Smoke Inhalation Research Articles

Analysis and visualization of the research progress on surgical smoke

BackgroundWith the advancement of medical technology, tools such as electrosurgical equipment, laser knives, and ultrasonic scalpels have made modern medical procedures more convenient and effective. However, the generation of surgical smoke during these procedures poses significant health risks to medical personnel. Despite this, only a few studies have examined the literature systematically in this area. By analyzing bibliometric data on surgical smoke, we can gain insights into current research hotspots and forecast future trends. MethodsThis study included literature related to surgical smoke from the Web of Science and China National Knowledge Infrastructure (CNKI) databases, covering the period from 2000 to 2024. We used VOSviewer, CiteSpace, and BioBERT to visualize research trends and hotspots. ResultsIn the early stages of research, the focus was mainly on the composition, generation mechanisms, and susceptible populations related to surgical smoke. In recent years, with the development of laparoscopic surgery and the global COVID-19 pandemic, research interests have shifted towards occupational protection of healthcare workers and public health. Currently, the research in this field primarily explores the promoting effects of surgical smoke on conditions such as inflammation and tumors, as well as occupational protection and health education for healthcare workers. Disease research focuses heavily on Smoke Inhalation Injury, Infections, Neoplasms, Postoperative Complications, and Inflammation. ConclusionWe explored future research directions in the field of surgical smoke using VOSviewer, CiteSpace, and BioBERT. Our findings indicate that current research focuses on investigating the promoting effects of surgical smoke on conditions such as inflammation and tumors, as well as on occupational protection and health education for healthcare workers. We summarized existing preventive measures, aiming to facilitate further research advancements and the translation of research outcomes into clinical results. These efforts provide new insights for advancing research in occupational protection of healthcare workers.

Associations between urinary hydroxylated polycyclic aromatic hydrocarbon biomarker concentrations and measures of timing of delivery and infant size at birth

Preterm birth is a leading cause of neonatal mortality and presents significant public health concerns. Environmental chemical exposures during pregnancy may be partially to blame for disrupted delivery timing. Polycyclic aromatic hydrocarbons (PAHs) are products of incomplete combustion, exposure to which occurs via inhalation of cigarette smoke and automobile exhaust, and ingestion of charred meats. Exposure to PAHs in the US population is widespread, and pregnant women represent a susceptible population to adverse effects of PAHs. We aimed to investigate associations between gestational exposure to PAHs and birth outcomes, including timing of delivery and infant birth size. We utilized data from the PROTECT birth cohort where pregnant women provided spot urine samples at up to three study visits (median 16, 20, and 24 weeks gestation). Urine samples were assayed for eight hydroxylated PAH concentrations. Associations between PAHs and birth outcomes were calculated using linear/logistic regression models, with adjustment for maternal age, education, pre-pregnancy BMI, and daily exposure to environmental tobacco smoke. Models accounted for urine dilution using specific gravity. We also explored effect modification by infant sex. Interquartile range (IQR) increases in all averaged PAH exposures during the second trimester were associated with reduced gestational age at delivery and increased odds of overall PTB, although these associations were not statistically significant (p > 0.05). Most PAHs at the second study visit were most strongly associated with earlier delivery and increased odds of overall and spontaneous PTB, with visit 2 2-hydroxynapthalene (2-NAP) being significantly associated with increased odds of overall PTB (OR:1.55; 95 %CI: 1.05,2.29). Some PAHs resulted in earlier timing of delivery among only female fetuses, specifically 2-NAP on overall PTB (female OR:1.52 95 %CI: 1.02,2.27; male OR:0.78, 95 %CI: 0.53,1.15). Future work should more deeply investigate differential physiological impacts of PAH exposure between pregnancies with male and female fetuses, and on varying developmental processes occurring at different points through pregnancy.

