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1.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(4): 409-413, 2020 Aug 22.
Artigo em Chinês | MEDLINE | ID: mdl-32935519

RESUMO

OBJECTIVE: To evaluate the association between blood test parameters and intensity of Plasmodium falciparum infections among imported falciparum malaria cases in Tianjin City from 2015 to 2019, so as to provide insights into the early diagnosis of imported P. falciparum malaria. METHODS: The epidemiological data of 37 imported cases with confirmed diagnosis of P. falciparum malaria in Tianjin City from 2015 to 2019 were collected, and the epidemiological features and clinical manifestations were retrospectively analyzed. In addition, the association between blood test parameters and intensity of P. falciparum infections was evaluated among the imported P. falciparum malaria cases. RESULTS: Among the 31 imported P. falciparum malaria cases, there were 31 cases (83.8%) with a reduction in platelet (PLT) counts, 16 cases (43.2%) with a reduction in red blood cell (RBC) counts, 16 cases (43.2%) with a reduction in hemoglobin (Hb) concentrations, 23 cases (62.2%) with a rise in neutrophil percentage (NEUT%), 32 cases (86.5%) with a rise in total bilirubin (TBIL) concentrations, 29 cases (78.4%) with a rise in alanine aminotransferase (ALT) concentrations, 28 cases (75.7%) with a rise in aspartate transaminase (AST) concentrations, and 23 cases (62.2%) with a rise in gamma-glutamyl transpetidase (GGT) concentrations. The PLT count and Hb concentration correlated negatively with the intensity of P. falciparum infections (Goodman-Kruskal γ = -0.568 and -0.521, both P values < 0.05) and the TBIL concentration and NEUT% correlated positively with the intensity of P. falciparum infections (Goodman-Kruskal γ = 0.496 and 0.610, both P values < 0.05) among imported falciparum malaria cases; however, there were no associations of ALT, AST, GGT levels or RBC count with the intensity of P. falciparum infections among the imported falciparum malaria cases (Goodman-Kruskal γ = 0.370, 0.497, 0.314 and -0.434, all P values > 0.05). CONCLUSIONS: PLT, Hb, TBIL and NEUT% may serve as markers for early auxiliary diagnosis of imported P. falciparum malaria, and PLT and TBIL may provide valuable information for the diagnosis of severe imported P. falciparum malaria.


Assuntos
Testes Hematológicos , Malária Falciparum , Carga Parasitária , China , Cidades/estatística & dados numéricos , Testes Hematológicos/estatística & dados numéricos , Humanos , Malária Falciparum/sangue , Malária Falciparum/parasitologia , Carga Parasitária/estatística & dados numéricos , Plasmodium falciparum/fisiologia , Estudos Retrospectivos
3.
Acta Biomed ; 91(3): e2020003, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921701

RESUMO

BACKGROUND: The COVID-19 outbreak is now a pandemic disease reaching as much as 210 countries worldwide with more than 2.5 million infected people and nearly 200.000 deaths. Amplification of viral RNA by RT-PCR represents the gold standard for confirmation of infection, yet it showed false-negative rates as large as 15-20% which may jeopardize the effect of the restrictive measures taken by governments. We previously showed that several hematological parameters were significantly different between COVID-19 positive and negative patients. Among them aspartate aminotransferase and lactate dehydrogenase had predictive values as large as 90%. Thus a combination of RT-PCR and blood tests could reduce the false-negative rate of the genetic test. METHODS: We retrospectively analyzed 24 patients showing multiple and inconsistent RT-PCR, test during their first hospitalization period, and compared the genetic tests results with their AST and LDH levels. RESULTS: We showed that when considering the hematological parameters, the RT-PCR false-negative rates were reduced by almost 4-fold. CONCLUSIONS: The study represents a preliminary work aiming at the development of strategies that, by combining RT-PCR tests with routine blood tests, will lower or even abolish the rate of RT-PCR false-negative results and thus will identify, with high accuracy, patients infected by COVID-19.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/diagnóstico , Pandemias , Pneumonia Viral/diagnóstico , RNA Viral/análise , Reação em Cadeia da Polimerase em Tempo Real/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Aspartato Aminotransferases/sangue , Biomarcadores/sangue , Infecções por Coronavirus/sangue , Infecções por Coronavirus/epidemiologia , Diagnóstico Diferencial , Reações Falso-Negativas , Feminino , Seguimentos , Testes Hematológicos/métodos , Humanos , Itália/epidemiologia , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/sangue , Pneumonia Viral/epidemiologia , Reprodutibilidade dos Testes , Estudos Retrospectivos
4.
Acta Biomed ; 91(3): e2020009, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921707

