This study aims to describe patterns, sources, and reasons for cannabis use among cancer patients during active treatment (+CDTX) compared to no-use during active treatment (-CDTX). Data are from 385 surveys collected via REDCap during phase I of an ongoing study among adult cancer patients seen at an NCI-designated comprehensive cancer center within the last 5 years of treatment. A harmonized survey was created with 11 other NCI centers to assess cannabis use patterns, sources, and reasons for use. Sociodemographics and cancer details were also collected via self-report. Descriptive statistics were calculated and stratified by +/-CDTX. Chi-squared tests were conducted to compare proportions between groups. Among the sample [49.5 years (SD 15.9); 53.0% male; and 41.6% Hispanic/Latino], 41.0% + CDTX and 59.0% -CDTX. A majority (71.8%) of +CDTX initiated use before diagnosis versus 44.1% in -CDTX (p < 0.0001); patients diagnosed with stage 4 cancer had a statistically significant higher prevalence of +CDTX (60.0%; p = 0.003); 53.3% in radiation reported +CDTX compared to 42.8% in chemotherapy, and 36.4% in immunotherapy. Dispensaries and local dealers were the top sources of cannabis in both groups. Among +CDTX, 44.3% consumed cannabis at least once a day DTX, dominant cannabinoids used were CBD (35.2%), Delta-8-THC (18.3%), and CBD + THC ratio (14.1%); 12.7% were unsure what they consumed. Joints were the most common inhalation method (61.5%), and store-bought candy was the most common edible (39.2%). Depression/mood, pain, and enjoyment were the top three reasons for +CDTX compared to enjoyment, depression/mood, and nausea/upset stomach in -CDTX (p = 0.02). Patterns, sources, and reasons for cannabis use varied between +CDTX and -CDTX. Future studies should examine the impacts of cannabis and specific cannabinoids on cancer treatment, drug interactions, survival outcomes, and quality of life.

Pulmonary alveolar proteinosis (PAP) is a rare lung disease in which build-up of surfactant-derived lipo-proteinaceous material can cause respiratory failure. Effective treatment is paramount to saving lives and existing options include partial or whole lung lavage, however, as there are limitations to this the development of new treatment options is needed. Dr Ryushi Tazawa of Tokyo Medical and Dental University (TMDU) is a member of Japanese PAP multi-disciplinary research team which has been working on the potential to treat PAP through the inhalation of granulocyte-macrophage colony-stimulating factor (GM-CSF), an essential agent for maintaining biological functions of alveolar macrophages to clean up alveoli. Originally, Dr Koh Nakata and his colleagues found in 1999 that most patients with PAP have the autoantibody against GM-CSF. The anti-GM-CSF autoantibody blocks GM-CSF and deteriorates alveolar macrophages and alveolar cleanliness. GM-CSF inhalation would represent a simple treatment that can be prescribed on an outpatient basis and inhaled at home. It is believed that inhaled CM-CSF could help restore functions of impaired alveolar macrophages and renew alveolar macrophages. Following a pilot study published in 2005 and a phase II study in 2010, Dr Koh Nakata secured the budget for regulatory approval of GM-CSF inhalation therapy for autoimmune PAP (aPAP) and a clinical trial for the treatment in 2016. The Pulmonary Alveolar Proteinosis GM-CSF Inhalation Efficacy (PAGE) trial with twelve institutions nationwide successfully demonstrated the safety and efficacy of GM-CSF inhalation for aPAP. Based on PAGE trial data, Japanese pharmaceutical authority approved GM-CSF inhalation as a therapy for aPAP in 2024. The research team is currently interested in optimising the inhalation modes using mathematical models and a combination therapy of whole lung lavage and inhalation methods for severe cases.

