Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 3.359
Filter
1.
Rev. colomb. anestesiol ; 49(3): e602, July-Sept. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1280185

ABSTRACT

Abstract Radical penectomy (RP) is infrequently performed as it is reserved for specific cases of penile cancer, hence the paucity of reports regarding surgical and anesthetic considerations. Acute postoperative pain, chronic post-surgical pain, concomitant mood disorders as well as a profound impact on the patient's quality of life have been documented. This case is of a patient with diabetes and coronary heart disease, who presented with advanced, over infected penile cancer, depressive disorder and a history of pain of neuropathic characteristics. The patient underwent radical penectomy using a combined spinal-epidural technique for anesthesia. Preoperatively, the patient was treated with pregabalin and magnesium sulphate, and later received a blood transfusion due to intraoperative blood loss. Adequate intra and postoperative analgesia was achieved with L-bupivacaine given through a peridural catheter during one week. Recovery was good, pain was stabilized to preoperative levels and the patient received pharmacological support and follow-up by psychiatry and the pain team.


Resumen La penectomía radical (PR) es una cirugía infrecuente, reservada para casos específicos de cáncer de pene, por lo que hay escasos informes sobre sus consideraciones quirúrgicas y anestésicas. Se ha documentado dolor agudo postoperatorio, dolor crónico posquirúrgico y alteraciones del estado de ánimo concomitantes, así como un profundo impacto en la calidad de vida posterior del paciente. Se presenta el caso de un paciente diabético y cardiópata coronario con cáncer de pene avanzado y sobreinfectado, trastorno depresivo y dolor previo de características neuropáticas, que recibe técnica combinada espinal-peridural para cirugía de penectomía radical. Se le trata también con pregabalina preoperatoria, sulfato de magnesio y transfusión por sangrado quirúrgico. Se otorgó una adecuada analgesia intra y postoperatoria, mediante catéter peridural con L-bupivacaína hasta por una semana. El paciente tuvo una buena recuperación, estabilización del dolor a niveles preoperatorios, controles y apoyo farmacológico por psiquiatría de enlace y equipo del dolor.


Subject(s)
Humans , Male , Aged , Penile Neoplasms , Penile Neoplasms/surgery , Catheters , Anesthetics , Pain, Postoperative , Psychiatry , Quality of Life , Blood Transfusion , Bupivacaine , Coronary Disease , Depressive Disorder , Pain Management , Analgesia , Anesthesia , Magnesium Sulfate
2.
Rev. bras. ortop ; 56(4): 463-469, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1341171

ABSTRACT

Abstract Objectives The present paper aims to (1) verify the incidence and volume of blood transfusion among patients undergoing unilateral cemented total knee arthroplasty (TKA) in a single Brazilian reference center; (2) identify pre and perioperative variables to determine subjects with higher risk (i.e., predictive factors) for blood transfusion within 48 hours following surgery; (3) estimate the risk of blood transfusion during the first 48 hours after the procedure. Methods The initial sample consisted of all patients undergoing TKA from August 2010 to August 2013. After applying the exclusion criteria, 234 patients aged 30 to 83 years old and diagnosed with primary or secondary osteoarthritis due to rheumatoid arthritis remained in the study. Results Preoperative hemoglobin levels ≤12.3 g/dL and ischemia time ≥87 minutes were independent predictors for post-TKA blood transfusion, with a relative risk of 2.48 and 1.78, respectively. Approximately half of the TKA patients (51.3%) presenting these two variables required a blood transfusion. Conclusion The incidence of post-TKA blood transfusion was 33.7%. On average, each transfused patient received 480 mL of packed red blood cells. Preoperative hemoglobin levels ≤12.3 g/dL (p < 0.001) and ischemia time ≥87 minutes (p < 0.047) were independent predictors for blood transfusion in TKA using a pneumatic cuff, with a relative risk of 2.48 and 1.78, respectively. Age, gender, diagnosis, or body mass index were not considered independent predictors for the need for blood transfusion upto 48 hours after the procedure.


Resumo Objetivos O presente estudo tem como objetivos (1) verificar a incidência e o volume de transfusão sanguínea entre os pacientes submetidos à artroplastia total do joelho (ATJ) unilateral cimentada em um único centro de referência nacional; (2) identificar variáveis pré e perioperatórias que nos permitam identificar os indivíduos sob maior risco (fatores preditores) quanto à necessidade de transfusão sanguínea nas 48 horas subsequentes à realização da cirurgia; (3) estimar o risco de transfusão sanguínea durante as primeiras 48 horas após o procedimento. Métodos A amostra inicial foi constituída por todos os pacientes submetidos à ATJ entre agosto de 2010 e agosto de 2013. Após aplicação dos critérios de exclusão, permaneceram no estudo 234 pacientes com idade entre 30 e 83 anos, portadores de osteaoartrose primária ou secundária a artrite reumatoide. Resultados A análise dos resultados mostrou que valores de hemoglobina préoperatória ≤12,3 g/dL e tempo de isquemia ≥87 minutos são preditores independentes para hemotransfusão após ATJ, com risco relativo de 2,48 e 1,78, respectivamente. Aproximadamente metade dos pacientes (51,3%) submetidos a ATJ com essas duas variáveis necessitaram de hemotransfusão. Conclusão A incidência de transfusão sanguínea após ATJ foi de 33,7%. Em média, cada paciente foi transfundido com 480 mL de concentrado de hemácias. Concentração de hemoglobina pré-operatória ≤12,3 g/dL (p < 0,001) e tempo de isquemia ≥87 minutos (p < 0,047) foram preditores independentes para hemotransfusão em ATJ sob uso de manguito pneumático, com risco relativo de 2,48 e 1,78, respectivamente. A idade, o gênero, diagnóstico ou índice de massa corporal não foram considerados preditores independentes para a necessidade de hemotransfusão até 48 horas após o procedimento de artroplastia.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Blood Transfusion , Arthroplasty, Replacement, Knee , Osteoarthritis, Knee
3.
Rev. cuba. invest. bioméd ; 40(2): e1119, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1347454

