Search Our Scientific Publications & Authors

Immunity 2021 Jun 10. Epub 2021 Jun 10.

Laboratory of Gene Regulation and Signal Transduction, Department of Pharmacology, School of Medicine, UCSD, La Jolla, CA 92093, USA.

Acute respiratory distress syndrome (ARDS), an inflammatory condition with high mortality rates, is common in severe COVID-19, whose risk is reduced by metformin rather than other anti-diabetic medications. Detecting of inflammasome assembly in post-mortem COVID-19 lungs, we asked whether and how metformin inhibits inflammasome activation while exerting its anti-inflammatory effect. We show that metformin inhibited NLRP3 inflammasome activation and interleukin (IL)-1β production in cultured and alveolar macrophages along with inflammasome-independent IL-6 secretion, thus attenuating lipopolysaccharide (LPS)- and SARS-CoV-2-induced ARDS. Read More

Am J Physiol Lung Cell Mol Physiol 2021 06 9. Epub 2021 Jun 9.

Pulmonary Hypertension Group, Center for Perinatal Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, Columbus, Ohio, United States.

Endothelial cell apoptosis is an early event in the development of acute lung injury (ALI). We have previously found that the Src family tyrosine kinase (STK) yes activates caspase-3, while the STK fyn inhibits caspase-3 activation in cultured pulmonary endothelial cells. We hypothesized that deficiency in yes or fyn in mice would have differential effects on lipopolysaccharide (LPS)-induced ALI. Read More

Pediatr Neonatol 2021 May 14. Epub 2021 May 14.

Department of Hematology/Oncology, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China; Hospital Administration, National Children's Medical Center, Children's Hospital of Fudan University, 399 Wan Yuan Road, Shanghai, China. Electronic address:

Background: The incidence and mortality of influenza in children had risen, but data are limited on children with severe influenza virus infection in China.

Methods: We conducted a retrospective case-control study and collected the patients' clinical data. Clinical data including demography, clinical presentation, laboratory findings, radiologic findings, treatment and outcomes were collected. Read More

Med Intensiva (Engl Ed) 2021 Jun 5. Epub 2021 Jun 5.

PICU, Children's Hospital Los Angeles, California, USA.

Objective: The "Open Lung Approach" (OLA), that includes high levels of positive end-expiratory pressure coupled with limited tidal volumes, is considered optimal for adult patients with ARDS. However, many previous meta-analyses have shown only marginal benefits of OLA on mortality but with statistical heterogeneity. It is crucial to identify the most likely moderators of this effect. Read More

J Formos Med Assoc 2021 Jun 4. Epub 2021 Jun 4.

Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background: To examine whether the patterns of head-size growth trajectory in the first month after birth are associated with different susceptibility to cognitive impairment outcomes at age 24 months.

Methods: This retrospective cohort study included 590 infants of very-preterm survivors born between 2001 and 2016 receiving neurodevelopmental assessment at age 24 months. 403 children were enrolled for analysis after excluding infants with small-for-gestational age and severe brain injury. Read More

Am J Med Sci 2020 Dec 26. Epub 2020 Dec 26.

Division of Pulmonary Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI, USA. Electronic address:

Acute respiratory distress syndrome (ARDS) is a clinically and biologically heterogeneous disorder associated with a variety of disease processes that lead to acute lung injury with increased non-hydrostatic extravascular lung water, reduced compliance, and severe hypoxemia. Despite significant advances, mortality associated with this syndrome remains high. Mechanical ventilation remains the most important aspect of managing patients with ARDS. Read More

Respir Res 2021 Jun 4;22(1):169. Epub 2021 Jun 4.

Division of Pediatric Critical Care, Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, MDCC 488, Los Angeles, CA, 90095, USA.

We identified a novel microRNA biomarker panel consisting of 6 microRNAs predicting mortality in pediatric acute respiratory distress syndrome patients. Each of the identified mRNA have potential mechanistic importance in acute respiratory distress syndrome and may lead to the development of pharmacologic targets. Read More

Ital J Pediatr 2021 Jun 3;47(1):129. Epub 2021 Jun 3.

Neonatal Department, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

Background: Neonatal respiratory distress syndrome (NRDS) is strongly associated with premature birth, but it can also affect term neonates. Unlike the extent of research in preterm neonates, risk factors associated with incidence and severity of NRDS in term neonates are not well studied. In this study, we examined the association of maternal and neonatal risk factors with the incidence and severity of NRDS in term neonates admitted to Neonatal Intensive Care Unit (NICU) in Cyprus. Read More

Wien Klin Wochenschr 2021 Jun 3. Epub 2021 Jun 3.

