Subscribe: MedWorm: Bronchopulmonary Dysplasia
http://www.medworm.com/rss/medicalfeeds/conditions/Bronchopulmonary-Dysplasia.xml
Preview: MedWorm: Bronchopulmonary Dysplasia

MedWorm: Bronchopulmonary Dysplasia



MedWorm.com provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in the Bronchopulmonary Dysplasia category.



Last Build Date: Tue, 22 Mar 2016 08:26:29 +0100

 



High Flow Nasal Cannula Use Is Associated with Increased Morbidity and Length of Hospitalization in Extremely Low Birth Weight Infants

Sat, 19 Mar 2016 00:00:00 +0100

To determine differences in the incidence of bronchopulmonary dysplasia (BPD) or death in extremely low birth weight infants managed on high flow nasal cannula (HFNC) vs continuous positive airway pressure (CPAP). (Source: The Journal of Pediatrics)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Inhibition of Beta-catenin Signaling Protects Against CTGF-induced Alveolar and Vascular Pathology in Neonatal Mouse Lung.

Fri, 18 Mar 2016 00:00:00 +0100

CONCLUSION: β-catenin signaling mediates the autocrine and paracrine effects of CTGF in the neonatal lung. Inhibition of CTGF-β-catenin signaling may provide a novel therapy for BPD.Pediatric Research (2016); doi:10.1038/pr.2016.52. PMID: 26991260 [PubMed - as supplied by publisher] (Source: Pediatric Research)



Csk/Src/EGFR signaling regulates migration of myofibroblasts and alveolarization

Tue, 15 Mar 2016 00:00:00 +0100

Bronchopulmonary dysplasia (BPD) is characterized by premature alveolar developmental arrest. Antenatal exposure to inflammation inhibits lung morphogenesis, thus increasing the risk of developing BPD. Alveolar myofibroblasts are thought to migrate into the septal tips and elongate secondary septa during alveolarization. Here we found lipopolysaccharide (LPS) disrupted the directional migration of myofibroblasts and increased actin stress fiber expression and focal adhesion formation. In addition, COOH-terminal Src kinase (Csk) activity was downregulated in myofibroblasts treated with LPS, while activation of Src or epidermal growth factor receptor (EGFR) was upregulated by LPS treatment. Specifically, decreased Csk activity and increased activation of Src or EGFR was also observed in prim...



Recurrent Copy Number Variants Associated with Bronchopulmonary Dysplasia.

Mon, 14 Mar 2016 00:00:00 +0100

CONCLUSION: These data identify novel loci that may harbor genes contributing to the genetic susceptibility of BPD.Pediatric Research (2016); doi:10.1038/pr.2016.23. PMID: 26974307 [PubMed - as supplied by publisher] (Source: Pediatric Research)



Defining neonatal sepsis

Sat, 12 Mar 2016 23:19:41 +0100

Purpose of review: Although infection rates have modestly decreased in the neonatal intensive care unit (NICU) as a result of ongoing quality improvement measures, neonatal sepsis remains a frequent and devastating problem among hospitalized preterm neonates. Despite multiple attempts to address this unmet need, there have been minimal advances in clinical management, outcomes, and accuracy of diagnostic testing options over the last 3 decades. One strong contributor to a lack of medical progress is a variable case definition of disease. The inability to agree on a precise definition greatly reduces the likelihood of aligning findings from epidemiologists, clinicians, and researchers, which, in turn, severely hinders progress toward improving outcomes. Recent findings: Pediatric consensus...



Long-Term Neurodevelopmental Outcome after Doxapram for Apnea of Prematurity.

Sat, 12 Mar 2016 00:00:00 +0100

CONCLUSIONS: This study suggests that doxapram is not associated with an increased risk of ND. These findings need to be confirmed or refuted by a large, well-designed, placebo-controlled randomized trial. PMID: 26967910 [PubMed - as supplied by publisher] (Source: Neonatology)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Association of BNP, NTproBNP, and early postnatal pulmonary hypertension in very preterm infants

Fri, 11 Mar 2016 00:00:00 +0100

ConclusionB‐type natriuretic peptides did not correlate with RVSP in the early postnatal period of very preterm infants. Pediatr Pulmonol. © 2016 Wiley Periodicals, Inc. (Source: Pediatric Pulmonology)



A 3-Dimensional Human Model of the Fibroblast Activation that Accompanies Bronchopulmonary Dysplasia Identifies Notch-Mediated Pathophysiology.

Fri, 11 Mar 2016 00:00:00 +0100

Authors: Sucre JM, Wilkinson D, Vijayaraj P, Paul MK, Dunn B, Alva-Ornelas JA, Gomperts BN Abstract Bronchopulmonary dysplasia (BPD) is a leading complication of premature birth and occurs primarily in infants delivered during the saccular stage of lung development. Histopathology shows decreased alveolarization and a pattern of fibroblast proliferation and differentiation to the myofibroblast phenotype. Little is known about the molecular pathways and cellular mechanisms that define BPD pathophysiology and progression. We have developed a novel 3-dimensional human model of the fibroblast activation associated with BPD and using this model we have identified the Notch pathway as a key driver of fibroblast activation and proliferation in response to changes in oxygen. Fetal lung fib...



Trends in Survival and Incidence of Bronchopulmonary Dysplasia in Extremely Preterm Infants at 23-26 Weeks Gestation.

Thu, 10 Mar 2016 16:16:02 +0100

Authors: Kim JK, Chang YS, Sung S, Ahn SY, Yoo HS, Park WS Abstract The aim of this study was to investigate the relationship between survival and incidence of bronchopulmonary dysplasia (BPD) in extremely premature infants, and identify clinical factors responsible for this association. Medical records of 350 infants at 23-26 weeks gestation from 2000 to 2005 (period I, n = 137) and 2006 to 2010 (period II, n = 213) were retrospectively reviewed. The infants were stratified into 23-24 and 25-26 weeks gestation, and the survival, BPD incidence, and clinical characteristics were analyzed. BPD was defined as oxygen dependency at 36 weeks postmenstrual age. The overall survival rate was significantly improved in period II compared to period I (80.3% vs. 70.0%, respectively; P = 0.028)...



The apelin–APJ axis: A novel potential therapeutic target for organ fibrosis

Thu, 10 Mar 2016 00:00:00 +0100

Publication date: 1 May 2016 Source:Clinica Chimica Acta, Volume 456 Author(s): Shifang Huang, Linxi Chen, Liqun Lu, Lanfang Li Apelin, an endogenous ligand of the G-protein-coupled receptor APJ, is expressed in a diverse number of organs. The apelin–APJ axis helps to control the processes of pathological and physiological fibrosis, including renal fibrosis, cardiac fibrosis, liver fibrosis and pulmonary fibrosis. However, the role of apelin–APJ in organ fibrosis remains controversial due to conflicting study results. The apelin–APJ axis is a detrimental mechanism which promotes liver fibrosis mainly via up-regulation the expression of collagen-II and platelet-derived growth factor receptor β (PDGFRβ). On the contrary, the apelin–APJ axis is beneficial for renal fibrosis, c...



Frequency of endotracheal suctioning for the prevention of respiratory morbidity in ventilated newborns.

Mon, 07 Mar 2016 00:00:00 +0100

CONCLUSIONS: There was insufficient evidence to identify the ideal frequency of ETT suctioning in ventilated neonates. Future research should focus on the effects in the very preterm newborns, that is, the most vulnerable population as concerns the risk of both lung and brain damage. Assessment should include the cases of prolonged ventilation, when more abundant, dense secretions are common. Clinical trials might include comparisons between 'as-scheduled' versus 'as-needed' endotracheal suctioning, that is, based on specific indications, as well frequent versus less frequent suctioning schedules. PMID: 26945780 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Pharmacological Closure of Patent Ductus Arteriosus: Selecting the Agent and Route of Administration

Mon, 07 Mar 2016 00:00:00 +0100

Abstract Opinions are divided regarding the management of a persistently patent ductus arteriosus (PDA). Some of the adverse effects associated with a large hemodynamically significant duct, including prolonged ventilation, pulmonary hemorrhage, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), and mortality, indicate that active management of infants with large ductal shunts may sometimes be necessary. Indomethacin and ibuprofen are the two US FDA-approved cyclooxygenase (COX) inhibitors used for the closure of a ductus in preterm babies. Both these drugs are effective in 70–80 % of extremely low birthweight infants. Treatment with COX inhibitors may be associated with renal impairment, gastrointestinal hemorrhage, NEC, and s...



