-
Frontiers in Pharmacology 2023Observational studies and meta-analyses have demonstrated a positive correlation between the use of angiotensin-converting enzyme inhibitors (ACEIs) and lung cancer....
Observational studies and meta-analyses have demonstrated a positive correlation between the use of angiotensin-converting enzyme inhibitors (ACEIs) and lung cancer. However, the findings remain controversial; furthermore, the relationship between ACEI-induced cough and lung cancer development remains unknown. We used Mendelian randomization (MR) to verify the association between ACEI use, ACEI-induced cough, and the risk of lung cancer. We performed a two-sample MR analysis to determine the unconfounded relationships between ACE inhibition, which mimics the effects of ACEIs, and genetic proxies for ACEI-induced cough and lung cancer. Single nucleotide polymorphisms that imitate ACE receptors and ACEI-induced cough were collected and integrated into a meta-analysis of existing genome-wide association studies for various lung cancers. The relationship was quantified using inverse variance weighting, weighted median, and MR-Egger methods. A statistically significant association was observed between ACE inhibition and the risk of small cell lung cancer for Europeans (excluding rs118121655/rs80311894). Associations were identified between ACEI-induced cough and the risk of lung cancer for Europeans, although not for Asians, and between ACEI-induced cough and lung adenocarcinoma (excluding rs360206). Our findings reveal a relationship between ACE inhibition and lung cancer development, as well as a significant association between ACEI-induced cough and a higher risk of lung cancer for Europeans. Patients with hypertension who experience dry cough as a side effect of ACEI use should consider switching to an alternative antihypertensive treatment.
PubMed: 37799968
DOI: 10.3389/fphar.2023.1267924 -
BMJ (Clinical Research Ed.) Jun 2024
Topics: Humans; Cough; Female; Dyspnea; Tomography, X-Ray Computed; Diagnosis, Differential; Middle Aged
PubMed: 38843893
DOI: 10.1136/bmj-2023-078329 -
Cell Communication and Signaling : CCS Mar 2024Pulmonary fibrosis (PF) is a progressive interstitial inflammatory disease with a high mortality rate. Patients with PF commonly experience a chronic dry cough and... (Review)
Review
Pulmonary fibrosis (PF) is a progressive interstitial inflammatory disease with a high mortality rate. Patients with PF commonly experience a chronic dry cough and progressive dyspnoea for years without effective mitigation. The pathogenesis of PF is believed to be associated with dysfunctional macrophage polarization, fibroblast proliferation, and the loss of epithelial cells. Thus, it is of great importance and necessity to explore the interactions among macrophages, fibroblasts, and alveolar epithelial cells in lung fibrosis, as well as in the pro-fibrotic microenvironment. In this review, we discuss the latest studies that have investigated macrophage polarization and activation of non-immune cells in the context of PF pathogenesis and progression. Next, we discuss how profibrotic cellular crosstalk is promoted in the PF microenvironment by multiple cytokines, chemokines, and signalling pathways. And finally, we discuss the potential mechanisms of fibrogenesis development and efficient therapeutic strategies for the disease. Herein, we provide a comprehensive summary of the vital role of macrophage polarization in PF and its profibrotic crosstalk with fibroblasts and alveolar epithelial cells and suggest potential treatment strategies to target their cellular communication in the microenvironment.
Topics: Humans; Pulmonary Fibrosis; Fibrosis; Macrophages; Cytokines; Signal Transduction; Fibroblasts
PubMed: 38461312
DOI: 10.1186/s12964-024-01557-2 -
Federal Practitioner : For the Health... Sep 2023
PubMed: 38562160
DOI: 10.12788/fp.0407 -
Revista Espanola de Enfermedades... Jul 2023A 36-year-old man was admitted to the emergency department due to a 30-day history of abdominal distention and epigastralgia. He had described a non-intentional 10kg...
A 36-year-old man was admitted to the emergency department due to a 30-day history of abdominal distention and epigastralgia. He had described a non-intentional 10kg weight loss, dry cough, and fever 6 months before his admission. He had a history of tobacco and cocaine abuse and reported recurrent oral and genital ulcers. Physical examination showed an extensive area of venous collateral circulation on the abdominal wall, hepatomegaly, signs of a moderate ascites, and lower limb edema. Liver and renal function tests were normal. The ascitic fluid analysis did not show an inflammatory or infectious pattern. Upper flexible endoscopy revealed esophageal fine-caliber varices and colonoscopy showed an isolated terminal ileal ulcer. Abdominal imaging revealed hepatomegaly, voluminous ascites, and thrombosis of hepatic veins, inferior and superior vena cava (Figure 1). Infections and coagulation or lymphoproliferative disorders were excluded. Thereafter, the diagnosis of Budd-Chiari Syndrome in Behçet disease was established and immunosuppression treatment was started with good initial clinical evolution.
