Analysis of the costs of the basic care line for sickle cell disease in Brazilian children under 5 years of age

ABSTRACT Objective: To evaluate and estimate the cost of basic care in sickle cell disease (SCD) for patients under five years of age, within the scope of the Unified Health System (SUS) and to discuss the costs related to possible complications of the disease from the literature. Methods: The main management and conduct recommendations in the SCD up to five years of age, with healthy and baseline health status, were extracted from the Basic Guidelines of the Care Line in the SCD of the Ministry of Health. Systematic data regarding costs of medicines were extracted from the Medicine Market Regulation Chamber. The SUS Table of Procedures, Medicines and Orthotics, Prosthetics and Auxiliary Means of Movement Management System was the guide for the values of complementary exams, as well as for medical consultations. The values applied to calculate the vaccination schedule were extracted from the Pan American Health Organization, adopting the perspective of the SUS-paying costs. Results: The total cost obtained for basic care of SCD in children up to five years of age, including the use of antibiotic prophylaxis, immunizations and the performance of transcranial Doppler ultrasound in the prevention and early detection of cerebrovascular accidents was, on average, $1020.96. Conclusion: The cost-effectiveness of prophylaxis in SCD, up to five years of age, exceeds the expenses resulting from hospitalizations due to complications of the disease. The study of expenses associated with SCD could be used to establish public policies, improve prevention strategies and treat the symptoms and complications of the disease.

Liga Acadêmica de Hematologia (HemoLiga): atuação no ensino, pesquisa e extensão / Academic League of Hematology (HemoLiga): performance in Teaching, Research and Extension*

Introdução: As Ligas Acadêmicas (LAs) são organizações universitárias muito presentes nos cursos de medicina no Brasil, são de caráter extracurricular e complementar, fundamentadas no tripé ensino, pesquisa e extensão (EPE). Suas atividades tendem a aprofundar os conhecimentos sobre determinado tema, estimular a criatividade, o autoaprendizado e o espírito crítico dos estudantes a fim de proporcionar uma melhor formação profissional. Objetivo: Relatar o histórico e a atuação da HemoLiga (HL) com foco na produção científica e compará-la com outras LAs de Medicina do Brasil descritas na literatura. Material e Métodos: Leitura e análise das atas de reuniões da HL para a documentação histórica da liga associada a busca dos Currículos Lattes dos atuais e ex-integrantes da HL para levantamento de dados sobre a produção científica da liga. As informações obtidas foram tabeladas em planilhas de acordo com os subtipos de trabalhos. Foram realizados análises e cruzamento de variáveis para confecção de gráficos. Resultados: A HL é uma liga vinculada a três faculdades de medicina e possui 14 anos de existência. Ela atua no ensino através de reuniões e estágios práticos na área de Hematologia. A pesquisa constitui sua principal atuação, integrando, inclusive, linha de pesquisa internacional. Assim, desde a sua fundação, a HL consta de uma lista de 217 trabalhos científicos produzidos, sendo 32 artigos científicos, 180 resumos, três capítulos de livros e dois livros. Na extensão, a liga agrega os projetos Unir para Cuidar, Doador do Futuro, Triagem Neonatal e Amigo de Sangue. Conclusão: A HL por meio do seu escopo de atuação, em consonância com outras LAs, contribui através de seu perfil de iniciação científica na formação acadêmica de seus membros, além de beneficiar a sociedade através de seus projetos de extensão.

Introduction: The Academic Leagues (ALs) are very present organizations in Medicine courses in Brazil. They are extracurricular and complementary activities which are based on tripod education, research, and extension, aiming to promote a more profound knowledge on a given topic. As a result, it stimulates creativity, self-learning, and critical thinking to provide better professional training. Objective: Report the history and performance of HemoLiga (HL), focusing on scientific production and compare it with other Brazilian Medicine ALs presented in the literature. Material and Methods: Reading and analysis of HL meeting minutes for the league's historical documentation associated with the study of the Lattes Curriculum of current and former HL members to collect data on the league's scientific production. The information obtained was tabulated in spreadsheets according to the subtypes of work. Analysis and crossing of variables were performed to produce graphics. Results: HL has been functioning for 14 years and it is linked to three Medicine courses in Juiz de Fora. The aim of education is obtained through meetings and internships in the area of Hematology. Research is its main activity, including an international line of research. Since its foundation, HL has produced a list of 217 scientific works, including 32 scientific articles, 180 abstracts, three book chapters, and two books. Regarding the extension aspect, the league worked on the projects Unir para Cuidar, Doador do Futuro, Triagem Neonatal and Amigo de Sangue. Conclusion: Through its scope of action, as other ALs, HL contributes through its scientific initiation profile to the academic training of its members, in addition to benefiting society through its extension projects.

Analysis of the costs of the basic care line for sickle cell disease in Brazilian children under 5 years of age.

