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Hypochromic Anaemias and Iron Overload. IN: Hoffbrand, A.V.; Moss, P.A.H.; Pettit, J.E. Essential Haematology. 5th ed. Williston, VT: Blackwell Publishing Inc. 2006. pp. 28-43.

This chapter on hypochromic anemias and iron overload is from a hematology textbook that offers a comprehensive look at the biochemical, physiological, and immunological processes involved in normal blood cell formation and function and the disturbances that may occur in different diseases. The authors discuss the nutritional and metabolic aspects of iron, iron deficiency, anemia associated with chronic disorders, sideroblastic anemia, and iron overload conditions. Specific topics include body iron distribution and transport, the regulation of ferritin and transferrin receptor 1 synthesis, hepcidin, dietary iron, iron absorption and iron requirements, the causes and clinical features of iron deficiency, diagnostic tests used to determine the cause of iron deficiency, oral and parenteral iron used to treat iron deficiency, and hemochromatosis. The chapter includes full-color illustrations and photographs. 15 figures. 10 tables. 18 references.

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ITP in Teens: Frequently Asked Questions. Potomac, MD: Platelet Disorder Support Association. 2007. 6 p.

Immune thrombocytopenic purpura (ITP) is a bleeding disorder caused when the body’s immune system destroys healthy blood platelets, mistaking them for disease-causing agents. This booklet provides information for adolescents newly diagnosed with ITP and their families. Written in a question-and-answer format, the booklet reviews the condition; the differences between acute and chronic forms of ITP; the physiology and role of platelets; normal platelet counts; the causes of ITP; symptoms; underlying disease; diagnostic tests that may be used to confirm ITP; treatment options; the side effects of treatments; the incidence of depression, fatigue, and mood problems in people with ITP; menstrual problems in girls with ITP; coping with curious friends and teachers; and where to meet other people with ITP and get more information. The treatments discussed include prednisone, intravenous gamma globulin (IVIG), and anti-Rho(D) immune globulin. For each treatment, the booklet explains the possible side effects. The booklet concludes with a brief description of the Platelet Disorder Support Association; readers are encouraged to join the organization and to consult its website at www.pdsa.org.

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Myelodysplastic Syndromes. White Plains, NY: Leukemia and Lymphoma Society. 2006. 33 p.

The term myelodysplastic syndromes (MDS) has been used since the late 1970s to describe a group of blood cancers. In MDS, blood cell counts are usually low, but the decrease in counts of red cells, white cells, and platelets may occur to different degrees. MDS subtypes can vary from those that are nonprogressive and have little effect on a person’s health to those that may result in anemia, other problems that require treatment, or serious effects on health and life expectancy. This booklet provides information about MDS for patients and their families. The booklet first describes the normal blood and marrow and then reviews the incidence, causes and risk factors, range of severity, and diagnosis of MDS. Disease subtypes are outlined, including the chronic or nonprogressive forms of MDS, progressive and symptomatic forms of MDS, how the disease normally progresses, and the use of the International Prognostic Scoring System. Additional sections cover determining need for treatment and treatment approaches, supportive care, lower-intensity therapy, higher intensity therapy, clinical trials, and the social and emotional aspects of MDS. The booklet includes a glossary of terms and a list of resources for more information, as well as the contact information for the Leukemia and Lymphoma Society. 1 figure. 2 tables. 13 references.

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Platelets, Blood Coagulation and Haemostasis. IN: Hoffbrand, A.V.; Moss, P.A.H.; Pettit, J.E. Essential Haematology. 5th ed. Williston, VT: Blackwell Publishing Inc. 2006. pp. 264-277.

An efficient and rapid mechanism for stopping bleeding from sites of blood vessel injury is necessary for survival. However, this mechanism must be balanced to prevent extensive clots from developing and to break down the clots once vascular damage is repaired. This chapter on platelets, blood coagulation, and hemostasis is from a hematology textbook that offers a comprehensive look at the biochemical, physiological, and immunological processes involved in normal blood cell formation and function and the disturbances that may occur in different diseases. The authors discuss the components of the hemostatic response, blood coagulation, fibrinolysis, the hemostatic response, and tests of hemostatic function. They stress that the normal hemostatic response to vascular damage depends on closely linked interactions between the blood vessel wall, circulating platelets, and blood coagulation factors. The authors conclude with a description of the tests of hemostatic function used to confirm diagnosis, including blood count and blood film examination, screening tests of blood coagulation, specific assays of coagulation factors, bleeding time, tests of platelet function, and testsof fibrinolysis. The chapter features full-color illustrations. 13 figures. 3 tables. 7 references.

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Acute Lymphocytic Leukemia. White Plains, NY: Leukemia and Lymphoma Society. 2005. 41 p.

Acute lymphocytic leukemia (ALL) is a type of blood cancer that starts with a change to a single cell in the bone marrow. This booklet provides information about ALL for patients and their families. The booklet first describes the normal blood, marrow, and lymphatic system and then outlines the symptoms and signs of ALL, which are common to many other illnesses. The booklet covers the causes and risk factors of ALL, subtypes of ALL, diagnostic approaches, treatment, side effects of treatment and how they can be managed, refractory leukemia, relapsed leukemia, patient care follow-up, clinical trials and how to participate in them, questions to ask the physician, and coping strategies and psychosocial issues for patients and families experiencing ALL. The booklet includes a glossary of terms and a list of resources for more information, as well as a description of the goals and activities of the Leukemia and Lymphoma Society. The booklet is illustrated with black-and-white photographs of a variety of patients. 4 figures. 3 tables. 17 references.

