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1.
Arch Pathol Lab Med ; 144(10): 1204-1208, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33002153

RESUMO

CONTEXT.­: Glycemic control requires accurate blood glucose testing. The extent of hematocrit interference is difficult to assess to assure quality patient care. OBJECTIVE.­: To predict the effect of patient hematocrit on the performance of a glucose meter and its corresponding impact on insulin-dosing error. DESIGN.­: Multilevel mixed regression was conducted to assess the extent that patient hematocrit influences Roche Accu-Chek Inform II glucose meters, using the Radiometer ABL 837 as a reference method collected during validation of 35 new meters. Regression coefficients of fixed effects for reference glucose, hematocrit, an interaction term, and random error were applied to 4 months of patient reference method results extracted from the laboratory information system. A hospital inpatient insulin dose algorithm was used to determine the frequency of insulin dose error between reference glucose and meter glucose results. RESULTS.­: Fixed effects regression for method and hematocrit predicted biases to glucose meter results that met the "95% within ±12%" for the US Food and Drug Administration goal, but combinations of fixed and random effects exceeded that target in emergency and hospital inpatient units. Insulin dose errors were predicted from the meter results. Twenty-eight percent of intensive care unit, 20.8% of hospital inpatient, and 17.7% of emergency department results were predicted to trigger a ±1 insulin dose error by fixed and random effects. CONCLUSIONS.­: The current extent of hematocrit interference on glucose meter performance is anticipated to cause insulin error by 1-dose category, which is likely associated with low patient risk.


Assuntos
Glicemia/análise , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Erros Médicos , Algoritmos , Hematócrito , Humanos , Medição de Risco , Estados Unidos
2.
Acta amaz ; 50(3): 223-231, jul. - set. 2020.
Artigo em Inglês | LILACS | ID: biblio-1118832

RESUMO

We assessed the effect of stocking density on physiological parameters (blood lactate, glucose, cortisol, hematocrit), water quality (temperature, dissolved oxygen, pH, unionized ammonia, carbon dioxide), and survival during the transportation of fingerling (24.5 ± 4.7 g) and juvenile (615.8 ± 122.2 g) pirarucu (Arapaima gigas) for six hours in plastic bags. The tested densities were 65, 80, 95, 110 and 125 g L-1 for fingerlings, and 50, 80, 110, 140 and 170 g L-1 for juveniles (three replicates each). Parameters were measured prior to and immediately after transportation, and at 24 and 96 hours recovery after transportation. No mortality was observed, except for fingerlings (< 3%) at densities of 110 and 125 g L-1 during recovery. All the water quality parameters were significantly altered after the transportation of fingerlings and juveniles. Water temperature, dissolved oxygen, carbon dioxide and unionized ammonia increased, but pH decreased. Only carbon dioxide and unionized ammonia differed among densities. Cortisol levels did not increase over time, except for the juveniles at 170 g L-1, which still had high cortisol after 96 hours. Glucose significantly increased after transportation for all the treatments and returned to the initial values during the recovery period. Conversely, the lactate values were still high after 96 hours. Hematocrit was assessed only for juveniles and was significantly lower after transportation. We conclude that fingerling and juvenile pirarucu can be safely transported at densities up to 95 g L-1 and 140 g L-1, respectively. (AU)


Assuntos
Hidrocortisona , Ácido Láctico , Glucose , Qualidade da Água , Hematócrito
3.
JAMA ; 324(6): 560-570, 2020 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-32780138

RESUMO

Importance: Red blood cell transfusions are commonly administered to infants weighing less than 1000 g at birth. Evidence-based transfusion thresholds have not been established. Previous studies have suggested higher rates of cognitive impairment with restrictive transfusion thresholds. Objective: To compare the effect of liberal vs restrictive red blood cell transfusion strategies on death or disability. Design, Setting, and Participants: Randomized clinical trial conducted in 36 level III/IV neonatal intensive care units in Europe among 1013 infants with birth weights of 400 g to 999 g at less than 72 hours after birth; enrollment took place between July 14, 2011, and November 14, 2014, and follow-up was completed by January 15, 2018. Interventions: Infants were randomly assigned to liberal (n = 492) or restrictive (n = 521) red blood cell transfusion thresholds based on infants' postnatal age and current health state. Main Outcome and Measures: The primary outcome, measured at 24 months of corrected age, was death or disability, defined as any of cognitive deficit, cerebral palsy, or severe visual or hearing impairment. Secondary outcome measures included individual components of the primary outcome, complications of prematurity, and growth. Results: Among 1013 patients randomized (median gestational age at birth, 26.3 [interquartile range {IQR}, 24.9-27.6] weeks; 509 [50.2%] females), 928 (91.6%) completed the trial. Among infants in the liberal vs restrictive transfusion thresholds groups, respectively, incidence of any transfusion was 400/492 (81.3%) vs 315/521 (60.5%); median volume transfused was 40 mL (IQR, 16-73 mL) vs 19 mL (IQR, 0-46 mL); and weekly mean hematocrit was 3 percentage points higher with liberal thresholds. Among infants in the liberal vs restrictive thresholds groups, the primary outcome occurred in 200/450 (44.4%) vs 205/478 (42.9%), respectively, for a difference of 1.6% (95% CI, -4.8% to 7.9%; P = .72). Death by 24 months occurred in 38/460 (8.3%) vs 44/491 (9.0%), for a difference of -0.7% (95% CI, -4.3% to 2.9%; P = .70), cognitive deficit was observed in 154/410 (37.6%) vs 148/430 (34.4%), for a difference of 3.2% (95% CI, -3.3% to 9.6%; P = .47), and cerebral palsy occurred in 18/419 (4.3%) vs 25/443 (5.6%), for a difference of -1.3% (95% CI, -4.2% to 1.5%; P = .37), in the liberal vs the restrictive thresholds groups, respectively. In the liberal vs restrictive thresholds groups, necrotizing enterocolitis requiring surgical intervention occurred in 20/492 (4.1%) vs 28/518 (5.4%); bronchopulmonary dysplasia occurred in 130/458 (28.4%) vs 126/485 (26.0%); and treatment for retinopathy of prematurity was required in 41/472 (8.7%) vs 38/492 (7.7%). Growth at follow-up was also not significantly different between groups. Conclusions and Relevance: Among infants with birth weights of less than 1000 g, a strategy of liberal blood transfusions compared with restrictive transfusions did not reduce the likelihood of death or disability at 24 months of corrected age. Trial Registration: ClinicalTrials.gov Identifier: NCT01393496.


