Search Results (3,437)

Urban industrial complexes have been expanding worldwide, reducing the spatial separation between agricultural, residential, and industrial zones, particularly in developing nations. Urban road dust contamination, a sensitive indicator of urban environmental quality, primarily originates in urbanization and industrialization. Its detrimental impacts on human health arise not only from particulate matter itself but also from toxic and harmful substances embedded within dust particles. Toxic metals in road dust can pose health risks through inhalation, ingestion and contact. To investigate the seasonal patterns, bioaccessibility levels and the potential human health risks linked to toxic metals (Cadmium (Cd), Nickel (Ni), Arsenic (As), Lead (Pb), Zinc (Zn), Copper (Cu), and Chromium (Cr)), 34 dust samples were collected from key roads in proximity to representative industrial facilities in Wuhan’s Qingshan District. The study found that the concentrations of Cd, Pb, and Cu in road dust were within the limits set by the national standard (GB 15618-2018), while Ni and As were not. Seasonally, Ni, As, Pb, Zn, and Cr exhibited higher concentrations during the summer than in other seasons, whereas Cd levels were lowest in spring and highest in autumn, the opposite of Cu. According to the Simplified Bioaccessibility Extraction Test (SBET), the average bioaccessibility rates of toxic metals were Cd > Zn > Cu > Ni > Cr > As > Pb. An improved health risk assessment model was developed, integrating metal enrichment, bioaccessibility, and parameter uncertainty. Results indicated that Cd, Ni, Zn, Cu, As, and Cr posed no significant non-carcinogenic risk. However, for children, the carcinogenic risks of Cd and As were relatively high, identifying them as priority control metals. Therefore, it is recommended to periodically monitor As and Cd and regulate their potential emission sources, especially in winter and spring. Full article

The lung is increasingly recognized as an organ with dual endocrine and respiratory roles, participating in a complex bidirectional crosstalk with systemic hormones and local/paracrine activity. Endocrine and paracrine pathways regulate lung development, ventilation, immunity, and repair, while pulmonary cells express hormone receptors and secrete mediators with both local and systemic effects, defining the concept of the “endocrine lung”. This narrative review summarizes current evidence on the endocrine–pulmonary axis. Thyroid hormones, glucocorticoids, sex steroids, and metabolic hormones (e.g., insulin, leptin, adiponectin) critically influence alveologenesis, surfactant production, ventilatory drive, airway mechanics, and immune responses. Conversely, the lung produces mediators such as serotonin, calcitonin gene-related peptide, endothelin-1, leptin, and keratinocyte growth factor, which regulate vascular tone, alveolar homeostasis, and immune modulation. We also describe the respiratory manifestations of major endocrine diseases, including obstructive sleep apnea and lung volume alterations in acromegaly, immunosuppression and myopathy in Cushing’s syndrome, hypoventilation in hypothyroidism, restrictive “diabetic lung”, and obesity-related phenotypes. In parallel, chronic pulmonary diseases such as chronic obstructive pulmonary disease, interstitial lung disease, and sleep apnea profoundly affect endocrine axes, promoting insulin resistance, hypogonadism, GH/IGF-1 suppression, and bone metabolism alterations. Pulmonary neuroendocrine tumors further highlight the interface, frequently presenting with paraneoplastic endocrine syndromes. Finally, therapeutic interactions are discussed, including the risks of hypothalamic–pituitary–adrenal axis suppression with inhaled corticosteroids, immunotherapy-induced endocrinopathies, and inhaled insulin. Future perspectives emphasize mapping pulmonary hormone networks, endocrine phenotyping of chronic respiratory diseases, and developing hormone-based interventions. Full article

