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Utilization Of Patient-Controlled Analgesia Reduces Length Of Stay Of Sickle Cell Crisis Hospitalizations, Brett M. Prestia, Talha Ramzan, Catherine Waldron, Ameer Malik, Robert M. Pallay, Candace R. Murbach, Mike Flynn, Eric Shaw PhD, Abdullah Kutlar, Daniel Lowe 2021 Memorial Health University Medical Center

Utilization Of Patient-Controlled Analgesia Reduces Length Of Stay Of Sickle Cell Crisis Hospitalizations, Brett M. Prestia, Talha Ramzan, Catherine Waldron, Ameer Malik, Robert M. Pallay, Candace R. Murbach, Mike Flynn, Eric Shaw Phd, Abdullah Kutlar, Daniel Lowe

HCA Healthcare Journal of Medicine

Background

Sickle cell crisis hospitalizations are emotionally and financially burdensome to patients and healthcare systems, and processes to decrease the frequency or length of stay of these crises should be examined.

Methods

This is a multicenter retrospective hospital record review of sickle cell crisis hospitalizations as defined by ICD-10 codes (D57.1-4), from January 2016 through December 2019, examining inpatient medication administration records and length of stay among admitted adults aged 18–65 years. Patient controlled analgesia orders using morphine, hydromorphone, fentanyl and/or merperidine at any point of an admission (n=188) were compared to admissions without any patient-controlled ...


Microangiopathic Haemolytic Anaemia Diagnosis And Management In Thrombotic Thrombocytopenic Purpura And Haemolytic Uraemic Syndrome: A Review, Adam P. Korneluk 2021 Munster Technological University

Microangiopathic Haemolytic Anaemia Diagnosis And Management In Thrombotic Thrombocytopenic Purpura And Haemolytic Uraemic Syndrome: A Review, Adam P. Korneluk

International Undergraduate Journal of Health Sciences

Microangiopathic haemolytic anaemia (MAHA) describes non-immune haemolysis by intravascular fragmentation of red blood cells, resulting from microvascular thrombosis characteristic of thrombotic microangiopathy (TMA). TMA-associated MAHAs include several diseases but are mostly associated with thrombotic thrombocytopenic purpura (TTP) and haemolytic-uremic syndrome (HUS). TTP is caused by a severe deficiency in ADAMTS13 proteinase, responsible for regulating coagulation, either due to presence of anti-ADAMTS13 (acquired iTTP; immune-mediated) or mutations in ADAMTS13 itself (congenital cTTP). HUS is caused by abnormal and uncontrolled complement activation, either by bacterial toxin activity (typical dHUS) or lack of normal regulatory proteins (atypical aHUS). This review focuses on TTP ...


Full Issue: The International Undergraduate Journal Of Health Sciences, Volume 1, Issue 1, June 2021, 2021 Munster Technological University

Full Issue: The International Undergraduate Journal Of Health Sciences, Volume 1, Issue 1, June 2021

International Undergraduate Journal of Health Sciences

The full June 2021 issue (Volume 1, Issue 1) of the International Undergraduate Journal of Health Sciences


Association Of Killer Cell Immunoglobulin-Like Receptors With Endemic Burkitt Lymphoma In Kenyan Children, Beatrice M. Muriuki, Catherine Forconi, Peter O. Oluoch, Jeffrey A. Bailey, Anita Ghansah, Ann M. Moormann, John M. Ong'echa 2021 University of Ghana

Association Of Killer Cell Immunoglobulin-Like Receptors With Endemic Burkitt Lymphoma In Kenyan Children, Beatrice M. Muriuki, Catherine Forconi, Peter O. Oluoch, Jeffrey A. Bailey, Anita Ghansah, Ann M. Moormann, John M. Ong'echa

Open Access Publications by UMMS Authors

Endemic Burkitt lymphoma (eBL) is an aggressive pediatric B cell lymphoma, common in Equatorial Africa. Co-infections with Epstein-Barr virus (EBV) and Plasmodium falciparum, coupled with c-myc translocation are involved in eBL etiology. Infection-induced immune evasion mechanisms to avoid T cell cytotoxicity may increase the role of Natural killer (NK) cells in anti-tumor immunosurveillance. Killer immunoglobulin-like receptor (KIR) genes on NK cells exhibit genotypic and allelic variations and are associated with susceptibility to diseases and malignancies. However, their role in eBL pathogenesis remains undefined. This retrospective study genotyped sixteen KIR genes and compared their frequencies in eBL patients (n = 104) and ...


