Orientação ao paciente antes da realização de exames laboratoriais / Patient orientation prior to laboratory examination

Os laudos laboratoriais são fundamentais na tomada de decisões médicas. Os avanços tecnológicos e estatísticos proporcionaram à medicina diagnóstica melhorias significativas em todas as suas fases laboratoriais. A fase pré-analítica corresponde a aproximadamente 70% dos erros de todas as fases analíticas, associados às inúmeras variáveis existentes. A literatura mostra que os erros são atribuídos aos laboratórios, embora o paciente não seja fator nulo. O trabalho teve como objetivo relatar as variáveis decorrentes da má preparação do paciente, as quais podem impactar nos resultados dos exames laboratoriais e conduzir a intervenções médicas desnecessárias. A pesquisa bibliográfica foi realizada em livros de medicina laboratorial e plataformas online (Lilacs, SciELO, PubMed e Google Acadêmico) utilizando as palavras-chave: "exames laboratoriais", "intervalos de referência no laboratório clínico", "interferentes em exames laboratoriais", "erros pré-analíticos", nas línguas portuguesa e inglesa. É evidente que diferentes setores laboratoriais podem emitir laudos não condizentes com a real situação clínica do paciente, decorrentes de uma má preparação do mesmo. As orientações repassadas devem ser claras e objetivas, garantindo o seu seguimento correto e assegurando a qualidade do serviço prestado. Diante do exposto, haveria minimização dos erros pré-analíticos externos ao laboratório e os laudos estariam de acordo com a situação clínica-patológica do indivíduo.

Laboratory reports are critical in medical decision making. Technologicaland statistical advances have provided diagnostic medicine with significant improvements in all laboratory stages. The pre-analytical phase corresponds to approximately 70% of the laboratory errors, associated to the innumerable variables. The literature shows that errors are attributed to laboratories, although the patient is not a null factor. The aim of the study was to report the variables resulting from poor patient preparation that may impact the results of laboratory tests and lead to unnecessary medical interventions. The bibliographical research was conducted in laboratory medicine books and online platforms (LILACS, SciELO, PubMed and Google Scholar) using the keywords: "laboratory tests", "reference intervals in the clinical laboratory", "interferents in laboratory tests", "pre-analytical errors" in Portuguese and English. It is evident that different laboratory sectors can issue reports that do not correspond to the actual clinical situation of the patient due to poor preparation of the same. The guidelines passed should be clear and objective, ensuring their correct follow-up and ensuring the quality of the service provided. Therefore, there would be a minimization of the preanalytical errors external to the laboratory and the reports would be in agreement with the clinical-pathological situation of the patient.

Antidiarrheal effects of water-soluble proteins from Plumeria pudica latex in mice.

The water-soluble protein fraction obtained from Plumeria pudica (LPPp) latex has previously been demonstrated to have anti-inflammatory and antinociceptive effects. In the present study, LPPp was tested for activity against diarrhea induced by castor oil, prostaglandin E2 (PGE2) or cholera toxin. Different doses of LPPp (10, 20 or 40mg/kg) significantly inhibited the percentage of diarrheal stools (31.18%, 42.97% and 59.70%, respectively) induced by castor oil. This event was followed by significant reduction of both intestinal fluid accumulation (31.42%; LPPp 40mg/kg) and intestinal transit (68.4%; LPPp 40mg/kg). The pretreatment of animals with LPPp (40mg/kg) prevented glutathione and malondialdehyde alterations induced by castor oil. The effects of LPPp against diarrhea induced by castor oil were lost when the fraction was submitted to protein denaturing treatment with heat. LPPp (40mg/kg) also inhibited the average volume of intestinal fluid induced by PGE2 (inhibition of 46.0%). Furthermore, LPPp (40mg/kg) prevented intestinal fluid secretion accumulation (37.7%) and chloride ion concentration (50.2%) induced by cholera toxin. In parallel, colorimetric assays demonstrated that proteinases, chitinases and proteinase inhibitors were found in LPPp. Our data suggest that the antidiarrheal effect of LPPp is due to its protein content and is probably associated with its anti-inflammatory properties.

The anti-inflammatory and antinociceptive activity of albumins from Crotalaria retusa seeds.

Seeds of Crotalaria retusa L. are used in popular medicine because of their pharmacological properties. The albumin fraction obtained from its seeds contains lectin, a protein known to have analgesic and anti-inflammatory properties. Thus, albumins extracted from C. retusa were investigated for their anti-inflammatory and antinociceptive effects. The intraperitoneal administration of different doses of albumins (5, 10 or 20mg/kg) significantly inhibited the mice paw edema induced by carrageenan (maximum inhibition rate of 80.9% at four hours, 20mg/kg), and this event was followed by diminishing paw myeloperoxidase measurements. Albumins (20mg/kg) also inhibited neutrophil migration into the peritoneal cavity induced by carrageenan. However, no effect was observed in the dextran-induced paw edema and abdominal contortions induced by acetic acid. Moreover, albumins (20mg/kg) significantly reduced the second (inflammatory) phase of the licking time induced by formalin. The detection of heammaglutinating activity against human erythrocytes in albumins evidences the presence of lectin in seeds of C. retusa. Our data showed that seeds of C. retusa had anti-inflammatory and antinociceptive properties and such activities are probably due to the inhibitory effect on neutrophil migration of lectin present in albumins.