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Revue Des Maladies Respiratoires Sep 2020The use of cannabis, cocaine or heroin can be responsible for many respiratory complications including asthma. (Review)
Review
INTRODUCTION
The use of cannabis, cocaine or heroin can be responsible for many respiratory complications including asthma.
OBJECTIVES
The aim of this systematic literature review of data was to expose the relations between cannabis, cocaine or heroin use and asthma.
RESULTS
Cannabis, cocaine or heroin use by inhalation may be responsible for respiratory symptoms (cough, wheezing), asthma onset, acute asthma exacerbations (which may require intubation and invasive ventilation) or deaths related to asthma. Lower adherence to asthma treatment is also observed. Cannabis induces a rapid bronchodilator effect. In contrast, its chronic use may induce a decrease in specific airway conductance. Studies on forced expiratory volume in one second (FEV1) reduction or decline are discordant.
CONCLUSION
Cannabis, cocaine or heroin use must be considered in cases of acute respiratory symptoms or asthma exacerbation in young persons and practitioners must help illicit substance users to stop their consumption.
Topics: Administration, Inhalation; Anti-Asthmatic Agents; Asthma; Cocaine-Related Disorders; Forced Expiratory Volume; Heroin Dependence; Humans; Marijuana Abuse; Medication Adherence; Respiratory Function Tests; Respiratory Sounds
PubMed: 32653338
DOI: 10.1016/j.rmr.2020.06.004 -
Journal of the American Veterinary... Dec 2018
Topics: Adenocarcinoma; Animals; Diagnosis, Differential; Euthanasia, Animal; Male; Nose Neoplasms; Respiratory Sounds; Sheep; Sheep Diseases; Tomography, X-Ray Computed
PubMed: 30668261
DOI: 10.2460/javma.253.12.1541 -
American Journal of Respiratory and... Sep 2021Preschool wheezing is heterogeneous, but the underlying mechanisms are poorly understood. To investigate lower airway inflammation and infection in preschool children... (Comparative Study)
Comparative Study
Preschool wheezing is heterogeneous, but the underlying mechanisms are poorly understood. To investigate lower airway inflammation and infection in preschool children with different clinical diagnoses undergoing elective bronchoscopy and BAL. We recruited 136 children aged 1-5 years (105 with recurrent severe wheeze [RSW]; 31 with nonwheezing respiratory disease [NWRD]). Children with RSW were assigned as having episodic viral wheeze (EVW) or multiple-trigger wheeze (MTW). We compared lower airway inflammation and infection in different clinical diagnoses and undertook data-driven analyses to determine clusters of pathophysiological features, and we investigated their relationships with prespecified diagnostic labels. Blood eosinophil counts and percentages and allergic sensitization were significantly higher in children with RSW than in children with a NWRD. Blood neutrophil counts and percentages, BAL eosinophil and neutrophil percentages, and positive bacterial culture and virus detection rates were similar between groups. However, pathogen distribution differed significantly, with higher detection of rhinovirus in children with RSW and higher detection of in sensitized children with RSW. Children with EVW and children with MTW did not differ in terms of blood or BAL-sample inflammation, or bacteria or virus detection. The Partition around Medoids algorithm revealed four clusters of pathophysiological features: ) atopic (17.9%), ) nonatopic with a low infection rate and high use of inhaled corticosteroids (31.3%), ) nonatopic with a high infection rate (23.1%), and ) nonatopic with a low infection rate and no use of inhaled corticosteroids (27.6%). Cluster allocation differed significantly between the RSW and NWRD groups (RSW was evenly distributed across clusters, and 60% of the NWRD group was assigned to cluster 4; < 0.001). There was no difference in cluster membership between the EVW and MTW groups. Cluster 1 was dominated by detection ( = 0.04), and cluster 3 was dominated by or or detection ( = 0.02). We identified four clusters of severe preschool wheeze, which were distinguished by using sensitization, peripheral eosinophilia, lower airway neutrophilia, and bacteriology.
