-
BMC Public Health Sep 2023Well-designed public health interventions ideally aspire to reduce health disparities between racial and ethnic groups. Yet, there remains virtually no research...
BACKGROUND
Well-designed public health interventions ideally aspire to reduce health disparities between racial and ethnic groups. Yet, there remains virtually no research examining racial/ethnic disparities in interventions for marginalized perinatal populations with substance use disorders (SUD). We sought to examine whether there were racial/ethnic differences at intake, in retention, and in program outcomes among pregnant or postpartum women with prenatal substance use enrolled in a three-year intensive case management intervention. We hypothesized that: (1) at baseline, numerous racial/ethnic disparities in well-being, health, and health care would be observed, and (2) after the three-year intervention few racial/ethnic disparities in maternal and child health and welfare would be found.
METHODS
We used self-reported data from 3,165 women aged 18 to 45 years enrolled in the Parent-Child Assistance Program in Washington State between May 10, 2006, and September 21, 2017. We used Fisher-Freeman-Halton Exact Tests and t-tests to compare racial/ethnic groups at program enrollment and exit and logistic regression to examine likelihood of completing the intervention by group, controlling for other factors.
RESULTS
Despite numerous racial/ethnic differences at enrollment, there were no such differences in outcomes among those who finished the program and completed an exit interview. Different racial/ethnic groups received comparable case manager time. American Indians/Alaska Natives were less likely to finish the program (Adjusted Odds = 0.66).
CONCLUSIONS
Participants who finished the program achieved comparable outcomes regardless of race/ethnicity. More work is needed to understand why American Indian/Alaska Native women were less likely than the others to finish the program and to close this service gap.
Topics: Child; Pregnancy; Humans; Female; Case Management; Mothers; Washington; Ethnicity
PubMed: 37730578
DOI: 10.1186/s12889-023-16670-z -
Biotechnology and Bioengineering Jan 2024The Coalition for Epidemic Preparedness Innovations' "100-day moonshot" aspires to launch a new vaccine within 100 days of pathogen identification, followed by...
The Coalition for Epidemic Preparedness Innovations' "100-day moonshot" aspires to launch a new vaccine within 100 days of pathogen identification, followed by large-scale vaccine availability within the "second hundred days." Here, we describe work to optimize adenoviral vector manufacturing for rapid response, by minimizing time to clinical trial and first large-scale supply, and maximizing output from the available manufacturing footprint. We describe a rapid virus seed expansion workflow that allows vaccine release to clinical trials within 60 days of antigen sequence identification, followed by vaccine release from globally distributed sites within a further 40 days. We also describe a perfusion-based upstream production process, designed to maximize output while retaining simplicity and suitability for existing manufacturing facilities. This improves upstream volumetric productivity of ChAdOx1 nCoV-19 by approximately fourfold and remains compatible with the existing downstream process, yielding drug substance sufficient for 10,000 doses from each liter of bioreactor capacity. This accelerated manufacturing process, along with other advantages such as thermal stability, supports the ongoing value of adenovirus-vectored vaccines as a rapidly adaptable and deployable platform for emergency response.
Topics: Humans; Adenoviridae; Adenovirus Vaccines; ChAdOx1 nCoV-19; Bioreactors; Disease Outbreaks
PubMed: 37747758
DOI: 10.1002/bit.28553 -
Annals of Agricultural and... Mar 2024This case report describes a case of exogenous lipoid pneumonia (ELP) resulting from the inhalation of a lipoid substance. Lipoid pneumonia, also known as cholesterol...
INTRODUCTION
This case report describes a case of exogenous lipoid pneumonia (ELP) resulting from the inhalation of a lipoid substance. Lipoid pneumonia, also known as cholesterol pneumonia or golden pneumonia, is an uncommon inflammatory lung disease characterized by the presence of lipid-laden macrophages in the alveolar walls and lung interstitial tissue. Exogenous lipoid pneumonia occurs when substances containing lipids enter the airways through aspiration or inhalation, triggering an inflammatory response.
CASE REPORT
The patient in this case study was an 83-year-old woman with hypertension and diabetes mellitus who had been using paraffin oil as a mouthwash for an extended period. The diagnosis of exogenous lipoid pneumonia was established based on the patient's history of exposure to liquid paraffin oil, typical radiological findings, and histopathological examination.
Topics: Female; Humans; Aged, 80 and over; Pneumonia, Lipid; Mineral Oil; Lung; Oils; Paraffin
PubMed: 38549489
DOI: 10.26444/aaem/168783 -
Journal of Neuroscience Methods Sep 2023Vestibular schwannoma (VS) is a benign tumor arising from the Schwann cells of the eighth cranial nerve. The complexity in treatment is associated with unpredictable...
