A5029453193- Complement system in diseases
- Blood groups and transfusion
- Hemoglobinopathies and Related Disorders
- Renal Diseases and Glomerulopathies
- Hemoglobin structure and function
- Mechanical Circulatory Support Devices
- Neonatal Health and Biochemistry
- Pain Management and Opioid Use
- Platelet Disorders and Treatments
- Blood disorders and treatments
- Pain Mechanisms and Treatments
- Erythrocyte Function and Pathophysiology
- Blood transfusion and management
- Opioid Use Disorder Treatment
- Therapeutic Uses of Natural Elements
- Hemostasis and retained surgical items
- Sepsis Diagnosis and Treatment
- Cardiac and Coronary Surgery Techniques
- Clinical Laboratory Practices and Quality Control
- Phagocytosis and Immune Regulation
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Blood Coagulation and Thrombosis Mechanisms
- Prion Diseases and Protein Misfolding
- Meta-analysis and systematic reviews
- Acute Myocardial Infarction Research
Yale University
2022-2025
Seattle Children's Hospital
2020-2024
Yale New Haven Hospital
2024
University of Washington
2020
Hospital Universitario Austral
2017
Pregnancy induces physiologic changes that can affect serologic and immunologic markers, potentially resulting in lower haptoglobin values than nonpregnant counterparts. Such variations may lead to concern for hemolysis pregnancy. This study aims analyze reference intervals (RIs) each trimester of We employed a quality improvement project total 401 remnant serum samples (BD Vacutainer SST) collected from routine outpatient pregnancy patients. Roche Cobas 8000 (c 502) systems were used...
ABSTRACT Immune thrombotic thrombocytopenic purpura (iTTP) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and microvascular occlusion secondary to acquired ADAMTS13 deficiency. Contemporary data regarding iTTP treatment practices in the US, including use of caplacizumab, are lacking. We aimed characterize demographics therapies, medications apheresis practices, patients with US. retrospectively analyzed cases at 15 sites US that provide comprehensive care for iTTP....
Prior studies have suggested that immune thrombotic thrombocytopenic purpura (iTTP) may display seasonal variation; however, methodologic limitations and sample sizes diminished the ability to perform a rigorous assessment. This 5-year retrospective study assessed epidemiology of iTTP determined whether it displays pattern. Patients with both initial relapsed (defined as disintegrin metalloprotease thrombospondin type motifs 13 activity <10%) from 24 tertiary centers in Australia, Canada,...
Objectives: Anticoagulation with unfractionated heparin remains the most common therapy used to prevent circuit thrombosis during extracorporeal membrane oxygenation, but no consensus exists on optimal method or targets for monitoring. From 2015 2018, we switched from monitoring oxygenation using activated clotting times anti-Xa activity assays. This study describes transition time assay and associated clinical changes. Design: Retrospective analysis at single institution. Setting: Referral...
Thrombosis in extracorporeal membrane oxygenation (ECMO) circuits remains a frequent complication. We characterize the location, extent, structure, and clinical implications of thrombi 53 ECMO from 46 pediatric patients. The tubing, pump, oxygenator were examined for visible thrombi. Representative samples collected histologic, immunofluorescence, immunohistochemical analysis. Thrombi found 81% circuits. most clinically significant inflow surface (11% circuits), arterial tubing (30%), venous...
Sublethal damage to red blood cells (RBCs) during extracorporeal life support (ECLS) may lead RBC loss. Using flow cytometry, phosphatidylserine-positive (PhS+) RBCs and extracellular vesicles were quantified as measures of sublethal injury in 41 pediatric ECLS runs, stored units, normal adult subjects. We estimated the clearance half-life PhS+ compared rates loss due phlebotomy, intravascular hemolysis, extravascular RBCs. Extracorporeal patients had 0.9% RBCs, sixfold higher than subjects...
Abstract Introduction Red blood cells (RBCs) express anionic phospholipids such as phosphatidylserine (PS) in their inner cell membrane layer. As RBCs age, physiochemical changes membranes, particularly exposure of PS on the outer layer, lead to phagocytosis and clearance from circulation. induces activation complement system, increasing binding C3 RBCs. Thus, quantifying PS-expressing (PS+) deposition (C3+) is a potential measure RBC injury may improve transfusion quality when used for...
Anti-glomerular basement membrane (anti-GBM) disease (formerly known as Goodpasture's syndrome) is a rare autoinflammatory condition that affects the renal and/or pulmonary capillaries. The standard therapeutic regimen for anti-GBM involves plasma exchange (TPE), cyclophosphamide, and corticosteroids to rapidly remove inhibit autoantibody production reduce organ inflammation. Herein we report an 82-year-old female who developed but expired despite therapy, secondary multi-organ failure in...
Abstract A woman in her second trimester of pregnancy (24 weeks gestation), diagnosed with B-cell acute lymphoblastic leukemia, received induction chemotherapy. On day six treatment, she required transfusion two red cell (RBC) units for anemia. Less than 12 hours later, laboratory results included elevated total bilirubin, 4.3 mg/dL [reference interval &lt;=1.2 mg/dL], direct 0.3 &lt;=0.3 haptoglobin below detection limit, &lt;10 interval: 30 - 200 and normal lactate...
Abstract The Heidenhain variant of Creutzfeld-Jakob disease (CJD) is a rare form that initially presents with visual disturbances. In early stages, the presentation can mimic neuromyelitis optica spectrum disorders (NMOSD) and lead to unnecessary treatment modalities. Herein, we describe case 66-year-old man who presented bilateral vision loss retro-orbital discomfort. addition immunosuppressive therapy, he received 4 rounds therapeutic plasma exchange after his preliminary diagnosis NMOSD....
Abstract A middle-aged woman with recent cervical diskectomy spinal fusion at C3-C4 suffered a mechanical fall bilateral upper extremity paresthesia requiring admission but no surgical intervention. Patient was seen by orthopedic service and recommended to continue using Aspen collar oxycodone for pain. Following discharge, drug urine screen test performed, showed positive immunoassay. Confirmatory liquid chromatography-tandem mass spectrometry (LC-MS/MS) detectable oxycodone, oxymorphone...
Red blood cell (RBC) alloimmunization can occur secondary to transfusion or pregnancy. It is observed most frequently among patients with hemoglobinopathies and myeloid neoplasms. Although previous antigen exposure generally required for alloimmunization, some alloantibodies may develop naturally without prior exposure. Other become evanescent, only reemerge at a detectable titer following stimulatory event. In minute fraction of cases, 'non-naturally occurring' appear known antigenic...