Epidural anesthesia with factor XI deficiency

Dr. Dana Shani  Back to your profile View as PDF Patient’s Summary 34 y/o pregnant female, factor XI def 53%, no history of bleeding.   This report will answer the following inquiry: Should she get an FFP transfusion prior to epidural anesthesia? Conclusion In general, quality studies addressing obstetric management of women with factor XI […]

Use of DOACs anticoagulants in patients with Antithrombin III deficiency

Dr. Dana Shani Back to your profile PDF Version Research Inquiry Can she be safely switched to DOACS? Patient’s Summary 40 years old WF, bx of massive PE, found to have AT III deficiency and has been on Coumadin for 15 years.  Conclusion While researching this inquiry, we found little high-quality data (RCTs, Meta-analysis) describing […]

Concomitant use of TKI sand Radiation therapy

Dr. Dana Shani Back to your profile PDF Version Research Inquiry A 78 years old white male, with a history of CML currently on Dasatinib, developed Prostate cancer and is in need of local radiation to the prostate.  This summarized report will review and present information regarding the safety of possible treatments using Dasatinib or […]

Hype viscosity & elevated serum antibodies titers – surgical safety

Dr. Dana Shani Hype viscosity & elevated serum antibodies titers – surgical safety Back to your profile PDF Version Research Inquiry 70 y/o male was found to have prolonged PTT prior to surgery…work up revealed elevated titers of lupus anticoagulants and anticardiolipin antibodies and elevated IgM 3225 (norm 35-242) with elevated serum viscosity of 2.6 […]

Hereditary Hemorrhagic Telangiectasia & Surgical Bleeding

Dr. Dana Shani Back to your profile View as PDF Research Inquiry 26 years old white female, history of Hereditary Hemorrhagic Telangiectasia (Osler -Weber -Randu), made by ears, nose and throat physician, but no genetic confirmation. History of multiple nose bleeds, but no Iron Deficiency Anemia (IDA), and normal coags. The patient had a traumatic […]

PNH

Dr. Dana Shani Back to your profile View as PDF Research Inquiry Based on recent literature, can the patient have a drug holiday from Ultomiris? Conclusion In conclusion, continuous administration of Ultomiris (Ravulizumab) in the treatment of PNH shows prominent advantages. No studies have been found discussing the discontinuation of Ultomiris. Discontinuation of Eculizumab, a […]

Lymphoplasmocytic Lymphoma

Dr. Dana Shani Back to your profile View as PDF Research Inquiry A 56-year-old obese diabetic woman was recently diagnosed with MYD88 Non-IgM Lymphoplasmacytic Lymphoma (LPL) by bone marrow aspirate and biopsy. An immunoglobulin blood test showed elevated IgG kappa of 4094 mg/dL, and Hb levels of 9.5 gr/dL indicating slight anemia. PET scan showed […]

Chronic Suboxone usage and DVT/PE/Intracranial bleed

Dr. Dana Shani Back to your profile View as PDF Research Inquiry Is chronic Suboxone use associated with DVT/PE and intracranial bleed? This summarized report will review the possible linkage between treatment with Suboxone (Buprenorphine + Naloxone) and Deep Vein Thrombosis, Pulmonary Embolism, and intracranial bleed, as described in the literature.  Medical Meta Findings Inquiry-focused […]

Lymphoplasmacytic Lymphoma with Amyloidosis

Dr. Dana Shani Back to your profile View as PDF Research Inquiry A 69 years old African American male with Chronic heart failure, Lymphoplasmacytic Lymphoma, and Amyloid on Lymph node biopsy. No evidence of cardiac amyloid.This summarized report will review and present information regarding possible treatments for Lymphoplasmocytic Lymphoma and the safety of those therapies, […]