Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Postpartum hemorrhage
Postpartum hemorrhage (PPH) is a loss of blood greater than 500 ml,
following vaginal delivery, or 1000 ml, following cesarean section.The
mortility rate is of 1000 women per 100,000 live births as a result of
Postpartum hemorrhage (PPH). In the evaluation of all randomly assigned
participants,active bleeding was
controlled within 20 min with study treatment alone for 440 (90%) women
given misoprostol and 468 (96%) given oxytocin (relative risk [RR] 0·94,
95% CI 0·91—0·98; crude difference 5·3%, 95% CI 2·6—8·6). Additional
blood loss of 300 mL or greater after treatment occurred for 147 (30%)
of women receiving misoprostol and 83 (17%) receiving oxytocin (RR 1·78,
95% CI 1·40—2·26). Shivering (229 [47%] vs 82 [17%]; RR 2·80, 95% CI 2·25—3·49) and fever (217 [44%] vs
27 [6%]; 8·07, 5·52—11·8) were significantly more common with
misoprostol than with oxytocin. No women had hysterectomies or died(1).
G.1. Causes and Risk factors
1. Causes
Causes of Postpartum hemorrhage (PPH) are of result of uterine atony, trauma, retained placenta, and coagulopathy(4Ts)
a. Uterine atony
Uterine atony is a loss of functions of compression of the vessels to reduce blood flow after child birth. According to the study of Department of Obstetrics and Gynecology, Duke University School of Medicine, omen with severe PPH
had a mean oxytocin area under the curve of 10,054 mU compared to 3762
mU in controls (P < .001). After controlling for race, body mass
index, admission hematocrit, induction status, magnesium therapy, and
chorioamnionitis using logistic regression, oxytocin area under the
curve continued to predict severe PPH(2).
b. Trauma
Trauma due to a body wound or shock as a sudden physical injure such as car accidence are associated to the to the cause of Postpartum hemorrhage (PPH.Uncontrolled bleeding continues to be a major cause of mortality in trauma, cardiac surgery, postpartum hemorrhage and liver failure, according
to the study of Use of Activated Recombinant Factor VII in Severe Bleeding - Evidence for Efficacy and Safety in Trauma, Postpartum Hemorrhage, Cardiac Surgery, and Gastrointestinal Bleeding(3).
c. Tissues
Blood clots or retained tissues after birth, including retained placenta accounts for 10% of PPH. The
primary tissue-based etiology of PPH is retained placenta. In the study of intravenous sulprostone infusion in the treatment of retained placenta, showed that the placenta was successfully expelled in 39.7% of cases, whereas 60.3% of women underwent manual removal of placenta. Blood loss was significantly lower in women with successful placental expulsion than in women who had manual removal of the placenta (582 ± 431 ml vs. 1275 ± 721 ml, p < 0.0001). Sulprostone infusion did not cause adverse effects or significant postpartum morbidity(4).
d. Coagulopathy
Coagulopathy is defined as a condition of coagulation abnormalities in
which blood clots fail to form. According to the study by the Duke
University Medical Center, Durham, systemic bleeding at the time of postpartum hemorrhage (PPH) is usually the result of coagulopathy that has developed acutely as a result of massive hemorrhage after uterotonics and sutures have failed(5).
e. Etc.
2. Risk factors
a. In vaginal delivery
According to the study of University of Uruguay, Montevideo, Uruguay, moderate and severe postpartum hemorrhage occurred in 10.8% and 1.9% of deliveries, respectively. The risk factors more strongly associated and the incidence of moderate postpartum hemorrhage in women with each of these factors
were: retained placenta (33.3%) (adjusted odds ratio [OR] 6.02, 95%
confidence interval [CI] 3.50-10.36), multiple pregnancy (20.9%)
(adjusted OR 4.67, CI 2.41-9.05), macrosomia (18.6%) (adjusted OR 2.36,
CI 1.93-2.88), episiotomy (16.2%) (adjusted OR 1.70, CI 1.15-2.50), and
need for perineal suture (15.0%) (adjusted OR 1.66, CI 1.11-2.49).
Active management of the third stage of labor, multiparity, and low
birth weight were found to be protective factors. Severe postpartum hemorrhage
was associated with retained placenta (17.1%) (adjusted OR 16.04, CI
7.15-35.99), multiple pregnancy (4.7%) (adjusted OR 4.34, CI
1.46-12.87), macrosomia (4.9%) (adjusted OR 3.48, CI 2.27-5.36), induced
labor (3.5%) (adjusted OR 2.00, CI 1.30-3.09), and need for perineal
suture (2.5%) (adjusted OR 2.50, CI 1.87-3.36)(6).
b. In caesarean section
caesarean section is associated to increased risk of recurrent massive
uterine bleeding, according to the report of a 37 yr old patient
suffered severe atonic bleeding requiring different
operating procedures (Clipping of the uterine arteries) in combination
with an uterotonic and haemostaseological medication as well as massive
transfusion of blood components and recombinant factor VIIa. After a
period of 17 days without any bleeding the patient presented to the
emergency room with recurrent massive uterine bleeding(7).
c. Racial and ethnic disparities
Hispanic ethnicity and Asian/Pacific Islander race were associated with a
statistically significant increased odds of atonic PPH in comparison
with Caucasians, despite adjustment for potential mediators (adjusted
odds ratio [OR] for Hispanics: 1.21, 99% confidence interval [1.18,
1.25]; for Asians/Pacific Islanders: 1.31 [1.25, 1.38], with Caucasians
as reference)(8).
d. Others risk factors
According to the study of Risk Factors for Postpartum Hemorrhage: Can We
Explain the Recent Temporal Increase?, major independent risk factors
for PPH included primiparity, prior Caesarean section, placenta previa or low-lying placenta, marginal umbilical cord insertion in the placenta, transverse
lie, labour induction and augmentation, uterine or cervical trauma at
delivery, gestational age < 32 weeks, and birth weight ≥ 4500 g.
An overall increase in rate of PPH over the study period (OR 1.029; 95%
CI 1.024 to 1.034 per year) disappeared (OR 0.995; 95% CI 0.988 to 1.001
per year) after inclusion of maternal age, parity, prior Caesarean
section, labour induction and augmentation, placenta previa or low-lying
placenta, and abnormal placenta, with most of the reduction
attributable to rises in previous Caesarean section and labour
augmentation(9). Also according to the length of the third stage of labor and the risk of postpartum hemorrhage, Obstet Gynecol.
2005;105:290–3 and Stones
RW,
Paterson
CM,
Saunders
NJ.
Risk factors for major obstetric haemorrhage.
