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2.
Br J Nurs ; 29(2): S27-S34, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31972102

RESUMO

BACKGROUND: Difficult venous access (DVA) is common in liver patients requiring blood collection using traditional peripheral approaches. This study aimed to understand the experience of DVA for liver patients and the acceptability of peripheral venepuncture versus external jugular venepuncture (EJV). A secondary aim was to explore the impact of EJV on local resource utilization. METHODS: Semistructured interviews with liver outpatients with DVA (n = 10) requiring venepuncture were firstly themed inductively. We then deductively applied the acceptability framework of Sekhon et al. as a further analytic lens. Audit data from DVA encounters (n = 24) allowed analysis of issues from multiple perspectives. The Consolidated Criteria for Reporting Qualitative Research reporting checklist guides this report. RESULTS: Peripheral venepuncture had poor prospective, concurrent, and retrospective acceptability, requiring significant mental and physical preparation. Fear, stigma, pain and distress, poor continuity of care, and poor effectiveness led to service disengagement. While EJV caused initial trepidation, it had high concurrent and retrospective acceptability. The significant improvement in patient experience was corroborated by audit data for both procedure duration (5 versus 15 minutes) and first attempt success (100 versus 28.5%) for EJV versus peripheral venepuncture, respectively. While EJV required a recumbent position, it required less staff. CONCLUSIONS: EJV is highly acceptable to patients, using less time and staff resources. EJV protocols and staff training should be considered where DVA presentations are common. Individualized care plans and careful care coordination could divert DVA patients needing venepuncture to services that use EJV preferentially. HIGHLIGHTS Peripheral venepuncture results in fear, stigma, pain, & distress for those with DVA. This poor acceptability of traditional venepuncture leads to service disengagement. External jugular venepuncture is highly acceptable & improves resource utilization.


Assuntos
Veias Jugulares , Hepatopatias/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Flebotomia/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
3.
Medicine (Baltimore) ; 98(44): e17526, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689754

RESUMO

RATIONALE: Hereditary hemochromatosis (HH) is a frequent autosomal recessive disease. The pathogenesis of disease is excessive intestinal absorption of dietary iron, resulting in pathologically high iron storage in tissues and organs. As a systemic disease, it has several manifestations including cirrhosis, diabetes mellitus, cardiomyopathy, joint disease. However, a proportion of patients are asymptomatic. PATIENT CONCERNS: A 34-year-old man who had abnormal liver function for 9 months without specific symptoms. He underwent various tests, including liver biopsy and genetic testing, which eventually ruled out common liver diseases and identified iron metabolic abnormalities. In addition, we confirmed the pathogenic genes by sequencing the genes of him and his families. DIAGNOSIS: Combined with the symptoms, auxiliary examinations and sequencing results, the patient was diagnosed as HH. INTERVENTIONS: The patient was given a low iron diet and phlebotomy therapy interval 2 weeks until the ferritin is <100 mg/L. OUTCOMES: The patient' condition is stable during the follow-up period. LESSONS: When clinicians are confronted with unexplained liver dysfunction, the possibility of the HH should be considered. Liver biopsy and gene sequencing are helpful in diagnosis. Phlebotomy treatment is the most economical and practical treatment for HH at present, but it should vary from person to person.


Assuntos
Proteínas de Transporte de Cátions/genética , Hemocromatose/genética , Adulto , Hemocromatose/diagnóstico , Hemocromatose/terapia , Humanos , Masculino , Flebotomia/métodos
4.
Crit Care Resusc ; 21(4): 251-57, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31778631

