Treatment of Leg UlcersLeg ulcers are a common manifestation of HbSS, although their prevalence varies depending on geographic distribution. For example, 75% of HbSS patients in Jamaica are affected, while only 8-10% of South American patients are affected. Potential contributing factors to leg ulcers include: obstructions due to cell sickling, venous incompetence, excessive vasoconstriction caused by dysfunction of autonomic control, and bacterial infections. In addition, impaired endothelial function caused by decreased nitric oxide bioavailability and chronic anemia or hypoxia are also linked. Additionally, phlebographic studies indicate that arteriovenous shunting is the primary cause of ulcerations rather than venous insufficiency. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953786/Treatment of leg ulcers is no different from normal treatment. Standard treatment involves antibiotics and debridement as well as a zinc oxide dressing and leg elevation. Red blood cell transfusion is also ideal because it can speed healing. In extreme cases, a skin graft may be necessary. (13) http://emedicine.medscape.com/article/205926-treatment#aw2aab6b6c13Stroke PreventionIdentifying and controlling risk factors for stroke or transient ischemic attack is crucial in people suffering from of HbSS. The AHA and ASA have established primary stroke prevention guidelines that are advised to be strictly adhered to. Standard treatment for stroke prevention includes antiplatelet drugs, hydroxyurea, and regular blood transfusions in adults, with the aim of reducing HbS to less than 30%. Blood transfusion is also currently considered standard stroke prevention in children with sickle cell disease; “The Stroke Prevention in Sickle Cell Disease (STOP) Trial showed that regular blood transfusions p...... middle of article...... Clarke M. Pulmonary Hypertension in Sickle Cell Disease [Online]. United States: Medscape; 2006. [cited February 25, 2014] Available at: http://www.medscape.org/viewarticle/547201University of Maryland Medical Center. Sickle cell anemia. [Online]. Baltimore, United States; University of Maryland Medical Center; [cited February 24, 2014] Available at: http://umm.edu/health/medical/reports/articles/sickle-cell-diseaseNational Heart, Lung, and blood Institute. How is sickle cell anemia treated? [Online]. USA; NIH; [cited February 24, 2014] Available at: https://www.nhlbi.nih.gov/health/health-topics/topics/sca/treatment.htmlUniversity of California, Los Angekes (UCLA). Stem cell gene therapy for sickle cell disease is progressing toward clinical trials. [Online]. United States: ScienceDaily; 2013. [cited February 25, 2014] Available at: http://www.sciencedaily.com/releases/2013/07/130701135032.htm