Clinical and laboratorial parameters: The following clinical parameters were investigated: demographic data, pre-existing diseases and current drug use. A complete physical examination was performed. All laboratory tests were performed in the Instituto de Nefrologia do Ceará, on the first and second days after the diagnosis of visceral leishmaniasis. All studies were performed beginning at 7AM after an overnight fast, with patients supine for 12h. The following parameters were measured: full blood count, total serum proteins, albumin and globulins, serum sodium and uric acid; plasma renin, ACTH, cortisol, aldosterone, TSH and free T 4 . First morning urine was collected simultaneously, and serum and urine osmolalities were determined. A daily urine sample was collected with patients on their usual diets for osmolality, sodium, urea and uric acid determinations. A second 24h-urine sample for 17-hydroxysteroids determination was collected using as conservation 20 mL of hydrochloric acid 8M. Creatinine clearance was calculated after fluid overload with 1500 mL of water drunk over 30 minutes. The bladder was empty and the time rigorously measured. There followed three periods of urine collection (one hour each) and mean creatinine clearance was calculated and adjusted to 1.73 m 2 body surface area. Urinary fractional excretions
A study (Jadad score equal to 4) performed upon 124 patients in the age range from 6 months to 15 years, with a body weight above 8 kg and undergoing elective or emergency surgery and who remain without eating for a minimum period of 8 hours after surgery. Patients with a signiicant blood loss during surgery, with surgery associated with an excess secretion of ADH (cranial or thoracic) or with abnormal secretion of ADH, nephrogenic diabetes insipidus, kidney disease, chronic pulmonary disease or disorders of the pituitary gland or hypothalamus, as well as those using dugs to stimulate the secretion of ADH were excluded. The patients were randomized for one of four luid systems: saline 0.9% or saline 0.45%, both with an addition of glycose at 5 or 2.5% in 50 or 100% of the maintenance rate calculated by the Holliday & Segar rule. Plasmatic electrolytes, osmolality and ADH in the anesthetic induction were measured, 8 and 24 hours after surgery. Glycose and ketones were measured in the blood every 4 hours. Electrolytes and osmolality were measured in urine samples. The plasmatic sodium concentrations dropped in both the groups which received saline 0.45% 8 hours after surgery (a group with a maintenance rate of 100%: -1.5 ±2.3 mmol/L, and a group with a maintenance rate of 50%: -1.9 ±2.0 mmol/L; p < 0.01). Hyponatremia was more common in the groups which received saline 0.45% than in the groups which received saline 0.9% 8 hours after surgery (30 versus 10%; p = 0.02) but not 24 hours after the surgical procedure. The authors concluded that the risk of hyponatremia was reduced by the isotonic saline solution, but not by the luid restriction.
In this paper’s study case, the patient had difficulty adhering properly to a low-iodine diet due to her low socioeconomic sta- tus and age; only laver, seaweed, and tangleweed were restrict- ed on her diet, and the level of sodium and the volume of water intake was not changed. Therefore, in the absence of an ade- quately low-iodine and low-sodium diet, the cause for her hy- ponatremia occurring from hypothyroidism has to be associat- ed with thyroid hormone withdrawal. Since residual thyroid tissue is thyroid stimulating hormone dependent, the blood concentration of thyroid stimulating hormone has to be in- creased to improve the efficiency of radioiodine intake. Con- ventionally, this has been done through thyroid hormone with- drawal. However, recent studies suggest that hypothyroidism induced by thyroid hormone withdrawal degrades the quality of the patient’s life, and an alternative way to increase the blood concentration of thyroid stimulating hormone was intro-
the patient was diagnosed with severe hyponatremia, his medications were reevaluated; however, no anti-depressants, diuretics or other medications that can cause hyponatremia were reported. The patient’s urine osmolarity was 280 mOsm/kg, and the urine sodium level was 96.02 mmol/L. A random cortisol level was detected as 17.6 ug/dL (reference range: 5-25 ug/dL). Arterial blood gas testing revealed a hypercarbia with pCO 2 of 66.2 mmHg and pH of 7.33. No signs of an acute cerebrovascular event or cerebral edema were detected in brain computed tomography. Myxedema coma was diagnosed, and L-thyroxine sodium 500 μg was administered once orally and continued at a dose of 100 μg/day by nasogastric tube. Isotonic saline was started at a rate of 100 mL/h. Hyponatremia recovered gradually with isotonic saline infusion and L-thyroxine therapy. On the ifth day of her hospitalization, the control serum sodium level was 134 mmol/L; the patient’s mental state was markedly improved, and the patient was discharged.
