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  1 / 4711 MEDLINE  
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[PMID]:28934679
[Au] Autor:Wang F; Jia JS; Wang J; Zhao T; Jiang Q; Jiang H; Zhu HH
[Ad] Endereço:Peking University People's Hospital, Peking University Institute of Hematology, Beijing 100044, China; Peking University International Hospital, Department of Hematology, Beijing, 102206, China.
[Ti] Título:The kinetics of white blood cell and the predictive factors of leukocytosis under oral or intravenous arsenic as the first-line treatment for acute promyelocytic leukemia.
[So] Source:Leuk Res;61:84-88, 2017 Oct.
[Is] ISSN:1873-5835
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: We aimed to compare the kinetics of white blood cell (WBC) and explore predictive factors of leukocytosis in non-high-risk acute promyelocytic leukemia (APL), with oral arsenic plus all-trans retinoic acid (ATRA) or intravenous arsenic trioxide (ATO) plus ATRA as a first-line treatment. METHODS: The absolute count, doubling time and peak time of WBC were analyzed in 64 newly diagnosed non-high-risk APL patients who were treated with different induction regimens containing either oral Realgar-indigo naturalis formula (RIF) (n=35) or ATO (n=29). The end points were the dynamic changes of the WBC counts during induction. The time points started at day 1 and were selected over 3-day intervals for 28days. RESULTS: Among the 64 included patients, the median initial and peak WBC counts were 1.78×10 /L (range 0.31-9.89) and 12.16×10 /L (range 1.56-80.01), respectively. The incidence of differentiation syndrome was 9.38%. The dynamic changes in leukocytosis showed a single peak wave in all the patients, and the median time to peak was 10 (range 2-26) days. A higher WBC count was observed in the RIF group than in the ATO group after 10days of treatment (9.22×10 /L vs. 4.10×10 /L, p=0.015). Patients with the peak WBC count >10×10 /L had a shorter WBC doubling time compared to patients with a lower peak WBC (RIF group 4days vs. 7days, p=0.001; ATO group 4.5days vs. 23days, p=0.002). Univariate and multivariable analyses showed that the doubling time of WBC is an independent factor for the peak WBC count. CONCLUSION: Different kinetics of WBC proliferation were observed during induction with oral arsenic plus ATRA and ATO plus ATRA. The doubling time of WBC is an important independent factor for predicting the peak WBC count.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Arsenicais/efeitos adversos
Medicamentos de Ervas Chinesas/efeitos adversos
Leucemia Promielocítica Aguda/sangue
Leucócitos/efeitos dos fármacos
Leucocitose/induzido quimicamente
Óxidos/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Arsenicais/administração & dosagem
Medicamentos de Ervas Chinesas/administração & dosagem
Feminino
Seres Humanos
Leucemia Promielocítica Aguda/tratamento farmacológico
Contagem de Leucócitos
Masculino
Meia-Idade
Óxidos/administração & dosagem
Ensaios Clínicos Controlados Aleatórios como Assunto
Estudos Retrospectivos
Tretinoína/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Arsenicals); 0 (Drugs, Chinese Herbal); 0 (Oxides); 0 (realgar-indigo naturalis); 5688UTC01R (Tretinoin); S7V92P67HO (arsenic trioxide)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170922
[St] Status:MEDLINE


  2 / 4711 MEDLINE  
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[PMID]:28873411
[Au] Autor:Mahmood E; Knio ZO; Mahmood F; Amir R; Shahul S; Mahmood B; Baribeau Y; Mueller A; Matyal R
[Ad] Endereço:Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America.
[Ti] Título:Preoperative asymptomatic leukocytosis and postoperative outcome in cardiac surgery patients.
