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Fed Pract 2017 Mar;34(3):38-40

is a hospitalist, and is chief, internal medicine, both at the Phoenix Indian Medical Center in Arizona.

Given the widespread use of nonsteroidal anti-inflammatory drugs, physicians should recognize the symptoms of colonic diaphragm disease, a rare but serious complication that can affect the large and small intestines. Read More

Pulm Med 2019 3;2019:6364376. Epub 2019 Jan 3.

Department of Pulmonary Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore-575004, India.

Background: Chronic Obstructive Pulmonary Disease (COPD) impairs the function of the diaphragm by placing it at a mechanical disadvantage, shortening its operating length and changing the mechanical linkage between its various parts. This makes the diaphragm's contraction less effective in raising and expanding the lower rib cage, thereby increasing the work of breathing and reducing the functional capacity.

Aim Of The Study: To compare the effects of diaphragmatic stretch and manual diaphragm release technique on diaphragmatic excursion in patients with COPD. Read More

Rev Mal Respir 2019 Jan 30. Epub 2019 Jan 30.

Service des maladies respiratoires, hôpital Haut-Lévêque, centre hospitalier universitaire de Bordeaux, 33600 Pessac, France.

Introduction: Lyme disease is not uncommon and can sometimes progress to neurological complications. We report here an unusual case of bilateral diaphragmatic paralysis secondary to Lyme neuroborreliosis.

Case Report: A 79-year-old man was admitted to the intensive care unit for acute respiratory distress requiring intubation and the long-term use of nocturnal non-invasive ventilation. Read More

Kardiologiia 2019 Jan 27;59(1):12-21. Epub 2019 Jan 27.

Pirogov Russian National Research Medical University.

Aim: to study changes in the volumes of muscle, fat, and connective tissue in postmortem issue samples (autoptates) from diaphragm, right ventricle, lower limb (gastrocnemius muscle), as well as morphological changes of the diaphragm muscular structure in patients with different functional classes of heart failure (HF), and to compare them with some intravital parameters of external respiration (with maximal inspiratory pressure and its amplitude simultaneously measured by ultrasound method in particular).

Materials And Methods: Autoptates of the diaphragm muscle, right ventricle, lower limb (n=39) from 20 men and 19 women (with in vivo diagnosis CHF NYHA functional class (FC) I-IV, hypertension, ischemic heart disease) were examined within 24 hours after the fatal outcome. Light optical microscopy was used to assess the percentages of muscle, connective, adipose tissue, numbers of fibroblasts, and collagen fibers. Read More

Ter Arkh 2018 May;90(5):93-100

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.

Aim: To present application of Chicago classification criteria of esophageal motility disorders defined in high resolution manometry in clinical practice.

Materials And Methods: High-resolution manometry is the most exact hi-tech diagnostic method for esophageal motor function disorders according to Chicago classification v3.0. Read More

PLoS One 2019 30;14(1):e0211384. Epub 2019 Jan 30.

Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom.

The mdx mouse is the most widely-used animal model of the human disease Duchenne muscular dystrophy, and quantitative PCR analysis of gene expression in the muscles of this animal plays a key role in the study of pathogenesis and disease progression and in evaluation of potential therapeutic interventions. Normalization to appropriate stably-expressed reference genes is essential for accurate quantitative measurement, but determination of such genes is challenging: healthy and dystrophic muscles present very different transcriptional environments, further altering with disease progression and muscle use, raising the possibility that no single gene or combination of genes may be stable under all experimental comparative scenarios. Despite the pedigree of this animal model, this problem remains unaddressed. Read More

Cell Death Dis 2019 Jan 28;10(2):82. Epub 2019 Jan 28.

The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel.

Duchenne muscular dystrophy (DMD) is a progressive, lethal, X-linked disease of skeletal and cardiac muscles caused by mutations in the dystrophin gene. Loss of dystrophin leads to muscle fiber damage and impairment of satellite cell asymmetric division, which are essential for muscle regeneration. These processes ultimately result in muscle wasting and the replacement of the degenerating muscles by fibrogenic cells, a process that leads to the generation of fibrotic tissues. Read More

Int J Mol Sci 2019 Jan 26;20(3). Epub 2019 Jan 26.

Clinic of Nephrology and Rheumatology, University Medical Center Goettingen, 37075 Goettingen, Germany.

