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Biomedical subjects

S Sarnaik

Publications and source records attributed to S Sarnaik.

26 records · Page 2Linked to original sources
PubMed1984

Diminished helper/suppressor lymphocyte ratios and natural killer activity in recipients of repeated blood transfusions.

Immunologic abnormalities qualitatively similar to those seen in acquired immunodeficiency syndrome (AIDS), including a low helper/suppressor lymphocyte ratio and low natural killer (NK) activity, have been observed in many hemophiliacs receiving clotting factor concentrates. To determine whether these changes also occur after repeated blood transfusion, we measured helper/suppressor (T4/T8) ratios and NK activity in four groups of test subjects: (A) 30 subjects with sickle cell anemia (SCA) receiving monthly transfusions, (B) 30 nontransfused sickle cell anemia subjects, (C) 87 individuals with hemophilia or severe von Willebrand's disease, and (D) 30 normal controls. Like the hemophiliacs, transfused SCA subjects had low T4/T8 ratios and low NK activity compared to controls. Nontransfused SCA subjects had normal values. These findings suggest that a modest decrease in T4/T8 ratio and NK activity may be part of the normal immune response to repeated transfusion.

Adolescent↗
PubMed1981

Preoperative exchange transfusion in sickle cell anemia.

Preoperative transfusion therapy is largely responsible for the recently improved morbidity and mortality in patients with sickle cell anemia undergoing surgery. The transfusion techniques recommended are several. Fifty patients have undergone 67 operations over the past 15 yr. The complications encountered in patients receiving simple transfusion or partial exchange transfusion do not differ. There remains theoretic advantage in the use of preoperative partial exchange transfusion with quantitation of hemoglobin S.

Adolescent↗
PubMed1980

Incidence of cholelithiasis in sickle cell anemia using the ultrasonic gray-scale technique.

Gray-scale ultrasound examination of the gallbladder was successfully performed in 226 patients with sickle cell hemoglobinopathy from 2 to 18 years of age. Sixty-three (27%) demonstrated the presence of gallstones; 14 additional patients had "sludge." The incidence of gallstones increased significantly with age, from 12% in the 2- to 4-year age group to 42% in the 15- to 18-year-old group. The proportion of females with gallstones increased significantly in adolescence. Patients with gallstones had higher mean bilirubin levels, but their mean hemoglobin values and reticulocyte counts were not significantly different from those in patients without gallstones. Ultrasound examination of the gallbladder is a simple, noninvasive technique for evaluating the biliary system. The incidence of gallstones in patients below the age of 10 is higher than expected and raises management questions that must be resolved.

Adolescent↗
PubMed1979

Periodic transfusions for sickle cell anemia and CNS infarction.

Recurrences of CNS infarction often lead to progressive neurologic disability in sickle cell anemia. To prevent such reccurrence, a periodic blood transfusion program was begun in 1969. Currently, 27 patients are on this regimen. Before inclusion in the program, 12 patients had had one to nine CNS recurrences each. Since the program was started, two patients have had transient CNS ischemia. There were no other recurrences and none of the patients have shown progression of neurologic abnormalities. In addition, there was a striking decrease in bacterial infection and pain. We conclude that periodic transfusions are effective in preventing recurrent CNS infarction in sickle cell anemia. The benefits must be weighed against the potentially serious problem of iron overload, as evidenced by moderately elevated serum ferritin values.

Adolescent↗
PubMed1976

IMFRA (intermittent intrathecal methotrexate and fractional radiation) plus chemotherapy in childhood leukemia.

A protocol for the prophylaxis of CNS leukemia was devised involving intermittent low-dosage radiation of the craniospinal axis combined with single intrathecal injections of MTX. The retionale for this protocol was the timing of first CNS relapses in patients not receiving prophylaxis which suggests that leukemic colonization of the CNS is not restricted to the initial stage of the disease and that periodic measures might be advantageous. The low dosage of radiation was chosen because it is well tolerated and has been found temporaily effective in overt CNS relapse. The two series of patients were comparable as to various parameters. Results after three years of observation were comparable to those obtained by other with a single initial course of high-dose radiation, with an expected 50% uninterrupted complete 5-year remission. On the basis of 30 months follow up in 26 patients, the therapy is well tolerated. An increase in morbidity due to infections in remission was not associated with a higher mortality.

Adolescent↗
PubMedDate not supplied

The incidence of development of irregular red cell antibodies in patients with sickle cell anemia.

Two hundred and forty-five patients with SS hemoglobinopathy were screened for alloimmunization; they had all been transfused previously. Their median age was 10 years. Nineteen patients (7.75%) were found to be sensitized to various red cell antigens. The median number of transfusions received by sensitized patients was 23 compared to three in the unsensitized group, indicating an increased risk with more transfusion exposures. Thirteen sensitized patients were re-exposed to transfusion and four (30%) developed new alloantibodies. Once immunized, the risk of developing more alloantibodies on re-exposure did not increase with increasing number of exposures. The most frequently observed alloantibody was anti-K, accounting for 38 percent of all instances. Anti-Lea and -Leb were next in frequency (24%); Rh antibodies were seen in 14 percent of cases. Children with sickle cell anemia who were multiply transfused had a low frequency of alloimmunization. Responders had an increased rate of further sensitization which did not increase with number of subsequent exposures. Phenotypically matched blood is probably not warranted in most patients receiving transfusions for sickle cell anemia.

Adolescent↗