Hope for the healing of patients with diabetes mellitus type I gives the transplant donor cells in the pancreas. Who will help this operation?
A new method of treating diabetes tells PhD, endocrinologist Division of Organ Transplantation Research Center of Surgery RAMS (Moscow), Alexander V. Podshivalin.
- Is the treatment of diabetes can not do drugs and diet, why need more and operation? - Surgery - this is an extreme measure. It is conducted when the pancreas rapidly destroyed cells that produce insulin, the patient's plight. In deciding on the operation, we proceed from the possibility of qualitatively improve the patient's life, always correlate favor of our intervention and the expected complications. - What is the surgery itself, as with its help can help the patient? - The operation is to transplant the donor cells in the pancreas. The fact is that when you are running a diabetes type-I's own cells that can produce insulin, usually there is very little.
And since no cells, no insulin. Without it, other cells in our body does not metabolize glucose and, therefore, deprived of one of the main sources of supply. Unclaimed glucose accumulates in the blood, which is very dangerous. Transplanted the cells if not in full, but reduced the production of essential hormones. Implantation procedure itself is technically difficult: the patient under local anesthesia makes a small incision. Through it in one of the veins injected donor cells in the pancreas. Once in the vein of the liver cells are fixed, take root and begin to produce insulin. - Do all patients can be transplanted pancreas cells? - Unfortunately, no. Now this operation is carried out only with type I diabetes, or as it is called insulin-dependent diabetes. - Does the operation completely abandon the insulin injections? - While not allow it. Injections of insulin a patient still has to do, but certainly not as often and as many as before the operation. At the same time change greatly facilitates the general condition of the patient, slow or even prevent the terrible complications of diabetes - kidney failure, blindness, heart disease. - And why do have to brand name viagra compensate for the lack of insulin donor cells, rather than injections of the insulin? - Those who receive insulin in the syringe, and the cells inside his body, much more immune to the complications of diabetes. The very course of the disease becomes more stable. Here is just one example. In women with diabetes, there are serious problems with childbirth. Often patients can not get pregnant, and if pregnancy occurs, it occurs with many complications. Transplantation of donor cells in most cases, normalizes during pregnancy reduces the risk of birth of dead children, prevents disease of the fetus, stops the development of diabetes complications. - How long is helping the operation?
- Theoretically enough of a single transplant. Donor cells of the pancreas are viable for many years. They also contain insulin-producing so-called B-cells and progenitor cells from which new form instead of dead B cells. But in practice, the positive effect of the operation is stored for long - so far only for one year. Then he needed a second operation. - And why is this happening?
- Clarity on this issue no. It is known that type I diabetes occurs because of failures in the immune system. Perhaps the immune system mistakenly adopt its own pancreas cells for the alien and starts to destroy them. It is this situation can significantly shorten the life of transplanted cells. So now scientists are looking for ways to protect the donor cells. For example, what they enter into a special capsule with a porous membrane. At right sized since the glucose will penetrate into the capsule, and synthesized insulin molecule - to go outside. Much larger in size lymphocytes and antibodies can not penetrate through the pores, which protects transplanted cells from rejection. - How do you take the donor material for transplantation?
- Now we use the cells in the pancreas of pigs and newborn rabbits, and fetal human cells. After their transplant rejection problems are rare. Therefore, patients do not need to take powerful drugs that suppress the immune system. Of course, the donor cells of animals helped us a lot. After all, they are readily available and inexpensive. The number of operations has increased several times, and their efficiency now exceeds 90%. By the way, the donor cells in the pancreas can be transplanted not only in the liver, but also in the eye tissue. Such experiences have also available. Due to this surgery can prevent one of the most serious complications of diabetes - diabetic blindness. Positive result - increase of visual acuity - says almost 80%. - Why do you use for cell transplantation is pigs and rabbits? - The fact that insulin in animals and humans is not the same. According to their structure and composition, he is a little different. The human hormone insulin is most similar to pig and rabbit. Our legislation does allow the use of such biological material for transplantation to man. In Europe and America do not. - By the way, as well as the problem of transplantation of the pancreas is solved abroad? - Do our foreign colleagues a slightly different approach. They went on more complicated and costly way.
