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Piracetam for reducing the incidence of painful sickle cell disease crises

Sickle cell disease is one of the most common genetic disorders and affects about 250 million people (5% of the world's population). It is characterised by sickle‐shaped red blood cells which may block blood vessels. This can lead to pain and damage to the major organs such as the brain, liver and spleen. Standard care is mainly supportive and in response to symptoms. Pain is controlled with drugs for pain relief and fluids to improve fluid levels. In vitro studies with piracetam have shown that it hinders the bonding of sickle haemoglobin and the bunching together of platelets. It also makes the blood less sticky and red blood cells more flexible. The authors of the review identified three trials, two of which had a cross‐over design. The quality of the trials was poor. There were wide differences in the people taking part, the drug dose and the outcomes measured. Three trials are included. They provide some weak and unreliable evidence that piracetam prevents painful sickle cell crises. This lack of reliable evidence illustrates some of the doubt and lack of support for the routine use of this treatment for reducing the incidence of painful sickle cell disease crises. The review authors conclude that future research should aim to provide evidence for people to make informed decisions about whether piracetam is of use. Further randomised controlled trials should be well‐designed and reported according to the 'Consolidated Standards of Reporting Trials (CONSORT)' statement.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Blood transfusions for people with sickle cell disease before they undergo surgery

Once they have given up their oxygen, red blood cells in people with sickle cell disease become shaped like crescents. These cells can block blood vessels, which causes problems throughout the body. People with sickle cell disease often need surgery, but this can increase the number of sickle‐shaped cells in the blood. Blood transfusions before an operation can help dilute the sickled red blood cells and increase the level of oxygen in the blood. This reduces the risk of blood vessels becoming blocked causing further damage. Blood transfusions can be full or partial. They can be linked to adverse events such as the development of antibodies to foreign red blood cells, iron overload, infection rates after surgery and length of stay in hospital. Two studies with 920 people are included in the review. One study compared full transfusion to partial transfusion. This showed no difference between the two treatments in preventing complications immediately after surgery, but partial transfusion was linked to fewer adverse events. The second study compared transfusion to standard care and did not show an advantage in transfusion. Both studies reported a range of complications related to transfusion. However, many details of study design were not recorded in the published papers and statistical analysis indicated a lack of certainty in the findings. There is not enough evidence to recommend blood transfusions before surgery for people with sickle cell disease as standard practice. A large study should look at the best use of this treatment and consider different risk groups.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Disclosing to parents newborn carrier status identified by routine blood spot screening

No guidance is available on the best approach to disclosing to parents newborn carrier status inadvertently identified by routine newborn blood spot screening.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Psychological therapies for the management of chronic and recurrent pain in children and adolescents

Psychological therapies (e.g. relaxation, hypnosis, coping skills training, biofeedback, and cognitive behavioural therapy) may help people manage pain and its disabling consequences. Therapies can be delivered face‐to‐face by a therapist, via the Internet, by telephone call, or by computer programme. This review focuses on treatments that are delivered face‐to‐face by a therapist. For children and adolescents there is evidence that both relaxation and cognitive behavioural therapy (treatment that helps people test and revise their thoughts and actions) are effective in reducing the intensity of pain in chronic headache, recurrent abdominal pain, fibromyalgia, and sickle cell disease immediately after treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Medical Encyclopedia

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    Sickle cell anemia is an inherited blood disease.
  • Blood and Marrow Stem Cell Transplant
    A blood and marrow stem cell transplant replaces a person's abnormal stem cells with healthy ones from another person (a donor).
  • Hemolytic Anemia
    Hemolytic anemia (HEE-moh-lit-ick uh-NEE-me-uh) is a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is up.
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Systematic Reviews in PubMed

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