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ΣΥΓΧΡΟΝΑ ΘΕΜΑΤΑ ΠΑΘΟΛΟΓΙΑΣ - CURRENT MEDICAL ISSUES

Ιστοσελίδα ενημέρωσης για παθολογικά ιατρικά θέματα από την ιατρό ειδική παθολόγο Αναστασία Μοσχοβακη. Αναζητείστε τον παθολογικό όρο που σας ενδιαφέρει, τοποθετώντας τον στο πλαίσιο αναζήτησης του ιστολογίου (search this blog) δεξιά στην οθόνη του υπολογιστή σας.

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ΑΔΥΝΑΜΙΑ ΣΤΑ ΠΟΔΙΑ (Ενημέρωση και στο http://xroniakoposi.blogspot.com) 03 Φεβ 2012, 18:08

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Το σύμπτωμα της αδυναμίας που εμφανίζεται αμιγώς στην περιοχή των κάτω άκρων είναι ένα δυσάρεστο σύμπτωμα, που οδηγεί τον πάσχοντα στον ειδικό παθολόγο. Η αδυναμία στα κάτω άκρα μπορεί να εμφανίζεται μόνο κατά τη διάρκεια της άσκησης ή να είναι συνεχής. Συνοδά συμπτώματα όπως τινάγματα, μυρμηγκιάσματα, μούδιασμα συνοδεύουν σε αρκετές περιπτώσεις την αδυναμία των ποδιών.

Τα κάτω άκρα είναι σημαντικά για τη στήριξη του σώματος, οι παθήσεις ωστόσο που προκαλούν αδυναμία στα κάτω άκρα, συχνά δεν εντοπίζονται αμιγώς σε αυτά. Η φυσιολογική λειτουργία των κάτω άκρων προϋποθέτει καλή μυϊκή ισχύ, καλή λειτουργία των οστών και των αρθρώσεων, καλή λειτουργία των νεύρων, επάρκεια αιματικής ροής, φυσιολογική τροφοδοσία των κάτω άκρων μέσω του αίματος με οξυγόνο θρεπτικά συστατικά και ιχνοστοιχεία και καλή λειτουργία του εγκεφάλου και των νευρικών οδών που δίνουν την εντολή της κίνησης και της ισορροπίας. Κατά την ιατρική εξέταση είναι σημαντικό να αξιολογηθεί εάν η αδυναμία είναι τοπική ή αφορά γενικότερα τον οργανισμό, εάν είναι ετερόπλευρη ή αμφοτερόπλευρη, εάν έχει εμφανιστεί οξέως ή έχει χρόνιο χαρακτήρα, εάν συνοδεύεται από παράλυση του άκρου ή όχι.

Τα νοσήματα που προκαλούν αδυναμία στα πόδια διακρίνονται σε:

• Συστηματικά νοσήματα (π.χ. ηλεκτρολυτικές διαταραχές, αναιμία, σύνδρομο χρόνιας κόπωσης, διαβήτης, υποξία)

• Νοσήματα στην περιοχή των κάτω άκρων (π.χ. μυασθένεια, μεταβολικές διαταραχές των μυών, δυσκινησία λόγω αρθρίτιδας, κακή κυκλοφορία άκρων, νευροπάθεια από παγίδευση)

• Νοσήματα εγκεφάλου ή νωτιαίου μυελού (π.χ. σκλήρυνση κατά πλάκας, εγκεφαλικό απόστημα, νεοπλάσματα κεντρικού νευρικού συστήματος, λοίμωξη κεντρικού νευρικού συστήματος, ισχαιμία εγκεφάλου)

• Ψυχιατρικά νοσήματα

Ορισμένες περιπτώσεις μυϊκής αδυναμίας έχουν μεικτό μηχανισμό.

Η σωστή παθολογική εξέταση έχει κομβικό ρόλο στην ορθή διαφορική διάγνωση και θεραπεία.

Δρ. Αναστασία Μοσχοβάκη

Ιατρός Eιδική Παθολόγος

Φραγκοπούλου 10 Κηφισιά

24ωρη γραμματεία νοσοκομειακά περιστατικά : 2106252770

E mail amoschovaki@yahoo.gr.

LINKS

http://twitter.com/amoschovaki H ΙΑΤΡΙΚΗ ΕΝΗΜΕΡΩΣΗ ΣΤΟ TWITTER

http://anastasiamoschovaki1.blogspot.com ΘΕΜΑΤΑ ΥΓΕΙΑΣ

http://xroniakoposi.blogspot.com ΧΡΟΝΙΑ ΚΟΠΩΣΗ

http://organicsexualdysfunction.blogspot.com ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ/ ΣΕΞΟΥΑΛΙΚΕΣ ΔΙΑΤΑΡΑΧΕΣ ΠΑΘΟΛΟΓΙΚΗΣ ΑΙΤΙΟΛΟΓΙΑΣ

http://frequentmedicaldisorders.blogspot.com FREQUENT MEDICAL DISORDERS (αγγλόφωνο)

http://infectiousdiseaseissues.blogspot.com ΠΥΡΕΤΟΣ – ΛΟΙΜΩΞΕΙΣ

http://highglucose.blogspot.com ΔΙΑΒΗΤΗΣ

http://systemichypertension.blogspot.com ΥΨΗΛΗ ΠΙΕΣΗ

http://alternativemedicinehellenicblog.blogspot.com ΕΝΑΛΛΑΚΤΙΚΗ ΙΑΤΡΙΚΗ

http://cholesterolandtriglycerides.blogspot.com ΧΟΛΗΣΤΕΡΙΝΗ - ΤΡΙΓΛΥΚΕΡΙΔΙΑ

http://internationaltravelmedicine.blogspot.com ΤΑΞΙΔΙΑ ΚΑΙ ΥΓΕΙΑ

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title="Digg this!"> Digg

ΔΥΣΛΕΙΤΟΥΡΓΙΑ ΤΟΥ ΑΡΤΗΡΙΑΚΟΥ ΕΝΔΟΘΗΛΙΟΥ: Ο ΠΙΟ ΚΟΙΝΟΣ ΠΑΡΑΓΟΝΤΑΣ ΣΤΥΤΙΚΗΣ ΔΥΣΛΕΙΤΟΥΡΓΙΑΣ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:52

