ABSTRACT
PURPOSE: The aim was to estimate seroprevalence and prevalence of hepatitis C virus (HCV) infection in a small health area of the Valencian Community, Spain. PATIENTS AND METHODS: This is a descriptive cross-sectional study aimed at estimation of HCV infection prevalence in the whole adult population (25-70 years old), that is, a pilot study for an eventual population-based screening program. RESULTS: A total of 5849 participants aged 25-70 years (51% male) were invited to participate by regular mail. Overall, 143 letters were returned owing to errors in the addresses. Of 5706 participants, 2637 (46.2%) participated in the study. Rapid test of anti-HCV antibody detection was positive in 30 cases (HCV seroprevalence 1.14%, 95% confidence intervals: 0.73-1.55%). Of those, seven were not aware of their condition. Participants who had a positive result in the rapid test of anti-HCV detection were given a confirmatory test by enzyme immune assay, and all had a positive result. RNA-HCV determination by quantitative PCR in positive anti-HCV patients showed positive viremia in 13 (43.3%) cases, of which five were not aware of the disease. Of the 17 patients who had negative viremia, two were unaware of their HCV status, one was a carrier of anti-HCV and was already aware of his condition, and 14 had been previously treated with satisfactory results. Regarding fibrosis, of the seven patients who were unaware of HCV infection, none of them had significant fibrosis. Moreover, 26 (86.7%) anti-HCV positive patients were reported to have one or more risk factors for HCV infection. CONCLUSION: HCV screening strategies applied to the general population are good means to diagnose and treat patients who are not aware of their infection, avoiding new transmissions as well as disease progression.
Subject(s)
Hepatitis C/diagnosis , Hepatitis C/epidemiology , Mass Screening/methods , Adult , Aged , Biomarkers/blood , Cross-Sectional Studies , Female , Hepatitis C/blood , Hepatitis C/therapy , Hepatitis C Antibodies/blood , Humans , Male , Middle Aged , Pilot Projects , Predictive Value of Tests , Prevalence , RNA, Viral/blood , Risk Factors , Seroepidemiologic Studies , Serologic Tests , Spain/epidemiologyABSTRACT
UNLABELLED: Gastrointestinal hemorrhage is a frequent complication in digestive diseases, requiring follow-up by specialized units such as the digestive bleeding unit. Hemoglobin is determined daily in the management of these patients, and consequently a rapid and reliable method for hemoglobin determination is required. OBJECTIVE: To study the reliability of HemoCue in patients with gastrointestinal hemorrhage and to determine whether there are any differences in hemoglobin measurement between HemoCue and the reference laboratory. MATERIALS AND METHODS: We performed a cross-sectional, observational paired sample study of 54 patients treated in the digestive bleeding unit. Hemoglobin was measured simultaneously by HemoCue (Angelholm, Switzerland) and by laboratory determination in patients with gastrointestinal bleeding, both in the acute phase (first 24h of bleeding) and in the stable phase. The results are expressed as means. To compare means, Student's t-test was used for paired data, Pearson's r was used for correlations and Bland and Altman analysis was used to quantify differences. RESULTS: Fifty-four patients (34 males) were included. The cause of the hemorrhage was duodenal/gastric ulcer in 26 patients, variceal bleeding in eight, esophagitis in five, Mallory Weiss syndrome in four, portal hypertensive gastropathy in nine and other causes in one. In the acute phase, mean arterial pressure (MAP) was 83.8, mean hemoglobin in capillary blood was 8.07 g/dl by HemoCue in 0.81 min, and mean hemoglobin in venous blood was 8.17 by laboratory determination in 44.87 min. Pearson's correlation coefficient was 0.979. In the stable phase, MAP was 100.7, and hemoglobin with HemoCue was 9.32 in 0.8 min and 9.4 by laboratory determination in 47.83 min. Pearson's correlation coefficient in the stable phase was 0.966. CONCLUSIONS: There is a good correlation between HemoCue and laboratory determinations. Consequently, HemoCue is a quick and reliable method both in the acute and stable phases of gastrointestinal bleeding.
