¿Es fiable una muestra de gasometría para hemoglobinas en rango transfusional? / Is a blood sample for hemoglobins in the transfusional range reliable?

Objetivo: Evaluar la correlación y la concordancia en nuestra unidad y en la población de la cifra de hemoglobina en gasometría versus hematimetría estándar; valorar errores en transfusión o falta de la misma. Resultados: Fuerte asociación entre los resultados del gasómetro (POC) y la hematimetría, con p<0,001, con un coeficiente de determinación r2 de 0,56, un coeficiente de correlación intraclase de 0,63 y un coeficiente de correlación de Lin de 0,65. Valores similares para el hematocrito. Para hemoglobinas menores de 7g/dl se obtiene una tasa de acierto del 29,41%. Conclusiones: Concordancia baja-moderada de la hemoglobina del POC con la hematimetría estándar. Alta probabilidad de errores en la indicación de transfusión en base a hemoglobinas de gasómetro, sobre todo en hemoglobinas bajas

Objective: To evaluate the correlation and agreement in our unit and population of hemoglobin in gasometry versus hematology analyzer, to evaluate errors in transfusion or lack thereof. Results: strong association between Point-of-care (POC) and hematimetry, with P<.001, with a coefficient of determination r2 of 0.56, an intraclass correlation coefficient of 0.63 and a Lin's concordance correlation coefficient of 0.65. For hemoglobins less than 7g/dL, a success rate of 29.41% was obtained. Conclusions: Low-moderate agreement of POC hemoglobin with standard haemothymetry. High probability of errors in the indication of transfusion based on gasometer hemoglobins, especially in low hemoglobins

Is a blood sample for hemoglobins in the transfusional range reliable? / ¿Es fiable una muestra de gasometría para hemoglobinas en rango transfusional?

OBJECTIVE: To evaluate the correlation and agreement in our unit and population of hemoglobin in gasometry versus hematology analyzer, to evaluate errors in transfusion or lack thereof. RESULTS: strong association between Point-of-care (POC) and hematimetry, with P<.001, with a coefficient of determination r2 of 0.56, an intraclass correlation coefficient of 0.63 and a Lin's concordance correlation coefficient of 0.65. For hemoglobins less than 7g/dL, a success rate of 29.41% was obtained. CONCLUSIONS: Low-moderate agreement of POC hemoglobin with standard haemothymetry. High probability of errors in the indication of transfusion based on gasometer hemoglobins, especially in low hemoglobins.

[Bilateral hydronephrosis secondary to ileocolic Crohn's disease]. / Hidronefrosis bilateral secundaria a enfermedad de Crohn ileocólica.

Unilateral hydronephrosis can complicate a far from negligible number of patients with Crohn's disease. Bilateral hydronephrosis associated with Crohn's disease is a much more unusual entity. In the other hand, the treatment for this condition is still controversial. We present the case of a 44 year old female with several bowel obstruction episodes caused by ileocolic Crohn's disease. During the last episode she was also diagnosed of bilateral hydroureter and hydronephrosis. After the resolution of the bowel obstruction and the placement of a double J catheter in both ureters, the patient was operated. Ileocolic resection and bilateral ureterolysis with omental wrapping were performed. Although urinary and wound infection complicated the postoperative course, and a enterocutaneous fistula had to be medically treated one year later, the patient is now free of symptoms and her renal function is normal.

Hidronefrosis bilateral secundaria a enfermedad de Crohn ileocólica / Bilateral hydronephrosis secondary to ileocolic Crohn's disease

La hidronefrosis unilateral puede complicar a un número no despreciable de pacientes con enfermedad de Crohn. La hidronefrosis bilateral también puede asociarse a la enfermedad de Crohn, pero aparece con mucha menos frecuencia. Por otro lado, existe controversia sobre el tratamiento más adecuado de esta entidad. Presentamos el caso de una paciente de 44 años con cuadros de obstrucción intestinal de repetición por enfermedad de Crohn ileocólica, que en el último ingreso fue diagnosticada también de hidrouréter e hidronefrosis bilateral. Tras la resolución del episodio obstructivo y previa colocación de catéteres doble J en ambos uréteres, la paciente fue sometida a resección ileocólica y ureterolisis bilateral con epiploplastia. Aunque aparecieron complicaciones menores inmediatas como infección urinaria y de herida y un año más tarde se trató médicamente una fístula enterocutánea, la paciente está actualmente asintomática y su función renal es normal (AU)

A field kit for sampling gunshot residue particles.

The application of scanning electron microscopy to gunshot residue particle detection requires a field sampling kit that can be used dependably by nonscientific field personnel. The kit developed by the authors uses adhesive tape on aluminum stubs to sample the suspect's hands. The kit evolved from prototypes that were subjected to extensive field tests. Comments by users pinpointed various shortcomings that were eliminated; the final version is suitable for rapid, straightforward application in the often hectic environment in which field officers must operate. The kit is also compact, durable, and inexpensive; it is thus especially suitable for large-scale fabrication, issue, and use on a regular basis.