ABSTRACT
Introdução: A lipoaspiração é o sendo segundo procedimento mais realizado no Brasil. Com os avanços da técnica, melhores equipamentos e aumento da segurança no ambiente cirúrgico, passaram-se a ser lipoaspiradas grandes áreas. Contudo, existe uma preocupação com a segurança do paciente. Comitês de segurança têm feito recomendações sobre a infiltração, anestesia, seleção do paciente, volume aspirado, entre outros. A Sociedade Brasileira de Cirurgia Plástica e o Conselho Federal de Medicina também determinaram parâmetros de volumes de segurança do aspirado e superfície corporal aspirada. Ainda assim, a literatura de apoio para as recomendações é escassa. O objetivo é avaliar as alterações dos níveis de hemoglobina, ferro sérico e proteínas totais no pré e pós-operatório mediato (7-10 dias), assim como seus reflexos nos pacientes. Métodos: Realizamos um estudo prospectivo, com pacientes submetidos à lipoaspiração isolada e associada à dermolipectomia abdominal, por indicações estéticas. Avaliamos 30 pacientes, sendo coletados dados demográficos, peso, Índice de Massa Corporal, níveis de hemoglobina, ferro sérico e proteínas totais, no pré-operatório, e entre 7 a 10 dias de pós-operatório. Resultados: A queda da hemoglobina foi entre 2-6g/dl, com média de 3,1g/dl aos 7-10 dia de PO. Tivemos como valor mínimo de hemoglobina 7,8g/dl no pós-operatório com 7-10 dias, enquanto o ferro sérico apresentou redução média de 44,87g/dl. Conclusão: A redução no nível da hemoblogina foi responsável pela sintomatolgia clinica apresentada. A reposição de ferro se mostrou necessária no pós-operatório imediato.
Introduction: Liposuction is the second commonest procedure performed in Brazil. The scope for liposuction has broadened with advances in the technique, with better equipment, and increased safety in the surgical environment. However, there are concerns about patient safety. Safety committees have made recommendations on various aspects of the procedure including infiltration, anesthesia, patient selection, and aspirated volume. The Brazilian Society of Plastic Surgery and the Federal Council of Medicine have also determined the parameters for aspiration safety volumes, and for the aspiration of body surface. However, supporting literature for the recommendations is scarce. The objective is to evaluate changes in hemoglobin, serum iron, and total protein levels in the peri-operative days (between 7 and 10 days), in addition to its impact in patients. Methods: We performed a prospective study, with patients submitted to either liposuction alone, or in conjunction with abdominal dermolipectomy for esthetic indications. We evaluated 30 patients, collecting their demographic data, weight, body mass index, hemoglobin, serum iron, and total protein levels in both, the pre-operative period, and between 7 and 10 post-operative days. Results: The fall in hemoglobin levels were between 2 and 6 g /dL, with an average of 3.1 g /dL between 7 and 10 post-operative days . A minimum hemoglobin value of 7.8 g/dL was noted between 7 and 10 days after surgery, while the mean reduction of serum iron was found to be 44.87 g/dL. Conclusion: The reduction in hemoglobin levels was responsible for the clinical symptoms. Iron supplementation was required in the immediate post-operative period.
Subject(s)
Humans , Female , Adult , Middle Aged , Surgical Procedures, Operative/methods , Lipectomy/methods , Abdominoplasty/adverse effects , Abdominoplasty/methods , Hypotension, Orthostatic/complications , Anemia, Hypochromic/complications , Postoperative Complications , Patient SafetyABSTRACT
Antecedentes: A pesar de los grandes avances en la medicina contemporánea; la Tuberculosis continúa siendo un reto diagnóstico, en especial al presentarse con características clínicas poco usuales. Caso clínico: Paciente masculino de 48 años, agri-cultor, de escasos recursos económicos, sin comorbilidades previas, el cual presenta sintomatología constitucional, pérdida de peso, iebre y dolor lumbar irradiado a ambos lancos de la región abdominal, de características poco especíicas, de un mes de evolución; acompañado de disuria y oliguria, y niega síntomas respiratorios. Al examen físico luce crónicamente enfermo, en mal estado nutricio-nal, sin deterioro de la conciencia, no se evidencia adenopatías cervicales ni inguinales; sin presencia de signos pulmonares, con leve dolor con la puño percusión renal bilateral, en el área genital, se identiica una masa de borde regular, móvil sobre el polo superior del testículo derecho. En el examen hematológico con presencia de Bicitopenia anemia microcitica hipocromica y trombocitopenia leve, en gases arteriales acidosis metabólica con Anión Gap elevado, además con hiperazoemia e hiperkalemia en la bioquímica sanguínea refractaria al tratamiento, razón por la cual fue sometido a Hemodiálisis aguda. Al evaluar radiografía de tórax se observa patrón micro-nodular difuso, no se realiza baciloscopias por falta de expectoración ni por lavado gástrico, en el ultrasonido renal y de vías urinarias se visualizó nefromegalia y la presencia de masa heterogénea de aspecto granulomatoso en testículo derecho; por lo que se solicitó tomografía toracoabdominal, en donde se observa patrón micronodular múltiple a nivel pulmonar, con afectación renal, ganglionar y testicular, se solicita BAAR de sedimento urinario seriado con resultados positivos, y la tinción Ziehl Neelsen en orina con resultado positivo; con ello se inicia terapia antiimica. Discusión: La Tuberculosis renal no tiene un cuadro clínico clásico; generalmente se presenta con manifestaciones atípicas; como en nuestro caso con sintomatología urinaria, hiperazoemia que culmino en terapia de restitución renal de emergencia, con posterior recuperación de la función renal.