Subject(s)
Gastrointestinal Hemorrhage/blood , Hematologic Tests/instrumentation , Hemoglobins/analysis , Aged , Cross-Sectional Studies , Female , Humans , Male , Reproducibility of ResultsABSTRACT
La hemorragia gastrointestinal es una complicación frecuente en enfermedades del aparato digestivo, que requiere un seguimiento a cargo de una unidad de semicríticos, como la Unidad de Sangrantes Digestivos (USD). En el seguimiento de estos pacientes se determina diariamente la hemoglobina, por lo que se necesita un método rápido y fiable. Objetivo:Estudiar la fiabilidad del HemoCue® en pacientes con hemorragia gastrointestinal y determinar si hay diferencias en la medición de hemoglobina entre el HemoCue® y el laboratorio de referencia. Material y métodos:Estudio transversal observacional de muestras emparejadas de 54 pacientes tratados en la USD. La hemoglobina de los pacientes con hemorragia digestiva, tanto en la fase aguda (24h tras el sangrado) como en la fase hemodinámicamente estable, se midió con el HemoCue® (Angelholm, Suiza) y, simultáneamente, con el laboratorio. Los resultados se expresan como medias; para la comparación de medias se utilizaron el test de la t de Student para datos emparejados, el test de la r de Pearson para las correlaciones y el análisis de Bland y Altman para la cuantificación de las diferencias.Resultados: La etiología de la hemorragia en los 54 pacientes (34 varones) fue úlcera gastroduodenal en 26 casos, várices esofágicas en 8 casos, esofagitis en 6 casos, síndrome de Mallory-Weiss en 4 casos, gastropatía de la hipertensión portal en 9 casos y otras causas en un caso.En la fase aguda, la presión arterial media (PAM) fue de 83,8mmHg, la hemoglobina media medida con HemoCue® fue de 8,07g/dl en 0,81min en sangre capilar y la hemoglobina media medida con el laboratorio fue de 8,17g/dl en 44,87min en sangre venosa. El coeficiente de correlación r fue de 0,979. En la fase estable, la PAM fue de 100,7mmHg; la hemoglobina medida con HemoCue® fue de 9,32g/dl en 0,8min, y la medida con el laboratorio fue de 9,4g/dl en 47,83min. El coeficiente de correlación r en la fase estable fue de 0,966 (AU)
Gastrointestinal hemorrhage is a frequent complication in digestive diseases, requiring follow-up by specialized units such as the digestive bleeding unit. Hemoglobin is determined daily in the management of these patients, and consequently a rapid and reliable method for hemoglobin determination is required. Objective:To study the reliability of HemoCue® in patients with gastrointestinal hemorrhage and to determine whether there are any differences in hemoglobin measurement between HemoCue® and the reference laboratory.Materials and methodsWe performed a cross-sectional, observational paired sample study of 54 patients treated in the digestive bleeding unit. Hemoglobin was measured simultaneously by HemoCue® (Angelholm, Switzerland) and by laboratory determination in patients with gastrointestinal bleeding, both in the acute phase (first 24h of bleeding) and in the stable phase. The results are expressed as means. To compare means, Student's t-test was used for paired data, Pearson's r was used for correlations and Bland and Altman analysis was used to quantify differences.Results: Fifty-four patients (34 males) were included. The cause of the hemorrhage was duodenal/gastric ulcer in 26 patients, variceal bleeding in eight, esophagitis in five, Mallory Weiss syndrome in four, portal hypertensive gastropathy in nine and other causes in one. In the acute phase, mean arterial pressure (MAP) was 83.8, mean hemoglobin in capillary blood was 8.07g/dl by HemoCue® in 0.81min, and mean hemoglobin in venous blood was 8.17 by laboratory determination in 44.87min. Pearson's correlation coefficient was 0.979. In the stable phase, MAP was 100.7, and hemoglobin with HemoCue® was 9.32 in 0.8min and 9.4 by laboratory determination in 47.83min. Pearson's correlation coefficient in the stable phase was 0.966 (AU)
Subject(s)
Humans , Hemoglobinometry/instrumentation , Gastrointestinal Hemorrhage/blood , Hemoglobins/analysis , Mallory-Weiss Syndrome/diagnosis , Esophageal and Gastric Varices/diagnosis , Peptic Ulcer/diagnosisABSTRACT
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