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1.
Rev. Soc. Argent. Diabetes ; 56(2): 41-42, mayo - ago. 2022.
Article in Spanish | LILACS, BINACIS | ID: biblio-1395820

ABSTRACT

La glucemia es una palabra de fácil definición, glucosa en sangre, pero deja de ser simple cuando quiere entenderse el significado de determinado resultado. El desafío es interpretar correctamente el valor hallado.


Subject(s)
Blood Glucose , Blood , Glucose
2.
Arch. endocrinol. metab. (Online) ; 66(1): 68-76, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364297

ABSTRACT

ABSTRACT The lowest dosage of empagliflozin (10 mg) showed similar benefits on glycated hemoglobin (HbA1c) level, body weight, blood pressure, and total and cardiovascular mortality in comparison with the highest available dose (25 mg) in the EMPAREG trial. These findings have not been clearly demonstrated for canagliflozin and dapagliflozin. The objective was to compare the effect of different doses of SGLT2 inhibitors commercially available in Brazil on HbA1c and body weight of patients with type 2 diabetes. MEDLINE, Cochrane and Embase databases were searched from inception until 11th October 2021 for randomized controlled trials of SGLT2 inhibitors in type 2 diabetes patients, lasting at least 12 weeks. HbA1c and body weight variations were described using standard mean difference. We performed direct and indirect meta-analysis, as well as a meta-regression with medication doses as covariates. Eighteen studies were included, comprising 16,095 patients. In the direct meta-analysis, SGLT2 inhibitors reduced HbA1c by 0.62% (95% CI −0.66 to −0.59) and body weight by 0.60 kg (95% CI −0.64 to −0.55). In the indirect meta-analysis, canagliflozin 300 mg ranked the highest regarding reductions in HbA1c and body weight. The remaining medications and dosages were clinically similar, despite some statistically significant differences among them. Canagliflozin 300 mg seems to be more potent in reducing HbA1c and body weight in patients with type 2 diabetes. The remaining SGLT2 inhibitors at different doses lead to similar effects for both outcomes. Whether these glycemic and weight effects are reflected in lower mortality and cardiovascular events is still uncertain and may be a topic for further studies.


Subject(s)
Humans , Diabetes Mellitus, Type 2/drug therapy , Sodium-Glucose Transporter 2 Inhibitors/therapeutic use , Hypoglycemic Agents/therapeutic use , Blood , Body Weight , Brazil , Glycated Hemoglobin A/analysis , Randomized Controlled Trials as Topic , Canagliflozin/therapeutic use
3.
Rev. bras. ciênc. vet ; 29(1): 36-40, jan./mar. 2022. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1393208

ABSTRACT

Hemoparasitoses vêm se tornando cada vez mais importantes na clínica médica de pequenos animais. Dentre os agentes causadores encontramos Ehrlichiacanis, Anaplasmaplatys., e Mycoplasma spp., torna-se de grande importância conhecer a epidemiologia nos gatos domésticos. Objetivou-se com esta pesquisa fazer um levantamento retrospectivo de fichas de gatos advindos de consultas no Hospital Veterinário Mário Dias Teixeira (HOVET) que realizaram exame de Reação de Cadeia da polimerase (PCR) no laboratório de biologia molecular, na Universidade Federal Rural da Amazônia, no ano de 2018 e 2019. No total foram 72 amostras de gatos domésticos processadas, sendo 33 machos e 39 fêmeas, 70 animais SRD e 2 Siameses, todos com trombocitopenia, além de outros sinais clínicos que os levaram a precisar de atendimento veterinário, foram categorizados os meses de entrada e processamento das amostras, bairros dos animais e grupos etários. De todos os animais testados, 34,7% obtiveram diagnóstico positivo para uma das enfermidades, sendo o gênero Mycoplasma spp. o que mais prevaleceu em amostras positivas, com maior frequência em fêmeas adultas, bem como foi descrita ocorrência de E. canis apenas nesse sexo, já A. platysfoi descrito com maior frequência em machos, além de achados de infecções concomitantes observado entre os agentes Anaplasmae Mycoplasma. Concluímos que os gatos atendidos no HOVET possuíam parasitismo por diferentes agentes infecciosos.


Hemoparasitosis have become increasingly important in the small animals' internal medicine. Among the causal agents, there are Ehrlichiacanis, Anaplasmaplatys. and Mycoplasma spp., which give the understanding of the epidemiology in domestic cats a great significance. This research aimed to make a retrospective survey of records from cats that came from appointments at the Veterinary Hospital Mário Dias Teixeira (HOVET) and underwent the Polymerase Chain Reaction (PCR) test at the molecular biology laboratory, at the Amazônia Federal Rural University (UFRA), in the years of 2018 and 2019. In total, 72 samples of domestic cats were processed, from which 33 were males and 39 females, 70 of them were mongrel cats and 2 siamese, all of them showed thrombocytopenia amongst other clinical signs that led them to need a veterinary appointment, the months of admission, processing of the samples, districts the animals came from and age group were categorized. 34,7% of all the animals tested showed positive results for one of the diseases, with the genus Mycoplasma spp. being the most prevalent in positive samples, showing a higher rate in adult females, as the occurrence of E. canis was reported only in females, while A. platys was reported with a higher rate in males, as well as concomitant infections following the observation of the agents Anaplasma and Mycoplasma. In conclusion, the cats admitted at HOVET showed parasitism by different infectious agents.