Background: Uncontrolled asthma remains a significant clinical challenge, often linked to impaired lung function and increased diaphragmatic workload. Recent studies have shown promising results using a triple inhaled therapy comprising beclomethasone dipropionate/formoterol fumarate/glycopyrronium (BDP/FF/G). This study assessed the real-world efficacy of BDP/FF/G on lung function and diaphragmatic workload in patients with uncontrolled asthma. Methods: A prospective observational study enrolled 21 adult patients diagnosed with uncontrolled asthma despite high-dose ICS/LABA therapy. Patients underwent lung function tests and right diaphragmatic ultrasound assessments at baseline and after three months of treatment with BDP/FF/G (172/5/9 mcg, administered as two inhalations every 12 h). Results: After three months, significant improvements were observed in FEV₁ (from 57.75 ± 12.30% to 75.10 ± 18.94%, p < 0.001) and FEF_25–75 (from 47.80 ± 19.23% to 75.10 ± 36.06%, p < 0.001). Additionally, during the same period, we recorded significant reductions in residual volume (from 130.10 ± 28.20% to 92.55 ± 21.18%, p < 0.001) and total airway resistance (R_tot) (from 164.60 ± 83.21% to 140.70 ± 83.25%, p < 0.05). The mean asthma control test (ACT) score increased by 5.6 points (p < 0.001), surpassing the established minimal clinically important difference (MCID) of 3 points and raising the cohort mean above the well-controlled threshold. The right diaphragmatic workload was significantly decreased, as shown by a reduction in thickening fraction (TF) (from 63.86 ± 17.67% to 40.29 ± 16.65%, p < 0.01). Correlation analysis indicated significant associations between diaphragmatic function and some lung function parameters (FEV₁, FEF_25–75, and R_tot). Conclusions: In this real-world pilot, triple BDP/FF/G was linked to improvements in airflow, hyperinflation, symptoms, and a reduction in diaphragmatic thickening fraction, indicating potential physiological benefit. Due to the small sample size, single-centre design, and 3-month follow-up, these results should be viewed as hypothesis-generating and need to be confirmed in larger, controlled, multicentre studies with longer follow-up. Full article

Lunar dust remains one of the most critical unresolved challenges to long-duration lunar missions. Its sharp, abrasive, and electrostatically charged particles are easily inhaled and can penetrate deep into the lungs, reaching the bloodstream and the brain. Despite airlocks and HEPA filtration systems, dust will inevitably infiltrate lunar habitats and threaten astronaut health. We present a novel patent protected helmet design. This system uses a multilayered, synergistic mitigation approach combining mechanical and electrostatic defenses. The mechanical system delivers HEPA-filtered, ionized air across the user’s face, while the electrostatic barrier repels charged particles away from the respiratory zone. These two systems work together to prevent dust from entering the user’s breathing space. Designed for use inside lunar habitats, this helmet represents a potential solution to an unaddressed, life-threatening problem. It allows astronauts to eat, talk, and sleep while maintaining a protected respiratory zone and provides targeted inhalation-level protection in an environment where dust exposure is otherwise unavoidable. This concept is presented at Technology Readiness Level 2 (TRL 2) to prompt early engagement and feedback from the scientific and engineering communities. Full article