Eur J Obstet Gynecol Reprod Biol.
1993;48:15–8., risk factors for postpartum hemorrhage also include a prolonged third stage
of labor, multiple delivery, episiotomy, fetal macrosomia, and history
of postpartum hemorrhage.
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Sources
(1) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961924-3/abstract
(2) http://www.ncbi.nlm.nih.gov/pubmed/21047614
(3) http://www.ncbi.nlm.nih.gov/pubmed/22670132
(4) http://www.ncbi.nlm.nih.gov/pubmed/22862433
(5) http://www.ncbi.nlm.nih.gov/pubmed/22430921
(6) http://www.ncbi.nlm.nih.gov/pubmed/19461428
(7) http://www.ncbi.nlm.nih.gov/pubmed/22628026
(8) http://www.ncbi.nlm.nih.gov/pubmed/22886840
Monday, 2 December 2013
Hemorrhaging: Vaginal bleeding - The Treatments
Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Vaginal bleeding
Vaginal bleeding is defined a condition of abnormal vaginal bleeding or spotting between periods as a result of hormonal imbalances (abnormal uterine bleeding), pregnancy, menopause, diseases, bleeding disorders, medications, etc. Researchers at the 2nd Department of Obstetrics and Gynecology, University of Athensuggested that the occurrence of irregular, prolonged or heavy abnormal uterine bleeding is one of the most urgent gynecological problems in adolescence and the diagnosis of dysfunctional uterine bleeding should be used only when all other organic and structural causes of abnormal vaginal bleeding have been ruled out(1).
F.4. Treatments
Treatments depends to the finding of the underlined causes of vaginal bleeding, such as
F4.1. Fibroids and uterine bleeding
Please check the women health section for the related articles http://kylejnorton.blogspot.ca/p/women-health.html
F.4.2. Endometriosis
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F.4.3. Ectopic pregnancy
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F.4.4. Polycystic ovary syndrome
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4. Permanently Eliminate All Types of Ovarian Cysts and PCOs Within 2 Months for Only $4?
F.4.5. Pelvic Inflammation Disease
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22846527
Vaginal bleeding
Vaginal bleeding is defined a condition of abnormal vaginal bleeding or spotting between periods as a result of hormonal imbalances (abnormal uterine bleeding), pregnancy, menopause, diseases, bleeding disorders, medications, etc. Researchers at the 2nd Department of Obstetrics and Gynecology, University of Athensuggested that the occurrence of irregular, prolonged or heavy abnormal uterine bleeding is one of the most urgent gynecological problems in adolescence and the diagnosis of dysfunctional uterine bleeding should be used only when all other organic and structural causes of abnormal vaginal bleeding have been ruled out(1).
F.4. Treatments
Treatments depends to the finding of the underlined causes of vaginal bleeding, such as
F4.1. Fibroids and uterine bleeding
Please check the women health section for the related articles http://kylejnorton.blogspot.ca/p/women-health.html
F.4.2. Endometriosis
Please check the women health section for the related articles http://kylejnorton.blogspot.ca/p/women-health.html
F.4.3. Ectopic pregnancy
Please check the women health section for the related articles http://kylejnorton.blogspot.ca/p/women-health.html
F.4.4. Polycystic ovary syndrome
Please check the women health section for the related articles http://kylejnorton.blogspot.ca/p/women-health.html
4. Permanently Eliminate All Types of Ovarian Cysts and PCOs Within 2 Months for Only $4?
F.4.5. Pelvic Inflammation Disease
Please check the women health section for the related articles http://kylejnorton.blogspot.ca/p/women-health.html
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22846527
Hemorrhaging: Vaginal bleeding - The Symptoms and Diagnosis
Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Vaginal bleeding
Vaginal bleeding is defined a condition of abnormal vaginal bleeding or spotting between periods as a result of hormonal imbalances (abnormal uterine bleeding), pregnancy, menopause, diseases, bleeding disorders, medications, etc. Researchers at the 2nd Department of Obstetrics and Gynecology, University of Athensuggested that the occurrence of irregular, prolonged or heavy abnormal uterine bleeding is one of the most urgent gynecological problems in adolescence and the diagnosis of dysfunctional uterine bleeding should be used only when all other organic and structural causes of abnormal vaginal bleeding have been ruled out(1).
Symptoms
a. Bleeding or spotting between periods
b. Bleeding after sex
In most case, it is caused by sexual transmitting diseases
c. Irregular menstruation (menstrual cycle less than 28 days (more common) or more than 35 days apart)
d. Variable menstrual flow ranging from scanty to profuse
e. Menopausal bleeding
f. Etc.
F.3. Diagnosis
After a complete physical exam, including pelvic examination and questions related to your general health, including episode of vaginal bleeding, last normal menstrual cycle, previous abnormal bleeding, use of birth control pill, numbers of sexual partners, history of abnormal bleeding, etc.
a. Bacteria culture
If you are experience vaginal bleeding, bacteria cultire may be the first that you doctor orders to rule out sexually transmitted diseases such as gonorrhea and chlamydia.
b. Pap smear
To rule out irregular cervicl cell growth cause of vaginal bleeding
c. Endometrial biopsy
If you doctor suspect that the bleeding is of result of endometrial cells overgrowth.
d. Pelvic ultrasound
Pelvic ultrasound allows your doctor to examine the structures and organs in the lower abdomen and pelvis with an aim to find the underlined causes of vaginal bleeding
e. Blood tests such as thyroid function tests, complete blood count
To rule out Ovulatory abnormal uterine bleeding caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease.
f. Pregnancy test
the aim of the Pregnancy test is to rule out the bleeding caused by complication of pregnancy,
g. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22846527
Vaginal bleeding
Vaginal bleeding is defined a condition of abnormal vaginal bleeding or spotting between periods as a result of hormonal imbalances (abnormal uterine bleeding), pregnancy, menopause, diseases, bleeding disorders, medications, etc. Researchers at the 2nd Department of Obstetrics and Gynecology, University of Athensuggested that the occurrence of irregular, prolonged or heavy abnormal uterine bleeding is one of the most urgent gynecological problems in adolescence and the diagnosis of dysfunctional uterine bleeding should be used only when all other organic and structural causes of abnormal vaginal bleeding have been ruled out(1).
Symptoms
a. Bleeding or spotting between periods
b. Bleeding after sex
In most case, it is caused by sexual transmitting diseases
c. Irregular menstruation (menstrual cycle less than 28 days (more common) or more than 35 days apart)
d. Variable menstrual flow ranging from scanty to profuse
e. Menopausal bleeding
f. Etc.
