Licensed books on medicine
<< Ahead || Next >> |
ANEMIA UNDER CONDITIONS OF FUNCTIONAL AGASTRY (AGASTRAL ANEMIA)
In contrast to the actual agastric anemia associated with partial or complete anatomical removal of the stomach, we distinguish anemia that develops in conditions of functional agastria, when the anatomically preserved stomach partially or completely turns off from the physiological process of digestion and, in particular, loses the ability to assimilate the external antianemic factor - Vitamin B12.
As a manifestation of functional agastria, we consider the anemia of the pernicious type described by us and N. T. Larchenko in connection with the stricture of the esophagus and the subsequent operation of an antetoracic esophagojejunostomy without additional fistula between the stomach and the jejunum.
In all the cases described, anemia was observed in young girls aged 23-26 years, and in one patient there was a pronounced iron deficiency anemia with latent B12-deficiency, and in 2 patients - anemia of pernicious, B12-deficient type with a cyclically relapsing course.
Pathogenesis. Anemia of patients with artificial esophagus can be called "agastral". Of primary importance is the lesion of the gastric mucosa itself - corrosive gastritis (especially with deep burns with extensive lesions of the gastric mucosa and its slowed regeneration), and the turning off of the gastric digestive phase (“functional agastria”) due to passage of food through esophagio-ano-anastomosis, bypassing the stomach, adversely affects the absorption of iron and vitamin B12. At the same time, in the figurative expression of B. V. Petrovsky, the stomach works as if “idle”, since the juices that are released during the meal, to a large extent can not affect the food masses that enter directly into the jejunum.
The known period (3-5 years), which runs from the time of the operation of creating an artificial esophagus (with the stomach turned off) to the onset of the pernicious-anemic syndrome, is due to the existence in the body (more precisely, in the liver) of reserves of vitamin B12 and folic acid, which can provide for a long time processes of physiological blood formation.
Under these conditions, the implementation of the perniciously-aemic syndrome occurs either due to a deep caustic burn with extensive damage and subsequent atrophy of the gastric mucosa (including the fundus), or due to depletion of vitamin B12 and folic acid in the liver under conditions of functional agastria arising in connection with the operation of esophagojejunostomy, or as a result of exposure to additional factors, such as taking sulfonamides, violating the biosynthesis of folic acid in the intestine (as was the case with s sick).
Treatment. Agastric (agastral) B12-deficiency anemia is treated according to the same principles as the treatment of Addison pernicious anemia — Birmer (see above).
If there are signs of hyposiderosis (erythrocyte hypochromia, hyposideremia, presence of characteristic trophic disorders), combined therapy with vitamin B12 and iron preparations with ascorbic acid, preferably parenterally administered (fercoven) according to the rules of iron deficiency anemia, is prescribed (see above).
Indications for blood transfusion (erythrocyte mass) are the same as for pernicious anemia.
Prevention. Prevention of agastric anemia is timely — even before the onset of B12 symptoms — insufficient supply of vitamin B12 in injections of 100–200? 1-2 times a month, starting from the first months after surgery. Iron preparations are used according to indications (erythrocyte hypochromia, sideropenia).
| << Ahead || Next >> |
| = Go to tutorial content = |
ANEMIA UNDER CONDITIONS OF FUNCTIONAL AGASTRY (AGASTRAL ANEMIA)
- ANEMIA DUE TO TOXIC EXPOSURE OF THE BONE MARROW (MYETHOXICAL ANEMIA)
THYROORTHEUS ANEMIA Thyroid stimulation anemia is anemia that develops on the basis of hypothyroidism. Experimental work confirms the important role of thyroid hormone - thyroxin - in stimulating normal blood formation. Animals deprived of the thyroid gland, quickly anemiziruyutsya, the introduction of the same thyroid drugs to thyroidectomized animals cures them from the effects of thyroid-induced
- Anemia associated with impaired synthesis of DNA and RNA (megaloblastic anemia)
Megaloblastic anemia unites a group of acquired and hereditary anemias, a common feature of which is the presence of megaloblasts in the bone marrow. Regardless of the etiology of the patients, hyperchromic anemia with characteristic changes in the erythrocyte morphology is revealed - oval red blood cells, large (up to 12-14 microns or more). There are red blood cells with basophilic cytoplasm, in many of
- Anemia associated with impaired synthesis or utilization of porphyrins (sideroachrestic, sideroblastic anemia)
This is a heterogeneous group of diseases, hereditary and acquired, associated with a violation of the activity of enzymes involved in the synthesis of porphyrins and heme. The term "sideroahresticheskaya anemia" was introduced by Iewer (1957). In case of sideroachrestric anemia, serum iron levels are elevated. In the bone marrow detect ring-shaped sideroblasts - nucleated red blood cells with a nucleolus corolla,
- Anemia due to bone marrow drainage, hypothyroidism, and aplastic anemia. MYELOPLASTIC SYNDROME
Despite the large number of studies devoted to the study of hypo-and aplastic anemias, it is still not possible to create a rational classification of these conditions, since not only the issues of pathomorphogenesis, but even the definition of the very concept of "hypo (a) plastic anemia" is debatable. In accordance with modern concepts of the genesis of hypo-
- Anemia due to blood loss, post-hemorrhagic anemia
Anemia due to blood loss, post-haemorrhagic
- Anemia in blood loss and destruction of red blood cells
Post-hemorrhagic anemia. Restoration of plasma volume after acute blood loss causes a temporary dilution of blood and a decrease in the number of red blood cells. The first sign of red blood cell regeneration after hemorrhage is reticulocytosis, the level of which indicates the activity of hematopoiesis. Occasionally erythrocytes with nuclei are found in bone marrow punctates - the result of proliferation
- During pregnancy, childbirth and the postpartum period with anemia
Anemia complicates the course of pregnancy and childbirth, affects the development of the fetus. Even with latent iron deficiency, 59% of women have an unfavorable course of pregnancy and childbirth. Features of the course of pregnancy with anemia. 1. The threat of miscarriage (20–42%). 2. Early toxicosis (29%). 3. Gestosis (40%). 4. Arterial hypotension (40%). 5. Premature detachment
- EFFICACY OF EPREX AND ARANESP IN TREATING ANEMIA BY INDUCED CHEMOTHERAPY
Snegovoi A.V., Manzyuk L.V., Osmanova L.I. RCRC im.N.Blokhina RAMS, Moscow Objectives of the study: To evaluate the effectiveness of epoetins in anemia induced by chemotherapy. Materials and methods: Included 29 patients receiving chemotherapy for various malignant tumors. Severe anemia with baseline hemoglobin (Hb) levels below 8 g / dl was observed in 4 (14%), moderate
- What are the features of anesthesia for sickle cell anemia?
