Open Heart Surgery in Jehovah’s Witnesses: A Propensity Score Analysis

Publication date: February 2020Source: The Annals of Thoracic Surgery, Volume 109, Issue 2Author(s): Hannes Müller, Thomas Ratschiller, Wolfgang Schimetta, Jens Meier, Hans Gombotz, Andreas ZiererBackgroundJehovah’s Witnesses (JW) refuse allogeneic blood transfusions and therefore pose a unique challenge in case of major surgery. This retrospective study reviewed an experience with JW patients who were undergoing open heart surgery.MethodsBy using patient blood management strategies, 35 adult JW patients underwent cardiac surgery at Kepler University Hospital in Linz, Austria between 2008 and 2017. Outcomes were compared with patients who accepted blood transfusions (non-JW patients) by using propensity score matching.ResultsThere were no significant differences in clinical and operative data between the groups. Twelve JW patients (34.3%) were pretreated with erythropoietin and iron, with a preoperative increase in mean hemoglobin of 2.0 g/dL. On admission, hemoglobin was 14.1 ± 1.1 g/dL in JW patients, compared with 13.2 ± 2.0 g/dL in non-JW patients (P = .022). The hematocrit in JW patients was higher throughout the hospital stay, even though 51.4% of non-JW patients received allogeneic red blood cell transfusions. The perioperative red blood cell loss was significantly lower in JW patients than in non-JW patients (619 ± 420 mL vs 929 ± 520 mL; P = .010). Major complication rates were not different between the groups. The hem...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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AbstractHematopoietic stem cell transplantation (HSCT) is the only treatment option for the hematological manifestations of Fanconi anemia (FA). Fludarabine based reduced intensity conditioning regimens have helped in improving outcomes significantly in FA patients. We retrospectively analyzed the outcomes of FA patients who underwent allogeneic HSCT at BLK Superspeciality Hospital, New Delhi from June 2011 to September 2019. Twenty FA patients underwent 23 transplants at our center. Overall survival and disease free survival were 65% and 50%, respectively at a median of 23  months. Overall mortality was 30%. HSCT for...
Source: Indian Journal of Hematology and Blood Transfusion - Category: Hematology Source Type: research
Conclusion: Post-transplant HLH is an important entity in benign hematological disorders, which needs to be identified early and treated promptly with steroids, monoclonal agents or immunosuppressive therapy. Serum ferritin levels are an important biomarker and help in monitoring response.
Source: Indian Journal of Hematology and Blood Transfusion - Category: Hematology Source Type: research
Conclusions: Preoperative blood transfusion is associated with severe postoperative complications following colectomy in moderate and severe anemic cancer patients. Further studies are needed to establish an optimal preoperative transfusional cutoff value to optimize postoperative outcomes and balance clinical costs. PMID: 32075458 [PubMed - as supplied by publisher]
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
Preoperative anemia is common in elective orthopedic surgical patients and is an independent risk factor for perioperative morbidity and mortality. The detrimental effects of anemia on surgical outcomes impact the costs associated with perioperative care as well. In addition to the direct expenditures related to the complications of anemia, perioperative anemia is the leading predictor of perioperative transfusion and it is estimated that up to 6 million dollars are spent on transfusion-related costs per hospital per year. Anemia is a preventable and manageable condition that can often be treated effectively without relyin...
Source: Techniques in Orthopaedics - Category: Orthopaedics Tags: Symposium Source Type: research
AbstractPurpose of ReviewTo provide an overview of the potential iatrogenic causes of acute decompensated heart failure (AHF) and an evidence-based management strategy to address this.Recent FindingsAs the heart failure (HF) population continues to age and become burdened with greater comorbidities and polypharmacy, patients become more susceptible to the iatrogenic precipitants of HF. The following clinical scenarios are familiar to clinicians, but the sequelae to AHF are often unanticipated: HF medications withdrawn during an intercurrent illness and not restarted, cardiotoxic therapy prescribed for cancer without timely...
Source: Current Heart Failure Reports - Category: Cardiology Source Type: research
Publication date: Available online 14 February 2020Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Dubravko Habek, Anis Cerovac, Ana Luetić, Ingrid Marton, Matija Prka, Tomislav Kulaš, Boris UjevićAbstractObjectiveA 15-year-experience of the personal modification of Misgav Ladach (ML) caesarean section in relation to the Dörffler method.Study designA retrospective clinical randomized observational study included 822 transperitoneal cesarean sections: 557 were performed via modified ML (without bladder catheterization, small transverse fascial incision with muscular st...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
RARITAN, NJ, February 10, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today the submission of a supplemental Biologics License Application (sBLA) to the U.S. Food and Drug Administration (FDA) seeking approval of DARZALEX® (daratumumab) in combination with Kyprolis® (carfilzomib) and dexamethasone (DKd) for relapsed/refractory multiple myeloma. The sBLA is supported by results from the Phase 3 CANDOR study, which compared treatment with DKd to carfilzomib and dexamethasone (Kd) in patients with multiple myeloma who relapsed after one to three prior lines of therapy. “Wh...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
ConclusionsNo association between PRBC transfusion and odds of mortality was observed amongst EC patients in this LMIC setting. An increased mortality association was found for patients receiving PRBC transfusions with an initial hemoglobin>5 mg/dL. Results suggest benefits from PRBC transfusion are limited as compared to HIC. Further research evaluating emergent transfusion thresholds for medical pathologies should be performed in LMICs to guide practice.
Source: African Journal of Emergency Medicine - Category: Emergency Medicine Source Type: research
In conclusion, the proposed rtPCR is fast, apparently more sensitive than all 18S rRNA amplification systems for detecting extremely low parasitemia. The rtPCR is also specific to P. malariae/P. brasilianum species. This new molecular tool could be applied to the detection of P. malariae/brasilianum infections with submicroscopic parasitemias in the context of epidemiological studies and blood bank safety programs.
Source: Parasitology International - Category: Parasitology Source Type: research
In this study, we describe the first case of congenital atransferrinemia in Tunisia and the 18th patient in the reported data. The patient was referred to our hospital to explore a severe hypochromic and microcytic anemia. The laboratory evaluation including hematological and biochemical examination was performed in the proband and her parents. All exons of the transferrin gene were PCR amplified. The products were screened for mutations by direct sequencing. Based on laboratory and clinical findings, diagnosis of congenital atransferrinemia was confirmed. DNA sequencing revealed the presence of a novel homozygous deletion...
Source: European Journal of Medical Genetics - Category: Genetics & Stem Cells Authors: Tags: Eur J Med Genet Source Type: research
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