Philipp Foessleitner, Konrad Hoetzenecker, Alberto Benazzo, Katrin Klebermass-Schrehof, Anke Scharrer, Herbert Kiss, Alex Farr
Pregnant women with influenza-A have an increased risk of developing acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) can be used as salvage therapy, with lung transplantation as a therapeutic option. However, successful bilateral lung transplantation during pregnancy has never been reported before. We herein report the case of a 34-year-old primipara, who was diagnosed with acute ARDS caused by influenza-A-induced pneumonia at early gestation. After considering all possible therapeutic options and being fully dependent on VV-ECMO support, she underwent bilateral lung transplantation...
July 31, 2021: American Journal of Transplantation
Xue-Min Gao, Yan-Ying Yu, Hao Zhao, Hao Cai, Lu Zhang, Xin-Xin Cao, Dao-Bin Zhou, Jian Li
POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome is a rare plasma cell dyscrasia without standard front-line treatment. Merely, few studies have reported the responses and outcomes of bortezomib plus dexamethasone (BDex) in POEMS syndrome. In this study, a total of 69 patients (40 males) treated with front-line BDex were included. The median age at diagnosis was 50 years (range, 30-78 years). After a median of 9 cycles BDex (range 1-9), fifty-two (88.1%), thirty-two (46...
July 31, 2021: Annals of Hematology
Sophie Breinig, Odile Dicky, Virginie Ehlinger, Yves Dulac, Marie-Odile Marcoux, Catherine Arnaud
The aim is to conduct a pilot study to prospectively describe echocardiographic parameters in neonates with pulmonary hypertension (PH) managed according to current recommendations and to identify those parameters that could predict worsening of short-term outcomes. All neonates less than 28 days old with a diagnosis of PH were prospectively enrolled in a tertiary care center for 1 year. Two echocardiograms were performed by a trained neonatologist. The first echocardiogram was performed at the time of diagnosis, whereas the second was performed just after basic therapeutic optimization...
July 31, 2021: Pediatric Cardiology
Nazareth N Rocha, Cynthia S Samary, Mariana A Antunes, Milena V Oliveira, Matheus R Hemerly, Patrine S Santos, Vera L Capelozzi, Fernanda F Cruz, John J Marini, Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
BACKGROUND: We evaluated the effects of abrupt versus gradual PEEP decrease, combined with standard versus high-volume fluid administration, on cardiac function, as well as lung and kidney damage in an established model of mild-moderate acute respiratory distress syndrome (ARDS). METHODS: Wistar rats received endotoxin intratracheally. After 24 h, they were treated with Ringer's lactate at standard (10 mL/kg/h) or high (30 mL/kg/h) dose. For 30 min, all animals were mechanically ventilated with tidal volume = 6 mL/kg and PEEP = 9 cmH2 O (to keep alveoli open), then randomized to undergo abrupt or gradual (0...
July 30, 2021: Respiratory Research
Thomas Yates, Francesco Zaccardi, Nazrul Islam, Cameron Razieh, Clare L Gillies, Claire A Lawson, Yogini Chudasama, Alex Rowlands, Melanie J Davies, Annemarie B Docherty, Peter J M Openshaw, J Kenneth Baillie, Malcolm G Semple, Kamlesh Khunti
BACKGROUND: Although age, obesity and pre-existing chronic diseases are established risk factors for COVID-19 outcomes, their interactions have not been well researched. METHODS: We used data from the Clinical Characterisation Protocol UK (CCP-UK) for Severe Emerging Infection developed by the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC). Patients admitted to hospital with COVID-19 from 6th February to 12th October 2020 were included where there was a coded outcome following hospital admission...
July 31, 2021: BMC Infectious Diseases
Dalia Rotstein, Colleen Maxwell, Karen Tu, Jodi Gatley, Priscila Pequeno, Alexander Kopp, Ruth Ann Marrie
BACKGROUND: Multiple sclerosis (MS) has been associated with certain comorbidities in general population studies, but it is unknown how comorbidity may affect immigrants with MS. OBJECTIVE: To compare prevalence of comorbidities in immigrants and long-term residents at MS diagnosis, and in matched control populations without MS. METHODS: We identified incident MS cases using a validated definition applied to health administrative data in Ontario, Canada, from 1994 to 2017, and categorized them as immigrants or long-term residents...