Pharmacological Closure of Patent Ductus Arteriosus: Selecting the Agent and Route of Administration.

Mon, 07 Mar 2016 00:00:00 +0100

Authors: Sivanandan S, Agarwal R Abstract Opinions are divided regarding the management of a persistently patent ductus arteriosus (PDA). Some of the adverse effects associated with a large hemodynamically significant duct, including prolonged ventilation, pulmonary hemorrhage, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), and mortality, indicate that active management of infants with large ductal shunts may sometimes be necessary. Indomethacin and ibuprofen are the two US FDA-approved cyclooxygenase (COX) inhibitors used for the closure of a ductus in preterm babies. Both these drugs are effective in 70-80 % of extremely low birthweight infants. Treatment with COX inhibitors may be associated with renal impairment, gastroint...



Late preterm neonatal morbidity in hypertensive versus normotensive women.

Thu, 03 Mar 2016 02:01:02 +0100

CONCLUSION: In both low- and high-risk women, mild PE/GH at ≥34 weeks is not associated with an increased risk of neonatal morbidity compared with normotensive women. Increased risk of composite neonatal morbidity related to severe PE/GH is confined to the subgroup of infants with non-respiratory morbidity, and disappears when including only late preterm infants. PMID: 26930156 [PubMed - as supplied by publisher] (Source: Hypertension in Pregnancy)



Nifedipine versus atosiban for threatened preterm birth (APOSTEL III): a multicentre, randomised controlled trial

Thu, 03 Mar 2016 00:00:00 +0100

Publication date: Available online 2 March 2016 Source:The Lancet Author(s): Elvira O G van Vliet, Tobias A J Nijman, Ewoud Schuit, Karst Y Heida, Brent C Opmeer, Marjolein Kok, Wilfried Gyselaers, Martina M Porath, Mallory Woiski, Caroline J Bax, Kitty W M Bloemenkamp, Hubertina C J Scheepers, Yves Jacquemyn, Erik van Beek, Johannes J Duvekot, Maureen T M Franssen, Dimitri N Papatsonis, Joke H Kok, Joris A M van der Post, Arie Franx, Ben W Mol, Martijn A Oudijk Background In women with threatened preterm birth, delay of delivery by 48 h allows antenatal corticosteroids to improve neonatal outcomes. For this reason, tocolytics are often administered for 48 h; however, there is no consensus about which drug results in the best maternal and neonatal outcomes. In the A...



Initiating nasal continuous positive airway pressure in preterm neonates at 5cm as against 7cm did not decrease the need for mechanical ventilation

Thu, 03 Mar 2016 00:00:00 +0100

ConclusionInitiating nCPAP at a higher pressure of 7cm in preterm neonates with respiratory distress, rather than the standard 5cm, did not decrease the need for mechanical ventilation during the first week of lifeThis article is protected by copyright. All rights reserved. (Source: Acta Paediatrica)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Comparison of two dose regimens of ibuprofen for the closure of patent ductus arteriosus in preterm newborns.

Thu, 03 Mar 2016 00:00:00 +0100

CONCLUSIONS: There was no difference in closure of the ductus arteriosus or occurrence of adverse effects between the two dose regimens. PMID: 26946966 [PubMed - as supplied by publisher] (Source: Jornal de Pediatria)



Hydrocortisone Curbs Lung Problems in Extremely Preterm InfantsHydrocortisone Curbs Lung Problems in Extremely Preterm Infants

Wed, 02 Mar 2016 22:02:59 +0100

Early low-dose hydrocortisone prompts a significant increase in bronchopulmonary dysplasia-free survival in extremely preterm infants, according to French researchers. Reuters Health Information (Source: Medscape Critical Care Headlines)



The apelin-APJ axis: A novel potential therapeutic target for organ fibrosis

Wed, 02 Mar 2016 00:00:00 +0100

Publication date: Available online 2 March 2016 Source:Clinica Chimica Acta Author(s): Shifang Huang, Linxi Chen, Liqun Lu, Lanfang Li Apelin, an endogenous ligand of the G-protein-coupled receptor APJ, is expressed in a diverse number of organs. The apelin-APJ axis helps to control the processes of pathological and physiological fibrosis, including renal fibrosis, cardiac fibrosis, liver fibrosis and pulmonary fibrosis. However, the role of apelin-APJ in organ fibrosis remains controversial due to conflicting study results. The apelin-APJ axis is a detrimental mechanism which promotes liver fibrosis mainly via up- regulation the expression of collagen-II and platelet-derived growth factor receptor β (PDGFRβ). On the contrary, the apelin-APJ axis is beneficial for renal fibrosis, c...



Hypoxia Challenge Testing in Neonates for Fitness to Fly

Tue, 01 Mar 2016 00:00:00 +0100

CONCLUSIONS: Term and preterm infants without BPD born at >39 weeks CGA do not appear to be likely to desaturate during a preflight HCT and so can be deemed fit to fly according to current British Thoracic Society Guidelines. (Source: PEDIATRICS)



Placental Complications and Bronchopulmonary Dysplasia: EPIPAGE-2 Cohort Study

Tue, 01 Mar 2016 00:00:00 +0100

CONCLUSIONS: Placenta-mediated pregnancy complications with fetal consequences are associated with moderate to severe BPD in very preterm infants independently of gestational age and birth weight, but isolated maternal hypertensive disorders are not. Fetal growth restriction, more than birth weight, could predispose to impaired lung development. (Source: PEDIATRICS)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Regulation of alveolar septation by microRNA-489

Tue, 01 Mar 2016 00:00:00 +0100

MicroRNAs (miRs) are small conserved RNA that regulate gene expression. Bioinformatic analysis of miRNA profiles during mouse lung development indicated a role for multiple miRNA, including miRNA-489. miR-489 increased on completion of alveolar septation [postnatal day 42 (P42)], associated with decreases in its conserved target genes insulin-like growth factor-1 (Igf1) and tenascin C (Tnc). We hypothesized that dysregulation of miR-489 and its target genes Igf1 and Tnc contribute to hyperoxia-induced abnormal lung development. C57BL/6 mice were exposed to normoxia (21%) or hyperoxia (85% O2) from P4 to P14, in combination with intranasal locked nucleic acid against miR-489 to inhibit miR-489, cytomegalovirus promoter (pCMV)-miR-489 to overexpress miR-489, or empty vector. Hyperoxia reduce...



Early intervention leads to long‐term developmental improvements in very preterm infants, especially infants with bronchopulmonary dysplasia

Tue, 01 Mar 2016 00:00:00 +0100

ConclusionThe Infant Behavioral Assessment and Intervention Program led to long‐term developmental improvements in the intervention group, especially in infants with bronchopulmonary dysplasiaThis article is protected by copyright. All rights reserved. (Source: Acta Paediatrica)



The apelin-APJ axis: A novel potential therapeutic target for organ fibrosis.

Tue, 01 Mar 2016 00:00:00 +0100

Authors: Huang S, Chen L, Lu L, Li L Abstract Apelin, an endogenous ligand of the G-protein-coupled receptor APJ, is expressed in a diverse number of organs. The apelin-APJ axis helps to control the processes of pathological and physiological fibrosis, including renal fibrosis, cardiac fibrosis, liver fibrosis and pulmonary fibrosis. However, the role of apelin-APJ in organ fibrosis remains controversial due to conflicting study results. The apelin-APJ axis is a detrimental mechanism which promotes liver fibrosis mainly via up- regulation the expression of collagen-II and platelet-derived growth factor receptor β (PDGFRβ). On the contrary, the apelin-APJ axis is beneficial for renal fibrosis, cardiac fibrosis and pulmonary fibrosis. The apelin-APJ axis alleviates renal fibrosis b...



