All about: medical tests | medical exams [2]

• What is a skin biopsy
• What is the bone marrow biopsy
• What is a liver biopsy
• What is the Bronchoscopy
• What is a catheterization
• What is the cystoscopy?
• What is a cervical cytology?
• What is colonoscopy?
• What is a colposcopy
• What is bone densitometry

What is a skin biopsy

Allows you to diagnose diseases of the skin whose existence the dermatologist has not been able to determine by other means.

Skin biopsy

The skin is an organ that extends over the whole surface of our body from external aggressions and synthesizing vitamins necessary for our organism. Its thickness varies depending on the region of the body, ranges from 0.5 cm to more than one 1 cm. Skin biopsy involves taking a piece of skin for later analysis under the microscope or in a laboratory. It is a test that is often carried out for the study of skin diseases such as autoimmune diseases, melanoma and other tumors.
Thanks to her has been diagnose diseases that could not be decrypted only with the exploration of the dermatologist. The main advantage that has the skin on other biopsies biopsy is that it is a body with very easy access, so you can take samples in a way very little invasive.
This ease of access has made that cutaneous biopsy will become a daily test in dermatology. In addition, risks associated are rare and usually not very serious. You can be performed in less than 20 minutes and the hospitalization is not necessary. Although it is a simple test allows knowing the patient's skin disease deeply, and so provide you with the most appropriate treatment.
There are three types of skin biopsies:
Punch or punchbiopsy: is performed with a hollow cylinder of sharp edges that a circular sample of skin from few millimeters in diameter.
Surgical biopsy: it is done with a scalpel, its size may vary according to the need for the study. Lets get subcutaneous fatty tissue.
Excisional biopsy: realized with scalpel and to be biopsied is caught all the skin lesion, eliminating it.

When doing a skin biopsy

Skin biopsy is a medical test that is performed for the following reasons:
A definitive diagnosis: Although many of the skin lesions may be diagnosed at a glance by a dermatologist, sometimes it is necessary to study under a microscope injured skin provide additional information that will help specialist to decide on a specific diagnosis.
Isolation of microorganisms: the skin sample can be processed in a microbiology laboratory to check for bacteria, fungus, virus, or parasite responsible for cutaneous lesions.
Molecular study: Although the specific diagnosis of a skin lesion is known, it is sometimes necessary to perform a skin biopsy to study biochemical components that help us to determine their severity and their most appropriate treatment.
Genetic study: on many occasions, to diagnose a genetic disease it is necessary to obtain cellular tissue from any part of our body to study their chromosomes. The skin is a tissue that is frequently used for this purpose because of its easy availability.
Stem cell therapy: Although today it is in phase of study, expected that in the future the skin removed with a biopsy can serve to extract stem cells.

Preparation for skin biopsy

If you are going to perform a skin biopsy these are issues that you must consider when go ready to test:
Duration: the test will last a total of 15 to 20 minutes. The biopsy itself will last from three to five minutes, the rest consists of the preparation of the material and the biopsy area.
Income: cutaneous biopsy can be performed in a query, a priests room or an operating room either. Hospital admission is not required in any case.
Is necessary to be accompanied?: no need to be accompanied to a cutaneous biopsy, but it is recommended. There are particularly sensitive people who can get dizzy with the test, but in the vast majority of the time will not notice anything.
Drugs: don't need to take any prior medication. Although it must be communicated to the doctor all the medicines taken regularly, especially antiplatelet agents, such as the add, or blood thinners, as the Sintrom. It is important to also inform of allergies to medications or anaesthetics, if you have them.
Food: don't need to stay in fasting prior to testing or after. If for any reason it should go on fasting to test the doctor would let you know in advance.
Clothing: can make the skin biopsy with the same clothes every day. When you get to the hospital or doctor's office ask you you to discover the part of the body that goes to biopsiarse.
Documents: is essential 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: cutaneous biopsy is not contraindicated in pregnancy or lactation, but that State should know because some alterations of the skin can be explained by these States unless they are necessarily pathological.
Contraindications: skin biopsy does not have any specific contraindication. Just be must evaluate the usefulness of the test and if it can help the patient to understand their disease.

How the skin biopsy

First, the dermatologist will evaluate in prior consultation if necessary or not to perform a skin biopsy. If deemed useful will inform you of how it's performed, what information we can provide and what are the possible risks involved. It will give you a document informed consent summarizing the main characteristics and you will have to sign it if you agree with its realization. Often it is only necessary to give an oral consent.
Skin biopsy may make you it the same day or in another different appointment. When go to make ask you, first of all, you discover the part of the body that go to biopsy. The dermatologist will mark with a pen or marker the skin lesion biopsy owed and will begin to prepare the area.
First and foremost is washing your hands and with some gloves will clean the area with an antiseptic that would eliminate the germs that could be on the surface of the skin. Then prepare the material needed to perform the biopsy and gloves will be changed by a few sterile. With them you can handle all the sterile material without polluting it.
First it numb eye area with a small subcutaneous injection. This prick can hurt a little and to introduce the anesthetic can moderately escocer. This will be the only step that you may be uncomfortable, then the area is numbed and you will not notice anything else. If at some point in the process you sintieses back pain will only have to notify the doctor and he will make you more anesthesia.
When the skin to biopsy area is numbed shall be to cut the skin to study sample. Punch biopsies will be used the punch, a few cylinders with sharp edge that you just have to press against the skin. If it is a surgical or Excisional biopsy will be directly used a scalpel. Once cut the piece of skin removed with pliers and cut its base to remove it. The piece of skin gets into a boat that keeps it until its study in the laboratory.
Once the biopsy, wound that remains should be sutured. The extracted fragment of skin does not usually exceed the centimetre, so do not worry by the wound and subsequent scar. In the majority of cases is sufficient to close the wound with one or two stitches and then the scar is almost invisible. He thinks that many times you have become larger wounds that did not leave marks on your skin.
When you have finished you will put a dressing which you can withdraw within 24 hours. You will have stitches you to remove a doctor or nurse at your usual Health Center, let them 7 to 14 days, depending on the area of the region of the biopsied skin. Then you can get dressed and pick up your things, it is not necessary for you to wait to any kind of documentation, since the results take time and you will be given another appointment.

Complications of skin biopsy

All biopsies have risks to be invasive tests, albeit slightly. They tend to be infrequent complications and in the majority of cases have easy solutions. They can appear during or after the test. Some of the most common cutaneous biopsy are:

• Bleeding from the point of biopsy.
• Local infection with fever.
• Reaction to anesthesia during the test.
• The biopsy wound opening spontaneously.
• Keloid scar when it cure.

Skin biopsy results

The results of the skin biopsy may take to be between one week and one month. The waiting time, it therefore tends to be long and requires patience and tranquility. The reason is that the sample biopsied need to be processed in order to study it properly. The following tests will be held on this sample:
Histological staining: using special dyes cells are colored and can be observed under the microscope directly.
Immunofluorescence studies: you can attach fluorescent substances to certain components of the cells and thus verify its existence.
Microbiological cultures: If infection is suspected sample can be grown in appropriate media that allow the growth of microorganisms.
Molecular studies: specific proteins that classified the types of cells that contain the sample can be identified.
All of these tests will be performed by the physician. Along with the symptoms, analytical studies and biopsy specialist can perform an accurate diagnosis most of the times. So you can explain what happens to you, and what are the treatments available to solve your skin disease.

What is the bone marrow biopsy?

Through a puncture with a fine needle in a bone it allows to study with depth hematologic diseases.

Bone marrow biopsy

Bone marrow is a soft and spongy tissue that is located on the inside of the bones in our body. Its main function is to hold the stem cells that are responsible for the production of blood cells: red blood cells, white blood cells, and platelets. Bone marrow biopsy involves taking a piece of this fabric together with a suction of blood that irrigates it through a puncture in the bone.
It is a test that is often carried out for the study of hematologic diseases such as anaemia, tumours and rare diseases. Thanks to it, have been achieved cure diseases that at the beginning of the 20th century were considered untreatable.
Their risks are similar to those of other types of biopsy and, however, the majority of the people has a special fear to be held because it is related to pain. Actually the bone marrow biopsy is a test that causes some pain, but current techniques have much diminished damage caused before, both in intensity and duration (only lasts a few seconds).
Although it appears that the bone marrow has a difficult access, is it easily reachable through superficial bones with a fine needle. It is an invasive technique, but little aggressive, and is performed easily without the need of a hospital admission. It takes less than half an hour and allows you to understand the disease of the patient with depth to provide you with the most appropriate treatment.

