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Biological Terrorist Agents
Published in Robert A. Burke, Counter-Terrorism for Emergency Responders, 2017
After several hours, profuse sweating occurred, which signaled the end of the symptomatic phase. Little data are available on human inhalation exposure, but victims would be expected to develop severe lung inflammation with a progressive cough, dyspnea, cyanosis, and pulmonary edema. When ricin enters the body through routes other than inhalation, it is not a direct lung irritant. Ingestion causes gastrointestinal hemorrhage with hepatic, splenic, and renal necrosis. Intramuscular injection would cause severe localized necrosis of muscle and regional lymph nodes with moderate visceral organ involvement. The toxicity of ricin compared to botulinum and SEB, based upon LD50 values, is much less. Natural intoxication from ricin can occur by the ingestion of the castor bean. This produces severe gastrointestinal symptoms, vascular collapse, and death. Terrorist uses may involve contamination of food or water supplies, use of ricin-laced projectiles, or aerosolization as a liquid or freeze-dried powder. When exposure to ricin occurs through inhalation of small particles, pathogenic changes can occur in as little as 8 hours. This is followed by severe respiratory symptoms and acute hypoxic respiratory failure. Intravenous injection may result in disseminated intravascular coagulation, microcirculatory failure, and multiple organ failure. Ricin is toxic to the cells in the body and acts by inhibiting protein synthesis. During tests conducted on rodents, ricin was more toxic through inhalation than ingestion. Little data are available to indicate the effects on humans.
In Vivo Testing of Biodegradable Mg Alloy Implants
Published in Yufeng Zheng, Magnesium Alloys as Degradable Biomaterials, 2015
Traditionally, the implantation of stents in young children with small blood vessels has been avoided as the presence of a metallic or fixed stent structure limits the ability to further dilate the stent with vessel growth. The biodegradable stent can address this problem. The first successful implantation of a biodegradable metal stent in a human was performed by Zartner et al. in the left pulmonary artery of a preterm baby with a congenital heart disease (Zartner et al. 2005). Reperfusion of the left lung was established and persisted throughout the 4-month follow-up period, and the degradation process of the stent was clinically well tolerated despite the small size of the baby. Unfortunately, the patient died from multiple organ failure caused by severe pneumonia about 5 months after implantation. At the autopsy, no evidence was found of an adverse effect of the stent on the cardiac situation.
Pulmonary complications of bone-marrow and stem-cell transplantation
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Bekele Afessa, Andrew D Badley, Steve G Peters
The majority of HSCT recipients with DAH require mechanical ventilator support for respiratory failure.115,129 HSCT recipients with DAH are at high risk for subsequent infectious complications.135,136 The reported mortality rate of DAH in HSCT recipients ranges between 48 and 100 per cent.115,129 Although the initial presentation of DAH is usually respiratory failure, the two most common reported causes of death had been multiple organ failure and sepsis.136,137 However, in two recent studies, respiratory failure was the most common cause of death in HSCT recipients with DAH.129,132
Synthesis of PEGylated cationic curdlan derivatives with enhanced biocompatibility
Published in Journal of Biomaterials Science, Polymer Edition, 2022
Muqier Muqier, Hai Xiao, Xiang Yu, Yifeng Li, Mingming Bao, Qingming Bao, Shuqin Han, Huricha Baigude
Next, we examined the cytotoxicity of the PEGylated 6AC-100 on HepG2 and N2a cells line. The various concentrations of the polymers were added to the cell culture medium, and the cell viability was assessed by MTT assay (Figures 3(A) and 4(B)). PEI and 6AC-100 were used as comparison groups. The results showed that PEI had highest toxicity for all cell types, with the cell viabilities of 32%−36% at a concentration of 90 µg/mL, compared to the nontreated (NT) group. The cells treated with 6AC-100 had 50% cell viability at a concentration of 90 µg/mL. However, the PEGylated cationic polymers were essentially low toxic (cell viability 53%-75%) to all of the cell types even at concentrations as high as 90 µg/mL. 6AC-2S PEG40 showed highest cell viability in both types of cells. To assess the hemolysis effect of the cationic polymers, all PEGylated 6AC-100 cationic polymers were incubated with 2% red blood cells for 2 h at 37 °C. Hemolysis is mainly defined as the destruction of red blood cells (RBCs) membrane and release of their contents (hemoglobin) into the surrounding fluids. Intravascular rupture of RBCs can lead to endothelial cell dysfunction and vascular thrombosis, even cause multiple organ failure and death [41]. As a result, hemolysis can be used as the main index to evaluate whether cationic polymers have side effects. The results showed that all cationic polymers had no apparent hemolysis effect (Figure 3(C,D)) compared with PEI and 6AC-100, indicating that all PEGylated 6AC-100 cationic polymers had a high biocompatibility and may be applicable for in vivo drug delivery.
