Journal of clinical medicine research最新文献

{"title":"Addition of Sacubitril/Valsartan to Mineralocorticoid Receptor Antagonist Therapy in Primary Aldosteronism: Effects on Plasma Aldosterone Concentration and Plasma Renin Activity.","authors":"Keisuke Okamura, Masatoshi Matsushima, Yosuke Takamiya, Tetsu Okuda, Hideto Sako, Akihiro Udo, Kenichiro Taniguchi, Shogo Morisaki, Ichiro Imamura, Hidenori Urata, Shin-Ichiro Miura","doi":"10.14740/jocmr6058","DOIUrl":"10.14740/jocmr6058","url":null,"abstract":"<p><p>In the pharmacologic treatment of primary aldosteronism (PA), titration of mineralocorticoid receptor antagonist (MRA) dosing is necessary to reverse the renin suppression caused by high aldosterone levels. However, we often encounter cases in which the plasma renin activity (PRA) does not achieve the target level, even with the maximum dose of MRA. In this setting, sacubitril/valsartan, a combination of a neprilysin inhibitor and an angiotensin II type 1 receptor blocker that is approved for use as adjunctive therapy with an MRA, has been reported to inhibit aldosterone secretion both <i>in vitro</i> and <i>in vivo</i>. If sacubitril/valsartan proves to be effective in this context, it may offer a promising treatment for PA. However, there are few reports on the use of sacubitril/valsartan in this disease. We used add-on sacubitril/valsartan in three patients with PA, in whom blood pressure was insufficiently reduced and PRA remained suppressed despite administering the maximum dose of MRA. With the addition of sacubitril/valsartan, the decrease in plasma aldosterone concentration (PAC) was more marked than the increase in PRA. Because MRAs do not suppress aldosterone production but instead act by blocking mineralocorticoid receptors, use of these agents actually promotes the renin-angiotensin system and leads to increased PAC resulting from positive feedback. The pathological significance of the phenomenon whereby PAC increases with MRA administration but decreases with the addition of sacubitril/valsartan is unclear. In PA, more effective treatment may be possible by suppressing aldosterone with sacubitril/valsartan and blocking the action of aldosterone with MRAs.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 10","pages":"509-517"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of Serum Calcium, 25-Hydroxy Vitamin D, Ferritin, and Uric Acid Levels on Colorectal Cancer Risk.","authors":"Abdulbari Bener, Ahmet Emin Ozturk, Unsal Veli Ustundag, Cem Cahit Barisik, Ahmet F Agan, Andrew S Day","doi":"10.14740/jocmr5296","DOIUrl":"10.14740/jocmr5296","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to investigate whether vitamin D, calcium, ferritin, and uric acids play a beneficial biomarker role in the prevention of colorectal cancer (CRC) risk.</p><p><strong>Methods: </strong>The case-control design was employed, including 650 CRC cases and 650 controls aged 35 to 70 years, comprising both men and women. The study encompasses sociodemographic data, clinical information, radiological diagnoses, and biochemical measurements.</p><p><strong>Results: </strong>Statistically significant differences were observed between CRC and controls in terms of age, diagnostic radiology, tomography, positron emission tomography/computed tomography (PET/CT), colonoscopy, CRC awareness, risk factors, age, genetics, exposure to chemicals, inadequate nutrition, smoking, hookah and alcohol use. Significant differences were also identified in intestinal inflammations, obesity, processed foods (P < 0.001), abdominal pain and cramps, diarrhea, constipation, blood in stool, bloating (gas), irritable bowel, nausea/vomiting, anemia, stress, fatigue, weakness, and weight loss. Regarding biochemical parameters, statistically significant differences were found between CRC and controls in terms of hemoglobin, glycated hemoglobin (HbA1c), fasting blood glucose (FBG), vitamin D, neutrophil level, red blood cell (RBC), white blood cell (WBC), platelet level, platelet count, hematocrit, potassium, sodium (Na), calcium, creatinine, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), bilirubin, uric acid, iron (Fe), ferritin, C-reactive protein (CRP), total protein, systolic blood pressure (SBP), and diastolic blood pressure (DBP) parameters (P < 0.001). Multivariate stepwise regression analysis was performed to find the best risk factors for the diagnosis of CRC as the dependent variable. As a result of the analysis, intestinal inflammation (P < 0.001), nausea/vomiting (P < 0.001), stomach pain (P = 0.003), hookah-smoking (P = 0.034), uric acid (P < 0.001), bilirubin (P < 0.001), cigarette smoke exposure (P = 0.033), processed food consumption (P = 0.002), calcium levels (P = 0.029), vitamin D deficiency (P < 0.001), and ferritin (P < 0.001) levels were identified as significant determinants for CRC.