Pre-operative transcranial Doppler ultrasound assessment of cerebral collateral circulation in children undergoing veno-arterial extracorporeal membrane oxygenation or cardiac surgery.

Children requiring veno-arterial extracorporeal membrane oxygenation (VA ECMO) or cardiac surgery often undergo cervical cannulation or carotid artery clamping, which can interrupt cerebral circulation. Inadequate collateral flow through the circle of Willis (CoW) may lead to cerebral ischaemia within the vascular territory and/or watershed regions. Pre-cannulation survey of the CoW using transcranial Doppler (TCD) ultrasound may be performed to predict and plan neuroprotection.

The Relationship Between Rehabilitation and Frailty in Advanced Heart or Lung Disease.

Background: Frailty increases morbidity and mortality in patients with advanced heart and lung disease. Emerging evidence shows that postoperative cardiac or pulmonary rehabilitation can improve the frailty status of these patients. The aim of this hypothesis-generating study was to test the relationship between prehabilitation and frailty in patients with advanced heart or lung disease referred for heart and lung transplantation.

A hole lot of trouble: Severe bilateral anastomotic dehiscence following bilateral single sequential lung transplant.

Airway complications post lung transplant including ischaemia and dehiscence have a significant associated mortality (2%-4%) and morbidity. We describe a case of a 22-year-old female who developed significant bilateral anastomotic dehiscence with severe ischaemia following a bilateral single sequential lung transplant (BSSLTx). Following an intensive antimicrobial regimen, judicious bronchoscopic surveillance, and a prolonged inpatient stay, the dehiscence resolved without requiring further surgical intervention.

Specific human leucocyte antigen-DQ risk epitope mismatches are associated with chronic lung allograft dysfunction after lung transplantation.

A high-risk epitope mismatch (REM) (found in DQA1∗05 + DQB1∗02/DQB1∗03:01) is associated with de novo donor specific antibodies after lung transplantation (LTx). Chronic lung allograft dysfunction (CLAD) remains a barrier to LTx survival. This study aimed to measure the association between DQ REM and the risk of CLAD and death after LTx.

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8.

Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health.

Frailty Measures in Patients Listed for Lung Transplantation.

Background: The study aimed to determine whether the addition of cognitive impairment, depression, or both, to the assessment of physical frailty (PF) is associated with the risk of lung transplant (LTX) waitlist mortality.

Methods: Since March 2013, all patients referred for LTX evaluation underwent PF assessment. Cognition was assessed using the Montreal Cognitive Assessment and depression assessed using the Depression in Medical Illness questionnaire.

Reversibility of Frailty after Lung Transplantation.

Background: Frailty contributes to increased morbidity and mortality in patients referred for and undergoing lung transplantation (LTX). The study aim was to determine if frailty is reversible after LTX in those classified as frail at LTX evaluation.

Methods: Consecutive LTX recipients were included.

Sexually dimorphic production of interleukin-6 in respiratory disease.

Diverging susceptibility and severity in respiratory diseases is prevalent between males and females. Sex hormones have inconclusively been attributed as the cause of these differences, however, strong evidence exists promoting genetic factors leading to sexual dimorphism. As such, we investigate differential proinflammatory cytokine (interleukin (IL)-6 and CXCL8) release from TNF-α stimulated primary human lung fibroblasts in vitro.

Frailty in lung transplantation: a systematic review.

: Lung transplantation is an effective treatment for certain types of end-stage lung disease. Frailty is a complex clinical syndrome associated with decreased physiological reserve and an increased risk for suboptimal health outcomes.: This article reviews the current literature on frailty in lung transplantation, with an emphasis on frailty measures, prevalence and impact of frailty on morbidity and mortality prior to and following lung transplantation.

Pulmonary Type B Niemann-Pick Disease Successfully Treated with Lung Transplantation.

Background: Niemann-Pick Disease (NPD) type B is a rare autosomal recessive disease characterised by hepatosplenomegaly and pulmonary disease, highlighted by preserved volumes and diminished diffusion capacity of the lung for carbon monoxide (DLCO) on pulmonary function tests (PFTs). There is no current accepted treatment for the disease. We present a case of a successful bilateral lung transplant in a patient with a DLCO of 14%, and significant pulmonary changes attributable to NPD type B on computed tomography (CT) chest, and both microscopic and macroscopic assessment of the lung explant.

Short-chain fatty acids increase TNFα-induced inflammation in primary human lung mesenchymal cells through the activation of p38 MAPK.

Short-chain fatty acids (SCFAs), produced as by-products of dietary fiber metabolism by gut bacteria, have anti-inflammatory properties and could potentially be used for the treatment of inflammatory diseases, including asthma. The direct effects of SCFAs on inflammatory responses in primary human lung mesenchymal cells have not been assessed. We investigated whether SCFAs can protect against tumor necrosis factor (TNF)α-induced inflammation in primary human lung fibroblasts (HLFs) and airway smooth muscle (ASM) cells in vitro.

High prevalence of diabetes before and after lung transplantation: target for improving outcome?

Background: Diabetes increases morbidity and mortality of lung transplantation. However, the reported prevalence of diabetes varies post-transplantation partly due to lack of detection protocols.

Aim: To determine the prevalence of diabetes in patients (i) waitlisted for lung transplant and (ii) early post-transplantation.

Prevalence of diagnosed ocular disease in veterans with serious mental illness.

Objective: To compare the prevalence of diagnosed ocular disease and eye disease treatment between Veteran's Administration (VA) patients with and without serious mental illness (SMI).

Methods: Retrospective comparison of diagnosed ocular disease and treatment prevalence among patients with and without diagnosed SMI in fiscal year 2011 in the VA Capitol Health Care System (VISN 5).

Results: We identified 6462 VA patients with SMI and 137,933 without SMI.

Liver and lung transplantation in cystic fibrosis: an adult cystic fibrosis centre's experience.

Liver disease develops in one-third of patients with cystic fibrosis (CF). It is rare for liver disease to have its onset after 20 years of age. Lung disease, however, is usually more severe in adulthood.

Post-transplant lymphoproliferative disease in heart and lung transplantation: Defining risk and prognostic factors.

Background: Heart and lung transplant recipients have among of the highest incidence rates of post-transplant lymphoproliferative disease (PTLD). Despite this, there is a paucity of data specific to this group. We collated data on heart, lung and heart-lung transplant recipients with PTLD to identify disease features and prognostic factors unique to this group of patients.

Oral ribavirin for respiratory syncytial virus infection after lung transplantation: Efficacy and cost-efficiency.

Background: Respiratory syncytial virus (RSV) causes serious respiratory tract infections in lung transplant (LTx) recipients, is associated with development of bronchiolitis obliterans syndrome, and has no proven effective therapy. We evaluated the efficacy, safety, and cost-effectiveness of oral ribavirin for the treatment of RSV infection after LTx.

Methods: Between December 2011 and May 2014, 52 LTx recipients developed 56 episodes of symptomatic RSV infection, which was diagnosed by positive RSV polymerase chain reaction on nasopharyngeal swabs.

Physiology of sleep and breathing before and after lung transplantation.

During the past 20 years, lung transplantation (LTX) has evolved and it is now accepted as a mainstream modality for care of patients with severe life-threatening respiratory diseases that are refractory to maximal conventional therapies. Improvements in surgical techniques and in antirejection medications have resulted in prolonged survival in these patients. Several studies have explored quality of life after LTX and its improvement has been noted especially in the early period between 3 and 6 months.