This is often associated with an infection by Parvovirus B-19. The bone marrow's replacement of the cells is disrupted. This usually manifests with a rapid drop in hemoglobin levels. Luckily, this condition is usually self limited, and the treatment is mostly supportive. ecovery is usually heralded by an increase in the reticulocyte count.
In children and in adolescents, sickle cell disease causes growth retardation, a delay in the manifestation of secondary sexual characteristics and sexual maturation, and usually results in the child being significantly underweight. It often happens in childhood that the spleen enlarges, especially in the first year of life, resulting from the sequestration of a large number of sickled cells within the spleen. This is a painful process. The spleen will then have repeated infarcts, and splenic function is impaired during the enlargement. Eventually, the repeated episodes of infarct leave the spleen fibrotic and it shrinks in size,…...

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References

Bailey, K; Morris, JS; Thomas, P; Serjeant, GR. 1992. Fetal hemoglobin and early manifestations of homozygous sickle cell disease. Arch. Dis. Child. 67:517-20.

Charache, et. al. 1995. Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia. N Engl J. Med 332:1317-22.

Platt, OS; Brambilla, DJ; Rosse, WF; Milner, PF; Castro, O; Steinberg, MH; Klug, PP. 1994. Mortality in sickle cell disease. Life expectancy and risk factors for early death. N. Engl. J. Med 330: 1639-44.

Powars, D, et al. 1993. Sickle cell anemia. Beta's gene cluster haplotypes as genetic markers for severe disease expression. Am. J. Dis. Child. 147:1197-1202.

[Harvard University] it is observed that younger patients are much better than adults in post transplantation recovery and Current statistics project a more successful picture with a reduced mortality rate for bone marrow transplantation at 5%. Also, this is a relatively new procedure with a total of only 200 people with the sickle cell disease having undergone it. [Debby Golonka]
Gene Therapy

With the advancements in genetic science the search for a cure to sickle cell disease by way of gene therapy is ongoing. It has been many years since researchers cloned the beta globin gene and current research is focused on the locus control region and the use of adeno-associated viruses as vectors. Research is also focused on inserting the AAV into pluripotent stem cells so as to trigger the synthesis of healthy beta-globin naturally. However, there are still a lot of biomolecular mechanisms involved that need to be clearly…...

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Bibliography

CDC, 'Sickle Cell Disease', retrieved on Feb 10th 2008, at  http://www.cdc.gov/ncbddd/sicklecell/hcp_data.htm 

Allan Platt, 'Emergency Management of Sickle cell Disease', Retrieved on Feb 10th 2008, from,  http://www.emorypa.org/LAPAsicklehandout.doc 

Nemours Foundation, "Sickle Cell Disease', Retrieved on Feb 10th 2008, at  http://www.kidshealth.org/parent/medical/heart/sickle_cell_anemia.html 

Doris L. Wethers, M.D, (2000), 'Sickle Cell Disease in childhood', Published by American Family Physician, Retrieved on Feb 10th 2008, from,  http://www.aafp.org/afp/20000901/1013.html

The use of hydroxyurea and postoperative heparin prophylaxes were also included in the recorded observations made by the researchers. Standard statistical techniques including regression analysis were used to determine the levels of correlation that existed between transfusion therapy, pharmaceutical use, and complications.
Materials

As this was a retrospective study that did not involve any direct experimentation or even direct observation, the materials used were rather minimal compared to many other clinical surveys. Patient records formed the entirety of the research materials used; these were accessed in accordance with privacy laws and ethical standards for the use of private medical information, with the records rendered anonymous prior to primary research being conducted and with full hospital permission. ecords were accessed primarily electronically, though hard copies of the seventy-five case histories actually used as subjects in the study were also obtained after having been sanitized of identifying information.

Materials used in analysis were equally…...

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References

Al-Smak, Z.; Al-Falaki, M. & Pasha, A. (2008). "Assessment of perioperative transfusion therapy and complication in sickle cell disease patients undergoing surgery." Middle east journal of anesthesiology 19(5), pp. 983-96.