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Το αρτηριακό ενδοθήλιο είναι ιστός που ευρίσκεται στο εσωτερικό τοίχωμα των αρτηριών. Το ενδοθήλιο δεν είναι μία στατική δομή αλλά μία δυναμική δομή που ευρίσκεται σε συνεχή αλληλεπίδραση με το κυκλοφορούμενο αίμα και ταυτόχρονα έχει σημαντική εκκριτική λειτουργία. Η δυσλειτουργία του ενδοθηλίου είναι η παθολογική κατάσταση κατά την οποία αλλοιώνεται σημαντικά η εκκριτική ικανότητα του ενδοθηλίου, η δομή ή η λειτουργία του. Η δυσλειτουργία του ενδοθηλίου (endothelial dysfunction) είναι το πιο συχνό οργανικό αίτιο στυτικής δυσλειτουργίας σε άτομα άνω των τριάντα ετών.

Η ομαλή λειτουργία του ενδοθηλίου είναι πολύ σημαντική για την καλή στύση. Προϋπόθεση της επαρκούς στύσης είναι η αύξηση της ροής του αίματος, φαινόμενο που εγκαθίσταται μετά την πλήρη χάλαση των αρτηριών και των λείων μυϊκών ινών των σωμάτων του πέους. Το μονοξείδιο του αζώτου ΝΟ, ουσία που εκκρίνεται από το άθικτο ενδοθήλιο συντελεί στο φαινόμενο αυτό της χάλασης, ενώ η επάρκεια της ελαστικότητας και διασταλτικής ικανότητας του αγγείου επιτυγχάνεται με την διατήρηση της ακεραιότητας της ανατομικής δομής του ενδοθηλίου. Το άθικτο ενδοθήλιο εκκρίνει επιπρόσθετα ένα σύνολο ουσιών (π.χ. ενδοθηλίνη), που έχουν κεντρικό ρόλο στην τοπική διατήρηση της ευαίσθητης βιοχημικής ισορροπίας.

Η ανάπτυξη δυσλειτουργίας του ενδοθηλίου και της σχετικής με αυτή στυτικής δυσλειτουργίας, συμβαίνει κυρίως στην κλινική πρακτική κατά την διάρκεια ανάπτυξης αθηρωματικής νόσου. Στην αθηρωματική νόσο, το ενδοθήλιο αλλοιώνεται, λιποπρωτεΐνες LDL, συρρέουν στον έσω χιτώνα της αρτηρίας, όπου υφίστανται βιοχημικές τροποποιήσεις (π.χ. οξείδωση, μη ενζυματική γλυκοζυλίωση), ενώ αναπτύσσεται μια ιδιότυπη φλεγμονώδης αντίδραση. Λευκά αιμοσφαίρια συρρέουν στην περιοχή, μονοκύτταρα μετατρέπονται σε φαγοκύτταρα που φαγοκυτταρώνουν το λίπος του τοιχώματος. Παράγοντες φλεγμονής και αυξητικοί παράγοντες συρρέουν τοπικά ενώ προοδευτικά αθροίζονται στην περιοχή της βλάβης, επιπροσθέτως, λεία μυϊκά κύτταρα και ινώδη στοιχεία. Ενεργές μορφές οξυγόνου (ρίζες οξυγόνου) που παράγονται, εξουδετερώνουν το φυσιολογικά παραγόμενο από το ενδοθήλιο μονοξείδιο του αζώτου που έχει κομβικό ρόλο στην ομαλή στύση. Επιπρόσθετα, χημικές ουσίες που παράγονται με την φλεγμονή, καταστρέφουν πλειάδα ενδοθηλιακών κυττάρων.

Η δυσλειτουργία του ενδοθηλίου δεν έχει συμπτώματα επί μακρόν. Σε αρκετές περιπτώσεις το πρώτο σύμπτωμα είναι η στυτική δυσλειτουργία. Είναι σημαντική η πρώιμη εντόπιση της παθολογικής αυτής κατάστασης και η πρώιμη παρέμβαση για την διατήρηση της φυσιολογικής στυτικής εφεδρείας. Είναι σημαντική επίσης η θεραπεία και αποκατάσταση των παραγόντων που οδηγούν στην εγκατάσταση του σοβαρού αυτού παθολογικού προβλήματος.

Οι κύριοι παράγοντες που προκαλούν δυσλειτουργία ενδοθηλίου σε βάθος χρόνου είναι:

Το κάπνισμα

Η υπέρταση

Η χαμηλή HDL χοληστερόλη

Η υψηλή LDL χοληστερόλη

Ο διαβήτης

Η παχυσαρκία

Η καθιστική ζωή

Η αυξημένη LpA

H αυξημένη ομοκυστείνη

Τα αυξημένα επίπεδα προφλεγμονωδών παραγόντων στο αίμα

Το μεταβολικό σύνδρομο

Τα αυξημένα επίπεδα προθρωμβωτικών παραγόντων στο αίμα

Η διαταραχή των επιπέδων της γλυκόζης νηστείας

Τα αυξημένα επίπεδα CRP

Η κακή κληρονομικότητα

Η φθορά του χρόνου

Δρ. Αναστασία Μοσχοβάκη

Ιατρός Eιδική Παθολόγος

Φραγκοπούλου 10 Κηφισιά

24ωρη γραμματεία νοσοκομειακά περιστατικά : 2106252770

E mail amoschovaki@yahoo.gr.