Background/Objectives: Diabetic neuropathy (DN) is a prevalent complication of diabetes mellitus, affecting up to 50% of long-term patients and causing significant pain, reduced quality of life, and healthcare burden. Conventional treatments, including anticonvulsants, antidepressants, and opioids, offer limited efficacy and are associated with adverse effects. Emerging evidence suggests that cannabis, acting via the endocannabinoid system, may provide analgesic and neuroprotective benefits. This study evaluates the long-term effects of inhaled cannabis as adjunctive therapy for refractory painful DN. Inhaled cannabis exhibits rapid onset pharmacokinetics (within minutes, lasting 2–4 h) due to pulmonary absorption, targeting CB1 and CB2 receptors to modulate pain and inflammation. Methods: In this prospective, observational study, 52 patients with confirmed painful DN, unresponsive to at least three prior analgesics plus non-pharmacological interventions, were recruited from a single clinic. Following a 1-month washout, patients initiated inhaled medical-grade cannabis (20% THC, <1% CBD), titrated individually. Assessments occurred at baseline and annually for 5 years, including the Brief Pain Inventory (BPI) for pain severity and interference; the degree of pain relief; Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) score; HbA1c; and medication usage. Statistical analyses used repeated-measures ANOVA, Kruskal–Wallis tests, Welch’s t-tests, and Pearson’s correlations via Analyze-it for Excel. Results: Of 52 patients (mean age 45.3 ± 17.8 years; 71.2% male; diabetes duration 23.3 ± 17.8 years), 50 completed follow-up visits. Significant reductions occurred in BPI pain severity (9.0 ± 0.8 to 2.0 ± 0.7, p < 0.001), interference (7.5 ± 1.7 to 2.2 ± 0.9, p < 0.001), LANSS score (19.4 ± 3.8 to 10.2 ± 6.4, p < 0.001), and HbA1c (9.77% ± 1.50 to 7.79% ± 1.51, p < 0.001). Analgesic use decreased markedly (e.g., morphine equivalents: 66.8 ± 49.2 mg to 4.5 ± 9.6 mg). Cannabis dose correlated positively with pain relief (r = 0.74, p < 0.001) and negatively with narcotic use (r = −0.43, p < 0.001) and pain interference (r = −0.43, p < 0.001). No serious adverse events were reported; mild side effects (e.g., dry mouth or euphoria) occurred in 15.4% of patients. Conclusions: Inhaled cannabis showed sustained pain relief, improved glycemic control, and opioid-sparing effects in refractory DN over 5 years, with a favorable safety profile. These findings are associative due to the observational design, and randomized controlled trials (RCTs) are needed to confirm efficacy and determine optimal usage, addressing limitations such as single-center bias and small sample size (n = 52). Future studies incorporating biomarker analysis (e.g., endocannabinoid levels) could elucidate mechanisms and enhance precision in cannabis therapy. Full article

Airborne bacterial aerosols are a significant yet understudied component of intensive poultry farming, particularly in cold climates. This study characterized the concentration, size distribution, and community composition of airborne bacteria in closed-cage broiler houses during winter in Hebei Province, China. Air sampling was conducted at three growth stages (7, 21, and 35 days) and analyzed using culture-based methods and 16S rRNA sequencing. Culturable bacterial concentrations increased significantly with broiler age, from 1.1 × 10³ to 1.6 × 10⁴ CFU/m³. The particle size distribution shifted from a predominance of large particles (≥4.7 µm) at day 7 to a dominance of small, inhalable particles (<4.7 µm) thereafter. Sequencing revealed increasing bacterial richness and diversity with age, alongside significant community structural shifts. Predominant genera included Stenotrophomonas, Lactobacillus, and Ruminococcus. Notably, potential zoonotic pathogens (Shigella and Acinetobacter) were detected in later stages. This study provides critical insights into winter bioaerosol dynamics, highlighting implications for animal welfare, occupational health, and public health. Full article

Background/Objectives: Black hairy tongue syndrome (BHT) is characterized by structural epithelial changes and a dark discoloration on the surface of the tongue, causing a variety of symptoms such as xerostomia, altered taste, and nausea. Methods: Herein, we report a 70-year-old female patient with a history of Sjogren’s syndrome, rheumatoid arthritis, and occasional use of intranasal and inhaled corticosteroids, who presented with BHT exacerbated by consumption of colored beverages and carbohydrates. We also provide a review of the literature on published articles reporting cases of BHT syndrome. Results: Our patient’s condition improved after implementing dietary restrictions in combination with local care. A literature review revealed that the most common reported exposures and underlying conditions in patients with BHT were the recent administration of antibiotics, solid organ or hematologic malignancy, immunosuppressants, smoking, corticosteroids, autoimmune conditions, receipt of antidepressants, local radiation therapy, proton pump inhibitors, and alcohol. The majority of cases were successfully managed with the elimination of implicated factors when possible and local hygiene. Conclusions: Different factors may contribute to the development of BHT. Discontinuation of implicated medications together with measures for topical care constitute the most effective ways to achieve resolution. Full article