Utility Of Cognitive Behavioral Therapy To Reduce Pain In Children With Sickle Cell Disease, Abigail Radomsky 2021 Wayne State University

Utility Of Cognitive Behavioral Therapy To Reduce Pain In Children With Sickle Cell Disease, Abigail Radomsky

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Schatz J, Schlenz AM, McClellan CB, et al. Changes in coping, pain, and activity after cognitive-behavioral training. The Clinical Journal of Pain 2015;31(6):536-47 https://doi.org/10.1097/ajp.0000000000000183

for a child with sickle cell disease.


Luspatercept Diminishes The Need For Red Blood Cell Replacement In Transfusion-Dependent Β-Thalassemia Patients, Joudeh B. Freij 2021 Wayne State University School of Medicine

Luspatercept Diminishes The Need For Red Blood Cell Replacement In Transfusion-Dependent Β-Thalassemia Patients, Joudeh B. Freij

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising:

Cappellini MD, Viprakasit V, Taher AT, et al. A phase 3 trial of luspatercept in patients with transfusion-dependent β-thalassemia. N Engl J Med. 2020;382(13):1219-1231. https://doi.org/10.1056/NEJMoa1910182

for a patient with transfusion-dependent beta-thalassemia.


Laser-Assisted Tooth Extraction In Patients With Impaired Hemostasis, Elena Larionova Dr., Ekaterina Diachkova Dr., Elena Morozova Prof., Albert Davtyan Dr., Svetlana Tarasenko Prof. 2021 Sechenov University

Laser-Assisted Tooth Extraction In Patients With Impaired Hemostasis, Elena Larionova Dr., Ekaterina Diachkova Dr., Elena Morozova Prof., Albert Davtyan Dr., Svetlana Tarasenko Prof.

BioMedicine

Introduction: The provision of efficient dental care to patients with hemostatic disorders is tied to difficulties and problems such as prolonged bleeding after or during surgical manipulation.

Aim: This study aims to increase the efficiency of oral surgery in patients with thrombocytopenia with the use of erbium laser on different stages of tooth extraction.

Methods: Patients (n = 96) were selected for tooth extraction on an outpatient basis: patients with confirmed thrombocytopenia (age 44 ± 15.4, 19–74) were included in the 1st group, and patients without impaired hemostasis (age 47.6 ± 15.3, 19¬81) were included in the 2nd ...


A Study Examining The Safety And Efficacy Of Ferric Carboxymaltose In A Large Pediatric Cohort, Chandni Dargan MD, David Simon DO 2021 Children's Mercy Hospital

A Study Examining The Safety And Efficacy Of Ferric Carboxymaltose In A Large Pediatric Cohort, Chandni Dargan Md, David Simon Do

Research Days

Background: Iron deficiency anemia (IDA) is common in the pediatric population with varying high-risk factors. Intravenous (IV) iron supplementation has become more desirable in patients with moderate to severe anemia and in patients who are either unresponsive to or have adverse side-effects secondary to oral iron. Iron sucrose and Iron dextran have been traditionally used in pediatrics while ferric carboxymaltose (FCM) has only been FDA approved in adults. One of the major advantages of FCM is the ease of dosing and efficacy. Though FCM was approved for adults in 2013 and there have been no safety concerns, it is not ...


Bleeding Disorder Referrals To Hematology Clinic: A Single Institution Experience, Zuri Hudson 2021 Children's Mercy Kansas City

Bleeding Disorder Referrals To Hematology Clinic: A Single Institution Experience, Zuri Hudson

Research Days

Background: Our center receives hundreds of referrals yearly for bleeding disorder evaluation both due to bleeding symptoms and secondary to routine preoperative laboratory testing. The evaluation for a bleeding disorder can be challenging due to the wide variability of symptoms as well as the need for accurately interpreting lab results. Bhasin et al showed that 4% of patients referred to hematology based on a preoperative coagulation evaluation had a clinically relevant bleeding disorder. Currently there is little published about the referral patterns to pediatric hematology and the outcomes of these referrals.

Objectives/Goal: To characterize our hematology referrals for bleeding ...


