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  1. Article ; Online: Clinical Aspects of B Cell Immunodeficiencies: The Past, the Present and the Future.

    Ahmed, Aisha / Lippner, Elizabeth / Khanolkar, Aaruni

    Cells

    2022  Volume 11, Issue 21

    Abstract: B cells and antibodies are indispensable for host immunity. Our understanding of the mechanistic processes that underpin how B cells operate has left an indelible mark on the field of clinical pathology, and recently has also dramatically reshaped the ... ...

    Abstract B cells and antibodies are indispensable for host immunity. Our understanding of the mechanistic processes that underpin how B cells operate has left an indelible mark on the field of clinical pathology, and recently has also dramatically reshaped the therapeutic landscape of diseases that were once considered incurable. Evaluating patients with primary immunodeficiency diseases (PID)/inborn errors of immunity (IEI) that primarily affect B cells, offers us an opportunity to further our understanding of how B cells develop, mature, function and, in certain instances, cause further disease. In this review we provide a brief compendium of IEI that principally affect B cells at defined stages of their developmental pathway, and also attempt to offer some educated viewpoints on how the management of these disorders could evolve over the years.
    MeSH term(s) Humans ; Immunologic Deficiency Syndromes ; B-Lymphocytes
    Language English
    Publishing date 2022-10-24
    Publishing country Switzerland
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2661518-6
    ISSN 2073-4409 ; 2073-4409
    ISSN (online) 2073-4409
    ISSN 2073-4409
    DOI 10.3390/cells11213353
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Clinical Aspects of B Cell Immunodeficiencies

    Aisha Ahmed / Elizabeth Lippner / Aaruni Khanolkar

    Cells, Vol 11, Iss 3353, p

    The Past, the Present and the Future

    2022  Volume 3353

    Abstract: B cells and antibodies are indispensable for host immunity. Our understanding of the mechanistic processes that underpin how B cells operate has left an indelible mark on the field of clinical pathology, and recently has also dramatically reshaped the ... ...

    Abstract B cells and antibodies are indispensable for host immunity. Our understanding of the mechanistic processes that underpin how B cells operate has left an indelible mark on the field of clinical pathology, and recently has also dramatically reshaped the therapeutic landscape of diseases that were once considered incurable. Evaluating patients with primary immunodeficiency diseases (PID)/inborn errors of immunity (IEI) that primarily affect B cells, offers us an opportunity to further our understanding of how B cells develop, mature, function and, in certain instances, cause further disease. In this review we provide a brief compendium of IEI that principally affect B cells at defined stages of their developmental pathway, and also attempt to offer some educated viewpoints on how the management of these disorders could evolve over the years.
    Keywords B cells ; immunodeficiency ; humoral immunity ; inborn errors of immunity ; Biology (General) ; QH301-705.5
    Subject code 610
    Language English
    Publishing date 2022-10-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Digital Antibiotic Allergy Decision Support Tool Improves Management of β-Lactam Allergies.

    Dunham, Theresa B / Gardner, Rebecca M / Lippner, Elizabeth A / Fasani, Danielle E / Moir, Elwyn / Halpern-Felsher, Bonnie / Sundaram, Vandana / Liu, Anne Y

    The journal of allergy and clinical immunology. In practice

    2023  Volume 11, Issue 4, Page(s) 1243–1252.e6

    Abstract: Background: Frontline providers frequently make time-sensitive antibiotic choices, but many feel poorly equipped to handle antibiotic allergies.: Objective: We hypothesized that a digital decision support tool could improve antibiotic selection and ... ...

    Abstract Background: Frontline providers frequently make time-sensitive antibiotic choices, but many feel poorly equipped to handle antibiotic allergies.
    Objective: We hypothesized that a digital decision support tool could improve antibiotic selection and confidence when managing β-lactam allergies.
    Methods: A digital decision support tool was designed to guide non-allergist providers in managing patients with β-lactam allergy labels. Non-allergists were asked to make decisions in clinical test cases without the tool, and then with it. These decisions were compared using paired t tests. Users also completed surveys assessing their confidence in managing antibiotic allergies.
    Results: The tool's algorithm was validated by confirming its recommendations aligned with that of five allergists. Non-allergist providers (n = 102) made antibiotic management decisions in test cases, both with and without the tool. Use of the tool increased the proportion of correct decisions from 0.41 to 0.67, a difference of 0.26 (95% CI, 0.22-0.30; P < .001). Users were more likely to give full-dose antibiotics in low-risk situations, give challenge doses in medium-risk situations, and avoid the antibiotic and/or consult allergy departments in high-risk situations. A total of 98 users (96%) said the tool would increase their confidence when choosing antibiotics for patients with allergies.
    Conclusions: A point-of-care clinical decision tool provides allergist-designed guidance for non-allergists and is a scalable system for addressing antibiotic allergies, irrespective of allergist availability. This tool encouraged appropriate antibiotic use in low- and medium-risk situations and increased caution in high-risk situations. A digital support tool should be considered in quality improvement and antibiotic stewardship efforts.
    MeSH term(s) Humans ; beta-Lactams/adverse effects ; Anti-Bacterial Agents/adverse effects ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/therapy ; Surveys and Questionnaires ; Hypersensitivity ; Penicillins
    Chemical Substances beta-Lactams ; Anti-Bacterial Agents ; Penicillins
    Language English
    Publishing date 2023-02-01
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2023.01.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 7086: Show issues Location:
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  4. Article ; Online: Paraneoplastic and Therapy-Related Immune Complications in Thymic Malignancies.

