Thoracoamniotic shunt placement for a right-sided congenital diaphragmatic hernia complicated by hydrops

AbstractMortality associated with congenital diaphragmatic hernia (CDH) is high, and the role of prenatal management continues to evolve. We report a case of a right-sided CDH complicated by fetal hydrops successfully managed with thoracoamniotic shunt placement. Subsequent ultrasounds indicated resolution of hydrops. Despite preterm premature rupture of membrane and preterm delivery at 32 3/7 weeks gestation, the infant survived to hospital discharge at 2.5 months of life. This is the first case of a hydropic right-sided CDH successfully treated with a thoracoamniotic shunt

Peptide and Peptide-Like Modulators of 20S Proteasome Enzymatic Activity in Cancer Cells

The involvement of the ubiquitin–proteasome pathway in the degradation of critical intracellular regulatory proteins suggested a few years ago the potential use of proteasome inhibitors as novel therapeutic agents being applicable in many different disease indications, and in particular for cancer therapy. This article reviews recent salient medicinal chemistry achievements in the design, synthesis, and biological characterization of both synthetic and natural peptide-like proteasome inhibitors, updating recent reviews on this class of agents. As shown herein, different compound classes are capable of modulating the subunit-specific proteolytic activities of the 20S proteasome in ways not previously possible, and one of them, bortezomib, has provided proof-of-concept for this therapeutic approach in cancer clinical settings

Pilonidal Disease Mimicking Fistula-in-Ano in a 15-Year-Old Female

Pilonidal disease typically presents with an abscess or intermittent pain and drainage in the sacrococcygeal region during the pubertal years. Further examination typically reveals pits in the midline of the sacrococcyx area due to entrapment of hair with recurrent entrapment, infection, and drainage. The following paper describes an unusual presentation of a pilonidal cyst with fissure and perianal drainage

Magnetic Mini-Mover Procedure for pectus excavatum IV: FDA sponsored multicenter trial.

PurposeThe Magnetic Mini-Mover Procedure (3MP) is a minimally invasive treatment for prepubertal patients with pectus excavatum. This multicenter trial sought to supplement safety and efficacy data from an earlier pilot trial.MethodsFifteen patients with pectus excavatum had a titanium-enclosed magnet implanted on the sternum. Externally, patients wore a custom-fitted magnetic brace. Patients were monitored closely for safety. Efficacy was determined by the Haller Index (HI) and satisfaction surveys. After 2 years, the implant was removed.ResultsMean patient age was 12 years (range 8-14), and mean pretreatment HI was 4.7 (range 3.6-7.4). The device was successfully implanted in all patients. Mean treatment duration was 25 months (range 18-33). Posttreatment chest imaging in 13 patients indicated that HI decreased in 5, remained stable in 2, and increased in 6. Seven out of 15 patients had breakage of the implant's titanium cables because of fatigue fracture. Eight out of 13 patients were satisfied with their chest after treatment.ConclusionThe 3MP is a safe, minimally invasive, outpatient treatment for prepubertal patients with pectus excavatum. However, the magnetic implant design led to frequent device breakage, confounding analysis. The HI indicated mixed efficacy, although surveys indicated most patients perceived a benefit.Study type/level of evidenceCase series, treatment study. Level IV

Magnetic Mini-Mover Procedure for pectus excavatum IV: FDA sponsored multicenter trial.

PurposeThe Magnetic Mini-Mover Procedure (3MP) is a minimally invasive treatment for prepubertal patients with pectus excavatum. This multicenter trial sought to supplement safety and efficacy data from an earlier pilot trial.MethodsFifteen patients with pectus excavatum had a titanium-enclosed magnet implanted on the sternum. Externally, patients wore a custom-fitted magnetic brace. Patients were monitored closely for safety. Efficacy was determined by the Haller Index (HI) and satisfaction surveys. After 2 years, the implant was removed.ResultsMean patient age was 12 years (range 8-14), and mean pretreatment HI was 4.7 (range 3.6-7.4). The device was successfully implanted in all patients. Mean treatment duration was 25 months (range 18-33). Posttreatment chest imaging in 13 patients indicated that HI decreased in 5, remained stable in 2, and increased in 6. Seven out of 15 patients had breakage of the implant's titanium cables because of fatigue fracture. Eight out of 13 patients were satisfied with their chest after treatment.ConclusionThe 3MP is a safe, minimally invasive, outpatient treatment for prepubertal patients with pectus excavatum. However, the magnetic implant design led to frequent device breakage, confounding analysis. The HI indicated mixed efficacy, although surveys indicated most patients perceived a benefit.Study type/level of evidenceCase series, treatment study. Level IV