keyword
https://read.qxmd.com/read/38523425/managing-suspected-myasthenia-gravis-and-myositis-induced-by-pembrolizumab-in-a-jehovah-s-witness-sarcoma-patient
#1
JOURNAL ARTICLE
Alexander Hutchinson, Danielle Eskens, Abigail Chan, Anika Bhargava, Ryan Bycroft
INTRODUCTION: Immune checkpoint inhibitors (ICIs) can cause a spectrum of adverse events known as immune-related adverse events (irAEs) that resemble autoimmune responses. Immune-mediated myasthenia gravis (MG) is a rare and serious neurologic adverse event that has been associated with ICIs requiring prompt treatment. In the Jehovah's Witness population, typical management of these adverse events may not be options, and alternative treatment choices would be needed. CASE REPORT: 73-year-old Jehovah's Witness patient with high-grade undifferentiated pleiomorphic sarcoma who developed immune-mediated MG approximately 4 weeks after initiation of pembrolizumab...
March 24, 2024: Journal of Oncology Pharmacy Practice
https://read.qxmd.com/read/38470400/arguments-for-a-ban-on-pediatric-intersex-surgery-a-dis-analogy-with-jehovah-witness-blood-transfusion
#2
JOURNAL ARTICLE
Catherine Clune-Taylor
This article argues for a ban on the performance of medically unnecessary genital normalizing surgeries as part of assigning a binary sex/gender to infants with intersex conditions on the basis of autonomy, regardless of etiology. It does this via a dis/analogy with the classic case in bioethics of Jehovah Witness (JW) parents' inability to refuse life-saving blood transfusions for their minor children. Both cases address ethical medical practice in situations where parents are making irreversible medical decisions on the basis of values strongly held, identity, and relationship-shaping values-such as religious beliefs or beliefs regarding the inherent value of binary sex/gender-amidst ethical pluralism...
March 12, 2024: Bioethics
https://read.qxmd.com/read/38446030/king-ghidorah-technique-for-a-trifurcation-lesion-in-a-very-high-risk-nstemi
#3
JOURNAL ARTICLE
Kevin Hernández-Flores, Paola Aceves-Chong, Heberto Aquino-Bruno, Roberto Ibarra-Sánchez, Marco Alcántara-Meléndez
A 66-year-old male Jehovah's Witness arrived at the emergency room having experienced typical persistent angina.
February 28, 2024: Journal of Invasive Cardiology
https://read.qxmd.com/read/38435957/anesthesia-approach-to-managing-severe-hemorrhagic-shock-and-anemia-with-non-transfusion-alternatives-in-a-practicing-jehovah-s-witness-a-case-report
#4
Colin Kirsch, Romain Rabany, Matthew Pon, Julia Shabanian, Anand Narayanappa
Traumatic hemorrhagic shock is a common yet life-threatening occurrence across the United States and is typically managed with blood transfusions as the standard of care. However, providers caring for a Jehovah's Witness patient who refuses transfusions due to religious reasons face unique ethical challenges in upholding evidence-based shock resuscitation protocols while respecting the patient's autonomy and faith-based stance that strictly prohibits blood products. We present a complex clinical case of a 46-year-old Jehovah's Witness who developed severe hemorrhagic shock, partial amputation, and critical anemia after a traumatic 40-mile-per-hour motorcycle collision resulting in comminuted fractures and arterial disruption...
January 2024: Curēus
https://read.qxmd.com/read/38400727/anesthetic-management-of-a-jehovah-s-witness-patient-for-coronary-artery-bypass-grafting-with-antiphospholipid-antibody-syndrome-and-renal-transplant
#5
JOURNAL ARTICLE
Katherine Greco, Dirk Varelmann, Jonah Patel
Anesthesia for cardiac surgical patients with antiphospholipid antibody syndrome (APLS) presents challenges with monitoring anticoagulation during cardiopulmonary bypass. Additionally, this condition is associated with other autoimmune diseases and comorbidities that need to be considered in caring for these patients, and there is minimal evidence for specific strategies during cardiac surgery. Separately, Jehovah's Witness (JW) patients typically do not consent to receiving blood products, presenting an additional challenge for resuscitation during cardiac surgery and especially in the context of APLS...
