Dr Mehmet Rami Helvaci
Specialist of Internal Medicine, TurkeyPresentation Title:
Red blood cell transfusions should be preserved just for emergencies in sickle cell diseases
Abstract
Background: Atherosclerosis may be the main cause of aging and death.
Methods: All patients with sickle cell diseases (SCD) were included.
Results: We studied 222 males and 212 females with mean ages of 30.8 vs 30.3 years, p>0.05, respectively. Smoking (23.8% vs 6.1%, p<0.001), alcohol (4.9% vs 0.4%, p<0.001), transfused red blood cells (RBC) in their lifespans (48.1 vs 28.5 units, p=0.000), disseminated teeth losses (5.4% vs 1.4%, p<0.001), ileus (7.2% vs 1.4%, p<0.001), cirrhosis (8.1% vs 1.8%, p<0.001), chronic obstructive pulmonary disease (25.2% vs 7.0%, p<0.001), coronary heart disease (CHD) (18.0% vs 13.2%, p<0.05), leg ulcers (19.8% vs 7.0%, p<0.001), clubbing (14.8% vs 6.6%, p<0.001), chronic renal disease (9.9% vs 6.1%, p<0.05), and stroke (12.1% vs 7.5%, p<0.05) were all higher in males.
Conclusion: As an accelerated atherosclerotic process, hardened RBC-induced capillary endothelial damage initiating at birth terminates with multiorgan failures in early years of life in the SCD. Probably, stroke and CHD are the main causes of deaths even in the SCD. Probably, hydroxyurea is the most effective method of prevention of acute painful crises. On the other hand, RBC transfusions are the most effective treatments in acute painful crises both to decrease the severity of pain and to lower the risks of sudden deaths, probably due to the stroke or CHD, again. Because of the increased prevalences of allo-antibodies parallel to the increased number of transfusions, RBC transfusions should be preserved just for acute painful crises, surgical operations, births, and medical or surgical emergencies in the SCD.
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