How can the doctor tell if a total knee replacement (TKR) is infected? The patient history, an exam, and lab results are helpful. Since lab studies are so important, researchers want to know if the lab values for infection are the same in a knee with an implant compared to a knee without an implant. Fluid from the knee can be removed and checked for infection. The number of white blood cells (WBCs) and neutrophils are counted. Neutrophils are the WBCs that destroy bacteria in the body. The American College of Rheumatology sets the levels for bacterial infection. They say more than 50,000 WBCs and more than 75 percent neutrophils suggest infection. Normal joint fluid has less than 200 WBCs and fewer than 25 percent neutrophils. Should these same values be used if a knee with an implant is infected? That's what these doctors tried to find out. They looked at the records of 440 patients with TKRs. Eighty-six had WBCs measured before their TKR was revised. There were 50 knees free of infect...
Sometimes we need to rely on our doctors. But checking our blood pressure isn’t one of those times.
If you are lucky, every time you see your primary care physician or endocrinologist, somebody in the office will check your blood pressure. If you are especially lucky, somebody will tell you what the numbers are and they will be pretty accurate. You will need that good luck. For several reasons you aren’t likely to get it. Many people have “ white-coat hypertension .” They become nervous at the doctor’s office and have higher readings that they normally would at home. The other problem is that medical people are a bit busy these days, and they often rush when they need to pause. I ran into that at my most recent visit to a doctor’s office. The nurse checked my blood pressure as soon as she came in the room. I’m sure that she knew as well as I did that patients are supposed to sit still for five minutes before the test. But she was too rushed, and my numbers were predictably too high.
It's well known high blood pressure increases your risk for stroke . A stroke occurs when blood flow to an area of the brain is blocked and brain cells become deprived of oxygen and die. Individuals with high blood pressure are 4-6 times more likely to have a stroke. An individual's risk of having a stroke is directly related to how elevated their blood pressure is.
A link between high blood pressure and dementia
Now there is evidence linking high blood pressure with dementia and the risk is also directly related to how high your blood pressure is.
A subset of participants enrolled in the Women's Health Initiative, comprised of 1403 women over the age of 65, were followed for eight years. MRI scans revealed increased white matter lesions in women with high blood pressure . White matter lesions indicate a weak insulation around nerve cells necessary for brain communication.
A second study led by Johns Hopkins University followed 983 middle age or older men and women for ove...
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