ABSTRACT
The association between tobacco smoke and acute myeloid leukemia (AML) is well established in adults but not in children. Individual-level data on parental cigarette smoking were obtained from 12 case-control studies from the Childhood Leukemia International Consortium (CLIC, 1974-2012), including 1,330 AML cases diagnosed at age <15 years and 13,169 controls. We conducted pooled analyses of CLIC studies, as well as meta-analyses of CLIC and non-CLIC studies. Overall, maternal smoking before, during, or after pregnancy was not associated with childhood AML; there was a suggestion, however, that smoking during pregnancy was associated with an increased risk in Hispanics (odds ratio = 2.08, 95% confidence interval (CI): 1.20, 3.61) but not in other ethnic groups. By contrast, the odds ratios for paternal lifetime smoking were 1.34 (95% CI: 1.11, 1.62) and 1.18 (95% CI: 0.92, 1.51) in pooled and meta-analyses, respectively. Overall, increased risks from 1.2- to 1.3-fold were observed for pre- and postnatal smoking (P < 0.05), with higher risks reported for heavy smokers. Associations with paternal smoking varied by histological type. Our analyses suggest an association between paternal smoking and childhood AML. The association with maternal smoking appears limited to Hispanic children, raising questions about ethnic differences in tobacco-related exposures and biological mechanisms, as well as study-specific biases.
Subject(s)
Leukemia, Myeloid, Acute/chemically induced , Tobacco Smoke Pollution/adverse effects , Adolescent , Adult , Case-Control Studies , Child , Child, Preschool , Female , Humans , Infant , Male , Odds Ratio , Parents , Pregnancy , Prenatal Exposure Delayed Effects/chemically induced , Risk , Socioeconomic FactorsABSTRACT
BACKGROUND: Nowadays, the breakthrough of COVID-19 pandemic around the world is the biggest health challenge for the clinicians, and it represents an unexpected effort to identify an effective treatment for those patients. No proven definitive therapies for this infection currently exist. Unfortunately, the infected patients increased in an alarming way every day, faster than medical evidence. At present, the expanding knowledge regarding SARS-COV-2 virology provides several potential drug targets. OBJECTIVE: Therefore, clinicians need a rapid review and guideline about the main adverse effects regarding the most prescribed drugs and, specifically, the efficacy and potential risk of each pharmacological therapy, during hospital care. METHODS: The articles review was performed using PubMed to identify relevant papers in English language reported through July 20th, 2020; a second review was performed using Web of Science until August 28th, 2020. Due to the lack of randomized clinical trials, we included case reports, case series and reviews. We found a total of 1606 related articles. The authors independently reviewed the titles and abstracts for inclusion. CONCLUSION: At present, despite the enormous medical effort for publishing several trials or case reports, we have not yet discovered a definitive therapy against the COVID-19 infection. This brief review aims to prompt identification of risk factors and main adverse effects in a systematic view related to therapy with partial evidence proposed to date.