Subject(s)
Animals , Cats , Parasitic Diseases/blood , Blood/parasitology , Epidemiologic Studies , Cats/parasitology , Polymerase Chain Reaction/veterinary , Ehrlichia canis , Parasite Load/veterinary , Anaplasma , Mycoplasma Infections/veterinary
4.
Rev. colomb. cir ; 37(2): 184-193, 20220316. tab, fig
Article in Spanish | LILACS | ID: biblio-1362887

ABSTRACT

Introducción. La resucitación hemostática es una estrategia para compensar la pérdida sanguínea y disminuir el impacto de la coagulación inducida por trauma. Debido a que la disponibilidad de transfundir una razón equilibrada de hemocomponentes es difícil de lograr en el entorno clínico, la sangre total ha reaparecido como una estrategia fisiológica, con ventajas logísticas, que le permiten ser accesible para iniciar tempranamente la resucitación hemostática. El objetivo de este estudio fue evaluar las propiedades celulares, coagulantes y viscoelásticas de la sangre total almacenada por 21 días. Métodos. Las unidades de sangre total fueron obtenidas de 20 donantes voluntarios sanos. Se procesaron mediante un sistema de leucorreducción ahorrador de plaquetas y fueron almacenadas en refrigeración (1-6°C) sin agitación. Se analizaron los días 0, 6, 11 y 21. Las bolsas fueron analizadas para evaluar las líneas celulares, niveles de factores de coagulación y propiedades viscoelásticas mediante tromboelastografía. Resultados. El conteo eritrocitario y la hemoglobina se mantuvieron estables. El conteo de plaquetas tuvo una reducción del 50 % al sexto día, pero se mantuvo estable el resto del seguimiento. Los factores de coagulación II-V-VII-X, fibrinógeno y proteína C se mantuvieron dentro del rango normal. La tromboelastografía mostró una prolongación en el tiempo del inicio de la formación del coágulo, pero sin alterar la formación final de un coágulo estable. Conclusiones. La sangre total leucorreducida y con filtro ahorrador de plaquetas conserva sus propiedades hemostáticas por 21 días. Este es el primer paso en Colombia para la evaluación clínica de esta opción, que permita hacer una realidad universal la resucitación hemostática del paciente con trauma severo.


Background. Hemostatic resuscitation is a strategy to compensate blood loss and reduce the impact of trauma-induced coagulopathy. However, balanced resuscitation presents challenges in its application in the clinical setting. Whole blood has re-emerged as a physiologic strategy with logistical advantages that offer the opportunity for early initiation of hemostatic resuscitation. The study aims to evaluate the cellular, coagulation, and viscoelastic properties of whole blood preserved for 21 days. Methods. Whole blood units were donated by 20 healthy volunteers. These units were processed using a platelet-sparing leukoreduction filtration system. Units were stored under refrigeration (1-6°C) without agitation and were sampled on days 0, 6, 11, 16, and 21. The units were tested to assess its cellular properties and coagulation factors levels. In addition, viscoelastic features were tested using tromboelastography.Results. Red blood cells count and hemoglobin levels remained stables. Platelet count had a 50% reduction on day 6, and then remained stable for 21 days. Factors II-V-VII-X, fibrinogen, and protein C remained within normal range. Tromboelastrography test showed that the reaction time of clot formation is prolonged, but the final clot formation is not altered. Conclusion. Whole blood retains its hemostatic properties for 21 days. This is the first step to evaluate the use of whole blood in the resuscitation protocols for Colombia allowing hemostatic resuscitation become a universal reality.


Subject(s)
Humans , Resuscitation , Blood Preservation , Shock, Hemorrhagic , Blood , Blood Transfusion , Hemostasis
5.
S. Afr. med. j ; 112(2): 102-107, 2022.
Article in English | AIM | ID: biblio-1358375

ABSTRACT

Background. Bloodstream infections are an important cause of mortality in children. Blood cultures (BCs) remain the primary means of identifying organisms and their antibiotic susceptibility profiles. A shortcoming of BCs is that up to 56% of positive cultures will represent contaminants. Poor adherence to standard practices applicable to BC sampling could explain an unacceptable contamination rate. Objectives. To determine: (i) the BC contamination rate in the departments of paediatrics and child health at two tertiary hospitals in central South Africa; and (ii) BC sampling practices among paediatric clinicians. Methods. The author determined the prevalence of BC contamination by analysis of laboratory data for the period 1 May - 27 August 2019, and assessed possible factors contributing to BC contamination by surveying paediatric medical staff with a self-administered BC practices questionnaire. Results. Of the 244 BCs reviewed, 25.4% were positive. The most commonly isolated pathogens were coagulase-negative staphylococci (CoNS) (33.3%), Escherichia coli (22.2%), Enterococcus faecium (16.7%) and Acinetobacter baumannii (11.1%). In total, 15.2% of the BCs yielded contaminants and 2.9% had polymicrobial growth. The most common contaminant was CoNS. Approximately 68% of clinicians were not aware of BC sampling guidelines, and even among those who were aware of the guidelines, non-compliance was reported. Conclusions. The BC contamination rate was higher than internationally accepted rates. Educating clinicians on specific BC sampling guidelines is strongly recommended to decrease the high rate of contamination observed in this study.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Pediatrics , Blood , Child Health , Blood Culture , Blood Safety , Tertiary Care Centers
6.
Sudan j. med. sci ; 17(3): 387-397, 2022. tales, figures
Article in English | AIM | ID: biblio-1398379

ABSTRACT

Background: Hepatitis E virus (HEV) is a hepatotropic pathogen that causes significant morbidity and mortality in humans. It is an important causative agent of viral hepatitis outbreaks. This study investigates the serological and molecular prevalence of HEV in blood donors attending the Central Blood Bank in Wad Medani City in Gezira State, Sudan. Methods: The study adopted a cross-sectional descriptive design. A structured questionnaire was used to collect data concerning demographic information and risk factors associated with HEV transmission. All enrolled participants (N = 300) were screened for HEV IgG antibodies using commercial ELISA kits, then strong positive samples (N = 84) were selected and rescreened for HEV IgM and HEV RNA by RT PCR. SPSS version 24.0 was used for analysis. Results: Out of 300 male participants, 36.3% (109/300) were positive for HEV IgG. However, only one participant was IgM positive, while the HEV RNA was negative. The highest prevalence rates of the virus were 42 (44.6%) among the age group of 31­40 years, 20 (48.8%) in those who consumed food from outside, 13 (50%) in three to four multiple blood donations, and 5 (62.5%) in those who consumed water from the river source. A significant association of HEV IgG prevalence concerning the occupation of the participants being students or farmers was detected using univariate and multivariate analysis (P-value = 0.007).


