Medicine and Health

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Order type: EssaySubject: Medicine and HealthAcademic level: UndergraduateStyle: Harvard
ART 1: PathophysiologyAccording to Foley et al. (2010, p. 347), metabolic syndrome is a combination of high blood pressure, low-density lipoprotein (HDL) cholesterol, increased triglycerides and blood glucose level. This could lead to type 2 diabetes, coronary heart disease and heart attack (American Heart Association 2016). Depression is a mental disorder that involves several symptoms such as low mood, energy, fatigue, feelings of guilt, suicidal thoughts and low self-esteem (Brigitta 2012, p. 7). It is suggested that depression is linked to functional deficiency of the brain monoaminergic transmitters dopamine, norepinephrine and 5-HT. Norepinephrine is synthesized from amino acid tyrosine and it is believed to play a role in mood control and emotional behavior. And serotonin (5-HT) is a neurotransmitter that involves in the control of mood (Depression Resource Centre n.d.). Depression could result from diminished monoaminergic transmitters level and changed signal transduction (Dunlop, Charles & Nemeroff 2007, p. 327). For example, there are studies had shown that reduced concentration of dopamine metabolites in cerebrospinal fluid and brain regions can mediate the mood and motivation (Dunlop, Charles & Nemeroff 2007, p. 327). In addition, transport proteins are essential in monoaminergic transamination. Abnormality in transamination can be caused by changes in receptor function (changing the coupling or the downstream sign transduction cascade) (Brigitta 2012, p. 7). Genetic vulnerability, severe life stressors, aging or unhealthy life styles can influence the incidence of depression (Beyond blue 2017). The relationship between depression and metabolic syndrome is “two ways street” which means that they influence each other and cause the incidence of each other. Prolonged high stress level (depression) results in the persist release of stress hormones (adrenaline and cortisol) that leads to the store of fat (increasing abdominal fat), increased heart rate, blood pressure and elevated BGL (James 2017). The incidence of metabolic syndrome is a risk factor for developing depression. Studies had shown that people with metabolic syndrome have higher chance of suffering from depression. It may link to body image or social pressure (KahI et al. 2015, p. 1).PART 2: Consideration of risks to decision-making and care planningThe metabolic syndrome is marked associated with increased cardiovascular risk such as hypertension, elevated BGL and dyslipidemia. It strongly increases the incidence of angina due to increased small LDL particles, serum triglyceride and apolipoprotein B as well as reduced level of HDL cholesterol (Alshehri 2010, p. 73). Prolonged high BGL can lead to severe complications which include developing hyperosmolar hyperglycemic state (HHS). HHS is characterized by significant elevations in the concentration of serum glucose and hypersmolality without large amount of ketosis (Pasquel & Umpierrez 2014, p. 3124). HHHS is a medical emergency and patients with HHS may present drowsiness, seizures, blurred vision, sensory deficits, delirium or even coma (Kitabcho et al. 2009, p.1335). Myocardial infarction is another complication caused by metabolic syndrome which could lead to irreversible heart tissue death because of disturbed blood supply (Abdou, Engberding & Wender 2015, p. 397). Depression is a chronic disorder that can affect physical health and daily life such as declining the capacity of undertaking the daily tasks (Fekadu, Shibeshi & Engidawrk 2016, p. 1). Antidepressant medication had proven that it is effective for patients with mild to moderate depression and it is recommended to depressed clients (Mcintyre et al. 2010, p. 5). When comes to priority of care, paramedics may need to think and assess the complications and the urgent (diagnostic overshadowing). In this case, compared to depression (which can be managed by medications for relative amount of time), the complications of the metabolic syndrome are more significant. Patients with hyperosmolar hyperglycemic state and myocardial infarction could dead in a short time if untreated.PART 3: Factors that influence transport and priority to tertiary careThere are a lot of factors that affect the priority and transport. Firstly of all, the physical health status of patient is one of them. According to Ebrahimina et al. (2014, p. 4), the presence of life-threatening disease or obvious acute signs or symptoms such as angina or shortness of breathe directly helps paramedics to make the decision about the priority of transporting patients. On the other hand, the absence of obvious acute signs or a serious disease may be suspicious for paramedics about a need to transport them. Secondly, equipment factors could contribute the priority such as medical equipment / supply failure or unable to establish medical control (Hick & Mahoney 2008, p. 3). Inaccessibility or defectiveness of essential equipment to assess the condition compels paramedics to transport patients to the hospital for further and urgent assessment. The presence of high-tech equipment could assist paramedics to make accurate decisions. In this case, if patients develop HHHS and there is not glucometer in the ambulances, paramedic will have difficulties to determine the diagnosis and how severity of the patients so they have to transport the patient as soon as possible (Ebrahimina et al. 2014, p. 5). The ability of paramedics would also affect the transport. It is important for paramedics to make a right choice and communicate effectively to the patients/ their families (Paramedics Australasia 2017). The reasoning ability (knowledge and experience) can influence the transportation- related decisions via responding, diagnosing medial problems and reaching sensible decision. If paramedics have better ability, they can make the decision more easily, quickly and accurately (Ebrahimina et al. 2014, p. 4)===============