Hess Test
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Hess Test
The Hess test or Rumpel-Leede test is a medical test used to assess capillary fragility. It is also called the Tourniquet test. To perform the test, pressure is applied to the forearm with a blood pressure cuff inflated to between systolic and diastolic blood pressure for 10 minutes. After removing the cuff, the number of petechiae in a 5 cm diameter circle of the area under pressure is counted. Normally less than 15 petechiae are seen. 15 or more petechiae indicate capillary fragility, which occurs due to poor platelet function, bleeding diathesis or thrombocytopenia, and can be seen in cases of scurvy, and Dengue fever Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. These may include a high fever, headache, vomiting, muscle and joint pains, and a characterist .... The test is named after Alfred Fabian Hess. References External links Physical examination
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Capillary
A capillary is a small blood vessel from 5 to 10 micrometres (μm) in diameter. Capillaries are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the smallest blood vessels in the body: they convey blood between the arterioles and venules. These microvessels are the site of exchange of many substances with the interstitial fluid surrounding them. Substances which cross capillaries include water, oxygen, carbon dioxide, urea, glucose, uric acid, lactic acid and creatinine. Lymph capillaries connect with larger lymph vessels to drain lymphatic fluid collected in the microcirculation. During early embryonic development, new capillaries are formed through vasculogenesis, the process of blood vessel formation that occurs through a '' de novo'' production of endothelial cells that then form vascular tubes. The term '' angiogenesis'' denotes the formation of new capillaries from pre-existing blood vessels and already present ...
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Medical Test
A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic testing, chemical and cellular analysis, relating to clinical chemistry and molecular diagnostics, are typically performed in a medical setting. Types of tests By purpose Medical tests can be classified by their purposes, the most common of which are diagnosis, screening and evaluation. Diagnostic A diagnostic test is a procedure performed to confirm or determine the presence of disease in an individual suspected of having a disease, usually following the report of symptoms, or based on other medical test results. This includes posthumous diagnosis. Examples of such tests are: * Using nuclear medicine to examine a patient suspected of having a lymphoma. * Measuring the blood sugar in a person suspected of having diabetes mellitus after ...
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TheFreeDictionary
''The Free Dictionary'' is an American online dictionary and online encyclopedia, encyclopedia that search aggregator, aggregates information from various sources. Content The site cross-references the contents of ''The American Heritage Dictionary of the English Language'', the ''Collins English Dictionary'', the ''Columbia Encyclopedia'', the ''Computer Desktop Encyclopedia'', the ''Hutchinson Encyclopedia'' (subscription), and Wikipedia, as well as the Acronym Finder database, several financial dictionaries, law dictionary, legal dictionaries, and other content. It has a feature that allows a user to preview an article while positioning the mouse cursor (user interface), cursor over a link. One can also double-click on any word to look it up in the dictionary. Site operator The site is run by Farlex, Inc., located in Huntingdon Valley, Pennsylvania, Huntingdon Valley, Pennsylvania. Farlex also maintains a companion title, ''The Free Library'', an online library of out-of-c ...
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Tourniquet Test
A tourniquet test (also known as a Rumpel-Leede capillary-fragility test or simply a capillary fragility test) determines capillary fragility. It is a clinical diagnostic method to determine a patient's haemorrhagic tendency. It assesses fragility of capillary walls and is used to identify thrombocytopenia (a reduced platelet count). The test is part of the WHO algorithm for diagnosis of dengue fever. A blood pressure cuff is applied and inflated to the midpoint between the systolic and diastolic blood pressures for five minutes. The test is positive if there are more than 10 to 20 petechiae A petechia () is a small red or purple spot (≤4 mm in diameter) that can appear on the skin, conjunctiva, retina, and mucous membranes which is caused by haemorrhage of capillaries. The word is derived from Italian , 'freckle,' of obscure origin ... per square inch. Limitations Some studies have shown that the tourniquet test may not have high specificity. Interfering factors with this t ...
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Blood Pressure
Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" refers to the pressure in the large arteries. Blood pressure is usually expressed in terms of the systolic pressure (maximum pressure during one heartbeat) over diastolic pressure (minimum pressure between two heartbeats) in the cardiac cycle. It is measured in millimeters of mercury ( mmHg) above the surrounding atmospheric pressure. Blood pressure is one of the vital signs—together with respiratory rate, heart rate, oxygen saturation, and body temperature—that healthcare professionals use in evaluating a patient's health. Normal resting blood pressure, in an adult is approximately systolic over diastolic, denoted as "120/80 mmHg". Globally, the average blood pressure, age standardized, has remained about the same since 1 ...
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Petechiae
A petechia () is a small red or purple spot (≤4 mm in diameter) that can appear on the skin, conjunctiva, retina, and mucous membranes which is caused by haemorrhage of capillaries. The word is derived from Italian , 'freckle,' of obscure origin. It refers to one of the three descriptive types of hematoma differentiated by size, the other two being ecchymosis (>1cm in diameter) and purpura (4-10mm in diameter). The term is always used in the plural (petechiae), since a single petechia is seldom noticed or significant. Causes Physical trauma The most common cause of petechiae is through physical trauma such as a hard bout of coughing, holding breath, vomiting, or crying, which can result in facial petechiae, especially around the eyes. Such instances are harmless and usually disappear within a few days. * Constriction, asphyxiation – petechiae, especially in the eyes, may also occur when excessive pressure is applied to tissue (e.g., when a tourniquet is applied to an extremity ...
