Heated tobacco product (IQOS) induced pulmonary infiltrates.

Background: Heated tobacco products (HTPs) have been marketed as safer alternatives to conventional cigarettes, but emerging evidence suggests potential respiratory risks. We present a case of pulmonary complications associated with IQOS, a popular HTP, contributing to the growing understanding of these risks. Case description: A 40-year-old chronic smoker switched to IQOS, consuming 1.5 packs per day. He presented with incidental chest radiographic abnormalities and peripheral eosinophilia. Computed tomography of chest revealed pulmonary nodules and ground glass opacities. Bronchoscopy indicated mild eosinophilia. After ruling out other causes, a lung biopsy was recommended but declined. Discontinuation of IQOS led to symptom resolution and radiographic improvement. This case adds to a limited literature on HTP-induced lung injury, with a unique presentation and favorable response to cessation. Conclusions: The case highlights potential pulmonary complications and the first describing an organizing pattern of lung injury associated with IQOS use, emphasizing the importance of recognizing and discontinuing HTPs in patients with respiratory symptoms or radiographic abnormalities. Further research is needed to elucidate the mechanisms underlying the harmful effects of HTPs and inform public health policies. This case underscores the importance of monitoring and educating individuals about the potential risks of HTPs to respiratory health, especially in the context of smokers switching to these products.

Primary intrapulmonary thymoma a case report.

Primary intrapulmonary thymoma (PIT), defined as the presence of thymoma tissue in the lung without an accompanying mediastinal component, is uncommon and so offers a diagnostic quandary. We describe the case of PIT in an 81-year-old man.

Cytotoxicity against A549 Human Lung Cancer Cell Line via the Mitochondrial Membrane Potential and Nuclear Condensation Effects of Nepeta paulsenii Briq., a Perennial Herb.

The genus Nepeta belongs to the largest Lamiaceae family, with 300 species, which are distributed throughout the various regions of Africa, Asia, India, and America. Along with other plant families distinguished by their medicinal and therapeutic values, the Nepeta genus of Lameaceae remains relatively valuable. Hence, the phytochemicals of N. paulsenii Briq. were extracted using different plant parts, i.e., leaves, stem, roots, flowers, and the whole plant by using various solvents (ethanol, water, and ethyl acetate), obtaining 15 fractions. Each extract of dried plant material was analyzed by FT-IR and GC-MS to identify the chemical constituents. The cytotoxicity of each fraction was analyzed by MTT assay and mitochondrial membrane potential and nuclear condensation assays against lung cancer cells. Among the ethyl acetate and ethanolic extracts, the flowers showed the best results, with IC50 values of 51.57 µg/mL and 50.58 µg/mL, respectively. In contrast, among the water extracts of the various plant segments, the stem showed the best results, with an IC50 value of 123.80 µg/mL. 5-flourouracil was used as the standard drug, providing an IC50 value of 83.62 µg/mL. The Hoechst 33342 stain results indicated apoptotic features, i.e., chromatin dissolution and broken down, fragmented, and crescent-shaped nuclei. The ethanolic extracts of the flowers showed more pronounced apoptotic effects on the cells. The mitochondrial membrane potential indicated that rhodamine 123 fluorescence signals suppressed mitochondrial potential due to the treatment with the extracts. Again, the apoptotic index of the ethanolic extract of the flowers remained the highest. Hence it can be concluded that the flower part of N. paulsenii Briq. was found to be the most active against the A459 human lung cancer cell line.

Toxicity and tolerance of nickel in sunflower (Helianthus annuus L.).

This study aimed at exploration of nickel (Ni) application (0, 10, 20, 30, and 40 mg L-1) on physiological and biochemical attributes of sunflower cultivars (Hysun-33 and SF-187) grown in sand culture. Results revealed a significant decrease in vegetative parameters in both sunflower cultivars by increasing Ni concentration, although low levels of Ni (10 mg L-1) improved growth attributes to some extent. Among photosynthetic attributes, 30 and 40 mg L-1 Ni application severely reduced the photosynthetic rate (A), stomatal conductance (gs), water use efficiency (WUE), and Ci/Ca ratio but improved the transpiration rate (E) in both sunflower cultivars. The same level of Ni application also reduced leaf water potential, osmotic potentials, and relative water contents but increased leaf turgor potential and membrane permeability. At low level (10 and 20 mg L-1), Ni improved the soluble proteins, while high Ni concentration decreased it. The opposite was true for total free amino acids and soluble sugars. To conclude, the high Ni concentration in various plant organs had a strong impact with the changes in vegetative growth, physiological and biochemical attributes. A positive correlation of growth, physiological, water relations, and gas exchange parameters at low levels of Ni and negative correlation at higher Ni level confirmed that the supplementation of low Ni levels greatly modulated studied attributes. Based on observed attributes, Hysun-33 showed high tolerance to Ni stress as compared to SF-187.

