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1.
Chemosphere ; 328: 138590, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37028726

RESUMO

Iron oxide nanoparticles (IONPs) are advanced materials for water remediation technologies. It is therefore relevant to evaluate the cellular and tissue behavior of fishes in response to IONPs and their associations with agrochemicals such as glyphosate (GLY) and glyphosate-based herbicides (GBHs). Iron accumulation, tissue integrity and lipid distribution in the hepatocytes of Poecilia reticulata (guppy) were investigated in a control group and in groups exposed to soluble iron ions, namely IFe (0.3 mgFe/L), IONPs (0.3 mgFe/L), and IONPs, associated with GLY (0.65 mg/L), GBHs 0.65 mgGLY/L (IONPs + GBH1), and 1.30 mgGLY/L (IONPs + GBH2), for 7, 14, and 21 days, followed by an equal period of postexposure in clean reconstituted water. The results showed that the accumulation of iron was greater in the subjects in the IONP treatment group when compared to that in the Ife group. In addition, the subjects in the mixtures with GBHs had a greater accumulation of iron than those in the IONP + GLY treatment group. Tissue integrity assessments demonstrated an intense accumulation of lipids, formation of necrotic zones and leukocyte infiltrates in all the treated groups, with a greater quantity of lipids in the animals treated with IONP + GLY and IFe. During postexposure, the results indicated an elimination of iron in all treated groups, reaching the same level as the control group, throughout the 21 days postexposure. Thus, the damage caused to animal livers by IONP mixtures is reversible, providing promising results for the development of safe environmental remediation practices using nanoparticles.


Assuntos
Herbicidas , Hepatopatias , Nanopartículas , Poecilia , Animais , Herbicidas/toxicidade , Ferro , Nanopartículas Magnéticas de Óxido de Ferro , Lipídeos , Compostos Férricos , Glifosato
2.
JMIR Mhealth Uhealth ; 8(7): e18132, 2020 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-32716303

RESUMO

BACKGROUND: Intervention with a mobile Health (mHealth) app can improve the efficacy of early detection of oral cancer and the outcomes for patients taking oral anticancer medications. The quality of life of oral cancer patients is significantly reduced within three months after surgery; also, their needs for nursing care and health information increase, mainly due to side effects and associated psychological problems. OBJECTIVE: This study aimed to evaluate changes in the care needs and quality of life of patients with oral cancer after receiving the intervention of a newly developed mHealth app. METHODS: After surgery, oral cancer patients were divided into an experimental group (n=50) who received the mHealth app intervention and a control group (n=50) who received routine health care and instruction. After 3 months of intervention, survey questionnaires were used to assess the patients' quality of life, nursing care needs, and acceptance of the mHealth app. RESULTS: The physiological care needs were significantly decreased in the experimental group compared with the control group (P<.05). Although the differences were not statistically significant, the psychological needs, communication needs, and care support needs all improved after the mHealth app intervention. The overall improvement in quality of life was higher in the experimental group than in the control group (-7.24 vs -4.36). In terms of intention to use, perceived usefulness, and perceived ease of use, the acceptability scores of the mHealth app were significantly increased after 3 months of intervention (P<.05). CONCLUSIONS: Compared with routine health care and instruction, for patients after surgery, the education/information intervention using the mHealth app significantly reduced their nursing care needs, improved their quality of life, and increased their acceptance of using an mHealth app on a mobile device. These findings can provide a theoretical basis for future health care app design and improvement. This study suggests that an mHealth app should be incorporated into the routine care of oral cancer patients to provide medical information quickly and improve their self-management abilities, thereby reducing the patients' need for physiological care and improving their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT04049968; https://www.clinicaltrials.gov/ct2/show/NCT04049968.


