Acoustic tracheal rupture provides insights into larval mosquito respiration

Severe tracheal tear due to endotracheal intubation: a case report

Background

Tracheobronchial injury is a life-threatening condition with a considerable missed diagnosis rate. The larger the tracheal lesion the more difficult it is to heal. Both conservative and non-conservative treatments are used to treat tracheal injury. This article reports a clinical scenario in which conservative treatment was successfully used to manage a severe tracheal tear.

Case Description

We present the case of a 63-year-old male with a cough for over a year who suffered from a 4-cm tracheobronchial injury (level IIIA, Cardillo classification) after endotracheal intubation for right lower bilobectomy. This injury showed full-layer tissue tearing of the tracheal wall, without esophageal injury or mediastinitis. The tracheal tear was discovered during the bronchoscopy examination on postoperative day one. The patient's vital signs were almost stable, including body temperature, blood pressure, heart rate, and oxygen saturation. We adopted a conservative treatment approach, including oxygen administration, painkillers, broad-spectrum antibiotics therapy, and nutritional support. Using this treatment, the 4-cm long tracheal rupture healed within four weeks. No tracheal tear was found in the bronchoscopy re-examination. The computed tomography scan showed that the mediastinal and subcutaneous emphysema had disappeared entirely. The patient fully recovered well without any complaints of discomfort.

Conclusions

Conservative treatment provides a valuable strategy for treating patients with massive tracheal lesions, representing an effective approach, especially in older patients with underlying diseases whose conditions are not suitable for operative treatments.

Synthesis of new series of quinoline derivatives with insecticidal effects on larval vectors of malaria and dengue diseases

Mosquito borne diseases are on the rise because of their fast spread worldwide and the lack of effective treatments. Here we are focusing on the development of a novel anti-malarial and virucidal agent with biocidal effects also on its vectors. We have synthesized a new quinoline (4,7-dichloroquinoline) derivative which showed significant larvicidal and pupicidal properties against a malarial and a dengue vector and a lethal toxicity ranging from 4.408 µM/mL (first instar larvae) to 7.958 µM/mL (pupal populations) for Anopheles stephensi and 5.016 µM/mL (larva 1) to 10.669 µM/mL (pupae) for Aedes aegypti. In-vitro antiplasmodial efficacy of 4,7-dichloroquinoline revealed a significant growth inhibition of both sensitive strains of Plasmodium falciparum with IC50 values of 6.7 nM (CQ-s) and 8.5 nM (CQ-r). Chloroquine IC50 values, as control, were 23 nM (CQ-s), and 27.5 nM (CQ-r). In vivo antiplasmodial studies with P. falciparum infected mice showed an effect of 4,7-dichloroquinoline compared to chloroquine. The quinoline compound showed significant activity against the viral pathogen serotype 2 (DENV-2). In vitro conditions and the purified quinoline exhibited insignificant toxicity on the host system up to 100 µM/mL. Overall, 4,7-dichloroquinoline could provide a good anti-vectorial and anti-malarial agent.

Ultrasonic Technology Applied against Mosquito Larvae

The effective management of mosquito vectors is a timely challenge for medical and veterinary entomology. In this study, we evaluated the acoustic Larvasonic device to control young instars of the mosquito Aedes aegypti in diverse freshwater environments. Under laboratory conditions, we investigated the effect of exposure time and distance from the transducer on the mortality of larvae and pupae of Ae. aegypti. Furthermore, we evaluated the effectiveness of the ultrasound window of the electromagnetic spectrum under different field conditions. Results showed that first and second instar larvae were more sensitive to the frequency range of 18–30 kHz of the Larvasonic device. Ultrasonic waves applied for 180 s at a frequency from 18 to 30 kHz caused 100% larval mortality at a distance of 60 cm from the transducer. No mortality was observed in the non-target copepod Megacyclops formosanus. The exposure to the soundwaves produced by the acoustic larvicidal device over different distances effectively damaged Ae. aegypti through destruction of the larval dorsal tracheal trunk, thorax and abdomen. Overall, results indicated that the Larvasonic device tested can provide an alternative tool to reduce young instar populations of Ae. aegypti, without any effects on non-target aquatic invertebrates like copepods. It turned out to be a useful device for mosquito biocontrol. This technology has a relevant potential to fight the spread of mosquito-borne diseases.