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https://www.readbyqxmd.com/read/28768736/congenital-diaphragmatic-hernias-from-genes-to-mechanisms-to-therapies
#1
REVIEW
Gabrielle Kardon, Kate G Ackerman, David J McCulley, Yufeng Shen, Julia Wynn, Linshan Shang, Eric Bogenschutz, Xin Sun, Wendy K Chung
Congenital diaphragmatic hernias (CDHs) and structural anomalies of the diaphragm are a common class of congenital birth defects that are associated with significant morbidity and mortality due to associated pulmonary hypoplasia, pulmonary hypertension and heart failure. In ∼30% of CDH patients, genomic analyses have identified a range of genetic defects, including chromosomal anomalies, copy number variants and sequence variants. The affected genes identified in CDH patients include transcription factors, such as GATA4, ZFPM2, NR2F2 and WT1, and signaling pathway components, including members of the retinoic acid pathway...
August 1, 2017: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/28749718/ectopic-intralaryngo-tracheal-thyroid-tissue-causing-neonatal-death
#2
Lauren Furnas, Huda Safa, Fiona Hutchinson, Lindsay Joseph, Jane E Armes
INTRODUCTION: Ectopic thyroid tissue can be found anywhere along the embryologic path of thyroid descent. Intralaryngo-tracheal thyroid tissue is the least common site of ectopia and can present with upper airways obstruction. Its presentation in the neonate is exceptional. CASE REPORT: We describe a term female neonate with subglottic thyroid tissue causing near-total occlusion of the larynx, which led to upper airways obstruction and neonatal death. CONCLUSION: This emphasizes the importance of considering intralaryngo-tracheal tumors as a cause of acute and otherwise unexplainable respiratory distress immediately after birth...
July 27, 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28734029/successful-treatment-of-metastatic-clear-cell-carcinoma-with-nivolumab-in-a-patient-receiving-dialysis-treatment
#3
Tadashi Tabei, Ichiro Natsume, Kazuki Kobayashi
The efficacy and safety of nivolumab for patients receiving dialysis treatment has not been established yet. Herein, we describe a patient on dialysis successfully treated with nivolumab as seventh-line therapy for metastatic renal cell carcinoma. Before initiating nivolumab, he had respiratory discomfort induced by a lesion occluding the left intermediate bronchus that originated from the metastatic lymph node behind the tracheal bifurcation. Four weeks after nivolumab was initiated, his symptom remarkably improved, and the occlusion disappeared according to the bronchoscopy examination...
July 21, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28641751/fetal-imaging-and-therapy-for-cdh-current-status
#4
Titilayo Oluyomi-Obi, Tim Van Mieghem, Greg Ryan
In congenital diaphragmatic hernia (CDH), herniation of the abdominal organs into the fetal chest causes pulmonary hypoplasia and pulmonary hypertension, the main causes of neonatal mortality. As antenatal ultrasound screening improves, the risk of postnatal death can now be better predicted, allowing for the identification of fetuses that might most benefit from a prenatal intervention. Fetoscopic tracheal occlusion is being evaluated in a large international randomized controlled trial. We present the antenatal imaging approaches that can help identify fetuses that might benefit from antenatal therapy, and review the evolution of fetal surgery for CDH to date...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28570606/effects-of-two-different-decellularization-routes-on-the-mechanical-properties-of-decellularized-lungs
#5
Jessica Julioti Urbano, Renata Kelly da Palma, Flávia Mafra de Lima, Paula Fratini, Leticia Lopes Guimaraes, Juan J Uriarte, Letícia Heineck Alvarenga, Maria Angelica Miglino, Rodolfo de Paula Vieira, Renato Araujo Prates, Daniel Navajas, Ramon Farrè, Luis Vicente Franco Oliveira
Considering the limited number of available lung donors, lung bioengineering using whole lung scaffolds has been proposed as an alternative approach to obtain lungs suitable for transplantation. However, some decellularization protocols can cause alterations on the structure, composition, or mechanical properties of the lung extracellular matrix. Therefore, the aim of this study was to compare the acellular lung mechanical properties when using two different routes through the trachea and pulmonary artery for the decellularization process...