July 30, 2021: Multiple Sclerosis: Clinical and Laboratory Research
Jing Cao, Lingjie Yang, Le Wang, Qian Zhao, Dian Wu, Mingxia Li, Yuming Mu
Pulmonary microvascular endothelial cell (PMVEC) apoptosis is the initial stage of adult pulmonary hypertension (PH), which involves high pulmonary arterial pressure and pulmonary vascular remodeling. However, the mechanism regulating PMVEC apoptosis and its involvement in the early stages of neonatal hypoxic PH (HPH) pathogenesis are currently unclear. The present study aimed to investigate the effects of heat shock protein 70 (HSP70) on hypoxia‑induced apoptosis in PMVECs. PMVECs isolated from neonatal Sprague‑Dawley rats were transfected with lentivirus with or without HSP70, or treated with the synthetic HSP70 inhibitor N‑formyl‑3,4‑methylenedioxy‑benzylidene-g-butyrolactam under hypoxic conditions (5% O2 ) for 24, 48 or 72 h...
October 2021: Molecular Medicine Reports
Michaël Sauthier, Nicolas Sauthier, Krystale Bergeron Gallant, Gregory A Lodygensky, Atsushi Kawaguchi, Guillaume Emeriaud, Philippe Jouvet
Objectives: Significant resources are devoted to neonatal prolonged mechanical ventilation (NPMV), but little is known about the outcomes in those children. Our primary objective was to describe the NPMV respiratory, digestive, and neurological outcomes at 18 months corrected age. Our second objective was on the early identification of which patients, among the NPMV cohort, will need to be ventilated for ≥125 days, which corresponded to the 75th percentile in the preliminary data, and to describe that subgroup...
2021: Frontiers in Pediatrics
Hassaan B Arshad, Valeria E Duarte
Pulmonary arterial hypertension is a common complication in patients with congenital heart disease (CHD), aggravating the natural course of the underlying defect. Pulmonary arterial hypertension (PAH) has a multifactorial etiology depending on the size and nature of the cardiac defect as well as environmental factors. Although progress has been made in disease-targeting therapy using pulmonary vasodilators to treat Eisenmenger syndrome, important gaps still exist in the evaluation and management of adult patients with CHD-associated PAH (PAH-CHD) who have systemic-to-pulmonary shunts...
2021: Methodist DeBakey Cardiovascular Journal
Sandhya Murthy, Raymond Benza
Pulmonary arterial hypertension (PAH) is a chronic debilitating disease that carries an unacceptably high morbidity and mortality rate despite improved survival with modern therapies. The combination of several modifiable and nonmodifiable variables yields a robust risk assessment across various available clinical calculators. The role of risk calculation is integral to managing PAH and aids in the timely referral to expert centers and potentially lung transplantation. Studies are ongoing to determine the role of risk calculators in the framework of clinical trials and to elucidate novel markers of high risk in PAH...
2021: Methodist DeBakey Cardiovascular Journal
Jordan Sugarman, Jason Weatherald
Pulmonary hypertension (PH) is a known complication of chronic parenchymal lung diseases, including chronic obstructive lung disease, interstitial lung diseases, and more rare parenchymal lung diseases. Together, these diseases encompass two of the five clinical classifications of PH: group 3 (chronic lung disease [CLD] and/or hypoxia) and group 5 (unclear and/or multifactorial mechanisms). The principal management strategy in PH associated with CLD is optimization of the underlying lung disease. There has been increasing interest in therapies that treat pulmonary arterial hypertension (group 1, PAH), and although some studies have explored the use of these oral PAH-targeted therapies to treat PH associated with CLD, there is currently no evidence to support their routine use; in fact, some studies suggest harm...
2021: Methodist DeBakey Cardiovascular Journal
Francesca Macera, Jean-Luc Vachiéry
Pulmonary hypertension due to left heart diseases (PH-LHD) is the most prevalent form of pulmonary hypertension. It frequently complicates heart failure with reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF) and negatively impacts prognosis, particularly when a precapillary component is present. PH-LHD is distinctive from pulmonary arterial hypertension (PAH) even though both conditions may share some common characteristics. In addition, the mechanisms involved in the development of a precapillary component are yet to be fully clarified, in particular in PH due to HFpEF...