ABSTRACT

Introducción: El desempeño competente del personal médico en medicina transfusional implica profundos conocimientos que no recibe durante el proceso formativo. Objetivo: Identificar elementos para la normalización de la competencia en medicina transfusional para la especialidad Anestesiología y Reanimación. Métodos: Estudio educacional de corte transversal. Se realizó un análisis documental sobre normalización de las competencias profesionales en Cuba y sobre los componentes de la competencia en medicina transfusional para la especialidad. Asimismo, se examinaron los contenidos y habilidades de medicina transfusional en el programa de la residencia. Finalmente, fueron entrevistados profesores de la especialidad. Resultados: La competencia abarca conocimientos sobre riesgos de transmisión de infecciones al paciente, prescripción segura de componentes sanguíneos, reconocimiento de las reacciones transfusionales, ejecución y enseñanza al no graduado de los procedimientos para la transfusión de sangre alogénica. Implica conocer y actualizarse en los aspectos éticos, científicos y legales involucrados. Incluye demostrar conocimientos, habilidades y valores para la preparación preoperatoria de los pacientes con anemia, riesgo hemorrágico y otras enfermedades hematológicas, para el empleo de alternativas y para el ahorro de componentes sanguíneos. Los profesores reconocieron que al comenzar la residencia es necesario un entrenamiento, para luego poder realizar una práctica transfusional segura. Conclusiones: Ser competente en medicina transfusional, subdisciplina de la especialidad Anestesiología y Reanimación, demanda movilizar un conjunto de conocimientos, habilidades, actitudes y valores de manera simultánea, interrelacionada y oportuna para transfundir menos y mejor, con más seguridad y menor costo(AU)


Introduction: Competent performance by the health care personnel in transfusion medicine implies deep knowledge not received during training. Objective: Identify elements of competence standardization in transfusion medicine for the specialty of anesthesiology and resuscitation. Methods: A cross-sectional educational study was conducted. A document analysis was carried out about standardization of professional competences in Cuba and about the components of competence in transfusion medicine for the specialty. Examination was also performed of transfusion medicine contents and skills in the residency program. Finally, professors from the specialty were interviewed. Results: Competence comprises knowledge about risks for the transmission of infections to patients, safe prescription of blood components, identification of transfusion reactions, and performance of and undergraduate training in allogeneic blood transfusion procedures. It implies knowledge and updated awareness of the ethical, scientific and legal aspects involved. It includes demonstrating knowledge, skills and values related to preoperative preparation of patients with anemia, hemorrhagic risk and other hematologic diseases, to use alternatives and save blood components. The professors recognized that training is required at the start of the residency program to ensure the performance of safe transfusion practices. Conclusions: Being competent in transfusion medicine, a subdiscipline of the specialty of Anesthesiology and Resuscitation, requires mobilization of a set of knowledge, skills, attitudes and values in a simultaneous, interrelated and timely fashion to transfuse less but better, with greater safety and at a lower cost(AU)


Subject(s)
Humans , Male , Female , Reference Standards , Blood Transfusion , Delivery of Health Care , Transfusion Medicine , Hematologic Diseases , Anesthesiology , Transfusion Reaction
4.
Rev. méd. Urug ; 37(1): e502, mar. 2021.
Article in Spanish | LILACS, BNUY | ID: biblio-1180964

ABSTRACT

Resumen: La transfusión de sangre ha sido identificada como uno de los procedimientos médicos más sobreutilizados en pacientes hospitalizados. Una estrategia que permitiría reducir la exposición de los pacientes a la sangre es a través de la implementación de una política de transfusión de una sola unidad, en lugar de dos, para pacientes estables, sin hemorragia y con anemia sintomática. La decisión de transfundir sangre es compleja y depende de varios factores, además, los riesgos de la transfusión se deben sopesar contra los beneficios esperados. La transfusión de dos unidades de sangre a la vez ya no se considera una forma de tratamiento "estándar" para pacientes anémicos sin sangrado activo. Existe una gran oportunidad para reducir el uso excesivo de la transfusión y fomentar las transfusiones de una sola unidad.


Summary: Blood transfusion has been identified as one of the most overused medical procedures in hospitalized patients. One strategy that would reduce the exposure of patients to blood is through the implementation of a single-unit regime for stable patients without bleeding and with symptomatic anemia. The decision to transfuse blood is complex and depends on several factors, in addition, the risks of transfusion must be weighed against the expected benefits. Transfusion of two units of blood at the same time is no longer considered a "standard" form of treatment for anemic patients without active bleeding. There is a great opportunity to reduce the overuse of transfusion and encourage single-unit transfusions.


Resumo: A transfusão de sangue foi identificada como um dos procedimentos médicos usados de mais em pacientes hospitalizados. Uma estratégia que reduziria a exposição dos pacientes ao sangue é por meio da implantação de uma política transfusional de unidade única para pacientes estáveis, sem sangramento e com anemia sintomática. A decisão de transfundir sangue é complexa e depende de vários fatores, além disso, os riscos da transfusão devem ser analisados em relação aos benefícios esperados. A transfusão de duas unidades de sangue ao mesmo tempo não é mais considerada uma forma "padrão" de tratamento para pacientes anêmicos sem sangramento ativo. Há uma grande oportunidade de reduzir o uso excessivo de transfusões e incentivar as transfusões de uma única unidade.


