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Blood refusal

Ana Margarida Monteiro, Olinda Marques, Sofia Martins, Ana Antunes
The authors report a case of a 15-year-old girl with hypopituitarism due to pituitary stalk interruption syndrome diagnosed in the neonatal period. The patient was admitted to the emergency room with impaired consciousness and hypoglycaemia. The day before, she increased her water intake to about 1.5 L to perform a pelvic ultrasound. In the following hours, she developed vomiting and food refusal. Blood analysis revealed hypoglycaemia, hyponatraemia, decreased serum osmolality and normal urinary density. Hyponatraemia and adrenal crisis were managed with a gradual but slow resolution of consciousness and electrolytic balance...
March 9, 2018: BMJ Case Reports
Dora Buonfrate, Paola Rodari, Daniele Brunelli, Monica Degani, Andrea Ragusa, Stefano Tais, Martina Todeschini, Zeno Bisoffi
BACKGROUND: An immunochromatographic rapid test (ICT; Schistosoma ICT IgG-IgM, LDBIO Diagnostics) demonstrated high sensitivity (96%) in the diagnosis of Schistosoma mansoni and S. haematobium . To date, the test has been validated for use on serum only, but in the absence of lab equipment, blood drop from fingerprick could be a useful option. This method is acquiring more interest because of the high flow of migrants rapidly moving across Italy and other European countries. OBJECTIVE: The aim of this prospective study was to evaluate the use of ICT on whole blood obtained from fingerprick...
March 3, 2018: BMJ Open
J Reinier F Narvaez, Jing Nie, Katia Noyes, Mary Leeman, Liise K Kayler
Understanding risk factors for deceased-donor kidney non-transplantation is important since discard rates remain high. We analyzed DonorNet® data of consecutive deceased-donor non-mandatory share primary kidney-only offers to adult candidates at our center and beyond between July 1, 2015 and March 31, 2016 for donor- and system-level risk factors of discard, defined as non-transplantation at our or subsequent transplant centers. Exclusions were HCV/HBV, blood type AB, and donor< 1 year based on low candidate waitlist size...
March 2, 2018: American Journal of Transplantation
Mariona Pinart, Katharina Nimptsch, Jildau Bouwman, Lars O Dragsted, Chen Yang, Nathalie De Cock, Carl Lachat, Giuditta Perozzi, Raffaella Canali, Rosario Lombardo, Massimo D'Archivio, Michèle Guillaume, Anne-Françoise Donneau, Stephanie Jeran, Jakob Linseisen, Christina Kleiser, Ute Nöthlings, Janett Barbaresko, Heiner Boeing, Marta Stelmach-Mardas, Thorsten Heuer, Eamon Laird, Janette Walton, Paolo Gasparini, Antonietta Robino, Luis Castaño, Gemma Rojo-Martínez, Jordi Merino, Luis Masana, Marie Standl, Holger Schulz, Elena Biagi, Eha Nurk, Christophe Matthys, Marco Gobbetti, Maria de Angelis, Eberhard Windler, Birgit-Christiane Zyriax, Jean Tafforeau, Tobias Pischon
Background: Joint data analysis from multiple nutrition studies may improve the ability to answer complex questions regarding the role of nutritional status and diet in health and disease. Objective: The objective was to identify nutritional observational studies from partners participating in the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) Consortium, as well as minimal requirements for joint data analysis. Methods: A predefined template containing information on study design, exposure measurements (dietary intake, alcohol and tobacco consumption, physical activity, sedentary behavior, anthropometric measures, and sociodemographic and health status), main health-related outcomes, and laboratory measurements (traditional and omics biomarkers) was developed and circulated to those European research groups participating in the ENPADASI under the strategic research area of "diet-related chronic diseases...
February 1, 2018: Journal of Nutrition
Mathieu Pioche, Christell Ganne, Rodica Gincul, Antoine De Leusse, Julien Marsot, Julien Balique, Alain Fond, Michel Bretagnolle, Luc Henry, Yann Billaud, Romain Malezieux, Marie-Georges Lapalus, Christine Chambon-Augoyard, Emilie Del Tedesco, Olivia Scalone, Jean-Charles Montoy, Benoit Russias, Antoine Detry, Frédéric Veniat, Jin Qiu, Pierre-Jean Valette, Annabel Taillandier, Jean-Christophe Saurin, Josiane Tomczyk-Ferrero, Clémentine Gandilhon, Léa Vecchiato, Patricia Soler-Michel, Thierry Ponchon
OBJECTIVE:  Some patients (10 % - 32 %) with a positive guaiac fecal occult blood test (gFOBT) do not undergo the recommended colonoscopy. The aim of this study was to compare video capsule endoscopy (VCE) and computed tomography colonography (CTC) in terms of participation rate and detection outcomes when offered to patients with a positive gFOBT who did not undergo the recommended colonoscopy. METHODS:  An invitation letter offering CTC or VCE was sent to selected patients after randomization...