Subject(s)
Blood , Blood Donors , Immunoglobulin M , Polymerase Chain Reaction , Risk Factors
7.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 459-467, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350804

ABSTRACT

ABSTRACT Introduction: A retrospective ecological longitudinal study was carried out with data on blood components use from two private hospital units that belong to the same organization located in Belo Horizonte between July 2017 and June 2019. Objectives: To describe the monthly series of red blood cells, platelets and plasma use and the rate of blood components use for general hospitalizations in the health network, from the perspective of time series. Methods: A total of 15 time series were created with monthly data related to the use of blood components. The stationarity of the series was verified by the unit root test, the trend, by the Cox-Stuart test and seasonality, by the Fisher test (significance levels of 10% for the first test and 5% for the last two). Results: All series tested positive for the trend component and showed an increasing trend for the use of blood components. Ten series showed statistically significant seasonality and eight series were identified as non-stationary. The percentage of transfusions of blood components due to hospitalization at hospitals 1 and 2 was 29% (22% at hospital 1 and 38.9% at hospital 2). Conclusion: This study was able to describe the components of blood components use dynamics, from the perspective of time series at hospitals. Due to the growing trend in demand for blood components and their high cost, we propose the reduction of blood components use and the expanded use of alternative blood transfusion strategies.


Subject(s)
Blood , Blood Transfusion , Plasma , Blood Platelets , Erythrocytes
8.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 482-488, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350797

ABSTRACT

ABSTRACT Introduction: Blood is a valuable life resource that depends on the donation of blood by the community. As a result, it is crucial that the manner in which this expensive resource is used be correct and reasonable. Objective: The purpose of this study was to investigate the Maximum Blood Ordering for Surgery (MSBOS) in general, orthopedic and neurosurgical elective surgeries at the Poursina Hospital in Rasht in 2017. Methods: According to the patient file number information, such as gender, age, type of surgery, number of blood units requested, number of cross-matched blood units, number of blood units transfusion, number of patients undergoing transfusion, number of patients who were cross-matched, initial hemoglobin and the underlying disease, was extracted from the HIS (Hospital Information System). Based on the collected data, a descriptive report of the cross-match to transfusion ratio (C/T), transfusion index (TI) and transfusion probability (%T) was performed, using average and standard deviation, by using the SPSS 16. Results: In the present study, 914 patients from the neurosurgery, orthopedic and general surgery wards of the Poursina Hospital were studied. Of these, 544 were male (59.5%) and 370 were female (40.5%), aged 1-99 years, with a mean age of 43 years. The frequency distribution of C/T in this study was 1.29 in neurosurgery, 1.95 in orthopedic surgery and 1.96 in general surgery. This study indicated that the C/T index was above the normal standard level in four different kinds of surgery, including leg fracture (2.71), cholecystectomy(2.71), forearm fracture (2.70), and skin graft (2.62).The C/T index was at the maximum normal level in thyroidectomy surgery (2.5). The other surgeries had the normal C/T index. Conclusion: Overall, all of the MSBOS indices were at the standard level in this study, although C/T indices were higher than the standard level in the surgeries for cholecystectomy, leg fracture, forearm fracture, hand fracture and skin graft.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Blood , General Surgery , Orthopedic Procedures
9.
NOVA publ. cient ; 19(37): 43-56, jul.-dic. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1365190

ABSTRACT

Resumen Introducción. El sistema sanguíneo ABO está compuesto por los antígenos A y B, los cuales varían de acuerdo a las sustituciones de nucleótidos, que determinan la especificidad de la enzima para la cual codifican. Su importancia clínica se extiende más allá de los procesos transfusionales, aparentemente está involucrado en la fisiopatología de varias enfermedades, como cáncer, infecciones, alteraciones cardiovasculares, entre otras. Metodología. estudio descriptivo retrospectivo, con 2708 datos de clasificación de grupo sanguíneo ABO en pacientes hospitalizados. Se realizó la prueba de Chi2 de independencia para determinar la relación entre enfermedades hematológicas y no hematológicas y el grupo sanguíneo. Resultados. El grupo sanguíneo O se presentó en el 59,2% y el AB en el 18% de los pacientes; las entidades clínicas que predominaron fueron las no hematológicas; entre ellas las más frecuentes la hemorragia gastrointestinal, diabetes mellitus y las fracturas tanto para el grupo A como el B. En el grupo AB se presentó la tuberculosis y hemorragia gastrointestinal. Para las enfermedades de la sangre y de los órganos hematopoyéticos, en los grupos sanguíneos A, AB y O predominó la anemia de tipo no especificada, por su parte en el grupo B se presentó la anemia falciforme en crisis. Conclusión. en el presente estudio no se pudo establecer desde el análisis estadístico la relación entre los antígenos de grupo sanguíneo y el desarrollo de una entidad clínica en particular, pero desde el punto de vista clínico si se pudo notar la tendencia de una frecuencia más alta de una enfermedad en un grupo sanguíneo específico.