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http://organicsexualdysfunction.blogspot.com ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ/ ΣΕΞΟΥΑΛΙΚΕΣ ΔΙΑΤΑΡΑΧΕΣ ΠΑΘΟΛΟΓΙΚΗΣ ΑΙΤΙΟΛΟΓΙΑΣ

http://frequentmedicaldisorders.blogspot.com FREQUENT MEDICAL DISORDERS (αγγλόφωνο)

http://infectiousdiseaseissues.blogspot.com ΠΥΡΕΤΟΣ – ΛΟΙΜΩΞΕΙΣ

http://highglucose.blogspot.com ΔΙΑΒΗΤΗΣ

http://systemichypertension.blogspot.com ΥΨΗΛΗ ΠΙΕΣΗ

http://alternativemedicinehellenicblog.blogspot.com ΕΝΑΛΛΑΚΤΙΚΗ ΙΑΤΡΙΚΗ

http://cholesterolandtriglycerides.blogspot.com ΧΟΛΗΣΤΕΡΙΝΗ - ΤΡΙΓΛΥΚΕΡΙΔΙΑ

http://internationaltravelmedicine.blogspot.com ΤΑΞΙΔΙΑ ΚΑΙ ΥΓΕΙΑ

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title="Digg this!"> Digg

ΟΜΟΚΥΣΤΕΙΝΗ ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:48

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Η ομοκυστεΐνη είναι αμινοξύ του σώματος. Ο ομαλός μεταβολισμός της ομοκυστεΐνης συγκρατεί το αμινοξύ σε χαμηλά επίπεδα στους ιστούς και το αίμα.

Η άθροιση του αμινοξέος στου ιστούς και στο αίμα (υπερομοκυστιναιμία) προκαλείται από τις εξής κατηγορίες νοσημάτων και παθολογικών καταστάσεων:

o Ανεπάρκεια ενζύμων που εμπλέκονται στο μεταβολισμό του αμινοξέος (π.χ. έλλειψη της β συνθετάσης κυσταθειονίνης)

o Ανεπαρκής πρόσληψη ή κακή απορρόφηση ορισμένων βιταμινών (π.χ. φυλλικού και βιταμινών συμπλέγματος β)

o Υπερπαραγωγή αμινοξέος (π.χ. ορισμένες λευχαιμίες)

o Διαταραχή της απεκκριτικής λειτουργίας του νεφρού (π.χ. νεφρική ανεπάρκεια)

o Παρουσία τοξικών ουσιών που παρεμβαίνουν στο μεταβολισμό του αμινοξέος (π.χ. κατάχρηση αλκοόλ)

o Διαταραχή σε ορμόνες που επηρεάζουν το μεταβολισμό του αμινοξέος (π.χ. ανεπάρκεια οιστρογόνων προγεστερόνης)

Η αύξηση της ομοκυστεΐνης δεν έχει εμφανή συμπτώματα, σε αρκετές όμως περιπτώσεις, ο πάσχων κινδυνεύει από σοβαρές επιπλοκές.

Η ομοκυστεΐνη, ανάλογα με το status υγείας του οργανισμού, αποτελεί παράγοντα δυσλειτουργίας του ενδοθηλίου και δρα συνεργικά με άλλους παράγοντες (π.χ. κάπνισμα, υπέρταση, διαβήτης, μεταβολικό σύνδρομο) για την ανάπτυξη στυτικής δυσλειτουργίας.

Η αύξηση της ομοκυστεΐνης σε ορισμένες περιπτώσεις αποτελεί ισχυρό παράγοντα κινδύνου και για εγκεφαλικά αγγειακά επεισόδια, στεφανιαία καρδιακή νόσο, περιφερική αγγειακή νόσο, θρόμβωση φλεβών.

Ανάλογα με το αίτιο και τους κινδύνους από την υπερομοκυστεΐναιμίας χορηγείται σήμερα κατάλληλη αγωγή.

Δρ. Αναστασία Μοσχοβάκη

Ιατρός Eιδική Παθολόγος

Φραγκοπούλου 10 Κηφισιά

24ωρη γραμματεία νοσοκομειακά περιστατικά : 2106252770

E mail amoschovaki@yahoo.gr.

LINKS

http://twitter.com/amoschovaki H ΙΑΤΡΙΚΗ ΕΝΗΜΕΡΩΣΗ ΣΤΟ TWITTER

http://anastasiamoschovaki1.blogspot.com ΘΕΜΑΤΑ ΥΓΕΙΑΣ

http://organicsexualdysfunction.blogspot.com ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ/ ΣΕΞΟΥΑΛΙΚΕΣ ΔΙΑΤΑΡΑΧΕΣ ΠΑΘΟΛΟΓΙΚΗΣ ΑΙΤΙΟΛΟΓΙΑΣ

http://frequentmedicaldisorders.blogspot.com FREQUENT MEDICAL DISORDERS (αγγλόφωνο)

