Aplastic Anemia

a psychiatrist.ntroduction to aplastic anemia - anemia Aloblastaip

Disease is aplastic anemia or anemia Aloblastaip of the rare cases but it's very dangerous. And affect all ages. And occur as a result of bone marrow failure in the production of various blood cells.
Introduction to aplastic anemia - anemia Aloblastaip
Has blood on various types of blood cells: red blood cells, white blood cells, and platelets. And each type of cell has an important role for the human body. The red blood cells to carry oxygen, white blood cells attack any infection you enter the body, whether bacterial, viral or parasitic, and platelets help blood to clot in the case of the wound and bleeding.

In the case of aplastic anemia - anemia Aloblastaip bone marrow stops producing new blood cells and this means lack of oxygen reaching the body, and an increased risk of infection, as well as lack of control over the bleeding when it occurs.

There are several ways to treat such drug therapy, blood transfusions, and bone marrow transplant.

Causes of aplastic anemia - anemia Aloblastaip

Cavity contains many of the bones of the body on a red spongy material called bone marrow.
Causes of aplastic anemia - anemia Aloblastaip
And bone marrow has the function of the utmost importance it contains cells called stem cells that are the primary cells for the manufacture of other blood cells (red blood cells, white blood cells, platelets). Are the production of various blood cells in the bone marrow to enter the bloodstream.
Stem cells
Need bone marrow to produce constantly new blood cells to replace old cells. Every type of blood cell has a life and live and die beyond needs to be compensated rather than by new cells. For example, red blood cells live for 120 days, platelets 7 days, and most of the white blood cells live one day or less. In the normal case the bone marrow to provide the needed numbers of blood cells. In the case of aplastic anemia - anemia occurs Aloblastaip the destruction of the bone marrow, causing a shortage in blood cells that are produced.

And summarized the reasons for the destruction of the bone marrow in the following:

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      Exposure to high doses of radiation (during radiation therapy) or chemotherapy in cases of treatment of diseases of cancer. Treatment is chemotherapy or radiation to destroy the cancer cells and does not distinguish between them and the primary cells of the bone marrow shall also destroyed, causing anemia non Tensji - Aloblastaip anemia.
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      Exposure to toxic chemicals.
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      Use of certain medications such as certain drugs to treat rheumatoid arthritis and some types of antibiotics.
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      Imbalance in the immune system.
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      Genetic factors.
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      Unknown reasons. Sometimes the injury occur aplastic anemia - anemia Aloblastaip for unknown reasons and called the poorest non-blood Tensji - Aloblastaip anemia is not known why

Symptoms and diagnosis of aplastic anemia - anemia Aloblastaip

Produce aplastic anemia - anemia Aloblastaip from a lack of one or more of the blood cells. And anemia Aloblastaip occur either suddenly or gradually over weeks or months. And without treatment may develop the disease and life-threatening.

The symptoms include the following:

Decrease in the number of red blood cells leads to anemia, causing:

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      The general feeling tired.
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      Dizziness and headaches.
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      Shortness of breath when doing effort.
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      Rapid heartbeat. And due to that when there was a shortage of red blood cells increases the heart from pumping blood so that it can compensate for the lack of red blood cells and delivering oxygen to all parts of the body.
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      Pale skin color.
     

Decrease in the number of white blood cells leads to:

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      Recurrent infections, whether bacterial infection, viral or otherwise.
     

Low number of platelets leads to:

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      Bruising in any part of the body without any apparent reason.
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      Spots or small red granules under the skin.

      Symptoms of aplastic anemia


      Nosebleeds and bleeding gums.
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      Increase the duration of bleeding at a wound infection.

Diagnosis of aplastic anemia - anemia Aloblastaip
Are diagnosed with aplastic anemia - anemia Aloblastaip through:

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      Analysis of complete blood picture: Shows a severe shortage in the number of red blood cells, white, and platelets.

