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I. Anemia Overview


Anemia describes the condition in which the number of red blood cells in the blood is low. For this reason, doctors sometimes describe someone with anemia as having a low blood count. A person who has anemia is called anemic.

Blood is comprised of two parts; a liquid part called the plasma and a cellular part. The cellular part contains several different cell types. One of the most important and most numerous cell types is the red blood cell. The other cell types are the white blood cells and platelets. Only red blood cells are discussed in this article. The purpose of the red blood cell is to deliver oxygen from the lungs to other parts of the body.

Red blood cells are produced through a series of complex and specific steps. They are made in the bone marrow (inner part of some bones that make most of the cells in the blood), and when all the proper steps in their maturation are complete, they are released into the blood stream. The hemoglobin molecule is the functional unit of the red blood cells and is the protein structure that is inside the red blood cells.

Even though the red blood cells (or RBCs) are made within the bone marrow, many other factors are involved in their production. For example, iron is a very important component of the hemoglobin molecule; erythropoietin, a molecule secreted by the kidneys, promotes the formation of red blood cells in the bone marrow.

A. Outlook

Many types of anemia can be mild, short term, and easily treated. Some types can even be prevented with a healthy diet. Other types can be treated with dietary supplements.
However, certain types of anemia may be severe, long lasting, and life threatening if not diagnosed and treated.

If you have signs and symptoms of anemia, you should see your doctor to find out whether you have the condition. Treatment will depend on what has caused the anemia and how severe it is.

B. Other Names for Anemia

Iron-poor blood
Low blood
Tired blood

There are many types of anemia with specific causes and traits. Some of these include:

II. Types of Anemia

Here are some of the types of anemia…

A. What Is Aplastic Anemia?

Aplastic anemia (a-PLAS-tik uh-NEE-me-uh) is a blood disorder in which the body's bone marrow doesn't make enough new blood cells. Bone marrow is a sponge-like tissue inside the bones. It makes stem cells that develop into red blood cells, white blood cells, and platelets (PLATE-lets).

Red blood cells carry oxygen to all parts of your body. They also remove carbon dioxide (a waste product) from your body's cells and carry it to the lungs to be exhaled. White blood cells help your body fight infections. Platelets are blood cell fragments that stick together to seal small cuts or breaks on blood vessel walls and stop bleeding.
It's normal for blood cells to die. The lifespan of red blood cells is about 120 days. White blood cells live less than 1 day. Platelets live about 6 days. As a result, your bone marrow must constantly make new blood cells.

If your bone marrow is unable to make enough new blood cells, a number of health problems can occur. These include arrhythmias (ah-RITH-me-ahs), an enlarged heart, heart failure, infections, and bleeding. Severe aplastic anemia can even cause death.

1. Overview

Aplastic anemia is a type of anemia. The term "anemia" usually refers to a condition in which your blood has a lower than normal number of red blood cells. Anemia also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow-bin). This iron-rich protein helps carry oxygen to your body.

In people who have aplastic anemia, the body doesn't make enough red blood cells, white blood cells, or platelets. This is because the bone marrow's stem cells are damaged. (Aplastic anemia also is sometimes called bone marrow failure.)

A number of diseases, conditions, and factors can cause damage to the stem cells. These causes can be acquired or inherited. "Acquired" means you aren't born with the condition, but you develop it. "Inherited" means your parents passed the gene for the condition on to you.
In more than half of the people who have aplastic anemia, the cause is unknown.

2. Outlook

Aplastic anemia is a rare, but serious disorder. In the United States, about 500-1,000 people develop this type of anemia each year. The disorder is two to three times more common in Asian countries.

Aplastic anemia can develop suddenly or slowly. It tends to get worse over time, unless its cause is found and treated. Treatments for aplastic anemia include blood transfusions, blood and marrow stem cell transplants, and medicines.

With prompt and proper care, many people who have aplastic anemia can be successfully treated. Blood and marrow stem cell transplants may offer a cure for some people who have aplastic anemia.

B. What Is Fanconi Anemia?

Fanconi anemia (fan-KO-nee uh-NEE-me-uh), or FA, is a rare, inherited blood disorder that leads to bone marrow failure. FA causes your bone marrow to stop making enough new blood cells for your body to work normally. FA also can cause your bone marrow to make many abnormal blood cells. This can lead to serious health problems such as cancer.

FA is a blood disorder, but it also can affect many of your body's organs, tissues, and systems. Children who inherit FA are at higher risk of being born with birth defects. People with FA are at higher risk for some cancers and other serious health problems.

FA is different from Fanconi syndrome. Fanconi syndrome affects a person's kidneys. It's a rare and serious condition found mostly in children. Children with Fanconi syndrome pass high amounts of key nutrients and chemicals through their urine, which leads to serious health and developmental problems.

1. Bone Marrow and Your Blood

Bone marrow is the spongy red tissue inside the large bones of your body. Healthy bone marrow makes three types of blood cells:

Red blood cells (also called RBCs), which carry oxygen to all parts of your body. They also remove carbon dioxide (a waste product) from your body's cells and carry it to the lungs to be exhaled.

