Programa de controle do tabagismo em Mato Grosso do Sul: oferta, adesão e efetividade / Smoking control program in Mato Grosso do Sul: offer, adherence and effectiveness / Programa de control del tabaquismo en Mato Grosso do Sul: oferta, adherencia y efectividad

Objetivo: O estudo teve por objetivo avaliar o Programa Nacional de Controle do Tabagismo (PNCT) em Mato Grosso do Sul, taxas de cobertura, abandono, cessação, uso de medicamentos, rede de serviços de saúde e as razões pelas quais algumas Equipes de Saúde da Família de Campo Grande ainda não aderiram ao programa. Métodos: Trata-se de uma pesquisa descritiva, com abordagem quantitativa, baseada em dados primários e secundários sobre o PNCT em Mato Grosso do Sul. Os dados primários foram obtidos por meio de questionário aplicado aos profissionais das Equipes de Saúde da Família (ESF) de Campo Grande, sem oferta do programa e avaliados quanto à frequência e presença de correlação entre as variáveis analisadas utilizando V de Cramer e teste de χ2. Os dados secundários foram obtidos do consolidado do Instituto Nacional de Câncer José Alencar Gomes da Silva com os registros produzidos pelos serviços. Resultados: As taxas de adesão, efetividade e apoio farmacológico na capital e interior foram: 66,80 e 59,79%; 20,58 e 34,91%; 32,14 e 99,86%, respectivamente. A oferta do programa ocorreu em 49,37% municípios e 43,85% das Unidades Básicas de Saúde (UBS) estimadas. Houve correlações entre ser capacitado e implantar o programa; treinamento de ingresso e oferta na UBS. As dificuldades relatadas pelos profissionais foram a pandemia de COVID-19, a sobrecarga e/ou equipe pequena e/ou falta de tempo e a ausência de capacitação/treinamento. Conclusões: O PNCT em Mato Grosso do Sul apresenta baixa cobertura e oferta restrita na rede de saúde, além do desempenho mediano de assistência aos tabagistas. Evidencia-se a necessidade de investimento em capacitação/treinamento, prioritariamente para as ESF de Campo Grande, dando-lhes condições de responder às necessidades de promoção da saúde, reconhecendo o programa como de maior custo-efetividade.

Objective: The objective of this study was to evaluate the National Tobacco Control Program (PNCT) in Mato Grosso do Sul, coverage rates, dropout, cessation, use of medication, the health services network and the reasons why Family Health Teams in Campo Grande have not yet joined the program. Methods: This was a descriptive study with a quantitative approach, based on primary and secondary data on the PNCT in Mato Grosso do Sul. The primary data were obtained by means of a questionnaire administered to Family Health Teams (ESF) in Campo Grande, which did not offer the program and evaluated the frequency and presence of correlation between the variables analyzed using Cramer's V test and the χ2 test. The secondary data were obtained from the consolidated records of the José Alencar Gomes da Silva National Cancer Institute with the records produced by the services. Results: The rates of adherence, effectiveness and pharmacological support in the capital and interior were: 66.80 and 59.79%; 20.58 and 34.91%; and 32.14 and 99.86%, respectively. The program was offered in 49.37% of the municipalities and 43.85% of the Basic Health Units (UBS) estimated. There were correlations between being trained and implementing the program and entry training and provision in the UBS. The difficulties reported by professionals were the COVID-19 pandemic, overload and/or a small team and/or lack of time and the absence of training. Conclusions: The PNCT in Mato Grosso do Sul has low coverage and restricted supply in the health network, in addition to average performance in assisting smokers. There is a clear need to invest in capacitation/training, primarily for the ESF in Campo Grande, enabling them to respond to the needs of health promotion, recognizing the program as more cost-effective.

Objetivo: El objetivo de este estudio fue evaluar el Programa Nacional de Control del Tabaco (PNCT) en Mato Grosso do Sul, las tasas de cobertura, el abandono, la cesación, el uso de medicamentos, la red de servicios de salud y las razones por las que los Equipos de Salud de la Familia en Campo Grande aún no se han unido al programa. Métodos: Se trata de un estudio descriptivo con abordaje cuantitativo, basado en datos primarios y secundarios sobre el PNCT en Mato Grosso do Sul. Los datos primarios se obtuvieron por medio de un cuestionario aplicado a los Equipos de Salud de la Familia (ESF) de Campo Grande, que no ofrecían el programa y evaluaron la frecuencia y la presencia de correlación entre las variables analizadas utilizando la V de Cramer y la prueba de la χ2. Los datos secundarios se obtuvieron de los registros consolidados del Instituto Nacional del Cáncer José Alencar Gomes da Silva con los registros producidos por los servicios. Resultados: Las tasas de adherencia, eficacia y apoyo farmacológico en la capital y en el interior fueron: 66,80 y 59,79%; 20,58 y 34,91%; 32,14 y 99,86%, respectivamente. El programa fue ofrecido en el 49,37% de los municipios y en el 43,85% de las Unidades Básicas de Salud (UBS) estimadas. Hubo correlación entre estar capacitado e implementar el programa; capacitación de entrada y oferta en las UBS. Las dificultades relatadas por los profesionales fueron la pandemia del COVID-19, la sobrecarga y/o un equipo pequeño y/o la falta de tiempo y la ausencia de capacitación. Conclusiones: El PNCT en Mato Grosso do Sul tiene baja cobertura y oferta restringida en la red de salud, además de un desempeño medio en la asistencia a los fumadores. Hay una clara necesidad de invertir en la creación de capacidad / formación, principalmente para la ESF en Campo Grande, lo que les permite responder a las necesidades de promoción de la salud, reconociendo el programa como más rentable.

Prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros / Smoking prevalence and lung cancer morbimortality in Brazilian states / Prevalencia del tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños

Introdução: O câncer de pulmão é uma doença grave, sendo a segunda maior causa de morte em todo o mundo, entretanto, em alguns países desenvolvidos, tornou-se já a primeira causa de morte. Cerca de 90% dos casos de neoplasia pulmonares são causados pela inalação da fumaça do cigarro. Objetivo: Correlacionar a prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, além de demonstrar a associação destes com sexo e faixa etária. Métodos: Estudo de caráter ecológico acerca da prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, nos períodos de 2013 e 2019, dividida por sexo e faixa etária. Foram utilizados bancos de coleta de dados como o Tabnet e Pesquisa Nacional de Saúde. Resultados: As maiores taxas de mortalidade e internações hospitalares foram do público masculino, em 2013, com taxa de 2,7 e 10, respectivamente, e em 2019 com 3,3 e 11,9, respectivamente. Ademais, a maior prevalência de tabagismo foi encontrada nos homens; entretanto seu índice tem caído, enquanto a quantidade de mulheres tabagistas tem aumentado. A Região Sul demonstrou maiores números de mortalidade em ambos os períodos estudados, com taxas de 4,9 e 5,8 por 100 mil habitantes, e morbidade hospitalar com 19,9 e 23,5 por 100 mil habitantes. Já a Região Norte se configurou com as menores prevalências: em 2013 apresentou taxa de óbito por câncer de pulmão de 1,0 e morbidade hospitalar de 3,5/100 mil habitantes, em 2019 apresentou taxa de mortalidade de 4,6 e internações de 1,6/100 mil habitantes. Os coeficientes de correlação de morbidade hospitalar e prevalência de tabagismo foram R2=0,0628, r=0,251 e p=0,042, enquanto os de mortalidade e prevalência de tabagismo foram R2=0,0337, r=0,183 e p=0,140. Conclusões: Na presente pesquisa, pode-se inferir que houve associação positiva na comparação entre taxa de morbidade hospitalar e prevalência de tabagismo; em contrapartida, não foi possível observar associação positiva na correlação da taxa de mortalidade por câncer de pulmão e prevalência de tabagismo.

Introduction: Lung cancer is a serious disease, being the second leading cause of death worldwide. Moreover, in some developed countries, it has already become the leading cause of death. About 90% of lung cancer cases are caused by cigarette smoking. Objective: To correlate the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states, and to demonstrate their association with sex and age group as well. Methods: An ecological study on the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states between 2013 and 2019, divided by sex and age group. The data collection databases Tabnet and National Health Survey were used. Results: The highest rates of mortality and hospital admissions were among men, in 2013 with a rate of 2.7 and 10, respectively, and in 2019 with 3.3 and 11.9, respectively. In addition, the highest prevalence of smoking was found in men, but this rate has fallen, while the number of women smokers has increased. The South region showed higher mortality rates in both periods studied, with rates of 4.9 and 5.8 per 100,000 inhabitants, and hospital morbidity with 19.9 and 23.5 per 100,000 inhabitants. The North region had the lowest prevalence, where in 2013, it had a death rate from lung cancer of 1.0 and hospital morbidity of 3.5/100 thousand inhabitants, and where in 2019, it had a mortality rate of 4.6 and hospitalizations of 1.6/100 thousand inhabitants. The correlation coefficients for hospital morbidity and smoking prevalence were R2=0.0628, r=0.251 and p=0.042, while for mortality and smoking prevalence, these were R2=0.0337, r=0.183 and p=0.140. Conclusions: In the present study, it can be inferred that there was a positive association between hospital morbidity rate and prevalence of smoking, while it was not possible to observe a correlation between lung cancer mortality rate and prevalence of smoking.

Introducción: El cáncer de pulmón es una enfermedad grave, siendo la segunda causa de muerte en todo el mundo, sin embargo, en algunos países desarrollados, ya se ha convertido en la primera causa de muerte. Alrededor del 90% de los casos de neoplasias pulmonares están causados por la inhalación del humo del cigarrillo. Objetivo: Correlacionar la prevalencia de tabaquismo y la morbimortalidad por cáncer de pulmón en los estados brasileños, además de demostrar la asociación de estos con el género y el grupo de edad. Métodos: estudio ecológico sobre la prevalencia de tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños, dentro de los períodos 2013 y 2019, divididos por sexo y grupo de edad. Se utilizaron bancos de recogida de datos como Tabnet y la Encuesta Nacional de Salud. Resultados: las mayores tasas de mortalidad e ingresos hospitalarios se dieron en el público masculino, en 2013 con una tasa de 2,7 y 10, respectivamente, y en 2019 con 3,3 y 11,9, respectivamente. Además, la mayor prevalencia del tabaquismo se encontró en los hombres, sin embargo, su tasa ha disminuido, mientras que la cantidad de mujeres fumadoras ha aumentado. La región Sur presentó cifras más altas de mortalidad en ambos periodos estudiados, con tasas de 4,9 y 5,8 por 100.000 habitantes, y de morbilidad hospitalaria con 19,9 y 23,5 por 100.000 habitantes. Mientras que la región Norte se configuró con las prevalencias más bajas, en 2013 presentó una tasa de mortalidad por cáncer de pulmón de 1,0 y una morbilidad hospitalaria de 3,5/100.000 habitantes, en 2019 presentó una tasa de mortalidad de 4,6 y hospitalizaciones de 1,6/100.000 habitantes. Los coeficientes de correlación para la morbilidad hospitalaria y la prevalencia del tabaquismo fueron R2=0,0628, r=0,251 y p=0,042, mientras que para la mortalidad y la prevalencia del tabaquismo fueron R2=0,0337, r=0,183 y p=0,140. Conclusiones: En la presente investigación se puede inferir que existe una asociación positiva en la comparación entre la tasa de morbilidad hospitalaria y la prevalencia de tabagismo, en contrapartida, no fue posible observar una asociación positiva en la correlación de la tasa de mortalidad por cáncer de pulmón y la prevalencia de tabagismo.

(Dis)satisfaction With Body Image, Lifestyles and Life Satisfaction in Higher Education Students / (In)satisfacción con la imagen corporal, estilos de vida y satisfacción con la vida en estudiantes de enseñanza superior

Abstract Objective: Body image is a predictor of physical, psychological, and social health. Therefore, it can be an indicator for detecting health problems, to be used in the context of higher education. The aim of this study was to assess body image satisfaction in higher education students and to determine whether body image dissatisfaction is related to lifestyle behaviours and life satisfaction. Methodology: This study included 166 Portuguese higher education students. Body image was assessed using the Figure Rating Scale. Active choices during everyday life were assessed using the Active Choice Index. The questionnaire also included questions about sleep behaviour and tobacco and alcohol consumption. Satisfaction with Life was assessed using a five-item scale previously adapted for the Portuguese population. Results: There was a predominance of boys dissatisfied with thinness (26.10%), while the majority of girls revealed that they were dissatisfied due to being overweight (55.70%). The results indicate statistically significant differences between boys and girls in terms of body image categories (p<0.001). However, when we analysed the behaviours separately according to gender, there were no differences. Active behaviours, as well as the other health behaviours analysed (hours of sleep per week and alcohol and tobacco consumption) did not differ between the different levels of body image satisfaction (p>0.05). Conclusion: Most of the students are dissatisfied with their body image, with the majority of girls showing dissatisfaction due to being overweight. Lifestyles and life satisfaction do not differ between students who are satisfied and those who are dissatisfied with their body image.

