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[PMID]:29431945
[Au] Autor:Sinitskaya TA; Malinovskaya NN
[Ti] Título:[Toxicological-hygienic justification of the acceptable daily intake of acetamiprid].
[So] Source:Gig Sanit;95(11):1055-8, 2016.
[Is] ISSN:0016-9900
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:Neonicotinoids are currently meaningful component of rotation schemes of insecticides of selective action in the system of integrated pest control, which have agricultural importance in many countries. The research results of the biological impact of acetamiprid (neonicotinoids) on the body of laboratory animals are given in the article. The study showed that the explored active substance is related to the moderately hazardous compounds (hazard category 3) in case of one-time per oral penetration. Acetamiprid has polytropic action in the case of chronic (12 months) oral entering the body of laboratory animals, it gives rise changes in functionality of the central nervous system, blood system, liver functioning. On the base of alterations of the studied indices there were established both the no-effect dose level (NOEL) and acceptable daily intake of acetamiprid for humans.
[Mh] Termos MeSH primário: Células Sanguíneas/efeitos dos fármacos
Sistema Nervoso Central/efeitos dos fármacos
Neonicotinoides
Envenenamento
[Mh] Termos MeSH secundário: Administração Oral
Animais
Comportamento Animal/efeitos dos fármacos
Modelos Animais de Doenças
Testes Hematológicos/métodos
Inseticidas/farmacologia
Inseticidas/toxicidade
Testes de Função Hepática/métodos
Concentração Máxima Permitida
Neonicotinoides/farmacologia
Neonicotinoides/toxicidade
Nível de Efeito Adverso não Observado
Órgãos em Risco
Envenenamento/sangue
Envenenamento/diagnóstico
Envenenamento/etiologia
Ratos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Insecticides); 0 (Neonicotinoids); 5HL5N372P0 (acetamiprid)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180213
[St] Status:MEDLINE


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[PMID]:29381918
[Au] Autor:Xu HY; Li CY; Su SS; Yang L; Ye M; Ye JR; Ke PP; Chen CS; Xie YP; Li YP
[Ad] Endereço:Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, PR China.
[Ti] Título:Diagnosis of tuberculous pleurisy with combination of adenosine deaminase and interferon-γ immunospot assay in a tuberculosis-endemic population: A prospective cohort study.
[So] Source:Medicine (Baltimore);96(47):e8412, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to identify the optimal cut-off value of T cell enzyme-linked immunospot assay for tuberculosis (T-SPOT.TB) and evaluate its diagnostic performance alone (in the peripheral blood) or in combination with the adenosine deaminase (ADA) activity test (in peripheral blood and the pleural fluid) in patients with tuberculous pleurisy.Adult patients presenting with pleural effusion were included in this prospective cohort study. Tuberculous pleurisy was diagnosed by T-SPOT.TB in peripheral blood and a combination of T-SPOT.TB and ADA activity test in pleural fluid and peripheral blood. Receiver operating characteristic (ROC) curve in combination with multivariate logistic regression was used to evaluate the diagnostic performance of the assays.Among a total of 189 patients with suspected tuberculous pleurisy who were prospectively enrolled in this study, 177 patients were validated for inclusion in the final analysis. ROC analysis revealed that the area under the ROC curve (AUC) for T-SPOT.TB in pleural fluid and peripheral blood was 0.918 and 0.881, respectively, and for the ADA activity test in pleural fluid was 0.944. In addition, 95.5 spot-forming cells (SFCs)/2.5 × 10 cells were determined as the optimal cut-off value for T-SPOT.TB in pleural fluid. Parallel combination of T-SPOT.TB and ADA activity test in pleural fluid showed increased sensitivity (96.9%) and specificity (87.5%), whereas serial combination showed increased specificity (97.5%). The combination of 3 assays had the highest sensitivity at 97.9%, with an AUC value of 0.964.T-SPOT.TB in pleural fluid performed better than that in peripheral blood and the ADA activity test in pleural fluid for tuberculous pleurisy diagnosis. The optimal cut-off value of T-SPOT.TB in pleural fluid was 95.5 SFCs/2.5 × 10 cells. Combination of 3 assays might be a promising approach for tuberculous pleurisy diagnosis.
[Mh] Termos MeSH primário: Adenosina Desaminase/imunologia
ELISPOT/métodos
Interferon gama/imunologia
Tuberculose Pleural/diagnóstico
Tuberculose Pleural/imunologia
[Mh] Termos MeSH secundário: Adulto
Idoso
ELISPOT/normas
Feminino
Testes Hematológicos
Seres Humanos
Masculino
Meia-Idade
Derrame Pleural/imunologia
Estudos Prospectivos
Curva ROC
Valores de Referência
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
82115-62-6 (Interferon-gamma); EC 3.5.4.4 (Adenosine Deaminase)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008412


