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Chest Aug 2020Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic...
BACKGROUND
Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic review on the management of chronic cough due to CB to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.
METHODS
This systematic review asked three questions: (1) What are the clinical features of the history that suggest a patient's cough-phlegm syndrome is due to CB? (2) Can treatment of stable CB improve or eliminate chronic cough? (3) Can therapy that targets chronic cough due to CB prevent or reduce the occurrence of acute CB exacerbations? Studies of adult patients with CB were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using the CHEST organization methodology.
RESULTS
The search strategy used an assortment of descriptors and assessments to identify studies of chronic cough due to CB.
CONCLUSIONS
The evidence supporting the management of chronic cough due to CB is limited overall and of low quality. This article provides guidance on treatment by presenting suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.
Topics: Adult; Bronchitis, Chronic; Cough; Humans; Quality of Life; Symptom Flare Up; United States
PubMed: 32105719
DOI: 10.1016/j.chest.2020.02.015 -
Recenti Progressi in Medicina Jan 2020In recent years there has been an enormous development in the use of electronic cigarettes (e-cig). In Italy, in the 2019, the users of e-cig are about 900.000. E-cig... (Comparative Study)
Comparative Study
BACKGROUND
In recent years there has been an enormous development in the use of electronic cigarettes (e-cig). In Italy, in the 2019, the users of e-cig are about 900.000. E-cig users tend to overlook the absolute risk of the e-cig product in favor of the relative risk compared to traditional ones. This is also due to the fact that at the moment there are large knowledge gaps on the health effects of using e-cig. Recently reports have emerged regarding serious health adverse effects (AE) related to their use. As of December 2019, the American Centers for Disease Control and Prevention (CDC) reported 2409 cases of lung disease associated with the use of e-cig, and 52 deaths.
AIM
To summarize the available evidence on the health effects of electronic cigarettes.
METHODS
We searched systematic reviews (SR) of the literature published up to September 2019.
RESULTS
The systematic searches led to the identification of 14 SRs (1037 studies included of which 77 provided useful information for this review) that met the inclusion criteria. Given the heterogeneity of the comparisons and of the outcome measures considered, the results are described narratively. Effects on the respiratory system: cough, phlegm, asthma and bronchitis symptoms, cases of chronic bronchitis and COPD have also been reported. Effects on the oropharyngeal system: lesions in the oral cavity, villous black tongue, allergic reactions, endogenous formation of carcinogens, development of oral cancer. Effects on the cardiovascular system: increased heart rate, increased systolic and diastolic pressure. Effects on skin and annexes: squamous and pruritic dermatitis. Any adverse effect: the most frequently reported AEs are cough, dry mouth, shortness of breath, irritation of the mouth and throat and headache. Effects of exposure to e-cig passive smoking: increase in cotinine levels in exposed environments.
CONCLUSIONS
These results, based on evidence from very low to moderate, show a series of possible risks linked to the use of e-cig. However, there is a need for further well-conducted studies with longer follow-up periods to confirm these results.
Topics: Electronic Nicotine Delivery Systems; Humans; Risk; Tobacco Smoke Pollution; Vaping
PubMed: 31992902
DOI: 10.1701/3294.32651