Resumen Objetivo: La imagen corporal es un factor predictivo de la salud psicológica, física y social. Por lo tanto, puede ser un indicador para detectar problemas de salud, para utilizar en el contexto de la educación superior. El objetivo de este estudio fue evaluar la satisfacción con la imagen corporal en estudiantes de enseñanza superior y determinar si la insatisfacción con la imagen corporal está relacionada con los comportamientos de estilo de vida y la satisfacción con la vida. Metodología: En este estudio participaron 166 estudiantes portugueses de enseñanza superior. La imagen corporal se evaluó mediante la escala Figure Rating Scale. Las elecciones activas durante la vida cotidiana se evaluaron mediante el Active Choice Index. El cuestionario también incluía preguntas sobre el comportamiento durante el sueño y el consumo de tabaco y alcohol. La satisfacción con la vida se evaluó mediante una escala de cinco ítems previamente adaptada a la población portuguesa. Resultados: Predominaron los chicos insatisfechos por delgadez (26.10%), mientras que la mayoría de las chicas revelaron estar insatisfechas por sobrepeso (55.70%). Los resultados indican diferencias estadísticamente significativas entre chicos y chicas en cuanto a las categorías de imagen corporal (p<0.001). Sin embargo, al analizar los comportamientos por separado en función del sexo, no se observaron diferencias. Las conductas activas, así como las demás conductas de salud analizadas (horas de sueño semanales y consumo de alcohol y tabaco) no difirieron entre los distintos niveles de satisfacción con la imagen corporal (p>0.05). Conclusiones: La mayoría de los estudiantes están insatisfechos con su imagen corporal, siendo mayoritaria la insatisfacción de las chicas por sobrepeso. Los estilos de vida y la satisfacción vital no difieren entre los alumnos satisfechos y los insatisfechos con su imagen corporal.

Exploring the cessation efficacy and harm reduction potential of heated tobacco and nicotine pouch products in smokers and smokeless tobacco users: study protocol of a 6-month randomized controlled switching trial

Background: Despite decades of research on pharmacological and behavioural smoking cessation treatments, current quit aids are of limited success. The introduction of new, combustion-free nicotine and tobacco products extended the tool kit for people who smoke to switch away from their risky habit. We performed a systematic review including 120 studies resulting in several recommendations for a robust study design to determine the cessation efficacy of a new nicotine or tobacco product. Consequently, we prepared this study protocol to assess the cessation efficacy of heated tobacco products (HTPs) and nicotine pouches (NPs). Methods: 250 subjects (125 exclusive smokers and 125 exclusive smokeless tobacco (SLT) users) will be recruited and offered a choice of HTPs in case of smokers and a choice of NPs in case of SLT users in order to switch. Subjects will undergo four visits (baseline, 1, 3, and 6 months) to collect biospecimens and for physical examinations. Use behaviour and questionnaires will be monitored on a regular basis by means of a smartphone-app. We describe a sensitive and specific compliance monitoring using suitable biomarkers of exposure. The sample size of 250 subjects and duration of 6 months will allow the quit rates to be assessed with sufficient statistical power. Finally, the choice between different products shall reflect the individuals’ preferences. Conclusions: This protocol can be applied generically, providing a robust determination of a products’ cessation efficacy. Trial Registration: The trial will be registered in the International Clinical Trials Registry Platform.

Exploring human mammaglobin: as a possible diagnostic and prognostic indicator in breast cancer tissue

Breast cancer is a major global health issue, with high diagnosis rates worldwide, especially in less developed areas, leading to significant mortality rates. This review focuses on the molecular characteristics of breast cancer, emphasizing the role of human mammaglobin-A (hMAM-A) as a diagnostic and prognostic marker. hMAM-A, a dimeric protein from the secretoglobin family, is produced exclusively by breast tissue and shows elevated levels in breast cancer cases, making it a highly accurate marker for disease detection. The review also examines various factors influencing breast cancer, such as age, tobacco use, menopausal status, and hormone replacement therapy (HRT). Younger age at diagnosis is associated with poorer outcomes, highlighting the importance of early detection. Tobacco smoke increases mortality rates in breast cancer patients. Menopausal status affects molecular subtypes and risk factors, impacting treatment and prognosis. HRT has a complex relationship with breast cancer risk. The review concludes by discussing the need for novel biomarkers, including hMAM-A, to improve breast cancer diagnosis and management.

Análisis comparativo entre regiones del mundo relacionado con el consumo de sustancias psicoactivas en las últimas tres décadas / Comparative analysis between regions of the world related to the consumption of psychoactive substances in the last three decades

Resumen El consumo de sustancias psicoactivas (SPA) trae efectos de adicción que modifican el pensamiento, la mente y el espíritu del adicto, no solo está generando un riesgo latente que afecta la salud de las personas, también trae consecuencias negativas para la sociedad misma, como mayor inversión económica en salud, presencia de habitantes de calle, aumento de delincuencia, entre otros aspectos. El objetivo del presente estudio consistió en evaluar las estadísticas relacionadas con el consumo de sustancias psicoactivas a nivel mundial en las últimas tres décadas. Para el análisis de la información se utilizó la técnica multivariada de la varianza MANOVA con contraste canónica ortogonal, se empleó el paquete estadístico SAS University en el proceso de la información. Como resultado destacado, se encontró divergencia estadística entre regiones, donde Norteamérica ocupa el primer lugar seguido de Asia y Oceanía. El mayor número de muertes por trastornos relacionados por el consumo de SPA se da en personas menores a los 49 años. El acelerado incremento y abuso en el consumo de SPA está generando altos índices de morbilidad y mortalidad a nivel global. Es una prioridad actuar con urgencia desde todos los frentes, profesionales de la salud, líderes políticos y comunitarios, entes educativos y núcleo familiar, para controlar esta problemática y tratar de disminuir el consumo y abuso de SPA.

Abstract The consumption of psychoactive substances (PAS) has addictive effects that modify the addict's thinking, mind and spirit, and not only generates a latent risk that affects people's health, but also has negative consequences for society itself, such as greater economic investment in health, the presence of street dwellers, and an increase in crime, among other aspects. The objective of this study was to evaluate the statistics related to the consumption of psychoactive substances worldwide in the last three decades. For the analysis of the information, the multivariate technique of variance MANOVA with orthogonal canonical contrast was used, and the SAS University statistical package was used to process the information. As an outstanding result, statistical divergence was found between regions, with North America occupying the first place followed by Asia and Oceania. The highest number of deaths due to disorders related to PAS consumption occurs in people under 49 years of age. The accelerated increase and abuse of PAS is generating high rates of morbidity and mortality globally. It is a priority to act urgently from all fronts, health professionals, political and community leaders, educational entities and the family nucleus, to control this problem and try to reduce the consumption and abuse of PAS.