Abstract Introduction. The ABO blood system is composed of A and B antigens, which vary according to nucleotide substitutions, which determine the specificity of the enzyme for which they code. Its clinical importance extends beyond transfusion processes, apparently it is involved in the pathophysiology of various diseases, such as cancer, infections, cardiovascular disorders, among others. Methodology. retrospective descriptive study, with 2708 ABO blood group classification data in hospitalized patients. The Chi2 test of independence was performed to determine the relationship between hematological and non-hematological diseases and blood group. Results. Blood group O was present in 59.2% and AB in 18% of the patients; the clinical entities that predominated were non-hematological ones; Among them the most frequent were gastrointestinal bleeding, diabetes mellitus and fractures for both group A and B. In group AB, tuberculosis and gastrointestinal bleeding occurred. For diseases of the blood and hematopoietic organs, anemia of unspecified type predominated in blood groups A, AB and O, while in group B there was sickle cell anemia in crisis. Conclusion. in the present study, the relationship between blood group antigens and the development of a particular clinical entity could not be established from the statistical analysis, but from the clinical point of view, the trend of a higher frequency could be observed. of a disease in a specific blood group.


Subject(s)
Humans , Hematologic Diseases , Blood , Hemorrhage , Infections
10.
Rev. med. Risaralda ; 27(1): 28-34, ene.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1280490

ABSTRACT

Resumen Introducción: La Enfermedad de Chagas también conocida como Tripanosomiasis americana es un problema de salud pública. Se calcula que en el mundo hay entre 6 y 7 millones de personas infectadas por Trypanosoma cruzi, la mayoría de ellas en América Latina. Objetivo: Identificar la prevalencia de infección por Trypanosoma cruzi en donantes de un banco de sangre del departamento de Boyacá 2016-2018. Materiales y métodos: Estudio descriptivo retrospectivo realizado en 25.920 donantes de sangre del departamento de Boyacá. La fuente de información fue secundaria. Se determinó la prevalencia de la infección por Trypanosoma cruzi y se compararon según sexo, grupo etario y tipo de donante a través de análisis de frecuencias. Resultados: Se evaluaron 9187 donantes durante el año 2016; 8517 en el 2017 y 8216 en el 2018, de los cuales 56,1% eran de sexo femenino y 43,9% masculino. La prevalencia de la infección por Trypanosoma cruzi fue 0,17 % en la tamización y 0,08 % con las pruebas confirmatorias de las cuales el 70,0% eran mujeres, el 85,0% donantes voluntarios por primera vez, el rango de edad en el que se presentó mayor prevalencia de este marcador serológico fue de 41 a 50 y de 51 a 65 años con un 35,0% cada uno . La prevalencia de la infección de Chagas presentó asociación estadísticamente significativa con la edad (p < 0,05). Conclusiones: Los bancos de sangre resultan ser una de las fuentes de información disponibles para monitorear el comportamiento de la enfermedad de Chagas y evaluar la toma de decisiones en salud pública, teniendo en cuenta que la enfermedad se caracteriza de manera asintomática y sin compromiso clínico en la mayoría de los casos.


Abstract Introduction: Chagas Disease, also known as American Trypanosomiasis, is a public health problem. It is estimated that in the world there are between 6 and 7 million people infected with Trypanosoma cruzi, most of them in Latin America. Objectives: To identify the prevalence of Trypanosoma cruzi infection in donors from a blood bank in the department of Boyacá 2016-2018. Materials and methods: Retrospective-descriptive study carried out in 25,920 blood donors from the department of Boyacá (Colombia). The source of information was secondary. The prevalence of Trypanosoma cruzi infection was determined and compared according to sex, age group and type of donor through frequency analysis. Results: 9187 donors were evaluated during 2016; 8,517 in 2017 and 8,216 in 2018, of which 56.1% were female and 43.9% male. The prevalence of Trypanosoma cruzi infection was 0.17% in screening and 0.08% with confirmatory tests of which 70.0% were women, 85.0% first-time volunteer donors, the range of The age at which the highest prevalence of this serological marker was found was 41 to 50 and 51 to 65 years with 35.0% each. The prevalence of Chagas infection showed a statistically significant association with age (p <0.05). Conclusions: Blood banks turn out to be one of the sources of information available to monitor the behavior of Chagas disease and evaluate decision-making in public health, taking into account the characteristics of the disease in which the majority of cases they are asymptomatic and without clinical compromise.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Trypanosoma cruzi , Blood Banks , Blood Donors , Chagas Disease , Tissue Donors , Volunteers , Blood , Mass Screening , Prevalence , Infections
11.
São Paulo; SES/SP; 2021.
Non-conventional in Portuguese | LILACS, ColecionaSUS, SES-SP, CONASS | ID: biblio-1224430
12.
São Paulo; SES/SP; 2 ed; 2021. 62 p. ilus.
Non-conventional in Portuguese | LILACS, ColecionaSUS, SES-SP, CONASS, SESSP-ACVSES | ID: biblio-1224717

Subject(s)
Blood , Blood Transfusion
13.
Rev. Assoc. Med. Bras. (1992) ; 67(supl.1): 74-79, 2021. tab, graf
Article in English | LILACS | ID: biblio-1287844