The fate of an inhaled cigarette puff in the human respiratory tract

Objective Cigarette smoking can lead to a host of adverse health effects such as lung and heart disease. Increased lung cancer risk is associated with inhalation of carcinogens present in a puff of smoke. These carcinogenic compounds deposit in the lung at different sites and trigger a cascade of events leading to adverse outcomes. Understanding the site-specific deposition of various smoke constituents will inform the study of respiratory diseases from cigarette smoking. We previously developed a deposition model for inhalation of aerosol from electronic nicotine delivery systems. In this study, the model was modified to simulate inhalation of cigarette smoke consisting of soluble and insoluble tar, nicotine, and cigarette-specific constituents that are known or possible human carcinogens. Materials and Methods The deposition model was further modified to account for nicotine protonation and other cigarette-specific physics-based mechanisms that affect smoke deposition. Model predictions showed a total respiratory tract uptake in the lung for formaldehyde (99%), nicotine (80%), and benzo[a]pyrene (60%). Results The site of deposition and uptake depended primarily on the constituent’s saturation vapor pressure. High vapor pressure constituents such as formaldehyde were preferentially absorbed in the oral cavity and proximal lung regions, while low vapor pressure constituents such as benzo[a]pyrene were deposited in the deep lung regions. Model predictions of exhaled droplet size, droplet retention, nicotine retention, and uptake of aldehydes compared favorably with experimental data. Conclusion The deposition model can be integrated into exposure assessments and other studies that evaluate potential adverse health effects from cigarette smoking.

Variety-dependent responses of common tobacco with differential cadmium resistance: Cadmium uptake and distribution, antioxidative activity, and gene expression

Cadmium (Cd), which accumulates in tobacco leaves, enters the human body through inhalation of smoke, causing harmful effects on health. Therefore, identifying the pivotal factors that govern the absorption and resistance of Cd in tobacco is crucial for mitigating the harmful impact of Cd. In the present study, four different Cd-sensitive varieties, namely, ZhongChuan208 (ZC) with resistance, ZhongYan100 (ZY), K326 with moderate resistance, and YunYan87 (YY) with sensitivity, were cultivated in hydroponic with different Cd concentrations (20 µM, 40 µM, 60 µM and 80 µM). The results indicated that plant growth was significantly decreased by Cd. Irrespective of the Cd concentration, ZC exhibited the highest biomass, while YY had the lowest biomass; ZY and K326 showed intermediate levels. Enzymatic (APX, CAT, POD) and nonenzymatic antioxidant (Pro, GSH) systems showed notable variations among varieties. The multifactor analysis suggested that the ZC and ZY varieties, with higher levels of Pro and GSH content, contribute to a decrease in the levels of MDA and ROS. Among all the Cd concentrations, ZC exhibited the lowest Cd accumulation, while YY showed the highest. Additionally, there were significant differences observed in Cd distribution and translocation factors among the four different varieties. In terms of Cd distribution, cell wall Cd accounted for the highest proportion of total Cd, and organelles had the lowest proportion. Among the varieties, ZC showed lower Cd levels in the cell wall, soluble fraction, and organelles. Conversely, YY exhibited the highest Cd accumulation in all tissues; K326 and ZY had intermediate levels. Translocation factors (TF) varied among the varieties under Cd stress, with ZC and ZY showing lower TF compared to YY and K326. This phenomenon mainly attributed to regulation of the NtNramp3 and NtNramp5 genes, which are responsible for the absorption and transport of Cd. This study provides a theoretical foundation for the selection and breeding of tobacco varieties that are resistant to or accumulate less Cd.

Exploring Dhumapana: The ancient art of Ayurvedic inhalation for health

Prayogika Dhumapana is a traditional Ayurvedic practice involving the inhalation of medicinal smoke derived from specific herbs and minerals, aimed at maintaining health and treating ailments, particularly those related to the Kapha and Vata Dosha in the Urdhva Jatru. Rooted in ancient Ayurvedic texts such as the Caraka Samhita and Sushruta Samhita, Prayogika Dhumapana is known for its efficacy in managing respiratory conditions, chronic cough, sinusitis, headaches, and stress-related disorders. This therapeutic approach utilizes the rapid absorption of bioactive compounds through the respiratory mucosa to provide immediate relief and therapeutic effects. Although traditionally practiced, Prayogika Dhumapana has potential for integration into modern clinical settings, with preliminary research indicating its benefits in managing chronic respiratory issues, migraines, and allergic rhinitis. However, further rigorous clinical trials are necessary to validate these findings and develop standardized treatment protocols. The practice of Prayogika Dhumapana exemplifies the convergence of ancient Ayurvedic wisdom with contemporary scientific inquiry, offering a holistic approach to health and well-being. Continued research and clinical evaluation will be essential to fully harness its therapeutic potential and ensure its safe application in modern healthcare.