Bronchopulmonary dysplasia impairs L‐type amino acid transporter‐1 expression in human and baboon lung

Mon, 29 Feb 2016 15:19:12 +0100

Summary Bronchopulmonary dysplasia (BPD) is an inflammatory lung disorder common in premature infants who undergo mechanical ventilation with supplemental oxygen. Inhaled nitric oxide (iNO) has been used to prevent experimental and clinical BPD. Earlier studies showed that NO effects in alveolar epithelial cells (AEC) are mediated by S‐nitrosothiol uptake via L‐type amino acid transporter‐1 (LAT1). Because LAT1 expression could influence the efficacy of iNO therapy, we sought to determine whether pulmonary LAT1 expression is altered in preterm baboons with experimental BPD and in human newborns susceptible to developing BPD. Using fixed lung obtained from 125 d to 140 d gestation baboon models of BPD, LAT1 immunostaining was measured in control and BPD animals. In adult controls ...



Bronchopulmonary Dysplasia Treatments

Mon, 29 Feb 2016 00:00:00 +0100

Severe lung immaturity in very preterm infants and the clinical interventions to save these infants often result in the poorly defined syndrome of bronchopulmonary dysplasia (BPD). This lung development, injury, and repair/remodeling syndrome results from antenatal exposures, postnatal treatments, and poorly understood repair mechanisms. The result is a spectrum of lung abnormalities that variably include direct lung parenchymal injury with inhibition of alveolar septation and microvascular development, small and large airway injuries, and control of breathing abnormalities that result in a diagnosis of BPD. Changes in clinical care practices have confounded the diagnosis for infants with milder forms of BPD (eg, room air with ventilatory support or very low flow with 100% oxygen). The goo...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




The proteomics of lung injury in childhood: challenges and opportunities

Mon, 29 Feb 2016 00:00:00 +0100

Abstract Proteomics, the large-scale study of the structure and function of proteins of a cell or organism, is a rapidly developing area of biomedical research which is perfectly suited to the study of pediatric lung injury, where a variety of samples are easily, and repeatedly, accessible including plasma (reflecting a whole body response) and broncheoalveolar lung fluid (reflecting the lungs response). When applied to pediatric lung injury, proteomics could be used to develop much needed early biomarkers of lung injury, elucidate pathological pathways and determine protein alterations associated with specific disease processes. However despite the obvious benefits and need, proteomics is rarely utilized in studies of pediatric injury. This review primarily reports on the last d...



Ancillary therapies to enhance success of non-invasive modes of respiratory support – Approaches to delivery room use of surfactant and caffeine?

Fri, 26 Feb 2016 00:00:00 +0100

During recent decades, non-invasive respiratory support has become popular for treating neonates with respiratory failure. Several prospective randomized controlled trials have been performed to compare use of continuous positive airway pressure (CPAP) as primary respiratory support in preterm infants with respiratory distress syndrome (RDS) to endotracheal intubation, mechanical ventilation and surfactant therapy. Systematic reviews of these studies suggest that routine CPAP at delivery is efficacious in decreasing bronchopulmonary dysplasia (BPD), death, or both. (Source: Seminars in Fetal and Neonatal Medicine)



Therapeutic potential of mesenchymal stem cells for pulmonary complications associated with preterm birth.

Fri, 26 Feb 2016 00:00:00 +0100

Authors: Laube M, Stolzing A, Thome UH, Fabian C Abstract Preterm infants frequently suffer from pulmonary complications resulting in significant morbidity and mortality. Physiological and structural lung immaturity impairs perinatal lung transition to air breathing resulting in respiratory distress. Mechanical ventilation and oxygen supplementation ensure sufficient oxygen supply but enhance inflammatory processes which might lead to the establishment of a chronic lung disease called bronchopulmonary dysplasia (BPD). Current therapeutic options to prevent or treat BPD are limited and have salient side effects, highlighting the need for new therapeutic approaches. Mesenchymal stem cells (MSCs) have demonstrated therapeutic potential in animal models of BPD. This review focuses on M...



Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial

Thu, 25 Feb 2016 00:00:00 +0100

The objective of the study was to determine whether vaginal progesterone prophylaxis given to reduce the risk of preterm birth affects neonatal and childhood outcomes. We defined three primary outcomes: fetal death or birth before 34 weeks and 0 days gestation (obstetric), a composite of death, brain injury, or bronchopulmonary dysplasia (neonatal), and a standardised cognitive score at 2 years of age (childhood), imputing values for deaths. Randomisation was done through a web portal, with participants, investigators, and others involved in giving the intervention, assessing outcomes, or analysing data masked to treatment allocation until the end of the study. Analysis was by intention to treat. This trial is registered at ISRCTN.com, number ISRCTN14568373. Findings Between Feb 2, 2009, ...



Systemic arterial stiffness in infants with bronchopulmonary dysplasia: potential cause of systemic hypertension

Thu, 25 Feb 2016 00:00:00 +0100

Authors: A Sehgal, A Malikiwi, E Paul, K Tan & S Menahem (Source: Journal of Perinatology)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Sustained inflation: Prophylactic or rescue maneuver?

Thu, 25 Feb 2016 00:00:00 +0100

Application of nasal continuous positive airway pressure (nCPAP) in the delivery room is a valid alternative to mechanical ventilation in the management of respiratory failure of preterm infants, with reduced occurrence of bronchopulmonary dysplasia and death. nCPAP at birth is still burdened by a high failure rate. Sustained inflation appears to be an intriguing approach to allow the respiratory transition at birth by clearing the lung fluid, thus obtaining an adequate functional residual capacity. (Source: Seminars in Fetal and Neonatal Medicine)



Increased levels of phthalates in very low birth weight infants with septicemia and bronchopulmonary dysplasia.

Wed, 24 Feb 2016 00:00:00 +0100

Authors: Strømmen K, Lyche JL, Blakstad EW, Moltu SJ, Veierød MB, Almaas AN, Sakhi AK, Thomsen C, Nakstad B, Brække K, Rønnestad AE, Drevon CA, Iversen PO Abstract Very low birth weight infants (VLBW; birth weight<1500g) are exposed to potentially harmful phthalates from medical devices during their hospital stay. We measured urinary phthalate concentrations among hospitalized VLBW infants participating in a nutritional study. Possible associations between different phthalates and birth weight (BW), septicemia and bronchopulmonary dysplasia (BPD) were evaluated. Forty-six VLBW infants were enrolled in this randomized controlled nutritional study. The intervention group (n=24) received increased quantities of energy, protein, fat, essential fatty acids and vitamin A, as compa...



Effect of early low-dose hydrocortisone on survival without bronchopulmonary dysplasia in extremely preterm infants (PREMILOC): a double-blind, placebo-controlled, multicentre, randomised trial

Tue, 23 Feb 2016 00:00:00 +0100

In this study, we aimed to assess whether low-dose hydrocortisone improved survival without bronchopulmonary dysplasia in extremely preterm infants. Methods In this double-blind, placebo-controlled, randomised trial done at 21 French tertiary-care neonatal intensive care units (NICUs), we randomly assigned (1:1), via a secure study website, extremely preterm infants inborn (born in a maternity ward at the same site as the NICU) at less than 28 weeks of gestation to receive either intravenous low-dose hydrocortisone or placebo during the first 10 postnatal days. Infants randomly assigned to the hydrocortisone group received 1 mg/kg of hydrocortisone hemisuccinate per day divided into two doses per day for 7 days, followed by one dose of 0·5 mg/kg per day for 3 days. Randomisation was stra...



