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1.
Sci Rep ; 10(1): 16496, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020546

RESUMO

This study aimed to analyze aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio in COVID-19 patients. After exclusion, 567 inpatients were included in this study and separated into two groups according to their AST/ALT ratio on admission. Death was regarded as poor prognosis in this study. Of 567 patients, 200 (35.3%) had AST/ALT ≥ 1.38. Of the 200 patients, older age (median age 60 years), myalgia (64 [32%] cases), fatigue (91 [45.5%] cases), some comorbidities and outcomes were significantly different from patients with AST/ALT < 1.38. They also had worse chest computed tomography (CT) findings, laboratory results and severity scores. Levels of platelet count (OR 0.995, 95% CI [0.992-0.998]) and hemoglobin (OR 0.984, 95% CI [0.972-0.995]) were independently associated with AST/ALT ≥ 1.38 on admission. Furthermore, a high AST/ALT ratio on admission was an independent risk factor for poor prognosis (OR 99.9, 95% CI [2.1-4280.5]). In subsequent monitoring, both survivors and non-survivors showed decreased AST/ALT ratio during hospitalization. In conclusion, high AST/ALT ratio might be the indication of worse status and outcomes in COVID-19 patients.


Assuntos
Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Adulto , Fatores Etários , Idoso , Biomarcadores/sangue , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/patologia , Fadiga/epidemiologia , Feminino , Hemoglobinas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Mialgia/epidemiologia , Pandemias , Admissão do Paciente/estatística & dados numéricos , Contagem de Plaquetas , Pneumonia Viral/epidemiologia , Pneumonia Viral/patologia , Análise de Sobrevida
2.
Rev Assoc Med Bras (1992) ; 66Suppl 2(Suppl 2): 65-70, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965359

RESUMO

INTRODUCTION: This study aims to evaluate changes in hematological parameters after the follow-up of patients who received treatment with favipiravir due to COVID-19 infections. METHODS: Sixty-two cases receiving favipiravir treatment for at least five days due to COVID-19 infection were evaluated retrospectively. Parameters including age, gender, nasopharyngeal swab positivity, and chronic diseases were analyzed. Hematologic parameters were analyzed before and after the treatment. RESULTS: The mean age of the patients receiving treatment with favipiravir was 63.7±12.3 years. Nasopharyngeal swab positivity was detected in 67.7%. The most common comorbid conditions detected in patients were hypertension in 25 cases (40.3%) and diabetes in 16 cases (25.8%). In the statistical analysis of the hematological parameters before and after treatment with favipiravir, WBC, PT-PTT-INR levels were found to be unaffected; the mean RBC was found to have decreased from 4.33 ± 0.58 M/uL to 4.16 ± 0.54 M/uL (p:0.003); the median hemoglobin level was found to have decreased from 12.3 g/dl to 11.9 g/dl (p:0.041); the hematocrit level decreased from 38.1% ± 4.8 to 36.9% ± 4.2 (p:0.026); the median neutrophil count decreased from 4.57 K/uL to 3.85 K/uL (p:0.001); the mean lymphocyte count increased from 1.22 ± 0.53 K/uL to 1.84 ± 1.19 K/uL (p:0.000); and the mean platelet count increased from 244.1 ± 85.1 K/uL to 281.9 ± 103.3 K/uL (p:0.005). CONCLUSION: We concluded that the pathological effect of treatment with favipiravir on the hematologic system was the suppression in the erythrocyte series, and there were no adverse effects in other hematologic parameters.


Assuntos
Amidas/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Pandemias , Pneumonia Viral/tratamento farmacológico , Pirazinas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Contagem de Linfócito CD4 , Infecções por Coronavirus/epidemiologia , Feminino , Hemoglobinas/análise , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Pneumonia Viral/epidemiologia , Estudos Retrospectivos
3.
Medicine (Baltimore) ; 99(36): e22028, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899057