When a bone marrow biopsy is done

Bone marrow biopsy is a test that is carried out or requested when the following alterations in a person:
Anemia of unknown cause: Although the most frequent causes of anaemia lack of iron or of specific vitamins, sometimes the reason is not known there are a low number of red blood cells in the blood. A bone marrow biopsy would know if there is a primary disturbance in blood stem cells.
Leukopenia: in the same way that anemia is decrease of red blood cells in blood, leukopenia is the decrease of white blood cells in blood. A transient leukopenia may appear in specific situations of infection in elderly people, but most of the time indicates a primary disease of the bone marrow that one must study.
Thrombocytopenia: thus calls the decline in the number of platelets in the blood. Their decline may be due to external diseases, but when they have ruled out the bone marrow should be studied to see what is the main cause of the thrombocytopenia.
Bone marrow Aplasia: is the combination of anemia, leukopenia, and thrombocytopenia. The bone marrow is consumed until already it can not produce any blood cell more.
Leukemia: one of the most common tumors of the white blood cells. Leukemia can be diagnosed through a blood test, but it is important to know if there is involvement of the bone marrow to know its gravity.
Lymphoma: another also frequent tumor of the white cells. In this case the first organs affected are the lymph nodes, but you can also pass into the blood and thus affect the bone marrow.
Multiple myeloma: is a tumor of the white cells type B that are responsible for producing antibodies that defend us against infections. This tumour appears initially in the bone marrow and the biopsy helps to know its features.
Myelofibrosis: in this disease the bone marrow atrophy until it literally dry. The biopsy is not possible because there is no fabric, but precisely by performing this test ensures the diagnosis.
Polycythemia vera: it is the polar opposite of anemia, here red blood cells are excessive and they make blood viscous. So blood flow is dense and slows metabolism, among other symptoms.
Infections: some infections affect in particular cells progenitors of blood. One of them is visceral leishmaniasis, a parasitic disease relatively common in exotic regions of Asia and South America.
Amyloidosis: occurs when certain proteins of the organism are synthesized evil, so that they cease to be soluble, and accumulate in organs throughout the body. The primary form is diagnosed with a bone marrow biopsy.
Cell therapy: treatment with stem cell research today, is booming. Many of these therapies are based on extracting stem cells from the bone marrow, modify them in the laboratory and implanted them in other areas of the body. He is currently a therapy study of which is not known its effectiveness.

How bone marrow biopsy

First, the doctor will assess in a consultation if necessary or not performing a bone marrow biopsy. If deemed necessary will inform you of why it thinks, how it's performed, what information we can provide and what are the possible risks. It will give you an informed consent document summarizing the main characteristics and you will have to sign it if you agree with its realization.
Bone marrow biopsy may make you it the same day or in another different appointment. When going to ask you in the first place that you change your clothes and views a comfortable gown for you and for the doctor that perform you the test. Then will measure you all 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.
Sometimes placed you a via vein in the arm if it had introduced some medically during the conduct of the test, although it is not common. Sometimes will offer you some relaxing drug remain sedated during the test, it is recommended if you are nervous or have you are particularly sensitive to pain.
Prepared once you will be asked you to tumbes on a stretcher in a position that facilitates the realization of the test. The bones where usually do the biopsy are the sternum (in the center of the chest), the iliac Crest (at the hip), tibia (in the leg) and vertebrae (on the back). Usually take the biopsy of the iliac Crest, if there are no impediments, so they ask you that you place lying on side and to relax.
To proceed with the biopsy, the first thing that will is clean the skin where it is made with alcohol or iodine compounds. So remove any contaminants germs from the skin surface. Then they will inject an anesthetic and most deep from the surface. You will feel a slight prick of the needle, and then a burning sensation at the very moment in which the anesthesia gets. Thus, this area of the body will be asleep and insensitive.
Then they introduce a longer needle to reach the bone and go through it, then you will notice a pressure very strong in bone, for some people is painful and for others is simple intense pressure. The first needle will carry out a vacuum to pick up blood and loose cells, then take a small cylinder of tissue.
Once the biopsy needles be removed. It is normal that the puncture point blood slightly, apply continued pressure for a few minutes to stop the bleeding. Then they placed an bandage or a compression dressing and you'll be ready to go home. It will not need to wait the results since they need to be processed for a time and at first glance not seen no alteration. The bandage must hold for at least two days, is normal in the days after the test to have pain in the area and need to take some pain reliever you your doctor will prescribe.

Complications of bone marrow biopsy

All 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. They can appear during or after the test, whenever they arise should go to the emergency room.
Some of the most common complications in bone marrow biopsy are:

• Bleeding from the point of biopsy.
• Local infection with fever.
• Uncontrollable pain.
• Reaction to anesthesia during the test.
• Perforation of other organs (very unlikely).

Preparation for bone marrow biopsy

If you are performing a bone marrow biopsy these are issues you must keep in mind to go well prepared to test:
Duration: the test will last a total of 15 to 20 minutes. The biopsy itself will be one minute, the rest consists of the preparation of the material and biopsy area.
Income: bone marrow biopsy can be performed on a query or a room of cures, in such a way that it does not require hospital admission.
Is necessary to be accompanied?: it is not necessary to be accompanied, but yes it is recommended, as there are sensitive people who are sore or something queasy after the test.
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, alcohol 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 perform the test with the same clothes every day. When you get to the hospital or doctor can give you a gown to change you should see fit, although often is enough to discover the part of the body that goes to biopsiarse.
Documents: is essential 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: bone marrow biopsy is not contraindicated during pregnancy or during lactation, but that State should know because some biological constants that are studied will be altered from itself during these stages.
Contraindications: this type of biopsy does not have any specific contraindication.

Bone marrow biopsy results

The bone marrow biopsy results may take from one week up to a month. The waiting time, it therefore tends to be long and requires patience and tranquility. The reason is that the sample biopsied can not be analyzed at the time. The following analysis will be carried out on this sample:
Histological staining: using special dyes cells are colored and can be observed under the microscope directly.
Immunofluorescence studies: you can attach fluorescent substances to certain components of the cells and thus verify its existence.
Microbiological cultures: If infection is suspected sample can be grown in appropriate media that allow the growth of microorganisms.
Molecular studies: specific proteins that classified the types of cells that contain the sample can be identified.
All of these tests will be performed by the physician. Along with the symptoms, analytical studies and biopsy the doctor will already have sufficient information most of the times to be able to make a diagnosis. So you can explain what happens to you, and what are the treatments available to solve your disease.

What is a liver biopsy

It is to take a piece of tissue that makes up the liver to check if any alterations at the cellular level.

Liver biopsy

The liver is one of the largest human body organs. It is in the abdomen, connected to the digestive tract, and performs many functions. Among the most important functions are the secretion of bile, cleansing of toxins, and the synthesis of clotting factors. Liver biopsy involves taking a piece of the fabric that makes up this body to study it under a microscope and check if there are any alterations at the cellular level.
It is a test that is performed frequently for the study of alterations of liver cirrhosis, hepatomegaly or hepatocellular carcinoma. Used from 1939 thanks to Drs. Ilvesen and Copenhagen Roholm; Since then has been to diagnose diseases that were not well classified at the beginning of the 20th century.
It is an invasive technique, but little aggressive, and is done quickly without the need for a hospital admission. It takes less than half an hour and allows us to know the patient's disease, deeply to provide you with the most appropriate treatment.
Their risks are similar to those of other types of biopsy; It is a test that causes some pain, although less that years ago thanks to current techniques, that have managed to reduce it, both in intensity and in duration (only lasts a few seconds). Although it seems that the liver has easy access is not easy to reach, since the abdominal wall is made up of several layers of muscles and ribs are also an impediment. In addition, it is the risk of puncturing a lung or tear the liver, that today this test is performed under ultrasound control.

When a liver biopsy is done

Liver biopsy He is performed when changes that suggest liver impairment in a person are. In recent years the liver biopsies have been reduced considerably thanks to the development of imaging such as ultrasound, magnetic resonance imaging or computed tomography techniques. The use of fibroscan, a novel technique that allows to know the density of the liver and which is already used on a routine basis was also implemented.
Disorders that may require the completion of a liver biopsy are:
Cirrhosis: when the liver is damaged inside appear fibrous scars that invade the body destroying its structure and limiting its operation. Cirrhosis has many causes, the most common are alcohol, viral hepatitis and other genetic diseases.
Autoimmune hepatitis: sometimes our body's defenses attack the liver. Lymphocytes and other white cells invade the spaces of the liver and destroy it. A biopsy allows you to visualize these changes.
Sclerosing cholangitis and biliary cirrhosis: these two diseases have an uncertain origin, probably the immune system is involved in some way. Biopsy helps to identify changes in the bile ducts.
Infections: some infections affect in particular the liver. Although no case of a biopsy, drainage of abscesses (bacterial or amoebic) is performed similarly to this technique.
Fatty liver: it is the accumulation of fat in the liver, so that the cells swell and prevent proper operation. It usually occurs in the context of alcohol consumption, but familial cases in people who do not take excessive amounts of alcohol are also given.
Lymphoma: Although lymphoma is a cancer of white blood cells of the immune system, many times is organized into specific organs such as the liver. Biopsy may remove doubts, since imaging techniques are often not conclusive.
Hepatocellular carcinoma: is the malignant tumor of the liver which has more importance in this body. Biopsy allows you to diagnose it safely and studying your degree of malignancy. Certain imaging techniques allow to avoid biopsy sometimes.

