The Experts below are selected from a list of 26475 Experts worldwide ranked by ideXlab platform
Lex W. Doyle - One of the best experts on this subject based on the ideXlab platform.
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Postnatal corticosteroids to prevent or treat Bronchopulmonary Dysplasia – Who might benefit?
Seminars in fetal & neonatal medicine, 2017Co-Authors: Lex W. Doyle, Jeanie L.y. CheongAbstract:Newborn infants born very preterm are at high risk of developing Bronchopulmonary Dysplasia, which is associated with not only mortality but also adverse long-term neurological and respiratory outcomes in survivors. Postnatal corticosteroids might reduce the risk of developing Bronchopulmonary Dysplasia, or reduce its severity. However, it is important to minimize exposure to the potentially harmful effects of corticosteroids, particularly on the developing brain. Systemic corticosteroids started after the first week of life have shown the most benefit in infants at highest risk of developing Bronchopulmonary Dysplasia, whereas inhaled corticosteroids have little effect in children with established lung disease. Systemic corticosteroids in the first week of life are not recommended, but inhaled corticosteroids, or corticosteroids instilled into the trachea using surfactant as a vehicle to distribute the corticosteroids through the lungs, offer promise with respect to prevention of Bronchopulmonary Dysplasia.
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long term outcomes of Bronchopulmonary Dysplasia
Seminars in Fetal & Neonatal Medicine, 2009Co-Authors: Lex W. Doyle, Peter J AndersonAbstract:Summary As more very preterm infants survive, more survivors will have Bronchopulmonary Dysplasia (BPD). Children with BPD have higher rates of cognitive, educational and behavioural impairments, and also reduced lung function, through childhood and into early life than would normally be expected. The importance of these neurological and respiratory problems later into adult life needs to be determined.
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Bronchopulmonary Dysplasia in very low birth weight subjects and lung function in late adolescence.
Pediatrics, 2006Co-Authors: Lex W. Doyle, Brenda Faber, Catherine Callanan, Nicholas Freezer, Geoffrey W. Ford, Nm DavisAbstract:OBJECTIVES. The purpose of this work was to determine the relationship between lung function in late adolescence and Bronchopulmonary Dysplasia, to establish whether lung function changed more from earlier in childhood in those with Bronchopulmonary Dysplasia, and to assess the effect of different definitions of Bronchopulmonary Dysplasia on respiratory outcome. METHODS. Subjects were composed of 147 survivors of birth weight RESULTS. All of the lung function variables reflecting airflow were substantially diminished in the Bronchopulmonary Dysplasia group, but lung volumes were not significantly different. More subjects in the Bronchopulmonary Dysplasia group had reductions in airflow in the clinically significant range (eg, forced expired volume in 1 second/forced vital capacity ratio CONCLUSIONS. Subjects of very low birth weight with Bronchopulmonary Dysplasia in the newborn period have poorer lung function in late adolescence than those without Bronchopulmonary Dysplasia, and their lung function may be deteriorating at a more rapid rate.
Ze D. Jiang - One of the best experts on this subject based on the ideXlab platform.
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Brainstem auditory abnormality in extremely premature babies and the impact of neonatal Bronchopulmonary Dysplasia.
Acta obstetricia et gynecologica Scandinavica, 2018Co-Authors: Cui Wang, Ze D. JiangAbstract:INTRODUCTION Extremely premature babies, particularly those who have neonatal Bronchopulmonary Dysplasia, are at risk of brain damage and neurodevelopmental impairment. This study aimed to examine functional status of the brainstem auditory pathway in extremely premature babies and assess the impact of Bronchopulmonary Dysplasia on function. MATERIAL AND METHODS Brainstem auditory evoked response was studied at term in babies born at ≤27 weeks of gestation with or without neonatal Bronchopulmonary Dysplasia. The normal controls were term babies without perinatal problems. RESULTS Compared with the normal controls, the extremely premature babies showed an elevated response threshold, increased latencies of waves I, III and particularly V. They also showed significantly increased I-V and III-V intervals. The amplitudes of waves I and V were moderately reduced. These abnormalities were clearly more significant in those with Bronchopulmonary Dysplasia than those without Bronchopulmonary Dysplasia. A direct comparison between the two groups of extremely premature babies revealed that wave V latency, and I-V and particularly III-V intervals were significantly longer in the babies with Bronchopulmonary Dysplasia than those without Bronchopulmonary Dysplasia. CONCLUSIONS Extremely premature babies have functional impairment of the brainstem auditory pathway. The impairment is clearly more significant in those with Bronchopulmonary Dysplasia than those without Bronchopulmonary Dysplasia. Neonatal Bronchopulmonary Dysplasia and associated unfavorable conditions are major contributors to brainstem auditory impairment in extremely premature babies.
