• Welcome to Religious Forums, a friendly forum to discuss all religions in a friendly surrounding.

    Your voice is missing! You will need to register to get access to the following site features:
    • Reply to discussions and create your own threads.
    • Our modern chat room. No add-ons or extensions required, just login and start chatting!
    • Access to private conversations with other members.

    We hope to see you as a part of our community soon!

Biology paper feedback needed!

TurkeyOnRye

Well-Known Member
I'm writing a Biology term paper on Cystic Fibrosis. It's still a rough draft, but I'm nearly finished and was hoping to get some feedback from people on grammar, formatting and accuracy of claims. By all means, tear it up! Any feedback would be much appreciated. :yes:









An Overview of Cystic Fibrosis:
Genetics, Symptoms, Diagnosis, & Treatment







Cystic fibrosis (CF) is a relatively rare yet life-threatening disease (Cystic Fibrosis Foundation-1, 2012). It affects approximately seventy thousand people world-wide including thirty thousand Americans (Cystic Fibrosis Foundation-1, 2012). Frequency of CF is highest among caucasians with an incidence of approximately 1 in 1000-4000 births depending on region (Shastri et al., 2008; Southern et al., 2007). Early recognition and treatment is vital to promoting a long and healthy life-span. Left untreated, CF is lethal and affected individuals die in early adolescence, however, modern treatment options are extending life-expectancy and improving quality of life for those affected (Cystic Fibrosis Foundation-1, 2012). To understand CF, we must consider several factors related to the disease including its genetic attributes, typical symptoms, the process of diagnosis and available treatment options.
CF is caused by a mutated autosomal recessive allele (Griesenbach and Boyd, 2005) that corresponds to the cystic fibrosis transmembrane conductance regulator (CFTR) gene located on chromosome seven (Shastri et al., 2008). Over seventeen hundred unique CFTR allele mutations are recognized (Lay-Son et al., 2011). Among them, Delta-F508 is the most common mutation (about 66% occurrence in CF individuals) and is characterized by a deletion of the codon used to create phenylalanine located at position 508 on the chromosome (Sinaasappel et al., 2002). The CFTR gene codes for the production of a protein channel required to regulate chloride ion concentration between the plasma membranes of associated cells (Griesenbach and Boyd, 2005). This protein is commonly expressed in the epithelial cells that line the airways of lungs and various passages of the pancreas, liver, intestines, reproductive organs and skin (Starr et al., 2009). Faulty CFTR alleles are responsible for creating defective variations of this protein or terminating its production and as a result, CF symptoms occur (Laurie and Fundukian, 2011).
The most universally characteristic and life-threatening symptom of CF is lung airway obstruction caused by progressive buildup of dehydrated mucus (Bilton and Hurt, 2012). In a healthy lung, chloride transport proteins move chloride ions out of an epithelial cell which creates a concentration gradient across the plasma membrane that water molecules follow via osmosis (Zemanick et al., 2010). As water molecules exit the cell, a thin fluid layer forms which supports cellular immunity and functions as an epithelial lubricant (Bilton and Hurt, 2012). In cystic fibrosis-afflicted lungs, the chloride transport proteins are rendered ineffective and as a result, chloride ions stagnate inside the cell failing to produce the concentration gradient necessary for water movement (Zemanick et al., 2010). Dry sticky mucus then persists on the surface of epithelial cells; this obstruction and irritation inevitably results in inflammation and bacterial infections of the lung tissue (Konstan et al., 2011). Pseudomonas aeruginosa, among others, is a bacterium commonly associated with these infections and is a primary contributor to the progressive decline in lung function (Ren et al., 2008).
CF is an inherited autosomal recessive trait which means that it is passed down by both parents and is not dependent on sex for its expression (Starr et al., 2009). Individuals that have inherited only one copy of the allele do not express the trait, but are carriers for it (Starr et al., 2009). This means that affected individuals possess a homozygous genotype while carriers-only have a heterozygous genotype (Starr et al., 2009). Heterozygous parents therefore present to each of their children a 25% chance of expressing the trait, a 50% chance of being carriers for it, and a 25% chance that they will neither express the trait nor be carriers for it (Starr et al., 2009).
CF can be difficult for both patients and loved ones due to the immense amount of suffering it causes. An important aspect of reducing such suffering is early diagnosis (Sims et al., 2005). Today, the United States has newborn screening (NBS) programs operating in all fifty states designed to detect CF (among many other common health abnormalities) through a variety of methods (Groose et al., 2010). NBS involves acquiring blood samples from newborn infants within the first few days following birth (Cystic Fibrosis Foundation-2, 2012). Infants who test positive for CF during a screening undergo more thorough testing to verify results, most commonly in the form of a sweat test (Southern et al., 2007).


