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Platelet Transfusions: Current Practices and Emerging Alternatives in the United States

Friedman, Mark; Costa, Victoria; Rafiee, Behnam; Hilbert, Timothy; Jafri, Mansab; Wu, Ding Wen
Platelet transfusions are a cornerstone of hemorrhage management in patients with thrombocytopenia or platelet dysfunction, yet their indications and dosing are largely based on expert opinion and low-quality evidence. This review offers a timely and comprehensive analysis of platelet transfusion practices in the United States (U.S.), uniquely integrating clinical evidence, such as the pivotal PLADO trial, with emerging technological advancements. Using a holistic approach, this manuscript addresses not only conventional practices (such as dosing standards and storage methods), but also cutting-edge alternatives like cold-stored and freeze-dried platelets, pathogen reduction technologies, and synthetic platelet substitutes. By juxtaposing U.S. practices with international standards, it highlights inefficiencies in dosing and supply management, proposing actionable solutions like lower-dose transfusions and diversified platelet inventories. Furthermore, the manuscript's exploration of whole blood-derived platelets and the ethical debate surrounding paid donors adds a forward-looking perspective. By examining these innovations alongside strategies to optimize supply, this work aims to provide a comprehensive overview of how transfusion medicine is adapting to meet clinical and logistical demands.
PMCID:12194688
PMID: 40566637
ISSN: 2075-1729
CID: 5889032

A dose of platelets: getting it just right

Friedman, Mark T; Costa, Victoria; Rafiee, Behnam; Hilbert, Timothy; Jafri, Mansab; Wu, Ding Wen
ORIGINAL:0017695
ISSN: 2521-361x
CID: 5889322

Porokeratotic variant of lichen planus or lichen planus with porokeratosis: report of a challenging case

Eftekhari, Hojat; Rafiei, Rana; Gharaienejad, Kaveh; Rafiee, Behnam
ISI:000915456700007
ISSN: 1687-1537
CID: 5430742

Retraction Note: Codelivery of HIF-1α siRNA and Dinaciclib by Carboxylated Graphene Oxide-Trimethyl Chitosan-Hyaluronate Nanoparticles Significantly Suppresses Cancer Cell Progression [Correction]

Izadi, Sepideh; Moslehi, Asma; Kheiry, Hadiseh; Kiani, Fariba Karoon; Ahmadi, Armin; Masjedi, Ali; Ghani, Sepideh; Rafiee, Behnam; Karpisheh, Vahid; Hajizadeh, Farnaz; Atyabi, Fatemeh; Assali, Akram; Tekie, Farnaz Sadat Mirzazadeh; Namdar, Afshin; Ghalamfarsa, Ghasem; Sojoodi, Mozhdeh; Jadidi-Niaragh, Farhad
PMID: 36369589
ISSN: 1573-904x
CID: 5430662

The concordance between wide-area transepithelial sampling with computer-assisted 3-dimensional analysis (WATS-3D) and standard endoscope biopsy in the detection of Barrett's esophagus and esophageal dysplasia

Zhao, Chaohui Lisa; Hossein-Zadeh, Zarrin; Dabiri, Bahram; Turunbedu, Solomon; Karalis, Gerasimos; Rafiee, Behnam; Rodriguez, Alex Pipas; Hanna, Iman
INTRODUCTION/BACKGROUND:Barrett's esophagus (BE) is a premalignant condition that leads to susceptibility to developing adenocarcinoma. The most common endoscopic surveillance technique is forceps biopsy, which involves sampling the specimen every 1 to 2 cm along the length of the lesion. This technique has a low sensitivity and often leaves the majority of the esophageal mucosa untested. Recently, the use of wide-area transepithelial sampling with computer-assisted 3-dimensional analysis (WATS-3D) has received much attention. However, there is little known about this novel technique, and this research aims to add to our knowledge of WATS-3D by comparing it to traditional forceps biopsy. MATERIALS AND METHODS/METHODS:A retrospective observational study was performed. All existing GI biopsy cases diagnosed with WATS-3D were identified from the institutional pathology databases of NYU Langone Hospital - Long Island from 2019 to 2021. Data collection included patients' age, sex, and dysplasia results. Existing pathology reports and CDx diagnostics were reviewed. All the existing slides of the biopsy cases were pulled out and reviewed. Dysplasia was classified as no dysplasia, indefinite for dysplasia, lowgrade dysplasia, and high-grade dysplasia. RESULTS:A total of 109 cases were included in this study. There are 59 cases diagnosed as BE with forceps biopsy, 72 cases by WATS-3D, and 77 cases by WATS-3D combined with forceps biopsy. The sensitivity of detecting BE was significantly increased by WATS-3D and further by WATS-3D combined with forceps biopsy. In 59 cases diagnosed as BE with forceps biopsy, 50 cases were classified as no dysplasia, 3 cases were indefinite for dysplasia, 5 cases were low-grade dysplasia, and 1 case was high-grade dysplasia. In 72 cases diagnosed as BE by WATS-3D, 64 cases were classified as no dysplasia, 7 cases were indefinite for dysplasia, 1 case was high-grade dysplasia, and no cases with low-grade dysplasia. In 77 cases diagnosed as BE by WATS-3D combined with forceps biopsy, 63 cases were classified as no dysplasia, 8 cases were indefinite for dysplasia, 5 cases with low-grade dysplasia, and 1 case was highgrade dysplasia. The maximal longitudinal extent of the esophageal mucosal changes strongly correlated with the severity of BE. CONCLUSION/CONCLUSIONS:Compared to traditional forceps biopsy, WATS-3D was more sensitive in finding intestinal metaplasia. However, WATS-3D could not clearly discriminate low-grade dysplasia from indefinite for dysplasia and tended to classify low-grade dysplasia as indefinite for dysplasia. The addition of WATS-3D to forceps biopsy resulted in an increase in diagnostic yield and thus an increase in the quality of patient care.
PMID: 35667232
ISSN: 1532-8198
CID: 5248222

