Nutrition, Physical Activity and Smoking Habit in the Italian General Adult Population: CUORE Project Health Examination Survey 2018-2019.

BACKGROUND: Tobacco consumption, incorrect nutrition and insufficient physical activity/sedentariness represent modifiable NCDs risk factors in Western countries. To evaluate recent lifestyle indicators in Italy, data from the national Health Examination Survey (HES), implemented in 2018-2019 within the CUORE Project, were assessed. METHODS: Age-sex standardized results from random samples of Italian general population (35-74 years) were reported by sex, age-class, educational level and geographical area. From 2106 participants, 2090 were considered for smoking habit, 2016 for physical activity and 1578 for nutrition. Standardized questionnaires were used for smoking habit and physical activity, and the EPIC questionnaire for nutrition. RESULTS: Total cigarette current smokers were 23% in men and 19% in women; sedentariness during leisure time was 34% in men and 45% in women and at work 45% and 47% in men and women, respectively. Prevalence of balanced eating behaviours for vegetables was 28% in men and 39% in women; and for fruits 50% and 52%, respectively; prevalence of correct lifestyle (not smoker, regular physical activity and following at least five correct eating behaviours) was 7% and 12% for men and women, respectively. CONCLUSIONS: In 2018-2019, levels of unhealthy lifestyles were found to be still epidemic and basically stable compared to 10 years earlier (slight smoking habit decrease, slight sedentariness increase and slight nutrition improvements); intersectoral strategies and monitoring need to be continued.

Experiences with smoking habits and the need for cessation among habitual smokers in Japan: a qualitative study based on semi-structured interviews.

BACKGROUND: Although more than half of the habitual smokers recognize that they want to quit smoking cigarettes, approximately half have failed to quit and experienced distress relapse; therefore, there is an urgent need to focus on these populations. When chronic behavior occurs, it is necessary to view the behavior in the context of the entire life of the person involved, considering the history of the person. In this study, we aimed to describe experiences with smoking from the onset to the present and the need for smoking cessation among habitual smokers in Japan and to explore efforts to address them. METHODS: Semi-structured interviews that lasted for 55-90 min were conducted with the cooperation of 16 habitual smokers who smoked cigarettes daily. The content of the interviews included demographic characteristics, experiences with smoking from the onset to the present, whether they have attempted to quit and related experiences, and their thoughts on smoking. Interviews were transcribed verbatim and analyzed qualitatively. The Medical Research Ethics Review Committee of Jikei University approved this study (approval number: 33-384(11008)). RESULTS: The participants were aged 26-59 years (mean ± SD: 40.8 ± 8.9 years) and included 10 men and 6 women. The participants started smoking between age 13 and 24 years. The highest number of cigarettes smoked in the participants' lives ranged from 10 to 80 daily, and 12 participants had attempted to quit smoking so far without success. Regarding experiences with smoking from the onset to the present, four themes of "expand one's world," "unconscious attachment," "attempts and failures," and "losing oneself" were extracted. Regarding the need for smoking cessation, four themes of "empowerment from experts," "peer interaction," "social commitment," and "recovery of confidence" were extracted. CONCLUSION: To support smoking cessation from the perspective of habitual smokers, in addition to improvements through the existing approaches, it is important to recover their confidence using ongoing activities in peer groups according to the target background and support from experts incorporating visual assessments of lung function, along with multiple short-term goals. It is also necessary to raise awareness in communities through activities.

Hyperthyroidism and cardiovascular disease: an association study using big data analytics.