Clinical signs of the presence of immune dysfunction/insufficiency, identified by questioning workers at the landfill for the storage and destruction of industrial toxic waste, were the basis for performing a screening study of immune status. This included a clinical blood test with determination of the leukocyte formula, assessment of the phenotypic status of lymphocytes for the main subpopulations, determination of the concentration in serum immunoglobulins of various classes, assessment of the migration activity of leukocytes, assessment of the microbicidal capacity of neutrophils and their ability to phagocytosis. When the examined employees were found to have more than 20% changes in the normative range of immune status parameters and the presence of combined disorders in different parts of immunoreactivity, in particular combined disorders in the cellular part of the immune system, it was the basis for conducting an in-depth stage of immunoepidemiological examination. This included determination of functional activity cellular elements of the adaptive component of immunity, assessment of the severity of autosensitization, assessment of the severity and specificity of atopic hypersensitization, assessment of cytokine status in normal conditions and in response to mitogen. When assessing the phenotypic status of immunoreactivity cells, it turned out that the absolute number of T lymphocytes (CD3+ phenotype), helper T lymphocytes (CD3+CD4+ phenotype) and killer T lymphocytes (CD3+CD8+ phenotype) was significantly reduced in the peripheral blood of test site employees (p ≤ 0.05, compared with similar indicators in the control group). On the contrary, the content of NK cells (CD3-CD56+ phenotype) tended to increase (both the absolute number and the proportion among other lymphocyte populations). Dysfunction of the cellular component of humoral immunoreactivity (a significant decrease in the absolute number of lymphocytes with the CD3-CD20+ phenotype [B lymphocytes] in the peripheral blood), as well as a significant increase in the concentration of serum IgA-class immunoglobulin and pronounced disimmunoglobulinemia in the serum of the examined individuals (compared to individuals in the control group ) indicated a predominantly inhalation method of exposure to immunotoxic industrial toxicants from the landfill on the immune system. Pathogenetically targeted immune-oriented therapy for the personnel of the test site was carried out with drugs that have thymomimetic activity (cytovir-3, thymogen) and are a means of replacement immunocorrection with a cytokine drug (genetically engineered recombinant yeast IL-2 [roncoleukin]). The established effectiveness of the immunotherapy, in particular the reduction in the incidence rate of various nosological forms of immune-related pathology among the site employees who received immunotherapy and the presence of an immunocorrective effect in the immunoactive drugs used for therapy, indicate the advisability of carrying out preventive medical measures in persons professionally exposed to xenobiotic influences as a component of improving medical provision.

Background: Several techniques had been developed to generate aerosolized medications during noninvasive ventilation (NIV) using variable inhalation methods. This study hypothesized that large spacers were more efficient significantly than small spacers and adapters during NIV. Objective: The main objective of this study was to compare the performance of newly developed spacers with standard T-piece in NIV chronic obstructive pulmonary disease (COPD) subjects. Methods: Sixty COPD subjects requiring NIV were included in this study. A dual-limb circuit was used, and the mode of ventilator was set in spontaneous volume-controlled mode. Dual-limb ventilation circuit, consists of inspiratory-limb and expiratory-limb, is pressure and volume controlled in response to subject expiration providing relatively high resistance to expiratory flow. Two experimental sets were evaluated: the first was introducing two preliminary pressurized metered-dose inhalers (pMDI) puffs before the nebulization of 1 ml of a respirable solution of salbutamol by vibrating mesh nebulizer (VMN) using Minimhal and Combihaler. The second was to only nebulize 1 ml of salbutamol respirable solution by VMN using Combihaler, Minimhal, and standard T-piece. Two urine samples were collected after aerosol delivery: urine sample after 30 min. (USAL0.5) as an indicator of lung deposition and all urine pooled 24 h (USAL24) post-inhalation as an indicator of systemic absorption. The amount of salbutamol extracted from urine samples was assayed by high-performance liquid chromatography. Results: Minimhal + pMDI + VMN delivered a higher percentage of salbutamol 30 min post-inhalation than Minimhal + VMN (p < 0.001). Also, Combihaler + pMDI + VMN delivered a higher percentage of salbutamol 30 min post-inhalation than Combihaler + VMN (p < 0.001). Combihaler + VMN delivered a higher percentage of salbutamol 30 min and 24 h post-inhalation than both Minimhal + VMN and T-piece + VMN (p < 0.001). Standard T-piece delivered the lowest aerosol amount delivered to the lung compared to both spacers (p < 0.05). Conclusions: Introducing two pMDI puffs significantly improved aerosol delivery by both spacers. Combihaler significantly improves aerosol delivery more than Minimhal.