Preparation for liver biopsy

If you are performing a liver biopsy these are the issues that you must take into account:
Duration: the test will last a total of 15 to 20 minutes. The biopsy itself will be one minute, the rest consists of the preparation of the material and the biopsy area.
Income: liver biopsy can be performed on a query or a room of cures, in such a way that it does not require hospital admission.
Is necessary to be accompanied?: is recommended, as there are sensitive people who are sore or somewhat dizzy after the test.
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. Consult your doctor before taking aspirin, ibuprofen, or other NSAIDs, a week before the test. Paracetamol is not contraindicated for this evidence.
Food: is necessary to remain in fasting 8 hours before the test, not even drinking water. Throughout the day, it is recommended to take a light meal and avoid taking all day coffee, alcohol and other exciting substances, including also the day prior to the test.
Clothes: you can go to the test with the same clothes every day. When you get to the hospital or doctor's office they will give you a gown to change you.
Documents: is essential 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. Before the test, they will make you sign an informed consent.
Pregnancy and breast-feeding: liver biopsy is not contraindicated in pregnancy or lactation, but that State should know because some biological constants that are studied will be altered from itself during these stages.
Contraindications: do not have any specific contraindication.

How the liver biopsy

First your doctor will assess in a consultation if necessary or not to perform a liver biopsy. If deemed necessary will inform you of the why, how is performed, what information can bring, and what are the possible risks. It will give you an informed consent document outlining the main features of the test, you will have to sign if you agree to its realization.
Biopsy may make you it the same day or in another different appointment. When going to ask you in the first place that you change your clothes and views a comfortable gown for you and for the doctor that perform you the test. Then will measure you all 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. You must inform the doctor all medications you are taking and if you have a problem with blood clotting.
Sometimes they placed you a via vein in the arm if it had to enter any medications during the conduct of the test, although it is not common. Sometimes they will offer you some relaxing drug to make you stay sedated during the test; It is recommended if you are nervous or if you're particularly sensitive to pain. Prepared once you will be asked you to tumbes on a stretcher in a position that facilitates the realization of the test. You may lie down face up and place your right hand below the neck, so you let all the right side exposed.
To proceed with the biopsy, the first thing that will will be clean the skin in the area where it is done with some antiseptic. Then they injected an Anaesthetic from the surface of the skin to deeper levels. You will feel a slight prick of the needle, and then a burning sensation at the very moment in which the anesthesiagets. This area of the body is asleep and insensitive and they may make a small incision with a scalpel, to separate the skin and expose the muscle. They will put a gel near the incision for a ultrasound that locate the liver and serve as a guide to needle done you at the same time.
Through the incision they inserted the needle, fine and long, reaching the liver; at that time, you will notice a very strong pressure on the side that can reach the right shoulder. The needle will catch a small cylinder of tissue and they will draw it at once. During this prick will give you instructions to keep an adequate rate of breathing that will help you to concentrate and to endure the hassle.
It is normal that the puncture point blood a little; Why apply pressure continued with firmness for a few minutes to stop the bleeding. Then they placed a bandage or a compression dressing and you'll be ready to go home. It will not need to wait on the results, since they need to be processed for a time, and at first glance not seen any alteration. The dressing will keep for at least two days; It is normal that the days of test have pain in the area and need to take some pain reliever you your doctor will prescribe.

Complications of liver biopsy

All 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. They can appear during or after the test, and if you are serious you should go to the emergency room. Some of the most common complications in a liver biopsy are:
Bleeding from the point of biopsy or internal bleeding.
Local infection with fever.
Pain.
Reaction to anesthesia or sedation during the test.
Drilling of other organs such as the gallbladder, kidney or lungs.

Liver biopsy results

The liver biopsy results may take from one week up to a month. The waiting time, it therefore tends to be long and requires patience and tranquility. The reason is that the sample biopsied can not be analyzed at the time, it has to be processed in a laboratory. The following analysis will be carried out on this sample:
Histological staining: using special dyes cells are colored and can be observed under the microscope directly. The basic stain is hematoxylin and eosin (purple and pink).
Staining metals: iron, copper and other deposits can be detected thanks to her.
Immunofluorescence studies: you can attach fluorescent substances to antibodies that bind to specific components of the cells and thus to detect its presence.
Microbiological cultures: If infection is suspected sample can be grown in appropriate media that allow the growth of microorganisms.
Molecular studies: specific proteins that classified the types of cells that contain the sample can be identified.
All of these tests will be performed by the physician. Along with the symptoms, analytical studies and biopsy, may make diagnosis most of the times. So you can explain what happens to you, and what are the treatments available to solve your disease.

What is the Bronchoscopy

Medical test used to diagnose and treat diseases of the respiratory tract and lungs.

Bronchoscopy

Bronchoscopy, also known as fibrobroncoscopia, is a medical test used to diagnose and treat diseases of the respiratory tract and lungs. Through a bronchoscope, a device that consists of a tube of about of half a centimeter in diameter and variable length, depending on the age of the patient, who has a video camera on its end. Lets you see clearly inside the Airways on a monitor. The bronchoscope tube also has several channels in its interior, where you can enter various instruments, and allow diagnostic testing such as the taking of biopsies, or even perform treatments such as Cauterization of bleeding vessels or the removal of polyps.

Types of bronchoscopes

There are two types of bronchoscopes. The flexible bronchoscope is used more frequently. It consists of a thin, flexible tube that is inserted through the nose and allows you to get very far in the airway with greater comfort for the patient. General anesthesia for use is not required. The rigid bronchoscope is a thick, short and rigid tube. It is inserted through the mouth and may not get as far as the flexible bronchoscope. Their use requires that the patient is under general anesthesia. The advantage of the rigid bronchoscope is that its light is very thick. Used in cases of massive bleeding which can prevent a correct visibility with the flexible bronchoscope. It is also used to perform biopsies of large size or to remove large foreign bodies that could not be removed with the flexible bronchoscope. There are procedures such as dilation of a bronchus which has narrowed, or the use of the laser to destroy a tumor, which are carried out by means of the rigid bronchoscope.

Bronchoscopy is done

The most common reasons why this test may be requested are as follows:

• Identify the cause of some symptoms such as chronic cough, bleeding (hemoptysis) cough or difficulty breathing.
• Take biopsies of the Airways of the lung or lymph nodes near, or samples to study possible respiratory infections, tumors, or other lung diseases.
• Diagnose and evaluate the extent of lung cancer.
• Remove foreign bodies in the airway.
• Treat bleeding that occurs in the Airways.
• Expand areas of the respiratory tract have been able to narrow by a tumor or other diseases. It allows the placement of a stent, which is like a spring self-expanding, which widens the strictured area and keeps it open.
• Treat cancer of the lung by means of the laser or by placing radioactive substances (brachytherapy)

Preparation for Bronchoscopy

These are the issues that you must take into account in preparation prior to submit to a Bronchoscopy:
Duration: the test is performed in about 30 minutes, but it can take longer depending on the findings, which are, or if any therapeutic procedure is done or take biopsies.
Entry: most common, i.e. flexible Bronchoscopy bronchoscopy, can be done on an outpatient basis. Rigid Bronchoscopy requires general anesthesia and may require income.
Is necessary to be accompanied?: is usually administer a sedative so stay quiet during the test, so it is recommended that someone accompany you to take you home then.
Drugs: is not required any special medication.
Food: is necessary to remain without ingesting water or food for 8-10 hours before the test.
Clothing: you can wear any clothes you want to but it should be easy to remove, as they will remove you most of the clothes and will facilitate you a hospital gown.
Documents: should be informed consent, which is a role where they explain you what is the test and its potential risks. You should read it carefully and take it signed. You must take the wheel of the test request.
Contraindications: You should not do a bronchoscopy in the following cases:

• Serious or "unstable" patients with significant hypotension, severe arrhythmia, etc.
• In patients with respiratory failure that will not tolerate the test. In these cases can sometimes be under general anesthesia and intubated in a unit of intensive surveillance (UVI)
• Pregnancy is a relative contraindication.
• Serious blood clotting problems.

Pregnancy and lactation: in general the test should be avoided during pregnancy, although on occasions it could be if it is considered that the benefits outweigh the risks. The minimum dose of sedatives is used possible and always with medications safe for the fetus. Breastfeeding in general is not a contraindication performing the test. Sedatives given to perform the procedure in general does not pose a risk to the infant, unless you have severe breathing problems.

Other considerations regarding the Bronchoscopy

You must tell your doctor if you have allergies to medications, particularly to anaesthetics.
If you are taking aspirin or NSAIDs may tell you to stop taking them the 7-14 days prior to the test. This is must be aspirin and anti-inflammatory drugs would facilitate the bleeding where necessary take a biopsy or remove a polyp. The doctor will instruct you when to resume this medication.
If you are taking anticoagulants, it is very important to warn the doctor, then it will be necessary to temporarily suspend them. The doctor will give you instructions in this sense depending on the anticoagulant that take.