[CONTINUED ON NEXT POST]
 
Last edited:

TurkeyOnRye

Well-Known Member
Health care providers may perform a sweat test using one or more techniques such as measuring sweat chloride levels, conductivity or a combination (Southern et al., 2007). This is frequently done using quantitative pilocarpine iontopheresis and is considered to be among the most reliable forms of testing (Beauchamp et al., 2005). If results indicate abnormally high chloride levels in sweat, CF diagnosis is likely: 98% of CF patient sweat chloride levels have been shown to be 3-5 times higher than controls in certain studies (Leonard et al., 2008). Borderline levels, however, may necessitate second tier evaluations such as gene analysis to arrive at reliable conclusions (Mayell et al., 2007).
Proceeding from a positive diagnosis for CF is the inevitable question of how to treat the disease, to which there is no simple solution. There are, however, a number of therapy and drug treatment options that show a limited degree of success. Postural drainage and percussion (PD&P) is one conventional physical therapy technique performed on CF patients and is simple enough to be learned and performed by non-healthcare professionals (Cystic Fibrosis Foundation-3). PD&P requires the patient to sit or lay down in a variety of different positions to receive manual percussion and vibration around the chest (Cystic Fibrosis Foundation-3). Combined with breathing exercise by the patient, PD&P makes coughing more productive and could make subsequent inhaled medication treatments more efficient (Cystic Fibrosis Foundation-3).
Inhaled medications such as dry powder mannitol (IDPM) have been shown to improve lung function in CF patients versus placebo in a recent trial (Bilton and Hurt, 2012). Mannitol is an inert sweet-tasting substance found in plants and is frequently used in pharmaceuticals (Bilton and Hurt, 2012). One trial of IDPM resulted in minimal side-effects among users (Bilton and Hurt, 2012). Research shows that its efficacy is in its ability to reduce the viscosity of respiratory mucous by interfering with their hydrogen bonds, a feature that could help reduce the appearance of infection (Bilton and Hurt, 2012).
P. aeruginosa is a particularly aggressive bacteria that tends to produce large amounts of biofilm and alginate bi-products in the lower respiratory tract and is commonly associated with CF (Hansen et al., 2005). The biofilm produced by the invading bacteria serves as a defense from immune responses and certain medications (Hansen et al., 2005). One study suggests, however, that azitromycin antibiotic treatment is an effective remedy for P. aeruginosa infection in CF patients and subsequently improves lung function (Hansen et al., 2005). This is significant because some research suggests that as many as 95% of CF patient deaths in the past have been due to respiratory infections associated with this bacteria (Hansen et al., 2005).
The cumulative impact of cystic fibrosis tends to result in delayed growth and wasting of the human body (Wilson and Pencharz, 1998). As a result, CF patients tend to have trouble putting on weight despite a generous diet (Sinaasappel et al., 2002). Body weight correlates directly to CF patient health and research suggests that high calorie diets rich in fat and protein may help to improve CF symptoms (Sinaasappel et al., 2002). Patients undergoing enteral feeding may benefit from growth-hormone supplementation as a means of stimulating growth and weight-gain (Hardin et al., 2004).
Perhaps the most promising treatment for CF patients comes in the form of a breakthrough new drug developed by Vertex Pharmaceuticals called "Kalydeco" (Cystic Fibrosis Foundation-4). In January of 2012, the Cystic Fibrosis Foundation made a press release regarding the FDA's approval of Kalydeco, a drug that reportedly helps to restore function to the defective protein in the 4% of the CF population that have the G551D mutation (Cystic Fibrosis Foundation-4). Two other Vertex drugs are currently being tested and could potentially treat CF patients with the Delta-F508 mutation if testing produces positive results (Cystic Fibrosis Foundation-4). This could be the medical science breakthrough that thousands of people all over the world have been waiting their entire lives for.
The affect of cystic fibrosis on the human body and spirit is tragic. Its impartial impact on men, women and children is detrimental and unforgiving. Its most devastating attribute is a certain and progressive deterioration of one's ability to breathe, something many of us take for granted. Without a solid cure, patients of cystic fibrosis are relegated to coping with its merciless symptoms through the use of medication and physical therapy. Yet today, cystic fibrosis patients are living longer then they ever have before (Cystic Fibrosis Foundation-1, 2012). Creative men and women of science are steadily unraveling the mysteries of cystic fibrosis. Thanks to modern medical science, patients may one day soon experience a breath of fresh air.