The Role Of A Monoclonal Gammopathy Of Undetermined Significance Diagnosis In Healthcare Utilization, Maira A. Castaneda-Avila 2021 University of Massachusetts Medical School

The Role Of A Monoclonal Gammopathy Of Undetermined Significance Diagnosis In Healthcare Utilization, Maira A. Castaneda-Avila

GSBS Dissertations and Theses

Background

Monoclonal Gammopathy of Undetermined Significance (MGUS) is an understudied precursor of multiple myeloma (MM), the second most prevalent hematologic malignancy in the United States. This dissertation was designed to: (1) Describe the trajectories of serum biomarkers over time in patients with an MGUS diagnosis, (2) Determine if an MGUS diagnosis is associated with changes in healthcare service utilization, and (3) explore the patient- and provider-level drivers of healthcare utilization in patients with MGUS.

Methods

Data sources include health claims and electronic health records from a community-based population of patients seeking care in central Massachusetts and primary qualitative data collected ...


Kshv Infection Drives Poorly Cytotoxic Cd56-Negative Natural Killer Cell Differentiation In Vivo Upon Kshv/Ebv Dual Infection, Nicole Caduff, Donal McHugh, Lisa Rieble, Catherine Forconi, John M. Ong'echa, Peter O. Oluoch, Ana Raykova, Anita Murer, Michelle Boni, Lara Zuppiger, Thomas F. Schulz, David J. Blackbourn, Obinna Chijioke, Ann M. Moormann, Christian Munz 2021 University of Zurich

Kshv Infection Drives Poorly Cytotoxic Cd56-Negative Natural Killer Cell Differentiation In Vivo Upon Kshv/Ebv Dual Infection, Nicole Caduff, Donal Mchugh, Lisa Rieble, Catherine Forconi, John M. Ong'echa, Peter O. Oluoch, Ana Raykova, Anita Murer, Michelle Boni, Lara Zuppiger, Thomas F. Schulz, David J. Blackbourn, Obinna Chijioke, Ann M. Moormann, Christian Munz

Open Access Publications by UMMS Authors

Herpesvirus infections shape the human natural killer (NK) cell compartment. While Epstein-Barr virus (EBV) expands immature NKG2A(+) NK cells, human cytomegalovirus (CMV) drives accumulation of adaptive NKG2C(+) NK cells. Kaposi sarcoma-associated herpesvirus (KSHV) is a close relative of EBV, and both are associated with lymphomas, including primary effusion lymphoma (PEL), which nearly always harbors both viruses. In this study, KSHV dual infection of mice with reconstituted human immune system components leads to the accumulation of CD56(-)CD16(+)CD38(+)CXCR6(+) NK cells. CD56(-)CD16(+) NK cells were also more frequently found in KSHV-seropositive Kenyan children. This NK cell subset is poorly ...


Optimizing Empiric Vancomycin Use In Febrile Neutropenia Patients, Nicole Tadros, Erika Dittmar, Radhan Gopalani 2021 Baptist Hospital of Miami

Optimizing Empiric Vancomycin Use In Febrile Neutropenia Patients, Nicole Tadros, Erika Dittmar, Radhan Gopalani

All Publications

Introduction: Febrile neutropenia (FN) is a complication of chemotherapy resulting in a temperature 100.4⁰F or greater plus an absolute neutrophil count (ANC) below 500 cells/mm3 or an ANC below 1000 cells/mm3 and expected to decrease below 500 cells/mm3 within 48 hours. Timely administration of broad-spectrum antimicrobial therapy is a cornerstone for the initial management of FN. However, prolonged empiric antimicrobial treatment can lead to resistance and toxicity. National guidelines and published literature do not support vancomycin as a routine part of empiric antimicrobial regimens in FN; it is only recommended in patients with ...


The Heme-Regulated Inhibitor Pathway Modulates Susceptibility Of Poor Prognosis B-Lineage Acute Leukemia To Bh3-Mimetics, Kaitlyn Hill Smith 2021 University of Tennessee Health Science Center

The Heme-Regulated Inhibitor Pathway Modulates Susceptibility Of Poor Prognosis B-Lineage Acute Leukemia To Bh3-Mimetics, Kaitlyn Hill Smith

Theses and Dissertations (ETD)

Anti-apoptotic MCL1 is one of the most frequently amplified genes in human cancers and its elevated expression confers resistance to many therapeutics including the BH3-mimetic agents ABT-199 and ABT-263. The anti-malarial, dihydroartemisinin (DHA) translationally represses MCL-1 and synergizes with BH3-mimetics. To explore how DHA represses MCL-1, a genome-wide CRISPR screen identified that loss of genes in the heme synthesis pathway renders mouse BCR-ABL+ B-ALL cells resistant to DHA-induced death. Mechanistically, DHA disrupts the interaction between heme and the eIF2α kinase heme regulated inhibitor (HRI) triggering the integrated stress response. Genetic ablation of Eif2ak1, which encodes HRI, blocks MCL-1 repression in ...