Assuntos
Aplicativos Móveis , Neoplasias Bucais , Qualidade de Vida , Cirurgia Bucal , Humanos , Neoplasias Bucais/cirurgia , Assistência ao Paciente , Telemedicina
3.
Cancer Nurs ; 43(1): 12-21, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30433894

RESUMO

BACKGROUND: Oral cancer is the fifth most common form of cancer in Taiwan in terms of incidence and death rate and results in at least 2700 deaths each year. OBJECTIVE: The aims of this study were to assess the postoperative health-related quality of life (QOL) and care needs of oral cancer patients comprehensively and to evaluate the correlation between health-related QOL and care needs. INTERVENTIONS/METHODS: This cross-sectional study enrolled 126 oral cancer patients who had received surgical treatment within the previous 2 years and were without cognitive impairment. Each patient completed a demographic questionnaire, the European Organisation for Research and Treatment of Cancer Head and Neck Cancer Quality of Life Scale, and the Short-Form Cancer Needs Questionnaire. RESULTS: Female patients and patients receiving 3 or more chemotherapy treatments were significantly associated with increased Short-Form Cancer Needs Questionnaire scores (higher level of care needs) (ß = 0.177 and 28.49, both P < .05) and patients receiving 3 or more chemotherapy treatments were significantly associated with increased Head and Neck Cancer Quality of Life Scale scores (higher level of symptoms and problems) (ß = 27.77, P = .007). Results of stepwise multiple linear regression analysis indicated that 4 oral cancer-related symptoms and problems, "trouble with social contacts," "swallowing problems," "teeth problems," and "feeling ill," were significantly associated with higher care needs in oral cancer patients (all P ≤ .05). CONCLUSION: A significant correlation exists between health-related QOL and care needs. IMPLICATIONS FOR PRACTICE: Using a valid health-related QOL scale may help nurses determine their perceived physical and psychological care needs.


Assuntos
Nível de Saúde , Neoplasias Bucais/psicologia , Cuidados Pós-Operatórios/psicologia , Qualidade de Vida/psicologia , Apoio Social , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/terapia , Período Pós-Operatório , Inquéritos e Questionários , Taiwan
4.
Anticancer Agents Med Chem ; 17(5): 712-718, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27600790

RESUMO

BACKGROUND: Gemin D (GD) is an ellagitannin found in several plant species rich in phenolic compounds. Its many beneficial properties include antioxidant and antitumoral. OBJECTIVE: The present study assessed the genotoxicity, cytotoxicity, antigenotoxicity, and anticytotoxicity of GD by in vitro and in vivo assays. METHOD: The Ames mutagenicity assay in Salmonella typhimurium, Micronucleus and Comet tests in mice were used to evaluate the biological activities mentioned above. To assess the GD's protective effects against DNA damage induced by different mutagens we performed co-, pre- and/or post-treatment in these assays. RESULTS: There was no genotoxic effect of GD via Ames and Micronucleus tests, but in the Comet assay the highest dose induced DNA damage. This same highest dose presented a significant cytotoxicity in mice. In the antigenotoxicity, GD protected DNA against the action of 4-nitroquinoline-1-oxide and sodium azide by Ames test, and also against the harmful action of cyclophosphamide in pre- and co-treatment by Micronucleus and Comet tests, but it did not protect DNA in post-treatment. Regarding to anticytotoxicity, GD provoked an anticytotoxic effect only during pre-treatment. CONCLUSION: Therefore, GD showed relevant antigenotoxic, anticytotoxic and cytotoxic effects, which indicate that it may be a probable candidate for chemoprevention or for the development of new cancer therapies.


Assuntos
Antibacterianos/farmacologia , Taninos Hidrolisáveis/farmacologia , Salmonella typhimurium/efeitos dos fármacos , 4-Nitroquinolina-1-Óxido , Animais , Antibacterianos/química , Ciclofosfamida , Dano ao DNA , Relação Dose-Resposta a Droga , Taninos Hidrolisáveis/química , Masculino , Camundongos , Testes de Sensibilidade Microbiana , Estrutura Molecular , Testes de Mutagenicidade , Salmonella typhimurium/genética , Azida Sódica , Relação Estrutura-Atividade
5.
Nutr Cancer ; 68(5): 848-55, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27352027

