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https://www.readbyqxmd.com/read/28428532/ceftriaxone-induced-hemolytic-anemia-in-a-jehovah-s-witness
#1
James Tasch, Pedro Gonzalez-Zayaz
BACKGROUND Drug-induced immune hemolytic anemia (DIIHA) is a rare condition that may result from the administration of an antibiotic, most notably the cephalosporin class, commonly used in both the adult and pediatric populations. A delay in recognition by a provider may lead to continuation of the offending agent and possibly result in fatal outcomes. CASE REPORT We report the case of a 65-year-old woman on ceftriaxone infusions after being diagnosed with acute mitral valve endocarditis 3 weeks prior, which presented with severe anemia and bilateral transient vision loss...
April 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28401611/pegylated-bovine-carboxyhaemoglobin-utilisation-in-a-thrombotic-thrombocytopenic-purpura-patient
#2
C Sam, P Desai, D Laber, A Patel, N Visweshwar, M Jaglal
OBJECTIVE: To determine if pegylated bovine carboxyhaemoglobin can be utilised in a thrombotic thrombocytopenic purpura (TTP) patient. BACKGROUND: TTP is a condition characterized by thrombotic microangiopathy and has a high mortality rate when left untreated. Therapeutic plasma exchange is well established as the most effective and evidence-based treatment of TTP. METHODS: The ability to administer plasma exchange therapy is limited in Jehovah's Witnesses who decline blood products due to religious beliefs...
April 12, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28328588/extreme-plasma-dilution-decreases-heparin-and-protamine-cardiopulmonary-bypass-requirements-a-case-report-on-a-jehovah-s-witness-patient
#3
Emilie Chang, Jason W Gatling, Scott Bode, Paul C Herrmann, Brian S Bull, Richard L Applegate
The primary focus of cardiopulmonary bypass management in Jehovah's Witness patients is the need to conserve blood. A consequence of these strategies inevitably results in hemodilution that is frequently extreme enough to dilute clotting factors and potentially impair coagulation. The purpose of this case report is to demonstrate that a hemodiluted patient requires less heparin to sustain anticoagulation and less protamine to reverse heparin at cardiopulmonary bypass termination. Patient harm may ensue unless the effects of extreme hemodilution are recognized...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28306583/successful-resuscitation-following-massive-obstetric-hemorrhage-in-a-patient-of-the-jehovah-s-witness-faith-a-case-report
#4
Richard M Hubbard, Jonathan H Waters, Mark H Yazer
Hemorrhage is a leading cause of maternal morbidity and mortality worldwide. It is especially difficult to treat in patients of the Jehovah's Witness faith because they refuse certain blood products. This case report describes the resuscitation of a parturient Jehovah's Witness whose postcesarean delivery course was complicated by massive hemorrhage from unrecognized arterial bleeding in the intensive care unit with significant hemodynamic instability that necessitated an emergency bedside laparotomy. Her hemoglobin nadir was 1...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28188676/hemoglobin-based-oxygen-carrier-rescues-double-transplant-patient-from-life-threatening-anemia
#5
M F Gomez, O Aljure, G Ciancio, M Lynn
This case describes a 46-year-old male recipient of a kidney-pancreas transplant who is Jehovah's Witness. Early in the postoperative period, he was found to have splenic vein thrombosis requiring heparin infusion. Two days later, he developed severe symptomatic anemia (hemoglobin <6 g/dL). Standard medical therapy for bloodless surgical patients with severe anemia was instituted. Nevertheless, the patient's hemoglobin concentration continued to decline to critical levels (2 g/dL). Because he was Jehovah's Witness, transfusion of allogeneic blood products was not an option, prompting use of a hemoglobin-based oxygen carrier (HBOC)...
February 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28132564/patient-consent-and-conscientious-objection
#6
John Tingle
John Tingle, Reader in Health Law at Nottingham Trent University, discusses an important court case on refusal of consent for a blood transfusion by a Jehovah's Witness and new guidance on caring for patients who refuse blood.