Ataga, K. & Key, N. (2007). "Hypercoagulability in Sickle Cell Disease: New Approaches to an Old Problem." Hematology.

Buck, J.: Casbard, A.; Llewelyn, C.; Johnson, T.; Davies, S. & Williamson, L. (2005). "Preoperative transfusion in sickle cell disease: a survey of practice in England." European journal of haematology 75, pp. 14 -- 21.

Haberkern, C.; Neumayr, L.; Orringer, E.; Earles, A.; Robertson, S.; Black, D.;…Vichinsky, E. (1997). "Cholecystectomy in Sickle Cell Anemia Patients: Perioperative Outcome of 364 Cases From the National Preoperative Transfusion Study." Blood 89(5), pp. 1533-42.

Variations of this technique include scatter photocoagulation and feeder vessel photocoagulation. Scatter photocoagulation is efficacious in the treatment for sea fan lesions. The desired outcome of this therapy is extraretinal fibroneovascular tissue regression. Localized scatter photocoagulation treats early proliferative changes. Once neovascularization invades the vitreous, localized scatter photocoagulation is generally less effective. If this technique does not result in regression of proliferative changes, feeder vessel photocoagulation may be used as an adjunct to induce infarction to the remaining sea fans.
Feeder vessel photocoagulation

Obliterating feeder vessels by retinal photocoagulation causes infarction of peripheral neovascular beds. This technique manages proliferative sickle retinopathy effectively, especially in cases where neovascularization persists after extensive scatter photocoagulation treatment 6. Feeder vessel photocoagulation is often complicated by vitreous hemorrhage, retinal detachments, choroidal ischemia, choroidal neovascularization, subretinal hemorrhage and/or fibrosis, or macular pucker and hole formation.

etinal cryotherapy

etinal cryotherapy is useful in treating peripheral retinal ischemia as opposed to…...

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References

1. Penman AD, Serjeant GR. Recent advances in the treatment of proliferative sickle cell retinopathy. Curr Opin Ophthalmol 1992;3:379-88.

2. Aiello LP. Clinical implications of vascular growth factors in proliferative retinopathies. Curr Opin Ophthalmol 1997;8:19-31.

3. Goldberg MF. Classification and pathogenesis of proliferative sickle retinopathy. Am J. Ophthalmol 1971;71:649-65.

4. Charache S. Eye disease in sickling disorders. Hematol Oncol Clin North Am 1996;10:1357-62.

Sickle Cell
What detracted or hindered participants from successfully completing the activity?

When viewing many of the team building, universal collaboration significantly hindered team performance. When performed alone, many participants performed particularly well. For example, in activity 4, participants that ran through the jump rope alone, did so with little trouble. However, when required to move in unison as a team, each member had to account for the others strengths and deficiencies. When looking at the video, some teams seemed disoriented when participating as they did not collaborate with one another. As the teams became larger throughout the activity, the complications regarding collaboration were exacerbated to the point that some teams failed the activity. During the jump rope activity, coordination and communication are important. These concepts hindered participants from successful completion of the task. Likewise, in activity 1, lack of communication hindered the participants. When drawing the home, each member had a…...

Sickle Cell Anemia: Ethical Considerations The only known cure for sickle cell disease is hematopoietic stem cell transplant (HSCT). Survival rates after HSCT are high, almost 100%, with cure rates of more than 90% (Nickel, Hendrickson & Haight, 2014; Nickel & Kamani, 2017). To receive HSCT most successfully, the donor is ideally a HLA-identical sibling. This raises several ethical concerns. The most pressing of all ethical concerns related to HSCT is whether the procedure should be offered to children with “less severe” cases of sickle cell disease (Nickel, Hendrickson & Haight, 2014; Nickel & Kamani, 2017). Less severe cases have been defined as those that do not have overt complications. However, Nickel, Hendrickson & Haight, (2014) point out that many “less severe” cases may become more severe over time, compelling healthcare workers to offer HSCT to all children with sickle cell disease. The same issue of access to HSCT is related…...

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References

Hoban, M.D., Cost, G. J., Mendel, M, C., et al (2015). Correction of the sickle cell disease mutation in human hematopoietic stem/progenitor cells. Blood 2015(125): 2597-2604.

