Author Interviews, Cannabis, CDC, JAMA, Pediatrics, Tobacco Research / 18.05.2020
EVALI: Adolescents More Likely to Obtain Vaping Products Through Informal Sources
MedicalResearch.com Interview with:
Susan Hocevar Adkins, MD
Lead Author, Senior Medical Officer, and Commander
United States Public Health Service
CDC
MedicalResearch.com: What is the background for this study?
Response: Since August 2019, the Centers for Disease Control and Prevention (CDC), the US Food and Drug Administration (FDA), and state, local, and territorial health departments have been investigating a national outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI). Although clinical presentation and outcomes of EVALI patients generally have been reported, data on adolescent patients are more limited.
This article fills this gap by using data from national EVALI surveillance at CDC to examine demographic, substance use, and clinical characteristics of adolescent EVALI patients relative to young adult and adult EVALI patients.

Prof. Dagna[/caption]
Prof. Lorenzo Dagna MD FACP
Ospedale San Raffaele and
Vita-Salute San Raffaele University
Milan, Italy
MedicalResearch.com: What is the background for this study?
Response: Upon encountering pathogens, our immune system produces pro-inflammatory mediators, called cytokines. Cytokines activate cells from the immune system. In most people, production of cytokines is an appropriate and protective response to infection. However, some individuals develop excessive and detrimental inflammatory responses, which are even more harmful than the pathogen itself to the host organism.
We hypothesized that some patients with COVID-19 might develop excessive and detrimental inflammation, and that treatment with anti-inflammatory agents might be beneficial in this population.
Anakinra is an inhibitor of the pro-inflammatory molecule interleukin 1 (IL-1). It was originally marketed for the treatment of rheumatoid arthritis, but is now mostly used to treat a variety of pediatric inflammatory diseases.

Dr. Hollingsworth[/caption]
Alex Hollingsworth PhD
Assistant Professor
O'Neill School of Public and Environmental Affairs
Indiana University
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I've been working with Coady Wing and Ashley Bradford on a few different studies of the effects of recreational marijuana laws on drug and alcohol use.
Soon after EVALI became a major issue, the prevailing theory from the CDC and others was that EVALI was caused by the use of vitamin E acetate in illegal THC vaping products.
Our group read about this and we thought about some of the things that often happen in black markets for illegal drugs. For instance, during the alcohol prohibition era, bootleg alcohol producers often made and sold alcohol products that were not that safe to drink. In more recent years, there are cases where black market sellers of illegal drugs like heroin try to increase profit margins by adding other substances, which can be harmful.
We thought that maybe something like that could be happening in EVALI. Perhaps people in states where recreational marijuana is legal tended to purchase marijuana products from the legal market and the legal market was not selling any marijuana vaping products that included vitamin E acetate.
Barbara Chaiyachati, MD PhD
SafePlace: The Center for Child Protection and Health
Division of General Pediatrics
The Children’s Hospital of Philadelphia,
Center for Pediatric Clinical Effectiveness
University of Pennsylvania
Philadelphia, Pennsylvania
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Children in foster care have high rates of medical problems including chronic diseases. There is less known about the differences in mortality for children in foster care.
Looking at national data from 2003 to 2016, this study finds that children (ages 1 to 18) in foster care have higher mortality compared to children in the general population and that the difference in mortality has increased over time.

Vasily Giannakeas[/caption]
Vasily Giannakeas, MPH
Epidemiologist/ Dedicated ICES Analyst
Women's College Hospital
Toronto, Ontario, Canada
MedicalResearch.com: What is the background for this study?
Response: As some health care systems approach collapse, a pressing need exists for tools modeling the capacity of acute and critical care systems during the COVID-19 pandemic.
We developed an online tool to estimate the maximum number of COVID-19 cases that could be managed per day within the catchment area served by a health care system, given acute and critical care resource availability.
The COVID-19 Acute and Intensive Care Resource Tool (CAIC-RT) is open access and available at


