1
|
Sharma Y, Bhat D, Sridevi P, Surti SB, Ranjit M, Sarmah J, Sudhakar G, Babu BV. Sickle cell disease in Indian tribal population: Findings of a multi-centre Indian SCD registry. Blood Cells Mol Dis 2024; 109:102873. [PMID: 39024737 DOI: 10.1016/j.bcmd.2024.102873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/30/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Sickle cell disease (SCD) registries provide crucial real-world data on demographics, epidemiology, healthcare, patient outcomes, and treatment efficacy. This paper presents findings from the Indian SCD Registry (ISCDR) on clinical manifestations, crisis episodes, disease management, and healthcare utilization in patients with SCD from 12 primary health centres (PHCs) in six tribal districts of India. METHODS The ISCDR was introduced along with a three-tier screening process. Its Android-based application incorporates two electronic case report forms for patient data collection over one year. This paper presents a year's data from the ISCDR's 324 patients with SCD. RESULTS Patients with SCD, aged one to 65 years, exhibited varied clinical manifestations. Most patients (85.2 %) were unaware of their SCD status before enrolling in ISCDR. Moderate to severe anaemia was prevalent (66.05 % and 30.56 %, respectively). Pain was a common complaint (80.86 %; CI: 76.17-85.00), while symptoms of stroke included sudden severe headaches (34.57 %; CI: 29.40-40.02). Common splenic sequestration symptoms included stomach pain (42.90 %; CI: 37.44-48.49) and abdominal tenderness (13.27 %; CI: 9.77-17.46), as a sign. Healthcare utilization was high, with 96.30 % receiving treatment and 83.64 % consuming hydroxyurea. Hospitalization occurred for 38.27 % (CI: 32.95-43.81), and 12.04 % (CI: 8.70-16.09) had blood transfusion during last year. CONCLUSIONS ISCDR serves as a dynamic digital database on SCD epidemiology, clinical aspects, treatment and healthcare utilization. Notably, many patients lacked prior awareness of their SCD status, underscoring the need for improved awareness and care management. Integrating the registry into the national programme can streamline treatment implementation, prioritize management approaches, and optimize individual benefits.
Collapse
Affiliation(s)
- Yogita Sharma
- Division of Socio-Behavioural, Health Systems & Implementation Research, Indian Council of Medical Research, New Delhi, India
| | - Deepa Bhat
- Department of Anatomy, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, India
| | - Parikipandla Sridevi
- Department of Biotechnology, Central Tribal University of Andhra Pradesh, Vizianagaram, India
| | - Shaily B Surti
- Department of Community Medicine, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, India
| | - Manoranjan Ranjit
- Division of Molecular Epidemiology, Indian Council of Medical Research-Regional Medical Research Centre, Bhubaneswar, India
| | - Jatin Sarmah
- Department of Biotechnology, Bodoland University, Kokrajhar, India
| | - Godi Sudhakar
- Department of Human Genetics, Andhra University, Visakhapatnam, India
| | - Bontha V Babu
- Division of Socio-Behavioural, Health Systems & Implementation Research, Indian Council of Medical Research, New Delhi, India.
| |
Collapse
|
2
|
Obeagu EI, Obeagu GU. Management of diabetes mellitus patients with sickle cell anemia: Challenges and therapeutic approaches. Medicine (Baltimore) 2024; 103:e37941. [PMID: 38669382 PMCID: PMC11049766 DOI: 10.1097/md.0000000000037941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
The coexistence of diabetes mellitus (DM) and sickle cell anemia (SCA) poses significant challenges in clinical management due to the complex interactions and overlapping complications associated with both conditions. Managing diabetes in individuals with SCA requires a comprehensive approach that addresses the unique physiological and pathological aspects of both diseases. This paper reviews the challenges encountered in the management of DM in patients with SCA and explores therapeutic strategies and approaches to optimize patient care. Challenges in the management of DM in individuals with SCA stem from several factors, including the impact of hemoglobin variants on glycemic control assessment, increased susceptibility to infections, altered immune response, and complications associated with both diseases. Moreover, the coexistence of SCA and DM heightens the susceptibility to infections due to compromised immune function, emphasizing the need for vigilant preventive measures, including vaccinations and close monitoring for infectious complications. Close collaboration among healthcare providers specializing in diabetes, hematology, and other relevant fields is crucial for developing comprehensive care plans. Individualized treatment strategies that balance glycemic control, pain management, and preventive care are essential to mitigate complications and optimize the overall health outcomes of patients with both DM and SCA. In conclusion, managing diabetes in the context of SCA necessitates a nuanced and patient-centered approach. By addressing the challenges and employing tailored therapeutic strategies, healthcare providers can improve the quality of life and health outcomes for individuals affected by both conditions.
Collapse
|
3
|
Mandviya SH, Hingway S, Wanjari M, Ingale SS, Panbude I, Yembewar A, Landge P. Sickle Cell Anomaly Meets Leukemic Challenge: A Case Report. Cureus 2024; 16:e57089. [PMID: 38681383 PMCID: PMC11053231 DOI: 10.7759/cureus.57089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/27/2024] [Indexed: 05/01/2024] Open
Abstract
This case report delves into the rare occurrence of sickle cell disease (SCD) and acute myeloid leukemia (AML) coexisting in a 36-year-old patient. The initial presentation, marked by escalating fatigue, pallor, and recurrent episodes initially attributed to sickle cell disease, unveiled an unexpected discovery of AML upon bone marrow examination. The diagnostic hurdles stemming from overlapping clinical features necessitated a thorough approach incorporating hematological, molecular, and imaging studies. Managing both conditions concurrently entailed navigating complexities addressed by a multidisciplinary team, tailoring chemotherapy regimens, and implementing personalized strategies to tackle complications associated with SCD. This case underscores the significance of tailored and comprehensive approaches in diagnosing and managing patients with overlapping hematological disorders. The insights gleaned from this instance contribute to the evolving comprehension of such intricate interplays, guiding future research endeavors and enhancing the care provided to patients simultaneously grappling with SCD and acute myeloid leukemia (AML). This case study investigates the unusual medical history of a 36-year-old male patient who concurrently has acute myeloid leukemia and sickle cell disease. Since childhood, the patient has endured severe anemia, necessitating frequent red blood cell transfusions or exchange blood therapy. Additionally, the patient was prescribed hydroxyurea (HU) for approximately 26 months.