RESUMO

Comparison of different anticoagulants in blood management and complications with tranexamic acid (TXA) in total hip arthroplasty (THA) is unclear. Our aim was to compare the efficacy and safety among receiving nadroparin calcium, enoxaparin sodium or rivaroxaban after TXA in THA.150 patients undergoing primary unilateral THA were received 15 mg/kg intravenous TXA (IV-TXA) before skin incision, followed by 1 of nadroparin calcium (Group A), enoxaparin sodium (Group B), or rivaroxaban (Group C) randomly during hospitalization. The primary outcome was hidden blood loss (HBL). Other outcomes such as the maximum hemoglobin (Hb) drop, total blood loss (TBL), the volume of drainage, transfusion rate, length of hospital stay (LOS), and complications were also compared.There were no statistically significant differences in HBL, the maximum hemoglobin (Hb) drop, transfusion rate, and complications among 3 groups. LOS was significantly higher for patients in Group B than Group A (P = .026). Neither deep venous thrombosis (DVT) nor pulmonary embolism (PE) occurred in any group.There were no differences in efficacy and safety in patients undergoing THA receiving nadroparin calcium, enoxaparin sodium, or rivaroxaban after anti-fibrinolysis with TXA.


Assuntos
Anticoagulantes/efeitos adversos , Antifibrinolíticos/efeitos adversos , Perda Sanguínea Cirúrgica/prevenção & controle , Ácido Tranexâmico/efeitos adversos , Administração Intravenosa , Idoso , Anticoagulantes/administração & dosagem , Antifibrinolíticos/administração & dosagem , Artroplastia de Quadril/efeitos adversos , Transfusão de Sangue/estatística & dados numéricos , China/epidemiologia , Enoxaparina/administração & dosagem , Enoxaparina/efeitos adversos , Feminino , Hemoglobinas/análise , Hospitalização , Humanos , Tempo de Internação/tendências , Masculino , Pessoa de Meia-Idade , Nadroparina/administração & dosagem , Nadroparina/efeitos adversos , Sangue Oculto , Estudos Retrospectivos , Rivaroxabana/administração & dosagem , Rivaroxabana/efeitos adversos , Segurança , Ácido Tranexâmico/administração & dosagem , Resultado do Tratamento
4.
Eur J Epidemiol ; 35(8): 763-773, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32816244

RESUMO

Iron metabolism and anemia may play an important role in multiple organ dysfunction syndrome in Coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to evaluate biomarkers of anemia and iron metabolism (hemoglobin, ferritin, transferrin, soluble transferrin receptor, hepcidin, haptoglobin, unsaturated iron-binding capacity, erythropoietin, free erythrocyte protoporphyrine, and erythrocyte indices) in patients diagnosed with COVID-19, and explored their prognostic value. Six bibliographic databases were searched up to August 3rd 2020. We included 189 unique studies, with data from 57,563 COVID-19 patients. Pooled mean hemoglobin and ferritin levels in COVID-19 patients across all ages were 129.7 g/L (95% Confidence Interval (CI), 128.51; 130.88) and 777.33 ng/mL (95% CI, 701.33; 852.77), respectively. Hemoglobin levels were lower with older age, higher percentage of subjects with diabetes, hypertension and overall comorbidities, and admitted to intensive care. Ferritin level increased with older age, increasing proportion of hypertensive study participants, and increasing proportion of mortality. Compared to moderate cases, severe COVID-19 cases had lower hemoglobin [weighted mean difference (WMD), - 4.08 g/L (95% CI - 5.12; - 3.05)] and red blood cell count [WMD, - 0.16 × 1012 /L (95% CI - 0.31; - 0.014)], and higher ferritin [WMD, - 473.25 ng/mL (95% CI 382.52; 563.98)] and red cell distribution width [WMD, 1.82% (95% CI 0.10; 3.55)]. A significant difference in mean ferritin levels of 606.37 ng/mL (95% CI 461.86; 750.88) was found between survivors and non-survivors, but not in hemoglobin levels. Future studies should explore the impact of iron metabolism and anemia in the pathophysiology, prognosis, and treatment of COVID-19.


Assuntos
Anemia/diagnóstico , Infecções por Coronavirus , Coronavirus/metabolismo , Ferro/metabolismo , Pandemias , Pneumonia Viral , Betacoronavirus , Biomarcadores/análise , Biomarcadores/sangue , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Eritropoetina , Ferritinas/sangue , Hemoglobinas/análise , Hemoglobinas/metabolismo , Hepcidinas/sangue , Hepcidinas/metabolismo , Humanos , Ferro/sangue , Pneumonia Viral/epidemiologia , Receptores da Transferrina/sangue , Transferrina/análise , Transferrina/metabolismo
5.
Medicine (Baltimore) ; 99(34): e21876, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846844

