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Procedure: Phlebotomy
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Total 34 results found since Jan 2013.
Validation of Sickle Cell Disease Severity Score in a Cohort of Hemoglobin SC Disease Patients
Conclusion: Despite having been derived from a SCD population that was 26% HbSC, the study was unable to validate the SSS within the cohort of HbSC patients. This may reflect the differences in patient population and/or therapeutic intervention between this cohort and the CSSCD cohort used in the construction of the SSS calculator. While SSS was found to correlate with 3 discrete markers of disease morbidity (TRJV, CVA, creatinine clearance), it appears that a new scoring system is required to accurately predict clinical mortality and morbidity in contemporary cohorts of adult HbSC disease patients.DisclosuresNo relevant c...
Source: Blood - November 21, 2018 Category: Hematology Authors: Rosart, R. M., Pestrin, O. A., Tomlinson, G. A., Ward, R., Pendergrast, J., Binding, A., Kuo, K. H. M. Tags: 903. Outcomes Research-Non-Malignant Hematology: Poster I Source Type: research
Red blood cell transfusion to treat or prevent complications in sickle cell disease: an overview of Cochrane reviews.
CONCLUSIONS: This overview provides support from two high-quality Cochrane Reviews for the use of RBC transfusions in preventing stroke in children and adolescents at high risk of stroke (abnormal TCDs or SCI) and evidence that it may decrease the risk of SCI in children with abnormal TCD velocities. In addition RBC transfusions may reduce the risk of ACS and painful crisis in this population.This overview highlights the lack of high-quality evidence in adults with SCD and the number of reviews that have no evidence for the use of RBC transfusions across a spectrum of SCD complications. Also of concern is the variable and ...
Source: Cochrane Database of Systematic Reviews - August 1, 2018 Category: General Medicine Authors: Fortin PM, Hopewell S, Estcourt LJ Tags: Cochrane Database Syst Rev Source Type: research
Interventions for preventing silent cerebral infarcts in people with sickle cell disease.
CONCLUSIONS: We identified no trials for preventing silent cerebral infarcts in adults, or in children who do not have HbSS SCD.Long-term red blood cell transfusions may reduce the incidence of silent cerebral infarcts in children with abnormal TCD velocities, but may have little or no effect on children with normal TCD velocities. In children who are at higher risk of stroke and have not had previous long-term transfusions, long-term red blood cell transfusions probably reduce the risk of stroke, and other SCD-related complications (acute chest syndrome and painful crises).In children and adolescents at high risk of strok...
Source: Cochrane Database of Systematic Reviews - May 13, 2017 Category: General Medicine Authors: Estcourt LJ, Fortin PM, Hopewell S, Trivella M, Doree C, Abboud MR Tags: Cochrane Database Syst Rev Source Type: research
Hydroxyurea (hydroxycarbamide) for sickle cell disease.
CONCLUSIONS: There is evidence to suggest that hydroxyurea is effective in decreasing the frequency of pain episodes and other acute complications in adults and children with sickle cell anaemia of HbSS or HbSβºthal genotypes and in preventing life-threatening neurological events in those with sickle cell anaemia at risk of primary stroke by maintaining transcranial doppler velocities. However, there is still insufficient evidence on the long-term benefits of hydroxyurea, particularly in preventing chronic complications of SCD, recommending a standard dose or dose escalation to maximum tolerated dose. There is also insuf...
Source: Cochrane Database of Systematic Reviews - April 20, 2017 Category: Journals (General) Authors: Nevitt SJ, Jones AP, Howard J Tags: Cochrane Database Syst Rev Source Type: research
Double the Trouble: Acute Coronary Syndrome and Ischemic Stroke in Polycythemia Vera
Vague symptoms turned out to be life-threatening conditions. A 50 year-old man with a history of polycythemia vera, presented to hospital with epigastric discomfort and clumsiness of the right hand for 5 days. Polycythemia vera was diagnosed 1 year prior with good control of hematocrit by intermittent phlebotomy. He did not have any other medical history, and was not taking any medications. He denied chest pain, shortness of breath, nausea, headache, vision change, or speech difficulty.
Source: The American Journal of Medicine - March 12, 2017 Category: Journals (General) Authors: Hitomi Hosoya, Jeffrey J. Levine, David H. Henry, Sheldon Goldberg Tags: Diagnostic Dilemma Source Type: research
Blood transfusion for preventing primary and secondary stroke in people with sickle cell disease.
