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October
2023
- Volume 17, Issue 2
Male
gender alone may be a bad prognostic factor in sickle cell
diseases
Mehmet
Rami Helvaci1, Valeria Pappel2, Kubra Piral2,
Selim Ozer2,
Mehpare Camlibel3, Huseyin Sencan1, Ramazan
Davran4, Abdulrazak Abyad5,
Lesley Pocock6
(1) Specialist of Internal Medicine,
MD, Turkey
(2) Manager of Writing and Statistics, Turkey
(3) Specialist of Emergency Medicine, MD, Turkey
(4) Specialist of Radiology, MD, Turkey
(5) Middle-East Academy for Medicine of Aging, MD, Lebanon
(6) edi-WORLD International, Australia
Corresponding author:
Prof Dr Mehmet Rami Helvaci, MD
07400, ALANYA, Turkey
Phone: 00-90-506-4708759
Email: mramihelvaci@hotmail.com
Received: August 2023; Accepted:
September2023; Published: October 2023
Citation: Helvaci MR et al. Male gender alone may be a bad
prognostic factor in sickle cell diseases. Middle East Journal
of Nursing 2023; 17(2): 39-52. DOI: 10.5742/MEJN2023.9378043
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ABSTRACT
Background:
Sickle cell diseases are inborn and destructive processes
on vascular endothelium, particularly at the capillaries.
Methods: All patients were
included.
Results: We studied 222 males
and 212 females with similar ages (30.8 vs 30.3 years, p>0.05,
respectively). Smoking (23.8% vs 6.1%, p<0.001), alcohol
(4.9% vs 0.4%, p<0.001), transfused red blood cells (RBCs)
in their lives (48.1 vs 28.5 units, p=0.000), disseminated
teeth losses (5.4% vs 1.4%, p<0.001), chronic obstructive
pulmonary disease (COPD) (25.2% vs 7.0%, p<0.001), ileus
(7.2% vs 1.4%, p<0.001), cirrhosis (8.1% vs 1.8%, p<0.001),
leg ulcers (19.8% vs 7.0%, p<0.001), clubbing (14.8% vs
6.6%, p<0.001), coronary heart disease (CHD) (18.0% vs
13.2%, p<0.05), chronic renal disease (CRD) (9.9% vs 6.1%,
p<0.05), and stroke (12.1% vs 7.5%, p<0.05) were all
higher, and autosplenectomy (50.4% vs 53.3%, p<0.05) and
mean age of mortality were lower in males (30.2 vs 33.3 years,
p<0.05).
Conclusion: The sickled or
just hardened RBCs-induced capillary endothelial damage initiates
at birth, and terminates with multiorgan failures even at
childhood. Although RBCs suspensions and corticosteroids in
acute, and aspirin with an anti-inflammatory dose plus low-dose
warfarin plus hydroxyurea both in acute and chronic phases
decrease severity, survivals are still shortened in both genders,
dramatically. Transfused units of RBCs in their lives, disseminated
teeth losses, COPD, ileus, cirrhosis, leg ulcers, clubbing,
CHD, CRD, and stroke were all higher, and autosplenectomy
and mean age of mortality were lower in males which can not
be explained by effects of smoking and alcohol alone at these
younger mean ages, relatively.
Key words: Sickle cell diseases,
sickled or just hardened red blood cells, capillary endothelial
edema, myocardial infarction, stroke, sudden deaths, male
gender
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