ABSTRACT
El uso de productos del tabaco novedosos, en especial el cigarrillo electrónico y los dispositivos de combustión parcial de tabaco (sistemas Heat not Burn), han aumentado de forma exponencial, sobre todo en jóvenes y adolescentes. Las autoridades sanitarias y las sociedades científicas han mostrado preocupación ante las dudas que existen sobre su seguridad y eficacia (como método de abandono del tabaco). Tras el estudio de la evidencia científica disponible no es posible asegurar la inocuidad de los vapores o humos que inhalan los usuarios de estos dispositivos. Respecto a la eficacia no pueden recomendarse tras los resultados contradictorios de diferentes ensayos clínicos y metaanálisis, máxime cuando existen tratamientos seguros y eficaces para ayudar a dejar de fumar (vareniclina, terapia sustitutiva con nicotina y bupropion, unido al asesoramiento psicológico)
The use of novel tobacco products, particularly the electronic cigarette (EC) and partial tobacco combustion devices (HnB systems: Heat not Burn), has increased exponentially, particularly among adolescents and young people. The health authorities and scientific societies have shown concern about issues surrounding safety and effectiveness (as a method of smoking cessation). A study of the available scientific evidence has concluded that the safety of the vapor or fumes inhaled by the users of these devices cannot be guaranteed. Contradictory results from various clinical trials and meta-analyses also mean that these devices cannot be recommended for their effectiveness in cessation, especially when safe and effective treatments are available to help quit smoking (varenicline, nicotine replacement therapy, and bupropion, combined with psychological counseling)
Subject(s)
Humans , Adult , Societies, Medical/standards , Electronic Nicotine Delivery Systems/methods , Treatment Outcome , Electronic Nicotine Delivery Systems/standards , Tobacco Use CessationABSTRACT
The use of novel tobacco products, particularly the electronic cigarette (EC) and partial tobacco combustion devices (HnB systems: Heat not Burn), has increased exponentially, particularly among adolescents and young people. The health authorities and scientific societies have shown concern about issues surrounding safety and effectiveness (as a method of smoking cessation). A study of the available scientific evidence has concluded that the safety of the vapor or fumes inhaled by the users of these devices cannot be guaranteed. Contradictory results from various clinical trials and meta-analyses also mean that these devices cannot be recommended for their effectiveness in cessation, especially when safe and effective treatments are available to help quit smoking (varenicline, nicotine replacement therapy, and bupropion, combined with psychological counseling).
Subject(s)
Electronic Nicotine Delivery Systems , Pulmonary Medicine , Societies, Medical , Thoracic Surgery , Tobacco Use Cessation Devices/adverse effects , Aerosols , Cardiovascular Diseases/etiology , Electronic Nicotine Delivery Systems/statistics & numerical data , Humans , Neoplasms/etiology , Respiratory System/drug effects , Smoking Cessation , Spain , Tobacco Use Cessation Devices/statistics & numerical dataABSTRACT
La inmunodeficiencia común variable es una de las alteraciones de la inmunidad más frecuentes. Suele manifestarse con infecciones respiratorias de repetición, desde neumonías hasta otitis, y puede asociarse a otras patologías, como bronquiectasias o enfermedades intersticiales. Presentamos el caso de un paciente de 28 años con infecciones respiratorias frecuentes e infiltrados nodulares pulmonares, que fue diagnosticado de inmunodeficiencia común variable y bronquiolitis folicular. La bronquiolitis folicular se asocia, en algunos casos, a inmunodeficiencias y debe realizarse un diagnóstico diferencial con la hiperplasia nodular linfoide, la neumonía intersticial linfocítica y el linfoma BALT de bajo grado(AU)
Common variable immunodeficiency is one of the most frequent immunity alterations. The most common clinical presentation occurs with recurrent respiratory infections, from pneumonia to otitis, and may be associated with other diseases such as bronchiectasis or interstitial lung diseases. We report the case of a 28-year-old patient with frequent respiratory infections and nodular pulmonary infiltrates, who was diagnosed with common variable immunodeficiency and follicular bronchiolitis. In some of the cases, follicular bronchiolitis is associated with immunodeficiencies and should be included in a differential diagnosis with lymphoid nodular hyperplasia, lymphocytic interstitial pneumonia and low-grade BALT lymphoma(AU)
Subject(s)
Humans , Male , Adult , Bronchiolitis/complications , Bronchiolitis/diagnosis , Immunologic Deficiency Syndromes/complications , Pneumonia, Pneumocystis/complications , Lung Diseases, Interstitial/complications , Lung Diseases, Interstitial/diagnosis , Respiratory Tract Infections/complications , Respiratory Tract Infections/diagnosis , Lung Diseases, Interstitial/physiopathology , Lung Diseases, Interstitial , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/physiopathology , Respiratory Tract Infections , Radiography, Thoracic , Diagnosis, DifferentialABSTRACT
Common variable immunodeficiency is one of the most frequent immunity alterations. The most common clinical presentation occurs with recurrent respiratory infections, from pneumonia to otitis, and may be associated with other diseases such as bronchiectasis or interstitial lung diseases. We report the case of a 28-year-old patient with frequent respiratory infections and nodular pulmonary infiltrates, who was diagnosed with common variable immunodeficiency and follicular bronchiolitis. In some cases, follicular bronchiolitis is associated with immunodeficiencies and should be included in a differential diagnosis with lymphoid nodular hyperplasia, lymphocytic interstitial pneumonia and low-grade BALT lymphoma.
Subject(s)
Bronchiolitis/etiology , Common Variable Immunodeficiency/complications , Adult , Bronchiolitis/diagnosis , Humans , MaleABSTRACT
El síndrome de apnea-hipopnea del sueño (SAHS) es una entidad con una elevada prevalencia en la poblacióngeneral que, debido a su repercusión sociosanitaria, se ha convertido en un problema de salud públicade primera magnitud. La defi nición del síndrome ha ido evolucionando, así como la defi nición de acontecimientorespiratorio. El papel de los mecanismos infl amatorios en el desarrollo de enfermedad cardiovascularse encuentra en plena investigación y es probable que en el futuro haya que añadir marcadores biológicostanto en la defi nición del síndrome como en la elección del tratamiento. Aunque la técnica de referenciaen el diagnóstico es la polisomnografía, la poligrafía respiratoria se ha convertido en una alternativa váliday complementaria al tratarse de un método simplifi cado, que puede realizarse en el domicilio, para descartaro confi rmar la enfermedad. Sistemas expertos como el monocanal quizá aporten nuevos datos en lasimplifi cación del diagnóstico. Actualmente el tratamiento con presión positiva continua de la vía aérea(CPAP) sigue siendo el método de referencia y su indicación principal en pacientes con SAHS moderado osevero en los cuales ha demostrado disminuir la mortalidad(AU)
Sleep apnea-hypopnea syndrome (SAHS) is a highly prevalent disease in the general population and, due toits social and health repercussions, has become a major public health problem. The defi nition of thissyndrome, as well as that of respiratory event, have been refi ned.The role of infl ammatory mechanisms in the development of cardiovascular disease is currently underinvestigation and biological markers will probably be added, both in the defi nition of SAHS and in thechoice of treatment. Although the gold standard in diagnosis is polysomnography, respiratory polygraphyhas become a valid and complementary alternative, since this technique is a simplifi ed method that can beperformed in the home to confi rm or exclude this disease. Expert systems such as single-channel devicesmay help to simplify diagnosis. Currently, the mainstay of treatment is still continuous positive airwaypressure (CPAP); this modality is mainly indicated in patients with moderate or severe SAHS and has beenshown to reduce mortality in this group(AU)