RESUMO

BACKGROUND: In Italy, one of the country most affected by the COVID-19 pandemic, the first autochthonous case appeared in Lombardy on February 20th, 2020. One month later, the number of -COVID-19 patients in Lombardy exceeded 17000 and about 3500 had died. Because of this rapid increase in infected people scientists wonder whether SARS-CoV-2 was already highly circulating in Lombardy before such date. Plasma levels of aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were shown to be -highly increased in COVID-19 patients. Monitoring their levels in Emergency Room patients during the months preceding February 20th, 2020, might shade light on the prevalence of the disease in the pre-COVID-19 period. METHODS: We retrospectively analyzed the AST and LDH levels from more than 30.000 patients admitted to the San Raffaele Hospital Emergency Room (ER) between September 2019 and May 2020 as well as between September 2018 and May 2019. The number of patients diagnosed with respiratory tract diseases were also analyzed. RESULTS: Data showed that the ER averaged AST and LDH levels are highly sensitive to the presence of COVID-19 patients. During, the months preceding February 20th, 2020, AST and LDH levels, as well as the number of patients diagnosed with respiratory tract diseases were similar to their 2019 counterparts. CONCLUSIONS: No significant evidence showing that a large number of COVID-19 patients were admitted to the San Raffaele Hospital ER before February 20th, 2020, was found. Thus, the virus was likely circulating, within the Hospital catchment area, either in low amounts or through asymptomatic individuals. Because of the high LDH and AST levels' variations induced by COVID-19, routine blood tests might be exploited as a surveillance indicator for a possible second wave.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Testes Hematológicos/métodos , Programas de Rastreamento/métodos , Monitorização Fisiológica/métodos , Pandemias , Pneumonia Viral/diagnóstico , Aspartato Aminotransferases/sangue , Biomarcadores/sangue , Infecções por Coronavirus/sangue , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Itália/epidemiologia , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/sangue , Pneumonia Viral/epidemiologia , Prevalência , Estudos Retrospectivos
5.
Bull Environ Contam Toxicol ; 105(4): 582-587, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32948914

RESUMO

Oreochromis niloticus was exposed to 10.0 ppb of organophosphate insecticide chlorpyrifos (CPF) and avermectin insecticides abamectin (ABM) and emamectin benzoate (EB) for 48 and 96 h. RBC and Hb decreased in CPF- and ABM-exposed fish after 96-h. Plasma ALT, AST, cortisol, and glucose increased in 96-h CPF-, ABM- and EB-exposed fish, while plasma ions declined in 96-h CPF-exposed ones. Insecticides caused alterations in liver oxidative stress parameters. In fish exposed to CPF, CAT increased after 48-h whereas it decreased after 96-h. Also, CAT declined in 48- and 96-h ABM-exposed fish, whereas it elevated in 48-h EB-exposed ones. Insecticides caused decreases in SOD at 48- and 96-h and in GR after 96-h. GSH elevated in CPF-exposed fish after 48-h, while it decreased in all the tested insecticide exposures after 96-h. Malondialdehyde of fish exposed to insecticides for 96-h increased. Consequently, toxic effects of insecticides on O. niloticus were generally as CPF > ABM > EB.


Assuntos
Clorpirifos/toxicidade , Ciclídeos , Inseticidas/toxicidade , Ivermectina/análogos & derivados , Poluentes Químicos da Água/toxicidade , Animais , Análise Química do Sangue/veterinária , Testes Hematológicos/veterinária , Ivermectina/toxicidade , Fígado/efeitos dos fármacos , Fígado/enzimologia , Oxirredução , Distribuição Aleatória , Testes de Toxicidade Aguda/veterinária
6.
Medicine (Baltimore) ; 99(36): e22090, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899087