Chicles de nicotina frente a cigarrillos electrónicos para la reducción del hábito tabáquico / Nicotine chewing gum against electronic cigarettes for the reduction of tobacco habit / Goma de mascar de nicotina contra cigarros eletrônicos para reduzir o hábito de tabaco

Resumen Objetivo: Comparar la efectividad de los chicles de nicotina frente al uso de cigarrillos electrónicos y mostrar si resultan más efectivos en la reducción del hábito tabáquico. Metodología: se incluyeron artículos en español, inglés y portugués disponibles en SciELO, Google Académico, EBSCO, Cochrane Library y LILACS, a través de ecuaciones construidas con MeSH y DeCS y operadores booleanos AND y OR (("Cigarrillos electrónicos" OR "e-Cigs" OR "Cigarros electrónicos") OR ("Chicle" OR "Goma de mascar de nicotina") AND ("Cesación de tabaquismo")), se clasificaron por nivel de evidencia y grado de recomendación. Las consideraciones éticas se adoptaron conforme a la Resolución 8430 de 1993. Resultados: la búsqueda inicial arrojó 1.468 artículos, que se redujeron a 28 textos que cumplieron los criterios de inclusión. Se construyeron cinco temáticas en las que se incluyen comparación de métodos, formas de evaluación, rangos etarios, índices de adicción, patologías asociadas e índice de mortalidad, componentes y efectos fisiológicos del cigarrillo electrónico y convencional. Conclusiones: se evidencia que las cantidades de nicotina de los cigarrillos electrónicos producen efectos adversos irreversibles para la salud y pueden generar mayor dependencia.

Abstract Objective: Compare the effectiveness of nicotine gum versus the use of electronic cigarettes and show whether they are more effective in reducing smoking. Methodology: Articles in Spanish, English and Portuguese, available from SciELO, Google Academic, EBSCO, Cochrane Library and LILACS, were included through equations built with MeSH and DeCS and Boolean operators AND Dec's OR (("Electronic cigarettes" OR "E-Cigs" OR "Electronic Cigars") OR ("Chewing gum" OR "Nicotine chewing gum") AND ("Smoking cessation")). The articles were critically read, and classified by level of evidence and degree of recommendation. Ethical considerations were adopted in accordance with Resolution 8430 of 1993. Results: The initial search yielded 1,468 articles, which were reduced to 28 units that contributed to the stated objective. Five themes were built, which include a comparison of methods, evaluation forms, age ranges, addiction rates, associated pathologies and mortality rate, components and physiological effects of the conventional and electronic cigarette. Conclusions: It is evident that the amounts of nicotine of e-cigarettes produce irreversible adverse health effects and can lead to increased dependency.

Resumo Objetivo: Compare a eficácia da goma de mascar de nicotina versus o uso de cigarros eletrônicos e mostre se eles são mais eficazes na redução do tabagismo. Metodologia: Os artigos em espanhol, inglês e português, disponíveis na SciELO, no Google Acadêmico, na EBSCO, na Cochrane Library e na LILACS, foram incluídos por meio de equações construídas com os operadores MeSH e DeCS e booleanos AND e OR (("cigarros eletrônicos" OU "E-Cigs" ou "charutos eletrônicos") OR ("goma de mascar" ou "goma de mascar de nicotina") AND ("cessação do tabagism")). Os artigos foram lidos criticamente e classificados por nível de evidência e grau de recomendação. Considerações éticas foram adotadas de acordo com a Resolução 8430 de 1993. Resultados: A pesquisa inicial produziu 1.468 artigos, reduzidos a 28 unidades que contribuíram para o objetivo declarado. Foram construídos cinco temas que incluem a comparação de métodos, formas de avaliação, faixas etárias, taxas de dependência, patologias e taxa de mortalidade associadas, componentes e efeitos fisiológicos dos cigarros convencionais e eletrônicos. Conclusões: É evidente que as quantidades de nicotina dos Os cigarros eletrônicos produzem efeitos adversos irreversíveis à saúde e podem levar ao aumento da dependência.

Burden of hypertension and associated risk factors among the Nicobarese tribe of Car Nicobar Island, India

Background: Hypertension, a significant risk factor for various non-communicable diseases, poses a preventable threat to mortality and disease burden. However, there remains a lack of data on hypertension within Indian tribes, particularly those residing in impoverished areas. Determining the prevalence of hypertension and identifying associated risk factors among the Nicobarese tribes. A cross-sectional survey was conducted, involving 2600 tribal individuals aged 18 years and above from ten randomly selected villages on Car Nicobar Island. Methods: A structured questionnaire was utilized to gather data on blood pressure (BP), anthropometric measurements, and detailed participant characteristics. Prevalence of hypertension was determined and analyzed in relation to various identified risk factors using chi-square, Karl Pearson coefficient of correlation, and generalized linear models. Prevalence ratio and adjusted risk ratio calculated, along with their corresponding confidence intervals. Results: Prevalence of hypertension was 57.9%. Several factors, including age, male gender, illiteracy, diabetes, smoking, alcohol consumption, and higher body mass index (BMI), were significantly associated with hypertension. Systolic and diastolic BP levels increased significantly with age, socio-economic scores, BMI, and weight. Conclusions: The prevalence of hypertension among the Nicobarese tribes is significantly higher compared to the general population. Adapting preventive strategies based on an understanding of the tribe's specific culture and lifestyle is important for controlling hypertension. However, it is also crucial to consider genetic and environmental influences that may contribute to the high prevalence of hypertension in this tribe.

Asociación entre obesidad abdominal, consumo de alcohol y actividad física en universitarios panameños / Association between abdominal obesity, alcohol consumption and physical activity in Panamanian college students

Introducción. La obesidad abdominal es considerada un factor de riesgo de enfermedad cardiovascular y diabetes. El consumo excesivo episódico de alcohol y la inactividad física también son factores de riesgo comportamentales asociados a enfermedades no transmisibles. Objetivo: Analizar la asociación entre la obesidad abdominal, el consumo de alcohol y la inactividad física en universitarios panameños. Materiales y métodos: Estudio transversal analítico realizado en 374 estudiantes universitarios panameños en el periodo abril ­ diciembre de 2021. Se implementó el cuestionario para la vigilancia de factores de riesgo de enfermedades no transmisibles de la Organización Mundial de la Salud y se evaluó la circunferencia de cintura. La obesidad abdominal se estableció con una circunferencia de cintura ≥80 cm en mujeres y ≥90 cm en hombres. Se realizaron análisis descriptivos, bivariados y múltiples usando modelos de regresión logística para determinar la asociación entre las variables del estudio. Las pruebas U Mann-Whitney y Chi cuadrado fueron utilizadas para analizar diferencias por sexo. Resultados: Una tercera parte de los universitarios participantes presentaron obesidad abdominal. Las mujeres reportaron mayores niveles de inactividad física (<0,0001) y conducta sedentaria (p=0,0010) que los hombres. Después de ajustar por sexo, edad y nivel socioeconómico, la obesidad abdominal estuvo asociada con la inactividad física (OR: 1,762, IC 95%: 1,040 ­ 2,985, p=0,035) y el consumo excesivo episódico de alcohol (OR 1,114, IC: 1,015 ­ 1,223, p=0,023). Conclusiones: Los universitarios panameños que reportaron bajos niveles de actividad física y consumo excesivo episódico de alcohol tuvieron una mayor probabilidad de registrar obesidad abdominal(AU)

