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1.
Allergol. immunopatol ; 48(3): 259-264, mayo-jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-192028

RESUMO

The clinical history is of importance in the investigation of allergic diseases but does have limitations. Many allergic conditions will be over-diagnosed if anamnesis alone is used for diagnostic criteria. Serum total immunoglobulin E (TIgE) quantification, as well as panels containing allergens prevalent in the studied population, may serve as screening tests and facilitate the diagnosis of allergic disease or its exclusion. We assessed the positivity of two versions of these tests, Phadiatop Europe® (PhEU) and Phadiatop Infant® (PhInf), as well as total IgE (TigE) values in patients with a medical diagnosis of allergic disease and non-allergic individuals. METHODS: A cross-sectional study performed in eleven Brazilian pediatric allergy centers with patients divided into groups according to the primary condition and a group of assessed control subjects. They were submitted to TIgE measurement and screening tests (PhEu and PhInf). RESULTS: TIgE mean serum levels were significantly higher among allergic patients, especially those with asthma/rhinitis or atopic dermatitis. The positivity of the screening tests, considering the total population, was 63.8% for PhEU and 72.6% for PhInf. These increased when we evaluated only the allergic subjects. The concordance index of the two tests was Kappa = 0.7 and higher among those of greater age. CONCLUSIONS: In the assessed population, there were significantly higher levels among those with positive screening tests and PhInf showed better performance in the identification of sensitized individuals, regardless of age. This is the first study to evaluate Phadiatop and Phadiatop Infant in the same population


No disponible


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Testes Hematológicos/métodos , Hipersensibilidade/diagnóstico , Imunoglobulina E/sangue , Técnicas Imunológicas/métodos , Hipersensibilidade/imunologia , Brasil , Estudos Transversais , Alérgenos/imunologia , Dermatite Atópica/imunologia , Asma/imunologia , Rinite Alérgica/imunologia , Sensibilidade e Especificidade
2.
Reumatol. clín. (Barc.) ; 15(6): 350-354, nov.-dic. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-189652

RESUMO

OBJECTIVE: Rheumatoid factor (RF) testing is used in primary care in the diagnosis of rheumatoid arthritis (RA); however a positive RF may occur without RA. Incorrect use of RF testing may lead to increased costs and delayed diagnoses. The aim was to assess the performance of RF as a test for RA and to estimate the costs associated with its use in a primary care setting. MATERIAL AND METHODS: A retrospective cohort study using the Information System for the Development of Research in Primary Care database (contains primary care records and laboratory results of >80% of the Catalonian population, Spain). Participants were patients ≥18 years with ≥1 RF test performed between 01/01/2006 and 31/12/2011, without a pre-existing diagnosis of RA. Outcome measures were an incident diagnosis of RA within 1 year of testing, and the cost of testing per case of RA. RESULTS: 495,434/4,796,498 (10.3%) patients were tested at least once.107,362 (21.7%) of those tested were sero-positive of which 2768 (2.6%) were diagnosed with RA within 1 year as were 1141/388,072 (0.3%) sero-negative participants. The sensitivity of RF was 70.8% (95% CI 69.4-72.2), specificity 78.7% (78.6-78.8), and positive and negative predictive values 2.6% (2.5-2.7) and 99.7% (99.6-99.7) respectively. Approximately €3,963,472 was spent, with a cost of €1432 per true positive case. CONCLUSIONS: Although 10% of patients were tested for RF, most did not have RA. Limiting testing to patients with a higher pre-test probability would significantly reduce the cost of testing


OBJETIVOS: El factor reumatoide (FR) se usa en atención primaria para el diagnóstico de la artritis reumatoide (AR); sin embargo, un FR positivo puede observarse en sujetos sin AR, y su uso inapropiado puede conllevar costes y retraso diagnóstico. En este contexto, estudiamos la utilidad y costes del FR como test diagnóstico de la AR en atención primaria. MÉTODOS: Estudio de cohortes retrospectivas basadas en datos de historia clínica informatizada de >80% de la población de Cataluña (SIDIAP). Se incluyeron sujetos de edad ≥18 años y con ≥1 medida de FR entre el 1/1/2006 y el 31/12/2011, sin diagnóstico previo de AR. El diagnóstico incidente de AR durante el año posterior a la medida de FR, y el coste por caso de AR fueron las medidas de interés. RESULTADOS: 495.434/4.796.498 (10,3%) pacientes tuvieron al menos una medida de FR 107.362 (21,7%) de estos fueron sero-positivos, de los cuales solo 2.768 (2,6%) fueron diagnosticados de AR en el año siguiente, comparado a 1.141/388.072 (0,3%) diagnósticos en sero-negativos. La sensibilidad del FR fue del 70,8% (IC 95%: 69,4 a 72,2%), especificidad 78,7% (78,6 a 78,8%), y valor predictivo positivo y negativo 2,6% (2,5 a 2,7%) y 99,7% (99,6 a 99,7%), respectivamente. El coste total estimado fue de 3.963,472€, alrededor de 1.432€ por caso de AR diagnosticado. CONCLUSIONES: Aunque el 10% de participantes (casi medio millón de personas) fueron sujetos de medición/es de FR, la mayoría no desarrollaron AR. El uso de FR en pacientes con mayor probabilidad pre-test reduciría de forma significativa su coste


