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Anemia is defined as a condition in which the body does not have enough healthy red blood cells in order for oxygen to be carried to tissues (Mayo Clinic, 2010). ed blood cells are shaped like discs and resemble doughnuts without holes in the middle (National Heart Lung and Blood Institute, 2010). ed blood cells are manufactured in bone marrow, and their function is to carry oxygen throughout the body and to remove waste from the body in the form of carbon dioxide (National Heart Lung and Blood Institute, 2010). Anemia can also manifest if red blood cells do not contain enough hemoglobin, an iron-rich protein that lends to the red color of blood (National Heart Lung and Blood Institute, 2010). Hemoglobin is the actual protein that aids red blood cells in the transport of oxygen from the lungs to various bodily tissues (National Heart Lung and Blood Institute, 2010).…
Bortolini, G.A. & Vitolo, M.R. (2010). Relationship between iron deficiency and anemia in children younger than 4 years old. Journal of Pediatrics (Rio de Janeiro), 86(6) (|Epub ahead of print). Retrieved November 20, 2010 from PubMed database.
Gautam, C.S., Saha, L., Sekhri, K. & Saha, P.K. (2008). Iron deficiency in pregnancy and the rationality of iron supplements prescribed during pregnancy. Medscape Journal of Medicine, 10(12), 283. Retrieved November 20, 2010 from PubMed database.
Gupta, S., Singh, P.K., Bhatt, M.L., Pant, M.C., Sundar, S., Verma, J., Paul, S., Kumar, D., Shah, A., Gupta, R., & Negi, M.P. (2010). Clinical benefits of two different dosing schedules of recombinant human erythroprotein in anemic patients with advanced head and neck cancer. Bioscience Trends, 4(5), 267-72. Retrieved November 20, 2010 from PubMed database.
Mayo Clinic (2010). Anemia. Retrieved November 20, 2010 from http://www.mayoclinic.com/health/anemia/DS00321 .
d.). According to Brody (2008), "Babies are born with about 500 milligrams (mg) of iron in their bodies. By the time they reach adulthood they need to have about 5,000 mg."
Tympa-Psirropoulou et al. (2008) outline the three stages during which iron deficiency anemia develops in infants. First, iron stores in the body become gradually depleted. "Iron is an essential part of hemoglobin, the oxygen-carrying protein in blood," (Brody 2008). This first stage is sometimes called the pre-latent iron deficiency stage. The second stage is the latent iron deficiency stage, at which "the level of serum iron starts decreasing in parallel with an offsetting increase in siderophylin synthesis," (Tympa-Psirropoulou et al. 2008). Finally, the third stage is full onset iron deficiency anemia.
Once iron deficiency anemia has been identified in the infant, the problem can be corrected by careful supplementation. If the infant is being breast fed, the mother may…
Bogen, D.L., Duggan, a.K., Dover, G.J., & Wilson, M.H. (1999). Screening for Iron Deficiency Anemia by Dietary History in a High-Risk Population. PEDIATRICS Vol. 105 No. 6 June 2000, pp. 1254-1259. Retrieved online: http://pediatrics.aappublications.org/cgi/content/abstract/105/6/1254
Brody, J.E. (2008) "Iron Deficiency Anemia - Children." New York Times: Health Guide. Retrieved online: http://health.nytimes.com/health/guides/disease/iron-deficiency-anemia-children/overview.html
"Iron deficiency anemia - children," (n.d.). MedlinePlus. Retrieved online: http://www.nlm.nih.gov/medlineplus/ency/article/007134.htm
KidsHealth (n.d.). Iron-deficient anemia. Retrieved online: http://kidshealth.org/parent/medical/heart/ida.html
Direct supplementation is often the best method to immediately counteract the effects of anemia. But supplementation alone on a long-term basis is seldom recommended as the sole course of treatment -- dietary rectification is usually required for sustained improvement. Food -- based strategies can include the introduction of iron-rich foods. But in many nations these types of foods may be poorly available, especially iron-rich meat. Iron fortification of foods is another realistic method for reducing the prevalence of deficiency through consumption. In industrialized countries such as America, breakfast cereals and nutritional bars and shakes are regularly supplemented with iron. The choice of breads and other carbohydrates as the vehicle of iron is deliberate, given that flour-based goods and grains like breads and cereals are "frequently consumed, staple foods. Bread is a particularly useful vehicle as the risk for organoleptic deterioration due to the pro-oxidative properties of iron is lower compared…
signs of anemia that is caused by blood loss. Anemia caused by blood loss can take place over long periods of time, and in Ms. A's situation, that could be what is taking place. According to her medical history, she has been suffering from "menorrhagia" and "dysmenorrhea," both of which are signs of anemia in women, especially during child-birthing years. Other signs of anemia in the patient include the fact that she feels fatigued, and the light-headedness she suffers while golfing. Additionally, she has been on aspirin for 10-12 years, and she also takes aspirin more often during the golfing season. As one report suggests; the use of "non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin or ibuprofen, can cause ulcers and gastritis" (ebMD, 2014) which, of course, can result in the type of chronic bleeding associated with anemia.
The case study shows the results of the patient's blood test, and…
Ford, J.; (2013) Red blood cell morphology, International Journal of Laboratory Hematology, Vol. 35, Issue 3, pp. 351 -- 357
Kansagara, D.; Dyer, E.; Englander, H.; Rongwei, F.; Freeman, M.; Kagen, D.; (2013) Treatment of anemia in patients with heart disease, Annals of Internal Medicine, Vol. 159, Issue 11, pp. 746 -- 757
WebMD (2014) Understanding anemia -- the basics, accessed on July 16, 2014 at http://www.webmd.com/a-to-z-guides/understanding-anemia-basics ,
Anemia Case Study
The circumstances and preliminary workup in Ms. A's case indicates that she is suffering from a certain type of anemia. Even though she is an apparently healthy woman, Ms. A's conditions worsen during her menstruation period. Generally, anemia is a condition that is brought by the impaired or increased generation of erythrocytes and is also known as iron poor blood. Athletes who engage in endurance training such as Ms. A are sometimes faced with the likelihood of developing anemia. Given the circumstances and laboratory test results of Ms. A, there is need to identify the specific type of anemia she is suffering from through proper diagnosis in order to provide the most suitable treatment.
Based on the evidence presented in this case, Ms. A is suffering from iron-deficiency anemia, which is a common type of anemia brought by decrease in iron concentration in blood and the levels…
American Society of Hematology. (n.d.). Iron-Deficiency Anemia. Retrieved November 27, 2016, from http://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx
Harper, J.L., Conrad, M.E. & Besa, E.C. (2016, November 14). Iron Deficiency Anemia. Retrieved November 27, 2016, from
Pernicious Anemia I uploaded instructions. The essay written ASA format, scholarly references pages.
Pernicious anemia is a medical condition where the body is unable to manufacture the required red blood cells due to the lack of enough vitamin B12. According to Ban-Hock and Alderuccio (2004)
vitamin B12 is used in the body for making healthy red blood cells and to ensure the nervous system is functioning properly. Persons suffering from pernicious anemia are unable to absorb the required vitamin B12 from the food they consume. The lack of intrinsic factor protein is the main cause of absorption failure. If a person's body does not have enough vitamin B12, their red blood cells will not divide normally, and they become too large. This will result in the red blood cells not been released from the bone marrow where they are made. The person's body will eventually not have enough red blood…
Ban-Hock, T., & Alderuccio, F. (2004). Pernicious Anaemia. [Article]. Autoimmunity, 37(4), 357-361. doi: 10.1080/08916930410001705439
Madara, B., & Pomarico-Denino, V. (2007). Pathophysiology. Burlington, MA: Jones and Bartlett Publishers.
Sun, A., Wang, Y., Lin, H., Chia, J., & Chiang, C. (2013). Do all the patients with gastric parietal cell antibodies have pernicious anemia? [Article]. Oral Diseases, 19(4), 381-386. doi: 10.1111/odi.12014
Megaloblastic anemia is a blood disorder in which there is anemia with larger than normal red blood cells. Anemia is a condition where the body does not have enough healthy red blood cells which are necessary for providing oxygen to body tissue (ADAM 2011). The common feature in megaloblastic conditions is a defect in DNA synthesis when cells are rapidly dividing. It associated with another condition which is known as pernicious anemia, a condition that is caused when not enough B12 vitamins are absorbed into the intestines and leads to a decrease in red cells. These dysfunctional red blood cells are found in the bone marrow of afflicted patients.
Etiology: People over the age of 60, those who have eating disorders like bulimia or anorexia nervosa, those with cancer can get the condition. Smoking and drinking are factors which contribute to megaloblastic anemia. Vitamin B12 deficiency, alcoholism, celiac disease, chronic…
ADAM Medical Encyclopedia (2011). Megaloblastic anemia. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001593/
Approach considerations (2012). Medscape Reference.
Prevalence and incidence of megaloblastic anemia (2011). Retrieved from http://www.rightdiagnosis.com/m/megaloblastic_anemia/prevalence.htm
Schick, P. (2012). Megaloblastic anemia. Medscape.
Sickle Cell Anemia
As an inherited condition, it is presence of hemoglobin which tends to be abnormal that brings about sickle cell anemia. In basic terms, hemoglobin is a red blood cell protein whose main function is carrying oxygen. It is this hemoglobin abnormality that informs 'sickled' or distorted red blood cells whose survival is compromised as a result of the distortion and fragility. Though the prevalence of the condition largely varies in accordance with the region, the Center for Disease Control and Prevention points out that of all blood disorders, sickle cell anemia has earned itself a distinction as the most commonly inherited in America. In this text, I come up with a complete and concise definition of the disorder and its prevalence. I also detail how the condition affects body systems and how it is treated.