Safety and effectiveness of left atrial appendage closure in patients with non-valvular atrial fibrillation and prior major bleeding
Published in Expert Review of Medical Devices, 2021
Mingzhong Zhao, Cody R. Hou, Xiaolin Xiong, Felix Post, Nora Herold, Jiangtao Yu
Inclusion criteria were patients with NVAF and high risk for stroke or systemic embolism [CHA2DS2VASc (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke/TIA, vascular disease, age 65 to 74 years, sex category) scores ≥2 or presence of a prior history of stroke, TIA, or peripheral embolism] or with high bleeding risk [HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile INR, elderly, drugs/alcohol concomitantly) scores ≥3 or positive history of intracranial hemorrhage or gastrointestinal bleeding or other major bleeding, as well as unstable INR], or OAC refusal. Patients with severe multiple organ failure, malignancy, life expectancy shorter than one year, and refusal to provide written informed consent were not enrolled in the study. The participants were divided into two groups: bleeding group and non-bleeding group, based on presence or absence of a history of previous major bleeding. The prior major bleeding included severe bleeding events during anticoagulant treatment or a history of previous hemorrhagic disorders. Bleeding events were defined according to standardized bleeding endpoint definitions by the Bleeding Academic Research Consortium (BARC) [12]. The clinical characteristics, peri-procedural severe complications, and major adverse events at follow up were recorded and analyzed for all participants. Figure 1 illustrates a flow diagram of the patient inclusion, management, and follow up.
An update on COVID-19: SARS-CoV-2 life cycle, immunopathology, and BCG vaccination
Published in Preparative Biochemistry & Biotechnology, 2021
Shankar M. Khade, Shivraj M. Yabaji, Jyoti Srivastava
The infection of 2019-nCoV-2 may result in the generation of innate and adaptive immunity challenges, if not controlled that leads to severe locally and systemically tissue damages. The patients with severe COVID-19 found to be struggling with the lymphopenia with a remarkable reduction in the CD4+ T cells, CD8+ T cells, B cells, NK cells[37,38] along with the decreased number of monocytes, eosinophils and basophils. Lymphocyte count is inversely related to the COVID-19 severity. Hence the % lymphocytes (LYM%) can be used as a measure for the prediction as well as the severity of the COVID-19.[39] Mostly the non-survivor adult and children COVID-19 patients treated with Extracorporeal membrane oxygenation (ECMO) have increased interleukin-6 (IL-6) up to 1.7 times compared to the survivors as studied by Ruan and colleagues.[40] In addition to this, the storm of cytokines and chemokines such as IL1-β, IL1Ra, IL7, IL8, IL9, IL10, Fibroblast growth factor 2, GCSF, GMCSF, IFNγ, IP10, MCP1, MIP1β, PDGFB, TNFα, and VEGFA were found to be profoundly elevated in the COVID-19 patients.[41] The extreme level of cytokines results in potential inflammatory responses causing acute respiratory distress syndrome (ARDS), multiple organ failure and eventually death in the extreme cases of 2019-nCoV-2 infection.[42]