Alleviation of cadmium toxicity in Zea mays L. through up-regulation of growth, antioxidant defense system and organic osmolytes under calcium supplementation.

Calcium (Ca) is a macronutrient and works as a modulator to mitigate oxidative stress induced by heavy metals. In this study, we investigated the role of Ca to ameliorate the Cd toxicity in Zea mays L. by modulating the growth, physio-biochemical traits, and cellular antioxidant defense system. Maize genotype Sahiwal-2002 was grown under a controlled glasshouse environment with a day/night temperature of 24 ± 4°C/14 ± 2°C in a complete randomized design with three replications and two Cd levels as (0 and 150 µM) and six regimes of Ca (0, 0.5, 1, 2.5, 5, and 10 mM). Maize seedlings exposed to Cd at 150 µM concentration showed a notable decrease in growth, biomass, anthocyanins, chlorophylls, and antioxidant enzymes activities. A higher level of Cd (150 µM) also caused an upsurge in oxidative damage observed as higher electrolyte leakage (increased membrane permeability), H2O2 production, and MDA accumulation. Supplementation of Ca notably improved growth traits, photosynthetic pigments, cellular antioxidants (APX, POD, and ascorbic acid), anthocyanins, and levels of osmolytes. The significant improvement in the osmolytes (proteins and amino acids), and enzymatic antioxidative defense system enhanced the membrane stability and mitigated the damaging effects of Cd. The present results concluded that exogenously applied Ca potentially improve growth by regulating antioxidants and enabling maize plants to withstand the Cd toxicity.

Isolated pulmonary cryptococcosis in a patient with Crohn's disease treated with infliximab: A case report and literature review.

Tumor necrosis factor-alpha (TNF-α) inhibitors are widely used to treat various inflammatory conditions, where they have demonstrated excellent efficacy and tolerability. However, increased risk of infections is one of the most important concerns associated with these agents. Reactivation of tuberculosis and fungal infections have emerged as significant infective complications of anti-TNF-α therapy. Cryptococcus infection is an opportunistic fungal infection that can occur in patients receiving anti-TNF-α treatment. We report a rare case of isolated pulmonary cryptococcosis in a patient undergoing anti-TNF-α therapy for Crohn's disease. Our case should alert clinicians to the increased incidence and atypical presentation of pulmonary cryptococcosis in patients receiving anti-TNF-α treatment.

Foliar architecture and physio-biochemical plasticity determines survival of Typha domingensis pers. Ecotypes in nickel and salt affected soil.

Six ecotypes of Typha domingensis Pers. Jahlar (E1), Sheikhupura (E2), Sahianwala (E3), Gatwala (E4), Treemu (E5) and Knotti (E6) from different ecological regions were collected to evaluate the leaf anatomical and biochemical attributes under different levels of salinity and nickel stress viz; L0 (control), L1 (100 mM + 50 mg kg-1), L2 (200 mM + 100 mg kg-1) and L3 (300 mM + 150 mg kg-1). Presence of salt and Ni in rooting medium consistently affected growth, anatomical and physio-biochemical attributes in all Typha ecotypes. Discrete anatomical modifications among ecotypes such as reduced leaf thickness, increased parenchyma area, metaxylem cell area, aerenchyma formation and improved metaxylem vessels were recorded with increasing dose of salt and Ni. The minimum anatomical damages were recorded in E1 and E6 ecotypes. In all ecotypes, progressive perturbations in ionic homeostasis (Na+, K+, Cl-, N) due to salt and metal toxicity were evident along with reduction in photosynthetic pigments. Maximum enhancement in Catalase (CAT), Superoxide dismutase (SOD), Peroxidase (POD) and modulated Malondialdehyde (MDA) activity was recorded in E1 and E6 as compared to other ecotypes. Accumulation of large amounts of metabolites such as total soluble sugars, total free amino acids content in Jahlar, Knotti, Treemu and Sahianawala ecotypes under different levels of salt and Ni prevented cellular damages in T. domingensis Pers. The correlation analysis exhibited a close relationship among different levels of salinity and Ni with various plant attributes. PCA-Biplot verified our correlational analysis among various attributes of Typha ecotypes. An obvious separation of Typha characters in response to different salinity and Ni levels was exhibited by PC1. We recommend that genetic potential of T. domingensis Pers. To grow under salt and Ni stresses must be investigated and used for phytoremediation and reclamation of contaminated soil.

Endobronchial metastases secondary to prostate cancer: A case report and literature review.

Metastatic disease from solid extrapulmonary tumours affects the lungs frequently. Endobronchial metastases (EM) however are very rare. Most commonly breast, colorectal and renal carcinomas can result in endobronchial metastases. EM secondary to a prostate primary are even more uncommon. We present an unusual case of a synchronous diagnosis of EM and primary prostate cancer. The diagnosis was confirmed on bronchoscopic endobronchial biopsies and immunohistochemical examination. Just 3 such cases have been reported to the best of our knowledge in the last 15 years. We discuss frequencies, similarities with previously reported cases, possible developmental modes and the diagnosis of EM. We conclude that patients with a current or previous diagnosis of an extrapulmonary malignancy with apparently trivial respiratory symptoms and/or unexplained weight loss should be considered for a bronchoscopy. Bronchoscopy and immunohistochemical profiling is the gold standard for diagnosing EM, as they may not be visible on cross sectional imaging.