Kidney injury due to focal segmental glomerulosclerosis (FSGS) is the most common primary glomerular disorder causing end-stage renal disease. Homozygous mutations in either glomerular basement membrane or slit diaphragm genes cause early renal failure. Heterozygous carriers develop renal symptoms late, if at all. Read More

J Cardiothorac Vasc Anesth 2019 Jan 4. Epub 2019 Jan 4.

Anesthesiology and Intensive Care Clinic, Department of Medicine, University of Udine, Udine, Italy.

Of the various muscles that make up the respiratory system, the diaphragm is the prima donna. In the past, only specialist research centers were able to estimate and challenge the effort of this muscle; this was achieved by measuring transdiaphragmatic pressure-an invasive technique involving a double-balloon probe inserted through the esophagus-or by measuring twitch pressure (ie, the pressure generated at the outside tip of the endotracheal tube). However, the prevalence of diaphragm dysfunction in critically ill patients requiring intubation can exceed 60% (at the time of hospital admission) and may rise to as high as 80% in patients requiring prolonged mechanical ventilation and experiencing difficult weaning. Read More

Medicine (Baltimore) 2019 Jan;98(4):e14117

Department of Gynecology, Guangdong Women and Children Hospital.

Rationale: It is extremely rare for an intrauterine contraception device (IUD) to cause uterine perforation and Sigmoid perforation for a long time without being detected.

Patient Concerns: We present a case of a patient who has suffered from abdominal pain after 4 years of placement of an IUD, and found that the IUD was incarcerated by ultrasound.

Diagnoses: Laparoscopic and hysteroscopic examination revealed that the incarcerated IUD caused uterine perforation and sigmoid perforation for a long time. Read More

Medicine (Baltimore) 2019 Jan;98(4):e13887

Myology Institute, Pitié Salpetriere Hospital, APHP, Paris.

Rationale: Diaphragm is the main inspiratory respiratory muscle and little is known about diaphragm ultrasound in facio-scapula-humeral muscular dystrophy, a neuromuscular disease characterized by an asymmetric skeletal muscle involvement.

Patient Concerns: Diaphragm function evaluation DIAGNOSIS:: Diaphragm muscle weakness attested by the drop of vital capacity (VC) value from sitting position (74%) to supine position (46%).

Interventions: A diaphragm ultrasound was performed in supine position, from the anterior subcostal window OUTCOMES:: We found an opposite side to side hemi diaphragm displacement, either during sniff maneuver or during deep inspiration maneuver, showing a cranial abnormal reduced motion of the right hemi diaphragm whereas the left hemi diaphragm moved caudally. Read More

Curr Opin Anaesthesiol 2019 Jan 21. Epub 2019 Jan 21.

Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Purpose Of Review: Hemorrhage is the major cause of early death in severely injured patients. In civilian emergency medical services, the majority of life-threatening bleedings are found in noncompressible body regions (e.g. Read More

J Electromyogr Kinesiol 2019 Feb 11;44:139-155. Epub 2019 Jan 11.

Department of Physical Therapy, Biological and Health Sciences Center, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil; Spirometry and Respiratory Physiotherapy Laboratory (LEFiR) at UFSCar, São Carlos/SP, Brazil.

Introduction: Electromyography (EMG) helps to evaluate disorders and pulmonary behavior, as impairments in respiratory muscle function are associated with the development of diseases. There is a wide range of methods and protocols used to record and analyze EMG obtained from respiratory muscles, demonstrating a lack of standardization.

Objective: To identify the most common procedures used to record surface EMG (sEMG) of inspiratory muscles in adults and elderly individuals through a systematic review (primary), and to evaluate the quality of the report presented by the studies (secondary). Read More

Multidiscip Respir Med 2019 14;14. Epub 2018 Dec 14.

1Unit of Internistic Ultrasound, Department of MedicineScience of Aging G. D'Annunzio University, Cesi -Met, via Luigi Polacchi, 66100 Chieti, (CH) Italy.

Background: Some previous works have tested LUS use in diagnosing and monitoring interstitial lung diseases. B-lines are main sonographic signs for interstitial diseases. Increasing evidences suggest that dyspnea and impaired exercise capacity in IPF patients can be related, at least in part, to respiratory muscle dysfunction, in particular to diaphragm functionality. Read More

Tremor Other Hyperkinet Mov (N Y) 2018 8;8:618. Epub 2019 Jan 8.