Right Ventricular Function in Infants with Bronchopulmonary Dysplasia: Association with Respiratory Sequelae

Thu, 18 Feb 2016 14:19:47 +0100

Conclusions: Impaired RV performance in the infants with severe BPD at 36 weeks' corrected gestation correlated with a longer duration of subsequent respiratory support.Neonatology 2016;109:289-296 (Source: Neonatology)



Intussusceptive-like angiogenesis in human fetal lung xenografts: Link with bronchopulmonary dysplasia-associated microvascular dysangiogenesis?

Thu, 18 Feb 2016 02:59:02 +0100

CONCLUSION: These observations in human fetal lungs ex vivo suggest that postcanalicular lungs can switch from sprouting angiogenesis to an aberrant intussusceptive-type of angiogenesis that is highly reminiscent of BPD-associated dysangiogenesis. While circumstantial evidence suggests hypoxia may be implicated, the exact triggering mechanisms, molecular regulation and clinical implications of this angiogenic switch in preterm lungs in vivo remain to be determined. PMID: 26495956 [PubMed - in process] (Source: Experimental Lung Research)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Preventing bioenergetic failure in the preterm infant

Thu, 18 Feb 2016 00:00:00 +0100

The failure to match postnatal nutritional requirements to support growth and well-being in the extremely preterm infant has been a long-standing challenge with slow progress. Several large prospective cohorts over the past 15 years demonstrate a high incidence of extrauterine growth restriction despite more recent improved nutritional delivery.1 2 Furthermore, a direct relationship exists between growth attainment and growth velocity and common neonatal morbidities such as bronchopulmonary dysplasia (BPD), necrotising enterocolitis (NEC), late-onset sepsis (LOS) and neurodevelopmental impairment (NDI).3 An ideal indicator of nutritional effectiveness is a physiological measure that accurately represents the health benefits attained as a result of nutritional intervention in a clinica...



Highlights from the literature

Thu, 18 Feb 2016 00:00:00 +0100

Seeing the cords Teaching and learning the technique of endotracheal intubation is an enduring challenge for both the experienced intubator and the learner. Over the years, people have practised direct laryngoscopy and tracheal intubation on cadavers, cats and mannikins, or just ‘learned by doing’ on babies needing resuscitation after delivery. An alternative technique, indirect videolaryngoscopy, has been mainly used in restricted groups of patients with particular airway issues, mostly by anaesthetists. Its potential as a teaching device for neonatal intubation has recently been explored by O'Shea et al (Pediatrics 2015;136:912–9). In a trial with an innovative design, trainees used the videolaryngoscope as a direct device for intubation (ie, without the ‘video&rs...



Right Ventricular Function in Infants with Bronchopulmonary Dysplasia: Association with Respiratory Sequelae.

Thu, 18 Feb 2016 00:00:00 +0100

CONCLUSIONS: Impaired RV performance in the infants with severe BPD at 36 weeks' corrected gestation correlated with a longer duration of subsequent respiratory support. PMID: 26886137 [PubMed - as supplied by publisher] (Source: Neonatology)



QUESTION 2: Vaccinating preterm infants in resource-poor settings: what is the incidence of apnoea, bradycardia and need for respiratory support?

Thu, 18 Feb 2016 00:00:00 +0100

Scenario A 27-week gestation infant is approaching 2 months of age in a resource-poor hospital with no continuous monitoring or facilities for intubation. WHO guidance advocates vaccinating at 2 months, but you wonder about the possible risks of apnoea and bradycardia. Structured clinical question In hospitalised premature infants (population) what is the incidence of apnoea, bradycardia and need for respiratory support (outcome) following routine vaccination (intervention). Search A PubMED search for ((‘Infant, Premature’ [Mesh] OR prematur* OR preterm) AND (‘Immunization’ [Mesh] OR ‘Vaccination’ [Mesh] OR Immunisation OR Immunization OR vaccination)) AND (‘Apnea’ [Mesh] OR apnoea OR apnea OR ‘Drug-Related Side Effects and Ad...



High-frequency ventilation for non-invasive respiratory support of neonates

Thu, 18 Feb 2016 00:00:00 +0100

This article reviews the application of high-frequency ventilation for non-invasive respiratory support in neonates, including basic science studies on mechanics of gas exchange, animal model investigations, and a review of current clinical use in human neonates. (Source: Seminars in Fetal and Neonatal Medicine)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Association between placental pathology and neonatal outcome in preeclampsia: a large cohort study.

Wed, 17 Feb 2016 22:59:03 +0100

CONCLUSION: Placental pathology in PE reflects adverse perinatal events and deviant placental weight predicts adverse neonatal outcome in preeclamptic women delivering preterm. Placental investigation without delay can contribute to neonatal risk assessment. PMID: 24303993 [PubMed - indexed for MEDLINE] (Source: Hypertension in Pregnancy)



Lung density standard deviations obtained using high-pitch dual-source computed tomography are valid predictors of bronchopulmonary dysplasia in preterm infants

Wed, 17 Feb 2016 00:00:00 +0100

This study aimed to validate standard deviations of lung densities obtained using high-pitch dual-source computed tomography (DSCT) densitometry as indices of bronchopulmonary dysplasia (BPD) severity in premature infants. (Source: Clinical Imaging)



VEGF and endothelium-derived retinoic acid regulate lung vascular and alveolar development

Mon, 15 Feb 2016 00:00:00 +0100

Prevention or treatment of lung diseases caused by the failure to form, or destruction of, existing alveoli, as observed in infants with bronchopulmonary dysplasia and adults with emphysema, requires understanding of the molecular mechanisms of alveolar development. In addition to its critical role in gas exchange, the pulmonary circulation also contributes to alveolar morphogenesis and maintenance by the production of paracrine factors, termed "angiocrines," that impact the development of surrounding tissue. To identify lung angiocrines that contribute to alveolar formation, we disrupted pulmonary vascular development by conditional inactivation of the Vegf-A gene during alveologenesis. This resulted in decreased pulmonary capillary and alveolar development and altered lung elastin and re...



Caffeine Prevents Hyperoxia-Induced Functional and Structural Lung Damage in Preterm Rabbits

Fri, 12 Feb 2016 09:07:49 +0100

Conclusion: In preterm rabbits, caffeine reduces the functional, architectural and inflammatory pulmonary changes induced by hyperoxia in the lung.Neonatology 2016;109:274-281 (Source: Neonatology)



Initial Suppression of Transforming Growth Factor-β Signaling and Loss of TGFBI Causes Early Alveolar Structural Defects Resulting in Bronchopulmonary Dysplasia

Fri, 12 Feb 2016 00:00:00 +0100

Septation of the gas-exchange saccules of the morphologically immature mouse lung requires regulated timing, spatial direction, and dosage of transforming growth factor (TGF)-β signaling. We found that neonatal hyperoxia acutely initially diminished saccular TGF-β signaling coincident with alveolar simplification. However, sustained hyperoxia resulted in a biphasic response and subsequent up-regulation of TGF-β signaling, ultimately resulting in bronchopulmonary dysplasia. Significantly, we found that the TGF-β–induced matricellular protein (TGFBI) was similarly biphasically altered in response to hyperoxia. (Source: American Journal of Pathology)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Caffeine Prevents Hyperoxia-Induced Functional and Structural Lung Damage in Preterm Rabbits.

Fri, 12 Feb 2016 00:00:00 +0100

CONCLUSION: In preterm rabbits, caffeine reduces the functional, architectural and inflammatory pulmonary changes induced by hyperoxia in the lung. PMID: 26866610 [PubMed - as supplied by publisher] (Source: Neonatology)



Initial Suppression of Transforming Growth Factor-β Signaling and Loss of TGFBI Causes Early Alveolar Structural Defects Resulting in Bronchopulmonary Dysplasia.

