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https://www.readbyqxmd.com/read/29138242/role-of-ecmo-in-congenital-diaphragmatic-hernia
#1
REVIEW
Merrill McHoney, Philip Hammond
Congenital diaphragmatic hernia (CDH) is typified morphologically by failure of diaphragmatic development with accompanying lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Patients who have labile physiology and low preductal saturations despite optimal ventilatory and inotropic support may be considered for extracorporeal membrane oxygenation (ECMO). Systematic reviews into the benefits of ECMO in CDH concluded that any benefit is unclear. Few randomised trials exist to demonstrate clear benefit and guide management...
November 14, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29127236/structural-and-functional-changes-of-the-pulmonary-vasculature-after-hypoxia-exposure-in-the-neonatal-period-a-new-swine-model-of-pulmonary-vascular-disease
#2
Daphne P M de Wijs-Meijler, Richard W B van Duin, Dirk J Duncker, Urs Scherrer, Claudio Sartori, Irwin K M Reiss, Daphne Merkus
Pulmonary vascular disease (PVD) represents an underestimated and increasing clinical burden in the neonatal period, but also later in life, when exercise-tolerance is decreased. Animal models performing long-term follow-up after a perinatal insult are lacking. This study aimed to develop and characterize a neonatal swine model with hypoxia-induced PVD, during long-term follow-up after re-exposure to normoxia, and to investigate the exercise response in this model. Piglets were exposed to a normoxic (N=10) or hypoxic environment (N=9) for four weeks...
November 10, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29126435/human-amnion-cells-reverse-acute-and-chronic-pulmonary-damage-in-experimental-neonatal-lung-injury
#3
Dandan Zhu, Jean Tan, Amina S Maleken, Ruth Muljadi, Siow T Chan, Sin N Lau, Kirstin Elgass, Bryan Leaw, Joanne Mockler, Daniel Chambers, Kristen T Leeman, Carla F Kim, Euan M Wallace, Rebecca Lim
BACKGROUND: Despite advances in neonatal care, bronchopulmonary dysplasia (BPD) remains a significant contributor to infant mortality and morbidity. While human amnion epithelial cells (hAECs) have shown promise in small and large animal models of BPD, there is scarce information on long-term benefit and clinically relevant questions surrounding administration strategy remain unanswered. In assessing the therapeutic potential of hAECs, we investigated the impact of cell dosage, administration routes and timing of treatment in a pre-clinical model of BPD...
November 10, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29115016/pulmonary-hypertension-in-stiff-left-atrial-syndrome-pathogenesis-and-treatment-in-one
#4
Micha T Maeder, Reto Nägele, Philipp Rohner, Daniel Weilenmann
We present the rare case of a patient with pulmonary hypertension in the context of the stiff left atrial syndrome after extensive catheter ablation, a unique constellation characterized by high pulmonary artery and pulmonary artery wedge pressures due to left atrial dysfunction but normal left ventricular end-diastolic pressure, normal mitral valve, and absence pulmonary vein stenosis. This patient was surprisingly oligosymptomatic, however, which may have been due to a persistent post-puncture atrial septal defect, which may have allowed for controlled left atrial decompression, which is in line with the novel concept of the catheter-based creation of an intracardiac shunt as a treatment for heart failure...
