A Review of the Use of Platelets

A Review of the Use of Platelets Introduction Blood is circulated by the heart around the body and performs many physiological functions because of the many components in blood. Half of the blood consists of cells, whereas the other half is plasma fluid. Plasma contains the nutritional material, waste, and proteins which play a part in haemostasis as discussed later in the review. Erythrocytes are one of the cells in blood, they contain haemoglobin and their main function is to transport oxygen from the lungs to the body tissues. Blood also contains leukocytes and plays a role in defending the body from pathogens and foreign antigens. Finally the blood contains platelets, which are very small and work together with coagulation factors to play a major role in haemostasis. In order to understand the use of platelets in transfusion their physiological function should be considered. Haemostasis is a normal physiological response that helps avoid excessive bleeding and haemorrhaging. They have other function such as making sure the blood is fluid and in motion thereby maintaining blood vessel integrity (Verhamme, 2009). Haemostasis is a response of three different stages that progress through time. The first response which is known as primary haemostasis and this is where the platelet cells in the blood are activated once they come into contact with the exposed endothelial cells, especially collagen due to the vascular damage. The final haemostasis response causes fibrinolysis to separate and dissolve the blood clot (Verstraeten, 2004). Going back to primary haemostasis the platelets release a substance that causes the vascular muscles in the vessel to constrict, and expose a phospholipid structure that reacts with proteins known as a coagulation factors including fibrinogen and are found in the plasma. The damaged vessel releases a certain lipoprotein (tissue thromboplastin) that activates coagulation in the plasma forming a fibrin clot, which is the pus that is released once the clot is penetrated. Use Of platelets There are several uses of platelets for transfusion purposes that are available for a variety of patients. Children with malignant diseases such as Acute Lymphoblastic Leukaemia (ALL) or Acute Myeloid Leukaemia (AML) are the most common type of patients that can receive transfusions. This technique is used to treat excessive bleeding and also when blood platelet levels fall drastically. If patients with ALL show symptoms of the disease or are bleeding continuously and prone to infections then prophylactic platelet transfusion therapy is used to raise the platelet count. In patients with AML platelet transfusions are carried out during induction chemotherapy and then later on again during stem cell transplantation. Higher threshold platelet count is required in patients suffering from disease-induced thrombocytopenia. Transfusion in stem cell recipients is another use of platelets, particularly before the engraftment phase of transplantation. ABO incompatibility may be an issue with platelet transfusions and therefore the composition must be consistent with both the donor and recipient. Children with congenital platelet disorders may also require transfusion. Inherited disorders such as Bernard-Soulier disease and Glanzmanns thrombasthenia may cause patients to bleed excessively during surgery or on other occasions. Apherisised platelets should be used. Transfusions may also be required in patients who have abnormal platelets as a result of diseases such as Wiskott-Aldrich or Fanconi anaemia. However transfusions should be carried out prudently and reserved mainly for major bleeding episodes. Platelet transfusion can also be used during pregnancy. Situations include excessive bleeding that can occur during the post-natal period, consumptive coagulopathy, placental breakage, and serious toxaemia or HELLP syndrome. Cytomegalovirus (CMV) status should be checked and if negative or unknown then CMV seronegative platelets should be administered. CMV and other infections in the newborn, such as rubella and syphilis may result in repression of platelet production that can lead to enlargement of the spleen and also a decreased platelet lifespan. Platelet transfusion for neonatal congenital infections may therefore be a possibility. Platelet alloimmunisation may cause foetal thrombocytopenia and therefore transfusion therapy into the uterus of the baby during pregnancy can be achievable to increase the platelet count. Intrauterine transfusions (IUT) are also used to avoid brain haemorrhages and other areas where excessive bleeding can occur. However IUTs are known to cause foetal death in approximately 1% of cases. Patients involved in ECMO therapy or having a cardiopulmonary bypass can also have platelet transfusion therapy. Abnormally high levels of bleeding can be replaced to return platelet levels to somewhere near normality. Infants with Foetomaternal Alloimmune Thrombocytopenia with or without Intra-cerebral haemorrhage can have transfusion to normalise or replace platelet loss, making sure also that platelet-specific antigen used is negative. References Verhamme, P and Hoylaerts, M. F. (2009). Hemostasis and inflammation: two of a kind? Thrombosis Journal. 7 (15), p1-3. Verstraeten, L et al. (2004). Journal de pharmacie de Belgique. The physiology of primary hemostasis. 44 (4), P302-307. Pisciotto PT, Benson K, Hume H, Glassman AB, Oberman H, Popovsky M, Hines D, Anderson K. Prophylactic versus therapeutic platelet transfusion practices in hematology and/or oncology patients. Transfusion 1995; 35; 498-502. Kelley DL, Fegan RL, Ng AT, Kennedy MK, Blanda E, Chambers LA, Kennedy MS, Lasky LC. High-yield platelet concentrates attainable by continuous quality improvement reduce platelet transfusion cost and donor exposure. Transfusion 1997: 37; 482-486. Hunt BJ. Indications for therapeutic platelet transfusions. Consensus conference on platelet transfusions. Blood Rev 1998; 12:227-233. HG Klein and DJ Anstee; Mollisons Blood Transfusion in Clinical Medicine Ch14 p611-612; ch15 p675. Sally V. Rudman; Textbook of Blood Banking and Transfusion Medicine; Ch14 p380-383. THE ROYAL CHILDRENS HOSPITAL, MELBOURNE (2008) Platelet transfusion [WWW]. Available from: http://www.rch.org.au/bloodtrans/about.cfm?doc_id=7374 [Accessed 24/02/10].

