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1.
Ann Clin Lab Sci ; 50(3): 299-307, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32581016

RESUMO

OBJECTIVE: An outbreak of pneumonia named COVID-19 caused by a novel coronavirus in Wuhan is rapidly spreading worldwide. The objective of the present study was to clarify further the clinical characteristics and blood parameters in COVID-19 patients. MATERIALS AND METHODS: Twenty-three suspected patients and 64 patients with laboratory-confirmed SARS-Cov-2 infection were admitted to a designated hospital. Epidemiological, clinical, laboratory, and treatment data were collected and analyzed. RESULTS: Of the 64 patients studied, 47 (73.4%) had been exposed to a confirmed source of COVID-19 transmission. On admission, the most common symptoms were fever (75%) and cough (76.6%). Twenty-eight (43.8%) COVID-19 patients showed leukopenia, 10 (15.6%) showed lymphopenia, 47 (73.4%) and 41 (64.1%) had elevated high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR), respectively, and 30 (46.9%) had increased fibrinogen concentration. After the treatment, the counts of white blood cells and platelets, and the level of prealbumin increased significantly, while aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and hsCRP decreased. COVID-19 patients with the hospital stay longer than 12 days had higher body mass index (BMI) and increased levels of AST, LDH, fibrinogen, hsCRP, and ESR. CONCLUSIONS: Results of blood tests have potential clinical value in COVID-19 patients.


Assuntos
Betacoronavirus/isolamento & purificação , Biomarcadores/sangue , Infecções por Coronavirus/complicações , Tosse/diagnóstico , Febre/diagnóstico , Leucopenia/diagnóstico , Linfopenia/diagnóstico , Pneumonia Viral/complicações , Adulto , Infecções por Coronavirus/virologia , Tosse/sangue , Tosse/etiologia , Feminino , Febre/sangue , Febre/etiologia , Humanos , Leucopenia/sangue , Leucopenia/etiologia , Linfopenia/sangue , Linfopenia/etiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Prognóstico
2.
Acad Radiol ; 27(7): 910-921, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32505599

RESUMO

RATIONALE AND OBJECTIVES: We aimed to assess the prevalence of significant computed tomographic(CT) manifestations and describe some notable features based on chest CT images, as well as the main clinical features of patients with coronavirus disease 2019(COVID-19). MATERIALS AND METHODS: A systematic literature search of PubMed, EMBASE, the Cochrane Library, and Web of Science was performed to identify studies assessing CT features, clinical, and laboratory results of COVID-19 patients. A single-arm meta-analysis was conducted to obtain the pooled prevalence and 95% confidence interval (95% CI). RESULTS: A total of 14 articles (including 1115 patients) based on chest CT images were retrieved. In the lesion patterns on chest CTs, we found that pure ground-glass opacities (GGO) (69%, 95% CI 58-80%), consolidation (47%, 35-60%) and "air bronchogram sign" (46%, 25-66%) were more common than the atypical lesion of "crazy-paving pattern" (15%, 8-22%). With regard to disease extent and involvement, 70% (95% CI 46-95%) of cases showed a location preference for the right lower lobe, 65% (58-73%) of patients presented with ≥3 lobes involvement, and meanwhile, 42% (32-53%) of patients had involvement of all five lobes, while 67% (55-78%) of patients showed a predominant peripheral distribution. An understanding of some important CT features might be helpful for medical surveillance and management. In terms of clinical features, muscle soreness (21%, 95% CI 15-26%) and diarrhea (7%, 4-10%) were minor symptoms compared to fever (80%, 74-87%) and cough (53%, 33-72%). CONCLUSION: Chest CT manifestations in patients with COVID-19, as well as its main clinical characteristics, might be helpful in disease evolution and management.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Biomarcadores/metabolismo , Broncografia/métodos , Proteína C-Reativa/metabolismo , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/patologia , Tosse/virologia , Diarreia/virologia , Feminino , Febre/virologia , Humanos , Leucopenia/virologia , Pulmão/patologia , Pulmão/virologia , Linfopenia/virologia , Masculino , Pessoa de Meia-Idade , Mialgia/virologia , Pandemias , Pneumonia Viral/patologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tórax
3.
Clin Chem Lab Med ; 58(7): 1106-1115, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32352397

