New progress of airway management in children with cystic fibrosis / 中华实用儿科临床杂志

Cystic fibrosis (CF) is a multisystem disease mainly caused by pathogenic mutation of the cystic fibrosis transmembrane conduction regulator gene.In recent years, with the deepened understanding of the disease and the popularization of gene detection technology, an increasing number of children are diagnosed with CF in China.Lung involvement is reported to affect the prognosis of the disease.Lung involvement is closely related to the airway, and good airway management can prolong the life of children.In this paper, the selection of airway clearance techniques and inhaled drugs were expounded, so as to improve the long-term airway management of children with CF in China.

Clinical trials of inhalation in pediatric population in China / 中国临床药理学与治疗学

AIM: To investigate the characteristics of clinical trials of inhalation in pediatric population in China. METHODS: The pediatric clinical trials of inhaled drugs in China registered on the www.Chinadrugtrials.org.cn and Clinical Trials in USA respectively until November 20, 2021 were reviewed. The characteristics of pediatric clinical trials of inhaled drugs including the clinical trial phases, drug indications and classificatio etc. were analyzed. RESULTS: There were 21 pediatric clinical trials of inhaled drugs registered on the www.Chinadrugtrials.org.cn, accounted for 8.9%(21/235) of inhalation clinical trials in all populations. 47.6% of them were generic drugs, mainly focusing on expectorants for Phlegm symptoms and inhaled preparations for asthma, which accounting for 71.4%(15/21). There were 34 pediatric clinical trials of inhaled drugs registered on the Clinical Trials in USA, the drug indications of which were mainly asthma and anesthesia, accounting for 76.5%(26/34). CONCLUSION: The pediatric clinical trials of inhalations in China started later, and the total number is small compared to adults, mainly focusing on generic drugs. We should pay attention to the research and development of new inhalation drugs, standardizing and promoting the clinical trials of inhaled drugs in pediatric population actively.

Actualización en abuso de drogas por vía nasal / Update on drug abuse by nasal route

La vía nasal, ya sea mediante la inhalación o aspiración, se ha convertido en una ruta atractiva para quienes abusan de sustancias, principalmente por la fácil accesibilidad y la rápida absorción sistémica, además de evitar las consecuencias asociadas al uso de drogas intravenosas (enfermedades de transmisión). El objetivo de esta revisión es presentar una actualización de diversas sustancias que son utilizadas por esta vía, enfocándose en aquellas en las que se ha documentado daños en la anatomía nasal.

The nasal route, either by inhalation or aspiration, has become an attractive route for substances abusers, mainly because of its easy accessibility, rapid systemic absorption and also to avoid the consequences associated with intravenous drug use (transmitted diseases). The objective of this review is to present an update of various substances that are used by this route, focusing on those in which damage to the nasal anatomy has been documented.

Neumomediastino espontáneo en paciente consumidor de cocaína inhalada / Spontaneous pneumomediastinum in a consumer of inhaled cocaine

El neumomediastino espontáneo es una patología poco frecuente, de curso predominantemente benigno. Se produce en personas con factores predisponentes como asma y enfermedad pulmonar obstructiva crónica y en presencia de factores desencadenantes como el consumo de cocaína inhalada (crack). La radiografía y la tomografía axial computarizada de tórax son herramientas de gran utilidad para orientar el diagnóstico. Se presenta el caso de un paciente masculino de 20 años de edad con antecedente de consumo de cocaína quien consulta por dolor torácico y disnea. La baja incidencia de esta patología hace que su diagnóstico sea un reto para el médico de emergencia por lo que es necesario un alto nivel de sospecha y conocimiento.

The spontaneous pneumomediastinum is a rare pathology that has a benign prognosis. It happens in patients with predisposing factors like asthma and COPD and in the presence of trigger factors like inhaled cocaine (crack) consumption. Chest radiography and CT scan are useful tools to orientate the diagnosis. We present the case of a 20 year-old male patient with dyspnea and chest pain with cocaine consumption history. The low incidence of the pathology makes the diagnosis a real challenge for the emergency room physician and its necessary a high level of suspicion and knowledge to do it.