RESUMO

BACKGROUND: Although surgical resection holds promise for curing pancreatic cancer, <20% of patients are suitable; however, early postoperative recurrence is common. Currently, radiographic examination is the primary method to determine whether pancreatic cancer has metastasized and to inform clinical staging before surgery. However, the method has a limited detection rate for micro-metastasis within the abdominal cavity; therefore, patients with advanced pancreatic cancer and existing micro-metastasis may receive unnecessary surgical treatment, delaying the timing of adjuvant chemotherapy and resulting in poor prognosis. Laparoscopic staging might be used as a supplement to detect micro-metastasis in patients with pancreatic cancer; however, there is no consistent standard to guide the use of this procedure. Therefore, it is necessary to conduct a trial to further explore the consistency and short-term and long-term efficacy of an intraoperative staging strategy for patients with radiographic non-metastasis. METHODS/DESIGN: This is a single-center cross-sectional and follow-up study. Patients diagnosed with pancreatic cancer without metastasis by radiographic examination and histopathological biopsy, who received intraoperative restaging, will be enrolled. The total sample size required for the trial is approximately 125 patients from May 2020 to December 2022. First, radiographic examination staging will be used. Then, laparoscopic exploration will be performed for patients without definite metastatic lesions. Data collection will include preoperative blood examination, radiographic examination, surgical information, and postoperative recovery. The patients will undergo follow-up every 3 months after surgery until death. The primary endpoint is the metastasis-positive rate via laparoscopic exploration. The secondary endpoints are the consistency, sensitivity, and specificity of the intraoperative restaging strategy and radiographic examination, the incidence of postoperative complications within 30 days, the 6-month relapse-free survival rate, and perioperative indicators (total cost, hospital stay, length of surgery, and intraoperative blood loss). DISCUSSION: We are conducting the trial to explore the metastasis-positive rate of intraoperative restaging strategy for diagnosing pancreatic cancer micro-metastasis. This new intraoperative restaging strategy would help pancreatic cancer patients with potential micro-metastasis avoid receiving unnecessary resection, allow systemic treatment as early as possible, and improve the prognosis of patients.


Assuntos
Endoscopia do Sistema Digestório/métodos , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Seguimentos , Testes Hematológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Pancreáticas/diagnóstico por imagem , Assistência Perioperatória/economia , Assistência Perioperatória/estatística & dados numéricos , Sensibilidade e Especificidade , Adulto Jovem
7.
Medicine (Baltimore) ; 99(34): e21718, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846790

RESUMO

BACKGROUND: Programmed death receptor-1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors have been demonstrated to improve the prognosis of patients with advanced non-small cell lung cancer (NSCLC) compared with chemotherapy. However, there were still some non-responders. Thus, how to effectively screen the responder may be an important issue. Recent studies revealed the immune-related indicator, neutrophil-lymphocyte ratio (NLR), may predict the therapeutic effects of anti-PD1/PD-L1 antibodies; however, the results were controversial. This study was to re-evaluate the prognostic potential of NLR for NSCLC patients receiving PD1/PD-L1 inhibitors by performing a meta-analysis. METHODS: Eligible studies were identified by searching online databases of PubMed, EMBASE and Cochrane Library. The predictive values of NLR for overall survival, (OS), progression free survival (PFS) and overall response rate (ORR) were estimated by hazard ratio (HR) with 95% confidence interval (CI). RESULTS: Twenty-four studies involving 2196 patients were included. The pooled analysis demonstrated that elevated NLR before PD-1/PD-L1 inhibitor treatment was a predictor of poor OS (HR = 2.17; 95% CI: 1.64 - 2.87, P < .001), PFS (HR = 1.54; 95% CI: 1.34 - 1.78, P < .001) and low ORR (HR = 0.64; 95% CI: 0.44 - 0.95, P = .027) in NSCLC patients. Subgroup analysis revealed the predictive ability of NLR for OS and PFS was not changed by ethnicity, sample size, cut-off, HR source, study design or inhibitor type (except the combined anti-PD-L1 group); while its association with ORR was only significant when the cut-off value was less than 5 and the studies were prospectively designed. CONCLUSION: Our findings suggest patients with lower NLR may benefit from the use of PD-1/PD-L1 inhibitors to prolong their survival period.


