Hydroxyurea in the sickle cell anemia: toxicity and effectiveness

Objective: to evaluate the use of hydroxyurea with regard to effectiveness and toxicity in people with sickle cell anemia. Method: this is a retrospective descriptive study, developed with 57 medical records of patients with sickle cell anemia, treated at the University Hospital Center of Campo Grande (Mato Grosso do Sul, Brazil), from 1993 to 2005. Inclusion criteria: electrophoresis of hemoglobin in medical record; regular use of drugs, for an average of 196 weeks; dosage; and hematological analyses before starting treatment. Exclusion criteria: living with other hemoglobinopathies. The variables evaluated were: neutrophils count; platelets; leukocytes; hemoglobin; time using hydroxyurea; drug response to the optimal dosage; and number and type of episodes of hospitalization. The research protocol was approved by the Ethics Committee of Universidade Federal de Mato Grosso do Sul, under the Protocol 645. Results: of the 57 medical records, 3 cases were evaluated. Comparing the hematological values, according to Portaria 872, enacted on 11/12/2002, it was found that: cases A, B, and C present an use of hydroxyurea (500 mg/day) for four years, with an average of 196 weeks. Case A, female, decreased painful episodes and frequency of hospitalization, keeping hematological values with no toxicity. In Case B, female, there was one hospitalization due to pain crises and important hemolysis. It stood out, in case C, male, neutropenia with hematological values < 2,000/mm3 . Conclusion: in the cases analyzed, we observed a drop in the number of hospitalizations with the decrease in painful crises from three to one a year, and there was no toxicity with regard to the dosage and time using hydroxyurea, in all three cases. For more comprehensive results, one suggests further study on this therapy with significant samples of this clientele.

Anemia and hemoglobinopathies in pregnant women attended in a public hospital

Objectives: to identify the demographic profile and frequency of anemia and hemoglobinopathies, as a basis for future implementation of actions aimed at pregnant women in the public health domain. Method: this is a cross-sectional study developed with pregnant women attended in a university hospital at Mato Grosso do Sul, Brazil. Blood samples were collected for the erythrogram analysis for detection of anemia and selective and specific tests for abnormal hemoglobin. The patients regarded as indigenous and mentally ill, as well as inmates, were excluded from the research, as they represent a vulnerable population which needs a cohort different from that of the sample. For data collection, a particular questionnaire was used. The research was approved by the Ethics Committee of Universidade Federal de Mato Grosso do Sul (UFMS), under the Protocol 873/2006. Results: of the 215 pregnant women under study, 20% were adolescents; 36.3% had incomplete primary education; 53.0% were non-Caucasian; 43.3% were from Campo Grande, Mato Grosso do Sul, Brazil; and 21.1% were of European descent. 17.7% had some type of anemia and, in the evaluation of hemoglobinopathies, 4.7% of patients were detected with some abnormal hemoglobin, with the following frequencies: 3.3% with HbAS; 0.9% with HbAC; and 0.5% with intermediate β-thalassemia. Conclusion: the frequencies of anemia and hemoglobinopathy found in these pregnant women showed the importance of early diagnosis, revealing indicators able to provide a basis for preventive and assistance actions for adequate clinical monitoring, reducing maternal and neonatal morbimortality in the public health services. Descriptors: pregnant women; anemia; hemoglobinopathies; public health; nursing.

Potential utility of melatonin as an antioxidant therapy in the management of sickle cell anemia