Argumentative Essay: Guns Save Lives :: Gun Control Essays

The NRA argues that the Second Amendment of the U.S. Constitution guarantees individuals the right to own and carry guns. They are concerned that federal regulations will continue to increase until owning a handgun will be difficult to achieve, infringing on their Constitutional rights. They also argue that if law-abiding citizens have guns, they are safer from criminals, bringing crime rates down. Con 1 Freedom has a price. For free speech the price is political dissent like flag burning, for freedom of religion you have to tolerate beliefs that differ from the masses. the right to assemble means that the nazis and clan can assemble too. The founding fathers felt that to protect these freedoms the population had to be armed. Hundreds of thousands of innocent people have died because of cars, and there's no movement to ban them. is the right to drive cars that much more important than protecting our freedom. CON 2 According to statistics there is 1 police officer for every 23,000 people in this country. Now how can that 1 policeman be there to protect me. The constitution does not guarantee us protection from murder or crime. It does provide us with a means to protect ourselves with the right to bear arms. We must stop trying to take hand guns away from law abiding citizens. Hand guns are here to stay and no legislation can rid the world of them. Think about it, there is a law making it illegal to own and use many drugs. Has that law stopped the drug problem we have in this country. CON 3 Even though there are statistics of gun violence, where are the charts of KNIFE violence or AUTOMOBILE violence? Not to mention deaths by screwdrivers, disease, baseball bats, crossbows, and on. IF a person really planned to kill anyone, that person would have found anything that would do the job. A disturbed person is more dangerous than a loaded gun, a gun is predictable, adisturbed person isn't. Two people hijacked a commercial jet liner with nothing beside a $5 box cutter that is readily available at your local hardware store, there is no restrictions on that. We already have over 20,000 gun laws on the books that are being ignored by criminals. In the Columbine High School tragedy, at least eighteen (18) existing anti-gun laws were broken. Does anyone really think the shooters cared they were breaking those anti-gun laws?