BACKGROUND: The cardiovascular (CV) system is profoundly affected by thyroid hormones. Both hypo- and hyperthyroidism can increase the risk of severe CV complications. OBJECTIVE: To assess the association of hyperthyroidism with major CV risk factors (CVRFs) and CV diseases (CVDs) using a big data methodology with the Savana Manager platform. MATERIAL AND METHODS: This was an observational and retrospective study. The data were obtained from the electronic medical records of the University Hospital Puerta de Hierro Majadahonda (Spain). Artificial intelligence techniques were used to extract the information from the electronic health records and Savana Manager 3.0 software was used for analysis. RESULTS: Of a total of 540,939 patients studied (53.62% females; mean age 42.2 ± 8.7 years), 5504 patients (1.02%; 69.9% women) had a diagnosis of hyperthyroidism. Patients with this diagnosis had a significantly (p < 0.0001) higher frequency of CVRFs than that found in non-hyperthyroid subjects. The higher frequency of CVRFs in patients with hyperthyroidism was observed in both women and men and in patients younger and older than 65 years of age. The total frequency of CVDs was also significantly (p < 0.0001) higher in patients diagnosed with hyperthyroidism than that found in patients without this diagnosis. The highest odds ratio values obtained were 6.40 (4.27-9.61) for embolic stroke followed by 5.99 (5.62-6.38) for atrial fibrillation. The frequency of all CVDs evaluated in patients with a diagnosis of hyperthyroidism was significantly higher in both women and men, as well as in those younger and older than 65 years, compared to subjects without this diagnosis. A multivariate regression analysis showed that hyperthyroidism was significantly and independently associated with all the CVDs evaluated except for embolic stroke. CONCLUSION: The data from this hospital cohort suggest that there is a significant association between the diagnosis of hyperthyroidism and the main CVRFs and CVDs in our population, regardless of the age and gender of the patients. Our study, in addition to confirming this association, provides useful information for understanding the applicability of artificial intelligence techniques to "real-world data and information".

Frecuencia de enfermedades periodontales y características clínicas de pacientes atendidos en la Cátedra de Periodoncia de la Universidad Autónoma de Asunción

Las enfermedades periodontales son consideradas entre las más comunes entre las patologías bucales. Su frecuencia es cada vez más elevada en la población y existen varias patologías sistémicas y hábitos que empeoran su cuadro clínico. El objetivo de este trabajo fue determinar la frecuencia y características clínicas de pacientes con enfermedades periodontales que acuden a la cátedra de periodoncia en la Universidad Autónoma de Asunción en el período de 2011 al 2019. Estudio Observacional, descriptivo, retrospectivo, se procesaron 477 fichas clínicas de pacientes de la cátedra de Periodoncia de la Universidad Autónoma de Asunción desde el año 2011 al 2019. El tipo de muestreo utilizado fue no probabilístico por conveniencia. De las 477 fichas solo se analizaron 317 pacientes que cumplieron con los criterios de inclusión. Fueron el 56.46 % de sexo femenino y 43,53 % de sexo masculino, la mediana de edad fue de 33 (23-48) años. El 53% los pacientes presentaban periodontitis crónica y comorbilidades como diabetes e hipertensión arterial. Solo el 11,9 % fueron fumadores. En cuanto a los pacientes diabéticos la mayoría eran de sexo femenino y de edad avanzada, presentando como diagnóstico más frecuente la periodontitis crónica. El diagnóstico clínico más frecuente de la población estudiada fue la periodontitis crónica, seguido por la gingivitis.

Periodontal diseases are considered among the most common among oral pathologies. Its frequency is increasingly higher in the population and there are several systemic pathologies and habits that worsen its clinical condition. The objective of this work was to determine the frequency and clinical characteristics of patients with periodontal diseases who attend the periodontics department at the Autonomous University of Asunción in the period from 2011 to 2019. Observational, descriptive, retrospective study, 477 clinical records were processed. of patients from the Department of Periodontics at the Autonomous University of Asunción from 2011 to 2019. The type of sampling used was non-probabilistic for convenience. Of the 477 records, only 317 patients who met the inclusion criteria were analyzed. They were 56.46% female and 43.53% male, the median age was 33 (23-48) years. 53% of the patients had chronic periodontitis and comorbidities such as diabetes and high blood pressure. Only 11.9% were smokers. Regarding diabetic patients, the majority were female and elderly, with chronic periodontitis as the most frequent diagnosis. The most frequent clinical diagnosis of the studied population was chronic periodontitis, followed by gingivitis.

Smoking influence in Takotsubo syndrome: insights from an international cohort.