2017: PloS One
https://www.readbyqxmd.com/read/28545478/ltb4-and-montelukast-in-transplantation-related-bronchiolitis-obliterans-in-rats
#6
Zheng-Liang Tu, Zhen-Yu Zhou, Hai-Chao Xu, Jin-Lin Cao, Peng Ye, Lu-Ming Wang, Wang Lv, Jian Hu
BACKGROUND: Lung transplantation is the only effective treatment for end-stage lung diseases. Bronchiolitis obliterans, which is known as non-infectious chronic lung allograft dysfunction (CLAD) in the new classification, is the greatest threat to long-term survival after lung transplantation. This study investigated the role of leukotriene B4 (LTB4) and montelukast in transplantation-related bronchiolitis obliterans and discussed the pathophysiological significance of LTB4 in chronic rejection...
May 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28530262/transtracheal-endoscopic-assisted-resection-of-a-rare-inflammatory-myofibroblastic-tumour-in-adult-trachea-a-case-report
#7
S Reddy, R Swamy, D V Kumar Irugu, K V V Ramji
Inflammatory myofibroblastic tumours (IMTs) are rare and clinically benign in childhood, and malignant in adults. The aetiology of IMTs is not clear, and recent studies report it as true neoplasm rather than a reactive or inflammatory lesion. IMTs can involve any part of the body, but are usually common in lungs. These are rarely seen in adults and tracheal involvement is also rare in both adults and children. We describe an 18-year-old woman who presented with respiratory difficulty to the emergency department...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28453870/clinically-relevant-discordances-identified-after-tertiary-reassessment-of-fetuses-with-isolated-congenital-diaphragmatic-hernia
#8
Elisa Done, Leonardo Gucciardo, Tim Van Mieghem, Koen Devriendt, Karel Allegaert, Paul Brady, Roland Devlieger, Luc De Catte, Liesbeth Lewi, Jan Deprest
OBJECTIVE: Fetoscopic Endoluminal Tracheal Occlusion (FETO) may improve outcome of severe isolated Congenital Diaphragmatic Hernia (iCDH). We aimed to identify any discrepancy between initial assessment at the referring hospital and the evaluation at the fetal surgery center, and to document parental decisions following counseling for fetal surgery. DESIGN: Single centre retrospective study on patients with presumed iCDH either referred for assessment and counseling or referred for fetal surgery...
April 28, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28440911/unnoticed-aspiration-of-palate-plate-impression-material-in-a-neonate-diagnosis-therapy-outcome
#9
Friedrich Reichert, Peter Amrhein, Frank Uhlemann
A 7 week old infant was admitted with respiratory failure. Chest X-ray showed an atelectatic right upper lobe, herniation of right middle and lower lobe into the left thorax, and compression-atelectasis of the left lung. Thoracic CT showed complete occlusion of the right superior bronchus with a radiopaque foreign material. Six weeks prior, an impression for a palate plate using polyvinylsiloxane was taken. The material was removed with a rigid endoscopy, in readiness of extracorporeal oxygenation in case of tracheal obstruction or bronchial rupture...
April 25, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28436022/ventilation-via-the-2-4%C3%A2-mm-internal-diameter-tritube-%C3%A2-with-cuff%C3%A2-new-possibilities-in-airway-management
#10
REVIEW
M S Kristensen, M W P de Wolf, L S Rasmussen
BACKGROUND: A small tube may facilitate tracheal intubation and improve surgical access. We describe our initial experience with the Tritube(®) that is a novel cuffed endotracheal tube with a 2.4 mm internal diameter. METHODS: The Tritube(®) was used in seven adult Ear-Nose-and Throat surgical patients with airway narrowing or whose surgical access was facilitated by this small-bore endotracheal tube. Ventilation through Tritube(®) is performed with the manually operated Ventrain(®) -ventilator that allows active suctioning during expiration, therefore facilitating normoventilation through small diameter airways...
