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https://www.readbyqxmd.com/read/28188676/hemoglobin-based-oxygen-carrier-rescues-double-transplant-patient-from-life-threatening-anemia
#1
M F Gomez, O Aljure, G Ciancio, M Lynn
This is a case of a 46-year-old male, Jehovah's Witness kidney-pancreas transplant recipient found to have early in the postoperative period, splenic vein thrombosis requiring heparin infusion. Two days later, he developed severe symptomatic anemia (Hb < 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). 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
#2
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
#3
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...
January 24, 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
#4
Iftach Sagy, Alan Jotkowitz, Leonid Barski
No abstract text is available yet for this article.
January 24, 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
#5
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...
December 29, 2016: Journal of Religion and Health
https://www.readbyqxmd.com/read/27995442/religion-alcohol-use-and-risk-drinking-among-canadian-adults-living-in-ontario
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27785141/postponed-surgery-of-an-acute-aortic-dissection-type-a-in-a-jehovah-s-witness-with-significant-hemostatic-disorders
#17
Andrzej Biskupski, Szymon Waligórski, Krzysztof Mokrzycki, Mirosław Brykczyński
In this case report, we present the treatment of an acute type A aortic dissection in a Jehovah's Witness patient. In accordance with the will of the patient, blood products were not used. Additionally, the patient had significant hemostatic disorders due to the use of antiplatelet drugs.
September 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27729708/perioperative-management-of-a-child-with-hypoplastic-left-heart-syndrome-of-the-jehovah-s-witness-faith-presenting-for-hybrid-comprehensive-stage-ii-procedure
#18
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
https://www.readbyqxmd.com/read/27703935/major-surgery-in-a-jehovah-witness-with-sickle-cell-disease-case-presentation
#19
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
https://www.readbyqxmd.com/read/27679789/hemoglobin-based-oxygen-carrier-for-traumatic-hemorrhagic-shock-treatment-in-a-jehovah-s-witness
#20
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
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