RESUMO

Silymarin (SM), a standardized extract from Silybum marianum (L.) Gaertn., is composed mainly of flavonolignans, and silibinin (SB) is its major active constituent. The present study aimed to evaluate the antimutagenic activities of SM and SB using the Ames mutagenicity test in Salmonella Typhimurium, as well as their anticytotoxic and antigenotoxic activities using the mouse bone marrow micronucleus test. To assess antimutagenicity, Salmonella Typhimurium strains were treated with different concentrations of SM or SB and the appropriate positive control for each strain. To assess antigenotoxicity and anticytotoxicity, Swiss mice were treated with different concentrations of SM or SB and mitomycin C (MMC). The results showed that SM was not significantly effective in reducing the number of frameshift mutations in strain TA98, while SB demonstrated significant protection at higher doses (P < 0.05). Regarding strain TA 100, SM and SB significantly decreased mutagenicity (point mutations) (P < 0.05). The results of the antigenotoxic evaluation demonstrated that SM and SB significantly reduced the frequency of micronucleated polychromatic erythrocytes (MNPCE) (P < 0.05). The results also indicated that SM and SB significantly attenuated MMC-induced cytotoxicity (P < 0.05). Based on these results, both SM and SB presented antimutagenic, antigenotoxic, and anticytotoxic actions.


Assuntos
Extratos Vegetais/farmacologia , Salmonella typhimurium/efeitos dos fármacos , Silybum marianum/química , Silimarina/farmacologia , Animais , Antimutagênicos/farmacologia , Antioxidantes/farmacologia , Medula Óssea/efeitos dos fármacos , Dano ao DNA/efeitos dos fármacos , Masculino , Camundongos , Testes para Micronúcleos , Mitomicina/farmacologia , Testes de Mutagenicidade , Silibina
6.
Toxicol In Vitro ; 27(1): 198-203, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23108037

RESUMO

Curcumin is considered to be a potential component for drug-eluting stents due to its anti-inflammatory properties. In this study we compared the mutagenicity and blood compatibility of curcumin to first generation drug eluting stent components: paclitaxel and sirolimus. The Ames test was used to assess mutagenicity. Blood compatibility was tested by measuring platelet activation and fibrinogen adsorption on poly (DL-lactide-co-glycolide, PLGA) films. We discovered that there was no significant increase in the number of revertants/plate following treatment with curcumin (up to 0.5mg/plate) or sirolimus (up to 0.5 µg/plate). However, a significant induction in the frequency of bacterial his(+) revertant colonies by paclitaxel at concentrations of 0.02, 0.05, 0.1, 0.2 and 0.5 µg/plate was observed. We also discovered a significant reduction in platelet activation by PLGA films containing 30% and 50% by weight curcumin. A similar reduction in platelet activation was also observed for PLGA films containing 1% by weight paclitaxel. In addition, we observed an increase of fibrinogen adsorption to PLGA-films containing curcumin. This would compromise the potential use of curcumin as a component of drug-eluting stents. Moreover, our data challenges the current view that paclitaxel does not significantly induce mutagenesis.


Assuntos
Antineoplásicos Fitogênicos/toxicidade , Curcumina/toxicidade , Mutagênicos/toxicidade , Paclitaxel/toxicidade , Adsorção , Antineoplásicos Fitogênicos/administração & dosagem , Curcumina/administração & dosagem , Stents Farmacológicos , Fibrinogênio/química , Humanos , Ácido Láctico/química , Testes de Mutagenicidade , Mutagênicos/administração & dosagem , Paclitaxel/administração & dosagem , Ativação Plaquetária/efeitos dos fármacos , Ácido Poliglicólico/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico , Salmonella typhi/efeitos dos fármacos , Salmonella typhi/genética , Sirolimo/administração & dosagem , Sirolimo/toxicidade
7.
Eur J Oncol Nurs ; 17(4): 436-41, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23218591