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Artrite Reumatoide/sangue , Fator Reumatoide/sangue , Artrite Reumatoide/diagnóstico , Estudos de Coortes , Custos e Análise de Custo , Testes Hematológicos/economia , Primeiros Socorros , Estudos Retrospectivos , Sensibilidade e Especificidade , Espanha
3.
Rev. lab. clín ; 12(4): e34-e53, oct.-dic. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-187310

RESUMO

El hierro es un elemento químico esencial para todos los organismos vivos, necesario para un amplio espectro de funciones metabólicas vitales. La exploración del metabolismo del hierro puede ser difícil en algunas situaciones, tales como en el paciente con una enfermedad crónica, por la respuesta de los biomarcadores frente a la inflamación. En los últimos años el laboratorio clínico ha incorporado nuevos biomarcadores a los tradicionalmente empleados, con el fin de mejorar su contribución al diagnóstico y seguimiento de la ferropenia. Se ha realizado una búsqueda sistemática de la evidencia científica publicada en los diez últimos años para los siguientes biomarcadores: el diagnóstico morfológico de la sangre periférica, los índices hematimétricos, y las concentraciones plasmáticas de transferrina (y sus índices), ferritina, receptor soluble de transferrina y hemoglobina, en la ferropenia. Se emiten recomendaciones para estos biomarcadores en relación al diagnóstico y manejo del paciente ferropénico


Iron is an essential chemical element for all living organisms, and is required for a broad spectrum of vital metabolic functions. The study of iron metabolism can be challenging in some situations, such as in patients with chronic diseases, due to the effect of inflammation response. In recent years, clinical laboratory research has introduced new biomarkers to those commonly used, with the aim of improving the diagnosis and management of iron deficiency. In this work, a systematic search of the scientific evidence reported during the last decade has been made for the following biomarkers: morphological diagnosis of peripheral blood, hematimetric indices, and plasma concentrations of transferrin (and its indices), ferritin, transferrin receptor, and haemoglobin, in iron deficiency. Recommendations are made for these biomarkers related to the diagnosis and management of the iron-deficient patient


Assuntos
Humanos , Anemia Ferropriva/diagnóstico , Deficiência de Ferro/diagnóstico , Distúrbios do Metabolismo do Ferro/diagnóstico , Ferritinas/sangue , Contagem de Reticulócitos/métodos , Índices de Eritrócitos , Transferrinas/sangue , Hemoglobinometria/métodos , Guias como Assunto , Técnicas de Laboratório Clínico/métodos , Biomarcadores/análise , Insuficiência Renal Crônica/complicações , Testes Hematológicos/métodos
5.
Rev. lab. clín ; 11(2): 97-100, abr.-jun. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-174362

RESUMO

El síndrome de Kabuki (SK) es una rara enfermedad genética que cursa con importantes alteraciones cardiacas e inmunológicas. La mayoría de los pacientes son diagnosticados en los primeros años de vida pese a que la edad de inicio no está bien definida. Los pacientes afectos presentan infecciones de repetición debido a su inmunosupresión pudiendo llegar a un estado de agranulocitosis. Aunque su pronóstico es bastante favorable, su esperanza de vida viene condicionada por este tipo de complicaciones. Por ello, conocer sus características analíticas particulares resulta interesante desde el punto de vista del laboratorio de hematología para contribuir en su orientación diagnóstica y en el seguimiento de los mismos. Presentamos el caso de un paciente diagnosticado de SK


Kabuki syndrome (KS) is a rare genetic disease that usually involves significant cardiac and immunological disorders. Most patients are diagnosed in the first years of life, despite the fact that the age of onset is not well-defined. Affected patients have recurrent infections due to their immunosuppression, and may reach a state of agranulocytosis. Although their prognosis is quite favourable, their life expectancy is determined by these types of complications. Therefore, to understand its particular analytical characteristics is interesting from the point of view of the Haematology Laboratory to contribute to their diagnosis and follow-up. The case is presented of a patient diagnosed with KS


Assuntos
Humanos , Feminino , Criança , Agranulocitose/diagnóstico , Agranulocitose/genética , Prognóstico , Neutropenia/genética , Mutagênese , Agranulocitose/complicações , Neutropenia/complicações , Otite/complicações , Otite/diagnóstico , Pseudomonas aeruginosa/isolamento & purificação , Deficiências do Desenvolvimento/complicações , Testes Hematológicos/métodos , Diagnóstico Diferencial
6.
Arch. bronconeumol. (Ed. impr.) ; 53(3): 114-119, mar. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-161796

