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Ghuman A, Choudhary P, Kasana J, Kumar S, Sawhney H, Bhat R, Kashwani R. A Systematic Literature Review on the Composition, Health Impacts, and Regulatory Dynamics of Vaping. Cureus 2024; 16:e66068. [PMID: 39229398 PMCID: PMC11368577 DOI: 10.7759/cureus.66068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Accepted: 08/03/2024] [Indexed: 09/05/2024] Open
Abstract
This comprehensive review deals with the multifaceted aspects of electronic cigarettes (e-cigarettes), examining their composition, health implications, regulatory challenges, and market dynamics. E-cigarettes, also known as vaping devices, function by warming a solution of liquid containing flavors, nicotine, and various other compounds to produce an aerosol for users to inhale. This review underscores the evolution and widespread adoption of e-cigarettes since their introduction in 2003, highlighting their appeal as alternatives to traditional tobacco smoking. The essential parts of e-cigarettes are the battery, heating element, e-liquid (or e-juice), and mouthpiece. Propylene glycol and vegetable glycerin are common ingredients in e-liquids, along with nicotine and other flavors. Concerns over the health impacts of e-cigarettes have grown, particularly in light of incidents like the e-cigarette or vaping-associated lung injury outbreak in 2019 linked to vaping-associated lung injuries. Evidence suggests that while e-cigarettes may pose fewer risks than conventional cigarettes, they are not without health consequences, including potential respiratory and cardiovascular effects. Regulatory efforts worldwide have struggled to keep pace with the rapid evolution of e-cigarettes, exacerbated by their diverse flavors and marketing strategies that appeal to youth. The review discusses global regulatory responses, including bans and restrictions, to curb youth uptake and address public health concerns. Furthermore, the rise of a black market for e-cigarettes poses additional challenges to effective regulation and tobacco control efforts. In conclusion, while e-cigarettes offer potential harm reduction benefits for adult smokers seeking alternatives to traditional tobacco products, their widespread availability and evolving landscape necessitate vigilant regulatory oversight to protect public health, especially among youth. Future research should continue to explore the long-term health impacts and efficacy of e-cigarettes as smoking elimination aids, informing evidence-based policies and interventions.
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Affiliation(s)
- Annayat Ghuman
- Department of Oral and Maxillofacial Surgery, Baba Farid University of Health Sciences, Faridkot, IND
| | - Priyanka Choudhary
- Department of Oral Pathology and Microbiology, Poornima Sethi Multi Speciality Hospital, New Delhi, IND
| | - Jyoti Kasana
- Department of Periodontology, North Delhi Municipal Corporation Medical College, Hindu Rao Hospital, New Delhi, IND
| | - Sumana Kumar
- Department of Microbiology, School of Life Sciences, JSS Academy of Higher Education and Research, Mysuru, IND
| | - Hemant Sawhney
- Department of Oral Medicine and Radiology, School of Dental Sciences, Greater Noida, IND
| | - Ramdas Bhat
- Department of Pharmacology, Rajiv Gandhi University of Health Sciences, Mangalore, IND
| | - Ritik Kashwani
- Department of Oral Medicine and Radiology, School of Dental Sciences, Greater Noida, IND
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Lee JU, Park JS, Seo E, Kim JS, Lee HU, Chang Y, Park JS, Park CS. Clustering analysis of HRCT parameters measured using a texture-based automated system: relationship with clinical outcomes of IPF. BMC Pulm Med 2024; 24:367. [PMID: 39080584 PMCID: PMC11290077 DOI: 10.1186/s12890-024-03092-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/09/2024] [Indexed: 08/02/2024] Open
Abstract
PURPOSE The extent of honeycombing and reticulation predict the clinical prognosis of IPF. Emphysema, consolidation, and ground glass opacity are visible in HRCT scans. To date, there have been few comprehensive studies that have used these parameters. We conducted automated quantitative analysis to identify predictive parameters for clinical outcomes and then grouped the subjects accordingly. METHODS CT images were obtained while patients held their breath at full inspiration. Parameters were analyzed using an automated lung texture quantification system. Cluster analysis was conducted on 159 IPF patients and clinical profiles were compared between clusters in terms of survival. RESULTS Kaplan-Meier analysis revealed that survival rates declined as fibrosis, reticulation, honeycombing, consolidation, and emphysema scores increased. Cox regression analysis revealed that reticulation had the most significant impact on survival rate, followed by honeycombing, consolidation, and emphysema scores. Hierarchical and K-means cluster analyses revealed 3 clusters. Cluster 1 (n = 126) with the lowest values for all parameters had the longest survival duration, and relatively-well preserved FVC and DLCO. Cluster 2 (n = 15) with high reticulation and consolidation scores had the lowest FVC and DLCO values with a predominance of female, while cluster 3 (n = 18) with high honeycombing and emphysema scores predominantly consisted of male smokers. Kaplan-Meier analysis revealed that cluster 2 had the lowest survival rate, followed by cluster 3 and cluster 1. CONCLUSION Automated quantitative CT analysis provides valuable information for predicting clinical outcomes, and clustering based on these parameters may help identify the high-risk group for management.