Subject(s)
Humans , Male , Middle Aged , Tuberculosis, Miliary/diagnosis , Tuberculosis, Renal/diagnosis , Anemia, Hypochromic/complicationsABSTRACT
El objetivo del presente estudio fue valorar los factores de riesgo que se asocian a la prevalencia de anemia ferropénica en un grupo de niños (1892) que ingresaron a la sala de hospitalización pediátrica en edades de dos a cinco años en el periodo correspondiente de Enero a Diciembre del 2009, de estos 357 presentaron hemoglobina menor de 11 gr/dl (valor de referencia por debajo del cual debe considerarse anemia según OMS) a partir de los cuales se seleccionaron 110 casos (niños anémicos) y 220 controles (no anémicos) a través del software Epi info 6.04 utilizando los siguientes parámetros: OR: 2, frecuencia de exposición entre los controles 50%, nivel de seguridad 95% y poder estadístico de 80%. El muestreo se realizó de forma aleatoria simple, tanto para los casos como para los controles. La prevalencia de anemia en el universo estudiado es de 18.9%, el 20% de los casos presentaba desnutrición con respecto a los controles los cuales tenían un 8.3%, el nivel de analfabetismo de la madre de los niños en ambos grupos alcanzó un 4.8%, la infección parasitaria en ambos grupos representó el 37.6%, de estos los más afectados son los niños anémicos (51.8%). La anemia microcítica hipocrómica fue la que predominó en el grupo casos, se observó un 5.4% de anemia moderada, con hemoglobina entre el rango de 7 a 9 gr/dl. Se concluyó que son factores de riesgo para anemia los siguientes: Presentar algún tipo de desnutrición, Ser hijo de madre que no haya estudiado o que sólo haya cursado primaria incompleta, que el niño tenga algún tipo de infección parasitaria (excepto por saprófito) y Presentar más de tres episodios en el año de enfermedad diarreica. Se recomendo Indicar tratamiento intrahospitalario y/o ambulatorio con hierro en los casos que lo ameriten y de no poderse indicar, se debe dar seguimiento por la consulta externa...
Subject(s)
Child , Anemia, Hypochromic/complications , Anemia, Macrocytic/complications , Malnutrition/complications , Risk FactorsABSTRACT
Os autores apresentam o caso de um paciente de 35 anos do sexo masculino, branco que apresentava lesöes pigmentadas orais associadas a disfagia, cujo único fator predisponente era anemia ferropriva de longa data, secundária e gastrectomia. O caso reveste-se de interese pela sua particularidade, assim como pelo diagnóstico diferencial com outras patologias, além do tempo necessário para identificar-se a etiologia
Subject(s)
Humans , Male , Adult , Anemia, Hypochromic/complications , Mouth Diseases/etiology , Iron/deficiency , Pigmentation , Anemia, Hypochromic/diagnosis , Diagnosis, Differential , Mouth Diseases/diagnosisSubject(s)
Humans , Male , Infant, Newborn , Hyperinsulinism/complications , Pulmonary Heart Disease/complications , Anemia, Hypochromic/complications , Diazoxide/administration & dosage , Hyperinsulinism/pathology , Hypoglycemia/complications , Cross Infection/complications , Neurologic Manifestations , Pancreatectomy , Pulmonary Heart Disease/pathology , Seizures/diagnosisABSTRACT
Se evaluaron 90 niños saludables entre 6 y 19 meses de edad, con el objeto de conocer la relación de la anemia por deficiencia de hierro con el desarrollo psicomotor. Se clasificaron en deficientes según el número de indicadores de la deficiencia de hierro alterados, y se hallaron valores promedio del índice mental significativamente más bajos en el grupo deficiente. No se encontró correlación significativa del nivel socioeconómico y cultural con el índice mental ni el índice motro. Se hallaron correlaciones significativas del índice mental con la hemoglobina y del índice mental con la protoporfirina eritrocitaria libre. Se concluye que las alteraciones del índice mental halladas en el presente estudio plantean, con una elevada probabilidad, la influencia de la deficiencia de hierro, dada en una de las muestras más numerosas y con anemia con deficiencia de hierro más ligera informada hasta el presente, después de descartar la presencia de otras carencias nutricionales, así como de un grupo de factores demográficos, sociales y del estado de salud