[So] Source:PLoS One;12(9):e0182118, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite showing a prognostic value in general surgical patients, preoperative asymptomatic elevated white blood cell (WBC) count is not considered a risk factor for cardiac surgery. Whereas there is sporadic evidence of its value as a preoperative risk marker, it has not been looked at methodically as a specific index of outcome during cardiac surgery. Using a national database we sought to determine the relationship between preoperative WBC count and postoperative outcome in cardiac surgical patients. METHODS: Cardiac surgeries were extracted from the 2007-2013 American College of Surgeons National Surgical Quality Improvement Program database. Leukocytosis was defined by a preoperative WBC count greater than 11,000 cells/µL. A univariate analysis compared the incidence of adverse outcomes for patients with and without leukocytosis. A multivariate logistic regression model was constructed in order to test whether leukocytosis was an independent predictor of morbidity and mortality. RESULTS: Out of a total of 10,979 cardiac surgery patients 863 (7.8%) had preoperative leukocytosis. On univariate analysis, patients with leukocytosis experienced greater incidences of 30-day mortality, wound complications, and medical complications. Wound complications included surgical site infection as well as wound dehiscence. The medical complications included all other non-surgical causes of increased morbidity and infection leading to urinary tract infection, pneumonia, ventilator dependence, sepsis and septic shock. After stepwise model adjustment, leukocytosis was a strong predictor of medical complications (OR 1.22, 95% CI: 1.09-1.36, p = 0.002) with c-statistic of 0.667. However, after stepwise model adjustment leukocytosis was not a significant predictor of 30-day mortality and wound complications. CONCLUSION: Preoperative leukocytosis is associated with adverse postoperative outcome after cardiac surgery and is an independent predictor of infection-related postoperative complications.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardíacos/efeitos adversos
Leucocitose/complicações
Cuidados Pós-Operatórios
Cuidados Pré-Operatórios
[Mh] Termos MeSH secundário: Seres Humanos
Contagem de Leucócitos
Leucocitose/sangue
Modelos Logísticos
Complicações Pós-Operatórias/etiologia
Terapêutica
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182118


  3 / 4711 MEDLINE  
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[PMID]:28858876
[Au] Autor:Lieberman F; Villgran V; Normolle D; Boyiadzis M
[Ad] Endereço:Division of Hematology and Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
[Ti] Título:Intracranial Hemorrhage in Patients Newly Diagnosed with Acute Myeloid Leukemia and Hyperleukocytosis.
[So] Source:Acta Haematol;138(2):116-118, 2017.
[Is] ISSN:1421-9662
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Mh] Termos MeSH primário: Hemorragias Intracranianas
Leucemia Mieloide Aguda
Leucocitose
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Hemorragias Intracranianas/sangue
Hemorragias Intracranianas/diagnóstico por imagem
Hemorragias Intracranianas/mortalidade
Hemorragias Intracranianas/terapia
Leucemia Mieloide Aguda/sangue
Leucemia Mieloide Aguda/diagnóstico por imagem
Leucemia Mieloide Aguda/mortalidade
Leucemia Mieloide Aguda/terapia
Leucocitose/sangue
Leucocitose/diagnóstico por imagem
Leucocitose/mortalidade
Leucocitose/terapia
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1159/000478690


  4 / 4711 MEDLINE  
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[PMID]:28816792
[Au] Autor:McNew BR; Darbro BW; Ma D; Gordon DJ
[Ad] Endereço:*University of Iowa Hospitals and Clinics, Iowa City, IA †Blank Children's Cancer and Blood Disorder Center, Des Moines, IA.
[Ti] Título:Development of Secondary Acute Myeloid Leukemia in a Pediatric Patient Concurrently Receiving Primary Therapy for Ewing Sarcoma.
[So] Source:J Pediatr Hematol Oncol;39(7):e370-e372, 2017 Oct.
[Is] ISSN:1536-3678
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ewing sarcoma is a pediatric bone and soft tissue sarcoma that requires intensive therapy, which can cause secondary malignancies. We present a rare case of early, treatment-related AML in a pediatric patient concurrently receiving primary therapy for Ewing sarcoma. Despite AML-directed therapy, our patient died secondary to complications of hyperleukocytosis. Cytogenetic and mutation profiling of the leukemia cells revealed the DNA-topoisomerase-II-inhibitor-associated t(9;11)(p22;q23) translocation and clonal KRAS and BRAF mutations. This report highlights the importance of monitoring for treatment-related effects in cancer therapy, as well as the need for novel, less toxic approaches in Ewing sarcoma therapy.
