Haemo Health Dictionary

Spitting of blood... haemoptysis

Bleeding; blood loss.... haemorrhage

Haemorrhoids, or piles, are varicose (swollen) veins in the lining of the ANUS. They are very common, affecting nearly half of the UK population at some time in their lives, with men having them more often and for a longer time.

Varieties Haemorrhoids are classi?ed into ?rst-, second- and third-degree, depending on how far they prolapse through the anal canal. First-degree ones do not protrude; second-degree piles protrude during defaecation; third-degree ones are trapped outside the anal margin, although they can be pushed back. Most haemorrhoids can be described as internal, since they are covered with glandular mucosa, but some large, long-term ones develop a covering of skin. Piles are usually found at the three, seven and eleven o’clock sites when viewed with the patient on his or her back.

Causes The veins in the anus tend to become distended because they have no valves; because they form the lowest part of the PORTAL SYSTEM and are apt to become over?lled when there is the least interference with the circulation through the portal vein; and partly because the muscular arrangements for keeping the rectum closed interfere with the circulation through the haemorrhoidal veins. An absence of ?bre from western diets is probably the most important cause. The result is that people often strain to defaecate hard stools, thus raising intra-abdominal pressure which slows the rate of venous return and engorges the network of veins in the anal mucosa. Pregnancy is an important contributory factor in women developing haemorrhoids. In some people, haemorrhoids are a symptom of disease higher up in the portal system, causing interference with the circulation. They are common in heart disease, liver complaints such as cirrhosis or congestion, and any disease affecting the bowels.

Symptoms Piles cause itching, pain and often bleeding, which may occur whenever the patient defaecates or only sometimes. The piles may prolapse permanently or intermittently. The patient may complain of aching discomfort which, with the pain, may be worsened.

Treatment Prevention is important; a high-?bre diet will help in this, and is also necessary after piles have developed. Patients should not spend a long time straining on the lavatory. Itching can be lessened if the PERINEUM is properly washed, dried and powdered. Prolapsed piles can be replaced with the ?nger. Local anaesthetic and steroid ointments can help to relieve symptoms when they are relatively mild, but do not remedy the underlying disorder. If conservative measures fail, then surgery may be required. Piles may be injected, stretched or excised according to the patient’s particular circumstances.

Where haemorrhoids are secondary to another disorder, such as cancer of the rectum or colon, the underlying condition must be treated – hence the importance of medical advice if piles persist.... haemorrhoids

The colouring compound which produces the red colour of blood. Haemoglobin is a chromoprotein, made up of a protein called globin and the iron-containing pigment, haemin. When separated from the red blood corpuscles – each of which contains about 600 million haemoglobin molecules – it is crystalline in form.

Haemoglobin exists in two forms: simple haemoglobin, found in venous blood; and oxy-haemoglobin, which is a loose compound with oxygen, found in arterial blood after the blood has come into contact with the air in the lungs. This oxyhaemoglobin is again broken down as the blood passes through the tissues, which take up the oxygen for their own use. This is the main function of haemoglobin: to act as a carrier of oxygen from the lungs to all the tissues of the body. When the haemoglobin leaves the lungs, it is 97 per cent saturated with oxygen; when it comes back to the lungs in the venous blood, it is 70 per cent saturated. The oxygen content of 100 millilitres of blood leaving the lungs is 19·5 millilitres, and that of venous blood returning to the lungs, 14·5 millilitres. Thus, each 100 millilitres of blood delivers 5 millilitres of oxygen to the tissues of the body. Human male blood contains 13–18 grams of haemoglobin per 100 millilitres; in women, there are 12–16 grams per 100 millilitres. A man weighing 70 kilograms (154 pounds) has around 770 grams of haemoglobin circulating in his red blood corpuscles.... haemoglobin

An inherited disorder of blood COAGULATION which results in prolonged bleeding even after minor injury. There is a de?ciency of factor VIII, an essential clotting factor in the coagulation cascade – the complex series of biochemical events that leads from injury of the wall of a blood vessel to the formation of a blood clot that checks bleeding. Haemophilia is a sex-linked recessive disorder (though a small number of cases arise by spontaneous mutation), so that, if females carry the disease, one-half of their sons will be affected and one-half of their daughters will be carriers. The sons of haemophiliacs are unaffected but one-half of their daughters will be carriers.

Haemophilia affects approximately 1:4,000 of the UK population but only 1:20,000 is severely affected. Severity of the disease depends upon the percentage, compared with normal, of factor VIII activity present. Less than 1 per cent and there will be spontaneous bleeding into joints and muscles; 1–5 per cent and there will be occasional spontaneous bleeding and severe bleeding after minor injury; 5–25 per cent and there will only be severe bleeding after major injury. Before treatment was available, severe haemophiliacs suffered from acute pain and deformity from bleeds into joints and muscles. Bleeding also occurred into the gut, kidneys and brain, and few survived past adolescence.