Collapse
Affiliation(s)
- Shruti H Mandviya
- Pathology and Laboratory Medicine, School of Allied Health Sciences, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Snehlata Hingway
- Pathology, School of Allied Health Sciences, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Sukanya S Ingale
- Pathology, School of Allied Health Sciences, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Isha Panbude
- Pathology, School of Allied Health Sciences, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Atharvi Yembewar
- Pathology, School of Allied Health Sciences, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Prachi Landge
- Pathology, School of Allied Health Sciences, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| |
Collapse
|
4
|
Batra N, Acharya S, Ahuja A, Saboo K. Guarding Health: A Comprehensive Review of Nosocomial Infections in Sickle Cell Anemia, a Multifaceted Approach to Prevention. Cureus 2024; 16:e53224. [PMID: 38425631 PMCID: PMC10902742 DOI: 10.7759/cureus.53224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
This comprehensive review explores the complex dynamics of nosocomial infections in individuals with sickle cell anemia (SCA) and advocates for a collaborative strategy to enhance prevention. SCA patients, marked by compromised immunity and susceptibility to infections, face unique challenges that necessitate tailored preventive measures. The review underscores the importance of vaccination, antibiotic prophylaxis, education, and environmental hygiene in mitigating the risk of nosocomial infections. Addressing socioeconomic factors, healthcare system limitations, patient-related issues, and cultural considerations is imperative for effective prevention. The call to action emphasizes the pivotal roles of healthcare professionals, policymakers, researchers, and community engagement in implementing targeted interventions. By fostering a collective effort, this review envisions an improved landscape for infection prevention in SCA patients, enhancing their overall health outcomes and quality of life.
Collapse
Affiliation(s)
- Nitish Batra
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Sourya Acharya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Abhinav Ahuja
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Keyur Saboo
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| |
Collapse
|
5
|
Gargot J, Parriault MC, Adenis A, Clouzeau J, Dinh Van KA, Ntab B, Defo A, Nacher M, Elenga N. Low Stroke Risk in Children With Sickle Cell Disease in French Guiana: A Retrospective Cohort Study. Front Med (Lausanne) 2022; 9:851918. [PMID: 35836958 PMCID: PMC9273747 DOI: 10.3389/fmed.2022.851918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/27/2022] [Indexed: 11/27/2022] Open
Abstract
One in every 227 babies born in French Guiana has sickle cell disease, which represents the greatest incidence in France. This study aimed to determine the incidence of stroke in children with sickle cell disease and its associated risk factors. This retrospective cohort study included all children with sickle cell disease diagnosed in the neonatal period who were born in French Guiana between 01/01/1992 and 12/31/2002. Of a total of 218 records, 122 patients were included. There were 70 HbSS/Sβ0 (58%), 40 HbSC (33%), and 11 Sβ + thalassemia (9%). The number of emergency admissions was significantly different between genotypes, with a higher number in SS/Sβ0 children (p = 0.004). There were significantly more acute chest syndromes (p = 0.006) and more elevated Lactate Dehydrogenase in SS/Sβ0 patients (p = 0.003). Three of these patients had ischemic strokes at a mean age of 6.9 years, and one had a hemorrhagic stroke at the age of 9,2 years. The incidence rate of ischemic stroke for SS/Sβ0 children was 3.1 (95% CI: 1.0–9.7) per 1,000 patient-years, and the clinically apparent stroke risk by the age of 15 years and 3 months was 6,4%. The incidence of hemorrhagic stroke was 1.1 (95% CI: 0.1–7.4) per 1,000 patients-years. No patient with SC or Sβ + thalassemia genotypes experienced any stroke.
Collapse
Affiliation(s)
- Julie Gargot
- Service de Pédiatrie, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | | | - Antoine Adenis
- CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Jérôme Clouzeau
- Service de Pédiatrie, Centre Hospitalier de l’Ouest-Guyanais «Franck Joly», Saint-Laurent-du-Maroni, French Guiana
| | - Kim-Anh Dinh Van
- Département d’Information Médical, Centre Hospitalier de Kourou, Kourou, French Guiana
| | - Balthazar Ntab
- Département d’Information Médicale, Centre Hospitalier de l’Ouest-Guyanais «Franck Joly», Saint-Laurent-du-Maroni, French Guiana
| | - Antoine Defo
- Service de Pédiatrie, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
| | - Narcisse Elenga
- Service de Pédiatrie, Centre Hospitalier Andrée Rosemon, Cayenne, French Guiana
- *Correspondence: Narcisse Elenga,
| |
Collapse
|
6
|
Ratanasopa K, Bulow L. Calorimetric Characterisation of the Binding Reaction Between Human Ferric Haemoglobins and Haptoglobin to Develop a Drug for Removal of Cell-Free Haemoglobin. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1395:341-345. [PMID: 36527659 DOI: 10.1007/978-3-031-14190-4_55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
High levels of cell-free haemoglobin (Hb) may occur in plasma as a consequence of e.g., pathological haemolysis or blood transfusion. These Hb molecules can be removed from blood circulation by forming a complex with the acute-phase protein haptoglobin (Hp) and thereby can also the intrinsic toxicity of free Hb be limited. In this study it is shown that ferric HbA, HbF, HbE and HbS, respectively, all bind firmly to Hp at 25 °C. By using isothermal titration calorimetry (ITC), it is demonstrated that ferric HbF has higher affinity to Hp (Ka = 2.79 ± 0.29 ×109 M-1) compared with HbA and HbS (1.91 ± 0.24 ×109 M-1) and 1.41 ± 0.34 ×109 M-1 for HbA and HbS, respectively. In addition, the affinity constant for HbE is slightly lower than the other haemoglobins (0.47 ± 0.40 ×109 M-1). Since Hp shows a general and high affinity to all Hb variants tested, it can be concluded that Hp may be useful as a therapeutic agent for several different haemolytic conditions by intravenous injection.