Assuntos
Antígeno B7-H1/antagonistas & inibidores , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Testes Hematológicos/métodos , Neoplasias Pulmonares/tratamento farmacológico , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Carcinoma Pulmonar de Células não Pequenas/patologia , Humanos , Neoplasias Pulmonares/patologia , Linfócitos , Neutrófilos
11.
PLoS One ; 15(8): e0237706, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817656

RESUMO

Endurance-trained sled dogs provide a unique translational model to characterize changes in hematologic and serum biochemical analytes due to the aging process. The primary objective of this study was to determine the effect of age and sex on specific hematologic and serum biochemical parameters in the endurance trained sled dog. Longitudinal and cross-sectional data were analyzed from 9,746 blood and serum samples from 4,804 dogs collected over 7 years as part of the Iditarod Trail Sled Dog Race pre-race examination program. Mixed models analysis was used for statistical analysis and P < 0.01 was considered significant. Dogs ranged from 1-12 years of age and 39% were female. Serum total calcium and phosphorus concentrations and white blood cell count decreased nonlinearly to asymptotic values by 6.6, 3.1, and 6.9 years of age, respectively, equivalent to estimated physiologic ages in human years of 44, 27, and 46 years. Serum glucose concentrations reached their lowest value at 7.8 years of age, equivalent to an estimated human physiologic age of 50 years, after which time the concentration increased. Serum globulin concentrations increased with age, but nonlinearly for females and linearly for males. Most sex-related differences were <5%; however, females had lower serum urea nitrogen (14.7%) and creatinine (7.3%) concentrations, lower serum alanine aminotransferase activity (16.6%), and higher serum total bilirubin concentration (12.8%) and platelet count (6.0%). The endurance-trained sled dog provides an excellent model to separate the physiologic effects of age from those of a sedentary lifestyle on hematologic and serum biochemical analytes.


Assuntos
Treino Aeróbico , Condicionamento Físico Animal/fisiologia , Resistência Física/fisiologia , Corrida/fisiologia , Animais , Nitrogênio da Ureia Sanguínea , Doenças do Cão/sangue , Doenças do Cão/fisiopatologia , Cães , Feminino , Testes Hematológicos , Humanos , Masculino , Soroglobulinas/metabolismo
13.
J Med Syst ; 44(8): 135, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32607737

RESUMO

The COVID-19 pandemia due to the SARS-CoV-2 coronavirus, in its first 4 months since its outbreak, has to date reached more than 200 countries worldwide with more than 2 million confirmed cases (probably a much higher number of infected), and almost 200,000 deaths. Amplification of viral RNA by (real time) reverse transcription polymerase chain reaction (rRT-PCR) is the current gold standard test for confirmation of infection, although it presents known shortcomings: long turnaround times (3-4 hours to generate results), potential shortage of reagents, false-negative rates as large as 15-20%, the need for certified laboratories, expensive equipment and trained personnel. Thus there is a need for alternative, faster, less expensive and more accessible tests. We developed two machine learning classification models using hematochemical values from routine blood exams (namely: white blood cells counts, and the platelets, CRP, AST, ALT, GGT, ALP, LDH plasma levels) drawn from 279 patients who, after being admitted to the San Raffaele Hospital (Milan, Italy) emergency-room with COVID-19 symptoms, were screened with the rRT-PCR test performed on respiratory tract specimens. Of these patients, 177 resulted positive, whereas 102 received a negative response. We have developed two machine learning models, to discriminate between patients who are either positive or negative to the SARS-CoV-2: their accuracy ranges between 82% and 86%, and sensitivity between 92% e 95%, so comparably well with respect to the gold standard. We also developed an interpretable Decision Tree model as a simple decision aid for clinician interpreting blood tests (even off-line) for COVID-19 suspect cases. This study demonstrated the feasibility and clinical soundness of using blood tests analysis and machine learning as an alternative to rRT-PCR for identifying COVID-19 positive patients. This is especially useful in those countries, like developing ones, suffering from shortages of rRT-PCR reagents and specialized laboratories. We made available a Web-based tool for clinical reference and evaluation (This tool is available at https://covid19-blood-ml.herokuapp.com/ ).