RESUMO

BACKGROUND: Patients admitted to intensive care units (ICUs) undergo multiple blood tests. Small volume vacuum phlebotomy tubes (SVTs) provide an important blood conservation measure. SVTs reduce summative blood loss and may reduce odds of transfusion. We aimed to determine whether low volume blood sampling using SVTs for routine diagnostic purposes translates to decreased fall in haemoglobin concentration, and examine downstream effects on anaemia and need for transfusion during ICU admission. STUDY DESIGN AND METHODS: A single-centre, controlled before-and-after study, evaluating a unit-wide changeover from conventional volume vacuum phlebotomy tubes (CVTs) to SVTs on April 2015. All ICU patients admitted for > 48 hours during the 12 months before and after the intervention were included in multivariate and univariate analysis. Groups were stratified into short admissions (2-7 days) and long admissions (> 7 days). RESULTS: A total of 318 patients were analysed. For short admissions, SVTs decreased fall in haemoglobin concentration (unstandardized coefficient, -6.7; P = 0.001) and episodes of severe anaemia (odds ratio, 0.37, P = 0.02). There were no changes to haemoglobin concentration in long admissions. No effects on need for transfusion were observed (short admissions, P = 0.05; long admissions, P = 0.11). SVTs reduced daily sampling volumes by 50% with no increase in laboratory error (short admissions, P = 0.61; long admissions, P = 0.98). A moderate correlation existed between blood draws and fall in haemoglobin concentration (short admissions, r = 0.5; long admissions, r = 0.32). CONCLUSION: SVTs reduce sampling volume without increasing laboratory error. Follow-on effects include reduced fall in haemoglobin concentration and severe anaemia. These correlations are absent in long admissions.


Assuntos
Estudos Controlados Antes e Depois , Unidades de Terapia Intensiva , Flebotomia , Adulto , Austrália , Transfusão de Sangue , Humanos , Flebotomia/instrumentação , Flebotomia/métodos , Vácuo
5.
Rev Assoc Med Bras (1992) ; 65(9): 1216-1222, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618341

RESUMO

INTRODUCTION: Iron overload is a broad syndrome with a large spectrum of causative etiologies that lead to iron deposition. When iron exceeds defenses, it causes oxidative damage and tissular disfunction. Treatment may prevent organ dysfunction, leading to greater life expectancy. METHODS: Literature from the last five years was reviewed through the use of the PubMed database in search of treatment strategies. DISCUSSION: Different pharmacological and non-pharmacological strategies are available for the treatment of iron overload and must be used according to etiology and patient compliance. Therapeutic phlebotomy is the basis for the treatment of hereditary hemochromatosis. Transfusional overload patients and those who cannot tolerate phlebotomy need iron chelators. CONCLUSION: Advances in the understanding of iron overload have lead to great advances in therapies and new pharmacological targets. Research has lead to better compliance with the use of oral chelators and less toxic drugs.


Assuntos
Quelantes de Ferro/uso terapêutico , Sobrecarga de Ferro/terapia , Hemocromatose/terapia , Humanos , Cooperação do Paciente , Flebotomia/métodos , Síndrome
7.
Crit Care ; 23(1): 278, 2019 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399052

RESUMO

BACKGROUND: As many as 90% of patients develop anemia by their third day in an intensive care unit (ICU). We evaluated the efficacy of interventions to reduce phlebotomy-related blood loss on the volume of blood lost, hemoglobin levels, transfusions, and incidence of anemia. METHODS: We conducted a systematic review and meta-analysis using the Laboratory Medicine Best Practices (LMBP) systematic review methods for rating study quality and assessing the body of evidence. Searches of PubMed, Embase, Cochrane, Web of Science, PsychINFO, and CINAHL identified 2564 published references. We included studies of the impact of interventions to reduce phlebotomy-related blood loss on blood loss, hemoglobin levels, transfusions, or anemia among hospital inpatients. We excluded studies not published in English and studies that did not have a comparison group, did not report an outcome of interest, or were rated as poor quality. Twenty-one studies met these criteria. We conducted a meta-analysis if > 2 homogenous studies reported sufficient information for analysis. RESULTS: We found moderate, consistent evidence that devices that return blood from flushing venous or arterial lines to the patient reduced blood loss by approximately 25% in both neonatal ICU (NICU) and adult ICU patients [pooled estimate in adults, 24.7 (95% CI = 12.1-37.3)]. Bundled interventions that included blood conservation devices appeared to reduce blood loss by at least 25% (suggestive evidence). The evidence was insufficient to determine if these devices reduced hemoglobin decline or risk of anemia. The evidence suggested that small volume tubes reduced the risk of anemia, but was insufficient to determine if they affected the volume of blood loss or the rate of hemoglobin decline. CONCLUSIONS: Moderate, consistent evidence indicated that devices that return blood from testing or flushing lines to the patient reduce the volume of blood loss by approximately 25% among ICU patients. The results of this systematic review support the use of blood conservation systems with arterial or venous catheters to eliminate blood waste when drawing blood for testing. The evidence was insufficient to conclude the devices impacted hemoglobin levels or transfusion rates. The use of small volume tubes may reduce the risk of anemia.