This study aimed to assess antioxidant effects of melatonintreatment compared to N-acetylcysteine (NAC) and to their combination in asickle cell suspension. Sickle erythrocytes were suspended in phosphate-buffered saline, pH 7.4, composing external control group. They were alsosuspended and incubated at 37°C either in the absence (experimental controlgroup) or in the presence of NAC, melatonin and their combination atconcentrations of 100 pM, 100 nM and 100 lM for 1 hr (treatment groups).The melatonin influences were evaluated by spectrophotometric [hemolysisdegree, catalase (CAT), glutathione S-transferase (GST), glutathioneperoxidase (GPx), glutathione reductase (GR), glucose-6-phosphatedehydrogenase (G6PDH), and superoxide dismutase (SOD) activities] andchromatographic methods [glutathione (GSH) and malondialdehyde (MDA)levels]. Incubation period was able to cause a rise about 64% on hemolysisdegree as well as practically doubled the lipid peroxidation levels (P < 0.01).However, almost all antioxidants tested treatments neutralized this incubationeffect observed in MDA levels. Among the antioxidant biomarkers evaluated,we observed a modulating effect of combined treatment on GPx and SODactivities (P < 0.01), which showed ~25% decrease in their activities. Inaddition, we found an antioxidant dose-dependent effect for melatonin onlipid peroxidation (r = 0.29; P = 0.03) and for combined antioxidanttreatments also on MDA levels (r = 0.37; P = 0.01) and on SOD activity(r = 0.54; P < 0.01). Hence, these findings contribute with important insightthat melatonin individually or in combination with NAC may be useful forsickle cell anemia management.

Avaliação farmacológica de candidatos a fármacos para o tratamento da anemia falciforme

A anemia falciforme (AF) é a doença hematológica hereditária crônica de maior prevalência no Brasil, causada por uma mutação pontual no gene da β-globina, levando as hemácias a adquirirem formato de foice quando em estado desoxigenado. Essa alteração estrutural causa aumento da adesão celular, hipóxia local, vaso-oclusão e alterações na coagulação. O quadro clínico dos pacientes é diversificado, predominando a dor causada pelo processo inflamatório agudo e crônico, além de complicações que podem ocasionar infarto de tecidos e órgãos, levando à morte. O único fármaco aprovado pelo FDA disponível para o tratamento da doença é a hidroxiuréia (HU), mas, devido a sua toxicidade, têm sido intensificadas as buscas por novas possibilidades terapêuticas. O fator de necrose tumoral alfa (TNF-α) é uma citocina pró-inflamatória presente em grande quantidade nos pacientes portadores da doença, e o óxido nítrico pode contribuir para vasodilatação e proteção vascular. Assim, propôs-se a síntese e avaliação farmacológica de candidatos a fármacos para o tratamento da AF, desenhados com o propósito de apresentar propriedades inibidoras do TNF-α e doadoras de óxido nítrico (NO). Foi avaliada a estabilidade química dos compostos sintetizados, em água, pH 1,2 e pH 7,4, sendo o Composto II o mais estável tanto em pH ácido como em água. Em pH básico, todos os compostos se mostraram instáveis. Os compostos III e VI apresentaram uma maior inibição da agregação plaquetária, atividade também atribuída à capacidade de doação de NO. O composto III foi o único a mostrar-se inibidor de TNF-α e IL-1β, em todas as concentrações avaliadas, e, também, mostrou-se inibidor de NO, no teste induzido por LPS. Diante de todos os ensaios realizados, o composto III é o mais promissor candidato a fármaco, entre os compostos sintetizados, para o tratamento dos sintomas da anemia falciforme.

Estresse oxidativo na anemia falciforme: antioxidantes endógenos como possíveis alvos terapêuticos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Energy deficit does not affect immune responses of experimentally infected pacu (Piaractus mesopotamicus)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Measured and modeled interactive effects of potassium deficiency and water deficit on gross primary productivity and light-use efficiency in Eucalyptus grandis plantations

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Foliar or soil applications of silicon alleviate water-deficit stress of potato plants

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

O sofrimento gera luta: o impacto da anemia falciforme e da vivência do adoecimento no desenvolvimento psíquico de portadores da doença

Pós-graduação em Saúde Coletiva - FMB

Farmacocinética e farmacodinâmica de derivado ftalimídico planejado para o tratamento da anemia falciforme

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

O papel da angiogênese e da hemólise na úlcera de perna de pessoas com anemia falciforme

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência da anemia ferropriva no eletroforetrograma de hemoglobina de leitões

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)