Subtype-Specific And Co-Occurring Genetic Alterations In B-Cell Non-Hodgkin Lymphoma, Man Chun John Ma, Benjamin J. Chen, Michael R. Green 2021 University of Texas MD Anderson Cancer Center

Subtype-Specific And Co-Occurring Genetic Alterations In B-Cell Non-Hodgkin Lymphoma, Man Chun John Ma, Benjamin J. Chen, Michael R. Green

Open Access Publications by UMMS Authors

B-cell non-Hodgkin's lymphoma (B-NHL) encompasses multiple clinically and phenotypically distinct subtypes of malignancy with unique molecular etiologies. Common subtypes of B-NHL such as diffuse large B-cell lymphoma (DLBCL) have been comprehensively interrogated at the genomic level. But rarer subtypes such as mantle cell lymphoma (MCL) remain sparsely characterized. Furthermore, multiple B-NHL subtypes have thus far not been comprehensively compared using the same methodology to identify conserved or subtype-specific patterns of genomic alterations. Here, we employed a large targeted hybrid-capture sequencing approach encompassing 380 genes to interrogate the genomic landscapes of 685 B-NHL tumors at high depth; including DLBCL, MCL ...


Lung Epithelial Cell Transcriptional Regulation As A Factor In Covid-19 Associated Coagulopathies, Ethan S. FitzGerald, Yongzhi Chen, Katherine A. Fitzgerald, Amanda M. Jamieson 2021 Brown University

Lung Epithelial Cell Transcriptional Regulation As A Factor In Covid-19 Associated Coagulopathies, Ethan S. Fitzgerald, Yongzhi Chen, Katherine A. Fitzgerald, Amanda M. Jamieson

COVID-19 Publications by UMMS Authors

SARS-CoV-2 has rapidly become a global pandemic. In addition to the acute pulmonary symptoms of COVID-19 (the disease associated with SARS-CoV-2 infection), pulmonary and distal coagulopathies have caused morbidity and mortality in many patients. Currently, the molecular pathogenesis underlying COVID-19 associated coagulopathies are unknown. Identifying the molecular basis of how SARS-CoV-2 drives coagulation is essential to mitigating short and long term thrombotic risks of sick and recovered COVID-19 patients. We aimed to perform coagulation focused transcriptome analysis of in vitro infected primary respiratory epithelial cells, patient derived bronchial alveolar lavage (BALF) cells, and circulating immune cells during SARS-CoV-2 infection. Our ...


Role Of Immunomodulation Of Bcg Therapy On Aml Remission, Alice Kennedy, Kamal Kant Sahu, Jan Cerny 2021 University of Massachusetts Medical School

Role Of Immunomodulation Of Bcg Therapy On Aml Remission, Alice Kennedy, Kamal Kant Sahu, Jan Cerny

Open Access Publications by UMMS Authors

Bacillus Calmette-Guerin (BCG) has been studied in various cancers for its immune modulation. Although the mechanism is yet to be completely understood, we do have positive experiences in many oncological cases. Hereby, we present a case of an 82-year-old male with acute myeloid leukemia (AML) post allogeneic Stem Cell Transplants (AlloSCT) as a salvage therapy, now in remission, who presented with hematuria. Workup confirmed non-muscle invasive Bladder Cancer (NMIBC), for which he was treated with nine sessions of intravesical BCG therapy. During BCG treatment, the patient developed gradually increasing lymphocyte counts. Flowcytometry of a peripheral blood sample showed polyclonal cell ...


