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https://www.readbyqxmd.com/read/29803315/fetoscopic-therapy-for-severe-pulmonary-hypoplasia-in-congenital-diaphragmatic-hernia-a-first-in-prenatal-regenerative-medicine-at-mayo-clinic
#1
Rodrigo Ruano, Denise B Klinkner, Karthik Balakrishnan, Victoria A Novoa Y Novoa, Norman Davies, Dean D Potter, William A Carey, Christopher E Colby, Amy B Kolbe, Katherine W Arendt, Leal Segura, Hans P Sviggum, Maureen A Lemens, Abimbola Famuyide, Andre Terzic
OBJECTIVE: To introduce the prenatal regenerative medicine service at Mayo Clinic for fetal endoscopic tracheal occlusion (FETO) care for severe congenital diaphragmatic hernia (CDH). PATIENTS AND METHODS: Two cases of prenatal management of severe CDH with FETO between January and August 2017 are reported. Per protocol, FETO was offered for life-threatening severe CDH at between 26 and 29 weeks' gestation. Regenerative outcome end point was fetal lung growth. Gestational age at procedure and maternal and perinatal outcomes were additional monitored parameters...
May 15, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29770109/fetoscopic-endoluminal-tracheal-occlusion-and-reestablishment-of-fetal-airways-for-congenital-diaphragmatic-hernia
#2
Lennart Van der Veeken, Francesca Maria Russo, Luc De Catte, Eduard Gratacos, Alexandra Benachi, Yves Ville, Kypros Nicolaides, Christoph Berg, Glenn Gardener, Nicola Persico, Pietro Bagolan, Greg Ryan, Michael A Belfort, Jan Deprest
Background: Congenital diaphragmatic hernia (CDH) is a congenital anomaly with high mortality and morbidity mainly due to pulmonary hypoplasia and hypertension. Temporary fetal tracheal occlusion to promote prenatal lung growth may improve survival. Entrapment of lung fluid stretches the airways, leading to lung growth. Methods: Fetal endoluminal tracheal occlusion (FETO) is performed by percutaneous sono-endoscopic insertion of a balloon developed for interventional radiology...
2018: Gynecological Surgery
https://www.readbyqxmd.com/read/29669344/unique-heterogeneous-topological-pattern-of-the-metabolic-landscape-in-rabbit-fetal-lungs-following-tracheal-occlusion
#3
Ahmed I Marwan, Uladzimir Shabeka, Julie A Reisz, Connie Zheng, Natalie J Serkova, Evgenia Dobrinskikh
INTRODUCTION: Fetal tracheal occlusion (TO) is currently an experimental approach to drive accelerated lung growth. It is stimulated by mechanotransduction that results in increased cellular proliferation and growth. However, it is currently unknown how TO affects the metabolic landscape of fetal lungs. MATERIALS AND METHODS: TO or sham was performed on fetal rabbits at 26 days followed by lung harvest on day 30. Mass spectrometry was performed to evaluate global metabolic changes...
April 18, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29627662/follow-up-of-fetuses-with-congenital-diaphragmatic-hernia-the-quantitative-lung-index
#4
Carlota Rodó, Tamara Illescas, Silvia Arévalo, Santiago Pérez-Hoyos, Elena Carreras
OBJECTIVE: To assess the longitudinal behavior of Quantitative Lung Index (QLI) for the follow-up of fetuses with congenital diaphragmatic hernia. STUDY DESIGN: Retrospective study of fetuses with isolated left congenital diaphragmatic hernia. The fetuses were assessed by ultrasound at different gestational ages and QLI was retrospectively calculated by means of previous lung-to-head ratio measurements. We used a random effects model (mixed model with repeated measurements) to compare the performance of the QLI in operated and non-operated fetuses throughout pregnancy...
June 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29582948/-advances-in-fetal-therapy-in-complicated-monochorionic-pregnancies-and-in-severe-congenital-diaphragmatic-hernia-five-years-experience
#5
Yuval Gielchinsky, Dan V Valsky, Nili Yanai, Firas J Abdeljawad, Mazen A Muhaisen, Dan Arbell, Yehuda Ginosar, Orna Ben-Yosef, Orite Winograd, Benjamin Bar-Oz, Simcha Yagel, Smadar Eventov-Friedman
INTRODUCTION: : Minimally invasive fetal therapeutic procedures reduce the morbidity and mortality in monochorionic (MC) twins and in fetuses with congenital diaphragmatic hernia (CDH). MC pregnancies share their blood systems due to communicating vessels over their single placenta and may develop specific complications: Twin-to-Twin transfusion syndrome (TTTS), Selective intrauterine growth restriction (sIUGR), Twin Anemia-Polycythemia Sequence (TAPS), Twin Reverse Arterial Perfusion Syndrome (TRAP) or anomalies in one...
