International classification and definition of myocardiodestrophia. Alimentary dystrophy - symptoms and treatment, reasons, prevention of myopathy Becker code on the ICD 10

01.02.2021

An alimentary dystrophy is a type of dystrophy (Greek. Dystrophe - food disorder of fabrics, organs or the body as a whole).

Dystrophy is considered as "violation of the natural process of assimilation of proteins, carbohydrates, fats that the body should absorb along with food."

But the alimentary (lat. Alimentum is the content) in this context means that the dystrophic state is developing as a consequence of a long lack of nutrition (that is, hunger) or malnutrition. In medicine, this term appeared during the blockade of Leningrad. Obviously, in statistical reports about the number of people who died from the hunger of the deposited city, the wording "death occurred due to an alimentary dystrophy" did not look so ignorant ...

In both cases, the normal functioning of all organs and systems of the body is broken due to protein and energy deficit.

Code of the ICD-10

E41 Alimentary Maramus

Causes of alimentary dystrophy

According to the statements of the UN Standing Committee on Nutrition (SCN), Diseases and Malnutrition (MalNutrition) are closely connected, and on a global scale, an alimentary dystrophy is one of the main causes of health problems.

According to World Food Program, an alimentary dystrophy at an early age leads to a decrease in the physical and mental development of children. Today in developing countries there are at least 147 million children with height delay due to constant malnutrition. Signs of food dystrophy have 14.3% of adults. Moreover, an alimentary dystrophy is the cause of 45% of deaths of children under five years: in Asia and Africa, 2.6 million children die annually from malnutrition.

The main causes of alimentary dystrophy are associated with a disadvantage in the diet of proteins and other necessary nutrients or - with their complete absence ...

In a word, this pathology occurs when a person walks hungry or eats something that in no way covers the energy costs of the body.

Symptoms of alimentary dystrophy

The appearance of characteristic symptoms of an alimentary dystrophy is due to the fact that without receiving an adequate replenishment of nutrients providing common metabolism, the body begins to spend fats and carbohydrates from their "stoves". And when they run out, the process of dissimulation (decay) of tissue proteins, protein structures of enzymes and hormones is launched.

This occurs during the oxidation of amino acids in the blood - to obtain missing energy, since the amino acids that are formed when digesting the proteins of food and come into cells, it is not enough.

Then the quick loss of proteins begins (more than 125 g per day). As a result, the metabolism and balance of blood proteins and proteins of tissues is disturbed, atrophic degenerative changes of skeletal muscles with muscle loss and loss of muscle functions occur with muscle loss; In the blood, the level of sugar and cholesterol is sharply reduced; The glycogen content in the liver parenchyma and muscle tissues is also reduced. In general, there are all signs of cachexia (Dr.-Greek. - poor condition) - the syndrome of extreme exhaustion of the body.

Key clinical symptoms of alimentary dystrophy are as follows:

painful (insatiable) hunger;
pallor and yellowness of skin, leather dry and wrinkled;
khudoba (significant body weight loss);
general weakness, dizziness;
reducing the body temperature (hypothermia) to + 35.5-36 ° C;
reduction of muscle and subcutaneous tissue (atrophy);
numbness (paresthesia) and muscle pain;
reduction of arterial and venous pressure and blood flow velocity;
heart rate disorders (bradycardia and tachycardia);
disorders of digestion and intestinal atony (dyspepsia, flatulence, constipation);
anemia (hypochromic or hyperchromic);
reducing the functions of the genital glands (amenorrhea, impotence);
increased irritability and excitability at the beginning of the disease; Apathy, drowsiness and inhibition - at later stages.

According to the severity, it is customary to distinguish between three degrees of alimentary dystrophy: 1st degree (light) - weakness and weight loss without muscle atrophy; The 2nd degree (average) is a sharp deterioration in the overall state, the presence of cachexic syndrome; The 3rd degree (severe) is the complete absence of subcutaneous fatty fiber and atrophy of skeletal muscles, reducing the functions of organs and systems.

In addition, the edema and dry varieties of alimentary dystrophy are distinguished. Cakexcic edema can be accompanied by an increase in the daily separation of urine (polyuria) and stagnation of liquids in the cavities. And dry dystrophy - with all other manifestations - is distinguished by more pronounced muscular atrophy and the presence of myocardium brown atrophy (decrease in the size of the heart and the thinning of its muscle fibers).