http://infectiousdiseaseissues.blogspot.com ΠΥΡΕΤΟΣ – ΛΟΙΜΩΞΕΙΣ

http://highglucose.blogspot.com ΔΙΑΒΗΤΗΣ

http://systemichypertension.blogspot.com ΥΨΗΛΗ ΠΙΕΣΗ

http://alternativemedicinehellenicblog.blogspot.com ΕΝΑΛΛΑΚΤΙΚΗ ΙΑΤΡΙΚΗ

http://cholesterolandtriglycerides.blogspot.com ΧΟΛΗΣΤΕΡΙΝΗ - ΤΡΙΓΛΥΚΕΡΙΔΙΑ

http://internationaltravelmedicine.blogspot.com ΤΑΞΙΔΙΑ ΚΑΙ ΥΓΕΙΑ

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src%3D%22https%3A%2F%2Fblogger.googleusercontent.com%2Ftracker%2F149228258215036960-6978528299511585376%3Fl%3Danastasiamoschovaki1.blogspot.com%22%20alt%3D%22%22%20%2F%3E%3C%2Fdiv%3E" title="Digg this!"> Digg

ΛΙΠΟΠΡΩΤΕΙΝΗ Α (LPA) ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:47

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Από το http://www.nature.com/ki/journal

Οι λιποπρωτεΐνες είναι συμπλέγματα πρωτεϊνών και λιπιδίων, τα οποία είναι απαραίτητα για τη μεταφορά της χοληστερόλης, των τριγλυκεριδίων και λιποδιαλυτών βιταμινών προς και από τους ιστούς, μέσω των υγρών του σώματος (αίμα, λέμφος, διάμεσο υγρό). Η πυκνότητα της λιποπρωτεΐνης καθορίζεται από την ποσότητα των λιπιδίων ανά σωμάτιο. Η λιποπρωτεΐνη Α, LpA, είναι μια χαμηλής πυκνότητας λιποπρωτεΐνη του αίματος που περιέχει μια ειδική πρωτεΐνη, την απολιποπρωτεΐνη A (αpoA). H αpoA συντίθεται στο ήπαρ, το οποίο αποτελεί και την κύρια θέση κάθαρσης της LpA.

H LpA σύμφωνα με μελέτες, τροποποιεί την ινωδόλυση και σε συνδυασμό με άλλους παράγοντες (π.χ. κάπνισμα, αυξημένη χοληστερόλη LDL, διαβήτη, μεταβολικό σύνδρομο, υπέρταση) προάγει την αθηρωμάτωση και την δυσλειτουργία του ενδοθηλίου.

Η καλή λειτουργία του ενδοθηλίου είναι απαραίτητη για την φυσιολογική στύση: Το άθικτο ενδοθήλιο εκκρίνει μονοξείδιο του αζώτου ΝΟ που προκαλεί στύση, ενώ άλλες εκκρινόμενες ουσίες (π.χ. ενδοθηλίνη), έχουν κεντρικό ρόλο στην διατήρηση της τοπικής ευαίσθητης βιοχημικής ισορροπίας κατά τη στύση. Η δυσλειτουργία του ενδοθηλίου που προάγεται με την αύξηση της LpA, διαταράσσει τους παράγοντες αυτούς. Τα άτομα που έχουν αυξημένη LPA είναι σε υψηλότερο κίνδυνο συγκριτικά με άτομα με φυσιολογικά επίπεδα LPA, να προσβληθούν από αθηρωμάτωση και διαταραχή της αιμάτωσης ζωτικών οργάνων, που αρδεύονται από τα αρτηριοσκληρυντικά αγγεία.

Τα βασικότερα αίτια αύξησης της LpA είναι:

• Νοσήματα νεφρών (π.χ. νεφρική ανεπάρκεια)

• Ορισμένες ορμονικές διαταραχές και διαταραχές παραγόντων μεταβολισμού (π.χ. διαβήτης)

• Φλεγμονές (π.χ. λοιμώξεις)

• Λήψη ορισμένων φαρμάκων (π.χ. αυξητική ορμόνη)

• Δυσμενής κληρονομικότητα.

Ανάλογα με το αίτιο και τους κινδύνους από την αυξημένη LpA χορηγείται σήμερα ειδική αγωγή.

Δρ. Αναστασία Μοσχοβάκη

Ιατρός Eιδική Παθολόγος

Φραγκοπούλου 10 Κηφισιά

24ωρη γραμματεία νοσοκομειακά περιστατικά : 2106252770

E mail amoschovaki@yahoo.gr.

LINKS

http://twitter.com/amoschovaki H ΙΑΤΡΙΚΗ ΕΝΗΜΕΡΩΣΗ ΣΤΟ TWITTER

http://anastasiamoschovaki1.blogspot.com ΘΕΜΑΤΑ ΥΓΕΙΑΣ

http://organicsexualdysfunction.blogspot.com ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ/ ΣΕΞΟΥΑΛΙΚΕΣ ΔΙΑΤΑΡΑΧΕΣ ΠΑΘΟΛΟΓΙΚΗΣ ΑΙΤΙΟΛΟΓΙΑΣ

http://frequentmedicaldisorders.blogspot.com FREQUENT MEDICAL DISORDERS (αγγλόφωνο)

