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[PMID]:29390381
[Au] Autor:Ek S; Rosenborg S
[Ad] Endereço:Department of Obstetrics and Gynecology, Center of Fetal Medicine, Karolinska University Hospital.
[Ti] Título:Mesalazine as a cause of fetal anemia and hydrops fetalis: A case report.
[So] Source:Medicine (Baltimore);96(50):e9277, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Mesalazine and its prodrug sulfasalazine are both used for inflammatory bowel disease. Sulfasalazine has been associated with hematological side-effects such as aplastic and hemolytic anemia in patients, but also in fetuses after intrauterine exposure. To our knowledge, we describe the first case of a fetus with severe anemia, and subsequent hydrops, where this drug was found at concentrations in the fetus corresponding to those in the mother and most likely responsible for the fetal condition. PATIENT CONCERNS: A uniparous woman was referred at 31 weeks of gestation due to a hydropic fetus with massive ascites and cardiomegaly. DIAGNOSES: The patient had Crohn's disease and was thus treated with 4 g mesalazine daily. The fetus had severe anemia with an initial hemoglobin level of 51 g/L. INTERVENTIONS: The maternal medication was discontinued and four intrauterine erythrocyte transfusions were given during three weeks. Plasma samples were drawn from mother and fetus during cordocentesis for later analysis of mesalazine. OUTCOMES: A healthy baby was born after 37 full weeks of gestation. Plasma levels of mesalazine were non-conspicuous in neither mother nor fetus. The mesalazine half-life in the fetus (37 h) was half that of the mother (80 h), both considerably longer than previously reported (about 19 h). LESSONS: A causal relationship must be suspected between the fetal anemia and the maternal use of mesalazine. This fetal side-effect should be considered in pregnant women on mesalazine (and its prodrug sulfasalazine).
[Mh] Termos MeSH primário: Anemia/induzido quimicamente
Anti-Inflamatórios não Esteroides/efeitos adversos
Doenças Fetais/induzido quimicamente
Hidropisia Fetal/induzido quimicamente
Mesalamina/efeitos adversos
[Mh] Termos MeSH secundário: Anemia/terapia
Transfusão de Eritrócitos
Feminino
Doenças Fetais/terapia
Seres Humanos
Hidropisia Fetal/terapia
Gravidez
Resultado da Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal); 4Q81I59GXC (Mesalamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009277


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[PMID]:29377071
[Au] Autor:Rees DC; Robinson S; Howard J
[Ad] Endereço:Department of Haematological Medicine, King's College Hospital, King's College London, London, UK.
[Ti] Título:How I manage red cell transfusions in patients with sickle cell disease.
[So] Source:Br J Haematol;180(4):607-617, 2018 02.
[Is] ISSN:1365-2141
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Sickle cell disease is one of the commonest serious inherited diseases in the world, and red cell transfusion is still one of the few effective treatments for acute and chronic complications. Transfusion corrects anaemia and dilutes out the number of red cells able to cause vaso-occlusion and vascular damage. Urgent red cell transfusions are used to correct acute anaemia, treat acute chest syndrome and patients with acute neurological symptoms. We use elective transfusions preoperatively for moderate risk surgery, and in some pregnant women. There is good evidence for the use of long-term regular transfusions in primary stroke prevention, with the aim of keeping the percentage of sickle haemoglobin below 30%. Long-term transfusions are also used in secondary stroke prevention, and the management of progressive organ damage, including renal impairment and pulmonary hypertension. Blood needs to be matched for ABO, RH and Kell, although alloantibodies may still develop and require more careful, extended cross-matching. Delayed haemolytic transfusion reactions are relatively common, difficult to diagnose and manage, and potentially fatal.
[Mh] Termos MeSH primário: Anemia Falciforme/terapia
Transfusão de Eritrócitos
[Mh] Termos MeSH secundário: Fatores Etários
Anemia Falciforme/complicações
Anemia Falciforme/diagnóstico
Anemia Falciforme/etiologia
Doadores de Sangue
Gerenciamento Clínico
Transfusão de Eritrócitos/efeitos adversos
Transfusão de Eritrócitos/métodos
Genótipo
Seres Humanos
Disseminação de Informação
Isoanticorpos/sangue
Isoanticorpos/imunologia
Fenótipo
Fatores de Tempo
Reação Transfusional
Conduta Expectante
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Isoantibodies)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1111/bjh.15115


