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"Bloodless" Neurosurgery Among Jehovah's Witnesses: A Comparison with Matched Concurrent Controls


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Highlights

•Neurosurgical outcomes in patients who refuse blood products are similar to control patients when blood management protocols are followed

•No significant differences in mortality or morbidity were identified

•No significant differences in hospital length of stay or readmission rates were identified

Abstract

Background

Jehovah's Witnesses (JW) are a Christian faith with > 1 million members in the United States who do not accept autologous blood transfusions. The optimal management of these patients undergoing neurosurgical procedures is not well defined. Here, we examined the feasibility and safety of JW undergoing neurosurgery in a blood management program.

Study Design and Methods

Sixty-eight JW patients including 23 males and 45 females (mean age 53 +/- 12 years) who underwent a variety of cranial (n=19) and spinal (n=49) neurosurgical procedures over a 5-year period were identified retrospectively and their hospital charts, anesthetic records and operative reports reviewed. A concurrent cohort of sex - age- and procedure-matched non-JW controls also was identified.

Results

Among JW patients a cell-saving system was used in 27 cases, with blood re-transfused in 13 cases. Lactated Ringers solution was used extensively intra-operatively; albumin was given to 15 patients. The median decrease in Hgb was 2.1 g/dL. One patient had a postoperative Hgb value < 7 g/dL. One patient returned to the operating room to revise a lumbar pedicle screw, and one patient had postoperative seizures. No cardiopulmonary complications, sepsis, pneumonia, or wound infection were observed. When compared to the matched control group, similar outcome results were observed. Blood loss and operative time also were similar in JW patients and controls.

Conclusions

Neurosurgical procedures in Jehovah's Witnesses are feasible, safe, and have similar outcomes to patients willing to accept transfusion when managed within a multidisciplinary blood management program.

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I had neurosurgery.  My Surgeon ask me how certain I was about not taking blood.  I replied that when Noah got off the ark, and the  rainbow covenant was made, we were allowed to eat meat, but must pour the blood out on the ground.  Jewish covenant, not allowed to eat blood. Christian covenant, Acts 15:28,29 "abstain from blood".  Never has any servant of God EVER been allowed to eat blood, or take it into their body.  When people are facing death, that's usually a time when they try to make peace with God.  As I am being operated upon, and things go south, my life is hanging by a thread, why would I want my last act on God's green earth to be thumbing my nose at my creator?

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      The history of blood transfusion dates back to very old civilization but documented research on this topic started after William Harvey discovered in the 16th century that blood flows in the arteries and veins. The blood transfusion often proved fatal. So different transfusions were tried like liquids from cows, goats, human milk as well as beer.
      The first cross-matched blood transfusion was done in the 20th century in Mt. Sinai Hospital in New York. Later advancements led to the Blood Component Therapy in which blood was separated into different components, which has made whole blood transfusion obsolete.
      Progress in the field led to improvements in the safety of blood transfusion with respect to decreasing transmission of blood-borne diseases such as HIV, Hepatitis B, and C etc.
      Who needs it?
      Artificial blood is used in cases which require a blood transfusion.
      The situations include;
      Patients of hemorrhagic shock: a state of decreased perfusion of organs due to the increased amount of bleeding. In case of emergency situations like roadside accidents In situations when blood donation is not accessible or not available such as remote or far-flung areas To meet the high demand for blood transfusion Types of Synthetic blood:
      Perfluorocarbon-based Hemoglobin-based Stem cells
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    • Guest Nicole
      By Guest Nicole
      Legislators ‘need to stopÂ’ working for institutions
      Dave Kohler, of Allentown, was abused by an ordained minister in the Jehovah’s Witnesses in November 1965. He was 9 years old. 
      When Kohler was 17, his abuser told him to never talk about the abuse again. 
      “So I obeyed and kept my mouth shut,” Kohler said. 
      He’s been coming to Harrisburg for about five years to show his support for statute of limitations reform. “Individuals vote them in, and then they work for institutions,” Kohler said of the state legislators. “That needs to stop.”
      If reform is passed that would allow Kohler the opportunity to sue his abuser, Kohler said he knows what he would do with any money he could collect.
      “I will hopefully be able to afford therapy,” he said.