RESUMO

Objectives In December 2019, there was an outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, and since then, the disease has been increasingly spread throughout the world. Unfortunately, the information about early prediction factors for disease progression is relatively limited. Therefore, there is an urgent need to investigate the risk factors of developing severe disease. The objective of the study was to reveal the risk factors of developing severe disease by comparing the differences in the hemocyte count and dynamic profiles in patients with severe and non-severe COVID-19. Methods In this retrospectively analyzed cohort, 141 confirmed COVID-19 patients were enrolled in Taizhou Public Health Medical Center, Taizhou Hospital, Zhejiang Province, China, from January 17, 2020 to February 26, 2020. Clinical characteristics and hemocyte counts of severe and non-severe COVID patients were collected. The differences in the hemocyte counts and dynamic profiles in patients with severe and non-severe COVID-19 were compared. Multivariate Cox regression analysis was performed to identify potential biomarkers for predicting disease progression. A concordance index (C-index), calibration curve, decision curve and the clinical impact curve were calculated to assess the predictive accuracy. Results The data showed that the white blood cell count, neutrophil count and platelet count were normal on the day of hospital admission in most COVID-19 patients (87.9%, 85.1% and 88.7%, respectively). A total of 82.8% of severe patients had lymphopenia after the onset of symptoms, and as the disease progressed, there was marked lymphopenia. Multivariate Cox analysis showed that the neutrophil count (hazard ratio [HR] = 4.441, 95% CI = 1.954-10.090, p = 0.000), lymphocyte count (HR = 0.255, 95% CI = 0.097-0.669, p = 0.006) and platelet count (HR = 0.244, 95% CI = 0.111-0.537, p = 0.000) were independent risk factors for disease progression. The C-index (0.821 [95% CI, 0.746-0.896]), calibration curve, decision curve and the clinical impact curve showed that the nomogram can be used to predict the disease progression in COVID-19 patients accurately. In addition, the data involving the neutrophil count, lymphocyte count and platelet count (NLP score) have something to do with improving risk stratification and management of COVID-19 patients. Conclusions We designed a clinically predictive tool which is easy to use for assessing the progression risk of COVID-19, and the NLP score could be used to facilitate patient stratification management.


Assuntos
Biomarcadores/sangue , Infecções por Coronavirus/diagnóstico , Hemócitos/citologia , Pneumonia Viral/diagnóstico , Adulto , Betacoronavirus/patogenicidade , China , Coronavirus/patogenicidade , Infecções por Coronavirus/sangue , Progressão da Doença , Feminino , Humanos , Contagem de Leucócitos/métodos , Leucopenia , Contagem de Linfócitos/métodos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Pandemias , Contagem de Plaquetas/métodos , Pneumonia Viral/sangue , Prognóstico , Estudos Retrospectivos , Fatores de Risco
4.
BMC Infect Dis ; 20(1): 346, 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410583

RESUMO

BACKGROUND: To analyze and discuss the transmission route of a cluster of cases of severe fever with thrombocytopenia syndrome bunyavirus (SFTSV). METHOD: We performed an epidemiological investigation and a genetic analysis of patients with severe fever with thrombocytopenia syndrome (SFTS) caused by SFTSV, their close contacts and the surrounding population. RESULTS: We found that all patients had contact with the blood of the first patient. The comparison of gene sequences in the three isolated SFTSV strains showed that the strains were closely related. Six close contacts and nine individuals in the surrounding population were positive for SFTSV IgM antibody. CONCLUSION: We suspect that the cluster outbreak was transmitted via blood and that the natural reservoir host of SFTSV exists in the patients' environment.


