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1.
Rev Esp Salud Publica ; 942020 Dec 16.
Artigo em Espanhol | MEDLINE | ID: mdl-33323918

RESUMO

Galician newborn screening program for early detection of endocrine and metabolic diseases began in 1978 and was a pioneer in expanded newborn screening in Spain with the incorporation of mass spectrometry in July 2000. As a primary objective, 28 diseases are screened, including those recommended SNS except sickle cell anemia which is in the inclusion phase. In its 20-year history, 404,616 newborns (nb) have been analyzed, identifying 547 cases affected by the diseases included, with a global incidence of 1: 739 newborns and 1: 1.237 of the screened inborn errors of metabolism (IEM) (1:1.580 nb if excluding benign hyperphenylalaninemia-HPA), with an average participation of 99.35%, progressively higher during the analyzed period. Among the pathologies screened, congenital hypothyroidism (1:2.211 nb), cystinuria (1:4.129 nb) and HPA (1:5.699 nb), followed by phenylketonuria and cystic fibrosis (1:10,936 nb) stand out for their incidence. Sixty-six cases of false positives were identified (seventeen of them in relation to maternal pathology) and five false negatives, being the overall PPV and NPV of the program respectively of 89.2% and 99.99%, with a sensitivity of 99.09% and a specificity of 99.98%. The mortality rate of diagnosed CME patients is 1.52%, with eleven cases presenting symptoms prior to the screening result (2%). The intelligence quotient of IEM patients at risk of neurological involvement is normal in more than 95% of cases.


El Programa Gallego para la Detección Precoz de Enfermedades Endocrinas y Metabólicas se inició en 1978 y fue pionero en España en el cribado neonatal ampliado con la incorporación de la espectrometría de masas en julio de 2000. Como objetivo primario se criban veintiocho enfermedades, incluyendo las de la cartera básica del Servicio Nacional de Salud excepto la anemia de células falciformes, que está en fase de inclusión. En sus veinte años de trayectoria se analizaron 404.616 recién nacidos (RN), identificando 547 casos afectos de las enfermedades incluidas, con una incidencia global de 1:739 RN vivos y de 1:1.237 RN de las enfermedades metabólicas congénitas (EMC) cribadas (1:1.580 RN excluyendo la hiperfenilalaninemia benigna-HPA), con una participación media del 99,35%, progresivamente creciente durante el período analizado. Entre las patologías cribadas destacan por su incidencia el hipotirodismo congénito (1:2.211 RN), la cistinuria (1:4.129 RN) y la HPA (1:5.699 RN), seguida de fenilcetonuria y fibrosis quística (1:10.936 RN). Se identificaron sesenta y seis casos de falsos positivos (diecisiete de los mismos en relación con patología materna) y cinco falsos negativos, siendo el VPP (valor predictivo positivo) y el VPN (valor predictivo negativo) global del programa del 89,2% y 99,99%, respectivamente, con una sensibilidad de 99,09% y una especificidad del 99,98%. La tasa de mortalidad de los pacientes con EMC diagnosticados fue del 1,52%, presentando once casos sintomatología previa al resultado del cribado (2%). El cociente intelectual de los pacientes con EMC y riesgo de afectación neurológica es normal en más del 95% de los casos.


Assuntos
Hipotireoidismo Congênito/diagnóstico , Fibrose Cística/diagnóstico , Erros Inatos do Metabolismo/diagnóstico , Triagem Neonatal , Hipotireoidismo Congênito/epidemiologia , Fibrose Cística/epidemiologia , Reações Falso-Positivas , Feminino , Humanos , Incidência , Recém-Nascido , Masculino , Erros Inatos do Metabolismo/epidemiologia , Triagem Neonatal/métodos , Triagem Neonatal/normas , Triagem Neonatal/tendências , Avaliação de Programas e Projetos de Saúde , Sensibilidade e Especificidade , Espanha/epidemiologia
2.
Rev. esp. salud pública ; 94: 0-0, 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-200462