November 8, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29109948/hemodynamic-and-pathologic-characterization-of-the-task-1-mouse-does-not-demonstrate-pulmonary-hypertension
#5
Melanie G Kitagawa, Julia O Reynolds, Xander H T Wehrens, Robert M Bryan, Lavannya M Pandit
Introduction: Pulmonary hypertension (PH) carries significant associated morbidity and mortality and the underlying molecular mechanisms of PH are not well understood. Loss-of-function mutations in TASK-1 potassium channels are associated with PH in humans. Although TASK-1 has been considered in the development of PH for over a decade, characterization of TASK-1 knockout mice has been limited to in vitro studies or in vivo studies in room air at isolated time points. The purpose of this study was twofold...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29108501/occult-massive-visceral-fat-necrosis-following-therapeutic-hypothermia-for-neonatal-encephalopathy
#6
Salwa Khedr, Anna Piskorski, Adrienne R Bingham, Justin Goldstein, Abbot R Laptook, Monique E De Paepe
Therapeutic hypothermia (head or whole-body cooling) improves survival and neurodevelopmental outcome in term newborns with moderate-to-severe encephalopathy. Hypothermia treatment is well tolerated; the most common side effect is thrombocytopenia. In about 1% of infants, focal subcutaneous fat necrosis has been reported. We describe a case of clinically unsuspected massive visceral fat necrosis in a term infant with Apgar score 0 at 1 min ("resuscitated apparently stillborn" infant) who was treated with therapeutic hypothermia for 72 h and expired on the 25th day of life following a neonatal course complicated by severe encephalopathy, pulmonary artery hypertension, persistent thrombocytopenia, hypoglycemia, and severe basal ganglia-thalamic abnormalities on magnetic resonance imaging...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/29097426/the-emerging-role-of-angiogenesis-in-adaptive-and-maladaptive-right-ventricular-remodeling-in-pulmonary-hypertension
#7
Andrea L Frump, Sebastien Bonnet, Vinicio A de Jesus Perez, Tim Lahm
Right ventricular (RV) function is the primary prognostic factor for both morbidity and mortality in pulmonary hypertension (PH). RV hypertrophy is initially an adaptive physiological response to increased overload; however, with persistent and/or progressive afterload increase, this response frequently transitions to more pathological maladaptive remodeling. The mechanisms and disease processes underlying this transition are mostly unknown. Angiogenesis has recently emerged as a major modifier of RV adaptation in the setting of pressure overload...
November 2, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29076888/role-of-perfusion-defects-at-follow-up-lung-scan-in-predicting-recurrences-after-a-first-episode-of-symptomatic-pulmonary-embolism-a-retrospective-analysis
#8
Liliana Villari, Roberta Pancani, Ferruccio Aquilini, Letizia Marconi, Laura Carrozzi, Antonio Palla, Alessandro Celi
The optimal duration of anticoagulant therapy after a first episode of unprovoked pulmonary thromboembolism is not fully defined. The identification of patients more prone to recurrence would be useful in this context but is currently relatively unreliable. Perfusion lung scan (PLS) is an established approach for the follow-up of patients with pulmonary embolism to identify recurrences and to help in the diagnosis of chronic thromboembolic pulmonary hypertension. The aim of the study was to investigate the potential role of residual perfusion defects at follow-up perfusion scans in predicting pulmonary embolism recurrences...
October 25, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29071783/age-is-not-a-good-predictor-of-irreversibility-of-pulmonary-hypertension-in-congenital-cardiac-malformations-with-left-to-right-shunt
#9
Amir-Reza Hosseinpour, Marie-Hélène Perez, David Longchamp, Jacques Cotting, Nicole Sekarski, Michel Hurni, René Prêtre, Stefano Di Bernardo
OBJECTIVE: Congenital cardiac malformations with high pulmonary blood flow and pressure due to left-to-right shunts are usually repaired in early infancy for both the benefits of early relief of heart failure and the fear that the concomitant pulmonary hypertension may become irreversible unless these defects are corrected at an early age. Age, however, has been a poor predictor of irreversibility of pulmonary hypertension in our experience, which is presented here. DESIGN: A retrospective observational study...
October 25, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29070092/late-management-of-truncus-arteriosus-20-years-of-humanitarian-experience
#10
Marielle Gouton, Vincent Lucet, Olivier Bical, Francine Leca
OBJECTIVES: Early surgical management of common arterial trunk is well established and has good prognosis. Late diagnosis is less common. We reviewed late-diagnosed common arterial trunk management and prognosis for children in developing countries. We also discuss the need for prior catheterisation. Material and methods We reviewed all common arterial trunk patients managed by our humanitarian organization since 1996. RESULTS: A total of 41 children with common arterial trunk were managed at a mean age of 3 years old...