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Functional impairment of the brainstem in infants with Bronchopulmonary Dysplasia.
Pediatrics, 2007Co-Authors: Andrew R. Wilkinson, Dorothea M. Brosi, Ze D. JiangAbstract:OBJECTIVES. To gain new insights into the influence of Bronchopulmonary Dysplasia on the immature brain and to detect abnormalities, we studied the functional integrity of the brainstem in infants with Bronchopulmonary Dysplasia. METHODS. Forty-one very preterm infants with Bronchopulmonary Dysplasia were studied at postconceptional ages of 37 to 42 weeks. Brainstem auditory evoked responses were recorded and analyzed by using the maximal length sequence technique. RESULTS. Compared with term control subjects, wave V latency in the maximal length sequence brainstem auditory evoked response of the infants with Bronchopulmonary Dysplasia increased significantly at all 91 to 910 clicks per second rates. Similarly, I–V and particularly III–V interpeak intervals increased significantly. The III–V/I–III interval ratio also increased significantly at all click rates. All of these abnormalities became more significant as the click rate was increased. Compared with healthy, very preterm control subjects, all of these maximal length sequence brainstem auditory evoked response variables increased significantly at all click rates, although the differences between the 2 groups were slightly smaller than those between the infants with Bronchopulmonary Dysplasia and the term control subjects. The wave I and III latencies and I–III interval in the infants with Bronchopulmonary Dysplasia did not show any abnormalities. The slopes of the wave V latency-rate function and I–V and particularly III–V interval-rate functions for the infants with Bronchopulmonary Dysplasia were significantly steeper than those for both term and healthy, very preterm control subjects. The slope of the III–V/I–III interval ratio-rate function for the infants with Bronchopulmonary Dysplasia was also significantly steeper than those for the 2 control groups. CONCLUSIONS. The results suggest poor myelination and synaptic function of the brainstem in infants with Bronchopulmonary Dysplasia, resulting in impaired functional integrity. In comparison, peripheral neural function was relatively intact.
Steven H Abman - One of the best experts on this subject based on the ideXlab platform.
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Airway Histopathology of Adolescent Survivors of Bronchopulmonary Dysplasia.
The Journal of pediatrics, 2019Co-Authors: Alfonso Galderisi, Steven H Abman, Fiorella Calabrese, Francesco Fortarezza, Eugenio BaraldiAbstract:Long-term survivors of Bronchopulmonary Dysplasia develop chronic obstructive lung disease. Herein we report in vivo histopathology from bronchial biopsies of 3 adolescent survivors of severe Bronchopulmonary Dysplasia. Thickened basement membranes with lymphocytic infiltrates and signs of immature neoangiogenesis in the absence of T-helper lymphocytes or eosinophils suggest the presence of an ongoing active airway process.
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Left ventricular diastolic dysfunction in Bronchopulmonary Dysplasia.
The Journal of pediatrics, 2008Co-Authors: Peter M. Mourani, D. Dunbar Ivy, Adam A. Rosenberg, Thomas E. Fagan, Steven H AbmanAbstract:We report 2 infants with severe Bronchopulmonary Dysplasia in whom left ventricular diastolic dysfunction contributed to clinical abnormalities, including pulmonary hypertension and recurrent pulmonary edema. We speculate that close monitoring for left ventricular diastolic dysfunction may assist with clinical management and improve outcomes of infants with severe Bronchopulmonary Dysplasia.
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Bronchopulmonary Dysplasia.
