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sickle cell acute pain management

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https://www.readbyqxmd.com/read/27913538/sickle-cell-disease-when-and-how-to-transfuse
#1
Jo Howard
Blood transfusion remains an important therapeutic intervention in patients with sickle cell disease (SCD), aiming to both increase the oxygen carrying capacity of blood and to reduce the complications of vaso-occlusion. Simple, manual exchange and automated exchange can be effective in reducing the acute and chronic complications of SCD, and the advantages and disadvantages of each methodology mean they all have a role in different situations. Evidence for the role of emergency transfusion in the management of the acute complications of SCD, including acute pain and acute chest syndrome, comes from observational data...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27800652/opioid-prescription-practices-at-discharge-and-30-day-returns-in-children-with-sickle-cell-disease-and-pain
#2
Leslie M Okorji, Devin S Muntz, Robert I Liem
BACKGROUND: Acute pain episodes in children with sickle cell disease (SCD) represent a leading cause of readmissions. We examined prescription practices at the time of discharge in children with SCD presenting with acute pain to determine their impact on 30-day emergency department (ED) revisits and readmissions. METHODS: In this single-institution, 5-year retrospective study, we reviewed 290 encounters of patients with SCD aged 7-21 years hospitalized or discharged from the ED with acute pain...
November 1, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27600384/ct-abdominal-imaging-findings-in-patients-with-sickle-cell-disease-acute-vaso-occlusive-crisis-complications-and-chronic-sequelae
#3
REVIEW
Carly S Gardner, Daniel T Boll, Priya Bhosale, Tracy A Jaffe
Sickle cell disease (SCD) is the most prevalent hemoglobinopathy. Survival in patients with SCD has improved over the past few decades. These patients experience a lifetime of repeated acute pain crises, which are thought to result from sickling and microvascular occlusions; acute abdominal pain is common. Moreover, repeated crises often lead to organ dysfunction, such as asplenia, hepatic failure, and renal failure. The spleen, liver, biliary system, kidneys, and gastrointestinal tract can all be affected...
September 7, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27553919/emergency-medicine-management-of-sickle-cell-disease-complications-an-evidence-based-update
#4
Erica Simon, Brit Long, Alex Koyfman
BACKGROUND: Sickle cell disease (SCD) affects approximately 100,000 individuals in the United States. Due to alterations in the structural conformation of hemoglobin molecules under deoxygenated conditions, patients with SCD are predisposed to numerous sequelae, many of which require acute intervention. OBJECTIVE: Our aim was to provide emergency physicians with an evidence-based update regarding the diagnosis and management of SCD complications. DISCUSSION: SCD patients experience significant morbidity and mortality secondary to cerebrovascular accident, acute chest syndrome, acute vaso-occlusive pain crises, SCD-related multi-organ failure, cholecystitis, acute intrahepatic cholestasis, acute sickle hepatic crisis, acute hepatic sequestration, priapism, and renal disease...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27494522/comparative-analysis-of-pain-behaviours-in-humanized-mouse-models-of-sickle-cell-anemia
#5
Jianxun Lei, Barbara Benson, Huy Tran, Solomon F Ofori-Acquah, Kalpna Gupta
Pain is a hallmark feature of sickle cell anemia (SCA) but management of chronic as well as acute pain remains a major challenge. Mouse models of SCA are essential to examine the mechanisms of pain and develop novel therapeutics. To facilitate this effort, we compared humanized homozygous BERK and Townes sickle mice for the effect of gender and age on pain behaviors. Similar to previously characterized BERK sickle mice, Townes sickle mice show more mechanical, thermal, and deep tissue hyperalgesia with increasing age...