      Dave Kohler, who said he was abused by an ordained minister in the Jehovah's Witnesses in Kutztown and Emmaus, talks about his experience, during the demonstration for statute of limitations reform to the state's childhood sexual abuse laws at the state capitol in Harrisburg on Monday. (Photo: Paul Kuehnel, York Daily Record)

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    • By The Librarian
      New research in the USA shows that Jehovah's Witnesses who refuse blood transfusions recover from heart surgery faster and with fewer complications than those who have transfusions.
      Patients who are Jehovah's Witnesses had better survival rates, shorter hospital stays, fewer additional operations for bleeding and spent fewer days in the intensive care unit than those who received blood trans­fusions during surgery, a study in the Archives of Internal Medicine shows.
      Jehovah's Witnesses undergo extensive blood conservation before surgery, including red blood-cell boosting erythropoietin drugs, iron and B-complex vitamins to guard against anaemia. The practice offered a "unique natural experiment" for scientists to study the short and long-term effects of the blood management strategy and may point to ways to reduce need for transfusions, researchers said.
      The study included 322 Jehovah's Witness patients and 87,453 other patients who underwent heart surgery at the Cleveland Clinic from 1983 to 2011. All Jehovah's Witness patients refused blood transfusions. In the other group, 38,467 did not receive transfusions while 48,986 did.
      The authors wanted to look at the difference between patients who receive blood transfusions during surgery and Jehovah's Witness patients, who undergo strict blood conservation practices before, during and after surgery, Koch said.
      While many patients do not have blood transfusions during and after heart surgery, they also do not undergo the same blood conservation practices that doctors use for Jehovah's Witness patients.
      Jehovah's Witness patients had an 86 per cent chance of survival at five years and a 34 per cent chance of survival 20 years after surgery, compared with 74 per cent at five years and 23 per cent at 20 years for non-Jehovah's Witness patients who had transfusions.

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    • By JOHN BUTLER
      Jehovah has clearly and unambiguously prohibited the use of blood for sustaining human life.  Many times, OT and NT.
      Can I question this point please ?
      Did Jesus ever forbid the use of blood to save a human life ?  Can you show me a scripture where JESUS forbids the use of blood to save a human life ? 
      Let us look at a few points here.
      I think it is true that the Jews / Nation of Israel practised something known as Pikuach Nefesh 
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      This meant life was precious and should be saved even if it meant going against the Law.
      Add to this that Jesus gave an example which in my opinion goes much deeper than the actual words of the scripture.  Matthew 12 v 9 through 12.
      9  After departing from that place, he went into their synagogue, 10  and look! there was a man with a witheredHello guest! Please register or sign in (it's free) to view the hidden content.  hand!Hello guest! Please register or sign in (it's free) to view the hidden content.  So they asked him, “Is it lawful to cure on the Sabbath?” so that they might accuse him.Hello guest! Please register or sign in (it's free) to view the hidden content. 11  He said to them: “If you have one sheep and that sheep falls into a pit on the Sabbath, is there a man among you who will not grab hold of it and lift it out?Hello guest! Please register or sign in (it's free) to view the hidden content. 12  How much more valuable is a man than a sheep! So it is lawful to do a fine thing on the Sabbath.”
      Surely here Jesus is saying that it is right to go against 'the Law' and /or the principles of it, to save a life. 
      And please tell me, from where do those 'blood bits' come from that the GB say the congregants can use ?  I honestly have no idea on that one. 
      However if those 'blood bits' come from blood itself then isn't that actually using blood ?
      My wife hates cherries in cakes, so she picks them out, but she still eats the cake. If a person uses bits out of blood then in my opinion they are still using blood. 
      Over to you guys. 
    • Guest Nicole
      By Guest Nicole
      SCHOHARIE, N.Y. — It was an intersection of two highways, one a steep downhill road, that residents had long warned was notoriously dangerous.
      On Saturday afternoon, their worst fears were realized: A limousine lost control, careening through the intersection and striking an empty car. The crash killed all 18 people in the white limousine and two pedestrians in an accident that left deep tire tracks in the ground and a small upstate New York town reeling.
      “That limo was coming down that hill probably over 60 miles per hour,” said Jessica Kirby, 36, the manager of the Apple Barrel Country Store, where she said customers were hit near the parking lot. “All fatal.”
      “I don’t want to describe the scene,” she added. “It’s not something I want to think about.”
      Read more: https://www.nytimes.com/2018/10/07/nyregion/wedding-limo-crash-schoharie-ny.html
    • Guest Nicole
      By Guest Nicole
      'Biased assumptions'
      While most of the comments on the post in the Facebook page debated the merits of the celebrations and the priorities of the district, some focused on the religious beliefs of those who don't celebrate Halloween.
      Halloween began as the Celtic festival Samhain, where people would light bonfires and wear costumes to frighten ghosts, according to History.com. Due to its roots, the holiday isn't celebrated by certain religions or groups, including Jehovah's Witnesses, some Christians, Orthodox Jews and Muslims.
      "It is the stated strategy of some to use our own laws against us," reads on comment on Facebook. "Wake up people. Nothing is an 'American Tradition' anymore. (And many who move here aren't doing so to become American)."
      Another comment asked "Who is ruining traditions?" The response from a different person, which has since been deleted, read: "Muslims."
      Kucinski said statements such as these are "very hurtful to people who are equally American but may be of a different culture, religion, or hold different beliefs than those who are making these comments."
      "This discussion has emboldened certain voices in our community to make sweeping biased assumptions against groups of people that may or may not be the ones that are holding their kids home from school," she said. "Does it matter what group or groups are keeping their kids home and missing a fun celebration at school? No."
      Littman said it's anyone's right to not celebrate a holiday, though others don't have to follow suit.  
      Read more: 
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    • Guest Nicole
    • Guest
    • Guest Nicole
      By Guest Nicole
      Many of the children described conditions at US Customs and Border Protection facilities, where they were taken and processed during the first days after crossing the border. In the reports they were only identified by their first names. Timofei, 15, from Russia, who sought asylum on the border with his parents for his beliefs as Jehovah's Witnesses, said they were crowded night and day in the closed and crowded room, detained along with other boys. He said there was only one window that opened onto an empty hallway and that they did not have soap in the bathroom, and that only sometimes, they gave him a toothbrush for individual use. He also said that he was offered a shower when he arrived at the facilities in San Ysidro, California, but he did not and the second or third day there did not allow him to do so.
      https://www.clarin.com/mundo/trataron-chicos-separados-padres-frontera-relatan-dias-detenidos-unidos_0_SJh7dyam7.html




