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Pico Notes Essay

3178 words - 13 pages

Title: Pain, Coping and Sleep in Children and Adolescents with Sickle Cell Disease (Quantitative?)
Abstract: Purpose The study examined the relationships among pain, pain coping, and sleep, and assessed factors (age, gender, frequency, and intensity of pain) that affect pain, coping, and sleep in children with sickle cell disease ( SCD). Methods Participants (66) were 39 children ( M = 11.5 years) and 27 adolescents ( M = 15.5 years) with SCD who completed an electronic visual analog scale ( eVAS), Pain Coping Questionnaire, and Pittsburg Sleep Quality Index. Results About two-thirds of the children reported pain the previous month. No significant differences were found between pain and ...view middle of the document...

DATA SOURCES: MEDLINE, EMBASE, TOXLine, and CINAHL were searched through 30 June 2007. STUDY SELECTION: Randomized trials, observational studies, and case reports evaluating efficacy and toxicity of hydroxyurea in adults with sickle cell disease, and toxicity studies of hydroxyurea in other conditions that were published in English. DATA EXTRACTION: Paired reviewers abstracted data on study design, patient characteristics, and outcomes sequentially and did quality assessments independently. DATA SYNTHESIS: In the single randomized trial, the hemoglobin level was higher in hydroxyurea recipients than placebo recipients after 2 years (difference, 6 g/L), as was fetal hemoglobin (absolute difference, 3.2%). The median number of painful crises was 44% lower than in the placebo group. The 12 observational studies that enrolled adults reported a relative increase in fetal hemoglobin of 4% to 20% and a relative reduction in crisis rates by 68% to 84%. Hospital admissions declined by 18% to 32%. The evidence suggests that hydroxyurea may impair spermatogenesis. Limited evidence indicates that hydroxyurea treatment in adults with sickle cell disease is not associated with leukemia. Likewise, limited evidence suggests that hydroxyurea and leg ulcers are not associated in patients with sickle cell disease, and evidence is insufficient to estimate the risk for skin neoplasms, although these outcomes can be attributed to hydroxyurea in other conditions. LIMITATION: Only English-language articles were included, and some studies were of lower quality. CONCLUSION: Hydroxyurea has demonstrated efficacy in adults with sickle cell disease. The paucity of long-term studies limits conclusions about toxicity.

Lanzkron, S., Strouse, J., Wilson, R., Beach, M., Haywood, C., Park, H., & ... Segal, J. (2008). Systematic review: Hydroxyurea for the treatment of adults with sickle cell disease. Annals Of Internal Medicine, 148(12), 939-955 17p.

The Association Between Hydroxyurea Treatment and Pain Intensity, Analgesic Use, and Utilization in Ambulatory Sickle Cell Anemia Patients (descriptive)

http://eds.b.ebscohost.com.libproxy.unh.edu/ehost/detail/detail?vid=30&sid=434544bc-27fb-45e1-a950-ff046bc92711%40sessionmgr115&hid=111&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=104895519&db=ccm
Abstract Background. We compared daily pain, home anal- gesic use, and utilization among ambulatory adults in the randomized Multicenter Study of Hydroxyurea in Sickle Cell Anemia (MSH). We related the fetal hemoglobin (HbF) hydroxyurea response to these response variables. Methods. Patients rated their sickle cell pain inten- sity (0–9), use of analgesics, and visits for pain daily. Diaries were collected biweekly, and intensity was collapsed into single interval ratings. The interval proportions of days of analgesic use and medical visits for pain were also calculated. Group compari- sons were made by intention to treat as well as by HbF change levels from baseline...

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