Protocols - Hemorio

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HEREDIRATY SPHEROCYTOSIS CLINICAL EVALUATION Anamneses Complete clinical exam Orientation about disease Supply explicative manual about the disease Start Folic Acid LABORATORIAL EVALUATION Complete Red Blood Cell Test Incubated osmotic fragility curve Biochemistry (glycemia, liver and renal function test, electrolytes) Serology (HIV, HTLV, hepatitis A, B, C, Chagas, VDRL) TAP and PTT SAE and Parasitology: feces OUTPATIENT FOLLOW-UP Subsequential outpatient follow-up will be every four months, followed by labs exams (complete red blood cell, biochemistry). Serologic exams will be performed annually Only patients younger than 18 years old are included in this follow-up. Symptomatic patients with Hb 25g/dl Hb ranging 8-13g/dl Reticulocytose Indirect Bilirubinemia TREATMENT: Use of folic acid Splenectomy See HEMOTERAPIC PROTOCOLS SPLENECTOMY INIDICATIONS: 1-Major hemolytic anemia (Hb
After splenectomy, antibiotic prophylaxis has to be made for 1-2 years with benzatine penicillin anos (600.000 IU) in children 10-20Kg and 1.200.000 IU above 20Kg) or 10mg/kg oral penicillin every 12/12h in children and 250-500mg every 12/12h in adult). In allergy patients, use erythromycin at usual dose. THROMBOSIS Splenectomized subjects have are more likely to thrombosis, so they have to continue using 100mg/day AAS. PREGNANCY Pregnant women with espherocytes must be kept with Hb≥10g/dl, it may need transfusions in case of anemia (Hb 18 years old, splenectomized who remained asymptomatic for 6 months after splenectomy; Patients >18 years old non-splenectomized, asymptomatic with Hb>11g/dl; The patients have to be discharged with orientation about screening reactivation criteria as: symptom of hemolytic anemia (pale, jaundice, tiredness), pregnant women during prenatal and major surgery. SUMMARY OF DIAGNOSE OF SPHEROCYTE Mild Moderate Slightly severe Severe Hemoglobin 11 – 13% 8 – 11% 6 – 8% 6% Reticulocyte 3 – 8% > 8% > 10% > 10% Total Bilirubin 1 - 2 2 - 3 > 3 Fragility Curve N or slightly changed Incubated Fragility Curve Transfusion requirement Changed Splenectmoy NI If vitality↓ 43 Clearly changed 0 - 1 0 - 2 > 3 regular Necessary < 5 year Necessary < 3 years
Page 2 and 3: PROTOCOLS INSTITUTE OF HAEMATOLOGY
Page 4 and 5: COORDINATION AND REVISION Clarisse
Page 6 and 7: SUMMARY: PART I - CLINICAL PROTOCOL
Page 8 and 9: 1.INICIAL CLINICAL EVALUATION SICKL
Page 10 and 11: TREATMENTO AND IN ADULTS AT ANY AGE
Page 12 and 13: SPLENECTOMY - INDICATIONS: (1) CHIL
Page 14 and 15: OUTPATIENT TREATMENT: It is based o
Page 16 and 17: ASPIRIN AND NSAID PARACETAMOL OPIOI
Page 18 and 19: CONDUCTION: - Hospitalization - Com
Page 20 and 21: ONE, TWO-DIMENSIONAL DOPPLER ECHOCA
Page 22 and 23: Hemianopsia Homonymous deficit of v
Page 24 and 25: TREATMENT OF CONVULSIVE EPISODES -
Page 26 and 27: INITIAL ATTENDANCE TO PREGNANT WOME
Page 28 and 29: - It may occurs acute thoracic synd
Page 30 and 31: 3 Diet with potassium restriction 4
Page 32 and 33: MICROALBUMINURIA Screening Patients
Page 34 and 35: RECURRENCE OF PRIAPISM: - Pain Trea
Page 36 and 37: SPECIAL CARES DEFERASIROX - The use
Page 38 and 39: TREATAMENT: DRUG Hydroxiurea (hard
Page 40 and 41: MAJOR AND INTERMIDIATE THALASSEMIA
Page 44 and 45: G6PD DEFICIENCY INITIAL EVALUATION
Page 46 and 47: LABS EXAMS TO DIAGNOSE APLASTIC ANE
Page 48 and 49: SELFIMMUNE HEMOLYTIC ANEMIA CONCEPT
Page 50 and 51: 2. Splenectomy: Vaccinate 14 days b
Page 52 and 53: IMMUNE THROMBOCYTOPENIC PURPURA LAB
Page 54 and 55: THROMBOTIC THROMBOCYTOPENIC PURPURA
Page 56 and 57: HEMORRHAGIC SYNDROME INTRODUCTION H
Page 58 and 59: MULTIDISCIPLINARY FOLLOW-UP OF HEMO
Page 60 and 61: LYOPHILIZED CONCENTRATES: They are
Page 62 and 63: TABLE 2: REPLACEMENT THERAPY TO PER
Page 64 and 65: CONDUCTION IN CONFIRMED INTRACRANIA
Page 66 and 67: Severe CET with neurological change
Page 68 and 69: PHARMACOKINETICS OF CLOTTING FACTOR
Page 70 and 71: INHIBITORS CLASSIFICATION The inhib
Page 72 and 73: - Extended surgeries require increa
Page 74 and 75: CLINICAL DIAGNOSIS: According to In
Page 76 and 77: DDAVP TEST The “test dose” must
Page 78 and 79: TREATMENT OF BLEEDING SITUATIONS SI
Page 80 and 81: TABLE 6 - REPLACEMENT THERAPY IN LE
Page 82 and 83: • Primary prophylaxis: controvers
Page 84 and 85: CLINICAL AND LABORATORIAL FOLLOW-UP
Page 86 and 87: MYELODISPLASIC SYNDROME LABORATORIA
Page 88 and 89: If EPO < 500 mU/ml : EPO (8000U 3x/
Page 90 and 91: ACUTE MYELOID LEUKEMIA LABORATORIAL
Page 92 and 93:
LMA LMA M3 - non-M3 LMA Protocol LM
Page 94 and 95:
Key: Volunteer to aggressive treatm
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Acute Promyelocytic Leukemia Transf