Fri, 12 Feb 2016 00:00:00 +0100

Authors: Ahlfeld SK, Wang J, Gao Y, Snider P, Conway SJ Abstract Septation of the gas-exchange saccules of the morphologically immature mouse lung requires regulated timing, spatial direction, and dosage of transforming growth factor (TGF)-β signaling. We found that neonatal hyperoxia acutely initially diminished saccular TGF-β signaling coincident with alveolar simplification. However, sustained hyperoxia resulted in a biphasic response and subsequent up-regulation of TGF-β signaling, ultimately resulting in bronchopulmonary dysplasia. Significantly, we found that the TGF-β-induced matricellular protein (TGFBI) was similarly biphasically altered in response to hyperoxia. Moreover, genetic ablation revealed that TGFBI was required for normal alveolar structure and function. Alt...






Utility of Exhaled Breath Condensate in Predicting Bronchopulmonary Dysplasia

Fri, 12 Feb 2016 00:00:00 +0100

(Source: PEDIATRICS)



Lung function gain in preterm infants with and without bronchopulmonary dysplasia

Thu, 11 Feb 2016 23:19:25 +0100

ConclusionsInfants who suffered from BPD have lower lung function (FVC, FEV0.5, FEF75, and FEF25–75), than those non‐BPD, at two different time points 1 year apart. During the study period, there was no lung function catch‐up in either BPD or non‐BPD infants. The increase in length is closely associated to the increase in lung function. Pediatr Pulmonol. © 2016 Wiley Periodicals, Inc. (Source: Pediatric Pulmonology)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Mesenchymal stem/stromal cells—a key mediator for regeneration after perinatal morbidity?

Thu, 11 Feb 2016 00:00:00 +0100

Abstract Perinatal complications in both term- and preterm-born infants are a leading cause of neonatal morbidities and mortality. Infants face different challenges in the neonatal intensive care unit with long-term morbidities such as perinatal brain injury and bronchopulmonary dysplasia being particularly devastating. While advances in perinatal medicine have improved our understanding of the pathogenesis, effective therapies to prevent and/or reduce the severity of these disorders are still lacking. The potential of mesenchymal stem/stromal cell (MSC) therapy has emerged during the last two decades, and an increasing effort is conducted to address brain- and lung-related morbidities in neonates at risk. Various studies support the notion that MSCs have protective effects. MSCs...



Binasal Prong versus Nasal Mask for Applying CPAP to Preterm Infants: A Randomized Controlled Trial

Wed, 10 Feb 2016 20:07:42 +0100

Conclusions: The NM was successfully used for delivering NCPAP in preterm infants, and no NCPAP failure was observed within the first 24 h. These data show that applying NCPAP by NM yielded a shorter duration of NCPAP and statistically reduced the rates of moderate and severe BPD.Neonatology 2016;109:258-264 (Source: Neonatology)



Binasal Prong versus Nasal Mask for Applying CPAP to Preterm Infants: A Randomized Controlled Trial.

Wed, 10 Feb 2016 00:00:00 +0100

CONCLUSIONS: The NM was successfully used for delivering NCPAP in preterm infants, and no NCPAP failure was observed within the first 24 h. These data show that applying NCPAP by NM yielded a shorter duration of NCPAP and statistically reduced the rates of moderate and severe BPD. PMID: 26859512 [PubMed - as supplied by publisher] (Source: Neonatology)



Pulmonary Vein Stenosis in Neonates with Severe Bronchopulmonary Dysplasia

Wed, 10 Feb 2016 00:00:00 +0100

Conclusions Compared with neonates with severe BPD alone, those with acquired PVS are at increased risk for worse outcomes, including higher mortality. Evidence-based recommendations regarding screening protocols and surveillance are needed in this high-risk subgroup of BPD neonates.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology)



Strabismus at Age 2 Years in Children Born Before 28 Weeks Gestation: Antecedents and Correlates

Mon, 08 Feb 2016 00:00:00 +0100

Children born very preterm are at greater risk of ophthalmic morbidities, including strabismus, than children born at term. We evaluated perinatal factors associated with strabismus at age 2 years in a large population of infants delivered before 28 weeks’ gestation. A total of 996 infants in the multicenter ELGAN (Extremely Low Gestational Age Newborn) study who had a retinal exam in infancy and a developmental assessment at 2 years corrected age are included. Their mothers were interviewed about the pregnancy, and both mother and newborn charts were reviewed. Certified examiners administered the Bayley Scales of Infant Development-II and performed an examination of ocular alignment. Time-oriented logistic regression risk models were created to evaluate the associations of character...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Fractal analysis of alveolarization in hyperoxia-induced rat models of bronchopulmonary dysplasia.

Fri, 05 Feb 2016 00:00:00 +0100

Authors: Porzionato A, Guidolin D, Macchi V, Sarasin G, Grisafi D, Tortorella C, Dedja A, Zaramella P, De Caro R Abstract No papers are available about potentiality of fractal analysis in quantitative assessment of alveolarization in bronchopulmonary dysplasia. Thus, we here performed a comparative analysis between fractal (fractal dimension (D) and lacunarity) and stereological parameters (mean linear intercept (Lm), total volume of alveolar air spaces, total number of alveoli, mean alveolar volume, total volume and surface area of alveolar septa, and mean alveolar septal thickness) in experimental hyperoxia-induced models of BPD. At birth, rats were distributed between the following groups: a) rats raised in ambient air for 2 weeks; b) exposed to 60% oxygen for 2 weeks; c) raised...



Erratum: Effect of Prophylactic Palivizumab on Admission Due to Respiratory Syncytial Virus Infection in Former Very Low Birth Weight Infants with Bronchopulmonary Dysplasia.

Thu, 04 Feb 2016 21:24:02 +0100

Authors: Abstract [This corrects the article on p. 924 in vol. 30, PMID: 26130956.]. PMID: 26839492 [PubMed - as supplied by publisher] (Source: Journal of Korean Medical Science)



Systematic Review of Inhaled Bronchodilator and Corticosteroid Therapies in Infants with Bronchopulmonary Dysplasia: Implications and Future Directions

Wed, 03 Feb 2016 00:00:00 +0100

Conclusion Whether inhaled bronchodilators and inhaled corticosteroids improve long-term outcomes in BPD remains unclear. Literature regarding these therapies mostly addresses evolving BPD. There appears to be heterogeneity in treatment responses, and may be related to varying modes of administration. Further research is needed to evaluate inhaled therapies in infants with severe BPD. Such investigations should focus on appropriate definitions of disease and subject selection, timing of therapies, and new drugs, devices and delivery methods as compared to traditional methods across all modalities of respiratory support, in addition to the assessment of long-term outcomes of initial responders. (Source: PLoS One)



[Respiratory outcome of bronchopulmonary dysplasia in school-age children].

Tue, 02 Feb 2016 00:00:00 +0100

CONCLUSIONS: Half of the children included in this "new-BPD" follow-up cohort had clinical respiratory morbidity and most of the children followed presented with persistent alterations in pulmonary function tests at school age, which were not associated with significant alterations in the maximum aerobic performance. PMID: 26850154 [PubMed - as supplied by publisher] (Source: Archives de Pediatrie)



Hydrogen‐rich water ameliorates bronchopulmonary dysplasia (BPD) in newborn rats

Mon, 01 Feb 2016 00:00:00 +0100

Summary Bronchopulmonary dysplasia (BPD) is characterized by developmental arrest of the alveolar tissue. Oxidative stress is causally associated with development of BPD. The effects of hydrogen have been reported in a wide range of disease models and human diseases especially caused by oxidative stress. We made a rat model of BPD by injecting lipopolysaccharide (LPS) into the amniotic fluid at E16.5. The mother started drinking hydrogen‐rich water from E9.5 and also while feeding milk. Hydrogen normalized LPS‐induced abnormal enlargement of alveoli at P7 and P14. LPS increased staining for nitrotyrosine and 8‐OHdG of the lungs, and hydrogen attenuated the staining. At P1, LPS treatment decreased expressions of genes for FGFR4, VEGFR2, and HO‐1 in the lungs, and hydrogen increased ...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




The Real-World Routine Use of Caffeine Citrate in Preterm Infants: A European Postauthorization Safety Study.