Food & Beverage Operations Management Essay

FOOD PRODUCTION It is a process of preparing food in which raw materials are transformed into ready-to-eat food products for human consumption in the home or in any food processing industries. Food production can be classified into various types which are: traditional, centralized, batch cooking, call order, Assembly cooking, sous-vide, cook-chill, cook-freeze. Traditional Cooking. It is the simple and fast way to cook food. This cooking is done mostly in clay pots as per our tradition. Cooking in clay pots maintains moisture, keeps food warm for hours and the flavor of the food is unique. Centralized. Centralized cooking is done in large kitchen units that have the capacity to cook up to 100,000 meals. This kitchen serves a set of schools, orphanages, etc†¦located around the unit. 3. Batch Cooking. In this, the cooking is done in large batches in advance to save time so that the work is done in speed on weekdays. 4. Call Order. It is produced specifically when someone requests the item so that the item can be made as per the desire of the customer. Most of the fast-food corners have adopted this method of cooking. 5. Assembly Cooking. It is also known as bulk cooking. It means cooking in advance which is then stored in the freezer for up to 2-3 days which can be cooked later and consume by the customers. It is a time-saving technique. 6. Sous-Vide. It is a method of cooking in which food is vacuum-sealed in a plastic pouch and placed in a water bath for longer than normal cooking times. 7. Cook-Chill. In this, the food is cooked and then chilled to 3 degrees C in a central kitchen. It preserves food for up to 4 days before it is reheated for eating. 8. Cook-Freeze. In this, the food is cooked and then frozen to -20 degrees C in a central kitchen. It preserves food for up to 8 weeks before it is reheated for eating. CITATION Loc l 2057 (Locus Assignments)Food and Beverage Service Systems. CITATION Sky l 2057 (Sky City Careers)There are mainly 5 categories of service which includes: 1. Table Service It is a style of food service where the diner sits at the table and the food is served by a waiter/waitress. This is the oldest form of service. This following service comes under this category: English Service French Service Silver Service American Service Russian Service Guerdon Service Snack Bar Service 2. Assisted Service In this category, the guest enters in the dining area and helps himself to the food from a buffet counter. This category of service includes only Buffet Service. 3. Self-Service In this type of service, the guest enters in the dining area, selects his own tray or from the food counter and carries food by himself to his seating place. This category includes Cafeteria Service. 4. Single Point Service In this category, the guest orders pay for his order and get served all at a single point. This following service comes under this category:- Take-Away Service Vending Machine Food Courts Kiosks 5. Specialized Service In this category, the guest is served at the place, which is not meant or designated for food & beverage service like guest rooms. This following service comes under this category:- Tray Service Grill Room Service Trolley Service Home-Delivery Lounge Service Room Service 1.2. DISCUSS FACTORS AFFECTING RECIPES AND MENUS FOR SPECIFIC SYSTEMS Factors affecting recipes and menus for specific systems are: Size of operation Objectives of the operation Quality of the operation Nature of the menu Quality of customers The budget of the customers Customer needs Availability of resources CITATION Loc l 2057 (Locus Assignments)1.3. Compare the cost and staffing implications for different systems. Self-service outlets and vending machines Costs implications -Food served is mostly made of readily available low-cost raw materials. Only minor storage requirements. Staff implications-Very low costs. Few or no kitchen staff at all. Service can be managed by one unskilled person. Cafeteria, pubs, bars and buffet services Costs implications- Low service costs. Food costs depending upon the business aims. Staff implications – Skilled, semi-skilled and unskilled kitchen and service staff. Fewer employees than table service restaurants. Restaurants(English and American table service) Costs implications – Ranging from low to high-quality production, material, and storage costs according to quality level of an outlet. Staff implications- Combining high-skilled and less-skilled assistants will help keep costs down. Restaurants (French and Russian table service), Gourmet restaurants, high-level event catering. Costs implications – High-quality raw materials, often seasonal ingredients. Staff implications – High-skilled kitchen and service staff. CITATION Nel l 2057 (Nelson College London)1.4. Justify the suitability of systems for particular food and beverage outlets. IN-FLIGHT CATERING CITATION runs l 2057 (RUS)TRAY SERVICE is done in airlines because of the following factors:- There is no place for the kitchen in flights. It is easy to serve. It is more hygienic. It takes less effort by the service staff. There are disposable utensils which are easy to clear. TASK 2; 2.1Discuss the use of financial statements in food and beverage operations. 2.2Demonstrate the use of cost and pricing processes. 2.3Analyze the purchasing processes. SUMMATIVE ASSESSMENT RECORD SHEET Programme Pearson BTEC Level 5 HND in Hospitality Management Learner Name Keerti Krishna Ratnala Assessor Name Mr. Osden Dias Unit No. & Title Unit 5: Food & Beverage Operations Management. Target Learning Aims Assignment No. & Title To understand different food & beverage production and service systems with financial controls used in food & beverage operations. Issue Date Interim Submission Date Final Submission Date Target criteria Criteria Achieved Final Assessment Comments Summative comments Resubmission authorization* Resubmission Date: * All resubmissions must be authorized. Only 1 resubmission is possible per assignment. Assessor Signature Date: Learner comments Learner Signature sd1719hndh_keerti@ragc.in Date: INTERNAL VERIFICATION – ASSESSMENT DECISIONS Programme title Pearson BTEC Level 5 HND in Hospitality Management Assessor Mr. Osden Dias Internal Verifier Unit(s) Unit 5: Food & Beverage Operations Management. Assignment title To understand different food & beverage production and service systems with financial controls used in food & beverage operations. Learner’s name Keerti Krishna Ratnala List which assessment and grading criteria the assessor has awarded. Pass Merit Distinction INTERNAL VERIFIER CHECKLIST Comments Do the assessment criteria awarded match those targeted by the assignment brief? Y/N Has the work been assessed accurately? Y/N Is the feedback to the learner: Constructive? Linked to relevant assessment and grading criteria? Identifying opportunities for improved performance? Agreeing actions? Y/N Does the assessment decision need amending? Y/N Assessor signature Date Internal Verifier signature Date Lead Internal Verifier signature (if required) Date Confirm action completed Remedial action is taken Assessor signature Date Internal Verifier signature Date Lead Internal Verifier signature (if required) Date