Freeze-dried factor VIII may be kept in domestic refrigerators. Haemophiliacs can use it to abort minor bleeds by reconstituting it and injecting it intravenously. More major bleeding or preparation for surgery involves raising factor VIII levels to 30–100 per cent by giving cryoprecipitate.

With treatment, most haemophiliacs lead normal lives, although obviously dangerous or contact sports should be avoided. Before donors of blood were screened for HEPATITIS B and C or for HIV infection (see AIDS/HIV), some individuals with haemophilia receiving factor VIII were unwittingly infected with those diseases. Today’s screening procedures make such infections very unlikely.

There is a National Haemophilia Register and each registered sufferer carries a card with details about his or her condition. Information may also be obtained from NHS haemophilia centres and the Haemophilia Society.... haemophilia

A disease in which cirrhosis of the liver (see LIVER, DISEASES OF), enlargement of the SPLEEN, pigmentation of the skin, and DIABETES MELLITUS are associated with the abnormal and excessive deposit in the organs of the body of the iron-containing pigment, haemosiderin. It is caused by an increase in the amount of iron absorbed from the gastrointestinal tract.... haemochromatosis

A method of removing waste products or poisons from the circulating blood using the principle of DIALYSIS. The procedure is used on patients with malfunctioning or non-functioning KIDNEYS. It is done using an arti?cial kidney or dialyser which restores blood to its normal state. The process has to be repeated, sometimes for many months, until a donor kidney is available for transplantation to replace the patient’s failing one.... haemodialysis

The presence of blood pigment in the URINE caused by the destruction of blood corpuscles in the blood vessels or in the urinary passages. It turns urine a dark red or brown colour. In some people this condition, known as intermittent haemoglobinuria, occurs from time to time, especially on exposure to cold. It is also produced by various poisonous substances taken in the food. It occurs in malarious districts in the form of one of the most fatal forms of MALARIA: BLACKWATER FEVER. (See also MARCH HAEMOGLOBINURIA.)... haemoglobinuria

The destruction of red blood corpuscles by the action of poisonous substances, usually of a protein nature, circulating in the blood, or by certain chemicals. It occurs, for example, gradually in some forms of ANAEMIA and rapidly in poisoning by snake venom.... haemolysis

A potentially serious disease of the newborn, characterised by haemolytic ANAEMIA (excessive destruction of red blood cells) and JAUNDICE. If severe, it may be obvious before birth because the baby becomes very oedematous (see OEDEMA) and develops heart failure – so-called hydrops fetalis. It may ?rst present on the ?rst day of life as jaundice and anaemia. The disease is due to blood-group incompatibility between the mother and baby, the commoneset being rhesus incompatibility (see BLOOD GROUPS). In this condition a rhesus-negative mother has been previously sensitised to produce rhesus antibodies, either by the delivery of a rhesus-positive baby, a miscarriage or a mismatched blood transfusion. These antibodies cross over into the fetal circulation and attack red blood cells which cause HAEMOLYSIS.

Treatment In severely affected fetuses, a fetal blood transfusion may be required and/or the baby may be delivered early for further treatment. Mild cases may need observation only, or the reduction of jaundice by phototherapy alone (treatment with light, involving the use of sunlight, non-visible ULTRAVIOLET light, visible blue light, or LASER).

Whatever the case, the infant’s serum BILIRUBIN – the bilirubin present in the blood – and its HAEMOGLOBIN concentration are plotted regularly so that treatment can be given before levels likely to cause brain damage occur. Safe bilirubin concentrations depend on the maturity and age of the baby, so reference charts are used.

High bilirubin concentrations may be treated with phototherapy; extra ?uid is given to prevent dehydration and to improve bilirubin excretion by shortening the gut transit time. Severe jaundice and anaemia may require exchange TRANSFUSION by removing the baby’s blood (usually 10 millilitres at a time) and replacing it with rhesus-negative fresh bank blood. Haemolytic disease of the newborn secondary to rhesus incompatibility has become less common since the introduction of anti-D (Rho) immunoglobulin. This antibody should be given to all rhesus-negative women at any risk of a fetomaternal transfusion, to prevent them from mounting an antibody response. Anti-D is given routinely to rhesus-negative mothers after the birth of a rhesus-positive baby, but doctors should also give it after threatened abortions, antepartum haemorrhages, miscarriages, and terminations of pregnancy.

