In recent years, Russia has seen a significant increase in incidence of atherosclerosis obliterans. Among all causes of death atherosclerotic lesions of the cardiovascular system are the first place. In this disease is the deposition of cholesterol plaques in the walls of the arteries, then these plaques penetrate calcium, and they begin to resemble the density of the stone.
Lumen of blood vessels decreases sharply, the blood flow to tissues and organs becomes insufficient. Such a condition called chronic ischemia. Depending on where the greatest vascular lesions produce chronic cerebral ischemia, which leads to strokes, coronary heart brand viagra disease and, finally, chronic lower limb ischemia. On this localization of atherosclerosis should be more detail. Symptoms of chronic lower limb ischemia are marked by different estimates of 7.5% of the male population as a whole and 35% in the older age group.
Initially, patients note fatigue of leg muscles during intensive activity (running, long walking, climbing stairs). If you do not establish a diagnosis and begin proper treatment, the disease is entering the stage of intermittent claudication. In this case, the patient is forced to stop when passing a certain distance. When this distance is greater than 200 meters, you can stop the progression of the disease correctly chosen treatment. When reducing the distance traveled by up to 100 meters or less the question of surgical treatment. Without treatment, atherosclerosis of lower limb arteries leading to disability in 30-50% of patients. In the final stage of the disease appear unbearable pain in the affected limb at rest, patients lose sleep and can come gangrene of the foot, with the inevitable amputation.
More dramatic things happen, if the atherosclerotic plaque is the cause of acute arterial thrombosis. If it affects the blood vessels of the brain is developing stroke, coronary artery - myocardial infarction, limb arteries - gangrene. In these cases, emergency surgery and therapeutic services can be effective only in half of cases.
Successful fight against atherosclerosis obliterans depends on two main points:
1. Early diagnosis, which can only assign a vascular surgeon. It involves the successive actions (inspection specialist, Doppler ultrasound, etc.).
2. Appointment depending on the stage of disease drug or surgical treatment.
Therapeutic treatment is aimed at restoring the vessel walls, reducing the risk of thrombosis, increase in oxygen consumption bodies. In the surgical treatment of thrombosed vessels are replaced with artificial ones, which are fully or partially restore blood flow to diseased organs and limbs.
Early treatment can save a full life for many years in 90-95% of patients with atherosclerosis obliterans and avoid life-threatening complications.
sensitivity to sodium
sympathetic activation
opposite effect
quantitative and qualitative
hormones
2011年1月21日金曜日
Degree-central
IV-crush, compression of the parenchyma, areas of necrosis and damage to the hepatic veins and portal vein.
Currently, the international distribution of the classification of liver damage was suggested in 1986 by E. Moore and formally adopted by the American Association of trauma surgeons principles laid down in this classification, similar to the principles of classification, VS Shapkina and JA Grinenko. It takes into account not only the morphology of the private damages and injuries of the liver, but also the dynamics of the injuries that do not require surgical treatment. In addition, the author has succeeded in one classification to combine features of a closed trauma and injuries of the liver. In 1996, she was somewhat detailed, it was introduced code ICD 9 th revision (864, 01-14) and scores the severity of the patient but the scale of AIS (from 2 to 6) [6].
This classification is as follows:
Grade I-subcapsular hematoma is stable, which occupies at least 10% of the surface and the wound depth at least 1 cm with no bleeding, 2 points;
Grade II-subcapsular hematoma is stable, which brand viagra online occupies 10-50% of the surface, a central, stable at least 2 cm in diameter and wound depth of less than 3 cm, length 10 cm, bleeding, 2 points;
Grade III - subcapsular hematoma is stable for more than 50% of the surface, or subcapsular unstable of any diameter, or podkapsusulnaya with rupture and hemorrhage, or central stable for more brand name levitra than 2 cm in diameter, or center unstable of any size and the wound deeper than 3 cm-3 points;
IV degree-central hematoma with rupture and bleeding and destruction of the parenchyma in the 25-50% interest, or from 1 to 3 segments of 4 points;
V-degree of destruction of the share of more than 50% or more than 3 segments and yukstapechenochnye vascular damage, 5 points;
VI degree-vascular lesions with a margin of liver, 6 points.