BACKGROUND
Vestibular schwannoma (VS) is a benign tumor arising from the Schwann cells of the eighth cranial nerve. The complexity in treatment is associated with unpredictable progression of this tumor. Some of the VS do not alter for years, while others rapidly increase in size. The mechanisms behind size progression are not well studied. Furthermore, despite several studies, there is no pharmacological treatment available for sporadic VS. Therefore, in vitro models are essential tools to study the cellular and molecular processes of VS. In addition, patient-derived cell cultures are important for substance screening to investigate pharmacological approaches in vitro.
NEW METHOD
This study presents a simple and fast method for culturing VS cells from patient tissue material obtained using a cavitron ultrasonic surgical aspirator (CUSA). In addition, the cells were characterized based on the expression of schwannoma markers, growth properties and screened for fibroblast contamination.
RESULT
We could show that CUSA obtained material is a suitable resource for isolation of VS primary cultures and enables real time analysis on living cells.
COMPARISON WITH EXISTING METHODS
To date, only a few protocols are available for culturing VS cells from patient tissue material. A disadvantage of these methods is the relatively large amount of tissue needed to obtain the primary cells, which can be difficult, especially in small VS. By obtaining the cells from the CUSA, there is the possibility to establish a primary culture even with limited material.
CONCLUSION
This approach could be particularly useful for testing substances that represent candidates for drug therapy of vestibular schwannoma.
Topics: Humans; Neuroma, Acoustic; Ultrasonics; Primary Cell Culture; Neurilemmoma; Schwann Cells
PubMed: 37611876
DOI: 10.1016/j.jneumeth.2023.109955 -
BMC Pulmonary Medicine Sep 2023Primary adenoid cystic carcinoma (AdCC) of the tracheobronchial tree is very rare with a high risk for recurrence and metastasis. The diagnosis of AdCC by histologic and...
BACKGROUND
Primary adenoid cystic carcinoma (AdCC) of the tracheobronchial tree is very rare with a high risk for recurrence and metastasis. The diagnosis of AdCC by histologic and immunohistochemical means has been well studied clinically. However, the identification of AdCC by cytologic features remains elusive due to the atypical features the cancer presents. This study aimed to describe the cytologic features of AdCC by using bronchial brushing, which could aid in distinguishing AdCC from other pulmonary carcinomas.
METHODS
The cytopathological features of bronchial brushing smears collected from seven cases were histologically diagnosed as AdCC. The defined cytologic features, which could potentially be diagnostic, were systemically analyzed.
RESULTS
Four out of the seven cytologic cases were inconcordance with the histologic diagnosis and cytologically classified as positive for malignant cells, small cell carcinoma, or atypical cells. Three cases showed a characteristic adenoid structure and magenta stroma forming globule, which was distinguished from the four cases. Cytologically, the above mentioned three cases were uniform with relatively small bland nuclei and little cytoplasm. In this study, only one case showed atypical polygonal medium-sized cells with conspicuous nucleoli.
CONCLUSIONS
Unlike fine-needle aspiration cytology, magenta stroma globules might offer an alternate clue for cytodiagnosis of AdCC clinically. Bronchial brushings cytology was more present in bland uniform cells with high nuclear to cytoplasmic ratios and background mucoid substance. More cases should be collected and confirmed using histopathology with careful film reading to reduce the rate of misdiagnosis.
Topics: Humans; Carcinoma, Adenoid Cystic; Rosaniline Dyes; Cytodiagnosis; Lung Neoplasms
PubMed: 37684618
DOI: 10.1186/s12890-023-02628-9 -
Cureus Jul 2023The symptoms of acute renal infarction (ARI) caused by atheroemboli are vague, making it rare. Early diagnosis of renal infarction can be made through contrast-enhanced...
The symptoms of acute renal infarction (ARI) caused by atheroemboli are vague, making it rare. Early diagnosis of renal infarction can be made through contrast-enhanced CT of the abdomen. However, diagnosing atheroemboli is more challenging. Kidney biopsy is the most accurate method to determine the cause, but it may not always be available in clinical settings. In cases where a thrombectomy is performed, white substances in thrombus aspiration or the patient's blood can suggest a diagnosis. Intervention is an effective technique, but there is controversy due to a lack of data, particularly in lobular artery infarction. We successfully treated one case using thrombus aspiration, and the specimens suggested atherosclerosis as the cause.
PubMed: 37575805
DOI: 10.7759/cureus.41842 -
Critical Care Explorations Sep 2023Ingestion and aspiration of caustic substances is a common problem in pediatrics and carries the risk of associated aspiration pneumonitis, laryngeal injury, and...