Assuntos
Infecções por Bunyaviridae/epidemiologia , Phlebovirus/genética , Idoso , Infecções por Bunyaviridae/virologia , China/epidemiologia , Surtos de Doenças , Fazendeiros , Humanos , Leucopenia/virologia , Masculino , Pessoa de Meia-Idade , Phlebovirus/isolamento & purificação , Trombocitopenia/virologia
5.
Zhonghua Nei Ke Za Zhi ; 59(5): 372-374, 2020 May 01.
Artigo em Chinês | MEDLINE | ID: mdl-32370466

RESUMO

To investigate the early changes of peripheral blood leukocyte differential counts in patients with COVID-19. Ten patients with COVID-19 and 30 patients with other viral pneumonia (non-COVID-19) admitted to The Sixth People's Hospital of Shanghai and Jinshan Branch Hospital from January 22 to February 17, 2020 were enrolled in this study. The differential counts of white blood cells (WBC) were analyzed. Patients in COVID-19 group showed relatively lower absolute WBC count 4.95(3.90,6.03)×10(9)/L, lymphocyte absolute count 1.20(0.98,1.50)×10(9)/L and eosinophil absolute count 0.01(0.01,0.01)×10(9)/L. Leukopenia developed in two patients(2/10), lymphocytopenia also in two patients(2/10). Seven over ten patients presented with eosinophil cytopenia. In non-COVID-19 group, absolute WBC count was 8.20(6.78,9.03)×10(9)/L (P<0.001), lymphocyte absolute count 1.75(1.20,2.53)×10(9)/L(P=0.036), eosinophil absolute count 0.02(0.01,0.03)×10(9)/L(P=0.005). Lymphocytopenia occurred in 16.7% patients, eosinophil cytopenia in 16.7% patients too. In conclusion, leukopenia, lymphocytopenia and eosinophil cytopenia are more common in COVID-19 patients than those in non-COVID-19 patients.


Assuntos
Infecções por Coronavirus/sangue , Leucócitos/citologia , Pneumonia Viral/sangue , Betacoronavirus , Estudos de Casos e Controles , China , Eosinófilos/citologia , Humanos , Contagem de Leucócitos , Leucopenia , Linfopenia , Pandemias
6.
Ann Hematol ; 99(6): 1205-1208, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32296910

RESUMO

Since December 2019, a novel coronavirus has spread throughout China and across the world, causing a continuous increase in confirmed cases within a short period of time. Some studies reported cases of thrombocytopenia, but hardly any studies mentioned how the virus causes thrombocytopenia. We propose several mechanisms by which coronavirus disease 2019 causes thrombocytopenia to better understand this disease and provide more clinical treatment options.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Trombocitopenia/etiologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/terapia , Humanos , Leucopenia/etiologia , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/terapia , Trombocitopenia/terapia , Trombopoese
7.
PLoS One ; 15(3): e0229920, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32134948

RESUMO

BACKGROUND: The prolonged manifestation of concurrent leukopenia, thrombocytopenia and normal C-reactive protein (CRP) (named as SFTS prediction score) in febrile diseases is not usual and may be used to make an initial differential diagnosis, which is a characteristic finding of severe fever with thrombocytopenia syndrome (SFTS). METHODS: The dynamics of SFTS prediction scores was investigated in SFTS patients. The study subjects for the comparison were febrile patients aged ≥ 16 years with SFTS scores of 2 (S2) or 3 (S3) who visited an emergency room for a 4-year study period. The dynamic distribution of S2 and S3 at presentation with regards to onset of illness, the characteristics of responsible diseases and the predictability of SFTS in both groups were described. RESULTS: In 104 patients with SFTS, the daily proportion of S2 or S3 ranged from 58.3 to 100% from day (D) 1 to D12 after the onset of illness. The S2 subtype of 'leukopenia plus thrombocytopenia' and S3 represented 72.7-100% of all scores. In contrast, for the 130 patients in the febrile cohort, 73.8% of evaluations were distributed between D1 and D4 after the onset of illness, and 68.8% of patients had the S2 subtype of 'leukopenia plus normal CRP'. Upper respiratory infection was the most frequent (50.0%) cause of diseases. Pneumonia (13.8%) and urosepsis (6.2%) initially presented with either S2 with normal CRP or S3 but had poor prognosis. The presence of S2 or S3 predicted SFTS with sensitivity and specificity of 0.85 (0.42-0.99; 95% CI) and 0.98 (0.98-0.98; 95% CI), respectively. CONCLUSION: The temporal distribution and composition of S2 or S3 were unique in several febrile diseases including SFTS, and the SFTS prediction score may be useful for differentiating febrile diseases in primary care settings of SFTS endemic areas.