RESUMO

BACKGROUND: Cancer continues to be a severe global health problem and the leading cause of death worldwide. Chemotherapy as the main treatment has various side effects, of which marrow suppression is the most common one. Acupuncture had shown clinical effects for marrow suppression after chemotherapy in many studies. However, the efficacy and safety of acupuncture therapy for marrow suppression after chemotherapy remains unclear. OBJECTIVE: This protocol aims to evaluate the efficacy and safety of acupuncture for marrow suppression after chemotherapy according to the existing randomized controlled trials. METHODS AND ANALYSIS: The randomized controlled trials on acupuncture therapy for marrow suppression after chemotherapy will be searched in the database of Embase, PubMed and Cochrane Library, Allied and Complementary Medicine Database (AMED), Chinese Biomedical Literature Database (CBM), China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI), WanFang Database (WF), and related registration platforms (WHO ICTRP, Clinical Trials, and Chinese Clinical Trial Register [ChiCTR]), Grey Literature Database from inception to 1 August 2020. The primary outcomes will be assessed using white blood cell (WBC) count, platelet count, hemoglobin count and the number of neutrophils (N). Review Manager V.5.3 software will be applied for statistical analyses. We will measure the risk of bias of the included studies with Cochrane Collaboration Risk of Bias Tool. Finally, Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) will be used to grade the overall quality of evidence. And we will use the intra-group correlation coefficient to assess the consistency of reviewers. RESULT: This systematic review and meta-analysis will put a high-quality synthesis of the efficacy and safety of acupuncture treatment in marrow suppression after chemotherapy. CONCLUSION: The conclusion of this systematic review will provide evidence to assess acupuncture therapy is an efficacy and safe intervention to treat and control marrow suppression after chemotherapy. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42020163336.


Assuntos
Terapia por Acupuntura/métodos , Antineoplásicos/efeitos adversos , Células da Medula Óssea/efeitos dos fármacos , Medula Óssea/efeitos dos fármacos , Medula Óssea/patologia , Tratamento Farmacológico/métodos , Feminino , Hemoglobinas/análise , Humanos , Contagem de Leucócitos/métodos , Masculino , Neoplasias/tratamento farmacológico , Neutrófilos/citologia , Contagem de Plaquetas/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Resultado do Tratamento
6.
PLoS One ; 15(8): e0237543, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776978

RESUMO

Sickle cell disease (SCD) impacts liver and kidney function as well as skin integrity. These complications, as well as the hyperinflammatory state of SCD, could affect serum albumin. Serum albumin has key roles in antioxidant, anti-inflammatory and antithrombotic pathways and maintains vascular integrity. In SCD, these pathways modulate disease severity and clinical outcomes. We used three independent SCD adult cohorts to assess clinical predictors of serum albumin as well its association with mortality. In 2553 SCD adult participants, the frequency of low (<35 g/L) serum albumin was 5%. Older age and lower hemoglobin (P <0.001) were associated with lower serum albumin in all three cohorts. In age and hemoglobin adjusted analysis, higher liver enzymes (P <0.05) were associated with lower serum albumin. In two of the three cohorts, lower kidney function as measured by Glomerular Filtration Rate (P<0.001) was associated with lower serum albumin. Lower serum albumin predicted higher risk of tricuspid regurgitation velocity ≥ 2.5 m/s (OR = 1.1 per g/L, P ≤0.01). In all three cohorts, patients with low serum albumin had higher mortality (adjusted HR ≥2.9, P ≤0.003). This study confirms the role of serum albumin as a biomarker of disease severity and prognosis in patients with SCD. Albumin as a biomarker and possible mediator of SCD severity should be studied further.


Assuntos
Anemia Falciforme/mortalidade , Biomarcadores/sangue , Hemoglobinas/análise , Albumina Sérica/análise , Adulto , Anemia Falciforme/sangue , Anemia Falciforme/patologia , Estudos de Coortes , Feminino , Humanos , Masculino , Prognóstico , Taxa de Sobrevida
7.
Ann Hematol ; 99(10): 2405-2416, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32813071

