New study suggests potential risk with e-cigarettes

(KXXV) -Many smokers have turned to e-cigarettes and vapes as an alternative to traditional tobacco products.

A new study suggests that these products are not without risks of their own.

 According to Dr. Donald Cross, Director of Cardiology of Baylor Scott & White Medical Center-Hillcrest, currently there is not much medical research on the effects.

"The e-cigarette is fairly new and scientifically we really don't know so we're starting to collect that data."

In a recent study from The Journal of the American Medical Association, they found habitual users of electronic cigarettes are more likely to show increased cardiovascular risks.

"The nicotine that's aerosolized in the e-cigarette may have some detrimental effects to the heart just like you get from the cigarette," Cross said. "If people are thinking the e-cigarette is something they are going to use lifelong because it's safe for them this research really brings this into question."

Many of the juices or liquids used in the e-cigarettes are offered with nicotine. The amount varies allowing users to cut down on their intake or eliminate it completely. Right now, Dr. Cross says that may be the most heart healthy choice.

"This study suggests more research needs to be done and we can't think that the e-cigarette is completely safe," he said.

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Resource : http://www.kxxv.com/story/34483264/new-study-suggests-potential-risk-with-e-cigarettes

Report: A quarter of teenagers who use e-cigarettes have tried ‘dripping’

In 2003, after his father died from a tobacco habit, a Chinese pharmacist named Hon Lik developed an electronic device to vaporize nicotine. A precursor to what are now called e-cigarettes or vaporizers, the device’s goal was to deliver nicotine without the carcinogens.

Mr. Lik’s first attempt relied on ultrasonic technology to create vapor, but the guts of electronic cigarettes today are, as a rule, battery-powered heating coils. These coils, known as atomizers, turn liquids — often flavored, with nicknames like e-liquid or juice, and frequently but not always containing nicotine — into vapor.

As e-cigarettes grew in popularity in the mid-to-late 2000s, users did not stop tinkering with the technology. Mass-produced cartridges, pre-filled with the nicotine liquid of various concentrations, are common.

But one technique eschews the tanks or cartridges; the juice is manually dropped directly onto the coil, and the resulting vapor inhaled. (Devices can now be purchased specifically for this purpose, or modified.) The technique, called “dripping,” may be popular among teenage e-cigarette users, reported researchers last week in the journal Pediatrics.

In a survey of 7,000 high schoolers in Connecticut, just over 1,000 reported using e-cigarettes. Of these, 1 in 4 said they had tried dripping. The concern, the authors noted, was that teenagers may be attempting to drip but accidentally exposing themselves to unsafe levels of e-liquids. “What we are discovering with our work with youth is that kids are actually using these electronic products for other behaviors, not just for vaping e-liquids from cartridges or tanks,” said Yale University psychiatry professor Suchitra Krishnan-Sarin, an author of the study, in a news release.

Between 2013 and 2014, rates of e-cigarette use by high schoolers increased from under 5 percent to 13.4 percent, the Centers for Disease Control and Prevention found, at the same time as tobacco use dropped. In 2016, federal law banned children under the age of 18 from buying e-cigarettes. As the new study indicates, the law has not halted teen vaping. But it could not be said from the report whether dripping was increasing or decreasing in popularity among the teenage crowd — the report was the first to examine the practice of dripping, at all, among the high school set.

Ms. Krishnan-Sarin and her colleagues found that most of those who dripped did so to produce “thicker clouds of vapor.” But a few teens reported they dripped because it made the flavors “taste better” or produced a “stronger throat hit”; a fifth said they dripped out of curiosity.

In the paper, the researchers warned that dripping, instead of a “standard puff” of an e-cigarette, possibly exposed the teenagers to higher concentrations of vaporized nicotine. “Everybody assumes vaping is a safer way [than cigarettes] of administering nicotine,” Ms. Krishnan-Sarin said, “but we know so little about the risks of vaping.”

The degree of Mr. Lik’s success in removing the danger from nicotine delivery has been the subject of intense debate. Some studies indicate that it is possible for e-cigarettes to help users quit smoking; others counter that e-cigarettes might complement a conventional tobacco habit, or even desensitize teenagers who vape to the dangers of smoking. But e-cigarette proponents point out that the devices, because they omit the tar-producing combustion of tobacco, are preferable to cigarettes.