Transplanted pancreas The rush of love misplaced entirely and often with kidneys. And the donor can only be a people. After a successful operation results clearly higher cell transplantation, which is used in our country. In many cases, can fully compensate for diabetes, normalize insulin. However, it is quite frequent complications. Due to receiving immunosuppressive drugs inevitably lowered immunity, resistance to infection, increased risk of tumors. Duration of therapeutic effect, too small - just one - a maximum of two years. As with any transplantation of human organs, we have to wait long for a suitable donor. - It turns out that transplantation of the pancreas is even worse than, say, heart? - You're right. In general, the transplantation of the pancreas until the inferior results of transplantation of kidney, heart and liver. But still, such operations are performed. Now the world is about 1000 pancreas transplants each year, with 80% - in the U.S.. - And we have a pancreas transplant did not try?
- Pancreas Transplant in Russia have only four patients. Unfortunately, all operations were unsuccessful. But it is not associated with low skills of our specialists. Rather, we are simply left behind in this regard. And the operation is very complicated. If you recall the story, then all 14 of the first transplants of pancreas were unsuccessful. - How do you assess the prospects for pancreas transplantation? - Of course they are. And related, primarily, with a transfer of transgenic organs. In this case would be solved almost all problems, including graft rejection, lack of donor organs and their high cost. But as long experience in transplants of transgenic human pancreas does not exist anywhere in the world. Also of interest are attempts to create "artificial pancreas - a compact automatic device that will enter the patient is strictly required amount of insulin in response to changes in blood sugar levels. But this is the future. - And what - the traditional treatment of diabetes with insulin injections become unnecessary? - Not at all. Probably for decades to insulin will faithfully serve the people with diabetes. The more that scientists and doctors create more efficient forms of this medication, constantly being improved technique of administration.
quarta-feira, 29 de dezembro de 2010
segunda-feira, 27 de dezembro de 2010
Blood
The concept of "blood" - is extremely broad. There are several hundred (!!!) parameters that can be subjected to the analysis, therefore, writing direction on the blood test, the doctor always said - what specific information he sought. This may be the search for microbial assessment of immunity, determination of hormones and enzymes, the study of physical and chemical properties and much more ...
Each case study gives the doctor some information. Obtaining this information takes time, effort and money. The ideal analysis - is when quickly, cheaply and easily able to obtain answers to complex diagnostic questions. Experience shows that people, things and events are almost never perfect, but the experience of practical medicine finds a pleasant exception. It is a clinical analysis of blood.
What is it - CBC?
The question, seemingly simple, but answering it is not very easy.
First of all, napomnit1 the blood - a special fabric of the human body. The liquid part of blood called plasma. In plasma, there are three kinds of cells - red cells, white cells and platelets. These cells are called blood cells.
Thus, the blood - it's plasma plus corpuscles.
Options corpuscles varied and diverse. White blood cells provide immune protection, platelets - clotting of blood, red blood cells - transport of oxygen and carbon dioxide. All the corpuscles in the blood in very specific amounts. Number of these are caused by person's age and his health. In addition, each individual formed element - this is a complete living cell, is born in the bone marrow and grow. That is, the corpuscles of one species, such as red blood cells may differ in size, degree of maturity and a number of other indicators. It is clear that the ability of bone marrow beget blood cells of a certain quality and in certain quantities are very closely linked to health in general and with the need for specific cells in particular. When blood loss will actively be produced red blood cells, with the loads on the immune system - white blood cells.
The essence of the above information is that
quantitative and qualitative properties of blood cells are extremely informative brand name viagra status indicators for human health. Evaluation of these properties - the main task of the clinical analysis of blood.