Assuntos
Testes Diagnósticos de Rotina/métodos , Febre/diagnóstico , Projetos de Pesquisa , Trombocitopenia/diagnóstico , Idoso , Proteína C-Reativa/análise , Estudos de Coortes , Diagnóstico Diferencial , Serviço Hospitalar de Emergência , Feminino , Humanos , Leucopenia/diagnóstico , Masculino , Pessoa de Meia-Idade , Prognóstico , República da Coreia , Sensibilidade e Especificidade , Síndrome
8.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 51(2): 131-138, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32220177

RESUMO

This review summarizes the ongoing researches regarding etiology, epidemiology, transmission dynamics, treatment, and prevention and control strategies of the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with comparison to severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and pandemic H1N1 virus. SARS-CoV-2 may be originated from bats, and the patients and asymptomatic carriers are the source of epidemic infection. The virus can be transmitted human-to-human through droplets and close contact, and people at all ages are susceptible to this virus. The main clinical symptoms of the patients are fever and cough, accompanied with leukocytopenia and lymphocytopenia. Effective drugs have been not yet available thus far. In terms of the prevention and control strategies, vaccine development as the primary prevention should be accelerated. Regarding the secondary prevention, ongoing efforts of the infected patients and close contacts quarantine, mask wearing promotion, regular disinfection in public places should be continued. Meanwhile, rapid detection kit for serological monitoring of the virus in general population is expected so as to achieve early detection, early diagnosis, early isolation and early treatment. In addition, public health education on this disease and prevention should be enhanced so as to mitigate panic and mobilize the public to jointly combat the epidemic.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Doenças Assintomáticas , Betacoronavirus/patogenicidade , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Tosse/etiologia , Diagnóstico Precoce , Febre/etiologia , Humanos , Vírus da Influenza A Subtipo H1N1 , Leucopenia/etiologia , Linfopenia/etiologia , Coronavírus da Síndrome Respiratória do Oriente Médio , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Vírus da SARS , Prevenção Secundária , Vacinas Virais
10.
Int J Clin Oncol ; 25(1): 203-209, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31520175

RESUMO

OBJECTIVE: This study aimed to evaluate the efficacy and toxicity of 4-day chemotherapy with methotrexate, etoposide, and actinomycin D (MEA) for patients who were diagnosed with choriocarcinoma and high-risk gestational trophoblastic neoplasia (GTN). METHODS: Between January 1999 and December 2015, 29 patients were treated with 4-day MEA after being diagnosed with choriocarcinoma or high-risk GTN. Complete remission to 4-day MEA and adverse effects were retrospectively evaluated. RESULTS: The complete remission rates were 79.3% (23/29) and 87.5% (21/24) in all patients and in those who received 4-day MEA as first-line therapy, respectively. Of six patients who developed drug resistance to 4-day MEA, three patients showed complete remission by other treatments, while the other three patients died of the disease. The major adverse effects were leukocytopenia, anemia, and nausea. Of 23 patients who were cured with 4-day MEA, treatment was changed to the etoposide and actinomycin D (EA) regimen in 14 patients, because of leukocytopenia, hepatotoxicity, and stomatitis. Among 20 patients who required hormonal therapy, 15 patients showed normal menstrual cycles after therapy. Five patients had nine conceptions (seven term live births and two spontaneous abortions). No babies were premature or had low birth weight nor did they have congenital anomalies. CONCLUSION: The results suggest that the efficacy and the adverse effects of 4-day MEA for choriocarcinoma and high-risk GTN may be the same level as EMA/CO. However, further study will be needed for determining the criteria of changing the treatment regimen from 4-day MEA to the EA regimen.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Coriocarcinoma/tratamento farmacológico , Doença Trofoblástica Gestacional/tratamento farmacológico , Neoplasias Uterinas/tratamento farmacológico , Adolescente , Adulto , Idoso , Anemia/induzido quimicamente , Dactinomicina/administração & dosagem , Etoposídeo/administração & dosagem , Feminino , Humanos , Leucopenia/induzido quimicamente , Ciclo Menstrual/efeitos dos fármacos , Metotrexato/administração & dosagem , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Gravidez , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
11.
Int J Radiat Oncol Biol Phys ; 106(2): 282-290, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31669564

