Assessing the comparative effects of interventions in COPD: a tutorial on network meta-analysis for clinicians.

To optimize patient outcomes, healthcare decisions should be based on the most up-to-date high-quality evidence. Randomized controlled trials (RCTs) are vital for demonstrating the efficacy of interventions; however, information on how an intervention compares to already available treatments and/or fits into treatment algorithms is sometimes limited. Although different therapeutic classes are available for the treatment of chronic obstructive pulmonary disease (COPD), assessing the relative efficacy of these treatments is challenging.

Jet versus vibrating mesh nebulizer for tobramycin aerosol in spontaneously breathing children with tracheostomies - a simulation study.

Tracheostomy tubes act as foreign bodies, predisposing the surrounding airway to respiratory infections. Initial treatment for infections is topical - nebulized tobramycin - although guidelines for standardized treatment are lacking. To quantify tobramycin delivery to simulated, tracheostomized children to inform future administration guidelines.

Changing Paradigms in Asthma Management.

Asthma is a complex clinical syndrome characterized by airway inflammation that can cause variable, usually reversible airway obstruction and bronchial hyperreactivity. This illness has a spectrum from intermittent to persistent that has mild, medium or severe intensity. As our understanding of the underling inflammatory pathway grows, so too does our catalogue of advanced treatments (such as monoclonal antibodies), opening the path for treatment individually curated for patients.

Environmental impact of volatile anesthetics at a high complexity teaching hospital from 2019 to 2022: A quantitative analysis.

Background: The healthcare sector emits 5% of greenhouse gases worldwide, inhaled anesthetic agents have contributed to this effect for years. Other countries measured and limited their use, leading to positive environmental changes. There is a lack of data on Colombia.

Gyosaponin ameliorates sevoflurane anesthesia-induced cognitive dysfunction and neuronal apoptosis in rats through modulation of the PI3K/AKT/mTOR pathway.

Background: Sevoflurane (Sev) is an inhalational anesthetic for surgical procedures where it can trigger cognitive dysfunction and neuronal apoptosis. Gyosaponin (GpS) was studied for its effects on brain morphology and cognitive behaviors in Sev-anesthetized rats.

Methods: Male Sprague-Dawley rats were induced by 3 % Sev anesthesia, and 25 mg/kg and 100 mg/kg GpS were injected into the rats by tail vein.

Primary healthcare's carbon footprint and sustainable strategies to mitigate its contribution: a scoping review.

Background: The escalating climate crisis poses a significant threat to global public health. The healthcare sector, designed to protect human health is a major contributor to greenhouse gas emissions, and thus, a key driver of climate degradation. This paradox endangers both planetary and human health, making the decarbonization of healthcare, including primary care, critical.

Influence of liberal versus conservative oxygen therapies on the hemodynamic parameters of mechanically ventilated patients with sepsis: a randomized clinical trial.

Background: There is no significant evidence verifying the efficacy of liberal versus conservative oxygen therapy on hemodynamics in patients with sepsis. We investigated how liberal and conservative oxygen therapy influenced stroke volume, cardiac output, and vasopressor needs in patients with sepsis undergoing mechanical ventilation.

Methods: This randomized clinical trial included 106 patients with an admission diagnosis of infection, a Sequential Organ Failure Assessment (SOFA) score of two points or higher and required invasive mechanical ventilation for at least 72 h.

Mechanistic insights into sevoflurane-induced hippocampal neuronal damage and cognitive dysfunction through the NEAT1/Nrf2 signaling axis in aged rats.

The use of anesthetics during surgery can cause severe neurological damage and cognitive dysfunction in elderly patients. However, this health issue currently lacks corresponding therapeutic strategies. This research involved the utilization of single-cell RNA sequencing (scRNA-seq) and transcriptomic assessment to pinpoint crucial cell classifications and molecular pathways, as well as the lncRNA expression profiles, that undergo substantial alterations in aged rats experiencing sevoflurane-induced cognitive impairment.

TRPA1 contributes to respiratory depression from tobacco aerosol.