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[PMID]:28745843
[Au] Autor:Ashurst J; Sergent SR; Wagner BJ; Kim J
[Ad] Endereço:Director of Emergency Medicine Residency Research, Duke Lifepoint Conemaugh Memorial Medical Center, Johnstown, PA.
[Ti] Título:Evidence-based management of potassium disorders in the emergency department [digest].
[So] Source:Emerg Med Pract;18(11 Suppl Points & Pearls):S1-S2, 2016 Nov 22.
[Is] ISSN:1559-3908
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hypokalemia and hyperkalemia are the most common electrolyte disorders managed in the emergency department. The diagnosis of these potentially life-threatening disorders is challenging due to the often vague symptomatology a patient may express, and treatment options may be based upon very little data due to the time it may take for laboratory values to return. This review examines the most current evidence with regard to the pathophysiology, diagnosis, and management of potassium disorders. In this review, classic paradigms, such as the use of sodium polystyrene and the routine measurement of serum magnesium, are tested, and an algorithm for the treatment of potassium disorders is discussed. [Points & Pearls is a digest of Emergency Medicine Practice].
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência
Medicina Baseada em Evidências
Hiperpotassemia
Hipopotassemia
[Mh] Termos MeSH secundário: Desequilíbrio Ácido-Base/diagnóstico
Desequilíbrio Ácido-Base/fisiopatologia
Desequilíbrio Ácido-Base/terapia
Resinas de Troca de Cátion/uso terapêutico
Gerenciamento Clínico
Testes Hematológicos/métodos
Seres Humanos
Hiperpotassemia/diagnóstico
Hiperpotassemia/fisiopatologia
Hiperpotassemia/terapia
Hipopotassemia/diagnóstico
Hipopotassemia/fisiopatologia
Hipopotassemia/terapia
Magnésio/sangue
Desequilíbrio Hidroeletrolítico/diagnóstico
Desequilíbrio Hidroeletrolítico/fisiopatologia
Desequilíbrio Hidroeletrolítico/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Cation Exchange Resins); I38ZP9992A (Magnesium)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180117
[Lr] Data última revisão:
180117
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE


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[PMID]:28448810
[Au] Autor:Doherty BT; Kwok RK; Curry MD; Ekenga C; Chambers D; Sandler DP; Engel LS
[Ad] Endereço:Department of Epidemiology, University of North Carolina at Chapel Hill,135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA; National Institute of Environmental Health Sciences, 111 TW Alexander Drive, Research Triangle Park, NC 27709, USA.
[Ti] Título:Associations between blood BTEXS concentrations and hematologic parameters among adult residents of the U.S. Gulf States.
[So] Source:Environ Res;156:579-587, 2017 07.
[Is] ISSN:1096-0953
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Studies of workers exposed to benzene at average air concentrations below one part per million suggest that benzene, a known hematotoxin, causes hematopoietic damage even at low exposure levels. However, evidence of such effects outside of occupational settings and for other volatile organic compounds (VOCs) is limited. OBJECTIVE: To investigate associations between ambient exposures to five VOCs, including benzene, and hematologic parameters among adult residents of the U.S. Gulf Coast. MATERIALS AND METHODS: Blood concentrations of selected VOCs were measured in a sample of adult participants in the Gulf Long-term Follow-up Study (GuLF STUDY) during 2012 and 2013. Complete blood counts with differentials were also performed on a subset of participants (n=406). We used these data together with detailed questionnaire data to estimate adjusted associations between blood BTEXS (benzene, toluene, ethylbenzene, o-xylene, m/p-xylene, and styrene) concentrations and hematologic parameters using generalized linear models. RESULTS: We observed inverse associations between blood benzene concentrations and hemoglobin concentration and mean corpuscular hemoglobin concentration, and a positive association with red cell distribution width among tobacco smoke-unexposed participants (n=146). Among tobacco smoke-exposed participants (n=247), we observed positive associations between blood VOC concentrations and several hematologic parameters, including increased white blood cell and platelet counts, suggestive of hematopoietic stimulation typically associated with tobacco smoke exposure. Most associations were stronger for benzene than for the other VOCs. CONCLUSIONS: Our results suggest that ambient exposure to BTEXS, particularly benzene, may be associated with hematologic effects, including decreased hemoglobin concentration, mean corpuscular hemoglobin concentration, and increased red cell distribution width.
[Mh] Termos MeSH primário: Poluentes Atmosféricos/sangue
Derivados de Benzeno/sangue
Compostos Orgânicos Voláteis/sangue
[Mh] Termos MeSH secundário: Adulto
Monitoramento Ambiental
Feminino
Testes Hematológicos
Seres Humanos
Masculino
Meia-Idade
Fumar/sangue
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., INTRAMURAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Air Pollutants); 0 (Benzene Derivatives); 0 (Volatile Organic Compounds)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180113
[Lr] Data última revisão:
180113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE


