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  1 / 1176 MEDLINE  
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Chebli, Júlio Maria Fonseca
Texto completo SciELO Brasil
[PMID]:28489125
[Au] Autor:Chebli JMF; Chebli LA; Ribeiro TCDR; Gaburri PD
[Ad] Endereço:Gastroenterology Professor at School of Medicine of Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
[Ti] Título:Severe hypoproteinemia as a harbinger of Ménétrier's disease in autoimmune pancreatitis.
[So] Source:Rev Assoc Med Bras (1992);63(3):215-218, 2017 Mar.
[Is] ISSN:1806-9282
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Ménétrier's disease is an extremely rare disease of unknown etiology causing gastric mucosal hypertrophy and protein-losing gastropathy. Rare cases of this condition have been reported in patients with autoimmune diseases. However, to the best of our knowledge, Ménétrier's disease associated with autoimmune pancreatitis (AIP) has never been reported. We described a case of severe hypoproteinemia as a harbinger of Ménétrier's disease associated with AIP. The patient was successfully treated with octreotide and high-protein diet, which led to symptomatic remission and significant improvement in serum levels of albumin and recovery of the nutritional status. Thus, in AIP patients presenting with severe and persistent hypoproteinemia without apparent cause, clinicians need to consider Ménétrier's disease in the differential diagnosis. In this setting, endoscopic evaluation with histological examination of gastric biopsy material, including a full-thickness mucosal biopsy of involved mucosa, may be helpful in promptly establishing the diagnosis and allowing appropriate and timely therapy.
[Mh] Termos MeSH primário: Doenças Autoimunes/complicações
Gastrite Hipertrófica/complicações
Hipoproteinemia/etiologia
Pancreatite/complicações
[Mh] Termos MeSH secundário: Doenças Autoimunes/sangue
Doenças Autoimunes/patologia
Biópsia
Endoscopia Gastrointestinal
Mucosa Gástrica/patologia
Gastrite Hipertrófica/sangue
Gastrite Hipertrófica/patologia
Seres Humanos
Hipoproteinemia/patologia
Masculino
Meia-Idade
Pancreatite/sangue
Pancreatite/patologia
Índice de Gravidade de Doença
[Pt] Tipo de publicação:CASE REPORTS
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE


  2 / 1176 MEDLINE  
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[PMID]:28338158
[Au] Autor:Gong K; Guo S; Wang K
[Ad] Endereço:Department of General Surgery, The First People's Hospital of Yunnan Province, Kunming 650032, China.
[Ti] Título:[Diagnosis and treatment of duodenal injury and fistula].
[So] Source:Zhonghua Wei Chang Wai Ke Za Zhi;20(3):266-269, 2017 Mar 25.
[Is] ISSN:1671-0274
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now. The primary treatment strategy of duodenal fistula is to determine the cause of disease and its key point is prevention, including perioperative parenteral and enteral nutrition support, improvement of hypoproteinemia actively, avoidance of stump ischemia by excessive separate duodenum intraoperatively, performance of appropriate duodenum stump suture to ensure the stump blood supply, and avoidance of postoperative input loop obstruction, postoperative stump bleeding or hematoma etc. Once duodenal fistula occurs, a simple and reasonable operation can be selected and performed after fluid prohibition, parenteral and enteral nutrition, acid suppression, enzyme inhibition, anti-infective treatment and maintaining water salt electrolyte and acid-base balance. Double tube method, duodenal decompression and peritoneal drainage can reduce duodenal fistula-related complications, and then reduce the mortality, which can save the lives of patients.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos
Procedimentos Cirúrgicos do Sistema Digestório/métodos
Duodenopatias/prevenção & controle
Duodenopatias/terapia
Duodeno/lesões
Duodeno/cirurgia
Fístula Intestinal/prevenção & controle
Fístula Intestinal/terapia
[Mh] Termos MeSH secundário: Traumatismos Abdominais/complicações
Anti-Infecciosos/uso terapêutico
Descompressão Cirúrgica
Drenagem
Duodenopatias/diagnóstico
Duodenopatias/etiologia
Duodeno/irrigação sanguínea
Nutrição Enteral
Seres Humanos
Hipoproteinemia/terapia
Fístula Intestinal/diagnóstico
Fístula Intestinal/etiologia
Isquemia/prevenção & controle
Apoio Nutricional
Nutrição Parenteral
Complicações Pós-Operatórias/prevenção & controle
Complicações Pós-Operatórias/terapia
Técnicas de Sutura
Traumatismos Torácicos/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE


  3 / 1176 MEDLINE  
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[PMID]:28281508
[Au] Autor:Parfenov AI; Krums LM
[Ad] Endereço:Moscow Clinical Research and Practical Center, Moscow Healthcare Department, Moscow, Russia.
[Ti] Título:[Protein-losing enteropathy].
[Ti] Título:Enteropatiya s poterei belka..
[So] Source:Ter Arkh;89(2):4-9, 2017.
[Is] ISSN:0040-3660
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:Protein-losing enteropathy (PLE) is a rare complication of intestinal diseases. Its main manifestation is hypoproteinemic edema. The diagnosis of PLE is based on the verification of protein loss into the intestinal lumen, by determining fecal α1-antitrypsin concentration and clearance. The localization of the affected colonic segment is clarified using radiologic and endoscopic techniques. The mainstay of treatment for PLE is a fat-free diet enriched with medium-chain triglycerides. Surgical resection of the affected segment of the colon may be the treatment of choice for severe hypoproteinemia resistant to drug therapy.
[Mh] Termos MeSH primário: Hipoproteinemia
Enteropatias Perdedoras de Proteínas
alfa 1-Antitripsina/metabolismo
[Mh] Termos MeSH secundário: Seres Humanos
Hipoproteinemia/diagnóstico
Hipoproteinemia/etiologia
Hipoproteinemia/terapia
Enteropatias Perdedoras de Proteínas/complicações
Enteropatias Perdedoras de Proteínas/diagnóstico
Enteropatias Perdedoras de Proteínas/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (alpha 1-Antitrypsin)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170311
[St] Status:MEDLINE
[do] DOI:10.17116/terarkh20178924-9


  4 / 1176 MEDLINE  
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[PMID]:28225680
[Au] Autor:Akita C; Saikawa Y
[Ad] Endereço:Kanazawa Medical University, Ishikawa, Japan saikawa@kanazawa-med.ac.jp.
[Ti] Título:Gastric Gyri - Pediatric Ménétrier's Disease.
[So] Source:N Engl J Med;376(8):774, 2017 Feb 23.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Gastrite Hipertrófica/diagnóstico por imagem
Estômago/diagnóstico por imagem
[Mh] Termos MeSH secundário: Pré-Escolar
Endoscopia Gastrointestinal
Gastrite Hipertrófica/complicações
Seres Humanos
Hipoproteinemia/etiologia
Masculino
Cintilografia
Estômago/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170307
[Lr] Data última revisão:
170307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMicm1605473


  5 / 1176 MEDLINE  
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[PMID]:27256079
[Au] Autor:Shi H; Na Q; Zhang X; Jiang X
[Ad] Endereço:Department of Clinical Nutrition, Yuxi Hospital, Yuxi, 653100, China.
[Ti] Título:Correlations between the levels of acute infection markers and serum albumin in elderly patients with hip fracture.
[So] Source:Aging Clin Exp Res;29(3):435-441, 2017 Jun.
[Is] ISSN:1720-8319
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to explore a clinical index that could predict the decline of serum albumin (ALB) in elderly patients (over 60 years old) with hip fractures in 2014. METHODS: All the data came from the retrospective survey, and the correlations between the ALB changes and acute infection markers were then analyzed using correlation analysis. The changes of infection markers and ALB before and after surgery were compared using the t test. RESULTS: There was no correlation of the serum ALB blood with interleukin-6 (IL-6) (r = 0.072, P = 0.588), C-reactive protein (CRP) (r = -0.249, P = 0.057), or calcitonin (PCT) (r = -0.038, P = 0.775) when patients were admitted, but it was negatively correlated with the total amount of infection markers (TAIMs) (r = -0.301, P = 0.020). The postoperative levels of IL-6 (154.23 ± 177.14 pg/mL) (P < 0.001), CRP (69.52 ± 39.84 mg/L) (P < 0.001), and PCT (1.27 ± 2.4 ng/mL) (P < 0.001) were significantly increased than those before surgery [IL-6 (44.96 ± 54.58 pg/mL), CRP (31.78 ± 29.90 mg/L), and PCT (0.42 ± 1.06 ng/mL)]. The postoperative level of serum ALB (29.93 ± 3.02 g/L) was significantly reduced than that before surgery (33.95 ± 3.69 g/L) (P < 0.001). The serum ALB level was negatively correlated with IL-6 (r = -0.333, P = 0.015) before surgery, but not correlated with TAIMs (r = -0.256, P = 0.061). The serum ALB level was negatively correlated with IL-6 (r = -0.292, P = 0.034) and TAIMs (r = -0.271, P = 0.050) after surgery. CONCLUSIONS: The serum IL-6 level could predict the changes of ALB during the disease process.
[Mh] Termos MeSH primário: Reação de Fase Aguda/sangue
Proteína C-Reativa/análise
Calcitonina/sangue
Fraturas do Quadril/complicações
Interleucina-6/sangue
Albumina Sérica/análise
[Mh] Termos MeSH secundário: Reação de Fase Aguda/etiologia
Idoso
Biomarcadores/sangue
Feminino
Fraturas do Quadril/sangue
Fraturas do Quadril/cirurgia
Seres Humanos
Hipoproteinemia/diagnóstico
Masculino
Meia-Idade
Período Pós-Operatório
Período Pré-Operatório
Precursores de Proteínas
Estudos Retrospectivos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Interleukin-6); 0 (Protein Precursors); 0 (Serum Albumin); 9007-12-9 (Calcitonin); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160604
[St] Status:MEDLINE
[do] DOI:10.1007/s40520-016-0585-7


