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2.
Arch. bronconeumol. (Ed. impr.) ; 57(supl.1): 21-34, ene. 2021. graf, ilus, tab
Artículo en Español | IBECS | ID: ibc-192603

RESUMEN

OBJETIVO: El objetivo del estudio ha sido responder a las siguientes preguntas: ¿se asocia el consumo de tabaco en pacientes con COVID-19 con una progresión negativa y desenlace adverso de la enfermedad? y, ¿se asocia el consumo de tabaco, actual y pasado a una mayor posibilidad de desarrollar COVID-19? MATERIAL Y MÉTODOS: Se realizó una revisión sistemática (RS) y metaanálisis (MA) de trabajos publicados previamente. La estrategia de búsqueda incluyó todos los descriptores conocidos sobre COVID-19 y tabaco, y se realizó en diferentes bases de datos. Se utilizaron modelos estadísticos adecuados para abordar el tamaño del efecto en un MA: modelo de efectos aleatorios y de efectos fijos. RESULTADOS: Fueron identificados 34 artículos en la RS de los cuales fueron incluidos 19 en el MA. Ser fumador o exfumador se mostró como un factor de riesgo para una peor progresión de la infección por COVID-19 (OR 1,96, IC del 95%, 1,36-2,83) y una mayor probabilidad de presentar una condición más crítica de la infección (OR 1,79, IC del 95%, 1,19-2,70). Como limitaciones del MA encontramos que la mayoría de los estudios analizados eran observacionales con un sesgo de publicación limitado y con 2 estudios discrepantes con el resto, aunque tras retirarlos del MA se mantenía el tabaco como un factor de riesgo de peor evolución. CONCLUSIÓN: El tabaquismo actual y pasado produce una forma clínica más grave de la COVID-19 y lleva con mayor frecuencia a estos pacientes a ingresar en Cuidados Intensivos, sean intubados y mueran


OBJECTIVE: The aim of this study was to determine if tobacco use in patients with Covid-19 is associated with a negative disease course and adverse outcome, and if smoking, current and past, is associated with a greater possibility of developing COVID-19. MATERIAL AND METHODS: A systematic review (SR) and meta-analysis (MA) of previously published works were performed. The search strategy included all known descriptors for Covid-19 and tobacco and was conducted in different databases. Appropriate statistical models were used to address the effect size in meta-analysis, namely random effects and fixed effects model. RESULTS: Thirty-four articles were identified in the SR of which 19 were included in the MA. Being a smoker or former smoker was shown to be a risk factor for worse progression of Covid-19 infection (OR 1.96, 95% CI, 1.36 - 2.83) and a greater probability of presenting a more critical condition (OR 1.79 95% CI, 1.19 - 2.70). As limitations of the MA, we found that most of the studies analyzed were observational with limited publication bias. Two studies that disagreed with the rest were included, although after withdrawing them from the MA, smoking was maintained as a risk factor for worse progress. CONCLUSION: Current and past smoking produces a more serious clinical form of Covid-19 and more frequently leads to intensive care admission, intubation, and death


Asunto(s)
Humanos , Fumar Tabaco/efectos adversos , Fumar Tabaco/fisiopatología , Infecciones por Coronavirus/fisiopatología , Neumonía Viral/fisiopatología , Pandemias , Índice de Severidad de la Enfermedad , Medicina Basada en la Evidencia
3.
Rev Bras Epidemiol ; 24: e210007, 2020.
Artículo en Español, Inglés | MEDLINE | ID: mdl-33331414

RESUMEN

OBJECTIVE: To update the estimation of tobacco attributable mortality (AM) in the Brazilian population aged 35 years old and older. METHODS: A prevalence-dependent analysis was applied based on the population attributed fraction. This method estimates the tobacco AM taking into account the mortality observed in Brazil (source: Brazilian Mortality Information System - 2016); the prevalence of smokers, former smokers, and never smokers (National Health Survey Brazil - 2013) and the excess of risk of death (relative risk) of smokers and former smokers in comparison to never smokers (derived from 5 North American cohorts). Estimates of overall AM are shown by gender, age group (35-54; 55-64; 65-74; and 75 years old and older) and 3 groups: malignant tumors, cardiometabolic diseases, and respiratory diseases. RESULTS: In 2016, tobacco consumption caused 163,831 deaths in Brazil, 67% (109,369) were in men and four out of ten (62,791) occurred before the age of 65. Without differences by gender, 42% of the AM is associated with cardiometabolic diseases, followed by respiratory diseases (34%) and malignant tumors (24%). CONCLUSION: During 2016, 14% of the deaths occurred in the Brazilian population aged 35 years old and older were attributed to tobacco consumption. Periodic tobacco AM estimations are mandatory to assess and strengthen smoking control strategies and policies.