RESUMO

El Programa Gallego para la Detección Precoz de Enfermedades Endocrinas y Metabólicas se inició en 1978 y fue pionero en España en el cribado neonatal ampliado con la incorporación de la espectrometría de masas en julio de 2000. Como objetivo primario se criban veintiocho enfermedades, incluyendo las de la cartera básica del Servicio Nacional de Salud excepto la anemia de células falciformes, que está en fase de inclusión. En sus veinte años de trayectoria se analizaron 404.616 recién nacidos (RN), identificando 547 casos afectos de las enfermedades incluidas, con una incidencia global de 1:739 RN vivos y de 1:1.237 RN de las enfermedades metabólicas congénitas (EMC) cribadas (1:1.580 RN excluyendo la hiperfenilalaninemia benigna-HPA), con una participación media del 99,35%, progresivamente creciente durante el período analizado. Entre las patologías cribadas destacan por su incidencia el hipotirodismo congénito (1:2.211 RN), la cistinuria (1:4.129 RN) y la HPA (1:5.699 RN), seguida de fenilcetonuria y fibrosis quística (1:10.936 RN). Se identificaron sesenta y seis casos de falsos positivos (diecisiete de los mismos en relación con patología materna) y cinco falsos negativos, siendo el VPP (valor predictivo positivo) y el VPN (valor predictivo negativo) global del programa del 89,2% y 99,99%, respectivamente, con una sensibilidad de 99,09% y una especificidad del 99,98%. La tasa de mortalidad de los pacientes con EMC diagnosticados fue del 1,52%, presentando once casos sintomatología previa al resultado del cribado (2%). El cociente intelectual de los pacientes con EMC y riesgo de afectación neurológica es normal en más del 95% de los casos


Galician newborn screening program for early detection of endocrine and metabolic diseases began in 1978 and was a pioneer in expanded newborn screening in Spain with the incorporation of mass spectrometry in July 2000. As a primary objective, 28 diseases are screened, including those recommended SNS except sickle cell anemia which is in the inclusion phase. In its 20-year history, 404,616 newborns (nb) have been analyzed, identifying 547 cases affected by the diseases included, with a global incidence of 1: 739 newborns and 1: 1.237 of the screened inborn errors of metabolism (IEM) (1:1.580 nb if excluding benign hyperphenylalaninemia-HPA), with an average participation of 99.35%, progressively higher during the analyzed period. Among the pathologies screened, congenital hypothyroidism (1:2.211 nb), cystinuria (1:4.129 nb) and HPA (1:5.699 nb), followed by phenylketonuria and cystic fibrosis (1:10,936 nb) stand out for their incidence. Sixty-six cases of false positives were identified (seventeen of them in relation to maternal pathology) and five false negatives, being the overall PPV and NPV of the program respectively of 89.2% and 99.99%, with a sensitivity of 99.09% and a specificity of 99.98%. The mortality rate of diagnosed CME patients is 1.52%, with eleven cases presenting symptoms prior to the screening result (2%). The intelligence quotient of IEM patients at risk of neurological involvement is normal in more than 95% of cases


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Hipotireoidismo Congênito/diagnóstico , Fibrose Cística/diagnóstico , Erros Inatos do Metabolismo/diagnóstico , Triagem Neonatal , Hipotireoidismo Congênito/epidemiologia , Fibrose Cística/epidemiologia , Reações Falso-Positivas , Incidência , Erros Inatos do Metabolismo/epidemiologia , Triagem Neonatal/métodos , Triagem Neonatal/normas , Triagem Neonatal/tendências , Sensibilidade e Especificidade , Espanha/epidemiologia , Avaliação de Programas e Projetos de Saúde
3.
Int J Pharm ; 564: 225-236, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31004716

