DALTON DE ALENCAR FISCHER CHAMONE

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Departamento de Clínica Médica, Faculdade de Medicina - Docente

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  • article 17 Citação(ões) na Scopus
    Demographic characteristics and prevalence of serologic markers among blood donors who use confidential unit exclusion (CUE) in Sao Paulo, Brazil: implications for modification of CUE polices in Brazil
    (2011) ALMEIDA-NETO, Cesar de; LIU, Jing; WRIGHT, David J.; MENDRONE-JUNIOR, Alfredo; TAKECIAN, Pedro L.; SUN, Yu; FERREIRA, Joao Eduardo; CHAMONE, Dalton de Alencar Fischer; BUSCH, Michael P.; SABINO, Ester Cerdeira
    BACKGROUND: This study evaluated demographic profiles and prevalence of serologic markers among donors who used confidential unit exclusion (CUE) to assess the effectiveness of CUE and guide public policies regarding the use of CUE for enhancing safety versus jeopardizing the blood supply by dropping CUE. STUDY DESIGN AND METHODS: We conducted a cross-sectional analysis of whole blood donations at a large public blood center in Sao Paulo from July 2007 through June 2009, compared demographic data, and confirmed serologic results among donors who used and who have never used CUE (CUE never). RESULTS: There were 265,550 whole blood units collected from 181,418 donors from July 2007 through June 2009. A total of 9658 (3.6%) units were discarded, 2973 (1.1%) because CUE was used at the current donation (CUE now) and 6685 (2.5%) because CUE was used in the past (CUE past). The CUE rate was highest among donors with less than 8 years of education (odds ratio [OR], 2.78; 95% confidence interval [CI], 2.51-3.08). CUE now donations were associated with higher positive infectious disease marker rates than CUE never donations (OR, 1.41; CI, 1.13-1.77), whereas CUE past donations were not (OR, 1.04; CI, 0.75-1.45). CONCLUSION: The CUE process results in a high rate of unit discard. CUE use on an individual donation appears predictive of a high-risk marker-positive donation and, thus, appears to contribute modestly to blood safety. The policy of discarding units from donors who have previously CUE-positive donations does not improve safety and should be discontinued.
  • article
    Bcl-2 protein in diffuse large B-cell lymphoma Response
    (2011) HALLACK NETO, Abrahao Elias; SIQUEIRA, Sheila Aparecida Coelho; DULLEY, Frederico Luiz; CHAUOBAH, Alfredo; BELESSO, Marcelo; SABOIA, Rosaura; RUIZ, Milton Artur; CHAMONE, Dalton Alencar Fischer; PEREIRA, Juliana
  • article 5 Citação(ões) na Scopus
    Outpatient treatment with intravenous antimicrobial therapy and oral levofloxacin in patients with febrile neutropenia and hematological malignancies
    (2011) BELLESSO, Marcelo; COSTA, Silvia Figueiredo; PRACCHIA, Luis Fernando; DIAS, Lucia Cristina Santos; CHAMONE, Dalton; DORLHIAC-LLACER, Pedro Enrique
    The purpose of this study was to evaluate outcomes such as success of the initial therapy, failure of outpatient treatment, and death in outpatient treatment during intravenous antimicrobial therapy in patients with febrile neutropenia (FN) and hematological malignancies. In addition, clinical and laboratory data and the Multinational Association for Supportive Care of Cancer index (MASCC) were compared with failure of outpatient treatment and death. In a retrospective study, we evaluated FN following chemotherapy events that were treated initially with cefepime, with or without teicoplanin and replaced by levofloxacin after 48 h of defervescence in patients with good general conditions and ANC > 500/mm(3). Of the 178 FN episodes occurred in 126 patients, we observed success of the initial therapy in 63.5% of the events, failure of outpatient treatment in 20.8%, and death in 6.2%. The success rate of oral levofloxacin after defervescence was 99% (95 out of 96). Using multivariate analysis, significant risks of failure of outpatient treatment were found to be smoking (odds ratio (OR) 3.14, confidence interval (CI) 1.14-8.66; p = 0.027) and serum creatinine levels > 1.2 mg/dL (OR 7.97, CI 2.19-28.95; p = 0.002). With regard to death, the risk found was oxygen saturation by pulse oximetry < 95% (OR 5.8, IC 1.50-22.56; p = 0.011). Using the MASCC index, 165 events were classified as low risk and 13 as high risk. Failure of outpatient treatment was reported in seven (53.8%) high-risk and 30 (18.2%) low-risk episodes (p = 0.006). In addition, death occurred in seven (4.2%) low-risk and four (30.8%) high-risk events (p = 0.004). Ours results show that MASCC index was able to identify patients with high risk. In addition, non-smoking, serum creatinine levels a parts per thousand currency sign1.2 mg/dL, and oxygen saturation by pulse oximetry a parts per thousand yen95% were protection factors.