Acute eosinophilic pneumonia (AEP) is a rare, potentially life-threatening pulmonary disease characterized by eosinophilic infiltration of the lung parenchyma. While usually idiopathic or associated to infectious or drug-induced etiologies, sertraline-induced AEP is exceedingly uncommon. We report a case of a 25-year-old female presenting with fever, dyspnea, and hypoxemic respiratory failure following 2 months of sertraline use and recent cigarette smoking initiation. Chest imaging revealed diffuse bilateral alveolo-interstitial infiltrates and bilateral pleural effusion. Extensive microbiological and autoimmune investigations were negative. Eosinophilia was identified in bronchoalveolar lavage (BAL) and pleural fluid cytology, suggesting the diagnosis of AEP. The patient required intensive care admission with non-invasive ventilation and bilateral pleural drainage, which significantly improved respiratory parameters. Discontinuation of sertraline and initiation of systemic corticosteroid therapy resulted in rapid clinical and radiological improvement. At follow-up, the patient remained asymptomatic with complete resolution of radiographic abnormalities and normalization of pulmonary function. This case underscores the importance of detailed drug history and multidisciplinary evaluation in diagnosing AEP. The temporal association between sertraline initiation and symptom onset, combined with eosinophilic findings, supports sertraline as the likely etiologic agent. While bilateral pleural effusions are common in AEP, reports of eosinophilic pleural involvement in drug-induced forms are rare. This case highlights the need for awareness of atypical drug-related causes of AEP. Sertraline-induced AEP is a rare, potentially life-threatening but reversible condition. Timely recognition and management are critical for favorable outcomes.

INTRODUCTION: Cystic fibrosis (CF), a prevalent autosomal recessive disorder, is characterized by chronic respiratory disease, pancreatic insufficiency, and increased oxidative stress due to mutations in the CFTR gene. Elexacaftor/tezacaftor/ivacaftor (ETI) therapy, by enhancing CFTR function, offers a new approach that not only improves pulmonary outcomes but also targets oxidative pathways contributing to CF pathophysiology.EVIDENCE ACQUISITION: A comprehensive literature search was conducted using databases such as PubMed and Cochrane Library, focusing on studies published from the early 2000s to October 2024. Keywords included “cystic fibrosis,“ “oxidative stress,“ and “ETI therapy.“ Study selection criteria centered on CF patients undergoing ETI treatment, with outcomes measured in terms of oxidative stress biomarkers, lung function, and quality of life.EVIDENCE SYNTHESIS: Collected data reveal significant reductions in oxidative stress markers like malondialdehyde (MDA) in patients treated with ETI, correlating with improved lung function and fewer exacerbations. The therapy’s effect on the lung microbiome also suggests potential synergies in reducing inflammation and oxidative stress. Longitudinal effects of ETI indicate its capacity to delay disease progression and reduce the incidence of comorbidities linked to CF.CONCLUSIONS: ETI represents a transformative advancement in CF treatment by addressing oxidative stress and improving clinical outcomes. Ongoing research into its long-term effects, personalized treatment strategies, and microbiome interactions could even further enhance its efficacy. This therapy should be widely integrated into clinical practice to optimize patient care and quality of life in CF.

miR-21, a microRNA extensively studied in pulmonary fibrosis, acts as a pivotal regulator of fibrotic processes. It plays a crucial role in fibroblast activation and promotion of epithelial-mesenchymal transition (EMT). It is overexpressed in fibrotic tissues, where it contributes to extracellular matrix production and disease progression by amplifying the TGF-β signaling pathway. Although the functions and molecular mechanisms of many miRNAs have yet to be determined, their aberrant expression plays a key role in the pathogenesis of diseases, including lung fibrosis. Therefore, this paper aims to review the specific role of miR21 in fibrotic process and the possible model to study the molecular mechanisms and the potential intervention to ameliorate lung fibrosis. The development of advanced ex-vivo models, such as precision-cut lung slices (PCLSs), represents a promising tool for elucidating the molecular mechanisms of miR-21 in fibrosis and accelerating the translation of these findings into innovative therapeutic approaches for clinical application.

Pulse oximetry is a critical, non-invasive tool in the management of patients within the emergency department. Its ability to provide immediate, continuous monitoring of arterial oxygen saturation and pulse rate makes it indispensable for early recognition of hypoxia, guiding oxygen therapy, and monitoring disease progression or response to treatment. This narrative review examines the technological underpinnings of pulse oximetry, highlights its diverse clinical applications in the emergency setting, and discusses known limitations such as reduced accuracy under conditions of hypoperfusion or skin pigmentation bias. Finally, we explore ongoing innovations, including the integration of artificial intelligence and wearable technologies, that promise to enhance the diagnostic and predictive utility of pulse oximetry in emergency medicine.

BACKGROUND: Inspiratory muscle training (IMT) has been widely used to enhance inspiratory muscle strength and pulmonary function. It may, therefore, have a role improving execution of wind musicians, however, this is largely unknown. This study investigated the impact of IMT on woodwind and brass players.METHODS: A cross-over randomized controlled study was conducted. Data on peripheral oxygen saturation, heart rate, electromyography-EMG, forced expiratory volume in the first second-FEV1, forced vital capacity-FVC and the ratio between FEV1/FVC, maximum inspiratory pressure-MIP, rate of perceived exertion and self-perceived levels of dyspnea were gathered before and after the intervention. Participants were also questioned about their instrumental study routines, daily habits and their experience with the IMT.RESULTS: Fourteen wind players, seven males and seven females, were included. Significant improvements in MIP were registered for time (F(1.26)=18.0, P<0.001, η2p=0.409) and for the interaction between time and groups (F(1.26)=12.9, P=0.001, η2p=0.331), with an increase in MIP scores favoring the EG. For the rate of perceived exertion a decrease was observed during performance with a significant difference, for time (F(1.26)=6.6, P=0.016, η2p=0.203) and for the interaction between time and groups (F(1.26)=5.1, P=0.033, η2p=0.163), favoring the EG.CONCLUSIONS: This study showed significant improvements in the MIP, decrease in the rate of perceived exertion after five-weeks of IMT in wind players. IMT may be effective in improving respiratory muscle strength in wind players.