RESUMO

At present, there is an increasing demand to improve the sustainability of surface-active compounds in dermal formulations. Biosurfactants, which are derived from living cells, are considered to be more environmentally friendly than synthetic surfactants. Thus, the use of biosurfactants is a promising strategy for the formulation of more environmentally friendly and sustainable dermal products. In this work, a biosurfactant extract (BS) obtained from corn wet-milling industry was studied for its potential use in dermal formulations. The corn derived BS possesses good surface-active properties and was found to be a suitable co-stabilizer for nanoemulsions and nanocrystals for dermal application. It also possesses antioxidative and skin protective properties and was also able to increase the dermal penetration efficacy for lipophilic actives. In dermal formulations the BS can therefore be used as co-stabilizer with antioxidative and penetration enhancing properties at the same time.


Assuntos
Antioxidantes/química , Tensoativos/química , Zea mays/química , Administração Cutânea , Animais , Antioxidantes/administração & dosagem , Portadores de Fármacos/administração & dosagem , Portadores de Fármacos/química , Emulsões , Nanopartículas/administração & dosagem , Nanopartículas/química , Pele/efeitos dos fármacos , Pele/metabolismo , Tensoativos/administração & dosagem , Suínos , Molhabilidade
4.
J Colloid Interface Sci ; 537: 34-42, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30419372

RESUMO

HYPOTHESIS: Vitamin E has interesting biological functions for the cosmetic and pharmaceutical industry because it can act as a fat-soluble antioxidant, as well as peroxyl radical scavenger. However, this vitamin is formed by a group of compounds that include tocopherols (γ-tocopherols, α-tocopherol) characterized by their poor solubility in water, what implies the need of using stabilizing agents such as biosurfactants or minerals, in order to make them soluble or stable in formulations composed by water and oil. EXPERIMENTS: In this work, it has been evaluated the synergic effect between a mining silicate mineral (mica) and a biosurfactant extract, obtained from corn steep liquor, to stabilize emulsions containing water and a non-aqueous soluble antioxidant consisting of Vitamin E, through the use of a triangular design. FINDINGS: The results show that the presence of biosurfactant extract improves the emulsion volume up to 70% after 22 days, for an emulsion composed of Vitamin E and biosurfactant, whereas the mica component was able to increase the emulsion stability until values of 80% after 30 days of experiment, for those emulsions containing 10% of mica. Hence, both novel ingredients produce a synergistic effect on the Pickering emulsions carried out in the study.


Assuntos
Silicatos de Alumínio/química , Tensoativos/química , Vitamina E/química , Emulsões/química , Tamanho da Partícula , Propriedades de Superfície
5.
Metas enferm ; 20(1): 18-23, feb. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-161318

RESUMO

OBJETIVO: conocer y analizar la realidad del paciente ostomizado desde el punto de vista de su posible reinserción laboral en la Comunidad Autónoma de Galicia. MÉTODO: estudio descriptivo, transversal y multicéntrico sobre los pacientes ostomizados desde la perspectiva de su reincorporación o no a la actividad laboral. El periodo de la investigación fue de octubre de 2014 a septiembre de 2015. Se realizó una única visita, en la que se recogieron una serie de datos basales con respecto a la ostomía, los antecedentes, la calidad de vida y cuestiones acerca de la situación laboral del paciente. Se emplearon el Cuestionario de Calidad de Vida (Stoma-QoL) y el Instrumento para la valoración de la piel periestomal (DET Score). RESULTADOS: se reclutaron un total de 138 pacientes entre los seis centros participantes en la Comunidad Autónoma de Galicia. La edad media de los participantes fue de 52,97 años y la mediana de 54,50 años. En el 71% de los casos incluidos se trataba de una ostomía definitiva frente a un 29% en el que esta tenía intención temporal. La neoplasia resultó ser el motivo más frecuente, con un porcentaje mayor al 68% de los casos, seguido por patologías inflamatorias con más del 15%. Un 80,26% de los pacientes ostomizados declaró su intención de reincorporarse a la vida laboral, sin embargo, solamente un 21,80% se reincorporó a su anterior puesto de trabajo. De los pacientes ya reincorporados a la vida laboral un 18,18% manifiesta haberse visto obligado a hacerlo por exigencias externas a su voluntad. Un 16,03% de la muestra declaró que la condición de la piel ha sido una barrera importante en su reincorporación laboral. CONCLUSIONES: aunque para el paciente ostomizado existen numerosas barreras para poder trabajar de nuevo, el estudio demuestra que los pacientes ostomizados que vuelven a su actividad laboral previa a la cirugía tienen una mayor calidad de vida, por lo que se evidencia la necesidad del apoyo de personal experto en el cuidado de las personas con ostomías, así como de un equipo multidisciplinar, no solo para el cuidado desde la perspectiva de la salud física, sino para intentar abarcar y dar apoyo sociolaboral