RESUMO

Predictive factors of response to hypomethylating agents (HMA) in elderly acute myeloid leukemia (AML) patients remain unclear in the real-life setting and no direct comparison between azacitidine (AZA) and decitabine (DEC) has been carried out. We retrospectively evaluated 110 AML patients treated with HMA (78 AZA, 32 DEC) as first-line therapy outside of clinical trials. Median age was 75 years (range 58-87). The median overall survival (OS) of the entire cohort was 8.0 months (95% CI 6.1-10), without significant differences among the subgroups: AZA 8.8 months vs DEC 6.3 months (p = 0.291). HMA treatment yielded an overall response rate (ORR) of 40% (AZA 37% vs DEC 47%, p = 0.237). A stable disease (SD) after 4 HMA cycles was not associated with a worse survival outcome compared with an early optimal response. Factors independently associated with a better OS were transfusion independence during treatment (p = 0.049), achievement of an optimal response to treatment (p < 0.001), and a baseline hemoglobin level ≥ 9.25 (p = 0.018). A bone marrow (BM) blast count ≥ 30% (p < 0.001) and a therapy-related AML (p = 0.008) remain poor survival predictors. Of the available biologic features, an adverse risk category according to the ELN classification was significantly associated with a shorter survival over the intermediate risk category (p = 0.034). Disease progression remains the primary cause of death. Infectious complications were more severe (p = 0.036) and occurred earlier (p = 0.006) in the DEC group compared with that of the AZA group. In conclusion, clinical prognostic factors associated to response and survival have been identified without significant associations concerning overall outcomes between the two HMAs.


Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Azacitidina/uso terapêutico , Metilação de DNA/efeitos dos fármacos , DNA de Neoplasias/efeitos dos fármacos , Decitabina/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/patologia , Causas de Morte , Contagem de Células , DNA de Neoplasias/química , Progressão da Doença , Intervalo Livre de Doença , Feminino , Hemoglobinas/análise , Humanos , Infecções/etiologia , Infecções/mortalidade , Estimativa de Kaplan-Meier , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Células-Tronco Neoplásicas , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Resultado do Tratamento
8.
PLoS One ; 15(8): e0237255, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764804

RESUMO

In this study, washing tests were performed using samples prepared by contaminating fabrics with hemoglobin, and a kinetic analysis was conducted based the probability density functional method, which expresses the cleaning power using two parameters σrl (related to the cleaning mechanism) and µrl (related to the level of cleaning power). This method allows for the processing of uncertainties specific to protein washing under the assumption that the soil adhesion and detergency are in accordance with a normal distribution. A certain amount of hemoglobin solution was soaked in a cloth, dried, and steam-treated, and then used as a sample for a cleaning test. Two parameters σrl and µrl were calculated based on the detergency (%) after 5 min, 10 min, 15 min, and 20 min of washing with respect to different pH and temperature levels, and different sodium dodecyl sulfate (SDS) concentration and temperature levels. Based on the results, the value of σrl indicated that the hemoglobin was removed by the dissolving action. In addition, µrl increased in accordance with an increase in the pH, SDS concentration, and temperature. With respect to µrl, the relationship of ΔX + ΔY = Δ(X+Y) was observed in several cases, where ΔX represents the effect of the pH or SDS concentration, ΔY is the temperature effect, and Δ(X+Y) is the combined effect. Therefore, there may be an additive relationship between the pH and temperature effects, and the SDS concentration and temperature effects.


Assuntos
Detergentes/química , Hemoglobinas/análise , Dodecilsulfato de Sódio/química , Têxteis/análise , Humanos , Concentração de Íons de Hidrogênio , Cinética , Probabilidade , Solubilidade , Temperatura
9.
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
12.
Niger Postgrad Med J ; 27(3): 190-195, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32687118

RESUMO

Background: Haemoglobin (Hb) disorders are among the most common blood genetic disorders worldwide, and they constitute an important cause of morbidity and mortality, especially in Nigeria. Despite the clinical significance of early diagnosis, newborn screening for these conditions is not routinely done in Nigeria. Objective: This study was undertaken to document the pattern of Hb phenotypes of newborn babies at the National Hospital Abuja and highlight the relevance of neonatal screening for early diagnosis of abnormal Hb phenotypes in Nigeria. Subjects and Methods: A prospective study of eligible newborn babies delivered in the hospital at the study site was undertaken following parental informed consent. Venous blood was collected from the babies into an ethylenediaminetetraacetic acid sample bottles. The samples were analysed using high-performance liquid chromatography (HPLC) techniques, and the Hb phenotypes obtained were documented. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 20 (IBM-SPSS, Armonk, NY, USA). Results: Three hundred and eleven newborns (male = 173, female = 138) aged 0-28 days were recruited. Two hundred and thirty-six (75.9%) babies had Hb AA (FA) phenotype, 63 (20.3%) Hb AS (FAS), 6 (1.9%) Hb SS (FS), 4 (1.3%) Hb AC (FAC) and 2 (0.6%) had abnormal HbA variants. The overall prevalence of abnormal Hb phenotype was 24.1%. The results showed a significant association of sex (P = 0.003) and ethnicity (P = 0.047) with Hb phenotype. Conclusion: There is a wide spectrum of abnormal Hb phenotypes in Nigeria, and these phenotypes can easily be detected at birth using HPLC. We, therefore, recommend routine neonatal screening for sickle cell disease by HPLC in Nigeria.