RESUMO

PURPOSE: Our purpose was to compare toxicity and biochemical control in postprostatectomy patients treated with conventional (66 Gy) or dose-intensified (72 Gy) radiation therapy. METHODS AND MATERIALS: Patients who had stage pT3-4, positive surgical margins, or rising prostate-specific antigen ≥ 0.2 ng/mL after radical prostatectomy were randomly assigned to receive either 66 Gy in 33 fractions or 72 Gy in 36 fractions. A primary endpoint was to assess the difference in biochemical progression-free survival (bPFS) between these 2 cohorts, and secondary endpoints were to assess differences in genitourinary (GU), gastrointestinal (GI), and hematologic toxicities between these 2 cohorts. bPFS was estimated by the Kaplan-Meier method and toxicities were compared using the χ2 test. RESULTS: Between September 2011 and November 2016, 144 patients were enrolled: 71 patients to the 66 Gy cohort and 73 patients to the 72 Gy cohort. The median follow-up time was 48.5 months (range, 14-79 months). There was no difference in 4-year bPFS between the 66 Gy and 72 Gy cohorts (75.9% vs 82.6%; P = .299). However, in patients with a higher Gleason score (8-10), the 72 Gy cohort had statistically significant improvement in bPFS compared with the 66 Gy cohort (79.7% vs 55.7%; P = .049). Toxicity analysis showed no difference in ≥2 acute or late GI or GU toxicities between these 2 cohorts. A total of 48 patients were scored as urinary incontinence before radiation therapy, of which 39 (81.3%) reported incontinence recovery or stable at 1-year follow-up, and only 9 (18.8%) patients reported worsening. There was no difference between the 2 cohorts in urinary incontinence either at baseline or at 1-year follow-up. CONCLUSIONS: Dose escalation (72 Gy) demonstrated no improvement in 4-year bPFS compared with the 66 Gy regimen. However, the dose escalation was not associated with greater acute or late GU or GI toxicities and did not increase urinary incontinence.


Assuntos
Neoplasias da Próstata/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Fracionamento da Dose de Radiação , Seguimentos , Gastroenteropatias/etiologia , Humanos , Calicreínas/sangue , Estimativa de Kaplan-Meier , Leucopenia/etiologia , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Gradação de Tumores , Período Pós-Operatório , Intervalo Livre de Progressão , Antígeno Prostático Específico/sangue , Prostatectomia , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Radioterapia Adjuvante/estatística & dados numéricos , Radioterapia Guiada por Imagem/efeitos adversos , Radioterapia de Intensidade Modulada/efeitos adversos , Terapia de Salvação/estatística & dados numéricos , Fatores de Tempo , Incontinência Urinária/complicações , Incontinência Urinária/radioterapia , Transtornos Urinários/etiologia
12.
Am J Clin Pathol ; 153(2): 266-273, 2020 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-31608361

RESUMO

OBJECTIVES: We wanted to evaluate the effectiveness of flow cytometry immunophenotyping (FCI) as a screening test for patients with leukocytosis and cytopenia. METHODS: We identified 320 patients during August 2016 to December 2016 and evaluated FCI and morphology of peripheral blood smears (PBSs). RESULTS: The most common indications for FCI included history of hematologic malignancy (HHM, n = 126), leukocytosis (n = 80), and cytopenia (n = 53). Positive FCI rate was low with a range of 4.4% to 12.5% in patients with absolute neutrophilia regardless of HHM, if cases with circulating blasts were excluded. Patients with absolute lymphocytosis had a 93% positive FCI rate. Patients with HHM and pancytopenia showed a higher incidence of positive FCI findings than patients without HHM and with isolated cytopenia. PBS morphology correlated strongly with FCI (P = .0001). CONCLUSION: PBS evaluation is an accurate and cost-effective screening test. FCI for patients with mature neutrophilia and isolated cytopenia has a very low yield.