OBJECTIVE: to understand and analyze the reality of patients with ostomy from the point of view of their potential reintegration into the work force in the Autonomous Community of Galicia. METHOD: a descriptive, transversal and multicenter study on patients with ostomy from the perspective of their reintegration to the work activity. The period of research was from October, 2014 to September, 2015. A single visit was conducted, where a series of basal data were collected regarding the ostomy, background, quality of life, and questions about the working status of the patient. The Questionnaire on Quality of Life (StomaQoL) and the Tool for Peristomal Skin Assessment (DET Score) were used. RESULTS: in total, 138 patients were recruited from the six participating centres in the Autonomous Community of Galicia. The mean age of participants was 52.97 years, with a median 54.50 years. In 71% of cases included, the ostomy was permanent, vs. 29% of cases where it was intended as temporary. Neoplasia appeared as the most frequent reason, with a >68% percentage of cases, followed by inflammatory conditions in >15% of cases. An 80.26% of ostomates declared their intention to reincorporate to working life; however, only 21.80% could return to their previous job position. From those patients already reintegrated to working life, 18.18% stated that they had been forced to do it by demands outside their own will, while 16.03% of the sample declared that the status of their skin had been a major barrier to their reincorporation to work. CONCLUSIONS: even though there are numerous barriers for ostomates to work again, this study showed that those patients with ostomy who returned to the work activity they held previously to surgery had a better quality of life; this makes evident the need for support by staff with expertise on care for ostomates, as well as for a multidisciplinary team, not only for care from a physical health perspective, but in order to try to include and provide social and occupational support


Assuntos
Humanos , Estomia/reabilitação , Neoplasias/cirurgia , Retorno ao Trabalho , Qualidade de Vida , Perfil de Impacto da Doença , Licença Médica/estatística & dados numéricos , Assistência Integral à Saúde
6.
Metas enferm ; 19(1): 27-31, feb. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-153575

RESUMO

Es conocido que un elevado número de personas portadoras de una ostomía, independientemente de la profesión que vinieran realizando antes de la cirugía, se les incapacita legalmente para continuar realizando su actividad laboral. A raíz de la experiencia de las enfermeras especialistas en el cuidado de pacientes ostomizados, surge la duda de si quizá haya casos en los que hay personas que son aptas y capaces de seguir desarrollando su labor, una vez que su estado de salud lo permita. Se presenta el caso de un paciente de 40 años de edad, buzo profesional, diagnosticado de adenocarcinoma de colon, tratado quirúrgicamente con una amputación abdominoperineal y con una colostomía permanente, que fue tratado posteriormente con quimioterapia y radioterapia. El deseo del buzo devolver a realizar su labor profesional, junto con el consejo y apoyo de la enfermera estomaterapeuta y otros colaboradores de otros servicios del hospital, hicieron posible la planificación de una estrategia para poder conseguir revertir esta situación y así volver a desempeñar su profesión. Desde entonces esta persona lleva a cabo una vida normal irrigándose y utilizando obturador, realizando inmersiones submarinas de carácter deportivo con botella de oxígeno hasta 40metros, sin presentar complicaciones o limitaciones que puedan impedir que desarrolle su actividad profesional adecuadamente