Collapse
Affiliation(s)
| | - Leif Bulow
- Department of Chemistry, Pure and Applied Biochemistry, Lund University, Lund, Sweden.
| |
Collapse
|
7
|
Elenga N, Vantilcke V, Martin E, Cuadro E, Selles P, Basset T. Red blood cell exchange in children with sickle cell disease. Int J Hematol 2021; 115:107-113. [PMID: 34550539 DOI: 10.1007/s12185-021-03221-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
The aim of our study was to assess the efficacy of red blood cell exchange (RBCx) using a Spectra Optia® automated apheresis system in children with sickle cell disease (SCD). We used automated RBCx to treat acute and chronic complications in 75 children with SCD who had a median age of 10 years [7-13]. We analyzed 649 RBCx sessions. Peripheral venous access was limited in a number of the children, and thus a femoral double-lumen central venous catheter was required. We recommend heparin locking with 500 units in each lumen of the catheter. To prevent complications, we ensured that all patients had achieved a post-RCE HbS level of < 30%. For chronic transfusion, with a post-RCE Hb level of approximately 10-11 g/dL, a blood exchange volume of ≥ 32 mL/kg, and an interval between each RBCx procedure of ≤ 30 days, the residual HbS level was maintained below 30%. For acute transfusion, a post-exchange Hb level ≥ 10 g/dL (p < 0.001) and a total exchange volume ≥ 35 mL/kg (p = 0.001) were the best way to reduce HbS to < 30%. AUC was 0.84. Our results show that erythrocytapheresis was useful and safe for children with SCD.
Collapse
Affiliation(s)
- Narcisse Elenga
- Sickle Cell Disease Center, Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana. .,Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana.
| | - Vincent Vantilcke
- Sickle Cell Disease Center, Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Elise Martin
- Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Emma Cuadro
- Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Pierre Selles
- Etablissement Français du Sang, Andrée Rosemon, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| | - Thierry Basset
- Centre Hospitalier de Cayenne, Rue des Flamboyants, BP 6006, 97306, Cayenne Cedex, French Guiana
| |
Collapse
|
8
|
Renella R. Biomarkers for the central nervous system complications of sickle cell disease: are we there yet? Proteomics Clin Appl 2021; 15:e2100026. [PMID: 34160906 DOI: 10.1002/prca.202100026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/19/2021] [Indexed: 11/10/2022]
Abstract
Sickle cell disease (SCD, OMIM #603903), an autosomal recessively inherited β-hemoglobinopathy, was the first human disorder delineated at a molecular level. The putative single nucleotide mutation in the HBB gene generates an abnormal hemoglobin species, which polymerizes in deoxygenated conditions causing irreversible changes in erythrocyte shape and function. Sickling erythrocytes are in turn responsible for microvascular vaso-occlusion, hemolysis and a systemic vasculopathy in patients. SCD has represented an attractive field for proteomic investigation since its methodological infancy. Clinically actionable biomarkers, especially for the prevention of cerebrovascular complications in children with the condition, are urgently needed and their discovery remains a major challenge. In this issue, Lance and colleagues report of their unbiased proteomic studies on samples from the participants of the landmark prospective, randomized, single-blind SIT trial (NEJM 2014). Their results reveal numerous brain-enriched plasma proteins specific for SCD, and for silent cerebral infarcts in this disorder, and further analyses highlight novel cellular mechanisms behind the brain damage in SCD. Although the goal of identifying reliable biomarker candidates for cerebrovascular complications could not be met, the dataset produced by the authors constitutes a significant contribution to the field and opens new horizons for further clinical and laboratory investigation.