White blood cells (also called WBCs), which help your body fight infections.
Platelets, which help your blood clot.

Blood cells live for a limited time. Then, they are replaced with new blood cells from your bone marrow. If your bone marrow can't make enough new blood cells to replace the ones that die, you can suffer from serious health problems.

2. Fanconi Anemia and Your Body

FA is one of many different types of anemia. The term “anemia” is used to describe conditions in which the number of red blood cells in a person's blood is lower than normal.
FA is a type of aplastic anemia. In aplastic anemia, the bone marrow slows down or stops making all three types of blood cells. Low levels of the three blood cell types can harm many of the body's organs, tissues, and systems.

With too few red blood cells, your body's tissues won't receive enough oxygen to work well.
With too few white blood cells, your body may have problems fighting infections. This can make you sick more often and make infections worse.

With too few platelets, you may suffer from excessive bleeding.

3. Outlook

If you or your child has FA, you face a greater risk than other people for some cancers. About 10 percent of people with FA develop leukemia, a type of blood cancer.

People with FA who survive to be adults are much more likely than others to develop cancerous solid tumors. The risk for solid tumors increases with age in those who have FA. These tumors can develop in your mouth, tongue, throat, or esophagus (the tube leading from your mouth to your stomach). Women who have FA are at much greater risk than women who don't have the disease for developing tumors in the reproductive organs.

FA is an unpredictable disease. The average life span for people who have FA is between 20 and 30 years. The most common causes of death related to FA are bone marrow failure, leukemia, and solid tumors.

New medical advances have improved the chances of surviving FA. Bone marrow transplant is the major advance in treatment. However, even with a bone marrow transplant, the risk for some cancers is greater in people who have FA.

C. What Is Hemolytic Anemia?

Hemolytic anemia (HEE-moh-lit-ick uh-NEE-me-uh) is a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is up.

Red blood cells are disc-shaped and look like doughnuts without holes in the center. These cells carry oxygen and remove carbon dioxide (a waste product) from your body. Red blood cells are made in the bone marrow—a sponge-like tissue inside the bones. They live for about 120 days in the bloodstream and then die.

White blood cells and platelets (PLATE-lets) also are made in the bone marrow. White blood cells help fight infection. Platelets stick together to seal small cuts or breaks on blood vessel walls and stop bleeding.

When blood cells die, the body's bone marrow makes more blood cells to replace them. However, in hemolytic anemia, the bone marrow can't make red blood cells fast enough to meet the body's needs.

Hemolytic anemia can lead to various health problems, such as fatigue (tiredness), pain, arrhythmias (ah-RITH-me-ahs), an enlarged heart, and heart failure.

1. Overview

Hemolytic anemia is a type of anemia. The term "anemia" usually refers to a condition in which your blood has a lower than normal number of red blood cells. This condition also can occur if your red blood cells don't contain enough hemoglobin (HEE-muh-glow-bin). This iron-rich protein helps carry oxygen to your body.

Anemia has three main causes: blood loss, lack of red blood cell production, or high rates of red blood cell destruction.

Hemolytic anemia is due to high rates of red blood cell destruction. A number of diseases, conditions, and factors can cause the body to destroy its red blood cells.

These causes can be inherited or acquired. "Inherited" means your parents passed the gene for the condition on to you. "Acquired" means you aren't born with the condition, but you develop it. Sometimes the cause of hemolytic anemia isn't known.

2. Outlook

There are many types of hemolytic anemia. Treatment and outlook depend on what type you have and how severe it is. The condition can develop suddenly or slowly. Symptoms can range from mild to severe.

Hemolytic anemia often can be successfully treated or controlled. Mild hemolytic anemia may need no treatment at all. Severe hemolytic anemia requires prompt and proper treatment or it may be fatal.

Inherited forms of hemolytic anemia are lifelong conditions that may require ongoing treatment. Acquired forms of anemia may go away if the cause of the condition is found and corrected.

D. Iron-deficiency anemia

This factsheet is for people who have anemia caused by a lack of iron, or who would like information about it.

Anemia is a condition where you have too few red blood cells or not enough hemoglobin in your blood. It can make you feel tired, breathless and faint. The most common type of anemia is caused when there is not enough iron in the body. This is known as iron-deficiency anemia.

1. About iron-deficiency anemia

You need iron for many important processes inside your body, especially for making the oxygen-carrying pigment in your blood called hemoglobin.

Iron is absorbed from the food and drink you eat by your small intestine. The iron is carried in the blood to the bone marrow - where blood cells are produced - where it's combined with proteins to make hemoglobin. Spare iron can be stored in the liver.

Iron is lost from your body in urine, faces, dead skin cells and when blood is lost from the body.

On average, men need 8.7mg of iron a day and women need 14.8mg a day. You can usually get all the iron you need from your diet. Certain groups of people are more likely to have iron-deficiency anemia. These include babies, teenagers and women who have heavy periods.

