RÉSUMÉ
【Objective】 To detect endogenous heparin substance in patients with epidemic haemorrhagic fever (EHF) using thromboelastography (TEG) combined with conventional coagulation indices(CCTs), explore the value of TEG combined with CCTs in detecting coagulation function abnormalities in such patients, aiming at providing guidance for clinical treatment. 【Methods】 APTT, TT, TEG plain cup R value and TEG heparinase cup R value were tested in 35 EHF patients of mild/moderate stage, severe stage and recovery stage. Intergroup differences were analysed using Friedman ANOVA. 【Results】 The mean R and heparin cup R values were 7.5 and 6.7 for mild cases of EHF, and TT, R and heparinase cup R values were 16.9, 6.2 and 6.1 for recovering cases, respectively.The normal cup R and heparinase cup R values for mild cases, as well as the TT, R and heparinase cup R values for recovering cases, were normally distributed, and the rest were non-normally distributed. Changes in APTT and TT in EHF patients at different stages were significantly different (P<0.05). The patients′ TEG R-values (coagulation reaction time) also showed statistically significant differences in mild-moderate, severe and recovery periods (P<0.05). Prolonged APTT, TT and R values in the severe phase compared to the mild-moderate phase indicated that the patient′s coagulation function continued to decrease. The difference of R-values minus the heparanase cup R-values in EHF patients was statistically significant in the mild-moderate, severe, and recovery phases (P<0.05). Residual accumulation of endogenous heparin-like substances was higher in the severe phase than in the mild-moderate and recovery phases. 【Conclusion】 Patients with EHF exhibit significant differences in the values of APTT, TT and R at different stages of the disease. The combined detection using TEG and CCTs indicates that the accumulation of endogenous heparin-like substances is one of the most important causes of coagulation disorders in patients with EHF. The combination of TEG and CCTs can detect the accumulation of endogenous heparin-like substances in patients with EHF, which can provide a laboratory basis for clinicians to adopt targeted therapeutic regimen.
RÉSUMÉ
Resumo Esta pesquisa analisou o impacto do Programa Bolsa Família (PBF) no tempo na escola, em seus componentes (matrícula, presença e jornada) e nas motivações relacionadas a partir dos suplementos especiais da Pesquisa Nacional por Amostra de Domicílios (PNAD) de 2004 e 2006. A expansão de 67% na cobertura do PBF no período permite testar efeitos-dosagem desse programa. Não se rejeitaram as hipóteses de impacto do PBF no tempo na escola e em seus componentes. Outra estratégia de identificação revela que os jovens marginalmente elegíveis em idade ao PBF apresentaram chances 62%, 8% e 6% maiores de frequentar a escola, cumprir a presença mínima e estudar mais do que 4 horas por dia, respectivamente, do que os quase elegíveis. Por fim, testes sobre as motivações alegadas para transgredir as condicionalidades escolares não descartam um efeito de alívio de renda corrente proporcionado pelo PBF.
Resumen Estudiamos el impacto del Programa Bolsa Familia (PBF) sobre el tiempo en la escuela, sus componentes (matrícula, presencia y jornada) y motivaciones relacionadas a partir de los suplementos especiales de la Encuesta Nacional de Hogares por Muestreo (PNAD) de 2004 y 2006. La expansión del 67% del PBF en el período permite probar efectos-dosificación del programa. No rechazamos la hipótesis de impacto del PBF sobre el tiempo en la escuela y sus componentes. Otra estrategia de identificación muestra que los jóvenes marginalmente elegibles en edad al PBF presentaron chances 62%, 8% y 6% mayores de asistir a la escuela, cumplir con la presencia mínima y estudiar más de 4h/día, respectivamente, que los casi elegibles. Evidencias acerca de las motivaciones para transgredir las condicionalidades no descartan un efecto de alivio de ingresos proporcionado por el PBF.
Abstract This article studies the impact of the Bolsa Família Program (BFP) on time spent in school, its components (enrollment, attendance, and school journey), and on the reasons students dropout or show low-attendance. The research uses data from the National Household Sample Survey (PNAD) for the years 2004 and 2006. During this period, the BFP coverage expanded by 67% enabling to test the dosage-effects of the program. The tests could not refute the hypothesis related to the impact of the BFP on time spent in school, and any of its components. Another identification strategy used shows that teenagers marginally eligible to BFP were 62% more likely to be enrolled at school, 8% more likely to comply with the attendance conditionality, and 6% more likely to study more than 4 hours per day. Finally, tests on the alleged reasons leading beneficiaries to fail in complying with the BFP conditions could not reject the existence of an effect of current income relief related to the program.