissues

        • Treated by phlebotomy - removal of blood from a vein

          • Works as a treatment by regularly removing blood from the body

        • People with hemochromatosis should avoid eating iron in their diet, such as spinach, red meat, etc. 

        • Dominant disease in people of European descent

        • Types 1, 2, and 3 are autosomal recessive while type 4 is autosomal dominant

          • Autosomal recessive - you need to have two faulty genes in order to actually have the disease, not simply be a carrier

          • Autosomal dominant - you only need one faulty gene to actually have the disease

        • Paradoxically causes macrophages to be starved for iron

          • Macrophages - a type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells

      • Iron in the blood lowered risk of the plague

    • Autosomal Dominant Compelling Helio Ophthalmic Outburst Syndrome (ACHOO syndrome) - Sneezing when going from dark to bright environments

      • Evolved as protection from fungi, etc., in caves

    • Cerumen - ear wax, protects the ear canal and is produced by glands in the skin

      • Evolved to repel insects

Most diseases can be described by a diathesis-stress model.

  • Diathesis - predisposition

  • Dis-ease results when insult exceeds protection, a combination of a person's predisposition and their exposure to stressor

  • E.g: skin cancer



Most diseases in developed countries are acquired and have a significant life-style component. 

  • Our genes have not changed but our life expectancy has doubled

  • The frequency of most diseases increases with age (time for lifestyle to matter)

    • Whack-a-mole medicine

    • Degenerative disease tends to cluster

  • The age pyramid is inverting in many countries, there are more older people than younger people

SES (Socioeconomic Status) is one of the most significant predictors of health/disease

  • Aging is different across SES 

  • In a study taking a train from one side of a city to another, and as you went from the rich to the poor side of the city, every other train stop represented a lost year of life expectancy

  • Whitehall studies

  • The poorest half of the world own less than 1% of the worlds wealth

  • Disease risk vs SES is not necessarily driven by the access to health care, but by education

  • Some exceptions to the rule: hospitalism, multiple sclerosis, skin cancer, endometriosis

    • Hospitalism - the adverse effects of a prolonged stay in hospital, such as the slowing of development in children

      • Common in the 30s, infants did poorly in hospitals and kept in incubators due to fear of harmful germs. But, infants actually benefit from touch, and this was deprived of them during this time

      • Premature infants are often kept in oxygenated incubators to carefully monitor oxygen levels once they are out of the constant levels of the mother's womb (an example of how iatrogenic effects can be hard to avoid)

    • Multiple sclerosis (MS) - a chronic disease where antibodies break down the myelin sheaths in the brain and spinal cord, which affects the central nervous system

    • Epidemiology - branch of science that studies the distribution/determinants of disease in specific populations

      • Prevalence vs. incidence

        • Prevalence - the total number of a population that has a specific characteristic at a given time 

        • Incidence - The number of new cases of a characteristic that develop in a population over a specified time period

          • E.g. of incidence and prevalence: There is a measurement of diabetes cases in a year. 15% of the population has diabetes for over a year and 5% got diabetes that year. Prevalence - 20% and Incidence - 5%

    • Endometriosis - When uterine tissue grows outside the uterus and causes painful periods and bleeding

      • Sticky endometrial cells within uterine cavity

      • More common in lean women, and it is more common to be lean as you are richer

    • Skin cancer - superficial spreading melanoma

      • Likely more common because they vacation to more places where they would develop sunburns, tanning beds, increased awareness and access to care

        • So, higher likelihood of skin cancers in richer populations not necessarily because they solely are more likely to get it but they are more likely to go to the doctor and get treatment for it

        • Also higher likelihood of treatment in populations with lighter skin tones, which has impacts on SES

    • All of these are more prevalent in richer populations

  • Poverty did not always translate to increased risk

Treatment is not always the answer.  (Addiction)

  • Treatments sometimes yield little actual benefit, are risky, or cause as many problems as they solve

  • Morbidity rate- the rate at which a disease or illness occurs in a population

  • Mortality rate - the number of deaths in a population

  • Alcohol use in the US

    • 35% abstain

    • 65% moderate drinkers (including binging)

    • 6-10% heavy drinkers

    • 10% addiction rate

  • Light alcohol use: French paradox, buffers stress, improves LDL/HDL ratio, interferes with fat absorption, antioxidants, etc. 