Subject(s)
Reference Standards , Blood Transfusion
5.
Pesqui. vet. bras ; 41: e06654, 2021.
Article in English | ID: biblio-1180877

ABSTRACT

This study aimed to determine the erythrocyte phenotypes of the feline AB system and to check the presence of antigens other than those present in the feline AB system in domestic cats from Ilhéus-Itabuna microregion, Bahia, Brazil. Three-hundred feline blood samples were collected at the Veterinary Hospital of the "Universidade Estadual de Santa Cruz" (UESC) and in home visits to perform blood phenotyping using the tube-method testing. The reverse phenotyping was made between cats that tested phenotype B with blood samples of cats that tested phenotype A to confirm the blood phenotype B. The cross-tested among cats with phenotype A was made in order to verify the presence of different antigens of AB system in this blood phenotype. The results underwent macroscopic and microscopic analyses. Among the 300 animals tested, regarding breed, 290 were mixed-breed cats and among the remaining ten, five were Persians, four Siamese, and one Angora. 297 (99%) presented with phenotype A (including all the breeding cats) and three (1%) with phenotype B, and all this cats were mixed-breed cats. None (0%) of the cats showed the phenotype AB. All phenotype B bloods reacted to reverse phenotyping with phenotype A, confirming the phenotype B of these cats. All phenotype A bloods were compatible among each other, so no further erythrocyte antigens were detected through this test. The mother of one of the phenotype B cats was identified and had phenotype A, demonstrating phenotype A parents with phenotype B offspring. This finding indicates heterozygosis in the studied population. This data enable to conclude that the studied population presented different erythrocyte phenotypes, subsequently highlighting the importance of conducting phenotype analyses in these animals before performing blood transfusion to avoid serious hemolytic complications associated with incompatibility.(AU)


O objetivo deste estudo foi determinar a frequência dos fenótipos eritrocitários do sistema AB felino e verificar a presença de outros antígenos, não pertencentes ao sistema AB felino, em gatos domésticos das cidades de Ilhéus e Itabuna, Bahia, Brasil. Amostras de sangue de 300 gatos foram coletadas no Hospital Veterinário da Universidade Estadual de Santa Cruz (UESC) e em visitas domiciliares para realizar a fenotipagem sanguínea usando o método de tubo. A fenotipagem reversa foi realizada em gatos que testaram o fenótipo B com amostras que testaram o fenótipo A, para confirmação do fenótipo sanguíneo. O teste cruzado foi realizado entre gatos do fenótipo A, para pesquisar a presença de diferentes antígenos do sistema AB dentro desse fenótipo sanguíneo. Os resultados foram submetidos a análises macroscópicas e microscópicas. Dos 300 animais testados, 110 eram machos e 190 fêmeas, e suas idades variaram de cinco meses à 15 anos. Sobre as raças, 290 eram gatos sem raça definida e dos 10 restantes, cinco eram Persas, quatro eram Siameses e um Angorá. 297 (99%) apresentaram fenótipo A (incluindo todos os gatos de raça) e três (1%) tiveram fenótipo B, sendo todos esses gatos sem raça definida. Nenhum (0%) dos gatos apresentou fenótipo AB. Todos os sangues com fenótipo B reagiram na fenotipagem reversa com o fenótipo A, confirmando o fenótipo B desses gatos. Todos os sangues com fenótipo A foram compatíveis entre si, portanto nenhum antígeno eritrocitário adicional foi detectado através deste teste. A genitora de um dos gatos com fenótipo B, foi encontrada e a mesma possuía fenótipo A, demonstrando pais com fenótipo A e cria com fenótipo B. Esse achado indica heterozigose na população estudada. Esses dados levam à conclusão de que diferentes fenótipos eritrocitários estão presentes na população estudada e destacam a importância da realização de testes fenotípicos nesses animais antes dos procedimentos de transfusão, a fim de evitar complicações hemolíticas graves decorrentes do envolvimento de animais incompatíveis.(AU)


Subject(s)
Animals , Cats , Phenotype , Blood Transfusion , Erythrocytes , Isoantibodies , Universities , Cats/blood
6.
São Paulo; SES/SP; 2 ed; 2021. 62 p. ilus.
Non-conventional in Portuguese | LILACS, ColecionaSUS, SES-SP, CONASS, SESSP-ACVSES | ID: biblio-1224717

Subject(s)
Blood , Blood Transfusion
7.
Article in Chinese | WPRIM | ID: wpr-880168

ABSTRACT

OBJECTIVE@#To investigate the indentification method of samples mistyped as O phenotype and to explore the precision transfusion strategy.@*METHODS@#The blood samples from donors and patients admitted in our center from 2018 to 2019 was collected. The samples with O phenotype suspected subtypes were further determined by tube test, adsorption-elution test, etc. Molecular testing was used to sequence the related blood type genes of the subjects.@*RESULTS@#Among 14 subjects misjudged as O, 11 different genotypes were identified, in which 3 blood donors were Ael02/O02, Bel03/O02, and one para-Bombay with B101/O02 (FUT1: h3h3; FUT2: Se@*CONCLUSION@#The phenotypes of Ael, Bel, Aw and para-Bombay subtypes are easily misjudged as type O. Molecular technology is helpful to identify the genotype of subtypes, and the corresponding transfusion strategies could be reasonably performed.


Subject(s)
ABO Blood-Group System , Alleles , Blood Transfusion , Fucosyltransferases/genetics , Genotype , Humans , Phenotype
8.
Article in Chinese | WPRIM | ID: wpr-880123