A Detailed Overview of the Condition
When it comes to individuals with…
Commonly, anemia presents as a condition where there is a deficiency of red blood cells in the body. Common symptoms to all cases of anemia include general fatigue and a basic lack of energy. In women, symptoms can become worse during pregnancy or menstruation. When one diagnoses a specific type of anemia, it is important to take into account not only the laboratory results, but also how these combine with the particular current symptoms presented, as well as the sufferer's medical history.
For Ms. A's specific case, I would diagnose iron deficiency anemia. There are various clues that led to this conclusion. First, she is reported to be apparently healthy before developing the symptoms that brought her to the clinic. She is also among one of the at-risk individuals for the condition, being a woman of child-bearing age (MedlinePlus, 2012).
In this group, iron deficiency anemia can manifest suddenly…
Johns Hopkins Medicine. (2012). Cardiomyopathy/Heart Failure. Retrieved from: http://www.hopkinsmedicine.org/heart_vascular_institute/conditions_treatments/conditions/cardiomyopathy.html
MedlinePlus (2012). Iron Deficiency Anemia. Retrieved from: http://www.nlm.nih.gov/medlineplus/ency/article/000584.htm
Sickle cell anemia according to the U.S. National Library of Medicine/National Institutes of Health - NLM/NIH (2013), "is a disease in which your body produces abnormally shaped red blood cells." As the NLM/NIH further point out, the cells produced in this case ordinarily have a crescent-like shape. The red blood cells of an individual usually have a disk-like shape. It is this disk like shape that enhances and eases their movement through the blood vessels of an individual. According to NLM/NIH (2013), sickle cells routinely get stuck in an individual's blood vessels thereby causing blood flow blockage. In addition to causing pain, such blockage could also lead to organ damage (NLM/NIH, 2013).
When it comes to the causes of the disease, it is important to note that genetics play a critical role on this front. In that regard, therefore, a parent can pass the sickle cell disease to their child.…
U.S. National Library of Medicine/National Institutes of Health - NLM/NIH (2013). Sickle Cell Anemia. Retrieved from http://www.nlm.nih.gov/medlineplus/sicklecellanemia.html
Another symptom that is often found is a yellowing of skin and eyes; this is a sign of jaundice due to the breakdown of red blood cells. Another sign is that children may show delayed growth and development. (Genetic Disease Profile: Sickle Cell Anemia)
One of the aspects that problematizes this disease are the complications that can arise as a result of the lowering of body defenses and the increased vulnerability to illness. This can be ascribed to spleen damage. The disease "....prevents the spleen from destroying bacteria in the blood. Infants and young children, especially, are susceptible to bacterial infections that can kill them in as little as 9 hours from onset of fever." (Genetic Disease Profile: Sickle Cell Anemia)
Stroke is anther serious possible consequence of this disease. This can result from defective cells damaging the walls of red blood vessels.
6. Brief historical overview.
hile the HbS…
Brief History of Sickle Cell Disease. May 31, 2006. http://sickle.bwh.harvard.edu/scd_history.html
Anemia, Sickle Cell. May 31, 2006. http://www.emedicine.com/EMERG/topic26.htm
Genetic Disease Profile: Sickle Cell Anemia. May 31, 2006. http://www.ornl.gov/sci/techresources/Human_Genome/posters/chromosome/sca.shtml
Sickle cell anemia. May 31, 2006. http://www.mayoclinic.com/health/sickle-cell-anemia/DS00324
Many people hate to go to the doctor's office -- especially when they know that they will be receiving an injection. However, I, along with millions of people the world over, consider ourselves very lucky to do just that, each and every month of our lives. You see, for people like me with a disorder known as "pernicious anemia," the doctor and her needle are the important link between a healthy life and a life of absolute misery. This is because, unlike classic anemia, the common form of the blood disorder that usually results in little more than fatigue, pernicious anemia can result in catastrophic changes in the body, chief among them severe neurological impairment that, in its severe form, can result in absolute madness. For those of us who suffer from this disease caused by an inherited deficiency, or caused from some disruption or disorder in the…
Intelihealth. "Pernicious Anemia." Web site. 2004. Retrieved from Web site on April 10, 2004 www.intelihealth.com/IH/ihtIH/WSIHW000/9339/20862.html
Medline Plus. "Pernicious Anemia." Medline Plus Medical Enclyclopedia. 2003 Retrieved from Web site on April 10, 2004 http://www.nlm.nih.gov/medlineplus/ency/article/000569.htm
Segal, J.B., et al., (2008), Hydroxyurea for the Treatment of Sickle Cell Disease,
Baltimore, MD: AHRQ
To determine efficacy, effectiveness, harms, and barriers of the use of hydroxyurea treatment of sickle cell disease for determining solutions and further research need.
Research studies based on variables.
Conducted by experts in sickle cell disease management, clinical trial methodology, systematic review, epidemiological studies, and ethics and adherence research.
Instruments were quality assessment, data extraction, and evidence grading. Literature inclusion tailored toward research questions. Studies on children and adults evaluated separately. Included randomized trials, non-randomized trials, cohort studies with control groups, and pre/post studies. Evaluations of data was based on variable-based research questions.
Hydroxyurea lowered the rate of hospitizations among children with sickle cell disease and raised HbF cell percentages.
Limited evidence for toxicity, barriers, and guide dosing. Insufficient evidence for efficacy and safety.
Diet Plan (Anemia)
The following iron rich diet plan is designed to help my 18-year-old sister address her iron deficiency anemia. Health needs include a more balanced diet and healthier eating habits with more consistency. This includes 18 milligrams of iron per day (based on age, condition and gender). This nutritional recommendation will decrease anemia effects such as general fatigue and body chills.
Three meals (with 2-3 snacks) per day are recommended for a balanced diet. This includes the appropriate intake of iron and other basic nutrients. Limits should be placed on white sugar, soda and sweets; they should be consumed in moderation or eliminated from her diet due to their low nutritional value. Iron rich foods are recommended -- lean poultry and fish are more easily absorbed sources of iron and foods high in Vitamin C aid in absorption. Choices include citrus juice and fruits,…
Pynaert, Delanghe, Temmerman, & De, H. (2007). Iron Intake in Relation to Diet and Iron Status of Young Adult Women. Annals of Nutrition & Metabolism, 51(2), 172-181. doi:10.1159/000103278
Hemolytic Disease of the Newborn (HDN) is also called erythroblastosis fetalis. This condition occurs when there is an incompatibility between the blood types of the mother and baby. "Hemolytic" means breaking down of red blood cells; "erythroblastosis" refers to making of immature red blood cells; "fetalis" refers to fetus (alker et al. 1957).
HDN most frequently occurs when an Rh negative mother has a baby with an Rh positive father. hen the baby's Rh factor is positive, like the father's, problems can develop if the baby's red blood cells cross to the Rh negative mother (Issit & Anstee 1998). This usually happens at delivery when the placenta detaches. However, it may also happen anytime blood cells of the two circulations mix, such as during a miscarriage or abortion, with a fall, or during an invasive prenatal testing procedure (i.e., an amniocentesis or chorionic villus sampling).
The mother's immune system sees…
Frigoletto, F., et al. "Ultrasonographic fetal surveillance in the management of the isoimmunized pregnancy." New England Journal of Medicine 315-1986: 430-32.
Issit, P. & Anstee, D. Applied Blood Group Serology, 4th Edition. Durham, NC: Montgomery
Scientific Publications, 1998.
Judd, W., et al. "Prenatal and perinatal immunohematology: recommendations for serologic management of the fetus, newborn infant, and obstetric patient." Transfusion 30, 1990: 175-83.
Syncope -- Cardiovascular and Anemia
Syncope, or fainting, can be caused by a number of different things. Some of the most common problems with fainting come from a sudden change in position and the corresponding drop in blood pressure that can come with that. Additionally, other causes for syncope are anemia and cardiovascular problems. Syncope that comes from cardiovascular issues can be among the most serious, since heart-related problems can often lead to significant health problems and even death. In order to fully address syncope issues that come from cardiovascular problems or anemia, one must understand how these issues should be treated and what kinds of treatment plans work the best for each individual patient.
Syncope -- Cardiovascular and Anemia
The purpose of this study is to increase understanding of evidence-based management of a common problem encountered in primary care. The problem addressed here will be syncope (fainting) as…
Dicpinigaitis, P.V., Lim, L., & Farmakidis, C. (2014). Cough syncope. Respiratory Medicine, 108(2): 244-251.
Freeman, R. (2011). Chapter 20: Syncope. In Longo, Dan L.; Kasper, D.L., Jameson, J.L., Fauci, A.S., Hauser, S.L., & Loscalzo, J. Harrison's principles of internal medicine (Textbook) (18th ed.). New York, NY: The McGraw-Hill Companies.
Gauer, R.L. (2011). Evaluation of syncope. American Family Physician, 84(6): 640-650.
Gaynor, D., & Egan, J. (2011). Vasovagal syncope (the common faint): What clinicians need to know. The Irish Psychologist, 37(7): 176-179.
Implications for ongoing research into genetic therapies and side effects/later developments are discussed at length.
Yannaki, E. & Stamatoyannopoulos, G. (2010). Hematopoietic stem cell mobilization strategies for gene therapy of beta thalassemia and sickle cell disease. Annals of the New York Academy of Sciences 1202: 59-63.