Assuntos
Citometria de Fluxo/métodos , Leucocitose/diagnóstico , Leucopenia/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Imunofenotipagem , Lactente , Laboratórios , Leucocitose/patologia , Leucopenia/patologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Toxicol Lett ; 318: 92-98, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31678399

RESUMO

Sulfur mustard (SM) is a vesicant chemical warfare agent. Recent studies reported alleged use of SM by non-state actors in Syria and Iraq. It has been shown that SM induced immunological and hematological complications. The aim of this study was to determine acute toxic effects of SM exposure on hematological parameters. Blood samples from a group of Syrian exposed to SM in 2016 were taken daily during the follow-up of the patients in intensive care unit. Initial leukocytosis was observed in all patients (100%) on the first 48 h after exposure. Following leukocytosis, isolated lymphopenia was observed in all patients (100%) between 2nd and 4th days. A decrease in hemoglobin level was noted in five patients (62.5%) between 4th and 5th days. Thrombocytopenia was observed in 75% of patients between 4th and 6th days for mild cases and between 9th and 11th days for severe cases. Three patients (37.5%) developed distinct leucopenia/neutropenia on 11th and 12th days. It was observed that human exposure to high dose of SM has direct toxic effect on hematological cells and bone marrow. New strategies on treatment of SM-induced myelosuppression could reduce the effects of hematological complications and could increase the survival rate in these patients.


Assuntos
Medula Óssea/efeitos dos fármacos , Terrorismo Químico , Substâncias para a Guerra Química/envenenamento , Leucocitose/induzido quimicamente , Leucopenia/induzido quimicamente , Linfopenia/induzido quimicamente , Gás de Mostarda/envenenamento , Trombocitopenia/induzido quimicamente , Adolescente , Adulto , Biomarcadores/sangue , Medula Óssea/patologia , Feminino , Hemoglobinas/metabolismo , Humanos , Leucocitose/sangue , Leucocitose/patologia , Leucopenia/sangue , Leucopenia/patologia , Linfopenia/sangue , Linfopenia/patologia , Masculino , Síria , Trombocitopenia/sangue , Trombocitopenia/patologia , Adulto Jovem
15.
Best Pract Res Clin Rheumatol ; 33(4): 101425, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31810545

RESUMO

Cytopenias may herald or concur with the onset of various systemic rheumatic diseases. Accordingly, patients with reduced blood cell counts are often referred for possible underlying autoimmune disease. Initial evaluation aims to exclude nonrheumatic causes such as drug toxicity, infections, or hematological/myelopoiesis disorders. Patient interview and physical examination are critical to unravel features related to or suggestive of rheumatic disease. Based on the clinical scenario, targeted immunological testing may provide additional diagnostic insights. Yet, not all patients may present with full-fledged, criteria-classified disease at early stages. Accordingly, physicians should have a high index of suspicion for individuals who present with a combination of immune/inflammatory cytopenia(s) and relevant clinical (e.g., synovitis) and/or serological manifestations, even if these are few in number or nonspecific (e.g., ANA). Ongoing studies in preclinical or early autoimmunity cohorts could lead to the discovery of diagnostic biomarkers applicable also to patients with cytopenias and suspected rheumatic disease.


Assuntos
Doenças Autoimunes , Leucopenia , Doenças Reumáticas , Doenças Autoimunes/complicações , Doenças Autoimunes/diagnóstico , Autoimunidade , Diagnóstico Diferencial , Humanos , Leucopenia/complicações , Doenças Reumáticas/complicações , Doenças Reumáticas/diagnóstico
17.
Zhonghua Xue Ye Xue Za Zhi ; 40(11): 962-964, 2019 11 14.
Artigo em Chinês | MEDLINE | ID: mdl-31856450
18.
Turkiye Parazitol Derg ; 43(4): 170-174, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31865651

