E-cigarette use and respiratory symptoms in residents of the United States: A BRFSS report.

PURPOSE: E-cigarettes are the most common type of electronic nicotine delivery system in the United States. E-cigarettes contain numerous toxic compounds that has been shown to induce severe structural damage to the airways. The objective of this study is to assess if there is an association between e-cigarette use and respiratory symptoms in adults in the US as reported in the BRFSS. METHODS: We analyzed data from 18,079 adults, 18-44 years, who participated at the Behavioral Risk Factor Surveillance System (BRFSS) in the year 2017. E-cigarette smoking status was categorized as current everyday user, current some days user, former smoker, and never smoker. The frequency of any respiratory symptoms (cough, phlegm, or shortness of breath) was compared. Unadjusted and adjusted logistic regression analysis were used to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: The BRFSS reported prevalence of smoking e-cigarettes was 6%. About 28% of the participants reported any of the respiratory symptoms assessed. The frequency of reported respiratory symptoms was highest among current some days e-cigarette users (45%). After adjusting for selected participant's demographic, socio-economic, and behavioral characteristics, and asthma and COPD status, the odds of reporting respiratory symptoms increased by 49% among those who use e-cigarettes some days (OR 1.49; 95% CI: 1.06-2.11), and by 29% among those who were former users (OR 1.29; 95% CI: 1.07-1.55) compared with those who never used e-cigarettes. No statistically significant association was found for those who used e-cigarettes every day (OR 1.41; 95% CI 0.96-2.08). CONCLUSION: E-cigarettes cannot be considered as a safe alternative to aid quitting use of combustible traditional cigarettes. Cohort studies may shed more evidence on the association between e-cigarette use and respiratory diseases.

Race/ethnicity and advanced stage of renal cell carcinoma in adults: results from surveillance, epidemiology, and end results program 2007-2015.

Non-Hispanic Blacks were shown to have an earlier stage of renal cell carcinoma (RCC) at diagnosis compared to non-Hispanic Whites. It is less clear whether disparities in RCC staging occurs for other minority races/ethnicities. We aimed to assess the association between racial/ethnic minorities and stage at diagnosis of RCC, and test for potential effect modification by histological subtype. Sourced from the Surveillance, Epidemiology and End Results (SEER) database, patients ≥20 years diagnosed with RCC from 2007 to 2015 were included (n = 37 493). Logistic regression analyses were performed to assess the independent association between race/ethnicity [non-Hispanic White, non-Hispanic Black, non-Hispanic Asian Pacific Islander, non-Hispanic American Indian/Alaskan Native (AI/AN) and Hispanic] and advanced RCC stage at diagnosis (i.e. regional spread or distant metastasis). Interaction terms were tested and stratified regression was performed accordingly. Twenty-eight percent of patients had advanced RCC stage at diagnosis. After adjusting for age, gender, year of diagnosis, histological subtype and insurance status, compared to non-Hispanic Whites, non-Hispanic Blacks had lower odds of advanced stage at diagnosis [odds ratio (OR) = 0.79; 95% confidence interval (CI) = 0.72-0.87 for clear cell; OR = 0.48; CI = 0.30-0.78 for chromophobe and OR = 0.26; CI = 0.10-0.35 for other subtypes]. Higher odds of advanced stage at diagnosis were found for non-Hispanic AI/AN in clear cell (OR = 1.27; CI = 1.04-1.55) and for Hispanics in papillary subtypes (OR = 1.58; CI = 1.07-2.33). Racial disparities in the RCC stage at diagnosis varied according to histological subtype. Further investigation on the racial disparities reported is warranted to optimize detection and ultimately improve the prognosis of patients with RCC.

Early growth patterns are associated with intelligence quotient scores in children born small-for-gestational age.

OBJECTIVE: To assess whether patterns of growth trajectory during infancy are associated with intelligence quotient (IQ) scores at 4 years of age in children born small-for-gestational age (SGA). METHODS: Children in the Collaborative Perinatal Project born SGA were eligible for analysis. The primary outcome was the Stanford-Binet IQ score at 4 years of age. Growth patterns were defined based on changes in weight-for-age z-scores from birth to 4 months and 4 to 12 months of age and consisted of steady, early catch-up, late catch-up, constant catch-up, early catch-down, late catch-down, constant catch-down, early catch-up & late catch-down, and early catch-down & late catch-up. Multivariate linear regression was used to assess associations between patterns of growth and IQ. RESULTS: We evaluated patterns of growth and IQ in 5640 children. Compared with children with steady growth, IQ scores were 2.9 [standard deviation (SD)=0.54], 1.5 (SD=0.63), and 2.2 (SD=0.9) higher in children with early catch-up, early catch-up and later catch-down, and constant catch-up growth patterns, respectively, and 4.4 (SD=1.4) and 3.9 (SD=1.5) lower in children with early catch-down & late catch-up, and early catch-down growth patterns, respectively. CONCLUSIONS: Patterns in weight gain before 4 months of age were associated with differences in IQ scores at 4 years of age, with children with early catch-up having slightly higher IQ scores than children with steady growth and children with early catch-down having slightly lower IQ scores. These findings have implications for early infant nutrition in children born SGA.