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      A sample of bone marrow:
  
      The doctor uses a thick needle to take a small sample of bone and bone marrow from the hipbone (groin), or any other large greatness in the body. This is done using local anesthetic. The doctor then pathologist examines the sample under the microscope, where a shortage in the number of blood cells than normal.

Treatment of aplastic anemia - anemia Aloblastaip

Severity of the disease ranging from aplastic anemia - anemia Aloblastaip the degree of simple, moderate, or severe (severe). In severe cases of the disease there is a severe shortage in the number of blood cells, which displays the patient's life at risk and need for admission to hospital immediately because the treatment in such cases, the bone marrow transplant. In simple cases of the disease or the medium you do not need to the hospital, and is treated in a blood transfusion and the use of medications.

The methods of treatment are as follows:

Transfusion

Most patients with non-Tensji anemia - anemia Aloblastaip frequent need to transport blood. Are the transfer of red blood cells or platelets or both depending on the status of the disease. And blood transfusion is not considered definitive cure of the disease, it is only offset the decrease in blood cells by bone marrow does not produced and thus controls the symptoms of those cells.

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      Red blood cells: the transfer of red blood cells leads to the high number of blood and thus disappear symptoms of anemia and fatigue suffered by the patient. And are selected donor blood group match with the patient's blood. And last cells in the blood of the patient transferred for one month or more.
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      Platelets: platelets are collected after separation of donated blood in a certain way is then given to the patient.
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      White blood cells: Due to the short life of white blood cells can be difficult to transfer to the patient. Therefore, the patient was an exhibition of infection is not easily found in the blood of white blood cells are sufficient to cope with any infection is exposed.

Inhibitor drugs for the immune system
In some cases, are discouraging the use of drugs for the immune system to treat because it may be the cause of anemia in non-Tensji - Aloblastaip anemia is a disorder of the immune system begins to attack the cells in the bone marrow. When you use these drugs inhibit the activity of the immune system does not affect the bone marrow and bone marrow begins producing new blood cells.

And an example of these drugs are anti-globulin for cells Iemusip -, cyclosporine. And are used next to corticosteroid drugs.

There are some drugs lead to stimulate and activate the bone marrow to produce new blood cells.

Bone marrow transplantation
Is replaced by the bone marrow of the patient bone marrow to another healthy person (donor). The bone marrow transplant is the only option in the successful cases of acute (severe) of disease, aplastic anemia - anemia Aloblastaip. And success rate of more than 50% of the cases where the donor is not a relative of the patient. And when the donor's relatives of the patient increases the chances of successful treatment Between all 5 cases, 4 cases are treated successfully.


When you find a suitable donor is the work of the necessary tests to him. Are exhausted and the patient's bone marrow using radiation or chemical drugs. Will then be taken from the donor bone marrow in a surgical procedure. After that you enter the bone marrow in the blood of the patient through a vein. Flies to the bone marrow cavities of bones and then begins to form new blood cells during 3-4 weeks.
Bone marrow transplantation
You need a bone marrow transplant to stay in the hospital for a long time with taking certain medications that prevent the body rejecting the bone marrow transferred to him.

Vocal cord dysfunction

Disorder and post vocal cords

Disorder and post vocal cords, which are commonly know paradoxical vocal fold movement, characterized by rounded abnormal folds during the respiratory cycle (especially during the inspiratory phase), this disorder results in obstruction to air flow at the level of the larynx.
May be treated in most cases without response to treatment - allergy was
And disorder and post vocal cords in most cases, like asthma, persistent and he has treated in most cases without response to treatment - allergy released - with high doses of corticosteroid inhaler or destruction, and bronchodilators, and through multiple visits to the emergency department, and admitted to hospital, and in some cases, the work of the cutdown tracheal (windpipe incision), and put a tube.
In some cases, the work of the cutdown tracheal (windpipe incision)