RESUMO

Introducción. El ancho de distribución eritrocitaria (ADE) describe el grado de heterogeneidad en el tamaño de los hematíes. Un incremento de ADE se ha asociado con exceso de mortalidad en insuficiencia cardiaca y otras enfermedades crónicas. Dado que existe mayor riesgo de morbimortalidad cardiovascular en apnea obstructiva del sueño (AOS), es posible que estos pacientes presenten un ADE elevado. Método. Se reclutaron sujetos de 18 a 60 años remitidos a la Unidad de Trastornos Respiratorios del Sueño (UTRS) por sospecha de AOS. Se excluyeron sujetos con cualquier comorbilidad. En la poligrafía respiratoria se determinó el índice de apnea-hipopnea (IAH). El ADE se obtuvo a partir del hemograma. Al año de seguimiento se determinaron los cambios de ADE tras tratamiento con presión positiva continua en la vía respiratoria (CPAP). Resultados. Se incluyeron 34 sujetos sin AOS y 138 con AOS con una edad de 40,5 ± 9,8 y 45,6 ± 9,2 (p = 0,004) respectivamente. El ADE fue mayor en sujetos con AOS que en sujetos sanos: 13,40 (12,40-14,40) vs. 13,15 (12,07-14,23) (p=0,036). El IAH mostró una relación positiva e independiente con ADE tanto en el conjunto de la población (r = 0,223; p = 0,002) como en el grupo con AOS (r = 0,231; p = 0,005). No se observaron cambios significativos de ADE tras un año de tratamiento con CPAP. Conclusiones. El ADE está aumentado en AOS en relación directa con su gravedad, sin embargo, sus niveles no se ven modificados por el tratamiento efectivo de la AOS con CPAP


Introduction. Red cell distribution width (RDW) describes heterogeneity in the size of red blood cells. An increase in RDW has been associated with excess mortality in heart failure and other chronic diseases. Since there is an increased risk of cardiovascular morbidity and mortality in obstructive sleep apnea (OSA), it is possible that these patients have a high RDW. Method. We recruited subjects aged 18 to 60 years referred to the sleep-disordered breathing unit for suspected OSA. Subjects with any comorbidity were excluded. Apnea-hypopnea index (AHI) was calculated from the respiratory polygraphy. The RDW was obtained from the complete blood count. Changes in RDW after one year of treatment with continuous positive airway pressure (CPAP) were determined. Results. We included 34 healthy subjects and 138 with OSA, aged 40.5 ± 9.8 and 45.6 ± 9.2 (P = .004) years, respectively. The RDW was higher in subjects with OSA compared to healthy subjects: 13.40 (12.40 to 14.40) vs. 13.15 (12.07 to 14.23) (P = .036). AHI showed a positive independent relationship with RDW in both the whole population (r = 0.223; P = .002) and the OSA group (r = 0.231; P = .005). No significant changes were found in RDW after one year of CPAP therapy. Conclusions. RDW increase in patients with OSA is directly associated with severity, although levels are not modified by the effective treatment of OSA with CPAP


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Índices de Eritrócitos , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono , Transtornos do Sono-Vigília/complicações , Poluição por Fumaça de Tabaco/efeitos adversos , Fumar/efeitos adversos , Testes Hematológicos/métodos , Biomarcadores/análise , Estudos Prospectivos , Protocolos/métodos , Análise de Variância
7.
Acta pediatr. esp ; 74(11): e233-e238, dic. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-158922

RESUMO

Introducción: Desde 1986 se ha introducido en nuestro país la esplenectomía parcial, que logra prevenir la recurrencia de la crisis de secuestro esplénico y disminuir la incidencia de sepsis sobreaguda postesplenectomía. Objetivo: Comparar desde el punto de vista clínico y de laboratorio los pacientes con esplenectomía total y parcial. Pacientes y métodos: Se estudiaron todos los pacientes con drepanocitosis, seguidos en el Instituto de Hematología e Inmunología, que se hubieran sometido a esplenectomía durante la edad pediátrica. Resultados: Se incluyeron 39 pacientes en cada método de esplenectomía; la mayoría eran varones (60,3%) y predominaba la anemia drepanocítica (69,2%). La edad de aparición de la esplenectomía fue menor en la de tipo parcial (4,7 años; p= 0,009) que en la total (6,7 años), y el tiempo de seguimiento fue de 12,5 años. El grupo de esplenectomía total presentó un mayor aumento de hemoglobina, leucocitos y plaquetas (p= 0,039), así como valores elevados de lactato deshidrogenasa (p= 0,015), hemoglobina plasmática (p= 0,001) y velocidad de regurgitación tricuspídea (p= 0,038). La crisis vasooclusiva dolorosa fue más frecuente tras la esplenectomía total (75,8 ± 14,3 frente a 39,8 ± 10,1; p < 0,001), al igual que las úlceras maleolares (p= 0,04). La crisis hepática y la mortalidad fueron también más frecuentes en la esplenectomía total aunque sin significación estadística (p= 007 y p= 0,305, respectivamente). Conclusiones: La esplenectomía parcial presenta menos complicaciones a largo plazo que la total (AU)