Local Health Unit of Reggio Emilia, Neurology Division, Castelnovo né Monti and Scandiano (RE), IT.

Background: Rarely, cardiac pacemaker implant can lead to the development of involuntary hyperkinetic movement disorders localized to the abdominal wall or the diaphragm.

Phenomenology Shown: We report a case of a 79-year-old female who developed rhythmic continuous clonic right abdominal movements caused by cardiac pacemaker lead dislodgement.

Educational Value: Our case highlights that, in the differential diagnosis of hyperkinetic abdominal movement disorder, the presence and the possible pathogenic role of a cardiac pacemaker should be kept in mind. Read More

Diagn Interv Radiol 2019 Jan;25(1):42-49

Department of Radiology, Huadong Hospital Fudan University, Shanghai, China.

Purpose: We aimed to analyze multislice computed tomography (MSCT) imaging features of vasculitis in immunoglobulin G4-related disease (IgG4-RD).

Methods: In this retrospective study, we diagnosed 21 definite or possible IgG4-RD patients (71.4% male; mean age, 52. Read More

Surg Case Rep 2019 Jan 14;5(1). Epub 2019 Jan 14.

Department of Thoracic Surgery, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Background: Pneumothorax during surgery under general anesthesia is a life-threatening situation for the patient because it can progress easily to the tension pneumothorax due to positive pressure ventilation unless appropriate treatments such as inserting a drainage tube in the thoracic cavity are initiated. The authors experienced a case of intraoperative pneumothorax and the diffuse dissection of visceral pleura during liver transplantation surgery, and achieved successful repair by a trans-diaphragmatic approach without changing patient's body position.

Case Presentation: A 66-year-old male with multiple liver and renal cysts caused by autosomal dominant polycystic kidney disease (ADPKD) was admitted to the authors' hospital for treating the infection of the liver cysts. Read More

Reg Anesth Pain Med 2019 Jan;44(1):69-75

Department of Anesthesiology, The 98th Clinical College of PLA, Anhui Medical University, Huzhou, China

Background And Objectives: Diaphragmatic paralysis following supraclavicular brachial plexus block (SCBPB) is ascribed to phrenic nerve palsy. This study investigated the effect of 2 volumes of 0.375% ropivacaine on efficacy of block as a surgical anesthetic and as an analgesic and examined diaphragm compound muscle action potentials (CMAPs) and pulmonary function before and after SCBPB. Read More

Scand J Gastroenterol 2019 Jan 13:1-6. Epub 2019 Jan 13.

b Department of Gastroenterology , Peking University Third Hospital , Beijing , PR China.

Objective: We described a case series of patients diagnosed with Meckel's diverticulum using capsule endoscopy (CE), reviewed the literature, and aimed to reveal the common CE characteristics of Meckel's diverticulum.

Materials And Methods: We reviewed a case series of Meckel's diverticulum in the Department of Gastroenterology, Beijing Shijitan Hospital Affliated to the Capital Medical University. In each case, primary upper endoscopy and colonoscopy failed to reveal a reason to explain the complaints (hematochezia in three cases and abdominal pain in one). Read More

J Am Soc Nephrol 2019 Feb 11;30(2):304-321. Epub 2019 Jan 11.

Department of Kidney Development, Institute of Molecular Embryology and Genetics, and

Background: Previous research has elucidated the signals required to induce nephron progenitor cells (NPCs) from pluripotent stem cells (PSCs), enabling the generation of kidney organoids. However, selectively controlling differentiation of NPCs to podocytes has been a challenge.

Methods: We investigated the effects of various growth factors in cultured mouse embryonic NPCs during three distinct steps of nephron patterning: from NPC to pretubular aggregate, from the latter to epithelial renal vesicle (RV), and from RV to podocyte. Read More

J Thorac Cardiovasc Surg 2018 Aug 24. Epub 2018 Aug 24.

Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China; Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, China. Electronic address:

Objective: The use of the frozen elephant trunk technique for type A aortic dissection in Marfan syndrome is limited by the lack of imaging evidence for long-term aortic remodeling. We seek to evaluate the changes of the distal aorta and late outcomes after frozen elephant trunk and total arch replacement for type A aortic dissection in patients with Marfan syndrome.