Revolutionizing respiratory health research: “commercially-available lung-on-a-chip and air-liquid interface systems”

Inhalation of ultrafine particles, aerosol contaminants, and cigarette smoke can induce respiratory diseases. As humans are constantly exposed to various exogenous substances, it is crucial to study their impacts on respiratory diseases and airway dysfunction. Recently, organ-on-a-chip technology has been applied in many research studies to understand disease mechanisms, drug screening, and drug testing. The combination of organ-on-a-chip technology and the air-liquid interface (ALI) culture method is emerging as a new platform for realistically mimicking the microenvironment and physiological motions of the human lungs. Breathing motion can be simulated through cyclic stretching, while blood flow can be replicated using channel flow within the chip. The ALI system is critical for mucociliary differentiation, pseudostratified morphology, and epithelial barrier function development. The combination of organ-on-a-chip technology and ALI systems allows the integration of cyclic stretch as a breathing motion and microfluidic channels as circulatory systems. The chip system can also integrate the lung epithelial cells, extracellular matrix, and microstructures, providing microenvironments such as fibroblast, collagen, and immune cells to the epithelial cells. This review discusses chip systems as effective tools for recapitulating human lung environments and how they are applied in biological studies against various pulmonary diseases such as infections or inflammation, fibrosis, and malignancy.

Protective Effects of Coenzyme Q10 on Testicular Histology in Rats Exposed via Chronic Mosquito Coil Smoke Inhalation.

To determine the preventive effect of coenzyme Q10 (CoQ10) on the testicular histology of rats exposed chronically to mosquito coil smoke. Experimental study. Place and Duration of the Study: Department of Anatomy, Army Medical College/National University of Medical Sciences, Rawalpindi, Pakistan, from January to December 2020. Thirty male Sprague Dawley rats were divided into three groups of 10 rats each. Group A was the healthy control. Group B rats were exposed to allethrin-based mosquito coil smoke for 12 weeks (4 hours/day). Group C rats received coenzyme Q10 (CoQ10, 10mg/kg/day) through oral gavage, in addition to 12 weeks of mosquito coil smoke exposure (4 hours/day). At the end of the study, testicular histology was compared among three groups including the germinal epithelium height, seminiferous tubule diameter, and testicular capsule thickness, while adjusting for the body weight variations among rats. The rats in Group B, exposed only to mosquito coil smoke showed testicular disruption, characterised by dilated seminiferous tubules (p <0.001), reduced germinal epithelial height (p <0.001), and thickened testicular capsule (p <0.007), as compared to the control group rats. However, the germinal epithelium height (p = 0.73) and testicular capsule thickness (p = 0.31) of rats receiving CoQ10 in addition to mosquito coil smoke inhalation were not significantly different from the control group. Prolonged inhalation of allethrin-based mosquito coil smoke can cause testicular disruption among rats. The oral CoQ10 administration can effectively prevent the histomorphological adverse effects on the testis among rats exposed to mosquito coil smoke. Allethrin, Coenzyme Q10, Germinal epithelium, Mosquito coil, Seminiferous tubules, Testicular capsule.

Посттравматичний вплив фосфорної зброї: від патогенезу до лікування

With the beginning of a full-scale war, the negative impact of harmful, dangerous substances due to the use of chemical, phosphorus bombs and other weapons, prohibited by the Geneva Convention, leads to unpredictable consequences for the health of combatants and the civilian population as well. Objectives of the study is to analyze injuries caused by white phosphorus of various types of phosphorus weapons, such as explosive weapons with a wide area of damage - mines, ammunition, long-range missiles; artillery, mortar shells, various types of grenades - in the conditions of the russian invasion of Ukraine. Materials and methods. The following methods were used when performing the work: content analysis, comparative analysis and systematization of the researched material. A study of scientific publications of domestic and foreign scientists was conducted using the PubMed and Google Scholar databases for the period 2001-2023. The results. Phosphorus munitions such as white phosphorus are known for their high effectiveness in combat operations, but their use leads to serious injuries and post-traumatic psychological changes. White phosphorus after a bomb explosion causes burns to the tissues of the human body, especially when in contact with burning material, as well as burns to the upper respiratory tract due to inhalation of smoke or gases released during combustion. The article analyzes the legal framework prohibiting the use of phosphorous ammunition in armed conflicts. Clinical cases of combined gunshot wounds of the limbs with a massive defect of soft tissues, gunshot fractures and the presence of multiple foreign bodies of metallic density due to the used phosphorous ammunition were considered. An analysis of scientific research by foreign scientists on this issue was carried out. The article presents the algorithms for providing first aid due to the effects of phosphorous ammunition, as well as the methodological recommendations of the Ministry of Health of Ukraine (Order of the Ministry of Health of Ukraine № 506 dated 20.03.2022) regarding the provision of medical assistance at the pre-hospital stage for burns, enteral poisoning, and eye contact phosphorus as a result of damage by the phosphorus component of the ammunition.

