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- What is lumbar puncture
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What is lumbar puncture?Lumbar puncture (also called spinal cord or spinal puncture) is a diagnostic test that allows the extraction for its study of cerebrospinal fluid (CSF). This fluid bathes the central nervous system (brain and spinal cord), avoiding colliding against the bone to make sudden movements and making exchanges of substances to allow good metabolism of neurons.
The test requires puncturing the spine from the back, with a needle so that the needle passes between the vertebrae and penetrate into the spinal canal. This channel consists of the meninges that surround the spinal cord.
Extracted CSF is subsequently studied in the laboratory analyzing its different components (glucose, cell, ions, etc). Alteration of each component can guide us towards specific pathologies of the nervous system, from infections such as meningitis to damage in the brain or bone marrow.
As it stands to reason, it is necessary to perform the test very carefully, as it can cause damage to the spinal cord with relative ease. However, the frequency of nerve damage after the test is very small. The main annoyance to persons who undergo a lumbar puncture is pain. The needle through the skin, muscles and ligaments of the spine, so it is usual that the procedure is painful. To avoid this can anesthetize the area doing this more bearable discomfort for the patient.
When a lumbar puncture is madeIf you have been quoted for to perform you this test maybe you wonder why, as well, a lumbar puncture is performed when appear following alterations in a person:
Meningitis: is an inflammation of the meninges, the membranes that surround the central nervous system. The cause of this inflammation is infectious in many cases (for bacteria or viruses).
Encephalitis: inflammation in this case focuses on the brain. May be associated with meningitis, in that case is called meningoencephalitis.
Hemorrhage subarachnoid: space where is the cerebrospinal fluid (CSF) is known as subarachnoid space. When a blood vessel breaks blood to this area can be overturned and a lumbar puncture in CSF dyed red would be.
Reye's syndrome: the cause of this disease is unknown, is only known to occur in young children with one viral infection (influenza, for example) that treats them with aspirin. Alterations of the CSF may be key to a quick diagnosis.
Myelitis: as in encephalitis, spinal cord can also ignite.
Suspicion of neurosyphilis: when a person infected by syphilis does not properly respond to treatment or neurological symptoms should be a lumbar puncture to rule out presence of the bacteria at that level.
Multiple sclerosis: Although the main suspect of this disease appears when there are specific neurological symptoms, cerebrospinal fluid can help definitely opt for the diagnosis.
Treatment of Hydrocephalus: Hydrocephalus refers to the accumulation of CSF that puts pressure on the brain. Although it can not be used as a chronic treatment, in a timely manner can be a lumbar puncture to relieve the internal pressure of cerebrospinal fluid in certain diseases. Improvement can be found even in certain pathologies with normal CSF pressures to drain it (for example, the normal pressure hydrocephalus).
Preparation for lumbar punctureIf they are going to perform a lumbar puncture these are the issues that you must take into account to prepare yourself before the test:
Duration: the test will last a total of 15 to 20 minutes. The taking of the cerebrospinal fluid (CSF) will actually be a minute, the rest consists of the preparation of the material and area to puncture.
Income: lumbar puncture can be a query or a room of cures, in such a way that it does not require hospital admission. If there is reason to enter it would be for the State of the patient by her illness, not by the test itself.
Is necessary to be accompanied?: Yes, is recommended. There are people that are sore or rather queasy after the test. Also, you may be lying one hour after its completion and you can not do physical activity throughout the day. He is not recommended driving, perform household chores, etc.
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 some, especially blood thinners or anti-inflammatory drugs. It is important to also inform of allergies to medications or other products, if you have them.
Food: no need to remain in fasting before puncturing 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 warn you of this.
Clothes: you can introduce yourself to the procedure with the same clothes every day. When you get to the hospital or doctor's office may give you a gown to change you.
Documents: is essential to bring with you the steering wheel which shows the realization of lumbar puncture. 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: lumbar puncture is not contraindicated in pregnancy or lactation, but that State should know because some biological constants that are studied and the anatomy of the spine will be altered during these stages.
Contraindications: lumbar puncture cannot be performed in people who have severe alterations of blood clotting or have very low levels of platelets. You may not be testing in people with low level of consciousness, clear neurological, suspected brain compression, etc. In many cases they have to the patient prior CT scan to make sure that there will be no complications of the central nervous system.
Lumbar puncture is doneFirst, the doctor will evaluate if it is necessary or not to perform a lumbar puncture, and if it must be urgently or it can be programmed for another day. The test urgently does not mean that you have more risk of complications, in any case the planning will be the same and be guaranteed the best conditions for the patient.
Your doctor will inform you of why can be positive to perform it, is, what information we can provide and what are the possible risks. It will give you an informed consent document outlining the main features of the procedure and you will have to sign it if you agree with its realization.
Sometimes, before the puncture, decides to do a CT scan to check that there are no changes in the nervous system that predispose to complications. It is not always necessary to perform this test. When to perform lumbar puncture ask you firstly that you change your clothes and views a comfortable gown for you and for the doctor who makes it for you. Then will measure you 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 process, although it is not common. Sometimes they will offer you some relaxing drug to make you stay sedated during the test, something that is recommended if you are nervous or are particularly sensitive to pain.
Prepared once you will be asked to you tumbes on a side table, with knees bent and embrace them. In this way, the back will be slightly curved and the vertebrae are separated, leaving holes for the passage of the needle. in a position that facilitates the realization of the test.
To proceed with the biopsy, the first thing that will will be clean skin with antiseptic to eliminate germs on its surface. Then they injected an Anaesthetic from the surface to deeper levels. You will feel a slight prick of the needle, and then a burning sensation at the very moment in which the anesthesia gets. When it did effect the local anesthesia will be a longer needle to reach the meninges and through them very carefully, just to take a sample of CSF but not reach the spinal cord. Throughout the process, you will notice a strong back pressure, but it is very important that you keep quiet all the time.
Once taken the sample be removed the needle. It is normal that the puncture point blood slightly, apply continued pressure for a few minutes to stop the bleeding. Then they will place a compressive dressing and you have to stay lying down for an hour. You can turn on yourself, but always lying.
The results may take from an hour to several days, depending on the urgency of the diagnosis. The dressing will keep it 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 lumbar punctureAll invasive procedures involve complications, but the most serious are rare. They can appear during or after the puncture, whenever they arise should go to the emergency room. Some of them are:
- Headache secondary to loss of cerebrospinal fluid (CSF) that if he is not relieved with conventional analgesia should go to emergency.
- Exit of CSF by the point of puncture.
- Bleeding from the puncture point (it can also appear a local hematoma).
- Local infection with fever and inflammation that require antibiotic treatment.
- Uncontrollable pain at the site of the puncture despite analgesia.
- Reaction to anesthesia during the test.
- Damage to the spinal cord (very unlikely).
Results of lumbar punctureThe results of lumbar puncture biopsy may take to be obtained and delivered from an hour to a few days. The following analysis will be carried out on the sample collected:
Outlet pressure: normal values are 70 to 180 mm H20. An elevation of the pressure may be due to occupation of space increased blood, cerebrospinal fluid (CSF) or tumor.
Aspect: it must be transparent, like water. If it is cloudy it may indicate infection.
Protein: normal values are from 15 to 60 mg per 100 mL. In the course of an infection total proteins increase.
Gamma globulin: is a special type of protein that is useful for the study of diseases such as multiple sclerosis. Their normal values are from 3% to 12% of total proteins.
Glucose: values tend to be around 80 mg per 100 mL. It is necessary to compare it with the levels of glucose in blood. In situations of infection will be decreased, since the germs feed on it.
Cells: typically found few white blood cells (from 0 to 5 per field) and no red cell. If there is white blood cells should rule out inflammation, and if there are red blood cells be ruled out due to own the puncture wound or a subarachnoid haemorrhage.
All of these tests will be performed by the physician. Along with the symptoms and the analytical studies can be a successful diagnosis to be able to advertise the necessary treatment.
What is the x-ray of thoraxThe chest x-ray is a diagnostic test that is very commonly used in routine medical consultation and also in emergency situations. It consists in capturing an image of the chest with the use of x-ray, electromagnetic waves capable of traversing the entire body and reach a detector that measures their presence at each point. In this way, the most solid organs not let rays X (bones, which have calcium) and the lighter allow its passage (the lungs, air-filled).
The test is very simple and very cheap; In addition, thanks to her are obtained clinical data of great importance to issue a diagnosis and to seek a correct treatment the person that needs it. The test is not free of risks, since they use x-rays, which are a source of ionising waves able to mutate cells and predispose to cancer. However, the carcinogenic potential of this test is extremely low. All radiological tests used in medicine (TAC, Digestive transit, hysterosalpingography, etc) is that less radiation submits to the patient, and their benefits outweigh the theoretical risks.
There are several types of chest x-rays:
Anteroposterior (AP): is the most commonly used chest x-ray. She gets a picture of the front of the chest, with the heart in the middle and the lungs on each side. In an emergency room of size medium can be to perform more than 400 AP chest x-rays.
Side: x-rays laterally across the chest. Thanks to this type of x-rays we can see if there is something behind the heart that was covered in the AP.
Espirada: usually chest x-rays always become inspired, i.e. with the air-filled lungs and holding the breath. But some diseases are more easily if the x-ray is performed having released all the air first.
Lordotic: is oblique way, from bottom to top. Thus X rays reach upper lungs probes without disturb the clavicles.
When a chest x-ray is doneA chest x-ray is done when it wants to study the interior of the thorax by a multitude of reasons. These problems are some of the most common reasons:
Dyspnea: named to the sense of lack of air or fatigue, which is usually a symptom of an respiratory failure, that's oxygen does not reach the blood from the lungs.
Chest pain: the pain in the chest is a sign of alarm from a heart infarction, and an x-ray allows us to rule out other causes of chest pain.
Chest trauma: when a person suffers a blow to the chest x-ray can help detect fractures in the ribs and discard internal damage.
Pneumonia suspected: a person with cough, phlegm and fever has a high probability of suffering from pneumonia. The x-ray is essential to establish the diagnosis.