July 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28373918/successful-treatment-of-carcinomatous-central-airway-obstruction-with-bronchoscopic-electrocautery-using-hot-biopsy-forceps-during-mechanical-ventilation
#11
Motoi Ugajin, Hisanori Kani
We report the case of a 72-year-old man with occlusion of the left main bronchus due to squamous cell carcinoma of the lung. He required tracheal intubation and mechanical ventilation because of the aggravation of atelectasis and obstructive pneumonia. Electrocautery using hot biopsy forceps was performed during mechanical ventilation with a 40% fraction of inspired oxygen. He was extubated following improvement in the atelectasis and obstructive pneumonia and discharged with shrinkage of the tumor after chemotherapy...
2017: Case Reports in Oncological Medicine
https://www.readbyqxmd.com/read/28267443/balloon-removal-after-fetoscopic-endoluminal-tracheal-occlusion-for-congenital-diaphragmatic-hernia
#12
Julio A Jiménez, Elisenda Eixarch, Philip DeKoninck, João R Bennini, Roland Devlieger, Cleisson F Peralta, Eduard Gratacos, Jan Deprest
BACKGROUND: Isolated congenital diaphragmatic hernia defect allows viscera to herniate into the chest, competing for space with the developing lungs. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension that is lethal in up to 30% of patients. Antenatal measurement of lung size and liver herniation can predict survival after birth. Prenatal intervention aims at stimulating lung development, clinically achieved by percutaneous fetal endoscopic tracheal occlusion under local anesthesia...
July 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28195963/mediastinitis-following-endobronchial-ultrasound-guided-transbronchial-needle-aspiration
#13
Aruna Jahoor, Shekhar Ghamande, Shirley Jones, Carl Boethel, Heath D White
Mediastinitis is a rare complication of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Recent reports of infectious complications following EBUS-TBNA involved oropharyngeal bacteria. Here, we report 2 unusual cases of post-EBUS-TBNA mediastinitis involving Streptococcus pneumoniae and Pseudomonas aeruginosa, which were likely the result of direct inoculation of the organisms at the time of transbronchial needle aspiration. The first case was successfully treated with computed tomography-guided drainage and antibiotics, whereas the second case had >50% distal tracheal obstruction and near total occlusion of the left main stem bronchus, requiring rigid bronchoscopy, stent placement, debulking, and antibiotics...
February 10, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28157247/congenital-diaphragmatic-hernia-pathogenesis-prenatal-diagnosis-and-management-literature-review
#14
Przemysław Kosiński, Mirosław Wielgoś
Congenital diaphragmatic hernia (CDH) is a developmental discontinuity of the diaphragm. It allows abdominal viscera to herniate into the chest and leads to lung hypoplasia. Congenital diaphragmatic hernia is one of the most severe birth defects, with extremely high neonatal mortality. This paper presents a review of the available literature on prenatal diagnosis, management and treatment options for CDH. In selected cases, a prenatal procedure to improve neonatal survival is possible. The authors of this manuscript believe their work might contribute to a better understanding of congenital diaphragmatic hernia and patient selection for the FETO (fetal endoscopic tracheal occlusion) surgery or expectant management...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28152192/effects-of-tracheal-occlusion-with-retinoic-acid-administration-on-normal-lung-development
#15
Amélie Delabaere, Geoffroy Marceau, Karen Coste, Loïc Blanchon, Pierre-Jean Déchelotte, Pierre Blanc, Vincent Sapin, Denis Gallot
INTRODUCTION: Tracheal occlusion (TO) is an investigational therapy for severe congenital diaphragmatic hernia that decreases pulmonary hypoplasia, but sustained TO also induces deficient surfactant synthesis. Intramuscular maternal administration of retinoic acid (RA) in a surgical rabbit model of congenital diaphragmatic hernia showed a beneficial effect on lung maturation. We evaluated the potential of RA delivery into the trachea and studied the combined effects of TO and RA on normal lung development...
