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Diaphragm Dysfunction

Lukas Schroeder, Heiko Reutter, Ullrich Gembruch, Christoph Berg, Andreas Mueller, Florian Kipfmueller
INTRODUCTION: Infants after surgical correction of congenital diaphragmatic hernia are at high risk for extubation failure, but little is known about contributing factors. Therefore, our study aimed to analyze clinical and echocardiographic parameters. MATERIALS AND METHODS: Data of 34 infants with congenital diaphragmatic hernia treated at our department (July 2013-December 2015) were analyzed. Inclusion criteria were: presence of congenital diaphragmatic hernia and echocardiography performed within 48 hours before the first, and, in case of reintubation, the final extubation attempt...
August 16, 2018: Paediatric Anaesthesia
Sunamita de Carvalho Lima, Lucas de Carvalho Porta, Álvaro da Costa Lima, Joana D'Arc Campeiro, Ywlliane Meurer, Nathália Bernardes Teixeira, Thiago Duarte, Eduardo Brandt Oliveira, Gisele Picolo, Rosely Oliveira Godinho, Regina Helena Silva, Mirian Akemi Furuie Hayashi
The high medical importance of Crotalus snakes is unquestionable, as this genus is the second in frequency of ophidian accidents in many countries, including Brazil. With a relative less complex composition compared to other genera venoms, as those from the Bothrops genus, the Crotalus genus venom from South America is composed basically by the neurotoxin crotoxin (a phospholipase A2), the thrombin-like gyroxin (a serinoprotease), a very potent aggregating protein convulxin, and a myotoxic polypeptide named crotamine...
August 6, 2018: PLoS Neglected Tropical Diseases
Yoshiharu Kinugasa, Mari Miyagi, Takeshi Sota, Kensaku Yamada, Takuya Ishisugi, Masayuki Hirai, Kiyotaka Yanagihara, Nobuhiko Haruki, Koichi Matsubara, Masahiko Kato, Kazuhiro Yamamoto
No abstract text is available yet for this article.
August 6, 2018: European Journal of Preventive Cardiology
Matthieu Le Dinh, Serge Carreira, Julie Obert, Ghislaine Gayan-Ramirez, Bruno Riou, Maud Beuvin, Thomas Similowski, Catherine Coirault, Alexandre Demoule
BACKGROUND: Short-term mechanical ventilation (MV) protects against sepsis-induced diaphragmatic dysfunction. Prolonged MV induces diaphragmatic dysfunction in non-septic animals, but few reports describe the effects of prolonged MV in sepsis. We hypothesized that prolonged MV is not protective but worsens the diaphragmatic dysfunction induced by a mild sepsis, because MV and sepsis share key signaling mechanisms, such as cytokine upregulation. METHOD: We studied the impact of prolonged MV (12 h) in four groups (n = 8) of male Wistar rats: 1) endotoxemia induced by intraperitoneal injection of Escherichia coli lipopolysaccharide, 2) MV without endotoxemia, 3) combination of endotoxemia and MV and 4) sham control...
2018: PloS One
Nens van Alfen, Jonne Doorduin, Marieke H J van Rosmalen, Jeroen J J van Eijk, Yvonne Heijdra, Andrea J Boon, Michael A Gaytant, Ries J M van den Biggelaar, Roy T M Sprooten, Peter J Wijkstra, Jan T Groothuis
OBJECTIVE: To describe the clinical phenotype and recovery of diaphragm dysfunction caused by neuralgic amyotrophy in a large cohort of patients, to improve accurate awareness of this entity, and to encourage adoption of a standardized approach for diagnosis and treatment. METHODS: This observational cohort study recruited adult patients with neuralgic amyotrophy and symptoms of idiopathic phrenic neuropathy from the database of the Dutch expert center for neuralgic amyotrophy and the Dutch centers for home mechanical ventilation...
July 27, 2018: Neurology
Matthias Eberhard, Gianluca Milanese, Michael Ho, Stefan Zimmermann, Thomas Frauenfelder, Fabian Nietlispach, Francesco Maisano, Felix C Tanner, Thi Dan Linh Nguyen-Kim
OBJECTIVES: To assess the value of pre-procedural computed tomography angiography (CTA) measurements of the suprahepatic inferior vena cava (IVC) to detect elevated central venous pressure (CVP) assessed by right heart catheterisation (RHC), and to predict post-procedural 1-year mortality in a cohort of patients undergoing transcatheter aortic valve implantation (TAVI). METHODS: We retrospectively evaluated 408 consecutive patients undergoing CTA before TAVI between January 2011 and December 2014...
