Recent North American trends point towards increased smoking of unregulated drugs and decreased injecting. While supervised consumption sites (SCS) offer a monitored environment for people who use drugs (PWUD), these sites have been less likely to accommodate inhalation in Canada. The objective of this study was to determine the factors associated with willingness to use supervised inhalation sites. We performed a cross-sectional survey of 499 PWUD in Edmonton, Canada. We used descriptive statistics to characterize willingness to use a supervised inhalation site and logistic regression to examine factors associated with willingness. Of 467 participants who reported smoking their drugs, the mean age was 43.7 years with 303 (64.9%) identifying as men and 320 (68.5%) identifying as Indigenous. A large proportion (64.9%, n = 303) of participants who smoked their drugs indicated a willingness to use a supervised inhalation site. While having overdosed by accident in the last 6 months (aOR = 2.70, 95% CI: 1.31-5.81) and having borrowed, lent or shared a pipe in the last 6 months (aOR = 2.22, 95% CI: 1.01-4.88) were both positively associated with willingness to use a supervised inhalation site, participants who stated that stimulants were the drugs smoked most frequently in the past 6 months (aOR = 0.43, 95% CI: 0.20-0.88) and those who reported always smoking in public places (aOR = 0.53, 95% CI: 0.28-0.97) were less likely to report willingness to use a supervised inhalation site. Our results outline significant interest among PWUD in supervised inhalation sites and suggest that individuals who have recently borrowed or shared a pipe or recently experienced an overdose would be more likely to use these sites. Implementation of these sites must include decolonizing approaches that create a welcoming space for Indigenous people.
Lung cancer remains a leading cause of cancer-related mortality worldwide, while the clinical utility of irinotecan-derived therapies is often constrained by poor drug solubility, suboptimal biodistribution, and systemic toxicity. To overcome these limitations, we developed polymeric nanomicelles co-loading 7-Ethyl-10-hydroxycamptothecin (SN38), the active metabolite of irinotecan, and quercetin, a naturally occurring flavonoid with intrinsic antitumor activity, for nebulized inhalation delivery. The dual-drug nanomicelles (SN38/QU-PPM) were prepared by nanoprecipitation and exhibited a uniform particle size distribution, excellent stability, and pH-responsive drug release under acidic conditions. In vitro studies demonstrated that quercetin co-loading enhanced cellular uptake of the nanomicelles and promoted intracellular accumulation of SN38, resulting in significantly greater cytotoxicity against LLC-Luc lung cancer cells compared with SN38-loaded nanomicelles alone. In an orthotopic lung cancer model, nebulized inhalation of SN38/QU-PPM achieved a 3.33-fold higher pulmonary SN38 concentration than intravenous administration at 24 h. Nebulized SN38/QU-PPM also exhibited superior antitumor efficacy, achieving a tumor inhibition rate of 80.7%, accompanied by increased apoptosis, reduced tumor cell proliferation. Histopathological examination and serum biochemical analyses indicated no apparent treatment-related abnormalities following inhalation administration. Collectively, SN38/QU-PPM delivered via nebulized inhalation represents an effective lung-targeted drug delivery strategy that enhances local drug exposure and potentiates the antitumor efficacy of SN38. This dual-drug nanomicelle platform holds considerable promise for the treatment of lung cancer through nebulized inhalation therapy.