Thu, 28 Jan 2016 00:00:00 +0100

CONCLUSIONS: The use of this caffeine citrate is safe for the management of AOP in a real-world setting. PMID: 26820884 [PubMed - as supplied by publisher] (Source: Neonatology)



Bronchopulmonary Dysplasia Within and Beyond the Neonatal Unit.

Wed, 27 Jan 2016 19:28:02 +0100

Authors: PMID: 26808517 [PubMed - in process] (Source: Advances in Neonatal Care)



GRP78 Regulates ER Homeostasis and Distal Epithelial Cell Survival During Lung Development.

Wed, 27 Jan 2016 00:00:00 +0100

Authors: Flodby P, Li C, Liu Y, Wang H, Marconett CN, Laird-Offringa IA, Minoo P, Lee AS, Zhou B Abstract Bronchopulmonary dysplasia (BPD), a chronic lung disease of prematurity, has been linked to endoplasmic reticulum (ER) stress. To investigate a causal role for ER stress in BPD pathogenesis, we generated mice (cGrp78f/f) with lung epithelial cell-specific knockout (KO) of Grp78, a gene encoding the ER chaperone 78-kDa glucose-regulated protein (GRP78), a master regulator of ER homeostasis and the unfolded protein response (UPR). Lung epithelial-specific Grp78 KO disrupted lung morphogenesis, causing developmental arrest, increased alveolar epithelial type II cell apoptosis and decreased surfactant protein and type I cell marker expression in perinatal lungs. cGrp78f/f pups died...



Assessment of chest X-ray images in newborns with respiratory disorders.

Wed, 20 Jan 2016 13:34:12 +0100

Authors: Czarnecki ŁM Abstract The aim of the study was to analyze major radiological signs on chest X-ray images of neonates with respiratory disorders. The analyzed group consisted of 84 neonates; 56 were born prematurely. In total, 386 X-ray photographs of the neonates were taken; of these, 301 were chest radiographs. The following conditions were diagnosed: pneumonia (n = 44), infant respiratory distress syndrome (n = 28), bronchopulmonary dysplasia (n = 9), atelectasis (n = 5), and meconium aspiration syndrome (n = 3). The initial X-ray images of 29 neonates were normal. Reduced aeration of lung tissue was diagnosed in 55 patients, increased lung tissue aeration in 6. A pathologically widened mediastinal shadow was observed in 4 newborns; in 4 cases, evaluation was not possib...



Biochemical Screening for Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia

Wed, 20 Jan 2016 06:46:07 +0100

Background: Pulmonary hypertension (PH) in infants with bronchopulmonary dysplasia (BPD) is associated with increased morbidity and mortality. Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and decreased levels of amino acid precursors of nitric oxide (NO) have been associated with PH, but have not been studied in infants with PH secondary to BPD. Objective: The aim of this study was to identify a biochemical marker for PH in infants with BPD. Methods: Twenty infants, born at (Source: Neonatology)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Recent advances in paediatric respiratory medicine

Wed, 20 Jan 2016 00:00:00 +0100

This review highlights important advances in paediatric respiratory medicine since 2014, excluding cystic fibrosis. It focuses mainly on the more common conditions, bronchopulmonary dysplasia, bronchiolitis and preschool wheezing, asthma, pneumonia and sleep, and highlights some of the rarer conditions such as primary ciliary dyskinesia and interstitial lung disease (ILD). (Source: Archives of Disease in Childhood)



Biochemical Screening for Pulmonary Hypertension in Preterm Infants with Bronchopulmonary Dysplasia.

Tue, 19 Jan 2016 00:00:00 +0100

CONCLUSION: NT-proBNP and the NO precursor citrulline may be cost-effective biochemical markers for screening for the presence of PH in preterm infants who have BPD. If validated in a larger study, such biochemical markers may, in part, replace PH screening echocardiograms in these patients. PMID: 26780635 [PubMed - as supplied by publisher] (Source: Neonatology)



Researchers identify process that causes chronic neonatal lung disease

Fri, 15 Jan 2016 19:01:28 +0100

A key component of the pathogenesis of bronchopulmonary dysplasia (BPD), a devastating and sometimes fatal lung disease that affects premature infants, has been uncovered by researchers. (Source: ScienceDaily Headlines)



UT Southwestern researchers identify process that causes chronic neonatal lung disease

Fri, 15 Jan 2016 05:00:00 +0100

(UT Southwestern Medical Center) Pediatric researchers at UT Southwestern Medical Center have identified a key component of the pathogenesis of bronchopulmonary dysplasia (BPD), a devastating and sometimes fatal lung disease that affects premature infants. (Source: EurekAlert! - Biology)



Rejuvenating cellular respiration for optimizing respiratory function: targeting mitochondria

Fri, 15 Jan 2016 00:00:00 +0100

Altered bioenergetics with increased mitochondrial reactive oxygen species production and degradation of epithelial function are key aspects of pathogenesis in asthma and chronic obstructive pulmonary disease (COPD). This motif is not unique to obstructive airway disease, reported in related airway diseases such as bronchopulmonary dysplasia and parenchymal diseases such as pulmonary fibrosis. Similarly, mitochondrial dysfunction in vascular endothelium or skeletal muscles contributes to the development of pulmonary hypertension and systemic manifestations of lung disease. In experimental models of COPD or asthma, the use of mitochondria-targeted antioxidants, such as MitoQ, has substantially improved mitochondrial health and restored respiratory function. Modulation of noncoding RNA or pr...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Csk / Src / EGFR Signaling regulates migration of myofibroblasts and alveolarization.

Fri, 15 Jan 2016 00:00:00 +0100

Authors: Li J, Li Y, He H, Liu C, Li W, Xie L, Zhang Y Abstract Bronchopulmonary dysplasia (BPD) is characterized by premature alveolar developmental arrest. Antenatal exposure to inflammation inhibits lung morphogenesis, thus increasing the risk of developing BPD. Alveolar myofibroblasts are thought to migrate into the septal tips and elongate secondary septa during alveolarization. Here we found lipopolysaccharide (LPS) disrupted the directional migration of myofibroblasts and increased actin stress fiber expression and focal adhesion formation. In addition, Csk activity was downregulated in myofibroblasts treated with LPS, while activation of Src or EGFR was upregulated by LPS treatment. Specifically, decreased Csk activity and increased activation of Src or EGFR were also obser...



Pharmacologic strategies in neonatal pulmonary hypertension other than nitric oxide

Thu, 14 Jan 2016 00:00:00 +0100

Inhaled nitric oxide (iNO) is approved for use in persistent pulmonary hypertension of the newborn (PPHN) but does not lead to sustained improvement in oxygenation in one-third of patients with PPHN. Inhaled NO is less effective in the management of PPHN secondary to congenital diaphragmatic hernia (CDH), extreme prematurity, and bronchopulmonary dysplasia (BPD). Intravenous pulmonary vasodilators such as prostacyclin, alprostadil, sildenafil, and milrinone have been successfully used in PPHN resistant to iNO. (Source: Seminars in Perinatology)



Improvement in perinatal care for extremely premature infants in Denmark from 1994 to 2011.