Introduction. Abdominal obesity is considered a risk factor for cardiovascular disease and diabetes. Episodic excessive consumption of alcohol and physical inactivity are behavioral risk factors associated with non-communicable diseases. Objective: To analyze the association between abdominal obesity, alcohol consumption and physical inactivity in Panamanian university students. Materials and methods: Analytical cross-sectional study conducted on 374 Panamanian university students in the period April ­ December 2021. The questionnaire for the surveillance of risk factors for non-communicable diseases of the World Health Organization was implemented and waist circumference was evaluated. Abdominal obesity was established with a waist circumference ≥80 cm in women and ≥90 cm in men. Descriptive, bivariate, and multiple analyzes were performed using logistic regression models to determine the association between the study variables. The Mann-Whitney U and Chi square tests were used to analyze differences by sex. Results: A third of the participating university students had abdominal obesity. Women reported higher levels of physical inactivity (<0,0001) and sedentary behavior (p=0,0010) than men. After adjusting for sex, age and socioeconomic status, abdominal obesity was associated with physical inactivity (OR: 1,762, 95% CI: 1,040 ­ 2,985, p=0,035) and episodic heavy alcohol consumption (OR 1,114, CI: 1,015 ­ 1,223, p=0,023). Conclusions: Students who reported low levels of physical inactivity and binge drinking were more likely to have abdominal obesity(AU)

Relación entre el consumo de sustancias psicoactivas, alcohol y cigarrillo en estudiantes de Enfermería. Un estudio de corte transversal / Relationship Between Psychoactive Substance, Alcohol and Cigarette use in Nursing Students. A Cross-Sectional Study

RESUMEN Introducción: El incremento del consumo de sustancias psicoactivas (SPA), alcohol y cigarrillo en población joven se ha convertido en un problema de salud pública. La identificación de los factores que aumentan o disminuyen el riesgo de la exposición a estas sustancias y la relación que puede haber entre ellas resulta fundamental para la planificación de estrategias con enfoque de riesgo, razón por la cual se planteó el presente estudio. El objetivo es establecer el perfil de consumo de SPA, alcohol y cigarrillo y los factores asociados con dicho consumo en estudiantes del programa de Enfermería de una institución de educación superior. Métodos: Estudio cuantitativo, observacional y analítico de tipo corte transversal. Resultados: Se incluyó a 310 estudiantes de los semestres I a IX de un programa de Enfermería de una institución privada de educación superior de Bogotá. La prevalencia de consumo de SPA en el último ario fue del 2,96% (IC95%, 1,36-5,54); la marihuana es la sustancia de mayor consumo (55,55%). Las prevalencias de consumo de alcohol y cigarrillo durante los últimos 12 meses se estimaron en el 86,64% (IC95%, 83,24-91,0) y el 12,16% (IC95%, 8,4315,88) respectivamente. Se encontró una asociación estadísticamente significativa entre los consumos: tomar alcohol se asoció con el consumo de cigarrillo (OR = 3,22; p = 0,006) y fumar se asoció con el consumo de SPA (OR = 15,4; p <0,001). Conclusiones: En esta población universitaria, el consumo de alcohol aumenta la posibilidad de consumo de cigarrillo, y este a su vez aumenta la posibilidad del consumo de SPA.

ABSTRACT Background: The increase in the use of psychoactive substances, alcohol and cigarettes in young people has become a public health problem. The identification of factors that increase or reduce the risk of exposure to these substances and the possible relationship between them is essential for planning strategies with a risk approach, hence the reason for this study. The objective was to establish the profile of use of psychoactive substances, alcohol and cigarettes and the factors associated with such use in nursing students of a higher education institution. Methods: Quantitative, observational, analytical cross-sectional study. Results: We included 310 students from 1st to 9th semester of a Nursing programme from a prívate higher education institution in Bogotá. The prevalence of psychoactive substance use in the last year was 2.96% (95%CI, 1.36-5.54), with marijuana being the substance most used (55.55%). The prevalence of alcohol and cigarette use during the last 12 months was estimated at 86.64% (95%CI, 83.24-91.0) and 12.16% (95%CI, 8.43-15.88) respectively. A statistically significant association was found between the use of these substances: alcohol use was associated with cigarette use (OR = 3.22; P = 0.006) and smoking was associated with psychoactive substance use (OR = 15.4; P < 0.001). Conclusions: Alcohol use increases the likelihood of smoking cigarettes, and this in turn increases the likelihood of psychoactive substance use, in this university population.

A cross sectional study on awareness and prevalence of tobacco use among adult males of Vanakbara village, Diu district

Background: Tobacco is used in various forms worldwide. The consumption of each pattern is different by the geographic area, economic status, socio-cultural and religious influence. The tobacco problem in India is more complex than that of any other country in the world, with a significant number of tobacco-related diseases and deaths. Over the years, India’s position has risen from third largest to the second largest unmanufactured tobacco consuming country in the world. This study's findings will aid in the future planning of tobacco control and prevention in Vanakbara village of Diu district. Methods: Community base cross-sectional study was conducted among adult males of Vanakbara village, Diu district. A study was conducted from September to November 2020, A sample was selected from the population by using a simple random sampling method. Data was collected using a preformed questionnaire. Data was entered in MS excel and analysis was done using statistical software like SPSS. Average, and the percentage considered and the frequency table and graphs were prepared wherever applicable. Results: According to the study, smokeless tobacco use was more prevalent among adult males (56.6%) than smoked tobacco (14.6%). The most common form of smokeless tobacco used was mawa. According to the majority of respondents (44.3%), smoking was started because they believe it aids in concentration at work, followed by their friends. The study revealed that 88.6% of respondents are aware that tobacco consumption leads to oral cancer. Conclusions: Our study indicates that there is an urgent need for taking actions aiming at increasing effectiveness of enforcing applicable tobacco control regulations in fisherman units.