March 2018: Harefuah
https://www.readbyqxmd.com/read/29577352/retinoic-acid-and-tracheal-occlusion-for-diaphragmatic-hernia-treatment-in-rabbit-fetuses
#6
Amélie Delabaere, Loïc Blanchon, Karen Coste, Gael Clairefond, Corinne Belville, Pierre Blanc, Geoffroy Marceau, Vincent Sapin, Denis Gallot
INTRODUCTION: Lung hypoplasia and pulmonary arterial hypertension (PAH) in congenital diaphragmatic hernia (DH) lead to a high perinatal mortality. Although sustained fetoscopic tracheal occlusion (TO) improves lung development, a major side effect is abnormal pneumocyte differentiation. This study evaluated the potential ability of intra-tracheal retinoic acid (RA) administration to reduce adverse effects of sustained TO in a rabbit model of DH. METHODS: A left diaphragmatic defect was created on d23 in time-dated pregnant rabbits...
March 25, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29575399/unique-application-of-awake-tracheoscopy-and-endobronchial-ultrasound-in-the-management-of-tracheal-mucoepidermoid-carcinoma
#7
Saad Rehman, Harold N Lovvorn, Otis B Rickman, Christopher T Wootten, Sivakumar Chinnadurai
BACKGROUND: Mucoepidermoid carcinoma of the trachea is a rare pediatric malignancy that presents unique challenges in diagnosis, operative management, and surveillance. METHODS AND RESULTS: We present a 17-year-old girl with primary tracheal mucoepidermoid carcinoma presenting in acute respiratory distress due to near-total occlusion of the tracheal airway. An algorithmic approach to preoperative planning was developed to evaluate and remove the tumor endoscopically without compromising oxygenation...
March 25, 2018: Head & Neck
https://www.readbyqxmd.com/read/29561395/suffocation-from-balloon-bronchoplasty
#8
Jorge L Morales-Estrella, Michael Machuzak, Bohdan Pichurko, Hanine Inaty, Atul C Mehta
Negative pressure pulmonary edema is a well-described complication of upper airway obstruction. However, the simultaneous occurrence of blood-stained secretions and petechial tracheobronchial hemorrhage are rarely recognized and a potential complication of transient intentional occlusion of the airways. We described a case of "hemorrhagic bronchial mucosa syndrome" and asymptomatic blood-tinged pulmonary edema after balloon bronchoplasty for a concentric tracheal stenosis using a flexible bronchoscopy...
April 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29479945/antenatal-management-of-congenital-diaphragmatic-hernia-today-and-tomorrow
#9
Lennart van der Veeken, Francesca M Russo, Johannes van der Merwe, David Basurto, Dyuti Sharma, Tram Nguyen, Marie P Eastwood, Namesh Khoshgoo, Jaan Toelen, Karel Allegaert, Philip Dekoninck, Stuart B Hooper, Richard Keijzer, Paolo DE Coppi, Jan Deprest
Congenital diaphragmatic hernia is rare birth defect, which can be easily corrected after birth. The main problem is that herniation of viscera during fetal development impairs lung development, leading to a 30 % mortality and significant morbidity. In isolated cases the outcome can be accurately predicted prenatally by medical imaging. Cases with a poor prognosis can be treated before birth; clinically this is by fetoscopic endoluminal tracheal occlusion. Obstruction of the airways triggers lung growth. This procedure and is currently being evaluated in a global clinical trial for left sided cases; right sided cases with poor prognosis are offered the procedure clinically...
February 23, 2018: Minerva Pediatrica
https://www.readbyqxmd.com/read/29478055/perfluorocarbons-prevent-lung-injury-and-promote-development-during-artificial-placenta-support-in-extremely-premature-lambs
#10
Joseph T Church, Elena M Perkins, Megan A Coughlin, Jennifer S McLeod, Katherine Boss, J Kelley Bentley, Marc B Hershenson, Raja Rabah, Robert H Bartlett, George B Mychaliska
BACKGROUND: Extremely premature neonates suffer high morbidity and mortality. An artificial placenta (AP) using extracorporeal life support (ECLS) is a promising therapy. OBJECTIVES: We hypothesized that intratracheal perfluorocarbon (PFC) instillation during AP support would reduce lung injury and promote lung development relative to intratracheal amniotic fluid or crystalloid. METHODS: Lambs at an estimated gestational age (EGA) 116-121 days (term 145 days) were placed on venovenous ECLS with jugular drainage and umbilical vein reinfusion and intubated...
