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Within the spectrum of sickle cell disease (SCD) are sickle cell anemia (SCA), presence of hemoglobin SS (HbSS), hemoglobin SC disease (HbSC), and sickle cell ß-thalassemia (Sß-thal). Asymmetric dimethylarginine (ADMA) competitively inhibits the binding of arginine to NOS, reducing NO production. In patients with HbSS, increased levels of ADMA have been reported, as well as changes in many hemostatic biomarkers, including the plasminogen activator inhibitor type 1 (PAI-1). We hypothesized that high levels of ADMA and PAI-1 may be associated with more severe SCD. Thus, ADMA and PAI-1 levels were determined in 78 individuals including 38 adult patients with SCD and 40 control subjects. Higher levels of ADMA were shown in HbSS and Sß-thal patients compared to controls. Concerning PAI-1, all patients showed high levels of PAI-1 compared to controls. As a role of NO in the pathogenesis of SCD has already been established, we concluded that high levels of ADMA should compromise, at least in part, NO synthesis, resulting in endothelial dysfunction. Elevated plasma levels of PAI-1 in all patients may indicate not only endothelial dysfunction but also a hypofibrinolytic state favoring thrombotic complications. Finally, high levels of ADMA and PAI-1 may be associated with more severe SCD.

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OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a disease caused by a newly discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which usually leads to non-specific respiratory symptoms. Although pregnant women are considered at risk for respiratory infections by other viruses, such as SARS and Middle East respiratory syndrome (MERS), little is known about their vulnerability to SARS-CoV-2. Therefore, this study aims to identify and present the main studies on the topic, including the postpartum period. METHODS: In this narrative review, articles were searched in various databases, organizations, and health entities using keywords compatible with medical subject headings (MeSH), such as: COVID-19, pregnancy, vertical transmission, coronavirus 2019, and SARS-CoV-2. RESULTS: The review of the scientific literature on the subject revealed that pregnant women with COVID-19 did not present clinical manifestations significantly different from those of non-pregnant women; however, there are contraindicated therapies. Regarding fetuses, studies were identified that reported that infection by SARS-CoV-2 in pregnant women can cause fetal distress, breathing difficulties and premature birth, but there is no substantial evidence of vertical transmission. CONCLUSION: Due to the lack of adequate information and the limitations of the analyzed studies, it is necessary to provide detailed clinical data on pregnant women infected with SARS-CoV-2 and on the maternal-fetal repercussions caused by this infection. Thus, this review may contribute to expand the knowledge of professionals working in the area as well as to guide more advanced studies on the risk related to pregnant women and their newborns. Meanwhile, monitoring of confirmed or suspected pregnant women with COVID-19 is essential, including in the postpartum period.

OBJETIVO: A Coronavirus disease 2019 (COVID-19) é uma doença causada por um coronavírus recém descoberto, o severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), que geralmente leva a sintomas respiratórios não específicos. Embora mulheres grávidas sejam consideradas em risco de infecções respiratórias por outros vírus, como SARS e Middle East respiratory syndrome (MERS), pouco se sabe sobre sua vulnerabilidade ao SARS-CoV-2. Portanto, este estudo tem como objetivo identificar e apresentar os principais estudos sobre o tema incluindo o período pós-parto. MéTODOS: Nesta revisão narrativa, foram pesquisados artigos em diversas bases de dados, organizações e entidades de saúde, utilizando palavras-chave compatíveis com o MeSH, tais como: COVID-19, gravidez, transmissão vertical, coronavírus 2019, e SARS-CoV-2. RESULTADOS: A revisão da literatura científica sobre o assunto revelou que as gestantes com COVID-19 não apresentaram manifestações clínicas significativamente diferentes das não gestantes, porém existem terapias contraindicadas. Em relação aos fetos, foram identificados estudos que relataram que a infecção por SARS-CoV-2 em mulheres grávidas pode causar sofrimento fetal, dificuldades respiratórias e parto prematuro, mas não há evidências substanciais de transmissão vertical. CONCLUSãO: Devido à falta de informações adequadas e às limitações dos estudos analisados, é necessário fornecer dados clínicos detalhados sobre as gestantes infectadas pelo SARS-CoV-2 e sobre as repercussões materno-fetais causadas por esta infecção. Assim, esta revisão pode contribuir para ampliar o conhecimento dos profissionais que atuam na área, bem como para orientar estudos mais avançados sobre o risco relacionado à gestante e seu recém-nascido. Enquanto isso, o monitoramento de gestantes confirmadas ou suspeitas com COVID-19 é essencial, incluindo o pós-parto.