Methods: Between 2003 and 2015, we performed frozen elephant trunk + total arch replacement for 172 patients with Marfan syndrome suffering from type A aortic dissection (94 acute; 78 chronic). Read More

Physiother Res Int 2019 Jan 9:e1766. Epub 2019 Jan 9.

Cardiopulmonary Physical Therapy Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, Recife, Brazil.

Background And Purpose: Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease that can cause repercussions on respiratory muscles and body composition. The aim of the current study was to evaluate inspiratory muscle strength, diaphragmatic mobility, and body composition in COPD subjects and to correlate these variables.

Methods: This was a cross-sectional study performed with 21 COPD patients. Read More

Respir Physiol Neurobiol 2019 Jan 6. Epub 2019 Jan 6.

Center for Respiratory Research and Rehabilitation, Department of Physical Therapy and McKnight Brain Institute, University of Florida, Gainesville, FL, 32610, USA. Electronic address:

Respiratory motor neuron death arises from multiple neurodegenerative and traumatic neuromuscular disorders. Despite motor neuron death, compensatory mechanisms minimize its functional impact by harnessing intrinsic mechanisms of compensatory respiratory plasticity. However, the capacity for compensation eventually reaches limits and pathology ensues. Read More

Ann Surg Oncol 2019 Jan 8. Epub 2019 Jan 8.

Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Background: The aim of this study was to identify factors associated with pleuropulmonary disease recurrence following cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) for appendiceal pseudomyxoma peritonei (PMP) and to evaluate the oncologic impact of pleuropulmonary disease recurrence compared with isolated peritoneal recurrence.

Methods: From a prospective database, we identified patients who developed pleuropulmonary recurrence, isolated peritoneal recurrence, or no recurrence following CRS/HIPEC for appendiceal PMP. Clinicopathologic, perioperative, and oncologic data associated with the index CRS/HIPEC procedure were reviewed. Read More

Eur J Surg Oncol 2018 Dec 29. Epub 2018 Dec 29.

Peritonectomy and Liver Unit, St George Hospital, NSW, Australia; University of New South Wales, Medicine, St George Clinical School, Australia. Electronic address:

Objectives: To assess the impact of short and long term outcomes of diaphragmatic interventions in cyto-reductive surgery (CRS) and intra-peritoneal chemotherapy (IPC).

Methods: 1230 consecutive CRS/IPC procedures were preformed between 1996 and 2018 in Sydney, Australia. Redo procedures and incomplete cyto-reductions were excluded. Read More

Medicine (Baltimore) 2019 Jan;98(1):e13993

Department of Neurology, Third Central Hospital of Tianjin.

Respiratory failure is common during acute exacerbation of chronic obstructive pulmonary disease (AE-COPD). Phrenic nerve conduction (PNC), transcranial magnetic stimulation (TMS), and cervical magnetic stimulation (CMS) are of great value in identifying the feature and site of AE-COPD.PNC, TMS, and CMS were performed in 20 AE-COPD patients with respiratory failure, and re-examined after weaning. Read More

Ann Transl Med 2018 Dec;6(23):464

Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Saga University, Saga, Japan.

We report a case of initial lung adenocarcinoma in which transformation to small cell lung carcinoma (SCLC) was observed after acquired resistance to the 3 generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) osimertinib and alternating treatment between chemotherapy and osimertinib was effective. A 61-year-old woman with EGFR mutation positive stage IV lung adenocarcinoma was administered 1 generation EGFR-TKI for 8 months as the first line therapy, then chemotherapy and 2 generation EGFR-TKI after progressive disease (PD). Four years after initial diagnosis, T790M was detected in a metastatic lesion of the right thoracic wall and osimertinib was prescribed. Read More

Pediatr Cardiol 2019 Jan 2. Epub 2019 Jan 2.

Advocate Children's Hospital, Advocate Children's Heart Institute, 4440 West 95th Street, Oak Lawn, IL, 60453, USA.

We assessed the feasibility and the impact of NAVA compared to conventional modes of mechanical ventilation in ventilatory and gas exchange parameters in post-operative children with congenital heart disease. Infants and children (age < 18 years) that underwent congenital heart surgery were enrolled. Patients were ventilated with conventional synchronized intermittent mechanical ventilation (SIMV) and subsequently transitioned to NAVA during their cardiovascular intensive care unit (CVICU) stay. Read More

PLoS One 2018 28;13(12):e0208697. Epub 2018 Dec 28.

