Black from the Harry Potter novels. Regulus Black: description and biography of the character

Part I. General pathophysiology.

Subject, tasks and methods of pathophysiology. General nosology(Lecture No. I).

1. Pathophysiology as a science and academic discipline, its subject, objectives and research methods.

2. Characteristics of the pathophysiological experiment, advantages and disadvantages of the experimental method.

3. Relationships between pathophysiology and other disciplines.

4. General nosology.

Pathological physiology is a science that primarily studies in animal experiments the general patterns of the occurrence, development and cessation of disease and pathological processes in humans. This is the science of the vital functions of a sick organism or general pathology. The subject of the study of pathophysiology is general patterns, primarily of a functional nature, at the level of cells, organs, systems and the diseased organism as a whole, which determine the occurrence and course of the disease, mechanisms of resistance, pre-disease, recovery and outcome of the disease. General patterns are derived from the study of pathological processes, conditions and pathogenesis of various syndromes and diseases.

Pathological physiology developed as an experimental science, but along with this, clinical pathophysiology also developed, which, using harmless research methods, studied issues of pathophysiology in the clinic. Thus, pathophysiology is a methodological science that teaches the doctor the most general laws of the development of the disease and, on their basis, how to solve complex situations.

Every science must have its own subject and its own method. The subject of pathophysiology is a sick person, and the method is a pathophysiological experiment, which makes it possible to reproduce animal models of human disease and pathological processes and to study the problems of pathological physiology on these models.

Pathological physiology solves 6 problems:

1) study of problems of general pathology - the creation of a general doctrine of disease or general nosology,

2) the study of the causes of illness and the creation of a general doctrine of causality in pathology - that is, laws governing causes - this is general etiology,

e) experiment gives unlimited possibilities scientific justification development of new treatment methods.

The experiment uses various methods: biophysical, physiological, biochemical, morphological, immunological.

Are used different kinds acute experiment (vivisection) and chronic (conditioned reflex method, implantation of electrodes into tissue, creation of fistulas).

Difficulties and disadvantages of the experimental method:

1) selection of an animal for experimental research,

2) all its diseases are modeled on animals,

3) it is difficult to transfer experimental data to the clinic,

4) it is difficult to create a disease model,

5) ethical problems.

Clinical pathophysiology has its own fundamental features, since various manifestations mediation biological and social processes are the most important link in the life of a healthy and sick person. The main apparatus of mediation is the nervous and other regulatory systems and labor activity, which, along with other factors, distinguishes a person from an animal.

Pathological physiology connects biological disciplines with clinical ones, like a transition bridge: the basis of pathophysiology as a science is biology, normal physiology, and biochemistry. Pathophysiology is associated with morphological disciplines (anatomy, histology, pathological anatomy), because studying function in isolation from cell structure is impossible. Close connection with normal physiology does not mean identity. The variety of disorders of the vital functions of cells, organs, and the body as a whole in pathology still does not have " prototype"of these disorders in a healthy body. Depending on the cause that caused the disease; on the reactivity of the body and the influence of the external environment, the most various combinations dysfunction and reactive changes. In diseases, a number of changes are caused by forms of response of cellular elements, organs, and physiological systems developed in the process of evolution and fixed by heredity under pathological conditions.

Pathophysiology as an academic discipline. When preparing a practicing physician, pathophysiology equips him with knowledge of the general laws of disease development, general principles disease management, equips the doctor with the correct methodology for analyzing the disease and pathological processes. Teaching pathophysiology aims to teach students to apply science at the bedside, i.e. understand the mechanism of disease development and recovery processes, based on general laws activities of organs and systems. Thus, pathological physiology equips the doctor the right method achieving the truth in the shortest way and simple methods, allowing you to quickly and economically analyze the pathology under study - i.e. is methodology.

Advantages of Pathophysiology- each disease consists of a small number of pathological processes - there are about 20 of them, which have general laws of development. Therefore, a thinking doctor can fully analyze any disease, and private details will no longer cause such difficulty (fever, inflammation develop everywhere according to the same laws, intertwine, form various combinations.