ABSTRACT

SUMMARY OBJECTIVE: This study aims to investigate and compare the coagulation parameters of coronavirus disease 2019 (COVID-19) patients with mortal and nonmortal conditions. METHODS: In this study, 511 patients diagnosed with COVID-19 were included. Information about 31 deceased and 480 recovered COVID-19 patients was obtained from the hospital information management system and analyzed retrospectively. Whether there was a correlation between coagulation parameters between the mortal and nonmortal patients was analyzed. Descriptive analyses on general characteristics of the study population were performed. Visual (probability plots and histograms) and analytical methods (Kolmogorov-Smirnov and Shapiro-Wilk test) were used to test the normal distribution. Analyses were performed using the SPSS statistical software package. RESULTS: Out of 511 patients, 219 (42.9%) were females and 292 (57.1%) were males. There was no statistically significant difference between males and females in terms of mortality (p=0.521). In total, the median age was 67 (22). The median age was 74 (13) in the nonsurvivor group and 67 (22) in the survivor group, and the difference was statistically significant (p=0.007). The D-dimer, prothrombin time, international normalized ratio, neutrophil, and lymphocyte median age values with p-values, in the recovered and deceased patient groups were: 1070 (2129), 1990 (7513) μg FEU/L, p=0.005; 12.6 (2.10), 13.3 (2.1), p=0.014; 1.17 (0.21), 1.22 (0.19), p=0.028; 5.51 (6.15), 8.54 (7.05), p=0.001; and 0.99 (0.96), 0.64 (0.84), p=0.037, respectively, with statistically significant differences. CONCLUSIONS: As a result of this study, D-dimer, prothrombin time, and international normalized ratio increase were found to be associated with mortality. These parameters need to be closely monitored during the patient follow-up.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , COVID-19 , Blood , Blood Coagulation , Retrospective Studies , Survivors , SARS-CoV-2 , Middle Aged
14.
Rev. colomb. anestesiol ; 48(4): e202, Oct.-Dec. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1144313

ABSTRACT

Abstract Introduction: Surgical site infection (SSI) is among the most common healthcare-related infections. Given their greater morbidity and surgical complexity, patients undergoing major surgery are exposed to a high risk of SSI. Objective: To determine the incidence of SSI in adult patients undergoing major elective non-cardiac surgery, and to identify risk factors associated with its occurrence within the first 30 days after surgery. Methods: An analytical study was designed on the basis of a prospective institutional registry. Clinical and laboratory variables associated with perioperative management were recorded. An active search was conducted in order to find SSI episodes, renal failure and multiple organ dysfunction during the first 30 days after surgery. Adjusted logistic regression was done to identify potential associations between risk factors and the development of SSI. Results: Overall, 1501 patients were included. The incidence of SSI during the first 30 days after surgery was 6.72% (95% CI 5.57-8.11). ASA III, abdominal surgery and longer procedures were more frequent in the SSI group. Association with the occurrence of SSI was documented for preoperative hemoglobin levels (adjusted OR 0.79 [95% CI 0.72-0.88], p = 0.04), intraoperative transfusion (adjusted OR 2,47 [95% CI 1.16-5.27], p = 0.02) and major blood loss (adjusted OR 3.80 [95% CI 1.63-8.88], p = 0.04). Conclusion: Preoperative hemoglobin level, intraoperative transfusion and major bleeding are independent risk factors associated with the occurrence of SSI in adult patients undergoing major elective non-cardiac surgery.


Resumen Introducción: La infección del sitio operatorio (ISO) ocupa los primeros lugares entre las infecciones asociadas a la atención en salud. Con una mayor morbilidad y complejidad quirúrgica, los pacientes de cirugía mayor están expuestos a un alto riesgo de ISO. Objetivo: Determinar la incidencia de ISO en pacientes adultos sometidos a cirugía mayor electiva no cardiaca e identificar factores de riesgo relacionados con su aparición durante los primeros 30 días postoperatorios. Métodos: Se diseñó un estudio analítico a partir de un registro institucional prospectivo. Se registraron variables clínicas y de laboratorio relacionadas con el manejo perioperatorio. Se realizó una búsqueda activa de episodios de ISO, sepsis, falla renal y disfunción multiorgánica durante los primeros 30 días postoperatorios. Las potenciales asociaciones entre factores de riesgo y el desarrollo de ISO fueron identificadas mediante regresión logística ajustada. Resultados: Se incluyeron 1.501 pacientes. La incidencia de ISO durante los 30 días postoperatorios fue de 6,72 % [IC 95 % 5,57-8,11). El estado ASA III, la cirugía abdominal y los procedimientos de duración prolongada fueron más frecuentes en el grupo ISO. Se documentó asociación con la ocurrencia de ISO para los niveles de hemoglobina preoperatoria (OR ajustado 0,79 [IC 95 % 0,72-0,88], p = 0,04), transfusión intraoperatoria (OR ajustado 2,47 [IC 95 % 1,16-5,27], p = 0,02) y sangrado mayor intraoperatorio (OR ajustado 3,80 [IC 95 % 1,63-8,88], p = 0,04). Conclusiones: El nivel de hemoglobina preoperatoria, la transfusión intraoperatoria y el sangrado mayor son factores de riesgo asociados de forma independiente a la ocurrencia de ISO en pacientes adultos llevados a cirugía mayor electiva no cardiaca.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Surgical Wound Infection , Hemorrhage , Blood , Risk Factors , Sepsis , Infections , Anemia
15.
Gac. méd. boliv ; 43(2): 228-231, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1249989

ABSTRACT

TRAP describe la perfusión crónica de un gemelo acardíaco por un gemelo de bomba a través de canales vasculares entrelazados permeables. La secuencia TRAP ocurre en 1 de cada 35.000 nacimientos o en 1 de cada 100 pares de gemelos monocigóticos. Se diagnostica mediante los hallazgos ecográficos de un feto de desarrollo normal y una masa amorfa con frecuencia con partes fetales perceptibles. El Doppler color revela el flujo sanguíneo reverso hacia el gemelo acardíaco dentro de la arteria umbilical lo que lleva a las complicaciones típicas del cuadro. El manejo expectante es razonable en ausencia de características pronósticas deficientes. El propósito de este artículo es revisar los aspectos básicos y el estado actual de esta condición, haciendo énfasis en el diagnóstico y el manejo expectante.


TRAP describes the chronic perfusion of an acardiac twin by a pump twin through permeable interlocking vascular channels. TRAP occurs in 1 in 35,000 births or 1 in 100 pairs of monozygotic twins. It is diagnosed by ultrasound findings of a normally developing fetus and an amorphous mass often with noticeable fetal parts. Color Doppler reveals the reverse blood flow to the acardiac twin within the umbilical artery, leading to typical complications of the condition. Expectant management is reasonable in the absence of poor prognostic characteristics. The purpose of this article is to review the basic aspects and current status of this condition, emphasizing the diagnosis and expectant management.


