DukeSpace
Find and submit publications, theses, and dissertations by Duke faculty and students.
Communities in DukeSpace
Select a community to browse its collections.
Recent Submissions
Quadratus Lumborum Blocks for Pediatric Bone Marrow Harvesting: A Case Report
(Cureus, 2023-10-25) McCoy, Nicole C; DePriest, Brittany P
Implementation of a Low-risk Algorithm for Outpatient Management of Febrile Pediatric Patients With Sickle Cell Disease
(Journal of Pediatric Hematology/Oncology, 2025-03) Erno, Jason; Noisette, Laurence; Bergmann, Shayla; Diaz, Charyse; Depriest, Brittany; Nietert, Paul J; Hudspeth, Michelle
Background:
Splenic dysfunction in children with sickle cell disease (SCD) increases the risk of serious bacterial infections; therefore, families are instructed to seek medical care in the presence of fever. Recurrent hospital admissions of patients with SCD cause financial and resource burdens on caregivers and the health care system, contributing to a lower quality of life in this patient population. Recent studies have documented a reduction of the incidence of bacterial infections among these patients managed on an outpatient basis with no association of increased morbidity and mortality. We decided to establish a partnership between our pediatric hematology/oncology division and pediatric emergency medicine division to initiate an algorithm to identify low-risk patients eligible for outpatient management.
Procedure:
We conducted a retrospective review of patients with SCD younger than 18 years of age, followed at the Comprehensive Care Sickle Cell Center at the Medical University of South Carolina (MUSC), who presented to our Pediatric Emergency Department (ED) with a temperature ≥101°F from July 1, 2018 to June 30, 2020.
Results:
The mean length of stay and age at admission were nearly equal between pre-implementation and post-implementation of the algorithm. The admission rates from the study for were 55.2% and 43.6% pre-implementation and post-implementation, respectively. Patients revisited the ED within 72 hours in 6.7% of patients in pre-implementation and 5.9% of patients in post-implementation. There were no patient deaths.
Conclusions:
Our pathway helps standardize the treatment of febrile pediatric patients with SCD. Although the decrease in admissions did not reach statistical significance, the > 10% decrease in admissions was likely meaningful to reduce health care burdens for patients and families.
Prospective assessment of risk biomarkers of sinusoidal obstruction syndrome after hematopoietic cell transplantation
(JCI Insight, 2023-05-22) Han, Yan; Bidgoli, Alan; DePriest, Brittany P; Méndez, Alejandra; Bijangi-Vishehsaraei, Khadijeh; Perez-Albuerne, Evelio D; Krance, Robert A; Renbarger, Jamie; Skiles, Jodi L; Choi, Sung W; Liu, Hao; Paczesny, Sophie
An overview of multiplexed analyses of CAR T-cell therapies: insights and potential
(Expert Review of Proteomics, 2021-09-02) DePriest, Brittany Paige; Vieira, Noah; Bidgoli, Alan; Paczesny, Sophie
Regenerating islet-derived protein 3-α is a prognostic biomarker for gastrointestinal chronic graft-versus-host disease
(Blood Advances, 2022-05-24) DePriest, Brittany Paige; Li, Hong; Bidgoli, Alan; Onstad, Lynn; Couriel, Daniel; Lee, Stephanie J; Paczesny, Sophie
Abstract
Prognostic biomarkers used to identify likelihood of disease progression have not been identified for chronic graft-versus-host disease (cGVHD), the leading cause of late nonrelapse mortality (NRM) in survivors of allogeneic hematopoietic cell transplantation. Gastrointestinal cGVHD (GI-cGVHD) has been particularly challenging to classify. Here, we analyzed 3 proteomics markers (Regenerating islet-derived protein 3-α [Reg3α], C-X-C motif ligand 9 [CXCL9], and Stimulation-2 [ST2]) in 2 independent cohorts of patients with cGVHD totaling 289 patients. Plasma concentrations of Reg3α were significantly increased in patients with GI-cGVHD (P = .0012) compared with those without (P = .01), but plasma concentrations of CXCL9 and ST2 were not. Patients with high Reg3α (≥72 ng/mL) vs low Reg3α had higher NRM (23% vs 11%; P = .015). Because Reg3α has been identified as a lower GI tract marker in acute GVHD, we correlated Reg3α with lower acute-like GI-cGVHD vs classical fibrotic-like esophageal manifestations and found that Reg3α did not differ between the subtypes. No difference was observed between upper GI tract and lower GI tract subtypes. Patients with extremely high Reg3α (≥180 ng/mL) had higher GI scores but not higher scores for the lower GI tract. In a multivariable Cox regression model, patients with high Reg3α were 1.9 times more likely to die without relapse. Our findings demonstrate the utility of Reg3α as a prognostic marker for GI-cGVHD. These data warrant prospective biomarker validation studies.