General nosology- general doctrine of illness, the most important elements which are:

A) damage,

b) reaction,

V) pathological process,

G) pathological condition,

d) disease.

Reaction- the phenomenon of counteraction to damage, aimed at eliminating it and restoring its original state. There is a certain correspondence between damage and reaction: with relatively weak damage, the level of reaction matches or exceeds the damage. With severe damage, the level of reaction may be lower. The doctor judges the level of damage not by the damage itself, but by the reaction to it. In the case where the level of reaction is sufficient, this is good, but if the reaction is not enough to eliminate the damage, it is necessary to increase it.

Types of reaction: 1) protective-adaptive adapts to damage;

2) pathological, by its mechanism also protective-adaptive, but due to unusual quantity or quality leads to secondary damage (fever, pus);

3) adaptive reactions - long-lasting reactions in the body under conditions of a changed environment.

Pathological process is a combination of damage phenomena, protective-adaptive and pathological reactions. A typical pathological process is a natural combination of its constituent elements with their always identical, strictly sequential inclusion (always in the same order, regardless of the location of the pathological process and its type). Character traits- dynamism and phasing.

If the pathological process has stopped at some point in development, this is already pathological condition(process without movement).

The pathological process is closer in structure to

disease, includes components, but the disease is a more complex phenomenon.

General biological characteristics health:

1) structural and functional usefulness of a healthy body;
2) homeostasis - constancy of indicators of the internal environment, the ability to maintain it and the optimal level of response;
3) balance of the body with the external environment, independence from it.

General biological characteristics illnesses:

1) the presence of a number of pathological processes with disruption of the structure and function of the organ;
2) disruption of homeostasis, at least partially;
3) disruption of the body’s adaptation to changing environmental conditions with

decrease in biological and social activity.

When diagnosing a disease, it is necessary to evaluate these 3 criteria of the disease and, in addition to biological indicators, indicators of adaptability to external environment. This is easiest to do under load during functional tests, but it must be done carefully.

Disease(morbus) is a complex phenomenon that consists of a number of basic elements. There are always two sides to illness: damage and reaction to it. The most important component disease element - disruption of homeostasis and interaction of the organism with the external environment.

During illness, there is a change in a number of homeostatic parameters that are held very rigidly in the body and their shift leads to death (for example, pH). Although it should be noted that the bulk of indicators may fluctuate to a certain extent (for example, body temperature, biochemical or cellular composition of the blood). Basically homeostasis - maximum efficiency of the functioning of the body, the possibility of more complete adaptation to changing environmental conditions. Homeostasis is useful in a healthy body, but in illness it is disrupted. Losing homeostasis, the body loses its normal regulatory mechanisms. Adaptation to the external environment will be defective (for example, a child with fever is very sensitive to hypoxia).

The term " disease" it is applied for:

1) designation of the disease of a particular person, the concept of the disease as a nosological unit and

2) a generalized concept of disease, both biological and social phenomenon. The idea of illness is associated with a qualitatively different form of existence of the organism from health. But at the same time, these states are in close unity, since the states of health and illness represent, although different, but inextricably linked forms of manifestation of life.

General etiology. Damage(Lecture No. II).

1. The concept of etiology.

2. Damage, its types.

3. Indicators of damage to cellular structures.

General etiology- general doctrine of causality in pathology. When considering the etiology of human diseases, difficulties arise in the fact that many pathogenic factors can act on the body simultaneously or sequentially, each of which can cause damage and therefore it is very difficult to determine which of them is truly causative (UVR, cold, microbes, poor quality food , emotional chronic overload).

Theories of etiology :

1. Monocausalism- single-causality. For a disease to occur, the action of one specific pathogenic factor is sufficient. This factor determines the picture of the disease, and the disease repeats its properties; it is, as it were, an imprint of the damaging effect of the factor. The merit of this theory is the discovery of the material substrate of the disease, its specific culprit.

2. How a counterweight to monocausalism arose conditionalism According to which a disease occurs under the influence of many equivalent factors, their combination should be considered the cause of the disease. Conditionalism does not identify a specific leading factor, but only a combination of equivalent factors.