    Lippner, Elizabeth A / Lewis, David B / Robinson, William H / Katsumoto, Tamiko R

    Current treatment options in oncology

    2019  Volume 20, Issue 7, Page(s) 62

    Abstract: Opinion statement: The thymus is a key organ involved in establishing central immune tolerance. Thymic epithelial tumors (TETs) include thymomas and thymic carcinomas. Thymomas, which are histologically distinct from thymic carcinomas, lead to ... ...

    Abstract Opinion statement: The thymus is a key organ involved in establishing central immune tolerance. Thymic epithelial tumors (TETs) include thymomas and thymic carcinomas. Thymomas, which are histologically distinct from thymic carcinomas, lead to dysregulated thymopoiesis via decreased thymic epithelial expression of AIRE and MHC Class II, as well as via alterations in thymic architecture, thereby resulting in autoimmune complications that manifest as paraneoplastic disorders (PNDs). Although progress has been made in elucidating the mechanisms underlying thymoma-associated PNDs, there remains a great need to further define the underlying mechanisms and to identify additional immune biomarkers, such as novel antibodies (in "seronegative" cases) to facilitate diagnosis and monitoring of patients. In addition, a better understanding of the pathogenesis of PNDs could lead to improved treatment strategies for both thymomas and their immune complications. In advanced, refractory cases of TETs (both thymoma and thymic carcinoma), additional therapeutic approaches are needed. Immune checkpoint inhibitors have revolutionized the treatment of several malignancies and hold promise in the treatment of TETs; however, the risks for immune-related adverse events (especially for inducing PNDs as well as in the setting of pre-existing PNDs) underscore the need to optimize patient selection and improve clinical management before there can be widespread acceptance of checkpoint inhibitor therapy in patients with TETs.
    MeSH term(s) Antineoplastic Agents, Immunological/adverse effects ; Antineoplastic Agents, Immunological/therapeutic use ; Biomarkers, Tumor/immunology ; Humans ; Paraneoplastic Syndromes/immunology ; Paraneoplastic Syndromes/pathology ; Thymoma/immunology ; Thymoma/therapy ; Thymus Neoplasms/immunology ; Thymus Neoplasms/therapy
    Chemical Substances Antineoplastic Agents, Immunological ; Biomarkers, Tumor
    Language English
    Publishing date 2019-06-22
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2057351-0
    ISSN 1534-6277 ; 1527-2729
    ISSN (online) 1534-6277
    ISSN 1527-2729
    DOI 10.1007/s11864-019-0661-2
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 5523: Show issues Location:
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  5. Article ; Online: Improving Inpatient Consult Communication Through a Standardized Tool.

    Pavitt, Sara / McHugh, Anne / Chi, Kevin / Hoang, Kim / Lippner, Elizabeth / Tsai, Jennifer / Goldstein, Rachel / Bassett, Hannah / Srinivas, Nivedita S

    Pediatrics

    2021  Volume 147, Issue 5

    Abstract: Objectives: To increase the number of essential consult elements (ECEs) included in initial inpatient consultation requests between pediatric residents and fellows through implementation of a novel consult communication tool.: Methods: Literature ... ...