RESUMO

PURPOSE: Oncology patients may respond to radiation treatment with anxiety expressed as stress, fear, depression, and frustration. This study aimed to investigate effects of music intervention on reducing pre-radiotherapy anxiety in oncology patients. METHODS: Quasi-experimental study with purposeful sampling was conducted in the Department of Radiation Oncology, at Far Eastern Memorial Hospital, Taipei, Taiwan. Subjects were assigned into a music group (n = 100) receiving 15 min of music therapy prior to radiation and a control group (n = 100) receiving 15 min rest prior to radiation. Both groups were evaluated for pre- and post-test anxiety using the State-Trait Anxiety Inventory. Physiological indicators of anxiety were measured pre- and post-test. RESULTS: Baseline State/Trait scores and vital signs were comparable between groups (P > 0.05). Mean change in pre- and post-test State/Trait scores showed significant decreases from baseline to post-test in both groups (all P < 0.05). A statistically significant difference was observed between music therapy and control groups in mean change of State anxiety scores (mean decreases 7.19 and 1.04, respectively; P < 0.001) and Trait anxiety scores (mean decreases 2.77 and 1.13, respectively; P = 0.036). In vital signs, both groups had significant decreases in pre- and post-test heart rate and respiration rate (P < 0.05). A statistically significant difference in mean change of systolic pressure was found between music and control groups (-5.69 ± 0.41 mmHg vs. -0.67 ± 1.29 mmHg, respectively; P = 0.009). CONCLUSIONS: Music therapy decreased State anxiety levels, Trait anxiety levels and systolic blood pressure in oncology patients who received the intervention prior to radiotherapy.


Assuntos
Ansiedade/terapia , Musicoterapia/métodos , Radioterapia/psicologia , Adulto , Ansiedade/diagnóstico , Pressão Sanguínea/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade , Radioterapia (Especialidade)/métodos , Resultado do Tratamento
8.
Braz. j. pharm. sci ; 46(4): 687-694, Oct.-Dec. 2010. graf
Artigo em Inglês | LILACS | ID: lil-622868

RESUMO

Stryphnodendron adstringens (Mart.) Coville, 1910 is a small tree, distributed widely throughout the Cerrado region of Brazil and named "barbatimão" by the Tupi-Guarani tribes, which presents astringent properties. Its ethnopharmacological uses comprise, among others, anti-inflammatory and wound healing action, and it is used in the treatment of diarrhea and gynecological problems. The phytotherapeutic use of 'barbatimão' is largely related to its tannin content, which is abundant in its bark. The main goal of the present study was to evaluate the cytotoxic, mutagenic, and genotoxic potential of the lyophilized solution of the stem bark of S. adstringens, using the Ames test, the SOS-Inductest and the SOS-Chromotest. S. adstringens presented cytotoxic activity in all tested systems, did not present mutagenic activity detectable by the Ames test and SOS-Chromotest, and showed some genotoxic effect on the SOS-Inductest. However, the metabolization of the extract by S9 fraction attenuated its genotoxic and cytotoxic activities.


Stryphnodendron adstringens (Mart.) Coville, 1910 é uma pequena árvore amplamente distribuída nas regiões de cerrado do Brasil, chamada de "barbatimão" pelas tribos Tupi-Guarani, que apresenta propriedade adstringente. Seu uso etnofarmacológico compreende, entre outros, efeitos antiinflamatório e cicatrizante, sendo empregada no tratamento de diarréias e problemas ginecológicos. Grande parte das aplicações do fitoterápico de barbatimão está relacionada aos taninos, abundantes em sua casca. O objetivo do presente trabalho foi avaliar os potenciais citotóxico, mutagênico e genotóxico da solução liofilizada da casca de S. adstringens, utilizando Teste de Ames, SOS-Induteste e SOS-Cromoteste. S. adstringens apresentou atividade citotóxica em todos os sistemas testados, não apresentou atividade mutagênica detectável pelo teste de Ames e SOS-Cromoteste e mostrou certo efeito genotóxico no SOS-Induteste. Porém, a metabolização do extrato pela fração S9 atenuou suas atividades genotóxica e citotóxica.


Assuntos
Estruturas Vegetais/toxicidade , Extratos Vegetais , Stryphnodendron barbatimam/análise , Stryphnodendron barbatimam/efeitos adversos , Stryphnodendron barbatimam/toxicidade , Citotoxinas/análise , Citotoxinas/toxicidade , Genotoxicidade/análise , Mutagênese , Mutagênese/genética , Medicamento Fitoterápico
9.
Braz. j. pharm. sci ; 45(3): 491-496, July-Sept. 2009. graf, tab
Artigo em Inglês | LILACS | ID: lil-533177