Diagnosis of alimentary dystrophy

Treatment of alimentary dystrophy

The treatment of an alimentary dystrophy is to be, first of all, in providing a patient with full nutrition (3000-4000 kcal per day) with an increased content of easily digestible proteins, vitamins, macro- and microelements. The number of food meals - in small quantities - at least six times a day. If there is diarrhea, food must be homogeneous. In this case, the consumption of the cooking salt should be limited (maximum 10 g per day), and the recommended amount of the liquid drinking is 1000-1500 ml during the day.

Patients passing the treatment of alimentary dystrophy is extremely important to respect physical peace and psycho-emotional equilibrium.

In the treatment of alimentary dystrophy of the 2nd and 3rd degree of severity, a strict bed mode is shown in the hospital. Power can be carried out using the probe. In addition, intravenous glucose injections are prescribed, as well as dosage transfusions of blood plasma or blood compounds. With digestive disorders, heart rate disorders, anemia and other symptoms, drug symptomatic therapy is carried out using appropriate drugs.

For example, during dyspepsia, patients take enzyme preparations: gastric juice, hydrochloric acid with pepsin, as well as Pancreatin, Abomin, Panzinorm-Forte, etc. Fixed assets against anemia - Vitamin B12, folic acid and iron-containing drugs (Parenteral - Ferrum-Lek, Ferbitol ; Inside - hemostimulin, ferroplex, etc.).

The forecast of an alimentary dystrophy - recovery, the transition to a chronic state or death is directly dependent on the degree of depletion of the body. In the case of the 1st and 2nd severity (light and medium), the forecast is favorable. An unfavorable forecast has a 3rd degree of pathology, since it exacerbates the state of complication of an alimentary dystrophy in the form of such in the form of diseases such as dysentery, pneumonia and tuberculosis.

The great doctor of antiquity Hippocrates said that when the "disappearance of the flesh" (that is, weight loss in chronic malnutrition, that is, the state that we call an alimentary dystrophy), "shoulders, clavicle, chest, fingers like melting. This is a state of death. "

Durane muscular dystrophy is a genetic disease caused by a congenital defect X-chromosome. Usually affects male representatives in childhood and is characterized by a disorder of the structure and weakness of muscle fibers. They gradually destroy and lead to loss of motor function, and soon after that - to death.

What is dystrophy or dushenna myopathy

This is the most common type of muscle dystrophy, striking approximately 1 of 4,000 men. Due to the congenital defect of the dystrophin gene, the muscle tissue loses its structure and does not develop. Muscles cannot move and shrink, which leads to irreversible degenerative changes in the musculoser and skeleton deformation. The disease quickly progresses, accompanied by violations in the work of the heart, respiratory organs, endocrine and nervous systems.

The patient from childhood is difficult to move difficulties. It has a specific gait and posture, later peers begins to walk and makes it worse. From 8-10 years old, the patient requires crutches, with a 12-wheelchair. Patients over 16 years not only can not move independently, but also have problems with breathing, intelligence, heart. Death on average occurs in 30 years, but there are people living longer.

The disease has a code on the ICD 10 - G71.0, is often defined as the Mopathy of Duzhenna Becker, but it is incorrect. There is a separate pathology - progressive muscular becker dystrophy. It is distinguished by slow flow and late manifestations. Symptoms arise solely at the age of 15-20 years, while during the disease Duzhenna youth in this period already chained to a wheelchair. Life expectancy at the Miopathy of Becker is also more. Thus, Durane-Becker's disease is not a single pathology, but two different states.

Also diagnose Amiotrophy Duzhenna, leading to violation in the work of the muscles. However, this is not independent pathology, but a group of progressive spinal diseases affecting adults.

Causes of Dystrophy Duzhenna

The reason for the appearance of the disease is a congenital defect of the sexual X-chromosome. The gene is amazed who is responsible for the production of muscular protein - dystrophin. It is he who is the basis of all muscle fibers at the cellular level. The substance is necessary for the correct development of the skeleton, the ability of the muscles to shrink and relax many times in a row.

During the disease Duzhenna, protein is absent at all or is defective, that is, does not perform its function. It is replaced with a fat or connective tissue, which is why the movement becomes impossible.

The disease has a recessive type of inheritance, adopted with the X chromosome, and occurs during mutations in both paired media. Pathology affects predominantly boys, since there is one X chromosome in their genetic set. If it is defective, the disease comes.

Pathogenesis during dunenery muscular dystrophy

Duzhenna Miodistrophia is due to mutation in the Distrophin gene responsible for the production of the same name protein. Because of this, there is no compounds of the cytoskeleton of each cell of muscle fibers with the main basal plate. In addition, excess calcium penetrates into the cell membrane. Mitochondria is filled with water and burst, their destruction leads to the elimination of the whole muscle cell. Those fibers that have undergone necrosis will no longer perform their function and now consist of other tissues.

