Useful Info
Metabolic Pathways   

The metabolic pathway is a series of chemical reactions that occur within a cell. Within each of these pathways, one chemical is transformed into another chemical through a series of steps. These reactions are catalyzed by enzymes and will often require vitamins and minerals in order to function properly.

One of the first studies of metabolic pathways was done by a British physician named Archibald Garrod in 1909. It was discovered that the most important metabolic pathways for humans are glycolysis—the first pathway discovered— Krebs cycle, oxidative phosphorylation and gluconeogenesis. The collection of all the pathways within the human body is called the metabolic network, and this determines the physiological and biochemical properties of a cell.

Enzymes are considered to be very important to they body metabolic pathway. They act as catalysts in various chemical reactions that occur in the body cells. Enzymes convert substrates into various molecules or products. Since enzymes are selective and will only catalyze a few chosen reactions, the set of enzymes made in a cell determines which metabolic pathways occur in that cell. Enzyme activity can be affected by other molecules; inhibitors will decrease their activity, while activators will increase it.
The body metabolism is divided into two phases: anabolism and catabolism. Anabolism uses energy to construct the components of a cell, such as proteins, whereas catabolism involves the breakdown of organic matter. The result of this metabolic process may either be stored by the cells or used to initiate another metabolic pathway. The metabolic pathway and its activities will depend on other factors as well, including the temperature and the chemical environment, also known as the pH level.

The metabolic pathway is usually believed to travel in one direction, and it is composed of a series of chemical reactions that are connected to each other. These processes allow living organisms to grow and adapt to their environment. The metabolic process will also determine which substances are nutritious and which ones are poisonous. The speed of metabolism in an organism is also known as the metabolic rate.

Other metabolic pathways that occur in most living organisms include fatty acid oxidation and the urea cycle. In humans, the urea cycle takes place primarily in the liver, and it involves the production of urea from ammonia. Fatty acid oxidation is the process in which fat molecules are broken down into free fatty acids and monoglycerides.




Neurologic emergencies
Recognizing a neurologic insult in neonates may be difficult. The clinical
symptoms may be nonspecific. The history may reveal only a change in feeding
pattern or subtle behavioral changes. A useful mnemonic to recall the broad
differential diagnosis of a neonate with altered mental status, ‘‘THE MISFITS,’’
is outlined in Box  Keeping this mnemonic in mind as well as a high index of
suspicion during the initial history and physical examination (non) will help
guide the evaluation and management
 Causes of altered mental status in a neonate: THE MISFITS

T–Trauma (nonaccidental and accidental)
H–Heart disease and hypovolemia
E–Endocrine (eg, congenital adrenal hyperplasia and thyrotoxicosis)
M–Metabolic (electrolyte imbalance)
I–Inborn errors of metabolism
S–Sepsis (eg, meningitis, pneumonia, and urinary tract infection)
F–Formula mishaps (eg, under- or overdilution)
I–Intestinal catastrophes (eg, volvulus, intussusception, and necrotizing enterocolitis)
T–Toxins and poisons

Dr Archibald Edward Garrod

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