Cohesin Mutations Alter Dna Damage Repair And Chromatin Structure And Create Therapeutic Vulnerabilities In Mds/Aml, Zuzana Tothova, Anne-Laure Valton, Sergey V. Venev, Job Dekker, Benjamin L. Ebert 2021 Dana-Farber Cancer Institute

Cohesin Mutations Alter Dna Damage Repair And Chromatin Structure And Create Therapeutic Vulnerabilities In Mds/Aml, Zuzana Tothova, Anne-Laure Valton, Sergey V. Venev, Job Dekker, Benjamin L. Ebert

Open Access Publications by UMMS Authors

The cohesin complex plays an essential role in chromosome maintenance and transcriptional regulation. Recurrent somatic mutations in the cohesin complex are frequent genetic drivers in cancer, including myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Here, using genetic dependency screens of stromal antigen 2-mutant (STAG2-mutant) AML, we identified DNA damage repair and replication as genetic dependencies in cohesin-mutant cells. We demonstrated increased levels of DNA damage and sensitivity of cohesin-mutant cells to poly(ADP-ribose) polymerase (PARP) inhibition. We developed a mouse model of MDS in which Stag2 mutations arose as clonal secondary lesions in the background of clonal hematopoiesis driven ...


Targeting Calcium Homeostasis For The Treatment Of Multiple Myeloma, Osama M. Elzamzamy 2021 West Virginia University

Targeting Calcium Homeostasis For The Treatment Of Multiple Myeloma, Osama M. Elzamzamy

Graduate Theses, Dissertations, and Problem Reports

Multiple myeloma (MM) is a hematological malignancy characterized by the neoplastic proliferation of the plasma cells. MM is a relatively rare cancer that accounts for about 1.8% of all cancers and is the second most common hematologic malignancies, and despite the advancement from untreatable to treatable malignancy, it is yet incurable. Calcium ions (Ca2+) play an important role as second messengers in regulating a plethora of physiological and pathological processes, hence cytoplasmic Ca2+ is tightly regulated with strict spatial and temporal control to initiate, maintain, and terminate appropriate signaling pathways and phenotypes including cellular proliferation, cell cycle ...


Efficacy Of The Nutritional Supplement, Evenflo, In The Management Of Sickle Cell Disease: A Randomized Controlled Trial, Richard Muga, Arthur Ajwang, James Ouma, Josephine Ojigo, Juliana Otieno, Peter Okoth, Caroline Wafula, Sophia Ajwang, David Ogolla, Abraham Hollist, James Adefisoye 2020 School of Clinical Medicine, Uzima University College; County Executive Committee Member for Heath, Home-Bay County

Efficacy Of The Nutritional Supplement, Evenflo, In The Management Of Sickle Cell Disease: A Randomized Controlled Trial, Richard Muga, Arthur Ajwang, James Ouma, Josephine Ojigo, Juliana Otieno, Peter Okoth, Caroline Wafula, Sophia Ajwang, David Ogolla, Abraham Hollist, James Adefisoye

Nursing & Health Sciences Research Journal

Background: In this study, we investigated if a combination of the nutraceutical supplement, EvenFlo and folic acid will be superior to the standard stand-alone use of folic acid.

Methods: We conducted a randomized double-blind, active-controlled, clinical trial. A total of 70 subjects with SCD ages 5-12 years were enrolled into the study with 35 in the intervention group and 35 in the control group; 61 completed the trial (32 from the intervention group and 29 from the control group).

Results: Participants in the intervention group were significantly less likely to experience crises compared to subjects in the control group. None ...


A Deep Learning Diagnostic Platform For Diffuse Large B-Cell Lymphoma With High Accuracy Across Multiple Hospitals, Dongguang Li, Jacob R. Bledsoe, Yu Zeng, Wei Liu, Yiguo Hu, Ke Bi, Aibin Liang, Shaoguang Li 2020 University of Massachusetts Medical School

A Deep Learning Diagnostic Platform For Diffuse Large B-Cell Lymphoma With High Accuracy Across Multiple Hospitals, Dongguang Li, Jacob R. Bledsoe, Yu Zeng, Wei Liu, Yiguo Hu, Ke Bi, Aibin Liang, Shaoguang Li

Open Access Publications by UMMS Authors

Diagnostic histopathology is a gold standard for diagnosing hematopoietic malignancies. Pathologic diagnosis requires labor-intensive reading of a large number of tissue slides with high diagnostic accuracy equal or close to 100 percent to guide treatment options, but this requirement is difficult to meet. Although artificial intelligence (AI) helps to reduce the labor of reading pathologic slides, diagnostic accuracy has not reached a clinically usable level. Establishment of an AI model often demands big datasets and an ability to handle large variations in sample preparation and image collection. Here, we establish a highly accurate deep learning platform, consisting of multiple convolutional ...


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