http://infectiousdiseaseissues.blogspot.com ΠΥΡΕΤΟΣ – ΛΟΙΜΩΞΕΙΣ

http://highglucose.blogspot.com ΔΙΑΒΗΤΗΣ

http://systemichypertension.blogspot.com ΥΨΗΛΗ ΠΙΕΣΗ

http://alternativemedicinehellenicblog.blogspot.com ΕΝΑΛΛΑΚΤΙΚΗ ΙΑΤΡΙΚΗ

http://cholesterolandtriglycerides.blogspot.com ΧΟΛΗΣΤΕΡΙΝΗ - ΤΡΙΓΛΥΚΕΡΙΔΙΑ

http://internationaltravelmedicine.blogspot.com ΤΑΞΙΔΙΑ ΚΑΙ ΥΓΕΙΑ

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title="Digg this!"> Digg

ΚΑΠΝΙΣΜΑ ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:45

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Το κάπνισμα είναι η πιο κοινή συνήθεια που συνδέεται με την ανάπτυξη στυτικής δυσλειτουργίας. Παρά το ό,τι οι καπνοβιομηχανίες στις διαφημιστικές εκστρατείες τους επιχειρούν να συνδέσουν τον ανδρισμό ή την ενηλικίωση με το τσιγάρο, οι καπνιστές παρουσιάζουν σε νεαρότερες ηλικίες προβλήματα στύσης, λόγω της τοξικής δράσης του καπνού στα αγγεία του πέους. Δυστυχώς, λόγω ελλιπούς πληροφόρησης η πραγματικότητα αυτή δεν είναι αντιληπτή στο ευρύ κοινό, στην Ελλάδα.

Οι μηχανισμοί ανάπτυξης στυτικής δυσλειτουργίας στον καπνιστή είναι σύνθετοι. Ο άκαυστος καπνός περιέχει νικοτίνη, καρκινογόνες ουσίες και τοξίνες, με την καύση όμως οι βλαπτικές ουσίες σύμφωνα με επιστημονικές έρευνες πολλαπλασιάζονται λόγω της εξαέρωσης, της πυρόλυσης της πυροσύνθεσης του καπνού και των άλλων χημικών προσθέτων που χρησιμοποιούνται για την παρασκευή των διαφόρων ειδών τσιγάρου. Η νικοτίνη, η κύρια εθιστική ουσία στο τσιγάρο, αποδίδεται πολύ γρήγορα στον εγκέφαλο και προκαλεί εξάρτηση. Οι εθισμένοι στην νικοτίνη καπνιστές ρυθμίζουν αυτόματα την πρόσληψη νικοτίνης βάσει των επιπέδων της στο αίμα καπνίζοντας όταν απαιτείται ώστε να προκληθούν τα ψυχοδραστικά αποτελέσματα της νικοτίνης και να αποφευχθούν τα συμπτώματα στέρησης.

Το κάπνισμα αλλοιώνει τα επίπεδα μονοξειδίου του αζώτου, το ενδοθήλιο και την ελαστικότητα των αγγείων του ανδρικού γεννητικού συστήματος και προάγει την ανάπτυξη δυσλειτουργίας του ενδοθηλίου. Αυξάνει τα επίπεδα του ινωδογόνου, μιας μεταβλητής που έχει συνδεθεί με αυξημένη επίπτωση αθηρωμάτωσης των αγγείων που τροφοδοτούν το ανδρικό γεννητικό σύστημα. Υπάρχει πολλαπλή αλληλεπίδραση του καπνίσματος με άλλους παράγοντες που προάγουν την γήρανση και την αθηροσκλήρυνση των αγγείων όπως η υπέρταση, η αυξημένη χοληστερόλη, ο διαβήτης, το μεταβολικό σύνδρομο.

Σύμφωνα με μελέτες η δυσμενής επίδραση του τσιγάρου συνδέεται τόσο με τον αριθμό των τσιγάρων που καταναλώνονται όσο και με την διάρκεια του καπνίσματος. Σύμφωνα με έρευνες οι καπνιστές έχουν διπλάσιο κίνδυνο εμφάνισης στυτικής δυσλειτουργίας συγκριτικά με τα άτομα που δεν κάπνισαν ποτέ. Η δυσμενής επίδραση του τσιγάρου είναι περισσότερο εμφανής στην δεκαετία σαράντα – πενήντα με τους μη καπνιστές να εμφανίζουν στυτικά προβλήματα σε μεγαλύτερες ηλικίες.

Επιπρόσθετα το κάπνισμα αναστέλλει την απελευθέρωση μονοξειδίου του αζώτου από κύτταρα του φυσιολογικού ενδοθηλίου και από χολινεργικές παρασυμπαθητικές και μη αδρενεργικές μη χολινεργικές οδούς, που κινητοποιούνται κατά την διάρκεια της στύσης, μετά την χορήγηση ορισμένων θεραπευτικών σκευασμάτων. Έτσι το κάπνισμα μειώνει την αποτελεσματικότητα ορισμένων θεραπευτικών παρεμβάσεων.

Δρ. Αναστασία Μοσχοβάκη

Ιατρός Eιδική Παθολόγος

Φραγκοπούλου 10 Κηφισιά

24ωρη γραμματεία νοσοκομειακά περιστατικά : 2106252770

E mail amoschovaki@yahoo.gr.

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http://organicsexualdysfunction.blogspot.com ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ/ ΣΕΞΟΥΑΛΙΚΕΣ ΔΙΑΤΑΡΑΧΕΣ ΠΑΘΟΛΟΓΙΚΗΣ ΑΙΤΙΟΛΟΓΙΑΣ

http://frequentmedicaldisorders.blogspot.com FREQUENT MEDICAL DISORDERS (αγγλόφωνο)

http://infectiousdiseaseissues.blogspot.com ΠΥΡΕΤΟΣ – ΛΟΙΜΩΞΕΙΣ

http://highglucose.blogspot.com ΔΙΑΒΗΤΗΣ

http://systemichypertension.blogspot.com ΥΨΗΛΗ ΠΙΕΣΗ

http://alternativemedicinehellenicblog.blogspot.com ΕΝΑΛΛΑΚΤΙΚΗ ΙΑΤΡΙΚΗ

http://cholesterolandtriglycerides.blogspot.com ΧΟΛΗΣΤΕΡΙΝΗ - ΤΡΙΓΛΥΚΕΡΙΔΙΑ

http://internationaltravelmedicine.blogspot.com ΤΑΞΙΔΙΑ ΚΑΙ ΥΓΕΙΑ

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title="Digg this!"> Digg

HDL ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:43

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Η χοληστερόλη, ευρέως γνωστή ως χοληστερίνη, είναι σημαντικό λιπίδιο του αίματος και μεταφέρεται στο αίμα με τις λιποπρωτεΐνες. Οι λιποπρωτεΐνες είναι σφαιρικά σωματίδια, τα οποία περιέχουν πρωτεΐνες γνωστές ως αποπρωτεΐνες.

