ABSTRACT
In this chapter we will focus on the potential applications of IgY in human medicine, summarizing some of in vivo and in vitro studies that support them. Respiratory infections caused by viruses and bacteria have a major impact in human health, and are associated with other major underlying conditions, such as cardiopulmonary disorders. Influenza and SARS-CoV-2 are good examples of how the effective airborne transmission via droplets and aerosols enables rapid viral spread, that ultimately lead to seasonal epidemic or pandemic outbreaks. These together with a number of emerging viral disease urges the development of vaccine alternatives where IgY immnunotherapies could be included. Moreover oral passive neutralization of bacteria causing dental caries or even chronic gastric inflamation leading to cancer has been sucessfully shown with IgY and will be presented herein. Finally, the robustness of IgY to neutralize lethal toxins and venoms will also be covered. © Springer Nature Switzerland AG 2021. All rights reserved.
ABSTRACT
Historically, patients requiring mechanical ventilation support were precluded from lung transplant listing, attributable to increased short and long-term mortality. We present a case of successful bilateral lung transplant for a patient supported with mechanical ventilation for 10 months following an episode of COVID associated ARDS with resultant fibrosis. Our patient is a 65-year-old man with chronic respiratory failure secondary to COVID-19 associated ARDS and pulmonary fibrosis. He initially presented with acute hypoxic respiratory failure requiring intubation and later cannulation for VV-ECMO, which lasted 136 days. Due to severe critical illness myopathy, he remained ventilator dependent via tracheostomy and required a gastrostomy tube for nutrition. His course was further complicated by recurrent ventilator associated pneumonia (VAP) due to Pseudomonas Aeruginosa (PsA) and Stenotrophomonas Maltophilia as well as acute venous thromboembolism. Subsequently, the patient was transferred to our hospital for a lung transplant evaluation following persistent ventilator dependence for a total of nine months since his initial hospitalization. The primary barrier towards transplant listing was the patient's severe deconditioning and myopathy. Our patient underwent aggressive physical therapy, and by the time of listing, he was able to bear weight and walk three feet with physical therapy. The patient underwent bilateral lung transplant six days after listing. His course was complicated by ventilator associated pneumonia due to multi-drug resistant PsA. He required prolonged mechanical ventilator support post-operatively, but his tracheostomy was successfully decannulated on POD 38. He was discharged to an inpatient rehabilitation facility on post-op day 42 and discharged home around POD 70. He continues to follow-up and reports doing well with stable spirometry with no evidence of allograft rejection. This report describes the successful transplantation of a ventilator dependent patient for 10 months with associated severe myopathy. Despite our patient's high-risk status and severe myopathy, he demonstrated good rehabilitation potential with resulting good outcome post-transplantation. He is currently 19 months post-transplant, and his course has been uncomplicated since discharge. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)