OBJECTIVE: To evaluate and estimate the cost of basic care in sickle cell disease (SCD) for patients under five years of age, within the scope of the Unified Health System (SUS) and to discuss the costs related to possible complications of the disease from the literature. METHODS: The main management and conduct recommendations in the SCD up to five years of age, with healthy and baseline health status, were extracted from the Basic Guidelines of the Care Line in the SCD of the Ministry of Health. Systematic data regarding costs of medicines were extracted from the Medicine Market Regulation Chamber. The SUS Table of Procedures, Medicines and Orthotics, Prosthetics and Auxiliary Means of Movement Management System was the guide for the values of complementary exams, as well as for medical consultations. The values applied to calculate the vaccination schedule were extracted from the Pan American Health Organization, adopting the perspective of the SUS-paying costs. RESULTS: The total cost obtained for basic care of SCD in children up to five years of age, including the use of antibiotic prophylaxis, immunizations and the performance of transcranial Doppler ultrasound in the prevention and early detection of cerebrovascular accidents was, on average, $1020.96. CONCLUSION: The cost-effectiveness of prophylaxis in SCD, up to five years of age, exceeds the expenses resulting from hospitalizations due to complications of the disease. The study of expenses associated with SCD could be used to establish public policies, improve prevention strategies and treat the symptoms and complications of the disease.

Hiperpigmentação Mucocutânea Associada à Terapia de Hidroxiureia em Paciente com Trombocitemia Essencial: Relato de Caso / Mucocutaneous Hyperpigmentation Associated with Hydroxyurea Therapy in a Patient with Essential Thrombocythemia: Case Report

Introdução: A hiperpigmentação mucocutânea é uma condição dermatológica que pode estar relacionada a tratamentos quimioterápicos, a exemplo das terapias com uso de hidroxiureia (HU). A HU é um fármaco citostático de amplo uso nas doenças mieloproliferativas e compõe a principal linha de tratamento da trombocitemia essencial (TE). O presente estudo tem por objetivo relatar um caso raro de hiperpigmentação mucocutânea em um paciente com TE. Relato do caso: Paciente do sexo masculino, 68 anos de idade, 89 kg, com diagnóstico de TE, em uso de HU 2 g/dia. Com três meses de terapia, apresentou lesões hiperpigmentadas de coloração acastanhadas em pele das mãos e mucosa oral (língua). Em decisão partilhada com o médico-assistente, o paciente optou pela continuação do uso do medicamento. Após seis anos de acompanhamento, as lesões mantêm-se estáveis. Conclusão: A hiperpigmentação mucocutânea associada à terapia com HU é um evento benigno secundário ao uso do fármaco e não exige a interrupção de uso, porém, sua retirada, ou redução das doses, geralmente leva à diminuição ou ao desaparecimento das lesões.

Introduction: Mucocutaneous hyperpigmentation is a dermatological condition that may be related to chemotherapy treatments, such as therapies using hydroxyurea (HU). HU is a cytostatic drug widely used in myeloproliferative diseases and is the main line of treatment for essential thrombocythemia (ET). The present study aims to report a rare case of mucocutaneous hyperpigmentation in a patient with ET. Case report: Male patient, 68 years old, 89 kg, diagnosed with ET using HU 2 g/day. After three months of therapy, he presented hyperpigmented brownish-colored lesions on the hands and oral cavity (tongue). In a decision shared with the assistant physician, the patient chose to continue using the drug. After six years of follow-up, the lesions remain stable. Conclusion: Mucocutaneous hyperpigmentation associated with HU therapy is a benign event secondary to the use of the drug and does not require discontinuation of use, however, its withdrawal or dose reduction usually leads to the reduction or disappearance of the lesions

Introducción: La hiperpigmentación mucocutánea es una condición dermatológica que puede estar relacionada con tratamientos de quimioterapia, como las terapias con hidroxiurea (HU). La HU es un fármaco citostático ampliamente utilizado en enfermedades mieloproliferativas y es la principal línea de tratamiento de la trombocitemia esencial (TE). El presente estudio tiene como objetivo reportar un caso raro de hiperpigmentación mucocutánea en un paciente con TE. Informe del caso: Paciente masculino de 68 años, 89 kg, diagnosticado de TE mediante HU 2 g/día. A los tres meses de tratamiento presenta lesiones hiperpigmentadas de color pardusco en manos y cavidad oral (lengua). En una decisión compartida con el médico asistente, el paciente optó por continuar usando el medicamento. Tras seis años de seguimiento, las lesiones se mantienen estables. Conclusión: La hiperpigmentación mucocutánea asociada a la terapia con HU es un evento benigno secundario al uso del fármaco y no requiere la suspensión de su uso, sin embargo, su retirada o reducción de dosis suele conducir a la reducción o desaparición de las lesiones.