Assuntos
Anemia/prevenção & controle , Flebotomia/métodos , Anemia/epidemiologia , Humanos , Doença Iatrogênica/epidemiologia , Doença Iatrogênica/prevenção & controle , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Flebotomia/normas , Flebotomia/tendências , Guias de Prática Clínica como Assunto
8.
Biochem Med (Zagreb) ; 29(3): 031001, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31379463

RESUMO

Introduction: Phlebotomy is an error-prone process in which mistakes are difficult to reveal. This case report describes the effect on laboratory results originating from a blood sample collected in close proximity to an intravenous catheter. Materials and methods: A 69-year-old male patient was referred to the Emergency department where pneumonia was suspected. Phlebotomy was performed to collect blood samples to assess electrolytes, renal function, liver function, infection and haematological parameters. Results: The laboratory analysis showed reduced potassium and calcium concentrations. To prevent life-threatening cardiac failure the clinician decided to correct those electrolytes. Remarkably, the electrocardiogram showed no abnormalities corresponding to hypokalaemia and hypocalcaemia. This observation, in combination with an overall increase in laboratory parameters with the exception of sodium and chloride, led to the suspicion of a preanalytical error. Retrospectively, an intravenous catheter was inserted in close proximity of the puncture place but no continuous infusion was started prior to phlebotomy. However, the intravenous catheter was flushed with sodium chloride. Since potential other causes were excluded, the flushing of the intravenous catheter with sodium chloride prior to phlebotomy was the most probable cause for the deviating laboratory results and subsequently for the unnecessary potassium and calcium suppletion. Conclusion: This case underlines the importance of caution in the interpretation of laboratory results obtained from specimens that are collected in the proximity of an intravenous catheter, even in the absence of continuous infusion.


Assuntos
Cateteres , Flebotomia/métodos , Idoso , Cálcio/sangue , Eletrocardiografia , Serviço Hospitalar de Emergência , Insuficiência Cardíaca/diagnóstico , Humanos , Masculino , Potássio/sangue , Fase Pré-Analítica , Cloreto de Sódio/química
9.
Sensors (Basel) ; 19(16)2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31426370

RESUMO

One of the most common means for diagnosis is through medical laboratory testing, which primarily uses venous blood as a sample. This requires an invasive method by cannulation that needs proper vein selection. The use of a vein finder would help the phlebotomist to easily locate the vein, preventing possible pre-analytical error in the specimen collection and even more discomfort and pain to the patient. This paper is a review of the scientific publications on the different developed low-cost vein finder prototypes utilizing camera assisted near infrared (NIR) light technology. Methods: Electronic databases were searched online, these included PubMed (PMC), MEDLINE, Science Direct, ResearchGate, and Institute of Electrical and Electronics Engineers (IEEE) Xplore digital library. Specifically, publications with the terms vein finder prototype, NIR technology, vein detection, and infrared imaging were screened. In addition, reference lists were used to further review related publications. Results: Cannulation challenges medical practitioners because of the different factors that can be reduced by the utilization of a vein finder. A limited number of publications regarding the assessment of personnel performing cannulation were observed. Moreover, variations in methodology, number of patients, type of patients according to their demographics and materials used in the assessment of the developed prototypes were noted. Some studies were limited with regard to the actual human testing of the prototype. Conclusions: The development of a low-cost effective near infrared (NIR) vein finder remains in the phase of improvement. Since, it is being challenged by different human factors, increasing the number of parameters and participants/human for actual testing of the prototypes must also be taken into consideration for possible commercialization. Finally, it was noted that publications regarding the assessment of the performance of phlebotomists using vein finders were limited.