Considering the increasing prevalence of pulmonary fibrosis (PF) and the increased exposure to risk factors contributing to its development, this study utilizes the bleomycin (BLM)-induced PF model to explore the potential early therapeutic strategies displayed by the bone marrow mesenchymal stem cells (BMMSCs) and their derived exosomes. The research assessed the efficacy of two administration methods: injection and inhalation by employing a comprehensive evaluation approach, including computed tomography imaging, biochemical assays, molecular analysis, and histopathological examinations. Fifty Wistar rats were divided into 5 groups; the CON group received saline intratracheally (IT) and served as the control group, the BLM group received IT BLM (5 mg/kg), the BMMSCs group received (BLM + BMMSCs in a dose of 106 cells per rat, I/P), the Exo-INJ group received (BLM + BMMSCs-derived exosomes 100 µg per rat I/P), and the Exo-INH group received (BLM + BMMSCs-derived exosomes 100 µg by inhalation). The oxidative status indicators, glutathione (GSH), glutathione peroxidase (GSH-Px), malondialdehyde (MDA), and the level of surfactant protein D (SP-D), a biomarker of lung damage, were evaluated. Furthermore, the level of genetic expression of inflammatory cytokines interleukin-10 (Il10), interleukin-1 beta (Il1b), pro-fibrotic and apoptotic markers, such as transforming growth factor-beta (Tgfb), Bcl-2-Associated X Protein (Bax), and fibroblast growth factor 2 (Fgf2), which functions as a growth factor to protect lung epithelial damage, were determined. Both BMMSCs and their derived exosomes exhibited antioxidant, anti-inflammatory, and regenerative properties and have early therapeutic effects against PF, underlining them as promising antifibrotic candidates. In addition, the inhalation approach demonstrated superior performance in a specific metric while yielding comparable results in another. Consequently, it cannot be regarded as the optimal strategy across all evaluation criteria. Therefore, more studies are required to substantiate its applicability and explore the potential improvement that could enhance its overall efficacy.
Carbon monoxide poisoning is one of the most common types of intoxication and is linked to a high mortality rate when not managed appropriately. We are discussing the case of a patient found unconscious after a house fire, presenting a smoke inhalation injury and particularly carbon monoxide poisoning. The clinical course was marked by the development of a massive bilateral pulmonary embolism despite thromboprophylaxis. This case highlights the increased thromboembolic risk, which can persist up to 90 days after carbon monoxide poisoning. We analyse the cardiovascular manifestations while focusing on the thromboembolic risks. Finally, we provide a brief overview of the pathophysiology and management of this condition. L’intoxication au monoxyde de carbone est l’une des causes les plus fréquentes d’intoxication et est liée à un taux de mortalité élevé en l’absence de prise en charge adéquate. Nous rapportons le cas d’un patient retrouvé inconscient après un incendie domestique, présentant une intoxication aux fumées et plus particulièrement au monoxyde de carbone. L’évolution a été marquée par la survenue d’une embolie pulmonaire massive bilatérale malgré une thromboprophylaxie. Ce cas illustre le risque thromboembolique accru qui peut persister jusqu’à 90 jours après l’intoxication au monoxyde de carbone. Nous décrivons les manifestations cardiovasculaires et, plus précisément, les risques thromboemboliques. Enfin, nous présentons un bref rappel de la physiopathologie et de la prise en charge de cette pathologie élusive.
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Tris(1-chloro-iso-propyl) phosphate (TCIPP) emerged as the predominant organophosphorus flame retardants (OPFRs) in both dust and air environments. This study investigated its respiratory toxicity using mouse inhalation model. Molecular docking and dynamics simulations revealed that TCIPP could binds to glutathione peroxidase 4 (GPX4) with an affinity of -5.3098 kcal/mol, stabilizing the protein conformation. Inhalation TCIPP exposure (34 μg/m3 for 1 h) significantly reduced GPX4 expression and GSH levels in lung tissue. Histopathological examination indicated severe pulmonary injury, including inflammatory cell infiltration, alveolar wall thickening and apoptosis after TCIPP inhalation. Besides, DHE staining revealed that the ROS level increased by 94.7% in the lung after TCIPP exposure. Meanwhile, the results revealed a 50.7% increase in lung iron content (Fe2+), along with elevated ferroptosis markers (p53, Transferrin Receptor 1 (TFR1)) and reduced FTH1 levels following TCIPP inhalation. These effects were counteracted by the ferroptosis inhibitor Fer‑1 (0.8 mg/kg), which also attenuated pathological damage, ROS accumulation, and NLRP3‑mediated pyroptosis. Concurrently, electron microscopy analysis demonstrated mitochondrial cristae membrane disruption and shrinkage, accompanied by dysregulated expression of mitochondrial dynamics regulators (down‑regulated Mfn1/2 and up‑regulated Drp1), all of which were reversed by Fer‑1. Collectively, the results indicate that TCIPP inhalation induces GPX4‑dependent ferroptosis, promoting inflammatory responses and mitochondrial imbalance, ultimately driving respiratory toxicity. Ferroptosis thus represents a potential therapeutic target for organophosphorus flame retardant‑associated lung injury, which may aid in biomarker discovery for related pulmonary diseases.