[Mh] Termos MeSH primário: Leucemia Mieloide Aguda/induzido quimicamente
Segunda Neoplasia Primária
Sarcoma de Ewing/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Evolução Fatal
Feminino
Seres Humanos
Leucemia Mieloide Aguda/genética
Leucocitose
Mutação
Sarcoma de Ewing/patologia
Prevenção Secundária
Translocação Genética
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171121
[Lr] Data última revisão:
171121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1097/MPH.0000000000000924


  5 / 4711 MEDLINE  
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[PMID]:28797003
[Au] Autor:Byun JM; Kim KH; Choi IS; Park JH; Kim JS; Shin DY; Koh Y; Kim I; Yoon SS; Lim HJ
[Ad] Endereço:Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
[Ti] Título:Pleural Effusion in Multiple Myeloma: Characteristics and Practice Patterns.
[So] Source:Acta Haematol;138(2):69-76, 2017.
[Is] ISSN:1421-9662
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:In many Asian countries battling with the double burden of increasing noninfectious diseases on top of infectious diseases, multiple myeloma (MM) patients presenting with pleural effusion (PE) pose a great diagnostic challenge. Thus, we aimed to analyze the clinical features and practice patterns of such patients. This is a multicenter retrospective study of newly diagnosed MM patients between January 2011 and December 2015. Among 575 MM patients diagnosed during the study period, 80 (13.9%) that were associated with PE were identified and analyzed. The most common cause of PE was parapneumonic (25%), followed by reactive (18.8%). Higher CRP levels and leukocytosis were indicators of parapneumonic PE. There were 7 (8.8%) with myelomatous PE and 2 (2.5%) with tuberculosis. Fifty-six patients underwent additional examinations to determine the exact cause of effusion; 28 patients received computed tomography (CT) of the chest, 5 patients underwent thoracentesis/biopsy, and 23 patients underwent both CT and thoracentesis/biopsy. On the other hand, 24 patients did not undergo additional analyses but were treated empirically. Real-world analyses of practice patterns in MM patients with PE showed the suboptimal use of invasive procedures to determine the exact cause of PE. Since reversible causes and tuberculosis pleurisy are not uncommon, invasive procedures should be actively incorporated as needed.
[Mh] Termos MeSH primário: Mieloma Múltiplo/diagnóstico
Derrame Pleural/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Proteína C-Reativa/análise
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Leucocitose/etiologia
Masculino
Meia-Idade
Mieloma Múltiplo/mortalidade
Mieloma Múltiplo/patologia
Derrame Pleural/mortalidade
Derrame Pleural/patologia
Prognóstico
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.1159/000477793


  6 / 4711 MEDLINE  
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[PMID]:28784932
[Au] Autor:Scanlon KM; Snyder YG; Skerry C; Carbonetti NH
[Ad] Endereço:Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
[Ti] Título:Fatal Pertussis in the Neonatal Mouse Model Is Associated with Pertussis Toxin-Mediated Pathology beyond the Airways.
[So] Source:Infect Immun;85(11), 2017 Nov.
[Is] ISSN:1098-5522
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In infants, can cause severe disease, manifested as pronounced leukocytosis, pulmonary hypertension, and even death. The exact cause of death remains unknown, and no effective therapies for treating fulminant pertussis exist. In this study, a neonatal mouse model of critical pertussis is characterized, and a central role for pertussis toxin (PT) is described. PT promoted colonization, leukocytosis, T cell phenotypic changes, systemic pathology, and death in neonatal but not adult mice. Surprisingly, PT inhibited lung inflammatory pathology in neonates, a result which contrasts dramatically with observed PT-promoted pathology in adult mice. Infection with a PT-deficient strain induced severe pulmonary inflammation but not mortality in neonatal mice, suggesting that death in these mice was not associated with impaired lung function. Dissemination of infection beyond the lungs was also detected in neonatal mice, which may contribute to the observed systemic effects of PT. We propose that it is the systemic activity of pertussis toxin and not pulmonary pathology that promotes mortality in critical pertussis. In addition, we observed transmission of infection between neonatal mice, the first report of transmission in mice. This model will be a valuable tool to investigate causes of pertussis pathogenesis and identify potential therapies for critical pertussis.