February 24, 2024: Seminars in Cardiothoracic and Vascular Anesthesia
https://read.qxmd.com/read/38353220/management-of-severe-anemia-in-a-jehovah-s-witness-patient-with-lung-abscess-secondary-to-malpositioned-laparoscopic-adjustable-gastric-band-a-case-report
#6
JOURNAL ARTICLE
Nina Ruan, Chloe Shi, Zain Al-Momani, Fouad Jaber, Ramy Ghaly, David Wooldridge
Jehovah's Witnesses is a Christian denomination widely recognized for their steadfast refusal of blood transfusions, even when facing severe anemia. We describe a unique case of a 42-year-old Jehovah's Witness woman with severe iron deficiency anemia. She necessitated surgical correction of a malpositioned gastric band within the context of a complex necrotizing aspiration pneumonia secondary to esophageal obstruction. Medical management of this severe anemia has been a challenge as traditional approaches, like a blood transfusion, are not possible...
2024: Journal of Investigative Medicine High Impact Case Reports
https://read.qxmd.com/read/38325404/knowledge-perceptions-and-practices-towards-blood-donation-among-undergraduate-medical-students-in-an-upcountry-ugandan-university-a-mixed-methods-study
#7
JOURNAL ARTICLE
Catherine Kagoya, Yahaya Gavamukulya, David Jonah Soita
BACKGROUND: Due to the different factors affecting the maintenance of a constant supply of human blood in health facilities, this study aimed at exploring the knowledge, perceptions, and practices towards blood donation among under graduate medical students at Busitema University Faculty of Health Sciences (BUFHS). METHODS: Using a convergent parallel mixed methods study design, 384 students were recruited into the study. Questionnaires and focused group discussions were used to collect the data...
January 2024: Global Public Health
https://read.qxmd.com/read/38310045/bloodless-management-of-significantly-elevated-transcranial-doppler-velocity-value-in-a-jehovah-s-witness-child-with-sickle-cell-disease-a-tertiary-centre-experience-a-case-report
#8
Chisom Adaobi Nri-Ezedi, Thomas Ulasi, Chilota Chibuife Efobi, John Chinawaeze Aneke, Nwanneka Ugwu, Chinekwu Nwosu
BACKGROUND: Effective management of complications in sickle cell disease (SCD), such as stroke prevention, often necessitates the use of blood transfusions. However, individuals who adhere to the religious tenets of Jehovah's Witnesses strictly abstain from accepting blood transfusions, thereby presenting a formidable challenge in clinical decision-making. CASE REPORT: This is a case of a 3 year old child Jehovah's Witness who was found to have significantly elevated transcranial Doppler (TCD) velocity values between 193 and 203 cm/s, following routine screening...
February 2, 2024: Journal of the National Medical Association
https://read.qxmd.com/read/38146509/optimized-complete-cytoreduction-in-ovarian-cancer-through-intraoperative-real-time-tumor-visualization-by-5-ala-a-case-report
#9
Laura Tascón Padrón, Eva K Egger, Damian Johannes Ralser, Lucia Otten, Özer-Altan Toksöz, Glen Kristiansen, Walter Stummer, Alexander Mustea
INTRODUCTION: Complete macroscopic cytoreduction represents the most important prognostic parameter for overall survival in ovarian cancer. This dogma remains tenacious despite significant improvements in adjuvant systemic treatment. Hence, optimization of surgical therapy is an overarching goal to improve patients' outcomes. In this context, intraoperative tumor-specific imaging might facilitate optimized cytoreduction. In neurosurgery, intraoperative 5-aminolevulinic acid (5-ALA) guided imaging is applied in clinical routine to assess surgical resection margins...
2023: Frontiers in Oncology
https://read.qxmd.com/read/38144674/major-abdominal-surgery-for-jehovah-s-witnesses-challenge-while-practicing-bloodless-medicine-in-a-middle-income-country
#10
Aleksandra Gavrilovska-Brzanov, Darko Gjambaz, Filip Naumovski, Nikola Brzanov, Marija Jovanovski Srceva, Atanas Sivevski, Kuzmanovska Biljana
We present a 59-year-old female Jehovah's Witness patient transferred from another facility to our tertiary center as an emergency case owing to anemia due to gastrointestinal bleeding. A computed tomography scan and gastroscopy confirmed an invasion of the duodenum by a malignant process. The patient underwent a Whipple procedure and a right hemicolectomy refusing blood transfusion. On the 17th postoperative day, the patient was discharged following a successful surgery. This article's objectives are to first highlight the moral and ethical quandary and then share our surgical experiences with this particular patient population...