Assuntos
Transtornos Cognitivos/etiologia , Transfusão de Eritrócitos/efeitos adversos , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Displasia Broncopulmonar/etiologia , Paralisia Cerebral/etiologia , Enterocolite Necrosante/etiologia , Enterocolite Necrosante/cirurgia , Transfusão de Eritrócitos/mortalidade , Transfusão de Eritrócitos/estatística & dados numéricos , Feminino , Transtornos da Audição/etiologia , Hematócrito/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido de Peso Extremamente Baixo ao Nascer/crescimento & desenvolvimento , Recém-Nascido , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Avaliação de Resultados em Cuidados de Saúde , Retinopatia da Prematuridade/terapia , Sensibilidade e Especificidade , Transtornos da Visão/etiologia
4.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(4): 750-754, 2020 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-32773814

RESUMO

OBJECTIVE: To compare the blood parameters related to erythrocyte and platelet between baseline and 3 months after initial periodontal therapy in patients with both type 2 diabetes mellitus and chronic periodontitis (DM-P). METHODS: According to the International Symposium on Classification of Periodontal Diseases and Conditions in 1999 and the diagnostic criteria of type 2 diabetes mellitus proposed by the World Health Organization in 1999, 35 patients with DM-P were recruited. All the participants received initial periodontal therapy, including oral hygiene instruction, scaling, and root planning provided by one senior periodontist. Original diet, exercise, and medication for blood glucose control were unchanged for all the participants. At baseline and 3 months after initial periodontal therapy, the clinical periodontal parameters, including probing depth (PD), bleeding index (BI) and clinical attachment loss (CAL); erythrocyte-related indexes, including red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), RBC volume distribution width (RDW); platelet-related indexes, including platelet (PLT) count, mean platelet volume (MPV), platelet distribution width (PDW), plateletocrit (PCT) were measured and compared. RESULTS: Compared with baseline, the periodontal parameters, including PD [(3.370±0.601) mm vs. (2.729±0.431) mm], BI [2.160 (1.550~3.410) vs. 1.420 (1.000~2.970)] and CAL [(3.307±1.577) mm vs. (2.990±1.587) mm], were significantly reduced (P < 0.001) three months after the initial periodontal therapy; the erythrocyte-related indexes, including RBC count [(4.727±0.392)×1012/L vs. (4.825±0.394)×1012/L, P=0.010], HGB [(145.886±11.792) g/L vs. (149.200±12.979) g/L, P=0.007] and HCT [43.40% (37.50%~48.50%) vs. 43.80% (38.50%~53.20%), P=0.003], were significantly increased three months after the initial periodontal therapy; PLT count [(216.714±61.900)×109/L vs. (205.886±62.051)×109/L, P=0.016] was significantly reduced 3 months after the initial periodontal therapy. CONCLUSIONS: The initial periodontal therapy can significantly improve blood parameters related to RBC and PLT, which might decrease the risk of vascular complications in DM-P patients.


Assuntos
Periodontite Crônica , Diabetes Mellitus Tipo 2 , Plaquetas , Eritrócitos , Hematócrito , Humanos
5.
PLoS One ; 15(8): e0237673, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790747

RESUMO

PURPOSE: This study investigated the acute changes in full spectrum differential blood cell count including reticulocytes and immature reticulocytes after a voluntary maximal dry apnea in non-elite divers. Aim of the present study is to obtain information on important regulatory compensation mechanisms and to provide insights into apneic regulatory processes. METHODS: Ten apnea divers performed a voluntary dry mean apnea time of 317 sec [SD ±111 sec]. Differential blood cell count including reticulocytes was measured before and immediately after a single maximal breath-hold. To evaluate kinetics, blood samples were also taken after 30 min and 4 h. Value distributions are presented with dot plots. P-values were calculated using a mixed linear model for time dependency. Four difference values were compared to baseline values with Dunnett's procedure. RESULTS: Significant changes were found in red blood cell parameters for erythrocytes, red cell distribution width, hematocrit, hemoglobin, MCV, reticulocytes and immature reticulocytes, and in white blood cell parameters for leucocytes, lymphocytes, immature granulocytes, monocytes, basophile granulocytes, neutrophil granulocytes and eosinophil granulocytes and for thrombocytes. CONCLUSION: Adaptive mechanisms regarding cell counts in elite apnea divers are not readily transferable to non-elite recreational sportspersons. Divers and physicians should be aware of the limited adaptive performance of humans in the case of extended apnea.