Occasionally haemolytic disease is caused by ABO incompatibility or that of rarer blood groups.... haemolytic disease of the newborn

An increase in the amount of iron stored in the body. Rarely, it may be due to ingestion of too much iron, but a more likely cause is repeated blood transfusions. The extra iron may affect the function of the heart and liver.... haemosiderosis

The process by which bleeding stops. It involves constriction of blood vessels, the formation of a platelet plug, and blood clotting. The term is also used for surgical interventions to stop bleeding – for example, the use of diathermy. (See COAGULATION; HAEMORRHAGE.)... haemostasis

Having the power to arrest bleeding... haemostatic

An e?usion of blood into the PLEURAL CAVITY.... haemothorax

A haemorrhage into the subarachnoid space in the BRAIN. It is usually the result of rupture of an ANEURYSM on the CIRCLE OF WILLIS. Head injury or intense physical exercise occasionally cause subarachnoid haemorrhage; the diagnosis is con?rmed by CT scan or by identifying blood in the CEREBROSPINAL FLUID at LUMBAR PUNCTURE. Cerebral ANGIOGRAPHY will usually pinpoint the site of bleeding. Treatment is bed rest, life-support measures and procedures to reduce blood pressure; sometimes surgery is carried out but not usually until several weeks after the acute episode. About 30 per cent of patients recover fully, whilst some have residual disabilities such as EPILEPSY, mental deterioration or paralysis. About 50 per cent of those affected die.... subarachnoid haemorrhage

A disease of children resulting in acute RENAL failure. A febrile illness of the gastrointestinal or respiratory tracts is followed by intravascular COAGULATION of blood which results in HAEMOLYSIS, ANAEMIA, THROMBOCYTOPAENIA and renal failure (resulting from ?brin deposition in renal arterioles and glomerular capillaries).

The death rate is 2–10 per cent and the majority of patients survive without renal failure. The longer the period of OLIGURIA, the greater the risk of chronic renal failure.

Treatment is supportive, with replacement of blood and clotting factors, control of HYPERTENSION, and careful observation of ?uid balance.... haemolytic uraemic syndrome

The presence of blood in the PERICARDIUM, the membranous sac which surrounds the heart. The condition may result from a myocardial infarction (see HEART, DISEASES OF), leaking ANEURYSM, injury, or tumour. Because the pericardial blood compresses the heart, the latter’s pumping action is impeded, reducing the blood pressure and causing cardiac failure. Urgent surgical drainage of the blood may be required.... haemopericardium

The formation of blood cells and PLATELETS – a continuous process throughout life. As ageing cells are removed from the circulation, new ones, generated in the BONE MARROW, replace them.... haemopoiesis

This is the basic cell from which all types of blood cells originate. Its appearance is believed to be similar to that of a LYMPHOCYTE.... haemopoietic stem cell

Gram-negative (see GRAM’S STAIN), rod-like, aerobic, non-sporing and non-motile parasitic bacteria. Mostly found in the respiratory tract, they may be part of the normal ?ora, but may also be responsible for several diseases. The main pathogenic species of haemophilus is H. in?uenzae, which may cause severe exacerbations of chronic BRONCHITIS, as well as MENINGITIS, EPIGLOTTITIS, SINUSITIS, and otitis media (see EAR, DISEASES OF). Other species may cause conjunctivitis (see EYE, DISORDERS OF) or CHANCROID. Haemophilus species are sensitive to a wide range of antibiotics, though generally resistant to penicillin. Infants are routinely immunised with Haemophilus B vaccine to prevent meningitis, septicaemia and epiglottitis

– all potentially fatal disesases.... haemophilus

A group of drugs used to treat bleeding disorders such as HAEMOPHILIA. Factor VIII is one of the clotting factors available for treatment: preparations of it are injected after abnormal bleeding or before surgery. Vitamin K preparations are another haemostatic group used to treat an overdose of ANTICOAGULANTS.

Haemostatic preparations of gelatine and cellulose are used to stem bleeding from the skin and gums, or as a result of tooth extractions.... haemostatics

Also called EBOLA VIRUS DISEASE. A usually fatal infection caused by a virus related to that of MARBURG DISEASE. Two large outbreaks of it were recorded in 1976 (one in the Sudan and one in Zaïre), with a mortality, respectively, of 50 and 80 per cent, and the disease reappeared in the Sudan in 1979. After an incubation period of 7–14 days, the onset is with headache of increasing severity, and fever. This is followed by diarrhoea, extensive internal bleeding and vomiting. Death usually occurs on the eighth to ninth day. Infection is by person-to-person contact. Serum from patients convalescent from the disease is a useful source of ANTIBODIES to the virus.... viral haemorrhagic fever

A herb that lyses red blood cells by causing them to rupture. Soapwort. ... haemolytic

Bleeding from the vagina after the 28th week of pregnancy. Antepartum haemorrhage is most commonly due to a problem with the placenta, such as placenta praevia or placental abruption. Bleeding can also be caused by cervical erosion or other disorders of the cervix or vagina.