January 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28121643/peripartum-care-of-the-jehovah-s-witness-patient
#7
Efrain Riveros-Perez, Rachel Kacmar
Postpartum hemorrhage is a leading cause of maternal mortality. Jehovah's Witnesses (JWs) refuse allogeneic blood transfusion, and thus treatment of hemorrhagic complications in this patient population is complex. Recognition and respect for religious beliefs are essential when caring for the JW parturient and several ethical and legal considerations must be taken into account. Interdisciplinary teamwork and communication as well as active patient participation are critical in the decision-making process for JW patients...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28120271/erratum-to-reflections-on-cultural-preferences-and-internal-medicine-the-case-of-jehovah-s-witnesses-and-the-changing-thresholds-for-blood-transfusions
#8
Iftach Sagy, Alan Jotkowitz, Leonid Barski
No abstract text is available yet for this article.
April 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28035631/reflections-on-cultural-preferences-and-internal-medicine-the-case-of-jehovah-s-witnesses-and-the-changing-thresholds-for-blood-transfusions
#9
Iftach Sagy, Alan Jotkowitz, Leonid Barski
Jehovah's witnesses oppose receiving blood transfusions based on religious grounds. This refusal raises complex medical, legal and ethical issues for the treating medical staff. In the past physicians attempted to force patients and children to accept transfusions when deemed medically necessary through the use of court orders. However, in recent years the threshold for blood transfusion has been gradually raised by medical experts as expressed in consensus guidelines, which means that Jehovah's witnesses' aversion to transfusion would have been partially justified medically...
April 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/27995442/religion-alcohol-use-and-risk-drinking-among-canadian-adults-living-in-ontario
#10
Andrew Tuck, Margaret Robinson, Branka Agic, Anca R Ialomiteanu, Robert E Mann
This research examines (1) the association between risk drinking and religious affiliation and (2) differences between religions for risk drinking among adults living in Ontario, Canada, for Christians, Buddhists, Sikhs, Muslims, Hindus, Jews, other religious groups and the non-religious. Data are based on telephone interviews with 16,596 respondents and are derived from multiple cycles (2005-2011) of the Centre for Addiction and Mental Health's (CAMH) Monitor survey, an ongoing cross-sectional survey of adults in Ontario, Canada, aged 18 years and older...
December 19, 2016: Journal of Religion and Health
https://www.readbyqxmd.com/read/27993880/providing-hemostatic-and-blood-conservation-options-for-jehovah-s-witness-patients-in-a-large-medical-system
#11
Yu Bai, Brian S Castillo, Amanda Tchakarov, Miguel A Escobar, Bryan A Cotton, John B Holcomb, Robert E Brown
People of the Jehovah's Witness faith believe that they shall "abstain from blood." Because of this belief, we encounter the challenges from Jehovah's Witness patients who actively seek medical care for themselves and their children, but refuse the transfusion of blood products, which may result in increased morbidity and mortality in this patient population. With the development/availability of new hemostatic/coagulation products and the advances in medical technology, we, in collaboration with our clinical colleagues and our local Jehovah's Witness leadership, have developed a clinical guideline comprising medical protocol and surgical strategy for patients refusing blood products...
December 2016: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/27909629/stereotactic-body-radiotherapy-for-hepatocellular-carcinoma-resulting-in-a-durable-relapse-free-survival-a-case-report
#12
Samual Francis, Ned Williams, Christopher J Anker, Akram Shaaban, Robin Kim, Dennis Shrieve, Jonathan Tward
The standard of care for localized hepatocellular carcinoma (HCC) is surgical resection. For patients who decline or who are unfit for surgery, stereotactic body radiotherapy (SBRT) is emerging as a viable treatment approach. We present a case of a 77-year-old female in whom an early stage HCC was incidentally discovered. Given her religious edicts as a devout Jehovah's Witness and her subsequent desire to avoid a blood transfusion, she declined surgical resection or transplant due to the risk of hemorrhage...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27893353/low-dose-erythropoietin-treatment-is-not-associated-with-clinical-benefits-in-severely-anaemic-jehovah-s-witnesses-a-plea-for-a-change
#13
Andrei M Beliaev, Sara J Allen, Paget Milsom, Parma Nand, Warren M Smith, Colleen J Bergin
BACKGROUND: Jehovah's Witnesses who refuse blood transfusion have high mortality. Erythropoietin (EPO) has been used as an alternative to blood transfusion. The optimal dosing of EPO in anaemic Jehovah's Witnesses is unknown. The aim of our study was to evaluate the clinical benefits of treatment with a low dose (<600 IU/kg/week) of epoietin beta (EPO-β). MATERIALS AND METHODS: This was an observational study, retrospectively considering a 10-year period during which 3,529 adult Jehovah's Witnesses with a total of 10,786 hospital admissions were identified from databases of four major public hospitals in New Zealand...