Assuntos
Adaptação Fisiológica/fisiologia , Suspensão da Respiração , Mergulho/fisiologia , Hipóxia/sangue , Adulto , Contagem de Células Sanguíneas , Hematócrito , Hemoglobinas/análise , Humanos , Hipóxia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
6.
Environ Health Prev Med ; 25(1): 44, 2020 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-32861244

RESUMO

BACKGROUND: Petrol is the non-specific term for petroleum which is used for inside combustion of engines. Petrol filling workers are highly vulnerable to occupational exposure to these harmful substances which lead to hemato-toxicity and blood disorders such as leukemia, aplastic anemia, and dysplastic bone marrow. Thus, this study was aimed to assess hematological parameters of petrol filling workers in Gondar town, Northwest Ethiopia. METHODS: A comparative cross-sectional study was conducted from January to March 2019 in Gondar town, Northwest Ethiopia. A total of 110 study participants comprising 55 study groups and 55 controls group were recruited by a convenient sampling technique. Socio-demographic data were collected using a structured questionnaire, and 3 ml of venous blood was collected for the determination of hematological parameters. The data were entered into Epi info 7.2.0.1 and analyzed by SPSS version of 20. Mean, standard deviation, median, and interquartile ranges were used to present the data. Independent t test and Mann-Whitney U test were used to compare the mean or median difference between parametric and non-parametric hematological parameters, respectively. Moreover, Pearson product-moment and Spearman's rank-order bivariable correlations analyses were used to describe the correlation between hematological parameters and duration of exposure to petrol. A P value of ≤ 0.05 was considered statistically significant. RESULTS: The study revealed that mean red blood cell count and hemoglobin level as well as the median hematocrit, mean cell hemoglobin concentration, platelet count, absolute lymphocytes count, and red cell distribution width values of petrol filling workers showed a significant increment compared with the control group. On the other hand, the mean cell hemoglobin value of petrol filling workers showed a significant decrement compared with healthy controls. Moreover, the duration of exposure to petrol showed a significant positive correlation with red blood cell count and mean cell hemoglobin concentration; however, a significant negative correlation was observed with mean cell volume. CONCLUSION: This study showed that the majority of hematological parameters of petrol filling workers showed an increment compared with healthy controls which might be associated with exposure to petrol chemicals. However, further longitudinal study with a larger sample size should be conducted to explore the impact of petrol exposure on hematopoiesis.


Assuntos
Contagem de Eritrócitos , Índices de Eritrócitos , Hematócrito , Contagem de Linfócitos , Exposição Ocupacional/análise , Indústria de Petróleo e Gás , Contagem de Plaquetas , Adulto , Estudos Transversais , Etiópia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Adulto Jovem
7.
PLoS One ; 15(7): e0234784, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32634149

RESUMO

The greater mouse-eared bat (Myotis myotis) is a flagship species for the protection of hibernation and summer maternity roosts in the Western Palearctic region. A range of pathogenic agents is known to put pressure on populations, including the white-nose syndrome fungus, for which the species shows the highest prevalence and infection intensity of all European bat species. Here, we perform analysis of blood parameters characteristic for the species during its natural annual life cycle in order to establish reference values. Despite sexual dimorphism and some univariate differences, the overall multivariate pattern suggests low seasonal variation with homeostatic mechanisms effectively regulating haematology and blood biochemistry ranges. Overall, the species displayed a high haematocrit and haemoglobin content and high concentration of urea, while blood glucose levels in swarming and hibernating bats ranged from hypo- to normoglycaemic. Unlike blood pH, concentrations of electrolytes were wide ranging. To conclude, baseline data for blood physiology are a useful tool for providing suitable medical care in rescue centres, for studying population health in bats adapting to environmental change, and for understanding bat responses to stressors of conservation and/or zoonotic importance.


Assuntos
Quirópteros/sangue , Quirópteros/fisiologia , Testes Hematológicos/normas , Animais , Regiões Árticas/epidemiologia , Clima , Hematócrito/normas , Hibernação , Valores de Referência , Estações do Ano , Espécies Sentinelas/fisiologia
8.
Biosci Rep ; 40(8)2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32725148

RESUMO

The new 2019 coronavirus disease (COVID-19), according to the World Health Organization (WHO), has been characterized as a pandemic. As more is being discovered about this virus, we aim to report findings of the complete blood count (CBC) of COVID-19 patients. This would serve in providing physicians with important knowledge on the changes that can be expected from the CBC of mild and normal COVID-19 patients. A total of 208 mild and common patients were admitted at the Dongnan Hospital located in the city of Xiaogan, Hubei, China. The CBCs of these patients, following a confirmed diagnosis of COVID-19, were retrospectively analyzed and a significant P<0.05 was found after a full statistical analysis was conducted using the Statistical Package for the Social Sciences (IBM SPSS). CBC analysis revealed changes in the levels of red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), and C-reactive protein (CRP). Clinicians should expect similar findings when dealing with the new COVID-19.


