ABSTRACT
Background: Dengue is an infectious disease with a recurring incidence, especially in developing countries. Despite recent economic growth, success in disease control has not been achieved, and dengue has evolved from cyclic epidemic outbreaks to a lack of seasonality. The lack of scientific basis for the proper management of cases with hemorrhagic manifestations, especially regarding transfusion procedures, might contribute to the high death rate in potentially avoidable cases. Objective: The aim of the study was to identify the clinical and laboratory manifestations in hemorrhagic dengue fever treated at the emergency services in Rio Branco, AC, Brazil, as well as to describe transfusion characteristics of patients and identify possible prognostic factors. Methods: A retrospective descriptive study was performed to analyze the distribution of relative frequencies of clinical and laboratory variables. The study was carried out in Rio Branco with confirmed dengue fever cases. Secondary data were obtained by Acre Epidemiological Surveillance teams of cases with bleeding or platelet counts under 100.0 × 109/L. The patients' clinical, laboratory and transfusion data were obtained from hospital records. Results: A total of 90,553 dengue cases were reported of which 7,447 had serologic confirmation; 267 cases had hemorrhagic manifestations and 193 patients were located. Nearly half of the patients had anemia and the mean of the lowest platelet count of these patients was 26.4 × 109/L. Platelet concentrate was transfused in 22.3% of cases with a mean of 7.5 IU/patient, fresh frozen plasma in 21.2% with a mean of 5.2 IU/patient and just 2.6% of patients received concentrated red blood cells with a mean of 3.2 IU/patient. Bleeding led to transfusions. Signs of plasma leakage and cardiopulmonary dysfunction were correlated to unfavorable outcomes...
Subject(s)
Humans , Blood Transfusion , Hemorrhagic Disorders , Platelet Transfusion , Severe DengueABSTRACT
A cross-sectional study was conducted to determine the distribution of serum cadmium (Cd) levels in blood donors in Rio Branco, Acre State, Brazil. Blood samples were obtained from 922 volunteer blood donors from 18 to 65 years of age at the Hemoacre blood center in 2010-2011. Mean serum Cd was 0.37µg/L (95%CI: 0.33-0.41). Increased serum Cd was associated with lower schooling; individuals with less than five years of schooling showed a mean Cd of 0.61µg/L (95%CI: 0.34-0.89), compared to 0.34µg/L (95%CI: 0.28-0.40) among those with more than nine years of schooling. Mean serum Cd was three times higher among smokers. Smoking showed a positive association with Cd level, with an OR of 12.36 (95%CI: 7.70-19.84). Meanwhile, serum Cd was lower among individuals that regularly drank tea, as compared to non-tea drinkers. Serum Cd levels were mostly below the reference value (88.3% of participants). Mean serum Cd in the current study indicates that in general the population studied here is not exposed to worrisome Cd levels.
Objetivou-se, por meio de estudo transversal, determinar a distribuição dos níveis séricos de cádmio (Cd) em doadores de sangue em Rio Branco, Acre, Brasil. O sangue foi obtido de 922 doadores voluntários entre 18 e 65 anos no Hemoacre, entre 2010-2011. A média da concentração de Cd foi de 0,37µg/L (IC95%: 0,33-0,41). Houve tendência de aumento com a diminuição do nível de escolaridade; indivíduos com menos de cinco anos de estudo apresentaram média de 0,61µg/L (IC95%: 0,34-0,89), enquanto aqueles com mais de nove anos de estudo obtiveram média de 0,34µg/L (IC95%: 0,28-0,40). A média da concentração de Cd apresentou-se três vezes maior entre os fumantes. O tabagismo demonstrou associação positiva com OR 12,36 (IC95%: 7,70-19,84). Já a concentração de Cd entre os indivíduos com hábitos de tomar chás apresenta- se menor quando comparada àqueles que não utilizam. Os níveis séricos de Cd foram, em sua maioria, abaixo do valor de referência (88,3% dos participantes). As médias encontradas no presente estudo indicam que, no geral, a população estudada não está exposta a níveis preocupantes de exposição ao Cd.
El objetivo de utilizar un estudio transversal para determinar la distribución de los niveles séricos de Cd en los donantes de Río Branco no expuestos al metal. Se obtuvo sangre de 922 voluntarios de entre 18 y 65 años en Hemoacre entre 2010-2011. La concentración media de Cd fue 0,37µg/L (IC95%: 0,33-0,41). Hubo una tendencia de aumento según el nivel educativo: las personas con menos de cinco años de estudio tenían una media de 0,61µg/l (IC95%: 0,34-0,89), mientras que quienes contaban con más de nueve años de escolaridad poseían un promedio 0,34µg/L (IC95%: 0,28-0,40). La concentración promedio de Cd se presentó tres veces mayor entre los fumadores. El consumo de cigarrillos mostró una asociación positiva con OR 12,36 (IC95%: 7,70-19,84). Ya la concentración de Cd en las personas con hábitos de tomar té era más pequeña en comparación con aquellos que no lo toman. Los niveles séricos de Cd fueron en su mayoría por debajo del valor de referencia (88,3% de los participantes). Los medios encontrados en este estudio indican que, en general, la población no está expuesta a niveles preocupantes de Cd.