Interventions for preventing silent cerebral infarcts in people with sickle cell disease

Lise J Estcourt1, Patricia M Fortin2, Sally Hopewell3

  • 1Haematology/Transfusion Medicine, NHS Blood and Transplant, Oxford, UK.

Insights

This review assesses treatments like red blood transfusions, hydroxyurea, and hematopoietic stem cell transplant (HSCT) for preventing sickle cell disease (SCD)-related spinal cord injury (SCI). It aims to determine the most effective interventions for this serious complication.

Area of Science:

  • Hematology
  • Neurology
  • Clinical Medicine

Background:

  • Sickle cell disease (SCD) is a genetic blood disorder associated with severe complications.
  • Spinal cord injury (SCI) is a debilitating consequence that can occur in individuals with SCD.
  • Current treatment strategies for preventing SCI in SCD require further evaluation.

Purpose of the Study:

  • To evaluate the efficacy of red blood transfusions in preventing SCI in SCD patients.
  • To assess the effectiveness of hydroxyurea, alone or in combination, for SCI prevention in SCD.
  • To determine the role of hematopoietic stem cell transplant (HSCT) in reducing or preventing SCI in SCD.

Main Methods:

  • This is a protocol for a systematic review.
  • The review will synthesize evidence on interventions for SCI prevention in SCD.
  • Data will be collected on red blood transfusions, hydroxyurea, and HSCT.

Main Results:

  • Results are pending completion of the systematic review.
  • The review will compare the effectiveness of different treatment modalities.
  • Evidence on the reduction or prevention of SCI will be analyzed.

Conclusions:

  • Conclusions will be drawn based on the synthesized evidence from the review.
  • The findings will inform clinical practice regarding SCI prevention in SCD.
  • Recommendations for future research and treatment guidelines will be provided.

Related Concept Videos

Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
784
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
356
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
457
Ischemic Heart Disease: Overview01:17

Ischemic Heart Disease: Overview

Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
3.7K
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
352
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
368