ABSTRACT
Introduction: The platelet function disorders remain largely undiagnosed or incompletely diagnosed in developing nations due to lack of availability of tests like lumiaggregometry, granule release assay or molecular testing. We performed a retrospective analysis of all the platelet function test (PFT) carried out in past 5 years by Light transmission aggregometery (LTA) using a panel of agonist. The indications and the test results were analyzed by two hematopathologist with the aim to look into the present diagnostic facilities or lack of it for correct diagnosis. This is essential for better management and genetic counselling. Materials and Methods: The PFT was performed both on patients and healthy unrelated age specific controls by light transmission aggregometry on Chronolog platelet aggregometer using platelet rich plasma. The panel of agonists included ADP (10?m/l and 2.0 ?m/l), epinephrine (10.0 ?m/l), collagen (2?g/ml), arachidonic acid (0.75 mM) and ristocetin (1.25 mg/ml & 0.25 mg/l). Results: The 5 years records of 110 cases were audited, 101 of these were tested for clinical bleeding , 35 adults and 66 children. The adults included 29 women and 6 men, 17 to 82 years of age. The children were 16 years to 3 months of age, 30 girls and 36 boys. Platelet function test abnormality was found in 31.6% (32/101) cases ,a majority remained undiagnosed of these about 21% had clinically significant bleeding.The cases diagnosed included Glanzmann Thromboasthenia-11 , von Willebrand Disease-6, Bernard Soulier'syndrome-1, storage pool disorder-6, mild defect of Epinephrine-3, isolated defect with collagen in1. Conclusion: An epidemiologically large proportion of platelet function disorders amongst people living in developing nations remain undiagnosed. This lacunae needs to be highlighted and addressed on larger scale. The options available are to increase the available armamentarium of tests or international collaboration with a specialized laboratory to aid in complete diagnosis.
ABSTRACT
Objetivo: Realizar la validación de la encuesta para diagnóstico indirecto de abuso/dependencia al alcohol en la sierra peruana. Material y método: Se usó la base de datos del Estudio Epidemiológico de Salud Mental 2003 realizado en la sierra peruana que contenía módulos que evaluaban la situación de salud mental. Se utilizó el módulo de diagnóstico directo de abuso/dependencia al alcohol, aplicado al adulto y la encuesta diagnóstico indirecto de abuso/dependencia al alcohol, aplicado a la mujer unida. La muestra fue de 1 302 parejas mujer unida û adulto. Para hallar la confiabilidad se utilizó el coeficiente alfa de Cronbach. Se realizó la validez de criterio comparándola con el cuestionario directo y la de constructo utilizando el análisis factorial. Resultados: Se obtuvo una coherencia interna de 93,1 por ciento. La probabilidad estimada de que el criterio externo y el cuestionario coincidan en el diagnóstico es 77 por ciento. Siendo el punto de mejor sensibilidad (70,4 por ciento) y especificidad (74,9 por ciento) en 2 ítems. El análisis factorial indica que la mayoría de ítems satura a un factor predominante. Conclusiones: El cuestionario indirecto para diagnóstico de abuso/ dependencia de alcohol es parcialmente válido para poblaciones con características similares a las de la sierra peruana.
Objective: Validation of a survey for making an indirect diagnosis of abuse/dependence of alcohol survey in the Peruvian Andes. Material and method: We used the database of The Mental Health Epidemiological Study conducted in the Peruvian Andes in 2003, which includes surveys assessing mental health. We used the direct diagnosis of alcohol abuse/dependence module in adult males, and indirect diagnosis of alcohol abuse/dependence survey in their spouses. The sample size was 1,302 adult couples. CronbachÆs Alpha coefficient was used in order to verify reliability of the tests. Validity of criteria was obtained by comparing them with the direct questionnaire and the validity of the construct was determined by using a factorial analysis. Results: The internal consistency of the questionnaire was 93.1 percent. The estimated probability of matching between the indirect survey and the external criteria is 77 percent. Best sensitivity (70.4 percent) and specificity (74.9 percent) values were located in 2 positive items. The factorial analysis indicated that most of the items saturate one predominant factor. Conclusions: The questionnaire for indirect diagnosis of alcohol abuse/ dependence is partially valid in populations with similar characteristics to those from the Peruvian Andes.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Alcoholism , Alcoholism/diagnosis , Data CollectionABSTRACT
Manifestation of infectious pathologies in fishes usually increases in environments where organic wastes are disposed. Specimens of Mugil platanus Günther, 1880 and water samples collected at three points of the Tramandaí river were analyzed during a one year period. The macroscopic observation revealed ulcerations in the caudal peduncle area covered with a mass of amorphous and whitened tissues. Histopathologic analysis showed the presence of negative gram bacteria, probably responsible for alterations of the normal structure of the epidermic tissues. Non-parametric statistical analysis for ammonia concentration showed a significant variation among the three collected spots as well as in the multiple comparison between two spots. In this study, we describe cutaneous lesions observed in Mugil platanus specimens and tested their correlation with environmental ammonia concentration.
A manifestação de patologias infecciosas em populações de peixes costuma ser incrementada em ambientes onde são lançados despejos orgânicos. Exemplares da espécie Mugil platanus Günther, 1880 coletados em três pontos do rio Tramandaí foram utilizados para análise das alterações, e amostras de água foram tomadas durante o período de um ano para verificação da presença de bactérias. A observação macroscópica revelou ulcerações na região do pedúnculo caudal revestidas por uma massa de tecido amorfo e esbranquiçado. A análise histopatológica mostrou a presença de bactérias gram negativas, que provavelmente foram as responsáveis pela alteração da estrutura normal dos tecidos de revestimento do corpo. O resultado da análise estatística não paramétrica para a concentração de amônia mostrou variação significativa entre os três pontos amostrados bem como nas comparações múltiplas entre os pontos dois a dois. Este trabalho descreve as lesões cutâneas observadas em Mugil platanus e testa sua correlação com a concentração de amônia.