Assuntos
Infecções por Coronavirus/diagnóstico , Testes Hematológicos/métodos , Aprendizado de Máquina , Pneumonia Viral/diagnóstico , Betacoronavirus , Humanos , Pandemias , Reação em Cadeia da Polimerase em Tempo Real
14.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(6): 732-736, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32684222

RESUMO

OBJECTIVE: To investigate the predictive value of early indicators changes in blood test on the prognosis of patients with acute paraquat poisoning. METHODS: The clinical data of patients with acute paraquat poisoning admitted to emergency department of Shengjing Hospital of China Medical University from January 2012 to June 2019 were retrospectively analyzed. The changes of blood test indexes within 24 hours after admission were collected, including white blood cell count (ΔWBC), neutrophils count (ΔNE), lymphocytes count (ΔLY), monocytes count (ΔMO), arterial partial pressure of oxygen (ΔPaO2), arterial partial pressure of carbon dioxide (ΔPaCO2), arterial blood pH (ΔpH), bicarbonate radical (ΔHCO3-), base excess (ΔBE), lactate (ΔLac), total protein (ΔTP), albumin (ΔALB), alanine aminotransferase (ΔALT), aspartate aminotransferase (ΔAST), total bilirubin (ΔTBil), direct bilirubin (ΔDBil), blood urea nitrogen (ΔBUN), serum creatinine (ΔSCr), serum calcium concentration (ΔCa2+), and serum potassium concentration (ΔK+). Multivariate Logistic regression was used to analyze the risk factors of prognosis in patients with acute paraquat poisoning, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of ROC curve for the death of patients with paraquat poisoning. RESULTS: A total of 251 patients with acute paraquat poisoning were included, with 99 cases dead, and the mortality was 39.4%. The increase of the markers including ΔWBC, ΔLac, ΔALT, ΔAST, ΔTBil, ΔDBil, ΔBUN, ΔSCr and ΔK+ within 24 hours of admission in the death group were significantly higher than that in the survival group; the decrease of the markers including ΔPaCO2, ΔHCO3-, ΔBE, ΔTP, and ΔALB in the death group were significantly greater than those in the survival group. The variables with statistical significance in the above single factor analysis were included in the multivariate Logistic regression analysis. The results showed that ΔLac, ΔSCr and ΔK+ were independent risk factors for the prognosis of patients with acute paraquat poisoning [odds ratio (OR) and 95% confidence interval (95%CI) were 1.662 (0.997-2.772), 1.045 (1.010-1.083) and 4.555 (1.190-17.429), respectively, all P < 0.05]. The area under the ROC curve (AUC) of ΔLac, ΔSCr and ΔK+ for predicting death of patients with acute paraquat poisoning was 0.639 (95%CI was 0.505-0773), 0.811 (95%CI was 0.704-0.917), and 0.649 (95%CI was 0.519-0.779), respectively. When the cut-off of ΔLac was 1.85 mmol/L, the sensitivity was 87.9%, the specificity was 47.7%, and the diagnostic accuracy was 70.2%; when the cut-off of ΔSCr was 37.75 µmol/L, the sensitivity was 84.4%, the specificity was 77.9%, and the diagnostic accuracy was 80.5%; when the cut-off of ΔK+ was 0.42 mmol/L, the sensitivity was 36.6%, the specificity was 90.7%, and the diagnostic accuracy was 68.3%. The efficiency of combination of ΔLac, ΔSCr, and ΔK+ was greater than a single indicator in predicting death of patients with acute paraquat poisoning, with AUC of 0.911, and 95%CI of 0.834-0.989. CONCLUSIONS: ΔLac, ΔSCr, ΔK+ within 24 hours of admission were all independent risk factors for the prognosis of patients with acute paraquat poisoning. ΔSCr > 37.75 µmol/L within 24 hours of admission would predict a poor prognosis in the patients with acute paraquat poisoning. Combined analysis of ΔLac, ΔSCr, and ΔK+ can predict the prognosis of paraquat poisoning patients more accurately than single index.


Assuntos
Testes Hematológicos , Paraquat/envenenamento , China , Humanos , Prognóstico , Curva ROC , Estudos Retrospectivos
17.
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
18.
J Vis Exp ; (160)2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32658205

RESUMO

A multiplexed droplet PCR (mdPCR) workflow and detailed protocol for determining epigenetic-based white blood cell (WBC) differential count is described, along with a thermoplastic elastomer (TPE) microfluidic droplet generation device. Epigenetic markers are used for WBC subtyping which is of important prognostic value in different diseases. This is achieved through the quantification of DNA methylation patterns of specific CG-rich regions in the genome (CpG loci). In this paper, bisulfite-treated DNA from peripheral blood mononuclear cells (PBMCs) is encapsulated in droplets with mdPCR reagents including primers and hydrolysis fluorescent probes specific for CpG loci that correlate with WBC sub-populations. The multiplex approach allows for the interrogation of many CpG loci without the need for separate mdPCR reactions, enabling more accurate parametric determination of WBC sub-populations using epigenetic analysis of methylation sites. This precise quantification can be extended to different applications and highlights the benefits for clinical diagnosis and subsequent prognosis.


