scholarly journals Coombs test positivity in cord blood: early detection of risky newborns and the assessment of their follow-up results

2021 ◽  
Vol 28 (1) ◽  
pp. 42-47
Author(s):  
Ali Ulaş Tuğcu ◽  
Faika Ceylan Çiftçi ◽  
Esra Aktepe Keskin
Keyword(s):  
Risk Factors ◽  
Cord Blood ◽  
Hemolytic Anemia ◽  
Demographic Data ◽  
Early Period ◽  
Serum Total Bilirubin ◽  
Specific Method ◽  
Coombs Test ◽  
Direct Coombs Test

Objective Direct Coombs test (DCT) is a screening process to detect antibodies which are produced against the antigens in the red blood cells of newborns and cause hemolytic disease. In our study, we aimed to compare the demographic data and early period outcomes of the newborns with and without DCT positivity. Methods The data of all newborns who were born in our hospital between January 2019 and September 2019, of whose mothers gave informed consent before the labor and whose cord blood samples were examined were reviewed retrospectively. The data were analyzed by using SPPS 25 (IBM Corp. Released 2017; IBM SPSS Statistics for Windows, Version 25.0; IBM Corp., Armonk, NY, USA) statistics software. Results A total of 302 newborns were included in the study. The results of Direct Coombs test were positive in 27 cases. The phototherapy rate of the cases with positive DCT results was 74% (20/27). It was found that the cases with positive DCT results underwent more phototherapy, started to undergo phototherapy earlier, were hospitalized longer and had lower serum total bilirubin levels compared to the cases with negative DCT results, and these differences were statistically significant (p=0.003, p=0.015, p=0.038 and p=0.026, respectively). Conclusion Today, there is no specific method to prevent jaundice particularly for the newborns with a risk factor. The only thing to do for newborns at this point is to detect if they have risk factors or not, and to follow up newborns with risk factors appropriately. Direct Coombs test has still been playing an important role to predict hemolytic anemia and potential manifestation of hyperbilirubinemia in association with hemolytic anemia in the newborns, and to initiate treatment process as soon as possible.

scholarly journals Can Phototherapy Requirements Be Predicted through Cord Blood Test Results in Newborns?

2020 ◽  
pp. 99-102
Author(s):  
Berna Hekimoğlu
Keyword(s):  
Cord Blood ◽  
Bilirubin Level ◽  
Early Discharge ◽  
High Rate ◽  
Coombs Test ◽  
Direct Coombs Test ◽  
Abo Incompatibility ◽  
Permanent Brain Damage ◽  
Positive Direct

Objective: Hyperbilirubinemia is one of the common problems in newborns. If not diagnosed and treated in time, high bilirubin levels can cause kernicterus and permanent brain damage. Therefore, early detection of hyperbilirubinemia development risk in newborns is important. Our aim is to determine whether the cord blood bilirubin level and the direct coombs test can be used as determinant parameters in order to predict babies with a high risk of developing hyperbilirubinemia requiring treatment. Material and Method: During the process of creating a hyperbilirubinemia follow-up protocol at Ordu University Training and Research Hospital, 300 babies born between January -June 2014with a birth weight ≥ 2500 g and gestational week ≥ 37 weeks were included in the study. The results of the cord blood bilirubin in of these babies, direct coombs test, maternal and infant blood groups and serum bilirubin levels of those who were hospitalized for phototherapy treatment within the first 24 hours were analyzed retrospectively. Results: Phototherapy was given to 35 of 300 (11.7%) newborns included in the study within the first 24 hours after birth. Direct coombs test was positive in 25 of them (8.3%). Phototherapy was given to 80% (n: 20) of the cases whose direct coombs test was positive. ABO incompatibility was found in the etiology of 51.5% of the cases with hyperbilirubinemia. It has been observed that patients with positive direct coombs test have a high rate of hospitalization (p<0.001). Cord blood bilirubin levels were found to be statistically higher in cases who received phototherapy (2.7±1.0 and 1.8±0.6, respectively, p<0.01). In determining the need for phototherapy, sensitivity was 77.1%, specificity was 77.0%, and negative predictive value was 96% for the cut off value of 2.0 mg/dl of cord blood bilirubin. Conclusion: Cord blood bilirubin level and direct coombs test are useful in predicting the possibility of pathological hyperbilirubinemia and hospitalization in newborns. Thus, detection of risky newborns with a noninvasive method within a few hours after birth will prevent early discharge and provide close follow-up and early treatment.