</p><p><strong>Conclusions: </strong>The current study demonstrated that vitamin D, calcium, ferritin, and uric acids play a beneficial biomarker role in reducing the risk of CRC prevention. The increase in CRC rates may be associated with lifestyle, environmental and hereditary factors, nutrition, alcohol consumption, hookah use, and cigarette smoking.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 10","pages":"483-490"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Specific Approach to Arterial Stiffness Prediction in Apparently Healthy Patients.","authors":"Anna Bragina, Yulia Rodionova, Natalia Druzhinina, Timur Gamilov, Ekaterina Udalova, Artem Rogov, Lubov Vasileva, Rustam Shikhmagomedov, Oksana Avdeenko, Anna Kazadaeva, Kirill Novikov, Valeriy Podzolkov","doi":"10.14740/jocmr5271","DOIUrl":"https://doi.org/10.14740/jocmr5271","url":null,"abstract":"<p><strong>Background: </strong>The high prevalence of traditional cardiovascular risk factors among the patients without cardiovascular disease (CVD) allows us to predict an increase in cardiovascular morbidity rate in the future. Arterial stiffness is one of the most important predictors and pathogenetic mechanisms of CVD development. The aim of our study was to evaluate the predictive differences of age-related and age-independent (universal) cardio-ankle vascular index (CAVI) reference values for detecting increased arterial stiffness in individuals without CVD.</p><p><strong>Methods: </strong>The study included 600 patients (43% men and 57% women, mean age 36.0 ± 18.3 years). All the patients underwent anthropometric measurements with obesity markers evaluation, assessment of arterial stiffness by sphygmomanometry. To create predictive models, we used universal and age-related CAVI thresholds: ≥ 9.0 (CAVI^{≥ 9}) and CAVI^Age according to the \"Consensus of Russian experts on the evaluation of arterial stiffness in clinical practice\".</p><p><strong>Results: </strong>In the < 50 years group, both the CAVI^Age and CAVI^{≥ 9} models were significant (CAVI^Age: b = 4.8, standard error b (st.err.b) = 0.27, P < 0.001; CAVI^{≥ 9}: b = 3.2, st.err.b = 1.6, P < 0.001). The CAVI^Age model demonstrated high sensitivity and specificity (> 70%) compared to the CAVI^{≥ 9} model (sensitivity 62%, specificity 58%). In the receiver operating characteristic (ROC) curve analysis, the CAVI^Age model had a significantly higher area under the ROC curve (AUC) = 0.802 than the CAVI^{≥ 9} model: AUC = 0.674. In the ≥ 50 years group, both models were significant: CAVI^Age (b = 2.6, st.err.b = 1.13, P < 0.001) and CAVI^{≥ 9} (b = 5.3, st.err.b = 0.94, P < 0.001). Both models demonstrated high sensitivity and specificity (> 70%). When ROC curves were analyzed for the CAVI^Age model, the AUC value of 0.675 was significantly lower when compared to the CAVI^{≥ 9} model (AUC = 0.787, P = 0.031).</p><p><strong>Conclusions: </strong>In the < 50 years group, the model based on age-specific CAVI thresholds has the higher predictive value, sensitivity, and specificity for identifying individuals with increased arterial stiffness. In contrast, in the ≥ 50 years group, a predictive model using a universal threshold value of CAVI^{≥ 9} has advantages.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 9","pages":"423-435"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tamsulosin and Dutasteride Combination Therapy for Asian Men With Moderate-to-Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Systematic Review of Clinical Considerations That Influence the Prescription.","authors":"Fan Yang, Rahab Hashim, Julia Philippou","doi":"10.14740/jocmr5255","DOIUrl":"https://doi.org/10.14740/jocmr5255","url":null,"abstract":"<p><p>The goal of combination therapy for moderate-to-severe lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH) is to ease both the dynamic and static symptoms by using agents that have complementary mechanisms of action. Similar to prescribing other drugs, LUTS/BPH combination therapy has been affected by multiple factors. Previous qualitative research discussed the individual perspectives that influenced combination therapy administration. Yet, until recently, there has been limited interest in clinical reasons that physicians have to consider before prescribing LUTS/BPH combination treatment. This systematic review aimed to identify the clinical considerations that influence the decision to prescribe combination therapy of tamsulosin 0.4 mg + dutasteride 0.5 mg for Asian men with LUTS/BPH. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was performed in databases Medline, CINAHL, the Cochrane Library, and Embase from inception until January 2024 using Medical Subject Headings (MeSH) terms and keywords with truncation for alternative acronyms. A citation search was performed to gather works of literature on LUTS/BPH combination treatment in addition to the \"PICO\" framework for search terms. Five English-language primary randomized controlled trials (RCTs) were included in the narrative analysis using the Critical Appraisal Skills Program (CASP) checklist after critical appraisal. Several dosages of tamsulosin (0.2 mg and 0.4 mg) have been administered in LUTS/BPH combination treatment over the last few decades despite 0.2 mg tamsulosin being standardized as an effective regime in Asian countries. A remarkable correlation between prostate volume (PV) and prostate-specific antigen (PSA) was found in Asian men, which requires higher PSA secretion to enlarge each prostate unit and causes an increased risk of moderate-to-severe LUTS. Additionally, BPH baseline variables may lead to a different response to combination therapy, especially the PV and PSA differences. In conclusion, compared with Caucasian men, a significantly higher risk of moderate-to-severe LUTS was found in Asian men. Initiation of combination therapy, especially dutasteride, depends on a larger PV (≥ 30 mL); it is possible, therefore, that earlier PV and PSA examinations and baseline variables assessments ought to be performed by physicians before the combination therapy prescription. Alternative treatment options may be considered for a patient who prefers an active pattern of sexual activity during their BPH combined pharmacotherapy. These clinical considerations may influence the prescription of tamsulosin 0.4 mg + dutasteride 0.5 mg combination therapy for Asian men with moderate-to-severe LUTS/BPH. This study was registered on PROSPERO (CRD42024575528).</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 9","pages":"385-397"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological Stimulus for the Synthesis of Basement Membrane Proteins Leading to Its Reconstruction.","authors":"Jose Maria Pereira de Godoy, Maria de Fatima Guerreiro Godoy, Ana Carolina Pereira de Godoy, Dalisio Santi Neto","doi":"10.14740/jocmr5266","DOIUrl":"https://doi.org/10.14740/jocmr5266","url":null,"abstract":"<p><p>The aim of the present study was to report the remodeling of the basement membrane through physiological stimulus during the treatment of fibrosis in a lower limb with lymphedema. A clinical trial was conducted involving the evaluation of the basement membrane in skin biopsies before and after treatment for clinical stage II lower limb lymphedema using the Godoy method for the reversal of lymphedema and skin fibrosis. The samples were stained with Gomori's reticulin stain and evaluated using Weibel's multipoint morphometric method at the Godoy Clinic. Prior to treatment for lymphedema, rupture and important discontinuity of the basement membrane was found. After treatment, structural continuity and thickness had returned to the regions of previous rupture. The difference was statistically significant (P < 0.05, paired <i>t</i>-test). The present study reports that physiological stimuli targeting the lymphatic system led to the clinical reversal of fibrosis, as well as stimulate the synthesis of extracellular matrix proteins and the reconstruction of the basal lamina of the skin.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 9","pages":"436-439"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Autopsy Case of Renal-Limited Granulomatosis With Polyangiitis Presenting With Acute Renal Failure and Initial Delirium.","authors":"Syuichi Tetsuka, Tomohiro Suzuki, Tomoko Ogawa, Yoh Dobashi, Ritsuo Hashimoto","doi":"10.14740/jocmr5273","DOIUrl":"https://doi.org/10.14740/jocmr5273","url":null,"abstract":"<p><p>Granulomatosis with polyangiitis (GPA) has three clinicopathological features, namely, necrotizing granulomatosis of the upper respiratory tract and lungs, focal segmental necrotizing glomerulonephritis of the kidney, and necrotizing vasculitis