3. As a variant of conditionalism - risk factor analysis diseases, when each factor is given a quantitative expression in the origin of the disease. On analysis large number cases one specific disease determine the relative frequency of factors in the origin of the disease.

4. Polyetiologism- as an approach to the analysis of etiology. Specific forms diseases can be caused by various specific factors (tumors are caused by: radiation exposure, chemical carcinogens, biological agents).

5. Dialectical materialism implies that the disease occurs under the influence of many factors; among which the main causal factor and conditions are identified. Characteristic properties causative factors are:

1) necessity,

2) it causes the emergence of a new phenomenon - a consequence,

3) it gives the disease specific features, and in to a greater extent the specificity of the initial damage.

The cause of a specific disease is a dialectical process of interaction between the etiological factor and the body in certain conditions. The conditions themselves do not determine the specificity of the disease, but their action is necessary for the emergence of a specific causal interaction. Highlight external conditions And internal, contributing And obstructive, sufficient And modifying.

Sufficient conditions are those without which the etiological factor will not cause pathology. These factors quantitatively determine the interaction of the causative factor with the body, facilitate or, on the contrary, counteract this interaction, but lack the main feature of the etiological factor - its specificity.

Thus, general etiology- the doctrine of the causes and conditions of the occurrence of disease; in more in the narrow sense The term “etiology” refers to the cause of a disease or pathological process. The cause of the disease is the interaction of the body with the etiological factor in specific conditions - as the initial trigger of the disease.

The most important constituent elements diseases - damage, reaction, pathological process.

Pathophysiology of damage(damage mechanisms). Disease is the life of a damaged organism. The basis of any pathology is damage and the reaction to this damage. Damage (alteratio - change) is a violation of homeostasis caused by the action of an etiological factor under certain conditions. It could be violation of morphological homeostasis, that is, a violation of the anatomical integrity of tissues and organs, resulting in a violation of their function, biochemical disorder homeostasis - pathological deviations in the content of various substances in the body in the form of excess or deficiency (hyperglycemia → diabetes → diabetic coma; hypoglycemia → hypoglycemic coma). Functional impairment homeostasis are pathological deviations in the functions of various organs and systems in the form promotion or reductions.

Types of damage, classification of damage:

I) in time:

1. primary, caused by the direct action of an etiological factor: burns, acids, alkalis, electric current, microbes - determine the specifics of the damage,

2. secondary - as a consequence of an excessive or perverted, inadequate reaction to primary damage.

II) specific And nonspecific.

III) by the nature of the process: acute and chronic.

IV) according to severity: reversible - necrobiosis and paranecrosis and irreversible - necrosis.

V) by outcome: complete or incomplete recovery and death.

Acute injury- the result of instant changes in homeostasis under the influence of powerful damaging factors (acutely developing cell ischemia): a) a sharp decrease in macroergs, b) a violation of lipid peroxidation, c) a decrease in membrane potential and cell death.

Chronic damage- slowly developing cell ischemia is manifested by: 1) accumulation of lipids as a result of a decrease in their peroxidation; 2) deposition of pigments (for example, cell aging pigment lipofuscin, which gradually accumulates and determines the lifespan of cells.

Acute cell swelling is reversible when signs of swelling disappear upon cessation of ischemia. Irreversible acute swelling is accompanied by a decrease in the macroergs of purine bases and leads to cell death due to the inability to continue life. Death is accompanied by cell necrosis, irreversible changes in cellular structures as a result of autolysis of proteins, carbohydrates, lipids by lysosomal enzymes - hydrolases. Death - cell death, can occur without necrosis under the influence of fixatives such as formaldehyde, glutaraldehyde, which quickly destroy tissue enzymes and prevent necrosis.

Pathophysiology went through a difficult path of development. The development of pathophysiology, scientific and practical medicine are closely interdependent processes. This is what determined the origin of pathophysiology in the past (when it was designated as “general pathology”) and significantly influences its development at the present time.