Assuntos
Anemia Falciforme/sangue , Cromatografia Líquida de Alta Pressão/métodos , Hemoglobinas Anormais/análise , Hemoglobinas/análise , Recém-Nascido/sangue , Traço Falciforme/sangue , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Anemia Falciforme/epidemiologia , Anemia Falciforme/genética , Criança , Pré-Escolar , Hemoglobina Falciforme , Hemoglobinas/classificação , Hemoglobinas Anormais/genética , Humanos , Lactente , Nigéria/epidemiologia , Fenótipo , Prevalência , Estudos Prospectivos , Adulto Jovem
13.
J Assoc Physicians India ; 68(5): 39-41, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32610864

RESUMO

Aim: To assess effect of daily vis-a-vis alternate day oral iron therapy in terms of hemoglobin, reticulocyte hemoglobin equivalent (RET-He) and GI side effects using hepcidin as a biomarker. Methods: A hospital based randomized interventional two-arm analytical study was done among patients of IDA (20 in each group). The study population was divided into two groups by randomisation. Group 1 received oral iron supplements on alternate day and Group 2 received iron supplements daily. Hemoglobin, RET-He, Serum ferritin and Hepcidin level were assessed. Results: On day 2nd, the rise in Hepcidin was not significant from base line in alternate day therapy group but was significantly increased in daily therapy group. On day 3, the rise in hepcidin was significant from base line in both the groups but the mean change in hepcidin was more in daily therapy group. RET-He began increasing on day 2nd in both the groups. In alternate day therapy group, the rise in RET-He was significant from base line from the day 2nd onwards while the rise in RET-He in daily therapy group was not significant even on day 3. In alternate day iron therapy group, the mean increase in hemoglobin on day 21th (1.58 ±0.53 gm/dl) was significantly more than mean increase among daily therapy (0.41 ± 0.25 gm/dl, P <0.05). Conclusion: Alternate day single tablet dosing schedule of oral iron therapy (60mg of elemental iron, ferrous sulfate) was more effective and better tolerated (gastrointestinal side effects) compared to daily supplementation in IDA.


Assuntos
Anemia Ferropriva , Ferro/uso terapêutico , Anemia Ferropriva/tratamento farmacológico , Biomarcadores , Suplementos Nutricionais , Hemoglobinas/análise , Hepcidinas , Humanos , Estudos Prospectivos
14.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32694147

RESUMO

OBJECTIVES: We evaluated 4 diagnostic strategies to predict the presence of inflammatory bowel disease (IBD) in children who present with chronic nonbloody diarrhea and abdominal pain. METHODS: We conducted a prospective cohort study including 193 patients aged 6 to 18 years who underwent a standardized diagnostic workup in secondary or tertiary care hospitals. Each patient was assessed for symptoms, C-reactive protein (>10 mg/L), hemoglobin (<-2 SD for age and sex), and fecal calprotectin (≥250 µg/g). Patients with rectal bleeding or perianal disease were excluded because the presence of these findings prompted endoscopy regardless of their biomarkers. Primary outcome was IBD confirmed by endoscopy or IBD ruled out by endoscopy or uneventful clinical follow-up for 6 months. RESULTS: Twenty-two of 193 (11%) children had IBD. The basic prediction model was based on symptoms only. Adding blood or stool markers increased the AUC from 0.718 (95% confidence interval [CI]: 0.604-0.832) to 0.930 (95% CI: 0.884-0.977) and 0.967 (95% CI: 0.945-0.990). Combining symptoms with blood and stool markers outperformed all other strategies (AUC 0.997 [95% CI: 0.993-1.000]). Triaging with a strategy that involves symptoms, blood markers, and calprotectin will result in 14 of 100 patients being exposed to endoscopy. Three of them will not have IBD, and no IBD-affected child will be missed. CONCLUSIONS: Evaluating symptoms plus blood and stool markers in patients with nonbloody diarrhea is the optimal test strategy that allows pediatricians to reserve a diagnostic endoscopy for children at high risk for IBD.


