BACKGROUND: Stroke is a potentially fatal complication of sickle cell disease in children between 2-16 years and transcranial Döppler has been recommended as a screening method in these cases. OBJECTIVE: The main goal of this study was to correlate transcranial Döppler results to complications related to stroke in sickle cell disease and baseline characteristics of the population. METHODS: This was an observational study of children and adolescents with ages between 2-16 years with sickle cell disease who were followed in three centers. RESULTS: From January 2008 to July 2009, 902 patients were enrolled in this study. The median age was 6.5 years (range: 1.8-15.8), 52.3% were male, 74.4% had hemoglobin SS; 221 (28.6%) had at least one complication associated with sickle cell disease. A total of 773 patients performed transcranial Döppler; in 91.2% this was a method of screening. Conditional or abnormal transcranial Döppler results were more common in patients with sickle cell disease complications versus those without complications (ODDS ratio = 3.18; 95% Confidence interval = 1.92-5.27). There was a significant difference in the frequency of conditional or abnormal transcranial Döppler results in patients with abnormal laboratory results compared to those without abnormalities (OR=4.03); 95% confidence interval = 2.30-7.06. CONCLUSIONS: Conditional or abnormal transcranial Döppler results were significantly more frequent in patients with complications of sickle cell disease confirming the increased risk of stroke in this subgroup of patients. This observation reinforces the recommendation of transcranial Döppler as a screening test for all patients with sickle cell disease with ages between 2 and 16 years.

OBJETIVO: Considerando a água como importante fonte de ingestão de flúor, o aumento da prevalência de fluorose dentária e do consumo de água mineral, o estudo realizado teve como objetivo avaliar o consumo de água mineral e sua concentração de flúor. MÉTODOS: A pesquisa foi realizada nos bairros do município de Bauru, SP. Foram visitadas mil residências que compunham uma amostra estratificada, obtida por conglomerados. Cada conglomerado correspondia a um quarteirão. Para efeito de sorteio os quarteirões foram numerados dentro das 17 regiões estabelecidas no plano diretor do município. Para coleta das amostras de água mineral foram usados frascos plásticos de 50 ml, previamente identificados. Na análise de flúor utilizou-se eletrodo íon sensível (Orion 9609) após tamponamento com TISAB II. Informações a respeito do consumo de água mineral foram obtidas com a aplicação de um questionário. RESULTADOS: Constatou-se que cerca de 29,7% da população do município consome água mineral. Nas 260 amostras analisadas, das 29 diferentes águas, a concentração de flúor variou de 0,045 a 1,515 mg/l. Em uma das águas, constava no rótulo o valor de 0,220 mg/l, mas na análise constatou-se 1,515 mg/l de flúor. Além disso, algumas águas não traziam especificado a concentração de flúor; e, na análise constataram-se valores variando entre 0,049 e 0,924 mg/l. CONCLUSÕES: Os resultados mostraram uma grande variação na concentração de flúor e reforçam a importância do controle dessas águas por parte da vigilância sanitária.

OBJECTIVE: Considering that water is an importance source of fluoride intake, and that the consumption of mineral water and prevalence of dental fluorosis have been increasing, the aim of this study was to evaluate the consumption of mineral water and its fluoride concentration. METHODS: The study was performed in residential districts of the municipality of Bauru, State of São Paulo, by means of stratified sampling via clusters. Each cluster corresponded to one residential block. For randomization purposes, the residential blocks were numbered within the 17 districts established by the city plan. One thousand homes were thus visited. Mineral water samples were collected using previously labeled 50 ml plastic flasks. Fluoride analysis was done using an ion-sensitive electrode (Orion 9609), after buffering using TISAB II. Information on the consumption of mineral water was obtained by means of applying a questionnaire. RESULTS: Around 29.72% of the city's population was consuming mineral water. In the 260 samples analyzed from 29 different brands of water, the fluoride concentration ranged from 0.045 to 1.515 mg/l. For one brand, the label stated that the fluoride concentration was 0.220 mg/l, but analysis revealed a concentration of 1.515 mg/l. Moreover, some brands did not specify the fluoride concentration on the label and, for these, the analysis showed concentrations ranging from 0.049 to 0.924 mg/l. CONCLUSIONS: The results demonstrated wide variation in fluoride concentrations and reinforce the importance of the control of such waters by the sanitary surveillance agency.

OBJETIVO: Considerando a água como importante fonte de ingestão de flúor, o aumento da prevalência de fluorose dentária e do consumo de água mineral, o estudo realizado teve como objetivo avaliar o consumo de água mineral e sua concentração de flúor. MÉTODOS: A pesquisa foi realizada nos bairros do município de Bauru, SP. Foram visitadas mil residências que compunham uma amostra estratificada, obtida por conglomerados. Cada conglomerado correspondia a um quarteirão. Para efeito de sorteio os quarteirões foram numerados dentro das 17 regiões estabelecidas no plano diretor do município. Para coleta das amostras de água mineral foram usados frascos plásticos de 50 ml, previamente identificados. Na análise de flúor utilizou-se eletrodo íon sensível (Orion 9609) após tamponamento com TISAB II. Informações a respeito do consumo de água mineral foram obtidas com a aplicação de um questionário. RESULTADOS: Constatou-se que cerca de 29,7% da população do município consome água mineral. Nas 260 amostras analisadas, das 29 diferentes águas, a concentração de flúor variou de 0,045 a 1,515 mg/l. Em uma das águas, constava no rótulo o valor de 0,220 mg/l, mas na análise constatou-se 1,515 mg/l de flúor. Além disso, algumas águas não traziam especificado a concentração de flúor; e, na análise constataram-se valores variando entre 0,049 e 0,924 mg/l. CONCLUSÕES: Os resultados mostraram uma grande variação na concentração de flúor e reforçam a importância do controle dessas águas por parte da vigilância sanitária.

OBJECTIVE: Considering that water is an importance source of fluoride intake, and that the consumption of mineral water and prevalence of dental fluorosis have been increasing, the aim of this study was to evaluate the consumption of mineral water and its fluoride concentration. METHODS: The study was performed in residential districts of the municipality of Bauru, State of São Paulo, by means of stratified sampling via clusters. Each cluster corresponded to one residential block. For randomization purposes, the residential blocks were numbered within the 17 districts established by the city plan. One thousand homes were thus visited. Mineral water samples were collected using previously labeled 50 ml plastic flasks. Fluoride analysis was done using an ion-sensitive electrode (Orion 9609), after buffering using TISAB II. Information on the consumption of mineral water was obtained by means of applying a questionnaire. RESULTS: Around 29.72% of the city's population was consuming mineral water. In the 260 samples analyzed from 29 different brands of water, the fluoride concentration ranged from 0.045 to 1.515 mg/l. For one brand, the label stated that the fluoride concentration was 0.220 mg/l, but analysis revealed a concentration of 1.515 mg/l. Moreover, some brands did not specify the fluoride concentration on the label and, for these, the analysis showed concentrations ranging from 0.049 to 0.924 mg/l. CONCLUSIONS: The results demonstrated wide variation in fluoride concentrations and reinforce the importance of the control of such waters by the sanitary surveillance agency.