Effect of pathologic fractures on survival in multiple myeloma patients: a case control study

<p>Abstract</p> <p>Background</p> <p>Multiple Myeloma (MM) is a B cell neoplasm characterized by the clonal proliferation of plasma cells. Skeletal complications are found in up to 80% of myeloma patients at presentation and are major cause of morbidity.</p> <p>Methods</p> <p>49 patients were enrolled with MM admitted to Black Sea Technical University Hospital between 2002–2005. Pathologic fractures (PFs) were determined and the patients with or without PF were followed up minumum 3 years for survival analysis.</p> <p>Results</p> <p>PF was observed in 24 patients (49%) and not observed in 25 patients (51%). The risk of death was increased in the patients with PF compared with patients who had no fractures. While overall survival was 17.6 months in the patients with PFs, it was 57.3 months in the patients with no PFs.</p> <p>Conclusion</p> <p>These findings suggest that PFs may induce reduced survival and increased mortality in the MM patients, however, larger sample size is essential to draw clearer conclusions added to these data.</p

Intrauterine growth curves for Turkish infants born between 25 and 42 weeks of gestation

Intrauterine growth curves should be specific to each population and are needed for the Turkish population. An analysis of birthweight, crown-heel length, and head circumference in newborns between 25 and 42 weeks of gestational age was made. A total of 2481 babies were evaluated. Mean, standard deviation, and percentile values were calculated for each gestational age and smoothed curves were obtained for each parameter. In our country, the use of these new curves is more appropriate than those obtained in other countries

Theoretical and spectroscopic investigations on the structure and bonding in B-C-N thin films

Cataloged from PDF version of article.In this study, we have synthesized boron, carbon, and nitrogen containing films using RF sputter deposition. We investigated the effects of deposition parameters on the chemical environment of boron, carbon, and nitrogen atoms inside the films. Techniques used for this purpose were grazing incidence reflectance-Fourier-transform infrared spectroscopy (GIR-FTIR), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM) and electron energy loss spectroscopy (EELS). GIR-FTIR experiments on the B-C-N films deposited indicated presence of multiple features in the 600 to 1700 cm(-1) range for the infrared (IR) spectra. Analysis of the IR spectra, XPS and the corresponding EELS data from the films has been done in a collective manner. The results from this study suggested even under nitrogen rich synthesis conditions carbon atoms in the B-C-N films prefer to be surrounded by other carbon atoms rather than boron and/or nitrogen. Furthermore, we have observed a similar behavior in the chemistry of B-C-N films deposited with increasing substrate bias conditions. In order to better understand these results, we have compared and evaluated the relative stability of various nearest-neighbor and structural configurations of carbon atoms in a single BN sheet using DFT calculations. These calculations also indicated that structures and configurations that increase the relative amount of C-C bonding with respect to B-C and/or C-N were energetically favorable than otherwise. As a conclusion, carbon tends to phase-segregate in to carbon clusters rather than displaying a homogeneous distribution for the films deposited in this study under the deposition conditions studied. (C) 2009 Elsevier B.V. All rights reserved

Effects of recombinant human erythropoietin in infants with very low birth weights

Anaemia of prematurity, a postnatal fall in haemoglobin concentration and haematocrit, is particularly common in those born at less than 32 weeks of gestation. Experimental and clinical data implicate inadequate erythropoietin production as an important reason. In this study recombinant human erythropoietin (r-HuEpo) was used in an attempt to treat or prevent this anaemia and thereby provide an alternative to erythrocyte transfusions. Premature infants (birth weight less than or equal to 1250 g and gestational age less than or equal to 32 weeks), who were likely to need transfusions, were randomly assigned to receive 4 weeks of treatment with either subcutaneously administered r-HuEpo (200 U; n = 12) or placebo (n = 12), three times weekly. All patients had oral supplements of elemental iron at a dose of 3 mg/kg/day. Treatment was started in the third week of life. Reticulocyte counts were significantly raised (P < 0.05) in the group treated with r-HuEpo at the end of treatment. The neonates in the group treated with r-HuEpo needed fewer erythrocyte transfusions than those in the placebo group during treatment. There were no toxic effects attributable to r-HuEpo. The results indicate that treatment of infants with very low birth weights with r-HuEpo will reduce their need for erythrocyte transfusions