Introduction: Since 1986 has been introduced in our country partial splenectomy, which prevent the recurrence of splenic sequestration crisis and possible reduce the number of overhelming septicemia. Objective: Compare clinical and laboratory aspects in patients with total and partial splenectomy. Patients and methods: All patients with sickle cell disease were studied, followed at the Instituto de Hematología e Inmunología, who have had a splenectomy in childhood. Results: 39 patients were included in each method of splenectomy, where a predominance of males (60.3%) and sickle cell anemia (69.2%). Splenectomy age was lower in the partial, 4.7 years than in total splenectomy, 6.7 years (0.009). Follow-up time was 12.5 years. Total splenectomy group had greater increase in hemoglobin, leucocytes and platelets (p= 0.039), elevated LDH levels (p= 0.015), plasma hemoglobin (p= 0.001) and tricuspid regurgitation velocity (p= 0.038). Vaso-occlusive painful crises was more frequent after total splenectomy (75.8 ± 14.3 vs. 39.8 ± 10.1; p <0.001), as leg ulcer (p= 0.04). Hepatic crisis (p <0.07) and mortality were higher in individuals with complete splenectomy (p= 0.305) but withouth significative statistics. Conclusions: Partial splenectomy has fewer long-term complications that total (AU)


Assuntos
Humanos , Criança , Anemia Falciforme/fisiopatologia , Esplenectomia , Arteriopatias Oclusivas/fisiopatologia , Complicações Pós-Operatórias/epidemiologia , Testes Hematológicos , Cuba/epidemiologia , Estudos Retrospectivos
9.
Rev. lab. clín ; 9(1): 25-28, ene.-mar. 2016. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-150653

RESUMO

El linfoma es la forma más prevalente de neoplasia hematológica, clasificándose en dos grandes grupos, Hodgkin y no Hodgkin. El linfoma de células del manto (LCM) es un subtipo de linfoma no Hodgkin tipo B, de carácter agresivo y que tiene su origen en células de la zona periférica del centro germinal o en la zona del manto del folículo linfoide. El LCM es uno de los linfomas menos frecuentes, suponiendo cerca del 7% de los casos de linfoma no Hodgkin en los EE. UU. y Europa, con una incidencia aproximada de 4 a 8 casos por millón de personas y año. En torno a tres cuartas partes de los pacientes son varones caucasianos, reduciéndose a la mitad la frecuencia en la raza negra. La edad media en el diagnóstico es de 68 años, desarrollando adenopatías en el 75% de los casos y produciéndose diseminación extranodal en el 25% restante (bazo, médula ósea, sangre, tracto gastrointestinal, mama, pleura y anejos oculares). El laboratorio es un pilar clave en el diagnóstico de LCM establecido mediante el estudio histológico, inmunofenotípico y molecular. El 70% de los pacientes que se diagnostican presentan la enfermedad en un estadio avanzado. Ello conlleva frecuentemente la extensión gastrointestinal y a médula ósea. Aunque los linfomas afectan principalmente a ganglios linfáticos y tejidos linfoides, en algunos casos invaden la médula ósea y sangre periférica. Este proceso recibe el nombre de leucemización y ocurre en el 35% de los casos. Ante una cifra de leucocitos elevada en un paciente diagnosticado de LCM, el cometido del laboratorio será observar el frotis de sangre periférica en busca de linfocitos de aspecto centrocítico. on los tratamientos convencionales, la supervivencia media era de 3 años, cifra que ha aumentado hasta los 7 años para los pacientes que reciben los nuevos tratamientos. El pronóstico de LCM leucemizado es inferior al de las formas ganglionares sin expresión periférica (AU)