F.3. Diagnosis
After a complete physical exam, including pelvic examination and questions related to your general health, including episode of vaginal bleeding, last normal menstrual cycle, previous abnormal bleeding, use of birth control pill, numbers of sexual partners, history of abnormal bleeding, etc.
a. Bacteria culture
If you are experience vaginal bleeding, bacteria cultire may be the first that you doctor orders to rule out sexually transmitted diseases such as gonorrhea and chlamydia.
b. Pap smear
To rule out irregular cervicl cell growth cause of vaginal bleeding
c. Endometrial biopsy
If you doctor suspect that the bleeding is of result of endometrial cells overgrowth.
d. Pelvic ultrasound
Pelvic ultrasound allows your doctor to examine the structures and organs in the lower abdomen and pelvis with an aim to find the underlined causes of vaginal bleeding
e. Blood tests such as thyroid function tests, complete blood count
To rule out Ovulatory abnormal uterine bleeding caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease.
f. Pregnancy test
the aim of the Pregnancy test is to rule out the bleeding caused by complication of pregnancy,
g. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22846527
Hemorrhaging: Vaginal bleeding - The Cause and Risk Factors
Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Vaginal bleeding
Vaginal bleeding is defined a condition of abnormal vaginal bleeding or spotting between periods as a result of hormonal imbalances (abnormal uterine bleeding), pregnancy, menopause, diseases, bleeding disorders, medications, etc. Researchers at the 2nd Department of Obstetrics and Gynecology, University of Athensuggested that the occurrence of irregular, prolonged or heavy abnormal uterine bleeding is one of the most urgent gynecological problems in adolescence and the diagnosis of dysfunctional uterine bleeding should be used only when all other organic and structural causes of abnormal vaginal bleeding have been ruled out(1).
Causes and Risk factors
1. Causes
a. Hormonal imbalance
Menstrual bleeding that falls outside the range of normal is often a cause of great concern, before treating with hormonal interventions or blood products, PCOS, should always be ruled out with clinical signs of hyperandrogenism, obesity, or insulin resistance. Attention must also be paid to signs or a family history of a bleeding disorder, as vWD is commonly associated with excessive uterine bleeding(2). Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia(2a).
b. Von Willebrand disease
Von Willebrand disease is defined as a hereditary condition of coagulation abnormality. There is a report of a 17 year old woman presented with severe anaemia due to menorrhagia. On investigation, she was shown to have abnormalities of her haemostatic mechanism consistent with von Willebrand's disease Type I, although there was no family history of this disorder(3).
c. cervical cancer
In the study to determine the presentation, pathological findings, treatment, and outcome of patients with cervical sarcom, f 1804 patients in the study with cervical malignancies, 8 cervical sarcomas were identified. All patients presented with vaginal bleeding and discharge(4).
d. Birth control pill
The Pill normally is prescribed by your doctor to reduce the heavy period blood for woman as well as in treating of period pain, or for contraceptive purpose ( 21 days on and 7 days off). Oral contraception is the dominant method of contraception for women in the world wide, in Canada there is more than 43% of sexually active women use it. It is defined as medications taken by mouth to prevent unwanted pregnancy. Bleeding and spotting is normal for the first six months for women starting any oral contraceptive combination pill because our body needs time to adjust to the new medication(5).
e. Endometrial hyperplasia
Endometrial hyperplasia is a condition of over growth of endometrial cell causing too thick of the endometrium of that can lead to abnormal bleeding. Researchers at the Department of Pathology, Aarhus University Hospital found that the mean (+/-s.d.) endometrial thickness was significantly different in patients with hyperplasia 11.5 mm (+/-5.0), polyps 11.8 mm (+/-5.1), sub-mucous myomas 7.1 mm (+/-3.4) and in patients without these abnormalities(abnormal uterine bleeding) 8.37 (+/-3.9) (p<0.001)(6).
f. Intrauterine device (IUD)
Researchers at the School of Medicine, Zhejiang University, in the study of the expression of angiopoietin-1 and -2 in the endometrium of women with abnormal bleeding induced by an intra-uterine device, found that Immunohistochemical analysis showed elevated Ang-2 protein levels in secretory phase endometrium from IUD patients compared with the control women. These results suggest that the angiopoietin/Tie-2 system promotes vascular remodelling in the endometrium and that changes in the expression of Ang-1, Ang-2 and Tie-2 may contribute to abnormal uterine bleeding in some IUD users(7).
h. Miscarriage or ectopic pregnancy
h.1. Miscarriage
Miscarriage is defined as the loss of an embryo before the 20th week of pregnancy as it is incapable of surviving independently. In medical terminology, miscarriage is a type of abortion, as it refers to the pregnancy ends with the death and removal or expulsion of the fetus, regardless of whether it is spontaneous or medically induced abortion. In US alone, over 15% of pregnancy ends in miscarriage.
Most common symptoms of miscarriage. 50% of bleeding during 20 weeks of pregnancy ends in miscarriage(8).
h.2. Ectopic pregnancy
Ectopic pregancy is defined as a condition in which the fertilized implant in somewhere else other than in the uterus. In most case, ectopic pregnancy occurrs in the one of the Fallopian tube, causinf tubal pregnancy. Ectopic pregnancy will end up in miscarriage as the fertilized can not survive outside of uterus. Bleeding occurs between 6 - 8 weeks of pregnancy may be a sign of miscariage due to the implant egg inability to survive out side of uterus(9).
i. Amenorrhea, age, PID, fibroids and ovarian masses
In the document sonographically identifiable causes of vaginal bleeding in secondarily amenorrhoeic women of child bearing age, showed that 75(73.2%) patients had pregnancy-related conditions, 14(13.7%) had normal, non-pregnant uteri while the remaining 13 (12.8%) had other gynaecological conditions namely pelvic inflammatory disease (PID), uterine fibroids and ovarian masses. Though pregnancy-related conditions are the major causes of vaginal bleeding in amenorrhoeic women of childbearing age, PID, fibroids and ovarian masses are possible findings(10).
j. Polycystic ovary syndrome
Polycystic Ovarian Syndrome is defined as endocrinologic diseases caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries as resulting of enlarged ovaries, leading to hormone imbalance( excessive androgen), resulting in male pattern hair development, acne,irregular period or absence of period, weight gain and effecting fertility. It effects over 5% of women population or 1 in 20 women(11).
h. Etc.
