What are the key components of blood crit. How do hematocrit and hemoglobin levels affect health. What causes thrombocytopenia and what are its symptoms. How is platelet count measured and interpreted. What are the potential complications of blood disorders. When should you seek medical attention for blood-related issues.

The Importance of Blood Composition: Hematocrit and Hemoglobin

Blood composition plays a crucial role in overall health and well-being. Two essential components of blood are hematocrit and hemoglobin. Hematocrit refers to the percentage of red blood cells in the total blood volume, while hemoglobin is the protein in red blood cells responsible for carrying oxygen throughout the body.

Why are these components important? Hematocrit and hemoglobin levels can indicate various health conditions, including anemia, dehydration, or blood disorders. Normal hematocrit ranges are typically 38.8% to 50% for men and 34.9% to 44.5% for women, while normal hemoglobin levels range from 13.5 to 17.5 grams per deciliter for men and 12.0 to 15.5 grams per deciliter for women.

Factors Affecting Hematocrit and Hemoglobin Levels

• Altitude
• Pregnancy
• Nutritional deficiencies
• Chronic diseases
• Blood loss
• Certain medications

Understanding Plateletcrit (PCT) and Its Significance

Plateletcrit (PCT) is a measure of the total volume of platelets in a given blood sample. It provides valuable information about platelet function and can be used to diagnose various blood disorders. PCT is typically reported as a percentage and is calculated by multiplying the platelet count by the mean platelet volume (MPV).

Is PCT the same as platelet count? While related, PCT and platelet count are different measurements. Platelet count refers to the number of platelets per unit volume of blood, whereas PCT represents the percentage of blood volume occupied by platelets. Both measurements are important for assessing platelet function and diagnosing blood disorders.

Normal PCT Values and Interpretation

Normal PCT values typically range from 0.22% to 0.24%. Values outside this range may indicate various conditions:

• Low PCT: May suggest thrombocytopenia or platelet dysfunction
• High PCT: Could indicate thrombocytosis or other blood disorders

Thrombocytopenia: Causes, Symptoms, and Diagnosis

Thrombocytopenia is a condition characterized by a low platelet count, typically below 150,000 platelets per microliter of blood. This disorder can arise from various causes and may lead to serious complications if left untreated.

Common Causes of Thrombocytopenia

1. Immune system disorders
2. Bone marrow problems
3. Certain medications
4. Viral infections
5. Pregnancy
6. Alcohol abuse

How is thrombocytopenia diagnosed? Diagnosis typically involves a complete blood count (CBC) to measure platelet levels, along with a physical examination and medical history review. Additional tests may include bone marrow biopsies or genetic testing in some cases.

Recognizing Thrombocytopenia Symptoms

Thrombocytopenia may present with various symptoms, including:

• Easy bruising (purpura)
• Petechiae (tiny red or purple spots on the skin)
• Prolonged bleeding from cuts
• Bleeding gums or nosebleeds
• Blood in urine or stool
• Unusually heavy menstrual flows
• Fatigue
• Enlarged spleen
• Jaundice (in some cases)

The Role of the Spleen in Platelet Regulation

The spleen plays a crucial role in platelet regulation and overall blood health. This small organ, located just below the rib cage on the left side of the abdomen, acts as a filter for blood and helps fight infections.

How does the spleen affect platelet count? In some conditions, an enlarged spleen (splenomegaly) can trap an excessive number of platelets, leading to a decrease in circulating platelets. This can contribute to thrombocytopenia and other blood disorders.

Conditions Associated with Splenic Platelet Sequestration

• Liver disease
• Blood cancers
• Infectious diseases
• Autoimmune disorders

Platelet Production and Destruction: A Delicate Balance

Maintaining a healthy platelet count involves a complex balance between platelet production in the bone marrow and their destruction or utilization in the body. Various factors can disrupt this balance, leading to thrombocytopenia or other platelet disorders.

Factors Affecting Platelet Production

• Leukemia
• Certain types of anemia
• Viral infections (e.g., hepatitis C, HIV)
• Chemotherapy drugs
• Heavy alcohol consumption

Conditions Causing Increased Platelet Destruction

• Pregnancy-induced thrombocytopenia
• Immune thrombocytopenia (ITP)
• Severe bacterial infections
• Thrombotic thrombocytopenic purpura (TTP)
• Hemolytic uremic syndrome (HUS)
• Certain medications

Can medications affect platelet count? Yes, certain medications can reduce platelet count by either suppressing production or increasing destruction. Examples include heparin, quinine, sulfa-containing antibiotics, and some anticonvulsants.