October 26, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29058384/nitric-oxide-for-the-treatment-of-preterm-infants-with-severe-rds-and-pulmonary-hypertension
#11
Carlo Dani, Iuri Corsini, Jessica Cangemi, Venturella Vangi, Simone Pratesi
BACKGROUND: Inhaled nitric oxide (iNO) cannot be recommended for the routine treatment of respiratory failure in premature neonates, but it has been suggested that the effectiveness of iNO therapy should be further studied in more select preterm infants, such as those with persistent pulmonary hypertension of the newborn (PPHN). OBJECTIVE: To evaluate the frequency of PPHN in very preterm infants with severe respiratory distress syndrome (RDS), to assess the effectiveness of iNO in these patients, and to individuate possible predictive factors for the response to iNO in preterm infants with RDS...
November 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29058246/factors-relating-caesarean-section-to-persistent-pulmonary-hypertension-of-the-newborn
#12
REVIEW
Niralee Babooa, Wen-Jing Shi, Chao Chen
BACKGROUND: Several studies have clearly demonstrated a significantly higher incidence of persistent pulmonary hypertension of the newborn (PPHN) in neonates delivered by caesarean section (CS) compared to those delivered vaginally. The pathophysiological factors underlying the link between CS and PPHN are still poorly understood. In this review, we describe the mechanisms that could explain the association between CS delivery and subsequent PPHN, as well as potential preventive measures...
December 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29047092/redox-signaling-and-persistent-pulmonary-hypertension-of-the-newborn
#13
Megha Sharma, Adeleye J Afolayan
Reactive oxygen species (ROS) are redox-signaling molecules that are critically involved in regulating endothelial cell functions, host defense, aging, and cellular adaptation. Mitochondria are the major sources of ROS and important sources of redox signaling in pulmonary circulation. It is becoming increasingly evident that increased mitochondrial oxidative stress and aberrant signaling through redox-sensitive pathways play a direct causative role in the pathogenesis of many cardiopulmonary disorders including persistent pulmonary hypertension of the newborn (PPHN)...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29047087/effects-of-hyperoxia-on-the-developing-airway-and-pulmonary-vasculature
#14
Christina M Pabelick, Michael A Thompson, Rodney D Britt
Although it is necessary and part of standard practice, supplemental oxygen (40-90% O2) or hyperoxia is a significant contributing factor to development of bronchopulmonary dysplasia, persistent pulmonary hypertension, recurrent wheezing, and asthma in preterm infants. This chapter discusses hyperoxia and the role of redox signaling in the context of neonatal lung growth and disease. Here, we discuss how hyperoxia promotes dysfunction in the airway and the known redox-mediated mechanisms that are important for postnatal vascular and alveolar development...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29046161/inhaled-nitric-oxide-in-preterm-neonates-with-refractory-hypoxemia-associated-to-oligohydramnios
#15
Alvarado Socarras Jorge, Castro M Javier, Fredi Alexander Diaz-Quijano
BACKGROUND: Therapy with inhaled nitric oxide (iNO) is effective in the management of pulmonary hypertension and severe hypoxemia. However, these benefits have not been demonstrated in preterm infants (<34 weeks). The objective of this report is to present the experience of eight cases of preterm neonates with respiratory distress syndrome (RDS) and refractory hypoxemia, with oligohydramnios history. METHODS: We evaluated the clinical feature of 8 preterm neonates with severe hypoxemia who had maternal antecedents of oligoamnios, mainly due to premature rupture of membranes...
October 17, 2017: Current Drug Discovery Technologies
https://www.readbyqxmd.com/read/29033108/clinical-course-in-infants-diagnosed-with-transient-tachypnea-of-newborn-a-clinical-trial-assessing-the-role-of-conservative-versus-conventional-management
#16
M Dehdashtian, M Aletayeb, A Malakian, M R Aramesh, H Malvandi
BACKGROUND: Transient tachypnea of the newborn (TTN) is a respiratory disorder secondary to inadequate or delayed clearance of lung fluids. Early symptoms of the disease are indistinguishable from neonatal respiratory distress syndrome, pneumonia, and persistent pulmonary hypertension. Therefore, these newborns, in addition to receiving conservative management, receive antibiotics until blood cultures provide definite results. In this study, we assessed the clinical course of neonates diagnosed with TTN who received conventional versus conservative management...