It is a fact that a high number of persons with ostomy, regardless of their profession before surgery, become legally disabled to continue with their work activity. Based on the experience of nurses specialized in care for ostomized patients, doubts have arisen about those potential cases in which persons are able to continue conducting their activity, once their health status allows them to. We present the case of a 40-year-old patient, who is a professional Scuba diver, diagnosed with colon adenocarcinoma, surgically treated with abdominoperineal resection and permanent colostomy, who was subsequently treated with chemotherapy and radiotherapy. The willingness by the Scuba diver to engage again in his professional work, together with the advice and support by the stoma therapist nurse and collaboration from staff in other hospital units, made it possible to plan a strategy in order to reverse this situation, so that he could go back to his profession. Since then, this person leads a normal life, irrigating himself and using a shutter, conducting submarine immersions of sports nature with an oxygen bottle up to 40 metres, without showing complications or limitations which might prevent him from conducting his professional activity adequately


Assuntos
Humanos , Masculino , Adulto , Estomia/estatística & dados numéricos , Neoplasias do Colo/cirurgia , Adenocarcinoma/cirurgia , Absenteísmo , Licença Médica/estatística & dados numéricos , Qualidade de Vida , Perfil de Impacto da Doença , Mergulho/fisiologia
9.
Allergol. immunopatol ; 41(1): 4-10, ene.-feb. 2013. tab, graf
Artigo em Inglês | IBECS | ID: ibc-109461

RESUMO

Background: Allergen-specific immunotherapy (SIT) is a long-term treatment of respiratory allergy. Objective: To look for early predictors of the effectiveness of Dermatophagoides pteronyssinus SIT. Methods: A prospective multi-centre study was carried out in Spain. Children with D. pteronyssinus rhinitis or asthma were invited to participate. The study was divided into times: T0 (recruitment); T1 (inclusion); T2 a-f (immunotherapy times) and T3 (the end of study). Efficacy of SIT was assessed by clinical scores, visual analogue scales (VAS) and lung function tests. We performed D. pteronyssinus skin tests at T1 and T3, and determined specific serum IgE, IgG4 and IL-10 at T1, T2f and T3.Data were analysed using Mann–Whitney and Kruskal–Wallis tests, compared using Wilcoxon and Chi-square tests, and correlated to Spearman test. All tests had a significance level of 0.05. Results: Thirty-eight children completed the study. At T1 all had rhinitis and 34 also had asthma. At T3, 30 patients had improved, six experienced no changes and two worsened. Improvement was associated to FEV1/FVC and VAS improvement; to a reduction in D. pteronyssinus skin prick test; to a progressive increase in serum levels of D. pteronyssinus IgE, and D. pteronyssinus, Der p1 and Der p2 IgG4. IL-10 levels showed an early increase at T2f (the end of initial build-up immunotherapy phase), and then a reduction at T3 (the end of a year of immunotherapy).Improvement associated to an early increase in IL-10 and was correlated with VAS and specific IgG4 evolution(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Interleucina-10/administração & dosagem , Interleucina-10/imunologia , Interleucina-10/uso terapêutico , Dermatophagoides pteronyssinus , Dermatophagoides pteronyssinus/imunologia , Antígenos de Dermatophagoides , Antígenos de Dermatophagoides/imunologia , Antígenos de Dermatophagoides/isolamento & purificação , Imunoterapia/métodos , Imunoterapia , Interleucina-10/isolamento & purificação , Interleucina-10/metabolismo , Imunoterapia/normas , Imunoterapia/tendências , Estudos Prospectivos , Resultado do Tratamento , Avaliação de Eficácia-Efetividade de Intervenções
10.
Meat Sci ; 93(2): 220-5, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22999312

