RESUMEN
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Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Hematopoyesis Extramedular , Anemia Perniciosa/diagnóstico , Anemia Perniciosa/tratamiento farmacológico , Vitamina B 12/administración & dosificación , Anemia Perniciosa/complicaciones , Anemia Perniciosa/patología , Pancitopenia/complicaciones , Toracocentesis/métodos , Derrame Pleural/complicacionesRESUMEN
Intradialytic hypotension is common complication in stage 5 chronic kidney disease patients on hemodialysis. Incidence ranges from 15 to 30%. These patients have levocarnitine deficiency. A randomized, placebo-controlled quadruple-blinded trial was designed to demonstrate the levocarnitine efficiency on intradialytic hypotension prevention. Patients were randomized into four groups, to receive levocarnitine or placebo. During the intervention period, levocarnitine and placebo was administered 0 and 30 min before each hemodialysis session, respectively. During the trial, 33 patients received 1188 hemodialysis sessions. We identified 239 (21.3%) intradialytic hypotension episodes. The intradialytic hypotension episodes were less frequent in the levocarnitine group (9.3%, 60 IH events) (P < 0.001). Hemodialysis is frequently perplexed by intradialytic hypotension episodes. Levocarnitine supplementation before each hemodialysis session efficiently diminishes the intradialytic hypotension episodes. This is a new application method that must be considered and explored.
Asunto(s)
Carnitina/administración & dosificación , Hipotensión/prevención & control , Fallo Renal Crónico/terapia , Diálisis Renal/métodos , Adulto , Carnitina/deficiencia , Método Doble Ciego , Femenino , Humanos , Hipotensión/epidemiología , Hipotensión/etiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Diálisis Renal/efectos adversos , Resultado del TratamientoRESUMEN
BACKGROUND: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. OBJECTIVE: We investigated the association between MPV and disease activity in adult patients with SLE. METHODS: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. RESULTS: MPV was significantly decreased with respect to those of inactive patients (7.16±1.39 vs. 8.16±1.50, p=0.005). At a cutoff level of 8.32fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r=0.407, p=0.001), which in turn is inversely associated with disease activity. CONCLUSIONS: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.
Asunto(s)
Plaquetas/citología , Lupus Eritematoso Sistémico/sangre , Volúmen Plaquetario Medio , Adulto , Humanos , Activación Plaquetaria , Estudios Prospectivos , Estudios RetrospectivosRESUMEN
ABSTRACT Background: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. Objective: We investigated the association between MPV and disease activity in adult patients with SLE. Methods: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. Results: MPV was significantly decreased with respect to those of inactive patients (7.16 ± 1.39 vs. 8.16 ± 1.50, p = 0.005). At a cutoff level of 8.32 fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r = 0.407, p = 0.001), which in turn is inversely associated with disease activity. Conclusions: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.
RESUMO Antecedentes: Existem poucos biomarcadores disponíveis para avaliar a atividade da doença no lúpus eritematoso sistêmico (LES). O volume plaquetário médio (VPM) foi recentemente estudado como um biomarcador inflamatório. Atualmente não está claro se o VPM também pode desempenhar um papel como um biomarcador da atividade da doença em pacientes adultos com LES. Objetivo: Investigou-se a associação entre o VPM e a atividade da doença em pacientes adultos com LES. Métodos: Neste estudo retrospectivo, compararam-se dois grupos de pacientes adultos divididos de acordo com a atividade da doença (36 por grupo). Os indivíduos foram pareados por idade e gênero. Resultados: O VPM esteve significativamente diminuído nos pacientes com doença ativa em comparação com os níveis em pacientes com doença inativa (7,16 ± 1,39 versus 8,16 ± 1,50, p = 0,005). Em um nível de corte de 8,32 fL, o VPM tem uma sensibilidade de 86% e uma especificidade de 41% para a detecção da atividade da doença. Encontrou-se uma correlação positiva modesta entre o VPM e a albumina (r = 0,407, p = 0,001), que por sua vez está inversamente associada à atividade da doença. Conclusões: Em resumo, o VPM está diminuído em pacientes adultos com lúpus ativo e positivamente correlacionado com a albumina, outro biomarcador da atividade da doença. São necessários estudos prospectivos para avaliar o valor prognóstico desse biomarcador.
Asunto(s)
Humanos , Adulto , Plaquetas/citología , Volúmen Plaquetario Medio , Lupus Eritematoso Sistémico/sangre , Activación Plaquetaria , Estudios Prospectivos , Estudios RetrospectivosRESUMEN
BACKGROUND: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. OBJECTIVE: We investigated the association between MPV and disease activity in adult patients with SLE. METHODS: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. RESULTS: MPV was significantly decreased with respect to those of inactive patients (7.16±1.39 vs. 8.16±1.50, p=0.005). At a cutoff level of 8.32 fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r=0.407, p=0.001), which in turn is inversely associated with disease activity. CONCLUSIONS: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.
RESUMEN
Mycobacterium tuberculosis as a cause of both chylothorax and chylous ascites is extremely rare. A 46-year-old non-adherent woman with AIDS and pulmonary tuberculosis presented to our clinic with dyspnea, pleuritic chest and abdominal pain. Chest x-ray demonstrated a left pleural effusion. Contrast-enhanced CT showed free abdominal fluid. Thoracentesis revealed a chylothorax, and paracentesis a chylous ascites. AFB staining and PCR for M. tuberculosis (GeneXpert MTB/ RIF Assay) were both negative. Malignant cells cytology also tested negative. Tuberculosis could account for both chylothorax and chylousascites, as she clinically improved when antituberculous drugs were resumed. Even when PCR tested negative, M. tuberculosis should be included in the differential diagnosis because of its therapeutic and prognostic implications. Keywords: Chylothorax, chylous ascites, Mycobacterium tuberculosis, acquired immunodeficiency syndrom, antituberculous drugs.