RESUMO

Curatella americana L., commonly known as "lixeira" in Brazil, has been used in folk medicine to treat ulcers and inflammations. The purpose of the present work was to evaluate the cytotoxic and genotoxic potential of the ethanolic extract of C. americana stem bark using the prophage λ induction test (SOS inductest). To evaluate the cytotoxicity of this plant, after treatment with different concentrations of the extract, Escherichia coli WP2s(λ) cultures were diluted in M9 buffer, inoculated into LB plates, and incubated for 24 h at 37 ºC. To assess genotoxicity, the lysogenic strain E. coli WP2s(λ) was treated with different concentrations of the extract. Then, the lysogenic strain was added to the indicator strain (RJF013), LB(1/2)(malt/amp), seeded into plates with the matches, and incubated for 24 h at 37 ºC. After this period, the total number of colonies and the number of plaques were counted to evaluate C. americana cytotoxicity and genotoxicity, respectively. Our results showed that although the extract of "lixeira" did not modify the survival of bacteria (p > 0.05), it caused a significant increase in prophage λ induction, especially at the higher concentrations (p<0.05). Therefore, we conclude that the ethanolic extract of C. americana stem bark did not present cytotoxic effect, but some genotoxic potential was observed.


Curatella americana L., comumente conhecida como "lixeira" no Brasil, é utilizada em medicina popular para tratamento de úlceras e inflamações. O presente trabalho teve como objetivo avaliar o potencial citotóxico e genotóxico do extrato etanólico das cascas de C. americana utilizando o Induteste SOS. Para avaliar a citotoxicidade da planta, depois de tratadas com diferentes concentrações do extrato, culturas de E. coli WP2s(λ) foram diluνdas em tampão M9 e semeadas em placas LB. Para avaliar a genotoxicidade da planta, a cepa lisogênica WP2s(λ) de E. coli foi tratada com diferentes concentrações do extrato. Em seguida, esta foi adicionada à cepa indicadora (RJF013) e ambas foram semeadas em placas em meio LB(1/2)(malt)(amp). Todas as culturas foram incubadas por 24 h a 37 ºC. Posteriormente, o número total de colônias e o número de centros infecciosos foram computados para a avaliação da citotoxidade e da genotoxicidade desta planta, respectivamente. Os resultados mostraram que embora o extrato de C. americana não tenha modificado a sobrevivência bacteriana (p > 0,05), provocou aumento significativo (p < 0,05) na indução do profago λ, especialmente nas concentrações mais altas. Assim, concluiu-se que o extrato etanólico das cascas de C. americana não apresentou atividade citotóxica, mas foi observada ação genotóxica direta.


Assuntos
Citotoxicidade Imunológica , Dilleniaceae , Genotoxicidade , Prófagos/patogenicidade , Análise de Variância , Ativação Transcricional/genética , Lisogenia
10.
Rev. bras. anal. clin ; 39(3): 237-239, 2007. tab
Artigo em Português | LILACS | ID: lil-501839

RESUMO

A relação entre eosinofilia e protozoários é pouco descrita na literatura científica. É importante assinalar que nem todos os parasitos intestinais são capazes de induzir eosinofilia, principalmente aqueles que estão na luz do intestino, sendo mais pronunciada quando há invasão tecidual. Dentre as protoparasitoses mais comuns, notadamente em crianças, destaca-se a giardíase, provocada pelaGiardia lamblia, parasito do intestino delgado, que causa diarréia e má-absorção. O objetivo deste trabalho foi identificar a existência de correlação entre eosinofilia e protoparasitose por Giardia lamblia, utilizando 1598 amostras de pacientes infectados, com idades variando entre zero e dez anos, oriundos da população de Goiânia que procuram o serviço do Laboratório Escola do Departamento deBiomedicina da Universidade Católica de Goiás. Desta amostragem 949 apresentavam eosinofilia (59,4 %). Essa proporção é significativamentediferente da esperada se não houvesse relação entre giardíase e eosinofilia (1:1) (c2 = 28.16; P < 0,01). Portanto, a eosinofilia é um parâmetro hematológico que deve ser considerado na abordagem e na avaliação do paciente que a apresenta, pois pode sugerir a existência de protoparasitose intestinal por Giardia lamblia, e ser um indicativo, com valor preditivo para a incorporação no tratamento conjunto com as doenças causadas por protozoários intestinais, entre outras parasitoses, bem como processos alérgicos