  • Binge drinking: 4th leading cause of death due to automotive accidents, 67% deaths due to homicide

  • Alcohol acts as a central nervous system depressant, which causes disinhibition

    • Disinhibition - the inability to control one's behavior or to suppress unwanted or inappropriate actions

  • Alcohol affects the Vestibular system (balance, equilibrium, spatial orientation)

    • Nystagmus (involuntary eye movements)

      • A condition that causes involuntary, rhythmic eye movements that can be rapid or slow

      • Reflexive eye movement in which the eyes track a  moving object and then snap back

      • Field sobriety testing

        • Putatively, 92% accuracy

    • Vestibular tests

      • Baranay Chair Test

        • Measure nystagmus or performance on tasks

        • Balance tests (stand on one foot with your eyes closed)

  • Alcohol effects

    • Alcohol use disorder (16.3 million)

    • Alcoholic gastritis ulceration and hemorrhaging

    • Korsakoff's disease

      • Due to brain damage caused by Vitamin B1 deficiency

      • Causes severe anterograde amnesia

        • Anterograde amnesia - Amnesia when you can't form new memories

    • Liver cirrhosis

      • Growth of connective tissue destroys liver cells, liver is scarred and permanently damaged

    • Pancreatic undigested food in stools, ascites, abdominal pain

    • Digestive cancers

    • Cardiovascular problems

    • Fetal alcohol syndrome (1%)

      • A group of conditions that can occur in a person whose mother drank alcohol during pregnancy

      • most susceptible during the first and second trimester of a woman's pregnancy

  • Addiction rates

    • 10% alcohol 

    • 70% smoking tobacco

  • Smoking prevalence (16%)

    • Falling prevalence, rising numbers

      • Since 1990, the prevalence of smoking has decreased steadily around the globe. However, as populations have grown, the total number of smokers have increased

  • There is the presence of classic conditioning in advertisements to get people to start smoking

    • Usage of celebrities (especially those who are known to be healthy) to get people to associate smoking with being attractive and cool

      • Would also use advertisements of doctors promoting smoking

    • Subliminal advertising towards Eros or sex

      • Attract the sex appeal to attract people to your product

    • Focus on vulnerable/susceptible groups (young)

      • E.g: the camel logo appealed towards children, handing out candy cigarettes to children who were too young to smoke, camel cash (contained toys in the catalog)

      • Camel was once perceived as the "old man's cigarette" but once advertising started, sales to the under 17 year age group went up by a factor of 80

      • This method is common, e.g. mcdonalds, vaping, etc. 

        • Vaping is technically healthier than smoking cigarettes

    • If you want something to be true, or don't want it to be true, take that as a red herring

      • Wanting something is antithetical to the actual truth, this is why the scientific method has many mechanisms for minimizing bias

  • Mucociliary escalator: The self-clearing mechanism in the lungs that removes particles and pathogens from the airways, lining of the trachea and bronchi

    • The tar in cigarettes especially defeats this mechanism and leads to things like lung cancer

  • How to get people to stop smoking? 

    • People have tried putting the physical consequences of smoking on packages, but this doesn't work because when people are addicted, they are not worried about their own health

    • Addiction is mediated by neural internal reward mechanisms ("because I enjoy it") 

  • Many substances/behaviors are addictive because they activate brain reward areas (reward circuit - dopamine)

    •  Medial forebrain bundle - area of the brain that mediates "reward" and is often stimulated by addiction (prefrontal cortex, nucleus accumbens, ventral tegmental area)

    • Intracranial self-stimulation was used to identify brain reward areas

      • Brains were injected into their medial forebrain bundle and they were given the choice to stimulate it. They would chose this over things like food and water, and would pretty much choose pleasure to death