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

2021 ◽  
pp. 000348942110155
Author(s):  
Leonard Haller ◽  
Khush Mehul Kharidia ◽  
Caitlin Bertelsen ◽  
Jeffrey Wang ◽  
Karla O’Dell
Keyword(s):  
Risk Factors ◽  
Medical Records ◽  
Assessment Tool ◽  
Demographic Data ◽  
Anterior Cervical Discectomy ◽  
Cervical Discectomy ◽  
Long Term Follow Up

Objective: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF). Methods: About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks—3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records. Results: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 ( P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively. Conclusion: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

scholarly journals P.1.37 A study of the incidence rate and risk factors of metabolic syndrome among workers of different job categories in taiwan

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A86.3-A87
Author(s):  
Chen-Chang Yang ◽  
Hsin-Chien Wu
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Incidence Rate ◽  
Demographic Data ◽  
Blood Cholesterol ◽  
Health Examination ◽  
Transportation Industry ◽  
The Us ◽  
Job Category

BackgroundIn Taiwan, the prevalence of metabolic syndrome among people over the age of 20 years is as high as 19.7%. With the increase in age, the prevalence of metabolic syndrome is even higher, with the prevalence being more than 30 years among those aged 45–65 years. Notably, very limited follow-up studies have examined the incidence and risk factors of metabolic syndrome among workers of different job categories in Taiwan.MethodsWe conducted a retrospective follow-up study that included 6,284 Taiwanese subjects who had been working in the same job category for 5 years and who received periodic health checkups at a regional hospital from 2006 to 2017 to better understand the incidence rate and risk factors of metabolic syndrome in Taiwan. All participants’ demographic data and health examination data were then analyzed. Metabolic syndrome was diagnosed according to the criteria proposd by the US National Cholesterol Education Program (NCEP) Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III).ResultsAfter an average follow-up of 6.0 years, the incidence rate of metabolic syndrome among workers who had been working in the same job category for five years was 32.42 per 1000 person-years. Moreover, the largest number of cases with metabolic syndrome appeared in the transportation industry.ConclusionThe results of this study should help the employers of various industries to better plan health education and monitoring programs of their employees to ameliorate the incidence of metabolic syndrome.

Megaloblastic Erythropoiesis in Acquired Hemolytic Anemia

Blood ◽  
1961 ◽  
Vol 17 (3) ◽  
pp. 351-356 ◽  
Author(s):  
M. L. N. WILLOUGHBY ◽  
M. A. PEARS ◽  
A. A. SHARP ◽  
M. J. SHIELDS
Keyword(s):  
Hemolytic Anemia ◽  
Coombs Test ◽  
Direct Coombs Test ◽  
Immune Hemolytic Anemia

Abstract 1. A case of auto-immune hemolytic anemia complicated by megaloblastic erythropoiesis is described. The possible mechanism is discussed. 2. The direct Coombs test is a useful adjunct in the diagnosis of megaloblastic anemias.

PERFIL EPIDEMIOLÓGICO Y FACTORES DE RIESGO DE MORTALIDAD EN ADULTOS CON COVID-19: ESTUDIO RETROSPECTIVO.

2020 ◽  
Vol 31 (1) ◽  
Author(s):  
Dayami Martínez Sosa ◽  
Oswaldo Vásconez Hatt ◽  
Katherine Rosero Arboleda ◽  
Fabian Zurita Alvarado ◽  
Mónica Hernández Lojano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Course ◽  
Demographic Data ◽  
Severity Of Illness ◽  
Factors Associated ◽  
Related Risk ◽  
Factores De Riesgo ◽  
New Type ◽  
Epidemiological Characteristics

By the ending of 2019 a new type of coronavirus was identified named SARS-CoV 2, and now known to be the etiological agent of the acute respiratory syndrome coronavirus (SARS-CoV-2). Known as coronavirus 2019 disease or (COVID-19) constitutes a challenge for the world in many unknown aspects and problems in public health. In Ecuador the first reported of a confirmed appeared on February 29 2020, and in March 12 an emergency health status is declared. Objective: To determine the epidemiological characteristics and factors related to death and survival in patients with COVID-19. Design: The study is of transversal retrospective design, the patients chosen were those seen in the respiratory or suspicious of COVID-19 area of Hospital Vozandes Quito between March 2 and April 30. Demographic data and related risk factors for mortality were obtained using the EPI-1 individual form, epidemiological research files, the VI Epi system and electronic promptuary of patients. Results: 250 patients were obtained for this study, 87 of those were confirmed COVID-19, out those eight died and 79 were alive at the ending of the follow up. Regarding the severity of illness, 61% of the patients were classified as mild and 6 % critical (p =<0.001). Elevated values of CRP (OR 1 IC 95% 1.000 – 1.024), age about 55 years old to diagnosis (OR 42,040 IC 95% 36,320 – 47,760) and the presence of hiporexia (OR 24 IC 95% 1.183 – 504.413) were associated with higher mortality levels amongst COVID-19 positive patients. Conclusions The majority of COVID-19 cases showed no serious manifestations, were treated symptomatically and home isolation. Elevated values of CRP and the presence of hiporexia at the diagnosis are factors consistently with death. Future investigations are required to determine the risk factors associated with worst clinical course and prognosis.

scholarly journals Post-stroke dementia: frequency, predictors, and health impact

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Bastawy Al Fawal ◽  
Ahmed Ibrahim ◽  
Mohamed Abd Elhamed
Keyword(s):  
Risk Factors ◽  
Recurrent Stroke ◽  
Demographic Data ◽  
Health Impact ◽  
Stroke Severity ◽  
Post Stroke ◽  
Abnormal Gait ◽  
Psychotic Features ◽  
Demographic Data Collection

