Mayo Clinic proceedings
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Mayo Clinic proceedings · Feb 2006
ReviewPharmacological therapy for acute respiratory distress syndrome.
Acute respiratory distress syndrome (ARDS) is an Inflammatory process caused by a variety of direct and indirect injuries to the lungs. Despite improvements in supportive care and advances in ventilator management, mortality in patients with ARDS remains high. ⋯ As more is understood about the pathophyslology of ARDS, treatment strategies such as increasing alveolar fluid clearance through activation of sodium channels, enhancing repair of alveolar epithelium with growth factors, inhibiting fibrin deposition, blocking proinflammatory transcription factors, preventing the effect of potent vasocontrictors such as endothelin, and using antibodies against key inflammatory cytokines are being explored. This review focuses on the pharmacological treatments studied clinically, proposed reasons for their lack of success, and new concepts emerging in ARDS therapy.
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Mayo Clinic proceedings · Feb 2006
ReviewHuman immunodeficiency virus-associated peripheral neuropathies.
Peripheral neuropathy has emerged as the most common neurologic complication of human immunodeficiency virus (HIV) infection. It will continue to play an Important role in HIV Infection given the fact that HIV-infected Individuals are living longer, are at risk of long-term metabolic complications, and face an Increasing exposure to potentially neurotoxic antiretroviral drugs. We review the various types of peripheral neuropathy that have been associated with HIV infection, including distal symmetrical polyneuropathy, toxic neuropathy from antiretroviral drugs, diffuse infiltrative lymphocytosis syndrome, inflammatory demyelinating polyneuropathies, multifocal mononeuropathies, and progressive polyradiculopathy.
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Mayo Clinic proceedings · Feb 2006
Clinical importance of cardiac troponin release and cardiac abnormalities in patients with supratentorial cerebral hemorrhages.
To determine the Incidence of cardiac troponin T (cTnT) elevation, electrocardiographic (ECG) changes, and arrhythmias in supratentorial intracerebral hemorrhage (ICH) and their association with early mortality. ⋯ The cTnT elevations in survivors of acute ICH are frequent but without confirmatory ECG changes that suggest mild myocardial injury. One-month mortality is not influenced by such cTnT elevations. In addition, ECG abnormalities are common but likely benign in patients with supratentorial ICH who survive the initial insult.
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Mayo Clinic proceedings · Jan 2006
Comparative StudySnowmobile injuries in children and adolescents.
To characterize the risk factors and patterns of injury for children involved in snowmobile incidents. ⋯ Snowmobiles are a significant source of multitrauma for children. Orthopedic injuries predominate, especially in older children, and can lead to long-term disabilities. Helmet use significantly reduces injuries; however, vulnerable younger patients do not frequently wear helmets.
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Mayo Clinic proceedings · Jan 2006
Randomized Controlled Trial Multicenter StudyRopinirole in the treatment of patients with restless legs syndrome: a US-based randomized, double-blind, placebo-controlled clinical trial.
To assess the efficacy, safety, and tolerability of the dopamine agonist ropinirole in the treatment of patients with moderate to severe primary restless legs syndrome (RLS). ⋯ This study confirms that ropinirole improves RLS symptoms and subjective measures of sleep, quality of life, and anxiety and that it is generally well tolerated.