  6 / 1176 MEDLINE  
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[PMID]:27416089
[Au] Autor:Galve J; Martín-Santiago A; Clavero C; Saus C; Alfaro-Arenas R; Pérez-Granero A; Balliu PR; Ferrando J
[Ad] Endereço:Department of Dermatology, Hospital Clínic, University of Barcelona, Spain.
[Ti] Título:Spontaneous repigmentation of silvery hair in an infant with congenital hydrops fetalis and hypoproteinemia.
[So] Source:Cutis;97(6):E1-5, 2016 Jun.
[Is] ISSN:2326-6929
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Silvery hair is a characteristic finding of 3 rare autosomal recessive disorders: Chédiak-Higashi syndrome (CHS), Elejalde syndrome (ES), and Griscelli syndrome (GS). We report the case of a 2-month-old male infant with transient silvery hair and generalized hypopigmentation of the skin and eyes who did not have one of these classic causative disorders. The patient was delivered at 35 weeks' gestation with congenital hydrops fetalis associated with a chromosomal abnormality (46,XY,add[2],[p23]), hypothyroidism, hypoproteinemia, and hypogammaglobulinemia. Over the course of follow-up, spontaneous brown repigmentation of the silvery hair was noted. We concluded that the silvery hair was induced by hypoproteinemia secondary to congenital hydrops fetalis.
[Mh] Termos MeSH primário: Doenças do Cabelo/patologia
Hipopigmentação/patologia
[Mh] Termos MeSH secundário: Agamaglobulinemia/complicações
Aberrações Cromossômicas
Hipotireoidismo Congênito/complicações
Doenças do Cabelo/complicações
Seres Humanos
Hidropisia Fetal
Hipopigmentação/complicações
Hipoproteinemia/complicações
Lactente
Masculino
Remissão Espontânea
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170418
[Lr] Data última revisão:
170418
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160715
[St] Status:MEDLINE


  7 / 1176 MEDLINE  
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[PMID]:26962779
[Au] Autor:Wang X; Jin H; Wu W
[Ad] Endereço:From the Department of Cardiology, Department of Respiratory Medicine, Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Título:Primary Intestinal Lymphangiectasia Manifested as Unusual Edemas and Effusions: A Case Report.
[So] Source:Medicine (Baltimore);95(10):e2849, 2016 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Primary intestinal lymphangiectasia (PIL) is a rare disorder of unknown etiology characterized by diffuse or localized dilation and eventual rupture of the enteric lymphatic vessels in mucosa, submucosa, and/or subserosa. Lymph, rich in all kinds of proteins and lymphocytes, leaks into the gastrointestinal tract via the affected lymphatic vessels causing hypoproteinemia and lymphopenia. The main symptom is variable degrees of pitting edemas of bilateral lower limbs. But edemas of any other parts of body, and mild serous effusions may also occur sometimes. PIL occurs in conjunction with a right hemifacial edema, a right upper limb lymphedema, asymmetric bilateral calves edemas, and a unilateral massive pleural effusion seems never to be reported before. In addition, increased enteric protein loss that may cause severe hypoproteinemia usually get overlooked, and the lymphatic system disorders always put the diagnoses in a dilemma.We described a case of a 17-year-old Chinese girl with a history of gradually progressive swellings of right-sided face, right upper limb, and bilateral calves since 3 to 4 months of age. A right-sided massive pleural effusion, a moderate pericardial effusion, and a mild ascites have been proved unchanged by a series of computerized tomography (CT) scans since 5 years ago. The diagnosis of PIL was finally confirmed by severe hypoproteinemia, endoscopic changes, and histology of jejunum biopsy. Further lymphoscintigraphy and lymphangiography also identified lymph leakage in her bowel and several abnormal lymphatic vessels. A high-protein, low-fat diet supplemented with medium-chain triglycerides (MCT) showed some benefit.This case suggested that PIL was a rare but important etiology of hypoproteinemia, effusions, and edemas. PIL, effusions, and lymphedema can be the features of multisegmental generalized lymphatic dysplasia. In addition, both lymphoscintigraphy and intranodal lymphangiography could be considered when lymphatic system disorders are suspected.
[Mh] Termos MeSH primário: Proteínas na Dieta/administração & dosagem
Edema
Jejuno/patologia
Linfangiectasia Intestinal
Derrame Pericárdico
Derrame Pleural
Triglicerídeos/administração & dosagem
[Mh] Termos MeSH secundário: Adolescente
Biópsia
Diagnóstico Diferencial
Dieta com Restrição de Gorduras/métodos
Edema/diagnóstico
Edema/etiologia
Endoscopia do Sistema Digestório/métodos
Extremidades/patologia
Feminino
Seres Humanos
Hipoproteinemia/etiologia
Hipoproteinemia/fisiopatologia
Linfangiectasia Intestinal/complicações
Linfangiectasia Intestinal/diagnóstico
Linfangiectasia Intestinal/dietoterapia
Linfangiectasia Intestinal/fisiopatologia
Derrame Pericárdico/diagnóstico
Derrame Pericárdico/etiologia
Derrame Pleural/diagnóstico
Derrame Pleural/etiologia
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dietary Proteins); 0 (Triglycerides)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160311
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000002849