Against the background of increasing antibiotic resistance among pathogens of bovine bronchopneumonia, interest in phagotherapy as a therapeutic tool is revived. Inhaled phagotherapy in turn has the potential to change the treatment regimen for bacterial respiratory infections, including those caused by antibiotic-resistant bacteria. Inhaled drug delivery tools allow the delivery of bacteriophages directly to the lesion. An important advantage, especially when it comes to bacteriophages, is the ability to use smaller doses of drugs than would be required if another route of administration were chosen. The article presents the results of evaluating the efficacy of the inhalation method of administration of commercial bacteriophage preparations in a mouse model. Mice were divided into five groups (1,2-animals exposed to &lt;I&gt;Klebsiella pneumonia&lt;/I&gt; infection and undergoing bacteriophage inhalation (n=6), 3-animals exposed to infection and not undergoing therapy (n=3), 4- control group of animals not exposed to infection (n=3)). Inhalations were performed using a compressor four-mode Neb-Aid inhaler (Flaem Nuova, Italy). Rapidflyam 2 nebuliser was used in mode I (particle size 0.8-2.0 μm). The results demonstrate the effectiveness of the developed therapy scheme, which allows further use of bactriophage-containing preparations in infectious diseases of animals.

Dysmenorrhea is pain during menstruation, caused by an imbalance of the hormones progesterone, prostaglandins, and stress or psychological factors. Although generally harmless, it can cause discomfort for women. Dysmenorrhea can be treated in various ways, one of which is with cinnamon aromatherapy which is one of the therapies of choice to treat dysmenorrhea in adolescent girls. Objective to determine the effect of cinnamon aromatherapy with inhalation method on dysmenorrhea pain intensity in female students at SMAN 1 Jogorogo Ngawi. This study used a pre-experimental design with a one group pretest-posttest design method with a total of 34 adolescent girls who experienced dysmenorrhea. The measuring instrument used NRS (Numeric Rating Scale) and data analysis using Wilcoxon Sign Rank test. The results of the study is the intensity of dysmenorrhea pain before being given cinnamon aromatherapy was dominated by moderate pain (85.3%) and the intensity of dysmenorrhea pain after being given cinnamon aromatherapy was dominated by mild pain (88,2%). The results of the Wilcoxon test showed a p value of 0.000 &lt;0.05, meaning that Ho was rejected and Ha was accepted. There is an effect of cinnamon aromatherapy with inhalation method on dysmenorrhea pain intensity in female students at SMAN 1 Jogorogo.

Purpose: Even after allergic rhinitis is diagnosed and treated, various symptoms such as runny nose, sneezing, and itchy nose recur periodically due to various environmental factors.Methods: This randomized controlled trial was conducted to confirm the effectiveness of mask-based aromatherapy as a method of alleviating allergic rhinitis during the coronavirus disease 2019 (COVID-19) pandemic. The study participants were adults between the ages of 19 and 60 who were diagnosed with allergic rhinitis and had a Total Nasal Symptom Score (TNSS) of 2 or more. Participants were randomly assigned to an aromatherapy group that was provided aromatherapy essential oils and a control group that did not receive aromatherapy. Participants in the aromatherapy group were asked to drop an aromatherapy essential oil onto a disposable face mask and wear it twice a day for two weeks.Results: The aromatherapy group experience significant alleviation of allergic rhinitis symptoms (visual analogue scale, F = 11.22, p &lt; .001; TNSS, F = 15.82, p &lt; .001). The aromatherapy group also showed significantly higher improvements in fatigue (F = 8.28, p &lt; .001), allergic rhinitis-specific quality of life (F = 11.12, p &lt; .001).Conclusion: The oils used in this study appeared to be effective in relieving the symptoms of allergic rhinitis. In particular, the mask drop inhalation method was applied in light of mandatory mask-wearing due to the global COVID-19 pandemic during this study period. Mask drop inhalation is a method of inhaling oil close to the nose and is considered an effective method for reducing the inconvenience of applying oil.