2. Symptoms

The symptoms of iron-deficiency anemia include:

breathlessness
feeling very tired
dizziness
feeling cold all the time, even when it's warm and most other people around you are comfortable
a rapid, weak pulse
palpitations
headaches
Less common symptoms can include tinnitus (ringing in the ears) and an altered sense of taste.
Iron-deficiency anemia can make people irritable and have poor concentration. It can affect children's growth, causing behavioral and learning difficulties.
Some people with iron-deficiency anemia develop thin skin and spoon-shaped or brittle nails. It can also cause painful cracks at the sides of the mouth and a sore tongue.
Occasionally, in women over 40, iron deficiency can be a symptom of a condition called Plummer-Vinson syndrome. This also causes difficulty swallowing due to small web-like growths in the esophagus (the pipe that runs from your mouth to your stomach).

3. Causes

Iron is an important ingredient of hemoglobin. A shortage, or deficiency, of iron in the body causes the bone marrow to make small red blood cells that don't contain enough hemoglobin. These red blood cells can't carry enough oxygen to the organs and tissues of the body.
In developed countries such as the UK, iron deficiency usually happens when there is not enough iron in the diet, or if the iron in the diet is not absorbed properly. It can also occur if too much iron is lost through blood loss.

4. Diet

A typical Western diet that includes meat contains enough iron for most adults. Vegans, vegetarians and dieters may not get enough iron. Toddlers and babies who drink cow's milk and are very "picky" about solid foods can also be short of iron.
Coeliac disease (gluten intolerance) damages the lining of the intestine, preventing the normal absorption of nutrients, including iron. Surgery on the stomach or small intestine can also interfere with normal absorption of iron.

5. Loss of blood

Bleeding due to an injury or surgery can lead to anemia. It is also possible to have invisible blood loss, especially from the digestive system (stomach and intestine). Causes of iron-deficiency anemia include:

heavy periods
an inflamed or irritated esophagus that bleeds
hiatus hernia with bleeding ulcer
stomach or duodenal ulcers
Crohn's disease or ulcerative colitis
piles
tumors of the stomach or colon, which can bleed into the gut

The most common cause of iron deficiency worldwide is hookworm infection. These parasites live in the intestines and feed on blood.

6. Other causes

Pregnancy can lead to iron-deficiency anemia because the growing baby needs iron and takes its supply from its mother. Iron deficiency is more likely to develop during pregnancy in women whose diet does not contain plenty of iron.

Premature babies and adolescents need extra iron for their growth spurts and there may not be enough in their diet.

The groups of people who are more likely to have iron-deficiency anemia are:
babies - especially babies who are fed on cows' milk, which is low in iron (breast milk and formula milk contain more iron)

children and teenagers - growth spurts take up extra iron
adults aged over 60 - people of this age group are more likely to have a poor diet
women - around one in seven pre-menopausal women have iron-deficiency anemia.

You are also more likely to have iron-deficiency anemia if you:

take aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) such as indometacin or naproxen - these can cause stomach bleeding
have problems with your digestive system that may lead to bleeding of your stomach or intestines
don't eat meat or dairy products

7. Diagnosis

If your doctor suspects you have iron-deficiency anemia, he or she will probably ask you to have a blood test called a full blood count (FBC).

The normal amount - or concentration - of hemoglobin for adults is at least 13g/dl for men (13 grams of hemoglobin per deciliter of blood - a deciliter is 100ml) and 11.5g/dl for women. If your hemoglobin levels are lower than this, you have anemia.

If your hemoglobin is low, and your red cells are small, you may have iron deficiency. Other tests may be needed to give an idea of your body's store of iron.

8. Treatment

Your doctor will first try to work out why you are deficient in iron. If you are pregnant or a growing teenager, your doctor may recommend a course of iron supplements (such as ferrous sulphate tablets). Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

The aim of a course of tablets is to make up for the shortage of iron and then build up your body's stores of iron to the normal level. This usually involves taking tablets three times a day for up to six months. If your doctor suspects another problem, such as blood loss, you may need treatment for this as well as a course of iron tablets.

Iron supplements can have side-effects. These include constipation, diarrhea, an upset stomach or feeling sick. They can also cause faeces to turn black. These side-effects can be off-putting, but they may be reduced by taking the tablets after meals.

People who can't take iron tablets by mouth may be given an injection into a muscle instead. This is quite uncomfortable and can stain the skin.

9. Prevention

The best way to prevent iron-deficiency anemia is to eat a diet that contains plenty of iron. The recommended daily amount is 8.7mg a day for men and 14.8mg a day for women.

Good sources of iron include: liver, meat, beans, nuts, dried fruit, whole grains (such as brown rice), fortified breakfast cereals, and most dark-green leafy vegetables (such as watercress and curly kale).

It's a good idea to eat foods containing vitamin C at the same time as eating sources of iron because this helps with iron absorption. Good sources of vitamin C include peppers, fruit juice, sweet potatoes, oranges and kiwi fruit.

Iron is stored in the body and too much iron can be harmful. The UK Food Standards Agency suggests you don't take more than 17mg a day of iron supplements per day unless this is recommended by your doctor or dietician.

E. What Is Pernicious Anemia?

Pernicious anemia (per-NISH-us uh-NEE-me-uh) is a condition in which the body can't make enough healthy red blood cells because it doesn't have enough vitamin B12.

