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- What is amniocentesis
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- What is a urine test and when
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What is amniocentesisIn this pregnancy test, a small amount of amniotic fluid is removed to study possible fetal disorders.
Amniocentesis is a diagnostic test that is performed during the pregnancy and in which a small amount of amniotic fluid is extracted in order to study possible fetal disorders.
Amniotic fluid surrounding the fetus and protects you. It is located within the amniotic sac, which is a bag that is in turn inside the uterine cavity. Amniotic fluid contains fetal cells and chemicals produced by the fetus that are that are studied after the completion of this test.
This liquid is obtained through a small puncture with a thin needle that is inserted through the abdominal wall and uterus. While the puncture is performed an ultrasound properly guide the direction of the needle to remove fluid from the right place.
When do an amniocentesis?The main indications of the amniocentesis are as follows:
· The study of malformations or genetic disease in the fetus, as for example Trisomy of chromosome 21 or Down's syndrome. Usually indicated when tests for screening of malformations that occur during pregnancy yield abnormal results. You can also indicate when any member of the couple is a carrier of a genetic defect or when there is a history of chromosomal alterations or fetal malformations, such as spina bifida, in previous pregnancies. It is usually done between weeks 15 and 18 of pregnancy.
· Used to determine if a fetus lungs are mature enough as for can be born safely. This may be indicated if they are considering ending pregnancy before time for risk to the mother or the fetus. This type of amniocentesis is performed between 32 and 36 week. Before the 32nd week it is likely that the lungs of the fetus are still immature.
· It serves to diagnose intrauterine infection.
· Determine the sex of the fetus.
· You can know the Rh factor of the baby and to assess the severity of anemia in the fetus in case of Rh incompatibility with the mother.
· You can use as a treatment to reduce the amount of amniotic fluid in cases in which there is fluid too much (polyhydramnios).
Preparation for amniocentesisThese are the issues that you must consider when you undergo an amniocentesis test:
Duration: an amniocentesis usually lasts about 15-20 minutes, although most of the time is dedicated to ultrasound guiding the puncture, which lasts less than two minutes.
Entry: the test is done on an outpatient basis, and the patient can go home the same day after its completion.
Is necessary to be accompanied?: don't have to be accompanied by although it might help if it makes you feel more relaxed.
Drugs: don't need to take any medication prior to this test. You can take your usual medication. If you put the anticoagulant medication (such as heparin) it should be noted it to your doctor.
Food: don't have to go on fasting. Nor do we need to go with a full bladder, as it is done for the Gynecologic ultrasound, because the amniotic fluid itself already allows ultrasound to look good.
Clothing: can wear the clothes you want.
Documents: prior to amniocentesis physician will explain the test to you and will provide you with an information sheet (informed consent) which must be signed and which details the procedure and potential associated side effects. Please read this document carefully and ask the doctor questions as it considers necessary before fimarlo.
Contraindications: there are some pathologies of the mother as chronic (such as HIV or hepatitis C) infections, clotting problems or pregnancy complications that may contraindicate the realization of the test. Refer to your doctor all of their prior history.
Pregnancy and lactation: this test is carried out on pregnant women.
Other considerations: before the test, can take you a blood sample to determine the Rh factor in blood. If you are Rh negative they can put a vaccine to prevent problems by Rh incompatibility between his blood and that of the fetus. Since the test has a small risk of complications, consult your doctor the possibility of performing alternative diagnostic tests or failure to perform the test if it will not change the attitude to pregnancy.
Procedure: how an amniocentesisDuring amniocentesis the patient lies down on a table face up.
He gets a special gel in the abdomen that facilitates the realization of an ultrasound that will locate the amniotic fluid.
Apply an antiseptic substance in the puncture area.
You can put any anesthetic in the puncture area substance although not always done, because the needle is very thin and is hardly noticeable.
In the abdomen puncture guided by ultrasound is made and extracted a small amount of amniotic fluid with a syringe. The amount of fluid being removed depends on the reason for the test.
After removing the fluid, the needle is removed and gets a small dressing in the puncture area.
After amniocentesisAfter the test, is recommended rest and avoid physical exertion such as lifting objects. Usually a next day already can be a normal life.
You may have some mild abdominal discomfort after amniocentesis. If after the test, you experience abdominal pains like cramping, leakage by the vagina, vaginal bleeding, fever or any discomfort that preoccupied him consult quickly a doctor.
The small amount of fluid removed is replaced naturally fast.
Complications or side effects of the amniocentesisAmniocentesis is a very safe technique. You can see a slight pain at the point of puncture and some abdominal discomfort when the needle passes through the uterus.
The major complication of amniocentesis is the risk of miscarriage. If done during the second quarter, it is estimated that abortion occurs in 1 of every 300-500 amniocentesis.
Very rarely, if the fetus is moved during the test sufir can a prick while the needle is getting. Serious puncture the fetus are extremely rare.
It is also uncommon to happen leakage of amniotic fluid from the vagina, which usually resolve spontaneously.
If the mother is Rh negative and the fetus is RH-positive problems could be generated by the lack of compatibility Rh are prevented with the administration of a vaccine.
The risk of uterine infection is very low.
Possible transmission of infection from mother to the fetus such as HIV or hepatitis C. Therefore in case of chronic infections in the mother, amniocentesis is contraindicated.
Results of an amniocentesisThe results of the test genetic tend to be available in a week or two. The results of the amniocentesis performed to determine fetal maturity of the foetus are available within a few hours.
The results of the test studying genetic defects or malformations are reliable, though not at 100% and also not diagnosed all genetic diseases or possible malformations.
If an abnormality in the fetus is detected your doctor will help you decide on the future of the pregnancy in those difficult moments or the following care.
What is the analysis of fecesIt is a simple and cheap test that can detect diseases throughout the digestive tract and associated glands.
Analysis of feces is a diagnostic test that is used in medicine for the study of the digestive disorders primarily. It consists of collecting a small amount of stool for later analysis in the laboratory. More frequent studies carried out on the stool are:
Physical study: value consistency, density, color and odor of feces.
Biochemical study: discusses the components that make up the stool. It should bear in mind that in normal stools are 70% water, and the remaining 30% are other components such as fats, proteins, bacteria and fibers, which cannot be Digest.
Van Kamer test: is a specific test to measure the amount of fat in the stool with more accuracy than a biochemical study. They are needed to collect several samples of stool.
Detection of enzymes: mainly explores the presence of pancreatic enzymes in the feces, which are essential for digestion.
Blood hidden in feces: allows to detect the presence of small amounts of blood mixed with the stool. Currently it is recommended that over the age of 50 have this test every year as an aid to diagnose colon cancer (although for this type of cancer early diagnosis the most effective test colonoscopy), and can also serve to detect unknown tumors. In some countries sold paper strips in pharmacies.
Cool review: consists of diluting the feces and observe them directly under the microscope. It allows to detect parasites and their eggs, and other large items.
Stool culture: in the same way that you can isolate microorganisms in the blood by a blood culture, or in the urine by a urine culture, stool can be a stool culture to isolate pathogens.
When doing an analysis of fecesIt analysis of feces is a test that is used with some frequency in medicine because it involves no big hassle do it, it is cheap, and it can provide much useful information. However, the information provided is limited to the digestive tract and glands associated mainly, why only asks when she is suspect alterations to these levels that can not be studied through a blood test or urine test, which are more comfortable to pick up.
Diseases in which most requested an analysis of stool are:
Inflammatory bowel disease: ulcerative colitis or Crohn's disease.
Intestinal malabsorption: from a celiac disease until a Whipple's disease. There are dozens of other causes.
Pancreatic insufficiency: when the pancreas secretes not enzymes needed for digestion.
Cancer in the digestive tract: may lead us to that diagnosis, although it is usually too late stage.
Infections: such as salmonellosis, giardiasis, amebiasis, etc.
Preparation for an analysis of fecesIf you are performing a basic analysis of feces , these are issues that you must take into account:
Duration: takes very little time. You can make the stool sample collection at home. Lee any time can be collected, and it should be avoided that they mix with the urine. Then, you will only have to dispose of it at the doctor's surgery in less than 24 hours.
Entry: admission is never needed. It is a test that can be done on an outpatient basis.
Is necessary to be accompanied?: no.
Drugs: is not necessary to take any prior medication. I must say your doctor all medications you are taking at that time, because some medications can alter the normal characteristics of the stool. Many of them are easy to relate (laxatives, for example), but others may go unnoticed (e.g., herbal products or slimming).
Food: you must maintain your normal diet and feces collect at any time. Avoid changing your dietary habits with especially fatty meals or much more fiber than you soles to take.
Clothing: you don't need special clothes or to collect the sample or to deliver it.
Documents: is advisable to carry your health insurance card and the wheel of proof when you go to deliver the sample.
Pregnancy and lactation: can be the test without modifying any attitude, although it is better that the doctor knows you are pregnant, because Lee may be slightly different.
Contraindications: there are no contraindications. Recommended not to perform sample collection when you have menstruation.
How an analysis of fecesWhen you get to the consultation the doctor will make you some general questions about your state of health: important diseases, risk factors, lifestyle, place of work and, above all, insist on the gastrointestinal symptoms that you have appreciated. You will ask for the number of bowel movements per day, its consistency and colour.
Other questions that can make you is if you have a fever or you've lost much weight in recent months. After perform you a general physical examination, and assess an analysis of feces. It will give you a flyer which requested the test and where designated data wanting tested in the laboratory.
Days after this first visit, or at the same time, can collect the sample and take her to the clinic. You will need a sterile pot that will give you at the doctor or have to buy at the pharmacy.
When you go to pick up sample is recommended to have your year and perineum clean to avoid contamination, and is better that not touches the edges of the pot or come into contact with anything. The sample collected must have the size of a chestnut it is solid stool, or approximately 10 mL if they are liquid. If you are older, you can gases that produce the bacteria to push the boat and ruptures.
When you are done collecting the specimen close the pot carefully but firmly so it is airtight. Leave the pot in the refrigerator and take him to the clinic in the next 24 hours. If you leave the boat for many hours at home can be contaminated with microbes or lose substances useful for analysis. When you reach the consultation only, you may deliver it and you can go. The results can take anywhere from hours to days, and will give them to you in the doctor.
Complications of the analysis of fecesThere are no complications of the analysis of feces.
Results of the analysis of fecesThe results of the analysis of feces can include the following parameters:
Composition: detected alterations in the percentage of the components of feces. The percentages are not exact and vary with the ease of a sample to another.
· Proteins: 2-3%. The greater presence of proteins in the stool can be associated with diet or a poor digestion of proteins. Is it related to constipation.
· FAT: 10-20%. When the fat percentage exceeds 20% can speak of steatorrhea. It is a maldigestion or malabsorption of fats in the digestive tract. It is associated with diarrhea.
· Minerals: 10-20%. They do not have much importance in the study of feces. Malabsorption of them is best studied in blood tests.