RESUMO

Objective: Malaria is an infection disease caused by plamodium parasite. Sporadic cases have not been observed since 2011, but imported cases still present owing to travel. In this study, we aimed to evaluate labotauary and clinical findings patients with malaria who were hospitalized and treated in our hospital. Methods: Between January 2012-November 2018, a total of 31 adult patients was evaluated retrospectively, in terms of their epidemiological, physical examination and laboratory findings, complaints, countries they traveled to, prophylaxis and treatment that they received. Data of the patients were taken from the hospital's database. Results: A total of 31 cases were diagnosed as having malaria. The causative microorganism was P. falciparum in 54.83% (17/31) of the patients, P. vivax in 32.25% (10/31), and P. falciparum-P. vivax co-infection in 12.9% (4/31) of the patients. Co-infections were excluded from the study. None of the cases had used prophylactic drugs for prevention of malaria. All of the cases suffered from chills with fever. The most frequently encountered pathologic laboratory findings were thrombocytopenia and leucopenia. Antibiotics had been initiated in 51.85% (14/27) of the patients with non-specific diagnoses. Rapid antigen test was used in 8148% (22/27) of cases. None of cases needed intensive care. Conclusion: It is important to inform persons who plan to visit malaria endemic areas about malaria and to make them take appropriate prophylaxis against malaria. Although P. falciparum which has a high mortality rate may be considered in the first plan, P. vivax, treatment of which is different due to risk of relapse, should not be overlooked.


Assuntos
Malária Falciparum , Malária Vivax , Viagem , Adolescente , Adulto , Antimaláricos/uso terapêutico , Calafrios , Doenças Endêmicas/prevenção & controle , Feminino , Febre , Humanos , Leucopenia/diagnóstico , Malária Falciparum/tratamento farmacológico , Malária Falciparum/epidemiologia , Malária Falciparum/prevenção & controle , Malária Vivax/tratamento farmacológico , Malária Vivax/epidemiologia , Malária Vivax/prevenção & controle , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Trombocitopenia/diagnóstico , Adulto Jovem
19.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 37(10): 737-745, 2019 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-31726503