Assuntos
Betacoronavirus/patogenicidade , Doença das Coronárias/diagnóstico , Infecções por Coronavirus/diagnóstico , Diabetes Mellitus/diagnóstico , Hipertensão/diagnóstico , Pneumonia Viral/diagnóstico , Insuficiência Respiratória/diagnóstico , Adulto , Idoso , Doenças Assintomáticas , Contagem de Células Sanguíneas , Proteína C-Reativa/metabolismo , China/epidemiologia , Comorbidade , Doença das Coronárias/sangue , Doença das Coronárias/epidemiologia , Doença das Coronárias/fisiopatologia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/fisiopatologia , Índices de Eritrócitos , Eritrócitos/patologia , Eritrócitos/virologia , Feminino , Hematócrito , Hemoglobinas/metabolismo , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Insuficiência Respiratória/sangue , Insuficiência Respiratória/epidemiologia , Insuficiência Respiratória/fisiopatologia , Estudos Retrospectivos , Índice de Gravidade de Doença
9.
Aquat Toxicol ; 226: 105563, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32673887

RESUMO

Climate warming and nitrate pollution are pervasive aquatic stressors that endanger the persistence of fishes prevailing in anthropogenically disturbed habitats. Individually, elevated nitrate and temperature can influence fish energy homeostasis by increasing maintenance costs and impairing oxygen transport capacity. However, it remains unknown how fish respond to simultaneous exposure to elevated temperature and nitrate pollution. Hence, we examined the combined effects of nitrate and elevated temperatures on aerobic scope (AS, maximum-standard metabolic rates) and cardiorespiratory attributes (haemoglobin HB, haematocrit HCT, relative ventricle mass RVM, and somatic spleen index SSI) in a freshwater salmonid, Thymallus thymallus. A 3 × 2 factorial design was used, where fish were exposed to one of three ecologically relevant levels of nitrate (0, 50, or 200 mg NO3- l-1) and one of two temperatures (18 °C or 22 °C) for 6 weeks. Elevated temperature increased AS by 36 % and the improvement was stronger when coupled with nitrate exposure, indicating a positive synergistic interaction. HB was reduced by nitrate exposure, while HCT was independent of nitrate pollution and temperature. Stressor exposure induced remodeling of key elements of the cardiorespiratory system. RVM was 39 % higher in fish exposed to 22 °C compared to 18 °C but was independent of nitrate exposure. SSI was independent of temperature but was 85 % and 57 % higher in fish exposed to 50 and 200 mg NO3- l-1, respectively. Taken together, these results highlight that simultaneous exposure to elevated temperatures and nitrate pollution offers cross-tolerance benefits, which may be underscored by cardiorespiratory remodeling.


Assuntos
Metabolismo Energético/efeitos dos fármacos , Água Doce/química , Temperatura Alta , Nitratos/toxicidade , Salmonidae/metabolismo , Poluentes Químicos da Água/toxicidade , Aclimatação/efeitos dos fármacos , Animais , Ecossistema , Eutrofização , Hematócrito , Consumo de Oxigênio/efeitos dos fármacos , Salmonidae/sangue
10.
Ecotoxicol Environ Saf ; 201: 110824, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32544747

RESUMO

The aim of the study was to investigate the effects of sublethal concentrations (0.3, 0.6 and 1.2 mg L-1) of the herbicide Ronstar on the hematology and some immune parameters in Clarias gariepinus juvenile (mean weight and length 58.72 ± 2.46 g and 27.60 ± 1.62 cm, respectively). The hematological and some immune parameters were studied for 21 days in a static renewal bioassay system in which the water and the herbicide were changed daily. The erythrocyte count, hemoglobin concentration (Hb), and packed cell volume (PCV) were significantly (p < 0.05) reduced in the treatment groups. When compared with the control, there were significant (p < 0.05) leucocytosis, lymphocytosis, neutropenia and monocytopenia in the treatment groups. Both the mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) were reduced ((p < 0.05) in the Ronstar-exposed fish. The result showed that the treated fish suffered hypochromic microcytic anemia. The total immunoglobulin and phagocytic indices (phagocytic capacity and phagocytic index) were significantly (p < 0.05) reduced in the treatment groups. while the respiratory burst was significantly (p < 0.05) increased in the treatment groups. The result showed that exposure to Ronstar had adverse effects on the hematology and immunocompetency of the fish.


