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1.
MMWR Morb Mortal Wkly Rep ; 69(9): 236-240, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32134907

RESUMO

On July 10, 2019, Wisconsin Department of Health Services (WDHS) was notified of five previously healthy adolescents with severe lung injuries who reported use of e-cigarette, or vaping, products before symptom onset. As of December 31, 2019, 105 confirmed or probable cases of e-cigarette, or vaping, product use-associated lung injury (EVALI)* had been reported to WDHS . Three social clusters (A, B, and C), comprising eight EVALI patients (cluster A = two patients, cluster B = three, and cluster C = three) were identified. WDHS investigated these clusters with standard and follow-up interviews; laboratory analysis of e-cigarette, or vaping, products; and analysis of bronchoalveolar lavage (BAL) fluid. All eight patients reported daily use of tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, product cartridges (THC cartridges) in the month preceding symptom onset. All THC cartridges were purchased from local illicit dealers, and all patients reported using THC cartridges labeled as "Dank Vapes," among other illicit brand names. At least two members of each cluster reported frequent sharing of THC cartridges before symptom onset. All eight patients also reported daily use of nicotine-containing e-cigarette, or vaping, products. Vitamin E acetate (VEA) was detected in all five THC cartridges tested from two patients, and in BAL fluid from two other patients. These findings suggest that THC cartridges containing VEA and sold on the illicit market were likely responsible for these small clusters of EVALI. Based on information presented in this and previous reports (1,2) CDC recommends not using THC-containing e-cigarette, or vaping, products, especially those obtained from informal sources such as friends, family, or in-person or online dealers (1). VEA is strongly linked to the EVALI outbreak and should not be added to e-cigarette, or vaping, products (1).


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Lesão Pulmonar/epidemiologia , Vaping/efeitos adversos , Adolescente , Análise por Conglomerados , Dronabinol/toxicidade , Feminino , Humanos , Masculino , Vaping/psicologia , Vitamina E/toxicidade , Wisconsin/epidemiologia , Adulto Jovem
2.
J Am Dent Assoc ; 151(3): 222, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32130951

Assuntos
Vaping , Humanos
3.
Orv Hetil ; 161(11): 413-418, 2020 Mar.
Artigo em Húngaro | MEDLINE | ID: mdl-32148093

RESUMO

Over 1000 respiratory cases have been linked to vaping at the Centers for Disease Control and Prevention (Atlanta, GA, USA). So far at least 800 cases were confirmed as vaping-associated lung injuries (VALI) with 18 patients succumbing to the illness. To our present knowledge, vape fluids may contain certain compounds with toxic properties. It is not yet understood though what component or components are responsible for the cluster of cases. However, federal and state investigators are focusing on vape cartridges that likely contained cannabinoids as most patients vaped legal or illegal cannabinoids. Until recently, USA and UK public health authorities have welcomed vaping as a safer alternative to smoking. In countries where cannabis has been legalised, vaporizers became an increasingly popular form of administration, however, no human studies have been performed with vaporized cannabinoid oils, hence the safety of such device is unknown. A 2018 review concluded that although vaping might not necessarily be safe, it is still preferable for both patients and their environment to smoking cannabis. Since 2015, Hungarian, Australian and European scientific bodies have called for ban on the unregulated e-cigarettes, but encouraged future research to understand all aspects of vaping cannabinoids. Should vaping itself prove harmless, it might open new avenues for research and potential administration of medical cannabis, however, the contrary may cause landslide in the tobacco industry. Orv Hetil. 2020; 161(11): 413-418.