Subject(s)
Female , Adult , Fetus , Perfusion , Twins , Blood
16.
Rev. colomb. nefrol. (En línea) ; 7(supl.2): 285-296, jul.-dic. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1251592

ABSTRACT

Resumen Introducción: el COVID-19 es una enfermedad causada por un nuevo beta coronavirus (SARS-CoV-2), cuyo espectro incluye casos severos con neumonía y complicaciones sistémicas que se dan como consecuencia de una liberación exagerada de mediadores inflamatorios conocida como "tormenta de citoquinas". En este tipo de pacientes las terapias de purificación sanguínea, incluyendo la hemoadsorción y la terapia plasmática podrían tener un beneficio clínico importante y evitar las complicaciones como disfunción multiorgánica y muerte. Objetivo: revisar toda la literatura disponible acerca de las terapias de purificación sanguínea y sus beneficios en los pacientes con COVID-19. Materiales y métodos: se realizó una búsqueda de la literatura en las bases de datos ClinicalKey, Embase, PubMed y Ovid con los términos "COVID-19", "SARS-CoV-2", "Tormenta de citoquinas", "terapias de purificación sanguínea", "sepsis", "hemoadsorción" y "CytoSorb". Resultados: se encontraron 246 referencias y luego de aplicar los filtros, se seleccionaron 61 publicaciones con contenido relevante para la presente revisión. Conclusión: teniendo en cuenta su gran evidencia científica en el manejo de la tormenta de citoquinas en otros escenarios, las terapias de purificación sanguínea, que incluyen técnicas difusivas, convectivas, de hemoadsorción y terapia plasmática, pueden ser herramientas de tratamiento muy prometedoras en pacientes con COVID-19.


Abstract Introduction: COVID-19 is a disease caused by a new beta coronavirus (SARS-CoV-2), whose spectrum includes severe cases with pneumonia and systemic complications that occur as a consequence of an exaggerated release of inflammatory mediators known as "cytokine storm". In this type of patients, blood purification therapies, including hemoadsorption and plasma therapy, could have an important clinical benefit and avoid complications such as multiple organ dysfunction and death. Objective: to review all available literature about blood purification therapies and their benefits in patients with COVID-19. Materials and methods: a literature search was conducted in the ClinicalKey, Embase, PubMed and Ovid databases using the terms "COVID-19", "SARS-CoV-2", "Tormenta de citoquinas", "terapias de purificación sanguínea", "sepsis", "hemoadsorción" and "CytoSorb". Results: 246 references were found and after applying filters, 61 publications with relevant content for the present review were selected. Conclusion: taking into account the great scientific evidence in the management of the cytokine storm in other scenarios, blood purification therapies, including diffusive, convective, hemoadsorption and plasma therapy techniques, could be very promising treatment tools for patients with COVID-19.


Subject(s)
Humans , Male , Female , Therapeutics , COVID-19 , Patients , Pneumonia , Blood , Colombia , Sepsis , Renal Insufficiency , Literature
17.
Rev. colomb. nefrol. (En línea) ; 7(2): 44-54, jul.-dic. 2020. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1251564

ABSTRACT

Abstract Objectives: to identify valid blood biomarkers to detect heart failure and kidney failure associated with kidney disease and hemodialysis Methods: systematic literature review conducted in August 2018 in the following: Web Of Science, PubMed, Scopus, Cinahal, Cochrane, Science Direct and Lilacs. The guiding question was: "What are the blood biomarkers used to detect heart failure and kidney failure?" A total of537 publications were found, 94 of these appeared more than once, 383 were excluded after reading titles and abstracts, 32 were excluded after reading the full texts, and 10 were excluded in the quantitative and qualitative synthesis. Results: 18 papers compose the final sample and report laboratory and imaging tests, instruments to assess the risk of kidney and heart failure, and also clinical management of the progression of kidney and heart failure. All the studies correlated risk of mortality and death outcome. Conclusion: laboratory tests are important to identifying kidney and heart failure and need to be used to improve clinical management of the hemodialysis treatment of people with chronic kidney disease in order to improve quality of life and life expectancy.


Subject(s)
Humans , Male , Female , Renal Dialysis , Kidney Diseases , Blood , Brazil , Biomarkers , Diagnostic Techniques and Procedures , Renal Insufficiency , Clinical Alarms , Heart Failure
18.
Rev. bras. ortop ; 55(5): 551-556, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144208

ABSTRACT

Abstract Objectives This study aimed to analyze the efficacy of platelet-rich plasma obtained from the peripheral, autologous blood of the patients in pain complaints reduction and functional improvement of knee osteoarthritis compared with the standard treatment with injectable corticosteroid, such as triamcinolone. Methods The patients were followed-up clinically at the preinfiltrative visit, with quantitative evaluation using the Knee Society Score (KSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Kellgren and Lawrence scales. In addition, they were reevaluated with the same scales after 1 month and 6 months of intervention with 2.5 mL of triamcinolone acetate or 5 mL of platelet-rich plasma. The study was performed on 50 patients with knee osteoarthritis treated at the Medical Specialty Center and randomly divided into equivalent samples for each therapy. Results The present study verified the reduction of pain scores, such as the WOMAC score, and elevations of functional scales, such as the KSS, evidenced in 180 days when using platelet-rich plasma, a therapy that uses the autologous blood of the patient and has fewer side effects. Conclusion Although both platelet-rich plasma and corticosteroid therapies have been shown to be effective in the reduction pain complaints and functional recovery, there was a statistically significant difference between them at 180 days. According to the results obtained, platelet-rich plasma presented longer-lasting effects within 180 days in the treatment of knee osteoarthritis.