This meta-analysis was designed to compare airway complication rates between deep vs. awake laryngeal mask airway (LMA) removal in pediatric non-airway surgery, while discussing the impact of anesthetic agents, patient position and age. We systematically searched PubMed, Web of Science, and Cochrane Library to identify studies meeting the inclusion criteria. The primary outcome measured was the incidence of overall airway complications, which included laryngospasm, airway obstruction, desaturation, breath-holding, cough, and excessive secretions. Secondary outcomes included subgroup analyses stratified by patient positioning during LMA removal, inhalational anesthetic agents and age. Pooled analysis of 10 randomized controlled trials (RCTs) (n = 1,713) revealed no significant difference in overall airway complications (relative risk (RR) of 0.93, 95% confidence interval (CI) [0.65-1.32], p = 0.68) or specific outcomes (laryngospasm, desaturation, breath-holding, cough) between deep and awake LMA removal; however, deep removal was associated with a significantly higher airway obstruction risk and a lower incidence of excessive secretions. Subgroup analyses demonstrated that inhalational anesthetic agents type (sevoflurane/isoflurane) did not alter most complications but universally increased airway obstruction risk, whereas positioning during deep removal reduced secretions in both lateral/supine positions yet increased obstruction, with lateral positioning uniquely lowering desaturation risk. Notably, age did not modulate the airway obstruction risk profile: children under 6 years and over 6 years exhibited comparably elevated obstruction risks with deep removal. This meta-analysis suggests awake LMA removal is associated with lower airway obstruction risk than deep removal, which primarily reduces secretions. Given the higher clinical severity of obstruction, clinicians may prioritize its prevention. This finding appears consistent across age groups, though caution is advised for infants (<2 years) due to limited data. Lateral positioning may mitigate desaturation during deep removal. We suggest risk-stratified protocols, with lateral positioning and monitoring advised if deep removal is performed.
Occupational arsenic exposure (OEA), mainly through inhalation in workplace settings, is an established carcinogenic hazard associated with lung, skin, and bladder cancers. However, long-term trends and the global cancer burden attributable to OEA remain insufficiently characterized. Data from the Global Burden of Disease Study 2021 were used to analyze the cancer burden attributable to OEA from 1990 to 2021. Indicators included summary exposure values (SEVs), deaths, years lived with disability (YLDs), and disability-adjusted life years (DALYs) at global, regional, and national levels. Estimates were reported with 95% uncertainty intervals (UIs) generated from 1000 Monte Carlo simulations. Age-standardized indicators, Joinpoint regression, inequality analysis, decomposition analysis, and frontier analysis were used to assess spatiotemporal trends, drivers, and disparities. Seven forecasting models were evaluated to predict trends from 2022 to 2036. Between 1990 and 2021, global OEA SEV increased from 0.408% to 0.496% (average annual percentage change [AAPC] = 0.288). Cancer deaths rose from 5.5 to 10.5 thousand, YLD from 1.5 to 3.3 thousand, and DALYs from 169.6 to 298.7 thousand. In contrast, age-standardized death rate (AAPC = -0.300) and DALYs rate (AAPC = -0.531) declined. Men bore higher overall burdens, but women experienced faster increases (AAPC 0.428 vs 0.171). High-socio-demographic index (SDI) countries showed continuous improvement, whereas middle- and low-SDI regions-particularly East, South, and Southeast Asia-experienced substantial increases. In East Asia, the AAPCs for age-standardized SEVs, age-standardized death rates, age-standardized YLDs rates, and DALYs rates were 0.953, 1.067, 1.849, and 0.809, respectively. Inequality analysis indicated stable absolute gaps but reduced relative disparities, with burdens still concentrated in low-SDI countries. Decomposition suggested that population growth was