Admission to hospital is necessary for investigation and treatment.

Ultrasound scanning is used to diagnose problems with the placenta.

If the bleeding is severe, the woman is given a blood transfusion, and the baby is delivered immediately by caesarean section.... antepartum haemorrhage

Bleeding within the brain due to a ruptured blood vessel (see intracerebral haemorrhage; stroke).... cerebral haemorrhage

A form of haemoglobin that is bound to the sugar glucose. In most people, 3–8 per cent of haemoglobin is glycosylated. In people with diabetes mellitus, the level of glycosylated haemoglobin may be raised if treatment has not kept the blood glucose level within the normal range. Glycosylated haemoglobin levels indicate blood glucose levels over the preceding 3 months.... glycosylated haemoglobin

A term used to describe the genetic disorders in which there is a fault in the production of the globin chains of haemoglobin.

Examples of haemoglobinopathies include sickle cell anaemia and the thalassaemias.... haemoglobinopathy

The surgical removal of haemorrhoids. The procedure is used to treat large, prolapsing, or bleeding haemorrhoids.... haemorrhoidectomy

Excessive blood loss after childbirth. It is more common after a long labour or after a multiple birth. The haemorrhage is usually due to excessive bleeding from the site where the placenta was attached to the uterus.... postpartum haemorrhage

Bleeding under the fingernails visible as tiny splinterlike marks.

Usually due to trauma, it can also be a sign of infective endocarditis.... splinter haemorrhage

A tick-borne arboviral infection extending in distribution from Eastern Europe and Asia through to Southern Africa.... congo-crimean haemorrhagic fever

Usually a second infection with a different serotype of the dengue virus (see dengue fever). A primary infection at a young age is common finding. Age of patient with DHF is often less than 5 years, but young adults may be affected. Severe illness with abnormal vascular permeability, hypovolaemia and abnormal clotting mechanisms. Bleeding into skin or internally. Dengue shock syndrome may also be a complication.... dengue haemorrhagic fever

This forms a small proportion of the total HAEMOGLOBIN in the blood. It di?ers from the major component, HbA, in that it has a glucose group attached. The rate of synthesis of HbA1c is a function of the blood-glucose concentration, and since it accumulates throughout the life span of the red blood cell – normally 120 days – the concentration of HbA1c is related to the mean blood-glucose concentration over the past 3–4 months. It is thus a useful indicator of medium-term diabetic control (see DIABETES MELLITUS) – a good target range would be a concentration of 5–8 per cent. When interpreting the HbA1c level, however, it is important to remember that wide ?uctuations in blood-glucose concentration, together with ANAEMIA or a reduced ERYTHROCYTES life span, may give misleading results.... glycosylated haemoglobin (hba1c)

A technique similar to HAEMODIALYSIS. Blood is dialysed using ultra?ltration through a membrane permeable to water and small molecules (molecular weight <12,000). Physiological saline solution is simultaneously reinfused.... haemofiltration

Abnormal HAEMOGLOBIN formation occurs in the haemoglobinopathies, which are hereditary haemolytic anaemias, genetically determined and related to race. The haemoglobin may be abnormal because: (1) there is a defect in the synthesis of normal adult haemoglobin as in THALASSAEMIA, when there may be an absence of one or both of the polypeptide chains characteristic of normal adult haemoglobin; or (2) there is an abnormal form of haemoglobin such as haemoglobin S which results in sickle-cell disease (see ANAEMIA). This abnormality may involve as little as one amino acid of the 300 in the haemoglobin molecule. In sickle-cell haemoglobin, one single amino-acid molecule – that of glutamic acid – is replaced by another – that of valine; this results in such a de?cient end product that the ensuing disease is frequently severe.... haemoglobinopathies

A bleeding pile... haemorrhoid

A complication of walking and running over long distances. It is due to damage to red blood cells in the blood vessels of the soles of the feet. This results in HAEMOGLOBIN being released into the bloodstream, which is then voided in the URINE – the condition known as HAEMOGLOBINURIA. No treatment is required.... march haemoglobinuria

A disorder characterised by irregular bouts of uterine (see UTERUS) bleeding – without previous OVULATION – due to excessive oestrogenic activity. It is associated with endometrial hyperplasia and cysts of the ovary.... metropathia haemorrhagica

Linear bleeding under the ?ngernails. Although they may result from injury, they are a useful physical sign of infective ENDOCARDITIS.... splinter haemorrhages

See: BLEEDING. ... eyes  - retinal haemorrhage

A blood condition due to abnormal destruction of red blood cells in the spleen.

