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Pulmonary complications of solid-organ transplantation
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
RSV, human metapneumovirus and influenza virus infections occur seasonally, with epidemics in the winter and spring months, while adenovirus and parainfluenza infections are seen throughout the year. Patients with lower respiratory tract involvement, in the form of bronchiolitis or pneumonitis, typically present with fever, dyspnoea, cough and wheezing. Chest radiographs may be normal or may show only subtle interstitial changes. CT of the chest is more sensitive and findings of ground-glass, air-space consolidation, nodules, and tree-in-bud opacities are seen. The diagnosis rests on demonstration of virus in respiratory secretions obtained by nasopharyngeal swabbing, nasal wash or bronchoalveolar lavage. Viral culture represents the gold standard for diagnosis but typically entails a period of 3–14 days before results are available. Rapid diagnostic tests utilizing enzyme-linked immunosorbent assays or immunofluorescence techniques to identify viral antigens are now available but results should be corroborated by standard viral culture.
Pulmonary effects of e-liquid flavors: a systematic review
Published in Journal of Toxicology and Environmental Health, Part B, 2022
Felix Effah, Benjamin Taiwo, Deborah Baines, Alexis Bailey, Tim Marczylo
Flavor additives in food may undergo enzymatic metabolism, which might produce fewer toxic metabolites due to phase I and II metabolism (Del Olmo, Calzada, and Nuñez 2017). In contrast, exposure to GRAS-like substances by inhalation after thermal degradation may produce pharmacologically active compounds that produce severe adverse health effects (Fedan et al. 2006). Rose (2017) reported that occupational diacetyl inhalation exposure might lead to bronchiolitis obliterans (BO), more commonly referred to as “popcorn lung.” Bronchiolitis obliterans induced severe coughing, wheezing, and shortness of breath, symptoms resembling chronic obstructive pulmonary disease (COPD) (Aguilar, Michelson, and Isakow 2016). van Rooy et al. (2007) conducted an epidemiological study in the Netherlands suggesting a causal link between BO and chemical workers producing diacetyl for food flavorings. The British Medical Association (BMA) believes flavors’ safety should be closely monitored as evidence for potential adverse effects are emerging after heating and inhalation of e-liquid aerosol (Sassano et al. 2018). The medicines and healthcare products regulatory agency (MHRA) collects UK reports of EC’s harmful effects and safety concerns through their yellow-card scheme (https://yellowcard.mhra.gov.uk/).