November 15, 2016: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#14
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27871571/spine-tumor-resection-among-patients-who-refuse-blood-product-transfusion-a-retrospective-case-series
#15
Alexandra E Kisilevsky, Liam Stobart, Kristine Roland, Alana M Flexman
STUDY OBJECTIVE: To describe the perioperative blood conservation strategies and postoperative outcomes in patients who undergo complex spinal surgery for tumor resection and who also refuse blood product transfusion. DESIGN: A retrospective case series. SETTING: A single-center, tertiary care and academic teaching hospital in Canada. PATIENTS: All adult patients undergoing elective major spine tumor resection and refusing blood product transfusion who were referred to our institutional Blood Utilization Program between June 1, 2004, and May 9, 2014...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27863765/a-clinical-challenge-treatment-of-acute-myeloid-leukemia-in-a-jehovah-s-witness
#16
Daniela Cárdenas-Araujo, Elías Eugenio González-López, Xitlaly Judith González-Leal, José Carlos Jaime-Pérez, David Gómez-Almaguer
No abstract text is available yet for this article.
October 2016: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/27850255/616-evaluation-of-erythropoiesis-stimulating-agents-in-acutely-anemic-jehovah-s-witnesses
#17
Hannah Dills, Morgan McLemore, Richard Tran, Marjorie Curry
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27844190/erratum-to-refusal-of-medical-blood-transfusions-among-jehovah-s-witnesses-emotion-regulation-of-the-dissonance-of-saving-and-sacrificing-life
#18
Hege Kristin Ringnes, Harald Hegstad
No abstract text is available yet for this article.
November 14, 2016: Journal of Religion and Health
https://www.readbyqxmd.com/read/27812729/-under-scrutiny-by-the-state-prosecutor-legal-pitfalls-in-emergency-medicine
#19
REVIEW
P Schelling
Physicians who allow a suicide attempt to happen, which from an ex ante viewpoint was completely voluntary, cannot be held punishable for homicide or failing to provide medical assistance when the suicide corresponds to the putative will of the patient according to plausible information supplied by an authorized person with healthcare proxy. Guidelines for resuscitation also play a central role in the forensic practice for assessment of whether and when resuscitation can be terminated; therefore, it is urgently advised to follow and implement these guidelines: deviations are possible if they can be factually justified...
November 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27793239/ethical-and-legal-duty-of-anesthesiologists-regarding-jehovah-s-witness-patient-care-protocol
#20
REVIEW
Augusto Key Karazawa Takaschima, Thiago Mamôru Sakae, Alexandre Karazawa Takaschima, Renata Dos Santos Teodoro Takaschima, Breno José Santiago Bezerra de Lima, Roberto Henrique Benedetti
BACKGROUND AND OBJECTIVES: Jehovah's Witnesses patients refuse blood transfusions for religious reasons. Anesthesiologists must master specific legal knowledge to provide care to these patients. Understanding how the Law and the Federal Council of Medicine treat this issue is critical to know how to act in this context. The aim of this paper was to establish a treatment protocol for the Jehovah's Witness patient with emphasis on ethical and legal duty of the anesthesiologist. CONTENT: The article analyzes the Constitution, Criminal Code, resolutions of the Federal Council of Medicine, opinions, and jurisprudence to understand the limits of the conflict between the autonomy of will of Jehovah's Witnesses to refuse transfusion and the physician's duty to provide the transfusion...
November 2016: Brazilian Journal of Anesthesiology
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