[Mh] Termos MeSH primário: Bordetella pertussis/patogenicidade
Interações Hospedeiro-Patógeno
Leucocitose/microbiologia
Pulmão/microbiologia
Toxina Pertussis/toxicidade
Coqueluche/microbiologia
[Mh] Termos MeSH secundário: Fatores Etários
Animais
Animais Recém-Nascidos
Bordetella pertussis/crescimento & desenvolvimento
Bordetella pertussis/imunologia
Modelos Animais de Doenças
Seres Humanos
Lactente
Leucocitose/imunologia
Leucocitose/mortalidade
Leucocitose/patologia
Pulmão/imunologia
Pulmão/patologia
Camundongos
Camundongos Endogâmicos BALB C
Neutrófilos/imunologia
Neutrófilos/microbiologia
Neutrófilos/patologia
Toxina Pertussis/biossíntese
Toxina Pertussis/imunologia
Análise de Sobrevida
Linfócitos T/imunologia
Linfócitos T/microbiologia
Linfócitos T/patologia
Coqueluche/imunologia
Coqueluche/mortalidade
Coqueluche/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 2.4.2.31 (Pertussis Toxin)
[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:170809
[St] Status:MEDLINE


  7 / 4711 MEDLINE  
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[PMID]:28719602
[Au] Autor:Hazeldine J; Naumann DN; Toman E; Davies D; Bishop JRB; Su Z; Hampson P; Dinsdale RJ; Crombie N; Duggal NA; Harrison P; Belli A; Lord JM
[Ad] Endereço:Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom.
[Ti] Título:Prehospital immune responses and development of multiple organ dysfunction syndrome following traumatic injury: A prospective cohort study.
[So] Source:PLoS Med;14(7):e1002338, 2017 Jul.
[Is] ISSN:1549-1676
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Almost all studies that have investigated the immune response to trauma have analysed blood samples acquired post-hospital admission. Thus, we know little of the immune status of patients in the immediate postinjury phase and how this might influence patient outcomes. The objective of this study was therefore to comprehensively assess the ultra-early, within 1-hour, immune response to trauma and perform an exploratory analysis of its relationship with the development of multiple organ dysfunction syndrome (MODS). METHODS AND FINDINGS: The immune and inflammatory response to trauma was analysed in 89 adult trauma patients (mean age 41 years, range 18-90 years, 75 males) with a mean injury severity score (ISS) of 24 (range 9-66), from whom blood samples were acquired within 1 hour of injury (mean time to sample 42 minutes, range 17-60 minutes). Within minutes of trauma, a comprehensive leukocytosis, elevated serum pro- and anti-inflammatory cytokines, and evidence of innate cell activation that included neutrophil extracellular trap generation and elevated surface expression of toll-like receptor 2 and CD11b on monocytes and neutrophils, respectively, were observed. Features consistent with immune compromise were also detected, notably elevated numbers of immune suppressive CD16BRIGHT CD62LDIM neutrophils (82.07 x 106/l ± 18.94 control versus 1,092 x 106/l ± 165 trauma, p < 0.0005) and CD14+HLA-DRlow/- monocytes (34.96 x 106/l ± 4.48 control versus 95.72 x 106/l ± 8.0 trauma, p < 0.05) and reduced leukocyte cytokine secretion in response to lipopolysaccharide stimulation. Exploratory analysis via binary logistic regression found a potential association between absolute natural killer T (NKT) cell numbers and the subsequent development of MODS. Study limitations include the relatively small sample size and the absence of data relating to adaptive immune cell function. CONCLUSIONS: Our study highlighted the dynamic and complex nature of the immune response to trauma, with immune alterations consistent with both activation and suppression evident within 1 hour of injury. The relationship of these changes, especially in NKT cell numbers, to patient outcomes such as MODS warrants further investigation.