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[PMID]:29341561
[Au] Autor:Dobrosavljevic A; Martic J; Rakic S; Pazin V; Jankovic-Raznatovic S; Sreckovic S; Dobrosavljevic B
[Ti] Título:Massive fetomaternal hemorrhage as a cause of severe fetal anemia.
[So] Source:Vojnosanit Pregl;73(11):1068-71, 2016 Nov.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Fetomaternal hemorrhage (FMH) is a transfu-sion of fetal blood into the maternal circulation. A volume of transfused fetal blood required to cause severe, life-threatening fetal anemia, is not clearly defined. Some authors suggest vol-umes of 80 mL and 150 mL as a threshold which defines mas-sive FMH. Therefore, a rate of massive FMH is 1 : 1,000 and 1 : 5,000 births, respectively. Fetal and neonatal anemia is one of the most serious complications of the FMH. Clinical manifesta-tions of FMH are nonspecific, and mostly it presented as re-duced fetal movements and changes in cardiotocography (CTG). The standard for diagnosing FMH is Kleihaurer-Betke test. Case report: A 34-year-old gravida (G) 1, para (P) 1 was hospitalized due to uterine contractions at 39 weeks of gesta-tion. CTG monitoring revealed sinusoidal fetal heart rate and clinical examination showed complete cervical dilatation. Im-mediately after admission, the women delivered vaginally. Ap-gar scores were 1 and 2 at the first and fifth minute, respec-tively. Immediately baby was intubated and mechanical ventila-tion started. Initial analysis revealed pronounced acidosis and severe anemia. The patient received intravenous fluid therapy with sodium-bicarbonate as well as red cell transfusion. With all measures, the condition of the baby improved with normaliza-tion of hemoglobin level and blood pH. Kleihaurer-Betke test revealed the presence of fetal red cells in maternal circulation, equivalent to 531 mL blood loss. The level of maternal fetal hemoglobin (HbF) and elevated alpha fetoprotein also con-firmed the diagnosis of massive FMH. Conclusion: For the successful diagnosis and management of FMH direct commu-nication between the obstetrician and the pediatrician is neces-sary as presented in this report.
[Mh] Termos MeSH primário: Anemia Neonatal/etiologia
Transfusão Feto-Materna/complicações
Circulação Placentária
[Mh] Termos MeSH secundário: Adulto
Anemia Neonatal/sangue
Anemia Neonatal/diagnóstico
Anemia Neonatal/terapia
Asfixia Neonatal/etiologia
Biomarcadores/sangue
Cardiotocografia
Transfusão de Eritrócitos
Feminino
Hemoglobina Fetal/metabolismo
Transfusão Feto-Materna/sangue
Transfusão Feto-Materna/diagnóstico
Transfusão Feto-Materna/terapia
Hidratação
Seres Humanos
Nascimento Vivo
Gravidez
Resultado do Tratamento
alfa-Fetoproteínas/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (AFP protein, human); 0 (Biomarkers); 0 (alpha-Fetoproteins); 9034-63-3 (Fetal Hemoglobin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150605130D


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[PMID]:29205497
[Au] Autor:Aboul-Hassan SS; Stankowski T; Marczak J; Peksa M; Nawotka M; Stanislawski R; Kryszkowski B; Cichon R
[Ad] Endereço:Department of Cardiac Surgery, MEDINET Heart Center Ltd., Nowa Sol, Poland.
[Ti] Título:The use of preoperative aspirin in cardiac surgery: A systematic review and meta-analysis.
[So] Source:J Card Surg;32(12):758-774, 2017 Dec.
[Is] ISSN:1540-8191
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Despite the fact that aspirin is of benefit to patients following coronary artery bypass grafting (CABG), continuation or administration of preoperative aspirin before CABG or any cardiac surgical procedure remains controversial. Therefore, we performed a systematic review and meta-analysis to assess the influence of preoperative aspirin administration on patients undergoing cardiac surgery. MATERIALS AND METHODS: Medline database was searched using OVID SP interface. Similar searches were performed separately in EMBASE, PubMed, and Cochrane Central Registry of Controlled Trials. RESULTS: Twelve randomized controlled trials and 28 observational studies met our inclusion criteria and were included in the meta-analysis. The use of preoperative aspirin in patients undergoing CABG at any dose is associated with reduced early mortality as well as a reduced incidence of postoperative acute kidney injury (AKI). Low-dose aspirin (≤160 mg/d) is associated with a decreased incidence of perioperative myocardial infarction (MI). Administration of preoperative aspirin at any dose in patients undergoing cardiac surgery increases postoperative bleeding. Despite this effect of preoperative aspirin, it did not increase the rates of surgical re-exploration due to excessive postoperative bleeding nor did it increase the rates of packed red blood cell transfusions (PRBC) when preoperative low-dose aspirin (≤160 mg/d) was administered. CONCLUSIONS: Preoperative aspirin increases the risk for postoperative bleeding. However, this did not result in an increased need for chest re-exploration and did not increase the rates of PRBC transfusion when preoperative low-dose (≤160 mg/d) aspirin was administered. Aspirin at any dose is associated with decreased mortality and AKI and low-dose aspirin (≤160 mg/d) decreases the incidence of perioperative MI.
[Mh] Termos MeSH primário: Aspirina/uso terapêutico
Procedimentos Cirúrgicos Cardíacos
Inibidores da Agregação de Plaquetas/uso terapêutico
Complicações Pós-Operatórias/prevenção & controle
Cuidados Pré-Operatórios/métodos
[Mh] Termos MeSH secundário: Aspirina/efeitos adversos
Procedimentos Cirúrgicos Cardíacos/mortalidade
Transfusão de Eritrócitos
Seres Humanos
Modelos Estatísticos
Razão de Chances
Inibidores da Agregação de Plaquetas/efeitos adversos
Complicações Pós-Operatórias/induzido quimicamente
Complicações Pós-Operatórias/epidemiologia
Hemorragia Pós-Operatória/induzido quimicamente
Hemorragia Pós-Operatória/terapia
Cuidados Pré-Operatórios/efeitos adversos
Reoperação
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1111/jocs.13250