Assuntos
Peixes-Gato , Herbicidas/toxicidade , Imunoglobulinas/sangue , Oxidiazóis/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Peixes-Gato/sangue , Peixes-Gato/imunologia , Relação Dose-Resposta a Droga , Contagem de Eritrócitos , Índices de Eritrócitos/efeitos dos fármacos , Eritrócitos/citologia , Eritrócitos/efeitos dos fármacos , Hematócrito , Hemoglobinas/análise , Fagócitos/citologia , Fagócitos/efeitos dos fármacos
11.
Acta Cir Bras ; 35(4): e202000403, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32578723

RESUMO

PURPOSE: To collect data capable of pointing out the effects of the ultracavitation treatment on the liver of rabbits after adipose tissue application, by means of histological analyses of the liver and hematological and biochemical exams. METHODS: This is an experimental study with 12 albino rabbits as sample, which were divided into 3 groups and submitted to a hypercaloric diet for one month. Subsequently, subjects underwent UCV treatment: 3 minutes, 30 W, continuous mode at 100%, every 2 ERAS = 441.02 J/cm2, intensity of 10w/cm2. They were then euthanized and underwent biopsy after 24 hours. RESULTS: After 48 hours from the ultracavitation treatment, the animals' livers presented greater amount of fat infiltration if compared to the amount presented 96 hours after the treatment. However, laboratory tests showed no alterations. Values were maintained within normal parameters of cholesterol, triglycerides, liver enzymes, hemoglobin and hematocrit levels. CONCLUSIONS: This study has identified that infiltrates may appear on livers after the treatment, despite high hematological and biochemical tests results. The fat infiltrates reduction 96 h after treatment suggests lower risks to animal health, if the period between applications is respected.


Assuntos
Tecido Adiposo/patologia , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Lipodistrofia/patologia , Lipodistrofia/terapia , Fígado/patologia , Alanina Transaminase/sangue , Animais , Aspartato Aminotransferases/sangue , Colesterol/sangue , Feminino , Hematócrito , Hemoglobinas/análise , Ablação por Ultrassom Focalizado de Alta Intensidade/efeitos adversos , Lipodistrofia/sangue , Masculino , Coelhos , Valores de Referência , Reprodutibilidade dos Testes , Fatores de Risco , Resultado do Tratamento , Triglicerídeos/sangue
12.
Ann Biol Clin (Paris) ; 78(3): 319-322, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32540818

RESUMO

The purpose of this work was to compare the measured red-cell volume (RCV) using sodium pertechnétate [RCV-99mTc] compared to the reference technique using sodium radiochromate [RCV-51Cr] and to assess the influence of technetium-99 elution on the RCV-99mTc value. Ten patients had simultaneous measurements of RCV-99mTc and RCV-51Cr. Elution of Tc-99m from red blood cells was 2.9% and led to an average overestimation of RCV-99mTc of 3.7%. The introduction of individual tracer elution rates in the RCV-99mTc calculation corrects this overestimation.


Assuntos
Radioisótopos de Cromo/farmacologia , Volume de Eritrócitos/efeitos dos fármacos , Eritrócitos/citologia , Eritrócitos/efeitos dos fármacos , Marcação por Isótopo/métodos , Tecnécio/farmacologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Relação Dose-Resposta a Droga , Contagem de Eritrócitos/métodos , Feminino , Hematócrito/métodos , Humanos , Marcação por Isótopo/efeitos adversos , Masculino , Pessoa de Meia-Idade , Técnica de Diluição de Radioisótopos
13.
J Pediatr Orthop ; 40(6): e454-e459, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32501914

RESUMO

BACKGROUND: ε-Aminocaproic acid (EACA) is an antifibrinolytic agent that has been shown to decrease blood loss and transfusion requirements in several populations undergoing various surgical procedures. However, the efficacy of EACA has not been assessed in pediatric patients with cerebral palsy undergoing bilateral varus rotational femoral osteotomies. The purpose of this study was to assess the efficacy of intravenous EACA in reducing calculated intraoperative blood loss and transfusions in this population. METHODS: Patients aged 18 years or younger were eligible. Patients were randomized to receive EACA or placebo (saline), and randomization was stratified based on sex and whether or not additional soft tissue or osseous procedures were performed. On the basis of retrospective data, the calculated sample size was 12 patients per arm to detect a difference of 250-mL blood loss. The primary outcome was calculated intraoperative blood loss. Secondary outcomes included transfusion requirements, 24-hour drain output, length of stay, and incidence of complications. RESULTS: The mean age of patients in this study was 8 years (SD: 2.4 y). There were no differences in age, sex, height, weight, type of anesthesia, operative time, and associated procedures between the EACA and placebo groups (P>0.05). Preoperative hematocrit was lower in the EACA group (37.1 vs. 40.0, P=0.04). Calculated intraoperative blood loss was 536 mL in the EACA group and 628 mL in the placebo group (P=0.45). Transfusions were required in 62% of patients in the EACA group and 67% of patients in the placebo group (P=0.68). Total 24-hour drain output was 72.5 mL in the EACA group and 103.3 mL in the placebo group (P=0.37). Length of stay was similar between both groups, and there were no drug or placebo-related complications in either group. CONCLUSIONS: There was no difference in blood loss or transfusion requirements associated with EACA compared with placebo; however, this study is underpowered to detect smaller differences in blood loss. Additional studies with larger sample sizes are needed to confirm these findings and further elucidate the indications for antifibrinolytic agents in pediatric patients. LEVEL OF EVIDENCE: Level I.


