ABSTRACT
OBJECTIVE: To assess the prevalence of clinical manifestations suggestive of depression in patients with sickle cell disease. METHODS: A systematic search was performed in the electronic databases PubMed® , LILACS and SciELO, with the following inclusion criteria: cross-sectional studies that assessed the prevalence of depression in patients with sickle cell disease, published in English or Portuguese in the last 10 years. The selection of the articles was performed in two stages by two independent researchers following the PRISMA (Preferred reporting items for systematic reviews and meta-analyses) recommendations. The first stage consisted on screening the titles and abstracts, and in the second stage the full text was appraised, both following the pre-defined inclusion and exclusion criteria. RESULTS: From the 42 articles available, nine were included in this review. Seven instruments were used to screen for depression with different cutoff points, and the Patient Health Questionnaire-9 (PHQ-9) was the most used instrument. The worldwide prevalence of clinical manifestations suggestive of depression ranged from 11 to 40%, according to several variables. CONCLUSION: The prevalence of clinical manifestations suggestive of depression in patients with sickle cell disease is higher compared to the prevalence of depression in the general population. Thus, the multidisciplinary follow-up for these people, with a focus on mental health, is of great importance.
OBJETIVO: Avaliar a prevalência mundial de manifestações clínicas sugestivas de depressão em portadores de doença falciforme. MÉTODOS: Realizou-se uma busca sistemática nas bases de dados eletrônicas PubMed® , LILACS e SciELO, para identificação dos estudos transversais, publicados em inglês ou português nos últimos 10 anos, que avaliaram a prevalência de depressão em portadores de doença falciforme. A seleção dos artigos foi realizada em duas etapas e por dois pesquisadores independentes seguindo a recomendação PRISMA (Preferred reporting items for systematic reviews and meta-analyses). A primeira etapa consistiu na triagem dos títulos e resumos e na segunda etapa foi realizada a análise completa do artigo, ambas seguindo os critérios de inclusão e exclusão predefinidos. RESULTADOS: Dos 42 artigos disponíveis, nove foram incluídos na revisão. Foram utilizados sete instrumentos diferentes para rastreio de depressão com diferentes pontos de corte, sendo The Patient Health Questionnaire-9 (PHQ-9) o instrumento mais utilizado. A prevalência mundial de manifestações clínicas sugestivas de depressão variou de 11% a 40%, conforme diversas variáveis verificadas. CONCLUSÃO: A prevalência de manifestações clínicas sugestivas de depressão encontrada para os portadores de doença falciforme é superior à prevalência de depressão descrita na população geral. Desse modo, é de suma importância o acompanhamento multidisciplinar para essas pessoas, com enfoque na saúde mental.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Depression/diagnosis , Depression/epidemiology , Depressive Disorder, Major/epidemiology , Anemia, Sickle Cell/diagnosis , Anemia, Sickle Cell/epidemiology , Prevalence , Cross-Sectional Studies , Surveys and QuestionnairesABSTRACT
Abstract The treatment of patients with relapsed and/or refractory multiple myeloma has improved considerably in the last 15 years, after the introduction of proteasome inhibitors and immunomodulatory drugs. The first clinical trials with new proteasome inhibitors have produced exciting results, particularly those comparing triplet regimens with standard doublet regimens, with a gain in progression-free survival accompanied by an acceptable safety profile and either similar or better health-related quality of life. New proteasome inhibitors hold the potential to fill unmet needs in multiple myeloma management regarding improvement of clinical outcomes, including delayed progression of disease in high-risk patients. This review summarizes the main pharmacological properties and clinical outcomes of these agents, and discusses their potential to change the whole multiple myeloma therapeutic landscape.