Resumo Objetivo Analisar a eficácia do uso de plasma rico em plaquetas, obtido do sangue periférico e autólogo dos pacientes, na redução das queixas álgicas e melhoria funcional dos pacientes portadores de osteoartrite de joelhos, em comparação com o tratamento padrão com injeção de corticosteroides de depósito, como a triancilonola. Métodos Os pacientes foram acompanhados clinicamente na consulta pré-infiltrativa, com avaliação quantitativa através das escalas Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), e Kellgren and Lawrence. Além disso, os pacientes foram reavaliados com as mesmas escalas após 1 mês e 6 meses de intervenção com 2,5 mL de acetato de triancinolona ou 5 mL de plasma rico em plaquetas. O estudo foi feito em 50 pacientes portadores de osteoartrite de joelhos atendidos no Centro de Especialidades Médicas, divididos em amostras equivalentes randomizadas para cada terapia. Resultados No presente estudo, verificaram-se redução dos valores em escalas álgicas, como a WOMAC, e elevação das pontuações em escalas funcionais, como a KSS, evidenciadas em 180 dias após o uso de plasma rico em plaquetas, uma terapia feita a partir do sangue autólogo do paciente e com menos efeitos colaterais. Conclusão Embora ambas as terapias com plasma rico em plaquetas e corticosteroides tenham se mostrado eficazes na redução das queixas álgicas e na recuperação funcional, houve diferença significativa entre as terapias aos 180 dias. De acordo com os resultados obtidos, no tratamento da osteoartrite do joelho, o plasma rico em plaquetas demonstrou efeitos mais duradouros em 180 dias.


Subject(s)
Humans , Osteoarthritis , Blood , Triamcinolone , Efficacy , Adrenal Cortex Hormones , Osteoarthritis, Knee , Platelet-Rich Plasma , Recycling , Injections
19.
Acta bioquím. clín. latinoam ; 54(3): 279-284, set. 2020. tab
Article in Spanish | LILACS | ID: biblio-1130602

ABSTRACT

El azúcar de mesa, que se obtiene de la caña de azúcar, es el edulcorante más utilizado en la elaboración de los alimentos. El azúcar es importante en la obtención de energía, es necesario para la síntesis de ácidos grasos, de ácidos nucleicos, evita el estrés oxidativo y el desarrollo de anemia. Puede ocasionar caries, diabetes, obesidad, arteriosclerosis y otras patologías. En el presente trabajo se valoró el efecto que tiene la ingesta crónica de agua endulzada con sacarosa al 30% sobre el consumo de alimento balanceado, el perfil lipídico, la concentración de glucosa sérica, y sobre algunos marcadores del estado nutricional como el peso y las proteínas séricas totales, en machos de ratas Wistar. El agua endulzada con sacarosa al 30% se administró a un grupo de 9 ratas Wistar durante 3 meses y se tomó como grupo control a un grupo de 9 ratas que bebieron agua natural. El consumo de alimentos por ambos grupos, así como los marcadores de química sanguínea se analizaron al final del tratamiento. Los niveles de glucosa, lípidos y proteínas séricas totales se midieron mediante espectroscopía. Los resultados mostraron que el consumo de agua endulzada con sacarosa al 30% redujo en más de un 90% el consumo de alimento balanceado; sin embargo, no afectó el perfil lipídico ni el nivel de glucosa en sangre, así como tampoco el nivel de proteínas séricas totales. El consumo de agua endulzada con sacarosa podría provocar desnutrición a largo plazo ya que ocasiona una reducción en la ingesta de alimento rico en nutrientes.


Sugar, obtained from sugarcane, is the most commonly used sweetener in food processing. Sugar is an important food for energy generation and it is necessary for the synthesis of fatty acids and nucleic acids. It prevents oxidative stress and anemia development. However, its consumption can cause dental caries, diabetes, obesity, arteriosclerosis and other pathologies. In the present work, the effect of chronic intake of water sweetened with 30% sucrose on balanced food consumption, lipid profile, serum glucose concentration, as well as some markers of nutritional status such as weight and total serum proteins was assessed in male Wistar rats. The water sweetened with 30% sucrose was administered to a group of 9 Wistar rats for 3 months, having 9 rats as a control group that drank natural water. Food consumption between both groups as well as blood chemistry markers were analyzed at the end of the treatment. Glucose, lipid levels as well as total serum proteins were measured by spectroscopy. The results showed that the consumption of water sweetened with 30% sucrose reduced the consumption of balanced food by more than 90%, however, it did not affect the lipid profile, the level of glucose in the blood or the level of total serum proteins concentration. Consumption of sucrose-sweetened water could lead to long-term malnutrition by reducing the intake of nutrient-rich food.


O açúcar comum, obtido a partir da cana de açúcar, é o adoçante mais utilizado na elaboração dos alimentos. O açúcar é importante para a geração de energia; necessário para a síntese de ácidos graxos e de ácidos nucleicos. Previne o estresse oxidativo e o desenvolvimento de anemia. No entanto, seu consumo pode causar cárie dentária, diabetes, obesidade, arteriosclerose e outras patologias. No presente trabalho, foi avaliado o efeito da ingestão crônica de água adoçada com sacarose a 30% sobre o consumo de alimentos ricos em nutrientes, perfil lipídico, concentração sérica de glicose e alguns marcadores do estado nutricional, como o peso. e as proteínas séricas totais em ratos Wistar machos. A água adoçada com sacarose a 30% foi administrada a um grupo de 9 ratos Wistar por 3 meses, tendo como grupo controle um grupo de 9 ratos que beberam água natural. O consumo de alimentos entre os dois grupos e os marcadores de química sanguínea foram analisados no final do tratamento. Os níveis de glicose, lipídios e proteínas séricas totais foram medidos por espectroscopia. Os resultados mostraram que o consumo de água adoçada com sacarose a 30% reduziu em mais de 90% o consumo de alimentos ricos em nutrientes, no entanto, não afetou o perfil lipídico, o nível de glicose em sangue nem o nível de proteínas séricas totais. O consumo de água adoçada com sacarose poderia levar à desnutrição no longo prazo, visto que produz uma redução na ingestão de alimentos ricos em nutrientes.