Though the clinical trial these two researchers are involved in does not yet have results that are ready for publication, the review of the risks they provide regarding the use of stem cell mobilization with G-CSF in patients with sickle cell is highly useful information. So, too, is the practice of pre-treating patients with hydroxyurea before administering the stem cell treatment, which the authors describe in detail and which forms the basis of the related clinical trial. Potential reduction of risks appears to be quite promising, though final results from the clinical trial and other supporting evidence will of course be required.
Ethics of Embryo Design
Selecting the Perfect Baby
With all the recent advances in science and technology, there are new options for couples looking to get pregnant. This includes not only first time couples who have had trouble getting pregnant, but also couple looking to design their perfect baby using science to pick out the most desired genetic markers. This is the choice given to the Shannons, who are looking to have certain genetic markers in their next child to avoid a diagnosis of fanconi anemia that their older child has, as well as to provide a potential future match for a bone marrow donor for their current daughter, Sally.
Thus, the Shannons are looking into the pre-implantation genetic diagnosis (PGD) procedure. According to the research, this procedure is "a technique that enables people with a specific inherited condition in their family to avoid passing it on to their children.…
American Pregnancy Association. (2013). Preimplantation genetic diagnosis: PGD. Infertility. Web. http://americanpregnancy.org/infertility/preimplantationgeneticdiagnosis.html
Human Fertilization & Embryo Authority. (2014). Pre-implantation genetic diagnosis (PGD). Treatment and Storage Options. Web. http://www.hfea.gov.uk/preimplantation-genetic-diagnosis.html
DIAGNOSIS AND TREATMENT PLAN
Diagnosis and Disease Processes
Using an appropriate patient assessment form (Sample Forms, 2013), D.M. has been found to have uncontrolled Type 2 diabetes, hypercholesterolemia, uncontrolled hypertension, chronic anemia, and probable hypothyroidism (Sample Forms).
Diabetes Type 2
is most probably on a poorly controlled diet of high cholesterol and high simple sugars. Diabetes mellitus type 2 is a metabolic disease wherein the body is not able to properly use ingested food because of insulin resistance. If more simple or refined sugars are consumed, the less the body is able to process them as nutrients. These tend to stay and float in the blood stream, un-used, and in this condition, they cause trouble in the different parts of the body. These include the end organs, such as the brain, the eyes, the kidneys, the heart, and even the feet. A poorly controlled diet and the lack…
Glasgow, R.E., et al. (2005). Development and validation of the patient assessment of chronic illness care. Vol. 43 # 5, Medical Care: PuMed. Retrieved on October 15,
2014 from http://www.ncbi.nlm.nih.gov/pubmed/15838407
Sample Forms (2013). Patient assessment form. Sample Forms.org. Retrieved on October 15, 2014 from http://www.sampleforms.org/patient-assessmentform.html
student, degree Health Adminstration. I worked a health care staffing supervisor 10 years. personal experience incorporated paper fact husband sickle cell anemia I cared 20 years.
I have always been drawn to helping people, both in my life and in my career pursuits. In planning the next phase of my life, I wanted to follow a path which would allow me to better the lives of others while also learning new things every day. I have come to realize that nursing is the profession that suits me best because of my interests, my experience, and my goals.
A degree in nursing would be the second degree that I have pursued. My first degree was in Health Administration. I chose to study that field because I knew that I wanted to work in a health care setting, where my actions would be at least indirectly responsible for aiding in the well-being…
CUBAN CASE STUDY Mrs. Demetilla Hernandez a 63-year- Cuban woman seeks consultation Liberty health-maintenance organization (HMO) clinic weakness, lethargy, fatigue experienced 2 months. A week ago, cooking dinner daughter, Mariana's house, momentarily lost balance slipped kitchen floor.
CUBAN CASE STUDY
As a health-care provider, what are the typical Cuban communication patterns you need to be aware of in dealing with Mrs. Hernandez?
Latino families are often multigenerational in their composition. As the grandmother, Mrs. Hernandez assumes control over the family meals. This is a very important part of her identity. ather than communicating directly, food is love and emotions and feelings are communicated through food.
Q2. Describe the traditional Cuban food patterns. How would you assist Mrs. Hernandez
in developing a plan for a 1500-calorie diet and regular exercise?
People who have grown up in poor, food-insecure settings often develop patterns of eating high-calorie, high-carbohydrate comfort foods and many Latino…
Ortiz, B. (et al. 2007). Complementary and alternative medicine use among Hispanics in the United States. The Annals of Pharmacotherapy, 41(6):994-1004.
Dura-Vila, Gloria, and Matthew Hodes. (2011). Cross-cultural study of idioms of distress among
Spanish nationals and Hispanic-American migrants: susto, nervios and ataque de nervios. Social Psychiatry and Psychiatric Epidemiology, 1-11. Retrieved: http://www-ncbi-nlm-gov.proxy1.cl.msu.edu/pubmed/22270268 .
For a fifty-seven-year-old man with a fairly unremarkable past medical history, surgery was recommended. Also, performing the surgery could have a positive impact upon his diverticulosis, urinary hesitation, Gerd, BPH (benign prostrate hyperplasia, or enlarged prostate) and mild anemia. A surgery to correct the inguinal hernia had been successfully performed in 1998 without incident, as did the patient's other surgeries, including his varicose vein stripping done in 1987 and eye surgery in 1995.
During an inguinal hernia repair procedure, first, the surgeon makes an incision and separates the muscle and tissues to expose the hernia sac. The sac is cut open and the contents are replaced into the abdomen, the neck of the hernia sac is tied, and the muscles and tissues are sutured. During a laparoscopic procedure the procedure is performed through tiny incisions, using an instrument with a camera attached and a video monitor to guide the repair.…
Culvert, Lee L. (2004). "Inguinal Hernia Repair." Gale Encyclopedia of Surgery.
General Anesthesia Information." (2007). Surgery. Retrieved 15 Sept 2007 at http://www.justbreastimplants.com/surgery/general_anesthesia.htm
Goverman, Jeremy (23 Jan 2006). "Hernia" Medline Encyclopedia Online. Retrieved 15 Sept 2007 at http://www.nlm.nih.gov/medlineplus/ency/article/000960.htm
R'os, J. Rodr'guez, P. Munitiz, D. Alcaraz, P. Perez, Flores. (Sept 2001)."Parrilla using a prosthesis." Hernia. 5(3): 1265-4906 (Print) 1248-9204 (Online). http://www.springerlink.com/content/a04wbnfjp82v60t2/
Myelodysplastic Syndromes, which were previously considered rare, are currently known as some of the most frequently occurring hematological neoplasms, perhaps affecting over 30,000 patients each year within the U.S. The nation's regulatory permission of lenalidomide, azacitidine and decitabine, from 2004 to 2006 appeared to indicate a new age in the improvement of therapy for disease modification for these disorders. However, no indications of drugs being approved for MDS appear to be present in the U.S. for the past 8 years. There are no curative drugs available so far. However, some compounds under development may be approved soon. Consequently, diagnoses of MDS are still quite a heavy load, both on patients and medical care systems (Bejar & Steensma, 2014).
Myelodysplastic Syndromes are a set of distinct disorders of the bone marrow that prevent the victim's bone marrow from producing sufficient fit blood cells. The disorders are often called "failure of…
History of Pediatric Hemolytic Monitoring
Retrospect to the career of physician, Dr. James A. olff I and his early progress in treatment of Rh hemolytic disease as described in Pochedly (1984), looks at the development of interest in hematology in European field hospitals during orld ar II. After the war period, the transformation of olff's research in this area was advanced by research conducted during a pediatric residency at the Boston Children's Hospital, between 1945 and 1947. During his tenure at Children's he was engaged with Dr. Louis Diamond in his seminal investigation on treatment of erythroblastosis fetalis by exchange transfusion.
Collaborative efforts with Drs. Diamond and Farber focused on preliminary clinical trials of aminopterin for the treatment of acute leukemia, of which olff was in observation. Instrumental to the development of the concept of treating erythroblastosis fetalis by exchange transfusion; collaborative in the area of pathophysiology of disease where…
Al-Eisa, A. And Al-Hajeri, M. Hemolytic uremic syndrome in Kuwaiti Arab children. Pediatric Nephrology 16.12 (2001): 1093-1098.
Blouin, P. et al. Syndrome d'Evans: etude retrospective de la societe d'hematologie et d'immunologie pediatrique (36 cas). Archives De Pediatrie: Organe Officiel De La Societe Francaise De Pediatrie 12.11 (2005): 1600-1607.
Feldman, S.D. And Tauber, A.I. Sickle Cell Anemia: Reexamining the First "Molecular Disease." Bulletin of the History of Medicine 71.4 (1997) 623-650
Friedmann, A.M. et al. Fatal autoimmune hemolytic anemia in a child due to warm-reactive immunoglobulin M. antibody. Journal Of Pediatric Hematology/Oncology: Official Journal Of The American Society Of Pediatric Hematology/Oncology 20.5 (1998): 502-505.