A new study in the journal Annals of Internal Medicine, also published last week, tracked the levels of nicotine and cancer-causing chemicals in 181 people, including e-cigarette users, former smokers who vape and cigarette smokers for six months. Those who restricted themselves to vaporizers or e-cigarettes only were exposed to lower levels of carcinogens. Former smokers who now only used e-cigarettes, for instance, had a 97.5 percent reduction of NNAL, the form of a tobacco-specific carcinogen that is excreted in urine.

“What we found is that using e-cigarettes alone results in very low exposure to toxins and carcinogens,” Lion Shahab, a health psychologist at University College London and an author of the Annals paper, told New Scientist on last week.

Almost all e-cigarette science comes with the caveat that more research is needed. Pinning down just how safe the technology is a challenge. One issue, noted Pennsylvania State University chemist Kurt Kistler to Motherboard in 2016, stems from the “huge variety of devices” used.

That variety is also reflected in nicotine delivery technique, like dripping over puffing. Research led by Virginia Commonwealth University’s Alan Shihadeh revealed that dripping at very high coil temperatures — between 266 degrees to upward of 662 degrees — produced “high toxicant emissions.”

“If I was in a torture chamber and you said I had to puff on something, I’d choose an e-cigarette over a regular cigarette,” Mr. Shihadeh told the New York Times in 2014. “But if you said I could choose an e-cigarette or clean air, I’d definitely choose clean air.” He went on to say: “And I definitely wouldn’t drip.”

Resource : http://www.post-gazette.com/news/health/2017/02/13/Report-A-quarter-of-teenagers-who-use-e-cigarettes-have-tried-dripping/stories/201702130073

Impacto diagnóstico prenatal en las cardiopatías congénitas

Se define como cardiopatía congénita a la malformación estructural o alteración funcional del corazón y sus grandes vasos, detectadas durante la gestación o presentes al momento de nacer y que se originan en las primeras semanas del embarazo por factores que actúan alterando el desarrollo embriológico del sistema cardiovascular.

Los embarazos de alto riesgo requieren una alta atención y excelente resolución para proveer un cuidado adecuado a través del mismo.

El tema es tratado por la cardióloga intervencionista del Centro de Diagnóstico, Medicina Avanzada y Telemedicina (Cedimat), Janet Toribio, quien trabaja con niños con enfermedades cardiovasculares, junto a un equipo de experimentados cardiólogos pediatras.

Las cardiopatías congénitas son las malformaciones más frecuentes, con una prevalencia de 8 a 10 por 1000 recién nacidos vivos, que es igual a decir que son el 1%.

Sin embargo estas estadísticas no toman en cuenta los abortos que en su mayoría obedecen a fetos con cardiopatias severas, ni las simples que pasan desapercibidas, por tanto, se puede afirmar que la prevalencia de las cardiopatías es mucho mayor.

El diagnóstico

A pesar de que el exemen ecocardiográfico fetal del segundo trimestre, en busca de defectos congénitos es una práctica ampliamente difundida en la mayor parte del mundo, la detección de cardiopatías congénitas en la población general por éste método ha mostrado una tasa de detección baja del 15 al 45 % (en paises desarrollados).

Así mismo, se ha demostrado que el 90 % de cardiopatias detectadas intraútero, no tenían alto riesgo. Por tal motivo, sigue aún en discusión si sólo se debe indicar ecocardiograma fetal a las embarazadas con alto riesgo o a todas.

La doctora dijo que la mayoría de las cardiopatía tienen un origen multifactorial, pero existen algunas indicaciones precisas de ecocardiograma fetal, lo que implica que tienen condiciones de alto riesgo, las que a su vez aumentan las posibilidades de que el feto padezca una cardiopatía congénita.

Mirada a las causas

De este modo tenemos causas maternas o familiares y condiciones fetales, afirma la especialista en cardiopatías infantiles.

Dentro de las causas maternas las enfermedades metabólicas como la diabetes, ya sea como condición previa al embarazo o adquirida durante el embarazo y la mal controlada son capaces de causar grandes cardiopatías congénitas, asegura.

La así también Fenilcetonuria, las enfermedades del tejido conectivo como el Lupus Eritematoso Sistémico, cuyos fetos pueden padecer Bloqueo de su Sistema de conducción desde edades tempranas del embarazo y las mismas deben tener seguimiento de cerca.

Las edades maternas extremas, más de 35 años para el primer embarazo o adolescentes. Otra causa son los Teratógenos como el alcohol, drogas, la hookah, el acido retinoico, el litio que se usa en las madres para la depresión, los anticonvulsivantes (usados para la epilepsia).

Resource : http://eldia.com.do/impacto-diagnostico-prenatal-en-las-cardiopatias-congenitas/