ABSTRACT
This study was performed in 15 female patients submitted to suction lipectomy as an isolated procedure, to establish blood loss in the procedure. A wide variation of blood-to-fat ratios was observed (17 to 59%) with a mean blood loss in lipoaspirates of 34 +/- 3%. Internal blood losses occurring in the first 72 post-operative hours were as important as or more important than external losses, and responsible for a mean 7% fall in the level of hemoglobin. Internal blood losses occurred between 72 hours and the 7th to the 10th post-operative days and were responsible for a mean 3% fall in the level of hemoglobin. Blood losses occurring in this study were demonstrated to be greater than usually assumed. Some prophylactic measures are recommended to provide for a safer treatment of these patients: an iron supplementation during the pre-operative period; careful clinical and laboratorial screening for bleeding disorders and for the intake of drugs that can interfere with coagulation; use of smaller-diameter cannulas for aspiration, auto-transfusion when aspirating in excess of 1,000 ml, and limiting the aspiration to 1,500 ml.
Subject(s)
Hemorrhage/etiology , Lipectomy/adverse effects , Adult , Female , Hematocrit , Hemoglobins/analysis , Hemostasis, Surgical , Humans , Middle Aged , Postoperative CareSubject(s)
Anemia, Hemolytic, Autoimmune , Adolescent , Adult , Aged , Anemia, Hemolytic, Autoimmune/diagnosis , Anemia, Hemolytic, Autoimmune/therapy , Asparaginase/therapeutic use , Child , Coombs Test , Female , Hematologic Tests , Humans , Male , Middle Aged , Prednisone/therapeutic use , SplenectomySubject(s)
Aged , Humans , Male , Anemia, Hemolytic, Autoimmune , Antibodies, Anti-Idiotypic , Leukemia, Hairy CellABSTRACT
Os autores analisam 30 casos de anemia hemolitica auto-imune estudados entre os anos 1953 e 1980, procurando avaliar sua incidencia quanto ao sexo, faixa etaria e raca. Os sinais, sintomas e parametros hematologicos mais frequentes, etiologia e estudo imuno-hematologico sao tambem apresentados, bem como a evolucao clinica e a terapeutica empregada e sua avaliacao quanto a eficacia. A incidencia mostrou-se maior em pacientes do sexo feminino, sem preferencia por raca, e mais incidente na terceira decada da vida. Quanto a clinica e ao laboratorio, os exames hematologicos e bioquimicos apresentaram-se com alteracoes comuns a todo processo hemolitico agudo; os exames imuno-hematologicos revelaram predominancia de auto-anticorpos frios de natureza inespecifica. Houve prevalencia de casos de etiologia idiopatica (60%). A terapeutica mais frequentemente empregada e com mais sucesso foi a prednisona. A L-asparaginase apresentou sucesso terapeutico nos 3 casos em que foi empregada. Dos 30 pacientes, 5 foram submetidos a esplenectomia por nao haverem respondido satisfatoriamente ao tratamento clinico; destes 5 pacientes, 60% apresentaram melhora do quadro clinico e hamatologico e em 1 deles a reacao de Coombs direta tornou-se negativa