the main driver of global burden increases, and frontier analysis highlighted limited improvement potential in low-SDI regions. Forecasting models indicated that the absolute burden of occupational arsenic exposure will continue to rise over the next 15 years. The cancer burden attributable to OEA is still increasing globally, with persistent prevention gaps and socioeconomic disparities. Focused interventions in low- and middle-SDI countries and rapidly industrializing regions are needed, including strengthened occupational exposure regulations, improved workplace arsenic monitoring, engineering controls, personal protective equipment, and regular health surveillance for workers in high-risk industries, to reduce inequalities and mitigate public health threats.
In vitro hepatic metabolic clearance data were generated for a diverse set of 207 chemicals to advance the collaborative initiative to establish an internal Threshold of Toxicological Concern (iTTC). The data reported herein are being used for chemical-specific physiologically based pharmacokinetic (PBPK) modeling to convert oral No Observable Adverse Effect Levels (NOAELs) into estimates of internal exposure. Hepatocyte assays were conducted at two concentrations (0.1 and 1 µM) using cryopreserved cells from multiple species, ensuring applicability to existing mammalian toxicity studies. The metabolic clearance measurements across chemicals varied significantly, ranging from 0 to 4294 µL/min/106 cells at 0.1 µM and from 0 to 2351 µL/min/106 cells at 1 µM. A substantial proportion of the chemicals (68% at 0.1 µM and 62% at 1 µM) exhibited clearance values below 30 µL/min/106 cells. Additionally, we observed a strong correlation (R = 0.8) between intrinsic clearance (CLint) values determined at the two concentrations. These data contribute to establishing robust iTTC values that can be utilized for: (1) extrapolating from an oral in vivo study to dermal and inhalation exposures, (2) risk-based screening of aggregate exposures of a given substance from multiple routes of exposures, and (3) risk-based screening of human biomonitoring results.
Aspiration pneumonia (AP), a serious condition resulting from the inhalation of foreign materials into the lungs, is a significant concern for patients with compromised swallowing mechanisms, especially those with neurological disorders. Sialorrhea (hypersalivation) exacerbates the risk of aspiration, and botulinum neurotoxin type A (BoNT-A) has been identified as a potential treatment to manage sialorrhea. However, the direct impact of BoNT-A on reducing AP risk remains inadequately explored, particularly in adult populations. BoNT-A works by inhibiting the release of acetylcholine at the neuromuscular junction, thereby reducing salivary gland stimulation and saliva production. This review aims to evaluate the current state of research on the use of BoNT-A for managing sialorrhea and its potential to reduce AP risk, with a specific focus on the adult population. A comprehensive review of existing literature was conducted, focusing on the efficacy of BoNT-A in treating sialorrhea in both pediatric and adult populations. Studies were assessed for their findings on the impact of BoNT-A on drooling and related complications, including the risk of AP. Meta-analyses and individual studies were reviewed to summarize the current knowledge and identify research gaps. In pediatric patients, BoNT-A has been shown to effectively reduce sialorrhea, with several studies and meta-analyses demonstrating its efficacy in managing drooling associated with neurological conditions such as cerebral palsy. However, evidence linking BoNT-A directly to reduced AP risk is limited. In adults, while BoNT-A has been beneficial in managing sialorrhea associated with conditions such as Parkinson's disease and brain injuries, studies specifically exploring its impact on AP risk are lacking. Current evidence supports the efficacy of BoNT-A in managing neurological sialorrhea across both adult and pediatric populations. However, a critical gap exists in studies directly investigation whether BoNT-A reduces AP risk in adults with neurological disease.
