Tracheopathia osteochondroplastica: a case report illustrating the importance of imaging in this rare disorder.

Background: Tracheopathia osteochondroplastica (TPO) is an uncommon and benign abnormality of the cartilaginous tracheal wall. It is characterized by multiple calcified nodules in the submucosa of the trachea and main bronchi. This disorder can present as a wide range of nonspecific symptoms; therefore, TPO is usually found as an incidental finding during bronchoscopy. However, it does pose a risk for complicated intubations and recurrent respiratory infection. The etiology of the disease is unknown, and treatments are often only for symptomatic relief, if necessary. Case Description: In this report, we present a case of a 71-year-old woman who presents with chest pain and dyspnea on exertion. She has a history of takotsubo cardiomyopathy, and the symptoms have been persistent since the diagnosis over 6 months ago. A chest computed tomography (CT) demonstrated possible endobronchial lesions and minimal fibrosis. A bronchoscopy was completed following this observation, and it revealed nodular lesions on the cartilaginous rings of the trachea. She was diagnosed with TPO. The patient also has a history of gastroesophageal reflux disease (GERD) and reports relief from chest pain and dyspnea post-esophageal dilation for dysphagia. Conclusions: This case illustrates the relationship between esophageal, cardiac, and pulmonary symptoms, and highlights the role of imaging in the diagnosis of TPO. It also demonstrates a possible treatment option for symptomatic TPO that hasn't previously been discussed.

Cellular therapies for chronic ischemic heart failure.

The development of stem cell therapies for chronic ischemic heart failure is highly sought after to attempt to improve morbidity and mortality of this prevalent disease. This article reviews clinical trials that investigate stem cell therapy for chronic ischemic heart failure. To generate this review article, PubMed was searched using keywords "stem cell therapy heart failure" with the article type "Clinical Trial" selected on 10/04/2016. The raw search yielded 156 articles; 53 articles were selected for inclusion in the review between the original literature search and manual research/cross-referencing. Additional reviews and original articles were also manually researched and cross-referenced. Cellular-based therapies utilizing peripheral blood progenitor cells, bone marrow cells, mesenchymal stem cells, cells of cardiac origin, and embryonic stem cells have yielded mixed results, but some studies have shown modest efficacy. Skeletal myoblasts raised concerns about safety due to arrhythmias. Optimizing cell type and delivery method will be of critical importance in enhancing efficacy of therapy within various subsets of chronic ischemic heart failure patients. Although much more work needs to be done to optimize treatment strategies, developing stem cell therapies for chronic ischemic heart failure could be of critical importance to lessen the impactful health burden that heart failure has on patients and society.

Active Vaccines for Alzheimer Disease Treatment.

INTRODUCTION: Vaccination against peptides specific to Alzheimer disease may generate an immune response that could help inhibit disease and symptom progression. METHODS: PubMed and Scopus were searched for clinical trial articles, review articles, and preclinical studies relevant to the field of active Alzheimer disease vaccines and raw searches yielded articles ranging from 2016 to 1973. ClinicalTrials.gov was searched for active Alzheimer disease vaccine trials. Manual research and cross-referencing from reviews and original articles was performed. RESULTS: First generation Aß42 phase 2a trial in patients with mild to moderate Alzheimer disease resulted in cases of meningoencephalitis in 6% of patients, so next generation vaccines are working to target more specific epitopes to induce a more controlled immune response. Difficulty in developing these vaccines resides in striking a balance between providing a vaccine that induces enough of an immune response to actually clear protein sustainably but not so much of a response that results in excess immune activation and possibly adverse effects such as meningoencephalitis. CONCLUSIONS: Although much work still needs to be done in the field to make this a practical possibility, the enticing allure of being able to treat or even prevent the extraordinarily impactful disease that is Alzheimer disease makes the idea of active vaccination for Alzheimer disease very appealing and something worth striving toward.