February 27, 2018: Endoscopy
M Mirzaei, N Dadkhah, B Baghbanzadeh-Nobari, A Agha-Tehrani, M Eshraghi, M Imani, R Shiasi-Sardoabi, M H Ghaffari
The objective of this study was to evaluate the effects of preweaning total plane of milk intake and weaning age on intake, growth performance, and blood metabolites of dairy calves. A total of 48 Holstein calves (40 ± 1.6 kg of body weight) were used in a 2 × 2 factorial arrangement with the factors of weaning age (d 60 vs. 75) and the total plane of milk intake (medium vs. high) during the preweaning period. Calves were assigned to 1 of 4 treatments: (1) calves fed medium plane of milk (MPM) intake and weaned on d 60 of age (MPM-60d, 4 L/d of milk from d 3 to 10, 6 L/d of milk from d 11 to 55, and 3 L/d of milk from d 56 to 60 of age; total milk intake = 317 L), (2) calves fed MPM intake and weaned on d 75 of age (MPM-75d, 4 L/d of milk from d 3 to 10 and 4...
February 21, 2018: Journal of Dairy Science
Joyce B Foryoung, Chobufo Ditah, Peter Nde Fon, Yannick Mboue-Djieka, Daniel N Nebongo, Noel D Mbango, Vanessa Balla, Simeon-Pierre Choukem
OBJECTIVES: There are limited data on mortality in patients with type 2 diabetes mellitus (T2DM) in Sub-Saharan Africa. We aimed at determining the mortality rate, and the causes and the predictors of death in patients with T2DM followed as outpatients in a reference hospital in Cameroon. DESIGN: Retrospective cohort study. SETTING: A reference hospital in Cameroon. PARTICIPANTS: From December 2015 to March 2016, patients with T2DM aged 18 years and older and who consulted between January 2009 and December 2014, were contacted directly or through their next of kin, and included in this study...
February 22, 2018: BMJ Open
Douglas P Olsen, Edie Brous
Editor's note: On July 26, 2017, Alex Wubbels, the charge nurse on the burn unit at the University of Utah Hospital in Salt Lake City, was arrested for refusing to allow a police officer to draw blood from an unconscious patient in her care. Her arrest, during which she was forcefully placed in handcuffs and dragged out of the hospital, was documented on body camera video and drew national attention. We asked our ethical and legal contributing editors to provide some insight on the issues of this case.
March 2018: American Journal of Nursing
Sofia Strömmer, Wendy Lawrence, Taylor Rose, Christina Vogel, Daniella Watson, Joanne N Botell, Nicholas C Harvey, Cyrus Cooper, Hazel Inskip, Janis Baird, Mary Barker
OBJECTIVE: To identify reasons underlying women's refusal to participate in a pregnancy trial and to identify ways of increasing recruitment. DESIGN: Mixed methods study using a questionnaire and qualitative interviews. SAMPLE: A questionnaire asking them to indicate reasons for their decision was completed by 296 pregnant women who declined to participate in one of two trials of nutritional supplementation in a large teaching hospital in southern England...
January 17, 2018: Social Science & Medicine
Chung-Jong Kim, Jeong-Eun Yi, Yookyung Kim, Hee Jung Choi
RATIONALE: Infective endocarditis (IE) is a life-threatening disease, mostly caused by gram-positive bacteria. Gram-negative bacteria were identified as a causative organism in relatively small number of cases. Although, antibiotic-resistant Escherichia coli is common cause of gram-negative endocarditis, AmpC beta-lactamase (BL)-harboring E coli is very rare cause of IE. Furthermore, emphysematous endocarditis is also a very rare manifestation of E coli infection. PATIENT CONCERNS: We report a case of 80-year-old female patient presenting with dizziness, fever, and altered mental status, who was finally diagnosed with emphysematous endocarditis caused by E coli harboring an AmpC BL gene...
February 2018: Medicine (Baltimore)
J K Clark, K P Coffey, W K Coblentz, B C Shanks, J D Caldwell, R E Muck, D Philipp, M A Borchardt, R T Rhein, W E Jokela, E A Backes, M G Bertram, W B Smith
Dairy slurry is used commonly as an animal-sourced fertilizer in agronomic production. However, residual effects of slurry application on intake and digestibility of alfalfa (Medicago sativa L.) silage from subsequent harvests are not well known. The objective of this study was to determine if moisture concentration of alfalfa silage and timing of dairy slurry application relative to subsequent harvest affected intake and digestibility by sheep. Katahdin crossbred ewes (n = 18; 48 ± 5.3 kg) in mid-gestation were stratified by BW and allocated randomly in each of 2 periods to 1 of 6 treatments arranged in a 2 × 3 factorial arrangement...