Causes: hereditary background with deficiency of cell enzymes or cell membrane weakness; wrongly matched blood transfusion, environmental chemicals, food additives, colourings, drugs, infections. Symptoms. Pale face, sore tongue, headache, dizziness, palpitations, breathlessness, angina, weakness, loss of weight and appetite, jaundice (yellow skin), feverishness, vague aches and pains, enlarged spleen and pain under left ribs.

Treatment. Under hospital supervision.

Echinacea has a long reputation for regeneration of red blood cells: experience shows it beneficial for this type of anaemia. To assist control of symptoms: Gentian, Motherwort, Mugwort, Barberry, Hops, Saw Palmetto.

Bitter herbs stimulate the stomach, liver and pancreas. By increasing the appetite they benefit digestion and are given half an hour before meals by tea or decoction: Hops, Quassia chips, Angostura, Feverfew, Bogbean.

Formula. Tea. Milk Thistle 2; Betony 1; Hops 1. Mix. 1-2 teaspoon to each cup boiling water. Infuse 5-15 minutes. 1 cup, thrice daily.

Decoction. Echinacea 1; Sarsaparilla 1; Peruvian bark half; Saw Palmetto half. Mix. 2 teaspoons to 2 cups water, simmer gently 20 minutes. Half a cup, cold, thrice daily before meals.

For weak heart add one part Hawthorn; neurasthenia (Ginkgo); swelling of ankles (Lily of the Valley); loss of hormonal balance (Ginseng).

Prognosis. Surgical removal of spleen may be necessary.

Diet. Dandelion coffee, molasses, desiccated or fresh calves’ liver. Green leafy vegetables, dried beans, apricots. Shellfish, milk, eggs, Soya, meats. Supplements. Daily. Vitamin B12 1mg; Vitamin C, 1g; Folic acid 400mcg; Floradix. ... anaemia: haemolytic

A group of powerful astringents clinical experience has shown to be effective in arresting mild to moderate internal bleeding.

Digestive tract: Marigold, Comfrey, Bur-Marigold, Matico, Shepherd’s Purse, Holy Thistle, American Cranesbill, Goldenseal.

Anal/Rectal: Pilewort, Plantain, Matico, Rhatany root, Witch Hazel.

Mouth: Tormentil.

Nose-bleeds: Nettles.

Uterus. Shepherd’s Purse, Ladies Mantle, Greater Periwinkle, Beth root, Avens, Goldenseal. Urinary system. Bistort, Plantain, Marigold, Stone root, Horsetail, Bur-Marigold.

Lungs. Bugleweed, Elecampane, Lungwort.

Colon. Greater Burnet, Matico, Comfrey, Bistort, Wild Yam, Holy Thistle, Avens, Tormentil. Capillary haemorrhage. Buckwheat. ... anti-haemorrhagics

Severe disease of the newly born and infants with jaundice and anaemia. Occurs when a Rhesus negative mother gives birth to a Rhesus positive child. There may be degeneration of nerve cells of the brain through circulating bile. Followed by water-logging of tissues lining lungs, abdomen or heart (hydrops).

Treatment. Purpose of medication is to stimulate flow of bile and support the liver.

Arthur Hyde, MNIMH recommends a selection from the following according to individual case: Balmony, Barberry, Dandelion, Goldenseal, Hops, Ladyslipper, Mistletoe, Passion flower, Stone root. Tinctures. Formula. Marigold 2; Barberry 2; Ginkgo 1. Dose: 2 drops in feed, or in water, thrice daily. Infants 3-5 years: 10 drops.

To be treated by or in liaison with a qualified medical practitioner. ... haemolytic disease of infants

An uncommon cause of kidney failure in children. The association of three processes: reduced platelets, haemolytic anaemia and kidney failure. Foodborne infection is spread by micro-organisms (E. coli, etc) with an affinity for the alimentary canal. The central nervous system is involved.

Onset: diarrhoea with streaks of blood, vomiting, breathlessness, feverishness, dizziness, jaundice and enlargement of the spleen.

Other causes may be mismatched food transfusion, environmental chemicals, nitrite food preservatives and analgesic drugs.

Alternatives. Tea. Combine herbs: Red Clover (to increase platelets) 3; Yarrow (kidneys) 2; Hops (cerebrospinal supportive) 1. 1-2 teaspoons to each cup boiling water; infuse 15 minutes. Half-1 cup freely.

Formula: Combine, Tinctures. Red Clover 2; Fringe Tree 1; Hops half. Dose: one 5ml teaspoon. Babies: 2 drops in feed; infants 3-5 years 10 drops in water and honey thrice daily.

