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Phrenic nerve

Susanna Maltoni, Antonella Negro, Maria D Camerlingo, Valentina Pecoraro, Biagio Sassone, Mauro Biffi, Giuseppe Boriani
AIMS: To perform an updated meta-analysis to assess efficacy, safety and technical performance of pulmonary vein isolation using cryoballoon or radiofrequency catheter ablation in patients with paroxysmal or persistent atrial fibrillation. METHODS: In June 2017, databases and websites were systematically searched for systematic reviews, randomized controlled trials and observational studies reporting data on efficacy, safety and technical performance outcomes at follow-up at least 12 months...
October 12, 2018: Journal of Cardiovascular Medicine
Uwe Walter, Panagiota Tsiberidou, Maxi Kersten, Alexander Storch, Matthias Löhle
Background: The vagus nerve has been suggested to represent one major route of disease progression in Parkinson's disease (PD). Here, we examined whether patients with idiopathic PD exhibit an atrophy of the vagus nerve in comparison to age-matched controls. Methods: In this cross-sectional study, performed between July 2017 and January 2018, we measured the caliber (cross-sectional area) of the mid-cervical vagus, accessory and phrenic nerves in 20 patients with PD (disease duration: 10.1 ± 7.4 years) and 61 (including 20 age-matched) controls using high-resolution ultrasonography...
2018: Frontiers in Neurology
Joseph F Welch, Bruno Archiza, Jordan A Guenette, Christopher R West, Andrew William Sheel
Women are more resistant to diaphragmatic fatigue (DF) and experience an attenuated inspiratory muscle metaboreflex relative to men. The effects of such sex-based differences on whole-body endurance exercise tolerance are yet to be examined. Healthy men (n = 9, age = 24 ± 3 years) and women (n = 9, age = 24 ± 3 years) completed a maximal incremental cycle test on day 1. On day 2, subjects performed isocapnic inspiratory pressure-threshold loading (PTL) to task failure followed by a constant load submaximal time-to-exhaustion (TTE) exercise test at 85% of the predetermined peak work rate...
October 11, 2018: Journal of Applied Physiology
A V Sazhin, T V Nechay, S M Titkova, A E Tyagunov, M V Anurov, K Yu Melnikov-Makarchuk, A A Tyagunov, I V Ermakov, N S Glagolev, L S Kurashinova, E A Ivanova, V S Nechay, A V Karpov, A T Mirzoyan, G B Ivakhov, Yu S Balakirev
AIM: To analyze outcomes of fast track rehabilitation in patients with acute appendicitis. MATERIAL AND METHODS: Prospective, randomized multi-center trial including 86 patients was conducted. There were 38 patients in the main group and 48 in the control group. All patients underwent laparoscopic appendectomy under endotracheal anesthesia. Protocol included informing, no premedication, glucose infusion prior to surgery, antibiotics administration, mesoappendix excision, limited deployment of drainage tubes, intraabdominal prolonged anesthesia, minimal pneumoperitoneum, limited irrigation, minimum power monopolar electrocautery, antiemetics, early activation and eating (2 and 6 hours after surgery)...
2018: Khirurgiia
Christoph Stellbrink, Bert Hansky, Philipp Baumann, Dennis Lawin
Sleep-related breathing disorders can be classified as either obstructive (OSA) or central sleep apnea (CSA). Whereas there is substantial knowledge about the pathophysiology and sound recommendations for the diagnosis and treatment of OSA, the origin of CSA is still incompletely understood, patient identification is difficult and the necessity for specific treatment is under debate. CSA often accompanies heart failure and is associated with an adverse prognosis. Optimized heart failure treatment reduces CSA and is thus the cornerstone of CSA treatment...
October 10, 2018: Herzschrittmachertherapie & Elektrophysiologie
Maria Rosa Costanzo, Piotr Ponikowski, Andrew Coats, Shahrokh Javaheri, Ralph Augostini, Lee R Goldberg, Richard Holcomb, Andrew Kao, Rami N Khayat, Olaf Oldenburg, Christoph Stellbrink, Scott McKane, William T Abraham
AIMS: The presence of central sleep apnoea (CSA) is associated with poor prognosis in patients with heart failure (HF). The aim of this analysis was to evaluate if using phrenic nerve stimulation to treat CSA in patients with CSA and HF was associated with changes in HF-specific metrics. METHODS AND RESULTS: All patients randomized in the remedē System Pivotal Trial and identified at baseline with HF were included (n = 96). Effectiveness data from treatment and former control groups were pooled based on months since therapy activation...