2016: PloS One
https://www.readbyqxmd.com/read/27412264/score-predicting-acute-chest-syndrome-during-vaso-occlusive-crises-in-adult-sickle-cell-disease-patients
#6
Pablo Bartolucci, Anoosha Habibi, Mehdi Khellaf, Françoise Roudot-Thoraval, Giovanna Melica, Anne-Sophie Lascaux, Stéphane Moutereau, Sylvain Loric, Orianne Wagner-Ballon, Jugurtha Berkenou, Aline Santin, Marc Michel, Bertrand Renaud, Yves Lévy, Frédéric Galactéros, Bertrand Godeau
BACKGROUND: Vaso-occlusive crisis (VOC), hallmark of sickle-cell disease (SCD), is the first cause of patients' Emergency-Room admissions and hospitalizations. Acute chest syndrome (ACS), a life-threatening complication, can occur during VOC, be fatal and prolong hospitalization. No predictive factor identifies VOC patients who will develop secondary ACS. METHODS: This prospective, monocenter, observational study on SS/S-β0thalassemia SCD adults aimed to identify parameters predicting ACS at Emergency-Department arrival...
August 2016: EBioMedicine
https://www.readbyqxmd.com/read/27353685/the-intersection-between-asthma-and-acute-chest-syndrome-in-children-with-sickle-cell-anaemia
#7
REVIEW
Michael R DeBaun, Robert C Strunk
Acute chest syndrome is a frequent cause of acute lung disease in children with sickle-cell disease. Asthma is common in children with sickle-cell disease and is associated with increased incidence of vaso-occlusive pain events, acute chest syndrome episodes, and earlier death. Risk factors for asthma exacerbation and an acute chest syndrome episode are similar, and both can present with shortness of breath, chest pain, cough, and wheezing. Despite overlapping risk factors and symptoms, an acute exacerbation of asthma or an episode of acute chest syndrome are two distinct entities that need disease-specific management strategies...
June 18, 2016: Lancet
https://www.readbyqxmd.com/read/27348613/delayed-hemolytic-transfusion-reaction-in-adult-sickle-cell-disease-presentations-outcomes-and-treatments-of-99-referral-center-episodes
#8
Anoosha Habibi, Armand Mekontso-Dessap, Constance Guillaud, Marc Michel, Keyvan Razazi, Mehdi Khellaf, Btissam Chami, Dora Bachir, Claire Rieux, Giovanna Melica, Bertrand Godeau, Frédéric Galacteros, Pablo Bartolucci, France Pirenne
Delayed hemolytic transfusion reaction (DHTR) is one of the most feared complications of sickle-cell disease (SCD). We retrospectively analyzed the clinical and biological features, treatments and outcomes of 99 DHTRs occurring in 69 referral center patients over 12 years. The first clinical signs appeared a median of 9.4 [IQR, 3-22] days after the triggering transfusion (TT). The most frequent DHTR-related clinical manifestation was dark urine/hemoglobinuria (94%). Most patients (89%) had a painful vaso-occlusive crisis and 50% developed a secondary acute chest syndrome (ACS)...
October 2016: American Journal of Hematology
https://www.readbyqxmd.com/read/27283268/does-attendance-at-a-sickle-cell-educational-conference-improve-clinician-knowledge-and-attitude-toward-patients-with-sickle-cell-disease
#9
Coretta M Jenerette, Cheryl A Brewer, Susan Silva, Paula Tanabe
Sickle cell disease (SCD) is a genetic disease associated with both chronic pain and acute painful events referred to as vaso-occlusive crises. Individuals with SCD suffer from a multitude of medical complications in addition to pain. Patients often are stigmatized as "drug-seeking" and receive inadequate pain management. The purpose of this study was to compare clinicians' SCD knowledge and attitudes toward patients with SCD before attending a 2-day conference on SCD (T1) with knowledge and attitudes immediately postconference (T2) and 2 months postconference (T3)...
June 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/27068408/east-mediterranean-region-sickle-cell-disease-mortality-trial-retrospective-multicenter-cohort-analysis-of-735-patients
#10
Pelin Kardaş Karacaoglu, Suheyl Asma, Aslı Korur, Soner Solmaz, Nurhilal Turgut Buyukkurt, Cigdem Gereklioglu, Mutlu Kasar, Demircan Ozbalcı, Selma Unal, Hasan Kaya, Emel Gurkan, Mahmut Yeral, Çagla Sariturk, Can Boga, Hakan Ozdogu
Sickle cell disease (SCD), one of the most common genetic disorders worldwide, is characterized by hemolytic anemia and tissue damage from the rigid red blood cells. Although hydroxyurea and transfusion therapy are administered to treat the accompanying tissue injury, whether either one prolongs the lifespan of patients with SCD is unknown. SCD-related mortality data are available, but there are few studies on mortality-related factors based on evaluations of surviving patients. In addition, ethnic variability in patient registries has complicated detailed analyses...