October 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29029716/balloon-pulmonary-angioplasty-in-chronic-thromboembolic-pulmonary-hypertension-new-horizons-in-the-interventional-management-of-pulmonary-embolism
#17
REVIEW
Michael D Rivers-Bowerman, Rebecca Zener, Arash Jaberi, Marc de Perrot, John Granton, John M Moriarty, Kong T Tan
Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed potential complication of acute or recurrent pulmonary thromboembolic disease. Multiple studies suggest that up to 5% of patients with acute pulmonary thromboembolic disease go on to develop CTEPH. The prognosis of untreated CTEPH is poor, but advances in medical and surgical treatments over the past few decades have improved patient outcomes. The gold standard and curative treatment for CTEPH is pulmonary endarterectomy; however, some patients are inoperable and others who have undergone pulmonary endarterectomy experience persistent or recurrent pulmonary hypertension despite medical therapy...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029023/comprehensive-evaluation-of-the-effectiveness-and-safety-of-balloon-pulmonary-angioplasty-for-inoperable-chronic-thrombo-embolic-pulmonary-hypertension-long-term-effects-and-procedure-related-complications
#18
Tatsuo Aoki, Koichiro Sugimura, Shunsuke Tatebe, Masanobu Miura, Saori Yamamoto, Nobuhiro Yaoita, Hideaki Suzuki, Haruka Sato, Katsuya Kozu, Ryo Konno, Satoshi Miyata, Kotaro Nochioka, Kimio Satoh, Hiroaki Shimokawa
Aims: Although balloon pulmonary angioplasty (BPA) improves haemodynamics and short-term prognosis in patients with inoperable chronic thrombo-embolic pulmonary hypertension (CTEPH), the long-term effects of BPA, and procedure-related complications remain to be fully elucidated. Methods and results: From July 2009 to October 2016, we performed a total of 424 BPA sessions in 84 consecutive patients with inoperable CTEPH. We used 3D reconstructed computed tomography to determine target lesions of pulmonary arteries and optical computed tomography to select balloon size, if needed...
November 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29028693/the-development-of-pulmonary-hypertension-results-in-decreased-post-transplant-survival
#19
Erin M Schumer, Michele Gallo, Michael P Rogers, Jaimin R Trivedi, Matthew C Black, H Todd Massey, Mark S Slaughter
The effects of pulmonary hypertension (PAH) on survival after heart transplantation are debated, especially for patients with left ventricular assist devices (LVAD). The United Network of Organ Sharing database was retrospectively queried from January 2005 to June 2015 to identify adult patients who underwent heart transplantation. Four groups were defined: patients without PAH, persistent PAH, resolved PAH, and developed PAH between listing and transplant. A total of 15,914 patients underwent heart transplant of which 4,662 (29%) were implanted with an LVAD...
October 10, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29027516/-chronic-thromboembolic-pulmonary-hypertension-recognition-diagnosis-and-treatment
#20
D Ruigrok, P Symersky, P W G Elbers, S Kamminga, L J Meijboom, H J Bogaard
- Chronic thromboembolic pulmonary hypertension (CTEPH), characterised by pulmonary hypertension and persistent perfusion defects despite adequate anticoagulation, causes significant morbidity and mortality.- Persistent dyspnoea after acute pulmonary embolism is frequent and an indication for additional diagnostics. Only a minority of these patients develop CTEPH.- Echocardiography and perfusion scintigraphy are the cornerstone of diagnostics when suspecting CTEPH. Right-heart catheterisation and pulmonary angiography should confirm the diagnosis...
2017: Nederlands Tijdschrift Voor Geneeskunde
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