scholarly journals The vaping product use associated lung injury: is this a new pulmonary disease entity?

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Hubert Mado ◽  
Edyta Reichman-Warmusz ◽  
Romuald Wojnicz
Keyword(s):  
Lung Injury ◽  
Age Groups ◽  
Causative Factor ◽  
The United States ◽  
Case Definition ◽  
Product Use ◽  
Number Of Patients ◽  
Systemic Symptoms ◽  
Oxygen Substitution ◽  
Almost All

AbstractIn the summer of 2019, an epidemic of e-cigarette or vaping product use associated lung injury (EVALI) broke out in the United States of America. EVALI is a lung disease that can be severe and life-threatening. It should be emphasized that EVALI is not a clinical diagnosis, but surveillance case definition. Due to the profile of users of such devices, the pathology mainly affects young adults, although cases of EVALI have been reported in almost all age groups, from teenage children to seniors. The worst prognosis is in patients over 35 years of age, with accompanying diseases. A significant number of patients declared the use of products containing tetrahydrocannabinol (THC). The most likely factor responsible for the occurrence of EVALI is vitamin E acetate, which is sometimes added to liquids necessary for the use of electronic cigarette type devices, especially those liquids that contain THC. Nevertheless, it is possible that other substances used in liquids may also be a causative factor. Typical for EVALI are respiratory, gastrointestinal and systemic symptoms, while in imaging tests, a characteristic feature of EVALI is the presence of opacities on the chest radiogram and ground-glass clouds on computed tomography scans. In the course of this disease, respiratory failure often occurs (58%). In the vast majority of cases oxygen substitution is necessary. Currently, the best treatment of EVALI is considered to be the administration of systemic glucocorticosteroids. Over 90% of patients with EVALI required hospitalization, while the mortality rate was about 2.42%. Median age of the fatalities was 51 years. The aim of this review is to summarise the available information on EVALI and to consider possible causative factors and pathomechanism.

scholarly journals 720. Efficacy of Fosfomycin for Injection (FOS) vs. Piperacillin–Tazobactam (PIP-TAZ) in Adults with Complicated Urinary Tract Infection (cUTI) and Acute Pyelonephritis (AP): ZEUS Study Outcomes in Patients With Reduced Study Drug Susceptibility

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S324-S324
Author(s):  
Keith S Kaye ◽  
Anita F Das ◽  
Paul B Eckburg ◽  
Steven P Gelone ◽  
Jennifer Schranz ◽  
...  
Keyword(s):  
Clinical Cure ◽  
Complicated Urinary Tract Infection ◽  
Study Drug ◽  
Fold Increase ◽  
The United States ◽  
Drug Susceptibility ◽  
Number Of Patients ◽  
Intent To Treat ◽  
Almost All

Abstract Background FOS is being pursued for US registration in cUTI/AP. Safety and efficacy of FOS vs. PIP-TAZ were demonstrated in the noninferiority ZEUS trial in hospitalized patients with cUTI/AP. Although FOS resistance has been observed in several in vitro studies, resistance rates in clinical settings have remained relatively stable despite >40 years of clinical use of FOS outside of the United States. Here we report outcomes in patients who developed reduced susceptibility to study drug (FOS or PIP-TAZ) after enrollment in ZEUS. Methods Patients received IV FOS 6g q8h or PIP-TAZ 4.5g q8h for 7 days (no oral switch allowed). The primary endpoint was overall success (clinical cure + microbiologic eradication) in microbiologic modified intent-to-treat (m-MITT) population at test-of-cure (TOC; Day 19–21). Reduced susceptibility to FOS or PIP-TAZ was defined as a ≥4-fold increase from baseline in minimum inhibitory concentration (MIC) at Day 5, end of treatment (EOT; Day 7–8), TOC, or late follow-up (LFU; Day 26 ± 2). Microbiologic eradication/persistence of baseline and postbaseline pathogens was confirmed post hoc by pulsed-field gel electrophoresis (PFGE). Results In all m-MITT patients, overall success/clinical cure/microbiologic eradication rates (with PFGE) at TOC were 69.0/90.8/70.7% (FOS) and 57.3/91.6/60.1% (PIP-TAZ). Reduced study drug susceptibility was identified in 7/184 (3.8%) FOS and 8/178 (4.5%) PIP-TAZ patients; all had monomicrobial infections (Table 1). Of these patients, almost all were aged ≥50 years (93%), male (73%), white (100%), and had a screening diagnosis of cUTI (93%). At TOC, 7/7 FOS patients and 7/8 PIP-TAZ patients had microbiologic persistence but all patients were clinical cures; these responses were all sustained through LFU (Table 1). Conclusion In the ZEUS study, few patients had urine isolates with reduced postbaseline susceptibility to either FOS or PIP-TAZ. No trend was observed in isolate species associated with decreased susceptibility to FOS or PIP-TAZ, including various Enterobacteriaceae species and Pseudomonas aeruginosa. Despite microbiologic persistence at TOC in a small number of patients, all of these patients were clinical cures at TOC and sustained cures at LFU. Disclosures All authors: No reported disclosures.