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Abstract Introduction The association between uterine cervix and anogenital carcinomas and human papillomavirus, HPV, is well established, however the involvement of this virus in the development of oral squamous cell carcinomas remains controversial. Objectives To evaluate the relationship between HPV infection and oral squamous cell carcinomas, and to estimate the incidence of this infection in these patients. Methods Four electronic databases were searched to find studies that met the following inclusion criteria: i) performed in humans; ii) were cohort, case-control or cross-sectional; iii) assessed the HPV oncogenic activity by the E6 and E7 mRNA; iv) included primary oral squamous cell carcinomas which; v) diagnosis had been confirmed by biopsy. Information about the country; study period; sample obtainment; sites of oral squamous cell carcinomas; number, gender and age range of the population; the prevalence of HPV infection and subtypes detected; use of tobacco or alcohol and oral sex practice were extracted. The methodological quality of included articles was assessed using 14 criteria. Results The search strategy retrieved 2129 articles. Assessment of the full text was done for 626 articles, but five were included. The total of participants included was 383, most of them male with mean age between 51.0 and 63.5 years old. Seventeen patients were HPV/mRNA-positive, being the subtypes 16 and 18 detected more frequently. Nine of the HPV/mRNA-positive oral squamous cell carcinomas occurred on the tongue. The quality score average of included articles was five points. Conclusions Among the 383 oral squamous cell carcinoma patients included, 17 (4.4%) were HPV/mRNA-positive, nevertheless it was not possible to assess if HPV infection was associated with oral squamous cell carcinomas because none of the studies included was longitudinal and cross-sectional investigations do not have control group.

Resumo Introdução A associação entre os carcinomas de colo uterino e anogenitais e o papilomavírus humano (HPV) está bem estabelecida; entretanto, o envolvimento desse vírus no desenvolvimento de carcinomas espinocelulares orais permanece controverso. Objetivos Avaliar a relação entre a infecção pelo HPV e os carcinomas espinocelulares orais e estimar a proporção dessa infecção nesses pacientes. Método Quatro bases de dados eletrônicas foram pesquisadas para encontrar estudos que atendessem aos seguintes critérios de inclusão: i) feitos em humanos; ii) estudos do tipo coorte, caso-controle ou transversal; iii) avaliaram a atividade oncogênica do HPV pelo mRNA E6 e E7; iv) incluíram CECOs primários, cujo diagnóstico foi confirmado por biópsia; v) o diagnóstico foi confirmado por biópsia. Informações sobre o país; período do estudos; obtenção da amostra; locais dos carcinomas espinocelulares orais; número, sexo e faixa etária da população; prevalência de infecção por HPV e subtipos detectados; informações sobre o uso de tabaco ou álcool e a prática de sexo oral foram obtidas. A qualidade metodológica dos artigos incluídos foi avaliada através de 14 critérios. Resultados A estratégia de busca recuperou 2.129 artigos. A avaliação de texto completo foi feita em 626 artigos, mas apenas cinco foram incluídos. O total de participantes incluídos foi de 383, a maioria do sexo masculino e com média de idade entre 51,0 e 63,5 anos. Dezessete pacientes eram HPV/mRNA-positivos, os subtipos 16 e 18 foram detectados com maior frequência. Nove dos carcinomas espinocelulares orais HPV/mRNA-positivos ocorreram na língua. A média do escore de qualidade dos artigos incluídos foi de cinco pontos. Conclusões Entre os 383 pacientes incluídos com carcinomas espinocelulares orais, 17 (4,4%) eram HPV/mRNA-positivos; entretanto, não foi possível avaliar se a infecção por HPV estava associada com carcinomas espinocelulares orais porque nenhum dos estudos incluídos era longitudinal e as investigações transversais não têm grupo controle.

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Abstract Objective Coronavirus disease 2019 (COVID-19) is a disease caused by a newly discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), which usually leads to non-specific respiratory symptoms. Although pregnant women are considered at risk for respiratory infections by other viruses, such as SARS and Middle East respiratory syndrome (MERS), little is known about their vulnerability to SARS-CoV-2. Therefore, this study aims to identify and present the main studies on the topic, including the postpartum period. Methods In this narrative review, articles were searched in various databases, organizations, and health entities using keywords compatible with medical subject headings (MeSH), such as: COVID-19, pregnancy, vertical transmission, coronavirus 2019, and SARS-CoV-2. Results The review of the scientific literature on the subject revealed that pregnant women with COVID-19 did not present clinical manifestations significantly different from those of non-pregnant women; however, there are contraindicated therapies. Regarding fetuses, studies were identified that reported that infection by SARS-CoV-2 in pregnant women can cause fetal distress, breathing difficulties and premature birth, but there is no substantial evidence of vertical transmission. Conclusion Due to the lack of adequate information and the limitations of the analyzed studies, it is necessary to provide detailed clinical data on pregnant women infected with SARS-CoV-2 and on the maternal-fetal repercussions caused by this infection. Thus, this review may contribute to expand the knowledge of professionals working in the area as well as to guide more advanced studies on the risk related to pregnant women and their newborns. Meanwhile, monitoring of confirmed or suspected pregnant women with COVID-19 is essential, including in the postpartum period.