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[PMID]:29261747
[Au] Autor:He Q; Su G; Liu K; Zhang F; Jiang Y; Gao J; Liu L; Jiang Z; Jin M; Xie H
[Ad] Endereço:Institute of Toxicological Detection, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China.
[Ti] Título:Sex-specific reference intervals of hematologic and biochemical analytes in Sprague-Dawley rats using the nonparametric rank percentile method.
[So] Source:PLoS One;12(12):e0189837, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hematologic and biochemical analytes of Sprague-Dawley rats are commonly used to determine effects that were induced by treatment and to evaluate organ dysfunction in toxicological safety assessments, but reference intervals have not been well established for these analytes. Reference intervals as presently defined for these analytes in Sprague-Dawley rats have not used internationally recommended statistical method nor stratified by sex. Thus, we aimed to establish sex-specific reference intervals for hematologic and biochemical parameters in Sprague-Dawley rats according to Clinical and Laboratory Standards Institute C28-A3 and American Society for Veterinary Clinical Pathology guideline. METHODS: Hematology and biochemistry blood samples were collected from 500 healthy Sprague-Dawley rats (250 males and 250 females) in the control groups. We measured 24 hematologic analytes with the Sysmex XT-2100i analyzer, 9 biochemical analytes with the Olympus AU400 analyzer. We then determined statistically relevant sex partitions and calculated reference intervals, including corresponding 90% confidence intervals, using nonparametric rank percentile method. RESULTS: We observed that most hematologic and biochemical analytes of Sprague-Dawley rats were significantly influenced by sex. Males had higher hemoglobin, hematocrit, red blood cell count, red cell distribution width, mean corpuscular volume, mean corpuscular hemoglobin, white blood cell count, neutrophils, lymphocytes, monocytes, percentage of neutrophils, percentage of monocytes, alanine aminotransferase, aspartate aminotransferase, and triglycerides compared to females. Females had higher mean corpuscular hemoglobin concentration, plateletcrit, platelet count, eosinophils, percentage of lymphocytes, percentage of eosinophils, creatinine, glucose, total cholesterol and urea compared to males. Sex partition was required for most hematologic and biochemical analytes in Sprague-Dawley rats. We established sex-specific reference intervals, including corresponding 90% confidence intervals, for Sprague-Dawley rats. CONCLUSIONS: Understanding the significant discrepancies in hematologic and biochemical analytes between male and female Sprague-Dawley rats provides important insight into physiological effects in test rats. Establishment of locally sex-specific reference intervals allows a more precise evaluation of animal quality and experimental results of Sprague-Dawley rats in our toxicology safety assessment.
[Mh] Termos MeSH primário: Fenômenos Bioquímicos
Caracteres Sexuais
Estatísticas não Paramétricas
[Mh] Termos MeSH secundário: Animais
Plaquetas/metabolismo
Peso Corporal
Eritrócitos/metabolismo
Feminino
Testes Hematológicos
Leucócitos/metabolismo
Masculino
Especificidade de Órgãos
Ratos Sprague-Dawley
Valores de Referência
Especificidade da Espécie
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189837