Stres akademik dengan intensitas perilaku merokok mahasiswa yang sedang menyusun skripsi

Smoking intensity is the state, extent, or amount of activity of a person who burns or smokes tobacco, and the potential for smoke inhalation by those around them. The purpose of this study was to clarify the relationship between academic stress and the intensity of students' smoking behavior during thesis writing. The population in this study was his 73 and the sampling used the total sampling method, namely 73 people. The instruments used in this study were the 23-item Academic Stress Scale and the 27-item Smoking Behavioral Intensity Scale. Based on the results of the product moment correlation test, the significance value for the two variables is less than 0.005, or 0.000. On the other hand, the results of Pearson's correlation test showed a value of 0.113 for both variables. The test results show a positive correlation between the academic stress variable (X) and the smoking behavior intensity variable (Y).

Visual detection and discrimination of nerve and blood agents using a dual-site fluorescent probe in living cells and mice

Of all chemical warfare agents (CWAs), only nerve and blood agents cause massive mortality at low concentrations. To better detect and discriminate nerve and blood agents, a reliable detection method is desirable. We report a series of fluorescent probes for nerve and blood agent detection. Among the tested probes, SR-Pip detected nerve and blood agents quickly (within 10 s for nerve agents and 1 min for blood agents). SR-Pip coupled with nerve agent produced a weak orange fluorescence with good sensitivity [limit of detection (LOD)= 5.5 μM]. Upon reaction with blood agent, the fluorescence of SR-Pip changed from orange fluorescence to blue fluorescence with detection limits as low as 9.6 nM. This probe effectively visualised different concentrations of nerve agents in living cells and mice. A portable test kit using SR-Pip instantly detected nerve and blood agents. To the best of our knowledge, SR-Pip is the first fluorescent probe for nerve and blood agent detection.

Assessing the Impact of Onion Juice on the Levels of Leutinizing Hormone and Follicle Stimulating Hormone in Female Mice Exposed to Transfluthrin Smoke

Assessing the Impact of Onion Juice on the Levels of Leutinizing Hormone and Follicle Stimulating Hormone in Female Mice Exposed to Transfluthrin Smoke

Toxicological Effects of Commonly Used Mosquito Coil Smoke on Liver and Lung Function in Rats

The utilization of mosquito coils as a household-level strategy for mosquito control is widely practiced in malaria-endemic regions spanning Africa, Asia, and South America. However, the continuous application of mosquito coils has prompted significant apprehensions concerning environmental and health implications. This research aims to evaluate the potential hepatic and pulmonary toxicities associated with the inhalation of mosquito coil smoke in rat subjects over both sub-chronic and chronic durations. A questionnaire was used to make inquiries regarding the prevalent types and brands of mosquito coils employed, the manner in which they are used, the durations for which they are utilized. A total of twenty-four albino rats were categorized into three distinct groups: the control group and two exposed groups. These groups were subjected to distinct brands of mosquito coil smoke across two distinct exposure regimens – a sub-chronic exposure lasting 4 weeks and a chronic exposure spanning 12 weeks. Following the exposure periods, blood samples were collected for the analysis of serum-based and biochemical markers, including serum aspartate aminotransferase (AST), alanine aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), bilirubin, serum bicarbonate, and Lactate dehydrogenase (LDH), oxygen saturation, C-reactive protein, total protein, and microscopic analysis of lung tissue and liver tissue. The histopathological analysis of lung tissue was appropriately included. However, the analysis of liver tissue was omitted. The results demonstrated a significant elevation in the levels of these biochemical markers among the exposed rats in comparison to the control group. Concurrently, a decrease in blood oxygen saturation was noted in the exposed rats when contrasted with the control group. Conversely, the serum concentrations of high-sensitivity C-reactive protein, total protein, and alanine aminotransferase (ALT) did not exhibit notable differences in relation to the control group. Additionally, microscopic analysis of lung tissue indicated the presence of histopathological lesions in the exposed rats, suggesting a detrimental impact of mosquito coil smoke exposure in a time-dependent progression.