July 17, 2018: European Radiology
Keita Hazama, Yuichiro Toda, Hideki Nakatsuka, Yoshihisa Fujita
There are various causes of dysfunction of the diaphragm. We present a case of diaphragm dysfunction caused by an excessive pneumoperitoneum in a 65-year-old woman. Her abdomen became distended during endoscopic investigation and circulatory failure occurred. A computed tomography scan revealed excessive pneumoperitoneum. Urgent laparotomy was performed to repair gastric perforation. Tracheal extubation was successfully performed in the intensive care unit. After extubation, a paradoxical breathing pattern appeared in addition to tachypnea...
July 5, 2018: A&A practice
Junxiang Wen, Yingchao Han, Song Guo, Mingjie Yang, Lijun Li, Guixin Sun, Jun Wang, Fangqiong Hu, Jing Liang, Li Wei, Qi Zhou, Weibin Zhang, Jun Tan
OBJECTIVE Respiratory dysfunction is the leading cause of mortality following upper cervical spinal cord injury (SCI). The authors' previous study suggested that vagus nerve (VN) and phrenic nerve (PN) anastomosis could partially improve respiratory function in rabbits that had been subjected to PN transection. As a branch of the VN and a motor fiber-dominated nerve, the recurrent laryngeal nerve (RLN) seems a better choice to anastomose with the PN for respiratory function restoration after upper cervical SCI...
July 6, 2018: Journal of Neurosurgery. Spine
Guo-Yu Zhang, Dan Lu, Shao-Feng Duan, Ying-Ran Gao, Shi-Yu Liu, Ya Hong, Peng-Zhen Dong, Ya-Ge Chen, Tao Li, Da-Yong Wang, Xiang-Shu Cheng, Fei He, Jian-She Wei, Guang-Yu Li, Qing-Yong Zhang, Dong-Dong Wu, Xin-Ying Ji
Diaphragm dysfunction is an important clinical problem worldwide. Hydrogen sulfide (H2 S) is involved in many physiological and pathological processes in mammals. However, the effect and mechanism of H2 S in diaphragm dysfunction have not been fully elucidated. In this study, we detected that the level of H2 S was decreased in lipopolysaccharide- (LPS-) treated L6 cells. Treatment with H2 S increased the proliferation and viability of LPS-treated L6 cells. We found that H2 S decreased reactive oxygen species- (ROS-) induced apoptosis through the mitogen-activated protein kinase (MAPK) signaling pathway in LPS-treated L6 cells...
2018: Oxidative Medicine and Cellular Longevity
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Cameron Green, Colin F Royse
BACKGROUND: Failed extubation from mechanical ventilation in critically ill patients is multifactorial, complex and not well understood. We aimed to identify whether combined transthoracic echocardiography, lung and diaphragmatic ultrasound can predict extubation failure in critically ill patients. RESULTS: Fifty-three participants who were intubated > 48 h and deemed by the treating intensivist ready for extubation underwent a 60-min pre-extubation weaning trial (pressure support ≤ 10 cmH2 O and positive end expiratory pressure 5 cmH2 O)...
July 4, 2018: Critical Ultrasound Journal
Ken D O'Halloran, David P Burns
Duchenne muscular dystrophy is a fatal neuromuscular disease associated with respiratory-related morbidity and mortality. Herein, we review recent work by our group exploring deficits and compensation in the respiratory control network governing respiratory homeostasis in a pre-clinical model of DMD, the mdx mouse. Deficits at multiple sites of the network provide considerable challenges to respiratory control. However, our work has also revealed evidence of compensatory neuroplasticity in the motor drive to breathe enhancing diaphragm muscle activity during increased chemical drive...
June 19, 2018: Respiratory Physiology & Neurobiology
Li-Fu Li, Yung-Yang Liu, Ning-Hung Chen, Yen-Huey Chen, Chung-Chi Huang, Kuo-Chin Kao, Chih-Hao Chang, Li-Pang Chuang, Li-Chung Chiu
Mechanical ventilation (MV) is often used to maintain life in patients with sepsis and sepsis-related acute lung injury. However, controlled MV may cause diaphragm weakness due to muscle injury and atrophy, an effect termed ventilator-induced diaphragm dysfunction (VIDD). Toll-like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) signaling pathways may elicit sepsis-related acute inflammatory responses and muscle protein degradation and mediate the pathogenic mechanisms of VIDD. However, the mechanisms regulating the interactions between VIDD and endotoxemia are unclear...
June 20, 2018: Laboratory Investigation; a Journal of Technical Methods and Pathology
Claire E Martin, Nina Jones
Podocytes are a major component of the glomerular blood filtration barrier, and alterations to the morphology of their unique actin-based foot processes (FP) are a common feature of kidney disease. Adjacent FP are connected by a specialized intercellular junction known as the slit diaphragm (SD), which serves as the ultimate barrier to regulate passage of macromolecules from the blood. While the link between SD dysfunction and reduced filtration selectivity has been recognized for nearly 50 years, our understanding of the underlying molecular circuitry began only 20 years ago, sparked by the identification of NPHS1 , encoding the transmembrane protein nephrin...