Collapse
Affiliation(s)
- Raffaele Renella
- Pediatric Hematology-Oncology Unit, Division of Pediatrics, Lausanne University Hospital, Lausanne, Switzerland
| |
Collapse
|
9
|
Domingues‐Hamdi E, Vasseur C, Pakdaman S, Moutereau S, Habibi A, Bartolucci P, Galactéros F, Baudin‐Creuza V. Hydroxycarbamide decreases the free alpha-hemoglobin pool in red blood cells of adult patients with sickle cell anemia. Am J Hematol 2020; 95:E302-E305. [PMID: 32720721 DOI: 10.1002/ajh.25947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Elisa Domingues‐Hamdi
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
| | - Corinne Vasseur
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
| | - Sadaf Pakdaman
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Etablissement Français du Sang (EFS) Créteil France
| | - Stéphane Moutereau
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Département de Biochimie‐Biologie Moléculaire, Pharmacologie, Génétique Médicale AP‐HP, Hôpitaux Universitaires Henri Mondor Créteil France
| | - Anoosha Habibi
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Unité des Maladies Génétiques du Globule Rouge Hôpital Universitaire Henri Mondor (AP‐HP) Créteil France
| | - Pablo Bartolucci
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Unité des Maladies Génétiques du Globule Rouge Hôpital Universitaire Henri Mondor (AP‐HP) Créteil France
| | - Frédéric Galactéros
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
- Unité des Maladies Génétiques du Globule Rouge Hôpital Universitaire Henri Mondor (AP‐HP) Créteil France
| | - Véronique Baudin‐Creuza
- Inserm U955‐ IMRB, Team « Transfusion et Maladies du Globule Rouge » Université Paris Est Créteil Créteil France
- Laboratory of Excellence GR‐Ex Paris France
| |
Collapse
|
10
|
Chamouine A, Saandi T, Muszlak M, Larmaraud J, Lambrecht L, Poisson J, Balicchi J, Pissard S, Elenga N. High fetal hemoglobin level is associated with increased risk of cerebral vasculopathy in children with sickle cell disease in Mayotte. BMC Pediatr 2020; 20:302. [PMID: 32563256 PMCID: PMC7305627 DOI: 10.1186/s12887-020-02187-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background Understanding the genetics underlying the heritable subphenotypes of sickle cell anemia, specific to each population, would be prognostically useful and could inform personalized therapeutics.The objective of this study was to describe the genetic modulators of sickle cell disease in a cohort of pediatric patients followed up in Mayotte. Methods This retrospective cohort study analyzed clinical and biological data, collected between January1st2007 and December 31st2017, in children younger than 18 years. Results We included 185 children with 72% SS, 16% Sβ0-thalassemia and 12% Sβ + thalassemia. The average age was 9.5 years; 10% of patients were lost to follow up. The Bantu haplotype was associated with an increase in hospitalizations and transfusions. The alpha-thalassemic mutation was associated with a decrease of hemolysis biological parameters (anemia, reticulocytes), and a decrease of cerebral vasculopathy. The Single Nucleotide Polymorphisms BCL11A rs4671393, BCL11A rs11886868, BCL11A rs1427407 and HMIP rs9399137 were associated with the group of children with HbF > 10%. Patients with HbF > 10% presented a significant risk of early onset of cerebral vasculopathy. Conclusions The most remarkable result of our study was the association of SNPs with clinically relevant phenotypic groups. BCL11A rs4671393, BCL11A rs11886868, BCL11A rs1427407 and HMIP rs9399137 were correlated with HbF > 10%, a group that has a higher risk of cerebral vasculopathy and should be oriented towards the hemolytic sub-phenotype.
Collapse
Affiliation(s)
- Abdourahim Chamouine
- Pediatric Unit, Mamoudzou General Hospital, 1, Rue de l'Hopital, BP 4, 97600, Mamoudzou, Mayotte, France.
| | - Thoueiba Saandi
- Pediatric Unit, Mamoudzou General Hospital, 1, Rue de l'Hopital, BP 4, 97600, Mamoudzou, Mayotte, France
| | - Mathias Muszlak
- Pediatric Unit, Mamoudzou General Hospital, 1, Rue de l'Hopital, BP 4, 97600, Mamoudzou, Mayotte, France
| | - Juliette Larmaraud
- Pediatric Unit, Mamoudzou General Hospital, 1, Rue de l'Hopital, BP 4, 97600, Mamoudzou, Mayotte, France
| | - Laurent Lambrecht
- Pediatric Unit, Mamoudzou General Hospital, 1, Rue de l'Hopital, BP 4, 97600, Mamoudzou, Mayotte, France
| | - Jean Poisson
- Pediatric Unit, Mamoudzou General Hospital, 1, Rue de l'Hopital, BP 4, 97600, Mamoudzou, Mayotte, France
| | - Julien Balicchi
- Pediatric Unit, Mamoudzou General Hospital, 1, Rue de l'Hopital, BP 4, 97600, Mamoudzou, Mayotte, France
| | - Serge Pissard
- APHP, GHU H Mondor, departement de genetique, INSERM-IMRB U955eq2/GREx, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil Cedex, France
| | - Narcisse Elenga
- Pediatric Medicine and Surgery, Cayenne General Hospital, Cayenne, French Guiana, France
| |
Collapse
|
11
|
Varughese TE, Hoyt CR, L’Hotta AJ, Ikemenogo PA, Howdeshell SG, Housten AJ, Abel RA, King AA. Stress and the Home Environment in Caregivers of Children with Sickle Cell. J Pediatr Psychol 2020; 45:521-529. [DOI: 10.1093/jpepsy/jsaa016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 02/19/2020] [Accepted: 02/25/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
Caregivers of young children with chronic illnesses are at high risk for elevated levels of stress and mental health symptoms. This study examined stress and mental health symptoms as well as the socioeconomic status (SES) and home environments of a cohort of caregivers of infants and toddlers with sickle cell disease (SCD).
Methods
Forty-two caregivers of infants and toddlers (aged 1–34 months) with SCD completed the Brief Symptom Inventory (BSI) and Parent Stress Index (PSI). The Home Observation for Measurement of the Environment (HOME) was used to assess family living environments.
Results
Compared to test norms, caregivers reported high levels of situational/demographic life stress [mean difference (MD) 5.7, p = .003] and child distractibility/hyperactivity (MD 3.62, p = .001) on the PSI. However, no significant differences in psychological symptoms of distress were noted on the BSI. Caregivers scored significantly lower than norms on PSI subdomains of acceptability (MD −1.88, p = .03), competence (MD −3.11, p = .002), depression (MD −3.94, p < .001), and the overall parent domain (MD −12.55, p = .005). Significant correlations were found between PSI scores and the HOME and between SES and the HOME.