· Indigestible remains 30% (fiber). It depends directly on the diet, it has no importance in any disease.
· 30% bacteria. The percentage tends to be fairly stable. The most important are the characteristics of those microorganisms that are studied with a stool culture.
Detection of enzymes: enzymes that act in the digestive tract are secreted by the stomach and pancreas mainly. There are also others who act own intestinal wall, but are fixed and not can be studied on a stool test. The most important are:
· Peptidase: secreted in the stomach, digested peptides. Don't usually study at Lee.
· Lipase: secreted by the pancreas, digests lipids.
· Tryptase: secreted in the pancreas, it digests certain proteins.
· Elastase: also secreted in the pancreas, digested elastic proteins.
The study of these enzymes is simply to detect their presence or not. When they are not it may be due to exocrine pancreatic insufficiency (which is related to chronic pancreatitis) or a blockage of the lower bile duct (by gallstones, for example).
Fresh test: with direct visualization of Lee dissolved in the serum can separate the larger Lees elements and observe the following structures:
· Fibers: what is more, his presence is normal.
· Parasites: it is easy to see amoebas or giardia when they are invading the gastrointestinal tract.
· Cysts: usually both the giardia and amoebas are seen in form of cyst in this type of examination. So it can withstand the passage through the year.
· Eggs: some parasites are too big and not come out for the year, but their eggs do. Is the case of pinworms type ascaris, Strongyloides, etc.
Stool: you can study the different strains of bacteria that are present in the feces. It is usual to find bacteria Diners of the large intestine, but in situations of infection pathogens such as salmonella or Shigella aggressive are observed.
What is a urine test and whenAnalyze a sample urine help to diagnose disease systemic, autoimmune, kidney or urinary tract infections.
Analysis of urineThe urine test is a diagnostic test that is used most often in medicine and consists of collecting a small amount of urine for later analysis in the laboratory. Thank you she can get information that helps in the diagnosis of pathologies regular or urgent.
Types of urine analysis according to the method of collection, although in essence they consist of the same type of study can be divided:
Basic urine test: collect urine at the urinated in a boat, avoiding the first jet of urine and last to avoid contamination from germs. It is the most frequent urine collection type.
24-hour urine test: is to collect all urine that is expelled in a day on a boat. It serves to calculate substances appearing sparingly in the urine.
Analysis of urine with probe: it's collecting urine through a tube that passes through the urethra and the bladder reaches. Many times it is made this way because the patient is already probed, but others choose to this technique because this results in urine without contamination from the bladder directly.
Multiple studies can be performed within urine test: Test Strip, sediment from urine, physico-chemical analysis or microbiological analysis. In the section on results we will see in what consist and what indicate data that we provide.
When a urine test is doneThe urine test is a test that is very frequently used in medicine because it involves no great inconvenience to do so, is very inexpensive and can provide lots of useful information. Why it calls routine to detect many diseases in early stages or control their treatment.
Diseases that more calls for a urine test are those that affect the kidney (Glomerulonephritis, urinary calculi, etc.). But it also calls in systemic diseases such as diabetes mellitus or autoimmune diseases (rheumatoid arthritis, lupus...). It is useful, in addition, in the detection of urine infections, whether mild or severe infections (cystitis or pyelonephritis complicated).
Preparation for urinalysisIf you are performing a basic urinalysis these are issues you must keep in mind to go well prepared to test:
Duration: lasts a very short time. You can make the urine sample collection at home. Preferred urine first thing in the morning and avoid the first jet to the urination. Then you will only have to dispose of it at the doctor.
Admission: admission is never needed. It is a test that can be done on an outpatient basis.
Is it necessary to be accompanied?: no.
Drugs: don't need to take any medication prior to the urine test. Although we must say to the doctor all medications you are taking at that time. Some drugs can alter the normal characteristics of the urine. Many of them are easy to relate (diuretics, for example), but others may go unnoticed (e.g. antibiotics).
Food: usually calls for the urine sample is collected after an eight-hour fast. I.e. simply collect urine first thing in the morning having dined early and light the night before.
Clothes: you don't need special clothes or to collect the sample or to deliver it.
Documents: it is advisable to carry your health insurance card and the wheel of proof when you go to give the sample of urine.
Pregnancy and breast-feeding: the test can be taken without modifying any attitude. It is better that the doctor knows you are pregnant because the urine may be slightly different.
Contraindications: there are no contraindications for this test.
How a urine testWhen you get to the consultation the doctor will make you some general questions about your state of health: important diseases, risk factors, lifestyle, work place and mostly insist on Voiding or urinary symptoms. After perform you a general physical examination, and assess the realization of a urine test. It will give you a flyer which asks the test and designated data wanting tested in the laboratory.
Days after this first visit, or at the same time, can collect the sample and take her to the clinic. You will need a sterile rubber boat that will give you at the doctor or have to buy at the pharmacy. When you go to collect the sample it is recommended to keep your private parts clean to avoid contamination, and is better do not touch the edges of the pot with nothing. It seeks to collect the urine in the first hour of the morning, it will be more concentrated and is most useful for analysis. The first jet of urine to the urination is better not pick it up because it is normal that it is contaminated with bacteria from the urinary tract.
When you are done collecting the specimen close the pot carefully. Recalls that you for enough analysis with low volume of urine, it does not need to fill it to the maximum. Leave the boat at room temperature, but take it to the clinic in the next hours. If you leave the boat for many hours outdoors can contaminate of microbes or lose substances useful for analysis.
When you reach the consultation only, you may deliver it and you can go. The results can take anywhere from hours to days and will give them to you in the doctor.
There are no complications when done a urine test.
Results of the analysis of urineMultiple studies can be performed in the analysis of urine. So when the doctor gives us urine results there are many numerical data accompanied by names and acronyms which are difficult to understand. The tests most commonly used are:
• Test strip: is immersed a strip of paper with reagents and chemicals that react with certain substances that can be in the urine. It is the same method that is used to test for pregnancy.
• Urine sediment: there are solid components dissolved in the urine. To study them, centrifuged urine and solids remain in the background. They are then studied under a microscope.
• Physico-chemical analysis: consists in the study of certain physical properties of the urine (such as density) and the chemical constituents that therein (ions, glucose, etc).
• Microbiological analysis: If an infection is suspected can be searched directly bacteria in the urine. When the doctor any other diagnostic test called urine culture you may consider necessary.
Then we will see in more detail how to decrypt the results that provide us with each of these specific studies of the urine.
Reagent StripThis method, the test strip, is the same that is used to confirm the existence of a pregnancy. It consists of a strip of paper impregnated with reagents and chemicals that enters the urine and throws us to the following possible data and results:
pHIt is the measure that is used to measure the acidity of the urine. One pH less than 7 is considered low and therefore acid, one pH greater than 7 is considered high and indicates that the substance is Basic. Urine normally has a pH that ranges between 4.5 and 7.5, i.e., it is slightly acid.
less than 4.5 pH: indicates that there is an excess of acidic substances in the body and that they are throwing out. This usually happens in severe infections or diabetes mellitus not controlled.
pH greater than 7.5: mainly happens when the kidneys are not able to eliminate acidic blood substances, so they accumulate and produce metabolic alterations. This happens in renal failure.
Ketone bodiesWhen the human body cannot produce energy through glucose and other sugars begins to burn fatty acids in an uncontrolled manner. This leads to the production of substances called ketones, which appear in lengthy fasts and diabetes Decompensated. Normal is that the urine does not exist, and when there is an altered sample. Its seriousness and importance according to the concentration of ketones is classified:
- Minor: 20 mg/dL.
- Moderate: 30 - 40 mg/dL.
- Grave: 80 mg/dL.
NitritesThere are waste substances whose main component is (e.g., urea) nitrogen in urine. When there are bacteria in the urine, by an infection, they can use those compounds to feed, so they transform nitrates into nitrites. Therefore the presence of nitrites in the urine geared towards an active infection.
HCGThe human chorionic gonadotropin (HCG) is a hormone whose presence in the urine is used to make the diagnosis of pregnancy. It appears in the blood in the first weeks of pregnancy since it is synthesized by the placenta. It has effects on various organs of the body and its function is to prepare the body of the woman for pregnancy.
Urinary sedimentIn the laboratory it can centrifuge urine sample, leaving solid sediments at the bottom that after study under a microscope they provide us these data, whose presence or alterations may indicate various medical problems:
ProteinsUsually proteins do not appear in urine because they are molecules too large to filter in the kidney. If they appear we can divide this finding:
Hyaline protein: can be considered normal the appearance of hyaline protein in moderate amount. This type of protein synthesizes them own kidney and do not indicate disease. When appear in excess may be due to a global damage of the kidney (a tubular necrosis acute, for example).
Microalbuminuria: the presence of albumin in the urine is always pathologic. When they are between 30 - 300 mg/dL is considered that there is a slight kidney damage. It is a very important fact in diabetes mellitus, and is a must start with medical treatment to correct this alteration. The presence of microalbuminuria is a vicious circle, because it damages the kidney itself.
Proteinuria: 300 mg/dL over talk about Frank proteinuria. Kidney damage is severe and sometimes treatment can only slow the disease. It sometimes occurs in the context of specific diseases that disappear in time, such as nephrotic syndrome.
Red blood cellsThe presence of red blood cells or red blood cells in the urine indicates that something not going well. Red blood cells are cells large enough to pass through the filter of the kidney in health conditions. They point to damage in the kidney (nephritic syndrome, for example) or in the urinary tract (spreadsheet that damaged the wall of ureters, or bladder tumors, for example). We can divide this finding:
- Microhematuria: when the urine is to simple view is not tinged with blood, but to see it under a microscope red blood cells are observed floating indicating a slight bleeding.
- Macrohematuria: in this case the urine is now tinged with blood and you can see even as is urine. When bleeding is not very abundant said that urine comes out in 'water washing meat', i.e. with dirty and reddish appearance.
- Urinary tract hemorrhage: bleeding through the urinary tract is so that it does not seem to urine. Under the microscope are observed as many cells as in a direct blood sample.
White blood cellsThe presence of leukocytes or white blood cells in the urine is always pathologic. The most frequent is to indicate that white blood cells of our immune system going into the urinary tract to resolve an infection. They can be also seen in renal, colic because impacted stone produces a local inflammation.
EosinophilsInside white blood cells, there is a special group called eosinophils. These cells are activated to allergic pictures or parasites. Its presence in the urine geared towards a picture of these features (for example, interstitial nephritis by an allergy to drugs).
BacteriaIt is normal to find some bacteria in the urine in isolation, most by contamination of the collected urine sample. A Gram stain, which consists of stained bacteria for observing them under the microscope and try to determine its origin must be in the presence of bacteria in the urine. If it is believed that bacteria may be causing an infection, a urine culture should be done to see which species is in particular.
