Hematological differences between patients with different subtypes of sickle cell disease on hydroxyurea treatment

OBJECTIVE: Sickle cell anemia and the interaction S/Beta thalassemia differ in hematological values due to microcytosis and hypochromia caused by the thalassemic mutation. The clinical benefit of long-term hydroxyurea treatment is undeniable in sickle cell disease with monitoring of the biological action of the drug being by the complete blood count. The objective of this work is to compare changes in some of the erythrocytic indexes between S/Beta thalassemia and sickle cell anemia patients on long-term hydroxyurea treatment. METHODS: The values of erythrocyte indexes (mean corpuscular volume and mean corpuscular hemoglobin) were compared in a retrospective study of two groups of patients (Sickle cell anemia and S/Beta thalassemia) on hydroxyurea treatment over a mean of six years. RESULTS: The quantitative values of the two parameters differed between the groups. Increases in mean corpuscular volume and reductions in mean corpuscular hemoglobin delay longer in S/Beta thalassemia patients (p-value = 0.018). CONCLUSION: Hematological changes are some of the beneficial effects of hydroxyurea in sickle cell disease as cellular hydration increases and the hemoglobin S concentration is reduced. The complete blood count is the best test to monitor changes, but the interpretation of the results in S/Beta thalassemia should be different.

Avaliação do estado nutricional e do desenvolvimento neuropsicomotor em crianças freqüentadoras de creche / Nutritional status and neurodevelopment of children enrolled in a day care center

OBJETIVO: Avaliar o estado nutricional e o desenvolvimento neuropsicomotor em crianças freqüentadoras de uma creche. MÉTODOS: Estudo transversal de 113 crianças com seis a 70 meses de idade, que freqüentavam a creche Irmã Sheila em Catanduva, São Paulo. A avaliação nutricional foi feita por antropometria e analisada pela classificação de Waterlow e a avaliação do desenvolvimento neuropsicomotor pelo Teste de Denver II, em todas as crianças incluídas no estudo. Dados adicionais foram obtidos por meio de um questionário respondido pelos pais em 70 por cento dos casos. RESULTADOS: Entre as crianças estudadas, observou-se 12 por cento de desnutrição aguda, 1 por cento de desnutrição pregressa e 16 por cento de obesidade. O Teste de Denver II detectou 37 por cento de suspeitos de atraso no desenvolvimento, sendo a linguagem a área mais acometida. A faixa etária mais comprometida foi a de 25 a 60 meses. O questionário mostrou que 87 por cento das crianças receberam aleitamento materno (57 por cento até o sexto mês), 96 por cento das mães trabalhavam fora de casa, 54 por cento delas possuíam ensino médio completo e 73 por cento das famílias tinham renda máxima de dois salários-mínimos. CONCLUSÕES: A alta prevalência de distúrbios nutricionais e possíveis atrasos no desenvolvimento observados em crianças da creche Irmã Sheila mostraram a necessidade de introduzir dietas balanceadas, incentivando o desenvolvimento de hábitos alimentares saudáveis, além de alertar para a questão da interferência negativa dos fatores socioeconômicos e culturais no crescimento e desenvolvimento infantil.

OBJECTIVE: Evaluate the nutritional status and neurodevelopment of children enrolled in a day care center. METHODS: This cross-sectional study enrolled 113 children aged six to 70 months, assisted in a nonprofit day care center in Catanduva, São Paulo. All children were submitted to evaluation of the nutritional status by anthropometry and classified according to Waterlow criteria. Child development was assessed according to Denver II Test. Further characteristics were obtained by a questionnaire answered by 70 percent of the children's parents. RESULTS: Among the evaluated children, 12 percent had acute malnutrition, 1 percent past malnutrition and 16 percent obesity. The Denver II Test detected 37 percent of children with suspect of development delay (the language was the ability area more frequently affected). Children aged 25 to 60 months had more delays. Data from the questionnaire showed that 87 percent of children received breastfeeding (57 percent until around the sixth month of age), 96 percent of the mothers worked outside home, 54 percent of them had high school and 73 percent of the families received less than two minimum wages. CONCLUSIONS: The high prevalence of nutritional problems and possible developmental delays observed in this study indicates the need of adopting balanced diets and improving education towards healthier alimentary habits. Attention should be given in order to act on the negative influence of the poor socioeconomic and educational background on children's growth and development.