Chapters authored
Pulmonary Effects of Passive Smoking Among Adults
Passive smoking, also known as environmental tobacco smoke (ETS) or second-hand smoke (SHS) represents the involuntary inhaling of tobacco released by others in the ambient air. Passive smoking exposure occurs in homes, workplaces, and in other public places such as bars, restaurants, and recreation venues. It consists of a complex mixture of mainstream smoke exhaled by smokers and the smoke given off by the combustion of tobacco products. Non-smokers, being exposed to the same toxic substances as identified in mainstream tobacco smoke are, therefore, at an increased risk for serious adverse health effects. Although attention has centered mainly on the harmful effects of SHS exposure in the pediatric population, epidemiologic data from the last 20 years showed increased risks on various respiratory pathologies of the adult. Inhaling SHS causes injury to the respiratory tract, resulting in a high prevalence of respiratory symptoms, asthma, impairment of lung function and increased bronchial responsiveness. In adults, passive smoking is also associated with an increased risk of lung cancer, especially in those with high exposure. On the basis of recent publications, we propose a review of history, biologic basis and effects on different respiratory pathologies of the exposure to SHS in adults.
Part of the book: Smoking Prevention and Cessation
Histoplasmosis: An Overview Treatment of Histoplasmosis
In 2000, the Infectious Diseases Society of America (IDSA) published a clinical practice guideline on managing patients with histoplasmosis and, in 2020, the first global guideline for diagnosing and managing disseminated histoplasmosis in people living with HIV (PLHIV). The classification of pulmonary histoplasmosis is done after clinical presentation and imaging. The optimal treatment depends on the patient’s clinical syndrome: acute mild/moderate, acute moderately/severe, chronic cavitary pulmonary, mediastinal lesions, or broncholithiasis. Asymptomatic patients or patients with mild cases of histoplasmosis with symptoms lasting less than four weeks do not usually require antifungal treatment. When necessary, itraconazole is the treatment of choice in mild to moderate acute forms of the disease, often for six weeks. For severe histoplasmosis, amphotericin B is recommended as initial therapy, followed by itraconazole as consolidation therapy. Long-term treatment for at least 12 months is recommended in patients with chronic cavitary histoplasmosis.
Part of the book: Histoplasmosis