Assuntos
Canabinoides/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina , Lesão Pulmonar/induzido quimicamente , Vaping/efeitos adversos , Austrália , Canabinoides/administração & dosagem , Humanos , Fumar Maconha
6.
Pneumologie ; 74(2): 77-87, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32016924

RESUMO

Beginning in April of 2019, the US saw > 2,000 cases of hospitalized, often young, patients with severe acute lung injury, of which over 40 died, and the only existing connection between patients was their use of electronic cigarettes (e-cigarettes). The acronym EVALI ("e-cigarette, or vaping, product use associated lung injury") has since been established for the condition. This review article is intended to provide an overview of recent, mainly US literature on EVALI, including the case definition, epidemiology, clinical presentation, typical disease progression, as well as potential triggers. Ancillary to this, the review further provides a general overview of the basic function of e-cigarettes, the ingredients of the liquids used in these (e-liquids), as well as a brief description of the associated potential inhalation risks.


Assuntos
Lesão Pulmonar Aguda/induzido quimicamente , Dronabinol/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina , Vaping/efeitos adversos , Lesão Pulmonar Aguda/epidemiologia , Canabidiol/administração & dosagem , Canabidiol/efeitos adversos , Surtos de Doenças , Dronabinol/administração & dosagem , Humanos , Nicotina/administração & dosagem , Nicotina/efeitos adversos , Fatores de Risco
12.
Am J Forensic Med Pathol ; 41(1): 1-4, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31977349

RESUMO

The popularity of e-cigarettes (vaping) has been on the rise in recent years, but the adverse effects of vaping have been greatly unknown. In 2019, the use of vaping products has been linked to an outbreak of severe lung disease, some cases of which have progressed to death. One death attributed to vaping is presented with emphasis on the gross and histopathological findings from the autopsy. These findings were correlated with the patient's clinical course and medicolegal investigation to determine the cause of death. To our knowledge, this is the first confirmed death in the United States that was directly attributed to the use of vaping.


Assuntos
Lesão Pulmonar Aguda/patologia , Sistemas Eletrônicos de Liberação de Nicotina , Pulmão/patologia , Síndrome do Desconforto Respiratório do Adulto/patologia , Vaping/efeitos adversos , Lesão Pulmonar Aguda/etiologia , Adulto , Canabinoides , Proliferação de Células , Pneumonia em Organização Criptogênica/diagnóstico , Feminino , Fibroblastos/patologia , Patologia Legal , Hemorragia/patologia , Humanos , Hipertensão , Hipertrofia Ventricular Esquerda/patologia , Macrófagos/patologia , Miocárdio/patologia , Obesidade Mórbida , Tamanho do Órgão , Óleos Vegetais , Alvéolos Pulmonares/patologia , Síndrome do Desconforto Respiratório do Adulto/etiologia , Estados Unidos , Remodelação Vascular
13.
MMWR Morb Mortal Wkly Rep ; 69(3): 84-89, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31971930

RESUMO

In 2019, the United States experienced an outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). Most EVALI patients have reported using tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, products obtained from informal sources (2,3), and vitamin E acetate in these products has been closely linked with EVALI (4,5). However, some EVALI patients report using only nicotine-containing products. This study compared demographic, product use, and clinical characteristics of EVALI patients in Illinois who reported using only nicotine-containing e-cigarette, or vaping, products with those of patients who reported using any THC-containing products. Among 121 interviewed Illinois EVALI patients, 17 (14%) reported using only nicotine-containing products, including nine (7%) patients who had no indication of any THC use, based on self-report or toxicology testing. Compared with patients who used any THC-containing products, these nine patients were significantly more likely to be older and female and were less likely to experience constitutional symptoms or to have leukocytosis on initial evaluation. Although vitamin E acetate has been strongly linked with EVALI, evidence is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC- or non-THC-containing products, in some reported EVALI cases. The contributing cause or causes of EVALI for patients reporting use of only nicotine-containing products warrants further investigation.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Lesão Pulmonar/epidemiologia , Nicotina/administração & dosagem , Nicotina/toxicidade , Vaping/efeitos adversos , Adolescente , Adulto , Idoso , Feminino , Humanos , Illinois/epidemiologia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Autorrelato , Adulto Jovem
14.
MMWR Morb Mortal Wkly Rep ; 69(3): 90-94, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31971931