May 2016: Annals of Hematology
https://www.readbyqxmd.com/read/27049331/preoperative-blood-transfusions-for-sickle-cell-disease
#11
REVIEW
Lise J Estcourt, Patricia M Fortin, Marialena Trivella, Sally Hopewell
BACKGROUND: Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Surgical interventions are more common in people with sickle cell disease, and occur at much younger ages than in the general population. Blood transfusions are frequently used prior to surgery and several regimens are used but there is no consensus over the best method or the necessity of transfusion in specific surgical cases...
April 6, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27000103/addressing-challenges-of-clinical-trials-in-acute-pain-the-pain-management-of-vaso-occlusive-crisis-in-children-and-young-adults-with-sickle-cell-disease-study
#12
Kerri A Nottage, Jane S Hankins, Lane G Faughnan, Dustin M James, Julie Richardson, Robbin Christensen, Guolian Kang, Matthew Smeltzer, Maria I Cancio, Winfred C Wang, Doralina L Anghelescu
BACKGROUND/AIMS: Neuropathic pain is a known component of vaso-occlusive pain in sickle cell disease; however, drugs targeting neuropathic pain have not been studied in this population. Trials of acute pain are complicated by the need to obtain consent, to randomize participants expeditiously while optimally treating pain. We describe the challenges in designing and implementing the Pain Management of Vaso-occlusive Crisis in Children and Young Adults with Sickle Cell Disease Study (NCT01954927), a phase II, randomized, double-blind, placebo-controlled trial to determine the effect of gabapentin for vaso-occlusive crisis...
August 2016: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/26969771/relationship-between-pulmonary-and-cardiac-abnormalities-in-sickle-cell-disease-implications-for-the-management-of-patients
#13
Maria Christina Paixão Maioli, Andrea Ribeiro Soares, Ricardo Bedirian, Ursula David Alves, Cirlene de Lima Marinho, Agnaldo José Lopes
OBJECTIVE: To evaluate the association between clinical, pulmonary, and cardiovascular findings in patients with sickle cell disease and, secondarily, to compare these findings between sickle cell anemia patients and those with other sickle cell diseases. METHODS: Fifty-nine adults were included in this cross-sectional study; 47 had sickle cell anemia, and 12 had other sickle cell diseases. All patients underwent pulmonary function tests, chest computed tomography, and echocardiography...
January 2016: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/26946885/traumatic-exposure-history-as-a-risk-factor-for-chronic-pain-in-adult-patients-with-sickle-cell-disease
#14
Teresa Works, Sasia Jones, James Grady, Biree Andemariam
This article describes the impact of the integration of a licensed clinical social worker (LCSW) with expertise in behavioral health on identification of risk factors for chronic pain in a cohort of adults with sickle cell disease. Authors conducted a retrospective chart review of all visits to the adult sickle cell center during the first six months of LCSW integration. Demographics, clinical history, and LCSW notes were reviewed. Overall, 71 patients were introduced to the LCSW; 55 percent of them had chronic pain...
February 2016: Health & Social Work
https://www.readbyqxmd.com/read/26896118/development-of-a-new-adult-sickle-cell-disease-center-within-an-academic-cancer-center-impact-on-hospital-utilization-patterns-and-care-quality
#15
Biree Andemariam, Sasia Jones
BACKGROUND: A national shortage of specialized centers with expertise in the management of adults with sickle cell disease (SCD) remains a concerning public health disparity. Yet, there is an abundance of cancer centers whose operational infrastructure is not only suited to the treatment of the oncology patient, but also can provide medical and procedural care essential to the management of the patient with SCD. Our adult SCD center was formally embedded within an academic hospital-based cancer center in 2009...
