Randolph T, eds. Harrison’s Principles of Internal Medicine, 14th edn. New York: McGraw-Hill, 1998: 2183–2194. 2. Hobbs WR, Sponseller PD, Weiss APC, Pyeritz RE. The cervical spine in Marfan syndrome. Spine 1997; 22: 983–989. 3. Herzka A, Sponseller PD, Pyeritz RE. Atlantoaxial rotatory subluxation in patients with Marfan syndrome. Spine 2000; 25: 524–525. 4. Place HH, Enzenauer RJ. Cervical sp...

Chest ultrasonography is a useful diagnostic tool for pediatricians. It can be used to complete and widen the general objectives of clinicalexamination in emergency situations, at the patient’s bedside. The diagnosis of pneumonia in children relies on history, physical examination, blood tests and chest X-rays. These methods have a low accuracy in the pediatric population that is even lower in ...

In patients with cervical spine injuries, respiratory function requires careful attention. Voluntary respiratory control is usually possible with lesions below C4 level although paralysis of the abdominal musculature results in a decreased ability to cough and to clear secretions, which may later lead to respiratory insufficiency. Therefore, injuries above C5 usually necessitate long term mecha...

Mechanical ventilation (MV) is a life-saving intervention for many critically ill patients. Unfortunately, prolonged MV results in the rapid development of diaphragmatic atrophy and weakness. Importantly, endurance exercise training results in a diaphragmatic phenotype that is protected against ventilator-induced diaphragmatic atrophy and weakness. The mechanisms responsible for this exercise-i...

Prolonged mechanical ventilation results in diaphragmatic oxidative injury, elevated proteolysis, fiber atrophy, and reduced force-generating capacity. We tested the hypothesis that antioxidant infusion during mechanical ventilation would function as an antioxidant to maintain redox balance within diaphragm muscle fibers and therefore prevent oxidative stress and subsequent proteolysis and cont...

BACKGROUND A diaphragmatic phonomyogram (PMG) evoked by maximal phrenic nerve stimulation at end expiratory lung volume (FRC) has been previously described as a good index of changes in diaphragmatic contractility with fatigue. A study was undertaken to assess whether this conclusion could be extended to different lung volumes. METHODS Diaphragmatic compound motor action potentials (CMAPs) we...

INTRODUCTION Many different prosthetic materials have been used for repair of large posterolateral congenital diaphragmatic hernias, which cannot be primarily repaired. Almost 50% of patch repaired diaphragmatic hernias will recur. The ideal prosthetic material for congenital diaphragmatic hernia repair has yet to be established. We report on two cases with unusual (calcification) and late comp...

Although life-saving, mechanical ventilation is associated with numerous complications. These include pneumonia, cardiovascular compromise, barotrauma, and ventilator-induced lung injury. Recent data from animal studies suggest that controlled mechanical ventilation can cause dysfunction of the diaphragm, decreasing its force-generating capacity--a condition referred to as ventilator-induced di...

Strenuous diaphragmatic contractions that are induced by inspiratory resistive breathing initiate an inflammatory response that involves the elevation of pro- and anti-inflammatory cytokines within the diaphragm, which may then spill into the circulation. The production of reactive oxygen species within working respiratory muscles increases in response to these strenuous diaphragmatic contracti...

BACKGROUND Traumatic diaphragmatic hernias (TDHs) are sometimes difficult to identify at an early stage and can consequently result in diagnostic delays with life-threatening outcomes. It is the aim of this case study to highlight the difficulties encountered with the earlier detection of traumatic diaphragmatic hernias. METHODS Clinical data of patients who received treatment for delayed tra...