Complications and Risks of Severe Thrombocytopenia

While mild thrombocytopenia may not cause significant symptoms, severe cases can lead to serious complications. Understanding these risks is crucial for proper management and timely intervention.

Potential Complications of Severe Thrombocytopenia

• Internal bleeding
• Bleeding into the brain (intracranial hemorrhage)
• Gastrointestinal bleeding
• Excessive bleeding during surgery or trauma

At what platelet count does the risk of severe bleeding increase? The risk of dangerous internal bleeding significantly increases when platelet counts fall below 10,000 platelets per microliter. However, bleeding risk can vary depending on individual factors and underlying conditions.

When to Seek Medical Attention for Blood-Related Issues

Recognizing the signs of potential blood disorders and knowing when to seek medical attention is crucial for early diagnosis and treatment. While some symptoms may be mild, others can indicate serious underlying conditions that require immediate care.

Warning Signs That Warrant Medical Evaluation

• Unexplained bruising or petechiae
• Prolonged bleeding from minor cuts or injuries
• Frequent nosebleeds or bleeding gums
• Blood in urine or stool
• Unusually heavy menstrual flows
• Extreme fatigue or weakness
• Yellowing of the skin or eyes (jaundice)

When is bleeding considered a medical emergency? Bleeding that cannot be controlled by standard first-aid techniques, such as applying pressure to the area, should be treated as a medical emergency. Seek immediate medical attention in such cases.

Diagnostic Approaches for Blood Disorders

Accurate diagnosis of blood disorders, including thrombocytopenia and other conditions affecting hematocrit and hemoglobin levels, involves a comprehensive approach. Healthcare providers use a combination of clinical assessment, laboratory tests, and sometimes specialized procedures to determine the underlying cause and severity of the condition.

Common Diagnostic Tests for Blood Disorders

1. Complete Blood Count (CBC)
2. Peripheral Blood Smear
3. Bone Marrow Biopsy
4. Coagulation Studies
5. Genetic Testing
6. Imaging Studies (e.g., ultrasound for spleen size)

How does a CBC help in diagnosing blood disorders? A CBC provides detailed information about the number, size, and shape of blood cells, including red blood cells, white blood cells, and platelets. It can help identify conditions such as anemia, thrombocytopenia, and leukemia.

Treatment Options for Thrombocytopenia and Related Disorders

The treatment of thrombocytopenia and other blood disorders depends on the underlying cause, severity of symptoms, and overall health of the patient. A personalized approach is often necessary to address the specific needs of each individual.

Common Treatment Strategies for Thrombocytopenia

• Treating underlying conditions
• Discontinuing or changing medications that may be causing the problem
• Corticosteroids to suppress the immune system
• Immune globulin therapy
• Platelet transfusions
• Splenectomy (in severe cases)
• Thrombopoietin receptor agonists

Are there any lifestyle changes that can help manage thrombocytopenia? While not a cure, certain lifestyle modifications can help manage symptoms and reduce the risk of complications. These may include avoiding activities with a high risk of injury, limiting alcohol consumption, and eating a balanced diet rich in nutrients that support blood health.

The Importance of Regular Blood Tests and Monitoring

Regular blood tests and monitoring play a crucial role in maintaining overall health and detecting potential blood disorders early. These tests can provide valuable insights into various aspects of health, including blood cell counts, nutrient levels, and organ function.

Benefits of Regular Blood Testing

• Early detection of blood disorders
• Monitoring of chronic conditions
• Assessment of overall health status
• Evaluation of medication effectiveness
• Identification of nutritional deficiencies

How often should blood tests be performed? The frequency of blood tests depends on individual factors such as age, health status, and existing medical conditions. Generally, adults should have a complete blood count at least once a year as part of their routine health check-up. However, those with known blood disorders or chronic conditions may require more frequent testing.

Emerging Research and Future Directions in Blood Disorder Management

The field of hematology continues to evolve, with ongoing research aimed at improving our understanding of blood disorders and developing more effective treatments. From gene therapy to targeted immunotherapies, new approaches are being explored to address various blood-related conditions.

