Laboratory monitoring should include a complete blood count , with special attention to the absolute neutrophil count ( WBC x % neutrophils), platelet count, and the appearance of the peripheral smear. Ticlopidine is occasionally associated with thrombocytopenia unrelated to TTP or aplastic anemia. Any acute , unexplained reduction in hemoglobin or platelet count should prompt further investigation for a diagnosis of TTP, and the appearance of schistocytes (fragmented RBCs) on the smear should be treated as presumptive evidence of TTP. A simultaneous decrease in platelet count and WBC count should prompt further investigation for a diagnosis of aplastic anemia. If there are laboratory signs of TTP or aplastic anemia, or if the neutrophil count is confirmed to be < 1200/mm³, then TICLID (ticlopidine hcl) should be discontinued immediately.
Having a gallbladder attach is a painful experience for anyone. The gallbladder is a small organ in the body that stores bile which is created by the liver. While the body is digesting fats, the gallbladder sends bile through the common bile duct into the small intestine where it aids in digestion. Occasionally the bile can harden into pieces, called gallstones, which can block the bile duct. In these cases, a patient will likely have pain, nausea, and/or vomiting. During this interactive procedure, you will learn what you need to know about laparoscopic gallbladder surgery, known to doctors as a Laparoscopic Cholecystectomy , and carry out a laparoscopic gallbladder removal. It’s time to start, so let’s scrub in!
Hematocrit, reticulocyte count, Vitamin B 12 , folate and iron levels should be obtained prior to treatment. Hematocrit and reticulocyte counts should be repeated daily from the 5 th to 7 th days of therapy and then frequently until the hematocrit is normal. If folate levels are low, folic acid should also be administered. If reticulocytes have not increased after treatment or if reticulocyte counts do not continue at least twice normal as long as the hematocrit is less than 35%, diagnosis or treatment should be reevaluated. Repeat determinations of iron and folic acid may reveal a complicating illness that might inhibit the response of the marrow.