February 23, 2018: Neonatology
https://www.readbyqxmd.com/read/29384483/occlusive-mycotic-tracheobronchitis-and-systemic-alphaherpesvirus-coinfection-in-a-free-living-striped-dolphin-stenella-coeruleoalba-in-italy
#11
Carla Grattarola, Federica Giorda, Barbara Iulini, Alessandra Pautasso, Marco Ballardini, Simona Zoppi, Letizia Marsili, Simone Peletto, Loretta Masoero, Katia Varello, Fulvio Garibaldi, Frine E Scaglione, Giovanni Di Guardo, Alessandro Dondo, Maria Goria, Laura Serracca, Walter Mignone, Cristina Casalone
A juvenile female striped dolphin Stenella coeruleoalba live stranded on 4 March 2016 at Alassio, western Ligurian Sea coast, Italy. The dolphin died shortly after stranding, and a complete postmortem examination was performed. Necropsy revealed severe tracheal occlusion and unilateral bronchial stenosis with luminal accumulation of abundant green-yellow mucous-gelatinous material. Histological features suggestive of tracheobronchial aspergillosis were observed. Cultures of lung tissue and tracheo-bronchial exudate isolated Aspergillus fumigatus, identified by a Microseq D2 LSUrDNA fungal sequencing kit...
January 31, 2018: Diseases of Aquatic Organisms
https://www.readbyqxmd.com/read/29341044/antenatal-medical-therapies-to-improve-lung-development-in-congenital-diaphragmatic-hernia
#12
Aidan Kashyap, Philip DeKoninck, Kelly Crossley, Marta Thio, Graeme Polglase, Francesca Maria Russo, Jan Deprest, Stuart Hooper, Ryan Hodges
Congenital diaphragmatic hernia (CDH) is a birth defect characterized by failed closure of the diaphragm, allowing abdominal viscera to herniate into the thoracic cavity and subsequently impair pulmonary and vascular development. Despite improving standardized postnatal management, there remains a population of severe CDH for whom postnatal care falls short. In these severe cases, antenatal surgical intervention (fetoscopic endoluminal tracheal occlusion [FETO]) may improve survival; however, FETO increases the risk of preterm delivery, is not widely offered, and still fails in half of cases...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29307026/correlation-of-symptoms-with-bronchoscopic-findings-in-children-with-a-prenatal-diagnosis-of-a-right-aortic-arch-and-left-arterial-duct
#13
Trisha V Vigneswaran, Eva Kapravelou, Aaron J Bell, Andrew Nyman, Kuberan Pushparajah, John M Simpson, Andrew Durward, Vita Zidere
A right aortic arch (RAA) with a left arterial duct (LAD) together encircle the trachea and have the potential to cause tracheobronchial compression and published guidelines recommend bronchoscopy in symptomatic patients. The aim of the study was to describe the incidence of tracheal compression in a cohort of prenatally diagnosed RAA and LAD. Retrospective review of clinical course and imaging of prenatal cases of RAA and LAD assessed with flexible bronchoscopy over an 11-year period. 34 cases of prenatally diagnosed RAA with LAD underwent bronchoscopy at median age of 9 months (range 0...
April 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29169875/current-and-future-antenatal-management-of-isolated-congenital-diaphragmatic-hernia
#14
REVIEW
Francesca Maria Russo, Paolo De Coppi, Karel Allegaert, Jaan Toelen, Lennart van der Veeken, George Attilakos, Mary Patrice Eastwood, Anna Louise David, Jan Deprest
Congenital diaphragmatic hernia is surgically correctable, yet the poor lung development determines mortality and morbidity. In isolated cases the outcome may be predicted prenatally by medical imaging. Cases with a poor prognosis could be treated before birth. However, prenatal modulation of lung development remains experimental. Fetoscopic endoluminal tracheal occlusion triggers lung growth and is currently being evaluated in a global clinical trial. Prenatal transplacental sildenafil administration may in due course be a therapeutic approach, reducing the occurrence of persistent pulmonary hypertension, either alone or in combination with fetal surgery...
December 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29056361/compensatory-plasticity-in-diaphragm-and-intercostal-muscle-utilization-in-a-rat-model-of-als
#15
Yasin B Seven, Nicole L Nichols, Mia N Kelly, Orinda R Hobson, Irawan Satriotomo, Gordon S Mitchell
In SOD1G93A transgenic rat model of ALS, breathing capacity is preserved until late in disease progression despite profound respiratory motor neuron (MN) cell death. To explore mechanisms preserving breathing capacity, we assessed inspiratory EMG activity in diaphragm and external intercostal T2 (EIC2) and T5 (EIC5) muscles in anesthetized SOD1G93A rats at disease end-stage (20% decrease in body mass). We hypothesized that despite significant phrenic motor neuron loss and decreased phrenic nerve activity, diaphragm electrical activity and trans-diaphragmatic pressure (Pdi) are maintained to sustain ventilation...
