Tìm thấy 10+ kết quả cho từ khóa "Anemia and Polycythemia"
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Anemia and Polycythemia. An overriding principle is to initiate treatment of mild to moderate anemia only when a specific diagnosis is made. Rarely, in the acute setting, anemia may be so severe that red cell transfusions are required before a specific diagnosis is made. Whether the anemia is of acute or gradual onset, the selection of the appropriate treatment is determined by the documented cause(s) of the anemia.. Often, the cause of the anemia may be multifactorial.
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Anemia and Polycythemia. Table 58-4 Calculation of Reticulocyte Production Index. Correction #1 for anemia:. This correction produces the corrected reticulocyte count. In a person whose reticulocyte count is 9%, hemoglobin 7.5 g/dL, hematocrit 23%, the absolute reticulocyte count = 9 x (7.5/15) [or x (23/45)]=. Correction #2 for longer life of prematurely released reticulocytes in the blood:. This correction produces the reticulocyte production index.
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Anemia and Polycythemia. Bone Marrow Examination. A bone marrow aspirate and smear or a needle biopsy may be useful in the evaluation of some patients with anemia. In patients with hypoproliferative anemia and normal iron status, a bone marrow is indicated. Marrow examination can diagnose primary marrow disorders such as myelofibrosis, a red cell maturation defect, or an infiltrative disease (Figs.
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Anemia and Polycythemia. Approach to the Patient: Anemia. The evaluation of the patient with anemia requires a careful history and physical examination. Nutritional history related to drugs or alcohol intake and family history of anemia should always be assessed. Certain geographic backgrounds and ethnic origins are associated with an increased likelihood of an inherited disorder of the hemoglobin molecule or intermediary metabolism..
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Anemia and Polycythemia. Erythropoietin levels in response to anemia.. When the hemoglobin level falls to 120 g/L (12 g/dL), plasma. erythropoietin levels increase logarithmically. In the presence of renal disease or chronic inflammation, EPO levels are typically lower than expected for a particular level of anemia. As individuals age, the level of EPO needed to sustain normal hemoglobin levels appears to increase.
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The cause of the anemia and increased red cell production may not be obvious. The ability to sustain a high reticulocyte production index reflects the ability of the erythroid marrow to compensate for hemolysis and, in the case of extravascular hemolysis, the efficient recycling of iron from the destroyed red cells to support red cell production. The level of response depends on the severity of the anemia and the nature of the underlying disease process..
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Approach to the Patient: Polycythemia. 58-18, the first step is to document the presence of an increased red cell mass using the principle of isotope dilution by administering. 51 Cr-labeled autologous red blood cells to the patient and sampling blood radioactivity over a 2-h period.. If the red cell mass is normal (<36 mL/kg in men, <32 mL/kg in women), the patient has spurious polycythemia.
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The key laboratory tests in distinguishing between the various forms of hypoproliferative anemia include the serum iron and iron-binding capacity, evaluation of renal and thyroid function, a marrow biopsy or aspirate to detect marrow damage or infiltrative disease, and serum ferritin to assess iron stores. Occasionally, an iron stain of the marrow will be needed to determine the pattern of iron distribution.
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An accurate reticulocyte count is key to the initial classification of anemia.. Normally, the reticulocyte count ranges from 1–2% and reflects the daily replacement of 0.8–1.0% of the circulating red cell population. A reticulocyte count provides a reliable measure of red cell production.. In the initial classification of anemia, the patient's reticulocyte count is compared with the expected reticulocyte response.
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Figure 58-4. Figure 58-5. Figure 58-6. Figure 58-7. Figure 58-8. Figure 58-9
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Preoperative Anemia and Postoperative Mortality in Patients with Aortic Stenosis Treated with Transcatheter Aortic Valve Implantation (TAVI):. Tohme S, et al. Preoperative anemia and postoperative outcomes after hepatectomy. Miceli A, et al. Preoperative anemia increases mortality and postoperative morbidity after cardiac surgery. Joshi SS, et al.
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A Rare Case of Incidentally Diagnosed Brucellosis in a Patient with Congenital Dyserythropoietic Anemia and IgA Nephropathy:. blood culture systems and automated identification systems makes the diagnosis delayed and inaccurate..
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Aplastic anemia can also be constitutional: the genetic diseases Fanconi's anemia and dyskeratosis congenita, while frequently associated with typical physical anomalies and the development of pancytopenia early in life, can also present as marrow failure in normal-appearing adults. Acquired aplastic anemia is often stereotypical in its manifestations, with the abrupt onset of low blood counts in a previously well young adult. Aplastic anemia is.
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Anemia and ringed sideroblasts are not features of ET, but they are features of idiopathic refractory sideroblastic anemia, and in some of these patients the thrombocytosis occurs in association with JAK2 V617F expression. Massive splenomegaly should suggest the presence of another myeloproliferative disorder, and in this setting a red cell mass determination should be performed because splenomegaly can mask the presence of erythrocytosis.
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Thus, in a patient with severe anemia, the relative quantity of reduced hemoglobin in the venous blood may be very large. when considered in relation to the total quantity of hemoglobin in the blood.. However, since the concentration of the latter is markedly reduced, the absolute quantity of reduced hemoglobin may still be small, and, therefore, patients with severe anemia and even marked arterial desaturation may not display cyanosis..
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In general, and in contrast to aplastic anemia and MDS, the unaffected lineages appear quantitatively and qualitatively normal.. Agranulocytosis, the most frequent of these syndromes, is usually a complication of medical drug use (with agents similar to those related to aplastic anemia), either by a mechanism of direct chemical toxicity or by immune destruction.. Agranulocytosis has an incidence similar to aplastic anemia but is especially frequent among the elderly and in women.
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A large number of hematologic, immunologic, and congestive causes of splenomegaly can lead to destruction of one or more cellular blood elements. In the majority of such cases, splenectomy can correct the cytopenias, particularly anemia and thrombocytopenia. In a large series of patients seen in two tertiary care centers, the indication for splenectomy was diagnostic in 10% of patients, therapeutic in 44%, staging for Hodgkin's disease in 20%, and incidental to another procedure in 26%.
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Importantly, approximately 45% of chronic IMF patients, like patients with its companion myeloproliferative disorders PV and ET, express the JAK2 V617F mutation, often as homozygotes. Survival in chronic IMF varies according to specific clinical features (Table 103-4) but is shorter than in patients with PV or ET. The natural history of chronic IMF is one of increasing marrow failure with transfusion-dependent anemia and increasing organomegaly due to extramedullary hematopoiesis..
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The effect of perioperative anemia on clinical and functional outcomes in patients with hip fracture. Haematological indices as surrogate markers of factors affecting mortality after hip fracture. The relationship between anemia at admission and outcome in patients older than 60 years with hip fracture. Anaemia impedes functional mobility after hip fracture surgery. Delayed surgery for patients with femur and hip fractures-risk of deep venous thrombosis.
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Multivariable logistic regression on polycythemia in subjects without anemia. Multivariable logistic regression. We thank the participants and the investigators who have participated in the COPDGene study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.