October 10, 2018: European Journal of Heart Failure
Dirk Prochnau, Konstantin von Knorre, Hans-Reiner Figulla, P Christian Schulze, Ralf Surber
Background: We sought to evaluate a temperature-guided approach of cryoballoon (CB) ablation without visualization of real-time recordings. Methods and results: We analysed 166 patients (34.9% female, 60 ± 11 years) with paroxysmal or short-term persistent atrial fibrillation (AF). Comorbidities included diabetes mellitus (n = 28), coronary artery disease (n = 24), hypertension (n = 122), previous stroke or TIA > 3 months (n = 12)...
December 2018: IJC Heart & Vasculature
Leonardo Diniz Correa Pinto, Cláudia Helena Ribeiro da Silva, Pedro Marcos Silva E Gonçalves, Roberto José Valadares
BACKGROUND AND OBJECTIVES: Ultrasound-guided upper limb blocks may provide great benefits to patients with serious diseases. Patients with Steinert's disease have muscle weakness and risk of triggering myotomy or malignant hyperthermia due to the use of anesthetic agents and surgical stress. The objective of this report was to demonstrate a viable alternative for clavicle fracture surgery with upper trunk and supraclavicular nerve block, thus reducing the spread of local anesthetic to the phrenic nerve in a patient with muscular dystrophy...
October 6, 2018: Revista Brasileira de Anestesiologia
Hui-Qiang Wei, Xiao-Gang Guo, Gong-Bu Zhou, Qi Sun, Jian-Du Yang, Hai-Yang Xie, Shu Zhang, Jackson J Liang, Jian Ma
INTRODUCTION: The procedural findings and clinical outcome of second-generation cryoballoon (CB2) ablation in patients with variant pulmonary vein (PV) anatomy have not been fully investigated. METHODS: A total of 424 consecutive patients who underwent PV isolation with CB2 were included. Computed tomographic (CT) scan was performed in all patients before the procedure. The study population was divided into common PV, accessory PV and non-variant PV groups according to the CT scan...
October 4, 2018: Journal of Cardiovascular Electrophysiology
Sandro Rostelato-Ferreira, Cháriston André Dal Belo, Pedro Ismael da Silva Junior, Stephen Hyslop, Léa Rodrigues-Simioni, Thomaz Augusto Alves Rocha-E-Silva
Purpose: Rhinella schneideri is a toad found in many regions of the South America. The poison of the glands has cardiotoxic effect in animals and neuromuscular effects in mice and avian preparation. The purpose of this work was to identify the toxin responsible for the neuromuscular effect in avian and mice neuromuscular preparation. Methods: The methanolic extract from R. schneideri poison was fractioned by reversed phase HPLC. The purity and molecular mass were determined by LC/MS mass spectrometry. Chick biventer cervicis and mouse phrenic-nerve diaphragm were used as neuromuscular preparations to identify the toxin...
August 2018: Advanced Pharmaceutical Bulletin
Sami Bennji, Diaeddin Sagar, Naeem Brey, Coenraad Koegelenberg
In this case report, we describe the course of a female patient who is known to have neuromyelitis optica (NMO) and developed left hemiparesis and unilateral diaphragmatic paralysis. She was initially treated with intravenous methylprednisolone 1 g daily for 5 days without improvement. Subsequently, she received five sessions of a plasmapheresis. Her hemiparesis had improved after few days. however, the phrenic nerve palsy remained.
September 28, 2018: BMJ Case Reports
Heather A Ballard, Olga S Leavitt, Anthony C Chin, Rashmi Kabre, Debra E Weese-Mayer, John Hajduk, Narasimhan Jagannathan
BACKGROUND: Congenital Central Hypoventilation Syndrome and Rapid-Onset Obesity with Hypothalamic dysfunction, Hypoventilation, and Autonomic Dysregulation are rare neurocristopathies characterized by autonomic dysregulation including bradyarrhythmias, abnormal temperature control, and most significantly, abnormal control of breathing leading to tracheostomy and ventilator dependence as life support. Surgical advancements have made phrenic nerve-diaphragm pacemakers available, to eliminate the tether to a mechanical ventilator for 12-15 hours each day...
September 24, 2018: Paediatric Anaesthesia
Obaid U Khurram, Matthew J Fogarty, Sabhya Rana, Pangdra Vang, Gary C Sieck, Carlos B Mantilla
Mid-cervical spinal cord contusion injury results in tissue damage, disruption of spinal pathways, and motor neuron loss. Unilateral C4 contusion results in loss of 40-50% of phrenic motor neurons ipsilateral to the injury (~25% of the total phrenic motor neuron pool). Over time after unilateral C4 contusion injury, diaphragm muscle (DIAm) electromyogram (EMG) activity increases both contralateral and ipsilateral to the side of injury in rats, suggesting compensation due to increased activation of the surviving motor neurons...