Assuntos
Flebotomia/métodos , Veias/fisiologia , Cateterismo , Análise Custo-Benefício , Humanos , Flebotomia/instrumentação , Semicondutores , Espectroscopia de Luz Próxima ao Infravermelho , Veias/anatomia & histologia
10.
Vox Sang ; 114(6): 588-594, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31273797

RESUMO

BACKGROUND AND OBJECTIVES: Phlebotomy is a central task for whole blood donation, yet there are no published standards regarding systematic donor vein assessment or the impact of vein quality on successful blood donation. Blood donation failures and related adverse events are highly predictive of donors not returning for future blood donation. A specific blood donation vein scoring tool was assessed to measure donor vein suitability for whole blood collection and investigate the correlation of the donor's veins with donation outcomes. MATERIALS AND METHODS: The vein assessment tool consisted of three questions using a 5-point Likert-type scale to measure responses. Two phlebotomists performed blinded assessments of each donor's veins on each arm using the tool. The individual measures were then aggregated to provide a total vein score out of 12. Inter-rater reliability of the vein score tool was assessed by calculating the intraclass correlation coefficient for absolute agreement. RESULTS: Fifty-seven phlebotomists across four fixed blood donation centres performed paired vein assessments on 553 blood donors. The intraclass correlation coefficient indicated moderate inter-rater reliability was achieved. The median scores for viable donations were 10, for non-viable donations were 6·5 and for failed phlebotomies were 4. Donation histories of donors with lower vein scores indicated lower success during blood donation. CONCLUSION: The vein score tool appears to be predictive of a successful donation outcome, however, since there was not a suitably high correlation between the scores of the two assessors, further refinement of the tool will be required prior to wider use.


Assuntos
Doadores de Sangue , Flebotomia/métodos , Veias , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
11.
Jpn J Nurs Sci ; 16(4): 491-499, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31222981

RESUMO

AIM: To compare the effectiveness of tapping and massaging venodilation techniques by evaluating venous cross-sectional area, venous depth, venous palpation score, and questionnaire responses of study participants. METHODS: This study had a quasi-experimental design. Between August 2016 and October 2016, healthy adult volunteers (n = 30, mean ± standard deviation of age: 22.3 ± 2.2 years) were enrolled in this study. Three venodilation techniques were evaluated: the application of a tourniquet (Control Group), the application of a tourniquet and tapping of the participant's forearm (Tapping Group), and the application of a tourniquet and massaging of the participant's forearm (Massage Group). RESULTS: In all three groups, venous cross-sectional areas increased significantly after the application of the venodilation technique. The change ratio of venous cross-sectional area was significantly larger in the Massage Group than in the Control Group. Additionally, 83.3% of the participants selected massaging as their preferred venodilation technique, stating the technique was comfortable and provided a feeling of relief. CONCLUSIONS: No significant differences were observed between the degrees of venodilation that were achieved using the three investigated venodilation techniques. Nonetheless, massaging was deemed the most effective technique after considering the participants' subjective comments.