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BMP LMA IN CHILDREN AND TEENAGERS
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Ara-c dose reduction by age: Age in
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ATRA RECOMMENDATION: ATRA is starte
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- venous hydration - leukapheresis
Page 106 and 107:
POLYCYTHEMIA VERA LABORATORIAL TEST
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TREATMENT - 2nd LINE - Indicated fo
Page 110 and 111:
ACUTE LYMPHOID LEUKEMIA LABORATORIA
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RE-INDUCTION Phase I (weeks 1-4) -
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Cycles 2, 4, 6, 8 - Methotrexate 20
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PHASE 2 Infusion CPM in 1 hour 1000
Page 118 and 119:
CURATIVE RADIOTHERAPY of CNS < 1 ye
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CHRONIC LYMPHOCYTIC LEUKEMIA LABORA
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fludarabine 25 mg/m VENOUS 2 D1-D3
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TRICHOLEUKEMIA LABORATORIAL TESTS -
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- age >45 years old - leukocytosis
Page 128 and 129:
- Leukemia / T-Cell Lymphoma in Adu
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INDICATIONS FOR THE TREATMENT: Symp
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1 st line Chemotherapy R- CHOP (21
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CODOX- M/IVAC Cycles 1 and 3 Cyclop
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BLOCK A DEXA VO/IV 10 mg /m2 in 3 d
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- Surgical treatment is only indica
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LEUKEMIA / T-CELLS LYMPHOMA OF THE
Page 142 and 143:
HN2 or PUVA (similar to the located
Page 144 and 145:
MULTIPLE MYELOMA LABORATORIAL TESTS
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RESPONSE CRITERIA Full Response Abs
Page 148 and 149:
WALDENSTRON MACROGLOBULINEMIA LABOR
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− If HLA-identical related donor
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TREATMENT PROTOCOL - ACUTE MYELOID
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TREATMENT PROTOCOL - MULTIPLE MYELO
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Post-autologous transplantation pro
Page 158 and 159:
PART II - TRANSFUSIONAL PROTOCOLS A
Page 160 and 161:
PRESERVATION AND CONSERVATION: The
Page 162 and 163:
TRANSFUSION OF RED BLOOD CELLS, PLA
Page 164 and 165:
FORMAL CONTRAINDICATIONS TO THE PLA
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1 - TRANSFUSION OF FROZEN FRESH PLA
Page 168 and 169:
COMMUNICATION FORM OF CRYOPRECIPITA
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Volume to be = changed (*) VOLEMIA
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HEMOTHERAPIC PROTOCOL TO FALCIFORM
Page 174 and 175:
5 - TRANSFUSIONAL CONDUCT AT THE SE
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CML - Subjects with symptoms relate
Page 178 and 179:
- Aplastic anemia bearers - HIV pos
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Severe reaction: anaphylactic shock
Page 182 and 183:
- Heart monitoring - Prescribe Furo
Page 184 and 185:
CARES AT THE PLATELETS CONCENTRATE
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ATTACHMENT I - HEMATOLOGICAL CLINIC
Page 188 and 189:
INFECTIOUS SPLENO MEGALIES IMMUNO L
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INVESTIGATION OF HEMORRHAGIC SYNDRO
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INVESTIGATION OF POLYGLOBULIAS: POL
Page 194 and 195:
ATTACHMENT III - HEMATOLOGY SPECIAL
Page 196 and 197:
IMMUNOPHENOTYPE PROFILE OF THE ACUT
Page 198 and 199:
ATTACHMENT IV - PAIN APPROACH ROUTI
Page 200 and 201:
If it is prescribed for more than 1
Page 202 and 203:
HOW TO PRESCRIBE OPIOID: SPECIAL CA
Page 204 and 205:
SPECIFICITIES OF EACH OPIATE (cont
Page 206 and 207:
METHADONE Intravenous (*) Oral path
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Psychic Dependence or “addiction
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CROSS TOLERANCE - The subject must
Page 212 and 213:
ATTACHMENT V - CHEMOTHERAPY SUBJECT
Page 214 and 215:
ATTACHMENT VII - IRON CHELATION GEN
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10. G N N - DFP DFP-100 mg/kg/day d
Page 218 and 219:
ATTACHMENT VIII - SEDATION IN CHILD
Page 220 and 221:
224 NOTES _________________________
Page 222 and 223:
224 NOTES _________________________
Page 224:
Expresso Gráfica e Editora Ltda-me
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