when and how often to check blood pressure
báo cáo sinh học:" Non-European Union doctors in the National Health Service: why, when and how do they come to the United Kingdom of Great Britain and Northern Ireland?" pdf
Ngày tải lên :
18/06/2014, 17:20
... regions,
overseas doctors comprise up to 50% of all junior doctors
[2]. General Medical Council (GMC), the United King-
dom's regulatory and licensing body for doctors, had a
total of 239 661 doctors registered ... Changes to immigration policy that fail to
factor in the aspirations and needs of doctors who have
already migrated to the UK are likely to disrupt the career
paths of many non-European doctors, ... Access
Research
Non-European Union doctors in the National Health Service: why,
when and how do they come to the United Kingdom of Great
Britain and Northern Ireland?
Jyothis T George*
1
, Kavitha...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 1) pptx
Ngày tải lên :
07/07/2014, 04:20
... hereditary spherocytosis or with cold agglutinin
disease may be diagnosed after years. This is due in large measure to the
remarkable ability of the body to adapt to anemia when it is slowly ...
Defects
Extracorpuscular
Factors
Hereditary
Hemoglobinopathies
Familial hemolytic
uremic syndrome (HUS)
Chapter 101. Hemolytic Anemias and Anemia
Due to Acute Blood Loss
(Part 1)
Harrison's ... more chronic, and they may vary from mild to very severe. The site
of hemolysis may be predominantly intravascular or extravascular. With respect
to mechanisms, HAs may be due to intracorpuscular...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 2) docx
Ngày tải lên :
07/07/2014, 04:20
... aspartate transaminase, and reduced haptoglobin. Urobilinogen
will be increased in both urine and stool. If hemolysis is mainly intravascular, the
telltale sign is hemoglobinuria, often associated ... pyknosis and actual loss of the nucleus.
Reticulocytes Increased
Bilirubin Increased (mostly unconjugated)
LDH
Increased (up to 10X normal with
intravascular hemolysis)
Haptoglobin Reduced to ... 5
mM) goes hand in hand with the gradual loss of cellular organelles and of
biosynthetic abilities. In the end the erythroid cell undergoes a process that has
features of apoptosis, including...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 3) pptx
Ngày tải lên :
07/07/2014, 04:20
... needs frequent blood transfusions. Chronic iron overload will cause
secondary hemochromatosis; this will cause damage, particularly to the liver,
eventually leading to cirrhosis, and to the heart ... components in the red cell: (1) hemoglobin, (2) the
membrane-cytoskeleton complex, and (3) the metabolic machinery necessary to
keep (1) and (2) in working order. Here we will discuss diseases of ... place in
the spleen, as is often the case, splenomegaly may become a prominent feature and
hypersplenism may develop, with consequent neutropenia and/ or
thrombocytopenia.
The increased red...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 5) ppt
Ngày tải lên :
07/07/2014, 04:20
... glycosylated, and they
carry antigenic determinants that correspond to blood groups. Underneath the
membrane, and tangential to it, is a network of other proteins that make up the
cytoskeleton. The ... (including ankyrin and the so-called band
4.1 and band 4.2), which thus connect these two structures intimately.
Figure 101-2
Diagram of red cell membrane/cytoskeleton.
(For explanation ...
cytoskeleton. The main cytoskeletal protein is spectrin, the basic unit of which is a
dimer of α-spectrin and β-spectrin. The membrane is physically linked to the
cytoskeleton by a third set of...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 6) doc
Ngày tải lên :
07/07/2014, 04:20
... Anemias and Anemia
Due to Acute Blood Loss
(Part 6)
Peripheral blood smear from patients with membrane-cytoskeleton
abnormalities. A. Hereditary spherocytosis. B. Hereditary elliptocytosis, ... elliptocytosis,
heterozygote. C. Elliptocytosis, with both alleles of the α-spectrin gene mutated.
[From L Luzzatto, in J Gribben and D Pravan (eds): Molecular Hematology, 2d
edition. Oxford, Blackwell, ... Blackwell, 2005; with permission.]
Table 101-3 Inherited Diseases of the Red Cell Membrane-
Cytoskeleton
Gene Chromoso
mal Location
Protei
n Produced
Disease(
s) with
Certain
Mutations
Comment
s...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 7) docx
Ngày tải lên :
07/07/2014, 04:20
... prophylaxis postsplenectomy is
controversial.
4. HS patients often may require cholecystectomy. It used to be
considered mandatory to combine this procedure with splenectomy, but this
may not ... HE causing clinical disease is similar to that of HS.