Assuntos
Massagem , Flebotomia/métodos , Veias/fisiologia , Adulto , Feminino , Antebraço , Humanos , Masculino , Torniquetes , Adulto Jovem
12.
Eur J Endocrinol ; 181(3): D15-D26, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31176302

RESUMO

Notwithstanding the high prevalence of primary aldosteronism (PA), probably the most common form of secondary hypertension, the diagnosis of PA is often neglected or delayed, thus precluding target treatment, which is curative in many cases. For selection of the most appropriate treatment, a fundamental step is the distinction between a lateralized form, mainly aldosterone-producing adenoma (APA), and bilateral adrenocortical hyperplasia (BAH), also known as idiopathic hyperaldosteronism (IHA). To this aim all current guidelines recommend adrenal vein sampling (AVS), a technically challenging procedure that often fails, particularly in non-experienced hands. Cosyntropin (synthetic ACTH) is administered in the attempt to maximize adrenal cortisol secretion and avoid pulsatile adrenocortical hormone secretion in about 40% of the referral centres around the world. However, the Endocrine Society guidelines do not advise about the use or not of cosyntropin as stimulus during AVS, as there are arguments in favour and against its use. These arguments are presented in this debate article reflecting the views of groups that currently use and do not use cosyntropin.


Assuntos
Glândulas Suprarrenais/irrigação sanguínea , Glândulas Suprarrenais/metabolismo , Aldosterona/metabolismo , Cosintropina/administração & dosagem , Hiperaldosteronismo/metabolismo , Flebotomia/métodos , Glândulas Suprarrenais/efeitos dos fármacos , Hormônios/administração & dosagem , Humanos , Hiperaldosteronismo/diagnóstico , Hiperaldosteronismo/tratamento farmacológico
13.
Rev Lat Am Enfermagem ; 27: e3125, 2019 Apr 29.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31038627

RESUMO

OBJECTIVES: during peripheral venipuncture, health professionals are recommended to use a tourniquet above the puncture site in order to potentiate venous distension. Given its characteristics and use in clinical settings, tourniquets may represent a source of microorganism dissemination. However, the results of scientific studies in this area are scattered in the literature. This scoping review aims to map the available evidence on health professionals' practices related with tourniquet use during peripheral venipuncture and associated microbiological contamination. METHODS: scoping review following the Joanna Briggs Institute methodology. Two independent reviewers analyzed the relevance of the studies, extracted and synthesized data. RESULTS: fifteen studies were included in the review. Overall, tourniquets were reused without being subject to recurring decontamination processes. It has been found that practitioners share these devices among themselves and use them successively for periods between two weeks and seven and half years. CONCLUSION: nursing practices related to tourniquet use during peripheral venipuncture are not standard. Reuse of tourniquets may jeopardize the patient's safety if reprocessing (cleaning and disinfection/sterilization) is not adequate, given the type of tourniquet material and microbiota found. New studies are needed to assess the impact of various types of reprocessing practices on tourniquet decontamination and patient safety.


Assuntos
Cateterismo Venoso Central , Desinfecção , Pessoal de Saúde , Flebotomia/métodos , Prática Profissional , Torniquetes/microbiologia , Contaminação de Equipamentos , Humanos , Segurança do Paciente , Portugal , Torniquetes/normas
14.
Games Health J ; 8(4): 285-293, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31135178

RESUMO

Objective: A large number of children report fear and distress when undergoing blood work and intravenous placement. In pediatric departments, Child Life interventions are considered to be the gold standard in nonmedical pain management techniques. Virtual reality (VR) has also been identified as an effective tool for pain distraction in children undergoing painful medical procedures. The aim of this study was to document the efficacy of VR as a mode of distraction during a medical procedure compared with two comparison conditions: watching television (TV, minimal control condition) and distraction provided by the Child Life (CL, gold standard control condition) program. Materials and Methods: A total of 59 children aged 8-17 years (35% female) were recruited through the emergency department (ED) of the Children's Hospital of Eastern Ontario and randomly assigned to one of the three conditions. The key outcome measures were visual analog scale ratings of pain intensity and fear of pain, administrated before and right after the procedure. Patient satisfaction was also measured after the intervention. Results: A significant reduction in fear of pain and pain intensity was reported in all three conditions. A larger and statistically significant reduction in fear of pain was observed among children who used VR distraction compared with the CL and TV conditions, but this effect was not observed for pain intensity. The children's satisfaction with the VR procedure was significantly higher than for TV and comparable to CL. Discussion: The advantages of using VR in the ED to manage pain in children are discussed.