Green Synthesis of Silver Nanoparticles Using the Plant Extracts of Vitex Agnus Castus L: An Ecofriendly Approach to Overcome Antibiotic Resistance

Ghani, Sepideh; Rafiee, Behnam; Bahrami, Samira; Mokhtari, Azam; Aghamiri, Shahin; Yarian, Fatemeh
BACKGROUND/UNASSIGNED:fruit extract. METHODS/UNASSIGNED:bacteria species and minimal inhibitory concentration (MIC) of Ag NPs against these two pathogens was measured. RESULTS/UNASSIGNED:fruit extract was shown. CONCLUSIONS/UNASSIGNED:It can be stated that the biosynthesis of Ag NPs using fruit extract of this plant is an environmentally friendly, economic and harmless method without any use of poisonous substances and no side effects. These Ag NPs can be considered as suitable antibacterial agents and replacements for antibiotics.
PMCID:9704479
PMID: 36452468
ISSN: 2008-7802
CID: 5430672

Antibody Fragment and Targeted Colorectal Cancer Therapy: A Global Systematic Review

Ghani, Sepideh; Deravi, Niloofar; Pirzadeh, Marzieh; Rafiee, Behnam; Gatabi, Zahra Rezanejad; Bandehpour, Mojgan; Yarian, Fatemeh
BACKGROUND AND AIMS/OBJECTIVE:Antibody-based therapeutics have been shown to be promising for the treatment of colorectal cancer patients. However, the size and long-circulating half-lives of antibodies can limit their reproducible manufacture in clinical studies. Consequently, in novel therapeutic approaches, conventional antibodies are minimized and engineered to produce fragments like Fab, scFv, nanobody, bifunctional antibody, bispecific antibody, minibody, and diabody to preserve their high affinity and specificity to target pharmaceutical nanoparticle conjugates. This systematic review for the first time aimed to elucidate the role of various antibody fragments in colorectal cancer treatment. METHODS:A systematic literature search in the web of sciences, PubMed, Scopus, Google Scholar, and ProQuest was conducted. Reference lists of the articles were reviewed to identify the relevant papers. The full-text search included articles published in English during 19902021. RESULTS:Most of the 53 included studies were conducted in vitro and in most conducted studies singlechain antibodies were among the most used antibody fragments. Most antibodies targeted CEA in the treatment of colorectal cancer. Moreover, a large number of studies observed apoptosis induction and tumor growth inhibition. In addition, few studies implicated the role of the innate immune system as an indirect mechanism of tumor growth by enhancing NK-cell killing. CONCLUSION/CONCLUSIONS:Antibody-based therapy was demonstrated to be of great promise in the treatment of colorectal cancer rather than common treatments such as radiotherapy, chemotherapy, and surgical operations. This type of specified cancer treatment can also induce the activation of the innate and specific immune systems to eradicate tumor cells.
PMID: 34375187
ISSN: 1873-4316
CID: 5430652

Blockade of HIF-1α and STAT3 by hyaluronate-conjugated TAT-chitosan-SPION nanoparticles loaded with siRNA molecules prevents tumor growth