Transient receptor potential ankyrin-1 (TRPA1) is expressed in the trigeminal nerves in the nasal cavity. It detects irritant chemicals such as formalin and acrolein, induces respiratory depression to protect against further inhalation, and elicits avoidance behavior. Although tobacco smoke contains formalin, acrolein, and other irritant chemicals, the possible contribution of TRPA1 to protection against tobacco smoke has yet to be fully understood.

Toluene is a cerebral artery constrictor acting via BK channels.

Acute intoxication by toluene usually follows intentional inhalation to achieve a "high", which may lead to repeated use due to toluene's reinforcing properties. In both acute and chronic intoxication brain function is primarily affected. Neuronal and glial elements participate in toluene's reinforcing properties and chronic toxicity, yet the targets underlying acute toxicity remain unknown.

Biotransport and toxic effects of micro- and nanoplastics in fish model and their potential risk to humans: A review.

The growing body of scientific evidence suggests that micro- and nanoplastics (MPs/NPs) pose a significant threat to aquatic ecosystems and human health. These particles can enter organisms through ingestion, inhalation, dermal contact, and trophic transfer. Exposure can directly affect multiple organs and systems (respiratory, digestive, neurological, reproductive, urinary, cardiovascular) and activate extensive intracellular signaling, inducing cytotoxicity involving mechanisms such as membrane disruption, extracellular polymer degradation, reactive oxygen species (ROS) production, DNA damage, cellular pore blockage, lysosomal instability, and mitochondrial depolarization.

Environmental exposure to common pesticide induces synaptic deficit and social memory impairment driven by neurodevelopmental vulnerability of hippocampal parvalbumin interneurons.

Environmental exposure to pesticides at levels deemed safe by regulatory agencies has been linked to increased risk for neurodevelopmental disorders. Yet, the mechanisms linking exposure to these disorders remain unclear. Here, we show that maternal exposure to the pesticide deltamethrin (DM) at the no observed adverse effect level (NOAEL) disrupts long-term potentiation (LTP) in the hippocampus of adult male offspring three months after exposure, a phenotype absent in female offspring.

Self-crystal electret poly(lactic acid) nanofibers for high-flow air purification and AI-assisted respiratory diagnosis.

Particulate matters (PMs), one of the major airborne pollutants, continue to seriously threaten human health and the environment. Here, a self-crystal-induced electret enhancement (SCIEE) strategy was developed to promote the in-situ electret effect and polarization properties of electrospun poly(L-lactic acid) (PLLA) nanofibers. The strategy specifically involved the elaborate pre-structuring of stereocomplex crystals (SCs) with uniform dimensions (∼300 nm), which were introduced into PLLA electrospinning solution as the electrets and physical cross-linking points of high density.

A survey of physicians, biomedical researchers and college-educated adults in urban north India about inhaled therapies.

We surveyed 15 persons with a medical qualification, 133 graduate students doing biomedical research and 56 students or working people with a college education in any discipline. Questions were designed to gauge awareness about inhaled therapies for tuberculosis (TB), non-tubercular mycobacterial lung disease (NTM-LD) and idiopathic pulmonary fibrosis (IPF). Respondents from six cities in North India, aged between 21 and 57 years answered 20 questions.

Smoking carcinogen induced inflammation promotes lung carcinogenesis via IRAK4 activation.

Purpose: Even though smoking is associated with lung cancer, the exact molecular pathways that link carcinogens with inflammation and oncogenic transformation are not well elucidated. Two major carcinogens in cigarette smoke, Nicotine-derived nitrosamine ketone, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and benzo(α)pyrene (BaP) have not been tested in models that mimic inhaled exposure for prolonged periods of time.

Experimental Design: ICR mice were treated with intratracheal delivery of NNK and BaP (NB) for 18 months.

Metal Pneumonitis from "Non-toxic" Decorative Cake Dust Aspiration: A Case Report.

Introduction: Metallic luster dusts are decorative agents for cakes and other confections. While some powders are labeled "non-edible," they are also marketed as "non-toxic." We present a case of a child who developed acute metal pneumonitis after accidental aspiration of metallic luster dust.

Exosomes of different cellular origins: prospects and challenges in the treatment of acute lung injury after burns.

