Case Report: What Does the Research Say?
In this assignment, learners are required to write a case report. The report should demonstrate a depth and breadth of the knowledge and skills gained in the current course and potentially solve an identified real-world practice problem.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
General Requirements:
Use the following information to ensure successful completion of the assignment:
· Use at least two additional scholarly research sources published within the last 5 years. Provide citations and references for all sources used.
· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
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Comprehensive Case Report Sample on Sickle Cell Anaemia-Solution
Sickle Cell Trait (SCT) has always been linked with Exercise Collapse Associated with Sickle Cell Trait (ECAST), exertional collapse, and exercise-related sudden demise in military warfighters and athletes. The causal mechanisms of ECAST give rise to controversy in the sports medicine field. Various anecdotal reports and case presentations hypothesize the function of extraordinary exercise intensity. However, different risk factors such as dehydration, genetic cofactors, dietary supplements, prior exertional rhabdomyolysis, and heat are considered as potential contributors of ECAST (Hardas, 2019). Other studies postulate that some of the mentioned underlying problems combine in a “perfect storm,” thus triggering ECAST with a subsequent potentially lethal “metabolic crisis.” This case report discusses ECAST, demonstrating the breadth and depth of knowledge of this potential illness. It gives a review of SCT as it relates to exercises in athletes and warfighters, identifies postulated and known risk factors connected to ECAST, and introduces the latent mechanical function of the “double hit” as a causal factor of ECAST.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Brief Synthesized Review
People with sickle cell trait have an alteration in one of the binary genes encoding for the hemoglobin molecule that transports oxygen in the red blood cells. The mutation in the gene may result in typically round red blood cells forming a ‘sickle’ or crescent shape during periods of low or insufficient blood oxygen (de Chavez et al., 2020). SCT is different from sickle cell disease, even though both hemoglobin genes are mutated in both cases. Sickled red blood cells can hinder blood vessels, thus causing damage to organs and muscles; nevertheless, SCT leads to very few illness episodes that the sickle cell disease. SCT affects over 300 million individuals worldwide; in America, it is manifested in around 10% of African Americans, 0.2% Caucasians, and O.5% in Hispanics (Moore et al., 2018). People suffering from SCT can regularly fully engage in any athletic pursuit. Although the sickle cell trait hardly affects athletic performance, in certain situations, athletes can suffer adverse impacts such as muscle pain, weakness, and collapse (de Chavez et al., 2020). In case of collapse, it gets referred to as ECAST. It is critical to view ECAST as a cause of the collapse in athletes as the relative risk of mortality is nearly 40 times higher in athletes affected by SCT than those without the trait. Nevertheless, early diagnosis and proper treatment of ECAST reduces complications, thus increasing an individual’s survival.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Description of the case/situation/condition
Five physicians published this case report regarding a 20-year old healthy African-American college student male. The student failed to complete his fitness evaluation due to weakness and severe leg pain seventy yards short of the completion of the 1.5-mile run. Before the run, he had performed situps and pushups without any problems. After the incident, he got assistance, water, and rest, although his symptoms failed to improve. He only complained of severe hamstring and thigh pain, causing difficulty in walking. The student denied any use of ergogenic or nutritional agents, medications, or recent illness. The patient had completed several severe, required military assessments with a lack of apparent issues and regularly trained for the semiannual fitness evaluations that necessitated running 1.5miles with ten and a half minutes and extra situps and pushups in a single minute. He was involved in intermural soccer almost daily. The patient had complained of exertional ‘muscle cramps’ during the two years prior, and his legs were taking a long time for recovery.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
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During the time of the collapse, the patient’s examination reported extreme tenderness to palpation in bilateral hamstrings and quadriceps, and pan on full knee exertion or any beyond 80- flexion. Initial lab results entailed lactate dehydrogenase (LDH) creatine kinase (CK), and blood trace on urinalysis dipstick testing and lack of red blood cells on urine microanalysis. The diagnosis made was exertional rhabdomyolysis that symptomatically improved after intravenous saline hydration, and the patient was released under instructions of avoiding exertion and increasing hydration. After two days, he reported a progressive resolution of the symptoms, and after a week’s followup, the symptoms had almost resolved apart from quadriceps pain during running and squats. There was a slight residual elevation of LDH, but CK reduced (Quattrone, Eichner, Beutler, Adams & O’Connor, 2015).(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Three weeks later, the patient collapsed again, 20 yards short of completion during a makeup fitness run, and complained severe and acute leg cramps although he had hydrated well, and the ambient temperature was cool; however, he did not state increased urination, thirst, and weight loss. The examination results were appropriate except the quadriceps spasms while the lab results before into blood glucose and bicarbonate, potassium, and CK. The diagnosis given was dehydration and potential new-onset diabetes and ketoacidosis. He received intravenous fluid and was transferred to the ICU, and after multiple hours the legs got weak, tense, and mottled, and a reduced sensation of light touches. He became acidotic with hyperphosphatemia, hyperkalemia, and hypocalcemia, and his urine turned brown with high levels of myoglobin. He got high intravenous hydration, insulin for hyperkalemia, furosemide for diuresis, and bicarbonate. By the second day at the hospital, an image of DIC (disseminated intravascular coagulation) emerged, needing blood and plasma products’ transfusion. He went through multicompartment fasciotomies of lower legs and thighs. Despite renal dialysis, hyperkalemia and acidosis were still problematic. Consequent serial exams indicated gluteal compartment syndrome and were operated gluteal fasciotomies and the debridement of necrotic lower extremity muscles. Renal failure manifested, and DIC worsened (Quattrone, Eichner, Beutler, Adams & O’Connor, 2015). He went through multiple debridements of necrotic tissue and considered amputation. As CK was high, hyperbaric oxygen therapy got started n an attempt to save nonnecrotic muscle. On the 23rd day in the hospital after a time of apparent improvement and clinical stabilization, brainstem reflexes could not be prompted with magnetic resonance, and computerized tomography scans revealing infarcts in the brainstem, upper cervical cord, subcortical area, and the midbrain. Following the lack of more neurologic function, life support got withdrawn, and the patient was pronounced dead. The autopsy showed multiple infarcts in the spleen, kidneys, brain, and consisted sickling. Postmortem results were positive for SCT.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