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[PMID]:29298142
[Au] Autor:Dean HM
[Ad] Endereço:Saint Vincent Hospital, Worcester, MA hmdean@massmed.org.
[Ti] Título:Adverse Effects of Red-Cell Transfusion.
[So] Source:N Engl J Med;378(1):97, 2018 01 04.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Transfusão de Eritrócitos
Eritrócitos
[Mh] Termos MeSH secundário: Seres Humanos
Doença Iatrogênica
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1714159


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[PMID]:29298141
[Au] Autor:Ness PM; Triulzi DJ; Carson JL
[Ad] Endereço:Johns Hopkins University School of Medicine, Baltimore, MD
[Ti] Título:Adverse Effects of Red-Cell Transfusion.
[So] Source:N Engl J Med;378(1):97-98, 2018 01 04.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Transfusão de Eritrócitos
Eritrócitos
[Mh] Termos MeSH secundário: Seres Humanos
Doença Iatrogênica
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMc1714159


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[PMID]:29245285
[Au] Autor:Park HM; Park SJ; Shim JR; Lee EC; Lee SD; Han SS; Kim SH
[Ad] Endereço:Center for Liver Cancer, National Cancer Center, Gyeonggi-do, South Korea.
[Ti] Título:Perioperative transfusion in pancreatoduodenectomy: The double-edged sword of pancreatic surgeons.
[So] Source:Medicine (Baltimore);96(49):e9019, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We designed the study to clarify the prognostic significance of perioperative (preoperative, intraoperative, and postoperative) red blood cell (RBC) transfusion following pancreaticoduodenectomy (PD) for periampullary cancers.This study retrospectively analyzed 244 periampullary cancer patients (pancreatic cancer, 124 patients; bile duct cancer, 63 patients; and ampullary cancer, 57 patients) treated by PD from June 2001 to June 2010 at the National Cancer Center, Korea (NCC2017-0106).A total of 112 (46%) of 244 patients had received transfusion (preoperative, 5%; intraoperative, 17%; and postoperative, 37%). The 5-year survival rate of patients without perioperative transfusion was 36%, whereas that of patients with a transfusion was 25% (P = .04). Perioperative transfusion and intraoperative transfusion were found to be independent poor prognostic factors [relative risk (RR): 1.52 and 1.95, respectively]. The independent factors associated with perioperative transfusion were being female, operation time >420 minutes, portal vein (PV) resection, and preoperative serum hemoglobin (Hb) < 12 mg/dL. As the amount of perioperative transfusion increased, overall survival (OS) decreased.Perioperative transfusion, especially intraoperative transfusion was an independent prognostic factor for survival after PD. Therefore, for patients with periampullary cancer, intraoperative bleeding and operation time should be minimized and preoperative anemia corrected.
[Mh] Termos MeSH primário: Transfusão de Eritrócitos/estatística & dados numéricos
Pancreaticoduodenectomia/métodos
Período Perioperatório/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Ampola Hepatopancreática
Feminino
Hemoglobinas/análise
Seres Humanos
Masculino
Meia-Idade
Duração da Cirurgia
Pancreaticoduodenectomia/mortalidade
Estudos Retrospectivos
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Hemoglobins)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009019