We believe it inappropriate to allocate the severity of a predetermined combination of violations, while in practice their combination can be varied. In addition to the existing classifications do not differentiate not only the severity of damage to extrahepatic vessels and ligaments, but often do not even take into account these parameters. An important, we believe, and an indication, along with the size of damage to the safety or violating the integrity of the hepatic capsule. Most appropriate, we assume the total assessment of the severity of damage to several groups of symptoms, taking into account every single one of them and for each degree to take this one does not score, but a certain segment, which will include a sum of points obtained in the comprehensive assessment. H. Patcher believes that in patients with concomitant injury severity of liver damage should be overestimated by one unit and damages I, II and III degree of damage to consider II, III and IV.
It should be emphasized that some of the details of this classification by different authors differ. The same H. Patcher to III degree include central hematoma of more than 10 cm in diameter, while N.L. Mischinger - more than 2 cm in diameter. However, these differences are not fundamental. The important thing is that this classification is specific to liver damage and foreign literature of the last decade to discuss the problems of liver injury occurs with reference to the severity of the damage on E. Moore. Important is that it generic levitra takes into account the condition of the liver, regardless of hirurgicheskgo intervention that allows us to estimate the dynamics of traumatic disease in the course of conservative treatment.
For practical use, in our opinion, the most efficient is the combination chetyrehstepennoy classification of liver injury proposed by Litvinova NA and Naydovym GI and classification by E. Moore. In our opinion, the latter very well considering the extent, type and morphology of the damage, while introducing ballroom system assessment of the severity of damage. Thus, if we take the above mentioned classification and take into account our view, the classification of liver injury and its numerical score is as follows.
emotions
lactic acidosis
epidemiology
normalization
Currently, the international distribution of the classification of liver damage was suggested in 1986 by E. Moore and formally adopted by the American Association of trauma surgeons principles laid down in this classification, similar to the principles of classification, VS Shapkina and JA Grinenko. It takes into account not only the morphology of the private damages and injuries of the liver, but also the dynamics of the injuries that do not require surgical treatment. In addition, the author has succeeded in one classification to combine features of a closed trauma and injuries of the liver. In 1996, she was somewhat detailed, it was introduced code ICD 9 th revision (864, 01-14) and scores the severity of the patient but the scale of AIS (from 2 to 6) [6].
This classification is as follows:
Grade I-subcapsular hematoma is stable, which occupies at least 10% of the surface and the wound depth at least 1 cm with no bleeding, 2 points;
Grade II-subcapsular hematoma is stable, which brand viagra online occupies 10-50% of the surface, a central, stable at least 2 cm in diameter and wound depth of less than 3 cm, length 10 cm, bleeding, 2 points;
Grade III - subcapsular hematoma is stable for more than 50% of the surface, or subcapsular unstable of any diameter, or podkapsusulnaya with rupture and hemorrhage, or central stable for more brand name levitra than 2 cm in diameter, or center unstable of any size and the wound deeper than 3 cm-3 points;
IV degree-central hematoma with rupture and bleeding and destruction of the parenchyma in the 25-50% interest, or from 1 to 3 segments of 4 points;
V-degree of destruction of the share of more than 50% or more than 3 segments and yukstapechenochnye vascular damage, 5 points;
VI degree-vascular lesions with a margin of liver, 6 points.
We believe it inappropriate to allocate the severity of a predetermined combination of violations, while in practice their combination can be varied. In addition to the existing classifications do not differentiate not only the severity of damage to extrahepatic vessels and ligaments, but often do not even take into account these parameters. An important, we believe, and an indication, along with the size of damage to the safety or violating the integrity of the hepatic capsule. Most appropriate, we assume the total assessment of the severity of damage to several groups of symptoms, taking into account every single one of them and for each degree to take this one does not score, but a certain segment, which will include a sum of points obtained in the comprehensive assessment. H. Patcher believes that in patients with concomitant injury severity of liver damage should be overestimated by one unit and damages I, II and III degree of damage to consider II, III and IV.