The Life Of A Slave Girl By Harriett Jacobs - 1037 Words

TaSheena Moore December 7, 2015 Professor Anita M. Diop African American Studies The Incidents in the Life of a Slave Girl Incidents in the Life of a Slave Girl is a story about a young girls experience during slavery in the south. She talks about the many struggles for self-definition and self-respect, and the disturbing details of a risky escape. Harriett Jacobs’s story highlights the special problems faced by female slaves, mainly sexual abuse and the anguish of slave mothers who are separated from their children. Incidents in the Life of a Slave Girl starts off introducing Harriett Jacobs, the author of the book under the name of Linda Brent. She was born into slavery in Edenton, North Carolina in 1813. She begins by telling us†¦show more content†¦Jacobs was very fond of her new mistress who treated her as if she was a second daughter. When Jacobs was 12, Margaret passed away. Margaret made it within her will that Jacobs be placed with her niece who was five years old at the time, so Mr. Flint became her new master. Throughout the years, Dr. Flint tried to pursue Harriet. Being strong willed and rebellious. She learned how to stand up for herself and she became really stubborn. Harriett struggles against Flint’s offers for several years. He pressures and threatens her, and she confronts and outsmarts him. Years later, Jacobs had a love affair with a white neighbor named Mr. Sands. She felt ashamed of the relationship but preferred that instead of being raped by Dr. Flint. She also has reasons for agreeing to the affair in hopes that once Dr. Flint found out about it, he will sell her to Sands in disgust. Instead, in 1835, Dr. Flint sends Jacobs to his plantation to be a field hand. Still a teenager, she ended up having two children, Benny and Ellen both by Mr. Sands. After being at the plantation for quite some time, Jacobs runs away from the plantation. She spent seven long years hiding in a tiny crawl space in the attic of her grandmother’s house. She was unable to sit or stand, and she eventually became physically disabled. Reading this story, I found that Jacobs, Loophole of retreat was her way of staying clear of Dr. Flint. Although, she remained confided to that area, she made due with her new