Resumo Objetivo A Coronavirus disease 2019 (COVID-19) é uma doença causada por um coronavírus recém descoberto, o severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), que geralmente leva a sintomas respiratórios não específicos. Embora mulheres grávidas sejam consideradas em risco de infecções respiratórias por outros vírus, como SARS e Middle East respiratory syndrome (MERS), pouco se sabe sobre sua vulnerabilidade ao SARS-CoV-2. Portanto, este estudo tem como objetivo identificar e apresentar os principais estudos sobre o tema incluindo o período pós-parto. Métodos Nesta revisão narrativa, foram pesquisados artigos em diversas bases de dados, organizações e entidades de saúde, utilizando palavras-chave compatíveis com o MeSH, tais como: COVID-19, gravidez, transmissão vertical, coronavírus 2019, e SARSCoV-2. Resultados A revisão da literatura científica sobre o assunto revelou que as gestantes com COVID-19 não apresentaram manifestações clínicas significativamente diferentes das não gestantes, porém existem terapias contraindicadas. Em relação aos fetos, foramidentificados estudos que relataram que a infecção por SARS-CoV-2 em mulheres grávidas pode causar sofrimento fetal, dificuldades respiratórias e parto prematuro, mas não há evidências substanciais de transmissão vertical. Conclusão Devido à falta de informações adequadas e às limitações dos estudos analisados, é necessário fornecer dados clínicos detalhados sobre as gestantes infectadas pelo SARS-CoV-2 e sobre as repercussões materno-fetais causadas por esta infecção. Assim, esta revisão pode contribuir para ampliar o conhecimento dos profissionais que atuam na área, bem como para orientar estudos mais avançados sobre o risco relacionado à gestante e seu recém-nascido. Enquanto isso, o monitoramento de gestantes confirmadas ou suspeitas com COVID-19 é essencial, incluindo o pós-parto.

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INTRODUCTION: The association between uterine cervix and anogenital carcinomas and human papillomavirus, HPV, is well established, however the involvement of this virus in the development of oral squamous cell carcinomas remains controversial. OBJECTIVES: To evaluate the relationship between HPV infection and oral squamous cell carcinomas, and to estimate the incidence of this infection in these patients. METHODS: Four electronic databases were searched to find studies that met the following inclusion criteria: i) performed in humans; ii) were cohort, case-control or cross-sectional; iii) assessed the HPV oncogenic activity by the E6 and E7 mRNA; iv) included primary oral squamous cell carcinomas which; v) diagnosis had been confirmed by biopsy. Information about the country; study period; sample obtainment; sites of oral squamous cell carcinomas; number, gender and age range of the population; the prevalence of HPV infection and subtypes detected; use of tobacco or alcohol and oral sex practice were extracted. The methodological quality of included articles was assessed using 14 criteria. RESULTS: The search strategy retrieved 2129 articles. Assessment of the full text was done for 626 articles, but five were included. The total of participants included was 383, most of them male with mean age between 51.0 and 63.5 years old. Seventeen patients were HPV/mRNA-positive, being the subtypes 16 and 18 detected more frequently. Nine of the HPV/mRNA-positive oral squamous cell carcinomas occurred on the tongue. The quality score average of included articles was five points. CONCLUSIONS: Among the 383 oral squamous cell carcinoma patients included, 17 (4.4%) were HPV/mRNA-positive, nevertheless it was not possible to assess if HPV infection was associated with oral squamous cell carcinomas because none of the studies included was longitudinal and cross-sectional investigations do not have control group.