HDLκαι αύξηση ΝΟ στο ενδοθήλιο, βασικό στοιχείο της φυσιολογικής στύσης
Από το http://www.jci.org/homepage

H υψηλής πυκνότητας HDL είναι η πυκνότερη οικογένεια των λιποπρωτεϊνών και αποτελείται κυρίως από αποπρωτεΐνες και χοληστερόλη. Ενώ με την αύξηση της LDL χοληστερόλης, μεγαλώνει ο κίνδυνος εναπόθεσης της χοληστερίνης στο τοίχωμα των αρτηριών, δυσλειτουργίας του ενδοθηλίου και στυτικής δυσλειτουργίας, η HDL χοληστερόλη προστατεύει τον άνδρα από τα παθολογικά αυτά φαινόμενα. Σύμφωνα με μελέτες η HDL προάγει την έκκριση ΝΟ, που αποτελεί βασική συνιστώσα της φυσιολογικής στύσης.

Η ευαισθησία των ατόμων στις επιδράσεις της HDL και LDL ποικίλλει. Αυτός είναι ο λόγος που οι στόχοι σήμερα είναι εξατομικευμένοι. Oι διαβητικοί, οι καπνιστές, οι στεφανιαίοι ασθενείς, οι υπερτασικοί, οι άνδρες με περιφερική αρτηριοπάθεια, τα άτομα με κακή κληρονομικότητα και διαταραχές ορισμένων αιματολογικών παραμέτρων, τα άτομα μεγάλης ηλικίας, οι παχύσαρκοι, οι άνδρες με μεταβολικό σύνδρομο είναι ιδιαίτερα ευαίσθητοι στις βλαπτικές επιδράσεις της LDL. Σε αυτά τα άτομα επιδιώκουμε σημαντικές αυξήσεις HDL, η οποία θα αυξήσει την ενδογενή άμυνα του οργανισμού απέναντι στις τοξικές αυτές επιδράσεις.

Κατά την εξέταση στο ιατρείο, καθορίζονται τα ιδανικά επίπεδα LDL HDL για το συγκεκριμένο άτομο που εξετάζεται, γεγονός που είναι σημαντικό για την αξιολόγηση της αναγκαιότητας θεραπευτικής παρέμβασης, αλλά και για τον καθορισμό του είδους της θεραπείας (διατροφή ή συνδυασμός διατροφής με φάρμακα). Στον καθορισμό των εξατομικευμένων στόχων κομβική σημασία έχουν τα ευρήματα από την σωστή ιατρική εξέταση και την λήψη ιστορικού (π.χ. ύπαρξη φυσημάτων, αυξημένη αρτηριακή πίεση, κακή κληρονομικότητα, κάπνισμα) και η εφαρμογή ορισμένων εξισώσεων και παραμέτρων που πρόσφατα έχουν εισαχθεί στην μαχόμενη ιατρική παθολογική πρακτική.Κατά την ιατρική μελέτη διερευνώνται επιπροσθέτως τα αίτια παρατηρούμενων διαταραχών.

Υπάρχουν πολλοί γενετικοί παράγοντες νοσήματα και φάρμακα εκτός από την διατροφή, που προκαλούν διαταραχές της HDL (π.χ. ηπατικά, νεφρικά νοσήματα, νοσήματα ενδοκρινών αδένων, λήψη ορμονών). Οι πιο κοινοί παράγοντες που προκαλούν παθολογική μείωση της HDL είναι η παχυσαρκία και η καθιστική ζωή. Η διατήρηση φυσιολογικού ΒΜΙ, που είναι ένας ειδικός δείκτης που χρησιμοποιείται σήμερα για την εκτίμηση του υπερβολικού βάρους και η καθημερινή βάδιση είναι πολύ σημαντικά. Η καλή διατροφή η οποία είναι επαρκής σε βιταμίνες και άλατα, ιδιαιτέρως μάλιστα στην βιταμίνη του συμπλέγματος Β νιασίνη, συντελεί σύμφωνα με μελέτες στην αύξηση της HDL. Ορισμένες περιπτώσεις επιβάλλουν την χορήγηση ειδικού φαρμάκου.

Δρ. Αναστασία Μοσχοβάκη

Ιατρός Eιδική Παθολόγος

Φραγκοπούλου 10 Κηφισιά

24ωρη γραμματεία νοσοκομειακά περιστατικά : 2106252770

E mail amoschovaki@yahoo.gr.