Alterations of Hematology and Cardiovascular Systems
Sickle Cell Anemia
Ms. A is suffering from Sickle cell anemia. In this disease, the red blood cells appear in the shape of sickles or letter C. The normal red blood cells are disk-shaped. The disk-shape allows them to move smoothly in the blood vessels. Normal red blood cells have hemoglobin. The hemoglobin is responsible the red color. It helps in the transportation of oxygen. Sickle cells, on the other hand, have abnormally low hemoglobin, which results in the C-shape. This form is sticky and stiff and so cannot move easily through the blood vessels. Ms. A's condition was a case of Menorrhagia as well as dysmenorrhea. The sickle cells lump together and block the flow of blood through the blood vessels leading to the organs and the limbs. Such blocked blood vessels may lead to pain, infections and even organ damage (Health 24,…
Health24. (2014, APRIL 30). The seven types of anaemia. Retrieved from Health24.com: http://www.health24.com/Lifestyle/Your-Blood/Anaemia-20130216-2
UoM. (n.d.). Sickle cell disease. Retrieved from University of maryland: https://umm.edu/health/medical/reports/articles/sickle-cell-disease
These, then, eventually die leaving the transfer of oxygen in your blood being absolutely limited and far below the point at which the flow of oxygen needs to be in a human body. The flow of blood and transfer of oxygen eventually slows down tremendously and can cause terrible pain as well as make the immune system to be vulnerable to a variety of different diseases. There are many medical procedures that can allow the individual to find a relief (Lozoff et al., 2003).
In our case study, we will mainly highlight how the mother's approach was tentative and skeptical and how the four points that have been mentioned initially (communication, social organization, spatial dynamics and locus of control) are impacted through her approach. The first important thing to note about the attitude of the mother is that she does seem very forthcoming to find out as much as she…
Black R. (2003) Micronutrient deficiency -- an underlying cause of morbidity and mortality. Bulletin of World Health Organization, 81:79.
Dr Izumi, S., (2008) Japanese Patients' Descriptions of 'The Good Nurse', accessed on February 28, 2009.
Kino*****a, J., & Palevsky, N. (1992) Gateway to Japan (Rev. ed.). Tokyo: Kodansha International.
Lozoff B, De Andraca I, Castillo M, Smith JB, Walter T, Pino P. (2003) Behavioral and developmental effects of preventing iron-deficiency anemia in healthy full-term infants. Pediatrics.112:846-854.
However, Harvard Medical School (HMS) reports that in that study of 1,400 patients, 222 "composite events occurred." Those "events" included 65 deaths, 101 "hospitalizations for congestive heart failure, 25 myocardial infarctions and 23 strokes."
In an understatement, the HMS report - written by Dr. Singh - concluded that while improving the lives of patients with CKD is "of paramount importance," this particular study reveals, "...Aiming for a complete correction of anemia is associated with increased risk, increased cost and no quality of life benefits." The study was published in the November 16, 2006 issue of the New England Journal of Medicine.
Meantime, the National Institutes of Health / Medline Plus (www.nim.nih.gov) explains that epoetin alfa is also used with people who have HIV, it is used prior to surgery and after surgery "to decrease the number of blood transfusions needed" in the predicable loss of blood during surgery. It is…
Harvard Medical School. (2005). Blood test can accurately diagnose heart failure in patients
With kidney dysfunction. Retrieved February 10, 2008, at http://www.hms.harvard.edu .
Harvard Medical School. (2006). Higher Doses of Anemia Drug for Chronic Kidney Disease
Does Not Improve Quality of Life and Increases Risk for Cardiovascular Events. Retrieved February 9, 2008, at
The patient is an 18-year-old of the Filipino-American origin. He has no known family history of ulcerative colitis or chronic illnesses similar to colitis. He is a high school senior student.
The patient complains of diarrhoea 3-4 times a month although it has been on and off for one year. There is no known allergy that the patient experiences.
He experienced rectal bleeding, rectal pain and often had an urgent need to empty his bowels. His diarrhoea had bloodstains with mucus at least once a month. This led to few red blood cells due to the low level of iron, which resulted from the bloody stool. He had belly pains, which he described as cramping and his belly felt sore if touched. He experienced constipation, but it was less frequent than diarrhoea. He had no signs of vomiting or nausea, but he…
Baumgart, D. (2012). Crohn's disease and ulcerative colitis: From epidemiology and immunobiology to a rational diagnostic and therapeutic approach. New York: Springer.
Bayless, T.M., & Hanauer, S.B. (2010). Advanced therapy of inflammatory bowel disease: Volume 1. New York: McGraw-Hill Medical.
Hanauer, S.B., & Marteau, P. (2001). Ulcerative colitis: Focus on topical treatment. Paris: J.
normal hemoglobin and below normal hematocrit percentages. Her erythrocyte count is also below the normal levels. For ten to twelve years (or for the majority of her life as a menstruating woman) she has suffered from menorrhagia and dysmenorrheal. Because of the heavy bleeding and cramps experienced during menses, as well as the levels of hemoglobin and hematocrit and microcytic/hypochromic cells in her BC, it is likely that Ms. A has iron-deficiency anemia. This paper will discuss the circumstances and preliminary workup regarding Ms. A's anemic condition explain why this diagnosis is the most likely.
Ms. A is an active, young, 26-year-old woman, who was treated for light headedness, loss of energy, low blood pressure, and elevated heart rate after feeling dizzy at her golf outing. She noted that during her menses (which it is assumed she was experiencing at the time), she typically suffered from heavy bleeding and cramps,…
Brady, P. (2007). Iron deficiency anemia: a call for. Southern Medical Journal,
McDonald, C., McDonald, S. (1998). A woman's guide to self-care. Natural Health, 1:
Beta thalassemia is the severer of the two main types of thalassemia -- an inherited blood disease resulting from defective production of hemoglobin. About 100,000 people are born worldwide every year with beta thalassemia which occurs most frequently in people of Italian, Greek, Middle Eastern, Southern Asian and African Ancestry. (Learning about...," 2004) People with beta thalassemia usually develop anemia, resulting in inadequate delivery of oxygen to the body's tissues and it proves fatal in most cases, if left untreated. In this paper we shall discuss the disease develops; the types of beta thalassemia, how it is inherited, its symptoms, diagnosis and treatment.
How Beta Thalassemia develops?
Hemoglobin, the protein that transports oxygen in the blood, is made up of four chains of amino acids: two identical alpha chains and two identical beta chains. Thalassemia is the result of an imbalance in the production of beta…
Beta Thellasemia." (2001) Child Health A-Z. Website of Children's Hospital, Boston Updated on 04/03/2004. Retrieved on April 4, 2003 at http://web1.tch.harvard.edu/cfapps/A2ZtopicDisplay.cfm?Topic=Beta%20Thalassemia
Beta Thellasemia." (2004) Medicinenet.com. Retrieved on April 4, 2003 at http://www.medicinenet.com/Beta_Thalassemia/article.htm
Learning About Thalassemia." (2004) National human Genome research institute. Genome.gov. Retrieved on April 4, 2003 at http://www.genome.gov/page.cfm?pageID=10001221
Nathan, David G. And Nisbet-Brown, Eric. (2003). "Thalassemia." Article in Encyclopedia Encarta, 2003
Human Genome Project
Launched in 1990 as a collaborative initiative between the National Institutes of Health and the U.S. Department of Energy, the Human Genome Project completed its goal ahead of time despite the enormous challenges that were involved (Greene, 2006). The goals of the Human Genome Project included developing comprehensive genetic and physical maps of the human genome in order to determine the complete nucleotide sequence of the three billion base pairs that make up the human DNA and to identify the estimated 100,000 genes that are contained within the human genome (Greene, 2006). To determine the importance and implications of the HGP, this paper reviews the relevant literature, followed by a summary of the research and salient findings concerning this initiative in the conclusion.
eview and Discussion
How will research in the Human Genome Project further medical research? What disorders are most likely to benefit from the…
Burnes, D.P. & Antle, B.J. (2008, August). Mothers raising children with sickle cell disease at the intersection of race, gender, and illness stigma. Health and Social Work, 33(3), 211-
Greene, L.A. (2006, January). Human Genome Project information. Environmental Health
Perspectives, 109(1), 19.
Human Genome Project. (2015). National Portfolio Online Reporting Tools. Retrieved from http://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=45&key=H#H .
Specifically focused on products for each phase of a persons' life, this business segment is the most mainstream in terms of promotional strategies. Skin Care, OTC and Nutritionals have successfully given JNJ a permanent marketing strategy for selling to women in the 25-34 and 25-45 segments, two of the fastest growing demographic markets for these products.
The biggest challenge for JNJ is the ability to quickly develop and launch products across all of their business units. This is the most challenging task internally for the entire company to coordinate on, specifically in the area of pharmaceuticals where Federal Drug Administration (FDA) guidelines and the need for compliance are very high.
The costs of producing a new drug can be well over $800M according to AM esearch (2004). An analysis of each phase of the development of a new drug is shown in the following graphic from PhMA (2005).…
AMR Research (2006) - Pharmaceutical and Life Sciences Industry Overview. AMR Research Alert. Monday June 5, 2006. Hussain Moorai and Roddy Martin.
Credit Suisse (2006) - Johnson and Johnson Research Brief. January 24, 2007.New York, NY.
Life Science Analytics (2007) - Life Science Analytics Johnson & Johnson Pipeline Report. January 3, 2007. Boston, MA
PhRMA (2005) - Pharmaceutical Research and Manufacturers of America (PhRMA) Conference Proceedings. Accessed from the Internet on February 10, 2007 at http://www.phrma.org/innovation/
In practical terms, there is very little difference between Gatorade and PowerAde. Both are forms of dietary supplements which often pose an unknown source of danger for individuals growing up to be sportsmen. All the growing up sportsmen should be educated on the subject as they are likely to face troubles in their life later, otherwise.
Many products that are marketed provide good returns for the marketing organization, but little benefits for the user.