Promising Areas of Research in Blood Disorders

1. Gene editing techniques (e.g., CRISPR-Cas9) for genetic blood disorders
2. Novel immunotherapies for autoimmune blood conditions
3. Artificial blood substitutes
4. Advanced diagnostic tools for early detection
5. Personalized medicine approaches based on genetic profiles

What potential breakthroughs can we expect in blood disorder treatment? While it’s difficult to predict specific breakthroughs, ongoing research in areas such as gene therapy and immunotherapy holds promise for more targeted and effective treatments for various blood disorders, potentially offering cures for previously untreatable conditions.

Living with Blood Disorders: Coping Strategies and Support

Living with a blood disorder can present various challenges, both physical and emotional. Developing effective coping strategies and seeking appropriate support can significantly improve quality of life for those affected by these conditions.

Tips for Managing Life with a Blood Disorder

• Educate yourself about your condition
• Adhere to prescribed treatment plans
• Maintain a healthy lifestyle
• Join support groups or seek counseling
• Communicate openly with healthcare providers
• Plan ahead for emergencies
• Consider wearing a medical alert bracelet

Where can individuals find support for living with blood disorders? Support can be found through various channels, including patient advocacy organizations, online forums, local support groups, and healthcare providers. These resources can offer valuable information, emotional support, and practical advice for managing daily life with a blood disorder.

The Role of Nutrition in Blood Health

Proper nutrition plays a vital role in maintaining blood health and supporting the body’s ability to produce and maintain blood cells. Certain nutrients are particularly important for hematological function and can help prevent or manage various blood disorders.

Key Nutrients for Blood Health

• Iron: Essential for hemoglobin production
• Vitamin B12: Crucial for red blood cell formation
• Folate: Necessary for DNA synthesis in blood cells
• Vitamin K: Important for blood clotting
• Copper: Aids in iron absorption and utilization
• Vitamin C: Enhances iron absorption

Can dietary changes improve blood disorders? While nutrition alone cannot cure most blood disorders, a balanced diet rich in key nutrients can support overall blood health and may help manage symptoms of certain conditions. In some cases, such as iron-deficiency anemia, dietary changes can play a significant role in treatment.

Foods That Support Blood Health

1. Leafy green vegetables (spinach, kale)
2. Lean meats and poultry
3. Fish (especially fatty fish like salmon)
4. Beans and lentils
5. Nuts and seeds
6. Whole grains
7. Citrus fruits

Understanding the complex interplay between blood composition, platelet function, and overall health is crucial for maintaining well-being and addressing potential blood disorders. By recognizing the importance of regular monitoring, seeking timely medical attention, and adopting healthy lifestyle practices, individuals can take proactive steps towards optimal blood health. As research in this field continues to advance, we can look forward to improved diagnostic tools and treatment options, offering hope for those affected by blood disorders and paving the way for more personalized and effective care strategies.

Plateletcrit (PCT) – Lab Results explained

A low platelet count is known as thrombocytopenia. Thrombocytopenia can occur as a result of a separate disorder, such as leukemia or an immune system problem. Or it can be a side effect of taking certain medications.

Symptoms

Thrombocytopenia may be mild and cause few signs or symptoms. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

Thrombocytopenia signs and symptoms may include:

Easy or excessive bruising (purpura):

Purpura, also called blood spots or skin hemorrhages, refers to purple-colored spots that are most recognizable on the skin. The spots may also appear on organs or mucous membranes, including the membranes on the inside of the mouth.

Petechiae:

Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs. Petechiae are tiny purple, red, or brown spots on the skin. They usually appear on your arms, legs, stomach, and buttocks. You might also find them inside your mouth or on your eyelids.

Prolonged bleeding from cuts

Bleeding from your gums or nose

Blood in urine or stools

Unusually heavy menstrual flows

Fatigue

Enlarged spleen

Jaundice:

In jaundice, the skin and whites of the eyes look yellow. Jaundice occurs when there is too much bilirubin (a yellow pigment) in the blood—a condition called hyperbilirubinemia.

Causes:

Thrombocytopenia can be inherited or it may be caused by a number of medications or conditions. Whatever the cause, circulating platelets are reduced by one or more of the following processes:

1. Trapped platelets

The spleen is a small organ about the size of your fist located just below your rib cage on the left side of your abdomen. Normally, your spleen works to fight infection and filter unwanted material from your blood. An enlarged spleen — which can be caused by a number of disorders — may harbor too many platelets, causing a decrease in the number of platelets in circulation.