Aims: To assess the influence of tobacco on acute and long-term outcomes in Takotsubo syndrome (TTS). Methods: Patients with TTS from the international multicenter German Italian Spanish Takotsubo registry (GEIST) were analyzed. Comparisons between groups were performed within the overall cohort, and an adjusted analysis with 1:1 propensity score matching was conducted. Results: Out of 3,152 patients with TTS, 534 (17%) were current smokers. Smoker TTS patients were younger (63 ± 11 vs. 72 ± 11 years, p < 0.001), less frequently women (78% vs. 90%, p < 0.001), and had a lower prevalence of hypertension (59% vs. 69%, p < 0.01) and diabetes mellitus (16% vs. 20%, p = 0.04), but had a higher prevalence of pulmonary (21% vs. 15%, p < 0.01) and/or psychiatric diseases (17% vs. 12%, p < 0.01). On multivariable analysis, age less than 65 years [OR 3.85, 95% CI (2.86-5)], male gender [OR 2.52, 95% CI (1.75-3.64)], history of pulmonary disease [OR 2.56, 95% CI (1.81-3.61)], coronary artery disease [OR 2.35, 95% CI (1.60-3.46)], and non-apical ballooning form [OR 1.47, 95% CI (1.02-2.13)] were associated with smoking status. Propensity score matching (PSM) 1:1 yielded 329 patients from each group. Smokers had a similar rate of in-hospital complications but longer in-hospital stays (10 vs. 9 days, p = 0.01). During long-term follow-up, there were no differences in mortality rates between smokers and non-smokers (5.6% vs. 6.9% yearly in the overall, p = 0.02, and 6.6%, vs. 7.2% yearly in the matched cohort, p = 0.97). Conclusions: Our findings suggest that smoking may influence the clinical presentation and course of TTS with longer in-hospital stays, but does not independently impact mortality.

Breathlessness and "exacerbation" questions predictive for incident COPD (MARKO study): data after two years of follow-up.

Aims: To determine the predictability of the MARKO questionnaire and/or its domains, individually or in combination with other markers and characteristics (age, gender, smoking history, lung function, 6-min walk test (6 MWT), exhaled breath temperature (EBT), and hsCRP for the incident chronic obstructive pulmonary disease (COPD) in subjects at risk over 2 years follow-up period). Participants and Methods: Patients, smokers/ex-smokers with >20 pack-years, aged 40-65 years of both sexes were recruited and followed for 2 years. After recruitment and signing the informed consent at the GP, a detailed diagnostic workout was done by the pulmonologist; they completed three self-assessment questionnaires-MARKO, SGRQ and CAT, detailed history and physical, laboratory (CBC, hsCRP), lung function tests with bronchodilator and EBT. At the 2 year follow-up visit they performed: the same three self-assessment questionnaires, history and physical, lung function tests and EBT. Results: A sample of 320 subjects (41.9% male), mean (SD) age 51.9 (7.4) years with 36.4 (17.4) pack-years of smoking was reassessed after 2.1 years. Exploratory factor analysis of MARKO questionnaire isolated three distinct domains (breathlessness and fatigue, "exacerbations", cough and expectorations). We have determined a rate for incident COPD that was 4.911/100 person-years (95% CI [3.436-6.816]). We found out that questions about breathlessness and "exacerbations", and male sex were predictive of incident COPD after two years follow-up (AUC 0.79, 95% CI [0.74-0.84], p < 0.001). When only active smokers were analyzed a change in EBT after a cigarette (ΔEBT) was added to a previous model (AUC 0.83, 95% CI [0.78-0.88], p < 0.001). Conclusion: Our preliminary data shows that the MARKO questionnaire combined with EBT (change after a cigarette smoke) could potentially serve as early markers of future COPD in smokers.

Primary Hyperparathyroidism and Cardiovascular Disease: An Association Study Using Clinical Natural Language Processing Systems and Big Data Analytics.

Primary hyperparathyroidism (PHPT) seems to be associated with different cardiovascular diseases (CVDs). We evaluated the association of PHPT with major CV risk factors (CVRFs) and CVDs by using artificial intelligence (AI) tools. An observational and retrospective study was conducted using data from the electronic health records (EHRs) of the Hospital Universitario Puerta de Hierro Majadahonda (Spain). Of a total of 699,157 patients over 18 years of age studied (54.7% females), 6515 patients (0.9%; 65.4% women; mean age 67.6 ± 15.9 years) had a diagnosis of PHPT. The overall frequencies of hypertension, dyslipidemia, diabetes mellitus, and smoking habit in the cohort of patients with PTHP were all significantly (p < 0.001) higher than those found in patients without a diagnosis of PTHP. The total frequency of stroke, ischemic heart disease, atrial fibrillation, deep vein thrombosis, and pulmonary embolism in the cohort of PHPT patients were significantly (p < 0.001) higher than that found in patients without the diagnosis of PHPT. A multivariate regression analysis showed that PHPT was significantly (p < 0.001) and independently associated with all the CVDs evaluated. Our data show that there is a significant association between the diagnosis of PHPT and the main CVRFs and CVDs in our hospital population.