Born disease

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      During the session, the natural respiratory vocal cords diverge partly with air to breathe, and partially converge with the end of the exhale, and allow the movement of the vocal cords - without obstruction - the entry of air into the lungs and out of it. While maintaining Psahlkip alveoli of the lungs, through the provision of respiratory positive pressure during exhalation (end-expiratory pressure positive or, and it is the throat valve first airways to help keep the lungs in the case of expansion, and throat rich supply of the nervous system and help to do its job, and the Activation of striated muscle and under voluntary control and reflex regulates the size, as well as both the nerve cells of the larynx and motor neurons affects the size of the glottis, and are also influenced by the activity vagal reflex that originates from receptors to the lungs and throat.
      Picture speculum examination of the normal throat
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      Mechanism that causes the narrowing gap oboe or intermittent closure during inspiration independent of any changes in the measurement of respiratory tract lower is not known, and when the people affected by the post-ROMs folds stop accidental, leading to bouts of acute intermittent disability or obstruction career paths respiratory, and be signs and symptoms similar to those that are observed in disorders such as paralysis of vocal cords, and asthma, inflammation of the epiglottis and laryngeal spasm, and vascular Alodomp resulting from anaphylactic shock.
      Development of vocal cords in a patient function vocal cords Anthae inspiration
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      Described recent reports of some cases, other reasons for disorder vocal cords of the larynx, such as the entrance to a different area of the status attached to the mucosa of the upper part of the esophagus, and exposure to a substance like Algelotharaladhead, and inhalation of swimmers and divers of chlorine.
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      Disorder appears to function as part of the vocal cords strikes respiratory tract caused by exposure because of occupation or profession, which include exposure to the exciting stuff, and psychological stress, which occurs Kadtrapat transformative in some people.
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      Remember One theory is that the vagus nerve may alter the tension laryngeal and reduces the threshold level of the stimuli to occur contraction Balohbal audio, or deposition rounding non-natural folds, and what has been written on this subject suggests a greater emphasis to the causes of membership such as Gastro-oesophageal reflux, and reflux laryngopharyngeal and that's where the laryngeal pharynx is very sensitive to raise stomach acid.

Spread of the disease

These cases are about 10% of patients who are on the assessment of their cases as cases asthma popular and which do not respond to treatment, and reveals the literature on this subject for a disturbance vocal cords when people with cases of psychological (such as depression, and Obsessive Compulsive Disorder and Personality Disorder borderline, and neuroses resulting from sexual abuse in childhood), and people who have increased body mass index and staff medical professionals, and may be a disruption of the vocal cords asthma complications at a small number of patients.


Morbidity and mortality

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      Do not know the mortality rates.
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      Disorders occur due to use of corticosteroids for long periods such as the syndrome are similar to Cushing disease, and loss of bone density, and inhibition of growth in children.

Sex-related disease
Notes the existence of this disease primarily in women, where the ratio between the patients in this situation are 3 women for every man almost.


Age-related disease
These cases are prevalent in the age period 20-40 years, but it is possible to occur between the ages 6-83 years, and recent literature to suggest an increase among children and adolescents.


Symptoms

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      Burr.
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      Cough / cough.
      Feeling of tightness in the throat
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      Feeling of tightness in the throat.
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      The presence of hoarseness, changing voice.
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      Occurrence of stridor (high pitched voice).
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      Shortness of breath.
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      Shortness of breath with stress
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      Difficulty of inspiration.
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      Sudden bouts of shortness of breath.
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      Failure to respond to Extenders bronchi and corticosteroid preparations.

Tags
Hear the buzzing sound on the chest

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      Hear the sound of the larynx can reveal the existence of a chirping sound during the presence of symptoms.
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      Could be heard buzzing sound on the chest (which is narrated from the upper respiratory tract).

Reasons
Problems that accompany the disorder and the function of vocal cords include the following:

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      Gastro-oesophageal reflux and laryngopharyngeal reflux.
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       Inflammation of the upper respiratory tract (such as rhinitis, or sinusitis, viral infections or recurrent).
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      Violent exercise.
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      Inhalation exposure to the exciting stuff is accidental or exposure by virtue of employment.
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      Exposure to Mstorjat (what is causing the allergy) or environmental contaminants.
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      Psychological reasons of origin (such as severe stress).

