Showing posts with label fibrinolysis. Show all posts
Showing posts with label fibrinolysis. Show all posts

Tuesday, 16 April 2024

Increase in the Number of Medical Requests for D-dimer during the First Wave of COVID-19: A Case Study of a University Hospital in the Metropolitan Region of the State of Rio de Janeiro | Chapter 3 | Recent Updates in Disease and Health Research Vol. 5

Introduction: COVID-19 is an infectious disease that mainly affects the respiratory system, and its etiologic agent is the severe acute respiratory syndrome virus. The number of medical requests for D-dimer increased during the COVID-19 pandemic.  D-dimer is a fibrin degradation product and is an indirect marker of fibrinolysis. If an individual infected with SARS-COV 2 evolves with aggravation, a result equal to or greater than four times the reference value of this marker at the time of admission is considered a predictor of mortality. The most important exam since the beginning of the pandemic, is due to the thrombotic manifestations resulting from the infection.

 

Objective: This study aims to evaluate the variation in the number of medical requests for D-dimer dosage at a given University Hospital and its profile in the first wave of the COVID-19 pandemic.

 

Methodology: This is a cross-sectional observational study, where the results of patients with a COVID-19 profile, identified in the Emergency Laboratory of a University Hospital, were quantified and medical causes for D-dimer dosages in the period from 03/01/2020 to 07/03/2020. Data were collected through qualitative research in the medical records of hospitalized patients with D-dimer requests, using the computerized system of the Clinical Pathology Service. Kruskal-Wallis test and Dunn's multiple comparison test were used for the statistical test.

 

Results: In the first half of 2020, 1017 requests were observed. Comparing the 1st quarter with the 2nd quarter of the same year, there was an abrupt increase of 1274%, no total occurrences from one quarter to the other, since no 1st quarter, only 69 requests were detected with a median 2231 ng / mL ( interquartile range 175-15605), no longer 2nd quarter this number jumped to a total of 948 requests with a median 2020 ng / mL (interquartile range 99-97026).

 

Conclusion: Although D-dimer does not have high specificity as a diagnostic tool, it has been very useful as a severity predictor for COVID 19. Despite the enormous impact generated by the substantial increase in demand for D-dimer demand in this University Hospital, has provoked a solution of continuity in the provision of services, further studies in risk and disaster management would be opportune, in order to improve the resolving flow for situations that, unfortunately, may occur.


Author(s) Details:

Paulo Sérgio de Abreu Junior,
Fluminense Federal University, Brazil.

Hye Chung Kang,
Fluminense Federal University, Brazil.

Please see the link here: https://stm.bookpi.org/RUDHR-V5/article/view/14028

Monday, 8 August 2022

Could FXIII Deficiency Influence Intracerebral Hemorrhage after Neurosurgery? | Chapter 9 | Current Practice in Medical Science Vol. 8

The main objective was to determine how perioperative FXIII levels affected ICH following brain surgery. An 18-month prospective observational study was conducted at a Spanish third-level hospital. It comprised all consecutive adults (18 years or older) who underwent elective brain tumour surgery and underwent postoperative care in the Neurointensive Care Unit (N-ICU). Ages under 18, informed refusals, deaths in operating rooms, inadequate blood samples, and non-tumor tissue were prohibited. FXIII levels in three blood samples were measured (A-presurgical, B-postsurgical and C-24 hours after surgery). The study involved 109 patients. Final ICH confirmation was made in 39 of them (35,78 percent). An association between the length of the ICU stay (p0,01) and the male gender (p0,03) and the ICH was found by inferential studies. Particularly in the B sample, ICH patients' average FXIII was lower (A 71,2 percent, B 51,57 percent, C 52,14 percent). After brain tumour surgery, acquired FXIIID (70%) elevated ICH, indicating that it might be employed as a risk marker for haemorrhage. Additionally, male gender, baseline variation, and a longer ICU stay were all associated with ICH. Tests for normal coagulation did not exclude FXIII disease. Future research may focus on FXIIID detection and replacement therapy as a therapeutic goal.

 

Author (s) Details

Estela Val Jordan

Department of Critical Care, Hospital Universitario Miguel Servet, Paseo Isabel La Católica, 1-3. 50009, Zaragoza, Spain.

 

Please see the link here:- https://stm.bookpi.org/CPMS-V8/article/view/7798