Acute lung injury (ALI) is a critical clinical disease caused by direct factors (inhalation injury, gastroesophageal reflux, ) or indirect factors (including infection, sepsis, burn, shock, trauma, acute pancreatitis, fat embolism, drug overdose, ). ALI is characterized mainly by diffuse interstitial and alveolar edema caused by an uncontrolled inflammatory response and damage to the alveoli-capillary barrier and has very high morbidity and mortality rates. Currently, there is no effective treatment strategy other than mechanical ventilation, fluid management or other supportive treatments.

Air versus supplemental oxygen for resuscitation of term or late preterm infants at birth.

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: Primary objective To assess the benefits and harms of air compared with supplemental oxygen for resuscitation of term or late preterm infants at birth in reducing rates of mortality and long-term neurodevelopmental impairment (NDI). Secondary objectives To assess whether the benefits and harms of air compared with supplemental oxygen differ according to different oxygen concentrations, gestational age (GA), whether oxygen was titrated to saturation curves and the income of the study country.

Myocardial Infarction Injury Is Exacerbated by Nicotine in Vape Aerosol Exposure.

Background: Vaping is touted as a safer alternative to traditional cigarette smoking, but the full spectrum of harm reduction versus comparable risk remains unresolved. Elevated bioavailability of nicotine in vape aerosol together with known risks of nicotine exposure may result in previously uncharacterized cardiovascular consequences of vaping. The objective of this study is to assess the impact of nicotine exposure via vape aerosol inhalation upon myocardial response to infarction injury.

Hydrogen gas inhalation prior to high-intensity training reduces attenuation of nitric oxide bioavailability in male rugby players.

Background: Inhalation of hydrogen gas (H) as an antioxidant supplement may alleviate exercise-induced oxidative damage and protect post-exercise hydrogen peroxide signaling, which may help mediate beneficial exercise adaptation. The aims of this study were to determine the effects of H inhalation on plasma nitric oxide (NO) level and its synthesis precursor in professional athletes.

Methods: A randomized, placebo-controlled, double-blind, crossover trial was conducted with professional male rugby players for 3 weeks.

First aid treatment and airway management for chemical burns combined with inhalation injury: A case report.

Chemical burns account for a small percentage of burn patients, and there are even fewer burn patients suffering from chemical burns combined with inhalation injury. As chemical substances corrode the airway, which leads to persistent necrotic shedding of the respiratory mucosa and scarring contracture as the airway heals, a proportion of patients develop airway stenosis, requiring more aggressive treatment or even surgery. A 38-year-old female chemical factory worker sustained an inhalation injury due to exposure to reactive substances (liquid and smoke) during production.

Efficacy of the intravenous formulation of fentanyl citrate administered orally as premedication in paediatric patients undergoing open cardiac surgery.

Background: Recently, fentanyl has become prevalent as a sedative premedication.

Methods: A non-inferiority parallel design quadruple-blinded randomised controlled trial of 1- to 7-year-old children scheduled for elective cardiac surgery was conducted. Participants were assigned a 1:1 allocation ratio to a control group ( = 50) given a parenteral formulation of midazolam 0.

Efficiency of combination therapy versus monotherapy for the treatment of infections due to carbapenem-resistant Gram-negative bacteria: a systematic review and meta-analysis.

Background: For resistant Gram-positive bacteria, evidence suggests that combination therapy is more effective. However, for resistant Gram-negative bacteria, no consensus has been reached. This study aims to comprehensively summarize the evidence and evaluate the impact of combination versus monotherapy on infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB).

Influence of an inspiratory muscle fatigue protocol on older adults on respiratory muscle strength, muscle oxygen saturation, and functional capacity: a randomized controlled trial.

Background: The fatigue of the inspiratory musculature, particularly the diaphragm, has been demonstrated to exert systemic effects on the body, impacting cardiovascular and performance outcomes. This study aimed to evaluate the influence of an inspiratory muscle fatigue protocol on respiratory muscle strength, functionality, and muscle oxygen saturation in older adults.

Methods: A single-blinded randomized controlled clinical trial was conducted on twenty-four older adults aged over 60 years, who met inclusion criteria were physically independent in terms of gait and functionality.