Holmes, M.C., Reik, A., Rebar, E.J., et al (2017). A potential therapy for beta-thalassemia (ST-400) and sickle cell disease. Blood 2017(130): 2066.

Lavery, S.A., Islam, R., Hunt, J., et al (2016). The medical and ethical challenges of fertility preservation in teenage girls. Human Reproduction 31(7): 1501-1507.

Nickel, R.S., Hendrickson, J.E. & Haight, A.E. (2014). The ethics of a proposed study of hematopoietic stem cell transplant for children with “less severe” sickle cell disease. Blood 2014(124): 861-866.

Nickel, R.S. & Kamani, N. (2017). The ethics of hematopoietic stem cell transplantation for sickle cell disease. In Meier E., Abraham A., Fasano R. (eds) Sickle Cell Disease and Hematopoietic Stem Cell Transplantation, Springer, pp. 199-219.

Sickle Cell Disease
Recent years have seen a number of different investigations of the issues involved in the transition of care -- from pediatric-oriented to adult-oriented services -- for those who suffer from sickle cell disease. Although different researchers have taken a number of different approaches to the question, which I hope to survey in order to provide some report on the current state of opinion regarding transition of care, all are agreed that the current flurry of investigative interest stems ultimately from a piece of very good news: the vertiginous decline in mortality rates for children suffering from sickle cell disease. The historic response to a diagnosis of pediatric sickle cell disease was to minimize patient and parental expectations for prognosis, for the prospect of reaching adulthood would be slight indeed. Telfair Loosier (2004) note that survival rates for pediatric sickle cell disease have improved so vastly that the vast…...

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Bibliography

Barakat, L.P., Lutz, M., Smith-Whitley, K., and Ohene-Frempong, K. (2005). "Is treatment adherence associated with better quality of life in children with sickle cell disease?" Quality of Life Research 14(2), 407-14.

Davies, S.C. And Oni, L. "Management of patients with sickle cell disease." (1997). British Medical Journal 315(7109), 656-60.

Doulton, D.M. (2010.) "From Cradle to Commencement: Transitioning Pediatric Sickle Cell Disease Patients to Adult Providers." Journal of Pediatric Oncology Nursing November 2009

Jenerette, C.M. And Brewer, C. (2010). "Health-related stigma in young adults with sickle cell disease." Journal of the National Medical Association 102.11 (2010): 1050-5.

III. Considering Current Challenges

As noted during the introductory chapter of this proposal, children routinely note how their parents cope with pain; their particular pain coping styles. During the implementation of this proposed study, this researcher expects to create a questionnaire... exploring the way parents of adolescents afflicted with SCD personally handled their pain. Both parents and adolescents will be solicited to contribute to the following components will the condensed/adapted to utilize in creating questions for parents of the adolescents with SCD, as well as, for interviewing and/or surveying adolescents with the disease.

Areas adolescents with SCD most need help

Obtaining accurate information about SCD

Considerations for coping with everyday challenges

Getting/giving help

Sharing strength; stories; suggestions with others

Supporting, as well as accepting support

How to best deal with family conflicts

How to cope when one feels he/she cannot

Learning to live, while living and learning

Simple strategies to solve complex problems

Securing spiritual strength

Surviving hospital stays

Having fallen even when it…...

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References

http://www.questiaschool.com/PM.qst?a=o&d=27269466

Bailey, E.J. (2000). Medical Anthropology and African-American Health. Westport, CT: Bergin & Garvey. Retrieved September 7, 2007, from Questia database:  http://www.questia.com/PM.qst?a=o&d=27269543 

Burlew, PhD, Kathleen, Telfair, DrPh, MSW, Joseph, Colangelo, MA, Linda, Wright, Ph., Elizabeth C.. "Factors That Influence Adolescent Adaptation to Sickle-cell Disease." Journal of Pediatric Psychology, Vol. 25, No. 5, 2000, PP. 287-299.