Neonatal Intensive Care Unit, Department of Perinatology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Šlajmerjeva 4, 1000, Ljubljana, Slovenia.

Retinopathy of prematurity (nROP) among extremely low gestational age newborns (ELGAN) in Slovenia has increased in recent years. At the same time mortality has further decreased and less invasive approaches for treatment of respiratory distress syndrome have been established. With the aim to study the possible association between the incidence of ROP and the duration of noninvasive ventilation, this retrospective study comprised ELGANs born during the first period (2010/2011), when invasive respiratory support was the prevalent method and in the second period (2015/2016), when noninvasive respiratory support was adopted. Read More

Med Intensiva (Engl Ed) 2021 Jun-Jul;45(5):318-319

Department of Paediatrics, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.

BMC Nephrol 2021 05 31;22(1):202. Epub 2021 May 31.

Pediatrics Department, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.

Background: Acute kidney injury (AKI) is a complication of coronavirus disease 2019 (COVID-19). The reported incidence of AKI, however, varies among studies. We aimed to evaluate the incidence of AKI and its association with mortality and morbidity in children infected with severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) who required hospital admission. Read More

Front Pediatr 2021 13;9:652857. Epub 2021 May 13.

Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Vertical transmission of SARS-CoV-2 is under investigation. A few reports suggest the possibility of SARS-CoV-2 transmission from mothers to their neonates. Most neonates have mild symptoms, but some develop multisystem involvement and shock. Read More

Front Pediatr 2021 12;9:647925. Epub 2021 May 12.

Department of Molecular Pathobiology, New York University College of Dentistry, New York, NY, United States.

The use of electronic cigarettes (e-cigarettes) and vaping among adolescents has risen exponentially in the last decade. E-cigarette flavors has driven adolescents to use these convenient, USB-like devices, designed to create a desired social image, while being seemingly unaware of the serious health consequences of their behavior. Vaping impacts protective pulmonary barriers by attenuating the mucociliary clearance and by increasing peribronchial inflammation and fibrosis. Read More

AJP Rep 2021 Mar 27;11(2):e65-e75. Epub 2021 May 27.

Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.

Kagami-Ogata syndrome (KOS) (OMIM #608149) is a genetic imprinting disorder affecting chromosome 14 that results in a characteristic phenotype consisting of typical facial features, skeletal abnormalities including rib abnormalities described as "coat hanger ribs," respiratory distress, abdominal wall defects, polyhydramnios, and developmental delay. First identified by Wang et al in 1991, over 80 cases of KOS have been reported in the literature. KOS, however, continues to remain a rare and potentially underdiagnosed disorder. Read More

AJP Rep 2021 Mar 27;11(2):e61-e64. Epub 2021 May 27.

Department of Pediatrics, Texas A&M Health Science Center, Baylor Scott & White McLane Children's Medical Center, Temple, Texas.

Pulmonary interstitial emphysema (PIE) occurs when air leaks into the pulmonary interstitium due to overdistension of distal airways, it occurs mainly in neonates with respiratory distress syndrome who need positive pressure ventilation but has also been reported in spontaneously breathing infants. Herein, we report on an extremely low birth weight infant with severe persistent PIE, while on invasive mechanical ventilation (high-frequency oscillatory ventilation, high-frequency jet ventilation, and neurally adjust ventilator assist) managed successfully with 2 weeks of selective right lung ventilation after failure of more conservative measures, including shorter periods of right mainstem intubation, before the prolonged trial that was successful. Read More

Pediatr Pulmonol 2021 May 28. Epub 2021 May 28.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Persistent air leak (PAL) complicates various lung pathologies in children. The clinical characteristics and outcomes of children hospitalized in the pediatric intensive care unit (PICU) with PAL are not well described. We aimed to elucidate the course of disease among PICU hospitalized children with PAL. Read More

Indian J Crit Care Med 2021 Apr;25(4):435-440

Department of Pediatrics, Calcutta Medical College, Kolkata, West Bengal, India.

Introduction: With the advancement of pediatric critical care services across India, many children require prolonged mechanical ventilation (MV), and tracheostomy is recommended to them. However, many pediatric intensivists have concerns regarding the safety, feasibility, and outcome of tracheostomy.We aimed to analyze clinical characteristics, indication, duration, and outcome of tracheostomized children with respect to timing of tracheostomy. Read More

J Paediatr Child Health 2021 May 22. Epub 2021 May 22.

Department of Paediatrics, Campbelltown Hospital, Campbelltown, New South Wales, Australia.

Aim: Minimally invasive surfactant therapy (MIST) is used to deliver exogenous surfactant to preterm neonates with respiratory distress syndrome. The objective of this study was to review the use of MIST in moderate to late preterm neonates born in a non-tertiary unit.