Ptosis and Miosis Associated with Fibrosing Mediastinitis.

BACKGROUND Fibrosing mediastinitis is a rarely seen, progressive disease. It results from an excessive fibrotic reaction in the mediastinum. We describe a presentation of fibrosing mediastinitis that, to our knowledge, has never been seen before. CASE REPORT A 30-year-old female Colombian flight attendant presented with a right eyelid droop. Examination revealed partial right-sided ptosis and miosis but no anhidrosis. An ill-defined firm swelling was palpable at the root of the neck. Chest radiography revealed a widened mediastinum, and computerized tomography (CT) showed a right paratracheal mass without calcification extending to the thoracic inlet, encasing multiple blood vessels. All basic blood tests, magnetic resonance imaging of the head, and ultrasound Doppler of the neck vessels were normal. History and work up for infections including fungal diseases, granulomatous diseases, vasculitis, and autoimmune diseases were negative. Positron emission tomography (PET) showed significant FDG uptake in the mediastinum. Mediastinal biopsy was histologically consistent with fibrosing mediastinitis. All relevant immunohistochemistry and microbiological studies were negative. Subsequently, the patient developed signs of superior vena cava compression; this was managed by balloon angioplasty, which resulted in improvement of symptoms. However, over time, her symptoms worsened progressively, resulting in a left-sided ptosis and radiological progression of the mass on CT. She received treatment with rituximab and concomitant steroids, which yielded excellent results: the treatment led to both resolution of her symptoms and regression of the mass and its metabolic activity on PET scan. CONCLUSIONS Fibrosing mediastinitis can present with an incomplete Horner's syndrome. Treatment with rituximab and steroids shows promising results in select cases of metabolically active idiopathic fibrosing mediastinitis.

Pleural effusion as an isolated finding in COVID-19 infection.

Common radiological findings of COVID -19 infection include bilateral ground-glass opacities in lower lobes with a peripheral distribution. Pleural effusion is considered a rare manifestation of COVID -19 infection. We present a 52 years old patient with a three-week history of right-sided pleuritic chest pain, fever, and dyspnea. Laboratory investigations revealed high C-reactive protein and ferritin levels and a positive COVID-polymerase chain reaction (PCR) from a nasopharyngeal swab. Chest X-ray and Computed tomography (CT) identified a moderate right-sided pleural effusion, which was exudative with mixed cellularity and high Lactate dehydrogenase (LDH). Histopathology of thoracoscopic pleural biopsy didn't reveal granulomas, malignancy, or any microbiological growth. We postulate that having ruled out any other cause the effusion was likely related to the Covid-19 infection. Our case highlights that COVID-19 can present with isolated pleural effusions, therefore it should be kept as an etiology of effusions especially if other possible causes have been ruled out.

Diagnostic value of bronchoalveolar lavage in the subset of patients with negative sputum/smear and mycobacterial culture and a suspicion of pulmonary tuberculosis.

BACKGROUND: The diagnostic value of bronchoalveolar lavage in patients with negative sputum/smear for tuberculous bacilli has been well studied. However, its value in the subset of patients with both negative sputum/smear and culture is seldom reported. METHODS: A retrospective study of patients referred for diagnostic bronchoscopy for the suspicion of pulmonary tuberculosis during the period from April 1st, 2015 to March 30th, 2016, and who had negative sputum/smear and culture for tuberculous bacilli. RESULTS: One hundred and ninety patients fulfilled the inclusion criteria. Bronchoalveolar lavage detected further 61/190 (32.1%) pulmonary tuberculosis cases. Bronchoalveolar lavage mycobacterial culture and polymerase chain reaction (positive in 60/190 (31.6%) and 58/190 (30.5%) of patients respectively) provided the highest diagnostic yield, whereas direct smear provided the lowest yield. Bronchoalveolar lavage had a sensitivity of 89.7%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 94.6%, and a test accuracy of 96.3% in suspected pulmonary tuberculosis cases with negative sputum/smear and culture. Positive bronchoalveolar lavage yield for tuberculosis was significantly associated with a positive QuantiFERON-TB Gold In-Tube test, positive purified protein derivative skin test, radiological evidence of upper zone abnormality and patient's origin being from the Indian subcontinent. CONCLUSION: Bronchoalveolar lavage should be pursued as a useful diagnostic tool for suspected pulmonary tuberculosis cases when sputum/smear and culture are negative. Its value is higher in the subset of patients with positive QuantiFERON-TB Gold In-Tube test, positive purified protein derivative skin test, upper zone abnormality on radiograph or being from the Indian subcontinent.