Pulmonary arterial hypertension

Reingardienė, Dagmara Ona

doi:10.3390/medicina43120128

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…19,21,22 It is reported that more than 80 Canadians die annually from overexposure to the cold, whereas 8000 die of hypothermia-related causes. 24,25 Although data are scarce concerning the pediatric population, a study from the US Armed Forces reported that soldiers younger than 20 years are at increased risk. 26…”

Section: Definition and Epidemiologymentioning

confidence: 99%

Frostbite in the Pediatric Population

Ma,

Pouoh,

Hogue

et al. 2024

Pediatr Emer Care

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Introduction Frostbite in the pediatric population, where skeletal maturity has not been achieved, can have important repercussions on subsequent growth. Yet, the optimal management of frostbite injuries in children remains vague. This review aims to summarize the current evidence for frostbite management in children and understand Canadian practice trends on this topic. Methods A review using Medline, Scopus, Web of Science, and gray literature was performed to identify relevant literature on the clinical manifestations, diagnostic methods, and treatment options in pediatric frostbite. An online survey was sent to plastic surgeons through the Canadian Society of Plastic Surgeons (CSPS) mailing list to further identify national practices and trends for pediatric frostbite management. Results A total of 109 articles were reviewed. No article provided a specific algorithm for pediatric frostbite, with existing recommendations suggesting the use of adult guidelines for treating children. Our survey yielded 9 responses and highlighted the rarity of pediatric frostbite cases, with no responder treating more than 10 cases per year. Most (55.6%) do not use a pediatric-specific treatment algorithm, whereas 30% apply adult guidelines. A conservative approach focusing on rewarming (55.6%), limb elevation (50%), and tetanus status verification (66.7%) was predominant. Imaging and surgical interventions seem to be reserved for severe cases. Conclusions The current literature for pediatric frostbite management lacks specificity. Canadian practices vary, with a trend toward a conservative approach. The limited evidence and rarity of experience highlight the need for further research, ideally in a collaborative multicentric manner, to create a consensus for pediatric frostbite care.

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Section: Definition and Epidemiologymentioning

confidence: 99%

Frostbite in the Pediatric Population

Ma,

Pouoh,

Hogue

et al. 2024

Pediatr Emer Care

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“…2,3 When convulsions occur in addition to these signs of preeclampsia, the condition is referred to as eclampsia. 4,5 Preeclampsia is primarily a disorder of nulliparous, but multiparous pregnant women with a new partner have an elevated risk of preeclampsia like that of nulliparous women. 6 Preeclampsia complicates 10% of all pregnancies; it was found that 3-5% of first pregnancies and 1% of subsequent pregnancies are complicated by preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

Maternal and perinatal outcome in severe preeclampsia and eclampsia at the Rivers State university teaching hospital, Nigeria

Awoyesuku

John

Lebara

2020

Int J Reprod Contracept Obstet Gynecol

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Background: Severe preeclampsia and eclampsia remain a challenge in tropical obstetric practice. It is a major contributor to feto-maternal morbidity and mortality in developing countries. This study seeks to determine the prevalence, associated risk factors and the feto-maternal outcome of severe preeclampsia and eclampsia at the rivers state university teaching hospital (RSUTH).Method: A retrospective study of all women who had severe preeclampsia and eclampsia and were delivered at the RSUTH in a two-year period, 1ST January 2018 to 31ST December 2019, was carried out. Data on patients’ age, parity, education, booking status, gestational age at delivery, diagnosis, complications, mode of delivery and fetal sex, birth weight and Apgar scores were retrieved using structured pro-forma. Data were analyzed using SPSS version 20.Results: There were 4496 deliveries of which 128 had severe preeclampsia and eclampsia, giving a prevalence of 2.85%. Of these, 94 (73.4%) had severe preeclampsia and 34 (26.6%) had eclampsia. The mean age of the women ± SD was 29.84±5.44 years, median parity was para 1, and mean gestational age ± SD was 35.38±3.84 weeks. There were 10 maternal deaths giving case fatality of 7.8%. The mean birth weight ± SD was 2.61±0.91 kg and stillborn rate was 14.4%. There was significant association with maternal age, education, booking status, method of delivery and Apgar score of the baby.Conclusion: The prevalence in this study is high with associated high maternal mortality and stillborn rates. Timely and appropriate intervention including primary management and judicious termination of pregnancy will reduce mortality of mother and fetus.