Vitamin B12 is a nutrient found in certain foods. The body needs this nutrient to make healthy red blood cells and to keep its nervous system working properly.

People who have pernicious anemia can't absorb enough vitamin B12 from food due to a lack of intrinsic (in-TRIN-sik) factor, a protein made in the stomach. This leads to vitamin B12 deficiency.

Other conditions and factors also can cause vitamin B12 deficiency. Examples include infections, surgery, medicines, and diet. Technically, the term "pernicious anemia" refers to vitamin B12 deficiency due to lack of intrinsic factor. Often, vitamin B12 deficiency due to other causes also is called pernicious anemia.

This article discusses pernicious anemia due to a lack of intrinsic factor and other causes.

1. Overview

Pernicious anemia is a type of anemia (a condition in which your body has a lower than normal number of red blood cells). In pernicious anemia, the body can't make enough healthy red blood cells because it doesn't have enough vitamin B12.

Without enough vitamin B12, your red blood cells don't divide normally and are too large. They may have trouble getting out of the bone marrow—a sponge-like tissue inside the bones where blood cells are made.

Without enough red blood cells to carry oxygen to your body, you may feel tired and weak. Severe or long-lasting pernicious anemia can damage the heart, brain, and other organs in the body.

Pernicious anemia also can cause other complications, such as nerve damage, neurological problems (such as memory loss), and digestive tract problems. People who have pernicious anemia also may be at higher risk for stomach cancer.

2. Outlook

The condition is called pernicious ("deadly") anemia because it was often fatal in the past, before vitamin B12 treatments were available. Now, pernicious anemia usually is easy to treat with vitamin B12 pills or shots.

With ongoing care and proper treatment, most people who have pernicious anemia can recover, feel well, and live normal lives.

Without treatment, pernicious anemia can lead to serious problems with the heart, nerves, and other parts of the body. Some effects of the condition may be permanent.

III. Anemia Causes

There are three primary causes of anemia: (1) reduced production of red blood cells; (2) excessive destruction of red blood cells; and (3) extensive bleeding.

A. Reduced Production of Red Blood Cells

Red blood cell production becomes impaired if the body has inadequate amounts of certain nutrients, including iron, vitamin B12, and folic acid, as well as the hormone erythropoietin, which is produced by the kidneys. Chronic illnesses, such as cancer, kidney disease, diabetes mellitus, and inflammatory bowel disease, may also lead to decreased red blood cell production.

B. Destruction of Red Blood Cells

Red blood cells normally live for about 120 days before the immune system removes them from the body. The body compensates by producing new red blood cells. But if the destruction of red blood cells exceeds the body’s ability to produce new red blood cells, anemia results.

Abnormal destruction of red blood cells may be caused by an enlarged spleen, an organ that removes worn red blood cells from the body. The larger the spleen grows, the more red blood cells it traps and destroys. In some cases red blood cells are destroyed by a malfunction of the immune system in which antibodies attach to red blood cells, marking them for destruction. Red blood cells may also be destroyed by some genetic conditions, such as thalassemia, that cause defects in the structure or function of red blood cells.

C. Bleeding

Excessive bleeding can cause dangerously low blood pressure as well as insufficient oxygen delivery to body tissues. Large amounts of blood loss may occur suddenly due to injury or surgery. In some cases, excessive bleeding may occur over time, such as from bleeding ulcers or tumors of the intestinal tract.

IV. Anemia Symptoms

Because a low red blood cell count decreases oxygen delivery to every tissue in the body, anemia may cause many signs and symptoms. It can also make almost any other underlying medical condition worse. If anemia is mild, it may not cause any symptoms. If anemia is slowly ongoing (chronic), the body may adapt and compensate for the change; in this case there may not be any symptoms until the anemia becomes more severe.

A. Symptoms of anemia may include the following:

Fatigue
weakness
shortness of breath
lightheadedness
palpitations (feeling of the heart racing or beating irregularly)
looking pale

B. Symptoms of severe anemia may include:

chest pain, angina, or heart attack
dizziness
fainting or passing out
rapid heart rate

C. Some of the signs that may indicate anemia in an individual may include:

Change in stool color, including black and tarry stools (sticky and foul smelling), maroon-colored, or visibly bloody stools if the anemia is due to blood loss through the gastrointestinal tract.

rapid heart rate
low blood pressure
rapid breathing
pale or cold skin
yellow skin called jaundice if anemia is due to red blood cell breakdown
heart murmur
enlargement of the spleen with certain causes of anemia

V. Who Is At Risk for Anemia?

A. Populations Affected

Anemia is a common condition. It occurs in all age groups and all racial and ethnic groups. Both men and women can have anemia, but women of childbearing age are at higher risk for the condition. This is because women in this age range lose blood from menstruation.

Anemia can develop during pregnancy due to low levels of iron and folic acid (folate) and changes in the blood. During the first 6 months of pregnancy, the fluid portion of a woman’s blood (the plasma) increases faster than the number of red blood cells. This dilutes the blood and can lead to anemia.