Abstract Background Cognitive impairment is an important aspect for stroke survivors. Little data are available about the frequency and risk factors of post-stroke dementia in Egypt. Objectives The aim of this study is to evaluate the frequency and predictors of post-stroke dementia and its impact on outcome. Methods A total of 380 patients with acute stroke were included. Patients were subjected to demographic data collection, neurological examination, and assessment of vascular risk factors. Furthermore, assessment of stroke severity by Barthel Index was done. After 6 months, patients were assessed for outcome and development of post-stroke dementia. Results Post-stroke dementia was detected in 20.8% of patient. It was recorded more in old ages, illiterates, unmarried, unemployed, and those with recurrent stroke and with cerebral infarction (significantly with cardio-embolic). Conclusion Post-stroke dementia is high in Egypt, especially in those with illiteracy, atrial fibrillation, brain atrophy, severe strokes, and those presented with hemiplegia, sphincter affection, abnormal gait, and psychotic features. Assessment for post-stroke dementia should be done during follow up of stroke patients.

scholarly journals Risk Factors for Prognosis after the Maze IV Procedure in Patients with Atrial Fibrillation Undergoing Valve Surgery

2021 ◽  
Author(s):  
Shenghua Zhou
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Bilirubin Level ◽  
Right Atrium ◽  
Total Bilirubin ◽  
Elevated Serum ◽  
Total Bilirubin Level ◽  
Valve Surgery ◽  
Serum Total Bilirubin

The present study evaluated risk factors related to persistent atrial fibrillation (AF) at discharge (AF-d) and recurrentatrial fibrillation (rAF) and all-cause death after the maze IV procedure. Two hundred nineteen patients (63 female,aged 52.5 ± 8.8 years) with valve disease and persistent AF undergoing valve surgery and the maze IV procedure in our center between 2015 and 2016 were included. Baseline demographic and clinical data were obtained by review of medical records. The median follow-up period was 27 months (interquartile range 21–34 months) in our patient cohort.The primary end point was all-cause death. The secondary end point was AF-d or rAF. rAF is defined as AF recurrenceat 3 months or later after the procedure. Twenty-eight patients (12.8%) died during follow-up. Multiple logistic regression analysis showed that thrombocytopenia, elevated serum total bilirubin level, a larger right atrium, AF-d, and rAF were independent determinants for all-cause death after the maze IV procedure after adjustment for age, sex, and clinical covariates, including New York Heart Association class III/IV disease, hypertension, and aortic regurgitation, while valvular disease duration and left atrial diameter greater than 80.5 mm were independent determinants for AF-d, and thrombocytopenia, elevated serum total bilirubin level, higher mean pulmonary artery pressure, and AF-d were independent predictors for rAF. In conclusion, thrombocytopenia, elevated serum total bilirubin level, an enlarged right atrium, AF-d, and rAF are independent predictors of all-cause death in patients undergoing the maze IV procedure.

scholarly journals Childhood Onset Systemic Lupus Erythematosus with Direct Coombs Test Positive in the Absence of Hemolytic Anemia – A Rare Case Report

2021 ◽  
Vol 8 (7) ◽  
pp. C105-107
Author(s):  
Vani Sreekumar ◽  
Mangaiyarkarasi .
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Hemolytic Anemia ◽  
Lupus Erythematosus ◽  
Reproductive Age ◽  
Coombs Test ◽  
Childhood Onset ◽  
Systemic Lupus ◽  
Direct Coombs Test ◽  
Positive Direct ◽  
Onset Systemic Lupus Erythematosus

Systemic Lupus Erythematosus being a chronic autoimmune multisystem inflammatory disease, affects predominantly women of reproductive age group. Childhood – Onset Systemic Lupus Erythematosus is a rare disease with an incidence of 10% - 20%. Positive direct Coombs test in the absence of hemolytic anemia indicates high disease activity and severe renal damage. Herein we report a case of 11-year-old female child diagnosed as Systemic Lupus Erythematosus with positive direct Coombs test in absence of hemolytic anemia which is very rare.

scholarly journals Hemolytic Anemia with Cold Detectable IgG Antibodies

Blood ◽  
1970 ◽  
Vol 36 (5) ◽  
pp. 549-558 ◽  
Author(s):  
MALCOLM R. MACKENZIE ◽  
NANCY C. CREEVY
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Red Cells ◽  
Coombs Test ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Configurational Change ◽  
Direct Coombs Test ◽  
Type 3

Abstract Erythrocytes obtained from patients who manifest autoimmune hemolytic anemia can be divided into at least three categories by the nature of their protein coats as determined by direct antiglobulin (Coombs) test: IgG alone, IgG and complement (C), C alone. IgG antibodies were detected by direct Coombs Test at 4°C but not at 37°C in patients of type 3 A.H.A. Experiments at 4, 10, 15, 20, 30 and 37°C demonstrated that the IgG antibody was not eluted from the red cells at 37°C but apparently underwent a configurational change above 10°C such that agglutination no longer occurred with the Coombs reagent. This change was reversible. The presence of cold detectable IgG antibodies provides a mechanism for C deposition on erythrocytes in some cases of A.H.A., ostensibly due to complement alone.

Sign in / Sign up

Export Citation Format

Share Document