CONCLUSIONS: There is no evidence for managing adults, or children who do not have HbSS sickle cell disease.In children who are at higher risk of stroke and have not had previous long-term transfusions, there is moderate quality evidence that long-term red cell transfusions reduce the risk of stroke, and low quality evidence they also reduce the risk of other sickle cell disease-related complications.In primary and secondary prevention of stroke there is low quality evidence that switching to hydroxyurea with phlebotomy has little or no effect on the liver iron concentration.In secondary prevention of stroke there is low-q...
Source: Cochrane Database of Systematic Reviews - January 16, 2017 Category: Journals (General) Authors: Estcourt LJ, Fortin PM, Hopewell S, Trivella M, Wang WC Tags: Cochrane Database Syst Rev Source Type: research
Telomere Length, Long-Term Black Carbon Exposure, and Cognitive Function in a Cohort of Older Men: The VA Normative Aging Study
Conclusions: TL and CRP levels may help predict the impact of BC exposure on cognitive function in older men.
Citation: Colicino E, Wilson A, Frisardi MC, Prada D, Power MC, Hoxha M, Dioni L, Spiro A III, Vokonas PS, Weisskopf MG, Schwartz JD, Baccarelli AA. 2017. Telomere length, long-term black carbon exposure, and cognitive function in a cohort of older men: the VA Normative Aging Study. Environ Health Perspect 125:76–81; http://dx.doi.org/10.1289/EHP241
Address correspondence to E. Colicino, Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Building 1, Room G03, Bos...
Source: EHP Research - January 2, 2017 Category: Environmental Health Authors: Web Admin Tags: Research Articles January 2017 Source Type: research
Educational Intervention Reduces Utilization of Low-Value Testing in Cerebrovascular Inpatients: An Example of Rapidly Implementable Quality Improvement (P2.309)
Conclusions: In this prospective quality improvement study, an educational intervention resulted in significant reduction in utilization of low-value tests in patients admitted to an inpatient cerebrovascular service. While the per-patient costs of these diagnostic tests were small, a similar approach at the system level could result in considerable avoidance of low value testing and associated costs, particularly if applied to higher-cost/lower-value investigations and procedures.Disclosure: Dr. Scharf has nothing to disclose. Dr. Jones has nothing to disclose. Dr. Martinez-Thompson has nothing to disclose. Dr. Pichler ha...
Source: Neurology - April 3, 2016 Category: Neurology Authors: Scharf, E., Jones, A., Martinez-Thompson, J., Pichler, M., Cohen, A., Clark, S., Nozile-Firth, K., Jones, L. Tags: Stroke Systems of Care Source Type: research
The Speed and Reliability of Pre-Hospital Point-of-Care Laboratory Testing on the Mobile Stroke Treatment Unit (P4.314)
Conclusion: Critical laboratory tests can be performed rapidly and successfully in a MSTU to assist in early pre-hospital ischemic stroke thrombolysis or warfarin reversal in ICH.Disclosure: Dr. Organek has nothing to disclose. Dr. Taqui has nothing to disclose. Dr. Cerejo has nothing to disclose. Dr. Itrat has nothing to disclose. Dr. Buletko has nothing to disclose. Dr. Cho has nothing to disclose. Dr. Sheikhi has nothing to disclose. Dr. Winners has nothing to disclose. Dr. Rasmussen has nothing to disclose. Dr. Hussain has nothing to disclose. Dr. Uchino has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Organek, N., Taqui, A., Cerejo, R., Itrat, A., Buletko, A., Cho, S., Sheikhi, L., Winners, S., Rasmussen, P., Hussain, M., Uchino, K. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Stroke, Prehospital, and Telemedicine Source Type: research
Recurrent right middle cerebral artery territory infarctions in a patient with JAK2 (V617F) point mutation positive polycythemia rubra vera (P2.258)
CONCLUSIONS: Hyperviscosity in polycythemia with hematocrit of more than 43[percnt] is known to cause ischemic events and it is evident in our case where our patient had recurrent ischemic strokes whenever the HCT is about 50[percnt] and the right MCA M1 segment though a mild stenosis, it becomes a critical factor for this patient as the patient had recurrent right MCA territory infarcts and hence in addition to regular phlebotomy to keep hematocrit less than 43[percnt], our patient might also need intervention in the form of cerebral angioplasty or stenting to treat even mild arterial stenosis. Study Supported by: ...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Suri Mohanram, S., Nattanmai Chandrasekaran, P. Tags: Cerebrovascular Disease and Interventional Neurology: Genetics and Stroke Source Type: research
Therapeutic phlebotomy is safe in children with sickle cell anaemia and can be effective treatment for transfusional iron overload
Summary
Serial phlebotomy was performed on sixty children with sickle cell anaemia, stroke and transfusional iron overload randomized to hydroxycarbamide in the Stroke With Transfusions Changing to Hydroxyurea trial. There were 927 phlebotomy procedures with only 33 adverse events, all of which were grade 2. Among 23 children completing 30 months of study treatment, the net iron balance was favourable (−8·7 mg Fe/kg) with significant decrease in ferritin, although liver iron concentration remained unchanged. Therapeutic phlebotomy was safe and well‐tolerated, with net iron removal in most children who completed 30...