scholarly journals E‐cigarette or Vaping Product Use–Associated Lung Injury Produced in an Animal Model From Electronic Cigarette Vapor Exposure Without Tetrahydrocannabinol or Vitamin E Oil

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Michael T. Kleinman ◽  
Rebecca Johnson Arechavala ◽  
David Herman ◽  
Jianru Shi ◽  
Irene Hasen ◽  
...  
Keyword(s):  
Vitamin E ◽  
Lung Injury ◽  
Inflammatory Cells ◽  
The United States ◽  
Electronic Cigarette ◽  
Alveolar Wall ◽  
Cigarette Use ◽  
Shortness Of Breath ◽  
Product Use ◽  
Vitamin E Acetate

Abstract E‐cigarette or vaping product use–associated lung injury was recognized in the United States in the summer of 2019 and is typified by acute respiratory distress, shortness of breath, chest pain, cough, and fever, associated with vaping. It can mimic many of the manifestations of coronavirus disease 2019 (COVID‐19). Some investigators have suggested that E‐cigarette or vaping product use–associated lung injury was due to tetrahydrocannabinol or vitamin E acetate oil mixed with the electronic cigarette liquid. In experimental rodent studies initially designed to study the effect of electronic cigarette use on the cardiovascular system, we observed an E‐cigarette or vaping product use–associated lung injury‐like condition that occurred acutely after use of a nichrome heating element at high power, without the use of tetrahydrocannabinol, vitamin E, or nicotine. Lung lesions included thickening of the alveolar wall with foci of inflammation, red blood cell congestion, obliteration of alveolar spaces, and pneumonitis in some cases; bronchi showed accumulation of fibrin, inflammatory cells, and mucus plugs. Electronic cigarette users should be cautioned about the potential danger of operating electronic cigarette units at high settings; the possibility that certain heating elements may be deleterious; and that E‐cigarette or vaping product use–associated lung injury may not be dependent upon tetrahydrocannabinol, vitamin E, or nicotine.

A case of vaping-induced acute respiratory distress syndrome requiring extracorporeal life support

Perfusion ◽  
2020 ◽  
pp. 026765912092563
Author(s):  
Sudhir Krishnan ◽  
Guramrinder Singh Thind ◽  
Mona Soliman ◽  
Leslie Tolle ◽  
Eduardo Mireles-Cabodevila ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
The United States ◽  
Product Use

Introduction: An upsurge of e-cigarette, or vaping, product use–associated lung injury has been reported in the United States. The potential role of extracorporeal life support in e-cigarette, or vaping, product use–associated lung injury merits consideration. Case report: We present a case of vaping-induced severe acute respiratory distress syndrome that was salvaged with extracorporeal life support and had excellent recovery. Discussion: The mechanistic reasons for the sudden outbreak of e-cigarette, or vaping, product use–associated lung injury are under active investigation. A predominantly diffuse, bilateral pattern of lung injury has been reported, with some cases meeting the criteria for severe acute respiratory distress syndrome. To date, 68 deaths from e-cigarette, or vaping, product use–associated lung injury have been confirmed by the centers of disease control. However, resolution of lung injury has been reported in most cases, thereby justifying candidacy for extracorporeal life support, if required. Conclusion: Extracorporeal life support can be successfully utilized as a bridge to recovery in vaping-induced severe acute respiratory distress syndrome.

scholarly journals Review of Cases of E-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) and Brief Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Amr Essa ◽  
Jeffrey Macaraeg ◽  
Nikhil Jagan ◽  
Daniel Kwon ◽  
Saboor Randhawa ◽  
...  
Keyword(s):  
United States ◽  
Lung Injury ◽  
The United States ◽  
Cigarette Use ◽  
Review Of The Literature ◽  
The Past ◽  
Product Use ◽  
Vitamin E Acetate ◽  
Pathologic Features ◽  
Growing Body