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Affiliation(s)
- Jong-Uk Lee
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, 22, Soonchunhyang-ro, Asan, 31538, Korea.
| | - Jong-Sook Park
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14584, Republic of Korea
| | - Eunjeong Seo
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, 22, Soonchunhyang-ro, Asan, 31538, Korea
| | - Jin Seol Kim
- Clinical Specialist Coreline Soft, 49 World-Cup Bukro 6-gil, Mapogu, Seoul, 03991, Korea
| | - Hae Ung Lee
- Clinical Specialist Coreline Soft, 49 World-Cup Bukro 6-gil, Mapogu, Seoul, 03991, Korea
| | - Yongjin Chang
- Clinical Specialist Coreline Soft, 49 World-Cup Bukro 6-gil, Mapogu, Seoul, 03991, Korea
| | - Jai Seong Park
- Department of Radiology, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Bucheon, 14584, Korea
| | - Choon-Sik Park
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon-si, Gyeonggi-do, 14584, Republic of Korea.
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Mukhopadhyay S, Sansano I. Smoking-Related Interstitial Lung Disease: Historical Perspective and Advances in the Twenty-first Century. Surg Pathol Clin 2024; 17:159-171. [PMID: 38692802 DOI: 10.1016/j.path.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
In the twenty- first century, there is widespread agreement that in addition to lung cancer, emphysema, and chronic bronchitis, cigarette smoking causes accumulation of pigmented macrophages, interstitial fibrosis, and Langerhans cell proliferation in various permutations. These histologic changes remain subclinical in some patients and produce clinical manifestations and imaging abnormalities in others. Debate surrounds terminology of these lesions, which are often grouped together under the umbrella of "smoking-related interstitial lung disease." This review summarizes modern concepts in our understanding of these abnormalities and explains how the recognition of smoking-related interstitial fibrosis has advanced the field.
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Affiliation(s)
- Sanjay Mukhopadhyay
- Department of Pathology, Pathology and Laboratory Medicine Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
| | - Irene Sansano
- Department of Pathology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Catalunya, Spain
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Lan D, Fermoyle CC, Troy LK, Knibbs LD, Corte TJ. The impact of air pollution on interstitial lung disease: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 10:1321038. [PMID: 38298511 PMCID: PMC10827982 DOI: 10.3389/fmed.2023.1321038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction There is a growing body of evidence suggesting a causal relationship between interstitial lung disease (ILD) and air pollution, both for the development of the disease, and driving disease progression. We aim to provide a comprehensive literature review of the association between air pollution, and ILD, including idiopathic pulmonary fibrosis (IPF). Methods We systematically searched from six online database. Two independent authors (DL and CF) selected studies and critically appraised the risk of bias using the Newcastle-Ottawa Scale (NOS). Findings are presented through a narrative synthesis and meta-analysis. Meta-analyses were performed exclusively when there was a minimum of three studies examining identical pollutant-health outcome pairs, all evaluating equivalent increments in pollutant concentration, using a random effects model. Results 24 observational studies conducted in 13 countries or regions were identified. Pollutants under investigation encompassed ozone (O3), nitrogen dioxide (NO2), Particulate matter with diameters of 10 micrometers or less (PM10) and 2.5 micrometers or less (PM2.5), sulfur dioxide (SO2), carbon monoxide (CO), nitric oxide (NO) and nitrogen oxides (NOx). We conducted meta-analyses to assess the estimated Risk Ratios (RRs) for acute exacerbations (AE)-IPF in relation to exposure to every 10 μg/m3 increment in air pollutant concentrations, including O3, NO2, PM10, and PM2.5. The meta-analysis revealed a significant association between the increased risk of AE-IPF in PM2.5, yielding RR 1.94 (95% CI 1.30-2.90; p = 0.001). Findings across all the included studies suggest that increased exposure to air pollutants may be linked to a range of health issues in individuals with ILDs. Conclusion A scarcity of available studies on the air pollutants and ILD relationship underscores the imperative for further comprehensive research in this domain. The available data suggest that reducing levels of PM2.5 in the atmosphere could potentially reduce AE frequency and severity in ILD patients.
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Affiliation(s)
- Doris Lan
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
| | - Caitlin C. Fermoyle
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
| | - Lauren K. Troy
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
| | - Luke D. Knibbs
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Public Health Unit, Public Health Research Analytics and Methods for Evidence (PHRAME), Sydney Local Health District, Camperdown, NSW, Australia
| | - Tamera J. Corte
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- National Health and Medical Research Council (NHMRC), Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
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