Conclusion
Caregivers of infants and toddlers with SCD experience elevated levels of life stress but, in turn, endorse high acceptance of their child and self-competence in parenting. Although life stress may be high in this population, symptoms of psychological distress were not identified. Caregivers reporting elevated life and illness-specific stressors may benefit from environmental supports and interventions.
Collapse
Affiliation(s)
- Taniya E Varughese
- Program in Occupational Therapy, Washington University School of Medicine
| | - Catherine R Hoyt
- Program in Occupational Therapy, Washington University School of Medicine
| | - Allison J L’Hotta
- Program in Occupational Therapy, Washington University School of Medicine
| | | | - Seth G Howdeshell
- Department of Medicine, University of Iowa Hospitals and Clinics
- Department of Psychiatry, University of Iowa Hospitals and Clinics
| | - Ashley J Housten
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine
| | - Regina A Abel
- Program in Occupational Therapy, Washington University School of Medicine
| | - Allison A King
- Program in Occupational Therapy, Division of Hematology and Oncology, Department of Pediatrics, Washington University School of Medicine, St. Louis Children’s Hospital
| |
Collapse
|
12
|
Kasai ET, Boemer F, Djang’eing’a RM, Ntokumunda JK, Agasa SB, Dauly NN, Opara JPA. Systematic Screening of Neonatal Sickle Cell Disease with HemoTypeSC<sup>TM</sup> Kit-Test: Case Study and Literature Review. ACTA ACUST UNITED AC 2020. [DOI: 10.4236/ojbd.2020.101002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
13
|
He Y, Wang ZJ. Spinal and afferent PKC signaling mechanisms that mediate chronic pain in sickle cell disease. Neurosci Lett 2019; 706:56-60. [PMID: 31051220 DOI: 10.1016/j.neulet.2019.04.055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
Abstract
Pain is the most characteristic feature of sickle cell disease (SCD). Patients with SCD live with unpredictable, recurrent episodes of acute painful crisis, as well as chronic unremitting pain throughout their lifetime. While most of the research and medical efforts have focused on treating vaso-occlusion crisis and acute pain, chronic pain remains a significant challenge faced by patients and physicians. Emerging evidence from human and animal studies has suggested the presence of a neuropathic component in SCD pain. New knowledge on the neurobiology of chronic pain in SCD has significant implications in unraveling the underlying mechanisms. This review focuses on the recent advances on the role of protein kinase C or PKC in promoting and maintaining chronic pain conditions. With a highlight of a specific PKC isoform, PKCδ, we aim to propose PKC as an essential regulator of chronic pain in SCD, which may ultimately lead to innovative therapeutic strategies for treating this devastating life-long problem in patients with SCD.
Collapse
Affiliation(s)
- Ying He
- Department of Biopharmaceutical Sciences and Center for Biomolecular Sciences, University of Illinois, Chicago, IL 60612, United States.
| | - Zaijie Jim Wang
- Department of Biopharmaceutical Sciences and Center for Biomolecular Sciences, University of Illinois, Chicago, IL 60612, United States.
| |
Collapse
|
14
|
Abstract
This study sought to examine if modern medical evaluations including newborn screening and early diagnosis along with better methods of disease control have improved rates of hearing loss in children with sickle cell disease (SCD). Audiometric and medical data for patients with SCD was obtained from the AudGen Database and analyzed for the presence of hearing loss, type of hearing loss, severity of hearing loss, and correlation with comorbid conditions. Children with sickle cell trait (SCT) were used as a comparison group. A total of 189 patients with SCD and 244 patients with SCT had sufficient audiologic data available. Hearing loss was present in 62% of children with SCD and 50% of children with SCT in the study population. Patients with SCD were significantly more likely than those with SCT to have a sensorineural component to their hearing loss (P<0.001, odds ratio: 2.41 [1.53 to 3.79]) and to have severe or profound hearing loss (P=0.02, odds ratio: 4.00 [1.14 to 14.04]). The true prevalence of hearing loss in children with SCD has not been established as routine screening is not being performed. Routine auditory testing should be done for these children to detect this loss before it impacts development.
Collapse
|
15
|
Mvundura M, Kiyaga C, Metzler M, Kamya C, Lim JM, Maiteki-Sebuguzi C, Coffey PS. Cost for sickle cell disease screening using isoelectric focusing with dried blood spot samples and estimation of price thresholds for a point-of-care test in Uganda. J Blood Med 2019; 10:59-67. [PMID: 30787644 PMCID: PMC6368125 DOI: 10.2147/jbm.s186528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Early identification through newborn screening is the first step in active management of sickle cell disease (SCD). Uganda currently screens newborns and infants under 2 years for SCD in high HIV-burden districts using isoelectric focusing with dried blood spot samples. Our analysis sought to estimate the costs per child screened for SCD using this method in Uganda and then to use those data to estimate the price threshold for screening with a point-of-care (POC) test. Methods We estimated the financial and economic costs per child screened for SCD using data from health facilities and the Central Public Health Laboratory. These costs included sample collection, transportation, and laboratory processing. Price thresholds for a POC test were estimated using two scenarios. Results The price threshold of an SCD POC test used for diagnosis would be $3.77 when taking into account only financial costs and $5.14 when taking into account economic costs. Thresholds for a POC test used for screening would be $3.07–$3.51 and $4.38–$5.09, respectively, depending on test specificity. Conclusion The price threshold of a POC test for SCD will depend on the assumptions on how it will be used – either as a screening or diagnostic test. If used for screening, test specificity will have significant impact. Results from this type of costing study can allow developers to incorporate quantitatively estimated price thresholds for innovative products into target product profiles early in the product development cycle.