Skin Symptoms That Appeared after Fixation with a Titanium Plate in a Jaw Deformity Patient Suffering from Palmoplantar Pustulosis: A Case Report.

Palmoplantar pustulosis (PPP) is a stubborn skin disease involving repeated aseptic small pustules on the palms and soles of the feet, which is triggered and exacerbated by metals and dental focal infections. There are few reports of an exacerbation of PPP symptoms after orthognathic surgery. The patient is a 40-year-old female who consulted an orthodontist at our hospital, complaining of a protruding maxilla and malocclusion. Under the diagnosis of skeletal prognathism, she underwent surgery for jaw deformity. Although no allergic symptoms were observed during the orthodontic treatment prior to surgery, postoperative scaling on the palms and soles of her feet worsened, and itching was observed on the skin, especially on the titanium plate used to secure the bone fragments. Under the diagnosis of metal allergy, treatment with steroids and vitamin D ointment failed to improve the condition, so surgery was performed to replace the metal plate with a non-metallic absorbable plate in the third postoperative month. Afterwards, the pruritus resolved, and erythema and scale on the palms and soles nearly disappeared. In the present case, though, oral bacterial infection, a past history of smoking, and stress from surgery were also considered to be possible causes of PPP exacerbation, and we concluded that one of the causes of PPP exacerbation was metal allergy from the plates or screws used to fix the bone fragments.

Increased risk of early lung function alterations in people with psychosis: A cross-sectional case-control study.

BACKGROUND: Tobacco smoking has been described as the main cause of chronic obstructive pulmonary disease (COPD) and this habit is clearly more frequent among individuals with psychosis than in the general population, with rates reaching up to 60%. However, little attention has been focused on the association of COPD and psychosis. We aimed to explore the risk of presenting early lung function alterations in a group of individuals with psychosis. METHODS: Following an observational cross-sectional design we studied a cohort of individuals with established psychosis (N=128), and compared them with a sex, age, and smoking habit matched control group (N=79). We evaluated respiratory symptoms by means of mMRC, CAT and Dyspnea-12 scales. And lung function through spirometry tests. RESULTS: Individuals with psychosis presented more respiratory symptoms than controls. Similarly, we observed significant differences in the lung function tests between these two groups, where individuals with psychosis presented worse results in most of the spirometry mean values (FEV1 or forced expiratory volume in the first one second: 3.29L vs. 3.75L, p<0.001; forced vital capacity or FVC: 4.25L vs. 4.72L, p=0.002; and FEV1/FVC ratio: 0.78 vs. 0.80, p=0.052). Patients also presented worse values of lung diffusion, with lower diffusing capacity for carbon monoxide (DLCO) than controls (6.95 vs. 8.54mmol/min/kPa, p<0.001). CONCLUSIONS: The individuals with psychosis in our study presented greater respiratory symptoms and poorer lung function measured through spirometry. These signs have been described as early signs of COPD.

Absent in melanoma 2 (AIM2) positive profile identifies a poor prognosis of lung adenocarcinoma patients.

The absent in melanoma 2 (AIM2) inflammasome has been demonstrated as involved in tumor growth. In this study we used human samples of lung adenocarcinoma (LUAD) patients, taking advantage of a mouse model of smoking cessation. Human samples were stratified according to the smoking status, high-risk factor for this type of tumor. Both public transcriptomic and human samples obtained by a clinical trial proved that AIM2 was upregulated either in terms of mRNA or protein, respectively, in the tumor mass according to the TNM stage, but it did not relate to the smoking status, age and sex. The upregulation of AIM2 was correlated to an immunosuppressive environment according to resting/non-active dendritic cells (DCs) and T regulatory cells, as demonstrated in both human samples and by means of an experimental model of smoking mice. Computational analysis showed that AIM2 upregulation was correlated to both an inflammasome profile, responsible for the poor prognosis of non-smoker and smoker LUAD patients, and to a non-inflammasome profile for former smoker. In conclusion, our study demonstrated that AIM2 is involved in lung carcinogenesis either in a canonical and non-canonical manner due to an immunosuppressive microenvironment associated to a dismal prognosis of LUAD patients.

