China
Africa
Explore chapters and articles related to this topic
Medical evaluation and management of pregnant patients undergoing non-obstetrical surgery
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Inhalation anesthetic agents (nitrous oxide, cyclopropane, diethyl ether, and halothane) are lipid soluble and readily cross the placenta. Animal models have raised some concern, as these agents have had teratogenicity in some animal models. The human data regarding these agents are not robust. However, anecdotal data, risk assessments, and epidemio-logic assessments point to the relative safety of these agents (14,16,17,27,28). Exposure to inhalation anesthetic agents in the first trimester of pregnancy (especially during the period of organogenesis 3–8 weeks) is estimated to produce a relative risk of malformation of approximately 0.2% to 0.5%. Neural tube, limb, cardiac, and gastrointestinal abnormalities have all been reported. Regional block anesthetic techniques are recommended in the first trimester. If surgery is semi-elective and can be safely delayed until at least 12 weeks, the fetus will not suffer exposure to these agents during a critical organ-forming period. If, however, the clinical situation requires a general anesthetic technique in the first trimester, the physician and the patient can be reassured that overall fetal risks are small, then these agents should not be withheld if clinically indicated (29). A few studies have critically assessed anesthetic drugs in pregnancy and no consistent pattern of human malformation has been observed (28–30).
Respiratory, endocrine, cardiac, and renal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Inhaled drugs are preferred because of their high therapeutic-toxic ratio, i.e. high concentrations of drug are delivered directly to the airways, with potent therapeutic effects and few systemic side effects. Several systems for inhalation exist: metered dose inhaler, dry powder inhaler or nebuliser. The use of a spacer, which facilitates the use of a metered dose inhaler, increases the deposition and decreases the side effects. For these reasons, a spacer is the treatment of choice in children below the age of 4 years. In infants and young children a spacer with a mask is indicated. Several factors will guide the choice of a spacer. Spacer and metered dose inhaler should fit properly, but also the mask or mouth piece should fit to the child. The volume of the spacer should be adapted to the lung volume of the patient and the child should be capable of moving the valves of the spacer. For children aged from 4 to 6 years, dry powder inhalers can be used, depending on the cooperation and inspiratory effort of the child. During attacks, since inspiratory effort is decreased, bronchodilators can be administered using metered dose inhaler and spacer, or using a nebuliser.
Acute Lung Injury In Children Due To Chemical And Physical Agents
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
The inhalation of noxious substances may cause extensive physical damage to the lungs and seriously impair gas exchange. Epithelial cells of the air passages may become necrotic and slough, causing airway obstruction. Bronchospasm due to the irritation of the lungs from inhaled liquids or particles may cause or aggravate airway obstruction. Surfactant may be damaged or washed out, predisposing to atelectasis. Damage to the basement membrane may led to leakage of intravascular fluid and blood into the alveoli and interstitial spaces.
Development of reliable quantitative structure–toxicity relationship models for toxicity prediction of benzene derivatives using semiempirical descriptors
Published in Toxicology Mechanisms and Methods, 2023
Ayushi Singh, Sunil Kumar, Archana Kapoor, Parvin Kumar, Ashwani Kumar
For many years, benzene derivatives have been employed in the chemical industry. These are used in insecticides, herbicides, and organic synthesis as solvents, propellants, additives, cooling agents, and other polymers (Sixt et al. 1995; Huang et al. 2003). Because of their toxicity, many of these derivatives can harm the environment, humans, animals, and plants (Martínez-López et al. 2017). Whether ingested orally, inhaled through the respiratory system, or absorbed via the skin, benzene possesses both chronic, and acute effects. Irritation of the mucous membranes, headaches, instability, euphoria, convulsions, excitement or depression, and unconsciousness are some of the acute effects of inhalation. Ingestion of benzene has been linked to the development of bronchitis and pneumonia, while skin exposure has been linked to erythema, blistering, and dryness (redness). Exposure to high quantities of benzene can result in death (Hosseini and Shafiei 2016).
Intra-articular injection PLGA blends sustained-release microspheres loaded with meloxicam: preparation, optimization, evaluation in vitro and in vivo
Published in Drug Delivery, 2022
Zheng Sun, Xuejing Gu, Teng Hao, Jiali Liu, Rongrong Gao, Yanli Li, Bin Yu, Hui Xu
Microspheres, as a new drug delivery system, usually refer to a particle dispersion system formed by drug adsorption or dispersion in the polymer matrix, with a diameter range of 1–1000 μm (Karan et al., 2020). Because of its rich structure and function, it has many advantages. For example, it can be administered in various ways, including subcutaneous injection, oral administration, and lung administration as an inhalation (Su et al., 2021; Chen & Fang, 2000). Moreover, as a commonly used drug delivery system, it can prolong the action time of drugs in the body, reduce the number of administrations, and improve the compliance of patients (Singh Malik et al., 2016). Poly (lactic-co-glycolic acid) (PLGA) is one of the most widely used drug delivery carriers, which has good biocompatibility and biodegradability. Therefore, the preparation of meloxicam sustained-release microspheres with PLGA carrier for local administration in the treatment of arthritis has good safety, which not only can achieve the long-term anti-inflammatory effect but also can reduce the gastrointestinal adverse reactions of NASID.
Enhanced antioxidant capacity prevents epitranscriptomic and cardiac alterations in adult offspring gestationally-exposed to ENM
Published in Nanotoxicology, 2021
Amina Kunovac, Quincy A. Hathaway, Mark V. Pinti, Andrya J. Durr, Andrew D. Taylor, William T. Goldsmith, Krista L. Garner, Timothy R. Nurkiewicz, John M. Hollander
Figure 7 provides an overview of the mechanisms involved in the long-term ramifications of maternal ENM inhalation exposure during gestation on offspring. Overexpression of mPHGPx in the pregnant dam limits H2O2 (ROS) production, thereby mitigating changes to mitochondrial bioenergetics and cardiac contractile function in adult progeny. However, without the overexpression of mPHGPx in the maternal environment, ROS production is not controlled following nano-TiO2 exposure during gestation, resulting in downstream effects on cardiac function and mitochondrial bioenergetics. This occurs, in part, as a result of elevated m6A methylation at the SECIS region of mPHGPx, which disrupts Sec incorporation and diminishes mPHGPx catalytic activity. The current study highlights the therapeutic potential of enhanced antioxidant protection in the maternal environment during gestation (Figure 7). Increased hydroperoxide scavenging through this approach can provide protection for offspring into adulthood from the deleterious effects of maternal particulate exposure during gestation, without the need for supplementation by the progeny. Overexpression of mPHGPx in the pregnant dam likely circumvents the initial surge of oxidative stress that is elicited by the xenobiotic exposure, through a mechanism that involves epitranscriptomic reprogramming.