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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 -
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 -
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 -
Respiratory Investigation Nov 2023Extrinsic lipoid pneumonia (ELP) results from the aspiration of lipid-containing substances. Tissue or cell histopathology after Oil-Red-O staining can confirm the...
Extrinsic lipoid pneumonia (ELP) results from the aspiration of lipid-containing substances. Tissue or cell histopathology after Oil-Red-O staining can confirm the diagnosis, which requires proper tissue handling and preparation during bronchoscopy. Here, we report a case of ELP in a quadriplegic patient with a long history of dysphagia and polyethylene glycol consumption. Computed tomography (CT) of the chest revealed multiple, progressively enlarging, fat-attenuated, nodular pulmonary lesions. Bronchoscopy with bronchoalveolar lavage (BAL) and a transbronchial forceps biopsy confirmed the diagnosis of lipoid pneumonia. We discuss the clinical, radiological, and pathological features of ELP and highlight the preparatory steps required for obtaining a successful diagnosis.
Topics: Humans; Pneumonia, Lipid; Polyethylene Glycols; Mineral Oil; Bronchoalveolar Lavage; Lung
PubMed: 37716285
DOI: 10.1016/j.resinv.2023.08.002 -
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 -
Clinical Journal of Oncology Nursing Mar 2023Standards of care and guidelines acknowledge insufficient evidence that defines frequency of flushing for implanted vascular access devices (IVADs). Manufacturers...
BACKGROUND
Standards of care and guidelines acknowledge insufficient evidence that defines frequency of flushing for implanted vascular access devices (IVADs). Manufacturers recommend 4 weeks, but guidelines suggest that extending to 12 weeks is safe based on functionality.
OBJECTIVES
The study reviewed current standards of care for IVAD flush maintenance frequency, examined the characteristics of blood from IVADs by aspirating and observing contents prior to flushing when maintenance care is delayed beyond four weeks, and identified whether more research is required to determine optimal IVAD maintenance flush frequency.
METHODS
An outpatient oncology clinic gathered data related to IVAD flush frequency during the COVID-19 pandemic. The concern was potentially harmful substances being flushed into the patient. A new method was developed to allow for observation of physiologic characteristics within the IVAD. Abnormal-appearing substances aspirated from the devices were discarded prior to use.
FINDINGS
Visible clots and alterations in color and appearance were observed in 25% of the 59 patients observed between 8 and 17+ weeks when the IVAD reservoir was aspirated prior to flushing.
Topics: Humans; COVID-19; Pandemics; Ambulatory Care Facilities; Evidence Gaps; Vascular Access Devices
PubMed: 37677837
DOI: 10.1188/23.CJON.165-171 -
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 -
Journal of Inflammation Research 2023Endothelial cells (ECs) are widely distributed inside the vascular network, forming a vital barrier between the bloodstream and the walls of blood vessels. These... (Review)
Review
Endothelial cells (ECs) are widely distributed inside the vascular network, forming a vital barrier between the bloodstream and the walls of blood vessels. These versatile cells serve myriad functions, including the regulation of vascular tension and the management of hemostasis and thrombosis. Inflammation constitutes a cascade of biological responses incited by biological, chemical, or physical stimuli. While inflammation is inherently a protective mechanism, dysregulated inflammation can precipitate a host of vascular pathologies. ECs play a critical role in the genesis and progression of vascular inflammation, which has been implicated in the etiology of numerous vascular disorders, such as atherosclerosis, cardiovascular diseases, respiratory diseases, diabetes mellitus, and sepsis. Upon activation, ECs secrete potent inflammatory mediators that elicit both innate and adaptive immune reactions, culminating in inflammation. To date, no comprehensive and nuanced account of the research progress concerning ECs and inflammation in vascular-related maladies exists. Consequently, this review endeavors to synthesize the contributions of ECs to inflammatory processes, delineate the molecular signaling pathways involved in regulation, and categorize and consolidate the various models and treatment strategies for vascular-related diseases. It is our aspiration that this review furnishes cogent experimental evidence supporting the established link between endothelial inflammation and vascular-related pathologies, offers a theoretical foundation for clinical investigations, and imparts valuable insights for the development of therapeutic agents targeting these diseases.
PubMed: 37641702
DOI: 10.2147/JIR.S418166 -
Vestnik Oftalmologii 2023Modern trends in advancement of phaco surgery techniques in patients with ectopia lentis (including patients with Marfan syndrome) are characterized by the transition...
Modern trends in advancement of phaco surgery techniques in patients with ectopia lentis (including patients with Marfan syndrome) are characterized by the transition from complete removal of the lens (lensectomy) to aspiration of the lens substance and attempts to preserve and reposition the capsular bag. This case study analyzes the results of surgical treatment of bilateral ectopia lentis in a 6-year-old patient with Marfan syndrome. The specifics of microinvasive phaco surgery consisted in capsular bag preservation and endocapsular fixation of the intraocular lens. The article presents the results of ophthalmological observation over a seven-year period.
Topics: Humans; Child; Ectopia Lentis; Marfan Syndrome; Lenses, Intraocular; Eye, Artificial; Lenses
PubMed: 37638573
DOI: 10.17116/oftalma202313904159 -
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