A5036741613- Hemoglobinopathies and Related Disorders
- Iron Metabolism and Disorders
- Pharmacological Effects and Toxicity Studies
- Healthcare Policy and Management
- Food Security and Health in Diverse Populations
- Primary Care and Health Outcomes
- Religion, Spirituality, and Psychology
- Opioid Use Disorder Treatment
- Emergency and Acute Care Studies
- Cannabis and Cannabinoid Research
- Blood groups and transfusion
- Adolescent and Pediatric Healthcare
- Prenatal Screening and Diagnostics
- Health Systems, Economic Evaluations, Quality of Life
- Neurological and metabolic disorders
- HIV/AIDS Research and Interventions
- Pain Management and Opioid Use
- Palliative Care and End-of-Life Issues
- Homelessness and Social Issues
- Chronic Disease Management Strategies
- Musculoskeletal pain and rehabilitation
- Healthcare cost, quality, practices
- Myeloproliferative Neoplasms: Diagnosis and Treatment
- Bone and Joint Diseases
- Childhood Cancer Survivors' Quality of Life
Virginia Commonwealth University
2016-2025
Virginia Commonwealth University Medical Center
2006-2023
Johns Hopkins University
2016-2023
University of California, Irvine
2023
Georgetown University
2023
University of Virginia
2008-2023
National Institute of Neurological Disorders and Stroke
2023
National Institutes of Health
2023
Vanderbilt Health
2023
Vanderbilt University
2023
Hydroxyurea increases levels of fetal hemoglobin (HbF) and decreases morbidity from vaso-occlusive complications in patients with sickle cell anemia (SCA). High HbF reduce mortality.To determine whether hydroxyurea attenuates mortality SCA.Long-term observational follow-up study SCA who originally participated the randomized, double-blind, placebo-controlled Multicenter Study Sickle Cell Anemia (MSH), conducted 1992-1995, to if reduces events. In MSH Patients' Follow-up, 1996-2001, could...
The up-regulation of P-selectin in endothelial cells and platelets contributes to the cell–cell interactions that are involved pathogenesis vaso-occlusion sickle cell–related pain crises. safety efficacy crizanlizumab, an antibody against adhesion molecule P-selectin, were evaluated patients with cell disease.
Background: Researchers of sickle cell disease have traditionally used health care utilization as a proxy for pain and underlying vaso-occlusion. However, may not completely reflect the amount self-reported or acute, painful episodes (crises). Objective: To examine prevalence relationship among pain, crises, in adults with disease. Design: Prospective cohort study. Setting: Academic community practices Virginia. Patients: 232 patients age 16 years older Measurements: Patients completed daily...
Oxidative stress contributes to the complex pathophysiology of sickle cell disease. Oral therapy with pharmaceutical-grade l-glutamine (USAN, glutamine) has been shown increase proportion reduced form nicotinamide adenine dinucleotides in erythrocytes, which probably reduces oxidative and could result fewer episodes cell–related pain.
A randomized, controlled clinical trial established the efficacy and safety of short-term use hydroxyurea in adult sickle cell anemia. To examine risks benefits long-term usage, patients this were followed for 17.5 years during which they could start or stop hydroxyurea. The purpose follow-up was to search adverse outcomes estimate mortality. For each outcome mortality, exact 95% confidence intervals calculated, tests conducted at alpha = 0.05 level (P-value <0.05 statistical significance)....
Pain in sickle cell disease (SCD) is associated with increased morbidity, mortality, and high health care costs. Although episodic acute pain the hallmark of this disorder, there an increasing awareness that chronic part experience many older adolescents adults. A common set criteria for classifying SCD would enhance research efforts epidemiology, mechanisms, clinical trials management interventions, ultimately improve assessment management. As collaborative effort between Analgesic,...
Abstract Background Sickle cell disease (SCD) is a chronic associated with high degrees of morbidity and increased mortality. Health-related quality life (HRQOL) among adults sickle has not been widely reported. Methods We administered the Medical Outcomes Study 36-item Short-Form to 308 patients in Pain Cell Epidemiology (PiSCES) assess HRQOL. Scales included physical function, emotional role bodily pain, vitality, social mental health, general health. compared scores national norms using...