Assuntos
Metilação de DNA/fisiologia , Testes Hematológicos/métodos , Reação em Cadeia da Polimerase Multiplex/métodos , Polímeros/química , Humanos , Leucócitos Mononucleares/química
19.
Ann Biol Clin (Paris) ; 78(4): 383-397, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32666924

RESUMO

The SFBC-CNBH-CNRHP "Neonatal bilirubin" working group performed a biological and clinical study on bilirubin use in neonates for reliable diagnosis and appropriate management of neonatal jaundice. A brief report of a national survey on analytical and biological practices in France is shown. The guidelines of the French Society of Neonatology (SFN) founded the decision of phototherapy set up upon an accurate lab measurement of total serum bilirubin. An abacus is proposed with defined thresholds, as a function of neonate lifetime in hours. However, several studies evidenced poor comparability of results obtained with the different available methods. This situation is partly due to the lack of reference materials, especially for high bilirubin concentrations. Clinical consequences might be observed. We present in this paper the results of a national harmonization study to progress on this issue. Beyond the analytical aspects, the clinical consequences of harmonization defects were investigated. Finally, guidelines for clinical laboratories are proposed, to be locally adapted.


Assuntos
Testes Hematológicos/normas , Hiperbilirrubinemia Neonatal/diagnóstico , Icterícia Neonatal/diagnóstico , Triagem Neonatal/normas , Guias de Prática Clínica como Assunto , Bilirrubina/sangue , França , Testes Hematológicos/métodos , Humanos , Hiperbilirrubinemia Neonatal/sangue , Hiperbilirrubinemia Neonatal/terapia , Recém-Nascido , Icterícia Neonatal/sangue , Icterícia Neonatal/terapia , Laboratórios/normas , Ensaio de Proficiência Laboratorial/normas , Triagem Neonatal/métodos , Fototerapia/métodos , Fototerapia/normas , Padrões de Referência
20.
Allergol. immunopatol ; 48(3): 259-264, mayo-jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-192028

RESUMO

The clinical history is of importance in the investigation of allergic diseases but does have limitations. Many allergic conditions will be over-diagnosed if anamnesis alone is used for diagnostic criteria. Serum total immunoglobulin E (TIgE) quantification, as well as panels containing allergens prevalent in the studied population, may serve as screening tests and facilitate the diagnosis of allergic disease or its exclusion. We assessed the positivity of two versions of these tests, Phadiatop Europe® (PhEU) and Phadiatop Infant® (PhInf), as well as total IgE (TigE) values in patients with a medical diagnosis of allergic disease and non-allergic individuals. METHODS: A cross-sectional study performed in eleven Brazilian pediatric allergy centers with patients divided into groups according to the primary condition and a group of assessed control subjects. They were submitted to TIgE measurement and screening tests (PhEu and PhInf). RESULTS: TIgE mean serum levels were significantly higher among allergic patients, especially those with asthma/rhinitis or atopic dermatitis. The positivity of the screening tests, considering the total population, was 63.8% for PhEU and 72.6% for PhInf. These increased when we evaluated only the allergic subjects. The concordance index of the two tests was Kappa = 0.7 and higher among those of greater age. CONCLUSIONS: In the assessed population, there were significantly higher levels among those with positive screening tests and PhInf showed better performance in the identification of sensitized individuals, regardless of age. This is the first study to evaluate Phadiatop and Phadiatop Infant in the same population


No disponible


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Testes Hematológicos/métodos , Hipersensibilidade/diagnóstico , Imunoglobulina E/sangue , Técnicas Imunológicas/métodos , Hipersensibilidade/imunologia , Brasil , Estudos Transversais , Alérgenos/imunologia , Dermatite Atópica/imunologia , Asma/imunologia , Rinite Alérgica/imunologia , Sensibilidade e Especificidade
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