International journal of clinical and experimental medicine
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The acute respiratory distress syndrome (ARDS) is a syndrome of acute respiratory failure associated with severe inflammation and diffuse alveolar damage. Recent studies have demonstrated that the soluble receptor for advanced glycation end products (sRAGE) plays an important role in the pathogenesis of ARDS. The aim of this study was to ascertain whether plasma levels of sRAGE were elevated in ARDS patients compared with appropriate controls. ⋯ There was no significant difference in plasma sRAGE levels between survivors and non-survivors (P=0.34). Our results demonstrate that elevated levels of plasma sRAGE may provide a useful marker for ventilated ARDS patients. Furthermore, the relationship between plasma sRAGE levels and PaO2:FiO2 ratio in the ARDS population provides the hypothesis that ventilatory strategy may influence alveolar epithelial damage in ARDS.
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Cytogenetic abnormalities have emerged as the major novel prognostic factors in multiple myeloma (MM) patients. This meta-analysis comprehensively investigates the association between the cytogenetic abnormalities and survival of MM patients. We searched the PubMed, EMBASE, SCOPUS, and Cochrane databases for articles published until February, 2014. ⋯ Our meta-analysis provides globally quantifiable confirmation of the adverse prognostic value of t (4; 14), del (17p), and Amp (1q21) in OS and PFS for MM patients. Lenalidomide- and bortezomib-based therapies were partly conducive to improve the prognosis of individuals with t (4; 14). Bortezomib-based therapy can partly improve the PFS of patients with Amp (1q21).
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In the pediatric hematology-oncology population, lumbar punctures (LP's) are commonly performed to administer intrathecal chemotherapy and obtain CSF samples. Difficult LP's can arise due to obesity, fibrous tissue formation due to repeated LP procedures, or spinal abnormalities. For difficult LP's that require imaging-guidance, fluoroscopy is generally?? Fluoroscopy, however, subjects the patient and healthcare providers to radiation while also potentially increasing procedure cost and time. ⋯ Our preliminary data suggests that ultrasound may be an efficacious alternative to fluoroscopy. By using ultrasound to identify the landmarks in the lumbar region, the appropriate puncture point can be determined allowing access to the intrathecal space with relative ease. This would decrease the need for fluoroscopy-guidance, the incidence of multiple punctures as well as reducing the procedure time and costs.
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The common intravenous anesthetic agent, propofol, is frequently reported to have negative inotropic and chronotropic effects. In the pediatric population, propofol is commonly used after inhalation induction to facilitate endotracheal intubation without the need for a neuromuscular blocking drug agent. In this setting, we have noted that propofol administration is commonly followed by tachycardia. The current study prospective evaluates heart rate and blood pressure changes following the administration of propofol to pediatric patients anesthetized with nitrous oxide (N2O) and sevoflurane. ⋯ Tachycardia following propofol administration occurs in approximately 50% of pediatric patients despite preceding inhalation induction and concurrent administration of N2O and sevoflurane. Future studies are needed to define the mechanism for this effect.