Infants younger than 2 years old also are at risk for anemia. This is because they may not get enough iron in their diets, especially if they drink a lot of cow's milk. Cow's milk is low in the iron needed for growth. Drinking too much cow’s milk may keep an infant or toddler from eating enough iron-rich foods. It also may keep his or her body from absorbing iron from iron-rich food.
Researchers continue to study how anemia affects older adults. More than 10 percent of older adults have mild forms of anemia. Many of these people have other medical conditions as well.

B. Major Risk Factors

Factors that raise your risk for anemia include:

A diet that is low in iron, vitamins, or minerals
Blood loss from surgery or an injury
Long-term or serious illnesses, such as kidney disease, cancer, diabetes, rheumatoid arthritis, HIV/AIDS, inflammatory bowel disease (including Crohn’s disease), liver disease, heart failure, and thyroid disease
Long-term infections
A family history of inherited anemia, such as sickle cell anemia or thalassemias

VI. How Is Anemia Diagnosed?

Your doctor will diagnose anemia based on your medical and family histories, a physical exam, and results from tests and procedures.

Because anemia doesn’t always cause symptoms, your doctor may find out you have it while checking for another condition.

A. Medical and Family Histories

Your doctor may ask whether you have any of the common signs or symptoms of anemia. He or she may ask whether you’ve had an illness or condition that could cause anemia.
Your doctor also may ask about the medicines you take, your diet, and whether you have family members who have anemia or a history of it.

B. Physical Exam

Your doctor will do a physical exam to find out how severe your anemia is and to check for possible causes. He or she may:

Listen to your heart for a rapid or irregular heartbeat
Listen to your lungs for rapid or uneven breathing
Feel your abdomen to check the size of your liver and spleen
Your doctor also may do a pelvic or rectal exam to check for common sources of blood loss.

C. Diagnostic Tests and Procedures

Your doctor may order various tests or procedures to find out what type of anemia you have and how severe it is.

1. Complete Blood Count

Often, the first test used to diagnose anemia is a complete blood count (CBC). The CBC measures many different parts of your blood.

This test checks your hemoglobin and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is the iron-rich protein in red blood cells that carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia.

The normal range of these levels may be lower in certain racial and ethnic populations. Your doctor can explain your test results to you.

The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of anemia, a blood disorder, an infection, or another condition.

Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells and a clue as to the cause of your anemia. In iron-deficiency anemia, for example, red blood cells usually are smaller than normal.

VII. When to Seek Medical Care

Because anemia is typically a clue to another underlying disease, it needs to be fully evaluated by a doctor, and proper testing needs to be undertaken to determine the cause. Therefore, if signs and symptoms of anemia are present, one should contact his or her physician for evaluation.

In the elderly and people with chronic medical conditions, such as heart disease or lung disease, the symptoms of anemia may be more significant, and a prompt medical evaluation is prudent.

The diagnosis of anemia at home is difficult unless bleeding is obvious. If significant bleeding is obvious, as in a severe injury, immediate medical attention is required and one may consider going to the emergency room. Generally, this kind of acute (short onset) anemia is more likely to cause immediate symptoms than chronic (long-lasting) types of anemia.

Many individuals with chronic conditions, such as sickle cell anemia, know when they may be having an attack related to their disease (sickle cell crisis) and may opt to seek medical attention promptly.

VIII. Exams and Tests

Doctors can easily detect anemia by drawing a blood sample for a complete blood count. Based on the results of the test and thorough evaluation of the patient, the doctor may order more tests to determine the exact cause of anemia. The complete blood count may be done as part of a routine general check-up or based upon the presence of signs and symptoms that can be related to anemia.

Because anemia is only a symptom of a disease, doctors will want to determine what is causing the anemia. Some people may need many tests, and some people may need very few. For example, an anemic person with known stomach ulcers may not need multiple blood tests but, may need to have his or her stomach visually evaluated and have the ulcers treated. On the other hand, a person with a family history of anemia and without an obvious source of blood loss may need multiple laboratory tests and other types of testing. Doctors also take into consideration the severity of the anemia when deciding the tests to order. When a person has severe anemia, the cause must be determined rapidly so that it can be treated appropriately.

Lab tests for anemia may include the following:

Complete blood count: Determines the severity and type of anemia (microcytic anemia or small sized red blood cells, normocytic anemia or normal sized red blood cells, or macrocytic anemia or large sized red blood cells) and is typically the first test ordered.

Stool hemoglobin test: Tests for blood in stool which may detect bleeding from the stomach or the intestines.

Peripheral blood smear: Looks at the red blood cells under a microscope to determine the size, shape, number, and color as well as evaluate other cells in the blood.

Iron level: An iron level may tell the doctor whether anemia may be related to iron deficiency or not. This test is usually accompanied by other tests that measure the body's iron storage, such as transferrin level and ferritin level.

Transferrin level: Evaluates a protein that carries iron around the body.

Ferritin: Evaluates at the total iron available in the body.

Folate: A vitamin needed to produce red blood cells, which is low in people with poor eating habits.

Vitamin B12: A vitamin needed to produce red blood cells, low in people with poor eating habits or in pernicious anemia.