Suspicion of lung cancer: is the first test to the diagnosis of lung cancer. However, the CT scan is which gets more accurately detect cancer. We must remember that chest radiography is not useful to use as a test for early detection of lung cancer in healthy people.
Preparation for operation: is a vital test to go to surgery, because it allows to detect possible complications that have gone unnoticed.
Preparation for chest radiographyIf they are going to perform a chest x-ray , these are the issues that you must take into account:
Duration: chest x-ray takes to take a few moments. Normally you will be in the hospital a few minutes while waiting, prepare yourself for the test, and is done.
Income: chest x-ray can be done on an outpatient basis. You can put yourself to the test and go your home a little while.
Is necessary to be accompanied?: no, not limited to the person once. It is normal that you can drive or go home by your own foot after.
Drugs: don't need to take any prior medication. All medications taken regularly, though rarely they will influence the outcome of the test must be communicated to the doctor.
Food: it is not necessary to remain in fasting prior to testing. You can drink and eat all you want.
Clothes: you can go to the appointment with the same clothes every day. However, to make the test ask you that you take off the clothes that cover you chest and any necklace or jewelry that is in the skin of the chest. Keep that in mind if you prefer to leave valuables at home.
Documents: just take your health insurance card if you had to sign in. You do not need your medical history to the test, nor will receive documentation at the end of it.
Pregnancy and breast-feeding: chest radiography is absolutely contraindicated in these situations. If there is a minimal chance of being pregnant you should not submit to this test. Usually the doctor performed a pregnancy test before I order. Breastfeeding does not imply a direct contraindication.
Contraindications: pregnancy would be the first absolute contraindication to performing this test. There are no other direct contraindications.
Is the chest x-rayFirst, the doctor will assess if you need to make you a chest x-ray. That day may make you the test, especially if it is a consultation in the Emergency Department, or you can also quote for another day; in that case, the day that you have proof you don't have to change your routine, and there is no reason to get nervous.
To perform the test ask you first that you take off all the clothing of the torso, from the shirt, until the holder in the case of women. Also have to take off your pendants, piercings, or any strange element that is on the surface of the chest or back. Once you've removed you clothes ask you come near the machine that makes the x-rays.
You will have to stand face to a metal plate, with the chest well glued to its surface. So the image will be more defined and you can study better chest. The surface of the plate will be cold, but it can withstand. X-ray technician will then exit the room to avoid radiation. It does not because the radioactive dose is very high, but must take into account that it is every day in that room, and if you receive daily radiation, however small, that is, you accumulate and damage you.
From the outside the technician will ask you to take air deeply. When you inflate the chest machine Fire x-rays and radiological imageis obtained. This lasts a moment, you will not even notice. The technician at the same time you can see the image and assessed broadly if it is valid to study chest. If it has not been, they will have to repeat the shot, but this happens very rarely.
Achieved once ideal image doctor can study it and look for alterations in it to help the diagnosis of the problem whereby the consultations. Today x-rays are almost always on the computer, but there are still places where the x-ray on plastic paper is printed.
Complications of chest radiographyChest x-rays have no real complications for those who undergo them. The radiation involved is minimal and not considered to be a risk factor for developing cancer if they are used in a timely manner in years. X-ray technicians and radiologists have detectors that measure radiation accumulated over weeks, since they must not exceed an annual limit to avoid risks.
Results of chest x-rayNothing else made the chest x-ray you can see the same data. However, small changes in the test may be misinterpreted, and therefore it is better the doctor carefully study them and assess them in relation to the rest of the evidence that you made.
In the the x-ray image be displayed the following structures:
Heart: must not occupy more than half of the chest. When it exceeds 50% of the width is considered that the heart is too big and is spoken of cardiomegaly.
Lungs: tend to be black, with small grey traces by the blood vessels and bronchi. If a pneumonia or heart failure, they are filled with liquid partially and white spots will be. The same thing happens when there is a tumor.
Breast costofrenicos: are the angles forming the ribs with the diaphragm. They are in most side and lower lungs, and to be the point lowest is the first site where in case of pleural effusion fluid accumulates.
Mediastinum: it is located in the central part of the thorax, contains the heart but also large vessels such as the aorta artery and vena cava, and nerve, lymph nodes.
Skeleton: x-ray also ribs, the shoulder joint and spine are. It is not the ideal testing to study the bones, but it can detect alterations.
What is the Nuclear magnetic resonance (NMR)Magnetic resonance imaging (MRI) is a diagnostic test that results in images of the inside of the body. It is based on the processing of radio waves that pass through the patient, which is subjected to a strong magnetic field. Unlike the TAC or Plain radiographs do not use ionizing radiation (x-rays).
Magnetic resonance imaging allows to obtain very detailed images of the body, in two and three dimensions, and from any perspective. It can provide information on diseases that are not with other imaging such as ultrasound or CT techniques. It is also used when other imaging tests, are contraindicated to as for example in case of allergy to iodinated contrast used in CT.
To carry out the patient must get into a machine, that patients describe as a big washing machine, and must remain still in its interior for 30-60 minutes. RMNM devices exist to Open that can be used in people with claustrophobia. These devices are not available in many centers and images that are obtained have poorer quality than those obtained with the standard closed devices.
Why is a nuclear magnetic resonanceMRI is usually done on a specific part of the body in which suspected illness. The most common reasons why the realization of an MRI can be requested are:
In the head you can see tumors, abscesses, aneurysms, bleeding, heart attacks or nerve damage. It can also serve to study pathologies in the eyes and ear or brain degenerative diseases.
In the chest is widely used to study cardiac Anatomy or pathology of coronary arteries. It is also used in the study of breast cancer or tumors of the lung.
Abdomen and pelvis allows you to study with great detail organs such as the pancreas, the kidneys or liver, the uterus and the ovaries in women, or the prostate in males. There you can find tumors, infections, malformations, etc.
The blood vessels are very well with the NMR. View thrombus, strokes, aneurysms, malformations, or bleeding.
MRI can diagnose many problems in bones and joints such as arthritis, fractures, ligaments, tendons and cartilage problems. In addition, as in other organs, tumors or infections can be. Used much to study problems of spine as the Herniated discs, as it allows to see in great detail the intervertebral discs, spinal cord and nerves that come out of the bone marrow. Also used frequently in the knee problems, to study their different ligaments or meniscus.
On many occasions, to perform this technique, it is necessary to manage a liquid called contrast that highlights the organs studied, and facilitates the interpretation of the images. The most widely used contrast is called gadolinium and unlike the contrast used to make a TAC, it is not composed of iodine, so it is unlikely that cause side effects or allergic. This contrast dye is administered intravenously.
Preparation for magnetic resonance imagingThese are the issues that you must consider when you undergo a magnetic resonance imaging:
Duration: the test is performed in about 30-60 minutes, although sometimes it can last more.
Entry: the test can be 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. Where the test produce much anxiety, or if the patient cannot be still inside the appliance, are often a relaxing medication. In such a case, it will need to be accompanied by someone who can drive you home.
Drugs: is not necessary to take any prior medication.
Food: depends on the organ being studied. In some tests that include the abdomen or pelvis may be necessary to do not eat food or water for several hours before the test.
Clothing: you can wear any clothes you want, but it should be easy to remove. You don't want to carry metal objects (earrings, bracelets, etc.), because they will be asked to remove them during the test.
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:
- If you are allergic to such as gadolinium MRI contrast media. In this case the test without contrast may be performed.
- The presence of metallic material in the body, such as plates, screws, heart valves, pacemakers, shrapnel, etc. This is because all materials are attracted to the magnetic field which is created within the resonance apparatus and may be dangerous. However, many materials that are deployed today allow the realization of an MRI. This feature is reflected in the specifications of the product.
- The use of intrauterine devices (IUDS), then the IUD may have metallic substances such as copper.
- Patients with claustrophobia that not tolerated to be inside the device during the test. In these cases, you can perform a sedation of the patient or use open NMR devices.
- Patients who can not remain still during the test. You can also solve this problem with sedation.
- Very obese patients who do not climb on the appliance. In this case also open NMR devices can be used.
- Patients with severe renal or hepatic insufficiency, or some diseases such as sickle cell anemia, in which the contrast can worsen the picture. In these cases the test without contrast can be.
- In some cases of recent surgery on a blood vessel.
- Patients clinically "unstable", i.e., that are very serious and they may require some medication, or even urgent cardiopulmonary resuscitation maneuvers, then inside the machine not can be properly monitored and his attention can be complicated.
Regarding breastfeeding, medium contrast manufacturers indicate that it is you should not breast-feed the baby for 24-48 hours after administration. However, American and European Radiology societies consider that the amount of gadolinium which is excreted into milk probably does not have toxic effects on the baby. Therefore, based on available data, they suggest that there is no risk in continue breastfeeding. Anyway, those mothers who are concerned about the risk that your child may have this slight exposure to contrast, can avoid breastfeeding during the 24 hours following the completion of the procedure. During these 24 hours the mother can remove the milk through a pump and discard. In anticipation of this period that won't be breastfeeding, the mother can also remove milk before testing, and store enough to cover the child's needs 24 hours.
Other considerationsNot do exercise immediately before the test and be as relaxed as possible, because any movement can alter the result should.
In addition to all metal objects, should remove any patch that may have on the skin, as if they carry something metal content may result in Burns.
How magnetic resonance imagingThe unit in which the test is cubic-shaped and inside moves a stretcher that is where lies down the patient, usually face up. The stretcher is moved inside the hub and there remains throughout the test. In general, it is necessary to change the clothes by a hospital gown. They will make you take off all metal objects, since they interfere with the x-ray images and can move with the magnetic field. If it is necessary the administration of contrast you will pick up a venous pathway in the arm and introduced the contrast there moments before the test. They can also give you a medication to be more relaxed. Inside the device can hold you arms, head and chest with straps to prevent movement. Also put a device in the chest that detects the respiration and heart rate.