ABSTRACT

OBJECTIVE@#To analyze the use of blood products in patients at different ages.@*METHODS@#The clinical datas of the 10 784 patients transfused in Sichuan provincial people's hospital at 2017-2018 were retrospectively analyzed, and the basic condition of clinical blood using was statistically described. The patients were divided into the groups according to age and disease, then the use of various blood products in the patients with different diseases in different age groups was analyzed.@*RESULTS@#The age of blood transfusion patients was mainly 40-80 years old, and the most common disease was tumor(about 28%). The average annual transfusion volumes of red blood cells(RBC) were 24 936.5 U, of platelets(PLT) were 3 795 therapeutic doses of plasma were 2 455 500 ml, of cryoprecipitate were 3 461.5 U in our hospital. Most patients with hematologic malignancies and liver cirrhosis were transfused with two or more blood productions. For the patients with hematologic malignancies, the irradiated RBC (76.4%), PLT (67.8%), and suspended RBC (59.9%) were commonly used. And for liver cirrhosis patients, the suspended RBC (64.2%) and fresh frozen plasma(FFP) (59.4%) were commonly used. For the patients with trauma and chronic kidney disease(CKD), the suspended RBC (95.7% and 91.5%, respectively) was commonly used. In hematologic malignancies patients, the transfusion volume of irradiated RBC, PLT and FFP in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05); in trauma patients, the transfusion volume of suspended RBC in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05). In hematologic malignancies, trauma and liver cirrhosis patients, the proportion of PLT and/or plasma transfusion in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05), and the elderly patients were more likely to receive RBC transfusion only.@*CONCLUSION@#There is a difference in the distribution of blood product between the patients aged<60 years old and ≥60 years old in the same disease, and it is more likely that the elderly patients (aged ≥60 years old) receive RBC transfusion only, and correction of hypoxia is a major clinical consideration, so blood using plans should be made according to the patient population, moreover, the different transfusion strategies should be developed for different population to maximize the efficiency of blood using.


Subject(s)
Adult , Aged , Aged, 80 and over , Blood Component Transfusion , Blood Transfusion , Hospitals , Humans , Middle Aged , Plasma , Retrospective Studies
9.
Article in Chinese | WPRIM | ID: wpr-880068

ABSTRACT

There were three new blood group systems including the KANNO blood group system, the Sid blood group system and the CTL2 blood group system (provisional status), have been registered by the International Society of Blood Transfusion (ISBT) registered Science August 2019. The main reason for this update is that the significant SNPs of the KANNO blood group system (rs1800014) and the Sid blood group system (rs7224888) have been found through genome-wide association studies and whole exome sequencing. The new genetic evidences are consistent with the current immunological findings. In addition, although CTL2 antigen has been found on erythrocyte ghost (erythrocyte membrane) since 2017, CTL2 blood group system is still in provisional status due to lack of serological and genetic evidence. In this review, the experimental research advances of these three ISBT blood group systems and discuss the clinical value of the relevant researches was summarized briefly.


Subject(s)
Blood Group Antigens , Blood Transfusion , Genome-Wide Association Study , Humans
10.
Article in Chinese | WPRIM | ID: wpr-880062

ABSTRACT

OBJECTIVE@#To investigate the irregular antibody positive rate and antibody specificity in children with thalassemia received long-term blood transfusion in Hainan area and analyze the causes of antibody screening positive.@*METHODS@#Micro-column gel method was used to screen the irregular antibody in 49 children who received transfusion treatment in our hospital, and the antibody specificity of the positive samples was evaluated.@*RESULTS@#Fourteen of 49 cases showed positive for screening. Among them, 11 cases showed Rh blood group antibody after detecting antibody specificity, 1 case showed the coexistence of irregular antibody and autoantibody. One case for anti-JK@*CONCLUSION@#Most of the antibodies produced after long-term blood transfusion in the children with thalassemia belong to Rh blood group antibodies; the children with mixed thalassemia are more likely to produce antibodies; the antibody screening positive rate of Li nationality is higher than that of Han nationality, which may be caused by the genetic difference of blood type between Li nationality and Han nationality.


Subject(s)
ABO Blood-Group System , Blood Grouping and Crossmatching , Blood Transfusion , Child , Female , Humans , Infant , Male , Rh-Hr Blood-Group System , beta-Thalassemia
11.
Braz. j. med. biol. res ; 54(3): e10292, 2021. tab
Article in English | LILACS | ID: biblio-1153524

ABSTRACT

Although some investigations have been performed to determine the effects of transfusion load and suction pressure on renal function during intraoperative salvage autotransfusion, the precise threshold is still undetermined. A total of 625 patients undergoing surgery with the Continuous AutoTransfusion System (CATSplus) were enrolled and divided into groups according to the utilized suction pressure and transfusion volume. Plasma free hemoglobin (FHB) and creatinine clearance (CCr) were assayed to indicate the renal function. Both 0.03 MPa suction (≥4-unit load) and >5 units transfusion changed the levels of FHB and CCr significantly when measured 24 h post-operation compared to pre-operation. Under 0.02 MPa suction (≥4-unit load), the alteration of FHB and CCr returned to normal after 24 h. Under 3 units transfusion, the levels of FHB and CCr at 6 and 12 h post-operation changed significantly compared to pre-operation (P<0.05 or P<0.01, respectively), and this alteration could be restored to normal at 72 h post-operation. After an exhaustive investigation, less than 4 units transfusion and less than 0.03 MPa suction pressure are recommended for intraoperative salvage autotransfusion.


Subject(s)
Humans , Blood Transfusion , Blood Transfusion, Autologous , Postoperative Period , Suction
12.
Texto & contexto enferm ; 30: e20190060, 2021.
Article in English | LILACS, BDENF | ID: biblio-1252281

ABSTRACT

ABSTRACT Objective: to characterize the work process of nurses in hemotherapy in terms of prescribed procedures, antecedent norms and real work. Method: a qualitative study, carried out from February to December 2017, in a blood center in the North of the country, involving a sample of twenty-two nurses. Methodological triangulation with data collected through semi-structured interviews, institutional documents and protocols, participant observation and notes in a field diary were used. For data treatment and analysis, the resources of the Atlas.ti 8.2.1 software (Qualitative Research and Solutions) and the fundamentals of Historical Dialectical Materialism and Ergology were used. Results: the results showed that nurses work in different activities, recreating work according to the needs of the service. The assistance, educational and managerial work permeates the activities developed and is carried out in accordance with the legislation, seeking to guarantee the donor's health, the quality of the products and transfusion safety. Conclusion: the work situations of these professionals indicate that its uses are present in their daily lives, promoting dynamism between the previous norms and the renormalizations.