    Abstract Objectives: To increase the number of essential consult elements (ECEs) included in initial inpatient consultation requests between pediatric residents and fellows through implementation of a novel consult communication tool.
    Methods: Literature review and previous needs assessment of pediatric residents and fellows were used to identify 4 specific ECEs. From February to June 2018, fellows audited verbal consult requests at a medium-sized, quaternary care children's hospital to determine the baseline percentage of ECE components within consults. A novel consult communication tool containing all ECEs was then developed by using a modified situation-background-assessment-recommendation (SBAR) format. The SBAR tool was implemented over 3 plan-do-study-act cycles. Adherence to SBAR, inclusion of ECEs, and consult question clarity were tracked via audits of consult requests. A pre- and postintervention survey of residents and fellows was used to examine perceived miscommunication and patient care errors and overall satisfaction.
    Results: The median percentage of consults containing ≥3 ECEs increased from 50% preintervention to 100% postintervention with consult question clarity increasing from 52% to 92% (
    Conclusions: Implementation of a standardized consult communication tool resulted in increased inclusion of ECEs. Use of the tool led to greater consult question clarity, decreased perceived miscommunication, and improved overall consult satisfaction.
    MeSH term(s) Child ; Communication ; Humans ; Inpatients ; Internship and Residency ; Pediatrics/education ; Referral and Consultation/standards
    Language English
    Publishing date 2021-04-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 207677-9
    ISSN 1098-4275 ; 0031-4005
    ISSN (online) 1098-4275
    ISSN 0031-4005
    DOI 10.1542/peds.2020-0681
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Um IV Zs.131: Show issues Location:
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  6. Article ; Online: Needs assessment survey for a food allergy control tool.

    Lippner, Elizabeth / Sicherer, Scott H / Land, Michael H / Schatz, Michael / Dinakar, Chitra

    The journal of allergy and clinical immunology. In practice

    2018  Volume 7, Issue 2, Page(s) 701–703.e2

    MeSH term(s) Allergens/immunology ; Asthma/epidemiology ; Clinical Decision-Making ; Feasibility Studies ; Food ; Food Hypersensitivity/epidemiology ; Humans ; Needs Assessment/statistics & numerical data ; Patient Education as Topic ; Physicians, Primary Care ; Pilot Projects ; Practice Guidelines as Topic ; Research Design ; Surveys and Questionnaires/standards ; Surveys and Questionnaires/statistics & numerical data ; United States/epidemiology
    Chemical Substances Allergens
    Language English
    Publishing date 2018-10-11
    Publishing country United States
    Document type Letter
    ZDB-ID 2843237-X
    ISSN 2213-2201 ; 2213-2198
    ISSN (online) 2213-2201
    ISSN 2213-2198
    DOI 10.1016/j.jaip.2018.09.035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  7. Article ; Online: Sequential Stem Cell-Kidney Transplantation in Schimke Immuno-osseous Dysplasia.

    Bertaina, Alice / Grimm, Paul C / Weinberg, Kenneth / Parkman, Robertson / Kristovich, Karen M / Barbarito, Giulia / Lippner, Elizabeth / Dhamdhere, Girija / Ramachandran, Vasavi / Spatz, Jordan M / Fathallah-Shaykh, Sahar / Atkinson, T Prescott / Al-Uzri, Amira / Aubert, Geraldine / van der Elst, Kim / Green, Sean G / Agarwal, Rajni / Slepicka, Priscila F / Shah, Ami J /
    Roncarolo, Maria G / Gallo, Amy / Concepcion, Waldo / Lewis, David B

    The New England journal of medicine

    2022  Volume 386, Issue 24, Page(s) 2295–2302

    Abstract: Lifelong immunosuppression is required for allograft survival after kidney transplantation but may not ultimately prevent allograft loss resulting from chronic rejection. We developed an approach that attempts to abrogate immune rejection and the need ... ...

    Abstract Lifelong immunosuppression is required for allograft survival after kidney transplantation but may not ultimately prevent allograft loss resulting from chronic rejection. We developed an approach that attempts to abrogate immune rejection and the need for post-transplantation immunosuppression in three patients with Schimke immuno-osseous dysplasia who had both T-cell immunodeficiency and renal failure. Each patient received sequential transplants of αβ T-cell-depleted and CD19 B-cell-depleted haploidentical hematopoietic stem cells and a kidney from the same donor. Full donor hematopoietic chimerism and functional ex vivo T-cell tolerance was achieved, and the patients continued to have normal renal function without immunosuppression at 22 to 34 months after kidney transplantation. (Funded by the Kruzn for a Kure Foundation.).
    MeSH term(s) Arteriosclerosis/genetics ; Arteriosclerosis/therapy ; Graft Rejection/prevention & control ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunologic Deficiency Syndromes/therapy ; Kidney/physiology ; Kidney Transplantation/adverse effects ; Nephrotic Syndrome/genetics ; Nephrotic Syndrome/therapy ; Osteochondrodysplasias/genetics ; Osteochondrodysplasias/therapy ; Primary Immunodeficiency Diseases/genetics ; Primary Immunodeficiency Diseases/therapy ; Pulmonary Embolism/genetics ; Pulmonary Embolism/therapy ; Transplantation Conditioning/methods
    Language English
    Publishing date 2022-06-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMoa2117028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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