Thus, the clinical analysis of blood - this is not one of some indicator, but a set of very specific studies.
A list of these studies is quite concrete, it is approved by medical authorities, and the doctor of any medical facility, writing direction on the CBC, knows exactly what parameters it finds in the blank, delivered to the laboratory.
By the way, on the form. Since the CBC - the most common form of additional laboratory tests, the Ministry of Health has approved the form of an appropriate form, which is filled with laboratory staff and has a strictly defined set of indicators.
Reasonable amateur, of course, possible, but in most cases, the form of clinical blood tentatively looks as shown.
The author is aware that the number of very clever words, submitted on this form, clearly exceeds the limits of reasonable sufficiency in relation to popular literature. But the words of a song you can not throw ... The excuse I note: to explain the meaning of these terms is quite real. Moreover, let me express my confidence that after reading this chapter, CBC will cease to seem so difficult.
A few important points before we start looking at specific elements of clinical blood.
· Concept of "CBC" is a synonym for "common blood". Moreover, the consequence of the last phrase is a common abbreviation OAK2. Main use is for this reduction lies in the fact that the KLA sounds prettier than AS. As an illustration, compare the sentences: "During the week we have twice made the KLA" and "For a week we have twice made as" ...
• In the analysis of blood form a graph of "Norma." I draw your attention to the fact that the norms for adults and children may differ materially. Special form of child clinical blood tests do not exist, and norms, as reflected in the document - it is the adult standards. All this leads to the fact that some mothers prematurely lose consciousness, allegedly found serious deviations in the resulting analysis.
· The main drawback of the analysis of blood - the blood is needed. Quite a bit, but necessary ... That is, the need to damage the skin, it is necessary to make a man (rebenku!) patients. Blood samples taken in two ways - from a vein with a syringe or ukolov finger, using special tubes or thin glass tubes. In the first case is obtained venous blood in the second - the capillary. Theoretically, venous and capillary blood are slightly different from each other, but to reveal this difference in practice is far from always.
· Again, theoretically, performance of clinical blood may vary depending on what time of day blood was taken, and have a relationship with food. Thus, the number of red blood cells is slightly higher after sleep, and the number of white blood cells - after eating. On this basis, it is recommended to take blood in the morning on an empty stomach, but this rule is not strictly necessary, rather rekomendatelnym3.
· Nevertheless, in a situation where for a short time (within one disease) is a few blood tests for comparisons, it is important to strive to ensure that these studies were performed under identical conditions: that the blood in both cases was a venous or capillary, so that both times the child was either well-fed and cheerful, or sleepy and hungry, etc.
· Capillary blood for clinical analysis of blood taken from the pads are usually nameless (IV) finger. Use for this particular form of needle, called scarifiers.
Attention: scarifier should be disposable, individually packaged, sterile.
• There is also more complex devices for taking blood from a fingertip. This so-called lancets - special devices made of plastic, often similar to a pen. Inside - spring, pressed the button - jumped to well-defined depth is very sharp needle. Special sharpening the needle causes the pain is minimal and bleeding is sufficient for a long time so that the child does not torture. The main drawback of lancets is quite obvious - they are many times more expensive than scarifiers.
So, we decided that this CBC. Found some common elements. It remains "very little" - to deal with the principal.
Before us is the result of the analysis - a lot of buzzwords and totally incomprehensible figures. But first a word everyone knows - hemoglobin.
Hemoglobin (Hb) - a special protein, which is inside the red blood cells. The main and unique feature of this protein is that it can be easily connected and easily parted with blood gases: united in the lungs with oxygen, this oxygen is delivered to the tissues, there is loaded with carbon dioxide, carbon dioxide is delivered into the lungs, unloaded, again united with oxygen and etc. The structure of hemoglobin is a special non-protein components - heme, which in turn contains iron. That gem gives hemoglobin, erythrocytes, blood red color.
In determining the amount of hemoglobin are finding out how many grams of hemoglobin contained in one liter of blood. That is, the unit of measurement - grams per liter (g / l).