It should be emphasized that some of the details of this classification by different authors differ. The same H. Patcher to III degree include central hematoma of more than 10 cm in diameter, while N.L. Mischinger - more than 2 cm in diameter. However, these differences are not fundamental. The important thing is that this classification is specific to liver damage and foreign literature of the last decade to discuss the problems of liver injury occurs with reference to the severity of the damage on E. Moore. Important is that it generic levitra takes into account the condition of the liver, regardless of hirurgicheskgo intervention that allows us to estimate the dynamics of traumatic disease in the course of conservative treatment.
For practical use, in our opinion, the most efficient is the combination chetyrehstepennoy classification of liver injury proposed by Litvinova NA and Naydovym GI and classification by E. Moore. In our opinion, the latter very well considering the extent, type and morphology of the damage, while introducing ballroom system assessment of the severity of damage. Thus, if we take the above mentioned classification and take into account our view, the classification of liver injury and its numerical score is as follows.
emotions
lactic acidosis
epidemiology
normalization
2011年1月10日月曜日
Transplantation practices
Operational techniques used in the global transplantation practices at the fence of the pancreas (pancreatic) necessitate exposure to two factors that make up the so-called "phenomenon of graft exclusion, in particular, vascular (including lymphatic), and nervous decentralization, as a result of a complete interruption anatomical connections to the body of the donor phase. The immediate effects of vascular decentralization in organ transplantation are well known - is ischemia and interstitial gland tissue lymphostasis. The question about the negative impact of denervation of the pancreas transplant for a long time remained open, but after the pathogenetic involvement of denervation and the so-called "neurodystrophic process" in all solid organs of the allograft to the mechanisms of implementation and reasons for the irreversibility of chronic rejection gave the subject that the original lack of importance, as a result that this problem a long time remained in the shadow of unresolvable problems of modern transplant [1,2,5,7].
The purpose of the work - to develop and prove experimentally neyrosohranyayuschie operational methods of preparing and allotransplantation pancreatoduodenal complex (MAC).
Materials and Methods: We studied bezporodnyh pankreatektomirovannyh dogs (= 30) weighing 18-21kg, were divided into 3 groups (10 animals in each group). For group 1 (control) - the fence of the graft was performed using a modified technique J.-M. Dubernard with preservation of duodenal segment: after opening the abdomen dissected gastrocolic ligament, mobilizing the spleen while tied up and cross the gastro-splenic ligament from the left gastro-omental artery and short gastric arteries, stomach divert upwards isolated celiac trunk, while from the aorta separated and crossed diaphragmatic feet, and from the celiac trunk was separated nervous and lymphatic tissues. Then ligated and cross the left gastric and common hepatic artery, and then pulling up for the spleen, pancreas, together with the splenic vessels removed from the retroperitoneal space, ligated and cross the inferior mesenteric vein. RV mobilized to the level of the superior mesenteric and portal veins, and superior mesenteric vein is isolated and crossed to the cranial hepatoduodenal ligament. Celiac trunk cut off from the aorta with its disk-shaped platform and then transplant pancreas is placed in cold intracellular solution was separated spleen and begin washing the graft [3]. For 2 and 3 of the fence MPC carried out according to our in INVH technique [2.4]: abdomen dissected cross-cut, then the transverse colon relegated downward and the greater omentum up and ripped up the gastrocolic ligament, were part of the omental bursa. By traction spleen anteriorly and downward, stretched gastro-splenic, splenic, renal, phrenicolienal and colonic-splenic ligament, which was dissected, and passing them previously ligated vessels at the time. Next up and assigned the spleen and anterior parietal peritoneum was dissected along the lower edge of the pancreas, away from the latter to 0,5 cm After that mobilized the pancreas to the posterior surface, the superior mesenteric artery and vein were ligated and crossed following a discharge from the last - lower pancreatoduodenal artery vein. Shaped segment of the duodenum - by cutting off the last of the stomach just below the pyloric sphincter and at 3 cm below the opening in the intestine of large and small papillary. In the hepatoduodenal conjunction isolated common bile duct and common hepatic artery, which crossed and tied, and the portal vein, which took taped. Then isolated organocomplexes with abdominal aorta (Fig.2-3) and in vitro began washing of the graft. Pancreas transplants in each group withdrew from the body of a living donor, and washed with a solution Eurocollins at +40 C with the addition of 5000ED heparin at the time of cold ischemia 1-1,5 hours. Blood flow in the graft was reduced formation mezhsosudistyh aortic anastomoses sites, including the celiac trunk, superior mesenteric artery (in group 1) and ganglionic artery (in 2 and 3 group), with the infrarenal aorta of the recipient-type end-to-side. " Between duodenal segment of the graft, namely the distal end and the small intestine of the recipient shaped anastomosis end-to-side. " And in Group 3 was carried out by the roots gangiopeksiyu mesentery of the small intestine of the recipient.