Bronchoscopy is done

Bronchoscopy is often make a medical specialist in pneumology together with an Assistant who may be nursing staff. The most frequent is a flexible bronchoscope is used. Initially, they will tell you to undress from the waist up and put on a hospital gown. You will also need to remove dentures, sonotone, contact lenses, sunglasses, jewelry, etc, and not to wear make-up. It is a good idea to go to urinate before the test so that they do not enter a desire during the procedure.
It will pick up a vein in the arm. There you can pass a drug that will make you to be relaxed and drowsy during the test. It is possible to then not remember much about the procedure. They put electrodes to control the heart rate and the amount of oxygen in the blood during the test. They also checked her blood pressure. It is usually given an anesthetic in the nose and throat spray to lessen the discomfort and facilitate the introduction of the bronchoscope.
The test is usually performed sitting on a chair similar to the dentists. The physician shall introduce the bronchoscope previously lubricated by the nose, although sometimes you can enter through the mouth. It reaches the vocal cords, where more anesthetic spray is administered. It can the doctor tell you that you will pick strong air pipe pass vocal cords. It is important that you do not attempt to speak during the procedure. Then the doctor will examine the trachea and bronchi.
The doctor has tools such as microtweezers, capsula, etc. that you can get the channels that has the bronchoscope, and allow you to perform some diagnostic or therapeutic procedures. For example, can suck secretions, take a biopsy, removing a polyp coagulate bleeding, remove a body odd, etc. Occasionally can be used at the same time an x-ray machine, which will be located on top of you and allows you to take x-ray images that can be on a video screen. This helps the doctor to locate certain areas of the lung and to perform various procedures.
After all, the bronchoscope be taken off carefully, and you can let you 2-3 hours in observation in any room annexed until it recovers the sedative effect. As an anesthetic throat have applied you, it is necessary not to eat or drink until you pass the effect of anesthesia. Otherwise, it could be that the food was by the respiratory route. Spit saliva and don't swallow it until you notice that it has passed the anesthetic of the throat is also recommended. It is recommended that you do not drive or operate dangerous machinery during the 12 hours following the test. You should not smoke at least 24 hours. Your doctor will instruct you when you can eat normally and restart the regular activities. This depends on the procedure that have yet done you and medication which provided him.
Rigid Bronchoscopy He is performed under general anesthesia and lying. It does need to be intubated, i.e., that have a tube placed in the trachea to be able to breathe. This tube is connected to a machine that is that insufflates her air. It then proceeds to introduce the rigid endoscope and make sampling or therapeutic procedures.

Complications of Bronchoscopy

Bronchoscopy is a very safe test. It is also rare to have side effects from drugs that can be administered as sedatives. The anesthetic spray that will have in the throat knows something bitter and makes you feel tingling and swelling in the throat and tongue. You can notice chest tightness or have some gagging or coughing while moving the bronchoscope. The airway is not blocked during the test never, but if you notice any significant discomfort can be noted is the doctor giving him a small hit in the arm or with any previously agreed signal.
After the procedure you will feel drowsy for a few hours and is likely to not remember much of what happened. You may notice some discomfort in the throat for a few days. These nuisances can calm down if gargling with warm salt water. If you've had a biopsy or have had your a polyp removed you can cough with some blood for a few days.
It is very rare that there is a grave by a Bronchoscopy complication, although it can occur. In rare cases the procedure can cause cardiac arrhythmias or spasm of the bronchi, which may hinder breathing (as occurs in asthma). Sometimes, the bronchoscope can damage the surface of the mucosa and cause bleeding. If the lung is punctured you can enter air between the lung and the chest wall and cause a collapse of the lung, a complication called pneumothorax. There is a minimal risk of infection by the procedure. Exceptional cases of death due to the test have been described.
You have a few tenths after the race may be normal. However, if after the test Note chest pain, shortness of breath, fever higher than 38 ° C, severe dizziness, cough up an appreciable amount of blood, or have any other symptoms that worry you, should immediately contact their doctor.

Results of Bronchoscopy

During Bronchoscopy airway surface, is seen with what your doctor can diagnose many diseases directly. It is possible that later you any results the day of the test. The specialist will make a written report that will give you a few days of the test, possibly along with some photos of possible pathological as polyps, ulcers or tumours findings.
When biopsies have been taken, the samples will be studied under a microscope by a pathologist and a report will be made separately with this result.
You can also that you have caught samples for microbiological study of possible lung infections. This will result in a third report by a specialist in microbiology. All these results may take several weeks to be available.
The Bronchoscopy result report will include data on tolerance test, territories explored with the bronchoscope, the medication that has been given him and possible eventualities that have occurred during the test. Describe the appearance of the airway and possible pathologies such as polyps, diverticula, tumors, ulcers, bleeding, inflammation, etc. Specify possible diagnostic or therapeutic procedures that have been made, like biopsies or removal of polyps, and to which lab extracted samples have been sent. The report will be completed in a few weeks with the results of these samples.
The doctor has asked the test will give you the results and will instruct you to need to make other complementary explorations or follow any treatment.

What is a catheterization

It is a technique that allows to study and treat certain diseases of the heart, as lesions of the coronary arteries.

Catheterization

Cardiac catheterization is a technique performed by cardiologists that allows to study the blood vessels supplying the heart, which are the coronary arteries. It consists of introducing a long wire, Catheter, called through a peripheral to the heart artery. Once inside coronary arteries a radiocontrast is instilled, and x-ray, we can see the vessels drawn in the image.
Thanks to this technique we study the anatomy of the coronary arteries, identify blockages, studying arrhythmias, or surgery. This test, for example, has meant a radical change in the management of the cardiac infarct, allowing that it saved hundreds of people with obstructive atheroma plaques in the coronary arteries.
This test was invented in 1927 by Portuguese Dr. Egas Moniz, the same doctor who developed the principles of angiography. In the first catheterisms simple, very sharp and rigid catheters were used so that they could move forward to upstream of the bloodstream without forming thrombi. Today, thanks to the Seldinger technique and anticoagulant drugs can be used flexible catheters, which are less likely to tear the walls of the arteries. Routes of entry as far away as the arteries in the groin or arm are currently used to get from there to the heart.
The complications of cardiac catheterization are rare. The few that happen often in relation to associated interventions, most with catheterization in itself. This test carried out in all cases by cardiologists experts who have the necessary training to carry out, and its use avoids having a cardiac surgeon to operate open heart. It is, therefore, an "operation by the groin".

When a cardiac catheterization is done

Cardiac catheterization He is performed when you want to study coronary arteries or heart to reach for one of the following reasons:
Unstable angina pectoris: when a person pain in the chest due to lack of mild blood flow in the coronary arteries is called angina pectoris. This angina can be stable and not pose an immediate danger, or have features of instability (pain at rest, appearance in the last month, etc.) and be on the verge of infarction. Catheterization should be to study the coronary and reopen some obstructions if there are any.
Myocardial infarction: occurs when a coronary artery is completely blocked the muscle of the heart, myocardial infarction. It is a very serious situation, and in many cases must be urgent cardiac catheterization to reopen the blocked artery.
Study of arrhythmias: not only catheter is used to reach the coronary arteries also can reach the internal cavities of the heart, the Atria and the ventricles. There can electrically stimulate the heart walls to trigger arrhythmias, which are detected simultaneously with an electrocardiogram and catheter itself. In fact, certain arrhythmias may be treated by catheterization, since you can burn the producer of arrhythmias heart tissue, and thus delete it so that I don't have any more problems.
Repair of heart valves: there are some surgical procedures that can be performed by cardiac catheterization, such as valvular stenosis, which through the catheter can be open and allow blood to pass.
Replacement of heart valves: one of the most innovative advances of recent years is the ability to put a new valve in the place of a defective valve. It is the so-called TAVI (Transcatheter Aortic Heart Valve).
Identification of vascular disorders: cardiac catheterization can help detect abnormal vessels or insufficient coronary arteries for the irrigation of the heart.
Surgery planning: in some special situations it is necessary to perform a cardiac catheterization to study the anatomy of the coronary circulation in the area that will be performed. Today is studied to replace this test with computed tomography (CT) thanks to advances in its definition of images.
Diagnosis and treatment of cardiac malformations: catheterisation can help the diagnosis of certain cardiac malformations, although most are already diagnosed by echocardiography. Some specific pathologies can be solved by Cath as small vsds (CIV).

How catheterization

You make the catheterization, firstly they will ask you if you're in agreement with submit to this test and you will be asked to sign the informed consent, where you will read what is. You cited for another day and explain how you have to go. If it's an emergency situation may be decided to put you to the test directly, since in such cases the most important is to save your life.
Can you enter the night before, or not. If you go directly in the morning you should not forget to remain in fasting eight hours earlier. Go to the quiet and accompanied, hospital with enough time to not have to 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 heart rate, and a vein in the other arm via in case you need to inject some drug. Tea will introduce the catheter by the iliac groin artery, although sometimes it chooses to use radial artery of the arm, or the subclavian artery in the shoulder. The area that is puncture is shaved and should be cleaned with antiseptic to maintain correct measures of asepsis. Not you shaving you the area before in your House, you can encourage local infection.
In the shave zone a little local anaesthesia prick before puncturing the main artery. Puncionada once, check that it has reached correctly; the best way to be sure is to check that it leaves bright red arterial blood with pulse (bleeding of all forms is minimal). Then will be a thin hollow tube through the needle, and then remove the needle leaving the tube inside the artery, and through this tube is inserted the catheter, which is like a flexible wire. Each catheter has a different curvature depending on the region of the heart that you want to achieve. At various times are made with low radiation x-rays to see where is the catheter.
When the catheter is in the area of the heart to study are you instil the radiocontrast. At this time it is normal that you feel heat, and even hot flashes; It is a normal feeling. Once studied the anatomy of the area will decide whether or not to intervene at the time. For example, in the case of the study of angina pectoris (which is one of the most frequent catheterization) is seen as the arteries have small notches on the edges of your drawing. This are atheroma plaques that partially obstruct blood flow, and it can expand the caliber of the artery with a small dock around.
Interventions carried out in the heart will go completely unnoticed by you. In no time you will notice anything except the feeling of flushing of the radiocontrast. When finished the catheter will be removed, and the area where the catheter went be pressed for several minutes (between 10 and 20 minutes) to facilitate coagulation of the wound; It should then be cleaned and covered with a bandage.
Finally, will you to another room to rest, and will keep you under surveillance a while. Then you will be taken to a hospital room, or you can go to your House taking care with the puncture wound.