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Activation of coagulation is an important hallmark of sickle cell disease (SCD) and it is believed that hypercoagulability plays a role to the disease pathophysiology. Studies have sought to identify how hemostatic biomarkers are expressed in SCD, however, the results are inconclusive. In this context, our objective was to evaluate the thrombin generation in vivo and ex vivo in SCD patients and the association between these biomarkers and the use of HU. This cross-sectional study was carried out with patients diagnosed with SCD, users or not of Hydroxyurea (HU), and healthy individuals as controls. D dimer (D-Di) was evaluated by ELISA and (TGT) thrombin generation test by CAT method. D-Di plasma levels were significantly higher in SCD patients when compared to the controls. TGT parameters such as peak, ETP and normalized ETP at low TF concentration and time-to-peak, peak, ETP and normalized ETP values at high TF concentration were lower in SCD patients than in controls. In contrast, the normalized activated protein C sensitivity ratio (nAPCsr) was higher in patients compared to controls, indicating resistance to the action of this natural anticoagulant. Regarding the use of HU, comparing users and non-users of this drug, no difference was observed in D-Di levels and in most TGT parameters. Our data analyzed together allow us to conclude that patients with SCD present a state of hypercoagulability in vivo due to the higher levels of D-Di and resistance to APC assessed ex vivo which is consistent with the coagulation imbalance described in SCD patients.

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Abstract Objectives: to evaluate the morbidity and mortality profile and factors associated with death due to severe acute respiratory syndrome (SARS) by COVID-19 in pregnant and postpartum women. Methods: this is a quantitative and retrospective research that analyzed the SIVEP-gripe Database (Influenza Epidemiological Surveillance Information System), from 01/01/2020 to 04/01/2021. All pregnant women and postpartum women diagnosed with SARS caused by COVID-19 in the State of Minas Gerais were included. After the descriptive analysis of the hospitalizations profile, the association between different exposure variables and the occurrence of death was evaluated. Results: of the 227 records obtained, 94.3% required hospitalization. Among hospitalizations in the Intensive Care Unit, 29.8% used invasive ventilatory support. Fifteen deaths were recorded. The most frequent clinical manifestations were: cough and fever; the predominant comorbidities were cardiovascular disease and diabetes mellitus. The variables "ICU stay", "use of ventilatory support" and "heart disease" were associated with the occurrence of deaths. Conclusions: hospitalization was necessary for most pregnant women with SARS and the presence of previous heart disease increased the risk of death. Knowing the SARS morbidity and mortality profile is important in the definition of public health strategies aimed at reducing the impacts of COVID-19 during pregnancy and the puerperium.

Resumo Objetivos: avaliar o perfil de morbimortalidade e fatores associados ao óbito pela Síndrome Respiratória Aguda Grave (SRAG) por COVID-19 em gestantes e puérperas. Métodos: tratase de urna pesquisa quantitativa e retrospectiva que analisou o Banco de Dados SIVEP-gripe (Sistema de Informação de Vigilância Epidemiológica da Gripe), no período de 01/01/2020 a 04/01/2021. Foram incluídas todas as gestantes e puérperas com diagnóstico de SRAG causada por COVID-19 no Estado de Minas Gerais. Após a análise descritiva do perfil das internações, avaliou-se a associação entre diferentes variáveis de exposição e a ocurrência de óbito. Resultados: dos 227 registros obtidos, 94,3% necessitaram de hospitalização. Dentre as internações em Unidade de Terapia Intensiva, 29,8%fizeram uso de suporte ventilatório invasivo. Quinze óbitos foram registrados. As manifestações clínicas mais frequentes foram: tosse e febre; já as comorbidades predominantes foram doença cardiovascular e diabetes mellitus. As variáveis "internação em UTI", "uso de suporte ventilatório" e "cardiopatia" apresentaram associação com ao corrência de óbitos. Conclusão: a hospitalização foi necessária para a maioria das gestantes com SRAG e a presença de cardiopatia prévia aumentou o risco de óbito. Conhecer o perfil de morbimortalidade por SRAG é importante na definição de estratégias de saúde pública que visem à redução dos impactos da COVID-19 na gestação e puerpério.

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Introduction: The epidemics claim changes in behavior and often completely change the lives of health professionals. In addition to instituting the need to evaluate old methods of disease prevention. This study aimed to analyze the aspects related to biosafety and the health conditions of health professionals in the context of the SARS-CoV-2 pandemic. Methods: In this narrative review, articles were searched in various databases, organizations, and health entities using keywords compatible with MeSH, including COVID-19, Pandemia, Health professionals, Coronavirus 2019, SARS-CoV-2, personal protective equipment (PPE), Biosafety. Results and Discussion: The review of articles and manuals published in this area revealed that health professionals are being infected with SARS-CoV-2 and effective prevention measures and the correct use of PPE are needed, in addition to health assessment and monitoring, including mental health, of these professionals. Conclusion: There is a lack of data on which PPE may have the best protective effect against SARS-CoV-2, as well as how to use, remove, disinfect, store and replace it. It is essential to offer support to health professionals, both the provision of PPE, as well as in training and maintenance of mental health to reduce the adverse effects that this pandemic can generate in this population.