Collapse
Affiliation(s)
- Mercy Mvundura
- Devices and Tools Global Program, PATH, Seattle, WA, USA,
| | - Charles Kiyaga
- Uganda Central Public Health Laboratory, Ministry of Health, Kampala, Uganda
| | | | - Carol Kamya
- Evaluation Projects, Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Jeanette M Lim
- Devices and Tools Global Program, PATH, Seattle, WA, USA,
| | | | | |
Collapse
|
16
|
Fearon A, Marsh A, Kim J, Treadwell M. Pediatric residents' perceived barriers to opioid use in sickle cell disease pain management. Pediatr Blood Cancer 2019; 66:e27535. [PMID: 30387290 PMCID: PMC6301127 DOI: 10.1002/pbc.27535] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Current guidelines recommend high-priority treatment of severe sickle cell disease (SCD) pain with opioids; however, patients with SCD have historically been undertreated. We used mixed methods to assess pediatric residents' perceptions toward opioid use in SCD pain management. METHODS We distributed a survey to 88 residents at an urban pediatric medical center in a cross-sectional study. Participants responded to questions about perceived barriers to acute SCD pain management and attitudes toward patients with SCD. Responses were examined using bivariate analyses. Five pediatric residents were interviewed, to provide more in-depth understanding of barriers to SCD pain management. RESULTS Fifty-three residents (60%) completed the survey. Participants were divided into "more experienced" (had seen ≥ 21 patients with SCD; 45.3%) or "less experienced." Both groups reported potential for tolerance and dependence as major barriers to opioid use in SCD. Less experienced residents reported a greater need for additional training in SCD pain management (P < 0.05), more concern about addiction, and greater empathy for patients with SCD (P < 0.05). Both groups agreed that patients with SCD were "frustrating to care for." Thematic analysis revealed that increased patient and provider barriers led to distrust, ultimately leading to undertreatment of pain and inadequate care. CONCLUSION Although more experienced residents reported feeling more comfortable treating acute SCD pain and were less concerned with addiction compared with less experienced residents, certain negative views of patients with SCD were prevalent among all residents. Findings suggest that residency training must address provider attitudes as well as knowledge about SCD.
Collapse
Affiliation(s)
- Amber Fearon
- Rosalind Franklin Chicago Medical School, North Chicago, IL
| | - Anne Marsh
- Department of Hematology/Oncology, UCSF Benioff Children’s Hospital Oakland, Oakland, CA
| | - Jennifer Kim
- Department of Hematology/Oncology, UCSF Benioff Children’s Hospital Oakland, Oakland, CA
| | - Marsha Treadwell
- Department of Hematology/Oncology, UCSF Benioff Children’s Hospital Oakland, Oakland, CA
| |
Collapse
|
17
|
|
18
|
Ahmad MF, Ansari MO, Jameel S, Wani AL, Parveen N, Siddique HR, Shadab GGHA. Protective role of nimbolide against chemotherapeutic drug hydroxyurea induced genetic and oxidative damage in an animal model. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2018; 60:91-99. [PMID: 29679812 DOI: 10.1016/j.etap.2018.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/28/2018] [Accepted: 04/05/2018] [Indexed: 06/08/2023]
Abstract
Nimbolide is known to be an antioxidant found in neem plant. Hydroxyurea is a medication frequently used in sickle-cell disease, different cancers and HIV infection. The present study aimed to evaluate the adverse effect of HU and possible amelioration by nimbolide in Wistar rats. To test our hypothesis, we performed genotoxicity tests, biochemical assays, and histopathological studies. We observed that HU caused higher levels of genotoxicity in the treated animals. The observed genetic and oxidative damage might be due to the presence of reactive species as HU increased the level of the malondialdehyde-a biomarker of oxidative damage. Interestingly, co-treatment of animals with HU and nimbolide showed a lower level of damage. We conclude that nimbolide significantly protects the cells from the adverse effect of HU and could be considered as a potential adjuvant for the patients under HU therapy.
Collapse
Affiliation(s)
- Md Fahim Ahmad
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Mohd Owais Ansari
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Sana Jameel
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Ab Latif Wani
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Nuzhat Parveen
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Hifzur R Siddique
- Molecular Cancer Genetics & Translational Research Lab, Section of Genetics, Department of Zoology, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India.
| | - G G H A Shadab
- Cytogenetics and Molecular Toxicological Laboratory, Section of Genetics, Department of Zoology, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India.
| |
Collapse
|
19
|
Di Maggio R, Hsieh MM, Zhao X, Calvaruso G, Rigano P, Renda D, Tisdale JF, Maggio A. Chronic Administration of Hydroxyurea (HU) Benefits Caucasian Patients with Sickle-Beta Thalassemia. Int J Mol Sci 2018; 19:ijms19030681. [PMID: 29495591 PMCID: PMC5877542 DOI: 10.3390/ijms19030681] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/23/2018] [Accepted: 02/26/2018] [Indexed: 01/10/2023] Open
Abstract
In sickle cell disease (SCD), hydroxyurea (HU) treatment decreases the number of vaso-occlusive crisis (VOC) and acute chest syndrome (ACS) by increasing fetal hemoglobin (HbF). Data are lacking regarding the frequency of HU dose modification or whether sub-therapeutic doses (<15 mg/kg/day) are beneficial. We reviewed the medical records of 140 patients from 2010 to 2014. The laboratory parameters and SCD complications were compared between the first and last visits based on HU use. Fifty patients (36%) never took HU or suspended HU (“no HU” group). Among patients taking <15 mg/kg/day HU on their first visit, half remained at the same dose, and the other half increased to ≥15 mg/kg/day. Among patients taking ≥15 mg/kg/day, 17% decreased to <15 mg/kg/day, and 83% stayed at ≥15 mg/kg/day. The “no HU” group had fewer episodes of VOC and ACS. Both HU treatment groups had a reduction in both complications (p < 0.0001). This improvement was observed in all SCD phenotypes. The white blood cell (WBC) counts were found to be lower, and HbF increased in both HU groups (p = 0.004, 0.001). The maximal HbF response to HU in HbS/β+-thalassemia was 20%, similar to those observed for HbSS (19%) and HbS/β0-thalassemia (22%). HbS/β+-thalassemia could have a similar disease severity as HbSS or HbS/β0-thalassemia. Patients with HbS/β0-thalassemia or HbS/β+-thalassemia phenotypes responded to HU.