Inside the unit, you will hear the noise of a fan and you will feel air moving. You will also hear a noise rattling while the images are taken. Sometimes a headset with which you can listen to music provided him. This can help reduce noise and can help relax you.
During the procedure, a technician will be watching you from an adjoining room and will instruct you to not move. You can sometimes tell you that you do not breathe for a few seconds. You can contact the technician if he deems it necessary.
MRI is a very safe test. The magnetic field which applies does not have any detrimental effect on the body. Sometimes you can feel something hot or cold with the introduction of the contrast. Fortunately, the allergic reaction to the contrast used for MRI are very rare. Somewhat annoying can be remain still long on the couch and you can feel some claustrophobia. People who have fillings may feel a little tingling in the mouth. It is normal to feel some heat in the area that is being explored. You can contact the technician who is doing the test in case of any major discomfort.
The greatest risk of NMR is derived from a possible movement of any metallic object that has in the body due to the strong magnetic field. For this reason, it is very important to remove all metal objects or notify the technician about any materials you may have implanted. You must also remove any patch that may lead to the skin, because if you hold something metal may lead to Burns.
People with tattoos might experience some irritation on the skin.
Results of the magnetic resonance imagingThe images obtained by NMR can be seen immediately. However, their interpretation requires much expertise and is carried out by medical radiologists. This specialist will make a written report that will give you a few days of the test along with the images obtained.
The result report will include data on the technique used, if it was necessary the use of contrast, and the findings found. The type of discovery can vary greatly depending on the pathology and studied organ. Often benign or malignant, tumors, signs that indicate various infections such as abscesses, inflammation or pathology found in bones, such as fractures or malformations. In the spine can see Herniated discs and affectations of the spinal cord or nerve roots coming out of the bone marrow. In the knee, they will tell you if there is any ligament or the meniscus involvement. In relation to the vessels that irrigate the various organs, you can find thrombus, vascular infarcts (due to the blockage of an artery) or bleeding. In the liver, you can very well see the bile and detect if there are any obstructions or tumors at that level.
It is sometimes necessary to repeat the test to see how evolve different injuries, either spontaneously or after any treatment. The doctor has asked the test will give you the results and will indicate the need to do any therapy or other complementary explorations.
What is the sperm (semen analysis)The sperm count or semen analysis consists of the male semen analysis to check the State of spermatozoa and its operation. It's a simple test to perform, at any time it is necessary to use needles or other invasive methods, to obtain sample is sufficient with the male ejaculates on a boat after masturbating. It is tremendously useful evidence to complete study of sterility to couples who cannot have children.
Another end of the semen analysis is to check the absence of sperm after a vasectomy.
This type of test is used since the beginning of the 20th century, when the study of cells under a microscope advanced enough to allow a detailed analysis of the sperm (its structure, motion, number, etc). During the last decade, the sperm has gained more importance, is increasingly more frequent that the sterility of a couple is due to malfunction of the sperm of the male, and not so much to female problems.
Dozens of semen analysis are carried out on a daily basis in health centers and clinics around the world. Why submit to this type of examination is commonplace and must not embarrass men who should do so. The results may take several days and should be interpreted by a physician to avoid confusion. It must be borne in mind that the sperm count or semen analysis rarely provides definitive results in isolation, you need to be complement to other tests to arrive at a final diagnosis.
When a sperm is madeThe sperm count or semen analysis is a test that is very frequently used in infertility consultations because it does not inconvenience to do so, is very cheap and provides lots of helpful information. In fact, all couples struggling to have children is a full study to woman and man, which includes a sperm count.
Also calls for a sperm count when it is suspected that the testes have been damaged for some reason. For example, after an infection (Orchitis or events) or a heart attack (by a testicular torsion which leaves no blood flow to the testicle). We must remember that even if a testicle is damaged the other may be sufficient to maintain a good sperm count.
Other situations in which the semen analysis is useful is to check that a vasectomy was successful and effective. In these cases it should be noted no sperm in the semen.
Preparation for a sperm countIf they are going to do an sperm count or semen analysis these are the issues you should keep in mind to go well prepared to test:
Duration: the time is variable. You can make the collection of the semen sample in your House or a room in the hospital. Then you will only have to deliver it to the nurse.
Admission: admission is never needed the semen analysis. It is a test that can be done on an outpatient basis.
Is it necessary to be accompanied?:, the collection of the semen sample is not possible without help.
Drugs: don't need to take any prior medication. I must say your doctor all medications that you are taking at that time, it is not common, but it may be necessary to suspend some prior to sample collection.
Food: you can eat while you eat every day. Not been shown that semen be amended by food.
Clothes: you don't need to wear a particular garment or to collect the sample or to deliver it.
Documents: it is recommended to bring your health insurance card and the wheel of proof when you go to deliver the sample.
Pregnancy and breast-feeding: is not a test that is performed on women.
Contraindications: there are no contraindications for the sperm.
How a sperm countWhen you get to the inquiry to submit yourself to the spermiogram or semen analysis, the doctor will make you some general questions about your state of health: important diseases, risk factors, workplace, sex life and urinary symptoms. After perform you a general physical examination, and assess the realization of a semen analysis. Will give you a flyer which asks the test you need to deliver the day you pick up the sample.
You will have to stay at least three to five days without ejaculating, but you can not exceed seven days without ejaculating, this sample will be optimal. To collect such a sample will need a sterile pot that will give you at the doctor or have to buy at the pharmacy. To obtain the sperm have to masturbate, but in hygienic conditions. This will require before washing your hands and intimate parts with SOAP and water to avoid contamination.
When you cum you will have to do it inside the jar directly, it is very important to gather all the semen from the beginning until the end of the ejaculation, if not the sample will not be enough and will have to wait another 3-5 days to take another sample. It should take into account found 75% of the sperm in the semen which ejaculates to the beginning.
The boat with the semen must close, kept at a temperature between 20 ° and 37 °, and due at the clinic an hour later as maximum. Sometimes the test is performed in a room of the hospital or clinic to deliver the sample immediately.
Another method of specimen collection is to use a sterilized condom during masturbation, so all the semen is collected in it and it can be delivered in its entirety. Commercial pharmacy condoms cannot be used, they have to be specific to the study.
Semen analysis will take several days, then it will give you an appointment where will explain you the results of the study.
Complications of the semen analysisThere are no complications of the semen analysis.
The semen analysis resultsThe results of the sperm or semen analysis are complex and difficult to interpret. They discussed multiple parameters that have a different meaning depending on the type of patient and the rest of tests performed. Is normal appearing one or several parameters altered in healthy people, so you should not worry if upon receipt of the documentation with the results of the semen analysis any data comes out altered. You must always wait for the doctor, where will explain the results, its importance and the therapeutic possibilities that are available today.
The most important data studied in the semen analysis are:
Volume: semen in ejaculation quantity must be greater than or equal to 2 mL. When the ejaculate is less spoken of hypospermia, and when it does not ejaculate nothing called aspermia. The maximum volume is around 6 mL, although occasionally it can be higher, especially if there is any infection of Genitourinary tract.
Viscosity: semen is usually a slightly viscous liquid. To study its viscosity plunges a thin stick and you remove it, it is normal to form a less than or equal to 2 cm smeared. If the trickle is greater the viscosity it will be augmented and semen will be very sticky.
Liquefaction: the freshly ejaculated semen is quite consistent and viscous. But within minutes it begins to liquify it and within half an hour has a consistency similar to water. Lumps may appear in pathological situations or even solidify the whole sample.
Colour and odour: at a glance, you can study the color of semen, which should be white mother of Pearl. It can be yellow or green during infections, red if you have remains of blood or transparent if there are few sperm. The usual smell of semen can be altered when there is presence of bacteria, leaving a smell of rot.
pH: with this parameter you can meet the degree of acidity or alkalinity having semen, the usual is to be 7 ' 2 and 8. When the pH is lower, i.e., more acid, may be due to failure of the seminal glands. When the pH is higher, i.e., more basic, Genitourinary infections is must be ruled out.
Concentration: analysis by microscope of the sample collected is used to to study the number of sperm that are in each milliliter. So are the sperm that there is in a particular field one by one, and then a fairly accurate estimate. Only include the complete spermatozoa, or with head and tail. It is normal that sperm concentration is greater than or equal to 20 million per mL. When is minor called oligozoospermia.
Number of sperm per ejaculation: once determined the volume of semen that you ejaculate and sperm concentration, you can calculate easily the total number of sperm that would be in an ejaculate. The number of sperm is usually greater than or equal to 40 million in each ejaculation.
Mobility: different patterns of movement of spermatozoa have been studied and classified into three types: progressive (that going forward), non-progressive (that move but does not go forward) and stationary. Typically, that at least 50% of the sperm to move and more than half of them have a progressive pattern. When these conditions are not met refers to asthenozoospermia. It is the most common cause of male sterility.
Morphology: on the contrary that in motion, the different semen studies carried out so far have not got a good classification of the shape of the sperm. It is considered that there must be more than 15% normal sperm in an ejaculation. When are less referred to as teratospermia.
Vitality: the study of the vitality of the sperm is to detect how many sperm are actually dead at the time of ejaculation. For that are commonly used stains that paint the dead sperm cells, although there are other methods of study for this. It is normal that 75% or more of the sperm not wrinkles, i.e. that are alive. If the percentage is lower is called necrozoospermia.
Agglutination: detects antibodies against the sperm. In normal situations more than half the sperm not must join the balls that are used to perform this analysis. It is a cause of sterility detected recently and today is being investigated much in this field.
What is the digital rectal examinationRectal examination is a kind of exploration that the doctor performed patients when it can provide information about their State of health. It is a clinical examination, i.e., it consists of a directly physical examination by the doctor, without appliances or sophisticated techniques. So the doctor will introduce a finger through the anus and will feel the inside of the end of the digestive tract, rectum, for pathological signs of interest. You can not only explore the straight, thanks to the anatomy of the area can be felt indirectly in the male prostate and posterior vaginal wall in women.