RESUMO

The effect of modified atmosphere and vacuum packaging on the shelf-life of "morcilla", a traditional cooked blood sausage, was investigated. A total of 99 "morcillas" were packaged under vacuum and in modified atmosphere using three different gas mixtures: 15:35:50/O(2):N(2):CO(2) (atmosphere 1), 60:40/N(2):CO(2) (atmosphere 2) and 40:60/N(2):CO(2) (atmosphere 3), and stored during 2, 4, 6 and 8 weeks at 4 °C. Shelf life evaluation was based on pH, water activity (a(w)), colour (CIE L*, a*, b*, C* and h*), TBARS formation and microbial counts. The results indicated that, in general, storage time affected (P<0.05) all parameters whereas no significant differences were observed (P>0.05) among packaging conditions. Based on the microbial counts, the shelf-life of "morcilla" would be greater than 8 weeks for all packaging conditions. Samples packaged with high CO(2) concentrations (40:60/N(2):CO(2)) showed the lowest values of TBARS at the end of storage.


Assuntos
Embalagem de Alimentos/métodos , Qualidade dos Alimentos , Produtos da Carne/análise , Animais , Dióxido de Carbono/análise , Fenômenos Químicos , Temperatura Baixa , Contagem de Colônia Microbiana , Cor , Comportamento do Consumidor , Culinária , Contaminação de Alimentos/prevenção & controle , Microbiologia de Alimentos , Humanos , Concentração de Íons de Hidrogênio , Metabolismo dos Lipídeos , Produtos da Carne/microbiologia , Oxirredução , Suínos , Substâncias Reativas com Ácido Tiobarbitúrico/análise , Vácuo , Água/análise
11.
Allergol Immunopathol (Madr) ; 41(1): 4-10, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22321665

RESUMO

BACKGROUND: Allergen-specific immunotherapy (SIT) is a long-term treatment of respiratory allergy. OBJECTIVE: To look for early predictors of the effectiveness of Dermatophagoides pteronyssinus SIT. METHODS: A prospective multi-centre study was carried out in Spain. Children with D. pteronyssinus rhinitis or asthma were invited to participate. The study was divided into times: T0 (recruitment); T1 (inclusion); T2 a-f (immunotherapy times) and T3 (the end of study). Efficacy of SIT was assessed by clinical scores, visual analogue scales (VAS) and lung function tests. We performed D. pteronyssinus skin tests at T1 and T3, and determined specific serum IgE, IgG4 and IL-10 at T1, T2f and T3. Data were analysed using Mann-Whitney and Kruskal-Wallis tests, compared using Wilcoxon and Chi-square tests, and correlated to Spearman test. All tests had a significance level of 0.05. RESULTS: Thirty-eight children completed the study. At T1 all had rhinitis and 34 also had asthma. At T3, 30 patients had improved, six experienced no changes and two worsened. Improvement was associated to FEV1/FVC and VAS improvement; to a reduction in D. pteronyssinus skin prick test; to a progressive increase in serum levels of D. pteronyssinus IgE, and D. pteronyssinus, Der p1 and Der p2 IgG4. IL-10 levels showed an early increase at T2f (the end of initial build-up immunotherapy phase), and then a reduction at T3 (the end of a year of immunotherapy). Improvement associated to an early increase in IL-10 and was correlated with VAS and specific IgG4 evolution.


Assuntos
Antígenos de Dermatophagoides/uso terapêutico , Proteínas de Artrópodes/uso terapêutico , Asma/terapia , Cisteína Endopeptidases/uso terapêutico , Dermatophagoides pteronyssinus/imunologia , Dessensibilização Imunológica/métodos , Interleucina-10/imunologia , Rinite Alérgica/terapia , Adolescente , Animais , Antígenos de Dermatophagoides/imunologia , Proteínas de Artrópodes/imunologia , Asma/imunologia , Criança , Pré-Escolar , Cisteína Endopeptidases/imunologia , Feminino , Humanos , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Masculino , Estudos Prospectivos , Rinite Alérgica/imunologia , Espanha , Escala Visual Analógica
12.
Rev. lab. clín ; 5(4): 188-194, oct.-dic. 2012.
Artigo em Espanhol | IBECS | ID: ibc-107854