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    • folens  »  Esther

      Bonsoir Esther et-ce celui-ci?

      Dieu accepte-_t-_il toutes les religions.docx
      · 0 replies
    • Esther  »  jpl

      Bonsoir Jpl
      Je recherche un discours qui avait pour thème " Dieu approuve t'il toutes les religions ? " C'est pour mon etudiante de la Bible. Si tu l'as écrit ou oral, peu importe, c'est pour qu'elle puisse l'écouter
      Merci beaucoup ! 
      Ta soeur dans la foi
      Esther
      · 2 replies
    • Esther  »  folens

      Bonsoir
      Je recherche un discours qui avait pour thème " Dieu approuve t'il toutes les religions ? " C'est pour mon etudiante de la Bible. Si tu l'as écrit ou oral, peu importe, c'est pour qu'elle puisse l'écouter
      Merci beaucoup ! 
      Ta soeur dans la foi
      Esther
      · 0 replies
    • the Sower of Seed

      Daniel 12:6 Jehovah sends an angel to ask another angel: “How long will it be to the end of these marvelous things?” The other angel "the man clothed in linen" is inspired by Jehovah, raises both hands to Heaven and answers twice! One at verse 7, then verses 11 & 12. Just as the angel raises both hands to Heaven, there are 2 fulfillments, there are 2 beasts, the first dies, but rises again with greater power today. This who Jesus spoke about at Matthew 24: 15 “Therefore, when you catch sight of the disgusting thing that causes desolation, as spoken about by Daniel the prophet, standing in a holy place (let the reader use discernment). 
      Today we can use discernment as we see the dashing to pieces of the “power” of the holy ones in the hindrance of the “public” ministry caused by Covid19. We will see a greater attack on that ministry of Spiritual Israel under the rule of the King of the South as the world turns on religion. 
      Jesus stated that no man knows the day or hour, that was true then, because only Jehovah knew how long He gave Satan to prove his point. Only Jehovah could look into the last days and see when the constant feature would stop, the days are counted from then until the first day people will enjoy true happiness. This is the most important day to live for.
      John 4:23 states "Nevertheless, the hour is coming, and it is now, when the true worshippers will worship the Father with spirit and truth, for indeed, the Father is looking for ones like these to worship him." Why is God having to search for "True Worshippers"? Because the world is almost all "False Worshippers", denied understanding as stated at Daniel 12:10.  It's amazing how He has hidden the truth from minds, religions formed before the last days were formed without all the facts, even though they could read it over and over, because of their heart’s inclination, He has hidden the facts from them. How the primary resurrection will occur on Earth, that the land would be apportioned out to those choosing to live as a subject of the sovereignty of the Almighty God Jehovah. 
      Jehovah longs to talk with His friends of old like Noah, Abraham, David as well as Daniel. Daniel has seen Michael/Jesus stand up and the start of the resurrection which will benefit him, how he will stand up for his lot. verse 13. God has promised them the "Promised Land", a greater land then the small area of Israel, the whole planet will become a blessed restoration of the Edenic starting place. Matthew 19:28 Jesus said to them: “Truly I say to you, in the re-creation, when the Son of man sits down on his glorious throne, you who have followed me will sit on 12 thrones, judging the 12 tribes of Israel. Consider too Acts 3:21 "Heaven must hold this one within itself until the times of restoration of all things of which God spoke through the mouth of his holy prophets of old." The true reward that so many have hoped for now has a starting date!    
      If you have given your life to Jehovah and enjoy a relationship with Him, Read and Meditate on Daniel 12, pray for insight and understanding, for knowledge, wisdom, for faith and integrity for the days ahead!  For whether we live or die, we belong to Jehovah and will enjoy our lot just like Daniel.

      · 1 reply
    • Esther  »  Gilles h

      Bonjour Gilles
      As tu les transcriptions des autres jours de l'Assemblée régionale stp ? Notamment la partie sur la création et les huit exemples de femmes de foi? 
      · 3 replies
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