The use of experimental animals is widely conducted in the medical field, both for research on the processes of disease occurrence (pathogenesis), the causes of disease (etiology), and research on therapy. Therefore, it is important to understand how euthanasia in experimental animals affects the integrity of the sample and its influence on research results. This article was compiled from several literature sources searched from Google Schoolar and PubMed published within the last 10 years, with keywords such as "code of ethics in experimental animals", "methods of euthanasia in experimental animals", "overdose anesthesia methods in animal euthanasia", "barbiturate injection methods in rats", "inhalation methods in animal euthanasia", "biochemical effects of euthanasia", and "histological effects of euthanasia". This paper discusses euthanasia methods, namely overdose anesthesia, inhalation, and injection. This paper aims to discuss how the method of euthanasia and the choice of drugs can impact the biochemical and histological changes in animals after the euthanasia process. Choosing the right euthanasia method is essential, as the species of animals involved and the research goals are considered. Using methods that align with the biological characteristics and behavior of the animals can help ensure the success of the research while also considering ethical aspects and animal welfare.

Nanoparticles (NPs) have shown significant potential for pulmonary administration of therapeutics for the treatment of chronic lung diseases in a localized and sustained manner. Nebulization is a suitable method of NP delivery, particularly in patients whose ability to breathe is impaired due to lung diseases. However, there are limited studies evaluating the physicochemical properties of NPs after they are passed through a nebulizer. High shear stress generated during nebulization could potentially affect the surface properties of NPs, resulting in the loss of encapsulated drugs and alteration in the release kinetics. Herein, we thoroughly examined the physicochemical properties as well as the therapeutic effectiveness of Infasurf lung surfactant (IFS)-coated PLGA NPs previously developed by us after passing through a commercial Aeroneb® vibrating-mesh nebulizer. Nebulization did not alter the size, surface charge, IFS coating and bi-phasic release pattern exhibited by the NPs. However, there was a temporary reduction in the initial release of encapsulated therapeutics in the nebulized compared to non-nebulized NPs. This underscores the importance of evaluating the drug release kinetics of NPs using the inhalation method of choice to ensure suitability for the intended medical application. The cellular uptake studies demonstrated that both nebulized and non-nebulized NPs were less readily taken up by alveolar macrophages compared to lung cancer cells, confirming the IFS coating retention. Overall, nebulization did not significantly compromise the physicochemical properties as well as therapeutic efficacy of the prepared nanotherapeutics.

This study investigates the molecular mechanism of Ma Huang-Ku Xing Ren, a traditional Chinese medicine formula, in treating pediatric pneumonia. The focus is on the regulation of caspase-3 activation and reduction of alveolar macrophage necrosis through network pharmacology and bioinformatics analyses of Ephedra and bitter almond components. Active compounds and targets from ephedrine and bitter almond were obtained using TCMSP, TCMID, and GeneCards databases, identifying pediatric pneumonia-related genes. A protein-protein interaction (PPI) network was constructed, and core targets were screened. GO and KEGG pathway enrichment analyses identified relevant genes and pathways. An acute pneumonia mouse model was created using the lipopolysaccharide (LPS) inhalation method, with caspase-3 overexpression induced by a lentivirus. The mice were treated with Ephedra and bitter almond through gastric lavage. Lung tissue damage, inflammatory markers (IL-18 and IL-1β), and cell death-related gene activation were assessed through H&E staining, ELISA, western blot, flow cytometry, and immunofluorescence. The study identified 128 active compounds and 121 gene targets from Ephedra and bitter almond. The PPI network revealed 13 core proteins, and pathway analysis indicated involvement in inflammation, apoptosis, and cell necrosis, particularly the caspase-3 pathway. Invivo results showed that Ephedra and bitter almond treatment significantly mitigated LPS-induced lung injury in mice, reducing lung injury scores and inflammatory marker levels. It also decreased caspase-3 activity and cell death in alveolar macrophages. In conclusion, the active ingredients of Ma Huang-Ku Xing Ren, particularly targeting caspase-3, may effectively treat pediatric pneumonia by reducing apoptosis in alveolar macrophages, as demonstrated by both network pharmacology, bioinformatics analyses, and experimental data.