Lymphoma is the most prevalent kind of hematopoietic neoplasm, and it can be classified into two groups, Hodgkin and non-Hodgkin lymphoma. Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas, with aggressive behavior and originates in peripheral zone cells of the germinal center or in the mantle zone of lymphoid. The mantle cell lymphoma is one of the less common lymphomas, and comprises about 7% of cases of non-Hodgkin lymphoma in the US and Europe, with an incidence of 4 to 8 cases per million persons per year. Around three-quarters of affected patients are Caucasian males, halving the rate in blacks. Median age at diagnosis is 68 years. Approximately 75% of patients initially present with lymphadenopathy and disease is the primary presentation in the remaining 25% (spleen, bone marrow, blood, gastrointestinal tract, breast, pleura and eye orbit). The Laboratory is a key pillar in the diagnosis of MCL established by histological, immunophenotypic and molecular study. Most patients with mantle cell lymphoma (70%) develope advanced stage disease at diagnosis, involving gastrointestinal tract and bone marrow. Although patients mainly present with lymphadenopathy and other lymphoid tissues participation, sometimes lymphoma invades the bone marrow and peripheral blood. This process is called leukemization and occurs in 35% of cases. Faced with a very high number of leukocytes in a patient already diagnosed with MCL, the role of the laboratory will be to observe the smear blood for lymphocyte centroblastic appearance. With conventional treatments median survival was 3 years, which has increased to 7 years with new treatments. Leukemized MCL prognosis is lower than in a ganglion forms without peripheral expression (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Linfoma de Célula do Manto/complicações , Linfoma de Célula do Manto/diagnóstico , Linfoma de Célula do Manto/patologia , Imuno-Histoquímica/métodos , Imuno-Histoquímica/normas , Testes Hematológicos/instrumentação , Diagnóstico Diferencial , Linfoma de Célula do Manto/sangue , Prognóstico , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais , Espaço Retroperitoneal/patologia , Espaço Retroperitoneal , Esplenomegalia/complicações , Esplenomegalia
10.
Allergol. immunopatol ; 42(5): 402-406, sept.-oct. 2014. tab, graf
Artigo em Inglês | IBECS | ID: ibc-127272

RESUMO

Background: Although some studies show that IL-22 and IL-25 play critical roles in the pathogenesis of asthma, little is known about the systemic production of these cytokines. The aim of this study was to assay IL-22 and IL-25 in serum, in mitogen-activated whole blood (WB), and in mitogen-activated peripheral blood mononuclear cell (PBMC) cultures of patients with severe asthma. Methods: In this cross-sectional study, a questionnaire was prepared to determine the severity of asthma. Through the questionnaire, information including clinical signs, clinical symptoms, and past medical history were acquired. Information collected allowed all patients who were active or ex-smokers to be excluded. A trained observer assessed airway reversibility, peak flowmetry, and spirometry in the remaining patients. Twenty-one patients and simultaneously, twenty age- and sex-matched healthy controls were selected. Sterile blood (10 ml) was taken from each study participant. Sera were isolated and anticoagulant blood used for WB and PBMC cultures and haematological tests. Phytohaemagglutinin and lipopolysaccharide (LPS) were used to activate WB and PBMC. The data from these two groups were compared using Student's t-test. Results: Although the total white blood cell count was elevated in the asthmatic group, other haematological indices, including IL-22 and IL-25 levels in the asthmatic group were not significantly (p > 0.05) different from controls. Conclusions: The levels of IL-22 and IL-25 in patients with severe asthma are no higher than those of non-asthmatic individuals. Any major role for IL-22 and IL-25 in severe asthma is likely to be localised to the lungs and bronchial tissues (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Asma/sangue , Asma/imunologia , Asma/prevenção & controle , Testes Hematológicos/tendências , Sangue/imunologia , Análise Química do Sangue/métodos , Análise Química do Sangue/tendências , Interleucinas/imunologia , Estudos de Casos e Controles
11.
Prog. obstet. ginecol. (Ed. impr.) ; 55(4): 193-195, abr. 2012.
Artigo em Espanhol | IBECS | ID: ibc-99713

RESUMO

La aparición de úlceras genitales en niñas y mujeres jóvenes, de aparente origen no venéreo, es una entidad infrecuente, descrita ya a principios del siglo pasado, conocida como úlcera vulvar aguda o de Lipschütz. Es una entidad de incidencia baja, por lo que es poco conocida y genera confusión cuando se presenta. La falta de una etiología clara y su presentación en una población a caballo entre la población pediátrica y mujeres jóvenes aumentan esta confusión. Detallamos un caso a continuación (AU)


The development of genital ulcers, of apparently non-venereal origin, in adolescents and young girls is a rare entity known as acute genital ulcer or Lipschütz ulcer. Because of their low incidence, these ulcers are little known and can cause confusion when they occur. This confusion is increased by the lack of a clear cause and the occurrence of these ulcers in an age group that falls between the pediatric and young adult populations. We describe a case of Lipschütz ulcer treated in our hospital (AU)


Assuntos
Humanos , Feminino , Criança , Adolescente , Doenças dos Genitais Femininos/complicações , Doenças dos Genitais Femininos/diagnóstico , Genitália Feminina/lesões , Úlcera/complicações , Úlcera/diagnóstico , Vulva/lesões , Corticosteroides/uso terapêutico , Testes Hematológicos/métodos , Testes Hematológicos , Gangrena/complicações , Gangrena/terapia
12.
Pediatr. aten. prim ; 14(53): 75-82, ene.-mar. 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-99950