Topics: Male; Humans; Adult; Budd-Chiari Syndrome; Behcet Syndrome; Ascites; Hepatomegaly; Vena Cava, Superior; Vena Cava, Inferior
PubMed: 36263811
DOI: 10.17235/reed.2022.9267/2022 -
Respiratory Medicine and Research Apr 2024Refractory chronic cough (RCC) patients typically complain of a dry cough. Sputum production in these patients has rarely been described in the literature. However,...
BACKGROUND
Refractory chronic cough (RCC) patients typically complain of a dry cough. Sputum production in these patients has rarely been described in the literature. However, sputum production in RCC may be common, troublesome and particularly challenging to manage.
AIMS
We aimed to characterise patients referred to our regional specialist cough clinic who have significant sputum production (≥1 teaspoon of sputum daily) and compare their demographics, symptomatology and investigation results to those presenting with a dry RCC.
METHODS
A retrospective case note analysis of all consecutive referrals to a tertiary cough clinic identified as having a productive cough (≥1 teaspoon of sputum daily) was performed over a 12-month period. They were compared to a paired number of patients with dry RCC.
RESULTS
Patients with productive cough represented nearly a quarter (98/398, 24.6 %) of new patient referrals to the clinic. Demographic information, symptomatology and investigation results were comparable to those with a dry RCC. Over a third, 35.8 % of patients with a productive cough reported expectorating an egg-cupful of sputum or more a day. Nearly half, 40% of those with high volume sputum production (≥egg-cupful daily) had both a normal CT thorax and normal spirometry.
CONCLUSIONS
Patients with RCC can expectorate significant volumes of sputum in the absence of underlying lung disease. This group have similar demographics to those with dry RCC. This is the first piece of work to our knowledge to describe this cohort. Future work needs to acknowledge this forgotten phenotype to ensure that they receive comprehensive evaluation and evidenced based treatment.
PubMed: 38843596
DOI: 10.1016/j.resmer.2024.101106 -
Acta Medica Portuguesa Oct 2023The COVID-19 pandemic has presented numerous challenges to healthcare systems. As the number of affected individuals continues to rise, it is crucial to find preventive,...
INTRODUCTION
The COVID-19 pandemic has presented numerous challenges to healthcare systems. As the number of affected individuals continues to rise, it is crucial to find preventive, diagnostic, and therapeutic approaches. This study aims to describe different COVID-19 sequelae within a Primary Health Care population.
METHODS
A retrospective cohort study was conducted in adults diagnosed with COVID-19 from March 2020 to April 2022, excluding pregnant women, minors, nursing home residents, hospitalizations, and deaths. Data was gathered from surveillance records on the Trace COVID-19® platform, a pre-set original questionnaire (which included the Portuguese version of the World Health Organization's Quality of Life Assessment Instrument), and, if needed, patient electronic health records. Information on sociodemographic and clinical characteristics of acute COVID-19 was collected along with long COVID symptoms.
RESULTS
This study included 284 patients, aged 19 to 99 years old. The five most prevalent acute COVID-19 symptoms were fever (50.0%), tiredness (48.2%), myalgias (44.7%), dry cough (37.7%) and odynophagia (36.3%). Symptoms related to the neurological system (23.2%) and tiredness (22.9%) were the most prevalent in long COVID symptoms. Acute tiredness and arthralgia were associated with all long COVID outcomes. The associations between acute COVID-19 symptoms with long COVID outcomes were stronger for anosmia [OR = 5.07, 95% confidence interval (CI) 2.49 - 10.36, p < 0.001] on a neurological chapter, acute tiredness for long lasting tiredness (OR = 4.07, 95% CI 2.07 - 8.02, p = 0.041), fatigue for muscles and/or bones chapter (OR = 7.55, 95% CI 3.06 - 18.66, p < 0.001), tiredness on an endocrine/hormonal chapter (OR = 6.54, 95% CI 2.37 - 18.04, p < 0.001), dyspnea for respiratory symptoms (OR = 5.67, 95% CI 1.92 - 16.74, p = 0.002) and fever for stomach or intestine symptoms (OR = 8.06, 95% CI 2.55 - 25.47, p < 0.001). Almost all quality of life dimensions were negatively associated with the number of long COVID symptoms.
CONCLUSION
A higher number of acute symptoms, as well as the presence of specific COVID-19 symptoms were associated with reported symptoms ≥ 12 weeks after infection. In the studied population, an increased number of symptoms in both acute and long COVID had a significant negative impact on the perception of overall quality of life. The identification of these relationships could provide a new perspective for post-COVID care.