Quality of life (QoL) in type 2 diabetes mellitus (T2DM) is frequently impaired by disease-related complications and symptoms. Aromatherapy has been proposed as a non-pharmacological means of improving QoL. This review evaluates randomized controlled trials (RCTs) of aromatherapy and QoL in adults with T2DM experiencing diabetes-related complications. The review was prospectively registered in PROSPERO (CRD42024625423) and reported according to PRISMA. Web of Science, PubMed, Scopus, CINAHL, Google Scholar and the Cochrane Library were searched between December 2024 and January 2025. Eligibility criteria followed the PICOS framework, and full database-specific search strings are reported. Two reviewers independently performed study selection, data extraction and quality appraisal using the Joanna Briggs Institute (JBI) checklist for RCTs. Owing to heterogeneity, the data were synthesized narratively. Four RCTs comprising 293 randomized participants were included; three enrolled patients with diabetic peripheral neuropathic pain and one patients with insomnia. Aromatherapy was delivered by massage in three trials and by inhalation in one. JBI scores ranged from 9 to 12 of 13 (three high, one moderate quality). Randomization, baseline comparability and analysis were adequate throughout, whereas allocation concealment was unclear in three trials and blinding was incomplete in the massage trials. All four trials reported significant QoL improvement. Aromatherapy may improve QoL in complicated T2DM, but the evidence is limited by few small trials and by susceptibility to performance and detection bias. Adequately powered, registered, placebo-controlled RCTs with concealed allocation and blinded outcome assessment are needed. The online version contains supplementary material available at 10.1007/s40200-026-02033-z.
Spray freeze-drying (SFD) is a cutting-edge technique for producing dry powders, ideal for pulmonary drug delivery, owing to its ability to generate porous microparticles with low density and excellent aerodynamic properties. The SFD process, involving atomisation, freezing, and drying, is particularly suited for formulating biologics, e.g., monoclonal antibodies (mAbs), due to its low-temperature conditions. However, the method poses challenges, including the potential denaturation of mAbs due to shear, freezing, and dehydration stresses during processing. Here, we investigated how formulation modulates mAb stability and delivery performance during and after SFD processing. A model mAb was spray freeze-dried in the presence of selected stabilizing excipients, including sugars/polyols, amino acids, cyclodextrins, and surfactants. MAb chemical stability was assessed by size exclusion chromatography after the SFD process to study the strength of the formulations in each stage. The resulting inhalable mAb powders demonstrated favourable aerodynamic properties, rapid dissolution rates, and stability under various storage conditions. Notably, trehalose combined with either leucine or HPβCD effectively preserved mAb stability throughout the SFD process, ensuring high fine particle fractions (50-60%), and good physical stability of the powders. The optimised dry powder was successfully administered to rats via inhalation, as evidenced by lung deposition and systemic exposure, supporting the suitability of inhaled mAb-based therapeutics. This work elucidates key formulation-process interactions governing the pulmonary delivery of inhalable mAbs and demonstrates how rational excipient design enables the production of stable, inhalable biologic dry powders via SFD.