Management of late anemia in Rhesus hemolytic disease: Use of recombinant human erythropoietin (A pilot study)

The management of (Rhesus) hemolytic disease of the fetus and newborn includes intrauterine transfusions to prevent the development of hydrops, treatment of the possible hyperbilirubinemia in the immediate postnatal period, and treatment of late anemia. Low levels of serum erythropoietin due to suppression of the bone marrow by multiple intrauterine transfusions is a suggested mechanism for this anemia. The aim of our study was to test whether recombinant human erythropoietin reduced the need for erythrocyte transfusions in these infants. Twenty infants with Rhesus isoimmunization were blindly randomized to treatment and control groups at the 2nd wk of life. The number of intrauterine and exchange transfusions and demographic data were similar in both groups. The infants in the treatment group received recombinant human erythropoietin, s.c. 200 U/kg of body weight three times a week for a period of 6 wk, whereas the infants in the control group received a placebo for the same period. In the treatment group, the mean number of erythrocyte transfusions was significantly lower than that of the control group (1.8 versus 4.2). The reticulocyte counts and Hb levels rose earlier in the treatment group. The platelet and neutrophil counts were similar in both groups throughout the study. This study demonstrates that recombinant human erythropoietin treatment decreases the need for erythrocyte transfusions in the late anemia of infants with Rh isoimmunization. Considering the risks of blood transfusions, this decrease in the donor exposure is worthwhile

Isoniazid and hypoglycaemia in a premature infant

Severe hypoglycaemia requiring more than 20 mg/kg per minute glucose infusion was seen in a premature infant. The infant was born to a woman with active tuberculosis, and she was on prophylactic isoniazid. Discontinuation of isoniazid resulted in prompt recovery of hypoglycaemia. Further pharmacological studies may be needed to establish a cause and effect relationship

Neonatal septicemia in a neonatal intensive care unit - Results of four years

The outcome of congenital and nosocomial septicemia has been documented in infants who were admitted to a neonatal intensive care unit over a four-year period. The overall incidence of neonatal septicemia in the neonatal intensive care unit was 5.4 percent. Common causes of neonatal septicemia were gram-negative bacilli and staphylococci. Gram-positive microorganisms were the major causative agents for early-onset septicemia. Since the most common pathogen in cases of nosocomial sepsis was gram-negative bacillus, higher mortality rates were observed in nosocomial sepsis. The overall mortality rate in neonatal sepsis was 44.2 percent. The mortality rate in infants in whom nosocomial septicemia developed was significantly higher than in the infants in whom early-onset septicemia developed. However, as gram-negative colonization of the nursery recently changed to gram-positive microorganisms, the mortality rate is hoped to decrease

HIGH-DOSE INTRAVENOUS IMMUNOGLOBULIN THERAPY FOR RHESUS HEMOLYTIC-DISEASE

Rhesus haemolytic disease is a continuing problem in the newborn especially in countries where the use of anti-D immunoglobulin is not prevalent. The fetuses may need intrauterine transfusions to prevent hydrops faetalis and they also may need exchange transfusions to treat the hyperbilirubinaemia that develops after birth. These interventions expose the baby to several blood donors, hence the risk of infection and exchange transfusions, This study was performed to test whether the use of high-dose intravenous immunoglobulin soon after the birth of these infants reduced the need for exchange transfusions. After randomization, intravenous immunoglobulin was given at a dose of 500 mg/kg to 22 infants in the treatment group. Nothing was given to the 19 controls. The number of exchange transfusions needed decreased significantly in the treatment group. No side-effects of intravenous immunoglobulins were seen