Asunto(s)
Fumadores/estadística & datos numéricos , Fumar Tabaco/mortalidad , Adulto , Distribución por Edad , Anciano , Brasil/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mortalidad , Prevalencia , Distribución por Sexo , Fumar Tabaco/efectos adversos
4.
Nicotine Tob Res ; 22(12 Suppl 2): S93-S95, 2020 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-33320258

RESUMEN

IMPLICATIONS: This commentary addresses the state of the evidence on tobacco products, nicotine, and COVID-19. The evidence of the effects of smoking on respiratory infections and the immune system in general are examined and the current understanding of tobacco products and risk for SARS-CoV-2 infection and the course of COVID-19 is addressed.


Asunto(s)
/complicaciones , Productos de Tabaco/efectos adversos , Fumar Tabaco/efectos adversos , Fumar Tabaco/epidemiología , Humanos
5.
Bone Joint J ; 102-B(11): 1549-1554, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33135438

RESUMEN

AIMS: The impact of tobacco use on readmission and medical and surgical complications has been documented in hip and knee arthroplasty. However, there remains little information about the effect of smoking on the outcome after total shoulder arthroplasty (TSA). We hypothesized that active smokers are at an increased risk of poor medical and surgial outcomes after TSA. METHODS: Data for patients who underwent arthroplasty of the shoulder in the USA between January 2011 and December 2015 were obtained from the National Readmission Database, and 90-day readmissions and complications were documented using validated coding methods. Multivariate regression analysis was performed to quantify the risk of smoking on the outcome after TSA, while controlling for patient demographics, comorbidities, and hospital-level confounding factors. RESULTS: A total of 196,325 non-smokers (93.1%) and 14,461 smokers (6.9%) underwent TSA during the five-year study period. Smokers had significantly increased rates of 30- and 90-day readmission (p = 0.025 and 0.001, respectively), revision within 90 days (p < 0.001), infection (p < 0.001), wound complications (p < 0.001), and instability of the prosthesis (p < 0.001). They were also at significantly greater risk of suffering from pneumonia (p < 0.001), sepsis (p = 0.001), and myocardial infarction (p < 0.001), postoperatively. CONCLUSION: Smokers have an increased risk of readmission and medical and surgical complications after TSA. These risks are similar to those found for smokers after hip and knee arthroplasty. Many surgeons choose to avoid these elective procedures in patients who smoke. The increased risks should be considered when counselling patients who smoke before undertaking TSA. Cite this article: Bone Joint J 2020;102-B(11):1549-1554.


Asunto(s)
Artroplastía de Reemplazo de Hombro , Readmisión del Paciente/estadística & datos numéricos , Fumar Tabaco/efectos adversos , Anciano , Anciano de 80 o más Años , Artroplastía de Reemplazo de Hombro/estadística & datos numéricos , Fumar Cigarrillos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Resultado del Tratamiento
7.
Acta Biomed ; 91(3): e2020062, 2020 08 27.
Artículo en Inglés | MEDLINE | ID: mdl-32921714

RESUMEN

The emergency caused by Covid-19 pandemic raised interest in studying lifestyles and comorbidities as important determinants of poor Covid-19 prognosis. Data on tobacco smoking, alcohol consumption and obesity are still limited, while no data are available on the role of e-cigarettes and heated tobacco products (HTP). To clarify the role of tobacco smoking and other lifestyle habits on COVID-19 severity and progression, we designed a longitudinal observational study titled COvid19 and SMOking in ITaly (COSMO-IT). About 30 Italian hospitals in North, Centre and South of Italy joined the study. Its main aims are: 1) to quantify the role of tobacco smoking and smoking cessation on the severity and progression of COVID-19 in hospitalized patients; 2) to compare smoking prevalence and severity of the disease in relation to smoking in hospitalized COVID-19 patients versus patients treated at home; 3) to quantify the association between other lifestyle factors, such as e-cigarette and HTP use, alcohol and obesity and the risk of unfavourable COVID-19 outcomes. Socio-demographic, lifestyle and medical history information will be gathered for around 3000 hospitalized and 700-1000 home-isolated, laboratory-confirmed, COVID-19 patients. Given the current absence of a vaccine against SARS-COV-2 and the lack of a specific treatment for -COVID-19, prevention strategies are of extreme importance. This project, designed to highly contribute to the international scientific debate on the role of avoidable lifestyle habits on COVID-19 severity, will provide valuable epidemiological data in order to support important recommendations to prevent COVID-19 incidence, progression and mortality.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Estilo de Vida , Pandemias , Neumonía Viral/epidemiología , Fumar Tabaco/efectos adversos , Femenino , Estudios de Seguimiento , Humanos , Italia/epidemiología , Masculino , Prevalencia , Estudios Prospectivos , Fumar Tabaco/epidemiología
8.
Health Qual Life Outcomes ; 18(1): 257, 2020 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-32736560