2. Risk factors
a. Physical, psychological and environmental factors
questionnaire survey was conducted on 14,752 women by trained doctors, when pregnant women came for the first antenatal examination, including sociodemographic characteristics, prior adverse pregnancy outcomes, diseases history, life event stress, adverse environmental exposure and detailed information on VB(12).
b. Age
The rate of postmenopausal vaginal bleeding during the study period peaks at the age of 55-59 years (25.9/1000 postmenopausal women/year) and declines thereafter(13).
c. Medical conditions and medication
People who have had medical conditions such as thyroid and pituitary disorders, diabetes, cirrhosis of the liver, and systemic lupus erythematosus or taken certain medication such as steroids or blood thinnersare at incresed risk of vaginal bleeding(14)
d. Inherited bleeding disorders (IBDs)
Inherited bleeding disorders (IBDs) are by definition life-long. Women with IBDs are more likely to suffer HMB, to be symptomatic, and to present with bleeding in association with gynaecological problems. Heavy and/or abnormal menstrual bleeding increases with age due increased anovulatory cycles and gynaecological pathologies in older women(15).
d. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22846527
(2) http://www.ncbi.nlm.nih.gov/pubmed/22764555
(2a) http://www.ncbi.nlm.nih.gov/pubmed/22230306
(3) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014910/
(4) http://www.ncbi.nlm.nih.gov/pubmed/22740005
(5) http://medicaladvisorjournals.blogspot.ca/2012/01/oral-contraception-pill-combined-oral.html
(6) http://www.ncbi.nlm.nih.gov/pubmed/11437723
(7) http://www.ncbi.nlm.nih.gov/pubmed/20233519
(8) http://medicaladvisorjournals.blogspot.ca/2012/01/miscarriage.html
(9) http://medicaladvisorjournals.blogspot.ca/2012/01/ectopic-pregnancy.html
(10) http://www.ncbi.nlm.nih.gov/pubmed/18923588
(11) http://medicaladvisorjournals.blogspot.ca/2012/01/overcome-infertility-fertility-and_13.html
(12) http://www.ncbi.nlm.nih.gov/pubmed/22584214
(13) http://www.ncbi.nlm.nih.gov/pubmed/20424279
(14) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014910/
(15) http://www.ncbi.nlm.nih.gov/pubmed/22445218
Vaginal bleeding
Vaginal bleeding is defined a condition of abnormal vaginal bleeding or spotting between periods as a result of hormonal imbalances (abnormal uterine bleeding), pregnancy, menopause, diseases, bleeding disorders, medications, etc. Researchers at the 2nd Department of Obstetrics and Gynecology, University of Athensuggested that the occurrence of irregular, prolonged or heavy abnormal uterine bleeding is one of the most urgent gynecological problems in adolescence and the diagnosis of dysfunctional uterine bleeding should be used only when all other organic and structural causes of abnormal vaginal bleeding have been ruled out(1).
Causes and Risk factors
1. Causes
a. Hormonal imbalance
Menstrual bleeding that falls outside the range of normal is often a cause of great concern, before treating with hormonal interventions or blood products, PCOS, should always be ruled out with clinical signs of hyperandrogenism, obesity, or insulin resistance. Attention must also be paid to signs or a family history of a bleeding disorder, as vWD is commonly associated with excessive uterine bleeding(2). Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia(2a).
b. Von Willebrand disease
Von Willebrand disease is defined as a hereditary condition of coagulation abnormality. There is a report of a 17 year old woman presented with severe anaemia due to menorrhagia. On investigation, she was shown to have abnormalities of her haemostatic mechanism consistent with von Willebrand's disease Type I, although there was no family history of this disorder(3).
c. cervical cancer
In the study to determine the presentation, pathological findings, treatment, and outcome of patients with cervical sarcom, f 1804 patients in the study with cervical malignancies, 8 cervical sarcomas were identified. All patients presented with vaginal bleeding and discharge(4).
d. Birth control pill
The Pill normally is prescribed by your doctor to reduce the heavy period blood for woman as well as in treating of period pain, or for contraceptive purpose ( 21 days on and 7 days off). Oral contraception is the dominant method of contraception for women in the world wide, in Canada there is more than 43% of sexually active women use it. It is defined as medications taken by mouth to prevent unwanted pregnancy. Bleeding and spotting is normal for the first six months for women starting any oral contraceptive combination pill because our body needs time to adjust to the new medication(5).
e. Endometrial hyperplasia
Endometrial hyperplasia is a condition of over growth of endometrial cell causing too thick of the endometrium of that can lead to abnormal bleeding. Researchers at the Department of Pathology, Aarhus University Hospital found that the mean (+/-s.d.) endometrial thickness was significantly different in patients with hyperplasia 11.5 mm (+/-5.0), polyps 11.8 mm (+/-5.1), sub-mucous myomas 7.1 mm (+/-3.4) and in patients without these abnormalities(abnormal uterine bleeding) 8.37 (+/-3.9) (p<0.001)(6).
f. Intrauterine device (IUD)
Researchers at the School of Medicine, Zhejiang University, in the study of the expression of angiopoietin-1 and -2 in the endometrium of women with abnormal bleeding induced by an intra-uterine device, found that Immunohistochemical analysis showed elevated Ang-2 protein levels in secretory phase endometrium from IUD patients compared with the control women. These results suggest that the angiopoietin/Tie-2 system promotes vascular remodelling in the endometrium and that changes in the expression of Ang-1, Ang-2 and Tie-2 may contribute to abnormal uterine bleeding in some IUD users(7).
h. Miscarriage or ectopic pregnancy
h.1. Miscarriage
Miscarriage is defined as the loss of an embryo before the 20th week of pregnancy as it is incapable of surviving independently. In medical terminology, miscarriage is a type of abortion, as it refers to the pregnancy ends with the death and removal or expulsion of the fetus, regardless of whether it is spontaneous or medically induced abortion. In US alone, over 15% of pregnancy ends in miscarriage.
Most common symptoms of miscarriage. 50% of bleeding during 20 weeks of pregnancy ends in miscarriage(8).
h.2. Ectopic pregnancy
Ectopic pregancy is defined as a condition in which the fertilized implant in somewhere else other than in the uterus. In most case, ectopic pregnancy occurrs in the one of the Fallopian tube, causinf tubal pregnancy. Ectopic pregnancy will end up in miscarriage as the fertilized can not survive outside of uterus. Bleeding occurs between 6 - 8 weeks of pregnancy may be a sign of miscariage due to the implant egg inability to survive out side of uterus(9).
i. Amenorrhea, age, PID, fibroids and ovarian masses
In the document sonographically identifiable causes of vaginal bleeding in secondarily amenorrhoeic women of child bearing age, showed that 75(73.2%) patients had pregnancy-related conditions, 14(13.7%) had normal, non-pregnant uteri while the remaining 13 (12.8%) had other gynaecological conditions namely pelvic inflammatory disease (PID), uterine fibroids and ovarian masses. Though pregnancy-related conditions are the major causes of vaginal bleeding in amenorrhoeic women of childbearing age, PID, fibroids and ovarian masses are possible findings(10).
j. Polycystic ovary syndrome
Polycystic Ovarian Syndrome is defined as endocrinologic diseases caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries as resulting of enlarged ovaries, leading to hormone imbalance( excessive androgen), resulting in male pattern hair development, acne,irregular period or absence of period, weight gain and effecting fertility. It effects over 5% of women population or 1 in 20 women(11).
h. Etc.
