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Jehovah witness

Sathappan Karuppiah, Christopher Mckee, Ashley Hodge, Mark Galantowicz, Joseph Tobias, Aymen Naguib
Over the years, there has been a growing recognition of the potential negative sequelae of allogeneic blood products on postoperative outcomes following cardiac surgery. In addition, followers of the Jehovah's Witness (JW) faith have a religious restriction against receiving blood or blood components. Advances in perioperative care, cardiopulmonary bypass (CPB), and surgical technique have minimized the need for allogeneic blood products. Specific blood conservation strategies include maximizing the preoperative hematocrit and coagulation function as well as intraoperative strategies, such as acute normovolemic hemodilution and adjustments of the technique of CPB...
September 2016: Journal of Extra-corporeal Technology
Udo Ego Anyaehie, Cajetan Uwatoronye Nwadinigwe, Arinze Duke Nwosu, Valentine Ogochukwu Ogbui
INTRODUCTION: A Jehovah's Witness belongs to the religious group that does not accept blood transfusion in any form, while a sickle cell disease patient has abnormal haemoglobins that do not last in circulation predisposing one to anaemia and other systemic complications. Performing a major surgery in a Jehovah's Witness who has sickle cell disease is tasking for a surgeon. CASE PRESENTATION: This case reports a 28-year-old African female with sickle cell disease who outrightly refused any form of blood transfusion as being a Jehovah's Witness and having a complex primary hip that required total hip replacement...
April 2016: Journal of Orthopaedic Case Reports
Joseph A Posluszny, Lena M Napolitano
INTRODUCTION: Treatment of severe hemorrhagic shock due to acute blood loss from traumatic injuries in a Jehovah's witness (JW) trauma patient is very challenging since hemostatic blood product resuscitation is limited by refusal of the transfusion of allogeneic blood products. CASE PRESENTATION: We describe a multifaceted approach to the clinical care of a severely anemic JW trauma patient including the early administration of a bovine hemoglobin-based oxygen carrier (HBOC) as a bridge to resolution of critical anemia (nadir hemoglobin 3...
June 2016: Archives of Trauma Research
Douglas A Hardesty, Sean Doerfler, Sukhmeet Sandhu, Robert G Whitmore, Patricia Ford, Scott Rushton, Peter D LeRoux
BACKGROUND: Jehovah's Witnesses (JW) are a Christian faith with > 1 million members in the United States who do not accept autologous blood transfusions. The optimal management of these patients undergoing neurosurgical procedures is not well defined. Here, we examined the feasibility and safety of JW undergoing neurosurgery in a blood management program. STUDY DESIGN AND METHODS: Sixty-eight JW patients including 23 males and 45 females (mean age 53 +/- 12 years) who underwent a variety of cranial (n=19) and spinal (n=49) neurosurgical procedures over a 5-year period were identified retrospectively and their hospital charts, anesthetic records and operative reports reviewed...
September 15, 2016: World Neurosurgery
Simona Silvetti, Martina Crivellari, Alessandro Castiglioni, Giovanni Landoni, Alberto Zangrillo, Ottavio Alfieri, Andreas Koster, David Faraoni, Daniel Bolliger, Kenichi A Tanaka
No abstract text is available yet for this article.
March 3, 2016: Journal of Cardiothoracic and Vascular Anesthesia
H Gouezec, I Lerenard, S Jan, E Bajeux, P Renaudier, P M Mertes
PURPOSE OF THE STUDY: The goal of this study is to assess the physician's management of patients who refuse blood transfusion. MATERIAL AND METHODS: A questionnaire to assess the experience, the acceptance or refusal and the operating methods in case of vital risk has been realized and circulated at a national scale. RESULTS: A total of 793 questionnaires were sent back and analysed according to 3 different categories: anesthesiologists, physicians and surgeons...