Although it seems an aggressive test, the rectal examination is painless, lasts a few seconds, and is tremendously useful. It is a test that is performed very often, both the doctor and the emergency room of any hospital. It allows the diagnosis of digestive diseases, Oncology and urological, which in many cases would be fatal diseases if not for their early detection thanks to the digital rectal examination. That is why what the rectal not only occurs in a particular specialty, but it is a test of general medicine that can perform any primary care physician, and also quite frequently urologists and gastroenterologists.
For all these reasons must not be fear of rectal, his bad press is not deserved, and plays a key role in medicine. Sometimes is not enough to make a simple rectal or this indicates that something is not going well, and is due to value the use of other more complex techniques such as the rectoscopia, sigmoidoscopy or colonoscopy, all of which consist of see the inside of the digestive tract through flexible hoses of cameras.
When a digital rectal examination is doneThis test is used to diagnose diseases or observe their evolution towards improvement or worsening. The situations in which it is indicated perform a rectal examination are:
Rectorragia: thus is called in medicine to the expulsion of blood per year, because it is mixed with feces or not. Blood may be bright red, which indicates that the bleeding occurs at the end of the digestive tract, or dark and smelly, that indicates that the bleeding is more superior and the blood is digested.
Prostate symptoms: symptoms that may indicate a problem of prostate in men are difficulty to urinate, interrupt the expulsion of urine, and even acute retention of urine. It usually indicates that there is a benign prostate hyperplasia, and rectal is key in its diagnosis since it will feel an elastic prostate and not soft, as it is usual.
Prostate cancer: tumors of the prostate in men do not usually provide any type of symptom, and not related to benign prostate hyperplasia. Why rectal becomes the cornerstone in its early diagnosis; with him is palpable prostate gland with hard nodules. All men over the age of 50 should undergo this test annually, because it is the only way to prevent prostate cancer (no analytical data replaces it, not even the PSA).
Prostatitis: although it is not common, prostate can become infected during the course of a complicated UTI. A rectal examination would cause pain, and that data would help the diagnosis.
Rectal cancer: just as with prostate cancer, rectal can feel a lump on the inside of the rectum and allow an early diagnosis. Although it is useful, it is less effective in prostate cancer, because the tumor may be more above and finger would not touch it.
Examination of gynaecological unit: on routine gynecological scan is frequent a rectal examination. Thanks to it is seen and felt indirectly the internal female sexual organs.
Fecaloma: named to the disproportionate accumulation of stool in the rectum, of such a size that cannot be it drive itself only and produces constipation, pain, and intestinal obstruction in some cases. Rectal can feel it, and can even help to mobilize it and eject it.
Hemorrhoids: rectal allows detecting Internal hemorrhoids and figure out how big are outer.
Anal fissures: this scan you can check the number of cracks, its depth and its gravity.
Anal fistula: fistula consists of the formation of a channel between the inner wall of the rectum and the skin around the year. This causes much pain and loss of stool without control. The rectal examination can identify the inner hole.
Perianal abscesses: when there is a bag of pus around the anus, rectal can detect and help to delimit it, for later planning surgery evacuadora.
Crohn's disease: the formation of complicated fistulas (towards the vagina, skin, bladder, etc) are common in this disease. The digital rectal examination is the simplest method to detect them.
Preparation for rectalIf you will perform a rectal examination , these are issues that you must take into account:
Duration: seconds. Rectal takes very little time to complete, and does not require a thorough preparation. Just notes that it has started, the doctor is already ending.
Income: the digital rectal examination is done on an outpatient basis. It is not necessary to enter for this test.
Is necessary to be accompanied?: is not necessary. It is a simple test and almost non-invasive. After it you will feel no discomfort or you will be unable to perform any type of activity.
Drugs: don't need to take any prior medication. Medicines that you are taking very seldom can affect this test. Only reports the doctor common medicines that you take, or if you've eaten food that can stain Lee; Thus you will avoid that it alarmed if your color is different from the usual.
Food: it is not necessary to keep fasting; You can eat and drink what you want before and after.
Clothes: you can keep the appointment with any type of clothing. Keep in mind that many times it is a test that is performed spontaneously, so it is normal that people go with any type of clothing.
Documents: don't need to take any special documentation.
Pregnancy and breast-feeding: is a test that can be performed safely during pregnancy and lactation.
Contraindications: do a rectal examination when there is acute complications of anal diseases. For example, in the hemorrhoidal thrombosis. A relative contraindication to is avoid increasing the pain to the patient.
How rectalWhen you go to the doctor for any reason, he may think that perform a rectal examination may be useful for your diagnostic process. Will you know, you will explain what is the test and the reasons for its realization, and then ask your oral consent. If you agree, I will tell you that you tumbes on a stretcher and you discover from waist down.
They can perform the rectal you in different positions. One fairly common is to ask you to tumbes sideways with bent legs and holding you knees with hands. It may also be done if you are a lying mouth up and with the legs elevated, as the gynecologist consultation or, sometimes, the urologist.
The doctor will be two gloves on each hand and one of them will miss lubricant on his index finger. Taking advantage of the position, it will look outside of the year in search of significant alterations (hemorrhoids, warts, fissures, etc). Then notify you that it is going to proceed to insert the index finger throughout the year, with calm, but in a direct way. You can recommend you catch air or relax, although sometimes is so short that it is not worth.
Once inserted the finger, the doctor will feel the inside of the rectum, will check that there are no masses, and will use to examine the prostate to men or the vaginal wall to the women. Then it will turn the finger to be able to feel the back wall of the rectum and act followed, it will draw it gently. When you're out you will notice your finger to study the color of stool, if it is that they have spotted something.
Once the test you can take cover again and get dressed. Exam not dirty you underwear, or cause you any discomfort. Although explained in detail may be extensive, in practice lasts less than 20 seconds.
Rectal complicationsRectal complications are very rare. In a few cases may cause some tearing small rectal Mucosa, and if cause it there would be no greater importance. Isolated cases of triggered arrhythmias when performing this test, have been anecdotally, but cases barely reach the ten and it was always serious heart sick.
Results of the rectalRectal examination allows the doctor examine the inside of the rectum in real time, so it can be interpreted immediately what has been observed and establish a successful diagnosis.
However, the doctor usually use this test as an exploratory data and adds it to the report which describes all the alterations, if any. A rectal examination results report will describe all parts of the rectum, the prostate in males, or vagina in women, as well as the State of the outer year.
When the results of a rectal examination provide pathological data, a diagnosis, which can be definitive, is carried out or serve to plan a test more specific. For example, if you suspect a lump in the rectum can be indicated a colonoscopy, with or without biopsy, or if a prostate tumor is suspected, a PSA test and a biopsy may be done.
What is the genetic TestEach person's DNA are in the interior of cells organized into genes. Each person has between 20,000 and 25,000 genes, and each is responsible for performing a function in the body and provides unique features of each individual. Many of these genes have a fundamental role in the development of some diseases, sometimes determine that appears or not a pathology, sometimes increase or alleviate its gravity and most of the times only indicate certain probability of getting sick.
The genetic test involves analyzing the DNA of a person in the search of certain useful genes in order to make a diagnosis or whether there is some predisposition to suffer from alterations of the health. Another very common use of this test is to analyze how it is serious according to genetic disease, which helps us to decide between a more or less aggressive treatment.
The test has no virtually no risk, but since it can give information of complex interpretation it is recommended that it is always indicated by a doctor who then explain your result. We must be wary of genetic tests free online sale or those that recommend anyone not belonging to risk groups, they are usually of little use genetic tests and results can be misinterpreted.
Not to be confused with karyotype testing genetic tests. The karyotype consists of the analysis of the set of all chromosomes, not each individual gene.
When a genetic test is doneHe is recommended to perform a genetic test only those people who can make a profit from their results, to prevent a disease that know how to have some risk factor or point out a specific treatment for a disease that already know have.
The groups of people in which the genetic test most frequently used are the following:
Newborn screening: today there are genetic tests that can be performed on newborn and thus know whether they suffer from any disease genetically determined. In this case the genetic test is very useful, because that gets the diagnosis until symptoms appeared and that the disease has developed, so that treatment can be very early.
Suspected genetic disease: there are certain genetic diseases that begin with a series of more or less characteristic symptoms. When the doctor suspects a disease you can indicate the realization of a genetic test that can confirm the diagnosis. Some pathologies which can be confirmed by genetic test are Huntington's disease or Cystic Fibrosis.
Relatives of patients: one of the main features of genetic diseases is they are transmitted from parents to children more or less frequently. By that when diagnosed diseases may be recommended performing the test to siblings, parents or children. However, to know with certainty that you have any of these diseases, many of them are intractable and with poor prognosis, is something that every person must decide.
Early cancer diagnosis: in this case the genetic test has a controversial role. It is to detect certain genes that provide certain predisposition to develop a type of cancer. The result is far from making an early diagnosis, perhaps in the future serves to prevent diagnostic tests more invasive. Today they do not have a real utility, and are being studied for application in the population. However, there are many private clinics that already offer the realization of these tests.
Detection of genetic predispositions: in the same way that there are test that analyzes the predisposition to develop cancer, there are others that can detect predispositions to other diseases, such as glaucoma or degeneration macular. You can even serve to detect predispositions to risk factors such as obesity or cardiovascular risk; Knowing this information can help prevent them harder. It should be remembered that in this type of provision it is rare that a single gene is the key, usually there are many genes involved, some of them unknown.
Preparation for a genetic testIf you will perform a genetic test these are the issues that you must consider when go prepared for the test:
Duration: usually takes very little time, depending on the type of specimen to collect can take seconds or minutes. That Yes, results take much longer to have, even several weeks.
Admission: admission is never needed. The genetic test can be done at a time.
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: don't need to take any prior medication. There are no medications that interact with a genetic test, except some chemotherapeutic agents. However it is always a good idea to tell your doctor all medications you are taking at that time.
Food: you can eat normally, you don't have to go on fasting. If the sample to collect saliva, is better not to eat anything about four hours prior to the test, it prevents be contaminated with food. It is also recommended not to attend the appointment with the washed teeth, not to alter the test.