Chair and Department of Thoracic Surgery, Faculty of Medicine and Dentistry, Medical University of Silesia, Katowice, Poland.

The diaphragm is well known for its role as the principal muscle of respiration. However, according to previous studies, its role is multifactorial, from breathing through pain perception, regulation of emotional sphere, collaborating in gastroesophageal functions, facilitating the venous and lymphatic return, to an essential role in the maintenance of lumbar spine stability. The purpose of the study was to examine whether diaphragm function parameters (thickness and range of motion) are associated with static balance maintenance. Read More

Spine Deform 2019 01;7(1):176-179

Department of Orthopedics, University Medical Center Utrecht, Heidelberglaan 100 3584 CX, Utrecht, the Netherlands.

Compression of the celiac artery by a tight arcuate ligament of the diaphragm is a rare syndrome that can arise after correction of severe kyphosis. Symptoms include abdominal pain and ileus and liver dysfunctions. These symptoms can be easily attributed to more common causes like the superior mesenteric artery syndrome, and a delay in the diagnosis of celiac artery obstruction may result in severe ischemic disease of the gastrointestinal tract. Read More

J Physiol 2019 Feb 13;597(3):831-848. Epub 2019 Jan 13.

Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland.

Key Points: Respiratory muscle weakness is a major feature of Duchenne muscular dystrophy (DMD), yet little is known about the neural control of the respiratory muscles in DMD and animal models of dystrophic disease. Substantial diaphragm muscle weakness is apparent in young (8-week-old) mdx mice, although ventilatory capacity in response to maximum chemostimulation in conscious mice is preserved. Peak volume- and flow-related measures during chemoactivation are equivalent in anaesthetized, vagotomized wild-type and mdx mice. Read More

PLoS One 2018 19;13(12):e0207720. Epub 2018 Dec 19.

Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, United States of America.

Importance: ICU-acquired muscle atrophy occurs commonly and worsens outcomes in adults. The incidence and severity of muscle atrophy in critically ill children are poorly characterized.

Objective: To determine incidence, severity and risk factors for muscle atrophy in critically ill children. Read More

J Neuromuscul Dis 2019 ;6(1):55-64

Service de Réanimation msédicale et unité de ventilation à domicile, CHU Raymond Poincaré, APHP, Université de Versailles Saint Quentin en Yvelines, Garches, France.

Background: Duchenne muscular dystrophy (DMD) is an X-linked recessive genetic muscle disorder. Respiratory muscle function is classically affected in this disease. Ultrasound recently emerged as a non-invasive tool to assess diaphragm function. Read More

Medicine (Baltimore) 2018 Dec;97(49):e13532

Department of Internal Medicine, Chonnam National University Medical School.

Rationale: Radiofrequency ablation (RFA) is a safe and effective local treatment modality with a low complication rate and is commonly used to treat hepatocellular carcinoma (HCC). The clinical outcome of RFA may be closely related to the location, size, and shape of index tumors, and major complications, including hemorrhage, liver abscess, infarction, visceral organ perforation, hemothorax, pneumothorax, tumoral seeding, and hepatic failure. Cardiac tamponade is a rare and serious life-threatening complication associated with RFA. Read More

J Neurosurg 2018 Nov 1:1-4. Epub 2018 Nov 1.

Departments of1Neurologic Surgery.

A carotid web is a shelf-like intraluminal filling defect typically arising from the posterolateral wall of the proximal internal carotid artery. It is recognized as a possible cause of ischemic stroke in young adults. However, its etiopathogenesis is controversial and remains to be fully elucidated. Read More

World J Hepatol 2018 Nov;10(11):887-891

Scripps Center for Organ Transplant, Scripps Green Hospital, La Jolla, CA 92037, United States.

Abdominal pain with elevated transaminases from inferior vena cava (IVC) obstruction is a relatively common reason for referral and further workup by a hepatologist. The differential for the cause of IVC obstruction is extensive, and the most common etiologies include clotting disorders or recent trauma. In some situations the common etiologies have been ruled out, and the underlying process for the patient's symptoms is still not explained. Read More

PLoS Genet 2018 12 10;14(12):e1007822. Epub 2018 Dec 10.

Department of Systems Biology, Columbia University Medical Center, New York, New York, United States of America.