Tue, 12 Jan 2016 19:20:02 +0100

CONCLUSIONS: Centralisation of treatment of extremely premature infants has been implemented because more children are being born at highly specialised perinatal centres. Care improved as more infants received evidence-based treatment. IVH 3-4 rates declined. A trend towards increased survival was observed for infants with a GA < 26 weeks. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 26726899 [PubMed - in process] (Source: Danish Medical Journal)



Influence of Respiratory Dead Space on Lung Clearance Index in Preterm Infants

Tue, 12 Jan 2016 00:00:00 +0100

Publication date: Available online 29 December 2015 Source:Respiratory Physiology & Neurobiology Author(s): Roland P. Neumann, J.Jane Pillow, Cindy Thamrin, Urs Frey, Sven M. Schulzke Lung clearance index (LCI), a marker of ventilation inhomogeneity derived from multiple breath washout (MBW), is used for clinical monitoring and as a key outcome of clinical trials in infants and children with cystic fibrosis. Utility of LCI is controversial in preterm infants with bronchopulmonary dysplasia (BPD) who tend to have high dead space to tidal volume ratio (V D/V T). We investigated the effect of V D/V T on LCI in a cohort of preterm infants with and without BPD and term healthy controls. We analysed MBW data from 455 infants at a mean (SD) of 43.4 (3.5) w postmenstrual age. V D wa...



Challenges and lessons learned in Neonatal Drug Therapies

Mon, 11 Jan 2016 00:00:00 +0100

Drugs are extensively used in the newborns and some of these pharmacologic agents are key elements contributing to the improved outcomes and survival of the sick neonates. This issue of the Seminars in Perinatology focuses on the more vexing and promising pharmacologic agents being used and may be potentially used in the newborn. Drugs are molecular entities that elicit a physiologic, biochemical, or molecular response. It is clear that stem cell-based therapies are potent pharmacologic strategies that represent the next breakthrough for neonatal morbidities such as bronchopulmonary dysplasia, periventricular leucomalacia and hypoxic ischemic encephalopathy where perinatal insults may compromise progenitor cells leading to the arrest in normal lung and neuronal growth and development. (Sou...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Bronchopulmonary Dysplasia Within and Beyond the Neonatal Unit.

Tue, 05 Jan 2016 00:00:00 +0100

Authors: Khetan R, Hurley M, Spencer S, Bhatt JM Abstract BACKGROUND: Bronchopulmonary dysplasia (BPD), also known as chronic lung disease of prematurity or chronic neonatal lung disease, is a major cause of respiratory illness in premature babies. Newborn babies survive at gestational ages of 23 to 26 weeks, earlier than when BPD was first described. New mechanisms of lung injury have therefore emerged and the clinical and pathological characteristics of pulmonary involvement have changed. PURPOSE: Improved neonatal intensive care unit modalities have increased survival rates; the overall prevalence of the condition, however, has not changed. Management of evolving BPD aims at minimizing lung injury. Management of established, especially severe BPD, still poses significant cli...



Noninvasive Respiratory Support

Mon, 04 Jan 2016 00:00:00 +0100

Mechanical ventilation is associated with increased survival of preterm infants but is also associated with an increased incidence of chronic lung disease (bronchopulmonary dysplasia) in survivors. Nasal continuous positive airway pressure (nCPAP) is a form of noninvasive ventilation that reduces the need for mechanical ventilation and decreases the combined outcome of death or bronchopulmonary dysplasia. Other modes of noninvasive ventilation, including nasal intermittent positive pressure ventilation, biphasic positive airway pressure, and high-flow nasal cannula, have recently been introduced into the NICU setting as potential alternatives to mechanical ventilation or nCPAP. Randomized controlled trials suggest that these newer modalities may be effective alternatives to nCPAP and may o...



Prevention of Bronchopulmonary Dysplasia: Are Intratracheal Steroids with Surfactant a Magic Bullet?

Fri, 01 Jan 2016 00:00:00 +0100

Authors: Bancalari E, Jain D, Jobe AH PMID: 26720788 [PubMed - in process] (Source: American Journal of Respiratory and Critical Care Medicine)



Morbidity in preterm infants with fetal inflammatory response syndrome

Wed, 30 Dec 2015 00:00:00 +0100

ConclusionsUmbilical cord blood IL‐6 concentrations greater than 26.7, 37.7, and 17.5 pg/mL in premature infants with FIRS were found to be predictive for RDS, death, and MOF, respectively. This article is protected by copyright. All rights reserved. (Source: Pediatrics International)



Regulation of Alveolar Septation by MicroRNA-489.

Wed, 30 Dec 2015 00:00:00 +0100

Authors: Olave N, Lal CV, Halloran B, Pandit K, Cuna AC, Faye-Petersen OM, Kelly DR, Nicola T, Benos P, Kaminski N, Ambalavanan N Abstract MicroRNAs are small conserved RNA that regulate gene expression. Bioinformatic analysis of miRNA profiles during mouse lung development indicated a role for multiple microRNA including microRNA-489 (miR-489). miR-489 increased on completion of alveolar septation (Postnatal day 42 (P42)), associated with decreases in its conserved target genes Insulin-like Growth Factor-1 [Igf1] and Tenascin-C [Tnc]. We hypothesized that dysregulation of miR-489 and its target genes Igf1 and Tnc contribute to hyperoxia-induced abnormal lung development. C57BL/6 mice were exposed to normoxia (21%) or hyperoxia (85% O2) from P4 to P14 in combination with intranasal...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Low levels of tissue inhibitor of metalloproteinase-2 at birth may be associated with subsequent development of bronchopulmonary dysplasia in preterm infants.

Wed, 23 Dec 2015 11:14:04 +0100

CONCLUSION: Low TIMP-2 serum levels at birth may be associated with the subsequent development of BPD in preterm infants. PMID: 26692876 [PubMed] (Source: Korean Journal of Pediatrics)



BPD dodges multiple bullets

Mon, 21 Dec 2015 22:46:22 +0100

Evidence-based, pharmacologic interventions to prevent bronchopulmonary dysplasia (BPD) are limited to caffeine, postnatal steroids, and vitamin A. Of these, only caffeine has gained wide acceptance, leaving practitioners searching for effective therapies to prevent BPD in at-risk infants. In this issue of The Journal, Ballard et al report a study in which an extremely high-risk group of infants – extremely low gestational age newborns still requiring mechanical ventilation at 7-14 days of age – were randomized to repeated doses of surfactant or sham instillation. (Source: The Journal of Pediatrics)



Reviewing the use of corticosteroids in bronchopulmonary dysplasia.

Sat, 19 Dec 2015 00:00:00 +0100

CONCLUSIONS: The association between risks and benefits of corticosteroid use in preterm infants needs to be considered due to the fact that some infant subpopulations may show more benefits than risks, such as those using mechanical ventilation with difficult weaning. PMID: 26709507 [PubMed - as supplied by publisher] (Source: Jornal de Pediatria)



Association of C609T-Inborn Polymorphism of NAD(P)H: Quinone Oxidoreductase 1 with the Risk of Bronchopulmonary Dysplasia in Preterm Neonates

Fri, 18 Dec 2015 00:00:00 +0100

Conclusion The higher incidence of NQO1 mutants among BPD neonates as well as the presence of the mutant allele in all neonates with ≤ 1,000 g who developed BPD provided the first evidence for a possible pathogenetic role of the C609T polymorphism in BPD susceptibility due to the reduction or loss of NQO1 enzymatic activity.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract  |  Full text (Source: American Journal of Perinatology)



On the Evolution of the Pulmonary Alveolar Lipofibroblast.