Topics: Asthma; Child, Preschool; Female; Genetic Variation; Genotype; Humans; Infant; Male; Phenotype; Respiratory Sounds; Risk Factors; Severity of Illness Index; Symptom Assessment
PubMed: 33961755
DOI: 10.1164/rccm.202009-3696OC -
Allergology International : Official... Sep 2012Modern understanding of lung sounds started with a historical article by Forgacs. Since then, many studies have clarified the changes of lung sounds due to airway... (Review)
Review
Modern understanding of lung sounds started with a historical article by Forgacs. Since then, many studies have clarified the changes of lung sounds due to airway narrowing as well as the mechanism of genesis for these sounds. Studies using bronchoprovocation have shown that an increase of the frequency and/or intensity of lung sounds was a common finding of airway narrowing and correlated well with lung function. Bronchoprovocation studies have also disclosed that wheezing may not be as sensitive as changes in basic lung sounds in acute airway narrowing. A forced expiratory wheeze (FEW) may be an early sign of airway obstruction in patients with bronchial asthma. Studies of FEW showed that airway wall oscillation and vortex shedding in central airways are the most likely mechanisms of the generation of expiratory wheezes. Studies on the genesis of wheezes have disclosed that inspiratory and expiratory wheezes may have the same mechanism of generation as a flutter/flow limitation mechanism, either localized or generalized. In lung sound analysis, the narrower the airways are, the higher the frequency of breathing sounds is, and, if a patient has higher than normal breathing sounds, i.e., bronchial sounds, he or she may have airway narrowing or airway inflammation. It is sometimes difficult to detect subtle changes in lung sounds; therefore, we anticipate that automated analysis of lung sounds will be used to overcome these difficulties in the near future.
Topics: Asthma; Bronchi; Bronchial Provocation Tests; Humans; Lung; Respiratory Sounds
PubMed: 22722817
DOI: 10.2332/allergolint.12-RAI-0449 -
Journal of Osteopathic Medicine Oct 2022
Topics: Bronchiolitis; Humans; Infant; Respiratory Sounds
PubMed: 35512006
DOI: 10.1515/jom-2022-0034 -
Yonsei Medical Journal Jun 2023The radiographic assessment of lung edema (RALE) score enables objective quantification of lung edema and is a valuable prognostic marker of adult acute respiratory...
PURPOSE
The radiographic assessment of lung edema (RALE) score enables objective quantification of lung edema and is a valuable prognostic marker of adult acute respiratory distress syndrome (ARDS). We aimed to evaluate the validity of RALE score in children with ARDS.
MATERIALS AND METHODS
The RALE score was measured for its reliability and correlation to other ARDS severity indices. ARDS-specific mortality was defined as death from severe pulmonary dysfunction or the need for extracorporeal membrane oxygenation therapy. The C-index of the RALE score and other ARDS severity indices were compared via survival analyses.
RESULTS
Among 296 children with ARDS, 88 did not survive, and there were 70 ARDS-specific non-survivors. The RALE score showed good reliability with an intraclass correlation coefficient of 0.809 [95% confidence interval (CI), 0.760-0.848]. In univariable analysis, the RALE score had a hazard ratio (HR) of 1.19 (95% CI, 1.18-3.11), and the significance was maintained in multivariable analysis adjusting with age, ARDS etiology, and comorbidity, with an HR of 1.77 (95% CI, 1.05-2.91). The RALE score was a good predictor of ARDS-specific mortality, with a C-index of 0.607 (95% CI, 0.519-0.695).
CONCLUSION
The RALE score is a reliable measure for ARDS severity and a useful prognostic marker of mortality in children, especially for ARDS-specific mortality. This score provides information that clinicians can use to decide the proper time of aggressive therapy targeting severe lung injury and to appropriately manage the fluid balance of children with ARDS.