Assuntos
Ácido Aminocaproico/administração & dosagem , Antifibrinolíticos/administração & dosagem , Perda Sanguínea Cirúrgica/prevenção & controle , Transfusão de Sangue , Osteotomia/métodos , Administração Intravenosa , Adolescente , Paralisia Cerebral/complicações , Criança , Método Duplo-Cego , Feminino , Fêmur/cirurgia , Hematócrito , Humanos , Masculino , Estudos Prospectivos
14.
Artigo em Inglês | MEDLINE | ID: mdl-32567994

RESUMO

The objective of this study was to investigate the effects of chronic environmental lead (Pb) exposure in blood lead level (BLL), δ-aminolevulinic acid dehydratase (ALAD) activity, hemoglobin (Hb) amount and hematocrit (Hct) value in primary schoolchildren and adults. Blood was obtained for BLL, ALAD, Hb and Hct measurements in 23 primary schoolchildren (girls and boys) and 117 adult residents (women and men) living in three villages (Kelmend, Boletin and Zhazhë) defined by concentric circles 2, 3 and 5 km in radius drawn around from the smelter-refinery complex "Trepça"in Zveçan and in Koliq village 40 km away. As expected, BLLs were substantially higher in the schoolchildren from smelter area compared with control (11 ± 4.2 µg/L and 6.9 ± 1.6 µg/L respectively) and in adult residents from Kelmend, Boletin and Zhazhë (24 ± 11.8, 12 ± 4.5, 11 ± 5.4 and 8.0 ± 2.8 µg/L respectively). Blood ALAD activity of children in Zhazhë is 16% inhibited compared to control and blood ALAD activity in adults in villages from smelter area is 32, 3%, 48, 4% and 17, 8% inhibited compared to control. There is no difference of Hb and Hct values in schoolchildren from Zhazhë and in adult residents from Kelmend and Zhazhë compared with control. Results of this study provide evidence of moderate inverse correlation between BLL and ALAD activity in both examined cohorts from smelter area. The inhibition of ALAD activity in primary schoolchildren and adults occurred at blood lead levels < 24 µg/L; consequently it can cause an increase of δ- Aminolevulinic acid.


Assuntos
Exposição Ambiental/análise , Poluentes Ambientais/sangue , Hemoglobinas/análise , Chumbo/sangue , Mineração , Sintase do Porfobilinogênio/sangue , Adulto , Biomarcadores/sangue , Criança , Feminino , Hematócrito , Humanos , Kosovo , Intoxicação por Chumbo/sangue , Masculino , População Rural , Instituições Acadêmicas
15.
PLoS One ; 15(4): e0232018, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32352972

RESUMO

INTRODUCTION: In many African countries, laboratory reference values are not established for the local healthy adult population. In Mozambique, reference values are known for young adults (18-24yo) but not yet established for a wider age range. Our study aimed to establish hematological, biochemical and immunological reference values for vaccine trials in Mozambican healthy adults with high-risk for HIV acquisition. METHODS: A longitudinal cohort and site development study in Mozambique between November 2013 and 2014 enrolled 505 participants between 18 to 35 years old. Samples from these healthy participants, were analyzed to determine reference values. All volunteers included in the analysis were clinically healthy and human immunodeficiency virus (HIV), hepatitis B and C virus, and syphilis negative. Median and reference ranges were calculated for the hematological, biochemical and immunological parameters. Ranges were compared with other African countries, the USA and the US National Institute of Health (NIH) Division of AIDS (DAIDS) toxicity tables. RESULTS: A total of 505 participant samples were analyzed. Of these, 419 participants were HIV, hepatitis B and C virus and syphilis negative including 203 (48.5%) females and 216 (51.5%) males, with a mean age of 21 years. In the hematological parameters, we found significant differences between sex for erythrocytes, hemoglobin, hematocrit, MCV, MCH and MCHC as well as white blood cells, neutrophils and platelets: males had higher values than females. There were also significant differences in CD4+T cell values, 803 cells/µL in men versus 926 cells/µL in women. In biochemical parameters, men presented higher values than women for the metabolic, enzymatic and renal parameters: total and direct bilirubin, ALT and creatinine. CONCLUSION: This study has established reference values for healthy adults with high-risk for HIV acquisition in Mozambique. These data are helpful in the context of future clinical research and patient care and treatment for the general adult population in the Mozambique and underline the importance of region-specific clinical reference ranges.


