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  1. Article: Life-threatening bronchospasm induced by an angiotensin-converting enzyme inhibitor in a chronically ventilated patient: Diagnostic pitfalls and literature review.

    Marcus, Esther-Lee / Hush, Amir / Atrash, Hisham / Shibli, Roaia / Heyman, Samuel N

    Respirology case reports

    2023  Volume 11, Issue 10, Page(s) e01224

    Abstract: Cough- and asthma-like symptoms are common adverse reactions to angiotensin-converting enzyme inhibitors (ACEi). However, attributing these symptoms to the use of ACEi might be masked by clinical confounders. We report a 68-year-old female residing in a ... ...

    Abstract Cough- and asthma-like symptoms are common adverse reactions to angiotensin-converting enzyme inhibitors (ACEi). However, attributing these symptoms to the use of ACEi might be masked by clinical confounders. We report a 68-year-old female residing in a long-term acute-care facility for patients requiring prolonged invasive mechanical ventilation treated for years with ACEi. Daily reversible bouts of life-threatening severe bronchospasm gradually developed over 6 weeks and abruptly resolved following the cessation of ACEi treatment. The late appearance of bronchospasm and the unique clinical setup of chronic invasive ventilation in a patient with smoking-related chronic obstructive lung disease are among the principal confounders that delay the identification of the causative association between ACEi and respiratory compromise. Chronic positive pressure ventilation may also conceal small airway reactivity and obstruction, similar to auto-positive end-expiratory pressure (auto-PEEP). Conceivably, angiotensin receptor blockers should be preferred over ACEi in such patients.
    Language English
    Publishing date 2023-09-20
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2750180-2
    ISSN 2051-3380
    ISSN 2051-3380
    DOI 10.1002/rcr2.1224
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Jerusalem's CoVID-19 Experience-The Effect of Ethnicity on Disease Prevalence and Adherence to Testing.

    Sorotzky, Michael / Raphael, Allon / Breuer, Adin / Odeh, Ma'aran / Gillis, Roni / Gillis, Michal / Shibli, Roaia / Fiszlinski, Judith / Algur, Nurit / Magen, Sophie / Megged, Orli / Schlesinger, Yechiel / Mendelovich, Joseph / Weiser, Giora / Berliner, Elihay / Barak-Corren, Yuval / Heiman, Eyal

    Journal of racial and ethnic health disparities

    2024  

    Abstract: Background: The management of the SARS-CoV-2 pandemic depends amongst other factors on disease prevalence in the general population. The gap between the true rate of infection and the detected rate of infection may vary, especially between sub-groups of ...

    Abstract Background: The management of the SARS-CoV-2 pandemic depends amongst other factors on disease prevalence in the general population. The gap between the true rate of infection and the detected rate of infection may vary, especially between sub-groups of the population. Identifying subpopulations with high rates of undetected infection can guide authorities to direct resource distribution in order to improve health equity.
    Methods: A cross-sectional epidemiological survey was conducted between April and July 2021 in the Pediatric Emergency Department of the Shaare Zedek Medical Center, Jerusalem, Israel. We compared three categories: unconfirmed disease (UD), positive serology test result with no history of positive PCR; confirmed disease (CD), history of a positive PCR test result, regardless of serology test result; and no disease (ND), negative serology and no history of PCR. These categories were applied to local prevailing subpopulations: ultra-orthodox Jews (UO), National Religious Jews (NRJ), secular Jews (SJ), and Muslim Arabs (MA).
    Results: Comparing the different subpopulations groups, MAs and UOs had the greatest rate of confirmed or unconfirmed disease. MA had the highest rate of UD and UO had the highest rate of CD. UD significantly correlated with ethnicity, with a low prevalence in NRJ and SJ. UD was also associated with larger family size and housing density defined as family size per number of rooms.
    Conclusion: This study highlights the effect of ethnicity on disease burden. These findings should serve to heighten awareness to disease burden in weaker populations and direct a suitable prevention program to each subpopulation's needs. Early awareness and possible intervention may lower morbidity and mortality.
    Language English
    Publishing date 2024-03-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2760524-3
    ISSN 2196-8837 ; 2197-3792
    ISSN (online) 2196-8837
    ISSN 2197-3792
    DOI 10.1007/s40615-024-01965-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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