[END]
 
Last edited:

Alex_G

Enlightner of the Senses
Very impressive man. Good job. Good effort on the referencing too, that’s something i always find to be a total *** ache!

Some thoughts of mine;

If you felt like expanding on the pathophys/clinical picture of Cystic Fibrosis, you could say that the increased viscosity of the mucus in these patients prevents the normal function of the muco-cilliary escalator, which is a natural defence mechanism from infection in the lungs. Also, the repeated lung infections and chronic inflammation leads to permanent dilation of the airways which is a condition called 'Bronchiectasis'. These dilated airways hold all the mucus, and have tendancy to collapse on themselves, exacerbating the obstructive aspect of the disease.(block airflow)
This is seen in many CF patients, especially those who are more advanced in the disease, or have had poor control over preventing infections.

just for interest, (i can explain it more for u if u need), the condition is usually monitored by the doctor by means of 'pulmonary function tests' and spirometry, which will assess the severity of the obstructive lung disease, (how much function is lost) and give an indication of how quickly the patient is deterioration generally, or how they are responding to a specific therapy regime.

Treatment wise you could briefly mention that the only effective cure for the lung disease in CF is bilateral lung transplantation, which does get performed on some patients with success.

Also when you mention the low BMI/ failure to thrive aspect of these patients, you could mention that its because the gene defect in the chloride channel prevents the pancreas from secreting its normal enzymatic juices into the gut (exocrine function), which results in the malabsorption of nutrients.


In paragraph 4, instead of saying 'parents present to each of their children a 25% chance of expressing the trait' I would clarify it by saying that they develop the disease. Maybe throw in the buzzword 'Mendelian Inheritance'. You could insert one of those punnet squares to illustrate the inheritance pattern. People always like a nice useful diagram. :)

In paragraph 8, the antibiotic you touch on is Azithromycin not Azitromycin i believe. And that in these patients antibiotics are often given for much longer periods than for the normal population. Sometimes they are to erraticate a current infection, but also given 'prophylactically' to prevent the development of an infection in the first place.

Also i noticed in your last paragraph you wrote 'the affect of cystic fibrosis' when it should be 'effect'.

Hope any of this helps :)

Alex
 
Last edited:

Skwim

Veteran Member
Unless your instructor is insisting that your source references appear within the text I would footnote them to the end of the paper.
 

lunamoth

Will to love
Re: this --> Left untreated, CF is lethal and affected individuals die in early adolescence

Just wondering if this is perfectly accurate. There are various levels of expression of CF. I believe that some people have a bit milder forms of CF that might not necessarily result in death in adolescence if untreated.

 

TurkeyOnRye

Well-Known Member
Very impressive man. Good job. Good effort on the referencing too, that’s something i always find to be a total *** ache!

Some thoughts of mine;

If you felt like expanding on the pathophys/clinical picture of Cystic Fibrosis, you could say that the increased viscosity of the mucus in these patients prevents the normal function of the muco-cilliary escalator, which is a natural defence mechanism from infection in the lungs. Also, the repeated lung infections and chronic inflammation leads to permanent dilation of the airways which is a condition called 'Bronchiectasis'. These dilated airways hold all the mucus, and have tendancy to collapse on themselves, exacerbating the obstructive aspect of the disease.(block airflow)
This is seen in many CF patients, especially those who are more advanced in the disease, or have had poor control over preventing infections.

just for interest, (i can explain it more for u if u need), the condition is usually monitored by the doctor by means of 'pulmonary function tests' and spirometry, which will assess the severity of the obstructive lung disease, (how much function is lost) and give an indication of how quickly the patient is deterioration generally, or how they are responding to a specific therapy regime.

