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Use and limitations of clinical data in the identification and classification of low molecular weight chemicals (LMWCs) as respiratory sensitizers: recommendations for improvement.
Crit Rev Toxicol
January 2025
Syngenta, Bracknell, United Kingdom.
While progress has been made in recent years, there are still no suitable and accepted , or models that can be used to accurately predict whether a chemical substance has the intrinsic property to cause immune-mediated chemical respiratory allergy, typically manifested as allergic asthma or allergic rhinitis which represents a severe health hazard. Regulatory authorities have relied primarily on clinical evidence (case reports, clinical databases, worker exposure studies) to classify substances as respiratory sensitizers, but this evidence can lack a proven immunological mechanism which is necessary to identify substances which can cause life-long sensitization and clinically relevant allergic symptoms in the respiratory tract in an exposed population (such respiratory allergens may be considered as "true" sensitizers, in analogy to the definition of skin sensitization, and in contrast to respiratory irritants). In light of this, the European Center for Ecotoxicology and Toxicology of Chemicals convened a Task Force to evaluate the types of clinical methods and data sources and the implications of relying on such data for regulatory decision making from a scientific perspective.
View Article and Find Full Text PDFPrimary bronchial leiomyosarcoma: a diagnostic challenge.
BMC Pulm Med
January 2025
Department of Pathology, Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, P.R. China.
Background: Pulmonary bronchial leiomyosarcoma is an extremely rare malignant tumour of the lung originating from the mesenchymal tissue. The retroperitoneal region is the most common site of leiomyosarcoma. It exhibits a high degree of malignancy and a poor prognosis, thereby highlighting the significance of early diagnosis of this disease.
View Article and Find Full Text PDFComplicated foregut duplication cyst presenting as broncho-oesophageal fistula.
BMJ Case Rep
January 2025
Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Oesophageal duplication cysts are a subtype of foregut cysts, associated with the presence of ectopic gastric mucosa. Gastric acid secreted by this mucosa can lead to complications. We report one such unusual case of complication leading to the formation of broncho-oesophageal fistula in a duplication cyst.
View Article and Find Full Text PDFNasal myiasis: an infrequent cause of sinusitis in a critical care patient.
BMJ Case Rep
January 2025
Critical Care Department, Finis Terrae University Faculty of Medicine, Santiago, Chile.
A patient in his 70s, admitted to the cardiac intensive care unit with cardiogenic shock, unexpectedly presented with nasal myiasis during a workup for persistently elevated inflammatory markers. CT scans revealed sinusitis and bronchial secretions, while bronchoscopy identified mucus with positive pathogen testing. Nasal endoscopy was crucial in diagnosing myiasis, and immediate mechanical removal of larvae was performed.
View Article and Find Full Text PDFAssessment of respiratory function in children after kidney transplantation.
Pediatr Nephrol
January 2025
Childhood Chronic Diseases Department, University Hospital of Nantes, 7 Quai Moncousu, 44093, Nantes, France.
Background: Severe respiratory complications following kidney transplantation have been reported, yet remain poorly understood in the pediatric population. This study aimed to document respiratory disease in this population.
Methods: At annual follow-ups, patients completed a respiratory symptoms questionnaire and underwent pulmonary function tests (PFTs).
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