[Mh] Termos MeSH primário: Imunidade Adaptativa
Imunidade Inata
Insuficiência de Múltiplos Órgãos/etiologia
Insuficiência de Múltiplos Órgãos/imunologia
Ferimentos e Lesões/complicações
Ferimentos e Lesões/imunologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Estudos de Coortes
Citocinas/sangue
Inglaterra
Feminino
Seres Humanos
Escala de Gravidade do Ferimento
Leucocitose/sangue
Leucocitose/etiologia
Leucocitose/imunologia
Masculino
Meia-Idade
Insuficiência de Múltiplos Órgãos/sangue
Estudos Prospectivos
Fatores de Tempo
Ferimentos e Lesões/sangue
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cytokines)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002338


  8 / 4711 MEDLINE  
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[PMID]:28700476
[Au] Autor:Hensel M; Grädel L; Kutz A; Haubitz S; Huber A; Mueller B; Schuetz P; Hügle T
[Ad] Endereço:aDepartment of Rheumatology, University Hospital Basel, Basel bDepartment Internal Medicine, Kantonsspital Aarau, Aarau cDepartment of Rheumatology, University Hospital Lausann (CHUV), Lausann, Switzerland.
[Ti] Título:Peripheral monocytosis as a predictive factor for adverse outcome in the emergency department: Survey based on a register study.
[So] Source:Medicine (Baltimore);96(28):e7404, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far.The aim of the article is to study monocytosis as an outcome factor in the emergency setting.In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital. Monocytosis was defined as 0.8×10 cells/L. Diagnoses were grouped into infection, cardiovascular, neurological, metabolic, gastrointestinal, pulmonary, or other. Thirty-day mortality was defined as the primary endpointA total of 1217 patients with monocytosis were identified. Patients with monocytosis at admission suffered more frequently from respiratory symptoms (17.7% vs 8.9%, P <.001) and infection as the final diagnosis (20.8% vs 10.3%, P <.001) while neurological diagnoses were significantly lower in the monocytosis group (15.3% vs 30.9%, P <.001). Patients with monocytosis suffered from more comorbidities such as congestive heart failure, chronic obstructive pulmonary disease, tumor, diabetes, or renal failure but not dementia. When adjusted for age, gender, comorbidities, and main diagnosis, the 30-day mortality (P = .002) and length of stay (P = .001) were significantly higher in patients with monocytosis. The 30-day mortality in patients with monocytosis was most notably influenced by a cardiological diagnosis (odds ratio 3.91).An increased monocyte count predicts adverse outcome in patients admitted to the emergency department. Mechanistic studies will be necessary to specify the potentially detrimental role of monocytosis in critical illness.
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência
Leucocitose
Monócitos
[Mh] Termos MeSH secundário: Adulto
Idoso
Comorbidade
Feminino
Seres Humanos
Tempo de Internação
Contagem de Leucócitos
Leucocitose/diagnóstico
Masculino
Meia-Idade
Mortalidade
Readmissão do Paciente
Prognóstico
Estudos Prospectivos
Controle de Qualidade
Sistema de Registros
Inquéritos e Questionários
Suíça
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170730
[Lr] Data última revisão:
170730
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007404


  9 / 4711 MEDLINE  
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[PMID]:28637937
[Au] Autor:Tsuboguchi S; Wakasugi T; Umeda Y; Umeda M; Oyake M; Fujita N
[Ad] Endereço:Department of Neurology, Nagaoka Red Cross Hospital.
[Ti] Título:Herpes simplex encephalitis presenting as stroke-like symptoms with atypical MRI findings and lacking cerebrospinal fluid pleocytosis.
[So] Source:Rinsho Shinkeigaku;57(7):387-390, 2017 07 29.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 73-year-old woman presented with sudden onset of right hemiparesis and was diagnosed as having cerebral infarction on the basis of diffusion-weighted brain MRI, which demonstrated lesions in the left parietal cortex. On the 3rd day, the patient developed right upper limb myoclonus, aphasia, and disturbance of consciousness with high fever. On the 6th day, she was transferred to our hospital with suspected viral encephalitis, and treatment with acyclovir was started. By the 6th day, the lesions detected by MRI had expanded to the gyrus cinguli, insula and thalamus, but not to the temporal lobe. At that time, the CSF cell count was 8/µl, and this later increased to 17/µl by the 13th day. Although herpes simplex virus DNA was detected in the CSF on the 6th day, there was no evidence of CSF pleocytosis or temporal lobe abnormalities demonstrable by brain MRI throughout the whole follow-up period. This was very atypical case of herpes simplex encephalitis characterized by a stroke-like episode, atypical MRI findings, and absence of cerebrospinal fluid pleocytosis. It is important to be mindful that herpes simplex encephalitis (HSE) can have an atypical presentation, and that sufficient acyclovir treatment should be initiated until HSE can be ruled out.