The products are sports drinks and they are promoted with the images of sportsmen and Michael Jordan appeared on Gatorade bottles, but he did not get the benefit of having his own flavor. Now there is a new favorite of the sports world, and he is LeBron James, and his image will be the advertising for PowerAde's Flava 23. When the flavor was selected, James was a part of the process. The process took…
Anemia and Blood Boosting. Sports Science Exchange. Vol: 14; No: 2; 1998. Retrieved from http://www.gssiweb.com/reflib/refs/276/sse81.cfm?pid=38 Accessed 21 September, 2005
Davis, Jeanie, Lerche. Sports Drinks Go Way beyond Gatorade. 19 April, 2002. Retrieved from http://my.webmd.com/content/article/18/1676_55034.htm Accessed 21 September, 2005
Dietary Supplements. Retrieved from www.wolverineaquatics.com/New/parents/Articles%20for%20parents/Dietary%20Supplements.doc Accessed 22 September, 2005
Gibala, Martin. J. The Role of Protein in Promoting Recovery from Exercise. Retrieved from http://www.gssiweb.com/reflib/refs/692/sports_science_news_protein.cfm?pid=38 Accessed 21 September, 2005
This is particularly the case in sub-Saharan Africa where clinicians have often come to rely on signs and symptoms alone to make diagnoses." (Nicoll, Walraven, Kigadye, Klokke, 1995)
The laboratory environment is critical to administering testing to determine population rates of HIV / AIDS throughout nations and perhaps continents where the lacking of resources facilitates a substandard environment for care. In the case of the African nation of Mozambique, which perhaps can be understood as a case indicative of the environmental assessment one would find throughout Africa and therefore, can be labelled to be a median statistical nation. A nation representing the median would indicate that half of the population nations that are categorized as resourced deficient, half would be above Mozambique in terms of resource allocation and half would fall below.
esearch into the quality of HIV / AIDS case-detection and case-reporting system in Mozambique was conducted by (Chilundo,…
Chappuis, F., Loutan, L., Simarro, P., Lejon, V., and Buscher, P. Options for Field Diagnosis of Human African Trypanosomiasis. Clinical Microbiology Reviews, January 2005, p. 133-146, Vol. 18, No.1
Chilundo, B., Sundeep S., Sundby J. The Quality of HIV / AIDS case-detection and case reporting systems in Mozambique. African Journal of AIDS Research 2004, 145-155. Copyright NISC Pty Ltd.
Clark. Blood Safety PPT. CDC, WHO
Loefler, I. Surgical wound infection in the Third World: the African experience. Journal of Medical Microbiology. Volume 47, 471-473. 1998. The Pathological Society of Great Britain and Ireland
More times than not, a patient will argue that he did not understand what the physician stated to him; even amidst documented proof the medical professional and the patient did engage in an informed conversation. "The fact that a meeting took place does not necessarily mean that there was a meeting of the minds" (Informed consent…, 2010, ¶ 5). This issue leads some health care providers to assert that informed consent forms possess little value, particularly when a legal battle ensues and the professional cannot prove the patient did, in fact, understand the informed consent process.
Currently, lawyers routinely challenge informed consent forms in courtrooms throughout the United States (U.S.). "The model consent forms incorporate substantial details of anesthesia techniques, risks and other elements of 'informed consent', so that a strong presumption is established on its face" (Informed consent…, 2010, ¶ 7). During the informed consent process, to help inoculate…
Anaesth, B.J. (2009). Perioperative visual loss: What do we know, what can we do? Department
of Anesthesia and Critical Care. University of Chicago. Retrieved January 25, 2010 from http://bja.oxfordjournals.org/cgi/content/short/103/suppl_1/i31
Booth, B. (2008). Informed consent at the heart of New York lawsuit. Retrieved January 26,
2010 from http://www.ama-assn.org/amednews/2008/03/10/prca0310.htm
The dexamethasone group showed meaningful improvements in several variables. After 48 hours, the women who received dexamethasone has a significantly reduced mean arterial pressure at 115 mm Hg v 94 m Hg, P < 0.05 and mean asparatate aminotransferase level at 100 IU/1 v 50 IU/1; P < 0.05. Their urine output also improved at 60 ml/h v 40 ml/h; P < 0.05 and a mean platelet count at 115-000 v 70 000; P < 0.05. The researchers concluded that their findings supported a high dose corticosteroid treatment of women with the HELLP syndrome. Although three control patients showed infectious complications, there were no statistically significant differences in morbidity.
As part of nursing and medical management, dexamethasone is often given to women with this condition and are between 24 and 34 weeks' gestation at risk of pre-term delivery to accelerate the maturation of fetal lungs (Matchaba and Moodley 2005). While…
Campbell, S. (2005). Preeclampsia Sufferers at Great Risk of HELLP Syndrome During Pregnancy. The North Scott Press. http://www.zwire.com/site/news.cfm?BRD=1839&deptAdviwarePtyLtd200/July_id_1104088newsid=13913304&PAG=461&rfi=9
Chen, P., reviewer (2004). HELLP Syndrome. University of Maryland Medical Center. http://www.umm.edu/pregnancy/specialcare/articles/hellp.html
2004). HELLP Syndrome. Medline Plus. U.S. National Library of Medicine, the U.S. National Institutes of Health and the Department of Health and Human Sciences. http://www.nlm.nih.gov/medlineplus/ency/article/00089.htm
Clenney, TL. And Vierra AJ. (2004). Costicosteroids for HELLP Syndrome, a clinical review, 329:270-272 (31 July), doi: 10.1136/bmj.329.7460.270. BMJ Publishing Group Ltd. http://bmjjournals.com/cgi/content/full/329/7468/270
ace and Genetics
On the surface, race seems like a legitimate way of categorizing human beings. Physical characteristics are passed down from parent to child, thereby recreating racial markers. However, the concept of race is generally rooted in ignorance. ace is an ephemeral construction, and genetic science is proving this to be so. If race were real, then there would be ways of tracing different races back to a few ancestors: such as an ancestral Polynesian, ancestral African, and ancestral Jew. As it stands, though, all human beings trace ancestry to the same basic gene pool from humanoid ancestors in Africa. This one fact alone is sufficient to debunk the concept that race "exists," or is a form of biological determinism. There are other reasons to believe that race is not as real as was once thought. ace is not real, and the reasons are rooted in genetic science, anthropology,…
Adelman, L. (2003). Race and gene studies: what differences make a difference? Retrieved online: http://www.pbs.org/race/000_About/002_04-background-01-02.htm
Entine, J. (2012). Jews Are a 'Race,' Genes Reveal. The Jewish Daily Forward. Retrieved online: http://forward.com/articles/155742/jews-are-a-race-genes-reveal/?p=all
Edit Research Premarital Screening
Evaluating Premarital Screening Knowledge in Saudi Students
The purpose of this research was to investigate the impact of premarital screening (PMS) in Saudi Arabia. The use of PMS as a means to identify and approach both and infectious and hereditary disease was investigated in order to determine the impact of this practical approach.
A cross-sectional study was conducted at Jazan University from January to June 2014 to perform this research. A self-administered questionnaire was distributed to 1000 Jazan University Students, both males and females. The questionnaire consisted of 3 main parts. The first part was based on socio-demographic data, the second part dealt with the students' knowledge about the premarital screening program while the third part explored their attitudes towards the screening program.
The vast majority of the participants (922; 94%) believed that a PMS program was a preventive measure. More than two thirds of…
In our high technological and global economy, we Americans think of malnutrition as a thing of the past. It is almost unheard of for our children to go hungry with a McDonald's on every corner. But that is only in our world. his report is a review of the 2003 report written by Karen Olness in the Journal of Developmental & Behavioral Pediatrics called "Effects On Brain Development Leading o Cognitive Impairment: A Worldwide Epidemic." In keeping with the theme of nutrition and iron deficiency, this story points out that the world food shortages and other epidemic situations in developing nations has a direct bearing on the brains of children. For the poor nations of the world things like malnutrition, genetic disease, infectious diseases like meningitis, parasites, and cerebral malaria, in utero drug and alcohol exposure, newborn asphyxia, low birth weight, head injuries, and endocrine disorders to name…
The author points out that iron deficiency has been attributed to behavior problems in children who suffered in infancy. These children are seen as problematic. They also have very high counts of anxiety or depression, social problems, and other attention issues. With these statistics, the author seems to be pointing out how crucial it is to help feed the mothers and children in third world nations. "More than 30% of pregnant women in developing countries have iron-deficiency anemia, and iron deficiency without anemia is even more widespread. If the central nervous system effects of iron deficiency in the developing infant lay the ground for later learning problems, there is a large population of children at risk." (Olness, 2003)
My thoughts & Do I agree/disagree
I feel, like the author, that these cognitive brain issues are preventable. Iron deficiency for example seems like a very simple problem to fix. Give these pregnant mothers and infants iron supplements. But that is easier said then done. The problem is -- how do we take the last Miss America up on her speech where she said that she would attempt to solve world hunger? Fine, when is she or any of us going to start? "It is reported that 38.5% of children in developing countries are underweight, and that 42% are stunted. The United Nations International Children's Emergency Fund (UNICEF) reports that 35% to 40% of children suffer from moderate malnutrition and that 10% of all children suffer a period of severe malnutrition during the crucial first 2 years of life." (Olness, 2003) I know I ate today and did not think once of a baby in Uganda not getting his share of the crop. I wonder if the last Miss America was more in line with
Genetic screening is one of the most controversial topics in the scientific arena today. The advent of the Human Genome Project, which maps the complete human genetic code, has brought this issue to the forefront. This paper will discuss the basic science that underlies genetic screening, applications of genetic screening, and investigate some of the common misconceptions and ethical questions about its use.