    • Brain "reward systems" are depressed in subjects with depression

    • There are also individual differences in addiction that reflect different diathesis (susceptibility)

    • Reward/pain relief is mediated by internal opiates (endorphins) and are closely associated, it is common to experience a pleasure that is closely related to pain, such as runner's high

    • Periaqueductal gray matter (PAG) - a brain region that plays a critical role in the modulation of pain

  • Opioid Epidemic: Addiction Statistics

    • Almost 50K people die every year from opioid overdose

    • Over 10 million people misuse opioids in a year

    • Opioids are a factor in at least 7 out of every 10 overdose deaths

  • Opioids

    • "Opioids" was originally used to refer to synthetic opiates only (drugs created to emulate opium). Now the term opioid is used for the entire family of opiates including natural, synthetic, and semi-synthetic

      • Ex: oxycontin, vicodin, morphine, methadone, fentanyl, etc. 

    • The crisis started with the legitimate need to deal with chronic pain

      • "More Americans are sick, in other words, than are healthy"

    • Strategies of companies: target youth, use HPs and celebrities, go overseas (less regulation)

      • Using health-care professionals

        • The more opioids doctors prescribe, the more they get paid

        • There used to be things such as "pill mills", where people could go for pain symptoms and doctors would loosely prescribe opioids

      • Go overseas

        • Oxycontin sales began to fall in the US, so companies refocused on their global business, particularly in the developing world

    • Methods to help:

      • Methods to get health professionals to stop prescribing: Use triplicate prescriptions

        • There had to be three copies of each prescription, one to give to pharmacy, one for patient, one for the HP to keep - held them accountable

        • "Oxycontin distribution was about 50% lower in triplicate states"

      • Naloxone (Narcan)

        • Overdose medication reduces deaths

        • Increase availability of narcan to most places people would need it, such as department stores, etc. 



Cellular basis of aging and disease 

  • Basic properties of cells explain much of health/illness

  • Nervous system

    • Vascularized, sensitive to hypoxia

      • Hypoxia - Occurs when oxygen is insufficient at the tissue level to maintain adequate homeostasis

    • Metabolism, sensitive to metabolic issues

    • Nutritionally responsive

  • Neurons have all the same organelles but do not undergo mitosis (mostly), neural disorders are hard to treat

  • The axon can regrow is the soma is kept viable - this is the idea of neural regeneration

    • E.g: Post-polio syndrome and collateral sprouting

      • Post-polio syndrome - A disorder of the nerves and muscles that happens to some people many years after they have had polio. Causes new muscle weakness due to weaker regenerated neurons

      • Collateral sprouting - The growth of intact axons into neighboring denervated territory

    • Wallerian degeneration - The process where the distal part of a damaged axon degeneration after injury (apart of neural regeneration)

      • Acute inflammation is mostly useful and can be used in regeneration, but chronic inflammation is a major promoter of chronic disease

    • You can even sometimes do things like face transplants and reattaching limbs, if with enough time, because of neural regeneration

  • Semi-permeable plasma membrane - receptors regulate the entry of materials into the cell

    • Regulation - the number of receptors increases or decreases depending on the concentration of the extracellular target

      • To compensate for decreased levels of a neurotransmitter like serotonin, the brain increases the number of receptors for that specific neurotransmitter

        • Upregulation - The process by which a cell increases its response to a substance or signal from outside the cell to carry out a specific function

        • Denervation supersensitivity - The growth of (upregulation) of membrane receptors in response to a deficiency

  • Miosis - Age-related shrinkage of the pupil, can be an indicator of early onset Alzheimer's

    • Can be tested by pupil dilation test

  • Diabetes

    • Insulin regulates entry of glucose

      • The pancreas produces insulin

        • Type I Diabetes - lack of insulin-producing cells (Islet cells) which exist in the pancreas

      • Excess sugar intake causes down regulation of insulin receptors on cell membrane