RESUMO

La ferropenia es un problema frecuente en el lactante. Distintos estudios relacionan la ferropenia con potenciales efectos sobre el neurodesarrollo, aunque aún no existe evidencia suficiente. La mayoría de organizaciones no recomiendan la suplementación universal en lactantes sanos nacidos a término, aunque hay consenso en suplementar si hay factores de riesgo. También es tema de controversia el cribado de la ferropenia en el lactante, mientras algunas organizaciones lo recomiendan solo a grupos de riesgo, otras entidades, proponen el cribado universal. El objetivo de este artículo es revisar las necesidades de hierro durante el primer año, así como las recomendaciones de los principales comités (AU)


Iron deficiency is a frequent condition during infancy. Recent studies relate it with neurodevelopment, although there are not conclusive results. Most organizations are not recommending iron supplementation in normal infants but there is consensus about supplementing if there are risk factors. There is also controversy about screening and some groups recommend screening infants at risk, and others propose general screening. The purpose of this article is to review the requirements of iron during infancy and the different current recommendations (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Programas de Rastreamento/história , Programas de Rastreamento/prevenção & controle , Grupos de Risco , Anemia/complicações , Anemia/diagnóstico , Deficiência de Ferro/diagnóstico , Deficiência de Ferro/tratamento farmacológico , Ferro/uso terapêutico , Ferro/deficiência , Deficiência de Ferro/complicações , Deficiência de Ferro/metabolismo , Deficiência de Ferro/prevenção & controle , Testes Hematológicos/métodos
14.
Rev. lab. clín ; 4(1): 3-14, ene.-mar. 2011. btab, ilus
Artigo em Espanhol | IBECS | ID: ibc-86244

RESUMO

Introducción. La revisión de la citología de sangre periférica es un punto de partida imprescindible para el diagnóstico de la mayoría de las enfermedades hematológicas, e incluso no hematológicas. Objetivo. Evaluar la concordancia entre los resultados obtenidos al realizar el recuento diferencial leucocitario mediante el sistema de análisis digital CellaVision DM96 (DM96) y el microscopio óptico convencional. Material y métodos. Se analizaron 234 extensiones de sangre periférica, de pacientes del Hospital Clínic de Barcelona con cifras de leucocitos entre 1,12 y 282×109/L. 177 preparaciones correspondieron a pacientes con enfermedades hematológicas. Se compararon los porcentajes de neutrófilos, bandas, eosinófilos, basófilos, linfocitos, monocitos, células linfoides reactivas, metamielocitos, mielocitos, promielocitos, blastos, células plasmáticas y eritroblastos PRE y POST obtenidos con el DM96 y al microscopio. Resultados. La correlación de los resultados del DM96 PRE con respecto al microscopio fue excelente para neutrófilos, linfocitos, monocitos, y blastos (r>0,87<0,94 y p<0,0001) y aceptable para bandas, eosinófilos, basófilos y células plasmáticas (r>0,74<0,81 y p<0,0001). Después de la reclasificación celular, los coeficientes de concordancia fueron excelentes (> 0,7) para promielocitos y mielocitos, intermedios para células linfoides reactivas y eritroblastos (> 0,5 y<0,7), y bajos (< 0,5) para los metamielocitos. No se observaron falsos negativos en la detección de blastos por el DM96 (97 casos). Con excepción de las células linfoides reactivas y blastos linfoides, el equipo no preclasificó otras células linfoides atípicas, que debieron ser identificadas por el citólogo. Conclusiones. El análisis morfológico de sangre periférica mediante el equipo CellaVision DM96 muestra una buena concordancia con respecto al microscopio, y representa un avance tecnológico para el laboratorio de Hematología con un número elevado de muestras. Tiene ventajas adicionales, tales como mejorar las condiciones ergonómicas, mayor rapidez, asegurar la trazabilidad y facilitar la docencia (AU)