CrystalsThere are substances dissolved into particles in urine. Sometimes these particles precipitate and form larger crystals that can be observed in the microscope. Some of these crystals appear naturally in the urine, others point to alterations of the kidney or the composition of urine. PH plays a fundamental role for the prevention of the formation of this type of crystals. The most common crystals are:
- Uric acid: hyperuricemia is cause frequent of crystals in the urine, often accompanied by drop.
- Cystine: the presence of these crystals is called Cystinuria, and it may be the first symptom of alterations in the metabolism of amino acids.
- Calcium oxalate: along with calcium phosphate with the two types of crystals in which calcium has a major role. Artichokes favour the emergence of these crystals, which in principle do not indicate abnormalities of the urinary system.
Physico-chemical analysis of urineThe detailed analysis of some physical properties of (volume, density, colour, appearance, smell) urine and chemical components containing allows you to diagnose some illnesses:
Color and appearanceAlthough it may seem too simple, direct urine sample display can give valuable information for diagnosis and also to guide the laboratory analysis. The color indicates which type of substances may also be dissolved in the urine, the most characteristic are:
· Color wine, cognac or cocacola: indicates the presence of bilirubin in excess in the urine.
· Pink flashing: indicates the presence of moderate bleeding, "water washing meat".
· Orange: appears when certain drugs are taken as rifampicin.
· Whitish: indicates presence of pus in the urine, pyuria is called.
GlucoseThe normal range of glucose in urine is 0-0, 8 mmol/L (0 - 15 mg/dL). I.e., typically don't have glucose in the urine or have very little. Glucose is very small and if filters in the kidney, but then reabsorbs nearly everything because it is a basic element for obtaining energy by our body. The presence of glucose in urine means that the amount of blood sugar is so high that kidney can not absorb everything and eliminates it. This occurs mainly in diabetes mellitus.
Bilirubin and urobilinogenoBilirubin and urobilinogen are synthesized in the liver and hence most passed to the digestive tract, although a small percentage of conjugated bilirubin passes into the blood and is removed by the kidneys. It is responsible for the yellowish color of the urine. When, for some reason, bilirubin cannot be deleted into the digestive tract (for example, a gallstone) the amount that passes into the blood is greater and urine stains from a more intense, even brown color.
DensityThe urine density is mass per unit volume that. Their normal values are between 1000-1030. It is an indirect way of measuring the concentration of particles that are dissolved.
- Less than 1000: means that the urine is very dilute and concentration of particles is very low. It happens when the kidney removes more water than normal, as when we take diuretics, we are suffering from diabetes mellitus or diabetes insipidus.
- More than 1030: urine has many concentrated substances. It often occurs in situations of dehydration, when the kidney reabsorbs water and urine appears more concentrated.
OsmolalityIt is a more accurate way of measuring the concentration of solutes in the urine. Normal values vary from 50-1200 mOsm/kg. It is really useful when we carry out comparative analyses in time after changes in water intake. I.e., if we are for a few hours without drinking water, the kidney should absorb it, urine would be more concentrated and its higher osmolality. On the contrary, if we drink a lot of water in a short space of time, kidney does not absorb water, the urine would be more diluted and its lower osmolality.
SodiumSodium is found naturally in the urine, it is indeed the most important element in all organic secretions. Normal values are 40-220 mEq/L/day. Retention by the kidney, and therefore water regulation of body hydration, uses it sodium is a mineral that captures water.
- Less than 40: kidney is re-absorbing sodium (and thus water) and therefore appears diminished in the urine. It happens in situations of dehydration, but also diseases like heart failure where the mechanism of water retention is altered.
- More than 220: the kidney removes sodium and there is too much in the urine. The most frequent cause is the treatment with diuretics.
What is the PSA (Prostate-Specific Antigen)This test measures the concentration of PSA molecules in the blood so it is a good marker for prostate cancer.
The PSA testPSA is an acronym that is known to the specific antigen of the prostate (Prostate-Specific Antigen). The prostate is a gland that exists only in the male and which embraces the urethra below the bladder. It is responsible for producing many substances, many of them necessary for the production of semen. These substances include the PSA, which is a molecule that can be measured in the blood, thus determining their concentration.
PSA production depends mainly on the amount of male sex hormones and the size of the gland. PSA levels in the blood are usually very low, are considered normal levels of 4 ng/mL. There are situations in which PSA can increase in blood, such as exercise or ejaculation. Also undergo a digital rectal examination, a biopsy of prostate or the fact of having taken a urinary catheter.
What is a PSA testThe reason that the PSA is best known is as a good marker for prostate cancer. When it appears a tumor in the prostate PSA production goes awry and increases its concentration in blood. It is considered a PSA suspicious if it is higher than 10 ng/mL. When PSA is between 4 and 10 ng/mL is recommended to study why which is high, without being so strong the suspicion of prostate cancer. The PSA test also serves to detect other diseases of the prostate such as benign prostate hyperplasia or infection of the prostate gland (prostatitis).
For years it has been thought that PSA could be a good method of early detection of prostate cancer in the general population. After many studies and experience, it can be concluded that PSA is not useful for detecting prostate cancer in patients who have no symptoms that make suspected prostate pathology. Ultimately there are cases of cancer of prostate PSA elevation and, above all, many of the cases that have elevated PSA do so for other reasons and undergo a prostate biopsy unnecessarily. In addition, prostate cancer is a disease that does not need treatment in early stages, and his diagnosis only increases the anxiety in the person suffering.
Therefore, the analysis of prostate should be performed only when the doctor sees it, it will be when your results to determine a diagnosis and specific treatment.
The PSA test It is a test of easy preparation and little aggressive, it's a simple blood test. Its results should be interpreted with caution. Test which is still today the most useful for detecting prostate cancer early is to perform a digital rectal examination annually from 50 years of age.
When doing a PSA testA single PSA (prostate specific antigen) test is recommended to the following persons and in the following circumstances:
Suspicious rectal: with rectal can feel the prostate, see its volume and consistency. When the prostate is too hard can be a test of the PSA last time to see their levels in blood.
Urinary symptoms: people who suffer from prostate may have symptoms when they urinate. Normally it costs them more time urination, tends to be choppy and at the end of may have leakage of urine for a while.
Screening for prostate cancer in over 50 years: today make a PSA for the diagnosis of prostate cancer is a recommendation that has been proven useless. In addition, it is normal that with age the PSA levels increase, since the prostate grow in size.
Staging of prostate cancer: after a biopsy that there is a prostate tumor is already known, the PSA can help determine to what degree it is. Higher PSA levels have been associated with tumors more aggressive and more widespread by the body.
Control of relapses: patients who removed the prostate by a tumor should be tracked periodically which can perform a PSA determination. It is normal to have very low levels in blood, but if there is a recurrence of the tumor may appear in blood clearly.
People with a family history of prostate cancer: the role of PSA as a method of early detection of cancer is under discussion in these cases. On the one hand it is people with higher risk than normal of having prostate cancer and the test will be more useful, on the other hand, prostate cancer is very common in any 60-year-old male, so there is not much difference with other people without family members who have had cancer.
Preparation for a PSA testIf they are going to do an PSA test these are the issues that you must consider when go prepared to test:
Duration: usually takes very little time, what it takes to be a blood analysis: seconds or minutes. Results take rather longer to receive, usually several days.
Admission: admission is never needed. The PSA test is a test that can be done at a time.
Is necessary to be accompanied?: , isn't just a prick to get analytics. It is not usually very painful and is minimally invasive, so you can only attend the clinic and return in the same way.
Drugs: don't need to take any prior medication. Although Yes there to tell your doctor all medications you are taking at that time, since some drugs can increase or decrease the levels of PSA. Many of them are easy to relate (medications for benign hyperplasia of prostate, for example), but others may go unnoticed (e.g. treatments for baldness).
Food: an analysis of PSA before you can eat normally, you don't have to go on fasting. But it is frequent to seize the prick of Analytics to measure yourself with other parameters in blood (sugar, cholesterol, etc.), it is best that you reports before or directly go on fasting if analytics is early.
Clothes: you can wear normal street clothes.
Documents: is advisable to go with your health insurance card, although most of the times is sufficient to bring the wheel with which the doctor sent you proof.
Pregnancy and breast-feeding: the evaluation of the PSA is a test that is performed only in men, so it makes no sense that the pregnancy or breast feeding are important factors for a man. Yes, it should be noted that the test does not imply any difficulty to find a baby with your partner, although recent ejaculation can be the result of the PSA.
Contraindications: there are no contraindications for the analysis of the PSA. So just rating if it really is worth the test and the results would serve as something.
How a PSA testWhen you reach the query for you an PSA test (prostate specific antigen) your doctor will make you some general questions about your state of health: important diseases, risk factors, lifestyle, work place and mostly insist on voiding or urinary symptoms (if it costs you to urinate, or do it in a choppy manner, etc). The doctor will ask the PSA test when necessary. After perform you a general physical examination, and assess the realization of a rectal examination accompanied or not measuring the levels of PSA in the blood.
Days after this first visit, you cite for you blood PSA. It is recommended that the five previous days do not make you intense physical exercise (gym, running, football...) to prevent the PSA data is changed. If between the query and the performance of the test they have made you a digital rectal examination or a catheterisation will have to remind you that you tell the doctor to collect the results, since these tests can alter PSA levels in blood.
The day of the analytics can make a normal life. In case of doubt it is better to go to analysis in fasting, if do you other tests. You must not go nervous, it's just a routine blood test. When you arrive at the clinic they ask you the wheel and then make you go to the room of blood extractions. There you sentarás on a Chair and discover you arm. The nurse will use an antiseptic substance to clean the area to puncture and then prick a vein in the forearm with a needle. Take one small tube of blood.
Once taken the sample they will leave you a cotton to pressure puncture site for a while to avoid bleeding and bruises are formed. You can then go for breakfast, if you have not already done so, and to make your daily routine until days or weeks later give you results in the doctor.
Complications of the PSA websiteComplications analysis of PSA are virtually non-existent. It is a safe test that does not entail risks for persons who are subjected to it. The only risk is to know about false positive test results requiring more aggressive testing.
The PSA test resultsThe results of the analysis of PSA (prostate specific antigen) may take several weeks since the blood is collected for study. To pick them up there to keep another appointment, since the documentation alone can not be interpreted by the patient. In consultation, the doctor will be the most appropriate interpretation of the results of the analytical.
When PSA levels are less than 4 ng/mL in blood is considered that alterations there are no. It is important to note that that does not rule out outright form of prostate cancer, PSA levels may be low in some tumors and may also decrease by medication or other situations.
If PSA levels are higher than 10 ng/mL in blood their cause should be considered. It is important to tell the doctor if you have situations that they have been able to raise PSA prior analytics. Rectal will be compulsory, if it has not already, and valuing all your aspects will decide whether or not to perform a prostate biopsy.