  8 / 1176 MEDLINE  
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[PMID]:26864729
[Au] Autor:Bartoletti M; Giannella M; Lewis RE; Viale P
[Ad] Endereço:a Infectious Diseases Unit, Department of Medical and Surgical Sciences, Sant'Orsola Hospital, University of Bologna , Bologna , Italy.
[Ti] Título:Bloodstream infections in patients with liver cirrhosis.
[So] Source:Virulence;7(3):309-19, 2016 Apr 02.
[Is] ISSN:2150-5608
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Bloodstream infections are a serious complication in patients with liver cirrhosis. Dysregulated intestinal bacterial translocation is the predominant pathophysiological mechanism of infections in this setting. For this reason enteric Gram-negative bacteria are commonly encountered as the first etiological cause of infection. However, through the years, the improvement in the management of cirrhosis, the recourse to invasive procedures and the global spread of multidrug resistant pathogens have importantly changed the current epidemiology. Bloodstream infections in cirrhotic patients are characterized by high mortality rate and complications including metastatic infections, infective endocarditis, and endotipsitis (or transjugular intrahepatic portosystemic shunt-related infection). For this reason early identification of patients at risk for mortality and appropriated therapeutic management is mandatory. Liver cirrhosis can significantly change the pharmacokinetic behavior of antimicrobials. In fact hypoproteinaemia, ascitis and third space expansion and impairment of renal function can be translated in an unpredictable drug exposure.
[Mh] Termos MeSH primário: Bacteriemia/epidemiologia
Cirrose Hepática/complicações
Cirrose Hepática/microbiologia
[Mh] Termos MeSH secundário: Antibacterianos/farmacocinética
Antibacterianos/uso terapêutico
Bacteriemia/tratamento farmacológico
Bacteriemia/mortalidade
Translocação Bacteriana
Endocardite Bacteriana/complicações
Endocardite Bacteriana/epidemiologia
Bactérias Gram-Negativas/efeitos dos fármacos
Bactérias Gram-Negativas/isolamento & purificação
Bactérias Gram-Negativas/fisiologia
Seres Humanos
Hipoproteinemia/complicações
Rim/efeitos dos fármacos
Rim/fisiopatologia
Cirrose Hepática/tratamento farmacológico
Cirrose Hepática/fisiopatologia
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170607
[Lr] Data última revisão:
170607
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160212
[St] Status:MEDLINE
[do] DOI:10.1080/21505594.2016.1141162