RESUMEN Objetivo: caracterizar el proceso de trabajo del enfermero en hemoterapia en relación a procedimientos prescritos, normas antecedentes y trabajo real. Método: estudio cualitativo, realizado de febrero a diciembre de 2017, en un banco de sangre de la región norte del país, con una muestra compuesta de veintidós enfermeros. Se utilizó triangulación metodológica con datos recolectados a través de entrevistas semiestructuradas, documentos y protocolos institucionales, observación participante y notas en un diario de campo. Para el tratamiento y análisis de los datos se utilizaron los recursos del software Atlas.ti 8.2.1 (Qualitative Research and Solutions) y los fundamentos del Materialismo Histórico Dialéctico y la Ergología. Resultados: los resultados mostraron que los enfermeros trabajan en diferentes actividades y recrean el trabajo de acuerdo a las necesidades del servicio. La labor asistencial, educativa y gerencial atraviesa las actividades desarrolladas y se lleva a cabo de conformidad con la legislación, a fin de garantizar la salud del donante, la calidad de los productos y la seguridad transfusional. Conclusión: la situación laboral de estos profesionales indica que los usos están presentes en su cotidianidad, y promueven el dinamismo entre las normas antecedentes y las renormalizaciones.


RESUMO Objetivo: caracterizar o processo de trabalho dos enfermeiros na hemoterapia quanto aos procedimentos prescritos, às normas antecedentes e ao trabalho real. Método: estudo qualitativo, realizado no período de fevereiro a dezembro de 2017, em um hemocentro na região norte do país, envolvendo uma amostra de vinte e dois enfermeiros. Foi utilizada a triangulação metodológica com dados colhidos através de entrevista semiestruturada, documentos e protocolos institucionais, observação participante e anotações em diário de campo. Para o tratamento e a análise dos dados, foram usados os recursos do software Atlas.ti 8.2.1 (Qualitative Research and Solutions) e os fundamentos do Materialismo Histórico-dialético e da Ergologia. Resultados: os resultados evidenciaram que os enfermeiros atuam em diferentes atividades, recriando o trabalho de acordo com as necessidades do serviço. O trabalho assistencial, educativo e gerencial permeia as atividades desenvolvidas e é realizado de acordo com as legislações, buscando garantir a saúde do doador, a qualidade dos produtos e a segurança transfusional. Conclusão: as situações de trabalho desses profissionais apontam que os usos de si se fazem presentes no seu cotidiano, promovendo o dinamismo entre as normas antecedentes e as renormalizações.


Subject(s)
Humans , Work , Blood Donors , Blood Transfusion , Hemotherapy Service , Nursing Care
13.
Rev. bras. oftalmol ; 80(4): e0026, 2021. graf
Article in English | LILACS | ID: biblio-1288636

ABSTRACT

ABSTRACT A 10-year-old Malay girl with underlying HbE/beta-thalassemia, on regular blood transfusion and deferoxamine iron chelation therapy, presented with two-month history of bilateral blurring of vision. On examination, her vision was 6/36 both eyes. Other optic nerve functions were normal. Anterior segment examination of both eyes was unremarkable. Fundus examination of both eyes revealed dull foveal reflex. Optical coherence tomography of both maculae showed increased central subfield thickness. Fundus fluorescence angiography showed patchy hypofluorescence over macular region for both eyes and late staining, indicating retinal pigment epithelium anomalies. A diagnosis of iron-chelation-therapy-related bilateral maculopathy was made. Patient was co-managed with pediatric hematology team to adjust the dose of deferoxamine, and was given three monthly appointments to monitor the progression of maculopathy at the ophthalmology clinic. However patient defaulted ophthalmology follow-up after the first visit.


RESUMO Uma menina malaia de 10 anos de idade com doença de base- B/beta-talassemia, em transfusão de sangue regular e terapia quelante de ferro deferoxamina, apresentou história de dois meses de visão turva bilateral. Ao exame, sua visão era de 6/36 em ambos os olhos. Outras funções do nervo óptico estavam normais. O exame do segmento anterior de ambos os olhos foi normal. Exame do fundo de ambos os olhos revelou reflexo foveal opaco. A tomografia de coerência óptica de ambas as máculas mostrou aumento da espessura do subcampo central. A angiografia de fluorescência do fundo mostrou hipofluorescência irregular sobre a região macular de ambos os olhos e coloração tardia, indicando anomalias de epitélio pigmentar da retina. Um diagnóstico de maculopatia bilateral relacionada à terapia quelante de ferro foi feito. A paciente foi avaliada em conjunto com a equipe de hematologia pediátrica para ajustar a dose de deferoxamina, e foram oferecidas três consultas mensais na clínica oftalmológica, para monitorar a progressão da maculopatia. No entanto, ela não compareceu para acompanhamento oftalmológico após a primeira visita.


Subject(s)
Humans , Female , Child , Siderophores/adverse effects , beta-Thalassemia/drug therapy , Deferoxamine/adverse effects , Transfusion Reaction , Macular Degeneration/complications , Blood Transfusion , Siderophores/therapeutic use , beta-Thalassemia/diagnosis , Deferoxamine/therapeutic use
14.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 65-71, jan.-dez. 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1146282

ABSTRACT

Objetivo: verificar a atuação da equipe de enfermagem durante a assistência em terapêutica transfusional. Método: pesquisa descritiva e exploratória, com abordagem quanti-qualitativa. Participaram do estudo 31 membros da equipe de enfermagem lotados em um hospital público e de ensino, habilitado como unidade de alta complexidade em oncologia. Os dados foram coletados entre setembro e dezembro de 2017 em duas etapas: por intermédio de entrevistas semiestruturadas e de um checklist para observação. Os dados foram agrupados, dispostos em tabelas e apresentados em frequência simples e valores absolutos e avaliados por análise temática. Resultados: a maioria dos profissionais referiu não se sentir apta a prestar a assistência transfusional. Observou-se não conformidade em aplicar normas de biossegurança, uma ineficaz monitoração do paciente e ausência do registro de informações sobre a assistência prestada. Conclusão: destaca-se a importância da capacitação contínua dos profissionais e a implementação de instrumentos que possam assegurar a assistência transfusional segura