2018: Frontiers in Endocrinology
Paolo Ciancarella, Fabio Fazzari, Valentina Montano, Marco Guglielmo, Gianluca Pontone
A 21 year old male with no relevant medical history presented to our Institution for further assessments of a right paracardiac mass founded on a chest X-ray. Chest computed tomography revealed a wide median defect of the diaphragm at the level of xiphoid process of the sternum, with the herniation of omental fat tissue in the mediastinum. Cardiac magnetic resonance confirmed the presence of a huge hernia originating from the foramen of Morgagni (sterno-costal hiatus), displacing the heart leftwards and posteriorly and compressing the right ventricle (RV), giving to it a tubular shape...
April 2018: Journal of the Saudi Heart Association
Wei-Lun Lin, Yu-Ruey Chen, Chun-Ting Lai, Shinya Yamada, Shin-Huei Liu, Yu-Hui Chou, Yun-Ching Fu, Cheryl C H Yang, Terry B J Kuo, Li-Wei Lo, Shih-Ann Chen
BACKGROUND: Sympathetic hyperactivity and poor sleep quality are reported in myocardial infarction (MI) patients and angiotensin-converting enzyme inhibitors (ACEI) can improve long-term survival in these patients. We aimed to evaluate ACEI effects on cardiac autonomic activity (CAA) and disordered sleep patterns in ambulatory rats after MI. METHODS: Polysomnographic recording was performed in sham (n = 8) and MI (n = 9) male rats during normal daytime sleep before and after captopril treatment...
August 2018: Sleep Medicine
Puneet Garg
BACKGROUND: Podocyte biology is a developing science that promises to help improve understanding of the mechanistic nature of multiple diseases associated with proteinuria. Proteinuria in nephrotic syndrome has been linked to mechanistic dysfunctions in the renal glomerulus involving the function of podocyte epithelial cells, including podocyte foot process effacement. SUMMARY: Developments in imaging technology are improving knowledge of the detailed structure of the human renal glomerulus and cortex...
2018: American Journal of Nephrology
Alessandra Stacchiotti, Gaia Favero, Antonio Lavazza, Maria Monsalve, Luigi Fabrizio Rodella, Rita Rezzani
Taurine (TAU) is a sulfur-containing beta amino acid that is not involved in protein composition and anabolism, conditionally essential in mammals provided through diet. Growing evidence supports a protective role of TAU supply in osmoregulation, calcium flux, and reduction of inflammation and oxidant damage in renal diseases like diabetes. Endoplasmic reticulum (ER) stress, due to abnormal proteostasis, is a contributor to nephrotic syndrome and related renal damage. Here, we investigated the effect of dietary TAU (1...
May 29, 2018: Nutrients
Tina Schreiber, Wolfram Windisch
In sarcoidosis, muscle involvement is common, but mostly asymptomatic. Currently, little is known about respiratory muscle and diaphragm involvement and function in patients with sarcoidosis. Reduced inspiratory muscle strength and/or a reduced diaphragm function may contribute to exertional dyspnea, fatigue and reduced health-related quality of life. Previous studies using volitional and non-volitional tests demonstrated a reduced inspiratory muscle strength in sarcoidosis compared to control subjects, and also showed that respiratory muscle function may even be significantly impaired in a subset of patients...
July 2018: Expert Review of Respiratory Medicine
Gul Gursel, Kamil Inci, Zenfira Alasgarova
Background: Diaphragm dysfunction (DD) is frequently seen in critically ill patients, and ultrasound could be a useful tool to detect it and to predict extubation success or failure in mechanically ventilated patients. Besides, it would also be useful in differential diagnosis of dyspnea and respiratory failure. The aim of this study is to evaluate usefulness and accuracy of pocket-sized ultrasound devices (PSDs) in assessment of DD in intensive care unit (ICU) patients in comparison with standard ultrasound devices (SD)...
2018: Critical Care Research and Practice
F Dennis McCool, Kamran Manzoor, Taro Minami
Pathologic processes that involve the central nervous system, phrenic nerve, neuromuscular junction, and skeletal muscle can impair diaphragm function. When these processes are of sufficient severity to cause diaphragm dysfunction, respiratory failure may be a consequence. This article reviews basic diaphragm anatomy and physiology and then discusses diagnostic and therapeutic approaches to disorders that result in unilateral or bilateral diaphragm dysfunction. This discussion provides a context in which disorders of the diaphragm and their implications on respiratory function can be better appreciated...
June 2018: Clinics in Chest Medicine
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