Herramientas para el tamizaje de aneurisma de aorta abdominal / Tools for abdominal aortic aneurysm screening

Introducción. El aneurisma de la aorta abdominal (AAA) es la dilatación de la aorta abdominal mayor de 1,5 veces el diámetro esperado. Su prevalencia es variable, con tasas reportadas de hasta el 12,5 %. Se considera como causa de muerte de más de 10.000 personas al año en los Estados Unidos. El objetivo de esta revisión de la literatura fue describir los factores de riesgo y las herramientas de tamizaje de AAA. Métodos. Se realizó una búsqueda de la literatura utilizando dos ecuaciones en bases de datos electrónicas, empleando términos seleccionados de "Medical Subject Heading" (MeSH) y "Descriptores en Ciencias de la Salud" (DeCS). Se evaluó la calidad de los estudios con la herramienta STROBE (Strengthening the Reporting of Observational Studies in Epidemiology). Resultados. Se recolectaron 40 artículos y a partir de ellos se construyó el texto de revisión, identificando en estos, los factores de riesgo asociados al desarrollo de AAA, tales como sexo masculino, tabaquismo, hipertensión arterial, antecedente familiar y obesidad, entre otros. La diabetes mellitus parece actuar como factor protector. Dentro de los instrumentos de tamizaje, el ultrasonido abdominal es uno de los más usados. Conclusión. El AAA es una patología multifactorial. En la actualidad la ultrasonografía de aorta es el método de elección para el tamizaje, permitiendo la detección precoz. El tamizaje de AAA con métodos no invasivos, como el ultrasonido, es útil sobre todo en zonas con prevalencia alta de la patología y en pacientes con determinados factores de riesgo.

Introduction. Abdominal aortic aneurysm (AAA) is a dilation of the abdominal aorta greater than 1.5 times the expected diameter. Its prevalence is variable, with reported rates of up to 12.5%. It is considered the cause of death of more than 10,000 people a year in the United States. The objective of this literature review was to describe risk factors and screening tools for AAA. Methods. A literature search was conducted using two equations in electronic databases, using terms selected from "Medical Subject Heading" (MeSH) and "Descriptors in Health Sciences" (DeCS). The quality of the studies was evaluated with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) tool. Results. Forty articles were collected and from them the review text was constructed, identifying the risk factors associated with the development of AAA, such as male sex, smoking, high blood pressure, family history and obesity, among others. Diabetes mellitus seems to act as a protective factor. Among the screening instruments, abdominal ultrasound is one of the most used. Conclusion. AAA is a multifactorial pathology. Currently, aortic ultrasonography is the method of choice for screening, allowing early detection. Screening for AAA with non-invasive methods, such as ultrasound, is useful especially in areas with a high prevalence of this pathology and in patients with certain risk factors.

Prevalência e Fatores de risco associados ao tabagismo e outras formas de consumo de tabaco em acadêmicos da saúde em Goiânia, Goiás / Prevalence and risk factors associated with smoking and other forms of tobacco consumption among health students in Goiânia, Goiás

Introdução: O presente estudo teve como objetivo investigar e identificar a prevalência e fatores de risco associados ao tabagismo e outras formas de consumo de tabaco entre acadêmicos da saúde. Métodos: A pesquisa contou com 407 acadêmicos dos cursos de Biomedicina, Educação Física, Enfermagem, Farmácia, Fisioterapia e Nutrição de uma Instituição de Ensino Superior. A coleta de dados foi realizada no mês de maio de 2020, por um formulário eletrônico, disponibilizado em e-mail institucional, grupos de estudos e redes sociais. O procedimento ocorreu após aprovação pelo Comitê de Ética, cujo parecer 3.966.951. Resultados: A maioria dos participantes (79,6%) eram do sexo feminino, solteiros (75,2%) com idade média de 25,32 anos. O consumo de tabaco foi confirmado por 10,8% participantes. Quanto ao consumo de produtos derivados de tabaco 24,1% dos entrevistados já consumiram produto de tabaco, 8,6% assumiram tabagismo ocasional, e 4,2% tabagismo ativo. Conclusões: A associação entre tabagismo e as variáveis sociodemográficas demonstrou que alunos do curso de Farmácia (OR: 5,25 [IC:1,34-20,22] p=0,017), homens (OR: 1,71 [IC: 1,01 ­ 2,91]), estudantes turno matutino (OR: 1,96 [IC:1,02-3,78] p=0,04) e que residem com tabagistas (OR:4,44 [IC: 2,24-8,80]) apresentaram maiores chances de serem tabagista. A associação em relação ao consumo de derivados do tabaco, os homens apresentaram maiores prevalências de consumo de derivados de tabaco (OR: 1,71 [IC: 1,01 ­ 2,91] p=0,045) bem como, alunos do curso de Farmácia (OR: 6,40 [IC:2,31-17,7] P<0,01), que estudam no turno Noturno (OR:1,85 [IC:1,16-8,82] p=0,009) e entre os que residem com tabagistas (OR: 4,49 [IC:2,24-8,80] p<0,001).

Introduction: The present study aimed to investigate and identify the prevalence and risk factors associated with smoking and other forms of tobacco consumption among health academics. Methods: The survey involved 407 students from Biomedicine, Physical Education, Nursing, Pharmacy, Physiotherapy and Nutrition courses at a Higher Education Institution. Data collection was carried out in May 2020, through an electronic form, available in institutional email, study groups and social networks. The entire procedure took place after approval by the Ethics Committee. Results: Most participants (79.6%) were female, single (75.2%) with a mean age of 25.32 years. Tobacco consumption was confirmed by 10.8% of the participants. As for the consumption of tobacco products, 24.1% of the interviewees had already consumed some tobacco product, 8.6% assumed occasional smoking, and 4.2% active smoking. Conclusions: The association between smoking and sociodemographic variables showed that Pharmacy students (OR: 5.25 [CI:1.34-20.22] p=0.017), men (OR: 1.71 [CI: 1.01 ­ 2.91]), morning shift students (OR: 1.96 [CI:1.02-3.78] p=0.04) and those who live with smokers (OR:4.44 [CI : 2.24-8.80]) were more likely to be smokers. The association in relation to the consumption of tobacco derivatives, men had a higher prevalence of consumption of tobacco derivatives (OR: 1.71 [CI: 1.01 ­ 2.91] p=0.045) as well as Pharmacy students (OR: 6.40 [CI:2.31-17.7] P<0.01), those who study the night shift (OR:1.85 [CI:1.16-8.82] p=0.009 ) and among those who live with smokers (OR: 4.49 [CI:2.24-8.80] p<0.001).

