February Discussion

This month’s article was a very interesting read. It discusses the relationship between hospitalization and death with e-cigarette, or vaping, product use–associated lung injury (EVALI). This is a very relevant topic because it is a growing problem that is happening in today's society. Everyone I know at university vapes or smokes cigarettes, I am the only one who doesn't. Those that vape believe it is a better alternative than smoking cigarettes. Those who smoke are only doing it for social reasons and believe that is okay because they are not doing it all the time. The article mentions there was a higher proportion of hospitalized EVALI patients with fatal cases that had cardiac disease, asthma, or chronic obstructive pulmonary disease. I agree with Karina. It does show how important as well as how it can be very harmful to withhold medically relevant information from medical professionals. Withholding this important information can delay treatment, misdiagnose and can lead to death. There was a correlation between those who withheld this information and were discharged, their symptoms would worsen and lead to death. This article was a great read and really eye-opened how it is important to include all the information even if it is bad or embarrassing and how any type of smoking can truly damages your body. Many young adults believe vaping is better than smoking. If there was more information about how it is not a better alternative, it could possibly decrease the number of people who smoke or vape and could save many lives.

I think this article proves that as much as people would like to say that e-cigarettes or vape pens are safe alternatives to smoking they really aren't. Although it's true they aren't as bad as smoking cigars or cigarettes, they still cause "lung injury" which can result in death. They've only been around for 14 years, they're not heavily regulated, any solvents can be used to manufacture them, these factors all make them very dangerous to use.

In the article it was mentioned that many of the fatal deaths suspected to be caused by EVALI had pre-existing health problems, many had comorbidities. It's difficult/might not be accurate to conclude that all the deaths that made up the fatality count were due to using e-cigarettes or vape pens.

Maybe some studies should be done exclusively with people whose deaths were suspected to be caused by these e-cigarettes but led generally healthy lives.

This month’s article was an interesting read. This article assessed the clinical characteristics of hospitalized patients with fatal or non-fatal cases of EVALI. The findings of this paper confirm that most of the patients hospitalized with fatal cases reported using THC-containing e-cigarette, or vaping products. Interestingly, most of the hospitalized patients with EVALI reported using THC containing products and it is reported that the aerosols generated by e-cigarette and vapes contain nicotine, flavorings, addictive additives such as Vitamin E acetate and can deliver other substances such as THC and cannabidiol. In addition, the case reports of three patients who died from EVALI revealed that most patients had multiple preexisting medical conditions such as asthma, chronic obstructive pulmonary disease, morbid obesity and pre-existing heart failure which contributed in worsening of respiratory distress followed by death. A common denominator among the hospitalized patients with EVALI, were the prior chronic conditions such as cardiac disease, asthma, chronic obstructive pulmonary disease. Hence, it is strongly suggested that clinicians should ensure an accurate and timely assessment of exposures to vaping and cessation of those exposures. Furthermore, initial gastrointestinal symptoms such as diarrhea and vomiting are most frequently reported in hospitalized patients with fatal cases. Hence, it is recommended that clinicians should consider EVALI in patients who present primarily with constitutional symptoms, gastrointestinal symptoms, or both. In outpatient settings, when symptoms are attributable to infections, limited research suggests the use of glucocorticoids may be beneficial in the treatment of EVALI. I think there needs to be more research to evaluate the efficacy of glucocorticoids since its use is warranted in severely ill patients suffering from life-threatening infections. The data that is presented in this paper has its limitations; as the researchers only counted patients with EVALI who died as a fatal case, whereas other patients were too either too ill to be interviewed or accounted for non-fatal cases. Thus, more-in depth data collection and follow up should be used for patients with non-fatal cases to account for reported clinical differences.

This article about hospitalization and death associated with e-cigarettes and vapes, also noted as EVALI, discussed experiences that those suffering had encountered in the hospital setting as well as what procedures were followed. It shined a light on the risk factors associated with these substances as well as how harmful it can be to withhold information from medical professionals when seeking help. In many cases, between the initial hospital visit and the final visit, the patients were discharged and not soon after they experienced worsen symptoms, as well those who were discharged were the ones who had withheld critical information which had sadly proven fatal. It was interesting to see that in many cases patients were ashamed or did not want to hear about the risks associated with what they were doing. As well it discussed the array of health issues that are common in all patients suffering from EVALI. Things such as acute respiratory distress syndrome, gastrointestinal symptoms, cardiac disease and asthma were seen in most if not all the patients that were treated with both fatal and nonfatal EVALI. This point emphasized the risk and dangers that come with these substances that are often not visible at first glance and demonstrates just how much of an impact they can have on one’s health. Overall, it was an interesting read that addresses many important topics in this newer area of electronic products associated with lung injury.

This article on vape and cigarettes gave off light on the health concerns that are associated with the use of them. I have a few friends that are nicotine addicts and now look towards vape pens instead of cigarettes as they think it is a better alternative. This article really shows that it is not a better alternative and promotes that smoking in general should be completely left behind. It is worrisome that more than half of the patients under study received a diagnosis for acute respiratory distress syndrome which can further complicate into respiratory failure. The discussion of this article also talked about cardiac disease, asthma, and obstructive pulmonary disease to be a concern for these people. The authors also touched base on patients with fatal cases having a mental condition as well. However, it is not clear to me if the article points out e-cigarettes/vape being a causal factor to poor mental health or if pre-existing mental health conditions can be factor to using e-cigarettes. Very interesting read!

The research article showed a lot of information on e-cigarette, or vaping, product use–associated lung injury (EVALI) and their contribution to fatal diseases. I was interested in the fact of obesity and their correlation to fatality along with EVALI. It was also interesting to see the correlation of THC products and cannabis with EVALI and its fatality.