Assuntos
Humanos , Hiperplasia Angiolinfoide com Eosinofilia , Criança , Eosinofilia , Giardia lamblia , Giardíase
11.
J. bras. patol. med. lab ; 42(6): 425-430, dez. 2006. tab
Artigo em Português | LILACS | ID: lil-446496

RESUMO

As anemias hereditárias, em especial as talassemias e hemoglobinas (Hb) variantes, são as mais comuns das alterações genéticas humanas; sua frequência na população brasileira é muito variável, dependendo dos grupos raciais formadores de cada região. O povoamento de Goiás, que teve início logo após o seu descobrimento, em 1726, motivado pela procura de ouro, foi composto principalmente por portugueses e escravos africanos, contexto que favoreceu a mestiçagem entre eles. Considerando que esses povos apresentam genes para as hemoglobinas anormais com frequências variadas, é esperado que se encontrem essas alterações genéticas na nossa população. O objetivo deste trabalho foi avaliar a a prevalência de talassemias e hemoglobinas variantes na população de Goiás. Para isso a casuística foi composta por 404 alunos participantes dos diversos cursos da Universidade Católica de Goiás (UCG), oriundos de 55 cidades do estado de Goiás. A prevalência de anemia hereditária por talassemias e hemoglobinas variantes em Goiás foi de 10,1 por cento, cuja ordem decrescente foi a seguinte: talassemia alfa heterozigótica (5,2 por cento), heterozigose para hemoglobina S (Hb AS) (2,2 por cento), heterozigose para hemoglobina C (Hb AC) (1 por cento), talassemia beta menor (0,7 por cento), associa��o entre talassemia alfa e heterozigose para Hb S (0,5 por cento), associação entre talassemia alfa e heterozigose para Hb C (0,3 por cento) e heterozigose para hemoglobina D (Hb AD) (0,3 por cento). Nenhum caso de homozigose foi encontrado no presente estudo. Este trabalho demonstrou a dispersão dos genes para Hb S, Hb C e Hb D, bem como de talassemias alfa e beta em uma população do estado de Goiás. Por essa razão, concluímos que é importante realizar programas com maior abrangência da população para estudo da epidemiologia das talassemias e hemoglobinas variantes no estado de Goiás.


The hereditary anemias, especially the thalassemies and hemoglobinopathies are the most common human genetic abnormalities. Their frequency in the Brazilian population is very variable depending on the racial groups typical of each region. The settlement of Goiás, that had its beginning after discovery in 1726 owing to the search for gold, was composed basically by Portuguese and African slaves, a context that favored the racial mixing among them. Considering that these groups present genes for abnormal hemoglobins with varied frequencies it is expected the finding of these genetic abnormalities within our population. The objective of this study was to evaluate the prevalence of thalassemies and variant hemoglobins in the population of Goiás. For this purpose the sample was composed by 404 participating students from several graduate courses of the Catholic University of Goiás originally from 55 cities of the state of Goiás. Laboratory tests were used taking into account the historical and demographic factors of the population. The prevalence of hereditary anemias by thalassemias and variant hemoglobins in Goiás was 10.1 percent, in which the decreasing order of these abnormalities was: alfa heterozygous thalassemy (5.2 percent); heterozygous hemoglobin S (Hb AS) (2.2 percent); heterozygous hemoglobin C (Hb AC) (1 percent); beta short thalassemy (0.7 percent); association between alpha thalassemy and heterozygous for hemoglobin S (0.5 percent); association between alpha thalassemy and heterozygous for hemoglobin C (0.3 percent); and heterozygous for hemoglobin D (0.3 percent). No homozygosity was found in the study group. This study demonstrates the need for large scale screening in human populations for epidemiological studies of the thalassemies and variant hemoglobins in the state of Goiás.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Anemia/genética , Hemoglobinopatias/epidemiologia , Hemoglobinopatias/etnologia , Talassemia alfa/epidemiologia , Talassemia beta/epidemiologia , Brasil/epidemiologia , Prevalência
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