Introduction. Differential leukocyte counts of peripheral blood cells are an important diagnostic tool. Objective. We evaluated the CellaVision DM96 (CellaVision AB, Lund, Sweden), an automated system for digital peripheral blood cell analysis. Material and methods. We analysed 234 blood films in which leukocyte values were from 1.12 to 282×109/L. A total of 177 blood films were from patients with hematological diseases. Results. Correlation coefficients between results obtained from the CellaVision DM96 pre-classification and by conventional direct microscopy were excellent for segmented neutrophils, lymphocytes, monocytes and blasts (r>0.87<0.94 and P<.0001) and good for band neutrophils, eosinophils, basophils and plasma cells (r>0.74<0.81 and P<.0001). After the reclassification of the cells, very good concordance coefficients were observed for promyelocytes and myelocytes (> 0.7), intermediate for reactive lymphocytes and erythroblasts (>0.5 and<0.7) and low (<0.5) for metamyelocytes. Whatever the pathology and the number of blasts on the films, all 97 patients were positive for blast detection on the DM96. Pathological cells such as prolymphocytes, large granular lymphocytes, hairy cells, Sézary cells and other atypical lymphocytes were reclassified by the user. Conclusions. Advantages of the CellaVision DM96 over direct microscopy include, requires less time than manual differentiation, is a good tool for educational purposes, improve the traceability of the results, and can have an important role in a modern Hematology Laboratory (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Hematológicas/sangue , Testes Hematológicos/instrumentação , Testes Hematológicos/métodos , Doenças Sanguíneas e Linfáticas/sangue , Doenças Sanguíneas e Linfáticas/diagnóstico , Células Sanguíneas/citologia , Células Sanguíneas , Contagem de Leucócitos/métodos , Leucócitos/citologia , Análise Estatística , Modelos Lineares , Modelos Logísticos , Escala Fujita-Pearson
15.
Enferm. intensiva (Ed. impr.) ; 21(3): 120-125, jul.-sept. 2010. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-84878

RESUMO

ObjetivoExaminar el perfil de pérdidas sanguíneas diagnósticas (extracciones analíticas) e iatrogénicas (técnicas de depuración extracorpórea [TDE]) en pacientes con trauma grave.MétodoEstudio descriptivo observacional prospectivo durante un año. Incluimos aquellos pacientes mayores de 15 años ingresados por trauma grave con Injury Severity Score (ISS) superior o igual a 16 puntos. Excluimos a aquellos pacientes a los que se hubiera indicado limitación del esfuerzo terapéutico. De 225 pacientes, con 1.619 días de evolución, analizamos volumen perdido/día/paciente, tipo de extracción, evolución clínica y presencia o no de TDE. Las variables se expresan como media±SD comparadas con la prueba de la t de Student.ResultadosEl promedio de pérdidas hemáticas/paciente/día ha sido de 55,5±32,2cm3. Encontramos diferencias estadísticamente significativas en el volumen sanguíneo extraído, comparando el primer día respecto al segundo (73,5±32,2 vs. 56,3±21,9cm3; p<0,001); evolución clínica (alta o éxitus) (54,8±33 vs. 60,7±24,9; p<0,05); gravedad (Injury Severity Score<31 o ≥31) (54,65±20 vs. 61,5±28,5; p<0,001) y sin TDE/TDE (50,9±18,9 vs. 97,2±72,6; p<0,001).ConclusionesLa mayor pérdida de sangre diagnóstica se produce en la fase de resucitación, en los pacientes que fallecen, en aquellos con mayor gravedad y los sometidos a TDE (AU)


ObjectiveTo analyze diagnostic (blood drawings) and iatrogenic (Continuous Renal Replacement Therapy, CRRT) blood losses (BL) in severe trauma patients.MethodA one-year descriptive, prospective and observational study. We included patients over 15 years of age, admitted with severe trauma and who had a score of ≥16 on the Injury Severity Index (ISS). Those patients in whom limitation of therapeutic effort had been indicated were excluded. A total of 225 patients with 1619 days of evolution were analyzed for volume of BL/day/patient, type of diagnostic test, clinical outcome and utilization of CRRT. The variables were described as mean ± standard deviation with the Student's T test.ResultsAverage blood loss of patient per day was 55.5±32.2cc. Statistically significant differences were found between the blood volume drawn when the first day was compared to the second day, 73.5±32.2 vs. 56.3±21.9 (p<0.001); clinical outcome (alive vs death) 54.8±33 vs. 60.7±24.9 (p<0.05); severity (ISS<31 or ≥31) 54.65±20 vs. 61.5±28.5 (p<0.001), No RRT vs RRT: 50.9±18.9 vs. 97.2±72.6 (p<0.001).ConclusionsThe greatest diagnostic BL occurs during the resuscitation phase, in the patients who die, in those with greater severity and those undergoing CRRT (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Ferimentos e Lesões/sangue , Anemia/etiologia , Testes Hematológicos/efeitos adversos , Estudos Prospectivos
16.
Endocrinol. nutr. (Ed. impr.) ; 57(7): 301-305, ago.-sept. 2010. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-87549