September 20, 2018: Journal of Applied Physiology
Miriam Patella, Andrea Saporito, Francesco Mongelli, Ramon Pini, Rolf Inderbitzi, Stefano Cafarotti
Background: Residual pleural space after lung resection associated with air leak is a challenging issue, potentially causing serious complications. We report a new, postoperative technique to reduce the pleural space, inducing a controlled and reversible paralysis of the diaphragm. Methods: Ten patients were enrolled (7 lobectomies, 2 bilobectomy, 1 wedge resection). Inclusion criteria were: digitally detected air flow >200 mL/min at post-op day 3, presence of empty pleural space at chest x-ray, absence of restrictive lung disease, absence of known arrhythmias...
August 2018: Journal of Thoracic Disease
Xia Wang, Ruijuan Guan, Xiaomei Zhao, Danian Zhu, Nana Song, Linlin Shen
The ventrolateral medulla (VLM), including the lateral paragigantocellular nucleus (LPGi) and rostral VLM (RVLM), is commonly considered to be a chemosensitive region. However, the specific mechanism of chemoreception in the VLM remains elusive. Acid-sensing ion channels (ASICs), a family of voltage-independent proton-gated cation channels, can be activated by an external pH decrease to cause Na+ entry and induce neuronal excitability. TWIK-related acid-sensitive potassium channels (TASKs) are members of another group of pH-sensitive channels; in contrast to AISICs, they can be stimulated by pH increases and are inhibited by pH decreases in the physiological range...
2018: Frontiers in Cellular Neuroscience
M L Yang, H M Zhao, J J Li, D G Yang, Q Wang, L J Gao, W P Deng, L J Du, H M Gong, L Chen, Y M Wang, Y M Jian, J Li
Objective: To report the use of implantable diaphragm pacer (IDP) in a patient with high cervical spinal cord injury(HCSCI). Methods: A 14-year-old male patient, who suffered from a HCSCI at C2 neurological level and had been on a ventilator for 2 years, received IDP in August 2017 at China Rehabilitation Research Center. A systematic literature review was performed on IDP in patients with HCSCI in Pubmed, CNKI, and Wanfang databases, using the keywords: phrenic nerve and electrical stimulation and spinal cord injury; IDP and spinal cord injury; breathing pacemaker system and spinal cord injury...
September 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Xiaoke Liu, James Palmer
INTRODUCTION: A technique was developed to eliminate radiation exposure for routine atrial fibrillation (AF) ablation, to simplify the procedure and to achieve cost effectiveness. We here report the outcomes of this approach. METHODS: 200 consecutive AF ablations (55% paroxysmal) were performed by a single operator. Pulmonary vein isolation (PVI) was achieved by antral ablation without left atrial anatomic mapping, guided by contact force sensing and intracardiac echocardiogram (ICE)...
September 8, 2018: Pacing and Clinical Electrophysiology: PACE
Etienne Abdelnour-Berchtold, Jean Perentes, Thorsten Krueger, Michel Gonzalez
The surgical treatment of myasthenia gravis involves the complete resection of the thymus and the mediastinal fat between the two phrenic nerves. This procedure has been shown to have a positive impact on the rate of remission. In this video tutorial we illustrate the technical aspects of radical thymectomy using a left thoracoscopic approach.
September 3, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Daniel B Zoccal, Josiane N Silva, William H Barnett, Eduardo V Lemes, Barbara Falquetto, Eduardo Colombari, Yaroslav I Molkov, Thiago S Moreira, Ana C Takakura
The retrotrapezoid nucleus (RTN) contains chemosensitive cells that distribute CO2-dependent excitatory drive to the respiratory network. This drive facilitates the function of the respiratory central pattern generator (rCPG) and increases sympathetic activity. It is also evidenced that during hypercapnia, the late-expiratory (late-E) oscillator in the parafacial respiratory group (pFRG) is activated and determine the emergence of active expiration. However, it remains unclear the microcircuitry responsible for the distribution of the excitatory signals to the pFRG and the rCPG in conditions of high CO2...
September 6, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
Amr Abdin, Kivanc Yalin, Evgeny Lyan, Noureddin Sawan, Sypridon Liosis, Roza Meyer-Saraei, Christian Elsner, Stefan A Lange, Christian-Hendrik Heeger, Charlotte Eitel, Ingo Eitel, Roland Richard Tilz
BACKGROUND: Catheter ablation (CA) is an established therapy for treatment of atrial fibrillation (AF). However, data about AF ablation using the cryoballoon (CB) in the elderly population are sparse. The aim of this single center retrospective study is to evaluate the safety and efficacy of CB ablation in patients ≥ 75 years compared to patients < 75 years. METHODS AND RESULTS: Fifty-five consecutive patients aged ≥ 75 years (elderly group) were compared with 183 patients aged < 75 years (control group)...
September 5, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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