The meaning of the symbols of risk, factor seen in a dream.

One of two proteins secreted from the lining of the stomach whose sole purpose is (it seems) to cradle B12 in a pre-fitted styrofoam mold and (A) carry it through the Seven Levels of Digestive Hell until it reaches those few absorption sites in the last foot of small intestine that understand its “Special Needs” (sounds either sexually kinky or the airplane dinner label on kosher food for flying Hassidim jewelers) and finally (B) slip it from one protein to the other, and thence into the cell membranes where its is turn handed over to (C) the specialized blood protein that can carry it safely to the final target tissues (3 times out of 4, the bone marrow). Cyanocobalamin (B12) has parts that fall off, radicals that twirl around in five directions on three charge potentials, and is as durable as a 49¢ water pistol. And, if we have an ulcer, chronic enteritis or long-standing steatorrhea, we either get B12 shots (and hope the liver still makes that blood carrier) or walk around with pernicious anemia and a hematocrit of 16.... intrinsic factor

An aspect of personal behaviour or lifestyle, an environmental exposure, or an inborn or inherited characteristic, which, on the basis of scientific evidence, is known to be associated with health-related condition(s) considered important to prevent.... risk factor

A coagulative blood protein that is a constituent of the COAGULATION cascade – an essential component in the clotting of blood. Those people with the inherited disorder, HAEMOPHILIA, have abnormally low amounts of factor VIII and so bleed more when cut. They are treated with a concentrated version to reduce the tendency to bleed.... factor viii

The function of identifying and assessing problems that could occur and bring about losses legally, clinically or financially.... risk management

See RISK REGISTER.... at-risk register

See BLOOD GROUPS.... rh factor

See BLOOD GROUPS.... rhesus factor

The probability that an event will occur.... risk

The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences.... risk assessment

The term is used in two ways. Firstly, it may comprise a list of infants whose obstetric and/or perinatal history suggests they might be at risk of illness or serious abnormality such as LEARNING DISABILITY.

Secondly – and more commonly termed the ‘At-risk register’ – this is a list held by social-service departments, and accessible to doctors in A&E departments, of children whom a local-authority social-services case conference has deemed to have been harmed or to be at risk of harm from mental, physical or sexual abuse (see also CHILD ABUSE).... risk register

The process of analysing and comparing, on a single scale, the expected positive (benefits) and negative (risks, costs) results of an action, or lack of an action.... risk-benefit analysis

A protein in blood that plays an important role in the clotting mechanism. A deficiency of factor causes a rare genetic bleeding disorder known as Christmas disease.... factor ix

Any of various chemicals involved in stimulating new cell growth and maintenance.

Some growth factors, such as vascular endothelial growth factor, which stimulates the formation of new blood vessels, are important in the growth and spread of cancers.... growth factor

The probability of an event in a population as contrasted with relative risk. See “relative risk”.... absolute risk

A measure of treatment effect that compares the probability (or mean) of a type of outcome in the control group with that of a treatment group.... absolute risk reduction

A risk that has minimal detrimental effects or for which the benefits outweigh the potential hazards.... acceptable risk

In a total population, the proportion of disease incidence, or risk of the disease, that can be attributed to exposure to a specific risk factor; the difference between the risk in the total population and the risk in the unexposed group.... attributable risk

Initially driven by anxiety about the possibility of medical negligence cases, clinical risk management has evolved into the study of IATROGENIC DISEASE. The ?rst priority of risk managers is to ensure that all therapies in medicine are as safe as possible. Allied to this is a recognition that errors may occur even when error-prevention strategies are in place. Lastly, any accidents that occur are analysed, allowing a broader understanding of their cause. Risk management is generally centred on single adverse events. The threat of litigation is taken as an opportunity to expose unsafe conditions of practice and to put pressure on those with the authority to implement change. These might include senior clinicians, hospital management, the purchasing authorities, and even the Secretary of State for Health. Attention is focused on organisational factors rather than on the individuals involved in a speci?c case.... clinical risk management

The process of gathering, analysing and comparing an individual’s prognostic health characteristics with a standard age group, thereby predicting the likelihood that a person may develop a health problem.... health risk appraisal

A chemical, psychological, physiological, social, environmental or genetic factor or conditions that predisposes an individual to the development of a disease or injury.... health risk factor

The study of the interrelationships between humans, the tools they use, and the environment in which they live and work.... human-factor research

An agent involved in the clotting mechanism of the blood. It helps in the activation of THROMBOPLASTIN in the blood PLASMA (see COAGULATION).... lipoid factor

Various compounds and processes that enable the liver to metabolize fats properly or prevent the formation of cholesterolic stones in the gall bladder by supporting the continued emulsification of gall bladder bile. EXAMPLES: Lecithin, choline, Aristolochia... lipotropic factors

More than one risk factor for the development of a disease or other outcome is present and their combined presence results in an increased risk. The increased risk may be due to the additive effects of the risks associated with the separate risk factors, or to synergism.... multiple risk / causation

The ratio of the risk of disease or death among the exposed to the risk among the unexposed; this usage is synonymous with risk ratio.... relative risk

An approach consisting of identifying and devoting more care to individuals or groups who, for biological, environmental or socioeconomic reasons, are at special risk of having their health impaired, contracting a specific disease, or having inadequate attention paid to their health problems.... risk approach

The practice of bringing several risks together for insurance purposes in order to balance the consequences of the realization of each individual risk.... risk pooling

Risk rating means that high-risk individuals will pay more than the average premium price.... risk rating

The practice of singling out or disaggregating a particular risk from a pool of insured risks.... risk selection

The distribution of financial risk among parties furnishing a service. For example, if a hospital and a group of medical practitioners form a corporation to provide health care at a fixed price, a risk-sharing arrangement would entail both the hospital and the group being held liable if expenses were to exceed revenues.... risk sharing

One of the blood proteins that maintains the balance between the blood clotting too easily or too slowly after an injury.