Wed, 16 Dec 2015 00:00:00 +0100

Authors: Torday JS, Rehan VK Abstract The pulmonary alveolar lipofibroblast was first reported in 1970. Since then its development, structure, function and molecular characteristics have been determined. Its capacity to actively absorb, store and 'traffic' neutral lipid for protection of the alveolus against oxidant injury, and for the active supply of substrate for lung surfactant phospholipid production have offered the opportunity to identify a number of specialized functions of these strategically placed cells. Namely, Parathyroid Hormone-related Protein (PTHrP) signaling, expression of Adipocyte Differentiation Related Protein, leptin, peroxisome proliferator activator receptor gamma, and the prostaglandin E2 receptor EP2- which are all stretch-regulated, explaining how and wh...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




A comparison of bilevel and ventilator-delivered non-invasive respiratory support

Mon, 14 Dec 2015 00:00:00 +0100

Conclusions We did not observe a statistically significant difference in the composite outcome of death or BPD between infants who received mostly bilevel NIPPV compared with mostly CMV NIPPV. Differences in component outcomes of morbidity and BPD may be due to the competing nature of these outcomes or differences in baseline characteristics of infants. Trial registration number NCT00433212. (Source: Archives of Disease in Childhood - Fetal and Neonatal Edition)



A single nucleotide polymorphism in the dimethylarginine dimethylaminohydrolase gene is associated with lower risk of pulmonary hypertension in bronchopulmonary dysplasia

Thu, 10 Dec 2015 00:00:00 +0100

ConclusionThe rs480414 SNP in DDAH1 may be protective against the development of PH in patients with BPD. Furthermore, the DDAH1 rs480414 may be a useful biomarker in developing predictive models for PH in patients with BPD.This article is protected by copyright. All rights reserved. (Source: Acta Paediatrica)



Use and safety of azithromycin in neonates: a systematic review

Wed, 09 Dec 2015 00:00:00 +0100

Conclusions Azithromycin significantly reduces the risk of BPD in preterm neonates. The relationship between azithromycin and IHPS requires further investigation. (Source: BMJ Open)



Postnatal CMV and Bronchopulmonary Dysplasia Risk

Mon, 07 Dec 2015 00:00:00 +0100

This cohort study reports that postnatal cytomegalovirus infection was associated with increased risk for bronchopulmonary dysplasia in very low-birth-weight infants. (Source: JAMA Pediatrics)



Bronchoconstriction following instillation of phenylephrine eye drops in premature infants with bronchopulmonary dysplasia: two cases report.

Sat, 05 Dec 2015 16:06:03 +0100

We report two cases of bronchoconstriction following instillation of mydriatic eye drops. One occurred during induction of anesthesia for laser photocoagulation and the other before screening of ROP. The most likely cause in each case was phenylephrine eye drops. We recommend that the minimal dosage of phenylephrine needed to attain proper mydriasis should be instilled to infant patients, and the possibility of bronchoconstriction occurrence kept in mind, especially for infants with low body weight with BPD. PMID: 26634087 [PubMed - as supplied by publisher] (Source: Korean Journal of Anesthesiology)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Alberta Infant Motor Scale (AIMS) Performance of Greek Preterm Infants: Comparisons With Full-Term Infants of the Same Nationality and Impact of Prematurity-Related Morbidity Factors.

Fri, 04 Dec 2015 00:00:00 +0100

CONCLUSIONS: AIMS norms were created for Greek PT infants. This study confirms that AIMS trajectories of PT infants are below those of FT infants of the same nationality. The influence of morbidity factors including RDS, IVH and ROP should be taken into account when performing AIMS in PT infants. PMID: 26637651 [PubMed - as supplied by publisher] (Source: Physical Therapy)



Effects of a Birth Hospital’s Neonatal Intensive Care Unit Level and Annual Volume of Very-Low-Birth-Weight Infant Deliveries on Morbidity and Mortality

Tue, 01 Dec 2015 06:00:00 +0100

ABSTRACT: Annual volume of deliveries better predicts risk-adjusted mortality among preterm infant than neonatal intensive care unit (NICU) levels. However, it is unknown whether NICU level and annual volume of very-low-birth-weight (VLBW) deliveries differentially affect neonatal morbidity. In this retrospective, population-based cohort study, the authors evaluated birth records of 72,431 infants (500- to 1499-g birth weight) born between 1999 and 2009, in order to assess independent effects of VLBW deliveries and NICU level on risk of various neonatal morbidities. Primary outcomes were individual morbidity-mortality composites of death or bronchopulmonary dysplasia, necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and severe intraventricular hemorrhage (IVH). Secondary ...



Nutritional Management of the Infant With Severe Bronchopulmonary Dysplasia

Tue, 01 Dec 2015 00:00:00 +0100

This article reviews concepts related to these challenges and provides recommendations for achieving successful nutrition in this population. (Source: NeoReviews recent issues)



Recent advances in the mechanisms of lung alveolarization and the pathogenesis of bronchopulmonary dysplasia

Tue, 01 Dec 2015 00:00:00 +0100

Alveolarization is the process by which the alveoli, the principal gas exchange units of the lung, are formed. Along with the maturation of the pulmonary vasculature, alveolarization is the objective of late lung development. The terminal airspaces that were formed during early lung development are divided by the process of secondary septation, progressively generating an increasing number of alveoli that are of smaller size, which substantially increases the surface area over which gas exchange can take place. Disturbances to alveolarization occur in bronchopulmonary dysplasia (BPD), which can be complicated by perturbations to the pulmonary vasculature that are associated with the development of pulmonary hypertension. Disturbances to lung development may also occur in persistent pulmona...



Early Caffeine Use in Very Low Birth Weight Infants and Neonatal Outcomes: A Systematic Review and Meta-Analysis.

Tue, 01 Dec 2015 00:00:00 +0100

Authors: Park HW, Lim G, Chung SH, Chung S, Kim KS, Kim SN Abstract The use of caffeine citrate for treatment of apnea in very low birth weight infants showed short-term and long-term benefits. A systematic review and meta-analysis of the literature was undertaken to document the effect providing caffeine early (0-2 days of life) compared to providing caffeine late (≥3 days of life) in very low birth weight infants on several neonatal outcomes, including bronchopulmonary dysplasia (BPD). We searched MEDLINE, the EMBASE database, the Cochrane Library, and KoreaMed for this meta-analysis. The quality of the included studies was assessed using the Newcastle-Ottawa Scale and Jadad's scale. Studies were included if they examined the effect of the early use of caffeine compared with th...

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.




Parenting behavior at 2 years predicts school‐age performance at 7 years in very preterm children

Sun, 29 Nov 2015 00:00:00 +0100

ConclusionsThe contribution of early parenting to VPT children's school‐age performance is significant, with stronger effects for lower medical risk children in some outcomes. These findings support the premise that parenting strategies should be included in the NICU and early interventions programs for VPT infants. (Source: Journal of Child Psychology and Psychiatry)



A Three-Dimensional Study of Alveologenesis in Mouse Lung.

Thu, 26 Nov 2015 00:00:00 +0100

Authors: Branchfield K, Li R, Lungova V, Veheyden J, McCulley D, Sun X Abstract Alveologenesis is the final step of lung maturation, which subdivides the alveolar region of the lung into smaller units called alveoli. Each of the nascent dividers serves as a new gas-exchange surface, and collectively they drastically increase the surface area for breathing. Disruption of alveologenesis results in simplification of alveoli, as is seen in premature infants diagnosed with bronchopulmonary dysplasia (BPD), a prevalent lung disease that is often associated with lifelong breathing deficiencies. To date, a majority of studies of alveologenesis rely on two-dimensional (2D) analysis of tissue sections. Given that an overarching theme of alveologenesis is thinning and extension of the epithel...



Does Breastmilk Influence the Development of Bronchopulmonary Dysplasia?

Wed, 25 Nov 2015 00:00:00 +0100

To assess whether breastmilk feeding is associated with a reduced risk of bronchopulmonary dysplasia (BPD). Secondary outcome measures analyzed were retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC). (Source: The Journal of Pediatrics)



Hypoxic Episodes in Bronchopulmonary Dysplasia

Fri, 20 Nov 2015 07:27:15 +0100

Hypoxic episodes are troublesome components of bronchopulmonary dysplasia (BPD) in preterm infants. Immature respiratory control seems to be the major contributor, superimposed on abnormal respiratory function. Relatively short respiratory pauses may precipitate desaturation and bradycardia. This population is predisposed to pulmonary hypertension; it is likely that pulmonary vasoconstriction also plays a role. The natural history has been well-characterized in the preterm population at risk for BPD; however, the consequences are less clear. Proposed associations of intermittent hypoxia include retinopathy of prematurity, sleep disordered breathing, and neurodevelopmental delay. Future study should address whether these associations are causal relationships. (Source: Clinics in Perinatolog...