Duodenal segment of the MAC function was brand viagra evaluated after 20 and 60 minutes after turning into the bloodstream, as well as 12 and 30 days after surgery during relaparotomy using electromyography. RV function was assessed by measuring apparatus Waldman pressure in the pancreatic duct (GD) pancreas, as well as indicators of activity of amylase in urine by Wohlgemuth and blood glucose. Pancreatic endocrine function was studied 30 days after transplantation using a test with insulin: insulin intravenously at the rate of 0.1 IU per 1 kg and measured blood glucose levels at 30, 120, 180, 240 minutes [6]. When processing the histological material used silver impregnation Bilshovskomu Gros, hematoxylin and eosin staining. Mediator activity of adrenergic components of nerve tissue graft gistoflyuorestsentnym investigated the detection of the method of Falk. Aksonotransportnuyu function of nerve grafts was assessed examining the retrograde movement in neurons injected into a body of highly purified preparation of horseradish peroxidase ..
Results and discussion: In group 1 after 20 minutes after turning into the blood stream segment of duodenal ulcer (DU) was atonichen, pressure to PP RV does not exceed 5-8 mm water column After 60 minutes of gut visually clearly not peristaltirovala, but recorded low-amplitude electromyographic ostsilyatsii, the pressure in the EP RV was 130 10 mm water column In Groups 2 and 3 in 20 minutes. KDP is clearly diminished, and asynchronously, electromyography recorded low ostsilyatsii, pressure to PP RV does not exceed 110 mm water column 5 After 60 minutes peristalsis in the duodenum is insignificant (p> 0.05) differed according to the electromyography of ostsilyatsy emanating from his own duodenal recipient, pressure to PP RV equal to 140 15 mm water column, which corresponded to close to baseline setting in PCB RV intact animal. After 12 days in group 1 ostsilyatsii not actually recorded, in group 2 recorded the ostsilyatsii electromyograph amplitude, which is 4-5 times decreased as compared with 60 min in Group 3 distinct differences between the indices shot after 60 minutes, and 12 days did not was. After 30 days in group 1 - PDK completely atonic, in group 2 - electromyograph recorded the ostsilyatsii who 1,5-2 times the amplitude decreased as compared with the shot in 12 days and in Group 3 - no change.
Evaluation of the results of biochemical analysis of blood and urine of animals at different times after transplantation are presented in Table 1.
Monitoring the concentration of glucose in the blood of animals after insulin load displayed in Figure 1. The data obtained show that using the autonomic nerve centers as "centers of the local nervous regulation" allow more finely regulate the function of the pancreas transplant, which is improved by using directional surgical gangliomezenterikopeksii, compared with the classical technique of transplantation of the MPC.
Histological examination after 8-10 days was observed destruction of almost all nerve cells of celiac nodes in group 1, while in groups 2 and 3 on the light-optical levels are found structurally Intact nerve tissue with reactive changes, suggesting that a necessary condition for preserving the viability of a neyrogangliev adequate blood supply. After 30 days in group 2 were found degenerative changes in nervous tissue of vegetative nodes and pancreas, and in Group 3 with no dynamics. Also in Group 3 remained retrograde axonal transport, which is confirmed by horseradish Viagra limit opportunities peroxidase stain. In the study by Falk slices into 3 groups determined by the glow of granules of norepinephrine.