Clothes: you can wear normal street clothes.
Documents: must not carry any type of document, only your personal identification.
Pregnancy and breast-feeding: neither pregnancy nor lactation are contraindications for performing this test.
Contraindications: no contraindication. Rating only if when you submit the proof really want to know its outcome whatever.
How a genetic testWhen you arrive at the clinic to make you the genetic test will make some General/about your state of health: important diseases, risk factors, lifestyle, place of work, etc. Also will ask you for your family's health: parents, siblings, children and even second-degree relatives as grandparents or uncles.
After perform you an general physical examination and are likely to indicate you the realization of a complete blood test , so have an idea of how you are and what type of genetic test may be more useful for you.
Days after this first visit, so it will give time to the analytical results, cite you to collect specimens for the genetic test. The type of sample to collect varies depending on the type of test that you will perform. The two most frequent signs are blood or saliva. In the case of the blood sample is collected as if it were a usual analytics. The only difference is that the sample is usually stored and treated in a special way, but that does not affect you.
When you study the saliva, collection is even easier, is to collect saliva in your mouth with a swab of cotton (a swab). For that it is recommended to keep the appointment without having eaten the previous hours or have been washing the teeth, so saliva which is collected is as pure as possible. Will ask you you to finish twice, thus limpiarás the mouth, then they will introduce you the stick and wipe the inside of both cheeks, tongue and the floor of the mouth. It is not annoying, it is rare to cause nausea because the back palate is not reached in no time. What is really important in this exhibition is not the saliva itself, which is mainly formed by water, but the cells that are found in saliva. The swab is stored in a sterile tube and thus preserving the DNA until it studied in the laboratory.
After pick up the show, which lasts a few seconds, you can collect your stuff and make a normal life until they cite you another day to collect the results. Before carrying out this type of test you have to be aware of what results you can provide and if you are sure that you want to know them are what are.
Complications of the genetic testComplications of the genetic test are not known. It is a completely safe test that does not entail risks for persons who are subjected to it. The only risk is to know some negative test results that perhaps would have preferred not to know.
The genetic test resultsThe results of the genetic test may take several weeks to get from that sample is collected for study. To pick them up have to keep another appointment, since the documentation alone can not be interpreted by the patient, it is necessary to receive a genetic counselingat the same time. The genetic Council consists of the interpretation of the results by the physician, the explanation of the same patient and recommendations should follow as a result of these findings.
The genetic test results have little variability, in them it is plasma if to study gene is mutated, present or absent. In short, if the test has positive or negative result. However, its interpretation is more complex. A positive test can be decisive in the case of purely genetic diseases, but in other cases only indicates a probability of developing or not a disease in the future. The doctor will explain each of these possibilities and be applied in a practical way to each person.
With all this, the genetic test results may not be conclusive. This may be because the study of the sample gives an ambiguous result, halfway between positive and negative, or predisposition to the disease does not depend on just a single gene, but several, so a positive result of an isolated gene has little value in the study of certain pathologies.
In the event that the genetic test is critical to make a diagnosis of confirmation of genetic pathologies, be very sure you want to submit to the test and the results. In many cases it is degenerative diseases with treatments few troops, knowing that they will suffer can cause significant distress. This is the case of many of the relatives of patients with Huntington's disease or similar. Genetic counselling in this case should also be before the test, so the subject to her decision in a fully conscious way.
What is the Test of O'SullivanThe O'Sullivan test is performed to all pregnant women in the sixth month of gestation
The O'Sullivan test is a medical test that is performed to all pregnant women to detect gestational diabetes. Pregnancy causes many hormonal changes in the woman's body to promote good fetal development. One of the consequences derived of these hormonal changes is that glucose accumulates in the blood, because the insulin is not at all effective purposes that get more sugar to the fetus.
In gestational diabetes insulin works especially poorly, so that sugar builds up in the blood (such as in diabetes mellitus) and reach the fetus in a lot. That produces an excess of power and the fetus has one greater than usual (fetal macrosomia) growth, as well as other associated complications.
Currently the O'Sullivan test is done to all pregnant women in the weeks 24-28 of pregnancy, i.e. within the sixth month of gestation. That time period was chosen because previous studies have shown that it is the best time to be able to detect gestational diabetes.
It is a very simple test. Just take a little sugar and measure the blood a little while to check what is the ability of insulin to lower blood sugar numbers. Does not have any risk for the baby or the mother (if it were not so it would not in pregnancy), and thanks to it avoided serious complications in the development of the fetus and at the time of delivery.
When doing a test of O'SullivanA test of O'Sullivan is recommended to all pregnant women who are between the week 24 and 28 of pregnancy. I.e., in the sixth month of pregnancy that is the latest in the second trimester of pregnancy. Today gynecologist or the midwife made is test to all women that are monitored by them due to her pregnancy.
It may happen that a woman is not doing right by Gynecology pregnancy tracking. This happens when a woman is not aware of that is pregnant until it has been months, because he had no access to health care, or because not concerned scientific control by a physician. In such situations should be the O'Sullivan test although I have passed week 28 of pregnancy and the third trimester of pregnancy has been reached already.
Other situations which the O'Sullivan test should be conducted prior to the scheduled dates, even during the first trimester of pregnancy are also given. These situations are:
Age of equal to or greater than 35 years mother.
Obesity, i.e. mass index body (BMI) equal to or greater than 30.
Intolerance to carbohydrate or other previous pregnancy gestational diabetes.
History of diabetes in first-degree relatives.
Have previously had a baby with fetal macrosomia.
Basal glucose in fasting between 100 and 125 mg/dl.
Preparing for a test of O'SullivanIf you are performing a test of O'Sullivan , these are issues that you must take into account:
Duration: usually lasts an hour, just the time that wait since you take 50 grams of glucose until they are measured in blood.
Admission: admission is never needed. It is a test that can be done at a time.
Is necessary to be accompanied?: not, is a painless and not invasive, so you can go alone to the clinic and back in the same way. In addition, is usually performed in a stage of pregnancy that you are still performing a normal everyday life.
Drugs: don't need to take any prior medication. You should tell the doctor all medications that you are taking at that time.
Food: you have to go to the test in fasting; It is the only way to check the amount of sugar in blood on an exact amount of sugar ingested.
Clothes: you can wear normal street clothes and which is adequate for pregnancy (light, wide and that do not tighten the abdomen).
Documents: must not carry any type of document, only your personal identification and your health insurance card, which is always best to take with you when you go to medical testing.
Pregnancy and breast-feeding: is a test that is performed precisely in pregnancy. It is difficult to be in period of lactation and new pregnant at the time of gestation; If so, you should consult with your Gynecologist to find out how to make the test more rigorously as possible.
Contraindications: do not have any contraindication.
How a test of O'SullivanWhen you get to the consultation of the gynecologist for the first time during your pregnancy will make you some general questions about your state of health: important diseases, risk factors, lifestyle, place of work, etc. Also will ask you for your family's health: parents, siblings, children, and even second-degree relatives as grandparents or uncles. After perform you a general physical examination and ask you a series of blood tests; Thus will have an idea of how you are. If all is well, the O'Sullivan test will delay it until the second trimester of pregnancy.
The day of the test you will have to go on fasting. Usually take advantage of this day to get blood and make you new analysis. Then you will be asked to take a glass of water with sugar or a small sugar pill. In any case, will be 50 grams of sugar that are accurate that the digestive tract and will quickly absorb into the blood. Then your insulin will be activated and you will begin to get sugar from the blood to cells all over your body but, if you have gestational diabetes, the insulin will not be able to put so much sugar as it should and will remain high blood glucose levels.
When you've taken the pill you have to wait seated and quiet. You must not perform any exercise that consumes glucose (or even go up a small flight of stairs), nor can smoking or eating other things. It is best that you take a book or anything else distracting you to spend that time in the query unless you do heavy. Sometimes the gynecologist takes advantage of that time to quote you and thus anticipate waiting time making you any ultrasound or other tests deemed appropriate.
An hour later they ask that you go back to the query of the midwife or the gynaecologist. There they will measure the amount of glucose in the blood with a simple test of capillary glucose; so you punctured with a very thin needle into a ball of a finger and take a drop of blood. A small device will be the result of the test, the doctor will perform and you will explain. Later you can you have breakfast and return to your daily routine.
Complications of the O'Sullivan testThe O'Sullivan test complications are not known. It is a completely safe test that does not imply any risk to women who are subjected to it.
The O'Sullivan test resultsThe results of the test of O'Sullivan receive them the same day that you go to the medical advice to make you the test. They should be interpreted by a gynecologist or a midwife so that they appreciate the measures to take if it's a problematic result. If it is normal, they will not do you any other test, and you can follow the usual controls of pregnancy without changes.
O'Sullivan test shows normal results when blood sugar is equal to or less than 140 mg/dL. If blood glucose numbers are larger turns on the suspicion of gestational diabetes. In that case, another test should be: an overloaded oral glucose (SOG). It is a very similar test, only that more glucose is taken and measured more often in blood.
If the SOG is positive, the diagnosis of gestational diabetes is made and recommended treatment for pregnant women, which is very similar to the one of any diabetic: exercise, diet, and insulin if necessary. The strict control of the treatment of gestational diabetes is very important, because so be avoided complications during pregnancy, both for the mother and baby, and at the time of delivery.
It should bear in mind that the diagnosis of gestational diabetes has long-term implications in other ways. For example, it has shown that women who have suffered from this condition during pregnancy are more likely to have diabetes again in other pregnancies, and even for diabetes mellitus type 2 when they exceed the age of 45.
Genes provide unique features to each person
What is a paternity testThe paternity test is a genetic study to a person and his alleged father to check whether their genes are equal and thus establish a family bond. Genes are found on the inside of the cells and each person has around 25,000 genes. They are responsible for different functions in the human body and bring unique features to each person.
To perform the test is required to take a sample of each individual study (son and father), which is usually a comfortable get such as sample:
Blood, through blood as in the analytical extraction.
Hairs, when collecting the hair root, which is where are the hair follicle cells.