Complete blood count and renal function tests (blood urea 25 mg/dl, serum creatinine 0.34 mg/dl) were within normal ranges. Hyponatremia (125 mEq/L), hypochloremia (90 mEq/l), hypo- kalemia (2.9 mEq/L), hypoalbuminemia (2.9 gr/dl) and hyper- cholesterolemia (293 mg/dl) were detected. Analysis of blood gases howed metabolic alkalosis (pH: 7.50, bicarbonates 29.8 mEq/L). Urinalysis indicated Ph of 7, density:1005 and +3 pro- teins. The 24-hour urine protein test result showed 159 mg/m2/ hr and the fractional excretion of sodium (FENa) was calculated to be 10% while the fractional excretion of potassium (FEK) was 14%. No glycosuria or hypercalciuria was found. The renin test performed in bed revealed 2500 pg/ml (2.77-61.80 pg/ml) and aldosterone was determined at 745 (30-350 pg/ml). The antidiuretic hormone was not evaluated.
The severe infantile form of PH1 is very rare (2,3,9). It is characterized by chronic renal insufﬁ ciency with massive parenchymal oxalosis; these patients did not develop renal calculi. Older children, on the other hand, present with symptomes of urolithiasis or, in some cases, complete obstruction with acute renal failure (9). Both patients were admitted exhibiting clinical picture of acute renal failure including elevated blood urea nitrogen and creatinine levels, hyperphosphatemia, hyperuricemia, hyponatremia, metabolic acidosis and hypertension, and they had severe anemia. On admission both unremarkable except for restlessness and cutis marmoratus. His
The clinical investigation included a review of all demographic characteristics, clinical signs, symptoms presented by each patient upon hospital admission, and use of antiretroviral drugs. Laboratory data included the assessment of serum urea, creatinine, transaminases (AST, ALT), direct and indirect bilirubin, lactate dehydrogenase (LDH), complete blood count, CD4+ T-cell count, HIV viral load, and urinalysis.
The hemodynamic parameters in the seventh day fol- lowing the trauma are presented on Table 2. Cardiac fre- quency and maximum systolic and diastolic blood pres- sure above normal limits in all cases. The patients in the hyponatremia group showed systolic blood pressure low- er than the normonatremia group (p <0.05). The hypona- tremics, when compared with the normonatremia group, also showed higher serum potassium (p <0.01), higher di- uresis (p=0.01) and negative water balance (p <0.01) on days 6 and 7 following the trauma (Table 3).
valley of Assam, Group O is the commonest with Rh-D antigen, the occurrence of blood Group A and B with Rh-D antigen is nearly equal and frequency of AB is least. The frequency of Rh-D negative is, although, slightly lower in present series than the data of the country. The present study is therefore useful in providing information on the status of ABO and Rh-D blood groups distribution of the region and the knowledge of it will help in effective management of regional blood transfusion service of the area. However, studies of other minor blood group antigens are also needed in order to effective management for repeated transfusion dependant transfusions.
nmol/L spot) by pipetting 30 μL of an 857 nmol/L aqueous solution on the pre-imprinted cir- cles along with 50 μl of whole blood surrogate (see below). After 2 h of drying, three spots were punched out entirely with the 3-mm hand puncher to investigate the degree of elution during (1) 60 min of ultrasonication. The remaining nine DMS were used to assess the relative recoveries after (2) incubation at 37°C in a water bath under constant agitation for enzymatic digestion of the polyglutamates, (3) heating and centrifugation, and (4) SPE clean-up. To investigate the analyte loss rates, [ 2 H 4 ]-5-CH 3 -H 4 folate was added after each extraction step
COX-1 acts primarily in the control of renal GFR, while COX-2 plays a role in sodium and water excretion. Blocking both enzymes prevents PGE2 production. This enzyme regulates the reab- sorption of sodium and water in the renal tubules (diuretic and natriuretic effect), besides optimi- zing blood perfusion to the renal medulla, whi- ch contributes to this effect. PGE2 is considered a tubular PG, while PGI2 is vascular. However, in physiological situations, such enzymes are not primary components of the hydroelectrolytic ho- meostasis generated in the kidneys, since the base- line production rate of prostaglandins is relatively
Yoshizaki et al. reported that all rice koji had anti-obesity and anti-diabetes effects through mechanisms other than regulation of food intake. Koji, particularly white and red koji, improves glucose tolerance by increasing the expression of glucose transporter 4 protein in muscle, thereby increasing glucose uptake (Yoshizaki et al., 2014). These finding and sake influence glucose metabolism and contribute to suppressing the elevation of blood glucose level after drinking these alcohol beverages. However, the molecular mechanism underlying the effect of the ingredients of shochu and sake on glucose metabolism is still unclear. But the detailed mechanisms underlying these beneficial effects of shochu and sake on the glucose metabolism are not fully understood.