Methods: A retrospective review was conducted of neonates receiving MIST in a non-tertiary unit. Read More

Indian J Pediatr 2021 May 20. Epub 2021 May 20.

Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.

Bronchopulmonary dysplasia (BPD) is a form of chronic lung disease that occurs in preterm infants, usually those receiving substantial respiratory support with either mechanical ventilation or supplementation with oxygen. The pathogenesis of BPD is multifactorial, and the clinical phenotype is variable. BPD is associated with substantial mortality and short- and long-term morbidity. Read More

Am J Transl Res 2021 15;13(4):3642-3649. Epub 2021 Apr 15.

Department of Paediatrics, The Third People's Hospital of Haikou City Haikou, Hainan Province, China.

Objective: To investigate the effect of pulmonary surfactant on the prevention of neonatal respiratory distress syndrome (NRDS) in premature infants.

Methods: A total of 216 premature infants in our hospital were selected. According to the guardian's choice, premature infants were grouped into treatment with pulmonary surfactant (PS) combined with nasal continuous positive airway pressure (NCPAP; the observation group) and treatment with NCPAP alone (the control group). Read More

Cureus 2021 Apr 16;13(4):e14528. Epub 2021 Apr 16.

Medicine, Alfaisal University College of Medicine, Riyadh, SAU.

Introduction A meta-analysis showed that 63.6% of the Saudi population have vitamin D deficiency, including many pregnant women. Studies showed that maternal vitamin D deficiency during pregnancy is a risk factor for low birth weight (LBW) in neonates. Read More

Mol Syndromol 2021 Apr 5;12(2):106-111. Epub 2021 Feb 5.

Division of Pediatric Genetics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Kaufman oculocerebrofacial syndrome is a rare autosomal recessive disorder which represents a phenotype mainly involving craniofacial and neurodevelopmental manifestations due to gene mutations. The vast majority of the affected individuals exhibit microcephaly, eye abnormalities, and typical facial gestalt including blepharophimosis, ptosis, telecanthus, upslanting palpebral fissures, dysplastic ears, and micrognathia. We encountered 2 siblings in whom severe psychomotor delay, distinctive facial features, hearing loss, and respiratory distress were observed. Read More

Physiol Rep 2021 May;9(9):e14871

Michigan Center for Integrative Research in Critical Care, University of Michigan, Ann Arbor, MI, USA.

To date, existing animal models of the acute respiratory distress syndrome (ARDS) have failed to translate preclinical discoveries into effective pharmacotherapy or diagnostic biomarkers. To address this translational gap, we developed a high-fidelity swine model of ARDS utilizing clinically relevant lung injury exposures. Fourteen male swine were anesthetized, mechanically ventilated, and surgically instrumented for hemodynamic monitoring, blood, and tissue sampling. Read More

Crit Care Med 2021 May 12. Epub 2021 May 12.

Division of Emergency Medicine, Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH. Department of Pathology & Laboratory Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA. Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Oklahoma College of Medicine, The Children's Hospital at University of Oklahoma Health Sciences Center, Oklahoma City, OK. Department of Anesthesia and Critical Care, ARCO Rome, Bambino Gesù Children's Hospital, Rome, Italy. Division of Pediatric Emergency Medicine, University of Toronto, Hospital for Sick Children, Toronto, ON, Canada. Division of Pediatric Emergency Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY. Department of Anesthesiology and Critical Care Medicine, Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Children's Hospital of Philadelphia, Philadelphia, PA. Division of Pediatric Surgery, Department of Surgery, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA. Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA. Department of Pediatrics, Critical Care Section, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI. Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine, Primary Children's Medical Center, Salt Lake City, UT. Division of Emergency Medicine, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Orange Park Medical Center, Orange Park, Florida. Division of Pediatric Surgery, Akron Children's Hospital, Akron, OH. Division of Critical Care Medicine, Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, OH. Division of Neonatology, Department of Pediatrics, University of California San Francisco Pritzker School of Medicine, University of California San Francisco Medical Center Parnassus, San Francisco, CA. Division of Pediatric Critical Care Medicine, Department of Child Health, University of Arizona College of Medicine, Phoenix Children's Hospital, Phoenix, AZ. Department of Surgery, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, IN. Department of Emergency Medicine, University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, MI. Department of Pediatrics, Dartmouth Hitchcock Medical Center, Children's Hospital at Dartmouth, Lebanon, NH. Division of Pediatric Hematology and Oncology, Department of Pediatrics, University of Minnesota Medical School, Department of Pediatric Critical Care Medicine, University of Minnesota Masonic Children's Hospital, Minneapolis, MN. Department of Pediatric Surgery, Vanderbilt University College of Medicine, Monroe Carell Jr Children's Hospital Nashville, TN. Keck School of Medicine of University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA. Department of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX. Department of Surgery, Texas A&M University College of Medicine, McLane Children's Hospital, Temple TX. Division of Pediatric Surgery, Alpert Medical School of Brown University, Hasbro Children's Hospital, Providence, RI. Southlake Pediatrics, Birmingham, AL. Department of Pediatrics, University of Alabama School of Medicine, Children's of Alabama, Birmingham, AL. Division of Critical Care, Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis Children's Hospital, St. Louis, MO.