Assuntos
Células Sanguíneas/química , Infecções por HIV/prevenção & controle , Testes Hematológicos/normas , Adulto , Plaquetas/química , Estudos de Coortes , Feminino , Infecções por HIV/sangue , Hematócrito/normas , Hemoglobinas/análise , Humanos , Contagem de Leucócitos/normas , Leucócitos/química , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Moçambique/epidemiologia , Valores de Referência , Fatores de Risco
16.
Medicine (Baltimore) ; 99(20): e20365, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32443389

RESUMO

Postoperative hyponatremia (POH) is thought to be a fearsome complication of orthopedic surgery. Primary aim of this cohort study was to evaluate the incidence of POH and its clinical relevance in elective surgery, outlining differences between total knee arthroplasty (TKA) and total hip arthroplasty, looking for the presence of any risk factor commonly related to POH.Four hundred two patients that underwent total hip arthroplasty and total knee arthroplasty performed between 2016 and 2017 were retrospectively examined. Serum electrolytes, hemoglobin, hematocrit, glucose, and creatinine were evaluated preoperatively and at day 0-I-II from surgery. Age, sex, body mass index, comorbidities, drugs, surgery data, transfusions, postoperative symptoms, and length of stay (LOS) were determined. All surgeries were performed by the same equipe. Patients had the same perioperative management, excluded those that took thiazides, already at risk of POH.Patients were divided in 2 groups: group A, patients with normal postoperative natremia (294 patients) and group B, patients who developed POH (108, 26.9%); 66.7% of these developed POH within 24 hours postoperatively. In group B mean postoperative natremia was 133.38 (127.78-134.85) mmol/L. Two patients (1.8%) developed moderate hyponatremia, no severe hyponatremia was documented. Type of surgery, operation time, LOS, and presence of postoperative symptoms did not show statistically significant differences within groups. At multivariate logistic analysis chronic use of thiazides was the only variable associated to a decreased risk of developing POH (OR = 0.39; P = .03). Hemoglobin postoperative values (OR = 1.22; P = .03), the need of postoperative transfusion (OR = 2.50; P = .02) and diabetes (OR = 2.70; P = .01) were associated to an increased risk of POH.Although 26.9% of our patients exhibited POH, the onset of this disorder had no implication on postoperative symptoms and on LOS. Diabetes and transfusion are factors most often associated to POH.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Hiponatremia/etiologia , Complicações Pós-Operatórias/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Glicemia , Índice de Massa Corporal , Comorbidade , Creatinina/sangue , Eletrólitos/sangue , Feminino , Hematócrito , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
17.
PLoS One ; 15(5): e0232414, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32437368

RESUMO

Current stroke risk assessment tools presume the impact of risk factors is linear and cumulative. However, both novel risk factors and their interplay influencing stroke incidence are difficult to reveal using traditional additive models. The goal of this study was to improve upon the established Revised Framingham Stroke Risk Score and design an interactive Non-Linear Stroke Risk Score. Leveraging machine learning algorithms, our work aimed at increasing the accuracy of event prediction and uncovering new relationships in an interpretable fashion. A two-phase approach was used to create our stroke risk prediction score. First, clinical examinations of the Framingham offspring cohort were utilized as the training dataset for the predictive model. Optimal Classification Trees were used to develop a tree-based model to predict 10-year risk of stroke. Unlike classical methods, this algorithm adaptively changes the splits on the independent variables, introducing non-linear interactions among them. Second, the model was validated with a multi-ethnicity cohort from the Boston Medical Center. Our stroke risk score suggests a key dichotomy between patients with history of cardiovascular disease and the rest of the population. While it agrees with known findings, it also identified 23 unique stroke risk profiles and highlighted new non-linear relationships; such as the role of T-wave abnormality on electrocardiography and hematocrit levels in a patient's risk profile. Our results suggested that the non-linear approach significantly improves upon the baseline in the c-statistic (training 87.43% (CI 0.85-0.90) vs. 73.74% (CI 0.70-0.76); validation 75.29% (CI 0.74-0.76) vs 65.93% (CI 0.64-0.67), even in multi-ethnicity populations. The clinical implications of the new risk score include prioritization of risk factor modification and personalized care at the patient level with improved targeting of interventions for stroke prevention.


Assuntos
Aprendizado de Máquina , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Idoso , Algoritmos , Boston/epidemiologia , Estudos de Coortes , Árvores de Decisões , Eletrocardiografia , Feminino , Hematócrito , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Cardiovasculares , Dinâmica não Linear , Estudos Prospectivos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Acidente Vascular Cerebral/prevenção & controle
18.
Am J Vet Res ; 81(6): 499-505, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32436791

RESUMO

OBJECTIVE: To assess the effect of packed RBC (pRBC) transfusion on thromboelastographic (TEG) tracings in dogs with naturally occurring anemia. ANIMALS: 22 clinically anemic dogs that received a pRBC transfusion. PROCEDURES: For each dog, a blood sample was collected before and within 3 hours after completion of the pRBC transfusion for a CBC, nonactivated TEG analysis, and measurement of blood viscosity. Wilcoxon signed rank tests were used to compare CBC, viscosity, and TEG variables between pretransfusion and posttransfusion blood samples. Multivariable linear regression was used to assess the effects of pretransfusion-posttransfusion changes in Hct, WBC count, and platelet count on changes in TEG variables. RESULTS: Median posttransfusion Hct (21%; range, 13% to 34%) was significantly greater than the median pretransfusion Hct (12.5%; range, 7% to 29%). Packed RBC transfusion was associated with a median increase in Hct of 6.2% (range, 1.2% to 13%). Maximum amplitude significantly decreased from 74.9 to 73.8 mm and clot strength significantly decreased from 14,906 to 14,119 dynes/s after pRBC transfusion. Blood viscosity significantly increased, whereas platelet and WBC counts significantly decreased after transfusion. Multivariable linear regression revealed that pretransfusion-posttransfusion changes in Hct, WBC count, and platelet count were not associated with changes in TEG variables. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that pRBC transfusion had only small effects on the TEG tracings of hemodynamically stable dogs. Therefore, large changes in TEG tracings following pRBC transfusion are unlikely to be the result of the transfusion and should be investigated further.