Lancet (London England), 2006Co-Authors: John P Kinsella, Anne Greenough, Steven H AbmanAbstract:Bronchopulmonary Dysplasia is a chronic lung disease that affects premature babies and contributes to their morbidity and mortality. Improved survival of very immature infants has led to increased numbers of infants with this disorder. This increase puts a heavy burden on health resources since these infants need frequent re-admission to hospital in the first 2 years after birth and, even as adolescents, have lung-function abnormalities and persistent respiratory symptoms. Unlike the original description of the disease in 1967, premature infants can develop chronic oxygen dependency without severe, acute respiratory distress; this "new Bronchopulmonary Dysplasia" could be the result of impaired postnatal lung growth. Whether such infants subsequently have catch-up lung growth, especially if given corticosteroids postnatally, is unknown. No safe and effective preventive therapy has been identified, but promising new treatments directed either at reducing lung injury or improving lung growth are under study.
Zubair H Aghai - One of the best experts on this subject based on the ideXlab platform.
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pepsin a marker of gastric contents is increased in tracheal aspirates from preterm infants who develop Bronchopulmonary Dysplasia
Pediatrics, 2008Co-Authors: Sabeena Farhath, Zhaoping He, Tarek Nakhla, Judy G Saslow, Sam Soundar, Jeanette Camacho, Gary E Stahl, Stephen Shaffer, Devendra I Mehta, Zubair H AghaiAbstract:OBJECTIVE: The objective of this study was to study the association between pepsin in tracheal aspirate samples and the development of Bronchopulmonary Dysplasia in preterm infants. METHODS: Serial tracheal aspirate samples were collected during the first 28 days from mechanically ventilated preterm neonates. Bronchopulmonary Dysplasia was defined as the need for supplemental oxygen at 36 weeks' postmenstrual age. An enzymatic assay with a fluorescent substrate was used to detect pepsin. Total protein was measured by the Bradford assay to correct for the dilution during lavage. Immunohistochemistry using antibody against human pepsinogen was performed in 10 lung tissue samples from preterm infants. RESULTS: A total of 256 tracheal aspirate samples were collected from 59 preterm neonates. Pepsin was detected in 234 (91.4%) of 256 of the tracheal aspirate samples. Twelve infants had no Bronchopulmonary Dysplasia, 31 infants developed Bronchopulmonary Dysplasia, and 16 infants died before 36 weeks' postmenstrual age. The mean pepsin concentration was significantly lower in infants with no Bronchopulmonary Dysplasia compared with those who developed Bronchopulmonary Dysplasia or developed Bronchopulmonary Dysplasia/died before 36 weeks' postmenstrual age. Moreover, the mean pepsin level was significantly higher in infants with severe Bronchopulmonary Dysplasia compared with moderate Bronchopulmonary Dysplasia. The mean pepsin level in tracheal aspirate samples from the first 7 days was also lower in infants with no Bronchopulmonary Dysplasia compared with those who developed Bronchopulmonary Dysplasia or developed Bronchopulmonary Dysplasia/died before 36 weeks' postmenstrual age. Pepsinogen was not localized in the lung tissues by immunohistochemistry. CONCLUSION: The concentration of pepsin was increased in the tracheal aspirate of preterm infants who developed Bronchopulmonary Dysplasia or died before 36 weeks' postmenstrual age. Recovery of pepsin in tracheal aspirate samples is secondary to gastric aspiration, not by hematogenous spread or local synthesis in the lungs. Chronic aspiration of gastric contents may contribute in the pathogenesis of Bronchopulmonary Dysplasia.
Jeffrey B. Smith - One of the best experts on this subject based on the ideXlab platform.
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Eosinophil cationic protein in tracheal aspirates of preterm infants with Bronchopulmonary Dysplasia
The Journal of pediatrics, 1997Co-Authors: Bhupala H Raghavender, Jeffrey B. SmithAbstract:Eosinophil cationic protein was elevated during the first week of life in tracheal aspirates from 11 preterm infants in whom Bronchopulmonary Dysplasia subsequently developed compared with 8 preterm and 8 term infants without Bronchopulmonary Dysplasia. Eosinophil cationic protein levels increased progressively with continued intubation in the infants with Bronchopulmonary Dysplasia but remained low in a comparison group of term infants. We suggest that eosinophils participate in the inflammatory process in Bronchopulmonary Dysplasia and may contribute to lung injury.