The name and place of pathophysiology have changed in the system of training doctors and in medical science, but there has always been and continues to be a need for it as an integrating and analytical scientific specialty and academic discipline. This is due to the fact that it is pathophysiologists who are engaged in identifying, describing and explaining the causes, conditions, specific and general mechanisms of occurrence, development, as well as outcomes of diseases and painful conditions. Based on this knowledge, principles and methods of their diagnosis, therapy and prevention are developed and justified.

Currently, the term "pathophysiology""is used to denote a section of medicine and biology that studies and describes specific mechanisms and general patterns of the occurrence, development and completion of diseases and pathological processes; formulating the principles and methods of their diagnosis, treatment and prevention; developing a general doctrine about illness and the sick person.

PATHOPHYSIOLOGY— SECTION OF MEDICINE AND BIOLOGY,

studies and describes specific causes, mechanisms and general patterns of occurrence, development and completion of diseases, pathological processes, conditions and reactions;
formulates the principles and methods of their identification (diagnosis), treatment and prevention;
develops the doctrine of disease and the sick organism, as well as theoretical principles of medicine and biology.

Subject (object) of studying pathophysiology

is not homogeneous and includes three components: “disease”, “typical pathological process” and “typical form of pathology”. All components of the subject “pathophysiology” (both as a science and as an academic discipline) are studied and described from the perspective of the etiology and pathogenesis of diseases or pathological processes, their manifestations and mechanisms of development, the principles of their diagnosis, treatment and prevention.

Tasks.

Pathophysiology develops the problems of the etiology and pathogenesis of diseases, the mechanisms of their manifestations, and formulates the principles of diagnosis, treatment and prevention of diseases.

Etiology.

Pathophysiology clarifies, describes and explains the causes and conditions for the occurrence of diseases, disease states and pathological processes. Knowing these factors allows us to answer the question “why does it arise?”

Pathogenesis.

Pathophysiology explores, describes and explains the mechanisms of development of diseases and pathological processes, the mechanisms of their manifestations. This makes it possible to answer the question “how is it developing?” disease or pathological process.

Diagnostics.

Pathophysiology formulates and substantiates the principles and methods of identifying (diagnosis) diseases and pathological processes. The solution to this problem is based on knowledge of the mechanisms of occurrence, development and completion of diseases and pathological processes. This makes it possible to scientifically substantiate a rational diagnostic search scheme for each specific patient, i.e. answer the question “how to identify?” disease or pathological process.

Treatment and prevention.

Pathophysiology formulates and argues the principles and methods of treatment, as well as the prevention of diseases and pathological processes, i.e. answers the question “how to treat and prevent?” disease.

Methods.

In pathophysiology, both in science and in an academic discipline, the following classes of methods are used: modeling, theoretical analysis, clinical research, as well as methods of other biomedical disciplines (biochemical, morphological, biophysical, statistical, etc.). All of these classes of methods make it possible to obtain objective information about the etiology, pathogenesis and manifestations of diseases and pathological processes in each individual patient, as well as in experimental conditions.

Sections.

Pathophysiology includes three main sections: general nosology, the study of typical pathological processes and the study of typical forms of pathology of tissues, organs and their physiological systems.

General nosology and the doctrine of typical pathological processes are designated as “general pathophysiology”, and the doctrine of typical forms of pathology of tissues, organs and their systems, as well as individual nosological forms - “particular pathophysiology”.

Admitted
All-Russian educational and methodological center
for continuing medical and pharmaceutical education
Ministry of Health of the Russian Federation
as a textbook for medical students

Medicine must move to ecological thinking
and abandon the idea of isolated healing of a person
without healthy environment.

1.1. Subject of pathophysiology

The subject of pathophysiology is the basic patterns of the occurrence of the disease, the mechanism of its development, recovery and rehabilitation. Knowledge of these general patterns allows the practitioner to conduct a targeted search specific signs diseases that allow a correct diagnosis to be made.