Introdução: As epidemias requerem mudanças de comportamento e muitas vezes mudam completamente a vida dos profissionais de saúde, além de instituir a necessidade de avaliar métodos antigos de prevenção de doenças. O objetivo desta revisão foi analisar os aspectos relacionados a biossegurança e as condições de saúde dos profissionais de saúde no contexto da pandemia por SARS-CoV-2. Métodos: Nesta revisão narrativa foram pesquisados artigos em várias bases de dados, organizações e entidades de saúde, utilizando palavras-chave compatíveis com MeSH, incluindo COVID-19, Pandemia, Profissionais de saúde, Coronavírus 2019, SARS-CoV-2, Equipamento de proteção individual (EPI) e Biossegurança. Resultados e Discussão: A revisão de artigos e manuais publicados nesta área revelou que os profissionais de saúde estão sendo infectados por SARS-CoV-2 e são necessárias medidas eficazes de prevenção e o uso correto de EPI, além da avaliação e monitoramento da saúde, incluindo a saúde mental, desses profissionais. Conclusão: Mais estudos e investimentos em estrutura e recursos humanos são necessários. Há uma falta de dados sobre quais EPI podem ter o melhor efeito protetor contra o SARS-CoV-2, bem como seu modo de uso, remoção, desinfecção, armazenamento e tempo de substituição. É essencial oferecer apoio aos profissionais de saúde, tanto no fornecimento de EPIs, quanto no treinamento e manutenção da saúde mental para reduzir os efeitos adversos que essa pandemia pode gerar nessa população.

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COVID-19, caused by SARS-CoV-2, can present respiratory complications that often lead patients to depend on mechanical ventilation (MV) for several days. It is known that Pneumonia Associated with Mechanical Ventilation (PAMV) is frequent in patients who use this equipment for a long time. As a consequence of COVID-19, its prolonged use can lead to a worse prognosis for the patients. For this reason, in addition to the insufficiency of devices for mechanical ventilation to meet the current demand, it is necessary to adopt measures aimed at preventing complications that may aggravate the patient's clinical condition and, consequently, increase the average hospital stay and the respective hospital care costs. Therefore, the objective of this study was to discuss, in a concise and practical way, and based on the available literature, the importance of adopting adequate oral hygiene protocols for patients on mechanical ventilation. Based on the data obtained, it was identified that the adoption of effective oral hygiene measures, especially under the supervision of dental professionals, can contribute to the reduction of morbidity and mortality associated with MV, resulting in greater availability of mechanical ventilation equipment. Since such equipment is in great demand during the COVID-19 pandemic, the knowledge and implementation of effective oral hygiene measures will undoubtedly have an impact on improving the quality of care offered to patients, therefore benefiting all those in critical health conditions and assisted in ICUs.

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SUMMARY COVID-19, caused by SARS-CoV-2, can present respiratory complications that often lead patients to depend on mechanical ventilation (MV) for several days. It is known that Pneumonia Associated with Mechanical Ventilation (PAMV) is frequent in patients who use this equipment for a long time. As a consequence of COVID-19, its prolonged use can lead to a worse prognosis for the patients. For this reason, in addition to the insufficiency of devices for mechanical ventilation to meet the current demand, it is necessary to adopt measures aimed at preventing complications that may aggravate the patient's clinical condition and, consequently, increase the average hospital stay and the respective hospital care costs. Therefore, the objective of this study was to discuss, in a concise and practical way, and based on the available literature, the importance of adopting adequate oral hygiene protocols for patients on mechanical ventilation. Based on the data obtained, it was identified that the adoption of effective oral hygiene measures, especially under the supervision of dental professionals, can contribute to the reduction of morbidity and mortality associated with MV, resulting in greater availability of mechanical ventilation equipment. Since such equipment is in great demand during the COVID-19 pandemic, the knowledge and implementation of effective oral hygiene measures will undoubtedly have an impact on improving the quality of care offered to patients, therefore benefiting all those in critical health conditions and assisted in ICUs.