Saliva, well rubbing the inner surfaces of the mouth to collect epithelial cells.
Any substance with cells and genetic material (semen, biopsy, etc).
The test has no virtually no risk, but since it can give information of complex interpretation it is recommended that it is always indicated by a specialist, who then explain your result. It must be wary of genetic free online sales testing, because normally it's little use test and whose results can be misinterpreted.
Paternity test laws is variable in each country, although usually the will of the so-called son prevails with respect to the father. In Spain it is possible to collect the sample from the father unless he knows it and carry out the study; that Yes, it has no legal value and would only be an informative nature. To collect the specimen of the supposed son always consent is needed. In the case of the mother, it is indifferent to participate in the process or not, and is not necessary to collect samples of it.
A paternity test to have legal value, and thus establish a family relationship in an official way, the collection of samples and laboratory under forensic supervision studies and with judicial authorization should be performed. Only thus will demonstrate that the sample collected actually corresponds to a specific individual. This is important to be able to resolve problems with inheritance or civil liability.
When a paternity test is doneA paternity test is carried out to all persons wishing to undergo testing to see if there is a family relationship between them, kind father and son. Most of the laws of the world is dominated by the will of the supposed son of the father, in such a way that if the child does not want to undergo the test does not why provide samples even if the father wants to do the study.
In the opposite case, if the son is who wants to know if a man is his father, the legislation varies between countries. It is necessary to obtain a judicial authorization allowing to collect the sample from the alleged father to analyze it, and may even require a court order that would oblige this person to provide biological samples for its study.
It is also possible to collect the sample from the so-called father unless he knows it and contributions for study in private anonymously. This is only an informational value to the son, who will know if the results are positive or not, but had no official status, because the child can never demonstrate that collected samples are from a particular person if they were not collected under forensic supervision.
The role of the mother in the realization of a paternity test is limited. If she wants to take the test and the son prefers not to know the identity of his father is not obliged to provide samples for testing. On the other hand, if the mother refuses to carry out the paternity test is not account his wish, because their participation in the process is not needed and the will of the son is more important than the mother's.
Preparation for a paternity testIf they are going to do a paternity test these are the issues you should keep in mind to go well prepared to test:
Duration: usually takes very little time, and depending on the type of sample to collect it can take seconds or minutes. The results are slow enough, several weeks.
Admission: admission is never needed, it can be done at a time.
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: don't need to take any prior medication. There are no medications that interact with the test, except some chemotherapy treatments. However, it is always a good idea to tell the doctor before you test all the medications you are taking at that time.
Food: you can eat normally, you don't have to go on fasting. If the sample to collect saliva, is better not to eat anything about four hours prior to the test, it prevents be contaminated with food. It is also recommended not to attend the appointment with brushed teeth, not to alter the test.
Clothes: you can wear normal street clothes.
Documents: you must carry with you your personal identification, especially if the test is performed under forensic supervision.
Pregnancy and breast-feeding: neither pregnancy nor lactation are contraindications for performing this test. This situation is contemplated only if the pregnant woman or infant who is his father in the role of daughter. A pregnant woman cannot force a so-called father to deliver samples to find out if the fetus is theirs.
Contraindications: no contraindication. Rating only if when you submit the proof really want to know its outcome, whatever.
How a paternity testWhen you want to create you a study of paternity leave you can go to specialized centers that exist in the private sector. If you want to test you to make it official you should start judicial procedures that facilitate the conduct of the test through the lega. The procedure is simple if the alleged father agrees with the test; If not, one must request a court order that will come forward if the context is favourable.
One day you cite to collect specimens for the paternity test. The type of sample to collect varies without specific reasons. All types of sample bring results with a similar reliability. The most frequent signs are blood, hairor saliva. In the case of the blood sample is collected as if it were a usual analytics. The only difference is that the sample is usually stored and treated in a special way, but that does not affect you. Hairs must be collected next to the hair root, which is where are the cells that can be studied.
When you study the saliva is even easier; It is to collect saliva in your mouth with a swab of cotton (a swab). For that it is recommended to keep the appointment without food the previous hours or have been washing the teeth. Will ask you you to finish twice, thus limpiarás the mouth, then they will introduce you the stick and rub it with the inside of both cheeks. It is not annoying, it is rare to cause nausea because the back palate is not reached in no time. What is really important in this exhibition is not the saliva itself, which is mainly formed by water, but the epithelial cells that are found in the mucous membranes. The swab is stored in a sterile tube and thus preserving the DNA until it studied in the laboratory.
After taking the sample, a process that lasts a few seconds, you can collect your stuff and make a normal life until they cite you another day to collect the results. Before carrying out this type of test you have to be aware of what results you can provide, and if you're sure you want to know them, what are.
Complications of the paternity testThere are no known complications of the paternity test. It is a completely safe test that does not represent any risk for people who are subjected to it. The only risk is to know about test results that would have preferred not to know. The number of false positive test is minimal; they are usually double studies to be sure of the result.
Results of the paternity testThe results of the paternity test may take several weeks since the sample is collected for study. To collect them there to attend another event in which you deliver the complete documentation of your study and they explain the results. The results have great reliability, a positive result is valid 99.99% of the time. To make the test positive DNA must match between father and son at a high percentage.
If the test has been performed in a private Center, the results have an informative nature for the son, and the father if he is aware of the study. I.e., it is only useful to know that indeed there is a family relationship that was unknown until then, but that cannot be made official. To make the relationship official study must be done under judicial supervision; in this way results does not give rise to doubts. In this case, sample collection will be under forensic supervision and will keep the chain of custody to his studio in a forensic laboratory.
The results have two important consequences. One would be the personal value that has, for both the son and the father. You can involve changes in affective relationships between them, establish an emotional bond if the result is positive, or damage it if it is negative. Other value would be legal, as when a parent subsidiary relationship a series of responsibilities between them and also a series of rights, are set as it is the right to inheritance or maintenance.
What is the Snellen testThe Snellen test is a test that is very commonly used by opticians and ophthalmologists. Thanks to him, the visual acuity of a person, i.e. the ability that has the human eye to distinguish objects at far distances can be studied. Visual acuity reached several tens of meters in people with a healthy view, but this capacity may be weakened by alterations eye like myopia or farsightedness that the eye has damaged its mechanism of refraction and focuses on evil.
The test was designed by Hermann Snellen, a Dutch physician, born in Utrecht in the 19th century. He was mathematically calculated the distance to which a healthy person correctly distinguishes two nearby objects in a separate way, so I can create a table with letters to different sizes that had to be interpreted within a specific distance each. Otherwise it is interpreted as a visual acuity deficit and had to investigate the cause.
It is a simple and very economical test (only required black letters of different sizes, drawn on a white surface), the Snellen test is used on a daily basis in consultations of Ophthalmology and optics around the world. In addition, it is the first step to study the optical diopters and its correction with lenses. Only does it take a few minutes to perform and is not no discomfort for the person who is subject to it.
When a Snellen test is doneThe Snellen test must be performed to all persons who believe to have a lack of visual acuity. A person can realize it when you notice changes in the ability to see from far away. Some examples could be: watch TV at the same distance from always blurred, not read posters in stores and difficulty interpreting traffic signs, etc.
But the changes in visual acuity tend to be progressive, so that people don't often realize losing vision of coup and become accustomed to see worse. So it recommended, unofficially, be a Snellen test with some frequency or in the following cases:
Children: a Snellen test should be performed at least two times in children separated by 5-6 years. Also when suspected of having difficulty to read slate.
Teenagers: at the beginning of high school and at the end of these studies must be a Snellen test to check that the growth has not altered the optics of the eye.
Young: once the growth phase of adolescence, only has to perform a Snellen test when they finish long phases of study (e.g., college or opposition).
Adults: single Snellen test need to be repeated approximately every 10 years.
Nursing: the test should be performed when a visual deficit is suspected, but is recommended to go to the eye doctor because many times it can be blamed to the formation of cataracts in the lens.
The Snellen test prepIf you will do a Snellen test , these are issues that you should keep in mind about your preparation:
Duration: the Snellen test can take several minutes, approximately 5-7 minutes. However, all the consultation with an ophthalmologist or eye doctor can last up to 15-20 minutes because you will be asked for your vision.
Income: under no circumstances must be entering no one to perform the test. You can go to the clinic and back home in a few minutes.
Is necessary to be accompanied?: do not need to be accompanied.
Drugs: don't need to take any prior medication. You must be communicated to the doctor all the medicines taken regularly, especially if you take anticholinergic drugs or you use eye drops eye.
Food: don't why stay in fasting prior to testing or after. Although it is recommended not to drink alcohol before the test.
Clothes: you can go dressed as you want, you won't have to take off any item at any time.
Documents: take the national document of identity and medical history about eye diseases, if you have them. After the test you can to give you a document explaining you the visual acuity deficit.
Pregnancy and breast-feeding: the Snellen test can be performed on any of these physiological situations without any problems. It is true that pregnancy can alter the visual acuity in some women temporary or permanently. He is recommended that expect to pass the stage of lactation to have final results.
Contraindications: do not have any specific contraindication.
How Snellen testThe ophthalmologist or optometrist is responsible for rating if it can be useful to make the Snellen test. That same query will perform the test, since no previous preparation is necessary. If you have dilated pupils to you you will not make you the test and will have to go another day.
Ask yourself that you feel in front of a white wall, about six meters from it. When you're sitting comfortably, they placed you glasses without lenses, but with one eye covered. Thus they will evaluate you an eye on each shift and the deficit of visual acuity in each eye must be measured separately. In front you will see the table with the letters that you have to identify. Sometimes these letters are projected on the wall, if so turn off the light.
The eye doctor will ask that you sign each letter one by one. You will have to tell what or what you think they are. Sometimes you will not see them clearly and you can not tell what is, tell it to the eye doctor. Usually it will ask that you try to guess what, so you can see what is the degree of deterioration of visual acuity that you have.
