ABSTRACT
The coronavirus (COVID-19) pandemic has led to a critical need in treating severe respiratory disease while providing adequate protection to healthcare workers. Critically ill COVID-19 patients have required prolonged intubation and mechanical ventilation, not limited to those with multiple comorbidities or the elderly. At the height of the pandemic in New York City; our institution intubated 192 COVID-19 patients. Many institutions have avoided performing tracheostomy in this population due to high risk of virus aerosolization. This study is a retrospective, IRB approved, single center case series of 14 consecutive tracheostomies in COVID-19 patients at a community hospital in Flushing, New York City. Data from 1 March to 31 May 2020 was collected from electronic medical records. All COVID-19 positive patients undergoing tracheostomy were included; patients undergoing tracheostomy that were not COVID-19 positive were excluded. Fourteen patients underwent tracheostomy during the study period. Average age was 62 and 64.3% were male (n=9). Hispanic males represented 50% of patients undergoing tracheostomy and 71.4% were from home. Average days from initial intubation to tracheostomy was 20.6, ranging from 12 to 43 days. With the exception of two patients, all underwent a single intubation. No involved operating room staff became ill during or after these procedures. Tracheostomy may be safely performed in COVID-19 patients while minimizing risk to staff; however, patient outcomes may not be significantly altered. Further research is needed to determine the optimal timing and overall benefit of tracheostomy in this population.
ABSTRACT
Objective@#To establish a mouse model of acute lung injury (ALI) via intratracheal aerosolization of paraquat (PQ).@*Methods@#Thirty male C57BL/6J mice of 8-10 weeks old were randomly(random number) divided into the paraquat model group (n = 15) and the saline control group (n = 15). Mice in the paraquat model group were administered PQ solution (0.4 mg/mL) at a single dose of 50 μL per mouse via intratracheal aerosolization. Mice in the saline control group received an equal volume of saline. Mice were sacrificed 72 h post-PQ administration and samples were collected. The general physical condition of mice including body weight as well as mortality was monitored daily. Pulmonary function, cell counting and classification of bronchoalveolar lavage fluid (BALF), proinflammatory cytokines (TNF-α, IL-1β, and IL-6) levels of BALF and serum, MPO activity and total protein concentration of BALF and pathological lung injury scores were obtained.@*Results@#The body mass of mice decreased progressively within 72 h after PQ intratracheal administration. The static compliance of lung decreased (P<0.01) and the resistance increased (P<0.01). The number of inflammatory cells in BALF was significantly higher than that of the saline control group (all P<0.01), the levels of proinflammatory cytokines were significantly upregulated in both BALF and serum (all P<0.01), and the activity of MPO in BALF was also remarkedly increased (P<0.01). The total protein concentration of BALF was significantly elevated (P<0.01). The pathological observation of lung tissue showed a large number of inflammatory cells infiltration accompanying pulmonary hemorrhage, alveolar collapse, hyaline membrane formation and alveolar septal thickening, and the lung injury scores significantly increased (P<0.01).@*Conclusions@#Intratracheal aerosolization of a single dose of 0.02 mg PQ can successfully induce ALI in mice.
ABSTRACT
Objective To establish a mouse model of acute lung injury (ALI) via intratracheal aerosolization ofparaquat (PQ).Methods Thirty male C57BL/6J mice of 8-10 weeks old were randomly(random number) divided into the paraquat model group (n =15) and the saline control group (n =15).Mice in the paraquat model group were administered PQ solution (0.4 mg/mL) at a single dose of 50 μL per mouse via intratracheal aerosolization.Mice in the saline control group received an equal volume of saline.Mice were sacrificed 72 h post-PQ administration and samples were collected.The general physical condition of mice including body weight as well as mortality was monitored daily.Pulmonary function,cell counting and classification of bronchoalveolar lavage fluid (BALF),proinflammatory cytokines (TNF-α,IL-1β,and IL-6) levels of BALF and serum,MPO activity and total protein concentration of BALF and pathological lung injury scores were obtained.Results The body mass of mice decreased progressively within 72 h after PQ intratracheal administration.The static compliance of lung decreased (P＜0.01) and the resistance increased (P＜0.01).The number of inflammatory cells in BALF was significantly higher than that of the saline control group (all P＜0.01),the levels of proinflammatory cytokines were significantly upregulated in both BALF and serum (all P＜0.01),and the activity of MPO in BALF was also remarkedly increased (P＜0.01).The total protein concentration of BALF was significantly elevated (P＜0.01).The pathological observation of lung tissue showed a large number of inflammatory cells infiltration accompanying pulmonary hemorrhage,alveolar collapse,hyaline membrane formation and alveolar septal thickening,and the lung injury scores significantly increased (P＜0.01).Conclusions Intratracheal aerosolization of a single dose of 0.02 mg PQ can successfully induce ALI in mice.
ABSTRACT
Human brucellosis is an occupational disease affecting workers in slaughterhouses, butcher shops and the milk and dairy product industry as well as individuals who work in clinical or research laboratories. We report the first outbreak of a Brucella abortus infection in a Brazilian laboratory and compare the data obtained with reports available in the literature. Exposure was a result of damage to a biological safety cabinet and failure of the unidirectional airflow ventilation system. An epidemiological investigation identified 3 seroconverted individuals, 1 of whom had clinical manifestations and laboratory results compatible with infection at the time of exposure (n=11; attack rate=9.1%).