Since the appearance of the E-Cigarette in the early 2000s, its industry, popularity, and prevalence have risen dramatically. In the past, E-Cigarette use with the vaping of nicotine or cannabis products had been associated with a few reported cases of lung injury. However, in 2019, thousands of cases of E-Cigarette or vaping product use-associated lung injury (EVALI) were reported in the United States. Evidence linked this outbreak with vaping of tetrahydrocannabinol (THC). We report two confirmed cases of EVALI and their associated clinical, radiologic, and pathologic features. This report supports the growing body of information regarding EVALI. It also discusses various substances, particularly vitamin E acetate, which has been suggested as a causative agent.

IT-INDUSTRY LEADERS: AN EXPERIENCE OF NARRATIVE INTERVIEW ANALYSIS

2021 ◽  
Vol 7 (1) ◽  
pp. 25-53
Author(s):  
Gulnara F. ROMASHKINA ◽  
Dmitriy I. Shashkin
Keyword(s):  
United States ◽  
Narrative Analysis ◽  
Age Groups ◽  
Personal Space ◽  
The United States ◽  
Business Strategies ◽  
Choice Situation ◽  
Strong Impact ◽  
It Industry ◽  
Almost All

The paper considers interviews of 100 leaders in the rating of key persons of the Russian Internet market, published by the Tagline agency during 2020. Only publicly available data with links to the original texts of the interviews was used for the narrative analysis. The use of the narrative method made it possible to capture general trends through the unique details of a person’s life. The purpose of the task was to determine whether there are behavioral features and motives for the decisions made in the choice situation. The main attention was paid to the leader’s life trajectory, habitual patterns of behavior and reaction to events, used business strategies, ways of achieving success and justification of actions choice. There was a gender bias: only 3 representatives of the rating were women. In addition, the opinion that the leaders of the young IT industry are mainly young people has not been confirmed. Average age 44 years, minimum 26 years, maximum 71 years. The three generations represented in the ranking differ in basic principles in their approach to business. By place of birth, the sample is biased towards Moscow and St. Petersburg. Moreover, St. Petersburg is represented only in the younger and middle age groups. Intergenerational transition enhances the effect of centralization. In almost all interviews, various aspects and expectations from the development of technology were highlighted, causing anxiety about the strong impact on a person’s personal space. It was noted that even businesses with the largest capitalization in the Russian rating are not included in the top world ratings. And those that were included are gradually falling in the ratings compared to the rapidly growing giants from China and the United States. A tendency of relocation, primarily in the United States, to search for investors and overcome distrust in Russian businessmen was noted. It is concluded that the experience of business development is mediated by the norms of personal interaction with people to a greater extent than with the market.

scholarly journals Demographics, Substance Use Behaviors, and Clinical Characteristics of Adolescents With e-Cigarette, or Vaping, Product Use–Associated Lung Injury (EVALI) in the United States in 2019

2020 ◽  
Vol 174 (7) ◽  
pp. e200756 ◽  
Author(s):  
Susan H. Adkins ◽  
Kayla N. Anderson ◽  
Alyson B. Goodman ◽  
Evelyn Twentyman ◽  
Melissa L. Danielson ◽  
...  
Keyword(s):  
United States ◽  
Substance Use ◽  
Lung Injury ◽  
Clinical Characteristics ◽  
The United States ◽  
Product Use

scholarly journals Research Combining Physical Activity and Sleep: A Bibliometric Analysis

2019 ◽  
Vol 127 (1) ◽  
pp. 154-181 ◽  
Author(s):  
Aamir R. Memon ◽  
Corneel Vandelanotte ◽  
Timothy Olds ◽  
Mitch J. Duncan ◽  
Grace E. Vincent
Keyword(s):  
Physical Activity ◽  
Bibliometric Analysis ◽  
International Collaboration ◽  
Age Groups ◽  
Final Analysis ◽  
The United States ◽  
Noncommunicable Diseases ◽  
The Mean ◽  
Almost All ◽  
Future Work