Objectives of pathophysiology:

Study of the most general (typical) patterns of deviations from the normal flow of work of cells and the body as a whole. This direction makes up the 1st and 2nd parts of the pathophysiology course: “General nosology” (the study of disease) and “Typical pathological processes”.
Study of the most common and characteristic deviations from the norm within organs or systems. Accordingly, the pathophysiology of the circulatory system, respiratory system, urination system, etc. is distinguished. This direction is called "Patophysiology of organs and systems."

Together with other sciences, pathophysiology contributes scientific progress in the field of prevention, curative medicine and rehabilitation, replacing traditional medical thinking with ecological thinking, identifying the causal relationships of the disease with environmental factors.

Pathophysiology is engaged in the development of indicators characterizing the state of the disease; after critical selection, it establishes general and specific signs to identify risk factors, make an accurate diagnosis and, thereby, targeted treatment, to develop criteria for monitoring the course of the disease, convalescence and rehabilitation, and preventive measures against adverse events. the impact of environmental factors on the health of the human population.

Clinical pathophysiology is primarily a clinical diagnostic part of our science. Its task is to develop and use standard methods for diagnosing prodromal conditions and monitoring the course of the disease, as well as taking into account the influence of external factors on the human body from the perspective of pathophysiology. Using all the capabilities of technology, clinical pathophysiology in close contact with the clinical activities of the doctor interpreting the data makes it possible to facilitate scientifically based diagnosis and treatment.

Pathological physiology and clinical physiology are based on the entire amount of knowledge of modern biochemistry, physiology, and anatomy. In this case, pathophysiology proceeds from the basic laws of the unity of nature and the commonality of development of living matter, i.e. It is precisely this that should form the foundations of ecological medicine in the doctor training system.

However, information from biochemistry, molecular biology and other natural sciences, obtained mainly in model experiments, must be critically assessed in terms of their applicability to humans.

A unilateral revaluation of the biological in man is unlawful. The essence of man is characterized by the unity of biological and social aspects.

A one-sided approach leads either to biologism or to the vulgarization of sociology. Both such directions should be rejected as unscientific.

The relationship between pathophysiology and biochemistry and pathological anatomy is especially close. These sciences, using their specific methods, study metabolic and structural disorders in pathology. It follows that only the close interaction of two independent sciences - pathophysiology and pathanatomy, which describe disorders of metabolism, function and structure, can provide a fully scientifically based interpretation of disease processes as pathology.

A disturbed function is always a disturbed structure and, conversely, a disturbed structure has a significant impact on metabolism and function. In table 1 schematically depicts the relationships between individual special disciplines. From bottom to top, the direction of formation of a doctor’s thesaurus (a set of his knowledge). Horizontally below - basic sciences, above sections of general pathology, and then, accordingly, diagnosis and treatment of individual nosological units based on existing knowledge.

Pathochemistry and immunology, as constituent areas of pathophysiology, belong to the most rapidly developing areas of the study of pathology, currently making the greatest contribution to the development of pathophysiology, its main fundamental sections: “General pathophysiology of the cell” and “Homeostasis”.

Pharmacology, which studies the effect of foreign substances such as drugs and poisons on the body, is closely related to the listed two sciences in order to find therapeutic principles and use them. Knowledge gained about hereditary diseases led to the conclusion about the relationship of pathophysiology with molecular genetics and human genetics.

1.2. Pathophysiology methods

The professional feature of a pathophysiologist is the presence of skills in the use of methods used in medicine (biochemical, physiological, etc.) and the creation of experimental models of diseases (immunological, morphological, physicochemical, etc.), taking into account causal relationships with environmental factors. Levels of research: molecular, subcellular and cellular, organ and, finally, organismal, systemic (ecological).

1.3. Main category of medicine

It seems to us that the main category of medicine should be the concept of “Ecological health” - the health of the human population associated with the unfavorable (disease) and favorable (adaptation) effects of environmental factors and which can be purposefully changed by influencing the environment.

1.3.1. Illness and health - two forms of life process

Disease and health are the main categories of medicine. WHO characterizes “health” as follows: “Health is a state of complete physical, mental and social well-being,” i.e. not only the absence of diseases and physical defects.