Bilirubin: Useful to determine if the red blood cells are being destroyed within the body which may be a sign of hemolytic anemia.

Lead level: Lead toxicity used to be one of the more common causes of anemia in children.
Hemoglobin electrophoresis: Sometimes used when a person has a family history of anemia; this test provides information on sickle cell anemia or thalassemia.

Reticulocyte count: A measure of new red blood cells produced by the bone marrow
Liver function tests: A common test to determine how the liver is working, which may give a clue to other underlying diseases causing anemia.

Bone marrow biopsy: Evaluates production of red blood cells and may be done when a bone marrow problem is suspected.

A. Other Tests and Procedures

If the CBC results show that you have anemia, you may need other tests such as:
Hemoglobin electrophoresis (e-lek-tro-FOR-e-sis). This test looks at the different types of hemoglobin in your blood. It can help diagnose the type of anemia you have.

A reticulocyte (re-TIK-u-lo-site) count. This test measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate.

Tests for the level of iron in your blood and body. These include serum iron and serum ferritin tests. Transferring level and total iron-binding capacity also test iron levels.

IX. Anemia Treatment

A. Self-Care at Home

Very little can be done to self-treat anemia, medical treatment is generally needed. It is important to continue to take any medication that is prescribed for other chronic (long-lasting) medical problems. If the reason for anemia is known, then measures to keep it under control are very important. For example, if anemia is caused by a stomach ulcer, then medications such as aspirin or ibuprofen should be avoided, unless otherwise directed by a doctor

B. Medical Treatment

Medical treatment of anemia varies widely and depends on the cause and the severity of anemia.
If anemia is mild and associated with no symptoms or minimal symptoms, a thorough investigation by a doctor will be done in the outpatient setting (doctor's office). If any cause is found, then treatment will be started. For example, if anemia is mild and is found to be related to low iron levels, then iron supplements may be given during further investigation to determine the cause of the iron deficiency is carried out.

On the other hand, if anemia is related to sudden blood loss from an injury or a rapidly bleeding stomach ulcer, then hospitalization and transfusion of red blood cells may be required to relieve the symptoms and replace the lost blood. Further measures to control the bleeding may occur at the same time to stop further blood loss.

Blood transfusion may be required in other less critical circumstances as well. For example, an individual who is receiving chemotherapy for a cancer may be expected by the treating physician to have bone marrow problems related to the chemotherapy. Therefore, the doctor may check blood counts routinely, and if the levels get to a low enough level, he or she may order a red blood cell transfusion to help with the symptoms of anemia.

C. Medications

Medications and treatments that correct the common underlying causes of anemia include the following:
Iron may be taken during pregnancy and when iron levels are low. It is important to determine the cause of iron deficiency and treat it properly.

Vitamin supplements may replace folate and vitamin B12 in people with poor eating habits. In people with pernicious anemia who are unable to absorb sufficient amounts of vitamin B12, monthly injections of vitamin B12 are commonly used to replete the vitamin B 12 levels and correct the anemia.

epoetin alfa (Procrit or Epogen) injection can be used to increase red blood cell production in people with kidney problems. The production of erythropoietin is reduced in people with advanced kidney disease, as described earlier.

Stopping a medication that may be the cause of anemia may also reverse anemia after consultation with a physician.

If alcohol is the cause of anemia, then in addition to taking vitamins and maintaining adequate nutrition, alcohol consumption needs to be stopped.

1. Surgery

There are no specific surgical interventions for the treatment of anemia. However, depending on the causes of the anemia, surgery may be a treatment option. For example, if colon cancer or uterine cancer that slowly bleeds is the cause of anemia, then surgical removal of the cancer would potentially treat the anemia.

2. Follow-up

Follow-up care for anemia will depend on its type. Most will require repeat blood counts. Also, repeat visits to the doctor's office are likely in order to determine the response to treatment.
X. Prevention

Some common forms of anemia are most easily prevented by eating a healthy diet and limiting alcohol use. All types of anemia are best avoided by seeing a doctor regularly and when problems arise. In the elderly, routine blood work ordered by the doctor, even if there are no symptoms, may detect anemia and prompt the doctor to look for the underlying causes.



presents >> anemia
Research Paper

ANEMIA

A Research Paper

Presented to

Mr. Neil A. Improgo

Faculty of the English Department

Manolo Fortich National High School

In Partial Fulfillment

of the Requirements for the Course

English IV

By:

Hanzhell J. Campugan

Irene Gaspi

October 12, 2009

i

ACKNOWLEDGMENT

The researchers would like to express their sincerest and profound thanks to the following persons who extended help and encouragement to make this study a reality;

Mr. Neil Improgo, English Teacher, for his valuable and expert advise, knowledge and excellent ideas, thus supporting, advising, supervising and guiding the researches with utmost patience that inspire to complete the study;

Dr. Erlinda C. Chico, Secondary School Principal II of Manolo Fortich National High School, for her understanding and cooperation in allowing the researchers to use the Computer Laboratory for their research work;

The parents of the researchers, for the financial support and concern that serves as the researcher’s inspiration during the making of the study.