Congenital diaphragmatic hernia (CDH) is a severe birth defect that is often accompanied by other congenital anomalies. Previous exome sequencing studies for CDH have supported a role of de novo damaging variants but did not identify any recurrently mutated genes. To investigate further the genetics of CDH, we analyzed de novo coding variants in 362 proband-parent trios including 271 new trios reported in this study. Read More

Nanomedicine 2018 Dec 7;16:34-44. Epub 2018 Dec 7.

Pediatric Neuromuscular Laboratory, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Felsenstein Medical Research Center (FMRC), Schneider Children's Medical Center, Tel-Aviv University, Israel. Electronic address:

Glucocorticosteroids are the most efficacious anti-inflammatory agents and the gold standard treatment in Duchenne muscular dystrophy (DMD). However, their chronic use may lead to severe side effects. We evaluated the use of a novel injectable steroidal nano-drug in mdx mouse model of DMD by comparing the efficacy of nano-liposomes remotely loaded with the steroid prodrug, methylprednisolone hemisuccinate (MPS) with the same steroid as-is, in short (4-weeks) and long-term (58-weeks) treatments. Read More

J Minim Invasive Gynecol 2018 Dec 8. Epub 2018 Dec 8.

Department of Surgical Gynecology (Drs, Magrina, Cuesta Guardiola, P. M. Magtibay, and Mr. P. M. Magtibay III), Mayo Clinic Hospital, Phoenix, Arizona.

Study Objective: To estimate pulmonary complications and diaphragm recurrence after resection of diaphragm metastases by minimally invasive surgery (MIS) for epithelial ovarian cancer (EOC).

Design: Retrospective analysis (Canadian Task Force classification III).

Setting: Mayo Clinic in Scottsdale, Arizona, from January 1, 2004, through January 31, 2014. Read More

Neurobiol Dis 2019 Apr 4;124:340-352. Epub 2018 Dec 4.

Departments of Neuroscience, Genentech, South San Francisco, CA, USA. Electronic address:

Amyotrophic lateral sclerosis (ALS), a neurodegenerative disease affecting motor neurons, is characterized by rapid decline of motor function and ultimately respiratory failure. As motor neuron death occurs late in the disease, therapeutics that prevent the initial disassembly of the neuromuscular junction may offer optimal functional benefit and delay disease progression. To test this hypothesis, we treated the SOD1 mouse model of ALS with an agonist antibody to muscle specific kinase (MuSK), a receptor tyrosine kinase required for the formation and maintenance of the neuromuscular junction. Read More

Am J Physiol Heart Circ Physiol 2018 Dec 28;315(6):H1691-H1702. Epub 2018 Sep 28.

Lund University, Department of Clinical Sciences, Lund, Clinical Physiology, Skåne University Hospital , Sweden.

Intracardiac hemodynamic forces have been proposed to influence remodeling and be a marker of ventricular dysfunction. We aimed to quantify the hemodynamic forces in patients with repaired tetralogy of Fallot (rToF) to further understand the pathophysiological mechanisms as this could be a potential marker for pulmonary valve replacement (PVR) in these patients. Patients with rToF and pulmonary regurgitation (PR) > 20% ( n = 18) and healthy control subjects ( n = 15) underwent MRI, including four-dimensional flow. Read More

Contraception 2018 Nov 30. Epub 2018 Nov 30.

The Ohio State University (OSU), College of Public Health (CPH), Division of Epidemiology, Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43210, USA. Electronic address:

Objectives: To calculate the prevalence and identify correlates of unmet need for contraception and to assess whether prevalence of use of effective contraception and long-acting reversible contraception (LARC) has changed over time among married or cohabiting, reproductive-age women in Vietnam.

Methods: Study population was drawn from nationally representative Multiple Indicator Cluster Surveys conducted in 2000, 2006, 2011 and 2014. Unmet need for contraception was defined as occurring when a fecund, married or cohabiting woman is not using any method of contraception but either does not want children or wants to delay birth for at least 1 year or until marriage. Read More

Chin Med J (Engl) 2018 Dec;131(23):2800-2807

Chronic Airway Disease Research Office, Department of Respiratory, Geriatric Hospital of Nanjing Medical University, Jiangsu Province Geriatric Hospital, Nanjing, Jiangsu 210024, China.

Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi-electrode catheter can be used as a feasible clinical physiological parameter in patients with chronic obstructive pulmonary disease (COPD) to provide useful information on the treatment response. However, it remains unknown whether the surface diaphragm electromyogram (EMGdi) could be used to identify the deterioration of clinical symptoms and to predict the necessity of hospitalization in acute exacerbation of COPD (AECOPD) patients.