“Disease” is the dialectical negation of health. Health and illness form a dialectical unity of opposites. Illness is a disorder of a person’s physical and mental health, as well as social relations.

At the extreme extremes, health and illness appear to be completely opposite, but in fact there is a hidden interaction between them that underlies recovery. Hence, it is clear that there are many ways to treat the “disease of the disease.” These are methods of vaccine therapy, the use of artificial fever for therapeutic purposes.

At the same time, illness is a qualitatively unique process. Different diseases are also qualitatively different from each other, which allows for differential diagnosis.

One of the aspects of the qualitative difference between illness and health was revealed by Marx, who noted that illness is a life constrained in its freedom." One of the conditions for freedom is the coincidence of what I should with what I want and can. In the patient In the same person, a gap inevitably occurs between what is desired and what should be, what is necessary and what is possible.

Disease is a structural-functional process in which the body, like any living system, is organized into a whole by a system of elements interacting with each other. Structure is what organizes the whole (system); it exists as a unity of elements and functional relationships between them.

In turn, the function "organizes" the thing as whole system. This leads to a conclusion that is fundamentally important for practical medicine: the fundamental indivisibility of structure and function excludes the existence of both purely functional and purely organic changes in pathology.

Morphological unity in the theory of pathology is the principle of structure in the modern understanding. The biological structure, as it were, “merges” the dynamic object of morphology with the formalized physiological process.

However, until now, theoretical recognition of the unity of structure and function peacefully coexists with the confidence that at the beginning of many diseases, changes in organs and systems do not go beyond the framework of so-called functional disorders. The use of modern molecular biology methods in medicine has made it possible to “confidently deny the existence of functional diseases; they make it possible to find a morphological substrate that is adequate to any dysfunction” (A.I. Strukov).

So, we, firstly, gave a definition of “health” and “disease” and, secondly, revealed their dialectical unity, and, finally, thirdly, showed that there is no dysfunction without a corresponding morphological substrate.

1.3.2. The course of the disease, its stages

The dynamics of the disease process can be schematically and simplified as follows. The dynamic state of health is indicated by a sinusoid indicating the normal limits (Fig. 1). The concepts of “health” and “normal” are not identical. From which it follows that “health” is a narrower concept. Each individual has his own norm; the initial values are important. Therefore, it is advisable to be treated by the same doctor. Treat not the disease, but the patient. Going beyond dynamic state“health” with fluctuations in quantitative parameters within normal limits leads, under the pressure of external and internal influences, to violation of the boundaries of normal values.

We designate this stage as presymptomatic latent or premorbid (pre-disease). In infectious diseases, it is called the incubation period. Its clinical and, in most cases, subjective signs are not yet noticeable, hence the name “presymptomatic” stage. There is no disease yet in the classical sense, so another name for this stage is “premorbid”. However, there are already registered changes in some biochemical parameters of metabolism. For example, in a latent form of diabetes, a prednisone-glucose test helps identify the pathology. The duration of this period of illness can even be years. With the appearance of the first subjective and clinical signs of illness common to many diseases (malaise, weakness, headache), the second phase of the disease begins - symptomatic or prodromal, lasting hours to days. And this is followed by the stage of severe disease. At this time, each disease develops its own symptoms.

1.3.3. Semiotics - the study of signs or symptoms of disease

One of the most common signs (symptoms) of the disease is pain, which serves as a signal of trouble in the body. In case of inflammation, for example, it, together with other signs, forms a set of 5 characteristic local signs (syndrome): redness, swelling, pain, heat and dysfunction. Treatment based on eliminating symptoms is called symptomatic.

A group of symptoms that are more or less constantly observed in a particular disease is called a syndrome. For example, the inflammatory syndrome discussed above. Nephrotic syndrome includes impaired diuresis (dysuria), proteinuria, detection of red blood cells in the urine (hematuria), hypoproteinemia, and edema. Weaning syndrome is associated with a lack of high-quality protein.