Abstract PO5-08-02: Endocrine Disruptors and Life STILe in Patients Carrying BRCA Pathogenic VAriants With Breast and/or Ovarian CAncer and Women Without Neoplasm: the STILVARCA study

Abstract Background. Pathogenetic variants (PVs) in the BRCA1/2 genes can be found in 20% of patients with breast (BC) or/and ovarian (OC) cancers. In subjects carrying PVs in these genes, the absence of repair of damage to the DNA double helix causes its accumulation favoring neoplasm development. Exposure to environmental pollutants (e.g. Cadmium (Cd), through contaminated food and drinking water, cigarette smoke, dust and fumes inhalation) may play a role in the development of BC and OC. Cd acts as an “endocrine disruptor” through its binding to the estrogen receptor, promoting cell proliferation and increase in mutation rate. Individual lifestyle habits may be associated with cancer onset and progression in these patients. Our aim was to evaluate the interference of environmental factors in the development of BC and/or OC in women carrying PVs in BRCA1/2 genes. Methods. We conducted an observational, multicentric, case-control, retrospective study of patients with PV in BRCA1/2 genes and with BC, OC, or both diagnosed from 2012 to 2020 (Group 1, G1), or without cancer (Group 2, G2). 89 patients (82.4%) developed BC, 17 (15.8%) OC, and 2 (1.8%) experienced both BC and OCs. We collect data about demographics, body mass index (BMI), occupation (divided in employed, educative professions/students, healthcare professions, unemployed/retired and other), type of BRCA mutation (mBRCA), smoking habits (SH), pack/year index, estroprogestinic (EP) use and duration, adherence to Mediterranean diet (with PREDIMED questionnaire) and physical activity (using IPAQ questionnaire). Fisher's exact test and Anova were used to compare patient’s features among the two group. A univariate and multivariable model were fitted to investigate the relationship between adherence to Mediterranean diet, physical activity, Cd exposure through smoking habits (SH), EP use, and cancer development. Results. We evaluated 208 patients, 108 (51.9%) in Group 1 and 100 (48.1%) in Group 2. Table 1 shows ed the features of enrolled patients. 128 (61.5%) had a mBRCA1, 80 (38.5%) a mBRCA2. Analysis of the two groups revealed significative differences in age (47.2 vs 35.6years in G1 and G2, respectively; p&amp;lt; .001), SH (38.9% in G1 and 20.0% in G2; p=.002), EP use (36.1% in G1 and 21.0% in G2; p=.021), and occupation (office workers develop cancer more easily, while professions associated with education/students have a lower possibility of developing cancer). No difference was found regarding pack/year index, EP intake duration, adherence to Mediterranean diet, and physical activity. At univariate analysis, predictive factors for cancer incidence were: SH (OR 2.545; 95% CI 1.363 – 4.752 - p=.003); EP use (OR 2.126; 95% CI 1.143 – 3.957 - p=.017); adherence to Mediterranean diet (OR 1.500; 95% CI 1.016 – 2.215 – p=.041). No relationship was found with BMI, occupation and physical activity. At multivariable analysis, SH (OR 2.606; 95% CI 1.370 – 4.959 - p=.004), EP use (2.340; 95% CI 1.224 – 4.474 - p=.010), and adherence to Mediterranean diet (OR 1.544; 95% CI 1-027 – 2.320 – p=.037) were predictive of cancer development. Conclusion. In this preliminary analysis, the risk of development of BC or/and OC in patients with BRCA mutation was influenced by SH, EP use, and adherence to Mediterranean diet. Many environmental factors seem to play a role in the carcinogenesis of mBRCA VP patients. Paths of lifestyle education are highly recommended in BRCAm-carrying women. Table 1. Characteristics of enrolled patients Citation Format: Antonio Franco, Alessandro Rossi, Daniela Andreina Terribile, Emanuela Lucci Cordisco, Ida Paris, Margherita Muratore, Elena Florio, Vanda Salutari, Francesco Pavese, Federica Francesca L'Erario, Antonella Palazzo, Enrico Di Guglielmo, Giulia Borghesiani, Ludovica Cardinali, Elisabetta Ferretti, Giovanni Terrana, Diana Giannarelli, Giovanni Scambia, Silvia Migliaccio, Alessandra Fabi. Endocrine Disruptors and Life STILe in Patients Carrying BRCA Pathogenic VAriants With Breast and/or Ovarian CAncer and Women Without Neoplasm: the STILVARCA study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-08-02.