RESUMO

Introducción. Los programas para cribado neonatal utilizan muestras de sangre impregnada en papel, en ellas se determinan los marcadores de las patologías incluidas. La presencia de anticoagulantes en las muestras puede producir interferencias en los métodos de medida y se recomienda su no utilización. No es posible reconocer las muestras recogidas con anticoagulante. Material y métodos. Se desarrolló y optimizó un procedimiento por espectrometría de masas en tándem con electrospray (ESI-MS/MS) para la determinación de EDTA (ácido etilendiaminotetraacético) en las muestras de sangre en papel y se valoró su inclusión en el perfil de aminoácidos y acilcarnitinas utilizado para la detección precoz neonatal de enfermedades metabólicas. Se estudió su influencia sobre las medidas de tirotropina (TSH), realizadas para el cribado neonatal de hipotiroidismo congénito. Resultados. Se optimizaron los parámetros que permiten la medida de EDTA en el eluato de sangre. Se ha determinado TSH en sangre en papel, suero y plasma de un grupo de 110 muestras y EDTA en otro grupo de 2.300 muestras provenientes del programa de cribado neonatal detectando su presencia en un 0,74% de las mismas. Conclusiones. El método desarrollado es válido para la determinación de este anticoagulante y se puede incluir en el perfil de aminoácidos y acilcarnitinas por MS/MS para detectar aquellas muestras que se extrajeron inadecuadamente. Se ha confirmado la influencia negativa del EDTA en la determinación de TSH mediante un fluoroinmunoensayo (AutoDELFIA(R)). Esto podría provocar un falso negativo en el cribado neonatal de hipotiroidismo congénito (AU)


Introduction. Newborn screening programs use blood impregnated paper to analyze disease markers. The presence of EDTA in samples may interfere in the analytical methods used to measure these markers. For this reason, it is recommended not use anticoagulants in these samples. Moreover, it is not possible to recognize samples that have been collected into EDTA. Material and Methods. We developed and optimized an electrospray tandem mass spectrometry (ES-MS/MS) method to determine EDTA (ethylenediaminetetraacetic acid) in dried blood spots (DBS) on paper. We also included the method in the amino acids and acylcarnitines profile used for metabolic diseases neonatal screening. We also studied the EDTA influence on thyrotropin (TSH) neonatal screening analysis. Results. Optimized parameters for EDTA analysis in the blood eluate were found. TSH analysis was performed on DBS, serum and plasma samples from 110 patients. EDTA analysis on 2000 neonatal screening samples detected 0.74% of cases with EDTA contamination. Conclusions. The negative influence of EDTA in the determination of TSH by fluoroimmunoassay (AutoDELFIA(R)) has been confirmed. This could cause a false negative in neonatal screening for congenital hypothyroidism. The developed method is valid for the determination of this blood anticoagulant and can be included in the profile of amino acids and acylcarnitines by MS / MS to detect those samples that were taken improperly (AU)


Assuntos
Humanos , Masculino , Feminino , Espectrometria de Massas em Tandem/métodos , Espectrometria de Massas em Tandem/normas , Espectrometria de Massas em Tandem , Diagnóstico Pré-Natal/instrumentação , Diagnóstico Pré-Natal/métodos , Receptores da Tireotropina/análise , Tireotropina , Doenças Metabólicas/diagnóstico , Diagnóstico Precoce , Hipotireoidismo Congênito/diagnóstico , Espectrometria de Massas em Tandem/classificação , Espectrometria de Massas em Tandem/instrumentação , Espectrometria de Massas em Tandem/tendências , Hipotireoidismo Congênito , Hipotireoidismo/diagnóstico , Medições Luminescentes/métodos
17.
Nefrología (Madr.) ; 30(1): 95-102, ene.-feb. 2010. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-104506