2023: SAGE Open Medical Case Reports
https://read.qxmd.com/read/38143626/challenges-and-insights-in-managing-device-related-thrombosis-post-watchman-implantation-a-case-report-of-surgical-thrombectomy-in-an-elderly-jehovah-s-witness-patient-with-atrial-fibrillation
#11
Yusuke Tsukioka, Valluvan Jeevanandam, Blaine Johnson
The WATCHMAN device offers a viable alternative to long-term oral anticoagulation for stroke prevention in nonvalvular atrial fibrillation, particularly for high-risk patients. Despite its success, device-related thrombosis (DRT) remains a concern, potentially restricting its wider use. We present an 83-year-old female Jehovah's Witness with atrial fibrillation who, after successful WATCHMAN device implantation, suffered multiple transient ischemic attacks six months later. Initial investigation revealed a thrombus on a slightly exposed strut of the almost completely endothelialized device...
November 2023: Curēus
https://read.qxmd.com/read/38108161/a-secure-blood-saving-protocol-for-jehovah-s-witnesses-in-primary-total-hip-replacement
#12
JOURNAL ARTICLE
Mustafa Fatih Dasci, Ozkan Kose, Beatriz Fernandez Maza, Beren Gozacan, N Amir Sandiford, Thorsten Gehrke, Mustafa Citak
OBJECTIVES: The study aimed to analyze the efficacy of the blood management protocol developed by our team for patients who are Jehovah's Witnesses (JW) presenting for primary total hip replacement (THR). PATIENTS AND METHODS: Thirty JW patients (6 males, 24 females; mean age: 70.1±9.8 years; range, 65 to 81 years) and 30 age- and sex-matched controls (6 males, 24 females; mean age: 68.7±9.1 years; range, 62 to 79 years) who underwent primary THR at our institution between January 2018 and June 2020 were retrospectively evaluated...
January 1, 2024: Joint diseases and related surgery
https://read.qxmd.com/read/38054541/ethical-issues-in-solid-organ-transplantation-transfusion-free-transplantation-in-jehovah-s-witness-patients
#13
REVIEW
Rick Selby, Taylor Selby-Medical, Michael Richman
PURPOSE OF REVIEW: Jehovah's Witnesses do not accept transfusion of major allogeneic blood fractions. Successful solid organ transplantation is challenging for Jehovah's Witnesses when anemia, coagulation disturbances, and difficult technical aspects co-exist, and key blood bank resources cannot be utilized. Organ availability for transplantation is limited and demand exceeds supply for all organ types. Historically, the likelihood of poor outcomes in Jehovah's Witnesses patients placed ethical limitations on transplant candidacy for this population violating the precept of maximal utilization of a limited resource...
February 1, 2024: Current Opinion in Organ Transplantation
https://read.qxmd.com/read/38032187/case-of-hemolytic-disease-of-the-fetus-and-newborn-treated-without-blood-products
#14
JOURNAL ARTICLE
Leah Hirschman, Ashley Munchel
Hemolytic disease of the fetus and newborn (HDFN) affects 3/100,000 to 80/100,000 patients yearly and can cause severe anemia and hyperbilirubinemia. Recombinant human erythropoietin has been used as an adjunct therapy in patients with HDFN and hypo-regenerative anemia in the setting of receiving intrauterine blood transfusions. This case describes a patient with HDFN, in which the family were Jehovah Witnesses, and blood transfusions were declined. The patient had symptomatic anemia with a hematocrit nadir of 18...
November 30, 2023: Journal of Pediatric Hematology/oncology
https://read.qxmd.com/read/37989156/blood-management-for-the-orthopaedic-surgical-patient
#15
JOURNAL ARTICLE
Norman A Smyke, Carol A Sedlak
Prevention and management of anemia and blood loss in the orthopaedic patient undergoing surgery is a major concern for healthcare providers and patients. Although transfusion technology can be lifesaving, there are risks to blood products that have led to increased awareness of blood management and development of hospital patient blood management programs. Use of patient blood management can be effective in addressing preoperative anemia, a major modifiable risk factor in patients undergoing surgery. In this informational article, evidence-based practice guidelines for perioperative blood management are addressed...