Complications of catheterization

Complications in the catheterization are not very frequent. Some that occur occasionally are:

• Upset, nausea and vomiting.
• Fainting and loss of consciousness.
• Cardiac arrhythmias.
• Tears in arteries through which passes the catheter.
• 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.

Preparing for catheterization

If they are going to perform a catheterization, these are the issues that you must take into account:
Duration: the duration of catheterization is variable. It can last from a few minutes to more than one hour. It tends to take longer when it was decided to intervene on the coronary arteries or other cardiac disorders.
Income: it may be necessary to enter the night before the test. After the test usually will stay a few hours in observation, and sometimes it is necessary to enter a night in the hospital.
Is necessary to be accompanied?: Yes, it is recommended to carry a passenger. Catheterization is not without risk, and is better then 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. Drugs that are usually recommended for testing are antiplatelet.
Food: must remain in fasting eight hours prior to the test.
Clothes: you can go to the Medical Center with the same clothes every day. For the test ask you that you take it off and will put a robe of income, which is more comfortable and hygienic.
Documents: it is recommended to carry the personal medical history, although the doctor will already have it with him. Before you undergo the test you will sign the informed consent with which you agree to make yourself the technique, and meet potential risks, which are rare. They will also a series of basic tests before the catheterization, such as an electrocardiogram or a blood analysis; take the results with you if you have taken them.
Pregnancy and breast-feeding: the catheterization is relatively 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. In rare cases it can be an emergency catheterization.
Breastfeeding does not imply a direct contraindication, but it is better to avoid the test until the end the period of breast feeding, unless it is strictly necessary.
Contraindications: pregnancy would be a relative contraindication to perform this test. It should not be if you have chronic kidney damage, since the radiocontrast can disable them, although this can be prevented by hydration and medication. People who have an active infection nor should undergo this test if it is not strictly necessary.

Catheterization results

Nothing else performed the catheterization because you can see their results. When the coronary arteries are clean they are well outlined, without nicks and loss of contrast. Because a diagnosis is possible at the time of the test, also interventions that solve the problem detected in a direct and effective way can carry out.
At other times, the study should be more detailed. This happens mainly in studies of arrhythmias, where slight alterations of the test may be misinterpreted, and hence the better the cardiologist carried it carefully study the results of the catheterization, and assess them in relation to the rest of the evidence that you made.
The most common is the cardiologist announce you the diagnosis and the results of the test just after making it (in some cases even as it takes place). But it also requires a few days after catheterization have a consultation with the cardiologist. There it will detail you what were the final results of the catheterization and will inform you a diagnosis and long-term treatment (if necessary). In addition, verify that all went well and that your evolution was favorable.

What is the cystoscopy?

Technique to visualize the inside of the bladder and make a diagnosis, take a biopsy, or practicing certain treatments.

Cystoscopy

Cystoscopy is a technique that allows to visualize the inside of the bladder to make a diagnosis, and also to guide certain treatments if necessary. This is a special type of Endoscope, a tube of about 40 cm long and 0.5 cm in diameter, containing a camera. The tube can be of two types:
Flexible: more comfortable for the patient, allows to visualize the inside of the bladder in a quick way for a first analysis.
Rigid: much more bothersome to the patient; in fact, local anesthesia is almost obligatory. Its main advantage is that it allows to visualize the inside of the bladder with much more clarity, because your camera's higher resolution. In addition, the rigid tube has several recesses by which instruments (forceps, rubber bands, scalpels, etc) can be entered.
The cystoscope was invented in 1877 by the German doctor Maximilian Nitze. At first it was a tube simple hollow which enabled viewing stones inside the bladder and gross alterations of the urethra, but soon added you a light and crevices, allowing you to manipulate the inside of the urinary tract. That is how emerged the first endoscopic interventions in history, long before Arthroscopy or laparoscopy. Dr. Nitze, in addition, used that same device to visualize the inside of the esophagus, stomach and larynx, although it was not as useful as when used to view the inside of the urethra.
Cystoscopy, therefore, is part of the minimally invasive techniques which save major surgery and complications associated with this, such as infections of surgical wounds.

When doing a cystoscopy

A cystoscopy is performed when you want to visualize the inside of the urinary bladder and urethra path to confirm a specific diagnosis. It also allows to take biopsies of the walls of the urethra and bladder and, if necessary, diseases can be treated. The most frequent indications of cystoscopy are:
Check if there is cancer in the walls of the urinary tract, and take biopsies to observe suspicious alterations.
Direct sampling of urine to analyze if there is infection, thus preventing contamination of the sample passes through the urethra and go outside.
Diagnose urinary tract malformations and repair them if possible.
Diagnosis and, occasionally, treatment of the benign prostate hypertrophy, which close the urethra, preventing the passage of urine.
Solve the urethral stenosis by Transurethral resections (TUR), which widen the inside of the urethra.
Remove urinary bladder in or impacted stones in the urethra.
Diagnose the presence of cysts, polyps, diverticula, and other pathological formations of the wall of the bladder. Sometimes they can be solved through cystoscopy.
Study in depth chronic cystitis which have not been resolved with antibiotics.
Identify ulcers in the urinary mucosa and take samples thereof if necessary.
Study the presence of blood in the urine, if its origin is a hemorrhage of the lower urinary tract.

Preparation for cystoscopy

If you will perform a cystoscopy, these are the issues that you must take into account in preparation prior to the test:
Duration: cystoscopy has a variable duration according to the technique that will be used. It can last a few minutes (if it is only necessary for the diagnosis or biopsy), or more than half hour (if any surgical treatment should be performed).
Income: cystoscopy can be done on an outpatient basis. You can put yourself to the test and go your home a little while. However, if it is necessary to carry out any surgical intervention is usually done in an operating room to take extra hygiene measures and regional anesthesia, and I can stay in observation longer.
Is it necessary to be accompanied?: Yes, it is recommended to carry a passenger when performing any surgical intervention during cystoscopy. However, it is not necessary to be accompanied when it comes to timely diagnostic cystoscopy.
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 the cystoscopy if you perform any surgery, such as aspirin, ibuprofen and other NSAIDs.
Food: is not necessary to stay in fasting prior to testing. Yes it is recommended to drink plenty of water the days after the test.
Clothing: can go to the appointment with the urologist with the same clothes every day. If the cystoscopy is performed in the operating room they will give you a comfortable robe to change it by the street clothes.
Documents: is advisable to take the medical history that details the urologic diseases, if you have them, although the doctor will already have it with him. Before you undergo surgery you will sign the informed consent, which you agree to make yourself the technique and you will know the potential risks. If the test is only diagnostic enough with oral consent.
Pregnancy and lactation: cystoscopy is not contraindicated in these situations, but if it is a risk pregnancy it is best to perform it only if we face a serious situation.
Contraindications: does not have any specific contraindication.

How cystoscopy

Firstly they will ask you if you're agree with you undergo cystoscopy, and testing can be done with a flexible cystoscope in consultation at the same time, if what we want is just to observe the inside of the bladder a few minutes or even take a biopsy. But if you want to perform any surgical technique you will have to sign a written consent and is performed in the operating room anesthesia, so you don't feel any pain throughout the procedure.
The anesthesia can be of three types: general, regional or local. The most frequent is to perform with regional anaesthesia wherever possible. For this practice you a small puncture in his back to anesthetize the nerve roots in the spinal cord directly. Thus, UTI to intervene will not have sensitivity and you'll be awake all the time, although you can sedate yourself so that you are more relaxed. Local anesthesia is not useful in this type of testing, but general anesthesia can be if used occasionally.
Before inserting the cystoscope, inlet of the urethra and genitals are disinfected. You will cover with a surgical sheet to limit the area. Usually wash the inside of the urethra with a liquid antiseptic, which also takes a little anesthesia to numb so the walls of the urethra.
It is then when the urologist inserted through the urethra the cystoscope. It can be very annoying and even painful at first. The camera allows to visualize the inside of the bladder and, at the same time, introduces normal saline into the bladder to defuse it. When the bladder is filled with serum it is normal that you feel urge to urinate.
The instruments that are inserted into the bladder are very varied: forceps, scissors, handles of coagulation, etc. With them the urologist will get solve the problem that exists. Throughout the procedure is recorded on video so that it can be displayed later by the physician or by yourself. If the test is a biopsy will be sufficient to use tweezers that caught a piece of the internal lining of the bladder, and you can feel a brief prick at that time.
When the intervention is completed the cystoscope is removed. It is normal that the urethra remains distressed for a few hours, and even make you urinate blood for a few days.