Subject(s)
Humans , Infant , Anemia, Hypochromic/complications , Child Development , Ferritins/analysis , Hemoglobins/analysis , Iron/analysis , Protoporphyrins/analysis , Transferrin/analysis , Child Day Care CentersABSTRACT
Investigation of aluminium uptake by human erythrocytes was the major aim of this study. Packed red blood cells were incubated in Earle's medium [pH 7.4] containing varying concentrations of aluminium [0-160 micro g/l] as A1K[SO[4]][2] and aluminium content of the cells were determined using flameless atomic absorption. There was significant increase in aluminium content of the cells. Addition of 5 mM glucose caused an elevation of red cell aluminium, whereas depletion of red cells from ATP caused a marked reduction in aluminium uptake. Both ouabain and vanadate, when added to the medium, caused a significant reduction in aluminium uptake in line with a decrease in ATP ase activity
Subject(s)
Anemia, Hypochromic/complications , Aluminum/blood , Kidney Failure, ChronicABSTRACT
Thirty patients of rheumatoid arthritis comprising 16 classical and 14 definite cases based on the ARA criteria were evaluated in a prospective and controlled study for iron status with special reference to serum ferritin levels. Serum ferritin levels were estimated by RIA technique and marrow iron status was ascertained by semi-quantitative estimation after Pearl's staining of marrow aspirate (G 0-6). Marrow iron stores were found absent to decreased in 17 patients (56.7%), normal in 2 (6.7%) and increased in 11 patients (36.6%). The serum ferritin levels in the iron depleted rheumatoid arthritis patients were significantly lower in comparison to patients with normal to increased marrow iron stores (23.91 +/- 11.45 ug/L vs 69.94 +/- 24.7 ug/L, p less than 0.001). There was a strong positive correlation between serum ferritin levels and marrow iron stores (r = +0.08, p less than 0.001). A serum ferritin value of less than or equal to 32 ug/L was a good predictor of decreased iron stores in the bone marrow, with a sensitivity of 88.2% and specificity of 84.5%. The test had a predictive value of 83.33%. There was no correlation between marrow iron stores and conventional indicators or iron status i.e. serum iron, TIBC, transferrin saturation and MCHC. It is concluded that serum ferritin correlates well with marrow iron stores and can be used as a simple non-invasive test for predicting iron-deficiency in patients of rheumatoid arthritis.
Subject(s)
Adult , Anemia, Hypochromic/complications , Arthritis, Rheumatoid/blood , Female , Ferritins/blood , Humans , Iron/metabolism , Male , Sensitivity and SpecificityABSTRACT
A prospective study of 41 patients (24 male and 17 female) aged over 40 years with iron deficiency anemia and hookworm infection was performed by endoscopy and barium enema to determine the incidence of GI lesions. Alcohol ingestion, smoking, abdominal pain, anorexia, loss in weight, bowel habit change, analgesic consumption and stool occult blood test were analyzed for their positive predictive value of GI lesions. The mean age of the patients was 62.8 years (SD = 10.1). The mean hemoglobin was 5.99 gm.% (SD = 1.9). Twenty patients (48.8%) had GI lesions. The lesions included 10 erosive gastritis, 1 erosive duodenitis, 5 gastric ulcers, 2 duodenal ulcers, 1 carcinoma of stomach and 1 carcinoma of colon. Gastric ulcer, duodenal ulcer and carcinoma were regarded as significant lesions. Abdominal pain was found in 16 of the 20 patients with GI lesions and 8 of the 21 without GI lesion (Chi square with Yate's correction, x2 = 5.78 p = 0.02). Four of the 17 patients without pain had GI lesions but only one of these 4 (5.8%) had gastric ulcer. Abdominal pain had an 80% sensitivity and 62% specificity for the positive prediction of GI lesions based on the above findings. GI investigation is recommended for all patients with abdominal pain. In those without pain, treatment of hookworm and iron therapy with follow-up may be justified.
