Interleukin-6 Gene Polymorphisms Influencing in hematological indices from sickle cell Anemia Patients

The homozygous hemoglobin SS is characterized Sickle Cell Anemia (SCA), altering the original structure of erythrocytes to a sickle shape.  The hemoglobinopathies encompass all genetic diseases of hemoglobin and the SCA is the one that presents the greatest clinical manifestations variability and also the most severe ones, causing chronic hemolysis, vaso-occlusive crises and severe anemia in patients. The present study aimed to investigate the role of rs2069832, rs2069835, rs2069840, rs2069845 and rs2069849 polymorphisms in the Interleukin-6 gene in the hematological values of SCA patients treated at Fundação HEMOAM, Manaus, AM. The inclusion of patients was carried out through outpatient care at HEMOAM. Genomic DNA was extracted using the QIAamp DNA Mini Kit (Qiagen) and molecular analyzes by TaqMan® probes on Applied Biosystems QuantStudio 6 Flex Real-Time PCR System. A total of 277 SCA patients were included in this study, having the female gender having a minimally higher frequency (55.3%). The mean age at diagnosis was approximately three years old, with brown race being the most predominant (77.6%). The rs2069832_AA and rs2069845_AA genotypes showed high values for red blood cell, hemoglobin and hematocrit indices, by having an important role as a protective factor for hemolysis in these patients. While the rs2069835_CC genotype showed decreased values for the same hematimetric indices, demonstrating to be a potential risk factor for increased hemolysis. No significant correlation in hematimetric indices was observed for the rs2069840 and rs2069849 genotypes. There are few studies correlating the genetic variants of the IL-6 gene in SCA in the state of Amazonas, however, it is known that IL-6 is involved in cell proliferation and greater response to inflammatory cytokines, and may modulate the clinical response in these patients, such as chronic hemolysis, vaso-occlusion and infections. Our work demonstrated associations of risk and protective IL-6 genotypes for possible hemolysis in patients with sickle cell anemia. We understand that an investigation with a larger number of patients would be recommended to elucidate the roles of the studied polymorphisms in sickle cell anemia. In addition, elucidating the role of Il-6 in sickle cell anemia may lead to the development of new strategies and therapies to prevent the systemic effects of excessive cytokine production and, consequently, reduce the severity of crises in these patients, providing better prognosis, clinical follow-up and welfare

Características endoscópicas e anatomopatológicas de uma série de 128 pólipos gástricos diagnosticados no Serviço de Endoscopia do Hospital Universitário Walter Cantídio

Objetivo: Avaliar a correlação entre o diagnóstico endoscópico e anatomopatológico dos pólipos gástricos e buscar possíveis associações. Metodologia: Estudo retrospectivo com análise de 128 pólipos em 121 pacientes , cujas informações foram colhidas a  partir dos bancos de dados dos setores de endoscopia e patologia do HUWC-UFC, no período de maio de 2010 a maio de 2012. Resultados: 22% dos pacientes eram do sexo masculino e 78%  do feminino. Quanto às características endoscópicas, observamos mais comumente pólipos únicos, localizados no corpo e medindo menos que 1,0 cm, 60,9% dos pólipos eram hiperplásicos, 17,2% inflamatórios, 9,4% de glândulas fúndicas e 4,6% adenomas. A análise comparativa entre os adenomas e os demais pólipos definiu que 50% dos adenomas eram maiores que 1 cm, enquanto que 88% dos não-adenomas eram menores que 1 cm (p<0,05). 66,7% dos pólipos adenomatosos localizaram-se no antro, enquanto que os pólipos não-adenomatosos ocorreram em 31% dos casos (p = 0,08). Conclusão: Houve predominância dos pólipos não-adenomatosos, principalmente do tipo hiperplásico. A associação da histologia de adenoma com pólipos maiores que 1,0 cm e localizados no antro foi encontrada

Consensus of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy (ABHH) and the Brazilian Ministry of Health - General management of blood and blood products on the tests necessary for the release of exceptional medicines for sickle cell disease

To date, hydroxyurea is the only effective and safe drug that significantly reduces morbidity and mortality of individuals with Sickle cell disease. Twenty years of real-life experience has demonstrated that hydroxyurea reduces pain attacks, vaso-occlusive events, including acute chest syndrome, the number and duration of hospitalizations and the need for transfusion. The therapeutic success of hydroxyurea is directly linked to access to the drug, the dose used and adherence to treatment which, in part, is correlated to the availability of hydroxyurea. This consensus aims to reduce the number of mandatory exams needed to access the drug, prioritizing the requesting physician's report, without affecting patient safety