Supplementation. Vitamin B-complex. C.

To be treated by or in liaison with a qualified medical practitioner. ... haemolytic-uraemia syndrome (hus)

Bleeding within or around the brain that is caused either by injury or by spontaneous rupture of a blood vessel. There are 4 possible types of brain haemorrhage: subdural, extradural, subarachnoid, and intracerebral. Extradural and subdural haemorrhages are usually the result of a blow to the head (see head injury). Subarachnoid and intracerebral haemorrhages usually occur spontaneously due to rupture of aneurysms or small blood vessels in the brain.... brain haemorrhage

 Caused by disease toxins that kill off red blood cells, or autoimmune disease.

Treatment: emphasis is on new red cell production. Dosage would be according to individual tolerance. Alternatives. Tea. Mix equal parts: Agrimony, Clivers, Red Clover flowers. 2 teaspoons to each cup boiling water; infuse 5-15 minutes; one cup every 3 hours.

Decoction. Equal parts: Fringe Tree, Gentian, Milk Thistle. 2 teaspoons to each cup water gently simmered 20 minutes. Half-1 cup every 3 hours, or as much as tolerated.

Tablets/capsules. Red Clover, Ginseng.

Formula. Equal parts: Fringe Tree, Yellow Dock root, Dandelion. Dose – Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid Extracts: one 5ml teaspoon. Tinctures: two 5ml teaspoons. Every 3 hours in water or honey. ... jaundice, haemolytic

A form of anaemia caused by premature destruction of red cells in the bloodstream (haemolysis). Haemolytic anaemias can be classified according to whether the cause of haemolysis is inside or outside the red cells.

When haemolysis is due to a defect inside the red cells, the underlying problem is abnormal rigidity of the cell membrane. This causes the cells to become trapped, at an early stage of their life-span, in the small blood vessels of the spleen, where they are destroyed by macrophages (cells that ingest foreign particles). Abnormal rigidity may result from an inherited defect of the cell membrane (as in hereditary spherocytosis), a defect of the haemoglobin in the cell (as in sickle-cell anaemia), or a defect of one of the cell’s enzymes. An inherited deficiency of the glucose-6phosphate dehydrogenase enzyme (see G6PD deficiency) may result in episodes of haemolytic anaemia since the red cells are prone to damage by infectious illness or certain drugs or foods.

Haemolytic anaemias due to defects outside the red cells fall into 3 main groups. First are disorders in which red cells are destroyed by buffeting (by artificial surfaces such as replacement heart valves, abnormal blood-vessel linings, or a blood clot in a vessel, for example). In the 2nd group, the red cells are destroyed by the immune system. Immune haemolytic anaemias may occur if foreign blood cells enter the bloodstream, as occurs in an incompatible blood transfusion, or they may be due to an autoimmune disorder. In haemolytic disease of the newborn, the baby’s red cells are destroyed by the mother’s antibodies crossing the placenta. Thirdly, the red cells may be destroyed by microorganisms; the most common cause is malaria. People with haemolytic anaemia may have symptoms common to all types of anaemia, such as fatigue and breathlessness, or symptoms specifically due to haemolysis, such as jaundice.

Diagnosis is made by examination of the blood (see blood film). Some inherited anaemias can be controlled by removing the spleen (see splenectomy). Others, such as G6PD deficiency, can be prevented by avoiding the drugs or foods that precipitate haemolysis. Anaemias due to immune processes can often be controlled by immunosuppressant drugs. Transfusions of red cells are sometimes needed for emergency treatment of life-threatening anaemia.... anaemia, haemolytic

Bleeding into the space between the inner surface of the skull and the external surface of the dura mater, the outer layer of the meninges. Extradural haemorrhage usually results from a blow to the side of the head that fractures the skull and ruptures an artery running over the surface of the dura mater. A haematoma (collection of clotted blood) forms and enlarges, causing an increase in pressure inside the skull and resulting in symptoms several hours or even days after the injury. Symptoms may include headache, drowsiness, vomiting, paralysis affecting one side of the body, and seizures. Untreated, extradural haemorrhage may be life-threatening.

CT scanning or MRI confirms the diagnosis.