September 12, 2016: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
Jong Oh Lee, Dong Won Kim, Mi Ae Jeong, Hee Jong Lee, Kyu Nam Kim, Dongho Choi
BACKGROUNDS/AIMS: Although perioperative therapies have improved greatly, pancreatectomies still often need blood transfusions. However, the morbidity from blood transfusions, the poor prognosis of blood transfused patients, high cost, and decreasing supply of blood products is accelerating transfusion-free (TF) surgery in the patients who have pacreatectomies. The aim of this study was to assess the feasibility of TF pancreatectomies for patients who are Jehovah's Witness. METHODS: We investigated the possibility of TF pancreatectomies for the Jehovah's Witness patients undergoing pancreatectomies between January 2007 and Februay 2014...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Usha Devi Appalsawmy, Habib Akbani
A 56-year-old man who was a Jehovah's Witness with an advanced directive against autologous procedures developed acute kidney injury needing renal replacement therapy while he was intubated and ventilated on the intensive care unit. He was being treated for hyperosmolar hyperglycaemic state. He also had a healing laparotomy wound, having undergone a splenectomy less than a month ago following a road traffic accident. His hyperkalaemia and metabolic acidosis were refractory to medical treatment. As he became oligoanuric, decision was taken to carry out acute peritoneal dialysis (PD) by inserting a Tenckhoff catheter in his abdomen using peritoneoscopic technique...
2016: BMJ Case Reports
Małgorzata Rajtar
Resulting from health care reform in Germany that was implemented in 2003-2004, a new medical classification system called the "Diagnosis Related Groups" (DRGs) was introduced in hospitals. According to the media, social scientists, and a few physicians interviewed in this study the policy negatively transformed the German health care system by allowing the privatization of the hospital sector consistent with the neoliberal health care model. Allegedly, this privileged economic values over the quality of health care and introduced competition between hospitals...
October 2016: Social Science & Medicine
Burak Zeybek, Andrew M Childress, Gokhan S Kilic, John Y Phelps, Luis D Pacheco, Michele A Carter, Mostafa A Borahay
IMPORTANCE: Obstetricians and gynecologists frequently deal with hemorrhage so they should be familiar with management of patients who refuse blood transfusion. Although there are some reports in the literature about management of Jehovah's Witness patients in obstetrics and gynecology, most of them are case reports, and a comprehensive review about these patients including ethicolegal perspective is lacking. OBJECTIVE: This review outlines the medical, ethical, and legal implications of management of Jehovah's Witness patients in obstetrical and gynecological settings...
August 2016: Obstetrical & Gynecological Survey
Yasmine N Campbell, Melissa D Machan, Marquessa D Fisher
Most members of the Jehovah's Witness community refuse blood transfusions, and there are variations in what alternatives they will accept depending on their personal decisions. To provide culturally competent care, healthcare providers need to be knowledgeable about substitutions for blood administration as well as the risks and benefits of available alternatives so that they can inform their patients. It has been recognized in the literature that preoperative optimization of hemoglobin levels with alternative treatment modalities through a multidisciplinary approach can improve clinical outcomes in patients who refuse blood products...
June 2016: AANA Journal
Ariane Willems, Veaceslav Savan, David Faraoni, Andrée De Ville, Laurence Rozen, Anne Demulder, Philippe Van der Linden
OBJECTIVE: Protamine is used to neutralize heparin after patient separation from cardiopulmonary bypass (CPB). Different bedside tests are used to monitor the adequacy of heparin neutralization. For this study, the interchangeability of the activated coagulation time (ACT) and thromboelastometry (ROTEM; Tem Innovations GmbH, Basel, Switzerland) clotting time (CT) ratios in children undergoing cardiac surgery was assessed. DESIGN: Single-center, retrospective, cohort study between September 2010 and January 2012...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
You-Sung Suh, Jae-Hwi Nho, Hyung-Suk Choi, Yong-Chan Ha, Jong-Seok Park, Kyung-Hoi Koo
INTRODUCTION: Arthroplasties of hip and knee are associated with blood loss, which may lead to adverse patient outcome. Performing arthroplasties in Jehovah's Witness patients who do not accept transfusion has been a matter of concern. We developed a protocol, which avoids transfusion in arthroplasties of Jehovah's Witness patients, and evaluated the feasibility and safety of the protocol. MATERIALS AND METHODS: The target of preoperative hemoglobin was more than 10 g/dL...