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Anemia. Nursing. 35(3): 35. March 2005.

Anemia is defined as not enough red blood cells in the blood. Red blood cells contain hemoglobin which helps carry oxygen throughout the body. This patient education fact sheet briefly explains the causes of anemia and its treatment. The text reviews the types of diagnostic tests that are conducted to determine the presence of anemia and notes the types of dietary additions that may prove helpful for readers with anemia (including liver, whole-grain breads and cereals, eggs, and dark green vegetables). The fact sheet includes a chart summarizing six types of anemia, and the cause and treatment of each. The types of anemia are: iron-deficiency anemia, vitamin B12 deficiency (also called pernicious anemia) anemia, folic acid deficiency anemia, lead-induced iron-deficiency anemia, acute blood loss anemia, and anemia of chronic disease. Treatment options outlined include diet changes, iron supplements, multivitamin supplements, rehydration, and erythropoietin.

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Chronic Lymphocytic Leukemia. White Plains, NY: Leukemia and Lymphoma Society. 2005. 37 p.

Chronic lymphocytic leukemia (CLL) is a type of blood cancer that starts with a change to a single cell in the bone marrow. This booklet provides information about CLL for patients and their families. The booklet first describes normal blood and marrow and then provides a description of CLL and its treatment. Topics include the lymphatic system, leukemia, CLL, the causes and risk factors of CLL, symptoms and signs, diagnostic approaches used to confirm the disease, the natural course of the disease, determining disease stage, chemotherapy, stem cell transplantation, monoclonal antibody therapy, complications and how they are treated, other related lymphocytic leukemias, the differences between lymphoma and lymphocytic leukemia, questions to ask the physician, and coping strategies and psychosocial issues for patients and families experiencing CLL. The booklet includes a glossary of terms and a list of resources for more information, as well as a description of the goals and activities of the Leukemia and Lymphoma Society. The booklet is illustrated with black-and-white photographs of a variety of patients. 4 figures. 3 tables. 13 references.

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Chronic Myelogenous Leukemia. White Plains, NY: Leukemia and Lymphoma Society. 2005. 45 p.

Chronic myelogenous leukemia (CML) results from an acquired change to the DNA of a stem cell in the bone marrow. The change in the stem cell’s DNA gives the malignant cell a growth and survival advantage over the normal stem cell. This booklet provides information about CML for patients and their families. The booklet describes the normal blood, marrow, and lymphatic system and then outlines the symptoms and signs of CML. The booklet covers the causes and risk factors of CML, diagnostic approaches, the three phases of CML, treatment, side effects of treatment and how they can be managed, other related disorders, clinical trials and how to participate in them, questions to ask the physician, and coping strategies and psychosocial issues for patients and families experiencing CML. The booklet includes a glossary of terms and a list of resources for more information, as well as a description of the goals and activities of the Leukemia and Lymphoma Society. The booklet is illustrated with black-and-white photographs of a variety of patients. 6 figures. 1 table. 18 references.

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How to Interpret and Pursue an Abnormal Complete Blood Cell Count in Adults. Mayo Clinic Proceedings. 80(7): 923-936. July 2005.

A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. This article provides practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities. These conditions include anemia (decreased hemoglobin, the oxygen-carrying compound of the blood), thrombocytopenia (decreased platelets in the blood), leukopenia (decreased white blood cells), polycythemia (increased erythrocytes, which are the red blood cells), thrombocytosis (increased platelets in the blood), and leukocytosis (increased white blood cells). The objective is to help the nonhematologist recognize when a subspecialty consultation is reasonable and when it may be foregone, thus allowing a cost-effective and intellectually rewarding practice. The authors conclude that, in general, it is prudent to perform a PBS (peripheral blood smear) in most instances of abnormal CBC, along with basic tests that are dictated by the type of CBC abnormalities encountered. The latter may include, for example, serum ferritin in patients with microcytic anemia or lymphocyte immunophenotyping by flow cytometry in patients with lymphocytosis. However, a prompt hematology consultation is encouraged in patients with severe cytopenia, pancytopenia, or extreme cytosis of any type or when a PBS report suggests thrombotic thrombocytopenic purpura (TTP) or acute leukemia. 6 figures. 4 tables. 114 references.

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Iron Overload in Patients with Bone Marrow Disease. Annapolis, MD: Aplastic Anemia and MDS International Foundation, Inc. 2005. 2 p.

This fact sheet discusses the problem of iron overload in patients with bone marrow disease. Those who develop iron overload from transfusions are dependent on red blood cell transfusions and most need ongoing transfusions due to lack of adequate blood production. Iron can be removed from the body by drugs called chelators, which have the ability to bind with the iron. The drug approved in the United States for this purpose is called deferoxamine, which is given intravenously or subcutaneously. The author reviews the diagnostic tests that monitor the body’s iron stores, discusses the administration and dosage of deferoxamine, and briefly mentions the development of new oral agents under evaluation for use in patients with transfusional iron overload. Readers are encouraged to contact the Aplastic Anemia and MDS International Foundation, an organization that fights bone marrow diseases through patient support and research, for more information.

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