February 1, 2018: Journal of Animal Science
Hironori Minami, Tsuyoshi Konishi, Hironori Fukuoka, Shun Miyanari, Satoshi Murahashi, Ian Fukudome, Shinsuke Suzuki, Hajime Ushigome, Toshiya Nagasaki, Takashi Akiyoshi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno
BACKGROUNDS: In the setting of routine use of preoperative chemoradiotherapy(CRT)for cStage II / III rectal cancer, shortcourse radiotherapy(short-RT)is selectively used for reducing local recurrence.The purpose of this study is to clarify the safety of laparoscopic surgery after preoperative short-RT for lower rectal cancer. METHODS: Twenty-eight patients who un- derwent short-RT followed by laparoscopic total mesorectal excision for cStage II / III lower rectal cancer were retrospectively analyzed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
A Olaussen, J Bade-Boon, M C Fitzgerald, B Mitra
INTRODUCTION: Management of major haemorrhage as a result of trauma is particularly challenging when blood is not an option (BNAO). Evidence on therapeutic strategies in this situation is limited. The aim of this study was to evaluate the management and outcomes of patients who identified themselves as Jehovah's Witnesses (who usually refuse blood products) with traumatic haemorrhage at an Australian major trauma centre. METHODS: A retrospective review of patients from The Alfred Trauma Registry was conducted, including patients who were Jehovah's Witnesses presenting between January 2010 and January 2017...
February 2, 2018: Vox Sanguinis
Miriam Martínez, Mar García Romero, Luis García Guereta, Marta Cabrera, Rita M Regojo, Luis Albajara, Maria L Couce, Miguel Saenz de Pipaon
RATIONALE: Infantile-onset Pompe disease, also known as glycogen storage disease type II, is a progressive and fatal disorder without treatment. Enzyme replacement therapy with recombinant human acid alpha-glucosidase (GAA) enhances survival; however, the best outcomes have been achieved with early treatment. PATIENT CONCERNS: We report a case of a newborn with infantile-onset Pompe disease diagnosed in the first days of life who did not undergo universal neonatal screening...
December 2017: Medicine (Baltimore)
Jae Woong Yoon, Du Young Choi, Seung Hyun Lee, Sae Ron Sin, Seung Taek Yu
Background: Influenza-associated myositis (IAM) is a rare and poorly recognized complication of influenza infection in children, and is characterized by acute onset of severe pain in the lower extremities and a refusal to ambulate walk. We sought to understand the association between IAM and influenza B infection and to investigate its clinical and laboratory characteristics in affected children. Methods: Influenza B-associated myositis (IBAM) cases diagnosed in the pediatrics department of Wonkwang University Hospital from January 2010 and March 2016 were analyzed retrospectively...
January 2018: Korean Journal of Family Medicine
Lawrence J Schneiderman, Nancy S Jecker, Albert R Jonsen
Two recent policy statements by major providers of critical care have rejected the concept and language of "medical futility," on the ground that there is no universal consensus on a definition. They recommend using "potentially inappropriate" or "inappropriate" instead. We argue that their proposed terms are vague-even misleading-in the ICU setting, where serious life-and-death decisions are made. Whatever specific meaning the exclusive world of critical care might wish to give to the word inappropriate, in the lay world the term is so broad it trivializes the activity...
2018: Perspectives in Biology and Medicine
Małgorzata Rajtar
Drawing from an ethics of care, relational approaches to autonomy have recently emerged in bioethics. Unlike individual autonomy with its emphasis on patients' rights, choice, and self-determination which has been the hallmark of bioethics consistent with the ideology of individualism in neoliberal democracies in Western countries, relational autonomy highlights the relatedness, interdependency, and social embeddedness of patients. By examining the mediating role that male Hospital Liaison Committee members in Germany play in facilitating care that supports Jehovah's Witnesses' refusal of blood transfusions, this article moves beyond 'dyadic relations' and contexts of caregiving...
March 2018: Bioethics
Jeremy D Kauffman, T Joseph Watson, Joseph J Campbell
A patient's refusal to receive blood products can pose both clinical and ethical challenges to the surgeon. In this report, we review the case of a Jehovah's Witness presenting with critical lower limb ischemia and severe anemia for whom the decision of whether to perform thrombolytic therapy was complicated by his refusal to accept blood products. The case demonstrates that thrombolytic therapy can produce favorable results in severely anemic patients even when transfusion is not an option. We conclude that offering thrombolytic therapy in this context is a reasonable therapeutic option from both a clinical and ethical perspective...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
Michael Tøstesen, Lene S G Østgård, Eigil Kjeldsen, Jesper Stentoft, Jan M Nørgaard
Untreated acute promyelocytic leukaemia (APL) is a rapidly lethal blood cancer. Conventional treatment consists of all-trans retinoic acid and chemotherapy. Standard chemo-therapy-containing treatments necessitate the use of blood products. This is a case report of typical APL in a 32-year-old female patient, who due to religious conviction refused supportive therapy with blood products. A treatment regimen consisting of all-trans retinoic acid and arsenic trioxide was successful without the use of blood transfusions...
January 15, 2018: Ugeskrift for Laeger
Ying-Ge Wang, Jin-Mei Cheng, Hai-Bo Ding, Xi Lin, Guo-Hao Chen, Mei Zhou, Sheng-Nan Ye
OBJECTIVE: To improve the diagnosis and treatment of Penicilliosis marneffei without human immunodeficiency virus infection. METHODS: Analyze and review the clinical features, diagnosis and treatment of six cases of P. marneffei without human immunodeficiency virus infection at The First Affiliated Hospital of Fujian Medical University. RESULTS: Two cases were diagnosed in the ENT Department, three cases in the respiratory department and one case in the dermatological department...
January 15, 2018: Mycopathologia
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