Genetic screening itself is simply "the systematic search within a population for persons possessing particular genotypes, which are either associated with disease, predisposing to disease, or leading to disease in descendants" (Miller). In simpler terms, genetic screening involves testing and determining whether "an individual's genetic material to predict present or future disability or disease either for oneself or one's offspring" (McCarrick). Essentially, genetic screening is conducted for several basic reasons, including the care of the ill and the prevention of disease, providing reproductive information, determining the incidence…
Alberts, Bruce. 2002. Molecular biology of the cell, 4th ed. New York: Garland Science.
Genetic Science Learning Center. 2004. Genetic Disorder Corner. University of Utah. 07 May 2004. http://gslc.genetics.utah.edu/units/disorders/
McCarrick, Pat Milmoe. 1993.Genetic Testing and Genetic Screening. Scope Note 22. National Reference Center for Bioethics Literature, Georgetown University, 1993. Kennedy Institute of Ethics Journal (KIEJ), Reprinted September 1993, 17 p. (Last updated February 2002). 07 May 2004. http://www.georgetown.edu/research/nrcbl/scopenotes/sn22.html
Miller, Kelly. 1999. Genetic Screening. Phil McClean, Professor, Ph.D. Colorado State University, PLSC 431/631 - Intermediate Genetics. 07 May 2004. http://www.ndsu.nodak.edu/instruct/mcclean/plsc431/students99/miller.htm. The mundane by excellent cinematography and an effective cast.
Rh incompatibility is a condition reported to occur during a woman's pregnancy when the woman's blood is Rh-negative and the baby's blood is Rh-positive. Rh-negative and Rh-positive are references to whether the individual's blood has Rh factor which is a protein reported to be on the individual's red blood cells. (National Heart, Lung and lood Institute, 2014, p. 1)
The problem with the mother with Rh-negative blood carrying a child with Rh-positive blood occurs when the baby's blood somehow crosses into the blood stream of the mother and this is reported to occur most often during delivery of the baby. The mother's body with Rh-negative blood will have a reaction to the blood of the baby as though the baby's blood were a foreign substance and the mother's body creates antibodies or proteins that fight against the blood of the Rh-positive baby. These antibodies are reported to be such that…
Rh Incompatibility: Erythroblastosis Fetalis (2014) Merck Manual. Retrieved from: http://www.merckmanuals.com/home/womens_health_issues/complications_of_pregnancy/rh_incompatibility.html
The Rh Factor: How It Can Affect Your Pregnancy (2013) The American College of Obstetricians and Gynecologists. Retrieved from: http://www.acog.org/Patients/FAQs/The-Rh-Factor-How-It-Can-Affect-Your-Pregnancy
What is Rh Incompatibility? (2014) National Heart, Lung, and Blood Institute. Retrieved from: http://www.nhlbi.nih.gov/health/health-topics/topics/rh/
The author of this report has been asked to review the results and history of a woman who has come for treatment. She is a woman with Irish descent and there are some fairly disturbing signs that can be seen through her medical history, her current results, what she is taking in terms of drugs and her list of diagnoses. Each of those factors, facts and diagnoses will be explored in terms of the implications, the likelihood of a problem and so forth. While anorexia would be a pretty bad thing for this patient to have, it does indeed seem to be the most pressing and likely thing going on with this patient.
Before getting to the primary and other diagnoses, there are a few things in the vitals and basic information that should be explored. First, the woman in question is a scant five feet tall and…
CDC. (2015). Adult BMI Calculator: English -- Assessing Your Weight -- Healthy Weight -- DNPAO -- CDC. Cdc.gov. Retrieved 20 October 2015, from http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html
Kaye, W., Bulik, C., Thornton, L., Barbarich, N., & Masters, K. (2004). Comorbidity of Anxiety Disorders With Anorexia and Bulimia Nervosa. American Journal Of Psychiatry, 161(12), 2215-2221. http://dx.doi.org/10.1176/appi.ajp.161.12.2215
Mayo. (2015). Hypothyroidism - Mayo Clinic. Mayoclinic.org. Retrieved 20 October 2015, from
neoplasm: "abnormal mass of tissue that results when cells divide more than they should or do not die when they should" ("NCI Dictionary of Cancer Terms," 2016)
benign: noncancerous ("NCI Dictionary of Cancer Terms," 2016)
malignant: cancerous ("NCI Dictionary of Cancer Terms," 2016)
carcinoma: "Cancer that begins in the skin or in tissues that line or cover internal organs," ("NCI Dictionary of Cancer Terms," 2016)
sarcoma: "A type of cancer that begins in bone or in the soft tissues of the body, including cartilage, fat, muscle, blood vessels, fibrous tissue, or other connective or supportive tissue" ("NCI Dictionary of Cancer Terms," 2016)
anaplasia: Features of cells which indicate malignancy ("Anaplasia," 2016).
Q2. Identify the correct name for both benign and malignant tumors in the following locations:
Benign Tumors/Malignant Tumors
Pancreas: Adenoma / Adenocarcinoma ("Tumors by name," 2016)
Fat: Lipoma / Liposarcoma ("Tumors by name," 2016)
Bone: Osteoma / Osteosarcoma ("Tumors…
About immunotherapy. (2016). Chemocare. Retrieved from:
Anaplasia. (2016). USC. Retrieved from:
Histotoxic Hypoxia refers to hypoxia specifically caused by toxins in the blood that interfere with the ability of hemoglobin to absorb oxygen even in the presence of sufficient quantities and at normal atmospheric pressure (Jepperson, 2007; USDOT,
2003). In that regard, alcohol is the most likely toxin to affect pilots, but other poisonous substances like cyanide and certain narcotics and other medications (including some sold over-the-counter) can also cause histotoxic hypoxia. Finally, Stagnant Hypoxia refers to insufficient oxygen absorption caused by underlying circulatory problems that reduce blood flow, and therefore, the efficient transport of oxygen, even where the quality of air, atmospheric conditions, and oxygen absorption by hemoglobin are normal (Jepperson,
2007; USDOT, 2003).
Signs and Symptoms of Altitude-Induced Hypoxia:
One of the most dangerous aspects of all forms of hypoxia is that its onset is not noticed by the pilot. Another danger is that while hypoxia severely reduces physical…
Jepperson. (2007). Guided Flight Discovery: Private Pilot Englewood, CO: Jepperson.
Jepperson. (2006). Guided Flight Discovery: Instrument Commercial Englewood, CO:
Reinhart, R.O. (2008). Basic Flight Physiology New York: McGraw-Hill.
A company cannot refuse to hire someone with sickle cell anemia (a disease that primarily affects persons of African ancestry), because the person might require costly health insurance, for so long as the person was strong enough to perform the job, discrimination would not be acceptable as it would affect persons disproportionately of one racial category.
Explain trade secret and how it could be protected legally and in day-to-day operations. Provide an example.
According to Nolo.com, an online legal dictionary, a trade secret is:
in] most states, a formula, pattern, physical device, idea, process, compilation of information or other information that 1) provides a business with a competitive advantage, and 2) is treated in a way that can reasonably be expected to prevent the public or competitors from learning about it, absent improper acquisition or theft" ("trade secret, 2007, Nolo.com). Perhaps the most famous trade secret in business is…
Elias, Stephen. (1998)."Trade Secret Law: Overview." Nolo Press. Retrieved 8 Apr 2007 at: http://www.marketingtoday.com/legal/tradesec.htm#1
Estoppel." (2007). Nolo.com. Retrieved 8 Apr 2007 at http://www.nolo.com/definition.cfm/term/7F1E56D5-7EC1-4CEB-86B3943F6990FF77
Messiha, Dominic J. & Hillary R. Ross. (May 2006). "EEOC Revises Compliance
Manual to Target More 'Contemporary' Forms of Discrimination." ASAP: Littler Mendelson Time Sensitive Newsletter. Retrieved 8 Apr 2007 at http://www.littler.com/collateral/print/61A7D18C32514B88187D50664174D11F.html
2003, p. 247).
The use of NSAID has been associated with increased risks of gastrointestinal bleeding in unselected patients, approximately five-fold for musculoskeletal pain and two fold for secondary prevention of cardiovascular disease with low-dose aspirin (Clinical Guideline 17: Dyspepsia 2004). Therefore, depending on the level of pain management required, a simple analgesic that can be used for pain management is paracetamol; this preparation does not cause bleeding of the stomach and it has been found to be highly effective in relieving mild to moderate pain; furthermore, it can be purchased without a prescription from chemists and supermarkets (Henderson & Wood 2000).
Discussion of Health Education Advice Required.
The U.K. Department of Health recommends the following educational advice and support for people suffering from gastrointestinal bleeding:
Patients and their relatives should be offered as much information as they want. GPs should ask what they would like to know, and give…
Barve, S., Hill, D., Marsano, L.L., Mcclain, C.J., & Mendez, C. (2003). "Diagnosis and Treatment of Alcoholic Liver Disease and Its Complications." Alcohol Research & Health 27(3):247.
Dyspepsia: Management of dyspepsia in adults in primary care. NICE Clinical Guideline 17. [Online]. Available: http://www.nice.org.uk/guidance/CG17/niceguidance/word/English .
Garcia, N., Jr., & Sanyal, a.J. (2001). "Portal hypertension." Clinics in Liver Disease, 5(2):509- 540.
Govoni, R., Mann, R.E., & Smart, R.G. (2003). "The Epidemiology of Alcoholic Liver Disease." Alcohol Research & Health 27(3):209.
