RESUMO
BACKGROUND: JAL (RH48) is a low-prevalence antigen in the Rh blood group system and anti-JAL has caused hemolytic disease of the newborn. JAL is associated with either a haplotype carrying depressed C and e antigens or one carrying depressed c and e antigens. Blood samples from JAL+ people were tested, published serologic findings were confirmed, serologic studies were extended to include expression of other Rh antigens, and the antibody specificities produced by three sensitized JAL+ probands are reported. STUDY DESIGN AND METHODS: Red blood cell (RBC) samples from 17 (12 probands) JAL+ persons were tested by hemagglutination using standard methods. RESULTS: RBCs from both the Caucasian JAL+ probands had the (C)(e) haplotype and weakened C, e, hr(B), and hr(S) antigens. JAL+ samples from black persons had the (c)(e) haplotype and expressed weakened c, e, f, V, VS, hr(B), and hr(S) antigens. Plasma from three sensitized c+e+ JAL+ probands contained alloanti-c, alloanti-e, or alloantibody of apparent anti-Rh17 specificity. This study shows that this alloanti-Rh17-like antibody recognizes the high-prevalence antigen antithetical to JAL that has been named CEST. CONCLUSIONS: The presence of the JAL antigen has a quantitative (weakening) effect on the expression of C, e, hr(B), and hr(S) antigens in Caucasian persons and of c, e, f, V, VS, hr(B), and hr(S) antigens in people of black African ancestry. A qualitative effect also was demonstrated by the presence of alloanti-c or alloanti-e in the plasma of two transfused c+e+ patients and by an antibody (anti-CEST) that recognizes the high-prevalence antigen antithetical to JAL.
Assuntos
Eritroblastose Fetal/sangue , Eritroblastose Fetal/genética , Sistema do Grupo Sanguíneo Rh-Hr/genética , Tipagem e Reações Cruzadas Sanguíneas , Eritroblastose Fetal/diagnóstico , Eritroblastose Fetal/epidemiologia , Família , Feminino , Frequência do Gene , Homozigoto , Humanos , Isoanticorpos/sangue , Masculino , Linhagem , Sistema do Grupo Sanguíneo Rh-Hr/sangue , Testes SorológicosRESUMO
In order to better understand aspects related to the nutritional assessment of patients in risk for pressure ulcers, we reviewed the national and international literature indexed on Medline and LILACS bibliographic databases, from 1987 to 2001. The aim of this research was to investigate the knowledge production on pressure ulcers and nutritional status, as well as to learn about the authors and the publication focus. We concluded that patients in risk for pressure ulcers can be early identified based on nutritional assessment, including biochemical data, anthropometric evaluation, clinical data, diet history and energetic consumption. The alterations are frequent in elderly patients, hospitalized patients, patients with a chronic disease such as a vascular cerebral accident, cancer and spinal cord injury.
Assuntos
Estado Nutricional , Úlcera por Pressão/epidemiologia , HumanosRESUMO
Para melhor compreender os aspectos envolvidos na avaliação nutricional de pacientes em risco para úlcera de pressão, desenvolvemos uma revisão bibliográfica da literatura nacional e internacional indexada nas bases de dados bibliográficas LILACS e MEDLINE, no período de 1987 a 2001. O objetivo foi investigar a produção do conhecimento sobre úlcera de pressão e estado nutricional, assim como a autoria principal e o enfoque das publicações. Concluiu-se que os pacientes que apresentam risco para o desenvolvimento de úlcera de pressão podem ser identificados precocemente através da avaliação nutricional, incluindo os dados bioquímicos, mensurações antropométricas, sinais clínicos, história dietética e gasto energético. As alterações são mais freqüentes em pacientes idosos, hospitalizados, portadores de doenças crônicas como acidente vascular cerebral, câncer e lesão de medula espinhal.