The investment you make in yourself must receive Top Priority.

When you GROW your entire world Expands...when you do not grow your whole world starts to become Very Small...that smallness reflects in all areas of life including your income."
Bob Proctor Author and Personal Coach

Inflammation

Fiziopatologia

Inflamatiei
Dupa: Dr. Venkatesh M. Shashidhar.
Associate Professor of Pathology Fiji School of Medicine

Shashi-3/04

Inflammation

Introducere:

In-flame a aprinde. (rosu, cald, durere) Inflamatia este un raspuns dinamic al tesuturilor vascularizate la injurie. Este un raspuns fiziologic, protectiv. Serveste la initierea mecanismelor de aparare & vindecare la locul injuriei.
Mar-05

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AVANTAJELE INFLAMATIEI

localizeaza si izoleaza agresiunile tisulare, protejand astfel tesutul sanatos vecin; neutralizeaza si inactiveaza substante toxice produse de factori umorali si de enzime; distruge (limiteaza) cresterea microorganismelor infectioase; prepara aria tisulara pentru vindecare si reparare eliminand tesuturile devitalizate si resturile celulare.

Mar-05

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DEZAVANTAJELE INFLAMATIEI
durerea si edemul asociate inflamatiei dau diferite grade de incapacitate morfologica si functionala; poate duce la rupturi de organe (apendicita perforata), hemoragii (marirea granulomului tuberculos); formarea de tesut cicatriceal excesiv, cu aderente, contractura, cheloid; formarea de fistule: abdominale, perirenale, bronhopleurale; se poate propaga prin distrugerea tesutului sanatos vecin; leziunile produse de inflamatie pot duce la dezvoltarea de alte leziuni inflamatorii: glomerulonefrita, artrita, reactii alergice (bronsita alergica), miocardita, encefalita.
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INFLAMATIA

Shashi-3/04

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Inflamatia Cauze: ..Injuria

Agenti fizici Trauma, radiatii, Infectia agenti microbieni Subst. chimice acizi, baze, toxine Ischemia / Infarctul insuficient sange.. Reactia imuna

Mar-05

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Aspectul Inflamatiei:
Pete rosii dilatatie capilara. Zone rosii - dilatatie arteriolara. Umflatura - exudat, edem.

Lewis Triple Response: - old!

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Semne Cardinale ale Inflamatiei

Calor : caldura Hiperaemia. Rubor : Roseata Hiperaemia. Dolor : Durere Nervi, Med Chimici. Tumor : Umflatura Exudatie Functio laesa: Afectare functionala (Virchow
1902)

Celsus, 30 BC - Latin
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Calor, Rubor, Dolor, Tumor, Loss of function.

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Inflammation

Plaga chirurgicala inflamata:

Calor, Rubor, Dolor, Tumor, Loss of function.

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Inflamatia - Mecanism
1. Vaso dilatatie 2. Exudat - Edem

3. Migratie celulara
4. Chemotaxis 5. Fagocitoza
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Mecanism Inflamatie:

Inflammation

Ulceratie aftoasa (gingivita)

Calor, Rubor, Dolor, Tumor, Loss of function.

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Laringita:

Calor, Rubor, Dolor, Tumor, Loss of function.

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Enterita acuta:

Calor, Rubor, Dolor, Tumor, Loss of function.

Mar-05

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Pneumonia Inflamatie la nivel pulmonar

Calor, Rubor, Dolor, Tumor, Loss of function..!

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Migrarea Leucocitelor

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Marginatia Neutrofilelor

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Plaman Normal / Pneumonie

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Pneumonia - Exudatia

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Normal - Meningita

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Cele 5 Semne Cardinale ale

Caldura

Roseata Umflatura

Durere

Afectare Mar-05 functionala

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Mediatori Chimici ai Inflamatiei:

Hormoni Celulari citokine. Eliberati de celule, actioneaza local sau in imediata vecinatate Fiecare faza a inflamatiei este orchestrata de o serie de mediatori chimici citokine. Modificand constelatia acestora se modifica dinamica si manifestarile inflamatiei medicamente Endogeni & Exogeni. Produsi Locali & Factori Plasmatici.

Mar-05

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Mediatori Chimici ai Inflamatiei:

Produsi Locali Histamina Serotonina/5HT Interleukinele. Prostaglandine* Leukotriene*

Derivati Plasmatici

Kinine Complement Sistemul Coagularii

Sistemul Plasminolizei

Altii: H2O2, NO, O2*rad.

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Mediatori Chimici ai Inflamatiei

Vasodilatatie: Histamina, Pgs, Oxid Nitric Permeabilitate: Hist, bradikinina, C5a, LB4 Fact de adez leucocit.: IL8, LB4, C5a, TNF Chemotaxie: LB4, IL8, bacterial toxins, C3, C5. Durere: Prostaglandine & Bradikinina.

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Mediatori Chimici ai Inflamatiei:

Amine Vasoactive - Histamina, Seratonina vaso dil. Sistem Complement C1-9 citoliza, opsonizare. Sistem Kinine Kalikreina Bradikinina Sistem Coagulare FXII, FX, Fibrina, Plasmina Metaboliti Acid Arahidonic: Prostaglandine - (cyclooxigenaza) - Piretic Leukotriene (Lipoxigenase) Lipoxine actiune anti-inflammatorie, de asemenea. Altii:

H2O2, Oxid Nitric, Lisozime,rad liberi O2

Mar-05

Mediatori Chimici ai Inflamatiei.

Distructie celulara

Fosfolipide membranare Acid Arahidonic 5-Lipoxygenase

Steroizi
Cyclooxygenase

NSAID
5-LO inhibitors Leukotrienes
LTC4, D4, E4 Prostaglandins Prostacyclins

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Tipuri de Inflamatie:

Timp:

Acuta & Cronica Supurativa neutrofile - bacteriana Fibrinoasa - fibrina - imune Seroasa fluid - virale Granulomatoasa cronice TB/fungus/Corpi straini. Eosinofilica parasitare, imune.

Proces Predominant:

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Tipuri de Inflamatie
Acuta pana la cateva zile.

Modif Vasculare : Hiperemia & exudatia. PMNs Neutrofile, Puroi/supuratiii.

Fara modif vasculare. Fibroze Cicatrice. MNs - Limfocites si macrofage

Cronica Saptamani pana la luni sau ani

Mar-05

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Rezultatul (evolutia) inflamatiei

Inflamatie Cronica

Injuri e

Inflamatie

Acuta

Vindecare

Abces Fistula Ulcer Sinus

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"It gives me great pleasure to converse with the aged. They have been over the road that all of us must travel and know where it is rough and where it is level and easy...!"
Plato

Mar-05