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[PMID]:29190288
[Au] Autor:Nabi G; Hao Y; Zeng X; Jinsong Z; McLaughlin RW; Wang D
[Ad] Endereço:Institute of Hydrobiology, the Chinese Academy of Sciences, Wuhan, Hubei, PR China.
[Ti] Título:Hematologic and biochemical differences between two free ranging Yangtze finless porpoise populations: The implications of habitat.
[So] Source:PLoS One;12(11):e0188570, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The goals of this study were to compare the serum chemistry and hematology values of wild and semi-natural free-ranging Yangtze Finless Porpoises (Neophocaena asiaeorientalis ssp. asiaeorientalis) populations and to ascertain how these values change with the different environmental condition. For this study, samples were collected from 81 YFPs, 35 living in the wild and 46 living in a semi-natural reserve. Each population was divided into 8 life history categories; Male Calf, Female Calf, Juvenile Male, Juvenile Female, Adult Male, Pregnant, Lactating and Pregnant plus Lactating. Statistically significant differences in the various parameters were observed in the same life history categories for both populations. Generally, Lipid Profile, Hepatic Enzymes, Creatine Kinase, Red Blood Cells, Hemoglobin, Hematocrit and Neutrophils were significantly higher in the Tian-E-Zhou Oxbow population while, Creatinine, Phosphate, Lactate Dehydrogenase, Bilirubin and Lymphocytes were significantly higher in the Poyang Lake YFPs. Across the groups in the Tian-E-Zhou Oxbow population, a significant decrease in serum Albumin, Alkaline Phosphatase and Calcium, while a significant increase in the Neutrophils and Platelets was observed. Similarly, in the Poyang Lake, Alkaline Phosphatase levels in the Female Calves group, High Density Lipoprotein Cholesterol in Lactating group, basophil counts in Pregnant plus Lactating group, lymphocytes counts in Juvenile Females group and Globulin and Total Protein levels in Pregnant group were significantly higher. This study in health assessments can help us to understand the effect of sex, age, reproductive status and environmental conditions on the well-being of Yangtze Finless Porpoises.
[Mh] Termos MeSH primário: Ecossistema
Toninhas/metabolismo
[Mh] Termos MeSH secundário: Animais
China
Testes de Química Clínica
Feminino
Testes Hematológicos
Masculino
Toninhas/sangue
Gravidez
Rios
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188570


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[PMID]:27776820
[Au] Autor:Gonzalez EA; Nandy P; Lucas AD; Hitchins VM
[Ad] Endereço:Laboratory of Microbiology and Infection Control, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, MD.
[Ti] Título:Designing for cleanability: The effects of material, surface roughness, and the presence of blood test soil and bacteria on devices.
[So] Source:Am J Infect Control;45(2):194-196, 2017 Feb 01.
[Is] ISSN:1527-3296
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cleaning reusable medical devices removes organic and inorganic soil, which allows for effective disinfection and sterilization. However, it is not always clear what variables to consider when validating cleaning. This study compared the ability of 3 different cleaning agents (ie, water, alcohol, and bleach) to remove bacteria (ie, vegetative and spores) and artificial blood test soil from 2 common device materials: polypropylene and ultra-high-molecular-weight polyethylene. There was a complex interaction between bacteria, soil, and surface roughness.
[Mh] Termos MeSH primário: Bactérias/isolamento & purificação
Contaminação de Equipamentos
Equipamentos e Provisões
Testes Hematológicos
Propriedades de Superfície
[Mh] Termos MeSH secundário: Descontaminação/métodos
Desinfecção/métodos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:27773731
[Au] Autor:Dadras H; Hayatbakhsh MR; Shelton WL; Golpour A
[Ad] Endereço:University of South Bohemia in Ceské Budejovice, Faculty of Fisheries and Protection of Waters, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, Zátisí 728/II, 389 25, Vodnany, Czech Republic. Electronic address: dadras@frov.jcu.cz.
[Ti] Título:Effects of dietary administration of Rose hip and Safflower on growth performance, haematological, biochemical parameters and innate immune response of Beluga, Huso huso (Linnaeus, 1758).
[So] Source:Fish Shellfish Immunol;59:109-114, 2016 Dec.
[Is] ISSN:1095-9947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to investigate effects of two dietary medicinal herbs, Rose hip (Rosa canina) and Safflower (Carthamus tinctorius) supplementation on growth performance, haematological, biochemical parameters and innate immune response of in juvenile beluga, Huso huso. Fish (26.3 ± 0.4 g) were allocated into 15 tanks (20 fish per tank) and triplicate groups were fed a control diet or diets containing 1% and 2% of medicinal herbs, respectively. Feed conversion ratio (FCR), specific growth rate (SGR) and condition factor (CF) did not show significant differences (P > 0.05) in fish given herbal diets. Significant differences were observed in number of white blood cells (WBC) and haemoglobin (Hb) values among the dietary treatments. The serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were significantly lower in supplemented diet groups compared with the control. Innate immune responses (lysozyme activity and ACH ) were significantly higher in 2% Safflower-fed fish compared with other groups (P < 0.05). These results indicate that medicinal herbs in diets can be considered as a beneficial dietary supplement for improving the physiological parameters and enhance the immune response of Persian sturgeon.
[Mh] Termos MeSH primário: Carthamus tinctorius/imunologia
Suplementos Nutricionais
Imunidade Inata
Rosa/imunologia
Salmonidae/imunologia
[Mh] Termos MeSH secundário: Ração Animal/análise
Animais
Análise Química do Sangue/veterinária
Carthamus tinctorius/química
Dieta/veterinária
Testes Hematológicos/veterinária
Plantas Medicinais/química
Plantas Medicinais/imunologia
Rosa/química
Salmonidae/sangue
Salmonidae/crescimento & desenvolvimento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171203
[Lr] Data última revisão:
171203
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161106
[St] Status:MEDLINE