Edible bird's nest alleviates pneumonia caused by tobacco smoke inhalation through the TNFR1/NF-κB/NLRP3 pathway.

Exposure to cigarette smoke directly damages the lungs and causes lung inflammation. The anti-inflammatory properties of edible bird's nest (EBN) have been reported. We aimed to determine the effect of EBN on pneumonia in a mouse model exposed to cigarette smoke. Fifty BALB/c mice were randomly divided into control, model, positive drug, low-dose EBN, and high-dose EBN groups (n = 10 each). Except for the control group, the mice in each group were exposed to four cigarettes once a day for 8 days. In addition, we validated the effects of EBN on A549 cells and investigated the mechanism by which EBN alleviates lung inflammation. Edible bird's nest (EBN) could alleviate the structural damage of lung tissue and the smoke-induced inflammatory response in mice. The best effect was observed at the high dose of EBN (0.019 g). The mice treated with EBN had a stronger ability than those in the model group to resist cigarette smoke stimulation, as indicated by a decrease in serum and lung inflammatory markers (interleukin 6 [IL-6], tumor necrosis factor-α [TNF-α], and interleukin 8 [IL-8]), an increase in serum interleukin 10 (IL-10) levels, and a decrease in the expression of inflammasome NOD-like receptor pyrin 3 (NLRP3). In addition, our cell experiments showed that EBN attenuated cigarette smoke-induced pulmonary inflammation mainly by inhibiting the tumor necrosis factor receptor 1 (TNFR1)/nuclear factor-kappa B (NF-κB)/NLRP3 pathway. These findings provide theoretical evidence for the positive nutritional qualities of EBN for the lung by demonstrating that it inhibits the TNFR1/NF-κB/NLRP3 signaling pathway, which prevents the development of cigarette smoke-induced pulmonary inflammation.

Hydroxocobalamin is not associated with methemoglobinemia in patients with inhalation injury and suspected cyanide toxicity and a proposed algorithm for hydroxocobalamin administration

BackgroundCyanide poisoning poses a significant threat to burn patients exposed to smoke in residential or workplace fires, leading to central nervous system dysfunction, hemodynamic instability, cardiovascular collapse, and death. Prompt administration of an effective antidote is critical. Hydroxocobalamin, a form of vitamin B12, is the gold standard treatment for cyanide toxicity, by binding to cyanide molecules and converting them into non-toxic cyanocobalamin that is eliminated by the kidneys. This mechanism is distinct from previous cyanide antidotes, which induce the formation of methemoglobin to bind to cyanide. Recent case studies have reported elevated methemoglobin levels after hydroxocobalamin administration, raising concerns regarding its safety. The current study investigates smoke inhalation patients treated with hydroxocobalamin at a single institution Burn Unit in hopes of enhancing our understanding of the complexities surrounding cyanide antidote therapy. MethodsAfter Institutional Board Approval, a retrospective cohort study was conducted. Our sample comprised burn patients with inhalation injury admitted to a single institution from 2013 to 2023 and treated with hydroxocobalamin for suspected cyanide toxicity. We also analyzed a matched control cohort of similar patients with inhalation injury not treated with hydroxocobalamin. We analyzed changes and peaks in methemoglobin levels, lactate levels, blood urea nitrogen (BUN) and creatinine, ventilator days, % total body surface area (TBSA), various types of medications and dressings, and mortality. Statistical analyses included t-tests, chi-square, linear and logistic regressions, and correlation analysis. ResultsIn the study, 36 patients with suspected inhalation injury were treated with hydroxocobalamin at the Los Angeles General (LAG) Burn Unit from 2013 to 2023, who were matched to 32 control patients with inhalation injury who were not treated with hydroxocobalamin. Demographic and baseline characteristics showed no statistically significant differences between the groups, including age, gender, BMI, and %TBSA. No significant differences were found in initial, final, peak, or change in methemoglobin levels. The study also revealed no significant disparities in initial lactate levels, mortality, kidney function tests, ventilator days, surgeries, or use of medications/treatments (e.g., Silvadene dressings, Vitamin C) between the two groups. When controlling for covariates, multiple linear regression analysis (age, gender, and %TBSA) indicated that hydroxocobalamin administration was not significantly associated with changes in methemoglobin or mortality. Increased %TBSA, however, was linked to elevated lactate levels. ConclusionsOur investigation sought to assess the potential risks associated with hydroxocobalamin administration in burn patients with concomitant inhalation injury. Contrary to our initial hypothesis, we found no statistically significant differences in methemoglobinemia, lactate levels, mortality, or kidney function. The influence of other factors, such as methemoglobinemia-inducing drugs or hydroxocobalamin's interference with co-oximetry, adds complexity. Although elevated methemoglobin levels were observed in some cases, their clinical significance was limited. However, this study's limitations, particularly the rarity of inhalation injury cases with concern for cyanide toxicity, warrant consideration. Further research is required to comprehensively elucidate the impact of hydroxocobalamin administration on burn patients' outcomes.