Topics: Pregnancy; Adult; Humans; Female; Young Adult; Middle Aged; Aged; Aged, 80 and over; Post-Acute COVID-19 Syndrome; COVID-19; Retrospective Studies; Pandemics; Quality of Life; Fever
PubMed: 37643476
DOI: 10.20344/amp.19566 -
European Journal of Case Reports in... 2023Organising pneumonia belongs to diffuse interstitial lung diseases; we distinguish the cryptogenic organising pneumonia, which is idiopathic, from the secondary...
INTRODUCTION
Organising pneumonia belongs to diffuse interstitial lung diseases; we distinguish the cryptogenic organising pneumonia, which is idiopathic, from the secondary organising pneumonia caused by drugs or a defined cause. Denosumab is a human monoclonal antibody, rarely inducing adverse pulmonary effects.
CASE DESCRIPTION
A 57-year-old female patient was admitted to our chest clinic for acute respiratory distress. She was treated with denosumab for severe osteoporosis. The patient described a dry cough and dyspnoea over the previous four months, increased after the last injection of denosumab. A high-resolution computed tomography scan showed bilateral basal parenchymal condensations. The aetiological investigation did not reveal any infectious or immunological origin. The favourable computed tomography imaging and clinical evolution after corticosteroid therapy led to the diagnosis of drug-induced organising pneumonia.
CONCLUSION
Denosumab could induce organising pneumonia. Therefore, clinicians should be aware of this pulmonary toxicity.
LEARNING POINTS
To the best of our knowledge denosumab, a human monoclonal antibody, may rarely induce organising pneumonia.Despite this, we advocate that clinicians be aware that exposure to this drug can cause pulmonary toxicity.The taking of denosumab by our patient does not in any way prove the causal link.
PubMed: 37789975
DOI: 10.12890/2023_004043 -
The Journal of International Medical... Nov 2023Angiosarcoma is the most invasive and malignant cardiac tumor and most commonly originates from the right atrium. Early diagnosis is essential, and echocardiography has...
Angiosarcoma is the most invasive and malignant cardiac tumor and most commonly originates from the right atrium. Early diagnosis is essential, and echocardiography has an important role in diagnosis. This tumor grows aggressively, and metastases to other sites makes it difficult to control. Surgical treatment remains the best option for patients who do not respond to chemoradiotherapy. We herein report a case of a 17-year-old patient with cardiac angiosarcoma who presented with dyspnea, chest pain, dry cough, and fever. Although we considered the most probable diagnosis to be constrictive pericarditis, pathologic examination revealed a primary angiosarcoma originating from the pericardium. The patient underwent total pericardiectomy. However, despite receiving chemotherapy for 2 weeks postoperatively, she developed complications including leukopenia and eventually died of respiratory failure. Late diagnosis of angiosarcoma often occurs, resulting in progression to end-stage disease and a very poor prognosis. Therefore, a thorough understanding of this entity, knowledge of its pitfalls in management, and establishment of an accurate treatment guideline would help to develop a reliable and life-saving treatment approach for these patients.
Topics: Female; Humans; Adolescent; Hemangiosarcoma; Mediastinal Neoplasms; Thymus Neoplasms; Heart Neoplasms; Chemoradiotherapy
PubMed: 37987637
DOI: 10.1177/03000605231211772 -
Current Medical Research and Opinion Oct 2023EA 575 (Prospan) is a herbal medicine containing a dried extract of ivy leaves (drug extract ratio 5-7.5:1; extraction solvent, 30% ethanol). Although widely used for... (Review)
Review
OBJECTIVES
EA 575 (Prospan) is a herbal medicine containing a dried extract of ivy leaves (drug extract ratio 5-7.5:1; extraction solvent, 30% ethanol). Although widely used for the treatment of cough, there remains a lack of clarity on the effects of EA 575 in children. This study aimed to evaluate the efficacy and tolerability of EA 575 in pediatric patients with cough, a literature review and expert survey.
METHODS
A MEDLINE/PubMed database search was performed to identify articles evaluating the efficacy and tolerability of EA 575 in pediatric patients with cough. An online survey of international pediatric cough experts was conducted to gather expert opinion regarding the use of EA 575 for pediatric cough.
RESULTS
Ten controlled clinical trials and nine observational studies were identified. Controlled trials reported improvements in lung function and subjective cough symptoms with EA 575, while observational studies indicated overall favorable efficacy. EA 575 was generally well tolerated, with a low incidence of adverse events in children of all ages, including those aged <1 year. Survey responses from ten experts aligned with findings from the reviewed studies. Most experts agreed that EA 575 may improve quality of life, and highlighted its potential benefits on sleep.
CONCLUSIONS
EA 575 has minimal side effects in pediatric patients with cough, as demonstrated by large, real-world studies. EA 575 may provide clinical benefits in pediatric patients; however, more robust clinical trials are needed to confirm its efficacy.
PubMed: 37731370
DOI: 10.1080/03007995.2023.2258777