Subject(s)
Adult , Aged , Aged, 80 and over , Anemia, Hypochromic/complications , Barium Sulfate/diagnosis , Comorbidity , Endoscopy , Enema , Female , Gastrointestinal Diseases/complications , Hookworm Infections/complications , Humans , Incidence , Male , Middle Aged , Prospective Studies , Risk Factors , Sensitivity and SpecificityABSTRACT
Of 50 preschool children having breath holding spells (M:F::3:1) (BHS), 80.0% were less than 18 months of age (mean age 16 +/- 5 mo). More children came from a lower social class (70.0%) and a nuclear family (64.0%). Seventy four per cent cases had onset of BHS within 12 months of age (mean 9.6 mo) and the commonest frequency was 1 to 3 spells per week (56.0%). Cyanosis and tonic-clonic spasms were seen in 96.0 and 84.0% cases, respectively. Anger and frustration were the common triggering factors in 90.0% cases. No ante-, peri- and postnatal factors were significantly associated with the study group as compared to the control cases. The mean scores on Behaviour Screening Questionnaire measuring child's habits related to feeding, toilet and sleep were not significantly different in the study and control groups but the difference was significant (p less than 0.05) for behaviour measuring child's social habits. Parental attitudes, measured on Attitude Screening Questionnaires, were also not significantly different in the study and control groups. Mean hemoglobin and percentage transferrin saturation were significantly lower in the study group as compared to the controls (p less than 0.001). There was a significant decrease in severity and frequency of spells with oral iron therapy.
Subject(s)
Anemia, Hypochromic/complications , Apnea/blood , Attitude , Child Behavior Disorders/blood , Child, Preschool , Female , Hemoglobins/analysis , Humans , Infant , Iron/blood , Male , Parents/psychology , Socioeconomic FactorsABSTRACT
A relacao entre a incidencia de infeccoes e o estado nutricional de ferro e bastante controvertida, sendo relatados tanto maioir susceptibilidade como maior resistencia a infeccoes na anemia ferropriva. O ferro e essencial para o cresciemnto de mocroorganismos e a sua carencia ao lado de limitar a proliferacao dos mesmos determina alteracoes imunologicas no hospedeiro. Estas anormalidades caracterizam uma imunodeficiencia multifatorial, porem parcial. Assim, a susceptibilidade a infeccoes nos pacientes com anemia ferropriva seria determinada pelo balanco entre as alteracoes imunologicas e a limitacao do crescimento dos microorganismos condicionada pela carencia de ferro. Variacoes do equilibrio deste binomio poderiam explicar os resultadosdiscrepantes assinaladosna literatura
Subject(s)
Anemia, Hypochromic/complications , Congenital Abnormalities , Immune System Diseases/etiology , Infections , Antibody Formation , Candida albicans , Deferoxamine/therapeutic use , Immunity, Cellular , Interleukin-1 , Yersinia enterocoliticaSubject(s)
Adolescent , Anemia, Hypochromic/complications , Animals , Cattle , Child , Diagnosis, Differential , Female , Humans , Infant , Iron/metabolism , Nutritional Requirements , PregnancySubject(s)
Adolescent , Adult , Anemia, Hypochromic/complications , Female , Humans , Iron/blood , Male , Middle Aged , Rhinitis, Atrophic/etiology , Rhinoscleroma/etiologyABSTRACT
Caso de una mujer de 50 años de edad con membrana esofágica superior y anemia ferropénica (sindrome de Plummer-Vinson) y su respuesta al tratamiento con la ruptura de dicha membrana y ferroterapia. Revisamos la bibliografia y actualizamos el método para su estudio
Subject(s)
Middle Aged , Humans , Female , Anemia, Hypochromic/complications , Deglutition Disorders/etiology , Esophageal Stenosis/diagnosis , Vitamin B DeficiencyABSTRACT
Se trató de establecer la relación entre la presencia de fracturas cromosómicas y la anemia por deficiencia de hierro en niños. De 16 niños que cumplieron los requisitos pra la investigación, 7 corresponden al grupo en estudio y 9 a casos control. Los niños se evaluaron antes y después de 3 meses del tratamiento con sulfato ferroso. Se analizó un promedio de 79 mitosis por niño, obtenidos por cultivo de linfocitos de sangre periférica, encontrándose un mayor porcentaje, estadísticamente significativo (p=0.0037) de fracturas cromosómicas en los niños anémicos con respecto a los controles. Posterior al tratamiento, la reducción del número de fracturas fue también estadísticamente significativa (p=0.0335), pero sin alcanzar las cifras de los controles, a pesar de la normalización de los valores hematológicos