Ameliorative effect of Quercetin and Omega-3 Fatty Acids on haematological and liver function impairment induced by mosquito coil smoke in male Wistar rats

The use of mosquito coils is one method adopted to control malaria Inhalation of the coil smoke causes adverse effects, including hepatic and haematological toxicities associated with oxidative stress. Therefore, this study investigated the effects of phytochemical antioxidants (Quercetin and Omega-3) on mosquito coil smoke-induced haematological and hepatic impairments. Twenty male Wistar rats were divided into 4 groups viz control, mosquito coil-only (MC), mosquito coil+Quercetin (MC+Q) and mosquito coil+Omega-3 (MC+OM3) groups of five rats each. Quercetin and Omega-3 were administered daily at 20mg/kg and 600mg/kg respectively. The duration of daily exposure and treatment was 42 days after which blood samples were collected via cardiac puncture for determination of relevant haematological and hepatic parameters. The RBC count was significantly reduced in the MC group compared with the control (P&lt;0.05) but was higher in the MC+Quercetin group than in the MC group. Haemoglobin was decreased in the MC and MC+Omega-3 groups compared with the control (P&lt;0.05). White blood cell count was higher in the MC group than in the control group (P&lt;0.05) but lower in the MC+OM3 and MC+Q groups than in the MC group (P&lt;0.05). The lymphocyte count was higher in the MC group than in the control group (P&lt;0.05). Serum aspartate transaminase and alanine transaminase were significantly increased (P&lt;0.05) in the MC group compared with the control group but were reduced (P&lt;0.05) in the MC+OM3 and MC+Q groups compared with the MC group. Serum alkaline phosphatase was significantly higher (P&lt;0.05) in the MC group than in control (P&lt;0.05) but significantly lower (P&lt;0.05) in the MC+OM3 group than in the MC group. Serum total bilirubin was significantly elevated in the MC group compared to that in the control group (P&lt;0.05). The serum concentration of direct bilirubin was significantly higher (P&lt;0.05) in the MC group than in the control group. We conclude that Omega-3 and Quercetin ameliorate haematological and hepatic function impairments in Wistar rats exposed to mosquito coil smoke.

Quantitative proteome and lysine succinylome characterization of zinc chloride smoke-induced lung injury in mice

The inhalation of zinc chloride (ZnCl2) smoke is one of common resources of lung injury, potentially resulting in severe pulmonary complications and even mortality. The influence of ZnCl2 smoke on lysine succinylation (Ksucc) in the lungs remains uncertain. In this study, we used a ZnCl2 smoke inhalation mouse model to perform global proteomic and lysine succinylome analyses. A total of 6781 Ksucc sites were identified in the lungs, with injured lungs demonstrating a reduction to approximately 2000 Ksucc sites, and 91 proteins exhibiting at least five differences in the number of Ksucc sites. Quantitative analysis revealed variations in expression of 384 proteins and 749 Ksucc sites. The analysis of protein-protein interactions was conducted for proteins displaying differential expression and differentially expressed lysine succinylation. Notably, proteins with altered Ksucc exhibited increased connectivity compared with that in differentially expressed proteins. Beyond metabolic pathways, these highly connected proteins were also involved in lung injury-associated pathological reactions, including processes such as focal adhesion, adherens junction, and complement and coagulation cascades. Collectively, our findings contribute to the understanding of the molecular mechanisms underlaying ZnCl2 smoke-induced lung injury with a specific emphasis on lysine succinylation. These findings could pave the way for targeted interventions and therapeutic strategies to mitigate severe pulmonary complications and mortality associated with such injuries in humans.