Above all, to Almighty GOD, for the enlightenment, strength, wisdom patience and guidance which He bestowed upon the researchers all times.

ii

DEDICATION

To

Our beloved parents,

friends and classmates;

our relatives, teachers and

most especially to

the school where our future lies

MANOLO FORTICH NATIONAL HIGH SCHOOL

This humble piece of work is dedicated.

Hanzhell J. Campugan

Irene Gaspi

iii

TABLE OF CONTENTS

Page

TITLE PAGE i

ACKNOWLEDGMENT ii

DEDICATION iii

TABLE OF CONTENTS iv

Outline 1 v

Introduction vi

Body vii

Conclusion viii

WORKS CITED 20 ix

APPENDICES x

iv

OUTLINE

ANEMIA

I. Overview

II. Causes

A. Reduced Production of Red Blood Cells

B. Destruction of Red Blood Cells

C. Bleeding

III. Symptoms

A. Symptoms of Anemia

B. Symptoms of Severe Anemia

C. Some of the signs that may indicate anemia

IV. Treatment

V. Prevention

VI. Summary

v

INTRODUCTION

Many people now a days, suffer from anemia which is a great problem globally, and worse in developing countries , but it is by no means absent in industrialized nations. It was been estimated of more than millions of numbers of people suffer from anemia. It is not just a single disease but a condition, like fever, with many possible causes and many forms. Like others, anemia also includes some causes like nutritional deficiencies, inherited genetic defects, medication-related side effects, and chronic disease.

This may also occur because of blood loss from injury or internal bleeding, the destruction of red blood cells, or insufficient red blood cell production. This may be temporary or long terms, and can be manifest in mild or severe forms.

Anemia, one of the more common blood disorders, occurs when the level of healthy red blood cells (RBCs) in the body becomes too low. This can lead to health problems because RBCs contain hemoglobin, which carries oxygen to the body's tissues. Anemia can cause a variety of complications, including fatigue and stress on bodily organs.

vi

BODY

Anemia describes the condition in which the number of red blood cells in the blood is low. The word ANEMIA comes from an Ancient Greek ἀναιμία anaimia, meaning “lack of blood.”

There are some common causes of anemia, which include the following: reduced production of red blood cells, destruction of red blood cells and bleeding. Red blood cell production becomes impaired if the body has inadequate amounts of certain nutrients, including iron, vitamin B12, and folic acid, as well as the hormone erythropoietin, which is produced by the kidneys. Red blood cells normally live for about 120 days before the immune system removes them from the body. The body compensates by producing new red blood cells. But if the destruction of red blood cells exceeds the body’s ability to produce new red blood cells, anemia results. Excessive bleeding can cause dangerously low blood pressure as well as insufficient oxygen delivery to body tissues. Large amounts of blood loss may occur suddenly due to injury or surgery. In some cases, excessive bleeding may occur over time, such as from bleeding ulcers or tumors of the intestinal tract.

Because a low red blood cell count decreases oxygen delivery to every tissue in the body, anemia may cause many signs and symptoms. It can also make almost any other underlying medical condition worse. If anemia is mild, it may not cause any symptoms. If anemia is slowly ongoing (chronic), the body may adapt and compensate for the change; in this case, there may not be any

symptoms until the anemia becomes more severe.

The common symptoms of anemia, regardless of the cause, consist of fatigue and weakness, along with faintness, palpitation, shortness of breath with exercise, and paleness of the skin, eyes, gums, and nailbeds (the nails in severe anemia may be deformed).

Anemia is a common condition. It occurs in all age groups and all racial and ethnic groups. Both men and women can have anemia, but women of childbearing age are at higher risk for the condition. This is because women in this age range lose blood from menstruation. Researchers continue to study how anemia affects older adults. More than 10 percent of older adults have mild forms of anemia. Many of these people have other medical conditions as well.

Anemia is a serious problem and should be treated promptly. If the reason for anemia is known, then measures to keep it under control are very important. For example, if anemia is caused by a stomach ulcer, then medications such as aspirin or ibuprofen should be avoided, unless otherwise directed by a doctor. Medical treatment of anemia varies widely and depends on the cause and the severity of anemia.

q Medications and treatments that correct the common underlying causes of anemia include the following: Iron may be taken during pregnancy and when iron levels are low.

q Stopping a medication that may be the cause of anemia may also reverse anemia after consultation with a physician.

q If alcohol is the cause of anemia, then in addition to taking vitamins and maintaining adequate nutrition, alcohol consumption needs to be stopped.

Some common forms of anemia are most easily prevented by eating a healthy diet and limiting alcohol use. All types of anemia are best avoided by seeing a doctor regularly and when problems arise. In the elderly, routine blood work ordered by the doctor, even if there are no symptoms, may detect anemia and prompt the doctor to look for the underlying causes.

Preventing anemia and having the correct number of red blood cells requires cooperation among the kidneys, the bone marrow, and nutrients within the body. If the kidneys or bone marrow are not functioning, or the body is poorly nourished, then normal red blood cell count and function may be difficult to maintain.