Objectives: The purpose of our study was to describe children with life-threatening bleeding.

Design: We conducted a prospective observational study of children with life-threatening bleeding events.

Setting: Twenty-four childrens hospitals in the United States, Canada, and Italy participated. Read More

Clin Infect Dis 2021 May 14. Epub 2021 May 14.

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA.

Background: Increased inflammation has been well defined in COVID-19, while definitive pathways driving severe forms of this disease remain uncertain. Neutrophils are known to contribute to immunopathology in infections, inflammatory diseases and acute respiratory distress syndrome (ARDS), a primary cause of morbidity and mortality in COVID-19. Changes in neutrophil function in COVID-19 may give insight into disease pathogenesis and identify therapeutic targets. Read More

JCI Insight 2021 05 10;6(9). Epub 2021 May 10.

Department of Microbiology and Immunology.

SARS coronavirus 2 (SARS-CoV-2) is a novel viral pathogen that causes a clinical disease called coronavirus disease 2019 (COVID-19). Although most COVID-19 cases are asymptomatic or involve mild upper respiratory tract symptoms, a significant number of patients develop severe or critical disease. Patients with severe COVID-19 commonly present with viral pneumonia that may progress to life-threatening acute respiratory distress syndrome (ARDS). Read More

Pediatr Res 2021 May 12. Epub 2021 May 12.

Division of Neonatology, Department of Pediatrics, Children's Mercy Kansas City, Kansas, MO, USA.

Background: Sepsis in premature newborns is a risk factor for bronchopulmonary dysplasia (BPD), but underlying mechanisms of lung injury remain unclear. Aberrant expression of endothelial cell (EC) angiopoietin 2 (ANGPT2) disrupts angiopoietin 1 (ANGPT1)/TIE2-mediated endothelial quiescence, and is implicated in sepsis-induced acute respiratory distress syndrome in adults. We hypothesized that recombinant ANGPT1 will mitigate sepsis-induced ANGPT2 expression, inflammation, acute lung injury (ALI), and alveolar remodeling in the saccular lung. Read More

Rev Bras Ginecol Obstet 2021 Apr 12;43(4):283-290. Epub 2021 May 12.

Obstetrics & Gynecology Department, Hospital Divino Espírito Santo, Ponta Delgada, Portugal.

Objective:  Cesarean section (CS) delivery, especially without previous labor, is associated with worse neonatal respiratory outcomes. Some studies comparing neonatal outcomes between term infants exposed and not exposed to antenatal corticosteroids (ACS) before elective CS revealed that ACS appears to decrease the risk of respiratory distress syndrome (RDS), transient tachypnea of the neonate (TTN), admission to the neonatal intensive care unit (NICU), and the length of stay in the NICU.

Methods:  The present retrospective cohort study aimed to compare neonatal outcomes in infants born trough term elective CS exposed and not exposed to ACS. Read More

Fac Rev 2021 30;10:33. Epub 2021 Mar 30.

Department of Pediatrics, College of Medicine, University of Illinois at Chicago, IL 60612, USA.

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are clinical syndromes that cause significant mortality in clinical settings and morbidity among survivors accompanied by huge healthcare costs. Lung-resident cell dysfunction/death and neutrophil alveolitis accompanied by proteinous edema are the main pathological features of ALI/ARDS. While understanding of the mechanisms underlying ALI/ARDS pathogenesis is progressing and potential treatments such as statin therapy, nutritional strategies, and mesenchymal cell therapy are emerging, poor clinical outcomes in ALI/ARDS patients persist. Read More

World J Clin Pediatr 2021 May 9;10(3):40-47. Epub 2021 May 9.

Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States.

Background: Chilaiditi syndrome is a rare disorder characterized by the hepatodiaphragmatic interposition of the intestine.

Case Summary: Here we report a case of a 12-year-old male who was admitted to the pediatric intensive care unit secondary to abdominal pain and severe respiratory distress. He was treated conservatively but the symptoms persisted requiring a surgical approach. Read More