2. Risk factors
a. Physical, psychological and environmental factors
questionnaire survey was conducted on 14,752 women by trained doctors, when pregnant women came for the first antenatal examination, including sociodemographic characteristics, prior adverse pregnancy outcomes, diseases history, life event stress, adverse environmental exposure and detailed information on VB(12).
b. Age
The rate of postmenopausal vaginal bleeding during the study period peaks at the age of 55-59 years (25.9/1000 postmenopausal women/year) and declines thereafter(13).
c. Medical conditions and medication
People who have had medical conditions such as thyroid and pituitary disorders, diabetes, cirrhosis of the liver, and systemic lupus erythematosus or taken certain medication such as steroids or blood thinnersare at incresed risk of vaginal bleeding(14)
d. Inherited bleeding disorders (IBDs)
Inherited bleeding disorders (IBDs) are by definition life-long. Women with IBDs are more likely to suffer HMB, to be symptomatic, and to present with bleeding in association with gynaecological problems. Heavy and/or abnormal menstrual bleeding increases with age due increased anovulatory cycles and gynaecological pathologies in older women(15).
d. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22846527
(2) http://www.ncbi.nlm.nih.gov/pubmed/22764555
(2a) http://www.ncbi.nlm.nih.gov/pubmed/22230306
(3) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014910/
(4) http://www.ncbi.nlm.nih.gov/pubmed/22740005
(5) http://medicaladvisorjournals.blogspot.ca/2012/01/oral-contraception-pill-combined-oral.html
(6) http://www.ncbi.nlm.nih.gov/pubmed/11437723
(7) http://www.ncbi.nlm.nih.gov/pubmed/20233519
(8) http://medicaladvisorjournals.blogspot.ca/2012/01/miscarriage.html
(9) http://medicaladvisorjournals.blogspot.ca/2012/01/ectopic-pregnancy.html
(10) http://www.ncbi.nlm.nih.gov/pubmed/18923588
(11) http://medicaladvisorjournals.blogspot.ca/2012/01/overcome-infertility-fertility-and_13.html
(12) http://www.ncbi.nlm.nih.gov/pubmed/22584214
(13) http://www.ncbi.nlm.nih.gov/pubmed/20424279
(14) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0014910/
(15) http://www.ncbi.nlm.nih.gov/pubmed/22445218
Hemorrhaging: Pulmonary hemorrhage (P-Hem) - The Complications and Treatments
Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Pulmonary hemorrhage (P-Hem)
Pulmonary hemorrhage is defined as a acute condition of lung bleeding from the from the upper respiratory tract or the endotracheal tube of the lung with the mortality of 30 to 40%.
Complication
1. Leptospirosis
Leptospirosis is a widespread zooanthroponosis that is prevalent in tropical regions due to the
favorable environmental survival conditions of its etiologic agent (Leptospira)(12).
2. Fetomaternal complications
Antenatal diagnosis and treatment of women with hereditary hemorrhagic telangectasia and pulmonary arteriovenous malformations might prevent potentially lifethreatening fetomaternal complications(13).
3. Pulmonary infection and respiratory failure
In the study of spinal cord injury (SCI) rats, pulmonary edema and hemorrhage were occurred in the early stage of SCI while the other organs were almost normal. And the location of lung edema and hemorrhage were the same as that of pulmonary infection(14).
4. Etc.
E.4. Treatments
Treatments depend on the diagnosis of each patient, if the underlined cause is due to medication, then medicine has to be stopped.
1. Immediate treatment
According to the Intensive Care Nursery House Staff Manual immediate treatment of P-Hem should include tracheal suction, oxygen and positive pressure ventilation. To assist in decreasing P-Hem, mean
airway pressure should be increased, either by a relatively high PEEP (i.e., 6 to 10
cmH2O) or by high frequency ventilation(15). In the infants, reserachers at suggested that current management of PH in VLBW infants includes ventilatory support using high positive end expiratory pressure, transfusion of blood and blood products to support the circulation and correct any hemostatic or coagulation defects and evaluation and treatment for patent ductus arteriousus (PDA). These strategies are often ineffective in preventing a poor outcome. rFVIIa is effective in controlling life-threatening hemorrhage in patients with hemophilia A and B with inhibitors, and in nonhemophiliacs with a variety of inherited or acquired hemostatic defects including platelet disorders, liver disease and von Willebrand's disease.(15a)
2. Embolization - Interventional treatment of pulmonary arteriovenous malformations
Acording to the study of Dr. Andersen PE and Dr. Kjeldsen AD. at the Odense University Hospital " Pulmonary arteriovenous malformations (PAVM) are congenital vascular communications in the lungs. The generally accepted treatment strategy of first choice is embolization of the afferent arteries to the arteriovenous malformations. It is a minimally invasive procedure and at the same time a lung preserving treatment with a very high technical success, high effectiveness and low morbidity and mortality. Embolization prevents cerebral stroke and abscess as well as pulmonary haemorrhage and further raises the functional level. Embolization is a well-established method of treating PAVM, with a significant effect on oxygenation of the blood. Screening for PAVM in patients at risk is recommended, especially in patients with HHT(16).
3. Corticosteroids
There is a report of a patient suffered from acute glomerulonephritis with modest renal impairment and life-threatening pulmonary hemorrhage. The pulmonary hemorrhage caused severe hypoxia that necessitated artificial ventilation. As a last resort, 1 g/day of methylprednisolone was administered intravenously. Rapid cessation of pulmonary hemorrhage ensued with clearing of the lungs fields. the suggestion of large doses of glucocorticosteroids should be administered to patients with life-threatening pulmonary hemorrhage before considering bilateral nephrectomy, especially if the renal function is still adequate. Bilateral nephrectomy is an irreversible approach and, as with massive doses of steroids, has yet to be proved to be a consistently effective mode of therapy(17).
4. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
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Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
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Sources
(12) http://saithan.net/pulmonary%20and%20sys%20disease/Pulmonary%20complications%20of%20leptospirosis.pdf
(13) http://ape.med.miami.edu/Doc/Resident%20Web%20Site%20Articles/Other%20diseases/Hereditary%20Hemorrhagic%20Telangiectasias/OB%20article%20+%20pulmAVMs.pdf
(14) http://www.ncbi.nlm.nih.gov/pubmed/22683446
(15) http://www.ucsfbenioffchildrens.org/pdf/manuals/29_PulmHemorrhage.pdf
(15a) http://www.nature.com/jp/journal/v22/n8/full/7210787a.html
(16) http://www.ncbi.nlm.nih.gov/pubmed/21160695
(17) http://annals.org/article.aspx?articleid=689575
Pulmonary hemorrhage (P-Hem)
Pulmonary hemorrhage is defined as a acute condition of lung bleeding from the from the upper respiratory tract or the endotracheal tube of the lung with the mortality of 30 to 40%.
Complication
1. Leptospirosis
Leptospirosis is a widespread zooanthroponosis that is prevalent in tropical regions due to the
favorable environmental survival conditions of its etiologic agent (Leptospira)(12).
2. Fetomaternal complications
Antenatal diagnosis and treatment of women with hereditary hemorrhagic telangectasia and pulmonary arteriovenous malformations might prevent potentially lifethreatening fetomaternal complications(13).
3. Pulmonary infection and respiratory failure
In the study of spinal cord injury (SCI) rats, pulmonary edema and hemorrhage were occurred in the early stage of SCI while the other organs were almost normal. And the location of lung edema and hemorrhage were the same as that of pulmonary infection(14).
4. Etc.
E.4. Treatments
Treatments depend on the diagnosis of each patient, if the underlined cause is due to medication, then medicine has to be stopped.
1. Immediate treatment
According to the Intensive Care Nursery House Staff Manual immediate treatment of P-Hem should include tracheal suction, oxygen and positive pressure ventilation. To assist in decreasing P-Hem, mean
airway pressure should be increased, either by a relatively high PEEP (i.e., 6 to 10
cmH2O) or by high frequency ventilation(15). In the infants, reserachers at suggested that current management of PH in VLBW infants includes ventilatory support using high positive end expiratory pressure, transfusion of blood and blood products to support the circulation and correct any hemostatic or coagulation defects and evaluation and treatment for patent ductus arteriousus (PDA). These strategies are often ineffective in preventing a poor outcome. rFVIIa is effective in controlling life-threatening hemorrhage in patients with hemophilia A and B with inhibitors, and in nonhemophiliacs with a variety of inherited or acquired hemostatic defects including platelet disorders, liver disease and von Willebrand's disease.(15a)
2. Embolization - Interventional treatment of pulmonary arteriovenous malformations
Acording to the study of Dr. Andersen PE and Dr. Kjeldsen AD. at the Odense University Hospital " Pulmonary arteriovenous malformations (PAVM) are congenital vascular communications in the lungs. The generally accepted treatment strategy of first choice is embolization of the afferent arteries to the arteriovenous malformations. It is a minimally invasive procedure and at the same time a lung preserving treatment with a very high technical success, high effectiveness and low morbidity and mortality. Embolization prevents cerebral stroke and abscess as well as pulmonary haemorrhage and further raises the functional level. Embolization is a well-established method of treating PAVM, with a significant effect on oxygenation of the blood. Screening for PAVM in patients at risk is recommended, especially in patients with HHT(16).
3. Corticosteroids
There is a report of a patient suffered from acute glomerulonephritis with modest renal impairment and life-threatening pulmonary hemorrhage. The pulmonary hemorrhage caused severe hypoxia that necessitated artificial ventilation. As a last resort, 1 g/day of methylprednisolone was administered intravenously. Rapid cessation of pulmonary hemorrhage ensued with clearing of the lungs fields. the suggestion of large doses of glucocorticosteroids should be administered to patients with life-threatening pulmonary hemorrhage before considering bilateral nephrectomy, especially if the renal function is still adequate. Bilateral nephrectomy is an irreversible approach and, as with massive doses of steroids, has yet to be proved to be a consistently effective mode of therapy(17).
4. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(12) http://saithan.net/pulmonary%20and%20sys%20disease/Pulmonary%20complications%20of%20leptospirosis.pdf
(13) http://ape.med.miami.edu/Doc/Resident%20Web%20Site%20Articles/Other%20diseases/Hereditary%20Hemorrhagic%20Telangiectasias/OB%20article%20+%20pulmAVMs.pdf
(14) http://www.ncbi.nlm.nih.gov/pubmed/22683446
(15) http://www.ucsfbenioffchildrens.org/pdf/manuals/29_PulmHemorrhage.pdf
(15a) http://www.nature.com/jp/journal/v22/n8/full/7210787a.html
(16) http://www.ncbi.nlm.nih.gov/pubmed/21160695
(17) http://annals.org/article.aspx?articleid=689575
Hemorrhaging: Pulmonary hemorrhage (P-Hem) - The Symptoms and Diagnosis
Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Pulmonary hemorrhage (P-Hem)
Pulmonary hemorrhage is defined as a acute condition of lung bleeding from the from the upper respiratory tract or the endotracheal tube of the lung with the mortality of 30 to 40%.
Symptoms
1. The onset of P-Hem is characterized by oozing of bloody fluid from the nose and mouth or endotracheal tube with associated rapid worsening of the respiratory status, cyanosis and, in severe cases, shock(7).
2. In the report of 3 cases of enterovirus 71 infection with pulmonary edema or pulmonary hemorrhage as the early clinical manifestation, found that pulmonary edema or pulmonary hemorrhage occurred in the 3 cases with EV71-infected infants. The initial presentation was often nonspecific with fever and vomiting, and sudden appearances of cyanosis, tachypnea, tachycardia, hypertension or hypotension, limb weakness may suggest pulmonary edema or hemorrhage. Excessive fluid resuscitation may deteriorate the illness, on the contrary, fluid restriction and inotropic agents, and early intubation with positive pressure mechanical ventilation may be the proper treatment(8).
3. Etc.
E.3. Diagnosis
1. The computed tomography (CT) scans and chest radiograph
In the study of the computed tomography (CT) scans and chest radiograph of seven patients with bronchoscopic or pathologically proven cases of pulmonary hemorrhage to determine the appearance and value of each modality, showed that CT revealed the presence and location in all cases while chest radiographs were falsely negative in two cases. The CT pattern was always an alveolar pattern while the pattern was more variable on chest radiographs. By providing better pattern definition than the chest radiographs, CT is the study of choice in detecting the presence of a suspected pulmonary hemorrhage(9).