Treatment wise you could briefly mention that the only effective cure for the lung disease in CF is bilateral lung transplantation, which does get performed on some patients with success.

Also when you mention the low BMI/ failure to thrive aspect of these patients, you could mention that its because the gene defect in the chloride channel prevents the pancreas from secreting its normal enzymatic juices into the gut (exocrine function), which results in the malabsorption of nutrients.


In paragraph 4, instead of saying 'parents present to each of their children a 25% chance of expressing the trait' I would clarify it by saying that they develop the disease. Maybe throw in the buzzword 'Mendelian Inheritance'. You could insert one of those punnet squares to illustrate the inheritance pattern. People always like a nice useful diagram. :)

In paragraph 8, the antibiotic you touch on is Azithromycin not Azitromycin i believe. And that in these patients antibiotics are often given for much longer periods than for the normal population. Sometimes they are to erraticate a current infection, but also given 'prophylactically' to prevent the development of an infection in the first place.

Also i noticed in your last paragraph you wrote 'the affect of cystic fibrosis' when it should be 'effect'.

Hope any of this helps :)

Alex

Wonderful feedback! For obvious reasons I cannot cite you as a source, but I will certainly search journals for CF-related bronchiectasis.

The reason I said that they will "express the trait" as opposed to something like "develop the disease" is that technically that is incorrect because the disease is caused by the trait. Theoretically, one could have the trait (the defective chloride transport protein) and not have any CF symptoms...with the right treatment of course.

I double-checked the journal article to see if it was spelled "azitromycin" and sure enough it was. Can't imagine the Journal of Cystic Fibrosis would let something like that slide, so I assume both are acceptable spellings.

Thanks a lot!
 
Last edited:

TurkeyOnRye

Well-Known Member
Unless your instructor is insisting that your source references appear within the text I would footnote them to the end of the paper.

I have an extensive Literature Cited page that I did not include here simply because it would've been messy to integrate into the post and I don't require feedback on its formatting anyway. My instructor requires us to use CSE name-year in-text citation format.
 

TurkeyOnRye

Well-Known Member
Re: this --> Left untreated, CF is lethal and affected individuals die in early adolescence

Just wondering if this is perfectly accurate. There are various levels of expression of CF. I believe that some people have a bit milder forms of CF that might not necessarily result in death in adolescence if untreated.


Thank you! I've just did a quick search about mild forms, and it looks like you are right, though they appear to be exceptionally rare. In any case, I will have to change that statement.
 

Alex_G

Enlightner of the Senses
Wonderful feedback! For obvious reasons I cannot cite you as a source, but I will certainly search journals for CF-related bronchiectasis.

The reason I said that they will "express the trait" as opposed to something like "develop the disease" is that technically that is incorrect because the disease is caused by the trait. Theoretically, one could have the trait (the defective chloride transport protein) and not have any CF symptoms...with the right treatment of course.

I double-checked the journal article to see if it was spelled "azitromycin" and sure enough it was. Can't imagine the Journal of Cystic Fibrosis would let something like that slide, so I assume both are acceptable spellings.

Thanks a lot!


Ah thats weird, ive never heard Azitromycin used as the spelling. Mainly because its a member of the macrolide antibiotic class that characteristically have '-thromycin' as part of their name, others like erythromycin, clarithromycin. Does actually seem like a typo to me! :p

Yeah i mean ur wording is fine on the trait bit. :p
 

TurkeyOnRye

Well-Known Member
Ah thats weird, ive never heard Azitromycin used as the spelling. Mainly because its a member of the macrolide antibiotic class that characteristically have '-thromycin' as part of their name, others like erythromycin, clarithromycin. Does actually seem like a typo to me! :p

Yeah, you're right about the trait thing. What was I thinking? Good going!

My hypothesis is that it's a more international spelling. Many languages do not have a "th" sound.
 
Top