Objective: this paper assesses the nurses' performance throughout transfusion therapy. Methods: it is a descriptive-exploratory research with both qualitative and quantitative approaches, which was performed with 31 members of the nursing team in a highly complex oncology unit at a public teaching hospital. Data collection took place from September to December 2017 by using semi-structured interviews and a checklist for observation. The data were organized in a spreadsheet for calculating simple frequencies and absolute values. After this, data were submitted to thematic analysis. Results: most professionals reported not being able to provide transfusion care, lacked information on proper care and monitored the patients ineffectively. Furthermore, they did not meet biosecurity standards. Conclusion: it is highlighted the importance of continuous training and implementation of instruments that can ensure safe transfusion care


Objetivo: verificar la actuación del equipo de enfermería durante la asistencia en terapéutica transfusional. Método: investigación descriptiva y exploratoria, con abordaje cuantitativo. Participaron del estudio treinta y un miembros del equipo de enfermería abarrotados en un hospital público y de enseñanza, habilitado como unidad de alta complejidad en oncología. Los datos fueron recolectados entre septiembre y diciembre de 2017 en dos etapas: por intermedio de entrevistas semiestructuradas y de un check list para observación. Los datos fueron agrupados, dispuestos en tablas y presentados en frecuencia simple y valores absolutos y también evaluados por análisis temático. Resultados: la mayoría de los profesionales mencionaron no sentirse aptos para prestar la asistencia transfusional. Se observó no conformidad en aplicar normas de bioseguridad, un ineficaz monitoreo del paciente y ausencia del registro de informaciones sobre la asistencia prestada. Conclusión: se destaca la importancia de la capacitación continua de los profesionales y la implementación de instrumentos que puedan asegurar la asistencia transfusional segura


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Blood Transfusion/nursing , Containment of Biohazards/nursing , Nursing, Team , Professional Training , Patient Safety , Medical Oncology , Monitoring, Physiologic/nursing , Nursing Care
15.
Rev. Col. Bras. Cir ; 48: e20202777, 2021.
Article in English | LILACS | ID: biblio-1250709

ABSTRACT

ABSTRACT The spleen is one of the most frequently affected organs in blunt abdominal trauma. Since Upadhyaya, the treatment of splenic trauma has undergone important changes. Currently, the consensus is that every splenic trauma presenting with hemodynamic stability should be initially treated nonoperatively, provided that the hospital has adequate structure and the patient does not present other conditions that indicate abdominal exploration. However, several topics regarding the nonoperative management (NOM) of splenic trauma are still controversial. Splenic angioembolization is a very useful tool for NOM, but there is no consensus on its precise indications. There is no definition in the literature as to how NOM should be conducted, neither about the periodicity of hematimetric control, the transfusion threshold that defines NOM failure, when to start venous thromboembolism prophylaxis, the need for control imaging, the duration of bed rest, and when it is safe to discharge the patient. The aim of this review is to make a critical analysis of the most recent literature on this topic, exposing the state of the art in the NOM of splenic trauma.


RESUMO O baço é um dos órgãos mais frequentemente afetados no trauma abdominal contuso. Desde os trabalhos de Upadhyaya, o tratamento do trauma esplênico vem sofrendo importantes modificações. Atualmente, é consenso que todo trauma esplênico que se apresenta com estabilidade hemodinâmica pode ser tratado inicialmente de forma não operatória, desde que o serviço possua estrutura adequada e o paciente não apresente outras condições que indiquem exploração da cavidade abdominal. Entretanto, vários tópicos permanecem controversos no que diz respeito ao tratamento não operatório (TNO) do trauma esplênico. A angioembolização esplênica é uma ferramenta de grande auxílio no TNO, porém não há consenso sobre suas indicações precisas. Não há uma definição na literatura a respeito da forma como o TNO deve ser conduzido, tampouco a respeito da periodicidade do controle hematimétrico, do limiar de transfusão que define falha do TNO, de quando iniciar a profilaxia contra tromboembolismo venoso, da necessidade de exames de imagem de controle, do período de repouso no leito, e de quando é seguro indicar alta hospitalar. O objetivo desta revisão é analisar de forma crítica a literatura a respeito desse tema, expondo o estado da arte no TNO do trauma esplênico.


Subject(s)
Humans , Wounds, Nonpenetrating/therapy , Abdominal Injuries , Spleen/injuries , Blood Transfusion , Injury Severity Score , Retrospective Studies , Treatment Outcome , Hemodynamics
16.
Rev. Hosp. Clin. Univ. Chile ; 32(3): 187-192, 2021. graf, tab
Article in Spanish | LILACS | ID: biblio-1353082

ABSTRACT

Background: Anaemia and transfusions are frequent in critically ill patients and there are avoidable causes such as routine laboratory tests. Patients and methods: Descriptive study during one continuous week including patients over 18-years old in a medical-surgical ICU. Results: 18 patients were included during a week in 12 beds in our unit, median age 62,5 years, 50% male. Median daily blood loss was 35ml, 45% in laboratory samples and 27% related to renal replacement therapy. 3 patients required 1 transfusion of red blood cells. Conclusions: There is a pattern of continuous blood loss in critically ill patients, primarily in routine laboratory tests. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Hemorrhage/etiology , Intensive Care Units , Blood Transfusion , Hemorrhage/epidemiology , Anemia/complications
17.
Acta Paul. Enferm. (Online) ; 34: eAPE01641, 2021. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1152651