When you take a certain number of right or wrong lyrics it will be over the test. If you've failed several can in sunglasses who have gotten you put lenses that alter the diopters of your eye, and you have to say if you see better or worse. Thus you graduate the vision to get glasses. After the test will give you a document (sometimes is not bigger than a card) with the visual deficit identified.
The Snellen test is a test devoid of risks and complications.
The Snellen test resultsFor the results of the Snellen test uses a very simple mechanism: each letter you've identified or failed under has a small number that helps the eye to know your degree of vision loss. This number indicates the meters to which letter should be identified. For example, a 12 will mean that that letter should be seen just 12 metres away.
To relate it to your loss of vision will be used a fraction whose denominator is the number of the table and the numerator the meters that you see it. For example, 6/12 means that a letter that should be 12 metres you can only see it at 6.
During the test you don't you walk away from the table, always remain approximately six metres of it. In order to study it without moving the letters change size from some very small to very large. Previous studies know which letter corresponds to far, so can be the test comfortably without leaving the site.
A common confusion related to the Snellen test results is to confound diopters as a measure of visual acuity. Diopter refer to the loss of the ability of the eye to focus for failures in its refraction. It really is the measure of correction of visual acuity.
What is the Gram stainColonies of gram-negative bacteria growing in a culture dish
The Gram stain, also known as Gram staining, is a laboratory technique that is used routinely in Microbiological studies of bacteria. It was designed by Christian Gram, a Danish scientist, in the year 1884. Gram aimed to get a proof that it was possible to differentiate between different groups of bacteria to study them and classify them. The test was a success and soon became a very useful technique not only for the study of bacteria, but also to be able to identify them quickly in infection and Select the most appropriate antibiotic to treat it.
The technique is based on applying a series of stains to a sample from any source (sputum, urine, pus, etc.) supposedly containing unidentified bacteria. Dyes stain the wall of purple bacteria, and after a few minutes, is a wash of coloring. After that you can that the dye remains in the bacterial wall or that he has left. In the first case would remain the color purple, and would be Gram positive bacteria, in the second, the wall would have a pink, and would be gram-negative.
These two groups of bacteria are the pillars on which is based the classification of most bacteria expands it. Each of the groups respond differently to each kind of antibiotics, therefore it is a useful technique to select the initial antimicrobial drug before an infection. It must be taken into account that in certain situations (such as sepsis) it is very important to start an adequate early antibiotic treatment, why the Gram stain calls urgently on many occasions.
The Gram stain also has certain limitations. Some bacteria have no wall, as for example the Chlamidias, and may not be identified as viruses. In such cases the stain not colored no germ. Another negative aspect of the test is that you can not identify the exact type of bacteria responsible for the infection. So, it is necessary to perform a microbiological culture which is always accompanied by an antibiogram to accurately study the most effective antibiotic.
When a Gram stain is madeA Gram stain is recommended in all situations in which you want to do a first approach to the classification of the isolated bacteria. In addition to her scientific research studies, also is performed in hospitals and clinics around the world to these diseases:
Pneumonia: you can pick up a sample of sputum that a Gram stain is performed to identify organisms responsible for.
Urine infection: the Gram-staining can be used in the urine with suspected infection. The sample should be collected with care not to contaminate it with bacteria of the vagina or the foreskin.
Urethritis: it is the most common sexually transmitted infection and tends to produce secretion through the urethra, which is collected to perform Gram stain.
Meningitis: Gram stain colorized maintained the bacteria that are infecting the cerebrospinal fluid.
Vaginal swab: Although there is multitude of bacteria in the vagina, the Gram stain can dye all of them and see the proportion of Gram positive and Gram negative. Thus the vaginosis, so common in menopausal women are diagnosed.
Abscesses: when accumulates pus anywhere should be drained and plan after antibiotic therapy if it is necessary, and so it is very useful to know which type of bacteria is the cause of the box.
Sepsis: in this case the sample collected is blood; a small tube of each arm.
A Gram stain preparationIf they are going to conduct a study with the Gram stain technique here are the points that you should keep in mind:
Duration: sample collection usually takes very little time, what it takes to be a blood analysis. It usually takes seconds or minutes. Depends on the area where you need to collect the sample (not a urine than a cerebrospinal fluid sample takes the same). Gram stain results take a little longer, usually about an hour.
Admission: admission is never needed. The sample collection is performed at the time. The case that made you the test during an entry to identify the bacteria that causes the infection, but in this case the reason for the income will be your state of health can also be.
Is necessary to be accompanied?: depends on the method of collection of the sample and your state of health. If the test is ordered urgent usually because your state of health is serious and is better you're accompanied.
Drugs: don't need to take any prior medication. You should tell your doctor all medications you are taking at that time. Some medications can give false negative results of the test, for example if you take antibiotics and want to detect the bacteria causing infection.
Food: you can eat normally, you don't have to go on fasting. But if the sample is blood you can to seize the prick of Analytics to measure yourself with other parameters in blood (sugar, cholesterol, etc.), and you must report it before so they know that they will be altered.
Clothes: you can wear normal street clothes.
Documents: it is recommended to carry your health card, although most of the times is enough to you to take the wheel with which the doctor sent you proof.
Pregnancy and lactation: this test can be normally in either of the two situations.
Contraindications: there are no contraindications.
Is a Gram stainWhen you get to the consultation the doctor will make you some general questions about your state of health: important diseases, risk factors, lifestyle, symptoms of infection, etc. The doctor will request a Gram stain when it considers it necessary and is the best way to guide your infection antibiotic treatment. Also perform you a general physical examination will assess if you can receive ambulant antibiotic therapy, and it is preferable that you stay logged.
Then conduct you sampling on which will be the Gram stain. According to the site's collection of taking one or other measures are recommended. For example, if urethral should not urinate two hours prior, if it is a best sputum that is first thing in the morning, and if it is better blood that matches a fever peak. But will those details you know the doctor before testing you, so you should not worry.
The Gram stain is performed in the laboratory, and you won't be aware of none of the steps of the technique. So know them summarized them below:
- Extends the sample collected (which tends to be viscous or liquid) on a glass slide, and let it air dry.
- Methanol is applied to the carrier; Thus, bacteria stuck on the surface.
- Gentian violet, a dye that stains all bacteria Purple is added. You should stop for a minute to make effect.
- Washing the colored water sample and add alcohol-acetona to fade the bacteria that are stained with gentian violet. It is the most important part of the test, since if it is left too long all bacteria are desteñirían. After it is washed again with water to eliminate alcohol.
- Add fuchsine, another dye which stains pink bacteria which do not have dyed purple. So you can see under a microscope, although they will be gram-negative.
- The microbiologist studied the sample under a microscope and identifies stained bacteria.
Complications of the Gram stainThe complications of the Gram stain are non-existent. It is a safe test that does not entail risks for persons who are subjected to it. The only risk is to accept false as positive or negative results, and take wrong steps in this regard, as happens when staining are not observed bacteria because an antibiotic has been previously taken. The sample does not usually entail risks, except those of lumbar puncture in the case of meningitis.
Gram stain resultsThe results of the Gram stain take between several minutes and one hour since the sample is collected for study. It is not often that you have to worry about collecting them, since it is usually your doctor which receives the test results (by phone if it is urgent, or with a report if you can wait 24 hours). In consultation, the doctor will be the most appropriate interpretation of the result. If you are admitted shall communicate them yourself during your stay in the hospital, or later if given medical discharge earlier.
The Gram stain is reported with identification or not bacteria. If there are bacteria, the microbiologist will indicate if Gram are positive (purple) or Gram negative (Roses), how have, and are organised. According to their shape they can be cocci (spheres), (thin cylinders) rods or coccobacilli. They can be arranged in cluster or chains; Sometimes they are scattered.
Usually the result of Gram stain can be summarized in bacteria Gram positive or Gram negative bacteria. Only with that is already sufficient to plan the initial antibiotic treatment. Days later will be the results of the microbiological culture, which will get the particular species of bacterium and its sensitivity to antibiotics; You can do the initial antibiotic is changed on the other.
Although it is a test useful may provide false positive and negative. It must keep in mind that the sample is caught in a specific time and is conditioned by the ability of the doctor or nurse that collects it and previous treatments of the patient (especially antibiotics). It must also take into account that the test result depends on the experience of the microbiologist who observes the stained sample.
What is a (PET) Positron Emission TomographyPositron Emission Tomography (PET by its English name, positron emission tomography) is a diagnostic test which, through the use of a small amount of a radioactive substance, allows to obtain images of the inside of the body.
Unlike other techniques such as computed tomography (CT) or magnetic nuclear (NMR), the PET resonance not gives anatomical information of the organism, but it detects the metabolic activity of cells you want to study. For example, you can determine the blood flow, oxygen consumption, or the consumption of sugar, certain cells. For this reason, used mainly for diagnosis and follow-up of patients with cancer, because the tumor cells have a different healthy cells metabolism.
PET can also be used in other fields such as in cardiology or Neurology. Using radioactive substances, is a technique that is included in a part of the so-called medicine nuclear medicine.
The PET machine is very similar to that used to make a TAC. It is a large machine shaped donut and a stretcher inside where the patient lies down. Prior to the taking of images is given a radioactive substance, called a radiopharmaceutical or liner, intravenous, oral or inhaled via, depending on the suspected diagnosis. This radiopharmaceutical circulates through the body and sticks to the tumor cells, which begin to emit a small amount of radiation. This radiation is detected by the machine's PET, which produces an image that highlight areas of the body where it has accumulated the radiopharmaceutical and that they may correspond to tumors.
In many occasions is a TAC while the PET is made. This allows to see images of the body by two different techniques, which can be merged into a single image and offers a very precise information about the possible pathology. Devices that have incorporated both technologies are used for this.
In which cases is performed tomography (PET) positron emission?The most common reasons for which you can request the realization of PET are as follows:
· Detect a cancer.
· Detect if a cancer has spread through the body, i.e. If metastasis has occurred.
· To determine the efficacy of a treatment against cancer, i.e., if the treatment has achieved a reduction or disappearance of tumors or metastases.
· To determine if cancer has come back after having been eliminated with treatment.