About 5 per cent of the population have an inherited mutation in the gene controlling factor V production, known as factor V Leiden.

They are at increased risk of deep-vein thrombosis (see thrombophilia), particularly if they are taking the oral contraceptive pill or go on long aircraft journeys.... factor v

Factors that lead to increased susceptibility to a disease.... predisposing factors

A group of hormones, produced by the hypothalamus in the brain, that stimulates the release of other hormones.

Luteinizing hormone-releasing hormone is one such releasing factor.... releasing factors

a group of *growth factors that promote new bone formation. Bone morphogenic protein (BMP), a naturally occurring substance that induces *osteoblast formation, has been genetically synthesized to form bone morphogenetic protein, which stimulates new bone formation and assists with fracture healing. Other bone growth factors include a type of transforming growth factor (TGF?) and insulin-like growth factor II (IGF-II), which encourage collagen formation.... bone growth factors

see coagulation factors.... clotting factors

(clotting factors) a group of substances present in blood plasma that, under certain circumstances, undergo a series of chemical reactions leading to the conversion of blood from a liquid to a solid state (see blood coagulation). Although they have specific names, most coagulation factors are referred to by an agreed set of Roman numerals (e.g. *Factor VIII, *Factor IX). Lack of any of these factors in the blood results in the inability of the blood to clot. See also haemophilia.... coagulation factors

(CSF) one of a group of substances (haemopoietic growth factors or hormones) that are produced in the bone marrow and stimulate the production of specific blood cells. Genetically engineered granulocyte colony-stimulating factor (G-CSF) stimulates neutrophil production and also limits bone marrow toxicity from chemotherapy.... colony-stimulating factor

(EGFR) a protein on the surface of cells (see receptor) that binds with epidermal *growth factor and is therefore involved in cell division. EGFR is expressed at increased levels in numerous tumours, particularly of the head and neck, and in colorectal cancer, in which it can be a target for antibody therapy with *cetuximab. *Tyrosine kinase inhibitors acting specifically on the EGFR include gefitinib and erlotinib in lung and pancreatic cancer.... epidermal growth factor receptor

n. (in biochemistry) a substance that is essential to a physiological process, often a substance the nature of which is unknown. See also coagulation factors; growth factor.... factor

an inherited mutation in the gene coding for coagulation Factor V, which results in an increased susceptibility to develop venous *thrombosis.... factor v leiden

a *coagulation factor normally present in blood. Deficiency of the factor is inherited, but rarely causes spontaneous bleeding. However, bleeding does occur after surgery or trauma to the blood vessels.... factor xi

an assessment tool that predicts a ten-year risk of developing cardiovascular disease based on gender, age, total and HDL cholesterol, blood pressure, and smoking, thereby enabling preventative treatment. It does not incorporate the presence of diabetes or familial history of cardiovascular disease into the scoring.... framingham risk score

(NGF) a protein (see growth factor), consisting of two polypeptide chains, that is required for the development and longevity of some neurons, including those in the sympathetic nervous system and some central nervous system and sensory neurons. Nerve growth factor is necessary for axon growth and also for initiating new neuronal connections with other cells. The role of NGFs in preventing the degeneration of brain cells is being explored in research into Alzheimer’s disease.... nerve growth factor

(PDGF) see growth factor.... platelet-derived growth factor

(RMI) a scoring system that combines ultrasound findings, menopausal status and age, and serum CA125 levels to give an estimate of the risk of malignancy in a woman with a mass in the Fallopian tubes or ovaries. If the total RMI score is <200 the risk of malignancy is considered to be low. If the total RMI score is >200 the chances of malignancy are raised and management should be planned with a gynaecological oncologist.... risk of malignancy index

(TGF) a protein – a *cytokine – that controls growth, proliferation, and other functions in most cells. It plays a role in asthma and other respiratory diseases and is also involved in diseases elsewhere in the body. There are two classes: TGF-? and TGF-?.... transforming growth factor

(TNF) either of two proteins, TNF-? or TNF-?, that function as *cytokines. Produced by macrophages, monocytes, T lymphocytes, and various other cells, they mediate many responses, including inflammation, and have a marked action against tumour cells. Anti-TNF drugs (see cytokine inhibitor) are used in the treatment of several disorders, especially rheumatoid arthritis and ankylosing spondylitis.... tumour necrosis factor

(VEGF) a *growth factor made by both normal cells and their abnormal or malignant counterparts to stimulate new blood vessel formation (see angiogenesis). It can be targeted by a family of drugs known as *angiogenesis inhibitors, which include *bevacizumab.... vascular endothelial growth factor