Smoking and colorectal neoplasia in patients with inflammatory bowel disease: Dose-effect relationship.

BACKGROUND AND AIMS: Prior studies on the effect of smoking on the risk of colitis-associated colorectal neoplasia (CRN) have reported conflicting results. We aimed to further elucidate the association between smoking, including possible dose-effects, and the development of colorectal neoplasia in patients with inflammatory bowel disease (IBD). METHODS: We performed a prospective multicenter cohort study including patients with colonic IBD enrolled in a surveillance program in four academic hospitals between 2011 and 2021. The effects of smoking status and pack-years at study entry on subsequent recurrent events of CRN (including indefinite, low- and high-grade dysplasia, and colorectal cancer [CRC]) were evaluated using uni- and multivariable Prentice, Williams, and Peterson total-time Cox proportional hazard models. Adjustment was performed for extensive disease, prior/index dysplasia, sex, age, first-degree relative with CRC, primary sclerosing cholangitis, and endoscopic inflammation. RESULTS: In 501 of the enrolled 576 patients, at least one follow-up surveillance was performed after the study index (median follow-up 5 years). CRN occurred at least once in 105 patients. Ever smoking was not associated with recurrent CRN risk (adjusted hazard ratio [aHR] 1.04, 95% confidence interval [CI] 0.75-1.44), but an increasing number of pack-years was associated with an increased risk of recurrent CRN (aHR per 10 pack-years 1.17, 95% CI 1.03-1.32; p < 0.05). Separate analyses per IBD type did not reveal differences. CONCLUSIONS: This study found that an increase in pack-years is associated with a higher risk of recurrent CRN in patients with IBD, independent of established CRN risk factors (NCT01464151).

Factors associated with diabetes control : results of a 2-year cohort study of outpatients with type 2 diabetes.

Type 2 diabetes is a typical lifestyle disease. We aimed to identify the factors affecting glycemic control in 64 outpatients with type 2 diabetes over a 2-year period. We defined poor glycemic control using a change in glycosylated hemoglobin (?HbA1c) of ??0.5% over 2 years and/or HbA1c ??7.5% at the end of the study period. We used a questionnaire to collect information on oral health behavior and lifestyle, including eating and smoking habits, and analyzed the relationships between indices of diabetes control and responses to the questionnaire. The mean (SD) HbA1c of the participants was 6.87% (0.77%) at a baseline, and 6.93% (0.69%) after 2 years. Twenty-three participants (36.0%) had poor glycemic control. ?HbA1c and the change in body mass index (?BMI) correlated (Spearman's rank correlation, r?=?0.350, p?

Aetiopathogenesis of Rotator Cuff Tear in Patients Younger than 50 Years: Medical Conditions Play a Relevant Role.

Background and Objectives: Studies on rotator cuff tears (RCT) in patients younger than 50 years have focused on the post-operative outcomes. Little is known about cuff tear etiopathogenesis, although it is a common belief that most tears are due to trauma. We have retrospectively verified the prevalence of medical conditions, whose role in tendon degeneration development have been widely demonstrated, in a group of patients younger than 50 years with postero-superior RCT. Materials and Methods: 64 patients [44M-20F; mean age (SD): 46.90 (2.80)] were enrolled. Personal data, BMI, smoking habit, diseases (diabetes, arterial hypertension, hypercholesterolaemia, thyroid diseases, and chronic obstructive pulmonary disease) were registered. The possible triggering cause and the affected side and tear dimensions were recorded, and statistical analysis was then performed. Results: 75% of patients had one or more diseases and/or a smoking habit for more than 10 years. In the remaining 25%, only four patients referred had had a traumatic event, while in the other eight patients, both medical condition and trauma were registered. The presence of two or more diseases did not affect RCT size. Conclusions: In our series, three quarters of patients with RCT had a smoking habit or medical conditions predisposing them to a tendon tear; therefore, the role of trauma in RCT onset in patients younger than 50 years is markedly resized. It is plausible that in the remaining 25%, RCT may be due to trauma or to genetic or acquired degeneration. Level of Evidence: IV.