The race between new drugs and new resistances has not stopped since then.... And in 1986, WHO's expert panel concluded that a magic solution could not be relied upon, and that furthermore, malaria patterns were determined by a variety of socioeconomic as well as biological, climatic and geographic factors. " (Banfield, 1998. p. 35)
The article refers as well to the impact of malaria on the people of Kenya "... where people in the Bomet district were dying at a rate of three or four a day..." (Banfield, 1998. p.35)
Another general study which includes informative data relative to the topic of this study is The Heavy Cost of Malaria and AIDS by De Giorgio (2000). This article refers to some significant economic aspects and to the way that the high rate of malaria infections is affecting the economy of Kenya, as well as other countries in the region. The…
ALAII J. et al. (2003) COMMUNITY REACTIONS TO THE INTRODUCTION OF PERMETHRIN-TREATED BED NETS FOR MALARIA CONTROL DURING A RANDOMIZED CONTROLLED TRIAL IN WESTERN KENYA. Retrieved November 3, 2006, at http://www.ajtmh.org/cgi/reprint/68/4_suppl/128.pdf http://www.questia.com/PM.qst?a=o&d=5002294055
Banfield, J. (1998, September). Malaria: Africa's Public Enemy No. 1. African Business 35+. Retrieved November 4, 2006, from Questia database:
Maternity Nursing, Labor & Delivery / Newborn
Labor and Delivery Terms
Para: Para refers to the number of live births a woman has had (it might be a stillbirth, or twins, or even triplets) past the 20-week gestation period (Zimmerman, p. 116).
Gravida: this refers to the number of times a woman has been pregnant, whether she actually gave birth, had an abortion or a stillbirth (Zimmerman, p. 116).
Amniotic Sac: this is a membrane around which the fetus is surrounded. It is a strong series of membranes that is visible after 7 weeks of gestation. (Jurkovic, et al., 2011).
Cervical Effacement: this phrase refers to the measurement of the expansion of the cervix as the baby gets closer to being born. hen the cervix is 50% effaced, it is halfway to being ready for the baby to be born (Jurkovic, et al., 2011).
Cervical dilation: Slowly but surely the…
Encyclopedia Britannica. (2010). Childbirth. Retrieved August 17, 2011, from http://www.britannica.com/bps/search?query=childbirth .
Heller, Michelle E., and Veach, Lynette M. (2008). Clinical Medical Assisting: A Professional,
Field Smart Approach to the Workplace. Florence, KY: Cengage Learning.
Jailkhani, R., Patil, VS., Laxman, HB, Shivashankara, AR, Kulkarni, SP, and Ravindra, MS.
The success was remarkable, according to the researchers: Even muscles that had already lost half of its mass, recovered visible. (Leppanen et al. p5549-65) At the same time, the mice survived for several weeks longer than their untreated counterparts and also developed a healthy appetite again. (Mantovani, p296) The new study is therefore interesting in two respects: First, it demonstrates that the muscle loss at least in animal models in fact, affects the chances of survival, and secondly, it shows a way, may be how to prevent this degradation, and even reversed. (Bruera et al. p857)
Muscle atrophy is a medical term that refers to the decrease in the size of skeletal muscle, losing muscle strength because of the strength of muscle is related to its mass. (Burnfoot, p323-34)
All changes in cell morphological character may affect isolated cells or groups of them, therefore the modification of a…
Africans had poor health care in the 1950s
There is much that still remains swept under the proverbial carpet about America's treatment to its African immigrants. One of the chapters, little known and often left untold has only recently started to emerge and concerns American health care system and its using Blacks as guinea pigs.
Attorney and author Vernellia . Tandall tells the story in her book 'Dying While Black' showing how America's health care system was built on the bodies of African-American individuals from the 19th century continuing to present days. Some f the information is unbelievable at best shocking at worst such as her allegations that AIDS was created by a government-sanctioned health care for the purposes of medical advancement.
Countless stories from Black residents of both North and South tell about how they were unwillingly and unknowingly abducted and exploited for medical experiments. There were the 'night…
Brooking Institute (2008) "Meeting the Dilemma of Health Care Access" (PDF). Opportunity 08: A Project of the Brookings Institution. Retrieved on 2/19/2011
Orlando Sentinel. (Dec., 04. 1993). Clinic On Wheels To Take Health Care To Elderly Poor . retreived 11/7/2011 from http://articles.orlandosentinel.com/1993-12-04/news/9312040190_1_clinic-project-care-seniors
Skloot, H. (2010) The immortal life of Henrietta Lacks NY. Random House.
Exposure Effects of Arsenic and Mercury
Exposure Effects of Mercury and Arsenic
Symptoms of Effects of Exposure to Arsenic and Mercury
Mercury is considered as toxic metal causing neurological disorders while Arsenic is considered as a human carcinogen. Mercury mainly affects areas which are associated with the sensory, visual and auditory functions and those concerned with co-ordination. On the other hand, Arsenic exposure results in chronic diseases pertaining to skin tumors, hyper pigmentation and hyperkeratosis of palms. This paper revolves around the explanation of symptoms pertaining to the harmful exposure effects of mercury and arsenic, and also highlights how the symptoms of both differ from each other.
Symptoms of Effects of Exposure to Arsenic and Mercury
Elevated levels of exposure to Mercury and Arsenic cause harmful effects to human health, deteriorating human reproductive and nervous systems. Coal burning power plants emit mercury; home thermometers, "button" batteries, the new energy-saving fluorescent…
Keil, D., E., Ritchie, B., J. & McMillin, G., A. (2011). Testing for Toxic Elements: A Focus on Arsenic, Cadmium, Lead, and Mercury. Lab Medicine, 42, Pp. 735-742, Retrieved
December 21, 2012, from http://labmed.ascpjournals.org/content/42/12/735.full
WHO (2010), Exposure to Arsenic: A Major Public Health Concern, WHO Document
Production Services, Geneva, Switzerland, Pp. 1-5, Retrieved December 21, 2011, from http://www.who.int/ipcs/features/arsenic.pdf
dozens of internal parasites that infect horses, the most dangerous and most capable of causing serious harm are the large strongyles parasite. They are considered to be the ones in charge of causing severe parasite related health problems in horses and they have the ability to kill. They have cylindrical bodies and unlike other parasites like tapeworms, strongyles have different sexes- male and female and can be told apart by the shape of their tails. The female lays eggs almost all the time and even though this makes it easier to detect any signs of infection, it does not stop it from growing. Several horses are affected by this disease every year, but careful research and study has been done and soon this disease will be a thing of the past and horses will be able to live a longer and healthier life.
Since an encounter against internal parasites was…
Gore, T., P. Gore, and J. Giffen. Horse Owner's Veterinary Handbook. John Wiley & Sons,
2008. 692. eBook.
The illustrated veterinary encyclopedia for horsemen. Equine Research Publications, 1975.
Anti-Cancer Drug Anaerobin
a) EFFECTS ON KIDNEYS, HEART AND BRAIN
Cytotoxic metabolites are created when bio-reductive drugs go through a metabolic process because they contribute to curing cancer by lowering oxygen to areas where the cancer affects the body. The local auto regulation process of the body provides the oxygen to all parts of the body where it is needed. The arterioles supplying that tissue for oxygen dilate to supply more oxygen than usual. This happens also in the case of the tumor when it demands more oxygen; it is supplied by the body and anaerobin affects the auto regulation process in all areas as it reduces the blood flow to all organs, except the lungs. It can reduce the oxygen and supply of nutrients to the tumor by up to 99%. Therefore this bio-reductive drug can help in treatment of cancer in modern therapy.
Anti-cancer drugs reduce the cell…
Linda Bren, 2005. Cancer Drugs: weighing the Risks and Benefits. FDA Consumer, 41(1), pp.10+.
Nootropic. Available at: Http://en.wikipedia.org/wiki/Nootropic#Vitamins_and_supplements (Accessed at 2 December 2011)
Paual Ravasco, Isabel Monterio-Grillo, Pedro Marques Vidal & Maria Ermelinda Camilio, 2005. Dietary Counseling Improves Patient Outcomes: A Prospective, Randomized, Controlled Trial in Colorectal Cancer Patients Undergoing Radiotherapy. Journal of Clinical Oncology, 23(7), pp. 1431-1438.
Strokes and African-Americans
African-Americans are reported to be nearly twice as likely to experience a stroke as their white counterparts however, African-Americans are much less likely to know the risk-factors and symptoms of stroke or to seek early treatment. The purpose of this study is to examine the issue of African-Americans and stroke. The significance of this study is the additional knowledge that will be added to the already existing base of knowledge in this area of study. The methodology employed in this study is of a qualitative and interpretive nature and has been conducted through a review of literature in this area of study.
Strokes and African-Americans
African-Americans are reported to be nearly twice as likely to experience a stroke as their white counterparts however, African-Americans are much less likely to know the risk-factors and symptoms of stroke or to seek early treatment.
Purpose of the Study
National Stroke Association (2010) What is Stroke? Retrieved from: http://www.stroke.org/site/PageServer?pagename=STROKE
The Office of Minority Health (2010) U.S. Department of Health & Human Services. Retrieved from: http://minorityhealth.hhs.gov/templates/content.aspx?ID=3022
National Stroke Association (2010) African-Americans and Stroke. Retrieved from: http://www.stroke.org/site/PageServer?pagename=AAMER
Neipris, Louis (1998) African-Americans and Stroke Risk. My Optum Health. Retrieved from: http://www.wtvm.com/global/story.asp?s=12834243
Direct to Consumer Advertising
HISTRY F DRUG ADVERTISING
THE DTC ADVERTISING PHENMENN
DECEPTIVE ADVERTISING - A WLF IN SHEEP'S CLTHING
CAUSE F DEATH
UTILIZATIN, PRICING, AND DEMGRAPHICS
LEGISLATIN, PLITICS AND PATENTS
LEGISLATIVE INITIATIVES REGARDING DTC
RECALLED and/or DEADLY DRUGS
In order to provide the most efficient method of evaluation, the study will utilize existing stores of qualitative and quantitative data from reliable sources, such as U.S. Government statistical references, University studies, and the studies and publications of non-profit and consumer oriented organizations. Every attempt will be made to avoid sources of information sponsored by or directly influenced by the pharmaceutical industry.