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[PMID]:29185590
[Au] Autor:Biagini S; Dale CS; Real JM; Moreira ES; Carvalho CRR; Schettino GPP; Wendel S; Azevedo LCP
[Ad] Endereço:Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brasil.
[Ti] Título:Short-term effects of stored homologous red blood cell transfusion on cardiorespiratory function and inflammation: an experimental study in a hypovolemia model.
[So] Source:Braz J Med Biol Res;51(1):e6258, 2017 Nov 17.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:The pathophysiological mechanisms associated with the effects of red blood cell (RBC) transfusion on cardiopulmonary function and inflammation are unclear. We developed an experimental model of homologous 14-days stored RBC transfusion in hypovolemic swine to evaluate the short-term effects of transfusion on cardiopulmonary system and inflammation. Sixteen healthy male anesthetized swine (68±3.3 kg) were submitted to controlled hemorrhage (25% of blood volume). Two units of non-filtered RBC from each animal were stored under blood bank conditions for 14 days. After 30 min of hypovolemia, the control group (n=8) received an infusion of lactated Ringer's solution (three times the removed volume). The transfusion group (n=8) received two units of homologous 14-days stored RBC and lactated Ringer's solution in a volume that was three times the difference between blood removed and blood transfusion infused. Both groups were followed up for 6 h after resuscitation with collection of hemodynamic and respiratory data. Cytokines and RNA expression were measured in plasma and lung tissue. Stored RBC transfusion significantly increased mixed oxygen venous saturation and arterial oxygen content. Transfusion was not associated with alterations on pulmonary function. Pulmonary concentrations of cytokines were not different between groups. Gene expression for lung cytokines demonstrated a 2-fold increase in mRNA level for inducible nitric oxide synthase and a 0.5-fold decrease in mRNA content for IL-21 in the transfused group. Thus, stored homologous RBC transfusion in a hypovolemia model improved cardiovascular parameters but did not induce significant effects on microcirculation, pulmonary inflammation and respiratory function up to 6 h after transfusion.
[Mh] Termos MeSH primário: Preservação de Sangue/métodos
Fenômenos Fisiológicos Cardiovasculares
Transfusão de Eritrócitos/métodos
Hipovolemia/terapia
Pneumonia/fisiopatologia
Fenômenos Fisiológicos Respiratórios
[Mh] Termos MeSH secundário: Animais
Preservação de Sangue/efeitos adversos
Citocinas/sangue
Modelos Animais de Doenças
Ensaio de Imunoadsorção Enzimática
Transfusão de Eritrócitos/efeitos adversos
Hemodinâmica
Masculino
Oxigênio/metabolismo
Reprodutibilidade dos Testes
Ressuscitação/métodos
Suínos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cytokines); S88TT14065 (Oxygen)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE


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[PMID]:29049654
[Au] Autor:Caram-Deelder C; Kreuger AL; Evers D; de Vooght KMK; van de Kerkhof D; Visser O; Péquériaux NCV; Hudig F; Zwaginga JJ; van der Bom JG; Middelburg RA
[Ad] Endereço:Center for Clinical Transfusion Research, Sanquin Research, Leiden, the Netherlands.
[Ti] Título:Association of Blood Transfusion From Female Donors With and Without a History of Pregnancy With Mortality Among Male and Female Transfusion Recipients.
[So] Source:JAMA;318(15):1471-1478, 2017 10 17.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Transfusion of red blood cells from female donors has been associated with increased mortality in male recipients. Objective: To quantify the association between red blood cell transfusion from female donors with and without a history of pregnancy and mortality of red blood cell recipients. Design, Setting, and Participants: Retrospective cohort study of first-time transfusion recipients at 6 major Dutch hospitals enrolled from May 30, 2005, to September 1, 2015; the final follow-up date was September 1, 2015. The primary analysis was the no-donor-mixture cohort (ie, either all red blood cell transfusions exclusively from male donors, or all exclusively from female donors without a history of pregnancy, or all exclusively from female donors with a history of pregnancy). The association between mortality and exposure to transfusions from ever-pregnant or never-pregnant female donors was analyzed using life tables and time-varying Cox proportional hazards models. Exposures: Red blood cell transfusions from ever-pregnant or never-pregnant female donors, compared with red blood cell transfusions from male donors. Main Outcomes and Measures: All-cause mortality during follow-up. Results: The cohort for the primary analyses consisted of 31 118 patients (median age, 65 [interquartile range, 42-77] years; 52% female) who received 59 320 red blood cell transfusions exclusively from 1 of 3 types of donors (88% male; 6% ever-pregnant female; and 6% never-pregnant female). The number of deaths in this cohort was 3969 (13% mortality). For male recipients of red blood cell transfusions, all-cause mortality rates after a red blood cell transfusion from an ever-pregnant female donor vs male donor were 101 vs 80 deaths per 1000 person-years (time-dependent "per transfusion" hazard ratio [HR] for death, 1.13 [95% CI, 1.01-1.26]). For receipt of transfusion from a never-pregnant female donor vs male donor, mortality rates were 78 vs 80 deaths per 1000 person-years (HR, 0.93 [95% CI, 0.81-1.06]). Among female recipients of red blood cell transfusions, mortality rates for an ever-pregnant female donor vs male donor were 74 vs 62 per 1000 person-years (HR, 0.99 [95% CI, 0.87 to 1.13]); for a never-pregnant female donor vs male donor, mortality rates were 74 vs 62 per 1000 person-years (HR, 1.01 [95% CI, 0.88-1.15]). Conclusions and Relevance: Among patients who received red blood cell transfusions, receipt of a transfusion from an ever-pregnant female donor, compared with a male donor, was associated with increased all-cause mortality among male recipients but not among female recipients. Transfusions from never-pregnant female donors were not associated with increased mortality among male or female recipients. Further research is needed to replicate these findings, determine their clinical significance, and identify the underlying mechanism.
[Mh] Termos MeSH primário: Doadores de Sangue
Transfusão de Eritrócitos/mortalidade
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Criança
Pré-Escolar
Eritrócitos/imunologia
Feminino
Seguimentos
Seres Humanos
Lactente
Masculino
Meia-Idade
Gravidez
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.14825


  10 / 7662 MEDLINE  
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[PMID]:28982913
[Au] Autor:Abe T; Amano H; Hanada K; Minami T; Yonehara S; Hattori M; Kobayashi T; Fukuda T; Nakahara M; Ohdan H; Noriyuki T
[Ad] Endereço:Department of Surgery, Onomichi General Hospital, Onomichi, Japan.
[Ti] Título:Perioperative Red Blood Cell Transfusion Is Associated with Poor Long-term Survival in Pancreatic Adenocarcinoma.
[So] Source:Anticancer Res;37(10):5863-5870, 2017 10.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIM: Perioperative red blood cell transfusion (RBCT) can negatively affect the host's immune system. We investigated the effects of perioperative RBCT on long-term survival among patients with pancreatic ductal adenocarcinoma (PDAC). PATIENTS AND METHODS: We retrospectively evaluated 148 patients with PDAC who underwent surgery with curative intent (33 who received RBCTs and 115 who did not). Significant prognostic variables on univariate analysis were subjected to multivariate analyses using a Cox proportional hazard regression model. RESULTS: Both groups exhibited significant differences in age, preoperative haemoglobin levels, carbohydrate antigen 19-9 levels, maximum tumour size, tumour staging, operative time, intraoperative blood loss, major vascular resection, and the proportion of pancreaticoduodenectomies performed. Patients who underwent RBCTs exhibited significantly poorer overall survival (p<0.001) and recurrence-free survival (p<0.001) compared to patients who did not. CONCLUSION: Perioperative RBCT was associated with poorer long-term survival among patients with PDAC who underwent surgery with curative intent.
[Mh] Termos MeSH primário: Perda Sanguínea Cirúrgica/prevenção & controle
Carcinoma Ductal Pancreático/cirurgia
Transfusão de Eritrócitos/mortalidade
Neoplasias Pancreáticas/cirurgia
Pancreaticoduodenectomia/mortalidade
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Perda Sanguínea Cirúrgica/mortalidade
Carcinoma Ductal Pancreático/mortalidade
Carcinoma Ductal Pancreático/patologia
Progressão da Doença
Intervalo Livre de Doença
Transfusão de Eritrócitos/efeitos adversos
Feminino
Seres Humanos
Cuidados Intraoperatórios
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Análise Multivariada
Neoplasias Pancreáticas/mortalidade
Neoplasias Pancreáticas/patologia
Pancreaticoduodenectomia/efeitos adversos
Pontuação de Propensão
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
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:171007
[St] Status:MEDLINE



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