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Diaphragmatic atrophy

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https://www.readbyqxmd.com/read/28725427/progressive-hypoventilation-due-to-mixed-cd8-and-cd4-lymphocytic-polymyositis-following-tremelimumab-durvalumab-treatment
#1
Sooraj John, Scott J Antonia, Trevor A Rose, Robert P Seifert, Barbara A Centeno, Aaron S Wagner, Ben C Creelan
BACKGROUND: The combination of CTLA-4 and PD-L1 inhibitors has a manageable adverse effect profile, although rare immune-related adverse events (irAE) can occur. CASE PRESENTATION: We describe an autoimmune polymyositis following a partial response to combination tremelimumab and durvalumab for the treatment of recurrent lung adenocarcinoma. Radiography revealed significant reduction in all metastases; however, the patient developed progressive neuromuscular hypoventilation due to lymphocytic destruction of the diaphragmatic musculature...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28716137/progressive-hypoventilation-due-to-mixed-cd8-and-cd4-lymphocytic-polymyositis-following-tremelimumab-durvalumab-treatment
#2
Sooraj John, Scott J Antonia, Trevor A Rose, Robert P Seifert, Barbara A Centeno, Aaron S Wagner, Ben C Creelan
BACKGROUND: The combination of CTLA-4 and PD-L1 inhibitors has a manageable adverse effect profile, although rare immune-related adverse events (irAE) can occur. CASE PRESENTATION: We describe an autoimmune polymyositis following a partial response to combination tremelimumab and durvalumab for the treatment of recurrent lung adenocarcinoma. Radiography revealed significant reduction in all metastases; however, the patient developed progressive neuromuscular hypoventilation due to lymphocytic destruction of the diaphragmatic musculature...
July 18, 2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28698263/ventilator-induced-diaphragmatic-dysfunction-diagnosis-and-role-of-pharmacological-agents
#3
REVIEW
Won-Young Kim, Chae-Man Lim
The use of controlled mechanical ventilation results in a major reduction of diaphragmatic contractile force together with atrophy of diaphragm muscle fibers, which is a condition known as ventilator-induced diaphragmatic dysfunction. Ventilator-induced diaphragmatic dysfunction is one of the major contributors to weaning difficulties and even increased mortality. This review summarizes the current data on the pathogenesis and diagnosis of ventilator-induced diaphragmatic dysfunction, and it outlines the use of ultrasonography for diaphragm evaluation...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28690873/spinal-cord-infarction-in-a-sick-neonate-from-predominant-haemorrhagic-aetiology-a-case-report
#4
Richa Kulshrestha, Joy R Chowdhury, Radhesh K Lalam, Nigel T Kiely
INTRODUCTION: Spinal cord injuries in new born infants following a traumatic delivery or umbilical cord catheterisation due to thromboembolism are well known. Cases with atraumatic acute onset of neonatal paraplegia have also been described in preterm babies or babies born small for gestational age with a stormy postnatal course related to ischaemic aetiology. We describe a rare case of infarction of the spinal cord from a predominant haemorrhagic aetiology. CASE PRESENTATION: A term female baby, first child of unrelated parents, was born by normal vaginal delivery...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28569270/heart-failure-hf-induced-diaphragmatic-atrophy-and-weakness
#5
Karina Huynh
No abstract text is available yet for this article.
July 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28549021/crus-atrophy-accuracy-of-computed-tomorgraphy-in-diagnosis-of-diaphragmatic-paralysis
#6
Warawut Sukkasem, Sherine G Moftah, Gregory Kicska, J David Godwin, Sudhakar Pipavath, Eric Stern
PURPOSE: The aim of this study was to measure the association between crus atrophy as depicted by computed tomography (CT) and fluoroscopic diagnosis of hemidiaphragmatic paralysis in patients with suspected diaphragmatic dysfunction. MATERIALS AND METHODS: A retrospective review of patient data was approved by our institutional review board and was HIPPA-compliant. We reviewed 90 patients who had undergone diaphragmatic fluoroscopy; 72 had CT scans available for measurement of crus thickness at the levels of the celiac and superior mesenteric arteries and the L1 vertebral body...
May 25, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28527575/coup-tf-genes-human-diseases-and-the-development-of-the-central-nervous-system-in-murine-models
#7
Xiong Yang, Su Feng, Ke Tang
COUP-TFI and -TFII are members of the steroid/thyroid nuclear receptor superfamily. Recent clinical studies reveal that COUP-TFI gene mutations are associated with Bosch-Boonstra-Schaaf optic atrophy syndrome displaying symptoms of optic atrophy, intellectual disability, hypotonia, seizure, autism spectrum disorders, oromotor dysfunction, thin corpus callosum, or hearing defects, and COUP-TFII gene mutations lead to congenital heart defects and/or congenital diaphragmatic hernia with developmental delay and mental defects...