BACKGROUND
Ingestion and aspiration of caustic substances is a common problem in pediatrics and carries the risk of associated aspiration pneumonitis, laryngeal injury, and esophageal injury. Extracorporeal membrane oxygenation (ECMO) has been used to support adults with acute respiratory distress syndrome (ARDS) from aspiration of cement dust, however, literature outlining pediatric management in cases of alkali lung and airway injuries is lacking.
CASE SUMMARY
A 6-year-old boy presented with ARDS from cement aspiration requiring high-pressure ventilation. He had further complications of tracheal injury with subsequent pneumomediastinum secondary to the alkali burn. He required ECMO to facilitate repeat bronchoscopy for cement particle washout and to enable recovery from ARDS and tracheal injury.
CONCLUSION
This case highlights the need to perform early bronchoscopy and gastrointestinal endoscopy for injury assessment and foreign body removal in alkali burns. It also emphasizes the value of ECMO support for respiratory failure and facilitating bronchoalveolar lavage when it is not otherwise tolerated.
PubMed: 37644977
DOI: 10.1097/CCE.0000000000000969 -
European Journal of Case Reports in... 2023We present a rare case of large bilateral pleural effusion, pericardial effusion and pneumomediastinum caused by a peripherally inserted central catheter (PICC) line...
UNLABELLED
We present a rare case of large bilateral pleural effusion, pericardial effusion and pneumomediastinum caused by a peripherally inserted central catheter (PICC) line rupturing the left brachiocephalic vein, causing severe respiratory failure. The PICC line had been inserted with the aim of providing total parenteral nutrition (TPN). The patient developed symptoms within a day with effusions diagnosed on computer tomography pulmonary angiogram (CTPA). Bilateral pleural drains were inserted with a white milk-like substance drained consistent with TPN, prompting a further review of the CTPA revealing the mediastinal-positioned PICC line. The patient was transferred to the thoracic unit and was successfully managed with conservative measures. We propose some ideas such as the use of intracavitary electrocardiogram (IC-ECG) guidance as an adjuvant to obtain a correct and safe position.
LEARNING POINTS
PICC lines, although seen as safer, have potential for catastrophic adverse effects.The use of intracavitary electrocardiogram may be a safe adjunct and even an alternative to the use of a chest X-ray.Aspirating blood from all lumens with particular emphasis on the distal most lumen is very important.
PubMed: 37920225
DOI: 10.12890/2023_004103 -
Experimental and Therapeutic Medicine Oct 2023Inhalation of acid fumes and aspiration of liquid substances or gastric contents may not initiate dyspnea within several hours after exposure but may result in delayed...
Inhalation of acid fumes and aspiration of liquid substances or gastric contents may not initiate dyspnea within several hours after exposure but may result in delayed onset of alveolar edema. The present report presents three cases of inhalation or aspiration of chemical substances that resulted in acute respiratory distress syndrome (ARDS). Due to different underlying reasons, three patients developed ARDS resulting from chemical pneumonitis and pulmonary infection. From patients with dyspnea, dry rales could be heard in both lungs, with <92% percutaneous oxygen saturation at room air. All patients were treated using a high-flow nasal cannula and sivelestat sodium. Oxygenation gradually improved and the patients were discharged without adverse events. These cases suggest that early treatment with sivelestat sodium may improve the clinical outcomes of patients with ARDS.
PubMed: 37753302
DOI: 10.3892/etm.2023.12175 -
Journal of Microorganism Control 2024During the disinfection of indoor spaces using gaseous hypochlorous acid (HOCl), inhalation is the most common route of exposure for humans. In this study, an artificial...
During the disinfection of indoor spaces using gaseous hypochlorous acid (HOCl), inhalation is the most common route of exposure for humans. In this study, an artificial human respiratory tract model was exposed to 12-140 ppb HOCl at an aspiration flow rate of 800 mL/s for 15 h in a 1 m chamber. The respiratory tract model was equipped with 5th order bronchi and all gas-contact parts were made of silicone rubber with no other chlorine-consuming substances. The concentration of HOCl reaching the lung pseudo-space was approximately 47.4% of the HOCl concentrations in the chamber and was calculated to be very close to zero when the chamber concentration was less than 20.5 ppb. The disappearance of HOCl during inhalation is likely due to the adsorption of HOCl on the gas-contact silicone rubber surfaces. The cytotoxicity of HOCl on respiratory epithelial cells was also examined using human air-liquid-interface airway tissue models. Human nasal epithelium and bronchiolar epithelium were exposed to 100 ppb and 500 ppb HOCl for 8 h and 5 d, respectively. No significant effects of HOCl on cell viability and ciliary activity were observed in any cell type, indicating that low concentrations of HOCl, less than 500 ppb, had no cytotoxic effect.
Topics: Humans; Hypochlorous Acid; Gases; Silicone Elastomers; Epithelial Cells; Lung
PubMed: 38508761
DOI: 10.4265/jmc.29.1_39