Gil, Karen M., Williams, David a., Thompson, Jr., Robert J., and. Kinney Thomas R. "Sickle Cell Disease in Children and Adolescents: The Relation of Child and Parent Pain Coping Strategies to Adjustment." Journal of Pediatric Psychology, Vol. 16. No. 5, 1991, pp. 643-663.

Implications for ongoing research into genetic therapies and side effects/later developments are discussed at length.
Yannaki, E. & Stamatoyannopoulos, G. (2010). Hematopoietic stem cell mobilization strategies for gene therapy of beta thalassemia and sickle cell disease. Annals of the New York Academy of Sciences 1202: 59-63.

Though the clinical trial these two researchers are involved in does not yet have results that are ready for publication, the review of the risks they provide regarding the use of stem cell mobilization with G-CSF in patients with sickle cell is highly useful information. So, too, is the practice of pre-treating patients with hydroxyurea before administering the stem cell treatment, which the authors describe in detail and which forms the basis of the related clinical trial. Potential reduction of risks appears to be quite promising, though final results from the clinical trial and other supporting evidence will of course be required.

Ye, L., Chang, J.,…...

Stem Cells
ithout a doubt, one of the most controversial topics of popular discourse is stem cell research. Indeed, one would be hard pressed to peruse the newspaper or magazine stand without encountering some reference to the global stem cell debate -- but what, exactly, are stem cells, and why are they so controversial?

Stem cells intended for use in human applications are harvested from humans, umbilical cords and embryos. The reason these cells are so valuable is because of their capability to produce or "become" other cell types -- for example, brain cells, heart cells, skin, etc. In short, these are "master cells," holding the ability to divide in cultures, and to be manipulated allowing it to transform into any type of cell. Of course, this is extremely important due to the fact that scientists can use this capability to either create organs (thereby helping to meet the tremendous shortage of…...

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Works Cited

Hall, MiMi and Kiely, Kathy. "Proponents of Stem-Cell Research Put on Pressure." USA Today. Online. July 2001. 10 April 2002. Retrieved from Web site on 15 March, 2004

Unfortunately, a tremendous amount of valuable research has been put on hold ever since the ban of federal funding for stem cell research. In the United States, the vast majority of medical research of all types that eventually lead to cures for disease are funded by the federal government. The federal ban on stem cell research does not completely prohibit it, but the effect is nearly the same, just as it would be if the federal government withdrew funding for cancer or diabetes research.

The main opposition to stem cell research comes from the Religious Right who believe that any form of research using fetal stem cells is wrong, because according to their religious views, every fertilized human egg should be considered as much a human being as any living person, even a microscopic zygote consisting of nothing more than four cells of human tissue. Certainly, the concept of religious freedom…...

Hydroxyurea
Segal, J.B., et al., (2008), Hydroxyurea for the Treatment of Sickle Cell Disease,

Baltimore, MD: AHRQ

Variables/Key Concepts

To determine efficacy, effectiveness, harms, and barriers of the use of hydroxyurea treatment of sickle cell disease for determining solutions and further research need.

Sampling

Research studies based on variables.

Conducted by experts in sickle cell disease management, clinical trial methodology, systematic review, epidemiological studies, and ethics and adherence research.

Instruments/Data Collection

Instruments were quality assessment, data extraction, and evidence grading. Literature inclusion tailored toward research questions. Studies on children and adults evaluated separately. Included randomized trials, non-randomized trials, cohort studies with control groups, and pre/post studies. Evaluations of data was based on variable-based research questions.

Results

Hydroxyurea lowered the rate of hospitizations among children with sickle cell disease and raised HbF cell percentages.

Strengths/Limitations

Limited evidence for toxicity, barriers, and guide dosing. Insufficient evidence for efficacy and safety.

Critique

Even with the use of experts, there was no appropriate design method mentioned. Identifies research…...