2. Decreased production of platelets

Platelets are produced in your bone marrow. If production is low, you may develop thrombocytopenia. Factors that can decrease platelet production include:

• Leukemia
• Some types of anemia
• Viral infections, such as hepatitis C or HIV
• Chemotherapy drugs
• Heavy alcohol consumption

3. Increased breakdown of platelets

Some conditions can cause your body to use up or destroy platelets more rapidly than they’re produced. This leads to a shortage of platelets in your bloodstream. Examples of such conditions include:

• Pregnancy. Thrombocytopenia caused by pregnancy is usually mild and improves soon after childbirth.
• Immune thrombocytopenia. This type is caused by autoimmune diseases, such as lupus and rheumatoid arthritis. The body’s immune system mistakenly attacks and destroys platelets. If the exact cause of this condition isn’t known, it’s called idiopathic thrombocytopenic purpura. This type more often affects children.
• Bacteria in the blood. Severe bacterial infections involving the blood (bacteremia) may lead to destruction of platelets.
• Thrombotic thrombocytopenic purpura. This is a rare condition that occurs when small blood clots suddenly form throughout your body, using up large numbers of platelets.
• Hemolytic uremic syndrome. This rare disorder causes a sharp drop in platelets, destruction of red blood cells and impairment of kidney function. Sometimes it can occur in association with a bacterial Escherichia coli (E. coli) infection, such as may be acquired from eating raw or undercooked meat.
• Medications. Certain medications can reduce the number of platelets in your blood. Sometimes a drug confuses the immune system and causes it to destroy platelets. Examples include heparin, quinine, sulfa-containing antibiotics and anticonvulsants.

Complications

Dangerous internal bleeding can occur when your platelet count falls below 10,000 platelets per microliter. Though rare, severe thrombocytopenia can cause bleeding into the brain, which can be fatal.

When to see a doctor

Make an appointment with your doctor if you have any warning signs that worry you. Bleeding that won’t stop is a medical emergency. Seek immediate help if you experience bleeding that can’t be controlled by the usual first-aid techniques, such as applying pressure to the area.

Interpretation of Arterial Blood Gases (ABGs)

Interpretation of ABGs

Interpretation of Arterial Blood Gases (ABGs)
David A. Kaufman, MD
Chief, Section of Pulmonary, Critical Care & Sleep Medicine
                Bridgeport Hospital-Yale New Haven Health
Assistant Clinical Professor, Yale University School of Medicine
(Section of Pulmonary & Critical Care Medicine)

Introduction:

Interpreting an arterial blood gas (ABG) is a crucial skill for physicians, nurses, respiratory therapists, and other health care personnel. ABG interpretation is especially important in critically ill patients.

The following six-step process helps ensure a complete interpretation of every ABG. In addition, you will find tables that list commonly encountered acid-base disorders.

Many methods exist to guide the interpretation of the ABG. This discussion does not include some methods, such as analysis of base excess or Stewart’s strong ion difference. A summary of these techniques can be found in some of the suggested articles. It is unclear whether these alternate methods offer clinically important advantages over the presented approach, which is based on the “anion gap. ”

6-step approach:

Step 1:  Assess the internal consistency of the values using the Henderseon-Hasselbach equation:

[H+] = 24(PaCO₂)
           [HCO₃-]

If the pH and the [H+] are inconsistent, the ABG is probably not valid.

Step 2:  Is there alkalemia or acidemia present?

pH < 7. 35  acidemia
pH > 7.45  alkalemia

• This is usually the primary disorder
• Remember: an acidosis or alkalosis may be present even if the pH is in the normal range (7.35 – 7.45)
• You will need to check the PaCO₂, HCO₃– and anion gap

Step 3:  Is the disturbance respiratory or metabolic?  What is the relationship between the direction of change in the pH and the direction of change in the PaCO₂? In primary respiratory disorders, the pH and PaCO2 change in opposite directions; in metabolic disorders the pH and PaCO₂ change in the same direction.

Step 4:  Is there appropriate compensation for the primary disturbance?  Usually, compensation does not return the pH to normal (7. 35 – 7.45).