In recent decades, concerns about microplastics increased as an important issue in the fields of environment and public health. This research evaluates the level of inhalation exposure to microplastics and examines their presence in the indoor air and nasal lavage fluid of beauty salon employees, both at home and during working hours in the salon. A total of 36 indoor air samples and 18 nasal lavage fluid samples were collected and analyzed. The results indicated the abundance of microplastics in the indoor air of beauty salons, and homes with mean values of 99.38 ± 4.1 and 36.61 ± 3.05 MPs/m3, respectively. Microplastics were also found in the nasal lavage samples of beauty salon workers and in homes, with the concentrations ranging from 12.33 to 23.78MP/ml and 9.32 to 20.12MP/ml, respectively. The average daily exposure to microplastics in homes, and beauty salons was calculated to be 211.55 ± 109 and 572.166 ± 238MPs/day, respectively. This research highlights the importance of reducing potential health hazards associated with microplastic exposure in these environments. The online version contains supplementary material available at 10.1007/s40201-026-00999-9.
Construction dust is a major source of air pollution and easily causes intractable respiratory diseases such as pneumoconiosis. Dust suppressants are effective for dust control, yet most existing studies only focus on dust suppression performance, lacking systematic toxicological assessments, especially data on extrapulmonary multi-organ toxicity. In this study, SPF male C57BL/6 mice were used to establish three subchronic inhalation exposure groups: dust alone, dust suppressant alone, and co-exposure of dust and suppressant. Indicators including body weight, organ coefficients, blood routine, serum cytokines, and liver, kidney, and heart pathological lesions were detected to investigate the extrapulmonary multi-organ toxicity of an eco-friendly composite dust suppressant. The suppressant had little effect on mouse body weight. At appropriate concentrations (4-20 mg/m3), it inhibited dust-induced inflammatory responses and alleviated liver and kidney injuries. When the concentration reached 100 mg/m3, the suppressant interacted with dust to increase DNA oxidative damage markers, indicating potential genotoxic risks. This study fills the gap in extrapulmonary toxicological research of dust suppressants, provides references for toxicology evaluation and experimental basis for determining safe application concentrations on construction sites.
Coastal waters impacted by fecal contamination pose health risks to recreational users through direct water contact; however, risk to users, workers and surrounding communities from potential airborne exposure remain poorly understood. This study quantified two human-associated sewage markers (HF183 and pepper mild mottle virus (PMMoV)) and two enteric viruses (norovirus GII (NoVGII) and human adenovirus (HAdV)) in paired water and air samples collected in San Diego County, USA, from the Tijuana River, a binational river flowing into the US from Mexico that is polluted with untreated and treated wastewater, a community site on the beach (Imperial Beach), and a northern reference site (La Jolla Shores). A total of 23 paired water and air samples were collected during the dry season, with 10 water samples collected during the wet season. All microbial targets were consistently detected at high concentrations in the Tijuana River water, while concentrations in Imperial Beach water were significantly lower. In contrast, airborne concentrations were comparable between the two sites, with PMMoV detected in all air samples. Log-transformed ratios of the concentrations in air and water samples indicate enrichment in the air samples from Imperial Beach compared to the Tijuana River. PMMoV showed the most consistent detection and the strongest relationship with airborne HAdV and NoV levels, suggesting PMMoV as a conservative indicator of aerosolized viruses of human fecal origin in such settings. These findings indicate that coastal surf zones may serve as important interfaces for aerosolization of wastewater-associated microorganisms and suggest that inhalation could represent a previously underrecognized exposure pathway in contaminated coastal environments.