When PSA levels between 4-10 ng/mL is difficult to make a direct decision. Once more the rest of tests are decisive. Sometimes you can choose to perform an analysis of the fraction-free PSA, which consists of study percentage of PSA is free in plasma, instead of going to other proteins. A more specific test that provides more data to consider is considered.
In people who already have a known prostate disease (cancer, benign prostatic hyperplasia, infections, etc.) the PSA test serves to control the disease through periodic analytical. Normally, PSA levels will be constant or decrease. If there is suddenly a sudden elevation of PSA will make us think that the disease goes wrong or has been extended.
What is a blood test?Know the results of an analysis, what are the normal levels and which indicate something wrong with our body.
Analysis of bloodBlood test is a medical test used and most important in clinical practice. It consists of removing a small amount of blood from the patient, which is then transported to the laboratory to analyse and determine its composition.
In an analysis we can find numerous data, many of which can be ringing us Chinese given their acronyms and different figures. Then we will try to clarify what each of them, what are the normal levels and which indicate that something is altered in our body.
Which are most requested for the study are normally, the blood count and blood Biochemistry:
Blood count: is a quantitative study that evaluates the concentration of each of the cellular elements of the blood. Also check if cells have normal a form and structure or, conversely, are altered. Example: red blood cells (also called RBCs), white blood cells, neutrophils...
Biochemistry: is the study of chemical substances present in the blood. Examples: potassium, calcium, sodium, magnesium, vitamins, hormones...
Why can the doctor request a blood test?Actually, the blood test is a test that can be requested for almost any medical consultation, in order to assess the general State of the patient. Along with its history, will serve to help the doctor to resolve two important issues: what happens to the patient and why it happens. An example: a person comes to consultation with remarkable tiredness, loss of appetite and pallor; in this case, a simple blood test can reveal itself a diagnosis: anemia, iron-deficiency (due to lack of iron). Thus, you can start now to treat your illness without need for further testing.
But we must bear in mind that the analysis of blood is not only a method to diagnose diseases, is also a way of controlling the State of the patient; for example, are made to patients undergoing chemotherapy routine Analytics to check the status of your immune system; and also before a hormonal treatment with oral contraceptives, it is important to know the level of hormones in the patient's blood.
Recommendations and preparation for the analysis of bloodThe most important thing when you go to make you an blood test is go on fasting, to avoid the presence of factors that may give errors in the results. Blood is usually done in the morning, so from the midnight patient should be fasting (usually corresponds to a period of 8-10 hours).
It's a little painful test for most people, although some may feel some pain or discomfort when you click them or during the extraction of the blood. Sometimes the patient may get dizzy or even lose consciousness due to fear of the analysis or to prolonged fasting, but in any case this incident is related to the extraction, since the amount of blood that is collected is very small. In any case, if you are prone to motion sickness, it is advisable that it is accompanied to the test.
As the adverse effects of the implementation of the analytical, may be an small hematoma or swelling in the area of extraction. This is because the output of blood from the vein by the place where has clicked. Hematoma goes away in a few days without treatment.
The only contraindication to the realization of a blood test is the intake of anticoagulants. These drugs could cause higher than normal, or very extensive bruising bleeding.
How to interpret blood test resultsThe presence in the results of an analysis of one or more of the blood abnormalities that are detailed below does not necessarily mean that will suffer any of these diseases. A blood test is a test that is complementary to many others that must occur before obtaining a final diagnosis.
The patient must not worry before an descent or isolated elevation of any of the parameters mentioned, is the doctor who has to assess its meaning, within the context of the history, and in relation to other symptoms and to the personal circumstances of the patient (lifestyle, presence of other illnesses, medication that are taking...).
Normal results of a blood testBelow, we present a series of data that are usually reflected in a common blood analysis , along with the values estimated would be within the normal or healthy.
Normal values of a blood count
- Red blood cells
- Hemoglobin (Hb)
- Hematocrit (HCT)
- MCV (mean corpuscular volume)
- MCH (mean corpuscular hemoglobin)
- ESR (sedimentation rate)
- 4.5 – 5.9 million/mm3 in males
- 4 - 5.2 million/mm3 in women
- 13, 5-17, 5 g/dl in men
- 12 - 16 g/dl in women
- 41-53% in men
- 36-46% in women
- 88-100 fl
- 27-33 PCs
- 1,300-4,000 /mL
- 4,500-11,500 mL
- 2,000-7,500 /mL
- 50-500 /mL
- 150000-400000 / mm3
- 0 - 10 mm/h for men
- 0 - 20 mm/h in women
A biochemistry normal values
- Uric acid
- Alkaline phosphatase
- 70 - 110 mg/dl
- 0.6 - 1.5 mg/dl
- 2 - 7 mg/dl
- 70 - 110 ml/min
- 120 - 200 mg/dl
- 42 - 90 mg/dl
- 0 - 160 mg/dl
- 30 - 280 mg/dl in men
- 30 - 220 mg/dl in women
- 7-40 units/liter
- 5-43 units/liter
- 12-55 units/liter
- 89-280 units/liter
- 8.5 - 10.5 mg/dl
- 50 - 150 mg/dl
- 3.5-4.5 mmol/litre
- 135-145 mmol/litre
- 0.2 - 1 mg/dl
Results and values of a blood countThe complete blood count (CBC) will reflect all the elements or components of blood, their number and their proportion in the organism and if suffer alterations:
- Red blood cells or red blood cells
- Hemoglobin (Hb)
- Henatocrito (OHT)
- Mean corpuscular volume (MCV)
- MCH (mean corpuscular hemoglobin)
- Leukocytes or white blood cells
- ESR (sedimentation rate)
Known as red blood cells, are the most important blood cells, since they are responsible for transporting oxygen to the rest of the cells of the body.
- Normal levels: 4,500,000-5.900.000 /ml in males
- 4.000.000-5.200.000/ml women
- Low levels: the number of red blood cells decreases significantly when there is bleeding (for example because of abundant menstruation), and this makes that not enough oxygen reaching the other cells of the body, which is what is known as anemia. All blood cells are produced in the bone marrow, so cell count failures may reflect a change at this level.
- High levels: an increase in the number of red blood cells is known as poliglobulia; This process makes blood thicker than normal, which facilitates the formation of thrombi in the blood vessels inside. It can be of unknown cause or be due to an excessive Hyperfunction of the bone marrow.
- Smoking reduces the amount of oxygen present in the blood, and this has resulted in an increase in the production of red blood cells, so a large number of red blood cells can also be related to smoking.
- In general, to a decrease of oxygen in the blood, the body tends to respond by producing more red blood cells, by what people who live in high areas may present a greater number of red blood cells without implying that they suffer from any disease.
- Normal levels: 13, 5-17, 5 g/dl in men.
- 12 - 16 g/dl in women.
- Low levels: as the amount of hemoglobin is proportional to the number of red blood cells (erythrocytes), a decline of this protein is reflected in an inefficiency of the function of red blood cells, which is called anemia.
- High levels: the elevation of this protein may contribute to the emergence of poliglobulia, an increase in the number of red blood cells that can cause clots. High levels in people with heart disease, chronic lung problems or people who live in areas of high altitude may appear.
- Normal level: 41-53% in men
- 36-46% in women
- Low levels: because, in reality, this parameter indicates the number of red blood cells, the main cause of a drop in hematocrit is anemia. Other reasons may be: bleeding, pregnancy, problems in the bone marrow, leukemia, hyperthyroidism...
- High levels: increasing the level of hematocrit may be produced by cardiac problems, lack of hydration, chronic lung diseases...
- Normal level: 88-100 fL (femtolitros by erythrocyte).
- High levels: high VCM (large red blood cells) may have its origin in a deficit of vitamin B12 or folic acid, disorders of the liver, or consumption of alcohol, and does not remain constant throughout life; in the newly born is high.
- Low: can be caused by anemia or Thalassemia (alteration of hemoglobin).
Thanks to this parameter anemias can be classified in a different way: the hipocromicas are those who are studying with a low level of HCM, and the hipercrómicas which have a high level of HCM.
- Normal levels: between 27 and 33 PCs (picograms).
- Low levels: the most common thing is that there is anemia due to lack of hemoglobin (normally by iron deficiency).
- High levels: there are rare cases of hipercrómicas anemia. They can alert a deficit of vitamin B12 or folic acid.
There are several different types of leukocytes, which are explained below:
Lymphocytes: is a type of Leukocyte that lacks granules. They are very important cells in the immune system, since they are able to respond to agents unknown to the body.
- Normal level: 1,300-4,000 /ml
- High levels: the increase in the number of lymphocytes is known as Lymphocytosis. It appears in infectious acute, chronic, drug allergies and processes Lymphoproliferative Disorders such as leukemia.
- Low levels: the decrease in the number of lymphocytes called lymphopenia, and it is common to find it in people whose immune system is defective or they are following treatment (chemotherapy) immunosuppressant.
- Normal levels: 2,000-7,500 /ml
- High levels: the high number of neutrophils (neutrophilia) appears before infections, inflammation, Burns, acute bleeding, smoking, and heat stroke. It may be associated with also processes in which the death of the cells of some tissue, such as myocardial infarction occurs.
- Low levels: is called neutropenia to the decline in the number of neutrophils, which gives the patient a special vulnerability to infections, even the most insignificant.
- Normal: 50-500 /ml
- High levels: Eosinophilia (increase in the number of these cells) may indicate the presence of parasites, allergies, asthma and infections. It is also associated with intestinal diseases such as Crohn's disease and celiac disease, and pulmonary diseases (Löffler).
- Low levels: the decline in the number of eosinophils is rare.
- Normal levels: between 150.000-400.000/ mm3.
- Low levels: lower than normal platelet count is what is known as thrombocytopenia. It may be due to an abnormal accumulation of platelets in the spleen or a bad function of the bone marrow. It has as a consequence poor blood clotting, resulting in bleeding (nose, gums, skin bruising, blood in urine and stool...). There is a disease of the immune system, the idiopathic thrombocytopenic purpura, which is characterized by the formation of antibodies that destroy platelets, failing to recognize them as their own body.
- High levels: the high number of platelets in the blood, is called thrombocytosis, and can cause the formation of thrombi within the arteries. It can appear without just cause, as reaction before an acute bleeding or certain diseases, or because a spinal cord malfunction.
- Normal levels: between 0 and 10 mm/hour in men and between 0 and 20 mm/h in women.
- High levels: there are many processes that can be studied with an increase of the VSG, such as myeloma, lymphomas, leukemias, chronic inflammatory processes such as rheumatoid arthritis and lupus. But his elevation does not necessarily indicate a pathology, since it also rises in some physiological processes such as pregnancy, menstruation or in the elderly.
- Low levels: ESR is usually rarely decreased. However, it is useful in the follow-up of patients data, since reducing ESR suggests that the tax treatment is being effective.