        • Type II diabetes - lack of membrane receptors for insulin

    • Often due to neovascularization

      • Neovascularization - The process of new blood vessels forming in the body, which can occur in the eye or elsewhere

        • Most common type of neovascularization - angiogenesis 

          • Angiogenesis - outgrowth of blood vessels from existing ones 

    • Increase in intake of refined sugar is one obvious driving factor of the increase in diabetes

      • Sugar is added to many seemingly healthy food items

      • Candy "seconds" sold to farmers to fatten livestock




How cells die (external stress vs internal programming)

  • Necrosis vs. Apoptosis

  • Necrosis - the death of body tissue or cells due to environmental factors, such as trauma, infection, oxidative stress, etc. 

  • Apoptosis - Programmed cell death that is triggered by internal signals, such as DNA damage, development, etc. 

  • Humans may have already reached their maximum lifespan

    • The lifespan in the absence of environmental insult is 126 years

    • Human maximum lifespan (126) has not changed (average has changed,  driven largely by changes in infant mortality)

    • Scientists may have discovered a way to slow aging by direct reprogramming of human cells

      • Hayflick number (limit) - the number of times a cell can divide (mitosis) before it dies (apoptosis)

        • Genetically determined

        • Often is disrupted by necrosis (environmental stressors)

    • Telomeres - chromosomal "end caps" that shorten with each cell division

      • Review: 22 pairs of autosomal chromosomes, 1 pair (2) sex chromosomes

      • Measuring telomere length is an important new tool for studying chronic disease and health

      • Most have the genetic program to live to around 80 years, less or more is largely due to behavioral/environmental factors (necrosis)

      • People with Hutchinson-Gilford Progeria Syndrome have shorter than average telomeres, which causes them to age faster than the average person

    • Free radical stress (oxidative stress) - When unstable molecules called free radicals build up in the body, which can damage cells, proteins, and DNA

      • Oxygen is easily converted to radical forms due to its chemical structure. Oxygen naturally has two unpaired electrons in its outer shell, which makes it prone to react with other molecules and form reactive oxygen species (ROS) (type of free radicals)

      • Acute effects of excess oxidative stress - retinopathy of prematurity

        • Retinopathy of prematurity - Retinal disease affecting premature babies

    • Early in evolution of life, plants used oxygen as a competitive tool (kill other plants), who then developed antioxidants to protect themselves

      • Subsequent species piggybacked on this defense

      • Antioxidants are electron rich, can quench radical reactions by donating electrons and preventing the buildup of these free radicals, therefore preventing necrosis

      • This is one of the reasons why plant-based diets can prevent chronic disease, because they provide such antioxidants to help prevent necrosis in all parts of our bodies

    • Chronic inflammation (inflammaging) is the other major driver of chronic disease

    • So, the top two drivers of chronic disease is oxidative stress and inflammaging









Miscellaneous: 

  • Microglia - Immune cells that live in the central nervous system and protect the brain and spinal cord from pathogens and damage

  • Major histocompatibility complex (MHC) - A group of genes that encode proteins that play a vital role in the immune system

  • Idiopathic - A disease of an unknown cause

  • Etiology - The study of the causes of diseases

  • Sarcopenia - age-related loss of muscle, inevitable


To add: 

  • Percentage of obese americans

  • Most common causes of mortality

  • Research methods

  • Relevant readings



Questions:

  • Homoscedasticity vs heteroscedasticity

    • Wouldn't presbyopia be heteroscedastic because it is a gradual loss and increases with age? There is contradiction in what I'm seeing online

  • What was the mnemonic device for Sarah, stare-uh? 

  • How much impact does the lobes of the brain have on the exam? 

  • How do antibodies promote evolution of more resistant microorganisms?

  • Is it important for us to know which forms of hemochromatosis are autosomal recessive vs dominant? 

  • How does hemochromatosis starve the macrophages of iron? 

  • What do you mean by whack-a-mole medicine?

  • Can you elaborate on the Whitehall studies?

  • Can you elaborate more on your definition of endometriosis?

  • Can you further explain how alcohol affects the VOR?