RESUMO

Introducción: El conocimiento de los factores que determinan el transporte peritoneal de potasio en diálisis peritoneal (DP) es incompleto. Los objetivos de este estudio fueron comparar el transporte peritoneal de potasio en pruebas de equilibrio peritoneal (PEP) con soluciones de glucosa al 2,27 y al 3,86%, y desvelar factores con influencia en este fenómeno. Método: Noventa pacientes en DP fueron sometidos a PEP al 2,27 y al 3,86%, en orden aleatorio. Comparamos el transporte de potasio en ambas pruebas, buscando correlaciones del cociente D/P de potasio a 240 minutos (variable principal) con marcadores de función peritoneal durante PEP, y con diferentes variables demográficas, clínicas y bioquímicas, usando una estrategia multivariante. Resultados: El D/P de potasio presentó buena concordancia en ambas PEP, mostrando asociación univariante con el D/P de creatinina, pero no con potasio plasmático, ultrafiltración o descenso de sodio. La edad, tipo de DP, carga peritoneal de glucosa, icodextrina, tratamiento con IECA-ARA o calcioantagonistas, potasio urinario y filtrado glomerular tuvieron una correlación univariante con el transporte de potasio. En el análisis multivariante, el D/P de creatinina a 240 minutos (B = 0,40 [IC 95%: 0,26-0,53] 2,27%; B = 0,36 [0,21-0,51] 3,86%; p <0,0005) fue el predictor esencial del D/P de potasio a 240’. La excreción urinaria de potasio también tuvo una correlación inversa con la variable principal. Asimismo, el tratamiento con IECA-ARA se asoció de forma consistente con el transporte peritoneal de potasio, pero sólo en la PEP al 3,86% (B = 0,08 [0,04-0,12]; p <0,0005). Conclusiones: Las PEP al 2,27 y al 3,86% estiman de manera concordante el transporte peritoneal de potasio. Aunque el transporte de creatinina es el predictor principal del de potasio, la excreción urinaria de potasio y el tratamiento con IECA-ARA se asocian de manera independiente con el fenómeno citado (AU)


BBackground: There are gaps in the knowledge of factors which influence peritoneal potassium transport in peritoneal dialysis (PD). The aims of this study were to compare peritoneal potassium transport in PD patients undergoing 2.27% and 3.86% peritoneal equilibration tests (PET), and to disclose clinical correlates of this phenomenon. Method: Ninety PD patients underwent 2.27% and 3.86% PET, in a random order. We compared peritoneal potassium transport in both tests, and searched for correlations between D/P potassium at 240 minutes (main study variable) and PET-derived markers of peritoneal function and selected demographic, clinical and biochemical variables, using a multivariate approach. Main results: D/P potassium showed a good agreement between both PET, and presented a univariate association with creatinine transport, but not with plasma potassium, ultrafiltration or sodium dip. Age, PD modality, peritoneal glucose load, icodextrin, ACEI-ARA and calcium antagonist therapy, urinary potassium and glomerular filtration rate were other univariate correlates of potassium transport. Multivariate analysis confirmed D/P creatinine at 240 minutes (B = 0.40 [95% CI 0.26-0.53] 2.27%, B = 0.36 [0.21-0.51] 3.86%,p <0.0005) as the main predictor of D/P potassium at 240’. Urinary potassium, rather than glomerular filtration rate, sustained also an inverse correlation with the dependent variable. Treatment with ACEI-ARA was consistently associated with peritoneal potassium transport (3.86% PET) (B = 0,08 [0.04-0.12], p <0.0005). Conclusions: The 2.27% and the 3.86% PET show a good agreement at the time of estimating peritoneal potassium transport. Urinary potassium excretion and treatment with ACEI-ARA (3.86% test) show an independent association with peritoneal potassium transport rate (AU)


Assuntos
Humanos , Diálise Peritoneal/métodos , Insuficiência Renal Crônica/fisiopatologia , Potássio/urina , Cavidade Peritoneal/fisiologia , Soluções para Hemodiálise/farmacologia , /uso terapêutico , Túbulos Renais/fisiopatologia
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