Collapse
Affiliation(s)
- Rosario Di Maggio
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, 90142 Palermo, Italy.
| | - Matthew M Hsieh
- Molecular and Clinical Hematology Branch, National Institute of Diabetes and Digestive and Kidney Diseases/National Heart, Lung, and Blood Institute, Bethesda, MD 20814, USA.
| | - Xiongce Zhao
- Office of Clinical Director, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD 20814, USA.
| | - Giuseppina Calvaruso
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, 90142 Palermo, Italy.
| | - Paolo Rigano
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, 90142 Palermo, Italy.
| | - Disma Renda
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, 90142 Palermo, Italy.
| | - John F Tisdale
- Molecular and Clinical Hematology Branch, National Institute of Diabetes and Digestive and Kidney Diseases/National Heart, Lung, and Blood Institute, Bethesda, MD 20814, USA.
| | - Aurelio Maggio
- Campus of Haematology Franco and Piera Cutino, AOOR Villa Sofia-V. Cervello, 90142 Palermo, Italy.
| |
Collapse
|
20
|
Alapan Y, Fraiwan A, Kucukal E, Hasan MN, Ung R, Kim M, Odame I, Little JA, Gurkan UA. Emerging point-of-care technologies for sickle cell disease screening and monitoring. Expert Rev Med Devices 2016; 13:1073-1093. [PMID: 27785945 PMCID: PMC5166583 DOI: 10.1080/17434440.2016.1254038] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Sickle Cell Disease (SCD) affects 100,000 Americans and more than 14 million people globally, mostly in economically disadvantaged populations, and requires early diagnosis after birth and constant monitoring throughout the life-span of the patient. Areas covered: Early diagnosis of SCD still remains a challenge in preventing childhood mortality in the developing world due to requirements of skilled personnel and high-cost of currently available modalities. On the other hand, SCD monitoring presents insurmountable challenges due to heterogeneities among patient populations, as well as in the same individual longitudinally. Here, we describe emerging point-of-care micro/nano platform technologies for SCD screening and monitoring, and critically discuss current state of the art, potential challenges associated with these technologies, and future directions. Expert commentary: Recently developed microtechnologies offer simple, rapid, and affordable screening of SCD and have the potential to facilitate universal screening in resource-limited settings and developing countries. On the other hand, monitoring of SCD is more complicated compared to diagnosis and requires comprehensive validation of efficacy. Early use of novel microdevices for patient monitoring might come in especially handy in new clinical trial designs of emerging therapies.
Collapse
Affiliation(s)
- Yunus Alapan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Arwa Fraiwan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Erdem Kucukal
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - M. Noman Hasan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Ryan Ung
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Myeongseop Kim
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
| | - Isaac Odame
- Division of Haematology/Oncology, The Hospital for Sick Children; Toronto, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jane A. Little
- Department of Hematology and Oncology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Seidman Cancer Center at University Hospitals, Case Medical Center, Cleveland, OH, USA
| | - Umut A. Gurkan
- Case Biomanufacturing and Microfabrication Laboratory, Mechanical and Aerospace Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Biomedical Engineering Department, Case Western Reserve University, Cleveland, OH, USA
- Department of Orthopedics, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
21
|
Dampier C, Barry V, Gross HE, Lui Y, Thornburg CD, DeWalt DA, Reeve BB. Initial Evaluation of the Pediatric PROMIS® Health Domains in Children and Adolescents With Sickle Cell Disease. Pediatr Blood Cancer 2016; 63:1031-7. [PMID: 26895143 PMCID: PMC4833539 DOI: 10.1002/pbc.25944] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/08/2016] [Indexed: 01/14/2023]
Abstract
BACKGROUND The Patient Reported Outcomes Measurement Information System (PROMIS®) has developed pediatric self-report scales measuring several unidimensional health attributes (domains) suitable for use in clinical research, but these measures have not yet been validated in sickle cell disease (SCD). PROCEDURE A convenience sample of SCD children, aged 8-17 years, from two sickle cell programs was recruited at routine clinic visits, including some for hydroxyurea monitoring or monthly transfusions. Children completed PROMIS pediatric items using an online data collection platform, the PROMIS Assessment Center Web site. RESULTS A total of 235 participants (mean age 12.5 ± 2.8 years, 49.8% female) participated in the study. Adolescents (ages 12-17 years) reported significantly higher pain interference and depressive symptoms, and worse lower extremity physical functioning domain scores compared to younger children (ages 8-11 years). Female participants reported significantly higher pain interference, fatigue, and depressive symptoms, and worse lower extremity physical functioning domain scores compared with their male counterparts. Participants with hip or joint problems that limited usual activities reported significantly higher pain, fatigue, and depressive symptoms scores, and worse upper/lower extremity physical functioning scores as did participants who had experienced sickle pain in the previous 7 days. CONCLUSIONS PROMIS pediatric measures are feasible in a research setting and identify expected differences in known group comparisons in a sample of SCD children. The large domain score differences between those with or without SCD-related complications suggest the potential usefulness of these measures in clinical research, but further validation studies are needed, particularly in clinical practice settings.