Existing data regarding the history, levels, content and growth of direct-to-consumer advertising will be examined. In addition, the industry's composition prior to and after the proliferation of direct-to-consumer advertising will be examined, with regard to market share, type of substances sold, benefits of substances sold, and…
On January 9, 2002, Dr. Darlene Jody, Vice President of Medical Marketing for Bristol-Myers Squibb, issued a manufacturer's "Important Drug Warning Including Black Box Information." The Important Drug Warning advises healthcare practitioners that "cases of life-threatening hepatic failure have been reported in patients treated with SERZONE." The manufacturer's Warning indicates that numerous persons have or will suffer liver failure, death or transplantation. The manufacturer's Warning also indicates that the current estimate of the rate of liver failure associated with Serzone use is "about 3-4 times the estimated background rate of liver failure." A new Warning is being added to the Serzone prescribing information, advising that "patients should be advised to be alert for signs and symptoms of liver dysfunction (jaundice, anorexia, gastrointestinal complaints, malaise, etc.) and to report them to their doctor immediately if they occur." According to Warnings, Serzone should be promptly discontinued if signs or symptoms suggest liver failure.
Vioxx belongs to a class of drugs known as COX-2 inhibitors. When the drugs were introduced a few years ago, COX-2 inhibitors were thought to be safer and more effective than other drugs such as Aspirin and Ibuprofen. However, several studies have questioned the cardiovascular safety of Vioxx. Studies indicate that people taking Vioxx have four times the risk of a heart attack.
In May 2002, the U.S. Food and Drug Administration (FDA) published a Talk Paper about new label warnings for the popular arthritis and pain drug know as Vioxx (rofecoxib). The new label warnings are based on the results of the Vioxx Gastrointestinal Outcomes Research (VIGOR). According to the FDA, recent studies demonstrate that Vioxx is associated with a higher rate of serious cardiovascular thromboembolic adverse events (such as heart attacks, angina pectoris, and peripheral vascular events). Based on the recent study, the FDA agreed with the Arthritis Advisory Committee recommendations February 8, 2001 that the label for Vioxx include gastrointestinal and cardiovascular warning information. Serious side effects attributed to Vioxx are heart attacks, seizures, strokes, or liver/kidney problems. http://www.recalleddrugs.com
Supplements, Fatigue and Lethargy
DO THEY HELP?
Vitamin E (p 1- 1.5)
Vitamin E is a fat-soluble vitamin and antioxidant, which inhibits the production of reactive oxygen species or ROS when fat is oxidized (NIH, 2013). The body produces ROS when it converts food into energy. As an antioxidant, Vitamin E protects body cells from the ill effects of free radicals. Free radicals are molecules containing an unshared electron. They damage cells and contribute to the development of heart diseases and cancer. Unshared electrons are very active and quickly react with oxygen to form ROS. Health experts conjecture that limiting the production of free radicals may, alone or through other mechanisms, help prevent or delay the formation of these dreaded chronic diseases associated with the action of free radicals. Vitamin E may serve that function (NIH).
As an antioxidant, it also plays a role in the immune function of the…
Bain, J. (2001). Andropause: testosterone replacement therapy for aging men. Vol. 47,
Canadian Family Physician: Janvier. Retrieved on February 28, 2014 from http://www.cfp.ca/content/47/1/91.long
NIH (2013). Vitamin E Office of Dietary Supplements: U.S. Department of Health & Human Services. Retrieved on February 28, 2014 from http://www.ods.od.nih.gov/factsheets/VitaminE-HealthProfessional
Watson, S. (2014). The causes of women's fatigue. WebMD Magazine: WebMD LLC.
Chonic Myelogenous Leukemia (CML): Teatment Options
Patients suffeing fom chonic myelogenous leukemia (CML) expeience ecuent infections, anemia, and thombocytopenia, signs and symptoms often manageable without pofessional help. Accodingly, patients often failed to seek medical cae until late in the disease couse and would have had a poo pognosis in the 20th centuy. Today, a numbe of effective teatments ae available, including the highly effective kinase inhibito imatinib. Kinase inhibitos suppess the activity of the fusion potein p210BCR-ABL, which is the poduct of a chomosomal tanslocation between chomosomes 9 and 22. Ove half of all CML patients will become symptom fee with the use of kinase inhibitos and live a long and poductive life, but a smalle pecentage will equie moe aggessive and iskie teatment appoaches, among which is allogeneic hematopoietic stem cell tansplantation following high dose chemotheapy.
Chonic myelogenous leukemia (CML) is a pogessive disease that impais…
oral daclatasvir plus asunaprevir for hepatitis C virus genotype 1b
Overview of current therapy
The treatment setting for chronic hepatitis C has gone through an upheaval, above all in genotype 1. However, the exception is the continuity of interferon-based therapy and its related tolerability problems, insufficient reaction rates and several baseline factors that influence reaction to therapy (Gutierrez et al., 2015). The main concern undertaken in the current research study is that it attempts to obtain a new treatment combination that seems to be tolerable and necessitate a shorter time for therapy (Hunyady et al., 2014). Hepatitis C virus (HCV) drug development has given rise to treatment courses of therapy made up of interferon-free, all-oral combinations of direct-acting antivirals. Despite the fact that the new courses of therapy are compelling and extremely useful, the full medical influence of HCV drug resistance, its inferences for retreatment, and the impending role of…
Gutierrez, J. A., Lawitz, E. J., & Poordad, F. (2015). Interferon free, direct acting antiviral therapy for chronic hepatitis C. Journal of viral hepatitis, 22(11), 861-870.
Hunyady, B., Gervain, J., Horvath, G., Makara, M., Par, A., Szalay, F., ... & Tornai, I. (2014). Diagnosis, treatment, and follow-up of hepatitis C-virus related liver disease. Hungarian national consensus guideline. Orvosi hetilap,155(Supplement 2), 3-24.
Kumada, H., Suzuki, Y., Ikeda, K., Toyota, J., Karino, Y., Chayama, K., ... & Izumi, N. (2014). Daclatasvir plus asunaprevir for chronic HCV genotype 1b infection. Hepatology, 59(6), 2083-2091.
Lontok, E., Harrington, P., Howe, A., Kieffer, T., Lennerstrand, J., Lenz, O., ... & Miller, V. (2015). Hepatitis C virus drug resistance -- associated substitutions: State of the art summary. Hepatology, 62(5), 1623-1632.
Identify the Disease
Graves' disease is a disorder of the immune system that results in too many thyroid hormones being produced, a situation that is called hyperthyroidism. Thyroid hormones impact many different body functions, so the " ... signs and symptoms" that are linked to Graves' disease cannot easily be zeroed in on specifically (Mayo Clinic). Anyone can be stricken with Graves' disease but it is far more common among women who haven't reached the age of 40 yet. To summarize, Graves' is actually caused by a "malfunction of disease-fighting immune system," which is, too many thyroid hormones are being produced.
The Mayo Clinic provides a list of signs and symptoms that a person may have Graves' disease. Some of the signs associated with Graves' disease include: being irritable or anxious; a fine tremor in hands or fingers; sensitive to heat and increased perspiration; losing weight though eating…
Acton, A.Q. (2013). Graves' Disease: New Insights for the Healthcare Professional. Atlanta,
Bahn, R.S. (2015). Graves' Disease: A Comprehensive Guide for Clinicians. New York:
Review of History and Physical Findings
The client is a 56-year-old Caucasian female who presents with complaints of fatigue that reportedly began 2 to 3 months prior to her visit. She reports that the fatigue is generalized and constant in duration, and has been progressively worsening since onset. The client reports feeling tired all the time and lacking the energy to do anything‘she could normally do’despite sleeping eight hours per night. No relieving factors were identified, although the client reports exertion as a possible aggravating factor. The client is married, has two grown kids, and works as a full-time office manager in an internal medicine office. She reports missing a day of work two weeks ago because she ‘couldn’t get out of bed’. She denies pain, fever, chills, or recent illnesses, but has gained 5 pounds since the last visit 6 months ago.
The client denies visual changes, ear pain,…
FDA (2017). LEVO-T: Highlights of Prescribing Information. Food and Drug Administration. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021342s023lbl.pdf
Lassale, C., Curtis, A., Abete, I., Van der Schouw, Y., Verschuren, M., Lu, Y., & Mesquita, B. (2018). Elements of the Complete Blood Count Associated with Cardiovascular Disease Incidence: Findings from the EPIC-NL Cohort Study. Scientific Reports, 8(1), doi: org/10.1038/s41598-018-21661-x
Samuels, M. H., Kolobova, I., Antosik, M., Niederhausen, M., Purnell, J., & Schuff, K. (2017). Thyroid Function Variation in the Normal Range, Energy Expenditure, and Body Composition in L-T4 Treated Subjects. Journal of Clinical Endocrinology & Metabolism, 102(7), 2533-42.
Soh, S., & Aw, T. (2019). Laboratory Testing in Thyroid Conditions – Pitfalls and Clinical Utility. Annals of Laboratory Medicine, 39(1), 3-14.
Dunphy, L.M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2019). Primary Care: The Art of Science of Advanced Practice Nursing (5th ed.). Philadelphia, PA: F.A Davis Company