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  1. Article ; Online: E-cigarette or vaping induced lung injury: A case series and literature review.

    Doukas, Sotirios G / Kavali, Leena / Menon, Rohan S / Izotov, Boris N / Bukhari, Amar

    Toxicology reports

    2020  Volume 7, Page(s) 1381–1386

    Abstract: Introduction: Recently, a rapidly increasing number of e-cigarette or vaping induced lung injury ... of lung injury and provide an up today summary of the known literature of EVALI-induced lung injury.: Methods ... often appear with constitutional and gastrointestinal symptoms. Based on the existing literature and ...

    Abstract Introduction: Recently, a rapidly increasing number of e-cigarette or vaping induced lung injury (EVALI) has been reported across the nation. Given the ongoing epidemic, it has been suggested that specific chemical substances used as additives in e-cigarettes could be highly related to EVALI. A history of vaping with positive radiographic changes and low suspicion for active infection are requirements for diagnosis but it still remains a diagnosis of exclusion. The course of the disease, mechanism of lung injury and the optimal management options need to be better understood. Here we aimed to discuss the clinical characteristics recognized in a case series of ten hospitalized EVALI patients with radiological findings of lung injury and provide an up today summary of the known literature of EVALI-induced lung injury.
    Methods: A retrospective chart review was conducted on ten patients who presented to Saint Peter's University Hospital in New Brunswick, NJ from July 2019 to February 2020, with a mean hospital stay of five days. According to the CDC recommended definition of the disease, our cases met the current working definition of confirmed or probable cases of EVALI.
    Results: Ten patients, with mean age 30.8 years (50 % male) and average years of vaping 1.708 with 60 % endorsing a simultaneous history of cannabis-related products use, went under a retrospective review. 3/10 (30 %) had documented medically-managed pulmonary disease history, 8/10 (80 %) presented with the respiratory-related chief complaint, 6/10 (60 %) presented with gastrointestinal symptoms and 7/10 (70 %) had constitutional symptoms. All patients (100 %) were found to have bilateral ground-glass opacities on chest imaging. 9/10 were admitted, 6/10 (60 %) had an oxygen saturation of <95 % requiring oxygen supplementation with 4/10 managed in the intensive care unit.
    Conclusion: EVALI patients with radiological findings of lung injury, although mainly present respiratory symptoms, may very often appear with constitutional and gastrointestinal symptoms. Based on the existing literature and our data it is argued that EVALI may be misdiagnosed and that closer monitoring is required to determine optimal diagnostic and therapeutic management of this condition. Our data and the existing literature suggest that laboratory and epidemiologic findings can be contributory for the diagnosis of the disease.
    Keywords covid19
    Language English
    Publishing date 2020-10-03
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 2805786-7
    ISSN 2214-7500 ; 2214-7500
    ISSN (online) 2214-7500
    ISSN 2214-7500
    DOI 10.1016/j.toxrep.2020.09.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: E-cigarette or vaping induced lung injury: A case series and literature review

    Doukas, Sotirios G / Kavali, Leena / Menon, Rohan S / Izotov, Boris N / Bukhari, Amar

    Toxicology reports. 2020, v. 7

    2020  

    Abstract: Recently, a rapidly increasing number of e-cigarette or vaping induced lung injury (EVALI) has been ... of lung injury and provide an up today summary of the known literature of EVALI-induced lung injury ... but it still remains a diagnosis of exclusion. The course of the disease, mechanism of lung injury and ...