September 2016: Archives of Orthopaedic and Trauma Surgery
Moncef Belaouchi, Eva Romero, Guido Mazzinari, Miguel Esparza, Consuelo García-Cebrían, Fernando Gil, Manuel Muñoz
No abstract text is available yet for this article.
July 12, 2016: Blood Transfusion, Trasfusione del Sangue
Muhammad Sajawal Ali, Benjamin I Mba, Farah Diba Ciftci, Ahya Sajawal Ali
We describe the case of an 81-year-old female, diagnosed with hyperthyroidism-related atrial fibrillation. Given her CHA2DS2VASc score of 3, she was started on warfarin for stroke prevention. One month later, she was admitted with cardiac tamponade. This tamponade was suspected to be secondary to hemopericardium, based on the elevated international normalized ratio (INR), drop in haemoglobin and the radiodensity (55 HU) of the pericardial effusion on CT. The patient was a Jehovah's witness who therefore initially refused measures for reversing coagulopathy...
2016: BMJ Case Reports
K E Rollins, U Contractor, R Inumerable, D N Lobo
Introduction Patients who are Jehovah's Witnesses pose difficult ethical and moral dilemmas for surgeons because of their refusal to receive blood and blood products. This article outlines the personal experiences of six Jehovah's Witnesses who underwent major abdominal surgery at a single institution and also summarises the literature on the perioperative care of these patients. Methods The patients recorded their thoughts and the dilemmas they faced during their surgical journey. We also reviewed the recent literature on the ethical principles involved in treating such patients and strategies recommended to make surgery safer...
July 14, 2016: Annals of the Royal College of Surgeons of England
Krzysztof Chojnowski, Agnieszka Janus, Katarzyna Bliźniewska, Marta Robak, Jacek Treliński
BACKGROUND: The treatment of patients with acute leukemia, who due to their religious beliefs refuse to accept blood transfusion, is a great challenge for hematologists. CASE REPORT: We present a case of acute pre-T-lymphoblastic leukemia in a Jehovah's Witness who did not accept blood transfusion during chemotherapy. Standard induction and consolidation chemotherapy was used (according to the PALG ALL-6 regiment). RESULTS: During consolidation cycles, darbepoietin alfa, intravenous iron, and total parenteral nutrition was administered...
July 7, 2016: Transfusion
Małgorzata Rajtar
Blood transfusions belong to standard and commonly utilised biomedical procedures. Jehovah's Witnesses' transfusion refusals are often referred to in bioethical and medical textbooks. Members of this globally active religious organisation do not, however, challenge biomedical diagnosis and treatment as such. A result of both their trust in and their interpretation of the Bible, they question only this medical treatment. In spite of the global presence of this religious community and its uniformly practised teachings, including those pertaining to blood, experiences and choices of Jehovah's Witness patients have been understudied...
August 2016: Anthropology & Medicine
Andrea Poggetti, Iacopo Castellini, Elisabetta Neri, Stefano Marchettil, Michele Lisanti
INTRODUCTION: Neglected bilateral anterior shoulder dislocation is a very rare condition, often related to seizures or major trauma. Open reduction is recommended whenever Hill-Sachs lesion is >25% of the joint and the dislocation is elder than 3 weeks. CASE REPORT: We describe a case report of a 28-year-old man left handed Jehovah's Witness laborer assessed 12 weeks after bilateral anterior shoulder dislocation. The patient was evaluated with clinical examination, and it was observed an asymptomatic intrarotation of both shoulders with a mild left circumflex nerve deficit...
July 2015: Journal of Orthopaedic Case Reports
Andreas Böning, Christof Schmid
No abstract text is available yet for this article.
December 2015: Thoracic and Cardiovascular Surgeon Reports
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