Among patients with decompensated heart failure and similar clinical conditions, those with Chagas disease had worse prognoses, probably because of a higher degree of cardiac impairment (reduced ejection fraction), greater hemodynamic instability (lower systolic blood pressure and heart rate), increased activation of the rennin-angiotensin system (lower serum sodium), and increased levels of cytokines (TNF-D).
infarct, metastasis, glioma, multiple sclerosis, enceph- alitis, and radiation or chemotherapy should be maid. The first step in the treatment of ODS is prevent neurological injury identifying which patients are at risk of the osmotic demyelination syndrome. The risk of ODS appears to be greatest when the rate of cor- rection is greater than 10-15 mmol/L/day. In symp- tomatic acute hyponatremia, the initial rate of cor- rection can be 1-2 mmol/L/h for several hours if on any day of treatment the total daily correction is not more than 8 mmol/L/day 26
The practice of auto-transfusion is highly considered due to its safety and economic beneficts. It comprises two basic modalities: “Reinfusion” and “Pre-Collection” of blood. The reinfusion uses the patient’s own blood spurted either from the patient’s previous hemorrhage or during the surgery. The auto-transfusion of Pre-Collect uses the patient’s blood tajen before surgery and it consists two basic modalities: The multiple Pre-Collection in which the blood is taken from the patient much before the scheduled sate of the surgery and the Pre-Collection done 10-30 minutes before surgery, which we presently designated as “Immediate Pre-Collection” (or Pre- Deposit for Immediate Utilization) which constitutes the basic topic of this essay (Rev. Col. Bras. Cir. 2008; 35(4): 259-263).
This paper is aimed to develop online blood donation information. The entire work has been developed keeping in view of the distributed client server computing technology, in mind. The system is to create an e- Information about the donor and organization that are related to donating the blood. Through this application any person who is interested in donating blood can register himself as a donor. Moreover if any general consumer wants to make request blood online, he can also take the help of this site. The work has been planned to be having the view of distributed architecture, with centralized storage of the database. The application for the storage of the data has been planned. Using the constructs of SQL Server, all the user interfaces have been designed using ASP.Net technologies. The database connectivity is planned using the “SQL Connection” methodology . The standards of security and data protective mechanism have been given a big choice for proper usage. The application takes care of different modules and their associated reports, which are produced as per the applicable strategies and standards that are put forwarded by the administrative staff.
After approval in the basis of questionnaire mentioned above, the next step before the blood donation consisted of filling out an anonymous self- exclusion card, in which the donors were asked if there was any possibility that they might be infected with HIV. Such cards were identified only and by a code that prevented other people from identifying the donor, and the cards were filed in locked boxes that were only opened in the absence of the donor. All subjects approved in the hematological prescreening and in the questionnaire were submitted to blood collection, and their blood was subsequently submitted for serologic laboratory analysis. The blood donations from those who replied affirmatively on the self-exclusion cards, were automatically discarded according to the rules routinely adopted by the blood bank for such cases, even if their exams did not identify any obstacle to donation.
from other pulmonary ﬁbrotic diseases such as hypersensitivity pneumonitis (HP) and non-speciﬁc interstitial pneumonia (NSIP). Gene microarray of lung biopsies from patients with IPF reveals a distinct pattern, with increased expression of tissue remodelling, epithelial, and myoﬁbroblast genes, whereas HP shows a greater expression of inﬂammatory and immune genes . Matrix metalloproteinases (MMPs), especially MMP7, also show increased gene expression in IPF lungs . Interestingly, NSIP, which is often difﬁcult to differentiate from IPF and HP, shows a different pattern of gene expression, although some cases resemble the proﬁle of either IPF or HP. These studies imply that different patterns of biomarkers might distinguish these different types of pulmonary ﬁbrosis, and they suggest that blood markers could be identiﬁed for this purpose.
Dengue is an endemic/epidemic arboviral disease with a variable symptomatic benign course, but potentially fatal. Once in an inhabited area, the disease will exist forever, with the best achievement being to keep vectors suppressed and the disease under control. Tiger mosquitoes (aedes aegypti, aedes albopictus) are active breeders and urban hunters, becoming resistant to pesticides. Global warming and population growth are propelling the disease worldwide at tropical and subtropical regions, victimizing new populations. Dengue virus is very infective, and has been transmitted by needlestick, intrapartum, through blood transfusion and mucosal contact with blood. One patient got den- gue while undergoing bone marrow transplantation. We address the growing dengue epidemics in Brazil, with more than half a million official cases in 2007, to estimate the risks of transfusion transmitted dengue. Calculations however were surpassed by reality: the major Blood Center in Brazil (FHSP-USP) has found dengue virus in one out of each thousand blood units. In 2007, industry sold 2,6 million disposable blood bags in Brazil. Plotting data from FHSP-USP to the whole country, 2600 blood units would have been infective. Through blood components, around 5000 patients must have received dengue virus intravenously. Beatty et al. estimated to be 1:1300 the risk for dengue transmission through blood transfusion in Puerto Rico, close to what has been demonstrated in Sao Paulo. Throughout Brazil, the average risk may be lower, but the epidemics grows towards a worst scenario. Whatever the risk is, it imposes that all blood units in Brazil (and wherever dengue is endemic) must be EIA tested for dengue NS1 antigen. This marker appears early after infection, and the EIA testing platform is available at all blood banks. Also, donors must report febrile states up to two weeks after donation. Morbidity from dengue virus injected in hospitalized patients is unknown, but it may lead to catastrophic outcomes and to occupational and institutional risks. Physicians and healthcare workers and managers might be aware of this threat – and must start enforcing testing. This EIA test must be included in donor serology for all kinds of transplantation. Rev. bras. hematol. hemoter. 2008;30(1):64-66.