Assuntos
Diarreia/etiologia , Doenças Inflamatórias Intestinais/diagnóstico , Adolescente , Área Sob a Curva , Biomarcadores , Proteína C-Reativa/análise , Criança , Técnicas de Apoio para a Decisão , Endoscopia Gastrointestinal , Ensaio de Imunoadsorção Enzimática , Fezes/química , Feminino , Hemoglobinas/análise , Humanos , Doenças Inflamatórias Intestinais/complicações , Complexo Antígeno L1 Leucocitário/sangue , Masculino , Estudos Prospectivos , Curva ROC , Proteína S100A12/análise , Sensibilidade e Especificidade
15.
Medicine (Baltimore) ; 99(27): e20952, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629702

RESUMO

Patients with stroke have a high risk of infection which may be predicted by age, procalcitonin, interleukin-6, C-reactive protein, National Institute of Health stroke scale (NHSS) score, diabetes, etc. These prediction methods can reduce unfavourable outcome by preventing the occurrence of infection.We aim to identify early predictors for urinary tract infection in patients after stroke.In 186 collected acute stroke patients, we divided them into urinary tract infection group, other infection type groups, and non-infected group. Data were recorded at admission. Independent risk factors and infection prediction model were determined using Logistic regression analyses. Likelihood ratio test was used to detect the prediction effect of the model. Receiver operating characteristic curve and the corresponding area under the curve were used to measure the predictive accuracy of indicators for urinary tract infection.Of the 186 subjects, there were 35 cases of urinary tract infection. Elevated interleukin-6, higher NIHSS, and decreased hemoglobin may be used to predict urinary tract infection. And the predictive model for urinary tract infection (including sex, NIHSS, interleukin-6, and hemoglobin) have the best predictive effect.This study is the first to discover that decreased hemoglobin at admission may predict urinary tract infection. The prediction model shows the best accuracy.


Assuntos
Acidente Vascular Cerebral/complicações , Infecções Urinárias/diagnóstico , Idoso , Biomarcadores/sangue , Proteína C-Reativa/análise , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Hemoglobinas/análise , Humanos , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Curva ROC , Medição de Risco/métodos , Infecções Urinárias/sangue , Infecções Urinárias/complicações
16.
Medicine (Baltimore) ; 99(28): e20906, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664083

RESUMO

Osteoporosis (OP) is a metabolic bone disease that can cause structural changes in bone marrow cavity. Bone marrow is the hematopoietic organ of adults. Accumulating evidence has shown a close connection between bone marrow hematopoietic function and bone formation. Some studies have revealed that OP is associated with hematopoiesis. However, the relationship is not definite.This study aimed to evaluate the association between peripheral blood cell counts (white blood cells [WBC], red blood cells [RBC], platelets [PLT]), hemoglobin [HGB], and bone mineral density [BMD]) in a sample of Chinese postmenopausal women. This is a retrospective study involving 673 postmenopausal women cases. The BMD of lumbar spine and left hip joint were measured by dual-energy X-ray absorptiometry. The levels of blood cell counts and HGB were measured and analyzed.The study results showed the WBC, RBC, PLT, and HGB levels of postmenopausal women in the OP group were all higher than those in the non-osteoporosis group. Spearman linear trend analysis and partial correlation analysis demonstrated that BMD was negatively correlated with WBC, RBC, PLT, and HGB in postmenopausal women.Due to the differences between different countries and races, and there are few studies on the association of BMD with peripheral blood cell counts and HGB in Chinese Postmenopausal Women. Therefore, more large sample studies are needed.