Collapse
Affiliation(s)
- Carlton Dampier
- Department of Pediatrics, Emory University School of Medicine and AFLAC Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta GA
| | - Vaughn Barry
- Department of Pediatrics, Emory University School of Medicine and AFLAC Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta GA
| | - Heather E. Gross
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yang Lui
- School of Social Sciences, Humanities, and Arts, University of California, Merced, Merced, CA
| | - Courtney D. Thornburg
- Department of Pediatrics, University of California, San Diego, Rady Children‟s Hospital, San Diego, CA
| | - Darren A. DeWalt
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC,Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Bryce B. Reeve
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC,Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
22
|
Renella R. Age-dependent pathophysiology of acute chest syndrome in children with sickle cell disease. Am J Hematol 2015; 90:367-8. [PMID: 25683565 DOI: 10.1002/ajh.23975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 02/10/2015] [Indexed: 02/02/2023]
Affiliation(s)
- Raffaele Renella
- Pediatric Hematology-Oncology Unit, Department of Pediatrics; University Hospital of Lausanne; Switzerland
| |
Collapse
|
23
|
Fernandes TAADM, Medeiros TMDD, Alves JJP, Bezerra CM, Fernandes JV, Serafim ÉSS, Fernandes MZ, Sonati MDF. Socioeconomic and demographic characteristics of sickle cell disease patients from a low-income region of northeastern Brazil. Rev Bras Hematol Hemoter 2015; 37:172-7. [PMID: 26041419 PMCID: PMC4459435 DOI: 10.1016/j.bjhh.2015.03.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 02/27/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To characterize the socioeconomic and demographic aspects of sickle cell disease patients from the state of Rio Grande do Norte (RN), Northeast Brazil, and their adherence to the recommended treatment. METHODS This cross-sectional descriptive study was performed at referral centers for the treatment of hematological diseases. One hundred and fifty-five unrelated individuals with sickle cell disease who went to these centers for outpatient visits were analyzed. All the patients, or their caregivers, were informed about the research procedures and objectives, and answered a standardized questionnaire. RESULTS The patients were predominantly younger than 12 years old, self-declared as mulatto, lived in small towns fairly distant from the referral center, and had low education and socioeconomic levels. Individuals who were ten or younger were diagnosed at an earlier age. Almost 50% of the patients were taking hydroxyurea, 91.4% reported having received pneumococcal/meningococcal vaccinations and 76.1% received penicillin as antibiotic prophylaxis. However, the majority of them reported having difficulties following the recommendations of the physicians, mainly in respect to attaining the prescribed medications and transportation to the referral centers. CONCLUSION These individuals have a vulnerable socioeconomic situation that can lead to an aggravation of their general health and thus deserve special attention from the medical and psychosocial perspectives. Thus, it is necessary to improve public policies that provide Brazilian sickle cell disease patients with better access to medical treatment, living conditions, and integration into society.
Collapse
|
24
|
Shahine R, Badr LK, Karam D, Abboud M. Educational intervention to improve the health outcomes of children with sickle cell disease. J Pediatr Health Care 2015; 29:54-60. [PMID: 25115311 DOI: 10.1016/j.pedhc.2014.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 06/10/2014] [Accepted: 06/21/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Although sickle cell disease (SCD) is the most common single gene disorder worldwide, caregivers of children do not have adequate knowledge about the illness and its management. The purpose of this study was to assess the efficacy of education along with tailored written materials in changing the behaviors of caregivers to help them provide better care for children with SCD. METHODS A preintervention and postintervention quasi-experimental design was used. A convenience sample of 43 caregivers of 57 children were asked to complete a questionnaire related to their knowledge of SCD before and after educational sessions. The educational sessions (the intervention) were provided to caregivers at the Children's Cancer Center in Lebanon by one registered nurse, one certified pediatric nurse practitioner, and one pediatric hematologist. Emergency department (ED) visits and hospitalizations were compared 2 months before and 2 months after the intervention. RESULTS A statistically significant increase was found in the knowledge of caregivers about the cause, symptoms, and management of the disease. A statistically significant decrease occurred in the number of hospitalizations before and after the intervention but not in the number of visits to the ED. Multiple regression analysis found that none of the background variables were related to knowledge, ED visits, or hospitalizations. CLINICAL IMPLICATIONS Education and written materials written in a simple language that is understood by 5th-graders were beneficial in improving the knowledge of caregivers and in decreasing the number of hospitalizations of children with SCD.
Collapse
|
25
|
Yacobovich J, Tamary H. Thalassemia major and sickle cell disease in adolescents and young adults. Acta Haematol 2014; 132:340-7. [PMID: 25228560 DOI: 10.1159/000360235] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The increased longevity of patients with thalassemia and sickle cell disease (SCD) introduces new clinical challenges due to the accumulation of disease-related morbidity, psychosocial issues and health care adjustments. Patients with thalassemia major now live into adulthood without suffering heart failure but must confront delayed puberty, impaired fertility and progressive bone disease. The increased survival in SCD brings to the front previously unrecognized complications including pulmonary hypertension, silent cerebral infarcts and also reproductive dysfunction. Adolescents and young adults (AYAs) have age-related psychosocial needs in their transition from the pediatric health care environment to the adult system. In this review we present the uniquely age-related medical issues facing the AYA thalassemia and SCD cohort in their transition into adulthood.
Collapse
Affiliation(s)
- Joanne Yacobovich
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | | |
Collapse
|