Subject(s)
Animals , Arteriosclerosis , Spectrum Analysis , Blood , Nucleic Acids , Rats, Wistar , Dietary Sucrose , Saccharum , Fatty Acids , Anemia , Sucrose , Therapeutics , Water , Affect , Dental Caries , Malnutrition , Growth and Development , Diabetes Mellitus , Sugars , Food , Food Handling
20.
Acta bioquím. clín. latinoam ; 54(3): 285-292, set. 2020. graf, tab
Article in Spanish | LILACS | ID: biblio-1130603

ABSTRACT

Los posibles efectos adversos que se producen en transfusiones incompatibles ABO son un riesgo latente en el uso de concentrados de plaquetas grupo O, por lo que la titulación de hemolisinas anti-A/B constituye una de las estrategias para su prevención. El objetivo de este estudio fue determinar la frecuencia de títulos de hemolisinas de isotipos IgG e IgM anti-A/B en donantes de sangre. Se trató de un estudio descriptivo, transversal y aleatorio simple con un tamaño muestral de 308 muestras. Se aplicó la metodología en tubo, gel salino y anti-inmunoglobulina IgG y, mediante soluciones seriadas, se evidenció el título. Adicionalmente, se realizó una encuesta sobre los posibles factores de riesgo para el aumento de estos títulos. Se aplicó estadística descriptiva mediante el uso del software informático SPSS versión 22.0 y la relación entre variables independientes a través del análisis estadístico de Chi-cuadrado y, para establecer la concordancia de las lecturas visuales de las tarjetas de gel, se aplicó el índice kappa. Se determinó la existencia de hemolisinas de isotipo IgG e IgM anti-A/B de títulos superiores a 1/64. Existió una relación estadísticamente significativa entre embarazos y títulos de IgG anti-A/B >1/128 y el aumento de hemolisinas de isotipo IgM y la ingesta de probióticos. Los resultados demostraron la necesidad de implementar la titulación de hemolisinas previo a la transfusión de concentrados plaquetarios no isogrupo, por lo que se recomienda una investigación de riesgo-beneficio y el seguimiento de pacientes con transfusiones de concentrados plaquetarios incompatibles ABO.


The possible adverse effects that occur in incompatible ABO transfusions are a latent risk in the use of group O platelet concentrates, so the titration of anti-A/B hemolysins is one of the strategies for its prevention. The objective of this study was to determine the frequency of hemolysins titers IgG and IgM anti-A/B isotypes in blood donours. It was a simple randomized descriptive cross-sectional study with a sample size of 308 samples. The methodology was applied in tube, saline gel and anti-IgG anti-immunoglobulin and by means of serial solutions the title was verified. Additionally, a survey was conducted on the possible risk factors for the increase in securities. Descriptive statistics were used through the application of the SPSS version 22.0 software and the relationship between independent variables through the Chi-square statistical analysis and the kappa index was applied to match the visual readings of the gel cards. The existence of IgG and IgM anti-A/B isotype hemolysins of titers greater than 1/64 was determined. There was a statistically significant relationship between pregnancies and anti-A/B IgG titres>1/128; and the increase in IgM isotype hemolysins and probiotic intake. The results demonstrate the need to implement hemolysin titration prior to transfusion of non-isogroup platelet concentrates, so a risk-benefit investigation and follow-up of patients with transfusions of ABO incompatible platelet concentrates is recommended.


Os possíveis efeitos adversos que ocorrem em transfusões incompatíveis ABO são um risco latente no uso de concentrados de plaquetas do grupo O, portanto a titulação de hemolisinas anti-A/B é uma das estratégias para sua prevenção. O objetivo deste estudo foi determinar a frequência de títulos de hemolisinas de isotipos IgG e IgM anti-A/B em doadores de sangue. Trata-se de um estudo descritivo transversal aleatório simples, com tamanho de amostra de 308 amostras. A metodologia foi aplicada em tubo, gel salino e anti-imunoglobulina IgG e utilizando soluções em série, o título foi verificado. Além disso, foi realizada uma pesquisa sobre os possíveis fatores de risco para o aumento destes títulos. A estatística descritiva foi utilizada através da aplicação do software informático SPSS versão 22.0 e a relação entre variáveis independentes por meio da análise estatística do qui-quadrado e, para estabelecer a concordância com as leituras visuais dos cartões de gel, o índice kappa foi aplicado. Foi determinada a existência de hemolisinas de isotipo IgG e IgM anti-A/B de títulos maiores que 1/64. Existiu uma relação estatisticamente significante entre gestações e títulos de IgG anti-A/B>1/128; e o aumento de hemolisinas do isotipo IgM e a ingestão de probióticos. Os resultados demonstram a necessidade de implementar a titulação da hemolisina antes da transfusão de concentrados de plaquetas não isogrupo, por isso, recomenda-se uma investigação de risco-benefício e acompanhamento de pacientes com transfusões de concentrados de plaquetas incompatíveis com ABO.


Subject(s)
Humans , Male , Female , Blood Platelets , Immunoglobulin Isotypes/blood , Software , Immunoglobulin G , Immunoglobulin M , Immunoglobulins , Risk Factors , Probiotics , Hemolysin Proteins , Volunteers , Blood , Blood Donors , Risk , Data Interpretation, Statistical , Morbidity , Titrimetry , Aftercare , Drug-Related Side Effects and Adverse Reactions , Disease Prevention
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