In adults, there is a clear difference in the amount of hemoglobin between men and women. Children have no such laws, so that the norms for boys and girls alike. At the same time, the principal feature of it is children that the baby hemoglobin and red blood cells very much. Immediately after birth, begins to decay "extra" red blood cells, and this process lasts two to three weeks, causing the development of physiological neonatal jaundice.
Red blood cells - key cells of the blood, in the sense that their blood many times more than all other form elements together. How many total units of red blood cells contained in one liter of blood? This is the main issue. To answer it, a certain, very small, but accurately measure the volume of blood is placed in a special container and count the number of red blood cells using a microscope. Then recalculate the result of the calculation to 1 liter. The resulting number simply monstrous, and contains twelve zeros! In addition to the zeros are present, of course, specific numbers, and these figures are the result of research, because the zeros in all the same.
In essence erythrocytes - a trailers for the transport of hemoglobin. Accordingly, each trailer can be "fit" quite certain amount of cargo. Quantity reflected in the index under the name "the average content of hemoglobin in one erythrocyte. Calculate the number is simple - we must take the amount of hemoglobin per liter and divided by the number of red blood cells in the same liter. And we get the index rate - 30-35 pg. PG - a picogram. At 1 gram - 1012 pg. A similar study of the meaning - the definition of the so-called color indicator.
Color index is calculated by a special formula, which, in addition to the results obtained, recorded and performance standards. In fact, the figures of hemoglobin and red blood cell count can be divided into normal figures. Clearly, if the figures are the norm, so the color index is unity.
Hematocrit (Ht) - a very important and very informative indicator. He characterizes the relationship between plasma volume and the volume of corpuscles. This explanation seems complicated at first glance. Imagine a liter of cherry compote. Fluid - plasma, cherries - forming elements. The number of cherries is different, and this determines the thickness compote. What is the volume occupied by cherries, if you drink fruit compote? That is the amount and will be, say, hematocrit compote. Well, the hematocrit of blood - this is, in fact, the rate of density of blood.
Reticulocytes - a young red blood cells, red blood cells adolescents. They are slightly different from adults, mature red blood cells. The emergence of new red blood cells - a continuous process. It is clear that the presence of reticulocytes - no sign of disease: they are in the blood is always in a very definite quantity, which depends on how high the current body's need for new red blood cells. Because for every one thousand red blood cells account for between five and twelve reticulocytes, normal rate is measured not in percentages but in promille4.
Now we should briefly interrupt our explanations and draw some preliminary conclusions.
All the indicators we have discussed are relevant to the investigation of only one of three types of form elements - to erythrocytes.
With regard to the subject of this book is no singular specificity of these indicators have not. In other words, OCR did not provide any special, a peculiar effect on red blood cells. Decrease in hemoglobin and red blood cell count may be a manifestation of a variety of anemiy5 may occur as a consequence of prolonged and (or) severe illness. Virtually any illness, not just OCR.
But at one point to be addressed. Taking place at ARI fever and shortness of breath are the way to lose body fluids of the child. Consequence - blood clots, which manifests itself primarily increased hematocrit and, of course, increase the amount of hemoglobin and red blood cells - in fact, these figures are calculated per liter of blood, and as soon as blood is thicker so it is understandable that in the same volume and red blood cells, and hemoglobin will be more.
Unfortunately, There is the popular opinion on the fact that the hemoglobin is higher, the more health. Apparently, it is not always so. So if you have a sick child suddenly found "remarkable", the high rate of hemoglobin, red blood cells, hematocrit - is usually not a reason to be proud of what our Vassenka Zdorovenki, but the real reason to run to the kitchen, cooking stewed fruit compote and add-on our active Vassenka drink ...
We can now continue its consideration of the clinical analysis of blood, but as another preliminary results give Viagra enhancing orgasm nevertheless a table of children's standards for those indicators that we have already considered.