Conditions provoking the onset of hemoglobin desaturation must be avoided and adequate cardiac output must be maintained. Hypo-and hyperthermia, acidosis, shpoxemia (even minor), hypotension, and hypovolemia should be prevented from developing. compensatory mechanism is
- ACQUIRED HEMOLYTIC ANEMIA
Acquired hemolytic anemias include: • immune hemolytic anemia; • drug hemolytic anemia; • traumatic and microangiopathic hemolytic anemia; • anemia caused by hemolytic poisons, chemicals, bacterial toxins; • paroxysmal night
- FIRST MEDICAL HELP IN EMERGENCY CONDITIONS DUE TO DISEASES OR FUNCTIONAL DISORDERS
In the previous lecture, we examined the methods of first aid in case of emergency due to various injuries, and in this case due to diseases or functional disorders. Such urgent conditions include: life-threatening pathological conditions; pathological conditions that are not life threatening at the moment, but lack of timely
Anemia - a condition characterized by a decrease in hemoglobin per unit volume of blood by reducing its total amount in the body. In most cases, anemia is also accompanied by a decrease in the number of red blood cells per unit volume of blood. From true anemia should be distinguished hydremia - blood thinning due to tissue fluid. At the heart of the development of anemia are various pathological processes in
- ANTHERAL ANEMIA
The intestine, the organ of absorption of blood-forming factors (vitamin B12, folic acid and iron), plays an independent role in blood formation. We are referring to the synthesis of a number of “growth factors”, vitamins by intestinal microorganisms, of which the most important in the physiology of the blood system are folic acid and vitamin B12. Impaired intestinal absorption
- Lecture. Anemia Hemorrhagic syndrome, 2010
Post-hemorrhagic anemia. Iron deficiency anemia. Aplastic (hypoplastic) anemia. Hemolytic
- Dizerythropoietic anemia (due to impaired erythropoiesis)
This group of diseases includes: a) anemia, combined by a common mechanism of occurrence associated with impairment or termination of erythropoiesis as a result of a deficiency of substances necessary for normal blood formation - deficient anemia (B12 -, B6 -, B2 - folic acid, iron-copper cobalt-deficient, protein-deficient), as well as anemia, arising from the inability of the bone marrow
- Acquired hemolytic anemia
This is a heterogeneous group of hemolytic anemias that occur under the influence of a number of factors that have the ability to damage red blood cells and cause their premature destruction. Classification of acquired hemolytic anemia [Idelson LI, 1975] I. Hemolytic anemia associated with exposure to antibodies. 1. Isoimmune hemolytic anemia 1) hemolytic disease of the newborn
Anemia (anemia) is a condition characterized by a decrease in hemoglobin concentration in a unit blood volume below normal. Often, but not always, this decrease occurs while simultaneously reducing the total mass of red blood cells per unit volume of blood. Anemia develops when the rate of their reproduction in the bone marrow decreases due to the destruction or loss of red blood cells. Therefore, there are two large
- Deficient anemia
-Anamnesis: eating disorders, digestive disorders -sm anemia: pallor of the skin and mucous membranes, reducing the amount of hemoglobin and red blood cells -hyperplastic sm: an increase in the liver and spleen according to the severity of the disease -hemolytic cm: jaundice, splenomegaly, increase in indirect bilirubin in the blood - hemorrhagic sm is expressed only in severe forms - laboratory
- Hemolytic anemia
Hemolytic anemias make up an extensive group of anemic states of various etiologies, a common feature of which is the pathologically increased destruction of red blood cells. It is known that the average lifespan of erythrocytes does not exceed 100-120 days. Hemolytic anemia is characterized by shortening the life span of red blood cells. Hemolysis can occur intracellularly or