Complications of cystoscopy

In general, if they have a cystoscopy you not presentarás no complications and is only recommended to drink between 4 and 6 glasses of water per day to maintain a proper flow of urine. You must see a doctor when you notice fever, chills, pain, or decrease in the amount of urine.
Complications in cystoscopy are not very frequent. Some that occur occasionally are:
The urethra or bladder wall damage. It may be from a small wound to a total rupture of the wall. They may be due to an error of the urologist or by anatomical abnormalities of the patient.
Urine infection after a cystoscopy. When it happens, antibiotic treatment is necessary. If the infection rises to the kidneys causing pyelonephritis treatment antibiotic should be provided intravenously.
Infection of the prostate, i.e., prostatitis. In this case the infection should be treated with an intravenous antibiotic.
Complications of anesthesia (respiratory depression, sedation allergies, nerve paralysis, etc).

Results of cystoscopy

When a diagnostic cystoscopy is performed in consultation, the urologist can get the test results at the same time. So then you can propose a solution or treatment if there is a problem.
If a biopsy performed during cystoscopy or takes samples to cultivate microbes, results may take several weeks.
In case of performing any treatment via cystoscopic, the results are very positive. After undergoing the technique is needed very little time to recover, and can go home the same day if all has gone well.

What is a cervical cytology?

Examination of the cells of the cervix in order to detect the existence of a possible cancer as soon as possible.

Cervical cytology

Cervical cytology is a diagnostic test in which cells of the cervix are examined. The neck of the uterus, also known as cervical, is bottom and narrower than the uterus and is located at the end of the vagina. The cells are obtained by inserting a brush and a small spatula in the vagina that is a soft scraping at the neck of the uterus. The sample extends in a Crystal called porta or gets into a preservative fluid to later watch it under the microscope.
Cytology cervical cervical or also called commonly Pap smear, vaginal smear or Pap test, in honor of a Greek doctor who developed this technique in the first half of the 20th century.
The objective of this test is to detect the existence of a cervical cancer of uterus, or precancerous lesions in the same, as soon as possible in order to treat it as early as possible. In almost all cases, cervical cancer is associated with an infection by a virus called the human papilloma virus (HPV), acquired sexually. This virus causes changes in the morphology and structures of the cells of the cervix which makes that they can transform into malignant cells. The scraping is done during the test includes these cells, which may have pre-malignant changes indicative of that are evolving into cancer, or may already be cancer cells.
HPV in samples taken from the cervix can also be detected. Therefore some of the samples that are taken from the cervix is sent to the lab to investigate the presence of this virus. However, still not been determined clearly when the detection of HPV and its utility test should be performed.

When should I do a cervical cytology?

Recommendations to make a cervical cytology change across countries and even change between medical institutions within the same country. In general it is recommended to start making them three years of onset of sexual relations, starting from age 21-25 depending on the countries, and repeat them at least every three years. Most common controls may be recommended if the previous results are not entirely normal or the woman has some factors that can facilitate the appearance of tumors, such as infection with HIV or other immune disorders.
When it has been five years of the last PAP, some organizations recommend annual Pap during the first two years and then every three years. Pregnant women and women who are vaccinated for HPV should also perform their cervical cytology with normality.
In the event that you perform a cytology together with a test for the detection of HPV, and both tests are negative, it is recommended to repeat cytology after five years.

When is it not necessary to do a Pap smear?

Cytology in very young women, age 21-25, are not recommended because before that age of cervical cancer is extremely rare. Moreover, in young women and adolescents is frequent that there are alterations in the cytology disappear spontaneously. Nor has been shown to be effective screening with cytology in young women. In general is not recommended to perform the test for the detection of HPV before age 30.
There to do a PAP to women who have not had sexual intercourse. This is because that cervical cancer is practically always associated infection by the human papillomavirus which is acquired through sexual. If you have not had sex, there was no infection by this virus or risk of cancer of the cervix. Women over 65 - 70, could stop to Pap smears if they have three normal Pap smears in the last 10 years, and the last has been done in the last five years, but it depends on if they remain sexually active.
Finally, there is also no that do Pap smears to women who have undergone a total hysterectomy for a benign disease, i.e. who is has removed completely the uterus fibroids or other pathology not tumor. If it has already removed this body, it is not possible that a cancer appears in the cervix. Pap smears are continuing if there has been a history of precancerous lesions or if the uterus has removed because of cancer of the cervix.

Preparation for a cervical cytology

These are the issues that you must consider when ready for a cervical cytology:
Duration: the test is performed in a few minutes.
Entry: the test is done on an outpatient basis.
Is necessary to be accompanied?: don't have to be accompanied by although it might help if it makes you feel more relaxed.
Drugs: is not necessary to take any prior medication. You can take your usual medication.
Food: don't have to go on fasting.
Clothing: you can wear any clothes you want, but it is important that you can undress easily from waist down.
Documents: in general any document does not lack.
Contraindications: You don't want to do the cytology if she is menstruating because the rule may be difficult interpretation of the sample. Pap smears don't occur in very young women or who have never had sexual relations.
Pregnancy and lactation: not contraindicate the realization of the test although it is important to tell your doctor the possibility of that is pregnant.

Other considerations on cervical cytology

It is important to avoid sexual intercourse, DOUCHING and using tampons or vaginal creams 24-48 hours before the test.
You can be more comfortable if you empty the bladder and the bowel prior to testing.
If you are allergic to latex should warn their doctor explore it with gloves made of other materials like vinyl.

How is a cervical cytology?

Cervical cytology is carried out in a health centre and is carried out by the doctor, nurse or any other trained health professional. Prior to performing the test will inform you of the procedure, which lasts just a few minutes and the possible inconvenience may cause, since it just has risks.
The female tomb is face-up on a special table that facilitates the exploration of the genital area. A Speculum is inserted into the vagina, which is an instrument with two valves that are separated and allow open the vaginal cavity and observe in the background of the cervix. With a small spatula and brush is a soft scraping on the inside and on the outside of the neck of uterus. Take several samples that extend into small glass that looks under a microscope, or enters a preservative fluid for further consideration.
It is very rare that this test may cause complications. There may be a minimum bleeding that causes a vaginal spotting small, but that is considered normal. The risk of infection is minimal. It is not a painful test, although the inclusion of the Speculum can be uncomfortable when the woman is not relaxed.

Results of a cervical cytology

The PAP cytology results are usually available within two weeks. It is advisable to go to pick up the result and not assume everything is normal because the results you are not delivered in a few weeks. The doctor will give you the results and will indicate the need for any treatment or other complementary explorations.
The results of a cervical cytology is often report follows:
Normal cytology, in which there is no evidence of malignant cells.
Inadequate cytology, which not is has been able to study properly sample so what is good to repeat it.
ASCUS, an acronym which comes from the English (atypical squamous cells of undetermined significance) and which translates as 'atypia of undetermined significance'. This result is quite common and means that the cells are not quite normal, but that changes that do not have a meaning clear. In many cases, these changes disappear spontaneously and require no treatment. In any case this diagnosis requires tighter control and to worsen abnormal changes may require treatment.
Low grade or SIL intraepithelial lesion (squamous intraepithelial lesions) of low grade. This means that cells have been found with abnormal changes caused by HPV. Called intraepithelial because they are cells that are within the layer that surrounds the neck of the uterus and epithelium. Like the ASCUS, low-grade SIL may disappear spontaneously and require no treatment, but requires more frequent controls if they develop into malignant cells.
High intraepithelial lesion grade or SIL of high degree. They are cells with large abnormalities and a high probability of evolving into cancer if not treated. Sometimes high grade SIL classified into several categories according to the degree of abnormality of the cells. These changes do not tend to disappear spontaneously and often require a more comprehensive study and treatment.
Squamous cell carcinoma. It means that they have been detected cancerous cells on cytology. This finding is very uncommon in people who have been properly made its revisions.

Limitations or errors in the results of cervical cytology

Although cervical cytology is one of the best tests of screening there in medicine, and has managed to decrease the incidence of cervical cancer by 50%, admittedly has some limitations. Sometimes, cytology does not detect cancerous cells that do exist, what is called a false negative, or conversely, can diagnose that there are abnormal cells when there is cancer, what we call false positive.
These errors can occur because samples are taken in areas where it is not the tumor or errors in the processing or analysis of the sample. That is why it is important to go to centers with good quality controls and get tested regularly.

What is colonoscopy?

Colonoscopy is a medical test used to diagnose and treat diseases of the colon (large intestine).

Colonoscopy

Colonoscopy is a medical test used to diagnose and treat diseases of the colon (large intestine). This is done through the colonoscope, which is a device that consists of a hose of about one centimeter in diameter and between 122 and 183 cm long. The colonoscope is inserted through the anal opening and can be forward through the entire colon. Lets you view the inside of the bowel, because it has a video camera on its end whose image is seen through a monitor. In addition, the colonoscope tube has several channels inside where you can enter various instruments, and allow diagnostic testing such as the taking of biopsies, or even perform treatments such as removal of intestinal polyps or tumors.
To perform a colonoscopy, it is necessary that the intestine is well clean of fecal remains. This requires preparation of the colon by means of some laxatives that are taken orally or enemas. These substances are given during the day or two days prior to the test and produce abundant diarrhoea, what gets the colon cleanse.