Hysteroscopy is considered the “gold standard” for endoscopic visualization of the uterine cavity. Various methods of anesthesia and analgesia for the hysteroscopy procedure are described, including general anesthesia, sedation, local anesthesia, oral analgesics, and inhalation anesthesia.The objective: to assess the use of inhalation sedation with methoxyflurane during office hysteroscopy.Materials and methods. A prospective clinical study was performed in 109 patients during 2022-2024 who admitted to the reproductive health center “Damia” for the treatment of infertility. During office hysteroscopy, all patients had examination of the uterine cavity and biopsy of the endometrium with forceps.I group included 57 women who were prescribed rectal ketoprofen 100 mg and per os paracetamol 500 mg as analgesia during hysteroscopy in outpatient settings; II group involved 52 patients who received methoxyflurane for analgesia through an individual device for inhalation use.The Spielberger–Hanin scale was used to determine the levels of personal and reactive anxiety; assessment of psychoemotional status for the study of depressive disorders was carried out using the Beck depression scale and determination of the effectiveness of analgesic therapy. Statistical processing of the research results was performed using the program “STATISTICA 10”.Results. The spread of chronic endometritis, which was diagnosed for the first time, was established in more than half of the patients (56.9%). When using methoxyflurane for analgesia by the inhalation method, the examined patients subjectively assessed the pain at a rather low level (0.14±0.05 points), and the intensity of pain in the I group was significantly higher (0.41±0.08 points; p=0.005).In the postoperative period in the patients of the I group there were significantly higher levels of depressive disorders (7.84±0.86 points vs 4.54±0.62 points in the II group; p=0.002), personal (27.12±2.32 points vs 19.64±2.04 points; p=0.017) and situational (21.92±2.14 vs 15.56±1.72 points; p=0.022) anxiety, a reduced level of mood and emotionality, which differed from the indicators of women of the II group. Among the most frequent complaints in the I group, dyspeptic disorders (31.6%) and pain in the epigastric area (21.05%) were observed. When using methoxyflurane, the most frequent complaints were headache and drowsiness (11.5% each).Conclusions. The use of inhalation anesthesia with methoxyflurane during hysteroscopy allows to reduce negative pain sensations, anxiety and can be the optimal method for anesthesia for its performance in outpatient conditions.

Modulatory effects of quercetin on histological changes, biochemical and oxidative stress of rat placenta induced by inhalation exposure to crude oil vapor

Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)

Herein, we examine the human exercise response following cannabis inhalation, taking into consideration varied cannabinoid concentrations and different inhalation methods. A semirandomized crossover study design was used, with measures of perceived exertion and physiological responses to submaximal and maximal exercise. Participants (n = 14, 9 males 5 females) completed exercise after 1) smoking Δ-9-tetrahydrocannabinol (THC)-predominant cannabis (S-THC), 2) inhaling aerosol (vaporizing) from THC-predominant cannabis (V-THC), 3) inhaling aerosol from cannabidiol (CBD)-predominant cannabis (V-CBD), or 4) under control conditions. All exercise was performed on a cycle ergometer, with submaximal testing performed at 100 W followed by an evaluation of maximal exercise performance using an all-out 20-min time trial. Metabolism was characterized via the analysis of expired gases while subjective ratings of perceived exertion (RPE) were reported. During submaximal cycling, heart rate was higher during S-THC and V-THC compared with both control and V-CBD (all P < 0.02). During maximal exercise, V̇e was lower in V-THC compared with control, S-THC, and V-CBD (all P < 0.03), as was S-THC compared with control (P < 0.05). Both V̇o2 and RPE were similar between conditions during maximal exercise (both P > 0.1). Mean power output during the 20-min time trial was significantly lower in the S-THC and V-THC conditions compared with both control and V-CBD (all P < 0.04). Cannabis containing THC alters the physiological response to maximal and submaximal exercise, largely independent of the inhalation method. THC-containing cannabis negatively impacts vigorous exercise performance during a sustained 20-min effort, likely due to physiological and psychotropic effects. Inhalation of cannabis devoid of THC and primarily containing CBD has little physiological effect on the exercise response or performance.NEW & NOTEWORTHY Inhalation of cannabis containing THC alters physiological responses to both submaximal and maximal exercise and reduces mean power output during a 20-min time trial, regardless of whether it is inhaled as smoke or aerosol. In contrast, cannabis devoid of THC and predominantly containing CBD has no effect on physiological responses to exercise or performance.