Results of a biochemical analysisAn analytical or biochemical routine analyzes the concentration in the organism of different chemical substances. Know what each value that appears in the results of a biochemical analysis, and what tell the fact that their levels are high, low, or normal:
- Uric acid
- Alkaline phosphatase
- Normal levels: 70 - 110 mg/dl
- Low levels: hypoglycemia (low blood - below 50 mg/dl glucose-) causes dizziness, drowsiness, loss of consciousness, spasms, heart rate decreased and, in severe cases, can even reach the coma. May be due to a wide fasting period, a defect in the formation of insulin, such as pancreatic insufficiency, tumors, alcohol intake; either be hereditary cause. Diabetes patients can suffer this condition because of too much on medication used to correct your problem.
- High levels: hyperglycemia (levels above 120 - 130 mg/dl) cause diabetes mellitus, which is usually hereditary. In these cases occurs increased food intake, blood vessels and peripheral nerve injuries. However, high levels can also indicate that there is glucose intolerance. Some medications and certain diseases (Cushing Syndrome, acute pancreatitis...) can raise levels of glucose.
- Normal: 0.6 - 1.5 mg/dl
- High levels: hyperuricemia, which is the elevation of that product, may be due to diets rich in proteins, to kidney failure, heart failure, bleeding or very prolonged fasting. Urea is also elevated in individuals who have high muscle mass. This increase may also be due to taking some medications that affect the kidneys, urinary calculi or tumor, by dehydration, or even when Burns have occurred in tissues.
- Low levels: the hipouricemia, on the other hand, is due to diets poor in proteins, pregnancy, malnutrition or liver failure.
- Normal levels: 2 - 7 mg/dl
- High levels: the main causes for that increase uric acid are figures: gout, renal lithiasis and kidney failure. Although it can also occur in cases of diabetes mellitus, and alcoholism. Frequently eating foods rich in protein such as seafood, spinach, blue fish and red meat also favors the increase of the level of uric acid. A high level after strenuous exercise may even appear.
- Low levels: the descent of uric acid appears in some disease in the renal tubules (Fanconi syndrome) or very low protein diets.
- Normal levels: 70 - 110 ml/min
- High levels: its increase is caused by dehydration, failure renal (for Glomerulonephritis or kidney stones), disorders of the urinary tract as the obstruction caused by a calculation or by increasing the size of the prostate, and is also seen in the early stages of muscle diseases (Dystrophies).
- Low levels: his descent is seen in patients that have low muscle mass, and can also be caused by serious Muscular Dystrophies.
- Normal levels: cholesterol (120 - 200 mg/dl); HDL (42 - 90 mg/dl), LDL (0 - 160 mg/dl)
- High levels: the rise in cholesterol produces Xanthomas (yellow nodules that appear on the skin) and xanthelasmas (in this case the nodules appear around the eyes). When the value of cholesterol is normal (between 0 and 200 mg/dL), it means that the level of fat in the body is suitable, but if it is high it is necessary to analyze the two kinds of cholesterol (HDL and LDL), taking into account that the total cholesterol is the sum of the other two.
- HDL: is the so-called 'good cholesterol'. It is a protein that is capable of transporting cholesterol from the inside of the arteries to the liver, where it will be metabolized.
- High levels: this protein imply protection against the risk of serious cardiovascular disease, such as myocardial infarction.
- Low levels: especially in women, are a risk factor for suffering episodes of cardiac ischemia.
- LDL: this type of cholesterol can build up in the cells of the arterial wall, even to obstruct them.
- High levels: the higher the level of this type of cholesterol, more likely to be heart disease due to arterial obstruction. Because of this risk, the optimum would be keep low levels of this cholesterol in the blood, and this is particularly important for those people who have already had a cardiovascular problem (in these cases recommended levels below 100 mg/dL).
- HDL: is the so-called 'good cholesterol'. It is a protein that is capable of transporting cholesterol from the inside of the arteries to the liver, where it will be metabolized.
- Normal levels: 30 - 280 mg/dl in men; 30 - 220 mg/dl in women
- High levels: hypertriglyceridemia, as well as the increase in LDL cholesterol, is a factor of cardiovascular risk for atherosclerosis. People with a tendency to have high both parameters should be eliminated from your diet fat and oils, which are responsible for the increase of this parameter. There is another reason to have elevated the level of triglycerides, which is the familial hypertriglyceridemia, an inherited disorder. The consumption of alcohol or tobacco influences also have high triglycerides.
- GOT: is a key protein in the liver and the heart, which is released into the blood when these organs are altered.
- Normal level: 7-40 units/liter.
- High levels: the elevation of this protein will detail it in the next section, since both transaminase elevation tends to be linked.
- GPT: is a protein that is found in large quantities in the liver and which, like the GOT rises when fails this organ.
- Normal: 5-43 units/liter.
- High levels: its elevation is caused by liver alterations, which may be mild (acute hepatitis or fatty liver), moderate (alcoholic hepatitis or paracetamol poisoning) or something more serious (chronic hepatitis).
- GGT: like the rest of transaminases, is a protein that is released from the liver when there is an injury. This in particular is associated with alcohol intake.
- Normal levels: 12-55 units/liter.
- High levels: the causes of the GGT elevation are similar to the alkaline phosphatase: cholestasis intra and extra-hepaticas (either by tumor causes, or alcoholic cirrhosis).
Alkaline phosphataseIt is a protein responsible for bone mineralization, so it is mostly in the bone. The causes of their elevation are the same causing the elevation of GGT, which are detailed in the previous section. Its increase is also related to diseases of bone, such as infection or tumor infiltrations.
- Normal level: 89-280 units/liter.
- High: during growth, children usually have high numbers of alkaline phosphatase, as occurring after a bone fracture during the time in which the bone is recovering from the trauma.
- Low levels: levels, however, decrease in cases of malnutrition.
- Normal levels: 8.5 - 10.5 mg/dl
- High levels: hypercalcemia is often due to an excessive function of the parathyroid glands. Cause alterations of consciousness, anorexia, vomiting, constipation, heart arrhythmias and renal and biliary lithiasis.
- Low levels: hypocalcemia, unlike that in the former case, is due to a hypofunction of the parathyroid glands, although also seen in cases of alcoholism and pancreatitis. In this case there may be grass tetany members and arrhythmias.
- Normal: 50 - 150 mg/dl.
- High levels: some diseases can cause a high level of iron in the body, such as hemochromatosis, which causes the body to absorb too much iron.
- Low: the low level of iron in the blood makes hemoglobin may not form properly, therefore oxygen and nutrients fail correctly to the rest of the body tissues. This is called iron deficiency anemia, manifesting itself, like the rest of anemias, such as fatigue, muscular weakness, drowsiness and pallor.
- Normal level: 3.5-4.5 mmol/litre.
- High levels: the increase of this element in blood is known as hyperkalemia. Its most important causes are: increased intake, decreased its elimination (renal failure), and hyperglycemia. It manifests clinically as heart arrhythmias, difficulty swallowing, and a feeling of numbness in hands and feet.
- Low levels: hypokalemia is a lower level of potassium in the blood. The most frequent causes are: decreased intake, losses (vomiting, diarrhea and use of diuretics), hypothermia and hormonal changes (increase of insulin). It manifests itself as fatigue, muscle cramps, weakness and paralysis in very advanced States, intolerance to carbohydrate carbon and increase the risk of cardiac arrhythmias.
- Normal: 135-145 mmol/litre
- High levels: hypernatremia is defined as a high level of sodium in the blood. This situation may be due to an increase in the intake of salt or to drink little water. The clinical manifestations are more serious mas rapid rises in blood sodium and tend to be: tremors, confusion, convulsions, and risk of brain bleeding.
- Low levels: at the other end, the low level of sodium in blood is known as hyponatremia. It may be due to sodium loss (vomiting, diarrhea, excessive sweating...), excessive diuresis, or defects in the adrenal hormones. In these cases can appear clinic hypotension, tachycardia, ocular and cutaneous dryness and weight loss.
- Normal levels: 0.2 - 1 mg/dl.
- High levels: the increase in bilirubin can be due to: hereditary disorders in the metabolism and elimination of this protein, alterations in the anatomy of the biliary or obstruction by stones in the gallbladder or liver disease (cirrhosis or hepatitis). If this substance greatly increases it will appear jaundice (yellowing of skin and mucous membranes) and dark urine (urine of dark, due to the urinary elimination of bilirubin).
What is the angiographyAngiography is a technique based on the x-ray that allows an anatomic study of the blood vessels.
AngiographyAngiography is a technique based on the x-ray that allows to study the blood vessels and their journey in any area of the body. It consists of introducing a long cable, called catheterthrough the blood vessels. Once inside, instills a radiocontrast into the vessels to study, and vessels 'drawn' in the image can be seen by x-ray. Some of its uses has been displaced by doppler ultrasound, which allows to measure the flow of blood, but still it is essential for the anatomical study of blood vessels, to schedule a surgery, or to intervene directly by catheterization.
This test was invented in 1927 by Portuguese Dr. Egas Moniz. At the beginning very sharp simple catheters were used so that they could move through the bloodstream without forming thrombi. Today, thanks to the Seldinger technique and anticoagulant drugs, can be flexible catheters.
It is not a risk-free test, but complications are rare. Today seeks to use less aggressive techniques to the study of the blood vessels whenever possible, but angiography becomes forced and especially useful technique when she is suspect diseases that can be treated through radiological intervention, i.e. through catheters which carry out different therapies in the organs through the arteries or veins.
When an angiogram is doneAngiography he is performed when you want to study blood vessels (arteries or veins) for any of these problems:
Partial or complete blood vessel obstruction: any artery or vein may see reduced its light; the most frequent cause is the formation of cholesterol plaques. Some of the consequences associated with this disorder are cardiac, cerebral or intestinal infarction, but any organ can be affected according to the blocked blood vessel.
Stenosis arterial: stenosis is a narrowing of the arteries that depends directly on all the glass, unlike obstructions, which are produced by the formation of obstacles inside. One of the most frequent and important stenosis is stenosis of the renal arteries.
Blood malformation: angiographic study allows us to visualize the ramifications of the arteries, that can sometimes be disorganized and weak. These anomalies can be present at birth or appear throughout life.
Internal bleeding: sometimes it is not easy to identify what is the point whereby a blood loss is occurring. Angiography allows you to see directly where the rupture of artery or vein that escapes the radiocontrast.
Venous varicosity: the venography is a technique that is not often used today, but is still useful to check the venous permeability in all respects and plan the surgery.
Identification of tumors: angiography can help locate malignant tumors, since the circulation in them is very irregular and can be seen with this test.
Surgery planning: in some special situations it is necessary to perform an angiogram to study the anatomy of the blood circulation in the area that will be performed, although today used very little, thanks to the development of the computerized axial tomography (CAT).
Buerger's disease: in this disease the arteries in the arms and legs suffer reactions fibrotic who cut them and deform them, thus preventing blood flow. Its main cause is tobacco, and angiography visualizes the characteristic shapes of the arteries in the form of corkscrew.
