Catherine Kim

Breast implant illness (BII) is an emerging clinical disorder characterized by systemic symptoms, such as fatigue, cognitive dysfunction, musculoskeletal pain, and autoimmune-like complications. Despite increasing patient awareness and improved clinical care, BII remains controversial due to the absence of standardized diagnostic criteria and accurate biomarkers. In this review, we address the current clinical and research gaps in symptoms, diagnosis, and treatment outcomes of BII by focusing on the underlying immunological mechanisms, aiming to identify potential biomarkers for improving these areas in the clinical care of BII. Through comprehensive literature analysis, it has been found that patient-reported data consistently indicate a high prevalence of systemic symptoms, with up to one-third of women reporting BII-related complaints. Outcomes following explantation are remarkably positive, with 57–96% of patients experiencing partial or complete symptom relief. Among many etiological factors, immunological mechanisms are identified to be more relevant to BII, including silicone-related autoimmune/inflammatory syndrome induced by adjuvants (ASIA), chronic inflammation induced by bacterial biofilms, immune responses to connective tissue remodeling, and genetic predisposition associated with different HLA alleles. Potential endocrine or neuroimmune responses to degraded silicone products also contribute to the development of BII symptoms. Immunological mechanisms related to BII clinical symptoms and their utility in the development of diagnostic and therapeutic strategies are also discussed.

Obstructive sleep apnea (OSA) is a highly prevalent yet frequently underdiagnosed condition that is associated with significant cardiopulmonary, metabolic, and neurocognitive outcomes. Risk factors for OSA overlap with illnesses commonly observed in intensive care unit (ICU) patients, resulting in a disproportionately elevated burden on healthcare. This structured narrative review synthesizes current evidence regarding the prevalence, diagnostic challenges, and clinical implications of obstructive sleep apnea (OSA) in critically ill adults admitted to intensive care units (ICUs) using PubMed, EMBASE, and Scopus. Key search terms included “obstructive sleep apnea,” “ICU,” and “critical illness.” Results showed that OSA is present in up to 60–70% of ICU patients, yet only ~5% are formally diagnosed during hospitalization. Underdiagnosis is linked to prolonged mechanical ventilation, extubation failure rates as high as 30%, 2-fold higher perioperative complication rates, cardiovascular instability, 1.8-fold greater 30-day ICU readmission rates, and 2.2-fold mortality. Standard screening tools have limited applicability in ICU patients. Emerging alternatives, such as overnight oximetry, polygraphy, and machine learning models lack validation. Our analyses reveal that current diagnostic and treatment strategies are poorly adapted to critically ill patients. Integration of OSA as a part of ICU management, diagnosis, and intervention may reduce readmissions and mortality.

Background: Asthma is the most prevalent chronic illness in children worldwide, contributing to significant morbidity, health care utilization, and economic burden. In the United States, approximately five million children are affected by asthma. This review explores the environmental contexts and lifestyle determinants of pediatric asthma, with a focus on the Inland Empire (IE) region of Southern California. The IE’s unique geographic landscape and importance as a major transportation hub highlights its critical role for understanding how both environmental and structural factors exacerbate asthma burden within the pediatric population. Variables such as household income, parental education levels, and lack of community-based asthma programs were explored. Despite significant burdens, the IE remains under-represented in asthma research, contributing to persistent disparity. Methods: A narrative literature review and regional data analysis were conducted via PubMed, Scopus, and Google Scholar (2000–2025), alongside data from the CDC, CDPH, and American Lung Association. Key words used included “pediatric asthma, Inland Empire, air pollution, asthma disparity, emergency department utilization, socioeconomic status.” Inclusion criteria were: (1) studies or reports focusing on pediatric asthma (ages 0–17), (2) articles addressing environmental, socioeconomic, or health care-related risk factors, and (3) research with either national, state-level, or IE-specific data. Exclusion criteria were: (1) articles not in English, adult-only asthma studies, and (3) publications without original data or reference to pediatric asthma burden, management, or outcomes. Titles and abstracts were screened for relevance, and full texts were reviewed when abstracts met inclusion criteria. A total of 61 studies, reports, and data sources met this criterion and were included into this review. Results: The IE—comprised of San Bernardino (SB) and Riverside Counties— is home to four of the top five most polluted cities in North America. Vehicle emissions and industrial waste are concentrated in the region due to limited air circulation from surrounding mountains that entrap pollutants. Pediatric asthma ED visit rates in SB and Riverside were 60.5% and 59.3%, compared to California’s average of 56.7%. Hospitalization rates for children aged 0–4 were also higher in SB (24.4%) compared to the state average (17.3%). The elevated rates among school-aged children underscore the crucial need for interventions aimed at improving air quality, enhancing asthma management, and increasing access to preventive health care. Conclusions: Pediatric asthma in the IE reflects heightened environmental risks, socioeconomic barriers, and gaps in health care access. Addressing these disparities requires targeted interventions, policies, and region-specific research to enhance long-term management strategies and outcomes for vulnerable pediatric populations.