Initially, iron deficiency anemia can be so mild that it goes unnoticed. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify.

MATO CLINIC

This form of iron deficiency anemia is treated with changes in your diet and iron supplements.

If the underlying cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and stopped. This may involve surgery.

• Rapid growth cycles (infancy, adolescence)
• Heavy menstrual bleeding or chronic blood loss from the GI tract
• Pregnancy
• Diets that contain insufficient iron (rare in the United States)
• Breastfed infants who have not started on solid food after six months of age
• Babies who are given cow’s milk prior to age 12 months

• AlcoholismMost often healthy red blood cells last between 90 and 120 days. Parts of your body then remove old blood cells. A hormone called erythropoietin (epo) made in your kidneys signals your bone marrow to make more red blood cells.To first diagnose the person with any anemia the following needs to be done to help the doctor in diagnostic tooling , which is tests to rule out and rule in what the actual problem isn’t or is. With the MD knowing the results of these tests it will guide the doctor knowing the correct diagnosis to use the best treatment to either cure or get the problem under control (Ex. What is curable is iron deficiency anemia but sickle cell anemia is not).

• Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their red color. People with anemia do not have enough hemoglobin.                                                                                                                                                                                                  
• Although many parts of the body help make red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form all blood cells.

The diagnosis tests that are usually done by a doctor are the following:                              

Physical exam. During a physical exam, your doctor may listen to your heart and your breathing. Your doctor may also place his or her hands on your abdomen to feel the size of your liver and spleen. He would look at the color of the skin and the eyes to look for paleness.

Blood Tests. Your doctor would do the basis blood tests being a CBC which is used to count the number of blood cells in a sample of your blood. For anemia, your doctor will be interested in the levels of the red blood cells contained in the blood particularly your hematocrit (the solids of the blood) and the hemoglobin (the liguid of your blood) in your bloodstream. If anemic both of these will be low and hematocrit below 7.0 down to 6.0 is critical.

Normal adult hematocrit values vary from one medical practice to another but are generally between 40 and 52 percent for men and 35 and 47 percent for women. Normal adult hemoglobin values are generally 14 to 18 grams per deciliter for men and 12 to 16 grams per deciliter for women.

Additional testing maybe ordered as well; like the following to help determine what the person has with the what treatment to tell the MD is needed to help the individual get better.

This could be: . A test to determine the size and shape of your red blood cells. Some of your red blood cells may also be examined for unusual size, shape and color. Doing so can help pinpoint a diagnosis. For example, in iron deficiency anemia, red blood cells are smaller and paler in color than normal. In vitamin deficiency anemias, red blood cells are enlarged and fewer in number.

If you receive a diagnosis of anemia, your doctor may order additional tests to determine the underlying cause. For example, iron deficiency anemia can result from chronic bleeding of ulcers, benign polyps in the colon, colon cancer, tumors or kidney problems.

Occasionally, it may be necessary to study a sample of your bone marrow to diagnose anemia.

                                                                                                                                                                                           ***Treatment for iron-deficiency anemia will depend on its cause and severity. Treatments may include dietary changes and supplements, medicines, and surgery.

Severe iron-deficiency anemia may require a blood transfusion, iron injections, or intravenous (IV) iron therapy. Treatment may need to be done in a hospital.

The goals of treating iron-deficiency anemia are to treat its underlying cause and restore normal levels of red blood cells, hemoglobin, and iron.*****

“Anemia is a condition in which you don’t have enough healthy red blood cells to carry adequate oxygen to the body’s tissues. Having anemia may make you feel tired and weak”

MAYO CLINIC

“Several years ago, it was all about West Nile and now Zika virus.  All kinds of celebrities are engaged in solutions to Malaria for third world countries.  Obviously, we’re familiar with all of them. But which disease are you most likely to get and which are you most likely to recuperate from?

A little bit of background on mosquitoes.  They must have water to lay eggs.  It doesn’t need to be much water at all – just enough to fill the palm of your hand.  The mosquitoes lay eggs that hatch into water-loving larva.  The larval stage is brief – only 3 days or so – and water is the essential ingredient.”

Greenbugallnatural

West Nile Virus 

The Department of Health in New York is taking action against mosquitoes who spread the Zika virus with the West Nile Virus.  Zika Virus is an epidemic already in Florida but NYC is trying to stop this.  How?  Well AM radio station  1010Wins stated yesterday that Tonight at 10pm till the am and now Fox news states tomottow at 6am the action will start; which is pesticides in the air will be dropped in the sky for hours to prevent amid growing concern of these mosquitoes spreading Zika or West Nile Virus to New York City areas.   Hopefully other areas of NY and the NE will be prevented long before a cases show up before the other cities/towns take action.