Cannabidiol (CBD) has gained sustained public, medical, and scientific attention in recent years. The prevalence of use of commercially available products containing CBD (CPC) is correspondingly high. Overview of the benefits and risks of CPC, taking into account certain aspects related to CBD as a pharmaceutical active ingredient. Selective literature search in the PubMed database. Currently, only one primarily CBD-containing drug is approved in Germany (Epidyolex®). CBD demonstrates good safety and tolerability. Elevated transaminases, sedation, decreased appetite, diarrhea, sleep disturbances, infections, and weight loss are possible side effects. CBD modulates the endocannabinoid system and interacts with numerous other molecular targets. CBD is metabolized via CYP2C19, CYP3A4, and UGT. The potential for pharmacokinetic interactions with CBD has not been well studied, but is theoretically high. The potential for abuse of CBD is negligible when administered orally, but should be investigated more thoroughly for inhalation and higher-dose use. Studies have found significant discrepancies between the stated and actual CBD content in many CPC; THC was frequently detected. There is no evidence supporting the health benefits typically claimed by manufacturers for ≤ 4.3 mg of oral CBD/kg/day, but there are indications of significant hepatotoxicity at ≥ 4.3 mg of oralCBD/kg/day. There is no robust evidence of health benefits associated with CPC. However, given the levels of exposure, product deficiencies, and the EFSA safety concerns, it must be assumed that there are relevant health risks (particularly hepatotoxicity) associated with the use of CPC. HINTERGRUND: Cannabidiol (CBD) hat in den letzten Jahren anhaltende allgemeine sowie medizinische und wissenschaftliche Aufmerksamkeit erlangt. Die Konsumprävalenz von kommerziell erhältlichen CBD-haltige Präparaten (KCP) ist entsprechend hoch. Übersicht über Nutzen und Risiken von KCP unter Beachtung einiger Aspekte, die CBD als pharmazeutischen Wirkstoff betreffen. Selektive Literaturrecherche in der Datenbank PubMeb. Aktuell ist nur ein primär CBD-haltiges Medikament in Deutschland zugelassen (Epidyolex®). CBD weist eine gute Sicherheit und Verträglichkeit auf. Transaminasenerhöhungen, Sedierung, Appetitminderung, Diarrhoe, Schlafstörungen, Infektionen und Gewichtsverlust sind mögliche Nebenwirkungen. CBD moduliert das Endocannabinoidsystem und interagiert mit zahlreichen weiteren molekularen Zielen. CBD wird über CYP2C19, CYP3A4 und UGT metaboliert. Das pharmakokinetisches Interaktionspotential von CBD ist nicht gut untersucht, theoretisch aber groß. Das Missbrauchspotential von CBD ist bei oraler Anwendung vernachlässigbar, sollte jedoch bei inhalativer und höher dosierter Anwendung stärker geprüft werden. In Studien fand sich bei vielen KCP eine ausgeprägte Diskrepanz zwischen angegebenem und tatsächlichem CBD-Gehalt; häufig konnte THC nachgewiesen werden. Es gibt keine die herstellerseitig typischerweise behaupteten gesundheitsbezogenen Vorteile von ≤ 4,3 mg oralem CBD/kg/d unterstützende Evidenz, aber Hinweise auf relevante Hepatotoxizität bei ≥ 4,3 mg oralem CBD/kg/d. Es gibt keine belastbare Evidenz für gesundheitsbezogene Vorteile von KCP. Unter Beachtung erreichbarer Expositionen, der Produktmängel sowie der Sicherheitsbedenken der EFSA müssen jedoch relevante Gesundheitsrisiken (v. a. Hepatotoxizität) bei der Anwendung von KCP angenommen werden.
Lactose (LA), the primary carrier in dry powder inhalers (DPIs), often exhibits excessive drug adhesion, which impairs aerosolization. In this study, four coating methods solid mixing, vapor deposition, suspension coating, and solution coating were evaluated to modify LA surfaces. Solution coating with leucine (Leu) proved optimal and was defined as Nanometer Layer Coating (NLC). When blended with jet-milled dexamethasone (DEX), NLC-LA increased the fine particle fraction from 20% to 50% and improved flowability, reducing Carr's Index to 24%. Reduced adhesion forces and increased surface smoothness of NLC-LA were confirmed by scanning electron microscopy, synchrotron radiation micro computed tomography and atomic force microscope. Continuous Leu coverage at nanometer-scale thickness was verified using Raman imaging, focused ion beam-scanning electron microscopy, time-of-flight secondary ion mass spectrometry, and synchrotron radiation x-ray microdiffraction. In vivo studies demonstrated that DEX DPI formulated with NLC-LA enhanced bioavailability and allowed a 30-fold dose reduction while maintaining therapeutic efficacy against high-altitude acute lung injury. Collectively, the NLC strategy bridges fundamental surface engineering with translational DPI performance, advancing inhalation science and formulation development.