Brucellosis, a zoonotic infectious disease, is a worldwide health issue affecting animals and humans. No effective human vaccine and the complications caused by the use of animal vaccines are among the factors that have prevented the eradication of the disease worldwide. However, bio-engineering technologies have paved the way for designing new targeted and highly efficacious vaccines. In this regard, the study aimed to evaluate immunity induced by mannosylated niosome containing Brucella recombinant trigger factor/Bp26/Omp31 (rTBO) chimeric protein in a mouse model. rTBO as chimeric antigen (Ag) was expressed in Escherichia coli BL21 (DE3) and, after purification, loaded on niosome and mannosylated niosome. The characteristics of the nanoparticles were assessed. The mice were immunized using rTBO, niosome, and mannosylated niosome-rTBO in intranasal and intraperitoneal routes. Serum antibodies (immunoglobulin [Ig]A, IgG, IgG1, and IgG2a) and splenocyte cytokines (interferon-gamma, interleukin [IL]-4, and IL-12) were evaluated in immunized mice. Finally, immunized mice were challenged by B. melitensis and B. abortus. A high antibody level was produced by niosomal antigen (Nio-Ag) and mannosylated noisomal antigen (Nio-Man-Ag) compared to the control after 10, 24, and 38 days of immunization. The IgG2a/IgG1 titer ratio for Nio-Man-Ag was 1.2 and 1.1 in intraperitoneal and intranasal methods and lower than one in free Ag and Nio-Ag. Cytokine production was significantly higher in the immunized animal with Ag-loaded nanoparticles than in the negative control group (p<0.05). Moreover, cytokine and antibody levels were significantly higher in the injection than in the inhalation method (p<0.05). The combination of mannosylated noisome and rTBO chimeric proteins stimulate the cellular and humoral immune response and produce cytokines, playing a role in developing the protective acquired immune response in the Brucella infectious model. Also, the intraperitoneal route resulted in a successful enhancement of cytokines production more than intranasal administration. Designing an effective vaccine candidate against Brucella that selectively induces cellular and humoral immune response can be done by selecting a suitable nanoniosome formulation as an immunoadjuvant and recombinant protein as an immune response-stimulating Ag.

Impact of neck angle variation on particle and virus-laden droplet transport from lung to lung using eighth-generation airway model

BackgroundDespite extensive human use of inhalation for ingesting opioids, models in rodents have mostly been limited to parenteral injection and oral dosing. Methods using electronic drug delivery systems (EDDS; “e-cigarettes”) have shown efficacy in rodent models but these do not faithfully mimic the most popular human inhalation method of heating heroin to the point of vaporization. New methodMiddle aged rats were exposed to vapor created by direct heating of heroin HCl powder in a ceramic e-cigarette type atomizer. Efficacy was determined with a warm water tail withdrawal nociception assay, rectal temperature and self-administration. ResultsTen minutes of inhalation of vaporized heroin slowed response latency in a warm water tail withdrawal assay and increased rectal temperature in male rats, in a dose-dependent manner. Similar antinociceptive effects in female rats were attenuated by the opioid antagonist naloxone (1.0 mg/kg, s.c.). Female rats made operant responses for heroin vapor in 15-minute sessions, increased their response rate when the reinforcement ratio increased from FR1 to FR5, and further increased their responding when vapor delivery was omitted. Anti-nociceptive effects of self-administered volatilized heroin were of a similar magnitude as those produced by the 10-minute non-contingent exposure. Comparison with existing methodsInhalation of directly volatilized heroin successfully produces heroin-typical effects, comparable to EDDS inhalation delivery. ConclusionsThis study shows that “chasing the dragon” methods of inhalation of heroin can be modeled successfully in the rat. Inhalation techniques may be particularly useful for longer term studies deep into the middle age of rats.