This study used a bibliometric analysis through the Scopus database to examine papers that combined physical activity and sleep, published between 1979 and 2018. Bibliometric indicators of productivity included publication volume and citation distribution, top 10 authors, average authors per paper, single- and multicountry collaboration, collaborative index, top 10 countries, leading journals, highly cited papers and network visualization for coauthorship, international collaboration, and co-occurrence of author keywords. The initial search identified 1,509 papers, of which 607 passed through comprehensive screening and were included in the final analysis. Most of the papers were research articles (90.8%) and published in English (90.8%). Most papers (81.4%) were published within the past decade, 2009–2018. The mean number of papers published per year was 15.2, the mean number of citations per paper was 257.3, and the mean number of authors per paper was 5.5. International collaboration was evident for 21.6% of the papers, and 95.6% of papers were multiauthored. The most prolific publishing institutions and authors were from the United States, Canada, Australia, Switzerland, and Brazil. Keyword analysis suggested that almost all age groups and study designs were covered, but most papers focus on noncommunicable diseases. Although there has been a rise in scientific production on combined physical activity and sleep research in recent years, future work in this area should include researchers from developing countries.

Old Patients and Uremia: Rates of Acceptance to and Withdrawal from Dialysis

1987 ◽  
Vol 10 (3) ◽  
pp. 166-172 ◽  
Author(s):  
D.G. Husebye ◽  
C.M. Kjellstrand
Keyword(s):  
Risk Factors ◽  
Medical Center ◽  
Age Groups ◽  
The United States ◽  
Living Situation ◽  
Term Survival ◽  
Old Patients ◽  
Hennepin County ◽  
Number Of Patients ◽  
Patients At Risk

We studied the entry of elderly uremic patients to chronic dialysis in the U.S. in 1979. We also reviewed long-term survival, causes of death, and risk factors for death in old patients on dialysis at one center for the period 1966 to 1983. A comparison of the number of patients at risk with the number entering dialysis in the United States in 1979 indicates that 80% of the patients aged 25-45 years, 30% of patients over the age of 65 years, and 6% of those over the age of 75 years entered dialysis during that period. Of 239 patients over the age of 70 years followed at the Regional Kidney Disease Program at Hennepin County Medical Center in Minneapolis, the seven-year cumulative survival was 17%. In this program withdrawal from dialysis was the commonest cause of death, accounting for 40% of all deaths. Age groups over 75 years, sex, time period, duration of dialysis, eight pre-existing degenerative diseases, living situation, family support, and site and type of dialysis were not risk factors for termination of dialysis, but living in a nursing home was. When compared to the young, total deaths and deaths from discontinuation were much higher, and this decision was made earlier. Half of the patients who died because dialysis was discontinued were competent and decided for themselves; the other half were incompetent and families and physicians made the decision. Thus, old patients do not live as long, and they withdraw from dialysis more frequently than the young. Qualitatively, though, the decisions to stop dialysis are no different from those decisions made by or for younger patients.

scholarly journals Status and prospects of the fight against diabetes

1997 ◽  
Vol 43 (6) ◽  
pp. 3-9
Author(s):  
M. I. Balabolkin
Keyword(s):  
Diabetes Mellitus ◽  
Total Population ◽  
Insulin Dependent Diabetes Mellitus ◽  
The United States ◽  
Dependent Diabetes Mellitus ◽  
Industrialized Countries ◽  
Average Life Expectancy ◽  
Number Of Patients ◽  
Insulin Dependent ◽  
Almost All

Diabetes mellitus remains one of the important medical and social health problems of almost all countries of the world. The prevalence of diabetes in industrialized countries is 5-6% and has a tendency to increase. This is mainly due to the increase in patients suffering from non-insulin-dependent diabetes mellitus (NIDDM, type II diabetes). So, according to S. R. Kahn (1995), in the United States about 6-7% of the total population are patients with NIDDM. Calculations showed that in the case of an increase in the average life expectancy of up to 80 years, the number of patients with NIDDM will exceed 17% of the total population.

Planning to reach for a rotating rod

2009 ◽  
Vol 41 (4) ◽  
pp. 207-213 ◽  
Author(s):  
Claes von Hofsten ◽  
Katarina Johansson
Keyword(s):  
Age Groups ◽  
Reach To Grasp ◽  
Almost All

Abstract. Hand adjustments of 6- and 10-month-old infants and adults were studied as they reach to grasp a rotating rod. It was found that the subjects in all three age groups adjusted the hand prospectively to the rotating rod during the approach of it. They also adjusted the reaches to the rotating rod in such a way that almost all of the grasps were overhand ones as predicted by the endpoint comfort hypothesis. Finally, it was found that the rotation of the hand was made up of movement units as translational movements are, and that the approach units were relatively independent of the rotational ones.

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