Symptoms of the progressive muscular dystrophy of Duzhenna

The main manifestation of the disease is muscular weakness, developing into atrophy. It concerns skeletal muscles located in the hips, pelvis, shoulders, legs. Later, the neck, hands and other parts of the body are affected. In addition, the symptoms of the disease are called:

clumsy gait;
increased tone of calf muscles;
chronic fatigue;
the inability to run or jump;
last Lordoz;
neurological and mental disorders;
difficulties with concentration;
worsening memory;
scoliosis;
hormonal disorders;
loss of ability to walk on their own.

Music forms

The disease has two forms: initial and progressive. They are inevitably connected with each other: one flows into the other with time. It is known that the Mopathic of Duzhenna, accompanied by muscle dystrophy at the initial stage, is noticeable in boys already at the age of 2 years. Progress the disease begins to 8-12 years.

Muscular dystrophy Duzhenna

First of all, the patient celebrates a strong increase in the icy muscles in size. Such a phenomenon is infrequently called the pseudo-booster muscle dystrophy of Duzhenna. It provokes difficulties when walking and frequent falls: the patient is forced to move, leaning on the tips of the fingers, and not on the entire foot. In addition, it tests:

pain in all skeletal muscles;
difficulties during monotonous seating or standing;
stiffness of movements.

Important! From the very beginning, the disease adversely affects the human ability to normally memorize and reproduce even the simplest information. Because of this, the child is late in development, speaks poorly, cannot concentrate.

Progressive dystrophy Duzhenna

In the later stages of the disease, a person is difficult to swallow, it requires a special tube for meals. Moreover, independent attempts to swallow food lead to the threat of aspiration pneumonia. In addition, the patient is observed:

inability to move;
reduction of muscle size and tendons;
difficulty breathing, often the patient breathes only with medical care;
strong curvature of the spine;
the defeat of the muscles of the heart and, as a result, serious interruptions in his work.

Methods of Diagnostic Disease Disease-Becker

Neurologist is engaged in the diagnosis of illness. To confirm the presence of pathology, a number of studies are carried out:

DNA test. Allows you to determine the presence of a gene mutation.
Muscular tissue biopsy. It is rarely used, lies in the fence of the sample of muscle fibers and the definition of the presence of dystrophin with a special dye.
Prenatal testing. It is held at 11 week of pregnancy to identify the risk of neuromuscular violations, especially if one or both parents are carriers.
Fetal blood fence. It is carried out at the 18th week of pregnancy, it is used in extreme cases by a genetic doctor.

Attention! Future parents should be careful with tests during pregnancy. However, if such a need arose, then preference should be given to early testing to minimize the likelihood of miscarriage.

Treatment of Muscular Dystrophy Duzhenna

There are no effective drugs to get rid of Miodistrophiya Duzhenna. Treatment, as a rule, symptomatic, which makes it easier for the patient's condition. It includes:

reception of corticosteroids: prednisolone and deflazing;
consumption of beta 2-agonists who slow down the progress of the disease;
moderate physical activity, such as swimming;
physiotherapy;
the use of wheelchair and orthopedic devices during sleep;
wearing respirators facilitating breathing.

In modern medicine, treatment with stem cells, which will be replaced by damaged myocytes. Injections with healthy cells make in all muscles every 2 mm: this procedure takes a lot of time.

Stem cells called pericitis, located in the blood vessels of skeletal muscles, are also known. Scientists receive their small amount, are grown by artificially and injected into the bloodstream. Some of them get into the muscles and fill them. The efficiency of the operation is uniquely not defined by scientists.

Prediction and prevention

For the prevention of complications of the disease, the patient must lead a healthy lifestyle, eating properly, sufficiently be in the fresh air. It is forbidden to limit the movement of a person and keep it in bed. Without at least minimal attempts to walk the muscles are destroyed very quickly.

Due to the fact that in dystrophy Duzhenna, not only skeletal muscles, but also the heart, respiratory organs, people can not live long in such a state. Even with the reception of drugs that facilitate the state, patients rarely live up to 35 years. More than 50% of them die in adolescence, without appropriate assistance - even faster.

With artificial ventilation of the lungs, the reception of supporting medicines for the heart, the use of a wheelchair and feeding tubes Some patients live 40-50 years. However, they need constant care and observation, as they cannot independently perform elementary hygienic procedures and even ask for help.