Background/Objectives: The post-COVID-19 condition frequently includes dysphonia. We aimed to assess objective and subjective voice disorders and short-term responses to multimodal therapy in patients with isolated post-COVID-19 dysphonia. Methods: This retrospective, single-center pre–post study screened 244 post-COVID-19 patients; a subset of 14 with isolated dysphonia underwent standardized assessment at baseline and at 1-month follow-up. Patient-reported outcomes (Voice Handicap Index, VHI; Voice-Related Quality of Life, V-RQOL) and endoscopic evaluation were performed using videolaryngostroboscopy (LVS) and high-speed videoendoscopy (HSV) with kymographic analysis to quantify parameters describing vocal fold oscillations. The treatment included short-term systemic corticosteroids, inhaled corticosteroids, hyaluronic-acid inhalations, and structured voice therapy. Results: At baseline, HSV revealed signs of glottal insufficiency—irregular and asymmetric vocal fold motion, reduced amplitude and pliability, a disrupted mucosal wave, and an increased open quotient. At follow-up, HSV showed increased oscillation, amplitude, and cycle regularity with reduced left–right asymmetry and phase differences; phonovibrograms displayed clearer and more structured patterns. Perturbation indices decreased across jitter and shimmer measures, and the mean fundamental frequency was lower. Improvements in instrumental measures aligned with better VHI and V-RQOL scores. Conclusions: In patients with persistent dysphonia after acute SARS-CoV-2 infection, comprehensive ENT evaluation with instrumental laryngeal assessment is warranted. Short-term multimodal management was associated with improvements in both HSV-derived measures and patient-reported outcomes; confirmation in controlled studies is needed. Full article

Background/Objectives: Correct inhalation technique (IT) is crucial in the management of airway obstructive diseases. However, inhaler misuse among patients is frequent. The aim of the study was to assess IT and analyze factors influencing inhalation errors in adults with asthma and COPD. Methods: This single-center case–control study involved 180 adults with asthma or COPD. IT was evaluated using a checklist of common errors, a four-grade dedicated scale, and peak inspiratory flow. Patients with correct and incorrect IT were compared across multiple factors, including demographics, disease duration and severity, motivation for treatment, spirometry results, cognitive function, visual or hearing disorders and prior training in inhaler use. Results: A total of 115 patients with asthma and 65 patients with COPD were analyzed. Among them, only 59 patients (32.8%) were treated with 1 inhaler. Sixty-eight patients (37.8%) used all their inhalers properly. Correct IT was observed more frequently among DPI compared to MDI users (p < 0.001). Only 76 patients (42.2%) reported previous training in IT. No differences were found between correct and incorrect inhaler users (MDI or DPI) regarding age, gender, education, treatment motivation, visual or hearing impairments or cognitive disorders. Among MDI users, those with correct IT more often read the drug leaflet (p = 0.015). Among DPI users, proper technique was associated with better self-assessment (p = 0.046) and a higher rate of prior inhalation training (p = 0.001). Conclusions: Most adults with asthma or COPD do not use their inhalers properly, particularly patients using MDI. Insufficient education in the field of proper IT is still a burning issue. Full article

Respiratory infections and chronic lung disease are major contributors to morbidity in children. Aztreonam lysine for inhalation (AZLI) delivers high local antibiotic concentrations while limiting systemic exposure; however, its safety in younger patients remains uncertain. This systematic review and meta-analysis searched MEDLINE, CENTRAL, and Google Scholar for randomized and observational studies reporting adverse events in children and adolescents (≤18 years) receiving AZLI, with no date limit. Fourteen studies were included. Most studies were moderate-to-high quality. Comparative analysis showed no clinically relevant increase in common adverse events relative to placebo or other inhaled antibiotics. The pooled relative risk for severe respiratory disorders (grade 3/4) was 1.65 (95% CI 1.07–2.57), suggesting a higher incidence of serious respiratory events, while a protective effect against decline in pulmonary function was observed (RR 0.70, 95% CI 0.54–0.90). Adverse events were generally mild; serious adverse events and hospitalizations were infrequent and comparable between groups. Cumulative prevalence estimates indicated that respiratory irritation occurred in 10–25% of patients, whereas systemic effects were uncommon. Overall, AZLI appears to have an acceptable tolerability and safety profile in children and adolescents, though careful monitoring is warranted, especially for severe respiratory events. Full article

Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), remains one of the most devastating infectious diseases worldwide, with rising multidrug resistance limiting the effectiveness of conventional treatments. Novel therapeutic approaches are urgently needed to complement or replace existing regimens. Among emerging candidates, antimicrobial peptides (AMPs) stand out as versatile molecules capable of exerting direct antimycobacterial effects while also modulating the host immune response. This review explores peptide-based strategies against TB, with a focus on four major axes of innovation. First, we examine host-directed pathways, including the vitamin D–cathelicidin axis and other immunomodulatory mechanisms and their regulatory role in the induction of endogenous AMPs such as cathelicidin LL-37, which contributes to host-directed defense. Second, we discuss peptide-based vaccines designed to elicit robust and durable protective immunity, representing a complementary alternative to classical vaccine approaches. Third, we highlight the synergistic potential of AMPs in combination with first-line and second-line anti-TB drugs, aiming to restore or enhance bactericidal activity against resistant strains. Finally, we analyze technological platforms, including nanocarriers and inhalable formulations, that enable targeted pulmonary delivery, improve peptide stability, and enhance bioavailability. By integrating molecular design, immune modulation, and advanced delivery systems, peptide-based strategies provide a multifaceted approach to overcoming the limitations of current TB therapy. Collectively, these advances position AMPs not only as promising standalone agents but also as key components in combination and host-directed therapies, with strong potential to reshape the future clinical management of tuberculosis. Full article

The enhancement of drug delivery into the lung surfactant is facilitated by research on the interaction between drugs and the lung surfactant. Drug designers must have a thorough theoretical understanding of a drug before performing clinical tests to reduce the experimental cost. The current study uses a coarse-grained molecular dynamics (MD) approach with the MARTINI force field to parameterize the corticosteroid drug mometasone furoate, which is used to treat lung inflammation. Here, we investigate the accurate parametrization of drug molecules and validate the parameters with the help of umbrella sampling simulations. A collection of thermodynamic parameters was studied during the parametrization procedure. The Gibbs free energy gradient was used to calculate the partition coefficient value of mometasone furoate, which was approximately 10.49 based on our umbrella sampling simulation. The value was then matched with the experimental and predicted the partition coefficient of the drug, showing good agreement. The drug molecule was then delivered into the lung surfactant monolayer membrane at the alveolar air–water interface, resulting a concentration-dependent drop in surface tension while controlling the underlying continual compression–expansion of alveoli that maintains the exhalation–inhalation respiratory cycle. The dynamical properties of the monolayer demonstrate that the drug’s capacity to diffuse into the monolayer is considerably diminished in larger clusters, and this effect is intensified when there are more drug molecules present in the monolayer. The monolayer microstructure analysis shows that the drug concentration controls monolayer morphology. The results of this investigation may be helpful for corticosteroid drug delivery into the lung alveoli, which can be applied to comprehend how the drug interacts with lung surfactant monolayers or bilayers. Full article

Micro- and nanoplastics (MNPs) are emerging environmental contaminants with increasing evidence of bioaccumulation in human tissues and potential toxicological effects. While extensive studies in the literature have investigated MNP exposure and health risks in adult populations, data specific to pediatric age remain scarce and fragmented. This narrative review represents the first integrated synthesis of current evidence on MNP exposure during early life, including the critical period of the first 1000 days, examining routes of absorption (oral, inhalational, dermal, and iatrogenic), biological distribution, and organ-specific effects in infants and children. Special attention is given to the presence of MNPs in pediatric lungs, thyroid, and intestinal microbiota, as well as to emerging non-invasive biomarkers for exposure assessment. The developing physiology of children, characterized by immature detoxification systems, critical windows of vulnerability, and prolonged life-course exposure, amplifies concern for long-term health consequences, including endocrine disruption, immune dysregulation, and neurodevelopmental impairment. This work fills a critical knowledge gap by consolidating pediatric data into a single comprehensive resource, and it is intended to serve both as a reference point for clinicians and researchers and a catalyst for future studies aimed at safeguarding child health in an increasingly plastic-contaminated world. Full article