Immediately it should be noted that this and all subsequent tables with the standards given by the author with extreme reluctance and only under the pressure of the surrounding community. Mother's heart is so sensitive to any deviation from the norm that such a table every now and are a cause for undue fuss and completely treatment attempts. Treatment is not a child, namely the analysis. I am sincerely hoping for sanity readers of this book on their understanding of the fact that the concept of the norm - rather conventionally. The table reflects the median age, and for hemoglobin, red blood cells and reticulocytes in brackets shows the permissible interval rule.
Next shaped element - platelets.
Plaque - the main cell of blood clotting. The platelet count is calculated in much the same as the number of red blood cells, and of a unit of measurement is similar - units per liter of blood. The boundaries of the normal values vary within broad limits - from 100 ? 109 / L to 400 ? 109 / l. Reducing platelet leads to bleeding, but reducing it should be expressed is very important - is lower than 50 ? 109 / l. Sometimes it is very rare and it is easy to guess, in principle, has no specific relationship to the subject before us cold.
Therefore, we can proceed. And start talking about the main thing. On leukocytes.
White blood cells - blood cells that represent the immune system. Since acute respiratory diseases are the closest contact with the impact on the immune system, the study of qualitative and quantitative characteristics of leukocytes can be very helpful diagnostically. The main thing that you can find out - this is, firstly, to assess the immune status and, secondly, guided by specific changes in the resulting analysis to obtain information about the cause of the disease - about who is actually guilty, and even what the properties of this author has .
Begins the study by counting the total number of leukocytes. Rules and standard techniques, we are already well known: take a small but accurately measure the volume of blood is placed in a special container and count the number of white blood cells using a microscope.
The resulting number is the number of leukocytes per liter of blood. Principled and very, very important feature of the child's body - the number of leukocytes in children on average much more than an adult. This is easily explained by the fact that children are in constant and active process of formation of immunity. It is not surprising that given in standard form blood rule 4-9 ? 109 / l is the real reason for the numerous parental strife, misunderstanding, since the 4 ? 109 / L - it is almost always small, and 10 ? 109 / L - almost always normal.
By the age norms we shall return in the final table, but now acquainted with two common medical terms:
Leukocytosis - increase the level of white blood cells above normal;
Leukopenia (syn. leykotsitopeniya) - reducing the level of leukocytes below normy6.
Leukocytosis occurs in acute infections, especially bacterial infections, in purulent inflammatory processes in oxygen deficiency and a dozen variety of reasons.
Leukopenia vysokoveroyatna in viral infections, serious infections and toxic conditions which are accompanied by bone marrow suppression, and some bacterial infections, radiation sickness, ... again, dozens of variety of reasons.
It is clear that information on the number of cells able to pay attention to the seriousness of the situation, to characterize the state of immunity to a certain clarity to the diagnostic process. But to understand the essence of what is happening, to be sure of the diagnosis - that, in most cases, is not enough.
How so? When they talked of hemoglobin, red blood cells, platelets, was actually one question: how much? How many grams, how many pieces - and all at once becomes clear. Why do things differently with leukocytes?
The answer to this question lies, strictly speaking, the most important information in relation to the global theme "The CBC and OCR.
Each case study gives the doctor some information. Obtaining this information takes time, effort and money. The ideal analysis - is when quickly, cheaply and easily able to obtain answers to complex diagnostic questions. Experience shows that people, things and events are almost never perfect, but the experience of practical medicine finds a pleasant exception. It is a clinical analysis of blood.
What is it - CBC?
The question, seemingly simple, but answering it is not very easy.
First of all, napomnit1 the blood - a special fabric of the human body. The liquid part of blood called plasma. In plasma, there are three kinds of cells - red cells, white cells and platelets. These cells are called blood cells.
Thus, the blood - it's plasma plus corpuscles.