of small vessels throughout the body. A 92-year-old man with clinically diagnosed probable Alzheimer's disease (AD) exhibited subacute deterioration in cognitive function. On admission, he was diagnosed with acute renal failure with an elevated creatinine level (5.48 mg/dL) as well as severe disturbance of consciousness. Antineutrophil cytoplasmic antibodies (ANCAs) directed against proteinase 3 (PR3-ANCA) were highly positive with ≥ 350 U/mL. The patient was diagnosed with GPA and was managed with steroid pulse therapy. However, he died without any improvement in renal function. As a result of the autopsy, the patient was diagnosed with definite AD, and his impaired consciousness was found not to be caused by central nervous system involvement due to GPA. As necrotizing crescentic glomerulonephritis was observed, the cause of the acute progressive renal failure was found to be PR3-ANCA-positive GPA. The autopsy revealed no GPA-related lesions in other parts of the body aside from the kidneys. It is rare to encounter cases of PR3-ANCA-positive GPA with renal-limited vasculitis and acute renal failure as the initial manifestation, as in the present case. Making an accurate clinical diagnosis of older patients suffering from various diseases in multiple organs is challenging. Although autopsy has the limitation of a terminal image, it is extremely useful in elucidating the pathophysiology of the older patient in this case.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 9","pages":"440-448"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Use of MicroRNA Technology in Thalassemia Therapy.","authors":"Lantip Rujito, Tirta Wardana, Wahyu Siswandari, Ita Margaretha Nainggolan, Teguh Haryo Sasongko","doi":"10.14740/jocmr5245","DOIUrl":"https://doi.org/10.14740/jocmr5245","url":null,"abstract":"<p><p>Thalassemia encompasses a group of inherited hemoglobin disorders characterized by reduced or absent production of the α- or β-globin chains, leading to anemia and other complications. Current management relies on lifelong blood transfusions and iron chelation, which is burdensome for patients. This review summarizes the emerging therapeutic potential of modulating microRNAs (miRNAs) to treat thalassemia. MiRNAs are small non-coding RNAs that regulate gene expression through sequence-specific binding to messenger RNAs (mRNAs). While they commonly repress gene expression by binding to the 3' untranslated regions (UTRs) of target mRNAs, miRNAs can also interact with 5'UTRs and gene promoters to activate gene expression. Many miRNAs are now recognized as critical regulators of erythropoiesis and are abnormally expressed in β-thalassemia. Therapeutically restoring levels of deficient miRNAs or inhibiting overexpression through miRNA mimics or inhibitors (antagomir), respectively, has shown preclinical efficacy in ameliorating thalassemic phenotypes. The miR-144/451 cluster is especially compelling for targeted upregulation to reactivate fetal hemoglobin synthesis. Advances in delivery systems are addressing previous challenges in stability and targeting of miRNA-based drugs. While still early, gene therapy studies suggest combinatorial approaches with miRNA modulation may provide synergistic benefits. Several key considerations remain including enhancing delivery, minimizing off-target effects, and demonstrating long-term safety and efficacy. While no miRNA therapies have yet progressed to clinical testing for thalassemia specifically, important lessons are being learned through clinical trials for other diseases and conditions, such as cancer, cardiovascular diseases, and viral. If limitations can be overcome through multi-disciplinary collaboration, miRNAs hold great promise to expand and transform treatment options for thalassemia in the future by precisely targeting pathogenic molecular networks. Ongoing innovations, such as advancements in miRNA delivery systems, improved targeting mechanisms, and enhanced understanding of miRNA biology, continue to drive progress in this emerging field towards realizing the clinical potential of miRNA-based medicines for thalassemia patients.