Application of transcriptome in time analysis and donor characterization in blood samples.

As an effective supplement to the current forensic DNA typing and one of the research hotpots in forensic science, the in-depth mining and characterization of biological evidence can provide rich and reliable clues for case investigation. In this study, the time-dependent variations of transcriptome were confirmed in in vitro blood samples within 0-168 days and a random forest model was established to realize the classification of blood samples with different TSD (time since deposition). Meanwhile, significant differences were observed in the transcripts of blood samples with different smoking habits and genders within a certain time period. HLA-DRB1, HLA-DQB1 and HLA-DQA2 were identified as markers for smoking habit identification, while the transcripts for RPS4Y1 and EIF1AY from the non-recombining region of the Y chromosome (NRY) were identified as markers for male sex identification. Thus, this study provides a theoretical foundation and experimental strategy for establishing a transcriptome-based method for characterizing blood sample retention time and donor characteristics in the field of forensic investigation.

Electrophysiological signature of the interplay between habits and inhibition in response to smoking-related cues in individuals with a smoking habit: An event-related potential study.

The rigid, stimulus-bound nature of drug seeking that characterizes substance use disorder (SUD) has been related to a dysregulation of motivational and early attentional reflexive and inhibitory reflective systems. However, the mechanisms by which these systems are engaged by drug-paired conditioned stimuli (CSs) when they promote the enactment of seeking habits in individuals with a SUD have not been elucidated. The present study aimed behaviourally and electrophysiologically to characterize the nature of the interaction between the reflexive and reflective systems recruited by CSs in individuals with a smoking habit. We measured the behavioural performance and associated event-related potentials (ERPs) of 20 individuals with a smoking habit and 20 controls, who never smoked regularly, in a modified Go/NoGo task during which smoking-related CSs, appetitive and neutral pictures, presented either in first or third-person visual perspective were displayed 250 ms before the Go/NoGo cue. We show that smoking-related cues selectively influence early incentive motivation-related attention bias (N2 after picture onset), motor readiness and behavioural inhibition (Go-P3, NoGo-P3 and Pc) of individuals with a smoking habit only when presented from a first-person visual perspective. These data together identify the neural signature of the aberrant engagement of the reflexive and reflective systems during the recruitment of an incentive habit by CSs presented as if they had been response-produced, that is, as conditioned reinforcers.

The effect of silica exposure on the risk of lung cancer: A meta-analysis.

Lung cancer is an incurable disease with an increased mortality rate caused by the inhalation of dust-containing crystalline silica particles. Silica exposure is one of the most important occupational hazards in the world. Whether the association between silica exposure and lung cancer is because of the fibrotic process or to the effect of respirable silica itself is unclear. The International Agency for Research on Cancer (IARC) classified silica as a human lung carcinogen. The opinion of lung cancer is a question that has been addressed in this review. Three electronic databases, including MEDLINE, Scopus, and Web of Science, were used to search for relevant literature from 2000 to 2022. To evaluate the relationship between exposure to silica and developing lung cancer, we performed a meta-analysis using the random-effects model. For each study, the overall odds ratio (OR), relative risk (RR) with 95% confidence intervals (CI), and p values were calculated. An extensive database search resulted in the selection of 20 (case-control and nested case-control studies were selected) out of 527 studies. Among the 20 selected studies, 7 studies showed a significant association between silica exposure and an increased risk of lung cancer. Further analysis showed that among the selected studies, six studies showed a significant correlation between combined exposure to silica and smoking with an increased risk of lung cancer. The data from the present study showed that smoking habits increased the impact of silica exposure on the initiation of lung carcinogenesis in exposed workers.

Smoking in Acute Myocardial Infarction Patients: Observations from a Registry Heart Hospital, Qatar.