Assuntos
Manejo da Dor/normas , Flebotomia/métodos , Realidade Virtual , Adolescente , Análise de Variância , Criança , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Medo/psicologia , Feminino , Humanos , Masculino , Ontário , Manejo da Dor/métodos , Manejo da Dor/estatística & dados numéricos , Flebotomia/psicologia , Flebotomia/normas
15.
J Clin Nurs ; 28(19-20): 3416-3429, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31112315

RESUMO

AIMS AND OBJECTIVES: To compare the results of haematology, blood chemistry and coagulation tests between two blood sampling methods via venipuncture and peripheral venous catheter. BACKGROUND: Laboratory results of the previous studies on blood sampling methods through peripheral venous catheter versus venipuncture are inconsistent. Therefore, it is necessary to better understand the discrepancies between the two blood sampling methods and to provide evidence for practice. DESIGN: Systematic literature review and meta-analysis were conducted in accordance with the PRISMA reporting guideline. METHODS: Reviewed articles for this study were searched through database, including PubMed, Cochrane Library, EMBASE, SCOPUS, Web of Science, ProQuest Dissertations & Theses, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and ERIC (Educational Resource Information Centre). Hand-searching was also conducted. RESULTS: We finally identified 17 studies for a systematic review, and 10 studies out of them were selected for a meta-analysis. A total of 678 participants were included in the meta-analysis. Overall, there was no significant difference in haematology, blood chemistry and coagulation test values between two sampling methods via venipuncture and peripheral venous catheter. CONCLUSION: Findings of this study provide substantial evidence that most blood tests via venipuncture and peripheral venous catheter would not be different. Patients will be benefitted by reducing the number of venipuncture if a series of blood tests can be conducted by using peripheral venous catheter. Thus, healthcare providers may refer to more reliable laboratory results on using peripheral venous catheter for without increasing the risk of bleeding events and pain on blood sampling sites due to frequent phlebotomies. RELEVANCE TO CLINICAL PRACTICE: The results of this study will be a good evidence to decide blood sampling methods in clinical practice.


Assuntos
Cateterismo Periférico/métodos , Flebotomia/métodos , Humanos
17.
Ann Biol Clin (Paris) ; 77(2): 131-154, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30998194

RESUMO

This document provides a joint recommendation for venous blood sampling of the European federation of clinical chemistry and laboratory medicine (EFLM) Working Group for preanalytical phase (WG-PRE) and Latin American working group for preanalytical phase (WG-PRE-LATAM) of the Latin America confederation of clinical biochemistry (COLABIOCLI). It offers guidance on the requirements for ensuring that blood collection is a safe and patient-centered procedure and provides practical guidance on how to successfully overcome potential barriers and obstacles to its widespread implementation. The target audience for this recommendation are healthcare staff members directly involved in blood collection. This recommendation applies to the use of a closed blood collection system and does not provide guidance for the blood collection with an open needle and syringe and catheter collections. Moreover, this document neither addresses patient consent, test ordering, sample handling and transport nor collection from children and unconscious patients. The recommended procedure is based on the best available evidence. Each step was graded using a system that scores the quality of the evidence and the strength of the recommendation. The process of grading was done at several face-to-face meetings involving the same mixture of stakeholders stated previously. The main parts of this recommendation are: 1) Pre-sampling procedures, 2) Sampling procedure, 3) Post-sampling procedures and 4) Implementation. A first draft of the recommendation was circulated to EFLM members for public consultation. WG-PRE-LATAM was also invited to comment the document. A revised version has been sent for voting on to all EFLM and COLABIOCLI members and has been officially endorsed by 33/40 EFLM and 21/21 COLABIOCLI members. We encourage professionals throughout Europe and Latin America to adopt and implement this recommendation to improve the quality of blood collection practices and increase patient and workers safety.