If the observed compensation is not the expected compensation, it is likely that more than one acid-base disorder is present.

Step 5:  Calculate the anion gap (if a metabolic acidosis exists): AG= [Na+]-( [Cl-] + [HCO₃-] )-12 ± 2

• A normal anion gap is approximately 12 meq/L.
• In patients with hypoalbuminemia, the normal anion gap is lower than 12 meq/L; the “normal” anion gap in patients with hypoalbuminemia is about 2.5 meq/L lower for each 1 gm/dL decrease in the plasma albumin concentration (for example, a patient with a plasma albumin of 2.0 gm/dL would be approximately 7 meq/L.)
• If the anion gap is elevated, consider calculating the osmolal gap in compatible clinical situations.
  • Elevation in AG is not explained by an obvious case (DKA, lactic acidosis, renal failure
  • Toxic ingestion is suspected
• OSM gap =  measured OSM – (2[Na+] – glucose/18 – BUN/2.8
  • The OSM gap should be < 10

Step 6:  If an increased anion gap is present, assess the relationship between the increase in the anion gap and the decrease in [HCO₃-].

Assess the ratio of the change in the anion gap (∆AG ) to the change in  [HCO3-] (∆[HCO₃-]): ∆AG/∆[HCO₃-]

This ratio should be between 1.0 and 2.0 if an uncomplicated anion gap metabolic acidosis is present.

If this ratio falls outside of this range, then another metabolic disorder is present:

• If  ∆AG/∆[HCO₃-] < 1.0, then a concurrent non-anion gap metabolic acidosis is likely to be present.

• If  ∆AG/∆[HCO₃-] > 2.0, then a concurrent metabolic alkalosis is likely to be present.

It is important to remember what the expected “normal” anion gap for your patient should be, by adjusting for hypoalbuminemia (see Step 5, above.)

Table 1:  Characteristics of acid-base disturbances

Table 2:  Selected etiologies of respiratory acidosis

• Airway obstruction
  – Upper
  – Lower
  • COPD
  • asthma
  • other obstructive lung disease
• CNS depression

• Sleep disordered breathing  (OSA or OHS)

• Neuromuscular impairment

• Ventilatory restriction

• Increased CO2  production: shivering, rigors, seizures, malignant hyperthermia, hypermetabolism, increased intake of carbohydrates

• Incorrect mechanical ventilation settings

Table 3:  Selected etiologies of respiratory alkalosis

• CNS stimulation: fever, pain, fear, anxiety, CVA, cerebral edema, brain trauma, brain tumor, CNS infection

• Hypoxemia or hypoxia: lung disease, profound anemia, low FiO2

• Stimulation of chest receptors: pulmonary edema, pleural effusion, pneumonia, pneumothorax, pulmonary embolus

• Drugs, hormones: salicylates, catecholamines, medroxyprogesterone, progestins

• Pregnancy, liver disease, sepsis, hyperthyroidism

• Incorrect mechanical ventilation settings

Table 4:  Selected causes of metabolic alkalosis

• Hypovolemia with Cl- depletion
  • GI loss of H+
    • Vomiting, gastric suction, villous adenoma, diarrhea with chloride-rich fluid
  • Renal loss H+
    • Loop and thiazide diuretics, post-hypercapnia (especially after institution of mechanical ventilation)
• Hypervolemia, Cl- expansion
  • Renal loss of H+:  edematous states (heart failure, cirrhosis, nephrotic syndrome), hyperaldosteronism, hypercortisolism, excess ACTH, exogenous steroids, hyperreninemia, severe hypokalemia, renal artery stenosis, bicarbonate administration

Table 5:  Selected etiologies of metabolic acidosis

• Elevated anion gap:
  • Methanol intoxication
  • Uremia
  • Diabetic ketoacidosis^a, alcoholic ketoacidosis, starvation ketoacidosis
  • Paraldehyde toxicity
  • Isoniazid
  • Lactic acidosis^a
    • Type A:  tissue ischemia
    • Type B:  Altered cellular metabolism
  • Ethanol^b or ethylene glycol^b intoxication
  • Salicylate intoxication

^a Most common causes of metabolic acidosis with an elevated anion gap
^b Frequently associated with an osmolal gap

