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https://www.readbyqxmd.com/read/28641751/fetal-imaging-and-therapy-for-cdh-current-status
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
April 23, 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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
https://www.readbyqxmd.com/read/27926636/feasibility-and-outcomes-of-fetoscopic-tracheal-occlusion-for-severe-left-diaphragmatic-hernia
#18
COMPARATIVE STUDY
Michael A Belfort, Oluyinka O Olutoye, Darrell L Cass, Olutoyin A Olutoye, Christopher I Cassady, Amy R Mehollin-Ray, Alireza A Shamshirsaz, Stephanie M Cruz, Timothy C Lee, David G Mann, Jimmy Espinoza, Stephen E Welty, Caraciolo J Fernandes, Rodrigo Ruano
OBJECTIVE: To evaluate feasibility and initial outcomes of fetoscopic tracheal occlusion for severe diaphragmatic hernia compared with a historical cohort who had not received fetal tracheal occlusion. METHODS: Outcomes in a prospective observational cohort who underwent fetoscopic tracheal occlusion for severe fetal left diaphragmatic hernia without associated anomalies were compared with our historical nontreated cohort of matched fetuses of similar severity. Fetuses were classified using the same ultrasonography and magnetic resonance imaging methodology-prospectively in the fetoscopic tracheal occlusion group and retrospectively in the historical nontreated cohort...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27891001/rigid-bronchoscopic-management-of-acute-respiratory-failure-in-a-30-year-old-woman
#19
Karan Madan, Ashesh Dhungana, Neha Kawatra Madan, Anant Mohan, Vijay Hadda, Rakesh Garg, Deepali Jain, Randeep Guleria
A 30-year-old woman presented with a history of progressive shortness of breath, cough, and hoarseness. Stridor was audible on examination. Chest X-ray showed normal lung fields and contrast-enhanced computed tomography thorax showed lower tracheal occlusion with endoluminal growth. Diagnostic flexible bronchoscopy demonstrated multiple whitish glistening nodules over both vocal cords and lower tracheal occlusion by whitish nodular growth. In view of critical central airway obstruction, rigid bronchoscopy and excision of the lower tracheal growth were performed...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27835782/laryngospasm-central-and-obstructive-apnea-during-seizures-defining-pathophysiology-for-sudden-death-in-a-rat-model
#20
K Nakase, R Kollmar, J Lazar, H Arjomandi, K Sundaram, J Silverman, R Orman, J Weedon, D Stefanov, E Savoca, L Tordjman, K Stiles, M Ihsan, A Nunez, L Guzman, M Stewart
Seizure spread into the autonomic nervous system can result in life-threatening cardiovascular and respiratory dysfunction. Here we report on a less-studied consequence of such autonomic derangements-the possibility of laryngospasm and upper-airway occlusion. We used parenteral kainic acid to induce recurring seizures in urethane-anesthetized Sprague Dawley rats. EEG recordings and combinations of cardiopulmonary monitoring, including video laryngoscopy, were performed during multi-unit recordings of recurrent laryngeal nerve (RLN) activity or head-out plethysmography with or without endotracheal intubation...
December 2016: Epilepsy Research
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