Anemia is actually a sign of a disease process rather than a disease itself. It is usually classified as either chronic or acute. Chronic anemia occurs over a long period of time. Acute anemia occurs quickly. Determining whether anemia has been present for a long time or whether it is something new, assists doctors in finding the cause. This also helps predict how severe the symptoms of anemia may be.

vii

CONCLUSION

The researchers therefore conclude that anemia is not just an ordinary condition but something that curtail one’s life. This must be taken seriously. Anemia is a silent enemy that caused so many health problems that is often ignored by all.

viii

WORK CITED

Hardinge, Mervyn G., and Shryock, Harold., Family Medical Guide to Health & Fitness, Vol. 3. Ontario, Canada: Pacific Press Publishing Association, 2002.


Nabili, Saimak T., MD, MPH, http://www.emedicinehealth.com/anemia/

Anemia: “The Silent Enemy”.(The Philippine Star) Updated September 22, 2009.

ix

APPENDICES






Anemia Ferropenica

Anemia

The Role of Red Blood Cells in Anemia

x


>>oUr pErsOnAl aCcOunT<<
>> Hanzhell<<

There are many memories I won’t ever forget. Memories that still brought with in my mind. Though these memories will not be happened again, still, I always kept it in my heart. Though the people and places behind these memories will change… still I will never ever change the way I used to be.

I’d like to share with you, one of the memories I have. But, honestly speaking, I’d like to share all the memories I have to you- to know how truly happy and enjoyable life is, together with your love one, friends, and family and many more. And how, grateful I am to be part of these memories.

One of the most memorable memories I have is when I reach the high school life, in the Manolo Fortich National High School. In this school, many have change with in me, the way I used to be, the way I socialize with others and the way I think and many more. Well, in this school, I met some people who become part of my life, being my friends, or even my sisters and brothers.

It’s been a while were I had celebrated my 15th birthday. That was on January 28, 2009. Five months had pass by, when I celebrated that 15th birthday of mine. As usual, waking up early in the morning is what I am doing. Everything is ready for school. Without any doubt, together with my brother, we went to school. Without any surprise, a multicar stops behind us. As a surprise, the driver of that multicar invites us to have a ride up to school without any fare. We are very glad about that. So we take his invitation. When we get in school, nothing has change, the way the peoples look on us, the way they smile on us, and many more. Well, that is life. With a smile on our faces, we went to our classroom. The first thing we heard when we were there is the phrases “happy birthday”. Well, they never forgot our birthday. After, we continued. And start cleaning with our assign cleaning area, the same as what we were doing then. Minutes have passed, I was surprise. Because in front of me, is a friend of mine from the 4th year. And they greet me a happy birthday. I never thought that they know when my birthday is, so I was surprise on it. After those happenings, I continued of my work. And then someone called my name. That was Cassandra. Well, she is my friend also. Without any hesitation, she gave me a present. I was surprise also. Because I never thought that somebody will gave me a present. While we were talking, Kariza was there. With a smile on here face, also she greet me a happy birthday. A smile comes out in my face. That was a very great birthday that I have. On the afternoon, after all the things happened in that morning, it is the time for the officers to call the aspirants. And that included me. That time, I even forgot that it is my birthday. Every one is very serious. All pockets their smile. And all focuses on the training. Afterwards, it comes out again in my mind. As what I am thinking, my co-aspirants and the officers don’t know that it is my special day. So I was very glad. But when it is time to dismiss, Edelyn, a CAT officer, suddenly went to Aiko, also a CAT officer. Both of them are my friend. And for my surprise, they sang a happy birthday song to me. The two of them just keep on laughing in front of me. So I have nothing to do, but to smile with them. Together with them, I celebrated my 15th birthday on our favorite spot, in the bread top. So funny right? But, all the things I have shared with you are true. And that was my happiest birthday that I have.

***all about my self***

Name; Hanzhell J. Campugan

Nickname; Hanzy, Yan-dick, Han2x, angel

Birthday; January 28, 1994

Zodiac sign; Aquarius

***favorites***

Colors; sky blue, pink, & light green

Cartoon Character; Pooh & Mickey Mouse

Anime; Lacorda & Alice Academy

TV Shows; many to mention

Food; chocolate cake & lechon baboy

Others; fan of BOF, why why love, devil beside me, tomorrow & miss no good

***significance***

Girl Scout of the year 2005-2006

Treasurer of the YES-O of the year 2008-2010

Elementary graduate

Honor student

CAT officer for the year 2009-2010

Campers

>>Hanzhell<<





***irene gaspe***


My favorite place is in silo-o,malibog because it has a beautifull falls and a clean wide river!.Many people likes to swim there because the river is deep and has very big stone that lie on the center of the river.Thier are lots of tall shady trees growing there beside the river that makes the place like a paradise.I like to go there because i want to hear the chirping of the birds and other insects with its unpleasant smell.
Every afternoon many people go there to stroll under the tall and shady trees,to rest in a cool and comfortable nice tree hause painted with blue by the people in that place and they enjoy the cool breeze.They also have a bamboo bridge that across the river.they use it in crossing the river going to the place they TABOK.But me, im afraid to cross the bridge because it might collapse and i don't know how to swim. This place is the best place of mine!!!