Methods: COPD patients visiting the outpatient department due to acute exacerbation were enrolled in this study. Read More

Pulmonology 2018 Nov 30. Epub 2018 Nov 30.

Pneumology Service, University Hospital Complex of Santiago, Santiago de Compostela, Spain; Interdisciplinary Research Group in Pulmonology, Institute of Sanitary Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.

The diaphragm is the main breathing muscle and contraction of the diaphragm is vital for ventilation so any disease that interferes with diaphragmatic innervation, contractile muscle function, or mechanical coupling to the chest wall can cause diaphragm dysfunction. Diaphragm dysfunction is associated with dyspnoea, intolerance to exercise, sleep disturbances, hypersomnia, with a potential impact on survival. Diagnosis of diaphragm dysfunction is based on static and dynamic imaging tests (especially ultrasound) and pulmonary function and phrenic nerve stimulation tests. Read More

Surg Radiol Anat 2018 Nov 29. Epub 2018 Nov 29.

Department of Surgery, Teikyo University Chiba Medical Center, 3246-3, Anesaki, Ichihara, Chiba, 299-0111, Japan.

Purpose: Left trisectionectomy (LT) extending to the segment I with bile duct resection for perihilar cholangiocarcinoma (PHC) is a technically demanding procedure with high morbidity. Liver transection during LT is generally conducted to expose the right hepatic vein (RHV) on the remnant side. In clinical practice, we have often encountered a discrepancy between the theoretical RHV-oriented plane and the actual right intersectional plane. Read More

Front Physiol 2018 14;9:1618. Epub 2018 Nov 14.

Clinical Exercise & Respiratory Physiology Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada.

We tested the hypothesis that abdominal binding (AB) would reduce breathlessness and improve exercise tolerance by enhancing neuromuscular efficiency of the diaphragm during exercise in adults with chronic obstructive pulmonary disease (COPD). In a randomized, controlled, crossover trial, 20 adults with COPD (mean ± SD FEV, 60 ± 16% predicted) completed a symptom-limited constant-load cycle endurance exercise test at 75% of their peak incremental power output with concomitant measures of the diaphragm electromyogram (EMGdi) and respiratory pressures without (CTRL) vs. with AB sufficient to increase end-expiratory gastric pressure (Pga,ee) by 6. Read More

Acta Cir Bras 2018 Oct;33(10):879-888

Associate Professor, Head, Department of Surgery and Anatomy, Laboratory of Experimental Fetal Surgery, Department of Surgery and Anatomy, Ribeirao Preto Medical School, USP, Ribeirao Preto-SP, Brazil. Scientific and intellectual content of the study, manuscript preparation, critical revision, final approval.

Purpose: To evaluate the vascular ventilatory response in different stages of lung development and to compare them to the neonates with congenital diaphragmatic hernia (CDH) in a rabbit model.

Methods: New Zealand rabbits were divided into 8 groups (n=5): E25, E27, E30, and CDH. All groups were ventilated on a FlexiVent (Scireq, Montreal, QC, Canada), compounding the other 4 groups. Read More

Iran J Parasitol 2018 Jul-Sep;13(3):430-439

Dept. of Medical Parasitology & Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Toxoplasmosis is a global zoonotic disease that causes critical medical complications in neonates and immunocompromised persons. Infection rates in cats, specifically stray cats, are believed to be the best sentry of the level of in the environment. Therefore, in this study, we surveyed infection in stray cats of Shiraz, one of the metropolises of Iran. Read More

Ophthalmologe 2018 Nov 26. Epub 2018 Nov 26.

Zentrum für Augenheilkunde, Universität zu Köln, Kerpenerstr. 62, 50924, Köln, Deutschland.

Background: Descemet membrane endothelial keratoplasty (DMEK) has become the standard surgical treatment for Fuchs' endothelial corneal dystrophy (FECD) in Germany. In addition to classical FECD, there are endothelial disorders amenable to DMEK associated with complex changes in the anterior segment of the eye, such as anterior synechia of the iris, larger iris defects, after glaucoma surgery, after vitrectomy and after trauma.

Objective: This article provides an overview of the possibilities to treat patients with complex anterior segment situations in the presence of corneal endothelial decompensation with DMEK. Read More