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Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21718
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Browsing Other by Author "Bowman, Paul"
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Item Hematopoietic Stem Cell Transplant in Pediatric Sickle Cell Disease: The Cook Children’s Experience(2016-03-23) Dhaliwal, Parneet; Johnson, Clarissa; Howrey, Richard; Torres, Marcela; Sweezer, Tonya; Kiel, Alice; Shah, Deep; Bowman, Paul; Joseph, JustinBackground Current treatments for sickle cell disease are mainly supportive and are aimed at symptom control rather than curing the disease. The only known cure for sickle cell disease is hematopoietic stem cell transplantation. Successful transplantation has been found to eliminate further end-organ damage related to sickle cell disease. A study of transplant experiences and assessment of outcomes could potentially improve the future management of sickle cell disease patients. Purpose The objective of this study was to evaluate a single institution experience of patients undergoing hematopoietic stem cell transplantation at Cook Children’s Medical Center for treatment of Sickle Cell Disease. The data was analyzed to assess indications and outcomes of the transplanted sickle cell patients in order to evaluate transplant as a viable treatment for sickle cell disease. Materials and Methods A comprehensive retrospective chart review was performed on all patients who received a hematopoietic stem cell transplant for the treatment of Sickle Cell Disease from March 25, 1999 to May 24, 2013 at Cook Children’s Medical Center. The clinical variables collected consisted of demographic data, disease and medication history, transplant indications and preparations, donor source, engraftment information, and post-transplant complications. All electronic data was stored on Cook Children’s server using REDCap database. Results Data was collected on 20 patients who met inclusion criteria. Thrombotic stroke was the main clinical indication for transplant. All 20 patients continue to survive post-transplant. Sixteen patients achieved successful long term engraftment. These patients had a median period of follow-up of 4.5 years, ranging from 11 months to 9 years 1 month. Two patients received a 2nd transplant with subsequent failure to engraft. Fourteen developed graft versus host disease, 11 had neurological symptoms, 17 acquired infection, and 1 was found to have intracranial hemorrhage post- transplant. Discussion Preliminary results support the use of hematopoietic stem cell transplant as a viable treatment for sickle cell disease. The survival rate for patients as well as the successful engraftment rate following first transplant were suggestive of the viability of stem cell transplant. Further analysis of post transplant complications, specifically delineating graft versus host disease in relation to organ system and grade, will aid in improving management of these patients.Item Identification Of A Clinicopathological Correlation Between Prevalence Of Testicular Torsion And Temperature In Adolescent Males Between Ten And Eighteen Years Of Age In The North Texas Climate(2016-03-23) Garg, Tushar; Hutchison, Sarah; Shipman, Mary; Tully, Briana; Sanchez, Irene; Bowman, Paul; Copus, CristinaThe objective of this study was to provide a detailed analysis of testicular torsion in adolescent males diagnosed at a single institution between January 2001 and June 2013, and to assess whether a correlation exists between prevalence of testicular torsion and atmospheric temperature in the 10-18 year adolescent male population in this region. Researchers collected available information regarding onset of symptoms, time of presentation, and radiological time frames (i.e. onset to surgery window, etc.). Pathological and clinical information regarding laterality and seasonality was also collected. Only descriptive analysis is available at the time of this abstract. A 179 number of patients met criteria for inclusion in the study. Of those, 40.54% identified as Caucasian, 27.57% as African/American and 2.16% as Asian, with 1.08% falling under the category of “Other.” The average age of patients was 13.8 years. Of these, left sided torsion was present in 53.1%, while right sided torsion was present in 44.7%. Bilateral torsion was identified in 2.2% of patients. Clinical findings resulted in orchiectomy in 36.3% of all patients. Our percentage of patients undergoing orchiectomy is in keeping with reports in the literature that approximately one third of all cases of clinically diagnosed torsion result in orchiectomy. Additionally, as is often mentioned as a risk factor for testicular torsion, our study suggests there may be an association with a decreased atmospheric temperature considering only left-sided torsion, based on the raw data collected. Given the annual Fort Worth temperature of 65.25°F, left-sided torsion occurred during an atmospheric temperature of 61.8°F. However, the atmospheric temperature at the time which right-sided torsion occurred did not deviate from the annual temperature, occurring at an average temperature of 65.2°F. And the average temperature including all torsions was recorded at 63.41°F, a 1.84°F difference. Statistical analyses are pending; however, our results may be more in line with those reports that suggest that cold weather causing testicular torsion may be unsubstantiated.