ABSTRACT

Resumo Objetivo: Analisar os estudos econômicos completos com enfoque nos tratamentos da Anemia Falciforme. Métodos: Estudo de revisão integrativa de literatura desenvolvido mediante coleta de dados nas bases eletrônicas National Library of Medicine - Medline via PubMed; Elservier's Scopus; Current Index to Nursing and Allied Health Literature; Science Direct e Web of Science com descritores indexados no Medical Subject Headings. Os estudos foram selecionados pelo teste de relevância e analisados de acordo com a classificação das análises econômicas em saúde e o sistema de Classificação da qualidade das evidências e a força das recomendações. Resultados: Fizeram parte desta revisão 09 artigos, dos quais sete recuperados na base Elservier's Scopus e dois na Medline via PubMed. Todos estudos completos com enfoque nas perspectivas do uso da Hidroxiureia e da transfusão sanguínea no tratamento da Anemia Falciforme. Conclusão: Não foram identificados estudos realizados no Brasil com este tipo de análise para Anemia Falciforme. Há muito a ser feito mundialmente para avaliação das tecnologias vigentes, reavaliação das utilizadas atualmente e implementação de diagnóstico e tratamento contínuo, com um sistema que garanta uma rede de atenção ativa e eficiente aos pacientes.


Resumen Objetivo: Analizar los estudios económicos completos con enfoque en tratamientos para la anemia falciforme Métodos: Estudio de revisión integradora de la literatura desarrollado mediante la recolección de datos en las bases electrónicas National Library of Medicine - Medline vía PubMed; Elservier's Scopus; Current Index to Nursing and Allied Health Literature; Science Direct y Web of Science con descriptores indexados en Medical Subject Headings. Los estudios fueron seleccionados mediante la prueba de relevancia y analizados de acuerdo con la clasificación de análisis económicos en salud y con el sistema de clasificación de la calidad de las evidencias y la fuerza de las recomendaciones. Resultados: Nueve artículos formaron parte de esta revisión, de los cuales siete fueron encontrados en la base Elservier's Scopus y dos en Medline vía PubMed. Todos son estudios completos con enfoque en las perspectivas del uso de hidroxiurea y transfusión sanguínea para el tratamiento de anemia falciforme. Conclusión: No se identificaron estudios realizados en Brasil con este tipo de análisis de anemia falciforme. Hay mucho por hacer a nivel mundial para evaluar las tecnologías vigentes, revaluar las que se utilizan en la actualidad e implementar el diagnóstico y tratamiento continuo, con un sistema que garantice una red de atención activa y eficiente para los pacientes.


Abstract Objective: To analyze complete economic studies focusing on sickle cell anemia treatments. Methods: Integrative literature review developed by collecting data in the electronic databases National Library of Medicine - Medline via PubMed; Elsevier's Scopus; Current Index to Nursing and Allied Health Literature; Science Direct and Web of Science with descriptors indexed in Medical Subject Headings. The studies were selected by the relevance test and analyzed according to the classification of economic analyses in health and the classification system of evidence quality and strength of recommendations. Results: Nine articles were part of this review, seven of which were retrieved from Elsevier's Scopus and two from Medline via PubMed. All articles reported on studies focusing on the perspectives of using hydroxyurea and blood transfusion in the treatment of sickle cell anemia. Conclusion: No studies were identified that were conducted in Brazil and involved this type of analysis for sickle cell anemia. Much remains to be done worldwide to assess existing technologies, reassess the technologies currently used and implement continuous diagnosis and treatment, by means of a system that guarantees an active and efficient care network for the patients.


Subject(s)
Health Care Economics and Organizations , Blood Transfusion , Databases, Bibliographic , Cost-Benefit Analysis , Costs and Cost Analysis , Hydroxyurea/therapeutic use , Anemia, Sickle Cell/drug therapy , Anemia, Sickle Cell/therapy
18.
Rev. bras. anal. clin ; 52(4): 366-370, 20201230. tab
Article in Portuguese | LILACS | ID: biblio-1247717

ABSTRACT

Objetivo: O objetivo deste trabalho foi realizar um estudo das frequências dos principais antígenos e fenótipos dos sistemas de grupo sanguíneo: ABO, Rh, Kell. Métodos: A partir dos dados da fenotipagem estendida disponíveis no Sistema de Banco de Sangue (SBS web) de doadores de sangue da Fundação Hemopa, foram avaliadas as frequências absolutas e relativas. Resultados: Dentre os 1.474 doadores analisados houve predominância do tipo O (62,6%) e quanto ao Rh: D (85,5%). O antígeno mais frequente do sistema Rh foi: e (94,9%), e o fenótipo mais frequente: DCcee (27,5%). O antígeno mais frequente do sistema Kell foi: Kpb (100%), e o fenótipo: k+ K- (95,7%), Kp (a- b+) (99,4%). Conclusão: A identificação das frequências desses antígenos em diferentes populações pode auxiliar na rotina hemoterápica, facilitando a busca por hemocomponentes compatíveis, melhorando a segurança transfusional imunológica.


Objective: To study the frequencies of the major antigens of bloodgroup systems:ABO, Rh, Kell. Methods: From data of extendedphenotyping available in the Blood Bank System (SBS web) in blooddonors of the Hemopa Foundation, were evaluated absolute and relativefrequencies. Results: Among the 1.474 donors analyzed there was apredominance of type O (62.6%) and RhD (85.5%). The most frequentantigen from system Rh was: e (94,9%), and the most commonphenotype: DCcee (27,5%). The most frequent antigen from systemKell was: Kpb (100%), and the most common phenotypes: k + K-(95.7%), Kp (a- b +) (99.4%). Conclusion: Identifying the frequenciesof these antigens in different populations may help in the routine bloodtherapy, facilitating the search for compatible blood components,improving the immunological transfusion safety.