RESUMO A COVID-19, causada pelo Sars-CoV-2, pode apresentar complicações respiratórias que, muitas vezes, levam o paciente a depender da ventilação mecânica por vários dias. Sabe-se que a Pneumonia Associada à Ventilação Mecânica (PAVM) é frequente nos pacientes que utilizam esse equipamento por um longo período de tempo e que sua ocorrência, consequente à COVID-19, pode cursar com um pior prognóstico para o paciente. Por esse motivo, e somado à insuficiência de aparelhos para atendimento da demanda atual, faz-se necessária a adoção de medidas que visem à prevenção de complicações que possam agravar o quadro clínico do paciente e, consequentemente, aumentar o tempo médio de internação e os respectivos custos da assistência. Sendo assim, o objetivo deste estudo foi discorrer de forma concisa e prática, com base na literatura disponível, sobre a importância da adoção de protocolos adequados de higiene oral nos pacientes em ventilação mecânica. Com base nos dados obtidos, identificou-se que a adoção de medidas efetivas de higiene oral, principalmente sob a supervisão do profissional dentista, pode contribuir para a redução da morbimortalidade associada à PAVM, resultando em maior disponibilidade de equipamentos de ventilação mecânica. Desde que tais equipamentos estão sendo muito demandados durante a pandemia da COVID-19, o conhecimento e a implantação de medidas efetivas de higiene oral, indubitavelmente, repercutirão na melhoria da qualidade da assistência oferecida aos pacientes, portanto, beneficiando todos aqueles em situação crítica de saúde e assistidos em UTIs.

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INTRODUÇÃO: A doença falciforme (DF) compreende um grupo de anemias hemolíticas hereditárias cuja principal característica é a presença do gene da hemoglobina S (Hb S) que pode combinar-se com outras anormalidades sanguíneas hereditárias. O quadro clínico varia desde quase assintomático até formas graves. A Hidroxiuréia (HU) é a terapia de maior sucesso. É uma doença crônica, cuja prevalência e morbidade são altas no Brasil, dessa forma a qualidade de vida (QV) surge como um importante desafio para os pacientes, familiares e profissionais de saúde. OBJETIVOS: Avaliar a QV de pacientes portadores de DF, suas características sociodemográficas e clínicas. MÉTODOS: Os dados foram coletados através do questionário de QV abreviado (WHOQOL-Bref), questionário sociodemográfico e prontuário clínico. RESULTADOS: foram entrevistados 39 pacientes, entre 18 e 54 anos, tratados na Fundação Hemominas em Divinópolis - MG. A maioria dos pacientes eram homens (56%), homozigotos para a Hb S (80%), solteiros (67%), segundo grau completo (31%) e não usuários de HU (61%). Dentre os pacientes avaliados 53,8% considerou ter boa QV (escore médio 74,2 ±20,3). O escore relacionado à QV geral foi de 71,5. Os domínios físico e meio ambiente obtiveram os menores escores médio (61,5 e 59,0, respectivamente). Não foram encontradas diferenças significativas entre os que utilizavam ou não HU. CONCLUSÕES: Os pacientes com DF apresentaram boa QV, sendo mais comprometida pelos aspectos relacionados ao domínio meio ambiente, (como recursos financeiros) e físico (como dor e desconforto) que se correlacionam com as características clínicas e sociais relacionadas a DF.

Introduction: sickle cell disease (SCD) comprises a group of hereditary hemolytic anemias whose main characteristic is the presence of the hemoglobin S (Hb S) gene that can be combined with other hereditary blood abnormalities. The clinical picture ranges from almost asymptomatic to severe forms. Hydroxyurea (HU) is the most successful therapy. It is a chronic disease whose prevalence and morbidity are high in Brazil, thus quality of life (QoL) emerges as an important challenge for patients, family members and health professionals. Objectives: This study aimed to evaluate the QoL of patients with SCD, their sociodemographic and clinical characteristics. Methods: Data were collected through the abbreviated QoL questionnaire (WHOQOL-Bref), sociodemographic questionnaire and clinical chart. Results: It has interviewed at the Hemominas Foundation in Divinópolis - MG, 39 patients aged 18-54. Most of the patients were male (56%), homozygous for Hb S (80%), unmarried (67%), completed high school (31%) and non HU users (61%). Among the patients evaluated, 53.8% considered having a good QoL (mean score 74.2 ± 20.3). The overall QoL score was 71.5. The physical and environmental domains had the lowest mean scores (61.5 and 59.0, respectively). No significant differences were found among those using or not using HU. Conclusions: Patients with SCD presented good QoL, being more affected by aspects related to the environmental domain (such as financial resources) and physical (such as pain and discomfort) those correlate with clinical and social characteristics related to SCD.