Conclusions: The data analysis revealed that the use of operational techniques neyrosohranyayuschih MPC allotransplantation positive impact on the structural and functional status of the transplanted pancreas in the MAC and increases the physiological quality, in particular, the myogenic tone and peristaltic activity of duodenal segment. Preservation of ganglion arteries and implementation gangliopeksii is a prerequisite for the viability of vegetative nodes, which respectively provide an improved and longer-term graft function. This allows us to reasonably recommend the use of techniques developed neyrosohranyayuschih transplant pancreas in clinical transplantation.
Culture method
hormonal agents
Swimming pool
The purpose of the work - to develop and prove experimentally neyrosohranyayuschie operational methods of preparing and allotransplantation pancreatoduodenal complex (MAC).
Materials and Methods: We studied bezporodnyh pankreatektomirovannyh dogs (= 30) weighing 18-21kg, were divided into 3 groups (10 animals in each group). For group 1 (control) - the fence of the graft was performed using a modified technique J.-M. Dubernard with preservation of duodenal segment: after opening the abdomen dissected gastrocolic ligament, mobilizing the spleen while tied up and cross the gastro-splenic ligament from the left gastro-omental artery and short gastric arteries, stomach divert upwards isolated celiac trunk, while from the aorta separated and crossed diaphragmatic feet, and from the celiac trunk was separated nervous and lymphatic tissues. Then ligated and cross the left gastric and common hepatic artery, and then pulling up for the spleen, pancreas, together with the splenic vessels removed from the retroperitoneal space, ligated and cross the inferior mesenteric vein. RV mobilized to the level of the superior mesenteric and portal veins, and superior mesenteric vein is isolated and crossed to the cranial hepatoduodenal ligament. Celiac trunk cut off from the aorta with its disk-shaped platform and then transplant pancreas is placed in cold intracellular solution was separated spleen and begin washing the graft [3]. For 2 and 3 of the fence MPC carried out according to our in INVH technique [2.4]: abdomen dissected cross-cut, then the transverse colon relegated downward and the greater omentum up and ripped up the gastrocolic ligament, were part of the omental bursa. By traction spleen anteriorly and downward, stretched gastro-splenic, splenic, renal, phrenicolienal and colonic-splenic ligament, which was dissected, and passing them previously ligated vessels at the time. Next up and assigned the spleen and anterior parietal peritoneum was dissected along the lower edge of the pancreas, away from the latter to 0,5 cm After that mobilized the pancreas to the posterior surface, the superior mesenteric artery and vein were ligated and crossed following a discharge from the last - lower pancreatoduodenal artery vein. Shaped segment of the duodenum - by cutting off the last of the stomach just below the pyloric sphincter and at 3 cm below the opening in the intestine of large and small papillary. In the hepatoduodenal conjunction isolated common bile duct and common hepatic artery, which crossed and tied, and the portal vein, which took taped. Then isolated organocomplexes with abdominal aorta (Fig.2-3) and in vitro began washing of the graft. Pancreas transplants in each group withdrew from the body of a living donor, and washed with a solution Eurocollins at +40 C with the addition of 5000ED heparin at the time of cold ischemia 1-1,5 hours. Blood flow in the graft was reduced formation mezhsosudistyh aortic anastomoses sites, including the celiac trunk, superior mesenteric artery (in group 1) and ganglionic artery (in 2 and 3 group), with the infrarenal aorta of the recipient-type end-to-side. " Between duodenal segment of the graft, namely the distal end and the small intestine of the recipient shaped anastomosis end-to-side. " And in Group 3 was carried out by the roots gangiopeksiyu mesentery of the small intestine of the recipient.