RESUMO

Las determinaciones plasmáticas de testosterona son fundamentales para el diagnóstico de las distintas causas de hipogonadismo, incluido el hipogonadismo de inicio tardío. Existen dificultades para interpretar los resultados de las concentraciones de testosterona debido a los cambios que se presentan con la edad y por la variabilidad de los distintos métodos utilizados. Objetivos Estudiar los rangos de normalidad de testosterona en varones jóvenes sanos y comparar los resultados de los distintos métodos analíticos utilizados.Material y métodosSe incluyeron 20 hombres sanos con una edad media de 24,5 años (desviación estándar (DE): 5,04), un índice de masa corporal (IMC) medio de 23,8% (DE: 3,3). Se determinaron las concentraciones de testosterona total (TT) mediante inmunoquimioluminiscencia (ICLA), de testosterona libre (TL) mediante radioinmunoensayo (RIA), y se calculó la testosterona libre calculada (TLc) y la testosterona biodisponible (TB) mediante la fórmula de Vermeulen. Se midieron las concentraciones séricas de lutropina (LH), folitropina (FSH) y proteína ligadora de hormonas sexuales (SHBG) por método inmunorradiométrico (IRMA).Resultados Las concentraciones medias de TT fueron de 20nmol/l (DE 4,96), las de TL de 0,054nmol/l (DE 0,01), los de TLc de 0,3834nmol/l (DE 0,09) y los de TB de 9,9nmol/l (DE: 2,8 ). No se encontró correlación entre las concentraciones de testosterona medidos por los distintos métodos, excepto entre TL y TLc (r=0,662; p<0,003) y entre TLc y TB (r=0,979; p<0,0001). Existe una asociación inversa entre IMC y las concentraciones de testosterona total (r: −0,52; p<0,017).Conclusiones Es necesario establecer el intervalo de normalidad para la testosterona en hombres jóvenes sanos en función del método analítico utilizado (AU)


Plasma testosterone concentrations are essential for the diagnosis of several causes of hypogonadism, including late-onset hypogonadism. Defining the normal range for testosterone concentrations poses certain difficulties due to the changes that occur with age and the variability of the different analytical methods used.O bjectives To study normal ranges of testosterone in healthy young men and to compare the results of distinct analytical methods. Material and methods We recruited 20 healthy men with a mean age of 24.5 years (standard deviation (SD): 5.04) and a mean body mass index (BMI) of 23.8% (SD: 3.3). Total testosterone (TT) was measured by immunochemiluminescence (ICLA) and free testosterone (FT) by radioimmunoassay (RIA). Calculated free testosterone (FTc) and bioavailable testosterone (BT) were calculated using Vermeulen's formula. Serum lutropin (LH), follitropin (FSH) and sex hormone binding globulin (SHBG) were measured by immunoradiometric assays (IRMA).Results The mean concentrations were 20nmol/l (SD: 4.96) for TT, 0.054nmol/L (SD: 0.01) for FT, 0.3834nmol/L (SD: 0.09) for FTc and 9.9nmol/L (SD: 2.8) for BT. There was no correlation between testosterone measured by different methods other than an association between FT and FTc (r=0.662, p<0.003) and between FTc and BT (r=0.979, p<0.0001). An inverse correlation was found between BMI and TT concentrations (r: −0.52, p<0.017).Conclusions The normal range for testosterone in healthy young men should be established in each laboratory based on the analytical method used (AU)


Assuntos
Humanos , Masculino , Adolescente , Pessoa de Meia-Idade , Testosterona/sangue , Testes Hematológicos/métodos , Valores de Referência
20.
Clin. transl. oncol. (Print) ; 10(7): 399-406, jul. 2008. tab
Artigo em Inglês | IBECS | ID: ibc-123470

RESUMO

Breast cancer is the most common type of cancer among women, and clinicians have long recognized its heterogeneity. Its detection and treatment in early stages allow for reduction of mortality. Despite the advances and new strategies for combining surgical, radiotherapy, and chemotherapy options, however, the percentage of patients developing metastases and advanced stages remains high. Even though serum tumor markers have been used for the early diagnosis of metastases, their systematic determination has not had an effect on survival. Methods that are more reliable are needed to detect metastases earlier than with the common clinical methods and thus start treatment before overt relapse. Early indicators of response or resistance to treatment are also an issue in clinical practice. Imaging techniques are time consuming, and it is difficult to detect changes that indicate response limited to therapy, and approaches to defining changes in tumor mass are time and resource consuming. In contrast, detection of circulating tumor cells (CTC) could be a useful tool in early detection of relapse and response to systemic chemotherapy. Extremely sensitive techniques are available that are easily applied to peripheral blood samples, which might provide enormous research possibilities in this area (AU)


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Assuntos
Humanos , Feminino , Neoplasias da Mama/sangue , Neoplasias da Mama/patologia , Testes Hematológicos/métodos , Testes Hematológicos , Células Neoplásicas Circulantes , Células Neoplásicas Circulantes/metabolismo , Células Neoplásicas Circulantes/patologia , Imunofluorescência/métodos , Imunofluorescência , Imuno-Histoquímica/métodos , Imuno-Histoquímica , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Reação em Cadeia da Polimerase Via Transcriptase Reversa
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