Options corpuscles varied and diverse. White blood cells provide immune protection, platelets - clotting of blood, red blood cells - transport of oxygen and carbon dioxide. All the corpuscles in the blood in very specific amounts. Number of these are caused by person's age and his health. In addition, each individual formed element - this is a complete living cell, is born in the bone marrow and grow. That is, the corpuscles of one species, such as red blood cells may differ in size, degree of maturity and a number of other indicators. It is clear that the ability of bone marrow beget blood cells of a certain quality and in certain quantities are very closely linked to health in general and with the need for specific cells in particular. When blood loss will actively be produced red blood cells, with the loads on the immune system - white blood cells.
The essence of the above information is that
quantitative and qualitative properties of blood cells are extremely informative brand name viagra status indicators for human health. Evaluation of these properties - the main task of the clinical analysis of blood.
Thus, the clinical analysis of blood - this is not one of some indicator, but a set of very specific studies.
A list of these studies is quite concrete, it is approved by medical authorities, and the doctor of any medical facility, writing direction on the CBC, knows exactly what parameters it finds in the blank, delivered to the laboratory.
By the way, on the form. Since the CBC - the most common form of additional laboratory tests, the Ministry of Health has approved the form of an appropriate form, which is filled with laboratory staff and has a strictly defined set of indicators.
Reasonable amateur, of course, possible, but in most cases, the form of clinical blood tentatively looks as shown.
The author is aware that the number of very clever words, submitted on this form, clearly exceeds the limits of reasonable sufficiency in relation to popular literature. But the words of a song you can not throw ... The excuse I note: to explain the meaning of these terms is quite real. Moreover, let me express my confidence that after reading this chapter, CBC will cease to seem so difficult.
A few important points before we start looking at specific elements of clinical blood.
· Concept of "CBC" is a synonym for "common blood". Moreover, the consequence of the last phrase is a common abbreviation OAK2. Main use is for this reduction lies in the fact that the KLA sounds prettier than AS. As an illustration, compare the sentences: "During the week we have twice made the KLA" and "For a week we have twice made as" ...
• In the analysis of blood form a graph of "Norma." I draw your attention to the fact that the norms for adults and children may differ materially. Special form of child clinical blood tests do not exist, and norms, as reflected in the document - it is the adult standards. All this leads to the fact that some mothers prematurely lose consciousness, allegedly found serious deviations in the resulting analysis.
· The main drawback of the analysis of blood - the blood is needed. Quite a bit, but necessary ... That is, the need to damage the skin, it is necessary to make a man (rebenku!) patients. Blood samples taken in two ways - from a vein with a syringe or ukolov finger, using special tubes or thin glass tubes. In the first case is obtained venous blood in the second - the capillary. Theoretically, venous and capillary blood are slightly different from each other, but to reveal this difference in practice is far from always.
· Again, theoretically, performance of clinical blood may vary depending on what time of day blood was taken, and have a relationship with food. Thus, the number of red blood cells is slightly higher after sleep, and the number of white blood cells - after eating. On this basis, it is recommended to take blood in the morning on an empty stomach, but this rule is not strictly necessary, rather rekomendatelnym3.
· Nevertheless, in a situation where for a short time (within one disease) is a few blood tests for comparisons, it is important to strive to ensure that these studies were performed under identical conditions: that the blood in both cases was a venous or capillary, so that both times the child was either well-fed and cheerful, or sleepy and hungry, etc.
· Capillary blood for clinical analysis of blood taken from the pads are usually nameless (IV) finger. Use for this particular form of needle, called scarifiers.
Attention: scarifier should be disposable, individually packaged, sterile.
• There is also more complex devices for taking blood from a fingertip. This so-called lancets - special devices made of plastic, often similar to a pen. Inside - spring, pressed the button - jumped to well-defined depth is very sharp needle. Special sharpening the needle causes the pain is minimal and bleeding is sufficient for a long time so that the child does not torture. The main drawback of lancets is quite obvious - they are many times more expensive than scarifiers.
