Publications by authors named "Alison R Perate"

6 Publications

  • Page 1 of 1

Moving Beyond the Ordinary: Transcending Traditions in Pediatric Anesthesia.

Anesthesiol Clin 2020 09;38(3):xv-xvi

The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address:

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http://dx.doi.org/10.1016/j.anclin.2020.07.001DOI Listing
September 2020

Pediatric Mass Casualty Preparedness.

Authors:
Alison R Perate

Anesthesiol Clin 2020 Sep 15;38(3):509-516. Epub 2020 Jul 15.

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address:

Disaster medicine refers to situations in which the need to care for patients outweighs the available resources. It is imperative for anesthesiologists to be involved at a leadership level in mass casualty/disaster preparedness planning. Mass casualty disaster plans should be clear, concise, and easy to follow. Terror events and natural disasters can differ significantly in anesthesia preparedness. Resiliency is an important aspect of the recovery phase that decreases psychological damage in the aftermath of a mass casualty event.
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http://dx.doi.org/10.1016/j.anclin.2020.05.002DOI Listing
September 2020

Pain Management in Trauma in the Age of the Opioid Crisis.

Anesthesiol Clin 2019 Mar 19;37(1):79-91. Epub 2018 Dec 19.

Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA. Electronic address:

It is imperative to find the balance between pain control and addressing the opioid epidemic. Opioids, although effective in the acute pain management, have multiple side effects and can lead to dependence, abuse, overdose, or death. Physicians should identify patients who abuse opioids, using their states' prescription drug-monitoring programs and use screening tools to identify patients at increased risk of developing opioid dependence. Multimodal analgesic plans, incorporating regional techniques, and nonopioid medications should be employed to reduce the amount of opioids received by patients.
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http://dx.doi.org/10.1016/j.anclin.2018.09.010DOI Listing
March 2019

BAFF receptors and ligands create independent homeostatic niches for B cell subsets.

Curr Opin Immunol 2015 Jun 30;34:126-9. Epub 2015 Mar 30.

Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.

The BAFF family of receptors and ligands controls B cell homeostasis and selection. Recent studies reveal distinct sources and roles for systemic versus locally produced BAFF. Moreover, the notion that differential BAFF receptor expression patterns establish independent homeostatic and selective niches has been strengthened. Finally, unique roles for BAFF family members in the regulation of antigen experienced and innate B cell subsets have been revealed. Herein, we overview current knowledge in these areas, emphasizing recent findings that inform these ideas.
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http://dx.doi.org/10.1016/j.coi.2015.03.005DOI Listing
June 2015

Supraclavicular block as a sole anesthetic technique in craniopagus twins.

Reg Anesth Pain Med 2013 Sep-Oct;38(5):456-8

Department of Clinical Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.

This is the first report in the literature of a sole regional anesthetic for adult craniopagus twins using a supraclavicular block for an elbow incision and drainage/bursa excision procedure. It demonstrates that for these complex medical patients, a total regional anesthesia technique is preferable when possible. There are several known general anesthetic complications in these patients. Anesthetic crossover between the twins can occur and may be variable; furthermore, the incidence and severity of the crossover effects of different anesthetics vary. Positioning of the twins can be difficult with both regional and general anesthesia. However, with regional anesthesia, the twins can position themselves and report any discomfort, which could go unnoticed under general anesthesia, leading to other complications. Craniopagus twins have a high likelihood of a difficult airway due to anatomy or positioning difficulties, which is avoided by regional anesthesia. This case emphasizes the unique challenges that these patients pose and the ability of regional anesthesia to help avoid the pitfalls of general anesthesia in these patients.
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http://dx.doi.org/10.1097/AAP.0b013e318296227eDOI Listing
April 2014

Alloreactive CD4 T cell activation in vivo: an autonomous function of the indirect pathway of alloantigen presentation.

J Immunol 2003 Dec;171(12):6502-9

Harrison Department of Surgical Research, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.

Activation of alloreactive CD4 T cells occurs via the direct and indirect pathways of alloantigen presentation. A novel TCR/alloantigen transgenic system was designed that permitted in vivo visualization of CD4 T cell priming through these pathways. When both pathways of alloantigen presentation were intact, CD4 T cell activation in response to cardiac allografts was rapid and systemic by day 4 after transplantation, in contrast to that seen in response to skin allografts, which was delayed until 10-12 days after transplantation. Despite this systemic CD4 T cell activation in response to cardiac allografts, there was a paucity of activated graft-infiltrating CD4 T cells at 4 days posttransplantation. This finding suggests that the initial priming of alloimmune CD4 T cell responses occurs within draining lymphoid organs. Furthermore, alloantigens derived from cardiac allografts failed to promote thymic negative selection of developing thymocytes expressing the alloreactive TCR clonotype. In the absence of a functional direct pathway, the kinetics of activation, anatomic localization, and effector function of alloreactive CD4 T cells remained unchanged. Overall, the present study defines the anatomic and temporal characteristics of CD4 T cell alloimmune responses and demonstrates that CD4 T cell priming via the indirect pathway proceeds optimally in the absence of the direct pathway of alloantigen presentation.
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http://dx.doi.org/10.4049/jimmunol.171.12.6502DOI Listing
December 2003