February 2, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28144067/stenting-of-critical-tracheal-stenosis-with-adjuvant-cardio-pulmonary-bypass
#16
Himanshu Bhardwaj, Ahmed Awab, Houssein A Youness, Brent Brown
Severe and critical central airway obstruction causing impaired ventilation and/or oxygenation can impose tremendous challenges on the interventional pulmonologist. Near total airway obstruction can rapidly evolve into potentially fatal complete airway occlusion during bronchoscopic airway manipulation under moderate sedation; as well as during the induction of the general anesthesia. Although there are currently interventional pulmonary procedures available to tackle the critical airway obstruction in extreme situations, cardio-pulmonary bypass should be considered prior to the intervention to maintain the adequate gas exchange during the procedure...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28125664/velcro-like-system-used-to-fix-a-protective-faecal-shield-on-weevil-larvae
#17
Jiří Skuhrovec, Robert Stejskal, Filip Trnka, Andrea di Giulio
The last instar larva and pupa of Eucoeliodes mirabilis (A. Villa & G. B. Villa, 1835) (Curculionidae: Ceutorhynchini) are described using drawings and SEM images and are compared and keyed with already described larvae of 58 other ceutorhynchinae taxa. The larval body has an effective combination of morphological adaptations that assist a unique biological defensive strategy. All larval stages of E. mirabilis feed ectophytically on leaves of Euonymus europaeus L. (Celastraceae), and the larval body is covered with a thick faecal shield...
2017: PloS One
https://www.readbyqxmd.com/read/28050517/prosthodontic-approach-in-management-of-prolonged-neonatal-intubation
#18
Vikas B Kamble, Shital K Shah, Vishnu B Rathod, Priyanka S Ambadkar, Charudutt N Patil
Intubation is a routine intervention in the Neonatal Intensive Care Unit (NICU) for preterm neonates with respiratory distress, inadequate gag reflex, poor sucking and swallowing. Prolonged intubation in neonates can be done by nasal or oral route. Although naso-tracheal intubation may reduce movement of the tube, it may contribute to airway obstruction, possible hypoxia, and occlusion of the nasal aperture during a crucial period of development further contributing to laboured breathing. Being obligate nasal breathers, oro-tracheal route is the preferred method of intubation in premature infants as oral mucosa is less susceptible to damage than nasal mucosa...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28049200/a-mouse-model-of-post-stroke-pneumonia-induced-by-intra-tracheal-inoculation-with-streptococcus-pneumoniae
#19
Eva Mracsko, Sabine Stegemann-Koniszewski, Shin-Young Na, Alexander Dalpke, Dunja Bruder, Felix Lasitschka, Roland Veltkamp
BACKGROUND: Stroke-induced immunodeficiency increases the risk of infectious complications, which adversely affects neurological outcome. Among those, pneumonia affects as many as one third of stroke patients and is the main contributor to mortality in the post-acute phase of stroke. Experimental findings on post-stroke susceptibility to spontaneous pneumonia in mice are contradictory. Here, we established a mouse model inducing standardized bacterial pneumonia and characterized the impaired pulmonary cellular and humoral immune responses after experimental stroke...
2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27951457/radiologic-assessment-of-fetal-tracheal-balloon-occlusion
#20
Eric J Jordan, Vickie A Feldstein, Willieford Moses, Andrew S Phelps
Fetal endoscopic tracheal occlusion (FETO) is a novel technique to treat cases of isolated severe congenital diaphragmatic hernia (CDH). Although there are benefits of MRI over ultrasound in assessing lung volumes, it is unknown whether there are benefits of MRI for localizing the tracheal balloon. This is a retrospective study reviewing the imaging characteristics of FETO in patients who underwent both MRI and ultrasound exams done to localize tracheal balloons.
March 2017: Clinical Imaging
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