RESUMO
Abstract INTRODUCTION: Dengue presents with a variable clinical course, ranging from mild illness to potentially fatal hemorrhage and shock. We aimed to evaluate the capabilities of various hematological parameters observed early in the course of illness for predicting the clinical outcomes of illness. METHODS: We retrospectively analyzed the records of children admitted in the pediatric inpatient services of the institute with dengue between 2017 and 2019. We determined the relationships between the hematological parameters observed during the first evaluation and the various clinical outcomes. RESULTS: We evaluated data from 613 patients (age range, 26 days to 17 years). Of these, 29.85% exhibited fever with warning signs, and 8.97% had severe dengue. Lower values of hemoglobin, platelet count, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean platelet volume, and higher values of total leukocyte count (TLC), hematocrit, and red cell distribution width variably correlated with numerous clinical outcomes-duration of hospital stay, development of complications, requirement of blood component transfusion, inotropic support, and mortality. Among the parameters, TLC ≥20,000/mL and initial platelet count ≤20,000/mL significantly associated with mortality, with odds ratios (95% confidence interval) of 11.81 (4.21-33.80) and 5.53 (1.90-16.09), respectively. CONCLUSIONS: Hematological parameters observed early during dengue infection may predict its clinical outcomes in infected children. Initial high TLC and low platelet count are potential predictors of fatal outcomes in the course of disease.
Assuntos
Humanos , Criança , Adulto , Dengue Grave/diagnóstico , Dengue/diagnóstico , Estudos Retrospectivos , Hematócrito , Índia/epidemiologia , Contagem de LeucócitosRESUMO
Background: Leukocytosis occurs as a response to a variety of infammatory processes. Aim: To determine if white blood cell count (WBCC) at admission among patients who suffer an acute coronary syndrome (ACS) has an independent prog-nostic value for the occurrence of new cardiovascular adverse events (CAE). Patients and Methods: Prospective study of 558 patients aged 68 ± 13 years (122 women) admitted to the hospital for an acute coronary syndrome. WBCC was measured at admission. A logistic regression model was used to assess the association of WBCC with the occurrence of CAE during the next six months after admission (post infarction angina, re-infarction, cardiac failure and mortality). Results: An univariate analysis showed that patients with a WBCC > 15.000 cell/mm³ had a signifcantly higher mortality and occurrence of CAE. The multivariate analysis showed that subjects with WBCC < 10.000 cell/mm³ experienced fewer CAE than subjects with a WBCC > 15.000 cell/mm³, with an odds ratio of 0.46 (95 percent confdence intervals = 0.21-0.97, p = 0,042). Conclusions: An elevated WBCC at admission among patients with an ACS is associated with a higher incidence of CAE in the ensuing six months.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Síndrome Coronariana Aguda/sangue , Insuficiência Cardíaca/sangue , Contagem de Leucócitos , Infarto do Miocárdio/sangue , Síndrome Coronariana Aguda/mortalidade , Análise de Variância , Angina Pectoris/sangue , Angina Pectoris/mortalidade , Insuficiência Cardíaca/mortalidade , Infarto do Miocárdio/mortalidade , Prognóstico , Estudos Prospectivos , Recidiva , Fatores de Risco , Análise de SobrevidaRESUMO
It was performed the leucocitary picture of 180 females buffaloes of the Jafarabadi, Hurrah and Mediterranea breeds, clinically healthy and created in the Vale do Ribeira region at Estado de São Paulo. The blood samples were obtained by puncture of jugular vein and collected in tubes containing 0.05 ml of a 10% EDTA solution. The counts of the global nunber of leucocytes were determined by Neubauer modified hemocytometer and the differential leucocytes counts were realized in blood smears stained by Rosenfeld"s technique. The means of global counts and of the types of leucocytes were showed in tables according to the animal breeds and ages. There was not found any statistically difference among breeds. According to the increase of the female buffaloes age it was verified a significant decrease of the global number of leucocytes, absolute and relative values of total and typical limphocytes and absolute values of atypical limphocytes and a significant increase of the relative values of sepnented and total neutrophils andabsolute and relative values of eosinophils.
Foi avaliado o quadro leucocitário de 180 búfalas das raças Jafarabadi, Murrah e Mediterrânea, clinicamente sadias e criadas na região do Vale do Ribeira, Estado de São Paulo. As contagens do número global de leucócitos foram feitas em hemocitômetro de Neubauer modificado, a partir de amostras de sangue colhidas por punção da veia jugular, em frascos contendo 0,05 ml de EDTA a 10%. As contagens diferenciais dos tipos leucocitários foram realizadas em esfregaços sanguíneos corados pela técnica recomendada por Rosenfeld. As médias das contagens globais e dos diferentes tipos celulares foram apresentadas em tabelas, segundo as raças e as faixas etárias dos animais estudados. Não foram encontradas quaisquer diferenças estatisticamente significantes nas variáveis estudadas entre as 3 raças acima definidas. Com oavançar da idade das búfalas, verificou-se uma diminuição significativa do núnero total de leucócitos, núnero relativo e absoluto de linfócitos típicos e totais e número absoluto de linfócitos atípicos e aumento significativo da porcentagem de neutrófilos segmentados e totais e do número relativo e absoluto de eosinófilos.