Preparation for angiographyIf they are going to carry out an angiography , these are issues that you must take into account:
Duration: the duration of angiography is variable. It can last from a few minutes to more than one hour. It tends to take more time when it decides to intervene on the vessels studied at the same time.
Income: it may be necessary to enter the night before the test, and after it is usual that you stay a few hours in observation, and is sometimes also necessary to enter one night in the hospital.
Is necessary to be accompanied?: Yes, it is recommended to carry a passenger. It is a test not exempt of risks and is better after you undergo the same there is someone to take home and remain at your side a few hours.
Drugs: you must tell your doctor all the medicines you take regularly, and will decide which suspend or maintain. Sometimes the doctor will recommend you take medication that will help to carry out the test, but should be assessed for each patient on an individual basis.
Food: must remain in fasting 8 hours before you undergo an angiogram.
Clothes: you can go with the same clothes every day, and when you get to the medical center you will be asked you to take it off and will put a robe of income, which is more comfortable and hygienic for the test.
Documents: it is recommended to carry the personal medical history, although the doctor will already have it with him. Before put you to the test you will sign the informed consent with which you agree to make yourself the technique and you will know the potential risks, which are rare. They will also a series of basic, such as an electrocardiogram or a blood analysis tests; take the results with you if you have taken them.
Pregnancy and breast-feeding: angiography is contraindicated in these situations. If there is a minimal chance of being pregnant not you should submit to this test, since exposure to X rays and the radiocontrast may harm the fetus. Usually the doctor performed a pregnancy test prior to women who do not deny being pregnant.
Breastfeeding does not imply a direct contraindication, but it is better to avoid testing until the breast feeding period is complete unless it is strictly necessary.
Contraindications: pregnancy would be a contra-indication for angiography. It should not be if you have chronic kidney damage since the radiocontrast can disable them. People who have an active infection nor should undergo this test if it is not strictly necessary.
How angiographyWhen you go to perform angiography, firstly they will ask you if you're in agreement with put yourself to the test and you will be asked to sign the informed consent, where you will read what is. You cite that you submit to the test another day and explain how you have to go to it.
To make you the proof may be required that you enter the night before or not. If you go directly in the morning you should not forget to remain in fasting 8 hours before. Go to the quiet and accompanied, hospital with enough time to not stress yourself before the test. Before entering the room where the test will make you ask yourself that you change your clothes and give you a batin's hospital. Once inside, you will see multiple monitors and a table where you tumbarás you face up.
Before starting the intervention you will you a sleeve on the arm to control blood pressure, several electrodes on the chest to control the heart rate, and a vein in the other arm via in case you need to inject some drug. Depending on the area to study they will introduce you the catheter on the one hand body or another. Normally they take advantage of large blood vessels to make it easier to puncture them, such as the iliac artery in the groin or the subclavian vein in the shoulder. The area that is puncture is shaved and should be cleaned with antiseptic to maintain correct measures of asepsis.
In the shave zone a little local anaesthesia prick before puncturing the main artery. Puncionada once, check that he has been properly reached and be introduced a thin hollow tube through the needle. After the needle is removed leaving the tube inside the artery, and through this tube is inserted the catheter, which is like a wire. Catheter brought to the region of the body that you want to study; There are different models with different curves to make it easy to iterate through the arteries or veins. All time low radiation x-rays are made to control the passage of the catheter.
When the catheter reaches the area of the body to study will instil radiological contrast. At that time, it is normal that notes heat and hot flashes. Once studied the vessels in the area will decide whether to intervene at the time or not, and when finished will withdraw the catheter. The area where the catheter went be pressed for several minutes to facilitate coagulation, will then be cleaned and will be covered with a bandage.
Finally, you will be into another room to rest and keep you under surveillance a time. Then you will be taken to a hospital room, or you can go to your House taking care with the puncture wound.
Complications of angiographyComplications in angiography are not very frequent. Some that occur occasionally are:
- Discomfort, nausea and vomiting.
- Fainting and loss of consciousness.
- Cardiac arrhythmias.
- Alterations of blood pressure suddenly.
- Allergic reaction to the x-ray contrast medium.
- Cardiac or cerebral infarction.
- Internal bleeding or pericardial.
- Local clots and embolisms.
Results of angiographyThe results of the angiography can be known anything over finished the test. When the blood vessels are intact are observed well shaped, without indentations and loss of contrast.
However, small changes in the test may be misinterpreted, and that it is better that the radiologist or physician who has done it carefully study them and assess them in relation to the rest of the evidence that you made.
More typically, a few days after angiography to cite you for a consultation with the doctor. There it will tell you what have been the results of the test and will inform you a diagnosis and treatment, if the test has been altered and is final.
What is anoscopy— Displays the inside of the anus, anal canal, and lower part of the rectum, and diagnose local pathologies or sampling.
AnoscopyAnoscopy is a technique that allows to visualize the interior of the year, anal canal, and the lower part of the rectum, i.e. the last 10 cm of digestive tract. Thanks to this study local diseases Diagnostics can be, and you may decide what treatment is necessary. This used an anoscope, a tube of about 8-10 cm long and about 3-4 cm in diameter. At the beginning of the 20th century the anoscope study was based on direct visualization through him, but anoscopy has evolved and now advanced display methods are used.
It is today commonly used cold light to perform anoscopy. This is a lamp with halogen light that emits no heat, and therefore can be introduced a little through the anoscope. This lamp is accompanied by a camera with optical fiber cable to view in detail the walls of the rectum and the anal canal. At the same time performed anoscopy can take photos or record video.
The technique that is used quite frequently is the high resolution anoscopy. It is a method of study similar to colposcopy which is used for study of the cervix in women. It involves the application of a substance on the walls of the rectum and the anal canal through the anoscope. Then uses a light that produces a fluorescence in pathological areas to study, usually malignant areas caused by the human papillomavirus (HPV) virus.
In addition to these studies, the anoscope allows you to perform other tests, such as sampling for microbiological cultures, studies of biopsies, and do simple procedures like putting elastic ligatures. While it seems a test quite invasive, at any time it causes pain to the patient, and the introduction of the anoscope is minimal (a few centimeters). Its easy implementation and their effectiveness, is considered a test of essential for the diagnosis of rectal tumors and other pathologies of the anal region.
When doing an anoscopyAnoscopy It is done when you want to visualize the inside of the rectum, anal canal, or year to confirm a specific diagnosis. It also allows to take biopsies of the walls of these structures, and if it is necessary to certain diseases can be treated. Anoscopy frequent indications are:
Anal pain: one of the most frequent causes are hemorrhoids and fissures. When they are not from the outside and are not felt with a digital rectal examination, can be evaluated perform anoscopy to check if it is inside.
Anal bleeding: anoscopy should be performed to identify the source of bleeding. It may be due to hemorrhoids, fissures, wounds or cancer, mainly.
Feeling of occupation or heaviness in the year: may be an early symptoms of rectal cancer, or also the main symptom of hemorrhoids, polyps, or an abscess.
Take biopsies: If there are suspicious alterations in the inside surface of the rectum or anal canal. The best test to direct the taking of biopsies is of high resolution anoscopy.
Anal sex: anal sex is associated with infection by HPV in the rectum and year, and therefore with a high risk of developing local epithelial cancer. The risk is increased in patients with HIV or who have suffered other sexually transmitted diseases.
Linking hemorrhoids: ligatures with bleeding Internal hemorrhoids banding can be.
Preparation for anoscopyIf you are performing an anoscopy these are the issues you should keep in mind to go well prepared to test:
Duration: anoscopy has a variable duration according to the technique you are going to be made. Usually lasts a few minutes (if only it is necessary to visualize the area), or more than 20 minutes (if it must be high resolution anoscopy or take biopsies).
Income: anoscopy can be done programmatically; Sometimes this is done in the same query. You can put yourself to the test and go your home a little while. However, if it is of high resolution anoscopy is usually done in a well equipped room, and so tend you to quote the other day.
Is it necessary to be accompanied?: no. Anoscopy is a technique very little invasive. It does not produce pain and rarely leave any discomfort which, in any case, will not limit you to drive or walk to your home or work.
Drugs: sometimes it is necessary to take laxatives or get an enema prior, before the test, since it must be done with the empty rectum. Should be communicated to the doctor all the medicines taken regularly and will decide which suspend or maintain. It is advisable to avoid taking drugs that hamper the clotting of the blood the week prior to the anoscopy is to be biopsy, such as aspirin, ibuprofen and other NSAIDs.
Food: it is not necessary to remain in fasting prior to testing. The days before and after to anoscopy is recommended taking a diet rich in fiber and staying well hydrated to avoid constipation.
Clothing: can keep the appointment with the doctor with the same clothes every day.
Documents: before you undergo the test can be asked you to sign a consent with which you accept to make you the technique and that will inform you of the possible risks. Sometimes just an oral consent. If you cite for you test a specific day, it is recommended that you carry with you the health card and the steering wheel in which the test is prescribed.
Pregnancy and breast-feeding: anoscopy is not contraindicated in these situations. The doctor must know that you are pregnant to consider whether it is appropriate to postpone the test, since sometimes there are physiological changes associated with pregnancy that can alter the results of the test.
Contraindications: not has no absolute contraindication, but preferably not the test during a hemorrhoid crisis, with or without thrombosis. It should not be if there is an active infection.
How anoscopyWhen you perform an anoscopy, firstly they will ask you if you're in agreement with put you to the test. If you give your consent, you can make it you even in that same moment in the consultation, if what we want is only observe the rectum inside a few minutes. But if you have to make any specific technique, it will be necessary to sign a written consent, and one will quote you another day to practice the test with the appropriate means.
Order to become anoscopy ask you that you have made depositions hours before submitting you to it, and if you have problems to do this, your doctor may prescribe you a few days before enemas or laxatives. Arriving at the inquiry you must go to the bathroom to empty the bladder, and then ask you that you take off the pants or skirt, and underwear. You tumbarás on a stretcher on hand, with legs flexed so that you can hug your knees.
Once the doctor first thing will make will be seen outside of the year. It will check if there are external injuries and if the skin has no alterations. Then perform you a rectal examination to touch the inside of the anal canal and check that the anal sphincter has correct contraction, neither in excess or defect.
Before introduce you the anoscope cleaned the area, sometimes using antiseptic products. Despite this, anoscopy does not require total asepsis measures, since the anal area is of by dirty, with common microorganisms in our body. It also does not require anesthesia, since it is not a painful test, or sedation, because it lasts a short time and the anoscope penetrates a few centimeters.
To introduce the anoscope you will notice a feeling of heaviness in the year, similar to that you feel during a bowel movement. It is very important to be relaxed and not double-clicking the sphincter, since the only thing you will get is having discomfort. Once introduced the anoscope camera with lamp will get to see the inside of the rectum. The anoscope is little by little, checked out to retreat through the rectum and see, step by step, throughout its length. When you reach the end, the anoscope will be removed and the area will be cleaned again. It is normal that after the test notes you annoyances, but it will be a few minutes.