RESUMO

Since August 2019, CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders have been investigating a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). This report updates patient demographic characteristics, self-reported substance use, and hospitalization dates for EVALI patients reported to CDC by states, as well as the distribution of emergency department (ED) visits related to e-cigarette, or vaping, products analyzed through the National Syndromic Surveillance Program (NSSP). As of January 14, 2020, a total of 2,668 hospitalized EVALI cases had been reported to CDC. Median patient age was 24 years, and 66% were male. Overall, 82% of EVALI patients reported using any tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, product (including 33% with exclusive THC-containing product use), and 57% of EVALI patients reported using any nicotine-containing product (including 14% with exclusive nicotine-containing product use). Syndromic surveillance indicates that ED visits related to e-cigarette, or vaping, products continue to decline after sharply increasing in August 2019 and peaking in September 2019. Clinicians and public health practitioners should remain vigilant for new EVALI cases. CDC recommends that persons not use THC-containing e-cigarette, or vaping, products, especially those acquired from informal sources such as friends, family members, or from in-person or online dealers. Vitamin E acetate is strongly linked to the EVALI outbreak and should not be added to any e-cigarette, or vaping, products (2). However, evidence is not sufficient to rule out the contribution of other chemicals of concern, including chemicals in either THC- or non-THC-containing products, in some reported EVALI cases.


Assuntos
Surtos de Doenças , Sistemas Eletrônicos de Liberação de Nicotina , Lesão Pulmonar/epidemiologia , Vaping/efeitos adversos , Adolescente , Adulto , Idoso , Dronabinol/toxicidade , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Lesão Pulmonar/terapia , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Vitamina E/toxicidade , Adulto Jovem
15.
MMWR Morb Mortal Wkly Rep ; 69(2): 44-49, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31945038

RESUMO

CDC, the Food and Drug Administration (FDA), state and local health departments, and public health and clinical stakeholders continue to investigate a nationwide outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) (1). EVALI patients in Illinois, Utah, and Wisconsin acquired tetrahydrocannabinol (THC)-containing products primarily from informal sources (2,3). This report updates demographic characteristics and self-reported sources of THC- and nicotine-containing e-cigarette, or vaping, products derived from EVALI patient data reported to CDC by state health departments. As of January 7, 2020, among 1,979 (76%) patients with available data on substance use, a total of 1,620 (82%) reported using any THC-containing products, including 665 (34%) who reported exclusive THC-containing product use. Use of any nicotine-containing products was reported by 1,128 (57%) patients, including 264 (13%) who reported exclusive nicotine-containing product use. Among 809 (50%) patients reporting data on the source of THC-containing products, 131 (16%) reported acquiring their products from only commercial sources (i.e., recreational dispensaries, medical dispensaries, or both; vape or smoke shops; stores; and pop-up shops), 627 (78%) from only informal sources (i.e., friends, family, in-person or online dealers, or other sources), and 51 (6%) from both types of sources. Among 613 (54%) EVALI patients reporting nicotine-containing product use with available data on product source, 421 (69%) reported acquiring their products from only commercial sources, 103 (17%) from only informal sources, and 89 (15%) from both types of sources. Adolescents aged 13-17 years were more likely to acquire both THC- and nicotine-containing products from informal sources than were persons in older age groups. The high prevalence of acquisition of THC-containing products from informal sources by EVALI patients reinforces CDC's recommendation to not use e-cigarette, or vaping, products that contain THC, especially those acquired from informal sources. Although acquisition of nicotine-containing products through informal sources was not common overall, it was common among persons aged <18 years. While the investigation continues, CDC recommends that the best way for persons to ensure that they are not at risk is to consider refraining from the use of all e-cigarette, or vaping, products.


Assuntos
Surtos de Doenças , Hospitalização/estatística & dados numéricos , Lesão Pulmonar/epidemiologia , Vaping/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dronabinol/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina , Feminino , Humanos , Lesão Pulmonar/terapia , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
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