Depression and anxiety are common in sickle cell disease (SCD) but relatively little is known about their impact on SCD adults. This study measured prevalence of depression adults, effects crisis noncrisis pain, quality-of-life, opioid usage, healthcare utilization.The Pain Sickle Cell Epidemiology Study a prospective cohort 308 Baseline variables included demographics, genotype, laboratory data, health-related depression, anxiety. Subjects completed daily diaries for up to 6 months,...
Racial and ethnic minorities often receive lower-quality health care than white patients, even when socioeconomic status, education, access, other factors are used as controls. To address these pervasive disparities, professionals should learn more about them the roles they can play in eliminating them, but few curricula focused on understanding addressing racial well-accepted guidelines what how to teach this complex area lacking. The Society of General Internal Medicine Health Disparities...
Summary Red blood cell (RBC) hydration is regulated in part by the Ca 2+ ‐activated K + efflux (Gardos) channel. Senicapoc selectively blocks potassium through Gardos channel, reducing RBC dehydration and haemolysis, increasing haemoglobin levels sickle disease (SCD). This randomized, placebo‐controlled trial was designed to determine safety clinical efficacy of senicapoc SCD patients. One hundred forty‐five patients were randomized receive 144 placebo for 52 weeks. Consistent with a...
Sickle cell disease (SCD) is the most common inherited blood disorder in United States. It a medically and socially complex, multisystem illness that affects individuals throughout lifespan. Given improvements care, children with SCD survive into adulthood. However, access to adult sickle care poor many parts of States, resulting increased acute utilization, disjointed delivery, early mortality for patients. A dearth nonmalignant hematology providers, lack national registry, absence...
Treatment options for sickle cell disease (SCD) pain could be tailored to locations. But few epidemiologic descriptions of SCD location exist; these are based on subjects over short time periods. We examined whether locations vary by genotype, gender, age, frequency pain, depression, crisis or healthcare utilization. enrolled 308 adults with in 2002-2004. Subjects kept daily diaries up 6months, including a body chart. Mixed model and generalized estimating equations were employed analyses....
New epidemiological findings recast pain in sickle-cell disease (SCD) as being more often a chronic manifestation than was previously thought, although acute is still the hallmark of disease. SCD intensity, number painful locations, and frequency hospitalizations due to may worsen with age. In adults even children, quantity severity be vastly underestimated, because most "iceberg" "submerged" at home, only tip iceberg seen by health care providers when rendered emergency rooms hospitals....
This descriptive, correlational study examined fatigue and potential biological behavioral correlates in adolescents young adults with sickle cell disease. Sixty disease completed the Brief Fatigue Inventory, Multidimensional Symptom Inventory–Short Form, Patient Reported Outcomes Measurement Information System (PROMIS) short form measures of pain, sleep quality, anxiety, depressive mood, stress, severity, quality life. Blood samples were obtained for hemoglobin cytokines. scores mostly...
Community health workers are increasingly recognized as useful for improving care and outcomes a variety of chronic conditions. can provide social support, navigation systems resources, lay counseling. Social cultural alignment community with the population they serve is an important aspect worker intervention. Although interventions have been shown to improve patient-centered in underserved communities, these not evaluated sickle cell disease. Evidence from other disease areas suggests that...
We conducted a multicenter pilot investigation of the safety and feasibility bone marrow transplantation (BMT) in adults with severe sickle cell disease (SCD) (NCT 01565616) using reduced toxicity preparative regimen busulfan (13.2 mg/kg), fludarabine (175 mg/m 2 ) thymoglobulin (6 mg/kg) cyclosporine or tacrolimus methotrexate for graft‐vs‐host (GVHD) prophylaxis. Twenty‐two patients (median age 22 years; range 17‐36) were enrolled at eight centers. Seventeen received from an HLA‐identical...