So, we decided that this CBC. Found some common elements. It remains "very little" - to deal with the principal.
Before us is the result of the analysis - a lot of buzzwords and totally incomprehensible figures. But first a word everyone knows - hemoglobin.
Hemoglobin (Hb) - a special protein, which is inside the red blood cells. The main and unique feature of this protein is that it can be easily connected and easily parted with blood gases: united in the lungs with oxygen, this oxygen is delivered to the tissues, there is loaded with carbon dioxide, carbon dioxide is delivered into the lungs, unloaded, again united with oxygen and etc. The structure of hemoglobin is a special non-protein components - heme, which in turn contains iron. That gem gives hemoglobin, erythrocytes, blood red color.
In determining the amount of hemoglobin are finding out how many grams of hemoglobin contained in one liter of blood. That is, the unit of measurement - grams per liter (g / l).
In adults, there is a clear difference in the amount of hemoglobin between men and women. Children have no such laws, so that the norms for boys and girls alike. At the same time, the principal feature of it is children that the baby hemoglobin and red blood cells very much. Immediately after birth, begins to decay "extra" red blood cells, and this process lasts two to three weeks, causing the development of physiological neonatal jaundice.
Red blood cells - key cells of the blood, in the sense that their blood many times more than all other form elements together. How many total units of red blood cells contained in one liter of blood? This is the main issue. To answer it, a certain, very small, but accurately measure the volume of blood is placed in a special container and count the number of red blood cells using a microscope. Then recalculate the result of the calculation to 1 liter. The resulting number simply monstrous, and contains twelve zeros! In addition to the zeros are present, of course, specific numbers, and these figures are the result of research, because the zeros in all the same.
In essence erythrocytes - a trailers for the transport of hemoglobin. Accordingly, each trailer can be "fit" quite certain amount of cargo. Quantity reflected in the index under the name "the average content of hemoglobin in one erythrocyte. Calculate the number is simple - we must take the amount of hemoglobin per liter and divided by the number of red blood cells in the same liter. And we get the index rate - 30-35 pg. PG - a picogram. At 1 gram - 1012 pg. A similar study of the meaning - the definition of the so-called color indicator.
Color index is calculated by a special formula, which, in addition to the results obtained, recorded and performance standards. In fact, the figures of hemoglobin and red blood cell count can be divided into normal figures. Clearly, if the figures are the norm, so the color index is unity.
Hematocrit (Ht) - a very important and very informative indicator. He characterizes the relationship between plasma volume and the volume of corpuscles. This explanation seems complicated at first glance. Imagine a liter of cherry compote. Fluid - plasma, cherries - forming elements. The number of cherries is different, and this determines the thickness compote. What is the volume occupied by cherries, if you drink fruit compote? That is the amount and will be, say, hematocrit compote. Well, the hematocrit of blood - this is, in fact, the rate of density of blood.
Reticulocytes - a young red blood cells, red blood cells adolescents. They are slightly different from adults, mature red blood cells. The emergence of new red blood cells - a continuous process. It is clear that the presence of reticulocytes - no sign of disease: they are in the blood is always in a very definite quantity, which depends on how high the current body's need for new red blood cells. Because for every one thousand red blood cells account for between five and twelve reticulocytes, normal rate is measured not in percentages but in promille4.
Now we should briefly interrupt our explanations and draw some preliminary conclusions.
All the indicators we have discussed are relevant to the investigation of only one of three types of form elements - to erythrocytes.
With regard to the subject of this book is no singular specificity of these indicators have not. In other words, OCR did not provide any special, a peculiar effect on red blood cells. Decrease in hemoglobin and red blood cell count may be a manifestation of a variety of anemiy5 may occur as a consequence of prolonged and (or) severe illness. Virtually any illness, not just OCR.
But at one point to be addressed. Taking place at ARI fever and shortness of breath are the way to lose body fluids of the child. Consequence - blood clots, which manifests itself primarily increased hematocrit and, of course, increase the amount of hemoglobin and red blood cells - in fact, these figures are calculated per liter of blood, and as soon as blood is thicker so it is understandable that in the same volume and red blood cells, and hemoglobin will be more.
