Trombocitopenia neonatal: Revisión. II. Trombocitopenias no inmunes; transfusión de plaquetas / Neonatal thrombocytopenia: A review.II. Non-immune thrombocytopenia; platelet transfusion

Las trombocitopenias de causa no inmunológica son ocasionadas por múltiples patologías; las más frecuentes son las debidas a infecciones extra- o intrauterinas y las secundarias a otras patologías involucradas en la interrelación niño-placenta-madre. En este segundo artículo, se enumeran sus causas y se describen en detalle las distintas patologías. La transfusión de plaquetas es ampliamente utilizada en neonatología, tanto para tratamiento como para profilaxis de hemorragias. Sin embargo, no hay aún consenso generalizado sobre el umbral de recuento plaquetario conveniente para indicar la transfusión ni sobre sus reales indicaciones. Se comentan artículos recientes sobre las distintas estrategias propuestas. Se enfatiza la discusión sobre los múltiples efectos adversos de las transfusiones de plaquetas, cuyo conocimiento está cambiando el paradigma relativo a sus indicaciones, lo que sugiere que se debe aplicar una política mucho más restrictiva al respect

Non-immune thrombocytopenia is caused by multiple pathologies; the most common causes are extra- or intrauterine infections, whereas secondary cases result from other pathologies involved in the fetal-placental-maternal interface. This second article lists its causes and provides details of the different pathologies. Platelet transfusion is widely used in neonatology, both as treatment and as bleeding prophylaxis. However, there is no general consensus about the platelet count threshold that is convenient to indicate a transfusion or actual indications. Recent articles are commented regarding the different proposed strategies. The emphasis is on discussing the multiple adverse effects of platelet transfusions because knowledge about them is changing the paradigm for indications, suggesting that a much more restrictive policy is required

Analysis of the influence factors of cirrhosis complicated with upper gastrointestinal hemorrhage / 中国综合临床

Objective To explore the influence factors of cirrhosis complicated with upper gastrointestinal bleeding,and to guide the clinical treatment of patients with cirrhosis and prevent upper gastrointestinal bleeding.Methods One hundred and seventy-five cases patients with cirrhosis and upper gastrointestinal bleeding were treated in the Infectious Disease Hospital of Tangshan and the Affiliated Hospital of North China University of Science and Technology from July 2013 to July 2015 as the case group.One hundred and eighty-two patients with cirrhosis and no upper gastrointestinal bleeding at the same period in hospital as the control group.A face to face questionnaire was used to fill in the questionnaire.Results Multifactor conditional Logistic regression analysis showed that onset season (OR =4.185,95％ CI:1.874-8.354),non steroidal drugs (OR =6.215,95％ CI:2.681-15.532),drinking (OR =5.481,95％ CI:3.205-11.225),portal vein highpressure gastropathy(OR =7.658,95％ CI:3.227-14.714),diameter of portal vein (OR =8.901,95％ CI:1.218-9.026),liver function classification (OR =13.124,95 ％ CI:2.107-15.228) and esophageal varices (OR =11.021,95％ CI:2.181-13.487) were related with patients with liver cirrhosis complicated with upper digestive tract hemorrhage.Conclusion The onset season,nonsteroidal anti-inflammatory drugs,drinking,portal hypertensive gastropathy,portal vein diameter,liver function classification and esophageal varices are the risk fators of liver cirrhosis complicated with upper digestive tract hemorrhage factors.

Incidencia y causas de hemorragia digestiva baja Instituto Gastroenterológico Boliviano Japones (1979 - 2005) / Incidence and causes of low intestine blooding at Intitute Gastroenterológico Boliviano Japones (1979-2005)

Resumen El objetivo de este trabajo es de estudiar y determinar retrospectivamente las causas y la frecuencia de presentación de la hemorragia digestiva baja , en pacientes del I.G.B.J, demostrado por endoscopía en un periodo de tiempo de 25 años. Se estudiaron 3591 pacientes (1275 mujeres y 1245 hombres), con diagnóstico de hemorragia digestiva baja, diagnóstico que se hizo en base a datos que fueron recolectados de la historia clínica y hallazgos endoscópicos. Se revisaron un total de 8314 procedimientos endoscópicos bajos, en un período de tiempo comprendido entre enero de 1979 a diciembre de 2005 realizados en el I.G.B.J, de Cochabamba, correspondientes a estudios endoscópicos de pacientes internados u ambulatorios, de diferente edad, sexo y patología. De estos 3591 (43,2%) presentan diagnóstico de HDB, de los cuales 2520 procedimientos (70,2%) son patológicos y 1071 procedimientos (29,8%) fueron normales. De los 2520 pacientes de nuestro estudio, el 49.4% son varones (1245 pacientes), y el 50,6% son mujeres (1275 pacientes). Las lesiones vasculares de tubo digestivo bajo como son las hemorroides, lesiones vasculares y proctitis actínica constituyen el mayor porcentaje causante de HDB, 975 pacientes (38,6%), cuya etiología difiere según frecuencia y según grupo etéreo de lo reportado en la literatura. El índice de mortalidad encontrado es del orden de 0.2 % significativamente menor al de la literatura que es del 5 % , esto probablemente a que en nuestro medio la casuística es menor. Se espera que el presente estudio sea el punto de partida para elaborar nuestro propio protocolo de manejo en nuestro hospital.

Abstract This work is a retrospective study and determine the causes and frequency of lower gastrointestinal bleeding in patients I.G.B.J demonstrated by endoscopy in a period of 25 years. We studied 3591 patients (1275 women and 1245 men), diagnosed with lower gastrointestinal bleeding, that diagnosis was based on data that were collected on clinical history and endoscopio findings. We reviewed a total of8314 low endoscopio procedures, in a period oftime from January 1979 to December 2005 in the I.G.B.J Cochabamba, endoscopio studies for inpatient or outpatient, in a different age, sex and pathology. Ofthese 3591 (43.2%) present diagnosis of HDB, ofwhich 2520 procedures (70.2%) are pathological and 1071 procedures (29.8%) were normal. Ofthe 2520 patients in our study, 49.4% are male (1245 patients) and 50.6% are women (1275 patients). The vascular lesions alimentary canal are as low as hemorrhoids, vascular lesions and ra diation proctitis constitute the largest cause of HDB, 975 patients (38.6%), whose etiology differs according to age group and as often as reported in the literature. The mortality rate isfound in the orderofO.2% significantly lower than in the literature that is 5%, this probably because in our case mix is lower. It is hoped that this study is the starting point for developing our own management protocol in our hospital.

Study on the antiplatelet effect of phospholipase C: release function and metabolism / 中国药理学通报

AIM To investigate the antiplatelet effect of PLC by de termining the concentration of TXB 2, 6-keto-PGF 1? and bleeding time( BT). METHODS TXB 2 and 6-keto-PGF 1? were detected by ra dioimmunity kit. Bleeding time were measured by routine methods. RESULTS Six doses of PLC can prolong BT significantly(P0 05). The inhibition on TXB 2 generation, of PLC 60 0～ 1 000 U?kg -1 with ADP revulsant, PLC 800～1000 U?kg -1 with AA revulsant and PLC 1 000 U?kg -1 with Collagen revulsant, is more significant than ASA (P