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title="Digg this!"> Digg

LDL ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:42

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Απόφραξη του αγγείου από την υψηλή χοληστερόλη LDL

Εκδηλώσεις αγγειακής απόφραξης από την LDL: Ανάλογα με την θέση της προσβολής, από αριστερά προς δεξιά στυτική δυσλειτουργία, καρδιακή στεφανιαία νόσος, εγκεφαλικό επεισόδιο, διαλείπουσα χωλότητα άκρων. Κάτω απαιτούμενη απόφραξη για την εμφάνιση συμπτωμάτων από αυτή
Από το http://www.europeanurology.com

Η χοληστερόλη ή χοληστερίνη, όπως είναι ευρέως γνωστή, είναι μία χημική ουσία (στερόλη), που αυξάνει στον οργανισμό με την κατανάλωση λιπαρών ουσιών. Το όχημα μεταφοράς της χοληστερόλης των τροφών είναι τα χυλομικρά μέσω των οποίων η εξωγενώς απορροφούμενη χοληστερόλη μεταφέρεται στο ήπαρ.

Εκτός όμως από την εξωγενή οδό απορρόφησης της χοληστερόλης το ήπαρ συνθέτει χοληστερόλη από πρώτες ύλες με μία καταιγίδα χημικών αντιδράσεων. Η ενδογενώς παραγόμενη χοληστερόλη αποτελεί και την κύρια ποσότητα της χοληστερόλης που χρησιμοποιεί ο οργανισμός. Το όχημα μεταφοράς στο αίμα είναι οι λιποπρωτεΐνες, που αποτελούνται από υδρόφοβα λιπίδια (εστέρες χοληστερόλης, τριγλυκερίδια), υδρόφιλα λιπίδια (φωσφολιπίδια, μη εστεροποιημένη χοληστερόλη) και πρωτεΐνες. Οι λιποπρωτεΐνες ανάλογα με την πυκνότητά τους διαιρούνται σε χυλομικρά, VLDL (very low density lipoprotein-πολύ χαμηλής πυκνότητας λιποπρωτεΐνη), IDL(Intermediate density lipoprotein-ενδιάμεσης πυκνότητας λιποπρωτεΐνη), LDL (low density lipoprotein-χαμηλής πυκνότητας λιποπρωτεΐνη) και HDL (high density lipoprotein-υψηλής πυκνότητας λιποπρωτεΐνη). Το τμήμα της χοληστερόλης που συνδέεται με την LDL, είναι εκείνο που, υπό προϋποθέσεις, προκαλεί δυσλειτουργία του ενδοθηλίου και αθηρωμάτωση. Η δυσλειτουργία του ενδοθηλίου είναι η παθολογική κατάσταση κατά την οποία αλλοιώνεται σημαντικά η εκκριτική ικανότητα του ενδοθηλίου, η δομή ή η λειτουργία του. Η ομαλή λειτουργία του ενδοθηλίου είναι πολύ σημαντική για την καλή στύση. Προϋπόθεση της επαρκούς στύσης είναι η αύξηση της ροής του αίματος, φαινόμενο που εγκαθίσταται μετά την πλήρη χάλαση των αρτηριών και των λείων μυϊκών ινών των σωμάτων του πέους. Το μονοξείδιο του αζώτου ΝΟ, ουσία που εκκρίνεται από το άθικτο ενδοθήλιο συντελεί στο φαινόμενο αυτό της χάλασης, ενώ η επάρκεια της ελαστικότητας και διασταλτικής ικανότητας του αγγείου επιτυγχάνεται με την διατήρηση της ακεραιότητας της ανατομικής δομής του ενδοθηλίου. Το άθικτο ενδοθήλιο εκκρίνει επιπρόσθετα ένα σύνολο ουσιών (π.χ. ενδοθηλίνη), που έχουν κεντρικό ρόλο στην τοπική διατήρηση της ευαίσθητης βιοχημικής ισορροπίας.

Όταν αυξάνεται η LDL και συντρέχουν ένας ή περισσότεροι από ορισμένους βλαπτικούς για το ενδοθήλιο των αγγείων παράγοντες (π.χ. κακή κληρονομικότητα, αυξημένη πίεση αίματος, αυξημένο σάκχαρο, κάπνισμα), λιποπρωτεΐνες LDL συρρέουν στον έσω χιτώνα της αρτηρίας, όπου υφίστανται βιοχημικές τροποποιήσεις (π.χ. οξείδωση, μη ενζυματική γλυκοζυλίωση), ενώ αναπτύσσεται μια ιδιότυπη φλεγμονώδης αντίδραση. Λευκά αιμοσφαίρια συρρέουν στην περιοχή, μονοκύτταρα μετατρέπονται σε φαγοκύτταρα που φαγοκυτταρώνουν το λίπος του τοιχώματος. Παράγοντες φλεγμονής και αυξητικοί παράγοντες συρρέουν τοπικά, ενεργές μορφές οξυγόνου (ρίζες οξυγόνου) παράγονται, χημικές ουσίες που εκλύονται καταστρέφουν πλειάδα ενδοθηλιακών κυττάρων με αποτέλεσμα την ανάπτυξη δυσλειτουργίας του ενδοθηλίου και την διαταραχή της στύσης. Ο αυλός του αγγείου προοδευτικά στενεύει και η αιματική ροή διαταράσσεται σημαντικά.

Πολλά ένζυμα εμπλέκονται στην ενδογενή παραγωγή και το μεταβολισμό της χοληστερόλης. Πολλές φορές τα αυξημένα επίπεδα LDL, οφείλονται σε αλλοιωμένη λειτουργία των ενζύμων αυτών ή σε παράγοντες που επεμβαίνουν στον κύκλο της χοληστερόλης.