Subject(s)
Blood Banks , Blood Group Antigens , Blood Transfusion , ABO Blood-Group System , Biological Variation, Population , Kell Blood-Group System
19.
Int. braz. j. urol ; 46(6): 943-949, Nov.-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1134249

ABSTRACT

ABSTRACT Objective There is limited data regarding surgeon volume and partial nephrectomy outcomes. The aim of this study is to report trifecta outcomes of robot-assisted partial nephrectomy (RAPN) performed by the low volume surgeon. Materials and Methods Thirty-nine patients with clinical T1-2 renal tumors who underwent RAPN between 2012 and 2018 were included in this study. Trifecta was defined as negative surgical margins, warm ischemia time ≤20 minutes, and no operative complications. Patient demographics, R.E.N.A.L. nephrometry score, operation time, estimated blood loss, warm ischemia time, length of hospital stay, renal functions, and oncological outcomes were analyzed retrospectively. Complications were graded based on the modified Clavien-Dindo classification system. Results The median R.E.N.A.L. nephrometry score was 6 (4-10). RAPN was successfully performed in all but one patient. The median operation time was 180 (90-240) minutes. Warm ischemia was performed only by segmental renal artery control in 35 and, by main renal artery control in three patients. The off-clamp technique was used in two patients. The median warm ischemia time was 16 (0-31) minutes. Seven patients had a warm ischemia time of longer than 20 minutes. Three patients had postoperative complications. The surgical margin was positive in one patient. As a result, the trifecta was achieved in 30 of the 39 patients (77%). Conclusion RAPN is a safe and effective minimally invasive alternative in the treatment of renal masses. The present study suggests that reasonable trifecta rates can be achieved even by low volume surgeons.


Subject(s)
Humans , Robotic Surgical Procedures , Kidney Neoplasms/surgery , Blood Transfusion , Retrospective Studies , Treatment Outcome , Surgeons , Nephrectomy
20.
Arq. gastroenterol ; 57(4): 459-465, Oct.-Dec. 2020. tab
Article in English | LILACS | ID: biblio-1142337

ABSTRACT

ABSTRACT BACKGROUND: There are quite a few studies examining prognostic factors in non-traumatic splenectomies compared to traumatic ones. OBJECTIVE: This study aimed to evaluate the predictors of mortality in patients who underwent splenectomy for non-traumatic spleen diseases. METHODS: Medical records of the patients, who had undergone total splenectomy for non-traumatic spleen diseases at a tertiary center between January 2009 and December 2019, were retrospectively reviewed. Exclusion criteria included patients younger than 18 years of age, partial splenectomies, splenectomies applied to facilitate surgery for malignancy on contiguous organs, and splenectomies performed during liver transplantation. Iatrogenic splenic injuries were regarded as trauma and these cases were also excluded. RESULTS: The current study included 98 patients. Nine (9.2%) patients died. In univariate analysis, age, the presence of hematological neoplasia, hematocrit, hemoglobin, white blood cell counts, neutrophil-to-lymphocyte ratio, indications for splenectomy, application of emergency surgery, surgical technique, and transfusion of blood components were all significantly associated with mortality. In multivariate analysis, the presence of hematological malignancy [P=0.072; OR=7.17; (CI: 0.386-61.56)], the application of emergency surgery [P=0.035; OR=8.33; (CI: 1.165-59.595)] and leukocytosis [P=0.057; OR=1.136; (CI: 0.996-1.296)] were found to be positively associated with mortality. CONCLUSION: Hematologic neoplasia, emergency surgery, and leukocytosis were the independent predictors of mortality in patients, who were operated on for non-traumatic spleen diseases. A thorough preoperative evaluation, early therapeutic intervention, and advanced surgical techniques are important and can serve to minimize complications and mortality in case of inevitable splenectomy. Immunological research can provide new therapeutic opportunities that may impact positively on patients by minimizing morbidity and mortality.


RESUMO CONTEXTO: Há alguns estudos que examinam fatores prognósticos em esplenectomias não traumáticas em comparação com os traumáticos. OBJETIVO: Este estudo teve como objetivo avaliar os preditores de mortalidade em pacientes submetidos à esplenectomia para doenças do baço não traumático. MÉTODOS: Os prontuários dos pacientes, submetidos à esplenectomia total não traumática para doenças do baço em um centro terciário entre janeiro de 2009 e dezembro de 2019, foram revisados retrospectivamente. Os critérios de exclusão incluíram pacientes menores de 18 anos, esplenectomias parciais, esplenectomias aplicadas para facilitar a cirurgia para a malignidade em órgãos contíguos e esplenectomias realizadas durante o transplante hepático. As lesões esplênicas iatrogênicas foram consideradas trauma e esses casos também foram excluídos. RESULTADOS: O presente estudo incluiu 98 pacientes. Nove (9,2%) pacientes morreram. Na análise univariada, idade, presença de neoplasia hematológica, hematócrito, hemoglobina, contagem de glóbulos brancos, razão entre neutrófilos-linfócitos, indicações de esplenectomia, aplicação de cirurgia de emergência, técnica cirúrgica e transfusão de componentes sanguíneos foram significativamente associadas à mortalidade. Na análise multivariada, a presença de malignidade hematológica [P=0,072; OR=7,17; (IC: 0,386-61,56)], aplicação de cirurgia de emergência [P=0,035; OR=8,33; (IC: 1,165-59,595)] e leucocitose [P=0,057; OR=1,136; (IC: 0,996-1,296)] verificou-se que estão positivamente associados à mortalidade. CONCLUSÃO: Neoplasia hematológica, cirurgia de emergência e leucocitose foram os preditores independentes da mortalidade em pacientes, operados por doenças não traumáticas do baço. Uma avaliação pré-operatória minuciosa, intervenção terapêutica precoce e técnicas cirúrgicas avançadas são importantes e podem servir para minimizar complicações e mortalidade em caso de inevitável esplenectomia. Pesquisas imunológicas podem fornecer novas oportunidades terapêuticas que podem impactar positivamente nos pacientes, minimizando a morbidade e a mortalidade.


Subject(s)
Humans , Splenectomy , Spleen/surgery , Blood Transfusion , Retrospective Studies , Abdominal Injuries
SELECTION OF CITATIONS
SEARCH DETAIL