At the first suggestion of aplastic anemia, a physician will
stop all medications and search, too, for possible exposure to toxic materials.
Diagnosis is made on the basis of changes in blood cells and the appearance of
bone marrow in a sample obtained by puncture of the sternum, or breastbone. In
some patients with aplastic anemia, a thymoma, or tumor of the thymus gland, is
found; removal of the tumor is sometimes done but without guarantee that this
will be helpful. Sometimes the spleen is enlarged and removal of the spleen may
be considered.
Transfusions may be used. And recently there have been
reports of promising results with the use of com- pounds related to the male
sex hormone, testosterone. These compounds appear to have a stimulating effect
on the bone marrow. What of replacement of diseased bone marrow by
transplantation as a tertiary preventive measure? This appears to be a likely
future measure as more experience is gained in the whole field of tissue and
organ transplantation. Miscellaneous Anemias There is a group of anemias that
are secondary to various diseases
.
For them, prevention, either primary or secondary, depends
upon diagnosis and successful treatment of the under- lying disease. Preventive measures aim at removing the
appendix before it has a chance to rupture. Primary preven- tion may be
considered to be the removal of a normal appendix before it has a chance even
to become in- flamed. Secondary prevention involves removal of an inflamed
appendix before it can rupture.
Tertiary prevention is treatment of the
complications of a ruptured appendix. Primary prevention is sometimes exercised
by a surgeon when he removes the appendix in the course of doing other surgery
in the abdomen such as removing the gallbladder or performing a hysterectomy.
This adds little time to the operation and virtually none to the postoperative
recovery period. The patient should make careful note of whether the surgeon
states that he removed the appendix incidental to another operation, for this
may be meaningful at a future time when abdominal pain is a diagnostic problem.