RESUMO

Objective: To investigate the antioxidant mechanism of diallyl sulfide (DAS) in antagonizing the reduction in peripheral blood white blood cells (WBC) induced by benzene in rats. Methods: A total of 60 specific pathogen-free adult male Sprague-Dawley rats, with a body weight of 180-220 g, were selected, and after 5 days of adaptive feeding, they were randomly divided into blank control group, DAS control group, benzene model group, benzene+low-dose DAS group, benzene+middle-dose DAS group, and benzene+high-dose DAS group, with 10 rats in each group. The rats in the benzene+low-dose DAS group, the benzene+middle-dose DAS group, the benzene+high-dose DAS group, and the DAS control group were given DAS by gavage at a dose of 40, 80, 160, and 160 mg/kg·bw, respectively, and those in the blank control group and the benzene model group were given an equal volume of corn oil; 2 hours later, the rats in the benzene model group, the benzene+low-dose DAS group, the benzene+middle-dose DAS group, and the benzene+high-dose DAS group were given a mixture of benzene (1.3 g/kg·bw) and corn oil (with a volume fraction of 50%), and those in the blank control group and the DAS control group were given an equal volume of corn oil. The above treatment was given once a day for 4 consecutive weeks. At 1 day before treatment, anticoagulated blood was collected from the jugular vein for peripheral blood cell counting. After anesthesia with intraperitoneally injected pentobarbital (50 mg/kg·bw), blood samples were collected from the abdominal aorta, serum was isolated, and the thymus, the spleen, and the femur were freed at a low temperature to measure oxidative and antioxidant indices. The femur at one side was freed for WBC counting in bone marrow. Results: Compared with the blank control group, the benzene model group had significant reductions in the volume, weight, and organ coefficient of the spleen and the thymus (P<0.05) ; compared with the benzene model group, the benzene+low-dose DAS group, the benzene+middle-dose DAS group, and the benzene+high-dose DAS group had significant increases in the volume of the spleen and the thymus and the weight and organ coefficient of the spleen (P<0.05), and the benzene+middle-dose DAS group and the benzene+high-dose DAS group had significant increases in the weight and organ coefficient of the thymus (P<0.05). Compared with the blank control group, the benzene model group had a significant reduction in WBC count in peripheral blood and bone marrow (P<0.05), and compared with the benzene model group, the benzene+middle-dose DAS group and the benzene+high-dose DAS group had a significant increase in WBC count in peripheral blood and bone marrow (P<0.05). Compared with the blank control group, the benzene model group had a significant increase in the serum level of malondialdehyde (MDA) (P<0.05) and significant reductions in total superoxide dismutase (T-SOD) activity, reduced glutathione (GSH) level, GSH/oxidized glutathione (GSSG) ratio, total antioxidant capacity (T-AOC) (P<0.05) ; compared with the benzene model group, the benzene+high-dose DAS group had a significant reduction in the serum level of MDA and significant increases in T-SOD activity, GSH level, GSH/GSSG ratio, and T-AOC (P<0.05). Compared with the blank control group, the benzene model group had a significant increase in the level of MDA (P<0.05) and significant reductions in GSH level, GSH/GSSG ratio, and T-AOC (P<0.05) in the spleen; compared with the benzene model group, the benzene+low-dose DAS group, the benzene+middle-dose DAS group, and the benzene+high-dose DAS group had a significant reduction in MDA level (P<0.05) and significant increases in GSH level and T-AOC (P<0.05), and the benzene+high-dose DAS group had significant increases in T-SOD activity and GSH/GSSG ratio (P<0.05). Compared with the blank control group, the benzene model group had a significant increase in the level of MDA in bone marrow cells (BMCs) and peripheral blood mononucleated cells (PBMCs) (P<0.05) and a significant reduction in T-AOC in PBMCs (P<0.05) ; compared with the benzene model group, the benzene+low-dose DAS group, the benzene+middle-dose DAS group, and the benzene+high-dose DAS group had a significant reduction in the level of MDA in BMCs and PBMCs (P<0.05), and the benzene+high-dose DAS group had significant increases in GSH level and GSH/GSSG ratio (P<0.05) . Conclusion: DAS can antagonize the benzene-induced reduction in peripheral blood WBC, possibly by exerting an anti-oxidative stress effect.


Assuntos
Compostos Alílicos/farmacologia , Antioxidantes/farmacologia , Leucopenia/tratamento farmacológico , Sulfetos/farmacologia , Animais , Benzeno/efeitos adversos , Glutationa/análise , Leucopenia/induzido quimicamente , Masculino , Malondialdeído/análise , Estresse Oxidativo , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Superóxido Dismutase/análise
20.
Am J Case Rep ; 20: 1497-1499, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31601777

RESUMO

BACKGROUND Radiofrequency ablation is a minimally invasive treatment for arrhythmias, including frequent ventricular premature. As a complication of radiofrequency ablation, pseudoaneurysm can be treated conservatively or by ultrasound-guided thrombin injection. CASE REPORT We report a case that a possible allergic reaction to thrombin injected into pseudoaneurysm after radiofrequency ablation. CONCLUSIONS We hope that the report of successful management of the allergic reaction in this case may be of help to other doctors; we also emphasize the importance of checking the patient's history of allergies to thrombin when considering treating pseudoaneurysm with thrombin injection.


Assuntos
Falso Aneurisma/terapia , Hipersensibilidade a Drogas/diagnóstico , Artéria Femoral , Hemostáticos/efeitos adversos , Trombina/efeitos adversos , Idoso de 80 Anos ou mais , Alanina Transaminase/sangue , Hipersensibilidade a Drogas/etiologia , Eletrocardiografia , Feminino , Febre/etiologia , Fibrina/análise , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Hemoglobinas/análise , Hemostáticos/administração & dosagem , Humanos , Hipotensão/etiologia , Injeções Intra-Arteriais , Leucopenia/etiologia , Náusea/etiologia , Ablação por Radiofrequência , Trombina/administração & dosagem , Trombocitopenia/etiologia , Complexos Ventriculares Prematuros/cirurgia
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