Assuntos
Anemia/veterinária , Transfusão de Eritrócitos/veterinária , Animais , Transfusão de Sangue/veterinária , Doenças do Cão , Cães , Hematócrito/veterinária , Tromboelastografia/veterinária
19.
Medicine (Baltimore) ; 99(19): e20103, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384484

RESUMO

Hidden blood loss (HBL) plays an important role in perioperative rehabilitation of patients underwent posterior lumbar fusion surgery. This study was to calculate the volume of HBL and evaluate the risk factors among patients after posterior lumbar fusion surgery.A retrospective analysis was made on the clinical data of 143 patients underwent posterior lumbar fusion surgery from March 2017 to December 2017. Recording preoperative and postoperative hematocrit to calculate HBL according to Gross formula and analyzing its related factors including age, sex, height, weight, body mass index (BMI), surgery levels, surgical time, surgery types, duration of symptoms, disorder type, specific gravity of urine (SGU), plasma albumin (ALB), glomerular filtration rate (GFR), glucose (GLU), drainage volume, hypertension. Risk factors were further analyzed by multivariate linear regression analysis and t test.Eighty-six males and 57 females, mean age 52.7 ±â€Š11.4 years, mean height 162 ±â€Š7.0, mean weight 61.5 ±â€Š9.4, were included in this study. The HBL was 449 ±â€Š191 mL, with a percentage of 44.2% ±â€Š16.6% in the total perioperative blood loss. Multivariate linear regression analysis revealed that patients with higher BMI (P = .026), PLIF procedures (P = .040), and more surgical time (P = .018) had a greater amount of HBL. Whereas age (P = 0.713), sex (P = .276), surgery levels (P = .921), duration of symptoms (P = .801), disorder type (P = .511), SGU (P = .183), ALB (P = .478), GFR (P = .139), GLU (P = .423), hypertension (P = .337) were not statistically significant differences with HBL.HBL is a large proportion of total blood loss in patients after posterior lumbar fusion surgery. BMI >24 kg/m, PLIF procedures, and more surgical time are risk factors of HBL. Whereas age, sex, surgery levels, duration of symptoms, disorder type, SGU, ALB, GFR, GLU, hypertension were not associated with HBL.


Assuntos
Perda Sanguínea Cirúrgica/estatística & dados numéricos , Vértebras Lombares/cirurgia , Hemorragia Pós-Operatória/epidemiologia , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Pesos e Medidas Corporais , Feminino , Hematócrito , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
20.
Wiad Lek ; 73(3): 546-550, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32285831

RESUMO

OBJECTIVE: The aim: The purpose of this research was to study the reasons adolescents are underdiagnosed in iron deficiency in Ukraine. PATIENTS AND METHODS: Materials and methods: We provided a data analysis of medical records on the reasons and frequency of requests for medical assistance among teenage children, including the age group10-19 years. The group of exclusion criteria included patients with traumatic brain injury, burns, eye diseases, congenital abnormalities of development, childhood infirmities, persons who had contact with radiation, oncological patients, patients who had surgery within the last 3 months. Moreover, the researched cases were provided by private medical institutions as we needed to compare the laboratory tests, which are not available in governmental primary care institutions. In this research were used such key methods as basic data analysis, correlation-analysis and summarizing of gathered results. RESULTS: Results: The number of referrals dominated initially to ENT (36.8%), family physicians (25.6%) and pediatricians (23.3%), with a nearly equal distribution of patients by gender. From all the cases there were 162 cases where clinical laboratory blood test was performed (56,8% male, 43,2% female). The distribution among specialties of doctors, who prescribed a blood test was: 64,2% family doctors , 9,3% ENT, 20,4% pediatricians, 6,1%- other specialists. Serum ferritin was discovered in 22 cases. They were found in 19,1% and there was no correlation between inflammation changes and number of erythrocytes, hemoglobin and qualitative signs of red blood cells. CONCLUSION: Conclusions: The analysis of medical records revealed the expediency of the syndromic distribution of causes of treatment, as well as the identification of risk groups and early diagnosis of pathologies among adolescent children in the practice of a family doctor. A fifth part of adolescent patients appointments was made up of healthy individuals, of whom (69.5%) belonged to the age group of 10-13 years. Inflammatory changes in the blood are not related to the amount of hemoglobin, erythrocytes and erythrocyte characteristics. Hemoglobin, hematocrit and erythrocyte counts are not informative in the diagnosis of iron deficiency.


Assuntos
Anemia Ferropriva , Adolescente , Criança , Feminino , Ferritinas , Hematócrito , Humanos , Ferro , Masculino , Ucrânia
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