Analysis of passive smoking exposure and its influencing factors in non-smokers aged ≥18 in Tianjin / 中华健康管理学杂志

Objective:To analyze the passive smoking exposure and its influencing factors in non-smokers aged≥18 in Tianjin.Methods:This was a cross-sectional study. Based on the 2018 Tianjin Adults Noncommunicable Disease and Nutrition Surveillance, non-smokers aged≥18 years old at 7 surveillance sites were selected as the research objects, taking 2018 population data of Tianjin as the standard population, the sample data were weighted to analyze the general demographic characteristics, the level of passive smoking exposure, the cognition of tobacco harm, and the influencing factors of passive smoking exposure. Pearson χ 2 test was used to compare the rate between groups, and the influencing factors were analyzed by unconditional logistic regression. Results:After weighted, the passive smoking exposure rate was 51.5%, among non-current smokers, the awareness rates of smoking related lung cancer and passive smoking related adult lung cancer were 83.3% and 80.0%, respectively. The awareness rates of smoking related stroke and passive smoking related heart disease in adults were 61.4% and 66.4%, respectively. The awareness rate that smoking related stroke was higher in the non-passive smoking exposed group than in the secondhand smoke exposed group (62.7% vs 60.3%, P<0.05). There was no statistical difference in the awareness rate of smoking related heart attacks and lung cancer as well as passive smoking related adult heart disease, adult lung cancer, and lung disease in children between the passive smoking exposed group and the non-passive smoking exposed group (all P>0.05). The awareness rate of smoking related three diseases (stroke, heart attack and lung cancer) was 57.9% and the awareness rate of passive smoking related three diseases (heart disease in adults, lung cancer and lung disease in children) was 64.9% in non-current smokers. Among men, undergraduate or above was a protective factor for second-hand smoke exposure. Heads, clerical and related personnel of state organs, party and mass organizations, enterprises and public institutions were risk factors for secondhand smoke exposure. Among women, age ≥60 years and high education were protective factors for secondhand smoke exposure. Conclusions:Non smokers aged 18 and above in Tianjin have a higher level of passive smoking exposure, and the awareness rate of tobacco exposure related cardiovascular diseases is low. In future, the health education of relevant knowledge should be strengthened.

Tobacco retailer outside middle schools in Wuhan City and its impact on smoking behavior among students / 中国学校卫生

Objective@#To understand the distribution of tobacco retailer within 100 meters outside middle schools in Wuhan City and its impact on smoking behavior of middle school students, so as to provide basis and feasible suggestions for the development of tobacco control policy for adolescents.@*Methods@#From February to May 2023, a multi stage stratified cluster random sampling method was used to select 20 middle schools from 4 districts in Wuhan City. To investigate the distribution of tobacco retailer within 100 metres outside the school and the sale of tobacco to minors. A total of 4 882 students were surveyed using the core questions of the 2021 Chinese Adolescent Tobacco Prevalence Questionnaire. Fisher exact probability test, Chi square test and Chi square trend test were used for statistical analysis.@*Results@#Nearly 70.00% of middle schools had tobacco retailer within 100 metres, with an average of (1.10±0.97) per middle school. The awareness rate (100.00%) and labeling rate (87.50%) of licensed tobacco retailer were higher than those of non licensed tobacco retailer (33.33%, 16.67%) ( P <0.05). The rates of tried smoking, current smoking and buying cigarettes within 30 days were 7.13%, 1.99% and 2.54%, respectively. The rates of students who tried smoking ( 8.58 %), current smoking (2.29%) and buying cigarettes within 30 days (2.85%) in schools with tobacco retailer within 100 metres were higher than those in schools without tobacco retailer (3.79%, 1.28%, 1.83%)( χ 2=35.80, 5.37, 4.37 , P <0.05). And as the grade increased, the rates of tried smoking, current smoking and buying cigarettes among middle school students all showed an upward trend ( χ 2 trend =66.20, 36.10, 16.17, P <0.05).@*Conclusions@#Middle school students in Wuhan City have high tobacco availability. The findings suggest that school ban should be extended from 50 meters to 100 meters, and the regulatory authorities must strictly prohibit selling tobacco products to minors at tobacco retailer.

Working Hours and Personal Protective Equipment Effect on Blood Cholinesterase Levels of Tobacco Plantation Workers

@#Introduction: Tobacco production is increasing in certain regions of Indonesia due to its high economic value. Tobacco and its products can have harmful effects on the health of consumers, producers and processing workers. Analysis of blood samples has shown that tobacco farmers are at risk of developing occupational diseases related to pesticide exposure and nicotine absorption through the epidermis of wet tobacco leaves. The aim of this study was to compare blood cholinesterase levels in tobacco plantation workers in relation to their working hours and use of personal protective equipment (PPE). Methods: This cross-sectional observational study was conducted in ten subdistricts in Jember district, Indonesia, and included 50 participants selected using proportional sampling. Spearman’s test was used to analyse the relationship between variables. Results: The significance value of the relationship based on Spearman’s test between working hours and blood cholinesterase levels of tobacco farmers in Jember was 0.058 > α (0.05). Meanwhile, the significance value of the relationship between working hours and complete blood count, specifically mean corpuscular haemoglobin concentration (MCHC), was 0.00 < α (0.05), and between PPE use and blood cholinesterase levels was 0.035 < α (0.05). Conclusion: Working hours were not associated with blood cholinesterase levels, but were associated with blood MCHC levels. Meanwhile, the use of PPE was found to be associated with cholinesterase levels in tobacco farmers.

Tobacco use and associated factors among high school students in Shannan City, Tibet in 2023 / 中国学校卫生

Objective@#To understand the current situation and related factors of tobacco use among high school students in Shannan City, so as to provide reference for tobacco control strategies for high school students.@*Methods@#A self administered questionnaire survey was conducted among 10 052 high school students from 6 high schools in Shannan City, Tibetan Autonomous Region by census methods from April to July in 2023. The comparison of rates was conducted by using Chi square test, and the influencing factors of tobacco use among high school students were analyzed using binomial classification Logistic regression.@*Results@#The rate of high school students in Shannan City trying cigarettes was 17.63%, and the current smoking rate was 10.07%, both of which were higher in boys than girls, and higher in urban areas than in rural areas ( χ 2 gender = 1 262.35 , 869.79; χ 2 area =35.90, 29.16, P <0.01). The smoking rate of students with parents and good friends smoking was higher than that of students with parents and good friends not smoking( χ 2= 190.50 ,1 741.44), and the current smoking rate showed an upward trend with age and age ( χ 2 trend =74.87, 122.86)( P <0.01). The tobacco dependence rate was 41.80%; 75.30% wanted to quit smoking, 83.99% had received smoking cessation assistance, but had received less professional smoking cessation assistance ( 13.41 %). Logistic regression analysis showed that vocational high school students, senior students (second and third grade), parents smoking (both smoking, mother smoking), and good friends smoking (some smoking, most smoking, all smoking) were positively correlated with smoking cigarettes among high school students ( OR=1.51, 1.54, 2.17, 2.22, 1.69, 5.30, 13.28, 8.59, P <0.05).@*Conclusions@#The smoking rate of high school students in Shannan City is high and second hand smoke exposure is common. Vocational high schools are the key to prevention and control. Effective cooperation between families, schools, and society should be strengthened to create a smoke free environment and protect students from tobacco hazards.