Duodenal segment of the MAC function was brand viagra evaluated after 20 and 60 minutes after turning into the bloodstream, as well as 12 and 30 days after surgery during relaparotomy using electromyography. RV function was assessed by measuring apparatus Waldman pressure in the pancreatic duct (GD) pancreas, as well as indicators of activity of amylase in urine by Wohlgemuth and blood glucose. Pancreatic endocrine function was studied 30 days after transplantation using a test with insulin: insulin intravenously at the rate of 0.1 IU per 1 kg and measured blood glucose levels at 30, 120, 180, 240 minutes [6]. When processing the histological material used silver impregnation Bilshovskomu Gros, hematoxylin and eosin staining. Mediator activity of adrenergic components of nerve tissue graft gistoflyuorestsentnym investigated the detection of the method of Falk. Aksonotransportnuyu function of nerve grafts was assessed examining the retrograde movement in neurons injected into a body of highly purified preparation of horseradish peroxidase ..
Results and discussion: In group 1 after 20 minutes after turning into the blood stream segment of duodenal ulcer (DU) was atonichen, pressure to PP RV does not exceed 5-8 mm water column After 60 minutes of gut visually clearly not peristaltirovala, but recorded low-amplitude electromyographic ostsilyatsii, the pressure in the EP RV was 130 10 mm water column In Groups 2 and 3 in 20 minutes. KDP is clearly diminished, and asynchronously, electromyography recorded low ostsilyatsii, pressure to PP RV does not exceed 110 mm water column 5 After 60 minutes peristalsis in the duodenum is insignificant (p> 0.05) differed according to the electromyography of ostsilyatsy emanating from his own duodenal recipient, pressure to PP RV equal to 140 15 mm water column, which corresponded to close to baseline setting in PCB RV intact animal. After 12 days in group 1 ostsilyatsii not actually recorded, in group 2 recorded the ostsilyatsii electromyograph amplitude, which is 4-5 times decreased as compared with 60 min in Group 3 distinct differences between the indices shot after 60 minutes, and 12 days did not was. After 30 days in group 1 - PDK completely atonic, in group 2 - electromyograph recorded the ostsilyatsii who 1,5-2 times the amplitude decreased as compared with the shot in 12 days and in Group 3 - no change.
Evaluation of the results of biochemical analysis of blood and urine of animals at different times after transplantation are presented in Table 1.
Monitoring the concentration of glucose in the blood of animals after insulin load displayed in Figure 1. The data obtained show that using the autonomic nerve centers as "centers of the local nervous regulation" allow more finely regulate the function of the pancreas transplant, which is improved by using directional surgical gangliomezenterikopeksii, compared with the classical technique of transplantation of the MPC.
Histological examination after 8-10 days was observed destruction of almost all nerve cells of celiac nodes in group 1, while in groups 2 and 3 on the light-optical levels are found structurally Intact nerve tissue with reactive changes, suggesting that a necessary condition for preserving the viability of a neyrogangliev adequate blood supply. After 30 days in group 2 were found degenerative changes in nervous tissue of vegetative nodes and pancreas, and in Group 3 with no dynamics. Also in Group 3 remained retrograde axonal transport, which is confirmed by horseradish Viagra limit opportunities peroxidase stain. In the study by Falk slices into 3 groups determined by the glow of granules of norepinephrine.
Conclusions: The data analysis revealed that the use of operational techniques neyrosohranyayuschih MPC allotransplantation positive impact on the structural and functional status of the transplanted pancreas in the MAC and increases the physiological quality, in particular, the myogenic tone and peristaltic activity of duodenal segment. Preservation of ganglion arteries and implementation gangliopeksii is a prerequisite for the viability of vegetative nodes, which respectively provide an improved and longer-term graft function. This allows us to reasonably recommend the use of techniques developed neyrosohranyayuschih transplant pancreas in clinical transplantation.
