ABSTRACT
INTRODUÇÃO: A deficiência de Vitamina D (VD) é frequente na doença falciforme (DF) em decorrência do status inflamatório crônico, danos renais, endoteliais, hiperhemólise e melanodermia. Atualmente, a suplementação desse nutriente em falcêmicos tem se mostrado importante devido sua ação sistêmica e imunológica. OBJETIVOS: Analisar o impacto da VD em crianças com DF. MÉTODOS: Trata-se de uma revisão integrativa da literatura, onde foram analisados estudos, publicados originalmente em inglês e português, dos últimos dez anos, em humanos, tendo como referência as bases de dados MEDLINE, SciELO e LILACS. A busca foi efetuada mediante a consulta ao MeSH. Os descritores utilizados foram: "children"; "vitamin D"; "sickle cell anemia"; "supplementation". Foram identificados 32 artigos a partir da frase de pesquisa. Ao aplicar os critérios de inclusão, nove artigos foram eleitos para o estudo. RESULTADOS: A partir da análise dos artigos incluídos, 6 avaliaram a prevalência da deficiência de VD em crianças com anemia falciforme e os outros três artigos relataram sobre a suplementação de VD em crianças também com anemia falciforme. Todos os estudos mostraram que as crianças tratadas com reposição de VD tiveram uma diminuição de idas ao pronto-socorro e maior estabilidade hemodinâmica durante os tratamentos. CONCLUSÃO: Outros ensaios clínicos randomizados devem ser realizados para identificar o papel da DV na qualidade de vida e na redução da morbidade falciforme. A contribuição deste artigo é reconhecer que há evidências sobre a vitamina D fora dos ensaios clínicos randomizados.
INTRODUCTION: Vitamin D (VD) deficiency is frequent in sickle cell disease (SCD) due to chronic inflammatory status, kidney and endothelial damage, hyperhemolysis and melanoderma. Currently, the supplementation of this nutrient in sickle cell patients is important due to its systemic and immunological action. Objectives: To analyze the impact of VD in children with SCD. METHODS: This is an integrative literature review, which analyzed studies, originally published in English and Portuguese, in the last ten years, in humans, using the MedLine, SciELO and LILACS databases as References. The search was performed by consulting the MeSH. The descriptors used were: "children"; "vitamin D"; "sickle cell anemia"; "supplementation". 32 articles were identified from the search phrase. When applying the inclusion criteria, nine articles were chosen for the study. RESULTS: Among the included articles, six evaluated the prevalence of VD deficiency in children with sickle cell anemia, and the other three reported on VD supplementation in children with sickle cell anemia. All studies showed that children treated with VD replacement had a decrease in emergency room visits and greater hemodynamic stability during treatments. CONCLUSION: Further randomized controlled trials should be carried out to identify the role of VD in quality of life and in the reduction of sickle cell morbidity. The contribution of this paper is to recognize that there is evidence about vitamin D outside of randomized controlled trials.
Subject(s)
Humans , Child , Adolescent , Vitamin D Deficiency , Dietary Supplements , Anemia, Sickle Cell/complicationsABSTRACT
ABSTRACT Introduction: In Brazil, the sickle cell trait (SCT) has an average prevalence of 4% in the general population and 6-10% among Afro-descendants. Although SCT is highly prevalent, a large segment of the population ignores their status. The Therapeutic Guidelines prohibit the transfusion of SCT red blood cells into patients with hemoglobin disorders or severe acidosis and newborns. Methods: This was a cross-sectional study with data from 37,310 blood donation candidates. The study included only eligible first-time donors qualified to be tested for the presence of hemoglobin S (HbS) at the Fundação Hemominas Juiz de Fora, Brazil. The variables studied were gender, skin color, age, type of donation, place of birth, blood type, result of the solubility test for hemoglobin S (HbST) and hemoglobin electrophoresis (HbEF). Statistical analysis was performed using the Q square test and the Kappa index of agreement for comparing biochemical methods. This project was approved by the National Research Ethics Committee. Results: The analysis of first-time donor data showed that 7166 were considered eligible. A total of 127 of the 7166 donors were carriers of SCT (1.77%). Among the blood donors, 73.23% were from the local area. The HbST and HbEF were found to be 100% in concordance. Sensitivity was not tested in the present study. Conclusions: The HbST is highly specific for identifying the HbS, but sensitivity was not tested in this study. The screening of blood donors for abnormal hemoglobins is useful, helping to detect and counsel heterozygous people. The study seeks to identify the prevalence of SCT in a region of Brazil.
Subject(s)
Humans , Male , Female , Blood Donors , Hemoglobin, Sickle , Anemia, Sickle Cell , Sickle Cell Trait , Prevalence , Cross-Sectional Studies , Retrospective Studies , ErythrocytesABSTRACT
Introdução: A pandemia determinada pelo novo coronavírus (SarsCoV-2), doença intitulada COVID-19, atingiu mais de 219 países com grande agravo e impacto à saúde mundial. A infecção pelo vírus desencadeia uma resposta imune explosiva, hiperativada e descontrolada, com manifestações clínicas graves em pessoas com doenças subjacentes. A Doença falciforme (DF), uma condição genética que determina imunosupressão, coloca os pacientes em maior risco de infecções respiratórias e complicações pulmonares dentro do contexto da pandemia. Objetivo: Analisar o impacto da COVID-19 em portadores de DF e propor uma diretriz de atendimento a esta população. Métodos: Trata- se de uma revisão sistemática de literatura onde foram analisados estudos, publicados originalmente em inglês, entre março a dezembro de 2020, tendo como referência as bases de dados MedLine, SciELO e LILACS. A busca foi efetuada mediante a consulta ao MeSH com os descritores "sickle cell disease", "covid-19"e "guideline". Foram identificados 64 artigos a partir da frase de pesquisa. Ao aplicar os critérios de inclusão, 7 artigos foram eleitos para o estudo. Resultados e Conclusão: A infecção pelo novo coronavírus pode precipitar intercorrências em pacientes com DF, como crises vaso-oclusivas e síndrome torácica aguda. Considerando esses dados, os autores formularam uma diretriz para orientação e cuidado aos indivíduos com DF
Introduction: The pandemic caused by the new coronavirus (SarsCoV-2), a disease called COVID-19, has reached more than 219 countries with great damage and impact on global health. The viral infection triggers an explosive, hyperactive and uncontrolled immune response, with severe clinical manifestations in people with underlying diseases. Sickle Cell Disease (SCD), a genetic condition that determines immunosuppression, causes patients a greater risk of respiratory infections and pulmonary complications within the context of the pandemic. Objective: To analyze the impact of COVID-19 in patients with SCD and propose a guideline to care for this population. Methods: This is a systematic literature review where studies were analyzed, originally published in English, between March and December 2020, using the MedLine, SciELO and LILACS databases as references. The search was carried out by consulting the MeSH with the descriptors "sickle cell disease", "covid-19" and "guideline". 64 articles were identified from the search phrase. When applying the inclusion criteria, 7 articles were chosen for the study. Results and Conclusion: The infection with the new coronavirus could cause complications in patients with SCD, such as vaso-occlusive crises and acute chest syndrome. Considering these data, the authors formulated a guideline for guidance and care for individuals with SCD.