2021: Methodist DeBakey Cardiovascular Journal
Kanza N Qaiser, Adriano R Tonelli
Pulmonary arterial hypertension (PAH) is a severe and progressive vascular disease characterized by pulmonary vascular remodeling, proliferation, and inflammation. Despite the availability of effective treatments, PAH may culminate in right ventricular failure and death. Currently approved medications act through three well-characterized pathways: the nitric oxide, endothelin, and prostacyclin pathways. Ongoing research efforts continue to expand our understanding of the molecular pathogenesis of this complex and multifactorial disease...
2021: Methodist DeBakey Cardiovascular Journal
C Gregory Elliott
A subgroup of patients diagnosed with pulmonary arterial hypertension (PAH) carry transmissible pathogenic gene mutations. For many of these patients, the heritable nature of their disease can only be uncovered by genetic testing. Because identification of PAH patients who carry pathogenic gene mutations has important implications for other family members, genetic counseling and testing should be offered to patients diagnosed with idiopathic or familial PAH. This review describes the current state of genetic counseling and testing for patients diagnosed with PAH...
2021: Methodist DeBakey Cardiovascular Journal
Isaac Tea, Imad Hussain
Pulmonary hypertension (PH) is a heterogenous disorder involving multiple pathophysiological processes that ultimately affect the vasculature within the lungs. Right heart catheterization (RHC) continues to be the benchmark for diagnosing PH. The use of provocation techniques during RHC can help sub-characterize the type of PH and thus assist in developing appropriate treatment strategies for the management of each PH subtype. This review examines proven and novel approaches for evaluating the pulmonary vasculature during RHC and aspires to provide an accurate, clinically relevant framework for using RHC to diagnose and manage PH...
2021: Methodist DeBakey Cardiovascular Journal
Beshay Sarah, Guha Ashrith, Sahay Sandeep
Pulmonary hypertension (PH) is a rare heterogenous disease characterized by elevated blood pressure in the lungs. Patients with PH require careful evaluation and management at an expert center. Understanding of the mechanisms underlying the development of PH has increased over the past two decades, and several treatment options for pulmonary arterial hypertension have emerged. Despite this progress, PH continues to carry high morbidity and mortality. The 6th World Symposium on Pulmonary Hypertension that occurred in late 2018 modified the clinical classification of PH into five groups...
2021: Methodist DeBakey Cardiovascular Journal
Ashrith Guha, Sandeep Sahay
No abstract text is available yet for this article.
2021: Methodist DeBakey Cardiovascular Journal
Sandeep Sahay, Ashrith Guha
No abstract text is available yet for this article.
2021: Methodist DeBakey Cardiovascular Journal
Noriyuki Enomoto, Seiichiro Suzuki, Hironao Hozumi, Masato Karayama, Yuzo Suzuki, Kazuki Furuhashi, Tomoyuki Fujisawa, Yutaro Nakamura, Keiichi Odagiri, Takamichi Ishikawa, Kensuke Kataoka, Yasuhiro Kondoh, Masato Maekawa, Naoki Inui, Hiroshi Watanabe, Takafumi Suda
Several biomarkers for detecting pulmonary hypertension (PH) have been reported. However, these biomarkers are deemed insufficient to detect PH in its early stages. We evaluated the utility of serum angiopoietin (ANGP), a glycoprotein related to angiogenesis, as a diagnostic and prognostic biomarker of PH. Patients with PH who underwent right-heart catheterization, were retrospectively studied. Serum concentrations of ANGP-1 and ANGP-2 were measured using an enzyme-linked immunosorbent assay in patients with PH (n = 32), those with idiopathic pulmonary fibrosis (IPF) without PH (as a disease control, n = 75), and age-matched healthy controls (HC, n = 60)...
July 29, 2021: Scientific Reports
Dietmar Schranz
No abstract text is available yet for this article.
August 3, 2021: Journal of the American College of Cardiology
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