While assuring residents that the virus is not spreading in New York City, it says local mosquitoes are spreading other diseases like the West Nile Virus.

With mosquito season upon us, the city is going to begin a three day aerial bombardment of marsh and other non-residential areas at some two dozen sites in the Bronx, Queens, Staten Island and Brooklyn Fox News states but all 5 buroughs covered 1010 wins states also.

Officials say they will use “environmentally friendly” larvicide to kill the infant mosquito larvae.

With projected hot and damp weather the mosquito population is expected to have huge growth this season.

Residents Fox News spoke to in Marine Park, Brooklyn said they were concerned and relieved that the city is taking action.

Mike Nagar said he’s skeptical about how safe the chemicals are that will be sprayed but would you rather be diseased with Zika or West Nile Virus or God knows what if no action is taken place.

Standing beside his pregnant wife, Daniel Cicolello said he’s concerned because the mosquito-borne Zika virus impacts pregnant women.

Those so terribly concerned should ease their conscious and get out of NY for TH,FRI and the Weekend and come home on SUN or deal with infection control measures rather than do nothing.

It is known to cause birth defects. It is not considered dangerous for most people and action to prevent an epidemic is a must to prevent a negative domino effect spreading it on or too many people or everyone to kill some and get others terribly sick with continuous spreading.  If the mosquitoes don’t get controlled neither will the Zika or West Nile Virus.

Health officials note that there have been 78 cases of Zika reported in the city, but that all the patients have recovered.

“I now realize that I have a platform to inspire young girls, and as someone who never had a role model who looked like me when I was growing up, I now hope to be able to show that albinism can be beautiful and is just another kind of normal.”

Thando Hopa  (#SouthAfrican #African #Africa #Motherland #Model #Albino)

The word “albinism” refers to a group of inherited conditions. People with albinism have little or no pigment in their eyes, skin, or hair. They have inherited altered genes that do not make the usual amounts of a pigment called melanin. One person in 17,000 in the U.S.A. has some type of albinism. Albinism affects people from all races. Most children with albinism are born to parents who have normal hair and eye color for their ethnic backgrounds. Sometimes people do not recognize that they have albinism. A common myth is that people with albinism have red eyes. In fact there are different types of albinism and the amount of pigment in the eyes varies. Although some individuals with albinism have reddish or violet eyes, most have blue eyes. Some have hazel or brown eyes. However, all forms of albinism are associated with vision problems.

Vision Problems

People with albinism always have problems with vision (not correctable with eyeglasses) and many have low vision. The degree of vision impairment varies with the different types of albinism and many people with albinism are “legally blind,” but most use their vision for many tasks including reading and do not use Braille. Some people with albinism have sufficient vision to drive a car. Vision problems in albinism result from abnormal development of the retina and abnormal patterns of nerve connections between the eye and the brain. It is the presence of these eye problems that defines the diagnosis of albinism. Therefore the main test for albinism is simply an eye examination.

Skin Problems

While most people with albinism are fair in complexion, skin or hair color is not diagnostic of albinism. People with many types of albinism need to take precautions to avoid damage to the skin caused by the sun such as wearing sunscreen lotions, hats and sun-protective clothing.

Types of Albinism

While most people with albinism have very light skin and hair, not all do. Oculocutaneous (pronounced ock-you-low-kew-TAIN-ee-us) albinism (OCA) involves the eyes, hair and skin. Ocular albinism (OA), which is much less common, involves primarily the eyes, while skin and hair may appear similar or slightly lighter than that of other family members.

Over the years, researchers have used various systems for classifying oculocutaneous albinism. In general, these systems contrasted types of albinism having almost no pigmentation with types having slight pigmentation. In less pigmented types of albinism, hair and skin are cream-colored and vision is often in the range of 20/200. In types with slight pigmentation, hair appears more yellow or red-tinged and vision may be better. Early descriptions of albinism called these main categories of albinism “complete” and “incomplete” albinism. Later researchers used a test that involved plucking a hair root and seeing if it would make pigment in a test tube. This test separated “ty-neg” (no pigment) from “ty-pos” (some pigment). Further research showed that this test was inconsistent and added little information to the clinical exam.

Recent research has used analysis of DNA, the chemical that encodes genetic information, to arrive at a more precise classification system for albinism. Four forms of OCA are now recognized – OCA1, OCA2, OCA3 and OCA4; some are further divided into subtypes.