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What Does the Research Say
The most significant way of preventing ECAST is testing individuals for SCT. Although ECAST if not typical, it is a real event that impacts individuals, frequently resulting in tragic outcomes (Pecker, & Naik, 2018). Improved information gathering is essential to educate medical providers and future trainers on monitoring of SCT in Warfighters and athletes, thus leading to the prevention of ECAST and better treatment efforts (Naik et al., 2018). The knowledge is crucial in the provision of a better understanding of the ‘perfect storm’ of related factors that trigger the mystifying phenomenon (Hardas, 2019). Genetic studies that are presently in development help to explore and establish the genetic cofactors that confound or contribute ECAST.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Conclusion
Athletes or military personnel who collapse when exercising and show ECAST signs and symptoms should get tested for sickle cell trait. Assessments for other illnesses such as muscle damage, lung and heart conditions, electrolyte abnormalities, and diabetes are also necessary. Individuals involved in sports and military should meet a doctor for the discussion of environmental factors, familial history, and medication that lead to an increase n the risk of collapse. Individuals need education regarding signs and symptoms of ECAST, the benefits of hydration, and the probability of future ECAST episodes when one exercises heavily in high temperatures. Individuals should show no symptoms at rest, and standard laboratory results with appropriate values before resuming military operation or exercises and resumption of training should be gradual per physician’s directions.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
References
de Chavez, A. C., Atkin, K. M., Babbington, F., Berghs, M. J., Dyson, S. M., Miller, A., & Whitelaw, D. C. (2020). Incidental Findings of Sickle Cell Trait From an Everyday Diabetes Test: Should General Health Care Providers and Testing Centers Report, Retest, or Refer?. Clinical Diabetes, 38(1), 101-107.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Hardas, D. (2019). Effectiveness of Hydroxyurea Therapy in Sickle Cell Disease and Sickle Cell Trait. Journal of Medical Science and Clinical Research, 7(8). DOI: 10.18535/jmscr/v7i8.74(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Moore, D., Onsomu, E. O., Darden, O., Bean, M., Reed, E., Broughton, C., & Joyner, M. (2018). Sickle-Cell Disease Knowledge Levels, Sources, and Information-Seeking Habits among African American and Hispanic/Latino College Students. Florida Communication Journal, 46(1).(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Naik, R. P., Smith-Whitley, K., Hassell, K. L., Umeh, N. I., De Montalembert, M., Sahota, P., … & Bonham, V. L. (2018). Clinical outcomes associated with sickle cell trait: a systematic review. Annals of internal medicine, 169(9), 619-627.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Pecker, L. H., & Naik, R. P. (2018). The current state of sickle cell trait: implications for reproductive and genetic counseling. Hematology 2014, the American Society of Hematology Education Program Book, 2018(1), 474-481.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Quattrone, R., Eichner, E., Beutler, A., Adams, W., & O’Connor, F. (2015). Exercise Collapse Associated with Sickle Cell Trait (ECAST). Current Sports Medicine Reports, 14(2), 110-116. DOI: 10.1249/jsr.000000000000013(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Question – What Does the Research Say?
Case Report: What Does the Research Say?
In this assignment, learners are required to write a case report. The report should demonstrate a depth and breadth of the knowledge and skills gained in the current course and potentially solve an identified real-world practice problem.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
General Requirements:
Use the following information to ensure successful completion of the assignment:
· Use at least two additional scholarly research sources published within the last 5 years. Provide citations and references for all sources used.
· Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
· This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
· You are required to submit this assignment to LopesWrite. for assistance.
As you continue, premiumacademicaffiates.com has the top and most qualified writers to help with any of your assignments. All you need to do is place an order with us. (What Does the Research Say)(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Directions:
Identify a particular real-world problem using a PICOT template that you have used in previous courses. Include the particular clinical setting and potential health/disease issue you will examine. Identify and fully describe the research that has taken place within the last 5 years.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
Your case report must include the following:
1. Introduction with a problem statement.
2. Brief synthesized review.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
3. Description of the case/situation/conditions.
4. Proposed solutions describing the validity and reliability of the research you have read.
5. Conclusion.
Portfolio Practice Hours:
Practice immersion assignments are based on your current course objectives and is application-based learning using your real-world practice setting. These assignments earn practice immersion hours and are indicated in the syllabus by a Portfolio Practice Hours statement which reminds you, the learner, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network.(Comprehensive Case Report Sample on Sickle Cell Anaemia)
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