Gingival Crevicular Fluid and Placental Tissue Levels of Interleukin-17 as a Possible Marker for Preterm Labor in Patients with Chronic Periodontitis

Background:  The present study was conducted to evaluate the levels of interleukin (IL)-17 in gingival crevicular fluid (GCF) and placental tissue samples of pregnant females as a possible marker in determining whether or not an association exists between chronic periodontitis and preterm labor. Methods:  This case-control study included a random sample of 40 female patients, aged 18 to 35 years, who were assigned to one of the following four groups (10 subjects each): group 1 included patients who underwent spontaneous preterm birth (PB) and were diagnosed with chronic periodontitis upon clinical examination (preterm/periodontitis); group 2 included patients who underwent spontaneous PB and who had a healthy periodontium upon clinical examination (preterm/healthy periodontium); group 3 included patients who underwent spontaneous normal term birth and were diagnosed with chronic periodontitis upon clinical examination (term/periodontitis); and group 4 included patients who underwent spontaneous normal term birth and who had a healthy periodontium upon clinical examination (term/healthy periodontium). GCF and placental tissue samples were obtained from each patient and IL-17 levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: GCF levels of IL-17 were significantly higher (P=0.010) in patients with chronic periodontitis compared to those with a healthy periodontium. No significant differences were observed in IL-17 levels in placental tissue samples of all study groups. Conclusion: An association between chronic periodontitis and preterm labor could not be established based on IL-17 levels measured in the present study

Congenital diaphragmatic hernia and retinoids: searching for an etiology

Congenital diaphragmatic hernia (CDH) is a major life-threatening cause of respiratory failure in the newborn. Recent data reveal the role of a retinoid-signaling pathway disruption in the pathogenesis of CDH. We describe the epidemiology and pathophysiology of human CDH, the metabolism of retinoids and the implications of retinoids in the development of the diaphragm and lung. Finally, we describe the existing evidence of a disruption of the retinoid-signaling pathway in CDH

Congenital Diaphragmatic hernia – a review

Congenital Diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of diaphragm. The pathophysiology of CDH is a combination of lung hypoplasia and immaturity associated with persistent pulmonary hypertension of newborn (PPHN) and cardiac dysfunction. Prenatal assessment of lung to head ratio (LHR) and position of the liver by ultrasound are used to diagnose and predict outcomes. Delivery of infants with CDH is recommended close to term gestation. Immediate management at birth includes bowel decompression, avoidance of mask ventilation and endotracheal tube placement if required. The main focus of management includes gentle ventilation, hemodynamic monitoring and treatment of pulmonary hypertension followed by surgery. Although inhaled nitric oxide is not approved by FDA for the treatment of PPHN induced by CDH, it is commonly used. Extracorporeal membrane oxygenation (ECMO) is typically considered after failure of conventional medical management for infants ≥ 34 weeks’ gestation or with weight >2 kg with CDH and no associated major lethal anomalies. Multiple factors such as prematurity, associated abnormalities, severity of PPHN, type of repair and need for ECMO can affect the survival of an infant with CDH. With advances in the management of CDH, the overall survival has improved and has been reported to be 70-90% in non-ECMO infants and up to 50% in infants who undergo ECMO