• Oculocutaneous albinism type 1 (OCA1 or tyrosinase-related albinism) results from a genetic defect in an enzyme called tyrosinase (hence ‘ty’ above). This enzyme helps the body to change the amino acid tyrosine into pigment. (An amino acid is a “building block” of protein.) There are two subtypes of OCA1. In OCA1A, the enzyme is inactive and no melanin is produced, leading to white hair and very light skin. In OCA1B, the enzyme is minimally active and a small amount of melanin is produced, leading to hair that may darken to blond, yellow/orange or even light brown, as well as slightly more pigment in the skin.
• Oculocutaneous albinism type 2 (OCA2 or P gene albinism) results from a genetic defect in the P protein that helps the tyrosinase enzyme to function. Individuals with OCA2 make a minimal amount of melanin pigment and can have hair color ranging from very light blond to brown.
• Oculocutaneous albinism type 3 (OCA3) is rarely described and results from a genetic defect in TYRP1, a protein related to tyrosinase. Individuals with OCA3 can have substantial pigment.
• Oculocutaneous albinism type 4 (OCA4) results from a genetic defect in the SLC45A2 protein that helps the tyrosinase enzyme to function. Individuals with OCA4 make a minimal amount of melanin pigment similar to persons with OCA2.
• Researchers have also identified several other genes that result in albinism with other features. One group of these includes at least eight genes leading to Hermansky-Pudlak Syndrome (HPS). In addition to albinism, HPS is associated with bleeding problems and bruising. Some forms are also associated with lung and bowel disease. HPS is a less common form of albinism but should be suspected if a person with albinism shows unusual bruising or bleeding.

“Health care-associated infections, or HAIs, are infections that people acquire while they are receiving treatment for another condition in a health care setting. HAIs may be caused by any infectious agent, including bacteria, fungi, and viruses, as well as other less common types of pathogens.”

Office of disease prevention and health promotion

THE KEY is to not allowing a Health Acquired Infection-HAI to even occur; this is through PREVENTION!

To reach this key is to understand exactly what a HAI is and how they work in spreading.  If you didn’t get a chance to read Tues. Part 1, Wed. Part 2 and Thurs. Part 3 articles do that first to learn what HAIs actually are.  The public has to get focused.

Prevention with the most common HAI is UTIs, the CDC recommends healthcare workers to do the following:

• Insert urinary catheters only for the appropriate indications & minimize their use in those at high risk of UTIs, especially the elderly, women, & immunocompromised patients.
• Leave catheters in place only for as long as needed. Remove catheters on postoperative patients as soon as possible, preferably within 24 hours unless there are appropriate indications for continued use.
• Avoid use of urinary catheters in patients and nursing home residents for the management of incontinence. It is better to be do 2hr checks on the patient&do clean up immediately.
• Ensure that only properly trained persons insert and maintain catheters.
• Insert catheters using aseptic technique and sterile equipment. Use proper CDC hand hygiene and standard or appropriate isolation precautions (see discussion of these topics later in this course) when inserting or handling catheters. Perform hand hygiene immediately before and after insertion or any manipulation of the catheter site or device.
• Maintain a closed drainage system with unobstructed urine flow. Urinary catheter systems with preconnected, sealed catheter-tubing junctions are suggested for use.
• Do not clamp indwelling catheters prior to removal and do not change indwelling catheters or drainage bags at routine intervals. Catheters and drainage bags should be changed based on clinical indications, such as infection, obstruction, or when the closed system is compromised.
• Any visitors should wash hands before entering and upon leaving following with antiseptic cleaner, like Purell. If the pt is on any isolation a sheet taped to the door will show all instructions of what the visitor should do before entering the room and if not sure the visitor can always ask the RN or staff.Prevention is key to eliminating central line acquired bloodstream infections in healthcare facilities. The CDC recommends healthcare professionals follow these guidelines to reduce CLABSIs in the workplace:
• Prevention of an infection regarding female as a gender there is nothing you can do about that or the anatomy of the urethra. After having sex there is something you can do in attempting prevention of a UTI.   A women can clean the perineal/vaginal area right after the activity to decrease the chance of an infection from occurring through entering her urethra or even or vagina, with thorough drying. Remember water attracts bacteria.                                                                                                                                                                                        Staff shold choose proper central line insertion sites to minimize infections and mechanical complications. Avoid the femoral site in adult patients.

• Staff follow proper insertion practices, including complying with hand hygiene recommendations; using maximum sterile barrier precautions, performing adequate skin antisepsis with > 0.5% chlorhexidine with alcohol; and covering the site with sterile gauze or sterile, transparent, semipermeable dressings.
• Staff accessing the line, scrub the hub/port with an appropriate antiseptic (e.g., chlorhexidine, povidone iodine, an iodophor, or 70% alcohol) and access lines only with sterile devices.
• Replace dressings that are wet, soiled, or dislodged. When changing dressings, use aseptic technique, including clean and sterile gloves, as per facility policy.
• Staff perform daily audits to determine if a central line is still needed, and remove unnecessary central lines.
• Any visitors should wash hands before entering and upon leaving. If the pt is on any isolation a sheet taped to the door will show all instructions of what the visitor should do before entering the room and if not sure the visitor can always ask the RN or staff.
• Prior to Surgery
• The key to prevention with surgery sites getting infected is the following:

• Administer prophylactic antibiotics in accordance with evidence-based standards and guidelines 1 hour before surgery. This will help prevent an infection from occurring.
• Whenever possible, identify and treat remote infections before elective surgery, or postpone surgery until the infection has resolved.
• Prep skin using an appropriate antiseptic agent and proper technique. Do not remove hair at the operative site unless it will interfere with the operation. If hair must be removed, razors should not be used.
• For colorectal surgery patients, mechanically prepare the colon (enemas, cathartic agents).
• During Surgery the following takes place:

• Keep operating room doors closed during surgery except as needed for passage of equipment, personnel, and the patient.
• Consider re-dosing antibiotics at the 3-hour interval in procedures lasting longer than 3 hours and adjust the antimicrobial prophylaxis dose for patients with a body mass index greater than 30.
• Consider using at least 50% fraction of inspired oxygen intra-operatively and immediately postoperatively in select procedures.
• After Surgery
• Protect the primary closure incision with a sterile dressing for 24–48 hours post op.
• Maintain immediate postoperative normothermia.

• For cardiac surgeries, control blood glucose levels during the immediate postoperative period. Glucose level should be measured at 6:00 a.m. on postop day 1 and day 2 (procedure day is postop day 0). Postop glucose level should be maintained at < 200mg/dL.
• Discontinue antibiotics according to evidence-based standards and guidelines (within 24 hours after surgery end time, or 48 hours for cardiac surgeries).
• Any visitors should wash hands before entering and upon leaving. If the pt is on any isolation a sheet taped to the door will show all instructions of what the visitor should do before entering the room and if not sure the visitor can always ask the RN or staff.
• Patients with MRSA, VRE, and C-DIFF HCIs are placed in single contact isolation rooms, or, if a single room is not available, cohort patients put the patients in the same room or in the same patient care area with the same HCI (Ex. Both patients with VRE in their urine). Treatment by healthcare workers for patients with MRSA, VRE, and C-DIFF infections is to use proper standard isolation techniques plus contact isolation techniques to prevent spreading of the HCI to anyone out of the room or to them-selves. Anyone visitor the patient with MRSA, VRE or C-DIFF would be educated on how to prevent spreading these HCIs out of the room with protecting themselves from getting the infection.

• Some bacteria does not need a living host to survive.  Microbes such as MRSA, vancomycin-resistant enterococci (VRE), and C. difficile can survive for long periods on environmental surfaces, such as bedrails and phones.  After being contaminated, these environmental surfaces become the source of infection.  A clean healthcare environment is essential for prevention of infection from these organisms.
• The other way in prevention of these HCIs are through cleaning and disinfection of the patient environment. This includes high touch surfaces, such as bedrails, carts, toilets, and doorknobs, as well as general housekeeping surfaces, such as floors, walls, and blinds. Proper disinfection and sterilization of medical and surgical instruments and devices are also vital in the prevention of HAIs.
• The Joint Commission includes infection prevention as one of its National Patient Safety Goals in hospitals, behavioral care facilities, and ambulatory care facilities, as well as home health care. Specifically, the Joint Commission emphasizes handwashing as key to infection prevention. Although hand hygiene and transmission precautions are routine in healthcare facilities, a review of evidence-based practice can remind healthcare professionals of the process of and rationale for these procedures.
• Handwashing is the single most effective way to prevent the transmission of infection.
• The public must get involved with medical staff to stay on top of prevention with HAIs.  This is to allow HAIs to go on a continual reduction.  This will only occur if both staff of a health care facility get involved with the public.  Having everyone nationally in all communities take part will only happen if increased health awareness is provided, which in the end will help decrease infection.  This will indirectly put a reduction on our medical debt, which will take time.  Our medical technology has taken us so far in learning and treating infection compared to 100 years ago or less; but we need the public to get more focused on how to prevent HAIs as well.  We can’t leave it up to the health care facilities staff to only take action to prevent HAIs.  The public needs to take part in this now.  Broadening the public’s knowledge will help prevent people from getting a HAI when admitted to the hospital or going to any type of medical facility for care.  It also will get the public more focused on HAIs allowing the family with the patient to take more action in prevention of HAIs (The key).
• We the people in our society are responsible in reaching the goal for better health.  The medical staff, who is already carrying out infection control measures, with the public’s help through increased knowledge on HAIs will only increase the chance of continued reduction in infections, to possibly minimal infections one day, in all types of hospitals or health care facilities.  We all must get focused!

“More action is needed at every level of public health and health care to improve patient safety and eliminate infections that commonly threaten hospital patients.”

CDC (Center for disease control and prevention).