2017: Current Topics in Developmental Biology
https://www.readbyqxmd.com/read/28515334/central-acting-therapeutics-alleviate-respiratory-weakness-caused-by-heart-failure-induced-ventilatory-overdrive
#8
Andrew J Foster, Mathew J Platt, Jason S Huber, Ashley L Eadie, Alicia M Arkell, Nadya Romanova, David C Wright, Todd E Gillis, Coral L Murrant, Keith R Brunt, Jeremy A Simpson
Diaphragmatic weakness is a feature of heart failure (HF) associated with dyspnea and exertional fatigue. Most studies have focused on advanced stages of HF, leaving the cause unresolved. The long-standing theory is that pulmonary edema imposes a mechanical stress, resulting in diaphragmatic remodeling, but stable HF patients rarely exhibit pulmonary edema. We investigated how diaphragmatic weakness develops in two mouse models of pressure overload-induced HF. As in HF patients, both models had increased eupneic respiratory pressures and ventilatory drive...
May 17, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28459396/-mechanical-ventilation-leads-to-remodeling-of-diaphragma-and-soleus-in-rats
#9
Lei Shao, Zhifang Wang, Feifei Wang, Jiaru Huang, Xiaoping Zhu
OBJECTIVE: To investigate the structural response of diaphragm and soleus of the rat after mechanical ventilation (MV), and to explore the specific mechanism of the dysfunction of both muscles. METHODS: Sixteen male Sprague-Dawley (SD) rats were randomly divided into control group and MV group, with 8 rats in each group. Rats in MV group were treated with controlled ventilation and maintained anesthesia, and those in control group were only anesthetized without MV and maintained anesthesia...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28290154/the-role-of-calpains-in-ventilator-induced-diaphragm-atrophy
#10
Xiaoping Zhu, Hieronymus W H van Hees, Leo Heunks, Feifei Wang, Lei Shao, Jiaru Huang, Lei Shi, Shaolin Ma
BACKGROUND: Controlled mechanical ventilation (CMV) is associated with diaphragm dysfunction. Dysfunction results from muscle atrophy and injury of diaphragm muscle fibers. Enhanced proteolysis and reduced protein synthesis play an important role in the development of atrophy. The current study is to evaluate the effects of the calpains inhibitor calpeptin on the development of diaphragm atrophy and activation of key enzymes of the ubiquitin-proteasome pathway in rats under CMV. METHODS: Three groups of rats were studied: control animals (CON, n = 8), rats subjected to 24 h of MV (CMV, n = 8), and rats subjected to 24 h of MV after administration of the calpain inhibitor calpeptin (CMVC, n = 8)...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28135290/global-proteome-changes-in-the-rat-diaphragm-induced-by-endurance-exercise-training
#11
Kurt J Sollanek, Jatin G Burniston, Andreas N Kavazis, Aaron B Morton, Michael P Wiggs, Bumsoo Ahn, Ashley J Smuder, Scott K Powers
Mechanical ventilation (MV) is a life-saving intervention for many critically ill patients. Unfortunately, prolonged MV results in the rapid development of diaphragmatic atrophy and weakness. Importantly, endurance exercise training results in a diaphragmatic phenotype that is protected against ventilator-induced diaphragmatic atrophy and weakness. The mechanisms responsible for this exercise-induced protection against ventilator-induced diaphragmatic atrophy remain unknown. Therefore, to investigate exercise-induced changes in diaphragm muscle proteins, we compared the diaphragmatic proteome from sedentary and exercise-trained rats...
2017: PloS One
https://www.readbyqxmd.com/read/27798315/detection-of-ventilator-autotriggering-by-an-esophageal-catheter-used-to-monitor-the-neural-input-and-diaphragm-excitation
#12
Harbaksh Sangha, Troy Whitacre
Patient-ventilator synchrony has been the focus of attention in the field of mechanical ventilation for quite some time now. Toward that end, the modern ventilators are equipped with very sensitive pneumatic triggering mechanisms, which allow for minimal wasting of patient effort. The increasingly sensitive pneumatic triggers have the potential to cause autotriggering, where stimuli other than neural signals (eg, cardiac oscillations) can trigger the mechanical breath. Although autotriggering has been well documented in brain-dead patients, its existence is difficult to prove in patients who have the ability to trigger breath through neural diaphragmatic activity...