Pediatric Polytrauma Fire Victim Simulation.

Pediatric trauma has long been one of the primary contributors to pediatric mortality. There are multiple cases in the literature involving cyanide (CN) toxicity, carbon monoxide (CO) toxicity, and smoke inhalation with thermal injury, but none in combination with mechanical trauma. In this 45-minute simulation case, emergency medicine residents and fellows were asked to manage a pediatric patient with multiple life-threatening traumatic and metabolic concerns after being extracted from a van accident with a resulting fire. Providers were expected to identify and manage the patient's airway, burns, hemoperitoneum, and CO and CN toxicities. Forty learners participated in this simulation, the majority of whom had little prior clinical experience managing the concepts highlighted in it. All agreed or strongly agreed that the case was relevant to their work. After participation, learner confidence in the ability to manage each of the learning objectives was high. One hundred percent of learners felt confident or very confident in managing CO toxicity and completing primary and secondary surveys, while 97% were similarly confident in identifying smoke inhalation injury, preparing for a difficult airway, and managing CN toxicity. This case was a well-received teaching tool for the management of pediatric trauma and metabolic derangements related to fire injuries. While this specific case represents a rare clinical experience, it is within the scope of expected knowledge for emergency medicine providers and offers the opportunity to practice managing multisystem trauma.

Guideline of Management of Acute Smoke Inhalation Injury: Systematic Review and Meta-Analysis of Last 10 Years

Guideline of Management of Acute Smoke Inhalation Injury: Systematic Review and Meta-Analysis of Last 10 Years

A200 EXPOSURE TO CANNABIS SMOKE IN UTERO AFFECTS THE DEVELOPMENT OF THE ENDOCANNABINOID SYSTEM IN THE GASTROINTESTINAL TRACT

Abstract Background Recreational use of cannabis has been legalized in Canada since 2018. Increasing numbers of women are using cannabis while pregnant, with reported rates ampersand:003E10%. There is a disconnect with societal perceptions, with up to one third of women believing that cannabis is safe for use in pregnancy, but with preclinical and clinical studies demonstrating negative neurodevelopmental outcomes. A key component of gut-brain axis regulation is found in the endocannabinoid system (ECS), of which receptors, ligands and enzymes are extensively distributed throughout the gastrointestinal (GI) tract and are actively involved in GI motility and sensation. Aims We tested the hypothesis that exposure to cannabis smoke in utero could influence the expression of ECS components in the developing GI tract. Methods We developed a “real world” cannabis smoke inhalation model in which CD-1 pregnant mouse dams were exposed daily to a delta-9-tetrahydrocannabinol (THC)-dominant strain of cannabis in a smoking chamber unit, from embryonic days 6 (E6) to E18. Control mice were placed in a restraining cage and exposed to room air for the equivalent time-period. Dams were sacrificed at E18, fetuses removed and the fetal GI tract (from stomach to distal colon) collected for RNA extraction. Key components of the ECS were investigated by developing a NanoString Custom CodeSet, including receptors (cannabinoid receptors 1 and 2; CB1 and CB2, transient receptor potential vanilloid type 1; TRVP1, GPR55) and enzymes (diacylglycerol lipase; DAGL, fatty acid amide hydrolase; FAAH, monoacylglycerol lipase; MAGL, N-acylphosphatidyletanolamine phospholipase D; NAPE-PLD). Samples (n=per litter; 7 cannabis-exposed and 8 control) were processed in the Farncombe Metagenomics Facility and NanoString data analyzed using nSolver Analysis Software. Results We found a significant increase in the expression of ECS receptors in the cannabis-exposed compared to control GI tract at E18, including CB2 (pampersand:003C0.05), TRPV1 (pampersand:003C0.05) and GPR55 (pampersand:003C0.0005). Interestingly, no significant change in mRNA expression was detected for CB1. We also found a significant increase in mRNA encoding the full panel of ECS enzymes, including DAGL (pampersand:003C0.005), FAAH (pampersand:003C0.05), MAGL (pampersand:003C0.05) and NAPE-PLD (pampersand:003C0.005) in cannabis-exposed compared to control GI tract. Conclusions In conclusion, we have found a significant increase in mRNA expression in a panel of key ECS receptors and enzymes in the GI tract at a point of maximal exposure to cannabis in utero. Future research will be needed to further characterize potential impacts on postnatal GI development and function. Funding Agencies CIHRThe Azrieli Foundation