Surgical treatment consists of craniotomy, draining the blood clot, and clipping the ruptured blood vessel.... extradural haemorrhage

See anaemia, haemolytic.... haemolytic anaemia

A rare disease in which red blood cells are destroyed prematurely and the kidneys are damaged, causing acute kidney failure. Thrombocytopenia can also occur. Haemolytic–uraemic syndrome most commonly affects young children and may be triggered by a serious bacterial or viral infection. Symptoms include weakness, lethargy, and a reduction in the volume of urine. Seizures may occur. Blood and urine tests can determine the degree of kidney damage. Dialysis may be needed until the kidneys have recovered. Most patients recover normal renal function.... haemolytic–uraemic syndrome

A bacterium (see bacteria) responsible for numerous cases of the infectious diseases epiglottitis and meningitis.... haemophilus influenzae

The medical term for blood in the semen (see semen, blood in the).... haemospermia

A group of drugs used to treat bleeding disorders and to control bleeding. Haemostatic preparations that help blood clotting are given to people who have deficiencies of natural clotting factors. For example, factor VIII is used to treat haemophilia. Drugs that prevent the breakdown of fibrin in clots, such as tranexamic acid, can also improve haemostasis.... haemostatic drugs

Bleeding into the brain from a ruptured blood vessel. It is 1 of the 3 principal mechanisms by which a stroke can occur. It mainly affects middle-aged or elderly people and is usually due to atherosclerosis. Untreated hypertension increases the risk of intracerebral haemorrhage.

The ruptured artery is usually in the cerebrum. The escaped blood seeps out, damaging brain tissue. The symptoms are sudden headache, weakness, and confusion, and often loss of consciousness. Speech loss, facial paralysis, or onesided weakness may develop, depending on the area affected. Surgery is usually impossible; treatment is aimed at lifesupport and the reduction of blood pressure. Large haemorrhages are usually fatal. For the survivor of an intracerebral haemorrhage, rehabilitation and outlook are as for any type of stroke.

intracytoplasmic sperm injection... intracerebral haemorrhage

Bleeding into the retina from 1 or more blood vessels, due to diabetes mellitus, hypertension, or retinal vein occlusion. When the macula

(site of central vision) is involved, vision is severely impaired.

Peripheral haemorrhages may be detected only when the eye is examined with an ophthalmoscope.... retinal haemorrhage

Bleeding under the conjunctiva that is usually harmless and disappears in a few days without treatment.... subconjunctival haemorrhage

Bleeding into the space between the outer and middle layers of the meninges, usually following head injury. The trapped blood slowly forms a large clot within the skull that presses on brain tissue. The symptoms, which tend to fluctuate, may include headache, confusion, drowsiness, and one-sided weakness or paralysis. The interval between the injury and the start of symptoms varies from days to months. Diagnosis is by CT scanning or MRI. In many cases, surgical treatment is needed. This involves drilling burr holes in the skull (see craniotomy), so that the blood can be drained out and damaged blood vessels repaired. If treatment is carried out at an early enough stage, the person usually makes a full recovery. A subdural haemorrhage that is small and produces few symptoms may not require any treatment. The affected

person is usually monitored with regular scans, and the clot may clear up on its own. (See also extradural haemorrhage.)... subdural haemorrhage

Bleeding into the vitreous humour. A common cause is diabetic retinopathy. Vitreous haemorrhage often affects vision; a major haemorrhage causes poor vision until the blood is reabsorbed, which may not be for several months, if at all.... vitreous haemorrhage

a disease caused by bunyaviruses that has occurred in the former USSR, the Middle East, and Africa. It causes bleeding into the intestines, kidneys, genitals, and mouth with up to 50% mortality. The virus is spread by various types of tick from wild animals and birds to domestic animals (especially goats and cattle) and thus to humans.... crimean congo haemorrhagic fever

sudden bleeding from the choroid, usually during a surgical procedure or trauma. This may force the ocular tissue out of the wound and is potentially one of the most devastating intraoperative complications of ocular surgery.... expulsive haemorrhage

(glycosylated haemoglobin) any derivative of haemoglobin in which a glucose molecule is attached to the haemoglobin molecule. The most abundant form of glycated haemoglobin is haemoglobin A1c (HbA1c), levels of which are significantly increased in diabetes. The percentage of the HbA molecules that become glycated is dependent on the general level of glucose in the plasma over the lifetime of the molecule (generally three months); this percentage is therefore used as the standard measure of the degree of control of *hyperglycaemia in a person with diabetes over this period. HbA1c values are now expressed in mmol per mol haemoglobin (mmol/mol) rather than as a percentage. The use of HbA1c as a screening tool for diabetes mellitus has become recognized.... glycated haemoglobin

n. see Bartonella.... haemobartonella

n. haemorrhage into the bile ducts, usually presenting as an acute upper gastrointestinal bleed (with bloody vomit or *melaena) or with a dropping blood count. The most common causes are liver injury, liver biopsy, hepatobiliary surgery, or use of instruments (such as *ERCP). Other causes include gallstones, inflammatory conditions, vascular abnormalities, tumours, and conditions that predispose to bleeding (such as using anticoagulant medication).... haemobilia