Reasons to perform a colonoscopy

The most common reasons that the realization of a colonoscopy may be requested are as follows:

• As colon cancer screening test.
• Especially in people with a family history of colon cancer or in over 50 years.
• As a study of episodes of bleeding by the rectum (rectal bleeding) or after the appearance of blood in the stool.
• To study chronic diarrhea.
• In cases of anemia iron deficiency (due to lack of iron) when it is suspected to be due to a chronic bleeding from the colon.
• In cases of sudden and unexplained weight loss that may cause to suspect a colon cancer.
• To study in more detail some alteration that has appeared in another test that examines the colon called barium enema.
• To diagnose and monitor an IBD like Crohn's disease or ulcerative colitis.
• In the study of chronic abdominal pain.

Sometimes, it is not necessary to explore all of the colon but only its final part. So the colonoscope is inserted by year but moves only by their final parts, i.e. by the rectum, the sigma and the descending colon. This test is called rectosigmoidoscopia. If some pathological finding is the doctor usually will advance the colonoscope until the end performing full colonoscopy.

Preparation for a colonoscopy

These are the issues that you must consider in preparation for a colonoscopy before you undergo this test:
Duration: the test is performed in about 30-45 minutes although it may take longer depending on the findings, which are or if some therapeutic procedure is carried out or take biopsies.
Entry: the test is done on an outpatient basis.
Is necessary to be accompanied?: is usually administer a sedative so the patient stays quiet during the test, so it is recommended that someone accompany you to take you home then.
Drugs: for testing will need to clean the colon during 1-2 days prior to the procedure. They will give you instructions to do so through laxatives for Administration via orally or by enema. Diet to be followed during this period depends on the type of laxative that would provide. Generally we recommend a low residue diet, why you should not eat vegetables, potatoes, or fruits from 48 hours prior to testing. The night before, you can only take liquids. These instructions can be changed, as he is sometimes recommended to follow a liquid diet 24 hours before the test. In any case, you will be given a sheet of instructions that must be followed strictly.
Food: in general it is possible that you can have breakfast sugary coffee or tea, but you must follow the instructions of your doctor in this sense.
Clothing: you can wear any clothes you want to but it should be easy to remove, as they will remove you most of the clothes and will facilitate you a hospital gown.
Documents: should be informed consent, which is a role where they explain you what is the test and its potential risks. You should read it carefully and take it signed. You must take the wheel of the test request.
Contraindications: You should not do a colonoscopy in the following cases:

• Diseases that may worsen if the test is used as in intestinal perforation, infections of the colon as acute diverticulitis, in cases of peritonitis, or after an operation on the recent colon.
• Pathologies in which is not useful as in upper gastrointestinal bleeding (eg: haemorrhage gastric or duodenal) or irritable bowel syndrome.
• Serious or "unstable" patients with significant hypotension, severe arrhythmia, etc.
• Pregnancy, especially in the second and third quarters.
• Intolerance or allergy to percutaneous solutions given for cleaning the intestine.
• Very serious coagulation disorders.

Pregnancy and lactation: in general the test should be avoided during pregnancy although occasionally it can be if it is considered that the benefits outweigh the risks. In such a case we must try to do it without sedation or with the minimum possible sedation. Breastfeeding in general is not a contraindication performing the test. Solutions to clean the bowel percutaneous tend to be compatible with breastfeeding, although some could give diarrhea in breastfed infants. Sedation is usually not contraindicate breastfeeding unless there is risk of infant respiratory depression. Always should inform the physician of the possibility of pregnancy or if it is breastfeeding if you can postpone the test or replaced by another more secure.

Other considerations prior to colonoscopy

You must tell your doctor if you have allergies to medications, particularly to anaesthetics.
If you are taking iron supplements or aspirin may tell you to stop taking them the 7-14 days prior to the test. This is due to that aspirin faciliaria bleeding in case that take a biopsy or remove a polyp, and the iron is needed is stuck on the wall of the intestine and hinders their exploration. The doctor will instruct you when to resume this medication.
If you are taking anticoagulants, it is very important to warn the doctor, then it will be necessary to temporarily suspend them. The doctor will give you instructions in this sense depending on the anticoagulant that take.
You must also tell if you've had a test with contrast of the colon in the four previous days as a barium enema. Barium used as contrast can remain in the intestine and make it difficult to scan.

How a colonoscopy

The test is often make a doctor specializing in digestive tract with a wizard that can be nurses. Initially take an IV in your arm. There passes a drug that will make you to be relaxed and drowsy during the test. It is possible to then not remember much about the procedure.
They will tell you to undress and put on a hospital gown. They defeated him on a stretcher on the left side and with knees bent toward chest. Initially the doctor will make you a rectal carefully exploring anal hole with a finger and some substance lubricant and anesthetic above the glove. Then proceed to introduce the scope previously lubricated by the anal opening and progress it slowly by the colon. In an attached screen the doctor can see the entire surface of the colon clear.
One can notice some abdominal cramps or the need to defecate or expel gases. Do not feel uncomfortable for this reason, because through the colonoscope is inserted air to defuse the colon and facilitate exploration. The expulsion of gases is therefore completely normal. Simply breathe deeply and slowly to relax the abdominal muscles. During the test you may be asked to change position to facilitate the movement of the colonoscope, and might be given some intravenous medications to relax the bowel.
The doctor has tools such as microtweezers, capsula, etc., that you can get the channels that has the scope and which allow you to perform some diagnostic or therapeutic procedures. For example, can suck secretions, take a biopsy, removing a polyp coagulate bleeding, remove a body odd, etc.
After all, the scope be taken off carefully with what it is expected to leave enough gas in the intestine, which will relieve him if I noticed any abdominal discomfort. Finally it will proceed to clean the anal area with paper and leave him 1-2 hours under observation in an enclosed room until it recovers the sedative effect. It is recommended that you do not drive or operate dangerous machinery during the 12 hours following the test. Your doctor will instruct you when you can eat normally and restart normal activities. This depends on the procedure that have yet done you and medication which provided him. When you are allowed to, drink plenty of fluids to recover losses of liquid that it may have suffered with diarrhea caused to prepare for the test.

Complications of a colonoscopy

Colonoscopy is a very safe test. It is also rare to have side effects from drugs that can be administered as sedatives. The most annoying thing of the procedure probably preparing the colon laxatives, since it causes a watery diarrhea which can be annoying.
During the test you can feel embarrassed by the procedure. There is no reason to do so. You may notice abdominal discomfort, but they tend to be small because they will be given sedatives and analgesics. If you experience pain, please tell it to the doctor during the test.
After the procedure you will feel drowsy for a few hours and is likely to not remember much of what happened. You may also notice abdominal bloating and gas, which will go out little by little. If you've had a biopsy or have had your a polyp removed you can see traces of blood in the stool for a few days. It is very rare that there is a serious complication for a colonoscopy.
Sometimes the colonoscope can damage the surface of the mucosa and cause bleeding. In rare cases the procedure may cause cardiac arrhythmias. Some cases of perforation of the intestine with the colonoscope, have been which is a completely exceptional circumstance. If after the test Note intense bleeding, severe abdominal pain, fever, intense dizziness, vomiting, or note the swollen and hard belly, you should immediately contact your doctor.

The colonoscopy results

During the test is the surface of the intestine with what your doctor can diagnose directly many pathologies. It is possible that later you any results the day of the test. The specialist will make a written report that will give you a few days of the test, possibly along with some photos of possible pathological as ulcers or polyps findings. Where biopsies are taken, the samples will be studied under a microscope by a pathologist and a report will be made separately with this result. You can also that you have caught samples for microbiological study of possible intestinal infections. This will result in a third report by a specialist in microbiology. All these results may take several weeks to be available.
The result report will include data on the quality of the preparation of the intestine, where has been reached with the colonoscope, the medication that has been given him and possible eventualities that have occurred during the test. Describe the appearance of the bowel and possible pathologies detected as polyps, diverticula, tumors, ulcers, bleeding, inflammation, hemorrhoids, etc. Specify possible diagnostic or therapeutic procedures undertaken as the outlet of biopsy or removal of polyps, and to which lab extracted samples have been sent. The report will be completed in a few weeks with the results of these samples.
It is advisable to go to pick up the result and not assume everything is normal because the results you are not delivered in a few weeks. The doctor has asked the test will give you the results and will instruct you if it is necessary to other complementary examinations or to follow any treatment.

What is a colposcopy

Colposcopy is the second step of early cervical cancer screening after cervical cytology.

Colposcopy

Colposcopy is a test that allows you to see expanded form the surface of the neck of the uterus or cervix. It serves to identify at an early stage potential injuries that are known to be precursors of cancer or injury already cancerous. It also allows to take biopsies of suspicious areas to study later in the laboratory, or remove these lesions thus solving the problem.

When should I do a colposcopy?

A colposcopy is usually done when the woman has a cytology of the cervix where abnormal cells which can be cancerous or precursor of cervical cancer are detected. It is considered the second step of the cervical cancer screening after cervical cytology. This test is sometimes requested when your doctor suspects any cervical pathology following a gynaecological review.