If an high resolution anoscopy test lasts a little longer, because at the same time that displays the zone applies a liquid that stained with fluorescent materials the walls of the rectum. It should leave this substance for a few minutes to make its effect. In the case that has zones that appear marked must be biopsiarlas. This introduces small tweezers that allow taking samples of the surface epithelium of the walls of the rectum and the anal canal. The take the biopsy can be a bit painful, and you will feel a prick in the area of puncture that will last for a moment. The days after the biopsy it is normal that you manches underwear with a little blood, but it should disappear within a few days.
Complications of anoscopyIn general, if they have an anoscopy not you presentarás any complication, but it is recommended to maintain a diet rich in fiber and staying well hydrated to maintain a proper bowel. You must see a doctor when you notice fever, chills, painor bleeding continued for the year.
Anoscopy complications are very rare. Some that occur occasionally are:
Damage to the wall of the rectum. It may be from a small wound to a total rupture of the wall.
Local infection. When it happens, antibiotic treatment is required. If the infection progresses it can cause an abscess, which sometimes should be drained and it's necessary to administer antibiotics intravenously.
Hemorrhage. If you have hemorrhoids it is normal to bleed a little during the procedure. Sometimes the bleeding continues over time and must be cut with surgical treatment. There is more risk of bleeding out of control in the biopsies.
Persistent pain. Anoscopy is not a painful test. If there is pain should go to the specialist to rule out complications or the emergence of new pathologies.
Anoscopy resultsWhen performing a diagnostic anoscopy in consultation the doctor can get the results of the test at the same time. So then you can propose a solution or treatment if you detect a problem, such as hemorrhoids, fissures, polyps, etc.
In the case of high resolution anoscopy maybe that specific alterations requiring biopsy are not observed at the same time. If so, your doctor will give you an appointment to check months or years later. In the event that affected areas a biopsy will be you, and weeks later cite you to give you the results in consultation.
In the quote from the results of a biopsy you will explain if they inform you if there are microscopic alterations of cells that have been collected. If any, explain to what extent are a factor of malignant risk and possible treatment options.
In the case of treatment carried out at the same time of the anoscopy, the results are positive in specific pathologies. Ligation of bleeding hemorrhoids can be useful as definitive treatment or maintenance, waiting for surgery. After undergoing this technique is needed very little time to recover, and can go home the same day if all has gone well.
What is ArthroscopyIt is a technique that allows to visualize the inside of joints to make a diagnosis or to carry out treatments.
ArthroscopyArthroscopy is a technique that allows to visualize the inside of joints for a diagnosis and also to carry out a treatment if necessary. So are small incisuras around the joint by where are introduced cameras, clamps and other very small tools that allow you to manipulate the joint inside without having to open it completely. Arthroscopy is part of the techniques of minimally invasive such as eRCP, laparoscopy or neuroendoscopy surgery among many others. Despite this, it should be in an operating room with adequate asepsis measures and under regional or general anesthesia.
First Arthroscopic interventions were carried out only in the knee, since it is the largest human body joint and which suffers from more ailments and diseases. Soon began to perform other joints such as the shoulder and hip arthroscopy, today almost all joints, even of the smallest arthroscopies are done.
Minimally invasive techniques have allowed that postoperative patients is shorter and less painful, also save health care costs. Arthroscopy reduces even the risk of surgical wound infections, which in turn helps to reduce the number of septic arthritis.
When Arthroscopy is doneArthroscopy is performed when you want to see the inside of the joint to confirm a specific diagnosis. It also allows to take samples and biopsies from the inside of the joint. But most importantly the arthroscopy is to carry out joint treatments. The most frequent are:
· Meniscus repair (sutures, transplant removal, etc).
· Reconstruction of the cruciate ligaments of the knee.
· Removal of loose bodies extra joint.
· Suture of tendon of the rotator cuff in the shoulder sleeve.
· The shoulder restraint to avoid repeated dislocations.
· Treatment of subacromial shoulder syndrome.
· Wash intra-articular in septic arthritis.
· Excision of ganglion of the wrist.
· Repair of acetabular hip labrum.
· Repair of some bone fractures.
· Treatment of inflammation of the synovial membrane, which is the layer that lines the joints.
· Realignment of the ball after a dislocation.
· (Common in rheumatoid arthritis) Baker's cyst removal.
How the arthroscopyBefore arthroscopy, firstly are you you numb eye so you don't feel any pain throughout the procedure. The anesthesia can be of three types: general, regional or local. The most common is that you carry out with regional anaesthesia wherever possible. To do so will be back a small puncture to anesthetize the nerve roots in the spinal cord directly. In this way the joint to intervene will not have sensitivity and you will keep awake all the time, although you can sedate yourself so that you are more relaxed.
Then be disinfected the outside of the joint and is covered with a surgical sheet which limited the area. Sometimes are placed a sleeve before joint to carry out pressure and limit the blood flow in the joint.
It is then when the orthopedic surgeon makes three or four incisuras in the joint to introduce them the camera, serum pump and other instruments. The camera allows you to see the inside of the joint, serum pump introduces saline within the joint to increase the space between bone and bone.
Instruments that are inserted into the joint are very varied: forceps, scissors, files, sutures, etc. With them the orthopedic surgeon will get solve the problem presented by the joint. Any intervention is recorded on video to view it later by the physician or by yourself.
When the intervention is completed all instruments are removed and the knee incisions are closed with stitches, leaving a very small wounds. After 24 hours you can begin exercises recommended by your health care provider to mobilize the joint.
Preparation for ArthroscopyIf they are going to perform an arthroscopic surgery these are the issues that you must consider when ready to test:
Duration: Arthroscopy has a variable duration according to the surgical technique that is going to be done. It will generally last two to three hours if there are no complications and treatment is simple.
Entry: Arthroscopy can be done on an outpatient basis. You can undergo the operation in the morning and in the evening you can go to your House. However it is frequent that the orthopedic surgeon prefer entering the patient for a minimum of 24 hours to observe their initial evolution.
Is necessary to be accompanied?: Yes, it is recommended to carry a passenger. After Arthroscopy joint should not support an excessive weight or carry large or sudden movements. This can make it difficult to drive or walk.
Drugs: is not necessary to take any prior medication. Should be communicated to the doctor all the medicines taken regularly and will decide which suspend or maintain. You should avoid taking medications that hamper the clotting of blood two weeks prior to arthroscopy, such as aspirin, ibuprofen and other NSAIDs.
Food: must remain in fasting between 6 and 12 hours prior to Arthroscopy.
Clothing: once the street clothes enters hospital is changed by a gown more comfortable and suitable for the operating room. If you enter at least one night is recommended to take clothes to sleep and comfortable shoes.
Documents: it is advisable to take the medical history on the joint is going to intervene, although the doctor will already have it with him. Before undergoing intervention sign informed consent that agree to make him the technique and know the potential risks.
Contraindications: Arthroscopy does not have any specific contraindication.
Pregnancy and lactation: Arthroscopy is not contraindicated in these situations, but should only be performed on pregnant women and nursing mothers in emergency situations or when joint damage more difficult day by day in a remarkable way. If it doesn't, it is best to wait until later.
Arthroscopy resultsArthroscopy treatment outcomes are very positive in general. Depending on the technique that is done will require more or less time to recover.
When ligaments or fractures are repaired it is frequent that joint is immobilized for several weeks and crutches for the joints of the leg should be. If the intervention has been minimal or has only been diagnostic, movements can be 24 hours later.
In any case it is advisable to perform simple exercises to prevent stiffness in the joint. If needed the doctor will tell you how to perform them before you get high. Few times will need rehabilitation, and when not needed is because Arthroscopy itself, but to the previous injury.
When performing a diagnostic Arthroscopy results can be offered to the patient shortly after making it, since there is the joint direct. If biopsy or microbiological samples taken results may take several days because they depend on the analysis in the laboratory.
A few days later one will quote the patient to remove stitches from injuries and check that they heal properly.
Arthroscopy complicationsArthroscopy complications are very rare. Some that can ever occur are:
· Articular cartilage damage, ligaments, tendons, or other structures that are within the knee. They may be due to a mistake by the surgeon or by anatomical abnormalities of the patient.
· Infection of surgical wounds or the inside of the knee. When it happens the intravenous antibiotic treatment is necessary to prevent the destruction of the joint.
· Injury of arteries, veins or nerves that pass around the joint. In general, they are unimportant.
· Limitation of motion of the joint after arthroscopy, can be temporary or permanent.
· Thrombosis of the veins, more frequent when hips, knees and ankles are involved.
· Pulmonary thromboembolism by immobility
· Complications of anesthesia (respiratory depression, sedation allergies, nerve paralysis, etc).
However, remember that these complications occur in rare cases.
What is the audiometryThis test evaluates the performance of the auditory system and allows you to determine a person's ability to hear the sounds.
AudiometryAudiometry is a test that allows to know the capacity that a person hear the sounds. Thus evaluates the proper functioning of the human auditory system. A proper hearing is a process which follows these steps:
- Reception of sounds in the pinna or ear, which helps us to differentiate from where a sound is emitted.
- Passage of the sound through the ear canal.
- Clash of the sound in the eardrum, which vibrates as if it were a drum.
- Transmission of vibration by the chain of ossicles, which connect the eardrum with the cochlea.
- Converting vibrations to electrical nerve impulses in the cochlea.
- Interpretation of the neuronal signals in the brain.
Modified in its intensity and tone sounds are used for testing. The intensity is the volume that has a sound and is measured in decibels; tone refers to the acute or grave that a sound is heard and is measured in Hertz. The sounds that humans can hear are 20-150 dB (the ears can be damaged from 85 dB) and 20-20000 Hz.
When a hearing test is doneA hearing test is recommended to everyone in which hearing loss, is logically suspect. There are also stages of life in which, although there is a clear suspicion of hearing loss, it is recommended to undergo a hearing test to detect hearing loss in time. It is advisable to a hearing test in the following cases:
Babies: nowadays between the medical evidence to the newly born is a special type of hearing test based on the "potentials"; These are reflexes that indicates if a baby hears or not without need to tell us it. Thanks to this test has decreased considerably the number of deaf from birth in our society, because it can be implanted them in time an artificial cochlea.
Over 65 years old: even without suspicion of deafness, it is recommended to perform this test to all people older than 65 years to detect hearing deficits in time. If the test is normal, it is recommended to repeat it every 3-5 years.
Suspicion of deafness: anyone at any age can suffer temporary or permanent hearing loss for different reasons. Audiometry helps the diagnosis of hearing loss and oriented towards the cause of it.
Following diseases risk: meningitis, mostly in children, brain trauma and extensive otitis are the most common causes of deafness that occur as a consequence of illness or accidents. Watch the hearing in all these cases it is recommended.