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ABSTRACT Introduction: Hemophilia is a coagulopathy caused by a deficiency in coagulation factors VIII (hemophilia A) or IX (hemophilia B). It is a chronic disease and, hence, impairs the quality of life (Qol) of the patients. This study aimed to evaluate the Qol of patients with hemophilia using the WHOQOL-bref and the Haemo-A-Qol instruments, its relation to the clinical condition and its sociodemographic variables. Methods: This is a cross-sectional, epidemiological study, comprising 17 patients with hemophilia, registered at the hemocenter, who met the eligibility criteria. Data were collected using three questionnaires: a semi-structured clinical evaluation form, the WHOQOL-bref and the Haem-A-Qol. Results: The average age was 30 years old, and most participants declared themselves to be single (58.82%), without children (64.70%) and employed (58.82%). Hemophilia A was observed in 14 patients and the most severe form of the disease was more prevalent (64.70%). The average score of Qol, estimated by the WHOQOL-bref questionnaire was 74.3; being "social relations" the domain with the highest average. The Haem-A-Qol measured an average of 36.2 and the domain with the highest result was "Family Planning". Conclusion: Hemophilia had a higher negative impact upon the physical, sports and leisure features in the sample subjects. The analysis of the questionnaires did not reveal statistical agreement between them. Based on this, the Haem-A-Qol is considered the most recommended to evaluate the Qol, as it addresses factors more specifically related to the disease. No statistical significance was observed between the scores of Qol, as for the presence of comorbidities, gravity of the hemophilia and positive serology for infections.

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INTRODUCTION: Hemophilia is a coagulopathy caused by a deficiency in coagulation factors VIII (hemophilia A) or IX (hemophilia B). It is a chronic disease and, hence, impairs the quality of life (Qol) of the patients. This study aimed to evaluate the Qol of patients with hemophilia using the WHOQOL-bref and the Haemo-A-Qol instruments, its relation to the clinical condition and its sociodemographic variables. METHODS: This is a cross-sectional, epidemiological study, comprising 17 patients with hemophilia, registered at the hemocenter, who met the eligibility criteria. Data were collected using three questionnaires: a semi-structured clinical evaluation form, the WHOQOL-bref and the Haem-A-Qol. RESULTS: The average age was 30 years old, and most participants declared themselves to be single (58.82%), without children (64.70%) and employed (58.82%). Hemophilia A was observed in 14 patients and the most severe form of the disease was more prevalent (64.70%). The average score of Qol, estimated by the WHOQOL-bref questionnaire was 74.3; being "social relations" the domain with the highest average. The Haem-A-Qol measured an average of 36.2 and the domain with the highest result was "Family Planning". CONCLUSION: Hemophilia had a higher negative impact upon the physical, sports and leisure features in the sample subjects. The analysis of the questionnaires did not reveal statistical agreement between them. Based on this, the Haem-A-Qol is considered the most recommended to evaluate the Qol, as it addresses factors more specifically related to the disease. No statistical significance was observed between the scores of Qol, as for the presence of comorbidities, gravity of the hemophilia and positive serology for infections.

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OBJECTIVE: This study aimed to describe and analyze clinical and laboratory characteristics of patients with sickle cell anemia treated at the Hemominas Foundation, in Divinópolis, Brazil. Furthermore, this study aimed to compare the clinical and laboratory outcomes of the group of patients treated with hydroxyurea with those patients that were not treated with hydroxyurea. METHODS: Clinical and laboratorial data were obtained by analyzing medical records of patients with sickle cell anemia. RESULTS: Data from the medical records of 50 patients were analyzed. Most of the patients were female (56%), aged between 20 and 29 years old. Infections, transfusions, cholecystectomy, splenectomy and systemic arterial hypertension were the most common clinical adverse events of the patients. The most frequent cause of hospitalization was painful crisis. The majority of patients had reduced values of hemoglobin and hematocrit (8.55±1.33g/dL and 25.7±4.4%, respectively) and increased fetal hemoglobin levels (12±7%). None of the clinical variables was statistically significant on comparing the two groups of patients. Among hematological variables only hemoglobin and hematocrit levels were statistically different between patients treated with hydroxyurea and untreated patients (p-value=0.005 and p-value=0.001, respectively). CONCLUSION: Sickle cell anemia requires treatment and follow-up by a multiprofessional team. A current therapeutic option is hydroxyurea. This drug reduces complications and improves laboratorial parameters of patients. In this study, the use of the drug increased the hemoglobin and hematocrit levels of patients.

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Abstract Objective: This study aimed to describe and analyze clinical and laboratory characteristics of patients with sickle cell anemia treated at the Hemominas Foundation, in Divinópolis, Brazil. Furthermore, this study aimed to compare the clinical and laboratory outcomes of the group of patients treated with hydroxyurea with those patients that were not treated with hydroxyurea. Methods: Clinical and laboratorial data were obtained by analyzing medical records of patients with sickle cell anemia. Results: Data from the medical records of 50 patients were analyzed. Most of the patients were female (56%), aged between 20 and 29 years old. Infections, transfusions, cholecystectomy, splenectomy and systemic arterial hypertension were the most common clinical adverse events of the patients. The most frequent cause of hospitalization was painful crisis. The majority of patients had reduced values of hemoglobin and hematocrit (8.55 ± 1.33 g/dL and 25.7 ± 4.4%, respectively) and increased fetal hemoglobin levels (12 ± 7%). None of the clinical variables was statistically significant on comparing the two groups of patients. Among hematological variables only hemoglobin and hematocrit levels were statistically different between patients treated with hydroxyurea and untreated patients (p-value = 0.005 and p-value = 0.001, respectively). Conclusion: Sickle cell anemia requires treatment and follow-up by a multiprofessional team. A current therapeutic option is hydroxyurea. This drug reduces complications and improves laboratorial parameters of patients. In this study, the use of the drug increased the hemoglobin and hematocrit levels of patients.