How a colposcopy

Colposcopy is performed by means of a special microscope called a colposcope. Through the colposcope gets very expanded view of the cervix at the end of the vagina.
During the test the female tomb is face-up on a special table with the legs apart. A Speculum will be inserted to separate the vaginal walls. The doctor observes the cervix and stained its surface with different liquids, such as acetic acid or the lugol, to highlight areas where there may be abnormal cells. These suspicious regions can biopsy to study them later or, occasionally, they can be removed in its entirety.
Take samples using a pair of pliers or, if there are no visible injuries, the inside of the cervix is gently scraped for a sample. A treatment of the suspected area with different instruments can sometimes be be (through heat, cold, excision of the lesion, etc).
Colposcopy complications are extremely rare, and the risk of infection is very low.
It is not a painful test, and the introduction of the Speculum does not usually be uncomfortable if the woman is relaxed.
A light stinging sensation you can feel when the doctor stained with acetic acid or lugol's neck to highlight abnormal areas. In addition, you may notice some slight pinch or cramp in the pelvic region if biopsies are taken or any treatment on the neck.
During the test, or after it, there may be some bleeding.

After the test

After the colposcopy most women can make a normal life.
When an injury has been treated, it is usually applied a paste which facilitates healing and that can produce a brownish flow for a few days.
If there have been interventions on the cervix should not use tampons, do not put anything into the vagina, or have sex for at least a week after the test, or until your doctor tells you to. Your doctor may also recommend not to lift weights or do vigorous exercises for a few days.
This test will not prevent you to get pregnant in the future.
If after the completion of the test appears bleeding or major abdominal pain, foul-smelling vaginal discharge, fever or any other symptoms that worry you, you should consult your doctor.

Preparation for colposcopy

These are the issues that you must consider when you undergo a colposcopy:
Duration: the test is performed in 10-15 minutes, although it may take more time if any treatment is done.
Entry: the test is usually 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 taken anticoagulants, check with your doctor.
Food: don't have to go on fasting.
Clothing: can wear the clothes you want.
Documents: prior to a colposcopy physician will explain the test 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: does not agree to perform a colposcopy during menstruation, because blood may interfere with the scan. No sexual intercourse, place any product within the vagina, nor be Douches, 24 hours prior to the test.
Pregnancy and lactation: not contraindicate the realization of the test although it is important to tell your doctor the possibility of that is pregnant.

Other considerations

You can be more comfortable if you empty the bladder and the bowel prior to testing.

Colposcopy results

The result of the study of the samples that have been taken during a colposcopy is usually available in two or three weeks.
Although there are different classifications, the result of colposcopy is usually report in the following manner:
Normal findings.
Abnormal findings: specifies the territory that affect (by within the canal of the cervix or outside), the type of discovery (abnormal, dotted vessels, etc.), and if the alteration is more or less important.
Suspicion of invasive cancer: when a suspicious lesion of cancer that goes beyond the surface of the neck and get inside.
Unsatisfactory colposcopy: when not has been able to perform well the technique.
Various finds: when inflammation, ulcers, or other diseases not related to cancer.
Your doctor will inform you about the results of the test, and will tell you if you need new revisions, or if you need to perform other procedures.

What is bone densitometry

Bone densitometry is a test used to measure the density of calcium in our bones.

Bone densitometry

Bone densitometry is a technique that allows you to measure the density of calcium which have bones. It is a useful test to detect osteoporosis at an early stage, and also serves to evaluate the response to treatment in people who suffer from it. It is a technique that is easy to perform for speed, cost and convenience for the patient, since it is not painful or require hospital admission. However, it is not shown to be necessary to carry out this test to all people at risk of osteoporosis, will only be useful to perform it to some specific groups of people.
They can be used to perform bone densitometry x-ray, ultrasound or radioactive isotopes. The oldest technique uses x-rays and is still today the most common because it is the most well known and easy to perform, is called to this technical specific DXA or DEXA. Densitometry using doses of x-ray very small and the damage to the cells of our organism is almost nil, in addition, the device is able to focus all of its broadcast in a single point thanks to a few special filters.
The test is usually performed on a single bone, normally hip or lower vertebrae of the spinal column. In some adults and children held throughout the body. The measuring device gets an image that detects the amount of calcium from bone and compared to normal values.

When a bone densitometry is made

Today it is in discussion when a bone densitometry should be performed. However, there are groups of individuals where densitometry seems to be a beneficial test to assess the loss of
Postmenopausal women with severe symptoms, without hormonal treatment and low consumption of estrogens (which are found in soya, for example).
Postmenopausal women who smoke or have smoked throughout his life, since the tobacco accelerates the loss of calcium in bones.
Men and women with diseases involving bone loss (multiple myeloma, diabetes type 1, renal or hepatic disease...).
Older people who have a history of hip or spine fracture family.
People who consume drugs causing loss of calcium in the bone (corticoids, antiepileptic drugs, alcohol, etc).
Anyone who have hyperparathyroidism, a disease where parathyroid hormone is elevated and makes the bones to release calcium have into the blood.
People who have had a fracture in any part of the body after a not very sharp blow, which makes us suspect that they are too fragile bones.
Children who suffer from genetic diseases that affect the formation of bone, such as osteogenesis imperfecta.

Preparation for bone densitometry

If you will make a bone densitometry these are the issues that you must consider when go well prepared for the test:
Duration: usually takes very little time, about 15-20 minutes at most.
Entry: not require income, can be done on an outpatient basis.
Is necessary to be accompanied?: not, is a painless and not invasive, so you can only attend the clinic and return in the same way.
Drugs: is not necessary to take any prior medication. You must tell your doctor all the medicines that you take so that you assess whether or not the test is required. If you take calcium supplements you should not eat them 24 hours before the test.
Food: you can eat normally, it is not necessary to go on fasting to the clinic.
Clothing: is best to attend the test with comfortable clothes, since there will change by a bathrobe to avoid belts and metal objects that might interfere with the measurement. Jewelry, glasses and false teeth also upset and should be removed.
Documents: there is any type of document, but may give you the results of bone densitometry in the time of completion of the test, and you need to save them.
Contraindications: only pregnancy and lactation may be relative contraindications.
Pregnancy and lactation: is not recommended to perform bone densitometry to pregnant women, since x-rays are used. Although the possible harm to the fetus is minimal is not considered to be an essential test for risk. Breast-feeding is not a contraindication, radioactive isotopes are used.

How bone densitometry

When you arrive at the clinic they ask you that passes to a dressing room where you can change your clothes for a more comfortable gown and leave your personal belongings. Sometimes you don't need to put on a gown and you can spend with your street clothes, provided you have no metallic elements that disturb. You will then go to the room where the device that is bone densitometry, you'll see a table or Chair and beside a machine with two arms, one going down the stretcher and the other above.
Then you recostarás you on the table differently depending on the area that want to measure. If hip is measured, the foot is placed in a sleeve that will make you to rotate the leg to properly position the hip. If you measure the spine, legs will be higher to support back on the couch. Once you are properly placed will not need to worry about anything else, just be relax and remain still.
The sanitary technician will handle the machine and begin to measure the bone sent bone density x-rays that will leave the lower arm and collected on the upper arm. Throughout this process you won't feel anything.
A few minutes later the sanitary technician will tell you that the test has finished and you can already get up from the couch. It may also prompted you to wait a few minutes in the waiting room to give you the results in a report, or perhaps send them is the doctor directly, it depends on if the radiologist doctor can write the report at the time or not.
After the test you won't feel anything unusual in the area that have measured the density of bone. You can collect your things from the dressing room and leave the clinic in the same way that you've come. It may be necessary to perform this test every two years if requested to verify the effectiveness of a treatment or detect osteoporosis at an early stage.

Complications of bone densitometry

Complications in bone densitometry are virtually non-existent. Yes it is true that there is a risk associated with radiation to always use x-ray and that therefore the usual in this type of testing, precautions as it happens in chest x-rays or CT, especially if the woman who undergoes the test might be pregnant. However, the radiation dose is much lower than in routine tests of x-ray and its theoretical complications are much less important.
Unlike that in other radiological tests do not need to use lead against radiation in any case, since the especially sensitive organs (thyroid, testicles or ovaries) not receive x-rays directly.

Bone densitometry results

Bone densitometry results are obtained at the same time make it, but we need a physician who specializes in this type of evidence to interpret them.
The doctor who usually take care of densitometry is the radiologist, oversees the performance of the test and analyses the results obtained writing a report that will deliver the doctor has ordered it (rheumatologist, family physician, endocrinologist...).
In the report, there will be a series of statistics which highlight two important:

T-score

This data indicates the density of calcium that has the bone in relation to the maximum amount that would have a bone in a similar person in a particular moment of her life:

• If the score is greater than - 1, we can consider it as normal.
• When the score is between - 1 and - 2'5 say that the person presents osteopenia, or bone density lower than normal.
• We believe that you have osteoporosis when the score is less than - 2'5. This is very important to assess the risk that have that person to suffer a fracture in one of his bones.

Z-score

This data indicates the density of calcium that has the bone in relation to the average of the population of people that suits you according to your age, sex, weight and size. This score itself does not diagnose osteoporosis because it is a fact that varies greatly from one person to another, but if it is outside the normal ends serves to alert us and ask for further tests.