The Centers for Disease Control and Prevention (CDC) classifies Bacillus anthracis as one of the most dangerous pathogens that may affect public health and national security. Due to its importance as a potential biological weapon, this bacteria has been classified in the highest category A, together with such pathogens as variola virus or botulinum neurotoxin. Characteristic features of this pathogen that increase its military importance are the ease of its cultivation, transport, and storage and its ability to create survival forms that are extremely resistant to environmental conditions. However, beyond bioterrorism, B. anthracis is also a naturally occurring pathogen. Anthrax outbreaks occur in livestock and wildlife, particularly in spore-contaminated regions of Africa, Asia, and North America. Spores persist for decades, leading to recurrent infections and zoonotic transmission through direct contact, inhalation, or consumption of contaminated meat. This work presents a new electrochemical method for detecting and quantifying B. anthracis in spore form using a selective immune reaction. The developed method is based on the thiol-modified electrodes that constitute the sensing element of the electrochemical system. Tests with the B. anthracis spore suspension showed that the detection limit for this pathogen is as low as 10³ CFU/mL. Furthermore, it was possible to quantify the analyte with a sensitivity of 11 mV/log (CFU/mL). Due to several features, such as low unit cost, portability, and minimal apparatus demands, this method can be easily implemented in field analyzers for this pathogen and provides an alternative to currently used techniques and devices. Full article

Background: Pulmonary hypertension (PH) in newborns is a rare but serious condition and potentially life-threatening disorder, often initially confused with congenital heart disease due to overlapping echocardiographic findings in the late third trimester. Evidence on prenatal predictors of postnatal PH is limited. We aimed to describe detailed third-trimester echocardiographic findings associated with postnatal PH in infants with prenatally suspected CoA based on a retrospective case series. Methods: We reviewed 18 years of fetal echocardiography (2004–2022) in a tertiary maternal–fetal–neonatal center. We identified fetuses with suspected coarctation of the aorta (CoA) in late gestation who were delivered at term (≥37 weeks) and had prolonged neonatal hospitalization (>10 days) without cardiac surgery or catheterization. Z-scores for cardiac dimensions were calculated. All examinations were performed by experienced fetal cardiologists. Postnatal evaluations confirmed PH based on echocardiographic and clinical findings. Results: Among 19,836 fetuses examined, 138 were prenatally suspected of CoA. In 70 cases, this diagnosis was not confirmed postnatally (false positives). Of these, eight infants (0.04% of the total cohort) developed postnatal PH. Postnatally, all eight neonates required intensive care. Prenatal features included ventricular/atrial disproportion (7/8), cardiomegaly (8/8), main pulmonary artery dilatation (10.2 ± 2.2 mm; Z-score +2.7 ± 1.3), tricuspid regurgitation (8/8), pulmonary regurgitation (4/8), and interventricular septal hypertrophy (>4.5 mm in 5/8). Postnatal evaluations confirmed PH based on echocardiographic criteria (elevated right ventricular pressure, septal flattening/bowing, right ventricular dilation or dysfunction, and abnormal shunt direction) combined with clinical compromise. All infants received prostaglandin E1 (PGE1) initially; none required extracorporeal membrane oxygenation-ECMO. Three died, while five survived with medical management (oxygen, inhaled nitric oxide, sildenafil). Conclusions: Specific functional abnormalities on late third-trimester echocardiography may indicate impaired pulmonary vascular adaptation and predict postnatal PH, particularly in cases initially suspected of CoA. Recognition and awareness of these findings can guide delivery planning, neonatal surveillance, and timely intervention. Prospective multicenter studies are needed to validate these associations and refine prenatal screening protocols. Full article