Culture method
hormonal agents
Swimming pool
2011年1月3日月曜日
Accumulation
When the blood is not enough platelets, but rather when their number in the blood is reduced, then the doctors say about thrombocytopenia. A lower limit of the normal number of platelets in peripheral blood - 150000 in 1 mm. Anything below this boundary - referred to as thrombocytopenia. And once I must say that in most cases it is a pathological condition - purchased. Of course, there are congenital thrombocytopenia. But this is rare. Which we also describe. And I do not offend the doctors, saying that many of them have forgotten (do not know, did not know so-and-forget) has gone from platelets. And it is not superfluous to my colleagues will refresh your memory, some details of origin of platelets, their lives and if you want, and death too. I am for what it's all I say. Yes, for only that kind to our hearts, users are not surprised a "buried" the material presented.
Thus, thrombocytopenia may occur brand name viagra due to less "birth" of platelets, increasing their "death" in the peripheral arteries and veins, or if they are hiding somewhere (or, as my colleagues say "sequestrants." Differentiation (ie differentiation ) of these forms of thrombocytopenia is possible. But only in a study of the bone marrow. Normally, when microscopic examination in a field of view from 3 to 7 megakaryocytes. Increasing the number of recent evidence of an increase sequestration (upryatyvanii or accumulation) of the spleen (while talking about hypersplenism) and / or an increased destruction ("dying") of platelets in the same place. As a general rule, if the peripheral blood contained more than 50000 platelets in 1 mm., then a severe bleeding can not speak.
People suffering from thrombocytopenia, should be mindful of the need to resort to a doctor in case of any injury, even innocuous at first glance. Better yet, if a sick person will avoid injuries. It is worth, perhaps, be said that these people ought to be avoided, and enemas, rectal and general studies to minimize, and intramuscular injections they do not have to perform. And with intravenous injections, a place vkola needles should press (within reason) for 10-12 minutes.
In general, these people need to treat yourself, how would it better and more accurate to say, with love and attention. Before you buy a toothbrush should ask - is not too hard bristle at it. A razors, toothbrushes thread generally excluded from "their diet." And yet - in patients with thrombocytopenia not use drugs that suppress platelet function. Such as nonsteroidal When the "no" means "yes" anti-inflammatory drugs - the same as acetylsalicylic acid and its derivatives, derivatives pirazolidindiona: Phenylbutazone, Pirabutol, Reopirin; derivatives phenylpropionic, phenylacetic, indoluksusnoy and anthranilic acids: ibuprofen, Ortofen, indomethacin, naproxen, piroxicam, etc.
Alarming symptom
Next two weeks
Thus, thrombocytopenia may occur brand name viagra due to less "birth" of platelets, increasing their "death" in the peripheral arteries and veins, or if they are hiding somewhere (or, as my colleagues say "sequestrants." Differentiation (ie differentiation ) of these forms of thrombocytopenia is possible. But only in a study of the bone marrow. Normally, when microscopic examination in a field of view from 3 to 7 megakaryocytes. Increasing the number of recent evidence of an increase sequestration (upryatyvanii or accumulation) of the spleen (while talking about hypersplenism) and / or an increased destruction ("dying") of platelets in the same place. As a general rule, if the peripheral blood contained more than 50000 platelets in 1 mm., then a severe bleeding can not speak.
People suffering from thrombocytopenia, should be mindful of the need to resort to a doctor in case of any injury, even innocuous at first glance. Better yet, if a sick person will avoid injuries. It is worth, perhaps, be said that these people ought to be avoided, and enemas, rectal and general studies to minimize, and intramuscular injections they do not have to perform. And with intravenous injections, a place vkola needles should press (within reason) for 10-12 minutes.
In general, these people need to treat yourself, how would it better and more accurate to say, with love and attention. Before you buy a toothbrush should ask - is not too hard bristle at it. A razors, toothbrushes thread generally excluded from "their diet." And yet - in patients with thrombocytopenia not use drugs that suppress platelet function. Such as nonsteroidal When the "no" means "yes" anti-inflammatory drugs - the same as acetylsalicylic acid and its derivatives, derivatives pirazolidindiona: Phenylbutazone, Pirabutol, Reopirin; derivatives phenylpropionic, phenylacetic, indoluksusnoy and anthranilic acids: ibuprofen, Ortofen, indomethacin, naproxen, piroxicam, etc.
Alarming symptom
Next two weeks
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