Unfortunately, There is the popular opinion on the fact that the hemoglobin is higher, the more health. Apparently, it is not always so. So if you have a sick child suddenly found "remarkable", the high rate of hemoglobin, red blood cells, hematocrit - is usually not a reason to be proud of what our Vassenka Zdorovenki, but the real reason to run to the kitchen, cooking stewed fruit compote and add-on our active Vassenka drink ...
We can now continue its consideration of the clinical analysis of blood, but as another preliminary results give Viagra enhancing orgasm nevertheless a table of children's standards for those indicators that we have already considered.
Immediately it should be noted that this and all subsequent tables with the standards given by the author with extreme reluctance and only under the pressure of the surrounding community. Mother's heart is so sensitive to any deviation from the norm that such a table every now and are a cause for undue fuss and completely treatment attempts. Treatment is not a child, namely the analysis. I am sincerely hoping for sanity readers of this book on their understanding of the fact that the concept of the norm - rather conventionally. The table reflects the median age, and for hemoglobin, red blood cells and reticulocytes in brackets shows the permissible interval rule.
Next shaped element - platelets.
Plaque - the main cell of blood clotting. The platelet count is calculated in much the same as the number of red blood cells, and of a unit of measurement is similar - units per liter of blood. The boundaries of the normal values vary within broad limits - from 100 ? 109 / L to 400 ? 109 / l. Reducing platelet leads to bleeding, but reducing it should be expressed is very important - is lower than 50 ? 109 / l. Sometimes it is very rare and it is easy to guess, in principle, has no specific relationship to the subject before us cold.
Therefore, we can proceed. And start talking about the main thing. On leukocytes.
White blood cells - blood cells that represent the immune system. Since acute respiratory diseases are the closest contact with the impact on the immune system, the study of qualitative and quantitative characteristics of leukocytes can be very helpful diagnostically. The main thing that you can find out - this is, firstly, to assess the immune status and, secondly, guided by specific changes in the resulting analysis to obtain information about the cause of the disease - about who is actually guilty, and even what the properties of this author has .
Begins the study by counting the total number of leukocytes. Rules and standard techniques, we are already well known: take a small but accurately measure the volume of blood is placed in a special container and count the number of white blood cells using a microscope.
The resulting number is the number of leukocytes per liter of blood. Principled and very, very important feature of the child's body - the number of leukocytes in children on average much more than an adult. This is easily explained by the fact that children are in constant and active process of formation of immunity. It is not surprising that given in standard form blood rule 4-9 ? 109 / l is the real reason for the numerous parental strife, misunderstanding, since the 4 ? 109 / L - it is almost always small, and 10 ? 109 / L - almost always normal.
By the age norms we shall return in the final table, but now acquainted with two common medical terms:
Leukocytosis - increase the level of white blood cells above normal;
Leukopenia (syn. leykotsitopeniya) - reducing the level of leukocytes below normy6.
Leukocytosis occurs in acute infections, especially bacterial infections, in purulent inflammatory processes in oxygen deficiency and a dozen variety of reasons.
Leukopenia vysokoveroyatna in viral infections, serious infections and toxic conditions which are accompanied by bone marrow suppression, and some bacterial infections, radiation sickness, ... again, dozens of variety of reasons.
It is clear that information on the number of cells able to pay attention to the seriousness of the situation, to characterize the state of immunity to a certain clarity to the diagnostic process. But to understand the essence of what is happening, to be sure of the diagnosis - that, in most cases, is not enough.
How so? When they talked of hemoglobin, red blood cells, platelets, was actually one question: how much? How many grams, how many pieces - and all at once becomes clear. Why do things differently with leukocytes?
The answer to this question lies, strictly speaking, the most important information in relation to the global theme "The CBC and OCR.
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