Identification and expression analysis of TCP family members in tobacco (Nicotiana tabacum L.) / 生物工程学报

TCP family as plant specific transcription factor, plays an important role in different aspects of plant development. In order to screen TCP family members in tobacco, the homologous sequences of tobacco and Arabidopsis TCP family were identified by genome-wide homologous alignment. The physicochemical properties, phylogenetic relationships and cis-acting elements were analyzed by bioinformatics. The homologous genes of AtTCP3/AtTCP4 were screened, and RT-qPCR was used to detect the changes of gene expression upon 20% PEG6000 treatment. The results show that tobacco contains 63 TCP family members. Their amino acid sequence length ranged from 89 aa to 596 aa, and their protein hydropathicity grand average of hydropathicity (GRAVY) ranged from -1.147 to 0.125. The isoelectric point (pI) ranges from 4.42 to 9.94, the number of introns is 0 to 3, and the subcellular location is all located in the nucleus. The results of conserved domain and phylogenetic relationship analysis showed that the tobacco TCP family can be divided into PCF, CIN and CYC/TB1 subfamilies, and each subfamily has a stable sequence. The results of cis-acting elements in gene promoter region showed that TCP family genes contain low docile acting elements (LTR) and a variety of stress and metabolic regulation related elements (MYB, MYC). Analysis of gene expression patterns showed that AtTCP3/AtTCP4 homologous genes (NtTCP6, NtTCP28, NtTCP30, NtTCP33, NtTCP42, NtTCP57, NtTCP63) accounted for 20% PEG6000 treatment significantly up-regulated/down-regulated expression, and NtTCP30 and NtTCP57 genes were selected as candidate genes in response to drought. The results of this study analyzed the TCP family in the tobacco genome and provided candidate genes for the study of drought-resistance gene function and variety breeding in tobacco.

Oral health of an indigenous population in northeastern Brazil: a cross-sectional Study of the Fulni-ô ethnic group

ABSTRACT BACKGROUND: There is a lack of studies evaluating the oral health of traditional indigenous communities in Brazil. OBJECTIVES: Thus, the objective of this study was to describe the oral health characteristics of the indigenous Fulni-ô ethnic group in Northeast Brazil. DESIGN AND SETTING: A cross-sectional observational investigation was conducted within the Project on Atherosclerosis among Indigenous Populations. METHODS: This study included participants of both sexes from the Fulni-ô ethnic group. The participants included in this investigation underwent a comprehensive oral health evaluation by a registered and experienced dentist to assess oral health and identify potentially malignant oral lesions. Participants with suspicious lesions were referred for biopsy. Shapiro-Wilk, Mann-Whitney, and Student's t-tests were used, and measures of central tendency and dispersion were described. Statistical significance was 5%. RESULTS: A total of 104 individuals were included in this study. The prevalence of the use of tobacco derivatives was 94.0%, with similarities between sexes. The prevalence of oral changes in this study population was 84.4%. Fifty-one individuals who underwent oral reassessment were referred for oral lesion biopsy. CONCLUSIONS: This study demonstrated a high prevalence of oral alterations in the Fulni-ô population. Histopathological analyses indicated the presence of mild oral epithelial dysplasia in five cases.

Impacts of environmental tobacco smoke on the onset and progression of multiple sclerosis: a systematic review / Impactos do fumo passivo no surgimento e na progressão da esclerose múltipla: uma revisão sistemática

Abstract Background Unlike cigarette smoking, environmental tobacco smoke (ETS) has not been as well described as an environmental risk for Multiple sclerosis (MS) nor as a risk factor for disease progression. Objective We systematically reviewed the association between ETS and the risk of onset and/or progression of MS. Methods We systematically screened MedLine/PubMed, Science Direct, LILACs, and SciELO searching for publications between January 1st, 2010, and July 5, 2021, with the following keywords: "multiple sclerosis and smoking"; "multiple sclerosis and passive smoking"; "multiple sclerosis and secondhand smoking". Results Fifteen articles were included in this review, which consisted of systematic reviews with meta-analysis (N = 2), systematic reviews (N = 2), and observational studies (N = 11). Both meta-analyses reported an impact of ETS on MS onset among secondhand smokers. One of the systematic reviews selected two observational studies showing the association between ETS and MS development, and one study that did not find a significant association between ETS and the risk of MS development. The other systematic review identified selected eight articles showing a relationship between ETS and MS. Seven observational studies reported higher odds of MS onset when associated with ETS. Four observational studies did not show a relationship between ETS and MS onset or progression. Conclusion Most articles showed a positive association between ETS exposure and the risk of developing MS. On the other hand, an association between ETS and a higher risk for MS progression could not be established.

Resumo Antecedentes Ao contrário do tabagismo ativo, o fumo passivo (FP) não é tão bem estabelecido como risco para o desenvolvimento de esclerose múltipla (EM) nem como um fator de risco para a progressão da doença. Objetivo Revisamos sistematicamente a associação entre FP e o risco de aparecimento e/ou progressão da EM. Métodos Fizemos uma triagem sistemática nas bases de dados MedLine/PubMed, Science Direct, LILACs e SciELO em busca de publicações entre 1° de janeiro de 2010 e 5 de julho de 2021 com as seguintes palavras-chave: "multiple sclerosis and smoking"; "multiple sclerosis and passive smoking"; "multiple sclerosis and secondhand smoking". Resultados Quinze artigos foram incluídos nesta revisão, que consistiu em revisões sistemáticas com metanálise (N = 2), revisões sistemáticas (N = 2) e estudos observacionais (N = 11). As metanálises relataram um impacto do FP no surgimento da EM entre fumantes passivos. Um revisão sistemática selecionou dois estudos observacionais mostrando a associação entre FP e desenvolvimento de EM, e um estudo que não encontrou associação significativa entre FP e o risco de desenvolvimento de EM. Outra revisão sistemática identificou oito artigos selecionados mostrando uma relação entre FP e EM. Sete estudos observacionais relataram maiores chances de aparecimento de EM quando associados a FP. Quatro estudos observacionais não mostraram uma relação entre FP e o desenvolvimento ou progressão da EM. Conclusão A maioria dos artigos mostrou uma associação positiva entre a exposição ao FP e o risco de desenvolver EM. Por outro lado, não foi possível estabelecer uma associação entre FP e maior risco de progressão da EM.