Introduction: Studies from the US and Europe showed a decline in smoking among patients with acute myocardial infarction (AMI), but limited data are available from the Middle East. In this study, we describe the temporal trend in the prevalence, associated risk factors, and outcomes of smoking among patients with AMI in Qatar. Materials and Methods: A total of 27,648 AMI patients were analyzed from the cardiology registry at Heart Hospital, Doha, Qatar. This spans from January 1991 to May 2022. Results: Of the total, 13,562 patients (49.1%, 95% confidence interval [CI]: 48%-50%) were smokers, with a clear majority of males (98.5%). Smoking habit was found to decrease in AMI patients with increasing age (age 51-60 years, adjusted odds ratio [OR]: 0.71, 95% CI: 0.67-0.76, P = 0.001, and age ≥61 years, adjusted OR: 0.45, 95% CI: 0.42-0.48, P = 0.001, in comparison to age ≤50 years). Smoking was associated with a lower risk of inhospital mortality (adjusted OR: 0.61, 95% CI: 0.54-0.70, P = 0.001), but triglyceride, obesity, and old myocardial infarction risk factors were associated with a higher risk. A decreasing trend in current smoking habits in each quantile of the 1996-2000 year (adjusted OR: 0.82, 95% CI: 0.71-0.93, P = 0.001), 2001-2005 year (adjusted OR: 0.70, 95% CI: 0.62-0.80, P = 0.001), 2006-2010 year (adjusted OR: 0.75, 95% CI: 0.67-0.84, P = 0.001), 2011-2015 year (adjusted OR: 0.48, 95% CI: 0.42-0.54, P = 0.001), 2016-2020 year (adjusted OR: 0.48, 95% CI: 0.43-0.54, P = 0.001), and ≥2021 year (adjusted OR: 0.46, 95% CI: 0.40-0.53, P = 0.001) was observed in comparison to the quantile 1991-1995 year. Similar results were also observed in the young population (age ≤50 years) including the non-Qataris, who had 25% more smokers in comparison to Qatari nationals. Conclusion: Smoking trended down significantly; however, it remained prevalent in 50% of patients among AMI patients. Smokers were younger, with fewer traditional risk factors, and had lower inhospital mortality.

Asociación del hábito de fumar con la periodontitis crónica y la artritis reumatoide / Association of smoking with chronic periodontitis and rheumatoid arthritis

Introducción: Porphyromonas gingivalis es un microorganismo presente en las periodontitis, productor de la enzima peptidil arginina desminasa, inductora de la citrulinación de proteínas que convierte en antígenos, y que son reconocidos por los anticuerpos antipéptido cíclico citrulinados, marcadores específicos de la artritis reumatoide. Estudios clínicos y epidemiológicos relacionan el hábito de fumar con la periodontitis y la artritis reumatoide. Objetivo: Evaluar la asociación entre el hábito de fumar, la periodontitis crónica y la artritis reumatoide. Métodos: Se realizó un estudio observacional, analítico, de corte transversal, de casos y controles de pacientes con diagnóstico de artritis reumatoide tratados en el Centro de Reumatología y pacientes atendidos por medicina interna en el Hospital Clínico Quirúrgico 10 de octubre de La Habana, en el periodo entre septiembre del 2017 y mayo del 2019. Se estudiaron las variables edad, sexo, hábito de fumar y estado periodontal evaluado a través del índice de enfermedad periodontal de Russell y el nivel de inserción clínica. Para identificar la asociación entre variables se empleó la prueba de ji al cuadrado y el odds ratio. Se respetaron las legislaciones éticas. Resultados: En el estudio prevaleció el grupo de 35 a 44 años y el sexo femenino. El hábito de fumar predominó en los pacientes artríticos, con manifiesto incremento de la prevalencia y gravedad de la enfermedad periodontal. Conclusiones: El hábito de fumar incrementó el riesgo de periodontitis crónica en ambos grupos, y con menos intensidad de riesgo en la artritis reumatoide.