[Mh] Termos MeSH primário: Encéfalo/diagnóstico por imagem
Encefalite por Herpes Simples/complicações
Encefalite por Herpes Simples/diagnóstico por imagem
Imagem por Ressonância Magnética
Neuroimagem
Acidente Vascular Cerebral/diagnóstico por imagem
Acidente Vascular Cerebral/etiologia
[Mh] Termos MeSH secundário: Aciclovir/administração & dosagem
Idoso
Antivirais/administração & dosagem
Biomarcadores/líquido cefalorraquidiano
Clonazepam/administração & dosagem
DNA Viral/líquido cefalorraquidiano
Quimioterapia Combinada
Encefalite por Herpes Simples/líquido cefalorraquidiano
Encefalite por Herpes Simples/tratamento farmacológico
Feminino
Seres Humanos
Leucocitose/líquido cefalorraquidiano
Metilprednisolona/administração & dosagem
Piracetam/administração & dosagem
Piracetam/análogos & derivados
Simplexvirus/genética
Acidente Vascular Cerebral/líquido cefalorraquidiano
Acidente Vascular Cerebral/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiviral Agents); 0 (Biomarkers); 0 (DNA, Viral); 230447L0GL (etiracetam); 5PE9FDE8GB (Clonazepam); X4HES1O11F (Acyclovir); X4W7ZR7023 (Methylprednisolone); ZH516LNZ10 (Piracetam)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001033


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[PMID]:28627004
[Au] Autor:Bortcosh W; Siedner M; Carroll RW
[Ad] Endereço:Massachusetts General Hospital, Boston, MA, USA.
[Ti] Título:Utility of the urine reagent strip leucocyte esterase assay for the diagnosis of meningitis in resource-limited settings: meta-analysis.
[So] Source:Trop Med Int Health;22(9):1072-1080, 2017 Sep.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Diagnosis of bacterial meningitis often requires cytometry, chemistry and/or microbiologic culture capabilities. Unfortunately, laboratory resources in low-resource settings (LRS) often lack the capacity to perform these studies. We sought to determine whether the presence of white blood cells in CSF detected by commercially available urine reagent strips could aid in the diagnosis of bacterial meningitis. METHODS: We searched PubMed for studies published between 1980 and 2016 that investigated the use of urine reagent strips to identify cerebrospinal fluid (CSF) pleocytosis. We assessed studies in any language that enrolled subjects who underwent lumbar puncture and had cerebrospinal fluid testing by both standard laboratory assays and urine reagent strips. We abstracted true-positive, false-negative, false-positive and true-negative counts for each study using a diagnostic threshold of ≥10 white blood cells per microlitre for suspected bacterial meningitis and performed mixed regression modelling with random effects to estimate pooled diagnostic accuracy across studies. RESULTS: Our search returned 13 studies including 2235 participants. Urine reagent strips detected CSF pleocytosis with a pooled sensitivity of 92% (95% CI: 84-96), a pooled specificity of 98% (95% CI: 94-99) and a negative predictive value of 99% when the bacterial meningitis prevalence is 10%. CONCLUSIONS: Urine reagent strips could provide a rapid and accurate tool to detect CSF pleocytosis, which, if negative, can be used to exclude diagnosis of bacterial meningitis in settings without laboratory infrastructure. Further investigation of the diagnostic value of using protein, glucose and bacteria components of these strips is warranted.
[Mh] Termos MeSH primário: Contagem de Leucócitos/métodos
Leucócitos
Meningites Bacterianas/diagnóstico
Fitas Reagentes
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Bactérias
Hidrolases de Éster Carboxílico/metabolismo
Criança
Pré-Escolar
Recursos em Saúde
Seres Humanos
Lactente
Recém-Nascido
Leucocitose/líquido cefalorraquidiano
Meningites Bacterianas/líquido cefalorraquidiano
Meningites Bacterianas/imunologia
Meia-Idade
Sensibilidade e Especificidade
Punção Espinal
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Reagent Strips); EC 3.1.- (leukocyte esterase); EC 3.1.1.- (Carboxylic Ester Hydrolases)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12913



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