Tests
Laboratory tests:

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      Count of eosinophils of white blood cells do not increase in cases of disorder and functions of vocal cords (which do not address the corticosteroid for extended periods), while more than in similar cases such as asthma, which increases when these cells by more than 5%.
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      Measurement of arterial blood gases be in the normal range in patients with vocal cords disorder, while showing hypoxemia in patients with asthma.

Radiology tests:

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      X-rays are normal, while showing excessive swelling of the lungs when the disease asthma.
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      Rays may be used to assess lung diseases, or diseases of the throat, or heart, which may explain, or support the symptoms suffered by the patient.

Other tests:

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      Measure supports the diagnosis of respiratory disorder vocal cords in patients who complain of symptoms.
      Spirometry
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      Plans breathing is the most that indicate that the distinction between disorder and post vocal cords and bronchial asthma, as it shows lack of flow of air inhalation in patients with disorder and post vocal cords, also shows a sudden drop and rise in the volume of air flow during the presence of symptoms and in the absence of a cough.
      Plans breathing
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      For patients whose physical activity is the catalyst for the disturbance and their function vocal cords, the physical activity staging a cause of heart
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      The work of skin sensitivity test may detect some cases of nasal allergies, asthma or allergic

Interventions

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      Work speculum examination of the larynx is the standard for the diagnosis of disorder and post vocal cords, where they are deliberately vocal cords in the abnormal convergence during inhalation.
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      Image shows the vocal cords during the examination of the telescope nearly two-thirds of the anterior vocal cords, also found a gap in the form of an urgent - in the back and the hole through which air flows during inspiration.

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      In the absence of symptoms during endoscopic examination of the patient may occur when the audio changes Balohbal work effort athlete, or increased breathing, or work a maximum inspiration followed by forced exhalation fast.

Treatment

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      Multidisciplinary treatment is effective when you need him, which includes treatment by a physician, and specialist treatment of pronunciation, and psychiatrist.
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      Speech therapy includes mainly training the patient to work relaxed the cords sound, and exercises for breathing, and in difficult cases this does treatment with psychological support associated with, and the role of the specialized treatment of pronunciation learning is impressive, and communicate through a treatment plan including the bands, with exercises suitable for breathing.
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      The role of psychotherapy is cognitive behavior therapy, or psychotherapy-General based on an assessment of psychological disorder, or personality disorder.
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      Recent studies show that psychological treatment for the disorder self-directed physical shape, and transformational disorders may increase the efficiency of treatment, when added to conventional therapy.
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      The patient is given a mixture of helium and oxygen, and the mixture is less dense than air, so it reduces the turbulence during inhalation, which is given the benefit of only the short term, but it can be helpful in emergency treatment for the disorder and the function of vocal cords.
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      Injection Sefan botulism symptoms of laryngeal released by disabling the start of acetylcholine, causing weakness of throat muscles, and facilitates the flow of air inhaled and exhaled.
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      Desperately cause relaxation of vocal cords and increase the converging of the glottis.
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      Put lotion topical laryngeal lidocaine, which reduces the contraction of muscles of the glottis and supraglottic.

Medical advice
The patient needs the advice of a specialist ear, nose and throat, and lung disease specialist, and a specialist allergy and immunology, and specialized treatment of pronunciation, and psychiatrist.


Food
There is no need to ban any type of foods.


Drugs
There is no specific drugs recommended giving it to the patient.


Follow-up
Is the follow-up the patient after discharge from the hospital, in order to determine a response to learning and speech therapy, and assess the extent of need for psychological care by a specialist.


Prevention
Prevention can be provided through the following guidelines for speech therapy, exercise, relaxation therapy, and other means


The fate of the disease
The fate of the disease is well with the response to speech therapy, which allows the patient to control the disorder.


Patient Education

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      The education of the patient through a variety of specialists, including a doctor, specialist speech therapy and a psychiatrist.