2. Bronchoalveolar lavage (BAL)
Bronchoalveolar lavage (BAL) is a medical procedure to collect and examine the lung fluid with the use of a bronchoscope, passing through the mouth or nose into the lungs. In the study to investigate the efficacy of bronchoalveolar lavage (BAL) in diagnosing pulmonary hemorrhage in 51 immunosuppressed patients with new pulmonary infiltrates, showed that Severe pulmonary hemorrhage was ultimately diagnosed in 14 cases, and a mild degree of hemorrhage was found in an additional 19 cases. Thrombocytopenia and invasive fungal infections were statistically associated with severe hemorrhage, as was an increased percentage of alveolar macrophages in the BAL sample(10).
3. CT-guided transthoracic lung biopsy
Higher rates of complications are significantly found with multiple punctures (pneumothorax risk multiplied by 7.4), longer intra-parenchymal needle tract (5 and 7% higher risk of pneumothorax and hemorrhage for every 1 mm increase in depth), and with smaller lesions (2 and 5% lower risk respectively for pneumothorax and hemorrhage for every 1 cm increase in lesion size). The presence of an interposing rib is associated with a higher rate of hemorrhage(11).
4. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(7) http://www.ucsfbenioffchildrens.org/pdf/manuals/29_PulmHemorrhage.pdf
(8) http://www.ncbi.nlm.nih.gov/pubmed/19099810
(9) http://www.sciencedirect.com/science/article/pii/089970719390021E
(10) http://www.ncbi.nlm.nih.gov/pubmed/3605828
(11) http://www.ncbi.nlm.nih.gov/pubmed/22645895
Pulmonary hemorrhage (P-Hem)
Pulmonary hemorrhage is defined as a acute condition of lung bleeding from the from the upper respiratory tract or the endotracheal tube of the lung with the mortality of 30 to 40%.
Symptoms
1. The onset of P-Hem is characterized by oozing of bloody fluid from the nose and mouth or endotracheal tube with associated rapid worsening of the respiratory status, cyanosis and, in severe cases, shock(7).
2. In the report of 3 cases of enterovirus 71 infection with pulmonary edema or pulmonary hemorrhage as the early clinical manifestation, found that pulmonary edema or pulmonary hemorrhage occurred in the 3 cases with EV71-infected infants. The initial presentation was often nonspecific with fever and vomiting, and sudden appearances of cyanosis, tachypnea, tachycardia, hypertension or hypotension, limb weakness may suggest pulmonary edema or hemorrhage. Excessive fluid resuscitation may deteriorate the illness, on the contrary, fluid restriction and inotropic agents, and early intubation with positive pressure mechanical ventilation may be the proper treatment(8).
3. Etc.
E.3. Diagnosis
1. The computed tomography (CT) scans and chest radiograph
In the study of the computed tomography (CT) scans and chest radiograph of seven patients with bronchoscopic or pathologically proven cases of pulmonary hemorrhage to determine the appearance and value of each modality, showed that CT revealed the presence and location in all cases while chest radiographs were falsely negative in two cases. The CT pattern was always an alveolar pattern while the pattern was more variable on chest radiographs. By providing better pattern definition than the chest radiographs, CT is the study of choice in detecting the presence of a suspected pulmonary hemorrhage(9).
2. Bronchoalveolar lavage (BAL)
Bronchoalveolar lavage (BAL) is a medical procedure to collect and examine the lung fluid with the use of a bronchoscope, passing through the mouth or nose into the lungs. In the study to investigate the efficacy of bronchoalveolar lavage (BAL) in diagnosing pulmonary hemorrhage in 51 immunosuppressed patients with new pulmonary infiltrates, showed that Severe pulmonary hemorrhage was ultimately diagnosed in 14 cases, and a mild degree of hemorrhage was found in an additional 19 cases. Thrombocytopenia and invasive fungal infections were statistically associated with severe hemorrhage, as was an increased percentage of alveolar macrophages in the BAL sample(10).
3. CT-guided transthoracic lung biopsy
Higher rates of complications are significantly found with multiple punctures (pneumothorax risk multiplied by 7.4), longer intra-parenchymal needle tract (5 and 7% higher risk of pneumothorax and hemorrhage for every 1 mm increase in depth), and with smaller lesions (2 and 5% lower risk respectively for pneumothorax and hemorrhage for every 1 cm increase in lesion size). The presence of an interposing rib is associated with a higher rate of hemorrhage(11).
4. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(7) http://www.ucsfbenioffchildrens.org/pdf/manuals/29_PulmHemorrhage.pdf
(8) http://www.ncbi.nlm.nih.gov/pubmed/19099810
(9) http://www.sciencedirect.com/science/article/pii/089970719390021E
(10) http://www.ncbi.nlm.nih.gov/pubmed/3605828
(11) http://www.ncbi.nlm.nih.gov/pubmed/22645895
Hemorrhaging: Pulmonary hemorrhage (P-Hem) - The Causes and Risk Factors
Hemorrhaging is also known as bleeding or abnormal bleeding as a
result of blood loss due to internal.external leaking from blood
vessels or through the skin.
Pulmonary hemorrhage (P-Hem)
Pulmonary hemorrhage is defined as a acute condition of lung bleeding from the from the upper respiratory tract or the endotracheal tube of the lung with the mortality of 30 to 40%.
Causes and Rick factors
A. Causes
1. Pulmonary Embolism
In the study to determine the characteristics of the history, physical examination, chest radiograph, electrocardiogram, and the ventilation/perfusion lung scan probability in elderly patients with pulmonary embolism who present with the syndrome of pulmonary infarction or hemorrhage, found that although a few clinical features of the pulmonary hemorrhage/infarction syndrome of pulmonary embolism in elderly patients differ from patients less than 40 years of age, in general, the clinical characteristics are comparable to younger patients(1).
2. Bacteria infection
Enterovirus 71 (EV71) infection with pulmonary edema or pulmonary hemorrhage as a fulminant and often fatal illness(2). Others report a case of a 63-year-old woman treated by intensive chemotherapy for acute myeloid leukemia (AML) who presented while severely neutropenic and thrombocytopenic a Sm pulmonary infection with hemoptysis leading to death in 48 h, according to the study of Lethal pulmonary hemorrhage caused by a fulminant Stenotrophomonas maltophilia respiratory infection in an acute myeloid leukemia patient(3).