Modern clinical methods use syndromic diagnosis. It is the basis for making a differential diagnosis. Hepato-renal, pancreato-duodenal and a number of other syndromes are known. Due to therapeutic effects or the functioning of one’s own defense mechanisms, the 3rd stage of complete recovery begins and qualitative changes aimed at restoring the state of “health” (Fig. 1). However, recovery is not just a return to the state before the disease, but the emergence of a new quality. For example, as a result of suffering from measles, the body acquires immunity and resistance to it. The return of the body to a state of health, but in a modified form, is a beautiful example of the dialectical law of spiral development. Another generalized version of this law by philosophers is formulated in the expression “You cannot enter the same river twice.” If we remember the definition of health, it will be clear that for a person an essential criterion of health will be a return to labor activity. Recovery in this case is called rehabilitation (from the word “ability” - suitability). This means both a return to previous work activity and retraining.

1.4. Death and its types

Biological death develops under the condition that the body’s protective and compensatory reactions and the implementation of therapeutic measures have failed to counteract the disease.

Natural death is genetically determined by a certain number of mitoses (50±10), which each cell can carry out and is the result of the natural end of the life of cells, one cell, organ, organism.

The object of our study will be “pathological” death, i.e. premature death (violent, from illness). During its development, “clinical” death is distinguished.

Signs of clinical death are cardiac and respiratory arrest. The boundary between clinical death and biological death is death from anoxia of the cerebral cortex, which is determined by an electroencephalogram. The critical period for the existence of the cerebral cortex under anoxic conditions is 5-6 minutes. The reason is that neurons replenish ATP through the aerobic processes of the tricarboxylic acid cycle. The reserve anaerobic pathway of formation - ATP - glycolysis - is poorly expressed in neurons and it is not able to supply a sufficient amount of ATP for their work. Neurons cannot use the second energy source - non-esterified fatty acids.

Unlike the brain, other organs (liver, myocardium, smooth muscle, mucous membranes) use non-esterified fatty acids and, in addition, have a powerful enzyme system for the anaerobic pathway of ATP formation. These organs function for a long time even after circulatory arrest occurs.

This served as the basis for the use of organs removed from corpses for the purpose of creating cell cultures of human tissue, or for the purpose of transplantation. Organs are taken from people who die suddenly.

Clinical death is preceded by agony (translated from Greek - struggle) - final stage life of a dying person. It occurs in two periods:

Terminal pause equal to seconds, minutes. A short-term decline during which blood pressure drops to almost zero as a result acute failure cardiac activity. This leads the dying body to a state of hypoxemia and hypoxia, which causes worsening heart failure. A vicious circle arises.
Actually agony - (struggle) - breathing becomes more powerful, but breaths are ineffective, the work of the heart increases, blood pressure rises; Consciousness, hearing and vision are briefly restored.

1.4.1. Reanimation

Resuscitation is the revival of the body, bringing it out of a state of clinical death. The first attempts were made by Russian scientists Kulyabko, Andreev and the inventors of the artificial blood circulation apparatus Bryukhonenko and Chechulin. The principles of resuscitation were developed during the Great Patriotic War by Pegovsky and his colleagues.

The main condition for successful resuscitation is the rapid restoration of blood flow with well-oxygenated blood. The resuscitation technique consists of external cardiac massage (rhythmic compression of the sternum by 3-5 cm with a frequency of 60 times per minute) and forced ventilation (mouth-to-mouth breathing). Activities are carried out until spontaneous contractions of the heart and breathing are restored. If they are performed alone, then after 3-4 rhythmic pushes, 1-2 deep exhalations are made into the patient’s lungs.

Emergency care in a hospital setting is performed first by centripetally pumping blood into an artery to restore spontaneous heart contractions and, after 30-40 seconds, into a vein to fill the right ventricle. In parallel, intubation and artificial ventilation of the lungs are performed, electron acceptors and antioxidants are administered intravenously.

Pathophysiology is a science that studies functional changes in a diseased organism. The term stands for suffering, nature and science.

Pathophysiology studies the main causes of the disease, the mechanisms of their development and outcomes, for prevention and treatment.