n. an increase in the proportion of red blood cells relative to the plasma, brought about by a decrease in the volume of plasma or an increase in the concentration of red blood cells in the circulating blood (see polycythaemia). Haemoconcentration may occur in any condition in which there is a severe loss of water from the body. Compare haemodilution.... haemoconcentration

n. a special glass chamber of known volume into which diluted blood is introduced. The numbers of the various blood cells present are then counted visually, through a microscope. Haemocytometers have been largely replaced by electronic cell counters.... haemocytometer

n. a form of renal replacement therapy that removes toxins by a combination of diffusion (as in conventional *haemodialysis) and convection (as in *haemofiltration), and is more efficient than either in the process.... haemodiafiltration

n. a decrease in the proportion of red blood cells relative to the plasma, brought about by an increase in the total volume of plasma. This may occur in a variety of conditions, including pregnancy and enlargement of the spleen (see hypersplenism). Compare haemoconcentration.... haemodilution

n. the use of a transmembrane hydrostatic pressure to induce filtration of plasma water across the membrane of a haemofilter. Solutes dissolved in the plasma water accompany their solvent to a greater or lesser extent dependent on molecular weight and the characteristics of the filter membrane (pore size).... haemofiltration

n. an instrument for determining the concentration of *haemoglobin in a sample of blood, which is a measure of its ability to carry oxygen.... haemoglobinometer

n. the results of a routine blood test, including an estimate of the blood haemoglobin level, the *packed cell volume, and the numbers of red and white blood cells (see blood count). Any abnormalities seen in microscopic examination of the blood are also noted.... haemogram

n. a substance capable of bringing about destruction of red blood cells (*haemolysis). It may be an antibody or a bacterial toxin.... haemolysin

n. the passage of blood through a sorbent column with the aim of removing toxic substances. The commonest sorbent in use is charcoal, microencapsulated with cellulose nitrate. Haemoperfusion might be considered for the treatment of poisoning with carbamazepine, theophylline, barbiturates, and Amanita mushrooms.... haemoperfusion

n. the presence of blood in the peritoneal cavity, between the lining of the abdomen or pelvis and the membrane covering the organs within.... haemoperitoneum

n. bleeding into the *vitreous humour of the eye: vitreous haemorrhage.... haemophthalmia

n. the presence of both blood and air in the pleural cavity, usually as a result of injury. Both must be drained out to allow the lung to expand normally. See also haemothorax.... haemopneumothorax

adj. associated with or resulting from blood loss (see haemorrhage). For example, haemorrhagic anaemia is due to blood loss (see anaemia).... haemorrhagic

a temporary disturbance in blood clotting caused by *vitamin K deficiency and affecting infants on the second to fourth day of life. It varies in severity from mild gastrointestinal bleeding to profuse bleeding into many organs, including the brain. It is more common in breast-fed and preterm infants. The condition can be prevented by giving all babies vitamin K, either by injection or orally, shortly after birth. Medical name: melaena neonatorum.... haemorrhagic disease of the newborn

n. see haematosalpinx.... haemosalpinx

n. an iron-storage compound found mainly in the cells of the *macrophage– *monocyte system in the marrow, in the *Kupffer cells of the liver, and in the spleen. It contains around 30% iron by weight.... haemosiderin

n. an iron-containing pigment present in the organisms that cause malaria (*Plasmodium species).... haemozoin

(IVH) see periventricular haemorrhage.... intraventricular haemorrhage

(PNH) a type of acquired haemolytic *anaemia that results from an abnormality of the red blood cell membrane. It is due to a defect in the formation of glycosylphosphatidylinositol (GPI), whose role is to anchor proteins to the lipid framework of the membrane. This leads to increased *complement-mediated destruction of red blood cells, which results in the release of haemoglobin in the circulation and then in the urine, giving the latter a reddish colour. Some patients may develop blood clots.... paroxysmal nocturnal haemoglobinuria

(PVH) a significant cause of morbidity and mortality in infants who are born prematurely in which bleeding occurs from fragile blood vessels around the *ventricles in the brain. Bleeding extending into the lateral ventricles is termed intraventricular haemorrhage (IVH) and in severe cases can extend into the brain tissue (cerebral parenchyma). Surviving infants may have long-term neurological deficits, such as cerebral palsy, developmental delay, or seizures.... periventricular haemorrhage

bleeding under the *aponeurosis of the scalp resulting from trauma to blood vessels crossing the space from the skull to the overlying scalp. It results from delivery by forceps or vacuum extraction. It is very uncommon but can be fatal. See also cephalhaematoma; chignon.... subaponeurotic haemorrhage