• Normal anion gap: will have increase in [Cl-]
  • GI loss of HCO₃–
    • Diarrhea, ileostomy, proximal colostomy, ureteral diversion
  • Renal loss of HCO₃–
    • proximal RTA
    • carbonic anhydrase inhibitor (acetazolamide)
  • Renal tubular disease
    • ATN
    • Chronic renal disease
    • Distal RTA
    • Aldosterone inhibitors or absence
    • NaCl infusion, TPN, NH₄+ administration

Table 6:  Selected mixed and complex acid-base disturbances

Suggested additional reading:

• Rose, B.D. and T.W. Post. Clinical physiology of acid-base and electrolyte disorders, 5th ed. New York: McGraw Hill Medical Publishing Division, c2001.
• Fidkowski, C And J. Helstrom. Diagnosing metabolic acidosis in the critically ill: bridging the anion gap, Stewart and base excess methods. Can J Anesth 2009;56:247-256.
• Adrogué, H.J. and N.E. Madias. Management of life-threatening acid-base disorders—first of two parts. N Engl J Med 1998;338:26-34.
• Adrogué, H.J. and N.E. Madias. Management of life-threatening acid-base disorders—second of two parts. N Engl J Med 1998;338:107-111.  

The American Thoracic Society improves global health by advancing research, patient care, and public health in pulmonary disease, critical illness, and sleep disorders. Founded in 1905 to combat TB, the ATS has grown to tackle asthma, COPD, lung cancer, sepsis, acute respiratory distress, and sleep apnea, among other diseases.

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British scientists figured out why Crete has so many centenarians

• Philippa Roxby
• BBC correspondent

May 27, 2017

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Image copyright, Getty Images

Image caption,

There are many centenarians in Greece, especially in remote villages

Scientists have discovered one single reason why there are so many healthy centenarians in remote Greek villages in northern Crete.

The reason lies in a newly discovered variant of the gene, which all the inhabitants of these villages carry, which apparently protects the heart by reducing the level of bad fats and cholesterol.

Despite the fact that the diet of the inhabitants of the Mylopotamos region is rich in animal fats, they do not suffer from cardiovascular diseases. Plus, they love cheese!

What is so special about it?

The remote villages of Zoniana and Anoia are located high up in the mountains of northern Crete.

The population there remains unchanged: few people come there for permanent residence, and few leave, but there are many centenarians.

Heart disease, heart attacks, strokes and other cardiovascular ailments are rare here, despite the fact that the locals eat a lot of lamb and their Cretan cheese.

By the way, a cheese festival is held in these villages every year.

How come?

These diets will usually lead to health problems, as they are high in saturated fats, which raise blood cholesterol levels, and high levels of low-density lipoproteins [LDL, the protein compounds that carry cholesterol from the liver to the tissues] increase the risk heart disease and stroke.

However, this does not happen to the inhabitants of these villages.

True, they have type 2 diabetes, like the general population of Greece, but they do not suffer from its usual consequences, such as diabetic nephropathy (kidney failure).

Image copyright, SANGER INSTITUTE

Image caption,

The village of Zoniana is high up in the mountains on the island of Crete

What is so special about their genes?

This is exactly the question scientists at the Sanger Institute, a British genomic research center founded by the Wellcome Trust, have asked themselves: is there something in these people’s genetic material that protects their heart muscles from disease?

The results of their study, published in the online publication Nature Communications, suggest that these people have a new version of the gene that has a positive effect on the heart.

Its essence is that it lowers the level of “bad” natural fats and “bad” cholesterol and is actually unique for the population of these two mountain villages.

According to scientists from the Sanger Institute, out of many thousands of people in other European countries who underwent the process of sequencing (decoding) the genome, only one person was found with the same variety – in Italy.

Image copyright, Crete Travel

Photo caption,

Grilled lamb, a traditional Greek dish

How did they find out?

To solve this mystery, scientists deciphered the genomes of 250 inhabitants of these villages.

This means that blood samples were taken from them, DNA was removed from them and a detailed analysis of its structure was carried out – a long chain of three billion base pairs that make up the human genome.

Image copyright Getty Images

Photo caption,

Homemade cheese is an essential part of the Cretan diet

What does this mean for you and me?

This discovery does not mean for all of us, unfortunately, that we can eat as much cheese and other animal fats as we want – quite the opposite, because we do not have this kind of gene, like the Cretan centenarians.

However, scientists say the discovery could help them understand which gene variants, or alleles, play a role in causing vascular disease.