3. Lung cancer
In the study to investigate the risk factors associated with fatal pulmonary hemorrhage (PH) in patients with locally advanced non-small cell lung cancer (NSCLC), treated with chemoradiotherapy, showed that f the 583 patients, 2.1% suffered a fatal PH. The numbers of patients with minimum, minor, and major cavitations were 13, 11, and 14, respectively. Among the 38 patients with tumor cavitation, all 3 patients who developed fatal PH had major cavitations. On multivariate analysis, the presence of baseline major cavitation (odds ratio, 17.878), and a squamous cell histology (odds ratio, 5.491) proved to be independent significant risk factors for fatal PH. Interestingly, all patients with fatal PH and baseline major cavitation were found to have tumors with squamous cell histology, and the occurrence of fatal PH in patients having both risk factors was 33.3%(4).
4. Pneumonia
In the review of the epidemiological, clinical and diagnosis findings of pneumonia and pulmonary hemorrhage observed in patients with leptospirosis in the period January 2007 to October 2009. A 64% (20/31) of patients diagnosed with leptospirosis presented pneumonia. Fifteen of them (75%) had severe pneumonia, of which seven (35%) were pulmonary hemorrhage. In ten patients (32%) reason for consultation and clinical early stage was a secretory gastroenteritis with fever and abdominal pain. Jaundice was only expressed in eleven patients (35%)(5).
5. Etc.
B. Risk factors
1. Extreme Exercise
There is a report of Exercise-induced pulmonary hemorrhage (EIPH) occurs in horses that race at high speeds(6)
2. Hereditary hemorrhagic telangiectasia and others
Hereditary hemorrhagic telangiectasia (Osler-Weber- Rendu disease) is inherited as an autosomal dominant trait with an incidence as high as 1:2300, according to the study of Hereditary hemorrhagic telangiectasia with pulmonary arteriovenous malformations. Prematurity is the factor most commonly associated with P-Hem; other associated factors are those that predispose to perinatal asphyxia or bleeding disorders, including toxemia of pregnancy, maternal cocaine use, erythroblastosis fetalis, breech delivery, hypothermia, infection, Respiratory Distress Syndrome, administration of exogenous surfactant (in some studies) and ECMO(7).
3. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/11416457
(2) http://www.ncbi.nlm.nih.gov/pubmed/19099810
(3) http://www.ncbi.nlm.nih.gov/pubmed/15360016
(4) http://www.ncbi.nlm.nih.gov/pubmed/22260460
(5) http://www.ncbi.nlm.nih.gov/pubmed/21550928
(6) http://www.ker.com/library/proceedings/04/EIPH_p95.pdf
(7) http://www.ucsfbenioffchildrens.org/pdf/manuals/29_PulmHemorrhage.pdf
Pulmonary hemorrhage (P-Hem)
Pulmonary hemorrhage is defined as a acute condition of lung bleeding from the from the upper respiratory tract or the endotracheal tube of the lung with the mortality of 30 to 40%.
Causes and Rick factors
A. Causes
1. Pulmonary Embolism
In the study to determine the characteristics of the history, physical examination, chest radiograph, electrocardiogram, and the ventilation/perfusion lung scan probability in elderly patients with pulmonary embolism who present with the syndrome of pulmonary infarction or hemorrhage, found that although a few clinical features of the pulmonary hemorrhage/infarction syndrome of pulmonary embolism in elderly patients differ from patients less than 40 years of age, in general, the clinical characteristics are comparable to younger patients(1).
2. Bacteria infection
Enterovirus 71 (EV71) infection with pulmonary edema or pulmonary hemorrhage as a fulminant and often fatal illness(2). Others report a case of a 63-year-old woman treated by intensive chemotherapy for acute myeloid leukemia (AML) who presented while severely neutropenic and thrombocytopenic a Sm pulmonary infection with hemoptysis leading to death in 48 h, according to the study of Lethal pulmonary hemorrhage caused by a fulminant Stenotrophomonas maltophilia respiratory infection in an acute myeloid leukemia patient(3).
3. Lung cancer
In the study to investigate the risk factors associated with fatal pulmonary hemorrhage (PH) in patients with locally advanced non-small cell lung cancer (NSCLC), treated with chemoradiotherapy, showed that f the 583 patients, 2.1% suffered a fatal PH. The numbers of patients with minimum, minor, and major cavitations were 13, 11, and 14, respectively. Among the 38 patients with tumor cavitation, all 3 patients who developed fatal PH had major cavitations. On multivariate analysis, the presence of baseline major cavitation (odds ratio, 17.878), and a squamous cell histology (odds ratio, 5.491) proved to be independent significant risk factors for fatal PH. Interestingly, all patients with fatal PH and baseline major cavitation were found to have tumors with squamous cell histology, and the occurrence of fatal PH in patients having both risk factors was 33.3%(4).
4. Pneumonia
In the review of the epidemiological, clinical and diagnosis findings of pneumonia and pulmonary hemorrhage observed in patients with leptospirosis in the period January 2007 to October 2009. A 64% (20/31) of patients diagnosed with leptospirosis presented pneumonia. Fifteen of them (75%) had severe pneumonia, of which seven (35%) were pulmonary hemorrhage. In ten patients (32%) reason for consultation and clinical early stage was a secretory gastroenteritis with fever and abdominal pain. Jaundice was only expressed in eleven patients (35%)(5).
5. Etc.
B. Risk factors
1. Extreme Exercise
There is a report of Exercise-induced pulmonary hemorrhage (EIPH) occurs in horses that race at high speeds(6)
2. Hereditary hemorrhagic telangiectasia and others
Hereditary hemorrhagic telangiectasia (Osler-Weber- Rendu disease) is inherited as an autosomal dominant trait with an incidence as high as 1:2300, according to the study of Hereditary hemorrhagic telangiectasia with pulmonary arteriovenous malformations. Prematurity is the factor most commonly associated with P-Hem; other associated factors are those that predispose to perinatal asphyxia or bleeding disorders, including toxemia of pregnancy, maternal cocaine use, erythroblastosis fetalis, breech delivery, hypothermia, infection, Respiratory Distress Syndrome, administration of exogenous surfactant (in some studies) and ECMO(7).
3. Etc.
Chinese Secrets To Fatty Liver And Obesity Reversal
Use The Revolutionary Findings To Achieve
Optimal Health And Loose Weight
Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
Back to General health http://kylejnorton.blogspot.ca/p/general-health.html
Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/11416457
(2) http://www.ncbi.nlm.nih.gov/pubmed/19099810
(3) http://www.ncbi.nlm.nih.gov/pubmed/15360016
(4) http://www.ncbi.nlm.nih.gov/pubmed/22260460
(5) http://www.ncbi.nlm.nih.gov/pubmed/21550928
(6) http://www.ker.com/library/proceedings/04/EIPH_p95.pdf
(7) http://www.ucsfbenioffchildrens.org/pdf/manuals/29_PulmHemorrhage.pdf
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