Source: British Journal of Haematology - January 22, 2015 Category: Hematology Authors: Banu Aygun, Nicole A. Mortier, Karen Kesler, Alexandre Lockhart, William H. Schultz, Alan R. Cohen, Ofelia Alvarez, Zora R. Rogers, Janet L. Kwiatkowski, Scott T. Miller, Pamela Sylvestre, Rathi Iyer, Peter A. Lane, Russell E. Ware, Tags: Short Report Source Type: research
Evaluation of the utility of the Vigileo FloTrac™, LiDCO™, USCOM and CardioQ™ to detect hypovolaemia in conscious volunteers: a proof of concept study
Summary
It is important to detect and treat hypovolaemia; however, detection is particularly challenging in the conscious, spontaneously breathing patient. Eight healthy male volunteers were monitored using four minimally invasive monitors: Vigileo FloTrac™; LiDCOrapid™; USCOM 1A; and CardioQ™ oesophageal Doppler. Monitor output and clinical signs were recorded during incremental venesection of 2.5% estimated blood volume aliquots to a total of 20% blood volume removed. A statistically significant difference from baseline stroke volume was detected after 2.5% blood loss using the LiDCO (p = 0.007), 7.5% blood loss ...
Source: Anaesthesia - January 13, 2015 Category: Anesthesiology Authors: E. O'Loughlin, M. Ward, A. Crossley, R. Hughes, A. P. Bremner, T. Corcoran Tags: Original Article Source Type: research
Haemodilution for acute ischaemic stroke.
CONCLUSIONS: The overall results of this review showed no clear evidence of benefit of haemodilution therapy for acute ischaemic stroke.These results are compatible with no persuasive beneficial evidence of haemodilution therapy for acute ischaemic stroke. This therapy has not been proven to improve survival or functional outcome.
PMID: 25159027 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 27, 2014 Category: Journals (General) Authors: Chang TS, Jensen MB Tags: Cochrane Database Syst Rev Source Type: research
Validating Laboratory Results in a National Observational Cohort Study without Field Centers: the Reasons for Geographic and Racial Disparities in Stroke Cohort.
CONCLUSIONS: Simulation of non-optimal field processing and shipment to a central laboratory showed high variability in analytes released by platelets. The majority of other analytes produced valid results, but platelet contamination in REGARDS samples makes measurement of platelet proteins unadvisable in these samples. Future analytes considered by REGARDS or similar studies should undergo similar pilot testing.
PMID: 25130959 [PubMed - as supplied by publisher]
Source: Clinical Biochemistry - August 14, 2014 Category: Biochemistry Authors: Gillett SR, Boyle RH, Zakai NA, McClure LA, Jenny NS, Cushman M Tags: Clin Biochem Source Type: research
Magnetic resonance imaging/angiography and transcranial Doppler velocities in sickle cell anemia: results from the SWiTCH trial
The Stroke With Transfusions Changing to Hydroxyurea (SWiTCH) trial compared standard (transfusions/chelation) to alternative (hydroxyurea/phlebotomy) treatment to prevent recurrent stroke and manage iron overload in children chronically transfused over 7 years before enrollment. Standardized brain magnetic resonance imaging/magnetic resonance angiography (MRA) and transcranial Doppler (TCD) exams were performed at entry and exit, with a central blinded review. A novel MRA vasculopathy grading scale demonstrated frequent severe baseline left/right vessel stenosis (53%/41% ≥Grade 4); 31% had no vessel stenosis on either ...
Source: Blood - August 7, 2014 Category: Hematology Authors: Helton, K. J., Adams, R. J., Kesler, K. L., Lockhart, A., Aygun, B., Driscoll, C., Heeney, M. M., Jackson, S. M., Krishnamurti, L., Miller, S. T., Sarnaik, S. A., Schultz, W. H., Ware, R. E., for the SWiTCH Investigators Tags: Pediatric Hematology, Sickle Cell Disease, Free Research Articles, Red Cells, Iron, and Erythropoiesis, Vascular Biology, Clinical Trials and Observations Source Type: research