October 25, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27766377/-diaphragm-dysfunction-facts-for-clinicians
#13
REVIEW
C S Bruells, G Marx
Diaphragm function is crucial for patient outcome in the ICU setting and during the treatment period. The occurrence of an insufficiency of the respiratory pump, which is predominantly formed by the diaphragm, may result in intubation after failure of noninvasive ventilation. Especially patients suffering from chronic obstructive pulmonary disease are in danger of hypercapnic respiratory failure. Changes in biomechanical properties and fiber texture of the diaphragm are further cofactors directly leading to a need for intubation and mechanical ventilation...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27673044/poster-285-ultrasound-guided-diaphragmatic-emg-in-patient-with-respiratory-decline-and-pre-existing-contralateral-diaphragm-atrophy-a-case-report
#14
Benjamin J Bonte, Jason Freeman, Gary Fang, Harald Sauthoff
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27620292/assessment-of-diaphragmatic-dysfunction-in-the-critically-ill-patient-with-ultrasound-a-systematic-review
#15
Massimo Zambon, Massimiliano Greco, Speranza Bocchino, Luca Cabrini, Paolo Federico Beccaria, Alberto Zangrillo
PURPOSE: Diaphragmatic dysfunction (DD) has a high incidence in critically ill patients and is an under-recognized cause of respiratory failure and prolonged weaning from mechanical ventilation. Among different methods to assess diaphragmatic function, diaphragm ultrasonography (DU) is noninvasive, rapid, and easy to perform at the bedside. We systematically reviewed the current literature assessing the usefulness and accuracy of DU in intensive care unit (ICU) patients. METHODS: Pubmed, Cochrane Database of Systematic Reviews, Embase, Scopus, and Google Scholar Databases were searched for pertinent studies...
January 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/27570397/spinal-muscular-atrophy-with-respiratory-distress-syndrome-smard1-case-report-and-review-of-literature
#16
Lokesh Lingappa, Nikit Shah, Ananth Sagar Motepalli, Farhan Shaik
Spinal muscular atrophy with respiratory distress syndrome (SMARD1) is a rare cause of early infantile respiratory failure and death. No cases have been currently described from India. Two low-birth-weight infants presented prior to 6 months of age with recurrent apnea and respiratory distress. Both required prolonged ventilation, and had distal arthrogryposis and diaphragmatic eventration. Nerve conduction study revealed motor sensory axonopathy. Genetic testing confirmed mutations in immunoglobulin mu binding protein (IGHMBP2)...
July 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27553431/diaphragm-dysfunction-in-mechanically-ventilated-patients
#17
Irene Dot, Purificación Pérez-Teran, Manuel-Andrés Samper, Joan-Ramon Masclans
Muscle involvement is found in most critical patients admitted to the intensive care unit (ICU). Diaphragmatic muscle alteration, initially included in this category, has been differentiated in recent years, and a specific type of muscular dysfunction has been shown to occur in patients undergoing mechanical ventilation. We found this muscle dysfunction to appear in this subgroup of patients shortly after the start of mechanical ventilation, observing it to be mainly associated with certain control modes, and also with sepsis and/or multi-organ failure...
March 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/27532030/prolonged-glucocorticoid-treatment-in-ards-impact-on-intensive-care-unit-acquired-weakness
#18
REVIEW
Gianfranco Umberto Meduri, Andreas Schwingshackl, Greet Hermans
Systemic inflammation and duration of immobilization are strong independent risk factors for the development of intensive care unit-acquired weakness (ICUAW). Activation of the pro-inflammatory transcription factor nuclear factor-κB (NF-κB) results in muscle wasting during disuse-induced skeletal muscle atrophy (ICU bed rest) and septic shock. In addition, NF-κB-mediated signaling plays a significant role in mechanical ventilation-induced diaphragmatic atrophy and contractile dysfunction. Older trials investigating high dose glucocorticoid treatment reported a lack of a sustained anti-inflammatory effects and an association with ICUAW...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27515219/renin-angiotensin-system-in-ventilator-induced-diaphragmatic-dysfunction-potential-protective-role-of-angiotensin-1-7
#19
Anna Sigurta', Vanessa Zambelli, Giacomo Bellani
Ventilator-induced diaphragmatic dysfunction is a feared complication of mechanical ventilation that adversely affects the outcome of intensive care patients. Human and animal studies demonstrate atrophy and ultrastructural alteration of diaphragmatic muscular fibers attributable to increased oxidative stress, depression of the anabolic pathway regulated by Insulin-like growing factor 1 and increased proteolysis. The renin-angiotensin system, through its main peptide Angiotensin II, plays a major role in skeletal muscle diseases, mainly increasing oxidative stress and inducing insulin resistance, atrophy and fibrosis...
September 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27469131/diaphragmatic-eventration-in-sisters-with-asparagine-synthetase-deficiency-a-novel-homozygous-asns-mutation-and-expanded-phenotype
#20
Jun Sun, Angela J McGillivray, Jason Pinner, Zhihui Yan, Fengxia Liu, Drago Bratkovic, Elizabeth Thompson, Xiuxiu Wei, Huifeng Jiang, Asan, Maya Chopra
BACKGROUND: Asparagine Synthetase Deficiency (ASNSD; OMIM #615574) is a newly described rare autosomal recessive neurometabolic disorder, characterised by congenital microcephaly, severe psychomotor delay, encephalopathy and progressive cerebral atrophy. To date, seven families and seven missense mutations in the ASNSD disease causing gene, ASNS, have been published. METHODS: We report two further affected infant sisters from a consanguineous Indian family, who in addition to the previously described features had diaphragmatic eventration...
2017: JIMD Reports
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