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We have recently investigated the association between the risk of developing PE and clinical, hemostatic, inflammatory and genetic parameters of 108 severe preeclamptic women. A multivariate logistic regression analysis was performed to assess what variables are independent risk factors for PE. Univariate analysis was performed including the variables in age, smoking condition, multiple pregnancy, blood group, phenotypes and alleles of IL-4, IL-5, IL-10, IL-6, IL-8, IL-12, IL-1ß, IFN-γ, TNF-α, and the plasma levels of FVII, FVIIa, FVIIa-AT, FVIII, FVW, ADAMTS13, D-Di, PAI-1, ADMA. Those variables whose P<0.20 (smoking, multiple pregnancy, blood group, phenotype IL-6, IFN-γ allele, IL-10 allele and FVII) were selected to the multivariate logistic regression. In the final model, only FVII, IFN-γ allele and smoking were independently associated to severe PE (P<0.0001, P<0.0001 and P=0.008, respectively). Increased FVII plasma levels and IFN-γ "T" allele were associated to an increased probability of developing PE (OR 1.001, 95% CI [1.001-1.002], and OR 4.81 95% CI [2.42-9.60], respectively). On the other hand, smoker status was associated with a 4.72 decreased chance of PE occurrence (OR 4.72, 95% CI [1.51-14.75]). In this article we also reviewed the studies that investigate the risk of PE in pregnant women who smoked, as well as the effect of tobacco extract in cells or animal models. The hypotheses proposed to explain the biological mechanism by which smoking during pregnancy reduces the risk of PE was also discussed.

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Introdução: a pré-eclâmpsia (PE) é um distúrbio grave, com fisiopatologia ainda não bem compreendida, de elevada incidência e pode causar sérias consequências para a gestante e para o feto. Objetivo: descrever e analisar as características clínicas e sociodemográficas das gestantes com PE atendidas na maternidade de um hospital referência na região centro-oeste de Minas Gerais, bem como a epidemiologia da doença, os desfechos clínicos neonatais e das gestantes e as condutas terapêuticasrealizadas. Métodos: foi realizado estudo retrospectivo descritivo a partir da análise de prontuários médicos. Resultados: foi obtida incidência de PE de 1,44% na instituição. Entre as gestantes atendidas, 97,9% apresentaram níveis pressóricos compatíveis com PE. Não foram evidenciadas alterações laboratoriais significativas. Somente 8%das gestantes sofreram hemorragia pós-parto, 2% sofreram internação em centro de terapia intensiva e não houve algum óbito materno. Os desfechos neonatais foram mais desfavoráveis, com 25,3% de internação em centro de terapia intensiva e 7% de óbito do recém-nascido. Apenas 18% das parturientes tiveram uso de medicação para prevenireclâmpsia. Conclusão: o estudo permitiu evidenciar a necessidade de implementação de protocolo de atendimento e manejo para PE, a fim de promover melhorias e consolidar a assistência às pacientes usuárias do serviço em questão.

Introduction: preeclampsia (PE) is a serious disorder with little-understood pathophysiology,of high incidence and that can cause serious consequences for the pregnant woman and fetus. Objective: to describe and analyze the clinical and socio-demographic characteristics of pregnant women with PE assisted in the maternity ward of a referral hospital in central-western Minas Gerais as well as the disease epidemiology, neonatal and mother clinical outcomes, and therapeutic proceduresperformed. Methods: this was a retrospective descriptive study based on the analysis of medical records. Results: a PE incidence of 1.44% was observed in the institution. Among the pregnant women, 97.9% had blood pressure levels compatible with PE. Significant laboratory abnormalities were not observed. Only 8% of pregnant women suffered postpartum hemorrhage, 2% have been hospitalized in the intensive careunit, and there was no maternal death. The neonatal outcomes were less favorable with 25.3% hospitalizations in the intensive care unit and 7% newborn deaths. Only 18% of mothers used medication to prevent eclampsia. Conclusion: the study highlighted the need to implement a PE protocol and management in order to promote improvements and consolidate assistance to patients assisted in this service.