Assuntos
Coleta de Amostras Sanguíneas/normas , Química Clínica/normas , Técnicas de Laboratório Clínico/normas , Flebotomia/normas , Fase Pré-Analítica/normas , Adulto , Coleta de Amostras Sanguíneas/métodos , Química Clínica/organização & administração , Criança , Técnicas de Laboratório Clínico/métodos , Europa (Continente) , Humanos , América Latina , Flebotomia/métodos , Fase Pré-Analítica/métodos , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Manejo de Espécimes/métodos , Manejo de Espécimes/normas
19.
J Vis Exp ; (144)2019 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-30774132

RESUMO

Blood sample collection is the basis of experimental animal research. It is of importance to obtain adequate blood samples for various research purposes. The tail veins of mice are small, and it is sometimes difficult to obtain the required blood volume by conventional puncture methods. This study investigates the superiority of repeated blood sample collection from tail veins of mice through use of a vacuum blood collection system and eyeglass magnifier (experimental group) compared to conventional blood sampling methods (conventional group), performed by beginners and experts, respectively. With the help of an eyeglass magnifier, a butterfly needle tip is inserted into the tail vein of each mouse in the experimental group. When the vein is penetrated successfully, a blood sample is collected in the vacuum collection tube by insertion of the rubber end of a butterfly needle into the vacuum blood collection tube. The plunger is then used to collect blood without the help of the eyeglass magnifier in the conventional group. Success rates of blood sample collection by the beginners and experts were shown to be 70% vs. 100% (p < 0.01) in the experimental group and 35% vs. 85% (p < 0.01) in the conventional group. For both beginners and experts, puncture times required for obtaining required blood sample were significantly lower in the experimental group compared to the conventional group (2.40 ± 0.75 vs. 2.90 ± 0.31, p < 0.05; 1.15 ± 0.37 vs. 1.55 ± 0.76, p < 0.05). In conclusion, the presented blood sampling technique is feasible and easy to practice and enables frequent sampling of adequate blood volumes from non-anesthetized mice.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Flebotomia/métodos , Cauda/irrigação sanguínea , Animais , Óculos , Camundongos , Vácuo
20.
J Med Case Rep ; 13(1): 17, 2019 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-30661508

RESUMO

BACKGROUND: The porphyrias are a rare group of metabolic disorders that can either be inherited or acquired. Along the heme biosynthetic pathway, porphyrias can manifest with neurovisceral and/or cutaneous symptoms, depending on the defective enzyme. Porphyria cutanea tarda, the most common type of porphyria worldwide, is caused by a deficiency of uroporphyrinogen decarboxylase, a crucial enzyme in heme biosynthesis, which results in an accumulation of photosensitive byproducts, such as uroporphyrinogen, which leads to the fragility and blistering of sun-exposed skin. Porphyria cutanea tarda is a condition that affects the liver and skin by reduction and inhibition of uroporphyrinogen decarboxylase enzyme in erythrocytes. Areas of skin that are exposed to the sun can generate blisters, hyperpigmentation, and, sometimes, lesions that heal leaving a scar or keratosis. Liver damage might present in a wide range of ways from liver function test abnormalities to hepatocellular carcinoma. The toxic effect of iron plays a role in liver damage pathogenesis. CASE PRESENTATION: A 59-year-old Turkish man presented with hyperpigmented skin lesions, fatigue, and elevated ferritin level and liver function tests. He was diagnosed as having porphyria cutanea tarda after a clinical investigation and treated with phlebotomy. CONCLUSION: Porphyria cutanea tarda is a rare condition of the liver but it must be remembered in a differential diagnosis of liver disease with typical skin involvement to decrease morbidity and health costs with early treatment.


Assuntos
Hiperpigmentação/patologia , Flebotomia/métodos , Porfiria Cutânea Tardia/diagnóstico , Uroporfirinogênio Descarboxilase/metabolismo , Fadiga/etiologia , Humanos , Hiperpigmentação/etiologia , Masculino , Pessoa de Meia-Idade , Porfiria Cutânea Tardia/terapia , Resultado do Tratamento
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