Topics: Adult; Humans; Child; Reproducibility of Results; Respiratory Sounds; Respiratory Distress Syndrome; Edema; Lung
PubMed: 37226565
DOI: 10.3349/ymj.2022.0653 -
The Journal of Allergy and Clinical... 2016Recurrent wheezing in the preschool children is a common clinical problem, often associated with significant morbidity related to acute episodes. The management of these... (Review)
Review
Recurrent wheezing in the preschool children is a common clinical problem, often associated with significant morbidity related to acute episodes. The management of these children has been complicated by a paucity of high-quality clinical trials in this age group. To fill this knowledge gap, National Heart, Lung, and Blood Institute's asthma research networks have performed a series of clinical trials in an effort to provide practitioners with guidance on appropriate management strategies. These studies establish daily inhaled corticosteroid (ICS) therapy in toddlers at high risk for subsequent asthma as an effective approach for the prevention of exacerbations and symptom reduction, but without evidence of disease-modifying properties. Additional studies have confirmed substantial heterogeneity in ICS response, in terms of both efficacy and effect on linear growth. Treatment with intermittent high-dose ICS was demonstrated to be an alternative approach to daily low-dose ICS for preventing severe exacerbations in toddlers with intermittent but significant wheeze and a positive modified asthma predictive index. This review details the findings and clinical implications derived from these studies, discuss the utility of biomarkers and the role of oral corticosteroids during acute exacerbations, and summarizes ongoing clinical trials in this age group.
Topics: Administration, Inhalation; Adrenal Cortex Hormones; Animals; Asthma; Biomedical Research; Child, Preschool; Clinical Trials as Topic; Disease Progression; Drug Dosage Calculations; Humans; National Heart, Lung, and Blood Institute (U.S.); Recurrence; Respiratory Sounds; United States
PubMed: 26772922
DOI: 10.1016/j.jaip.2015.10.003 -
Internal and Emergency Medicine Sep 2022During the Coronavirus-19 pandemic, chest X-ray scoring system have been validated by Al-Smadi and Toussie in this group of patients and even RALE score, previously...
During the Coronavirus-19 pandemic, chest X-ray scoring system have been validated by Al-Smadi and Toussie in this group of patients and even RALE score, previously designed for ARDS, have been used to estimate correlation with mortality. The aim of this study was to evaluate the prognostic value of As-Smadi, Tuossie and RALE scores in predicting death in the same population of patients when associated to clinical data. In this retrospective clinical study, data of patients with COVID-19, admitted to our hospital from 1st October 2020 to 31st December 2020 were collected. CXR images of each patient were analyzed with the three different scores above mentioned. 144 patients (male 96 aged 68.5 years) were included in the study. 93 patients reported a least 1 comorbidity and 36 died. The association with increasing age, presence of comorbidities, and lower hemoglobin was significantly associated with risk of death for all the regression models. When considering the radiological score, a significant effect was found for the Al Smadi and RALE scores, while no evidence of association was found for the Toussie score. The fraction of new information is 16.7% for the Al Smadi score, 12.9% for the RALE and 5.1% for the Toussie score. The improvement in the prognostic usefulness with respect to the base model is particularly interesting for the Al Smadi score. The highest c-index was also obtained by the model with the Al Smadi score.
Topics: COVID-19; Humans; Male; Prognosis; Respiratory Sounds; Retrospective Studies; SARS-CoV-2
PubMed: 35596103
DOI: 10.1007/s11739-022-02985-z -
Thorax Jun 1991
Topics: Asthma; Humans; Mental Disorders; Respiration; Respiratory Sounds; Vocal Cords; Voice Disorders
PubMed: 1858076
DOI: 10.1136/thx.46.6.401 -
Indian Pediatrics Dec 2020
Topics: COVID-19; Child; Child, Preschool; Humans; Infant; Respiratory Sounds; SARS-CoV-2
PubMed: 33318329
DOI: 10.1007/s13312-020-2078-1