It is impossible to cure Miodistrophi Durane, but medicinal and orthopedic agents will help alleviate the patient's condition. Due to significant lesions of the internal organs, patients usually die at a young age. But modern achievements in the field of stem cell use make it possible to hope for an increase in the average life expectancy in people suffering from this disease.

The retina dystrophy includes a number of diseases in which the work of this part of the visual organs is disturbed. They are characterized by dieting tissues and vessel defects. The retina is the likeness of the radio. Only she catches no sound, and pulses of light, allowing to project an image. If this part of the eye is subject to illness, then its functionality is lost, and the vision begins to deteriorate. The characteristic of the disease corresponds to such a description:

Dystrophy retina Code on the ICD-10

The CCC-10 code does not have, but it can be found in the list of retinal diseases under the H35 number.

Classification of dystrophy retina

The retina dystrophy is divided into two large views. This is hereditary and acquired forms of the disease. If we talk about hereditary dystrophy, then destruction occurs at the level of receptors, allowing to see at dusk. These types of hereditary lesions are distinguished:

Generalized - pigment type degeneration, congenital blindness or no night vision, violation or lack of color perception.
Peripherals - the stratification of the retina due to the features of chromosomes, the defeat of the connective tissue, the violation of the functions of rod and columine systems.
Central - hereditary macula degeneration with the appearance of spots or yellow lesions, dystrophy on the background of age-related changes.

If we talk about the secondary (purchased) form of the retinal dystrophy, then it is also divided into peripheral and central. The disease of the central type in turn is divided into wet and dry manifestation of dystrophy. In the first case, the formation of new vessels is observed in the affected area. They are very fragile, so the elements contained in the blood are seeping through them. As a result, the edema and photosensitive elements of visual organs are damaged. Such a disease occurs hard, so its treatment is paid to increased attention.

Dry central retinal dystrophy is found in 90% of cases. It becomes the result of metabolic disorders. At the same time, accumulations of products involved in metabolism are formed between the retina and vessels.

Peripheral dystrophy

Such a manifestation is characteristic of short-lived people and very often leads to retinal detachment. There are two types of peripheral dystrophy: chorioretinal and vitreoretinal. Peripheral chorioretinal dystrophy (PCHD) affects the shell of vessels. Peripheral vitreochorioretinal dystrophy (PVHD) affects the state of the cornea. In addition, peripheral dystrophy may be cystic, inner-like and lattice.

Causes of retinal dystrophy

The causes of dystrophic changes of the retina can be such factors:

The formation of scarring as a result of violations of the vascular system or a decrease in local immunity.
Failure to comply with the supply mode and use of harmful or poor-quality food.
Harmful habits, in particular smoking and excessive consumption of alcoholic beverages.
Reliable attitude towards the treatment of infectious diseases.
The presence of chronic diseases. It may be diabetes mellitus, pressure jumps, diseases of cardiovascular and endocrine systems.
Opera on the eyes.
Obesity as a result of metabolic disorders.

These manifestations worsen the state of the circulatory system and slow down the metabolic processes. Because of this, the retina is affected. Here's what they say about the reasons of the retina dystrophy on the Internet:

Symptoms of dystrophy retina

General features for all types of retinal dystrophy are such manifestations:

The absence or reduction of color perception.
The appearance of image defects (flies, lightning, outbreaks, fog).
Launch of central vision.
Perception of objects on the side, as a fuzzy picture.
Reducing visual acuity.
Loss of sense of movement. The subject in the state of rest is difficult to distinguish from the one that moves.
The need for excessive lighting during writing or reading.

If we talk about the individual forms of the disease, the peripheral dystrophy is expressed by the appearance of flashes and points before the eyes. The damage to Makula is accompanied by the rejection of visible lines. Dry retinal dystrophy distorts visual images. The patient cannot work with small objects and fonts. He sees poorly in the dark and distinguishes faces.

Here is one of the examples of the development of retinal dystrophy and its treatment:

In most cases, the manifestation of symptoms is characteristic of one eye. In addition, the initial stage of retinal dystrophy proceeds imperceptibly. Finding the first signs indicating the occurrence of the disease, you need to immediately consult a doctor.

Retina dystrophy during pregnancy

During pregnancy, the retina dystrophy arises due to a decrease in blood flow to the eyes as a result of low blood pressure. If it does not stop the development of the disease on time, it can lead to a rupture or retinal detachment. To avoid such consequences, a planned caesarean section or a laser coagulation procedure is carried out. Laser adaging is appointed until the 35th week of pregnancy. The procedure is the creation of a reliable connection of the vascular shell with the retina. The result of such an intervention is to reduce the risk of complications into visual organs with natural childbirth.