Pathophysiology is divided into three sections:

1) General pathophysiology

2) The doctrine of typical pathological processes

3) Particular pathophysiology – pathphysis of the organ system.

General pathophysiology studies disease (nosology), studies the causes of disease development (etiology), and studies pathogenesis (mechanisms of disease development).

Nosology - the doctrine of the essence of disease.

Disease is a disorder of the body’s vital functions that develops under the influence of pathogenic (disease-causing) factors. and is characterized by limited ability to work (except for children and the elderly) and adaptability.

Adaptive reactions is a reaction aimed at eliminating the influence of everyday factors. For example: constriction of the pupil in bright light.

Defensive reaction – this is a reaction to the action of damaging factors of excessive strength, aimed at eliminating or weakening them.

For example: blood clotting when injured, sneezing, coughing.

Compensatory reactions – these are reactions aimed at replenishing the lost function of one organ by enhancing the work of other organs and systems. For example: with severe blood loss, a compensatory increase in heart function occurs.

Vicarization – compensation of lost function by enhancing the function of paired organs.

Pathological changes:

1) A pathological reaction is any reaction that goes beyond physiological fluctuations. For example: body temperature.

2) The pathological process is a set of pathological and protective-adaptive reactions.

a. A typical pathological process is the most frequently repeated combination of protective and pathological reactions.

3) Typical pathological processes - inflammation, allergy, tumor growth, hypoxia, thrombosis, fever.

a. Proceed as standard ( For example: thrombosis)

b. They can be caused by various reasons (thrombosis)

c. They lie in the pathogenesis of various diseases (inflammation)

d. Do not have precise localization

4) A pathological condition is a slowly occurring pathological process or its consequences (congenital or acquired).

There are 4 main stages in the development of an infectious disease:

1) Latent (incubation) is the period from the moment of action of the pathogenic factor to the first signs of disease.

2) Prodromal - during this period the first non-specific symptoms, characteristic of many diseases, appear.

3) The period of development of the disease or the period of its height - the appearance of a characteristic clinical picture of the disease, specific signs.

4) The period of outcome is recovery, which can be complete or incomplete, or transition to a chronic form of the disease and death.

5) Death - cessation of vital activity important systems and the impossibility of the body functioning as a single whole system.

a. Clinical death– cessation of activity of the cardiovascular and respiratory systems, but brain neurons are viable and resuscitation is possible.

b. Biological death - on average 5 minutes after clinical death, death of the cerebral cortex.

6) Remission - with a chronic disease, this is a state close to recovery.

7) Relapse is a return or a new cycle of the disease.

Pre-disease – typical for non-infectious diseases, such as ischemic heart disease, tumors, peptic ulcers, etc., for the pre-illness period it is typical:

1) Absence of clinical manifestations

3) Reduced resistance (resistance) to endogenous factors

4) The appearance of pathological reactivity.

2) Etiology is the science of the cause and conditions for the development of disease.

a) Cause is a factor that determines the possibility of developing the disease and its manifestation (tuberculosis).

b) conditions are factors that promote (unfavorable) or hinder (favorable) the development of the disease.

c) The etiological factor is the cause + condition.

d) Iatrogenesis is a disease that is caused by the actions of medical workers.

a. Bibliogenies are diseases caused by reading. medical literature incompetent people (third mustache syndrome).

b. Psychogenies are caused by improper mental contact between the patient and the doctor.

c. True iatrogenies are caused by preventive (vaccinations), diagnostic, and therapeutic measures.

e) A risk factor is a factor whose frequency coincides with the frequency of development of a given disease (for example: smoking is a risk factor for lung cancer)

3)Pathogenesis - This is the doctrine of the mechanism of disease development.

a) the main link of pathogenesis is all the structural and functional changes without which the disease does not develop. (diabetes mellitus is the main link in the pathogenesis of insulin deficiency)

b) The ongoing pathogenetic factor is a consequence of the main link in pathogenesis.

c) Cause-and-effect relationships - (vicious circle) a chain of events that naturally follow each other, sometimes this chain closes and a vicious circle arises.