Assuntos
Grupo com Ancestrais do Continente Asiático/etnologia , Contagem de Células Sanguíneas/métodos , Densidade Óssea/fisiologia , Hemoglobinas/análise , Pós-Menopausa/sangue , Absorciometria de Fóton/métodos , Idoso , Contagem de Células Sanguíneas/tendências , Doenças Ósseas Metabólicas/diagnóstico , Doenças Ósseas Metabólicas/epidemiologia , Doenças Ósseas Metabólicas/fisiopatologia , Estudos de Casos e Controles , Feminino , Hematopoese/fisiologia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/fisiopatologia , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Osteogênese/fisiologia , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Osteoporose/fisiopatologia , Estudos Retrospectivos
17.
Medicine (Baltimore) ; 99(29): e21133, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702866

RESUMO

The aim of the study is to discuss the risk factor of right heart failure (RHF) especially the association of iron deficiency with RHF in Tibetan children who live in high altitude area. In this retrospective study, we collected the data of Tibetan children from January 2011 to December 2018 in our hospital. The patients included in the study had the following data: age, gender, ferritin, echocardiography, hemoglobin, C-reaction protein, and altitude of residence. According to whether RHF was diagnosed, the patients were divided into RHF group and non-RHF group. Totally 133 patients were included with 59 in RHF group and 74 in non-RHF group. In single factor analysis, age (P = .008), altitude of residence (P < .001), ferritin (P < .001), and pulmonary arterial systolic pressure (P < .001) showed significant difference between the 2 groups. Binary logistic regression was performed to further identify the association of the clinical factors with RHF. Higher pulmonary arterial systolic pressure (odds ratio: 29.303, 95% confidence interval: 5.249-163.589, P < .001) and lower ferritin level (odds ratio: 5.849, 95% confidence interval: 1.585-21.593, P = .008) were independent risk factors associated with RHF. In receiver-operating characteristic curve, the optimal cutoff value of ferritin level was 14.6 µg/L with the sensitivity of 81.4% and specificity of 89.2%. As continuous variable, the correlation between ferritin and RHF was not certain (P = .281). Due to the possibility that iron deficiency be a risk factor of RHF in Tibetan children, prevention and treatment of iron deficiency might be a potential way in reducing the incidence of RHF in this high altitude area.


Assuntos
Altitude , Anemia Ferropriva/complicações , Insuficiência Cardíaca/etiologia , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/fisiopatologia , Proteína C-Reativa/análise , Distribuição de Qui-Quadrado , Ecocardiografia/métodos , Ecocardiografia/estatística & dados numéricos , Feminino , Ferritinas/análise , Ferritinas/sangue , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/fisiopatologia , Hemoglobinas/análise , Humanos , Lactente , Modelos Logísticos , Masculino , Estudos Retrospectivos , Tibet/epidemiologia , Disfunção Ventricular Direita/sangue , Disfunção Ventricular Direita/epidemiologia , Disfunção Ventricular Direita/etiologia
18.
PLoS One ; 15(7): e0235902, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32701949

RESUMO

BACKGROUND: Post-colonoscopy bleeding (PCB) is an important colonoscopy quality indicator that is recommended to be routinely collected by colorectal cancer screening programs and endoscopy quality improvement programs. We created a standardized and reliable definition of PCB and set of rules for attributing the relatedness of PCB to a colonoscopy. METHODS: PCB events were identified from colonoscopies performed at the Forzani & MacPhail Colon Cancer Screening Centre. Existing definitions and relatedness rules for PCB were reviewed by the authors and a draft definition and set of rules was created. The definition and rules were revised after initial testing was performed using a set of 15 bleeding events. Information available for each event included the original endoscopy report and data abstracted from the emergency or inpatient record by a trained research assistant. A validation set of 32 bleeding events were then reviewed to assess their interrater reliability by having three endoscopists and one research assistant complete independent reviews and three endoscopists complete a consensus review. The Kappa statistic was used to measure interrater reliability. RESULTS: The panel classified 28 of 32 events as meeting the definition of PCB and rated 7, 8 and 6 events as definitely, probably and possibly related to the colonoscopy, respectively. The Kappa for the definition of PCB for the three independent reviews was 0.82 (substantial agreement). The Kappa for the attribution of the PCB to the colonoscopy by the three endosocopists was 0.74 (substantial agreement). The research assistant had a high agreement with the panel for both the definition (100% agreement) and application of the causal criteria (kappa 0.95). CONCLUSIONS: A standardized definition of PCB and attribution rules achieved high interrater reliability by endoscopists and a non-endoscopist and provides a template of required data for event adjudication by screening and quality improvement programs.


Assuntos
Colonoscopia/efeitos adversos , Hemorragia/etiologia , Neoplasias do Colo/diagnóstico , Pólipos do Colo/patologia , Pólipos do Colo/cirurgia , Hemoglobinas/análise , Humanos
20.
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
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