Budi, Hendrik Setia; Izadi, Sepideh; Timoshin, Anton; Asl, Sima Heydarzadeh; Beyzai, Behzad; Ghaderpour, Amir; Alian, Fatemeh; Eshaghi, Farzaneh Sadat; Mousavi, Seyedeh Mahboubeh; Rafiee, Behnam; Nikkhoo, Afshin; Ahmadi, Armin; Hassannia, Hadi; Ahmadi, Majid; Sojoodi, Mozhdeh; Jadidi-Niaragh, Farhad
HIF-1α and STAT3 are two of the critical factors in the growth, proliferation, and metastasis of cancer cells and play a crucial role in inhibiting anti-cancer immune responses. Therefore, we used superparamagnetic iron oxide (SPION) nanoparticles (NPs) coated with thiolated chitosan (ChT) and trimethyl chitosan (TMC) and functionalized with hyaluronate (H) and TAT peptide for delivery of siRNA molecules against STAT3 and HIF-1α to cancer cells both in vivo and in vitro. The results indicated that tumor cell transfection with siRNA-encapsulated NPs robustly inhibited proliferation and migration and induced apoptosis in tumor cells. Furthermore, simultaneous silencing of HIF-1α and STAT3 significantly repressed cancer development in two different tumor types (4T1 breast cancer and CT26 colon cancer) which were associated with upregulation of cytotoxic T lymphocytes and IFN-γ secretion. The findings suggest inhibiting the HIF-1α/STAT3 axis by SPION-TMC-ChT-TAT-H NPs as an effective way to treat cancer.
PMID: 33667724
ISSN: 1549-9642
CID: 5430642

Recent developments in antibody derivatives against colorectal cancer; A review

Ghani, Sepideh; Bahrami, Samira; Rafiee, Behnam; Eyvazi, Shirin; Yarian, Fatemeh; Ahangarzadeh, Shahrzad; Khalili, Saeed; Shahzamani, Kiana; Jafarisani, Moslem; Bandehpour, Mojgan; Kazemi, Bahram
Colorectal cancer (CRC) is the fourth most common cause of cancer and mortality worldwide and is the third most common cancer in men and women. Surgery, radiotherapy, and chemotherapy are conventionally used for the treatment of colorectal cancer. However, these methods are associated with various side effects on normal cells. Thus, new studies are moving towards more effective and non-invasive methods for treatment of colorectal cancer. Targeted therapy of CRC is a promising new approach to enhance the efficiency and decrease the toxicity of the treatment. In targeted therapy of CRC, antibody fragments can directly inhibit tumor cell growth and proliferation. They also can act as an ideal carrier for targeted delivery of anticancer drugs. In the present study, the structure and function of different formats of antibody fragments, immune-targeted therapy of CRC using antibody fragments will be discussed.
PMID: 33220288
ISSN: 1879-0631
CID: 5430632

Pathological findings in the postmortem liver of patients with coronavirus disease 2019 (COVID-19)

Zhao, Chaohui Lisa; Rapkiewicz, Amy; Maghsoodi-Deerwester, Mona; Gupta, Mala; Cao, Wenqing; Palaia, Thomas; Zhou, Jianhong; Ram, Bebu; Vo, Duc; Rafiee, Behnam; Hossein-Zadeh, Zarrin; Dabiri, Bahram; Hanna, Iman
Although coronavirus disease 2019 (COVID-19) is transmitted via respiratory droplets, there are multiple gastrointestinal and hepatic manifestations of the disease, including abnormal liver-associated enzymes. However, there are not many published articles on the pathological findings in the liver of patients with COVID-19. We collected the clinical data from 17 autopsy cases of patients with COVID-19 including age, sex, Body mass index (BMI), liver function test (alanine aminotransaminase (ALT), aspartate aminotransaminase (AST), alkaline phosphatase (ALP), direct bilirubin, and total bilirubin), D-dimer, and anticoagulation treatment. We examined histopathologic findings in postmortem hepatic tissue, immunohistochemical (IHC) staining with antibody against COVID-19 spike protein, CD68 and CD61, and electron microscopy. We counted the number of megakaryocytes in liver sections from these COVID-19-positive cases. Abnormal liver-associated enzymes were observed in 12 of 17 cases of COVID-19 infection. With the exception of three cases that had not been tested for D-dimer, all 14 patients' D-dimer levels were increased, including the cases that received varied doses of anticoagulation treatment. Microscopically, the major findings were widespread platelet-fibrin microthrombi, steatosis, histiocytic hyperplasia in the portal tract, mild lobular inflammation, ischemic-type hepatic necrosis, and zone 3 hemorrhage. Rare megakaryocytes were found in sinusoids. COVID-19 IHC demonstrates positive staining of the histiocytes in the portal tract. Under electron microscopy, histiocyte proliferation is present in the portal tract containing lipid droplets, lysosomes, dilated ribosomal endoplasmic reticulum, microvesicular bodies, and coronavirus. The characteristic findings in the liver of patients with COVID-19 include numerous amounts of platelet-fibrin microthrombi, as well as various degrees of steatosis and histiocytic hyperplasia in the portal tract. Possible mechanisms are also discussed.
PMCID:7722493
PMID: 33307078
ISSN: 1532-8392
CID: 4770842