Alterations of Hematology and Cardiovascular Systems
Sickle Cell Anemia

Ms. A is suffering from Sickle cell anemia. In this disease, the red blood cells appear in the shape of sickles or letter C. The normal red blood cells are disk-shaped. The disk-shape allows them to move smoothly in the blood vessels. Normal red blood cells have hemoglobin. The hemoglobin is responsible the red color. It helps in the transportation of oxygen. Sickle cells, on the other hand, have abnormally low hemoglobin, which results in the C-shape. This form is sticky and stiff and so cannot move easily through the blood vessels. Ms. A's condition was a case of Menorrhagia as well as dysmenorrhea. The sickle cells lump together and block the flow of blood through the blood vessels leading to the organs and the limbs. Such blocked blood vessels may lead to pain, infections and even organ damage (Health 24, 2014).

Sickle cell…...

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Bibliography

Health24. (2014, APRIL 30). The seven types of anaemia. Retrieved from Health24.com:  http://www.health24.com/Lifestyle/Your-Blood/Anaemia-20130216-2 

UoM. (n.d.). Sickle cell disease. Retrieved from University of maryland:  https://umm.edu/health/medical/reports/articles/sickle-cell-disease

Pathophysiology
What's Gone Wrong?

CVI is generally an indication of blood stasis or venous reflux, most commonly valvular incompetence in the low-pressure superficial venous system. The inability of blood to return to the heart from the legs causes it to pool and clot. CVI generally occurs within the deep veins (Deep Vein Thrombosis), may also be related to varicose twisting, valve malformations or pelvic tumors.

isk Factors

Obesity, inactivity, pregnancy, smoking and extended periods of standing or sitting tend to be the activity factors of most importance. Women often present varicose veins; men DVT but this may be associated with delayed reporting. Type II Diabetes may also suggest different gender propensities. People over 50 predominately display indicators.

Etiology

CVI results from damage caused to the veins, though clotting itself can precipitate vascular dilation. Varicose veins are often hereditary as may be valve defections which can result in venous reflux. Other venous pathologies are associated with transient…...

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REFERENCES

Collins, L.M. (2012). Taking blood pressure in both arms may find silent heart disease. Viewable:  http://www.deseretnews.com/article/700220373/Taking-blood-pressue-in-both-arms-may-find-silent-heart-disease.html 

Weiss, R. (2012). Venus Insufficiency. Medscape Reference. Viewable at  http://emedicine.medscape.com/article/1085412-overview .

CVI

CV You

student, degree Health Adminstration. I worked a health care staffing supervisor 10 years. personal experience incorporated paper fact husband sickle cell anemia I cared 20 years.
I have always been drawn to helping people, both in my life and in my career pursuits. In planning the next phase of my life, I wanted to follow a path which would allow me to better the lives of others while also learning new things every day. I have come to realize that nursing is the profession that suits me best because of my interests, my experience, and my goals.

A degree in nursing would be the second degree that I have pursued. My first degree was in Health Administration. I chose to study that field because I knew that I wanted to work in a health care setting, where my actions would be at least indirectly responsible for aiding in the well-being of…...

I. Introduction
A. Definition of gene editing and its potential applications in medicine
B. Ethical considerations and potential risks

II. Techniques for Gene Editing
A. CRISPR-Cas9 system
B. Other gene editing technologies (e.g., TALENs, ZFNs)
C. Comparison of different techniques

III. Applications of Gene Editing in Medicine
A. Treatment of genetic diseases (e.g., sickle cell anemia, cystic fibrosis)
B. Cancer therapy (e.g., CAR T-cell therapy)
C. Regenerative medicine (e.g., tissue engineering, organ transplantation)

IV. Ethical and Societal Implications of Gene Editing
A. Off-target effects and unintended consequences
B. Long-term health risks and the need for monitoring
C. Concerns about genetic enhancement and the....

Innovative Medical Treatments and Technologies Pioneered by the Cleveland Clinic

The Cleveland Clinic, a world-renowned academic medical center, has a long-standing history of innovation and pioneering cutting-edge medical treatments and technologies. With its commitment to research and development, the Clinic continues to push the boundaries of healthcare, offering patients access to the latest advancements in medicine. Here are some of the innovative treatments and technologies currently being pioneered by the Cleveland Clinic:

1. Robotic Surgery:

The Cleveland Clinic is a leader in robotic surgery, using advanced robotic systems to perform complex procedures with greater precision, accuracy, and minimally invasive techniques. The da Vinci....