Other: taking medications that damage the ear (gentamicin, for example), or the rupture of eardrum (to use after a very loud noise or cleaning swabs), are also frequent causes of hearing loss, and the patient may benefit from a hearing test
Preparation for audiometryIf they are going to do a hearing test, these are issues that you must take into account:
Duration: usually takes very little time, as much as 30 minutes.
Admission: admission is not needed, it can be done on an outpatient basis by a specialist or other medical in the hospital. There are also settlements in many localities. If you decide to do it in a private facility, be sure that meets the necessary conditions and that perform you a full hearing test.
Is it necessary to be accompanied?: no, is a painless and not invasive, so you can only attend the clinic and return in the same way.
Drugs: don't need to take any prior medication. You must tell your doctor all the medicines that you eat so that you assess if they could be that cause of the lack of hearing.
Food: you can eat normally, it is not necessary to go on fasting to the clinic.
Clothes: you can wear normal street clothes. Prevents wear helmets of music the hours prior to the test.
Documents: there is no type of document, but may give you the results at the time of completion of the test and you need to save them.
Pregnancy and breast-feeding: neither pregnancy nor lactation are contraindications for performing this test.
Contraindications: do not have any contraindication. If the person who needs a hearing test can not communicate (for example, by being in a coma, suffering from some mental retardation or be a baby) should be a test of "evoked potential".
How audiometryMake you a hearing test, when you arrive at the clinic will make you a few general questions about your state of health and about the situations in which you have noticed difficulty to hear sounds, if so. Immediately afterward, they'll see you with the Otoscope inside the ear canal and eardrum. After this basic study, you will be asked to pass to a cabin where you put different helmets with speakers.
First, you will be asked to put a case on the right ear and then another in the left ear. Air conduction, i.e. the transmission of sound normally through the auditory system is studied with these helmets. Then they will put a pair of headphones that are placed behind each ear, supported by bone. With them we have studied bone conduction, which serves to find out if the nervous system work properly as to understand sounds.
With each of these helmets, the Director of the test beeps different with different intensity and tone. It will ask you to do a signal whenever you hear a beep; so you can identify what volume and tone do not hear well sounds. It will then try with every helmet if you understand different words be pronounced correctly, but will hear different tones and intensity. It will ask that you repeat them immediately after listening to them. The second part of the test is the most important, since we study how in every day there is difficulty understanding words or phrases.
Throughout the test you can be sitting or standing. In no time you will notice pain or discomfort, since it's a simple test. If you have a sound system very sick can you feel dizziness, as it can happen in other situations. If it happens to you, it notifies the technical test so interrupt it for a moment.
Immediately after the test results may be obtained. The professional who carried out the test or a doctor can interpret the results at the time, and even recommend some treatment, such as a hearing aid. Due to the high price of these devices, it is recommended you think during a time before the disbursement, and that you consult a doctor before, if it has not already.
Complications of audiometryAudiometry complications are not known. It is a completely safe test that does not entail risks for persons who are subjected to it. The only problem that could arise is that testing is done improperly and its results are not reliable, which can lead to the patient to perform an unnecessary expense in a hearing aid. Therefore it is recommended to always consult the specialist in case of doubt and go to centers offering guarantees.
The audiometry resultsThe audiometry results obtained at the same time the test, and must be interpreted by an expert. The report shall contain a series of data that help to understand which type of hearing loss or deafness have.
Tonal audiometry data: a table that relates the intensity of sounds with his tone. In the table are marked the sounds you heard correctly and so will note if there is a decrease in the perception of some sounds by its own characteristics. Listening to sounds by air or by bone, compares, in addition, which helps detect if the problem is in one way or another.
Data delete audiometry: it exposes the percentage of words that have been correctly repeated completely, partially, or not have understood nothing.
Although the data have statistical limits which are used to decide if the hearing problem deserves to be taken into consideration or not, is the person who suffers from deafness and people live with that, those who know if it is a problem for every day.
What is chorionic biopsyIt consists of a sample of the placenta to analyse and identify possible genetic diseases and malformations in fetuses.
Chorionic biopsyChorionic biopsy is a diagnostic test that involves taking a sample of placenta in order to scan it for possible genetic diseases and malformations in fetuses that have high risk for them. Its accuracy is very high, and allow prospective parents to decide to terminate the pregnancy if the fetus is not viable or the illness being treated that their quality of life will be diminished.
The placenta is generated throughout the first weeks of gestation from a first marriage between the embryo and the wall of the uterus. From 10 weeks of pregnancy, as a maximum, this body has already fully developed and we can distinguish different areas; one of them is the Chorion. The Chorion is the part of the placenta coming into direct contact with the wall of the uterus; It is there where is the exchange of nutrients and is the most external part.
The Chorion biopsy is performed between weeks 11 and 13 of pregnancy. You can do before, but the risk of fetal malformation or abortion is not acceptable, and later is not a cost-effective technique, since the results take time and not so advanced pregnancy can be interrupted. It may be done in two ways:
- Transabdominal: abdomen skin punctures made points to pass through the abdominal wall and reach the placenta. There are clamp or a sample of Chorion aims to analyse later under a microscope. The process is guided by ultrasound.
- Transcervical: sample collection is performed through the vagina and cervix. In this case there are punctures made points skin, but the same measures of antisepsis should be maintained to prevent infection in the placenta. Ultrasound is also used to guide the process.
When a chorionic biopsy is doneThe chorionic biopsy is a test that is recommended to a pregnant in the following situations:
· High risk of chromosome in the embryo disease calculated by screening that is done to all pregnant women (used ultrasound and analytical parameters).
· Study of molecular or biochemical diseases that, although they do not cause physical malformations, may compromise the life of the fetus outside the womb.
· Children or previous unborn fetuses with genetic diseases.
· Father or mother genetic disorders known.
· Confirmation of pre-implantation studies, i.e., those who perform in fertilized eggs until they are implanted in the uterus.
· Alterations in the growth or development of the foetus detected by ultrasound in the first quarter, even when screening was negative or indeterminate.
Therefore, Chorion biopsy is a diagnostic method of genetic diseases and malformations of the foetus with high accuracy. He is not recommended for use if parents have decided to continue the pregnancy regardless of the result of the test.
Preparation for chorionic biopsyIf you are performing a chorionic biopsy these are the issues that you must take into account:
· Duration: the test will last approximately 30-60 minutes. The biopsy itself lasts 10 minutes maximum, the rest consists of the preparation of the material and the biopsy area.
· Income: the chorionic biopsy can be performed on a query or an aseptic room of cures. Depending on the Center may require hospital admission or not. If your health is good you can go home soon.
· Is necessary to be accompanied?: is recommended to be accompanied. After the test you may be distressed or somewhat dizzy. He is not recommended that you drive or travel alone then.
· Drugs: don't need to take any prior medication. Should be communicated to the doctor all the medicines taken regularly and will decide if we will suspend any. It is important to also inform of allergies to medications or other products, if you have them.
· Food: it is not necessary to remain in fasting prior to testing or after. Take a light meal and avoid taking all day coffee and other exciting substances, including also the day prior to the test. If for any reason it should go on fasting to test the doctor you warn.
· Clothes: you can go with the same clothes every day. When you get to the hospital or doctor's office it is possible that you are given a robe to change you should see fit, although often is enough to discover the part of the body that is to biopsy.
· Documents: it is important to bring with you the steering wheel which shows the performance of this test. The health insurance card is recommended. Normally you will not you any document after the test because it takes time to analyze the results.
· Pregnancy and breast-feeding: is a test that can only be performed during the first trimester of pregnancy.
· Contraindications: should not be in pregnancies who have had a previous abortion threat, unless there is no choice but to do. Nor is recommended before the week 11 of pregnancy or after the 13. You should discourage couples that they don't shuffle the possibility of terminating the pregnancy regardless of the result.
How the chorionic biopsyFirst your doctor will study if you are a possible candidate to perform you a chorionic biopsy. It will only recommend it when the risk that the embryo has a genetic disease is high according to the screening that is done in the first trimester of pregnancy. If the risk is low is not recommended to perform this test, since it is very likely that everything goes well. To make you test will count with your consent, and will remind you that the result can be both positive and negative, and that you must face that possibility.
You will quote for you Chorion biopsy another different day. When it comes to ask you first of all that you change your clothes and views a comfortable gown for you and for the doctor that perform you the test. He then measured all your vital signs, such as blood pressure, heart rate, respiratory rate and temperature, to check that you are in optimal conditions to put you to the test.
Prepared once you will be asked you to tumbes on a stretcher in a position that facilitates the realization of the test. Normally lying face up with the legs apart, just like when make you a Pap. The first thing that will be an ultrasound done to determine where is the placenta at that time. Then proceed to perform the biopsy via transabdominal or transcervical route.
The most used technique is the transcervical; to do so, the first thing that will will be cleaning the vagina and cervix with antiseptic solutions. Thus eliminate polluting surface germs. They then inserted a very thin and long needle through the cervix to reach the Chorion and a sample. At that time, you will notice a pressure in the lower part of the abdomen (similar to the menstrual pain or discomfort of a PAP), for some women is painful, while others feel only a simple pressure intense.
Once the biopsy gynecologist will withdraw the needle. It is not usual that you bleed, although if you can stain a little. If you are a woman with blood group Rh negative will be at that moment gamma globulin prophylaxis. Then you remain awhile in observation to check that everything went well. It will not need to wait on the results, since they need to be processed for a time and at first glance not seen no alteration.
The chorionic biopsy complicationsAll biopsies have risks to be evidence that invade the body organs, albeit slightly. They tend to be infrequent complications and in the majority of cases have easy solutions.
Possible complications are added to the chorionic biopsy during pregnancy, and they can appear during or after the test. Whenever they arise you should go to the emergency room. Some of the more common in chorionic biopsy complications are:
· Bleeding from the biopsy with moderate bleeding point.
· Local infection with fever.
· Abortion (< 1%).
· Uncontrollable pain .
· Drilling of other organs (very unlikely).
· Proved wrong, both positive and negative, that can be done to take attitudes wrong with the pregnancy.
Chorionic biopsy resultsThe results of the chorionic biopsy may take from 48 hours up to one week. The time of waiting requires patience and tranquility. You should not worry unnecessarily by the final results of the test; It is best that you don't think about it.
Histological, genetic, cellular and molecular analysis will be made on the sample biopsied. Alterations on many levels can be detected in this way. We must remember that detected alterations can be highly variable, from serious disorders that put on a serious commitment to the future baby's life, until others milder affecting deficits. Therapeutic end the doctor will recommend the indication and prospective parents must make the final decision.
All results will be interpreted by the gynecologist and geneticist, if necessary. They may as well explain what happens to the embryo and what options are available according to your experience. One cannot forget that the test is indeterminate in 2% of cases, so it may be necessary to perform more tests, or simply make decisions with the information available. The possibility of terminating the pregnancy must meditate seriously and will only be a viable option in some countries.