  9 / 1176 MEDLINE  
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[PMID]:26853984
[Au] Autor:Dainaka K; Isozaki Y; Kunieda K; Takayama S; Mukai R; Yamada N; Morimoto Y; Nagao Y; Oyamada H; Kawabata K
[Ad] Endereço:Department of Gastroenterology, Matsushita Memorial Hospital.
[Ti] Título:[A case of gastrointestinal amyloidosis and hypoproteinemia improved by tocilizumab].
[So] Source:Nihon Shokakibyo Gakkai Zasshi;113(2):245-53, 2016.
[Is] ISSN:0446-6586
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A woman in her 70s presented with dehydration and malnutrition due to watery diarrhea. She was examined and diagnosed with gastrointestinal amyloidosis accompanied by a protein-losing gastroenteropathy secondary to rheumatoid arthritis. She first underwent treatment with an anti-tumor necrosis factor alpha (TNF-α) antibody for secondary amyloidosis, but due to lack of adequate response, she was switched to an anti-interleukin (IL)-6 receptor antibody. Her clinical symptoms subsequently improved, and endoscopy revealed a marked decrease of amyloid protein deposits in the digestive tract. She was followed up for 3 years while continuing to receive the anti-IL-6 receptor antibody, with no recurrence. Although secondary amyloidosis is a fatal disease associated with chronic inflammatory diseases, clinical symptoms and prognosis have recently been improved by intervention with biological therapies. In particular, anti-IL-6 receptor antibodies have been reported to be superior to anti-TNF-α antibodies in the treatment of secondary amyloidosis and are expected to play a central role in treating secondary amyloidosis in the future.
[Mh] Termos MeSH primário: Amiloidose/tratamento farmacológico
Anticorpos Monoclonais Humanizados/uso terapêutico
Hipoproteinemia
[Mh] Termos MeSH secundário: Idoso
Amiloidose/etiologia
Amiloidose/patologia
Artrite Reumatoide/complicações
Biópsia
Endoscopia Gastrointestinal
Feminino
Seres Humanos
Hipoproteinemia/etiologia
Interleucina-6/imunologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); 0 (IL6 protein, human); 0 (Interleukin-6); I031V2H011 (tocilizumab)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160209
[St] Status:MEDLINE
[do] DOI:10.11405/nisshoshi.113.245


  10 / 1176 MEDLINE  
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[PMID]:26465222
[Au] Autor:Stove V; Slabbinck A; Vanoverschelde L; Hoste E; De Paepe P; Delanghe J
[Ad] Endereço:1Department of Clinical Chemistry, Microbiology and Immunology, Ghent University, Ghent, Belgium. 2Department of Laboratory Medicine, Ghent University Hospital, Ghent, Belgium. 3Department of Critical Care Medicine, Ghent University Hospital, Ghent, Belgium. 4Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium.
[Ti] Título:How to Solve the Underestimated Problem of Overestimated Sodium Results in the Hypoproteinemic Patient.
[So] Source:Crit Care Med;44(2):e83-8, 2016 Feb.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The availability of a fast and reliable sodium result is a prerequisite for the appropriate correction of a patient's fluid balance. Blood gas analyzers and core laboratory chemistry analyzers measure electrolytes via different ion-selective electrode methodology, that is, direct and indirect ion-selective electrodes, respectively. Sodium concentrations obtained via both methods are not always concordant. A comparison of results between both methods was performed, and the impact of the total protein concentration on the sodium concentration was investigated. Furthermore, we sought to develop an adjustment equation to correct between both ion-selective electrode methods. DESIGN: A model was developed using a pilot study cohort (n = 290) and a retrospective patient cohort (n = 690), which was validated using a prospective patient cohort (4,006 samples). SETTING: ICU and emergency department at Ghent University Hospital. PATIENTS: Patient selection was based on the concurrent availability of routine blood gas Na⁺(direct) as well as core laboratory Na⁺(indirect) results. INTERVENTIONS: In the pilot study, left-over blood gas syringes were collected for further laboratory analysis. MEASUREMENT AND MAIN RESULTS: There was a significant negative linear correlation between Na⁺(indirect) and Na⁺(direct) relative to changes in total protein concentration (Pearson r = -0.69; p < 0.0001). In our setting, for each change of 10 g/L in total protein concentration, a deviation of ~1.3 mmol/L is observed with the Na⁺(indirect) result. Validity of our adjustment equation protein-corrected Na⁺(indirect) = Na⁺(indirect) - 10.53 + (0.1316 × total protein) was demonstrated on a prospective patient cohort. CONCLUSIONS: As Na⁺(direct) measurements on a blood gas analyzer are not influenced by the total protein concentration in the sample, they should be preferentially used in patients with abnormal protein concentrations. However, as blood gas analyzers are not available at all clinical wards, the implementation of a protein-corrected sodium result might provide an acceptable alternative.
[Mh] Termos MeSH primário: Análise Química do Sangue/normas
Gasometria/normas
Serviço Hospitalar de Emergência
Hipoproteinemia/sangue
Unidades de Terapia Intensiva
Sódio/sangue
[Mh] Termos MeSH secundário: Seres Humanos
Projetos Piloto
Estudos Prospectivos
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
9NEZ333N27 (Sodium)
[Em] Mês de entrada:1605
[Cu] Atualização por classe:160116
[Lr] Data última revisão:
160116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:151015
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000001304



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