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Platelet
Platelets, also called thrombocytes (from Greek θρόμβος, "clot" and κύτος, "cell"), are a component of blood whose function (along with the coagulation factors) is to react to bleeding from blood vessel injury by clumping, thereby initiating a blood clot. Platelets have no cell nucleus; they are fragments of cytoplasm that are derived from the megakaryocytes of the bone marrow or lung, which then enter the circulation. Platelets are found only in mammals, whereas in other vertebrates (e.g. birds, amphibians), thrombocytes circulate as intact mononuclear cells. One major function of platelets is to contribute to hemostasis: the process of stopping bleeding at the site of interrupted endothelium. They gather at the site and, unless the interruption is physically too large, they plug the hole. First, platelets attach to substances outside the interrupted endothelium: ''adhesion''. Second, they change shape, turn on receptors and secrete chemical messengers: ''activatio ...
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Bleeding Diathesis
In medicine (hematology), bleeding diathesis is an unusual susceptibility to bleed (hemorrhage) mostly due to hypocoagulability (a condition of irregular and slow blood clotting), in turn caused by a coagulopathy (a defect in the system of coagulation). Therefore, this may result in the reduction of platelets being produced and leads to excessive bleeding. Several types of coagulopathy are distinguished, ranging from mild to lethal. Coagulopathy can be caused by thinning of the skin (Cushing's syndrome), such that the skin is weakened and is bruised easily and frequently without any trauma or injury to the body. Also, coagulopathy can be contributed by impaired wound healing or impaired clot formation. Signs and symptoms Complications Following are some complications of coagulopathies, some of them caused by their treatments: Causes While there are several possible causes, they generally result in excessive bleeding and a lack of clotting. Acquired Acquired causes of coagu ...
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Thrombocytopenia
Thrombocytopenia is a condition characterized by abnormally low levels of platelets, also known as thrombocytes, in the blood. It is the most common coagulation disorder among intensive care patients and is seen in a fifth of medical patients and a third of surgical patients. A normal human platelet count ranges from 150,000 to 450,000 platelets/microliter (μl) of blood. Values outside this range do not necessarily indicate disease. One common definition of thrombocytopenia requiring emergency treatment is a platelet count below 50,000/μl. Thrombocytopenia can be contrasted with the conditions associated with an abnormally ''high'' level of platelets in the blood - thrombocythemia (when the cause is unknown), and thrombocytosis (when the cause is known). Signs and symptoms Thrombocytopenia usually has no symptoms and is picked up on a routine complete blood count. Some individuals with thrombocytopenia may experience external bleeding, such as nosebleeds or bleeding gums. S ...
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Scurvy
Scurvy is a disease resulting from a lack of vitamin C (ascorbic acid). Early symptoms of deficiency include weakness, feeling tired and sore arms and legs. Without treatment, decreased red blood cells, gum disease, changes to hair, and bleeding from the skin may occur. As scurvy worsens there can be poor wound healing, personality changes, and finally death from infection or bleeding. It takes at least a month of little to no vitamin C in the diet before symptoms occur. In modern times, scurvy occurs most commonly in people with mental disorders, unusual eating habits, alcoholism, and older people who live alone. Other risk factors include intestinal malabsorption and dialysis. While many animals produce their own vitamin C, humans and a few others do not. Vitamin C is required to make the building blocks for collagen. Diagnosis is typically based on physical signs, X-rays, and improvement after treatment. Treatment is with vitamin C supplements taken by mouth. Improvemen ...
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Dengue Fever
Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin itching and skin rash. Recovery generally takes two to seven days. In a small proportion of cases, the disease develops into a more severe dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs. Dengue is spread by several species of female mosquitoes of the ''Aedes'' genus, principally ''Aedes aegypti''. The virus has five serotypes; infection with one type usually gives lifelong immunity to that type, but only short-term immunity to the others. Subsequent infection with a different type increases the risk of severe complications. A number of tests are available to confirm the diagnosis including detecti ...
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Alfred Fabian Hess
Alfred Fabian Hess (9 October 1875, in New York City – 5 December 1933) was an American physician known for his work on the role of nutrition in scurvy and rickets and for describing the Hess test. Biography Hess was born on October 15, 1875 to a Jewish family, the son of Josephine (née Solomon) and Selmar Hess. He graduated from Harvard University in 1897 and received his M.D. from the Columbia University College of Physicians and Surgeons in 1901. He worked as an intern at Mount Sinai Hospital, New York for two and a half years, and spent a year studying in Prague, Vienna and Berlin before starting practice in New York in 1905. He married Sara Straus, daughter of Isidor Straus. He worked as a pediatrician at the Rockefeller University before going into private practice. He also worked at the Beth Israel Hospital, New York, and at the Hebrew Infant Asylum in New York, modernising the institution. He was able to study nutrition in patients who were admitted for long p ...
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