November 2023: Orthopaedic Nursing
https://read.qxmd.com/read/37822074/successfully-managing-severe-anemia-in-a-trauma-patient-who-refused-blood-transfusion-a-case-report
#16
JOURNAL ARTICLE
Irene F Sanchez, Han-Young Lee, Jae-Myeong Lee
BACKGROUND Surgical management in patients who undergo traumatic blood loss but who refuse blood transfusion can be challenging, but physicians and surgeons must comply with the wishes and beliefs of their patients. This report describes the management of severe anemia, with hemoglobin level of 2.5 g/dL, in a 71-year-old male Korean trauma patient who declined blood transfusion. CASE REPORT A 71-year-old man was admitted to hospital with severe blood loss following trauma. He declined blood transfusion due to his religious belief as a Jehovah's Witness...
October 12, 2023: American Journal of Case Reports
https://read.qxmd.com/read/37741590/the-history-of-louse-borne-typhoid-and-geomedizine
#17
JOURNAL ARTICLE
Agnieszka Polak, Katarzyna Pawlikowska-Łagód, Anna Zagaja, Andrzej Grzybowski
The experience of World War I made popular the concept of medical geography which become part of Nazism's philosophy of national welfare, safety, and solidarity. The Nazis used it to create propaganda to show some groups as rats, vermin, and Untermenschen (subhumans). In this way, more than ten million people were killed under the Nazi regime: six million Jews, plus more than 5 million Gypsies, Jehovah's Witnesses, and other groups who were not part of the German theory of "master race." The Germans' fear of typhus that spread in the Wehrmacht was so immense that during the occupation, Polish doctors used this phobia to organize a resistance movement...
September 21, 2023: Clinics in Dermatology
https://read.qxmd.com/read/37720708/the-role-of-multidisciplinary-team-and-stepwise-pelvic-devascularization-to-minimize-blood-loss-during-total-pelvic-exenteration-for-patients-refusing-blood-transfusion
#18
Valentina Le Thanh, Richard Bell, Nicholas Symons, Hooman Soleymani Majd
KEY CLINICAL MESSAGE: Radical gynecology oncology surgeries are feasible in patients refusing blood transfusion, when performed with careful preoperative (with hemoglobin optimization and patients' counseling), intraoperative (with hemostasis and stepwise devascularization, hemodilution, and autologous cell salvage) and postoperative (considering iron infusion or erythropoietin) planning with a multidisciplinary team involvement. ABSTRACT: We describe the case of a female Jehovah's Witness patient in her 60s undergoing pelvic exenteration, focusing on the preoperative, intraoperative, and postoperative measures that allowed an uncomplicated surgery without blood transfusion...
September 2023: Clinical Case Reports
https://read.qxmd.com/read/37716536/optimizing-safety-and-success-the-advantages-of-bloodless-cardiac-surgery-a-systematic-review-and-meta-analysis-of-outcomes-in-jehovah-s-witnesses
#19
REVIEW
Marco Gemelli, Enrico Giuseppe Italiano, Veronica Geatti, Mariangela Addonizio, Irene Cao, Arnaldo Dimagli, Aleksander Dokollari, Vincenzo Tarzia, Michele Gallo, Enrico Ferrari, Mark S Slaughter, Gino Gerosa
OBJECTIVE: Transfusions are extremely frequent after cardiac surgery, and they have a considerable economic burden and impact on outcomes. Optimal patient blood management (PBM) could play a fundamental role in reducing the rate of transfusion and Jehovah's Witnesses (JW) represent the ideal surrogate study population. This meta-analysis compares outcomes of JWs and non-JWs' patients undergoing cardiac surgery, assessing the safety of a bloodless cardiac surgery. METHODS: A scoping review was conducted using a search strategy for studies assessing outcomes of JW undergoing cardiac surgery...
September 14, 2023: Current Problems in Cardiology
https://read.qxmd.com/read/37713712/caplacizumab-without-plasma-exchange-for-thrombotic-thrombocytopenic-purpura-in-a-jehovah-s-witness
#20
JOURNAL ARTICLE
Caleb Spencer, Ziad Abuhelwa, Azizullah Beran, Anas Alsughayer, Taha Sheikh, Drew Oostra, Ragheb Assaly, Danae M Hamouda
No abstract text is available yet for this article.
September 2023: American Journal of Therapeutics
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