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“…Pulmonary arterial hypertension (PAH) is a chronic debilitating cardiopulmonary disease characterized by abnormal remodeling of peripheral lung vasculature resulting in progressive vasoconstriction [1]. PAH is associated with an elevated pulmonary arterial pressure (> 25 mm Hg at rest to > 30 mm Hg with exercise) and if left untreated leads to right-heart hypertrophy, and consequently heart failure [2].PAH could be classified as idiopathic (formerly known as primary pulmonary hypertension) or associated with autoimmune, infectious, vascular, metabolic, and congenital disorders [1].The underlying pathology of PAH involves the recruitment of inflammatory cells with release of cytokines which enhance cell proliferation and elastin fibers degradation [3]. Histologically, PAH is characterized by intimal fibrosis, increased medial thickness, predominance of complex plexiform lesions resulting in vasoconstriction and pulmonary arteriolar occlusion [4].…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, in IPF, treatment is mainly geared towards relieving symptoms as much as possible and slowing down the progression. The prognosis ofPAH and IPF is poor [1,6], hence, there is a clear necessity to develop new therapies.…”

Section: Introductionmentioning

confidence: 99%

ETS-Related Gene (ERG) and Friend leukemia integration – 1 (FLI-1) Transcription Factors in the Precision Treatment of Pulmonary Arterial Hypertension and Pulmonary Fibrosis

Reddy¹

2019

J Can Epi Treat

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Pulmonary arterial hypertension (PAH) is a chronic debilitating cardiopulmonary disease characterized by abnormal remodeling of peripheral lung vasculature resulting in progressive vasoconstriction. Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and irreversible disease that is often associated with significant morbidity and poor quality of life. The prognosis of PAH and IPF is poor and currently available medications focus on relieving symptoms and slowing down progression. Hence, there is a clear necessity to develop new therapies. ETS-related genes and Friend leukemia integration-1 (FLI-1) are transcription factors involved in angiogenesis, cellular homeostasis, vascular remodeling, and the genetic regulation of inflammation, apoptosis, and fibrosis seen in PAH and IPF. Simultaneous small-interfering-RNA (siRNA) knockdown of ERG and FLI-1 in human pulmonary artery endothelial cells (HPAEC) and human pulmonary microvasculature endothelial cells (HPMEC) has been associated with up-regulation of pro-inflammatory genes and interferon (IFN) pathway-related genes. Notably, the endothelium in normal lungs has also been shown to have high levels of nuclear ERG and Fli-1 compared to significantly lower levels in diseased lungs. Recently, ERG upregulation was found to promote liver homoeostasis by regulating canonical TGFβ1-SMAD signaling and promoting the SMAD1 pathway while repressing SMAD3 activity. Improvement in pulmonary fibrosis through medications that suppress the TGF-β1/Smad3 pathway has also been a subject of study. In this review, we hypothesize that targeting the regulation of ERG, FLI-1 and ERG-mediation of TGF-β1/Smad3 signaling may be a promising therapeutic strategy in PAH and IPF.

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Pulmonary arterial hypertension

Cited by 4 publications

References 24 publications

Frostbite in the Pediatric Population

Frostbite in the Pediatric Population

Maternal and perinatal outcome in severe preeclampsia and eclampsia at the Rivers State university teaching hospital, Nigeria

ETS-Related Gene (ERG) and Friend leukemia integration – 1 (FLI-1) Transcription Factors in the Precision Treatment of Pulmonary Arterial Hypertension and Pulmonary Fibrosis

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