The painful crises of sickle cell disease - is Jamaican experience relevant?
In. United Medical and Dental Schools of Guy's & St. Thomas' Hospitals; King's College School of Medicine & Dentistry of King's College, London; University of the West Indies. Center for Caribbean Medicine. Research day and poster display. s.l, s.n, Jun. 30, 1997. p.1.
Non-conventional
in En
| MedCarib
| ID: med-832
Responsible library:
JM3.1
Localization: JM3.1; R855.5.C72C46 1997
ABSTRACT
Bone marrow necrosis, is the most common cause of the painful crises in the sickle cell disease, is a recurrent cause of morbidity. In Jamaica, these events increase in incidence in late teenage, are most common in young adults and decrease progressively in frequency and severity after the age of 30 years. Precipitating events include cold exposure, exertion, infections, and stress but skin cooling is the commonest factor in Jamaica. Risk factors include pregnancy, especially the last trimester and immediate post partum period and a high haemoglobin level. The MRC Laboratories [Jamaica] undertakes the management of over 5000 patients islandwide and treats 4-12 painful crises daily. Crises admitted to the day care centre are deemed of sufficient severity to require narcotic analgesia and patients are given rehydration and their response to analgesia monitored during the day. After assessment at 4pm. they are given the option of hospital admission or discharge home with similar analgesia in oral form. Over 90 percent elect to return home. It is estimated that the South East London Health Authority spent 1.9 million pounds on the inpatient management of the painful crises last year, four times the entire budget of the MRC Laboratories [Jamaica] which supervises the outpatient clinical care and research programmes among a much larger population. It is proposed that the Jamaican model of outpatient care for the painful crises may provide a more acceptable and less socially disruptive therapeutic approach and would free resources which could be used to improve other aspects of patient care in sickle cell disease. Its applicability should be explored in the United Kingdom.[AU]
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Collection:
01-internacional
Database:
MedCarib
Main subject:
Bone Marrow
/
Anemia, Sickle Cell
/
Necrosis
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
Country/Region as subject:
Caribe ingles
/
Jamaica
Language:
En
Year:
1997
Document type:
Non-conventional