Έτσι αυξημένα επίπεδα LDL προκαλούν εκτός από την κακή διατροφή:

Κληρονομικοί παράγοντες

Η φθορά του χρόνου

Ορμονικές διαταραχές (π.χ. υποθυρεοειδισμός)

Νεφρωσικό σύνδρομο

Παθήσεις ήπατος, χοληφόρων

Ορισμένες μορφές νευρικής ανορεξίας

Φάρμακα

Μεταβολικές διαταραχές (π.χ. διαβήτης)

Η σωστή παθολογική εξέταση έχει κομβική σημασία στη σωστή διαφορική διάγνωση και θεραπεία.

Δρ. Αναστασία Μοσχοβάκη

Ιατρός Eιδική Παθολόγος

Φραγκοπούλου 10 Κηφισιά

24ωρη γραμματεία νοσοκομειακά περιστατικά : 2106252770

E mail amoschovaki@yahoo.gr.

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v%3E%3Cdiv%3E%3Cimg%20width%3D%221%22%20height%3D%221%22%20src%3D%22https%3A%2F%2Fblogger.googleusercontent.com%2Ftracker%2F149228258215036960-9171273678999784966%3Fl%3Danastasiamoschovaki1.blogspot.com%22%20alt%3D%22%22%20%2F%3E%3C%2Fdiv%3E" title="Digg this!"> Digg

ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ ΚΑΙ ΜΕΤΑΒΟΛΙΚΟ ΣΥΝΔΡΟΜΟ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:40

PHP Σφάλμα [Warning]

PHP Σφάλμα [User Warning]

Το μεταβολικό σύνδρομο είναι ένα παθολογικό σύνδρομο, χωρίς συμπτώματα στα αρχικά στάδια, που χαρακτηρίζεται από τρεις ή περισσότερες από τις διαταραχές που αναφέρονται παρακάτω:

Κοιλιακή παχυσαρκία

Υψηλά τριγλυκερίδια

Αρτηριακή πίεση σε ανώτατα φυσιολογικά επίπεδα

Σάκχαρο νηστείας σε προ διαβητικό επίπεδο

Χαμηλή HDL

To σύνδρομο εντοπίζεται κατά την διάρκεια της σωστής παθολογικής εξέτασης (δεν έχει συμπτώματα επί μακρόν) και πρέπει να αποκαθίσταται άμεσα διότι συνδέεται με:

Την εμφάνιση διαβήτη

Την ανάπτυξη ανδρικής ανικανότητας

Την εμφάνιση καρδιοεγκεφαλικών επεισοδίων

Ο μηχανισμός της ανάπτυξης της στυτικής δυσλειτουργίας στο μεταβολικό σύνδρομο δεν είναι επαρκώς γνωστός. Η αντίσταση στην ινσουλίνη, η μειωμένη απομάκρυνση των λιπιδίων από το αρτηριακό τοίχωμα, η ανάπτυξη δυσλειτουργίας του ενδοθηλίου ενοχοποιούνται για τη στυτική δυσλειτουργία του μεταβολικού συνδρόμου.

Δρ. Αναστασία Μοσχοβάκη

Ιατρός Eιδική Παθολόγος

Φραγκοπούλου 10 Κηφισιά

24ωρη γραμματεία νοσοκομειακά περιστατικά : 2106252770

E mail amoschovaki@yahoo.gr.

LINKS

http://twitter.com/amoschovaki H ΙΑΤΡΙΚΗ ΕΝΗΜΕΡΩΣΗ ΣΤΟ TWITTER

http://anastasiamoschovaki1.blogspot.com ΘΕΜΑΤΑ ΥΓΕΙΑΣ

http://organicsexualdysfunction.blogspot.com ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ/ ΣΕΞΟΥΑΛΙΚΕΣ ΔΙΑΤΑΡΑΧΕΣ ΠΑΘΟΛΟΓΙΚΗΣ ΑΙΤΙΟΛΟΓΙΑΣ

http://frequentmedicaldisorders.blogspot.com FREQUENT MEDICAL DISORDERS (αγγλόφωνο)

http://infectiousdiseaseissues.blogspot.com ΠΥΡΕΤΟΣ – ΛΟΙΜΩΞΕΙΣ

http://highglucose.blogspot.com ΔΙΑΒΗΤΗΣ

http://systemichypertension.blogspot.com ΥΨΗΛΗ ΠΙΕΣΗ

http://alternativemedicinehellenicblog.blogspot.com ΕΝΑΛΛΑΚΤΙΚΗ ΙΑΤΡΙΚΗ

http://cholesterolandtriglycerides.blogspot.com ΧΟΛΗΣΤΕΡΙΝΗ - ΤΡΙΓΛΥΚΕΡΙΔΙΑ

http://internationaltravelmedicine.blogspot.com ΤΑΞΙΔΙΑ ΚΑΙ ΥΓΕΙΑ

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title="Digg this!"> Digg

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ΣΥΓΧΡΟΝΑ ΘΕΜΑΤΑ ΠΑΘΟΛΟΓΙΑΣ - Ροή Ειδήσεων

Ροή Ειδήσεων

ΣΥΓΧΡΟΝΑ ΘΕΜΑΤΑ ΠΑΘΟΛΟΓΙΑΣ - CURRENT MEDICAL ISSUES

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ΟΜΟΚΥΣΤΕΙΝΗ ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:48

ΛΙΠΟΠΡΩΤΕΙΝΗ Α (LPA) ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:47

ΚΑΠΝΙΣΜΑ ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:45

HDL ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:43

LDL ΚΑΙ ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:42

ΣΤΥΤΙΚΗ ΔΥΣΛΕΙΤΟΥΡΓΙΑ ΚΑΙ ΜΕΤΑΒΟΛΙΚΟ ΣΥΝΔΡΟΜΟ (Ενημέρωση και στο http://organicsexualdysfunction.blogspot.com) 03 Φεβ 2012, 16:40

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