January 2018: Experimental Neurology
https://www.readbyqxmd.com/read/28977797/evaluation-of-magnetic-resonance-imaging-safety-and-imaging-issues-associated-with-the-occlusion-balloon-used-during-fetoscopic-endoluminal-tracheal-occlusion
#16
Teresa Victoria, Ann M Johnson, N Scott Adzick, Holly L Hedrick, Frank G Shellock
INTRODUCTION: Congenital diaphragmatic hernias can be successfully treated by fetoscopic tracheal occlusion (FETO), a minimally invasive procedure that may improve postnatal survival. The endoluminal balloon utilized for FETO contains a metallic component that may pose possible risks for the fetus and mother related to the use of magnetic resonance imaging (MRI). The objective of this study is to evaluate MRI-related imaging and safety issues (magnetic field interactions, heating, and artifacts) for the occlusion balloon used in FETO...
October 5, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28924068/-endovascular-treatment-for-carotid-blowout-syndrome-after-radiation-for-esophageal-cancer-a-case-report
#17
Shigefumi Takahashi, Tomohiro Kawaguchi, Kuniyasu Niizuma, Atsuhiro Nakagawa, Miki Fujimura, Takenori Ogawa, Yukio Katori, Teiji Tominaga
Here, we discuss a case of carotid blowout syndrome successfully treated with endovascular parent artery occlusion. A 71-year-old woman underwent treatment for esophageal cancer resection, followed by 50-Gy radiotherapy, 19 years prior. Due to local recurrence, she underwent 66- and 72-Gy radiation treatments at 2 and 4 years after the initial treatment, respectively. Afterward, tracheostomy and enterostomy were performed. This time, she was transported to our emergency department because of acute eruptive bleeding from the tracheal tube...
September 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28891233/fetoscopic-tracheal-occlusion-for-treatment-of-non-isolated-congenital-diaphragmatic-hernia
#18
Viola Seravalli, Eric B Jelin, Jena L Miller, Aylin Tekes, Luca Vricella, Ahmet A Baschat
Fetoscopic endotracheal occlusion (FETO) is a prenatal treatment that may increase survival in severe congenital diaphragmatic hernia (CDH). In the USA, FETO is offered for isolated severe left-sided CDH in the context of an FDA-approved feasibility study. FETO in non-isolated cases of severe CDH is only performed with a compassionate use exemption from US regulatory bodies. Anomalies frequently associated with CDH include congenital cystic lesions of the lung and cardiac defects. We describe two cases of non-isolated severe left-sided CDH that underwent prenatal FETO, survived after birth and underwent postnatal surgical repair...
October 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28882976/endobronchial-carcinoid-tumor-totally-occluding-the-left-main-bronchus-without-producing-symptoms-of-bronchial-obstruction
#19
Diamantis I Tsilimigras, Demetrios Moris, Ioannis Ntanasis-Stathopoulos, Davide Patrini, Nikolaos Panagiotopoulos
BACKGROUND: Bronchial carcinoid tumors (BCTs) are rare neuroendocrine neoplasms of the lung that mainly have a central distribution. They are classified as typical and atypical, with the former variant generally conferring a more favorable survival. Central tumors are usually symptomatic with features of bronchial obstruction, whereas peripheral tumors may remain silent. CASE REPORT: A 36-year-old woman presented to our hospital due to an episode of massive hemoptysis 5 days prior to admission...
September 2017: In Vivo
https://www.readbyqxmd.com/read/28866670/clinical-outcome-for-congenital-diaphragmatic-hernia-at-the-age-of-1-year-in-the-era-of-fetal-intervention
#20
Eva Van Ginderdeuren, Karel Allegaert, Herbert Decaluwe, Jan Deprest, Anne Debeer, Marijke Proesmans
BACKGROUND: Congenital diaphragmatic hernia (CDH) is an abnormal development of the diaphragm leading to high neonatal mortality and morbidity. Beyond the neonatal period, prospective data on overall long-term outcome in CDH survivors is scarce. In particular, for those treated with fetoscopic endoluminal tracheal occlusion (FETO), a promising new technique to increase survival chances for severe cases, the outcomes are even less documented. AIM: To prospectively document the clinical outcome of CDH at 1 year including FETO-treated infants in relation to ante- and postnatal variables...
2017: Neonatology
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