And this, in turn, may help explain why some people suffer from cardiovascular disease and others do not.

In this study, scientists have discovered a variant of a gene that was previously completely unknown, but they do not know why the inhabitants of these two isolated populations have it.

Does it have to do with the way of life of the people of Zoniana and Anoia, with the environment, or is it simply passed down from generation to generation?

Is it worth studying isolated populations?

Large. Other studies of isolated populations, such as the Amish in the United States, the Innuit in northern Greenland, and the Orkney Islands in Scotland, also help to understand how members of these communities manage to rarely get sick and live long.

Treatment of Hemorrhoids – Hemorrhoidopathy – Dr. Prokopakis

LIST OF OUR SURGICAL SPECIALTIES – Medical Office of General Surgery HERAKLION CRETE

The disease is characterized by insufficiency of the venous plexus (network) of the anus. Anatomically, these veins are located in the submucosal layer of the anal canal, but it includes arteriovenous anastomoses with pure arterial blood, mainly in the internal venous plexuses. According to the anatomical border of the anal canal, the dentate gyrus, hemorrhoids are divided into two groups: 1) located above the dentate gyrus and are called internal and 2) located below the dentate gyrus and are called external. The hemorrhoid mesh completes the closure of the anal canal and contributes to the gas and fecal retention mechanism. The decade with the highest incidence of hemorrhoids is 40-50 years. Hemorrhoids are three times more common in men than in women. In patients with hemorrhoids, hypertension of the internal sphincter is observed, which prevents the return of blood from the hemorrhoids to the heart. Others believe that hypertension and the external sphincter coexist, and this explains why patients with paralysis of the lower extremities do not have hemorrhoids. Other secondary causes are: 1) dysfunction of arteriovenous anastomoses, 2) blood stasis, 3) increased intra-abdominal pressure and compression of the veins of the lower abdomen (for example, with constipation, prostatic hypertrophy and pregnancy). Other conditions such as a sedentary lifestyle, specific professions (eg taxi drivers, motorists in general, pilots, etc.), alcohol and spices negatively affect the proper functioning of hemorrhoids. Symptoms of the disease are proctalgia, prolapse of the mucous membrane, bleeding and itching of the ring. Hemorrhoids are divided into four degrees of severity: 1st degree swelling of blood vessels is detected during a finger examination, 2nd degree – prolapse of hemorrhoids during defecation, but automatically reduced at the end of it, 3rd degree – prolapse of hemorrhoids only with the help of a hand and 4 degrees reduction of hemorrhoids is impossible.

CONSERVATIVE TREATMENT OF HEMORROPATHY

Hygiene of the anus and anal area is carried out by washing with plain water without the use of soap (soap is irritating) and stopping the use of toilet paper (paper is painful). Baby wipes and the use of paraffin oil are recommended to achieve soft stools, resulting in quick and easy bowel movements. The use of ointments with local analgesics (xylocaine) or with a mixture of cortisone (proctosinalar). In advanced cases, oral flavonoids (Daflon) are used.

Surgical treatment of hemorrhoids. Three incisions to remove hemorrhoids during the 3rd, 7th and 11th hours of the anal region, which remain open and heal over time.

2. HEMORRHOIDECTOM BY FERGUSSON (CLOSED METHOD). It is very similar to the above method, but the wounds are sutured at the end of the operation. This speeds up wound healing and eliminates discomfort.

3. HALL – TD. Methods for repositioning hemorrhoids and at the same time correcting a mild form of prolapse of the rectal mucosa without removing tissues and special trauma to the rectal region. They are not recommended for severe forms of hemorrhoids.

4. LOGO METHOD.

5. CLOSED HEMORRHOIDECTOMY USING HARMONIC. Micro-invasive surgery method with very good results and little post-operative discomfort.

6. LASER. A promising method with unknown long-term results due to several years of use.

All of the above methods are performed under general or dorsal anesthesia. The general instruction is to analyze each method in a patient who is a candidate for surgery, so that he knows what to expect in general after surgery. Of course, the patient must give his written consent to the surgeon in order to proceed with the most appropriate invasive method to solve his problem.

The choice of the applied method (the final decision) remains with the surgeon during the operation, because only then does he have a complete idea of ​​the size of the problem. So that he can apply the most appropriate method to achieve the best postoperative result in the long term.