Less frequently, and outside the field of cancer, it can be used for the following:
- Study of blood flow to the heart and see the effect of myocardial infarction on the cardiac muscle. After a heart attack, the PET can identify areas of the heart muscle that are still viable and that can benefit from revascularization treatment.
- Evaluate the functioning of the brain in disorders such as the problems of memory, epilepsy and other neurological diseases.
Preparation for the (PET) Positron Emission TomographyThese are the issues that you must consider when you undergo a Tomography (PET) positron emission:
Duration: the imaging within the PET machine can last about 20-30 minutes. The radiopharmaceutical will manage about 60 minutes before the shooting.
Entry: the test can be 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
Food: must be that it do not eat neither food nor water for hours before the test.
Clothing: you can wear any clothes you want, but it is preferable that it is easy to remove. You don't want to carry metal objects (earrings, bracelets, etc.) because they will be asked to remove them during the test.
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: It should not do an enema in the following cases:
- If you perform a CT and PET, contraindications to the test will be those of the TAC, as for example the allergy to iodinated contrast.
- In pregnancy, because technique is performed with x-rays, which may harm the fetus.
Other considerationsNot do exercise immediately before the test and be as relaxed as possible, because any movement can alter the result should.
How is tomography (PET) positron emissionThe unit in which the test is donut-shaped and inside moves a stretcher that is where lies down the patient, usually face up. The couch moves on the inside hole of the CT scanner, and remains within 20-30 minutes while images are taken. Unlike MRI, this test does not usually cause claustrophobia, because the patient does not remain within a closed site. Noise is not heard. In general, it may be necessary to change the clothes by a hospital gown, but it depends on the centers. They will make you take off all metal objects, including dentures or the sonotones, because they may interfere with the images obtained.
About 60 minutes before the images you will be given the radiopharmaceutical orally, intravenously, or through inhaled. If the radiopharmaceutical is administered intravenously they will catch a vein via the arm to insert it.
During the procedure, a technician will be watching through a glass from an adjoining room, and will instruct you to not move. Where is done a CT with PET, usually first CT images are taken and then those of the PET. Sometimes, after the PET, repeats the TAC using contrast. Depending on the organ studied, may require a different procedure. For example, to study the heart you can be a PET before and after exercise, or before and after the administration of a drug that increases the cardiac blood flow.
After the test, can tell you to wait a little bit to that technician see the quality of the images if it is necessary to repeat something. The fact of repeating the Imaging does not mean that they have found something wrong, so should not be cause for concern. After testing the IV arm, they withdraw unless you have to repeat some procedure that same day.
PET is a very safe test because the dose of radiation administered is very small. Allergic reactions to the radiopharmaceutical can occur, but are extremely rare. The injection of the radiopharmaceutical can cause mild discomfort in the arm, but very short. The radiopharmaceutical administered orally does not have any flavor, and the administration of the radiopharmaceutical inhaled via is no different from inhalation of ambient air.
Results of the (PET) Positron Emission TomographyThe images obtained by the CT scanner can be seen immediately. However, their interpretation requires much expertise and is carried out by physicians specializing in nuclear medicine. This specialist will make a written report that will give you a few days of the test along with the images obtained.
The result report will include data on the technique used, the radiopharmaceutical used and found finds. The type of discovery can vary greatly depending on the pathology and studied organ. The most frequent is to perform as part of the diagnosis or monitoring of a cancer, and that report of the presence or absence of lesions compatible with pathology, tumor, cancer cells have a different to normal cells metabolism, so it highlighted in the images obtained by the PET. Often compares the new study with previous studies, and are informed of possible changes in the lesions and the presence of new lesions. In the case of cardiac pathology it is reported the presence of metabolic activity of the cells of the heart, indicating their viability after myocardial infarction. In the case of the brain, inform you of possible sources that may be causing epilepsy, or alterations in the activity of the brain being related to any disease in particular. In the case that a TAC is completed while the PET inform you of findings from these images as tumors, inflammations, etc, and its coincidence or not with lesions that may appear in the PET.
It is advisable to go to pick up the result and not assume that everything is normal because the results you are not delivered in a few weeks. The physician who requested 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 computed tomography (CT)The computed tomography or CT, also known as scan or CT scan (computed tomography), is a diagnostic test that allows x-ray images of the inside of the body in the form of transverse cuts through the use of x-rays, or, if necessary, in the form of three-dimensional images.
In which cases is performed a CT scan or CT scan?
The most common reasons that the realization of a CT or computed tomography may be requested are as follows:
In the case of trauma to detect bleeding, lesions of the internal organs or fractures.
To diagnose tumors and see its possible extension.
To study diseases of the spinal cord or spinal column.
To diagnose certain infections.
To guide some interventions such as the taking of biopsies or drainage of abscesses.
On many occasions, it is necessary to manage a liquid called contrast, which tends to be a compound of iodine, and that highlights in images obtained with the TAC, which facilitates the interpretation of the test. This contrast medium is usually administered intravenously, although they may also administer via oral or rare times, in other ways.
Prior preparation for a TACIf you will make you a TAC these are the issues that you must provide in advance:
Duration: the test is performed in a few minutes. What takes longer is undress and take a venous route when the administration of intravenous contrast injection is needed. If you perform an intervention as an outlet of biopsies or drainage of an abscess can last more.
Entry: the test can be 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.
Food: depends on the organ being studied, in general it is necessary to go on fasting if administer you a contrast.
Clothing: you can wear any clothes you want, but it should be easy to remove. You don't want to carry metal objects (earrings, bracelets, etc.), because they will be asked to remove them during the test.
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. It has to take the wheel of the test request.
Other considerationsThe use of an anti-diabetic drug called metformin may be associated with severe side effects when administered with intravenous contrast. That is why, in some patients, particularly in patients with kidney, heart or liver, disease it should stop taking metformin before performing a CT with contrast and it may be necessary to monitor kidney function prior to reintroduce it.
It should be noted the technician the possibility of having allergies to iodine or the iodinated contrast, because it is a contraindication for the realization of a CT scan with contrast
Not exercising immediately before the test and be as relaxed as possible, because any movement can alter the result should
Contraindications of TACIt should not be a TAC in the following cases:
If you have allergies to iodine or dye can be proof, but avoiding the administration of contrast.
The contrast by mouth is contraindicated in cases of suspicion of perforation of the digestive tract and prior to an endoscopy or surgery involving the digestive tract.
The use of intravenous contrast is contraindicated if there is renal or cardiac disease serious and in some tumors such as pheochromocytoma or myeloma. It is also contraindicated in the case of some diseases of the thyroid, as iodine which carries the contrast may be harmful for the thyroid.
Pregnancy is a contraindication for the test, with or without contrast.
The TAC during pregnancy and lactationThe TAC should be avoided in pregnancy, especially during the first quarter, because of the risk of radiation to the fetus. Breastfeeding in general is not a contraindication performing the test, even if administered intravenous contrast. The amount of contrast that can be excreted by the milk is less than 1% of the administered and the amount baby absorbed through the intestine is less than 1% of what they eat. Therefore, the amount that can reach the baby is so small that it is not recommended to stop breastfeeding to perform a CT scan with contrast.
However, those mothers who are concerned about the risk that you may have about your child this minimal exposure to contrast, can avoid breastfeeding during the 24 hours following the completion of the procedure. This is the time that it takes to eliminate all the contrast of the blood of the mother. During these 24 hours the mother can remove the milk through a pump and discard. In anticipation of this period that won't be breastfeeding, the mother can remove milk before testing and store enough to cover the needs of the child for 24 hours.
Procedure: how is a CTThe device which is a CT scanner or scanner, donut -shaped and inside moves a stretcher that is where lies down the patient, usually face up. The table moves on the inside hole of the scanner for a few seconds and then going doing multiple x-rays. Unlike MRI, this test does not usually cause claustrophobia, because the patient does not remain within a closed site. Noise is not heard.
In general, it is necessary to change the clothes by a hospital gown. If you perform a cranial CT it is generally not necessary to change clothes. They will make you take off all metal objects because they interfere in radiographic images.
In case that contrast is administered oral are given to drink previously tested a kind of porridge containing barium. If the contrast is intravenously they will pick up a venous pathway in the arm and introduced the contrast there moments before the shooting.
During the procedure, a technician will be watching him through a glass from an adjoining room and will instruct you that does not move. You can sometimes tell you that you do not breathe for a few seconds. At the end of the test, if they have administered contrast, can tell you to wait a few minutes in an adjacent room if an allergic reaction appear.
The TAC is a very safe test. The more severe reaction may be an allergy to the contrast oral or intravenous. The symptoms of this allergy can range from a feeling of heat and the appearance of a skin rash, to a very severe allergic reaction called anaphylactic shock. But quiet, there will always be a health care Manager to solve these rare eventualities. Allergy is often immediately after administration of contrast. However, very rarely, you may receive allergy hours after contrast administration, causing itching, difficulty swallowing or breathing. In such a case you should urgently contact a doctor.
Intravenous contrast sometimes gives some heat into the body through the vein. When getting out of the vein during its introduction can cause local inflammatory reactions.
Intravenous contrast in rare cases can cause kidney failure. This was more frequent in the past with contrast media that is no longer used. On the other hand, the dose of radiation that is received in a TAC is very small and does not produce side effects.
Results of a CT scanThe images obtained by the CT scanner can be seen immediately. However, their interpretation requires much expertise and is carried out by medical radiologists. This specialist will make a written report that will give you a few days of the test along with the radiographic images obtained.
The result report will include data on the technique used, if it was necessary the use of contrast and the findings found. The type of discovery can vary greatly depending on the pathology and studied organ. Many times you can find tumors benign or malignant, signs that indicate various infections like abscesses or cavity in any organ, or pathology in the bones, such as fractures or malformations. In relation to the vessels that irrigate the various organs, you can find thrombus, vascular infarcts (due to the blockage of an artery) or bleeding. It is often necessary to repeat the test to see how to evolve different injuries either spontaneously or with treatment.
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 to need to make other complementary examinations or treatment.