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[PMID]:29068869
[Au] Autor:Park KM; Yang EJ; Lim YT
[Ad] Endereço:Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea.
[Ti] Título:Dural Venous Sinus Thrombosis and Pulmonary Embolism Following Immunoglobulin Treatment in Pediatric Patient With Immune Thrombocytopenic Purpura.
[So] Source:J Pediatr Hematol Oncol;39(8):e508-e511, 2017 Nov.
[Is] ISSN:1536-3678
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intravenous immunoglobulin (IVIG) is a widely used agent as the first choice of treatment of immune thrombocytopenic purpura (ITP). IVIG has several side effects, but it is a relatively safe treatment. Life-threatening thrombosis has been reported in adults and rarely in children. We report a case of a 14-year-old boy with dural venous sinus thrombosis and pulmonary embolism after treatment with IVIG for ITP. The patient was treated with low-molecular-weight heparin followed by warfarin and the symptoms were recovered. If a patient with ITP shows mental change or respiratory difficulty, we should consider thrombosis as well as hemorrhage.
[Mh] Termos MeSH primário: Embolia Pulmonar/diagnóstico
Embolia Pulmonar/etiologia
Púrpura Trombocitopênica Idiopática/complicações
Trombose dos Seios Intracranianos/diagnóstico
Trombose dos Seios Intracranianos/etiologia
[Mh] Termos MeSH secundário: Adolescente
Anticoagulantes/uso terapêutico
Biópsia
Medula Óssea/patologia
Testes Hematológicos
Heparina de Baixo Peso Molecular/uso terapêutico
Seres Humanos
Imunoglobulinas Intravenosas/administração & dosagem
Angiografia por Ressonância Magnética
Masculino
Embolia Pulmonar/tratamento farmacológico
Púrpura Trombocitopênica Idiopática/diagnóstico
Púrpura Trombocitopênica Idiopática/terapia
Trombose dos Seios Intracranianos/tratamento farmacológico
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Trombose Venosa/diagnóstico
Trombose Venosa/etiologia
Varfarina/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 0 (Heparin, Low-Molecular-Weight); 0 (Immunoglobulins, Intravenous); 5Q7ZVV76EI (Warfarin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/MPH.0000000000000841


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[PMID]:29059268
[Au] Autor:Vanderbilt CM; McFarland C; Lind SE
[Ad] Endereço:Departments of Pathology.
[Ti] Título:Evaluation of a Reflex Testing Algorithm for Suspected Heparin-Induced Thrombocytopenia.
[So] Source:Am J Clin Pathol;148(5):390-397, 2017 Nov 02.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: We implemented a policy of reflex serotonin-release assay (SRA) testing for all patients with a positive heparin-induced thrombocytopenia (HIT) immunoassay. Methods: We identified all patients who had SRA testing sent as a consequence of a positive HIT immunoassay test. We reviewed charts of patients to calculate the 4Ts clinical score, determined the effect of testing on clinical management, and documented the change in utilization of direct thrombin inhibitors (DTIs). Results: The likelihood of a positive SRA varied with the optical density (OD) of the immunoassay. The performance of the immunoglobulin G (IgG)-specific and polytypic enzyme-linked immunosorbent assay was not statistically different. Both OD and 4Ts score correlated with the likelihood of a positive SRA but demonstrated poor specificity. Discontinuation of DTIs in patients with negative SRAs resulted in decreased drug utilization. Conclusions: The IgG-specific HIT immunoassay OD correlates with the likelihood of a positive SRA but does not achieve high specificity. The reflex testing algorithm allows for definitive classification of patients, and the cost of such a reflex testing program may be offset by decreased utilization of DTIs.
[Mh] Termos MeSH primário: Algoritmos
Testes Hematológicos
Trombocitopenia/diagnóstico
[Mh] Termos MeSH secundário: Anticoagulantes/efeitos adversos
Testes Hematológicos/economia
Testes Hematológicos/métodos
Heparina/efeitos adversos
Seres Humanos
Imunoensaio
Ativação Plaquetária
Serotonina/secreção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 333DO1RDJY (Serotonin); 9005-49-6 (Heparin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171024
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx078



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