Poor Respiratory Health Following Relapsing SARS-CoV-2 Infection in Children with Cystic Fibrosis

Children with cystic fbrosis (CF) constitute a high-risk group for COVID-19 with underlying chronic lung disease. COVID19 severity varying from mild infection to need of intensive care has been described in children with CF. Two children with signifcant underlying pulmonary morbidity are described here, who developed severe disease following SARS-CoV-2 infection. Case 1 (a 9-y-old boy) had pneumonia with respiratory failure requiring noninvasive ventilation support. He had delayed clearance of SARS-CoV-2, with recurrence of symptomatic disease with short asymptomatic period in between. He was also diagnosed with CF-related diabetes and allergic bronchopulmonary aspergillosis during the second episode. Case 2 (an 18-mo-old boy) had two episodes of SARS-CoV-2–related severe lower respiratory infection within a period of 2 mo, requiring high-fow nasal oxygen support. Both children had 3rd pulmonary exacerbation but SARS-CoV-2 was not detected in respiratory secretions. To conclude, children with CF with underlying pulmonary morbidity, can develop severe COVID-19 and prolonged SARS-CoV-2 shedding.

Respiratory impact of electronic cigarettes and low-risk tobacco

Abstract Electronic cigarettes, handheld devices that generate an aerosol that may contain nicotine by heating a solution or e-liquid, have been increasingly used especially in the young population. The aerosol's composition is determined by temperature, and by the substances contained in the heated liquid: glycerin, propylene glycol, nicotine in variable concentrations, flavoring agents, and other non-nicotine compounds. >80 compounds (including known toxics, e.g., formaldehyde, acetaldehyde, metallic nanoparticles, and acrolein) have been found in e-liquid and aerosols. Airway irritation, mucus hypersecretion, and inflammatory response, including systemic changes, have been observed after the exposure to e-cigarettes, leading to an increase in respiratory symptoms and changes in respiratory function and the host defense mechanisms. E-cigarette has been linked with an increase of symptoms in individuals with asthma, cystic fibrosis, and chronic obstructive pulmonary disease. One of the major concerns in public health is the rise in e-cigarette experimentation among never-smokers, especially children and adolescents, which leads to nicotine addiction and increases the chances of becoming with time a conventional smoker. There is an urgent need to regulate e-cigarettes and electronic nicotine delivery systems, at least with the same restrictions to those applied to tobacco products, and not to consider them as harmless products.

Association of biomass fuel smoke exposure and copd in women of rural India – A cross sectional hospital based study.

Background and Objectives: Commonly used biomass fuel in developing world is equally harmful for lung health as tobacco smoke and unfortunately it is increasing the prevalence of chronic respiratory diseases like COPD specially among women of rural India. Study conducted to find out the prevalence of COPD among biomass users and epidemiological factors associated with excess use of biomass fuel in our country.Methods: A cross sectional questionnaire based epidemiological hospital based study . A study was conducted among hospital visited women>18 years of age belonging to rural areas of Haryana. Questionnaire was filled to get the relevant information and complete clinical examination and pulmonary function test was done to make the diagnosis. Collected data was compiled and analysed by using standard statistical methods as Chi square test, p<.05 consider as significant, RR risk with 95% CI also calculated.Results: 560 subjects were included in the study, out of them 494(88.21%) were biomass users, literacy rate was very poor among biomass users 105(21.26%), than non users .COPD was observed as commonest chronic respiratory problem in biomass users 75.40% than non users , RR was 1.43(95%CI 1.31-1.55) and it was in more severe form in subjects who were exposed for prolonged period of biomass smoke. Conclusion: Study shows that risk of COPD increases by the constant exposure of biomass smoke in under ventilated houses and it was also found that the severity of diseases also increase with duration of exposure.

Razones para el enfoque práctico de la salud pulmonar / Reasons for the practical approach of lung health

El enfoque práctico de la salud pulmonar (Practical Approach to Lung Health), conocido como Atención Integral a la Tuberculosis y Enfermedades Respiratorias, es un abordaje sindrómico integral para mejorar la atención de salud en un grupo con estas afecciones respiratorias (tuberculosis, neumonía, asma, enfermedad pulmonar obstructiva crónica) y elevar la satisfacción de los usuarios. Se esclarecen los elementos de su propósito, contenidos e implementación de sus guías de prácticas clínicas óptimas para la atención primaria de salud en el contexto cubano.

The practical angle to the lung health, known as Integral Care for the tuberculosis and Respiratory Diseases, is an integral syndromic approach to improve the health care in a group of persons presenting with these respiratory affections (tuberculosis, pneumonia, asthma, chronic obstructive pulmonary disease) and to increase the user's satisfaction. The elements of its objective, contents and implementation of its guides of optimal clinical practices to the primary health care in the Cuban context.