March 2016: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/26853841/responsiveness-of-promis%C3%A2-pediatric-measures-to-hospitalizations-for-sickle-pain-and-subsequent-recovery
#16
Carlton Dampier, Byron Jaeger, Heather E Gross, Vaughn Barry, Lloyd Edwards, Yang Lui, Darren A DeWalt, Bryce B Reeve
BACKGROUND: The Patient-Reported Outcomes Measurement Information System(®) (PROMIS(®) ) created pediatric self-report scales measuring a variety of health attributes (domains), but their responsiveness to changes in health status has not yet been determined in children with sickle cell disease (SCD). PROCEDURE: A convenience cohort of symptomatic SCD children, aged 8-17 years, was asked to complete PROMIS pediatric scales at an initial clinic visit, at the end of a subsequent hospitalization for sickle pain, at a subsequent clinic visit or at home 2-3 weeks after hospitalization, and at a clinic visit 1-2 years after their initial assessment...
June 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/26836899/crises-in-sickle-cell-disease
#17
REVIEW
Enrico M Novelli, Mark T Gladwin
In spite of significant strides in the treatment of sickle cell disease (SCD), SCD crises are still responsible for high morbidity and early mortality. While most patients initially seek care in the acute setting for a seemingly uncomplicated pain episode (pain crisis or vaso-occlusive crisis), this initial event is the primary risk factor for potentially life-threatening complications. The pathophysiological basis of these illnesses is end-organ ischemia and infarction combined with the downstream effects of hemolysis that results from red blood cell sickling...
April 2016: Chest
https://www.readbyqxmd.com/read/26760593/management-of-sickle-cell-disease-recommendations-from-the-2014-expert-panel-report
#18
Barbara P Yawn, Joylene John-Sowah
Family physicians are the primary and sometimes only health care resource for families affected by sickle cell disease. Recently published guidelines provide important recommendations for health maintenance, acute care, and monitoring of disease-modifying therapy in persons with this condition. This overview highlights some of the most important clinical activities that can and should be carried out in the community care setting. Children with sickle cell anemia should receive prophylactic penicillin from birth through at least five years of age, and all persons with sickle cell disease require vaccination to prevent invasive pneumococcal disease...
December 15, 2015: American Family Physician
https://www.readbyqxmd.com/read/26728612/a-prospective-cohort-study-of-the-clinical-presentation-of-non-traumatic-osteonecrosis-of-the-femoral-head-spine-and-knee-symptoms-as-clinical-presentation-of-hip-osteonecrosis
#19
Jean-Philippe Hauzeur, Michel Malaise, Viviane de Maertelaer
PURPOSE: To study the clinical presentation of femoral head osteonecrosis (ONFH). Publications dedicated to this aspect of ONFH are rare. Our aim was to systematically collect and describe the clinical data. METHODS: A prospective survey was conducted in a cohort of ONFH recruited from a dedicated clinic for osteonecrosis. The history of symptoms, medical management, and physical findings were obtained from 88 patients suffering from 125 ONFH. Subgroups were formed: bilateral versus unilateral ONFH, radiological stages 1-2 (pre-fractured) versus fractured stage 3 versus stage 4...
July 2016: International Orthopaedics
https://www.readbyqxmd.com/read/26688919/sickle-cell-disease-in-adults-developing-an-appropriate-care-plan
#20
Nadine Matthie, Coretta Jenerette
BACKGROUND: Sickle cell disease (SCD) is primarily characterized by pain. This chronic pain with acute exacerbations is the most common reason for hospital visits, admissions, and readmissions, particularly in young adults (aged 18–39 years). People who present to the hospital for pain crises often report that nurses lack knowledge of SCD and, consequently, they do not provide appropriate, timely care. OBJECTIVES: Because pain episodes often result in hospital admissions, this article highlights prominent issues that staff nurses need to know...
October 2015: Clinical Journal of Oncology Nursing
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