The respiratory system, particularly the lungs, is highly vulnerable to various diseases due to the inhalation of contaminated air and the aspiration of drenches. This study aimed to determine the prevalence of gross lung abnormalities and their economic impact in cattle slaughtered at the Gondar ELFORA abattoir. A cross-sectional study was used in the study period between December 2023 and June 2024. Systematic random sampling was used to examine every fourth lung hung on the rail. A total of 382 lung samples were examined by visual inspection, palpation, and incision and analysed using descriptive statistical analysis, including calculation of prevalence and the χ2 test. The study showed that 231 (60.45%) of the lungs examined had one or more lesions. The prevalence of specific lung conditions was as follows: emphysema (18.06%; p value < 0.001), hydatid cyst (13.87%; p value < 0.001), atelectasis (7.33%; p value < 0.001), pulmonary abscess (6.54%; p value < 0.001), haemorrhage (5.75%; p value < 0.001), fibrosis (3.14%; p value = 0.004), calcification (2.87%; p value = 0.036), oedema (2.6%) and lung worm infestation (0%). Hydatidosis and emphysema were significantly influenced both by body condition and age (p < 0.05). Cattle with thin body conditions showed significant associations with both atelectasis (p = 0.029) and abscess (p = 0.001). In contrast, there was no significant association between age and atelectasis (X 2 = 1.4595; p = 0.227) and abscess (X 2 = 2.6145; p = 0.106). Of the affected lungs, 176 were condemned due to aesthetic concerns and suspected zoonotic risks, representing a total rejection rate of 46%. The estimated annual economic loss due to lung rejection was approximately $11,836.95 (1,850,115.30 ETB) per year. During the study period, nearly half of the lungs of slaughtered cattle were rejected due to zoonotic concerns and aesthetic values. The substantial rate of pulmonary lesions with a predominant rate of hydatidosis and emphysema resulted in a considerable rejection rate, implicating a critical public health concern. The significant rate of economic loss from this abattoir with low slaughter volume could indicate huge economic loss at the country level and the urgency of improving herd health management.
Malignant hyperthermia is a rare but potentially fatal complication of general anesthesia caused by inhalational anesthetics and depolarizing skeletal muscle relaxants. The mechanism of the disease involves an uncontrolled increase in skeletal muscle metabolism as a result of abnormal calcium regulation. Early diagnosis, immediate discontinuation of the triggering agent, and rapid administration of dantrolene are crucial for patient survival. We present the case of a 32-year-old man who underwent elective rhinoseptoplasty at a city 1-day surgery clinic where dantrolene was not available. During the procedure, the patient experienced an increase in body temperature, followed by cardiac arrest. The patient was transferred to the emergency department of a tertiary care university hospital, where dantrolene treatment was initiated and the patient was qualified for extracorporeal cardiopulmonary resuscitation. Despite several hours of intensive care, the patient died.
Microplastics (MPs) are pervasive environmental contaminants with potential implications for human health. Although inhalation is considered a major route of exposure, most investigations have focused on the lower respiratory tract, leaving the upper airway relatively understudied. Recent studies have detected MPs in nasal lavage fluid, specimens from patients with allergic rhinitis, tissue from patients with chronic rhinosinusitis, and the olfactory bulb of the human brain. Concerns have also been raised that synthetic polymerbased medical devices, including nasal irrigation bottles and continuous positive airway pressure systems, may contribute to upper airway exposure. This review summarizes current evidence on the detection and characterization of MPs in the human nasal cavity and upper airway, discusses environmental and medical device-related exposure pathways, and examines emerging implications for rhinologic diseases. Methodological limitations and priorities for future research are also reviewed.