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 9","pages":"411-422"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sodium-Glucose Cotransporter 2 Inhibitors on Cardiovascular and Renal Outcomes in Heart Failure Patients With Type 2 Diabetes: A Literature Review.","authors":"Jordan Llerena-Velastegui, Melisa Santamaria-Lasso, Melany Mejia-Mora, Andrea Granda-Munoz, Martin Trujillo-Delgado, Claudia Hurtado-Alzate, Ana Clara Fonseca Souza de Jesus, Pedro Moraes Coelho, Jurgen Baldelomar-Ortiz","doi":"10.14740/jocmr5230","DOIUrl":"https://doi.org/10.14740/jocmr5230","url":null,"abstract":"<p><p>The management of heart failure (HF) in patients with type 2 diabetes has significantly evolved with the introduction of sodium-glucose cotransporter 2 (SGLT2) inhibitors. This article aims to consolidate existing knowledge on the efficacy of these inhibitors in managing HF in this patient population. Major medical databases, including PubMed, Scopus, and Web of Science, were reviewed, prioritizing research from the last decade. The results of this review highlight the mechanisms of action of SGLT2 inhibitors, their clinical benefits, challenges in patient management, and outcomes associated with their use. These medications were found to not only improve glycemic control but also offer significant cardiovascular and renal benefits, reducing cardiovascular mortality and major adverse cardiovascular events. However, challenges and knowledge gaps persist, particularly regarding long-term effects and safety in diverse populations. The conclusions of this review underscore the importance of updating clinical guidelines to incorporate these findings and propose the need for future research to address existing gaps and optimize the use of SGLT2 inhibitors in clinical practice.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 9","pages":"398-410"},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11426172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital Spinal Muscle Mass Is Unlikely to Be a Predictor of COVID-19 Mortality.","authors":"Josef Finsterer","doi":"10.14740/jocmr5152","DOIUrl":"10.14740/jocmr5152","url":null,"abstract":"","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 7-8","pages":"381-383"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Autologous Blood Donation for Rh-Negative Pregnant Women Undergoing Cesarean Sections.","authors":"Siriwan Wannoon, Parinya Saringkanan, Rachasak Boonhok, Nateelak Kooltheat, Nurdina Charong","doi":"10.14740/jocmr5227","DOIUrl":"10.14740/jocmr5227","url":null,"abstract":"<p><strong>Background: </strong>Cesarean sections (C-section) often require blood transfusions in cases of severe bleeding, particularly challenging in Rh-negative pregnancies due to the scarcity of Rh-negative donors, with only approximately 0.3% of the population in Thailand. Autologous blood donation, where individuals donate their own blood before surgery, offers a promising solution. Our study focused on preparing preoperative autologous blood donations (PAD) for Rh-negative pregnancies.</p><p><strong>Methods: </strong>We conducted blood screening on 7,182 pregnancies at Takuapa Hospital from October 2013 to September 2018, identifying 21 Rh-negative pregnant women. We established criteria based on hemoglobin (Hb) levels, which are crucial for autologous blood preparation (Hb at 11.0 g/dL, and hematocrit (Hct) above 33%). Blood samples were collected twice during pregnancy, at 36 and 37 weeks, with the second collection 1 week before the C-section. Pregnancies testing positive for infectious markers were excluded following standard blood donation guidelines. Twelve pregnant women testing negative for infectious markers were enrolled.</p><p><strong>Results: </strong>The demographic data showed 12 subjects aged 17 to 41 years, with an average of 27.83. Initial blood tests indicated Hb and Hct levels of 12.5 g/dL, and 36.4%, slightly decreasing to 12.2 g/dL and 35.8% in the second collection. On the day of the cesarean, levels further declined to 11.6 g/dL and 34.4%, respectively, within normal ranges. At discharge, the Hct measured 34.8%. Maternal and infant health post-C-section were good, with baby weights ranging from 2,640 to 4,080 g. None of the 12 cases required autologous blood transfusion, validating the safety of standard autologous blood preparation practices.</p><p><strong>Conclusions: </strong>This study highlights the safety of autologous blood donation for pregnant women with rare blood types, which was achieved through effective planning and collaboration among hospital departments. These findings can serve as a model for other hospitals and significantly reduce the burden of searching for Rh-negative donors.</p>","PeriodicalId":94329,"journal":{"name":"Journal of clinical medicine research","volume":"16 7-8","pages":"335-344"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}