Hydroxyurea for children with sickle cell anemia in Sub-Saharan Africa (Record no. 12448)
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| 000 -CABECERA | |
|---|---|
| campo de control de longitud fija | 03525nas a2200277 4500 |
| 003 - NÚMERO DE CONTROL | |
| campo de control | CO-MdCUR |
| 005 - FECHA Y HORA DE ACTUALIZACIÓN | |
| 005 | 20190726103204.0 |
| 007 - CAMPO FIJO DE DESCRIPCIÓN FÍSICA--INFORMACIÓN GENERAL | |
| campo de control de longitud fija | ta |
| 008 - LONGITUD FIJA | |
| campo de control de longitud fija | 170814s2019 xxu||||| |||| 00| 0 eng d |
| 040 ## - FUENTE DE CATALOGACIÓN | |
| Centro/agencia transcriptor | Remington |
| Centro catalogador/agencia de origen | CO-MdCUR |
| Normas de descripción | rda |
| 041 ## - IDIOMA | |
| Código de idioma | Inglés |
| 082 ## - CLASIFICACIÓN DECIMAL DEWEY | |
| edición | 21 |
| 773 0# - ENLACE AL DOCUMENTO FUENTE | |
| Número bibliográfico anfitrión | 11137 |
| Número de ítem anfitrión | 22572 |
| Encabezamiento principal | Massachusetts Medical Society |
| Lugar, editor y fecha de publicación | Boston, Massachusetts Medical Society. |
| Otro identificador del documento | 29071 |
| Título | The New England journal of medicine. |
| Número de control del registro | 11137412 |
| Número Internacional Normalizado para Publicaciones Seriadas | 0028-4793 |
| 100 1# - AUTOR PERSONAL | |
| 9 (RLIN) | 38653 |
| nombre | Tshilolo, Léon |
| 245 ## - TÍTULO PROPIAMENTE DICHO | |
| título | Hydroxyurea for children with sickle cell anemia in Sub-Saharan Africa |
| 264 ## - PIE DE IMPRENTA | |
| lugar (ciudad) | Boston : |
| editorial | Massachusetts Medical Society , |
| fecha | 2019 |
| 300 ## - DESCRIPCIÓN FÍSICA | |
| Extensión | páginas 121 - 131 |
| 520 3# - RESUMEN | |
| Resumen | BACKGROUND<br/>Hydroxyurea is an effective treatment for sickle cell anemia, but few studies have been conducted in sub-Saharan Africa, where the burden is greatest. Coexisting conditions such as malnutrition and malaria may affect the feasibility, safety, and benefits of hydroxyurea in low-resource settings.<br/><br/>METHODS<br/>We enrolled children 1 to 10 years of age with sickle cell anemia in four sub-Saharan countries. Children received hydroxyurea at a dose of 15 to 20 mg per kilogram of body weight per day for 6 months, followed by dose escalation. The end points assessed feasibility (enrollment, retention, and adherence), safety (dose levels, toxic effects, and malaria), and benefits (laboratory variables, sickle cell–related events, transfusions, and survival).<br/><br/>RESULTS<br/>A total of 635 children were fully enrolled; 606 children completed screening and began receiving hydroxyurea at a mean (±SD) dose of 17.5±1.8 mg per kilogram per day. The retention rate was 94.2% at 3 years of treatment. Hydroxyurea therapy led to significant increases in both the hemoglobin and fetal hemoglobin levels. Dose-limiting toxic events regarding laboratory variables occurred in 5.1% of the participants, which was below the protocol-specified threshold for safety. During the treatment phase, 20.6 dose-limiting toxic effects per 100 patient-years occurred, as compared with 20.7 events per 100 patient-years before treatment. As compared with the pretreatment period, the rates of clinical adverse events decreased with hydroxyurea use, including rates of vaso-occlusive pain (98.3 vs. 44.6 events per 100 patient-years; incidence rate ratio, 0.45; 95% confidence interval [CI], 0.37 to 0.56), nonmalaria infection (142.5 vs. 90.0 events per 100 patient-years; incidence rate ratio, 0.62; 95% CI, 0.53 to 0.72), malaria (46.9 vs. 22.9 events per 100 patient-years; incidence rate ratio, 0.49; 95% CI, 0.37 to 0.66), transfusion (43.3 vs. 14.2 events per 100 patient-years; incidence rate ratio, 0.33; 95% CI, 0.23 to 0.47), and death (3.6 vs. 1.1 deaths per 100 patient-years; incidence rate ratio, 0.30; 95% CI, 0.10 to 0.88).<br/><br/>CONCLUSIONS<br/>Hydroxyurea treatment was feasible and safe in children with sickle cell anemia living in sub-Saharan Africa. Hydroxyurea use reduced the incidence of vaso-occlusive events, infections, malaria, transfusions, and death, which supports the need for wider access to treatment. (Funded by the National Heart, Lung, and Blood Institute and others; REACH ClinicalTrials.gov number, NCT01966731.) Fuente : https://www.nejm.org/doi/full/10.1056/NEJMoa1813598 |
| 650 #0 - MATERIA GENERAL | |
| 9 (RLIN) | 32347 |
| Término de materia o nombre geográfico como elemento inicial | Anemia en Niños |
| Subdivisión geográfica | África |
| 700 1# - COAUTOR PERSONAL | |
| 9 (RLIN) | 38654 |
| Nombre de persona | Tomlinson, George |
| 700 1# - COAUTOR PERSONAL | |
| 9 (RLIN) | 38655 |
| Nombre de persona | Williams, Thomas N. |
| 942 ## - PUNTO DE ACCESO ADICIONAL KOHA | |
| Fuente del sistema de clasificación o colocación | Dewey Decimal Classification |
| Tipo de ítem Koha | Hemeroteca |
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