However, an asymptomatic form, referred to as Southeast Asian ovalocytosis, has
a frequency of up to 7% in certain populations, presumably ... first diagnosed when anemia is
investigated during pregnancy. The main clinical findings are jaundice, an
enlarged spleen, and often gallstones; frequently it is the finding of gallstones in a
young...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 8) pdf
Ngày tải lên :
07/07/2014, 04:20
... the jaundice persists and is usually
associated with a very high reticulocytosis. The anemia is of variable severity;
sometimes it is so severe as to require regular blood transfusions; sometimes ... Chapter 101. Hemolytic Anemias and Anemia
Due to Acute Blood Loss
(Part 8)
Abnormalities of the Glycolytic Pathway
(Fig. 101-1) Since ... be delayed, and in some cases it is made in young adults—for
instance, in a woman during her first pregnancy, when the anemia may get worse.
In part the delay in diagnosis is due to the fact...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 9) ppsx
Ngày tải lên :
07/07/2014, 04:20
... later in life or may even remain
asymptomatic and be detected incidentally when a blood count is done for
unrelated reasons. The spleen is often enlarged. When other systemic
manifestations occur, ... decrease in
G6PD activity in most tissues, this is less marked than in red cells, and it does not
seem to produce symptoms.
Figure 101-4
Diagram of redox metabolism in the red cell. G6P, glucose ... directly and via reduced
glutathione (GSH), defends these cells against oxidative stress. G6PD deficiency
is a prime example of an HA due to interaction between an intracorpuscular and an
extracorpuscular...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 10) pps
Ngày tải lên :
07/07/2014, 04:20
... Mediterranean
Sea, in the Middle East, and in India; G6PD A– in Africa and in Southern Europe;
G6PD Vianchan and G6PD Mahidol in Southeast Asia; G6PD Canton in China;
and G6PD Union worldwide. The heterogeneity ... anemia is over, and in the absence of comorbidity, full recovery from
acute HA associated with G6PD deficiency is the rule.
Chapter 101. Hemolytic Anemias and Anemia
Due to Acute Blood Loss ... remain clinically
asymptomatic throughout their lifetime. However, all of them have an increased
risk of developing neonatal jaundice (NNJ) and a risk of developing acute HA
when challenged by...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 11) doc
Ngày tải lên :
07/07/2014, 04:20
...
blood smear
Different
causes ranging
from
endothelial
damage to
heman
gioma to
leaky prosthetic
heart valve
March
hemoglobinuria
Abrupt
Mechan
ical destruction
Targete
d history ...
of large dish of
fava beans; but
t
rigger can be
Chapter 101. Hemolytic Anemias and Anemia
Due to Acute Blood Loss
(Part 11)
Table 101-
5 Drugs that Carry Risk of Clinical Hemolysis in ... Primaquine Chloroq
uine
Quinine
Dapsone/chlorp
roguanil
Sulphonamides/s
ulphones
Sulphametoxaz
ole
Sulfasala
zine
Sulfisoxaz
ole
Phenazopyridin
e (Pyridium)
Acetamino
phen
Phenacetin
...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 12) doc
Ngày tải lên :
07/07/2014, 04:20
... exposure to potentially hemolytic drugs, and blood transfusion may be
indicated when exacerbations occur, mostly in concomitance with intercurrent
infection. In rare patients, regular blood transfusions ... increased susceptibility to
bacterial infections.
Laboratory Diagnosis
The suspicion of G6PD deficiency can be confirmed by semiquantitative
methods often referred to as screening tests, which ... of NNJ due to other causes.
In cases with CNSHA, if the anemia is not severe, regular folic acid
supplements and regular hematologic surveillance will suffice. It will be important
to avoid...
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Chapter 101. Hemolytic Anemias and Anemia Due to Acute Blood Loss (Part 13) pptx
Ngày tải lên :
07/07/2014, 04:20
... due to a
contaminated blood unit. Occasionally HA is seen, especially in children, with
sepsis or endocarditis from a variety of organisms.
Chapter 101. Hemolytic Anemias and Anemia
Due to ...
prosthetic heart valves, especially when paraprosthetic regurgitation is present. If
the hemolysis consequent to mechanical trauma to the red cells is mild, and
provided the supply of iron is ... hemolysis is due to an inherited defect, but this is external to
drumming. The other situation, which has been called microangiopathic hemolytic
anemia, (Table 101-6) is chronic and iatrogenic;...
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