    Abstract Recently, a rapidly increasing number of e-cigarette or vaping induced lung injury (EVALI) has been reported across the nation. Given the ongoing epidemic, it has been suggested that specific chemical substances used as additives in e-cigarettes could be highly related to EVALI. A history of vaping with positive radiographic changes and low suspicion for active infection are requirements for diagnosis but it still remains a diagnosis of exclusion. The course of the disease, mechanism of lung injury and the optimal management options need to be better understood. Here we aimed to discuss the clinical characteristics recognized in a case series of ten hospitalized EVALI patients with radiological findings of lung injury and provide an up today summary of the known literature of EVALI-induced lung injury.A retrospective chart review was conducted on ten patients who presented to Saint Peter’s University Hospital in New Brunswick, NJ from July 2019 to February 2020, with a mean hospital stay of five days. According to the CDC recommended definition of the disease, our cases met the current working definition of confirmed or probable cases of EVALI.Ten patients, with mean age 30.8 years (50 % male) and average years of vaping 1.708 with 60 % endorsing a simultaneous history of cannabis-related products use, went under a retrospective review. 3/10 (30 %) had documented medically-managed pulmonary disease history, 8/10 (80 %) presented with the respiratory-related chief complaint, 6/10 (60 %) presented with gastrointestinal symptoms and 7/10 (70 %) had constitutional symptoms. All patients (100 %) were found to have bilateral ground-glass opacities on chest imaging. 9/10 were admitted, 6/10 (60 %) had an oxygen saturation of <95 % requiring oxygen supplementation with 4/10 managed in the intensive care unit.EVALI patients with radiological findings of lung injury, although mainly present respiratory symptoms, may very often appear with constitutional and gastrointestinal symptoms. Based on the existing literature and our data it is argued that EVALI may be misdiagnosed and that closer monitoring is required to determine optimal diagnostic and therapeutic management of this condition. Our data and the existing literature suggest that laboratory and epidemiologic findings can be contributory for the diagnosis of the disease.
    Keywords chest ; electronic equipment ; gastrointestinal system ; hospitals ; lungs ; males ; oxygen ; radiography ; respiratory tract diseases ; therapeutics ; toxicology ; New Brunswick
    Language English
    Size p. 1381-1386.
    Publishing place Elsevier B.V.
    Document type Article
    Note NAL-AP-2-clean
    ZDB-ID 2805786-7
    ISSN 2214-7500
    ISSN 2214-7500
    DOI 10.1016/j.toxrep.2020.09.010
    Database NAL-Catalogue (AGRICOLA)

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  3. Article ; Online: Adolescent e-cigarette or vaping product use-associated lung injury: A case series and review of the literature.

    Singh, Alvin

    Pediatric pulmonology

    2022  Volume 57, Issue 4, Page(s) 1076–1084

    Abstract: Background: Adolescent e-cigarette or vaping product use-associated lung injury (EVALI) has ... concomitant diagnoses. We review the literature and describe how our analysis adds to the literature ... increased in prevalence, and while cases describing various pulmonary manifestations have been reported ...

    Abstract Background: Adolescent e-cigarette or vaping product use-associated lung injury (EVALI) has increased in prevalence, and while cases describing various pulmonary manifestations have been reported, reports on the presentations and outcomes in teenage patients are sparse.
    Methods: We retrospectively describe eight EVALI patients with different presentations, laboratory and imaging findings, treatment, and concomitant diagnoses. We review the literature and describe how our analysis adds to the literature.
    Findings: Eight males, aged 15-18 years of age presented with various symptoms. Four patients were Caucasian while four were of Hispanic origin. All patients presented with respiratory symptoms; six also had GI symptoms; five were hypoxemic; all but one patient admitted to using products containing tetrahydrocannabinol (THC). All patients had changes on imaging with ground-glass opacities. One patient underwent lung biopsy and bronchoscopy showing eosinophilic pneumonia. All patients received antimicrobial therapies without improvement until systemic steroids were administered. Six patients underwent pulmonary function testing, and five required medications for newly diagnosed persistent asthma. One patient developed pulmonary hypertension, which resolved after treatment. One patient required noninvasive ventilation. No patients were positive for SARS-CoV2. Two had coinfections with other microbes. Five patients required escalation of asthma therapies at follow-up with pulmonology.
    Conclusion: This analysis of eight adolescent males hospitalized for EVALI highlights the unpredictable spectrum of disease presentation and management. These patients can be misdiagnosed without proper screening and may have residual respiratory complications necessitating outpatient management by a pulmonologist.
    MeSH term(s) Adolescent ; Asthma/complications ; COVID-19 ; Electronic Nicotine Delivery Systems ; Humans ; Lung Injury/chemically induced ; Lung Injury/diagnostic imaging ; Male ; RNA, Viral ; Retrospective Studies ; SARS-CoV-2 ; Vaping/adverse effects
    Chemical Substances RNA, Viral
    Language English
    Publishing date 2022-01-31
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.25832
    Database MEDical Literature Analysis and Retrieval System OnLINE

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