Introduction: Porphyromonas gingivalis is a microorganism present in periodontitis, producer of the enzyme peptidyl arginine deminase that induces citrullination of proteins, turning them into antigens, which are recognized by anti-citrullinated cyclic peptide antibodies, specific markers of rheumatoid arthritis. Clinical and epidemiological studies link smoking with periodontitis and rheumatoid arthritis. Objective: To evaluate the association between smoking, the presence of chronic periodontitis and rheumatoid arthritis. Methods: An observational, analytical, cross-sectional study of cases and controls of patients with a diagnosis of rheumatoid arthritis treated at the Rheumatology Center and patients treated by Internal Medicine in 10 de Octubre Surgical- Clinic Hospital in Havana, between September 2017 and May 2019. The variables were: age, sex, smoking habit and periodontal status evaluated through the Russell Periodontal Disease Index and Level of Clinical Insertion. For the association and relationship between variables, the chi square and the odds ratio were used. Ethical legislation was respected. Results: In the study the group of 35 to 44 years old and the female sex prevailed. Smoking prevailed in arthritic patients with a remarkable increase in the prevalence and severity of periodontal disease. Conclusions: Smoking increased the risk of chronic periodontitis in both groups with less intensity of risk in rheumatoid arthritis.

Smoking and combined oral contraceptives should be considered as an independent variable in sex and gender-oriented studies.

The influence of sex combined with smoking and combined oral contraceptives (COC) use on atherogenic indexes is scarcely studied. Thus, traditional lipid parameters were measured, and non-traditional atherogenic indexes were calculated in a young and healthy population of men, COC-free women, and COC users. Total cholesterol (TChol), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and HDL/LDL ratio were lower in men, while triglycerides (TG)/HDL ratio, atherogenic index of plasma (AIP), Castelli's Risk Index I (CRII) and CRI-II, atherogenic coefficient (AC), creatinine, creatinine clearance, and estimated glomerular filtration rate (eGFR) were higher in men. The use of COC modified TChol, HDL, TG, TG/HDL, and AIP which had significantly higher values in COC users. In addition, TG were also increased in COC users in comparison with men. Smoking reduced sexually divergent parameters: BMI, TG, HDL/LDL, TG/HDL, AIP, CRII, CRI-II, and AC became similar among the three cohorts, losing the reported sex differences. Smoking also reduced differences in TChol, HDL, TG, and AIP between COC-free women and COC users, but it does not affect CRII, CRI-II, creatinine, creatinine clearance, and eGFR, underlining that COC users and COC-free women have to be considered two different populations. Our results represent a complex landscape suggesting that for both sexes smoking should be an independent variable in medical studies. Moreover, in women, the use of COC evidenced two different cohorts. Thus, more variables should be considered during a single study indicating that sex, smoking, and COC should be studied together to get a picture of the real-life context.

Mortalidad por cáncer de pulmón en el municipio de Caimanera

Introducción: El cáncer de pulmón es una enfermedad crónica y constituye un problema de salud pública en el mundo. Objetivo: Determinar factores relacionados con la mortalidad del cáncer de pulmón. Métodos: Se realizó un estudio descriptivo y transversal, en 7 pacientes con cáncer de pulmón en el policlínico "Ramón López Peña" del municipio de Caimanera, provincia Guantánamo en el período comprendido entre los años 2017 y 2019. Resultados: En el estudio realizado el sexo femenino fue predominante con 5 pacientes fumadoras que representó el 42,8 %, comprendido en el grupo de edad entre los 60-69 años con el 71,4 %. De los pacientes estudiados con antecedentes patológicos personales de enfermedad respiratoria crónica, se obtuvo mayor frecuencia los que tenían la enfermedad pulmonar obstructiva crónica que representó el 85,7 %. El cáncer de pulmón como la causa básica de muerte. En el año 2018 aumentó la mortalidad en tres casos, y en el año 2019 descendió a dos casos. Conclusiones: Se determinó los factores relacionados con el descenso de la mortalidad por cáncer de pulmón a partir del aumento de otros cánceres.

Introduction: Lung cancer is a chronic disease and it constitutes a public health problem worldwide. Objective: To determine factors related to lung cancer mortality. Methods: A descriptive and cross-sectional study was carried out in 7 patients with lung cancer at Ramón López Peña polyclinic in Caimanera municipality, Guantánamo province from 2017 to 2019. Results: In the study, the female sex predominanted with 5 smoking patients who represented 42.8%, included in the age group between 60-69 years (71.4%). Out of the patients studied with personal pathological history of chronic respiratory disease, those with chronic obstructive pulmonary disease were more frequent, representing 85.7%. Lung cancer was the basic cause of death. In 2018, mortality increased in three cases, and in 2019 it decreased to two cases. Conclusions: It was determined the factors related to the decrease in lung cancer mortality from the increase in other cancers.