Chest
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Observational Study
Predicting Mortality and Morbidity after Elective Cardiac Surgery Using Vasoactive-Inflammatory Biomarkers; with and without the EuroSCORE model.
In cardiac surgery, preoperative mortality risk assessment tools like the EuroSCORE help to guide physicians in optimizing perioperative care of patients. We investigated the value of preoperative levels of inflammatory (procalcitonin [PCT]) and vasoactive (C-terminal pro-arginine vasopressin [CT-proAVP], midregional pro-atrial natriuretic peptide [MR-proANP], midregional proadrenomedullin [MR-proADM], and C-terminal pro-endothelin-1 [CT-proET-1]) biomarkers for risk assessment of mortality and morbidity and compared it with the EuroSCORE. ⋯ In elective cardiac surgery, preoperative levels of MR-proADM and CT-proET-1 are predictors of 30-day mortality and could improve the predictive accuracy of the EuroSCORE. Further research should confirm the place of these new biomarkers in the prediction of mortality and identification of patients at risk.
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Antiphospholipid syndrome is an autoimmune disorder characterized by a hypercoagulable state, leading to arterial and venous thrombosis. We present a 23-year-old patient, suspected of having Budd-Chiari syndrome due to antiphospholipid syndrome, who developed severe and progressive hypoxemia, requiring prolonged mechanical ventilation. ⋯ Restoring normal blood flow from the azygos vein into the right atrium by stenting the azygos-superior vena cava junction resolved the hypoxemia immediately. Within the same procedure, the hepatic outflow obstruction was successfully treated by stenting a severe stenosis of the suprahepatic inferior vena cava caused by calcified thrombus.
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NBS LabChip G2-3 is a novel, ultrafast, chip-type portable real-time polymerase chain reaction (PCR) system. We evaluated the clinical usefulness of this system in detecting pulmonary TB and assessed its diagnostic performance compared with a conventional tube-type PCR system. ⋯ The NBS LabChip G2-3 system has potential as an ultrafast, cost-effective diagnostic tool for pulmonary TB with high sensitivity and specificity.
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Hepatocyte growth factor (HGF) and vascular endothelial growth factor (VEGF) are involved in the pathogenesis of various lung diseases. This study was designed to determine the possible interactions of these growth factors in the development of COPD. ⋯ Upregulated HGF probably compensated for the reduced levels of VEGF and preserved the pulmonary function in smokers without COPD. By contrast, both HGF and VEGF levels were decreased in smokers with COPD, which likely led to the development of COPD. Thus, the level of HGF relative to that of VEGF may be a reliable indicator of the risk for COPD.
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Outcomes after in-hospital CPR in older adults with chronic illness are unclear. ⋯ Older CPR recipients with any of the six underlying chronic diseases investigated generally have much worse outcomes than CPR recipients without chronic disease. These findings may substantially affect decisions about CPR in patients with chronic illness.