Diagnosis of the disease

Detection of dystrophy and setting the correct diagnosis implies such studies:

Check of visual acuity (visometry).
Detection of the visual field (perimetry).
Checking for the distortion of visible lines - the Assistant test.
Detection of anomalous deviations in the refraction of light rays (refractometry).
Bomicroscopy.
Ophthalmoscopy.
Determination of the degree of color perception.
Electricaloretinography.
Determination of the degree of adaptation of visual functions in dotters (adaptometry).
Finding amazed areas.
Retino and coherenthotromography.
Ultrasound procedure.
Collect analyzes.

Depending on the clinical picture, the patient is assigned to the consultation of the doctors of other specialties.

Treatment of retinal dystrophy

The standard diagram of treating the dystrophy of the drug method looks like this:

Preparations, strengthening and expanding vessels. The dosage of complimine, nos, papaverine or ascorutin is selected individually for each patient.
Funds preventing the appearance of thrombov. It may be aspirin, tiklodipine or clopidogrel.
Vitamin B, introduced intramuscularly, and a complex of other vitamins in the form of tablets.
Medicines that do not allow to form new painful vessels (Lucentis).
Preparations that reduce cholesterol indicators.
Means for improving the metabolism inside the eye. Enter intravenously or directly into the structure of visual organs.
Retinalamine, within 10 days entered into the field of the lower eyelid or the shell of the eye.
Eye drops accelerating the healing process and metabolism.

Conservative treatment is complemented by physiotherapy. Patients are prescribed such procedures as photo and electrostimulation, electrophoresis, magnetic therapy. If we talk about the use of small doses of laser radiation, they are used as an impact on the retina and blood.

Laser treatment

The laser beam extends its action directly to the affected areas of visual organs. They are irradiated with the purpose of stimulating and launching the metabolic process. The laser is able to strengthen the vessels with their coagulation and separate the affected areas from healthy, thereby stopping the spread of the disease. This process implies the soldering of defective tissues.

Operational intervention

If conservative and laser treatment methods have not helped to cope with the retina dystrophy, the doctor decides to appoint operation. Depending on the complexity of each case, such surgical interventions are carried out.:

Revascularization - restoration of vessels.
Vasoconstruation is the narrowing of the lumen between the vessels.
Vitretomy - full or partial removal of the vitreous body.

After the operation, it is necessary to observe measures to help restore the visual functions faster. It is necessary to ensure that the eyes are not overwhelmed, wearing sunglasses on the street, drink vitamins. In addition, it is necessary to abandon smoking and excessive alcohol consumption.

Folk methods for the treatment of retinal dystrophy

Recipes of traditional medicine during dystrophy should be used in conjunction with the main treatment scheme appointed by the doctor. Not bad effects provide such funds:

Milk from the goat, diluted with boiled water in the same proportions. During the week, the resulting solution is injected into the eyes, covering them after that dark tissue. As a result, the retinal detachment process will stop.
During the month they drink half a liter on the day of the beam. For its preparation, it takes 5 parts of the needles, 2 parts of the berry of the rosehip and the husk from the bow. They are poured boiling water and boiled 10 minutes.
In the eyes burst with a decoction of cumin and flowers of cornflower 2 times a day.
Within a month 3 times a day, the decoction from Cleuster is buried.
Take inside the tincture of birch, horsetail, lingers, mustard.
The wheat grain leaves to germinate in a warm place. The embryos are grinding and eating the mixture.
For 9 days in the eye, the mumiyo and aloe juice are dripped, cooked in proportions 5: 1.

Before using folk remedies, you need to consult with your doctor and make sure that the components of the decoctions do not cause allergic reactions.

Note:If when a disease is detected, refuse to help your doctor and engage in self-medication, the disease can develop to a serious stage. It is able to lead to complete loss of vision, which is characterized by the irreversibility of the process.

Network Distribution Prevention

In order to reduce the risk of retinal dystrophy, such rules must be followed.:

Take care that the workplace is correctly illuminated.
Any burden on visual organs must be accompanied by periodic rest.
You need to visit an ophthalmologist once a year.
The diet should consist of products containing vitamins and trace elements necessary for normal metabolism.
It is necessary to abandon bad habits (alcohol, smoking).

Massage and exercises strengthen the visual organs and normalize blood flow to them. Watch your health. Contact a doctor at the first signs of the disease in order to begin treatment on time.