Aim: Volatile solvent abuse (VSA), is the third most common form of substance abuse after alcohol and cigarettes. The aim of this study was to determine the incidence of fatalities due to butane gas. Material and Methods: From 8,075 autopsies conducted in our center in Şanlıurfa, Türkiye in a 10-year period, 10 deaths were determined to be due to butane gas intoxication. Results: All the fatalities were males (mean age: 17.6 years). Friends reported chronic use of lighter gas by the fatalities prior to the incident. In contrast, close relatives stated that it was the first instance of VSA. The preferred inhalation methods were bagging (i.e., inhaling gas from a plastic bag, n=4) and direct inhalation (i.e., spraying the gas directly in the mouth, n=6). The scene of incident findings revealed more than one lighter gas cartridge at the scene in nine cases and many lighters at the scene in one case. The autopsy examinations revealed minimal grazing on the body in three cases and no traumatic findings in seven cases. Butane was detected in blood samples in all 10 cases and in lung tissue samples in eight cases. In all 10 cases, there were areas of intra-alveolar swelling, edema, and bleeding in the lungs. Conclusion: The actual incidence of VSA-related deaths is likely much higher than the number of reported cases, as our center is located near the Syrian border and has one of the highest populations of children and young people in Türkiye.

The flow of the inhalation procedure during inhalation therapy can be divided into three successive stages: a pre-inhalation preparatory stage, a drug inhalation stage, and a post-inhalation stage. Among these, the second stage, drug inhalation, is the most important and obscure. Using ambiguous verbal expression, the drug inhalation method is communicated to the patient using terms such as strongly, deeply, and slowly. Patients usually determine their optimal method of drug inhalation device independently, based on their own interpretation and understanding of the verbal instructions. This may make the precise inhalation using an inhalation device unpredictable. The Tokico Inhalation Monitor TM (TIM) was developed to resolve the unpredictability of this second (drug inhalation) stage. The TIM can simultaneously measure the inhalation flow rate, duration, and total volume, and display them on the screen in real-time. This mini-review demonstrates the effects of inhalation instruction using TIM, which allows the second stage of therapy, drug inhalation, to be displayed on a screen in real-time.

Epidemiological evidence indicates a relationship between maternal exposure to crude oil vapors (COV) during pregnancy and adverse pregnancy outcomes. Quercetin (QUE) is a plant flavonoid with purported antioxidant and anti-inflammatory effects, which has been shown to prevent birth defects. This study was aimed to investigate the protective role of QUE on fetal development and congenital skeletal anomalies caused by exposure of pregnant rats to COV. Twenty-four pregnant Wistar rats were randomly categorized into four groups of control, COV, COV + QUE, and QUE (50 mg/kg). The inhalation method was used to expose pregnant rats to COV from day 0 to 20 of pregnancy, and QUE was administered orally during this period. On day 20 of gestation, the animals were anesthetized and a laparotomy was performed, and then the weight and crown rump length (CRL) of the fetuses were determined. Skeletal stereomicroscopic evaluations of fetuses were performed using Alcian blue/Alizarin red staining method, and the expression of osteogenesis-related genes (Runx2 and BMP-4) was evaluated using qPCR. This study showed that prenatal exposure to COV significantly reduced fetal weight and CRL, and expression of Runx2 and BMP-4 genes. Moreover, COV significantly increased the incidence of congenital skeletal anomalies such as cleft palate, spina bifida and non-ossification of the fetal bones. However, administration of QUE with exposure to COV improved fetal bone development and reduced congenital skeletal anomalies. QUE can ameliorate the teratogenic effects of prenatal exposure to COV by increasing the expression of osteogenesis-related genes.