RESUMEN

BACKGROUND: Perceived dental health has shown to have a significant predictive effect on overall health perception and life satisfaction. Thus, it seems plausible that Health Related Quality of Life (HRQOL) measures are associated with Oral Health Related Quality of Life (OHRQOL) dimensions in Nepalese context as well. The adverse effects of tobacco on oral health are reported worldwide including Nepal. However, evidence which can quantify effects of tobacco smoking on dental health perception is limited. Thus, a study was designed to find association of smoking and socio demographic characteristics with OHRQOl and to determine association between OHRQOL and HRQOL among dental patients in Nepal. METHODS: A cross sectional study was conducted among 125 current smokers and 125 non-smokers who attended oral surgery OPD of a teaching hospital in Kathmandu, Nepal. The study participants were enrolled through consecutive sampling and data was collected through a semi-structured questionnaire. The questionnaire consisted of questions related to sociodemographic characteristics, tobacco history, Oral Health Impacts Profile (OHIP)-14 and World Health Organization Quality of Life Brief version (WHOQOL-Bref) to assess OHRQOl and HRQOL respectively. Descriptive and inferential statistics were calculated by using SPSS version 18.0. The level of significance was set at 5%. RESULTS: Among the socio demographic characteristics, patients with education of more than Class 12 had significantly higher average OHRQOL scores (p = 0.013) compared to illiterate patients. Current smokers reported significantly poorer scores in sub scales of psychological disability (p = 0.001), social disability (p = 0.003), physical pain (p < 0.001), functional limitation (p = 0.007) and also overall perceived oral health compared to nonsmokers. OHRQOL was significantly correlated with overall HRQOL in physical (p = 0.015) and psychological (p = 0.04) domains in this study sample. CONCLUSIONS: Improvements in OHRQOL may require a multidimensional approach with focus of social factors like education and behavioral factors like cigarette smoking. Also, improvement in OHRQOL might also lead to betterment of perceived overall health as they are interlinked.


Asunto(s)
Salud Bucal/estadística & datos numéricos , Calidad de Vida , Fumar Tabaco/efectos adversos , Adolescente , Adulto , Estudios de Casos y Controles , Estudios Transversales , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nepal , Encuestas y Cuestionarios , Fumar Tabaco/psicología , Adulto Joven
9.
PLoS One ; 15(8): e0238111, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32853266

RESUMEN

BACKGROUND: Chronic kidney disease (CKD) is a public health problem, and an unfavorable lifestyle has been suggested as a modifiable risk factor for CKD. Cigarette smoking is closely associated with cardiovascular disease and cancers; however, there is a lack of evidence to prove that smoking is harmful for kidney health. Therefore, we aimed to determine the relationship between cigarette smoking and CKD among healthy middle-aged adults. METHODS: Using the database from the Korean Genome and Epidemiology Study, we analyzed 8,661 participants after excluding those with baseline estimated glomerular filtration rate (eGFR)<60 ml/min/1.72 m2 or proteinuria. Exposure of interest was smoking status: never-, former-, and current-smokers. Primary outcome was incident CKD defined as eGFR <60 ml/min/1.73 m2 or newly developed proteinuria. RESULTS: The mean age of the subjects was 52 years, and 47.6% of them were males. There were 551 (6.4%) and 1,255 (14.5%) subjects with diabetes and hypertension, respectively. The mean eGFR was 93.0 ml/min/1.73 m2. Among the participants, 5,140 (59.3%), 1,336 (15.4%), and 2,185 (25.2%) were never-smokers, former-smokers, and current-smokers, respectively. During a median follow-up of 11.6 years, incident CKD developed in 1,941 (22.4%) subjects with a crude incidence rate of 25.1 (24.0-26.2) per 1,000 person-years. The multivariable Cox regression analysis after adjustment of confounding factors showed hazard ratios (95% confidence interval) of 1.13 (0.95-1.35) and 1.26 (1.07-1.48) for CKD development in the former- and current-smokers, compared with never-smokers. CONCLUSION: This study showed that smoking was associated with a higher risk of incident CKD among healthy middle-aged adults.


Asunto(s)
Insuficiencia Renal Crónica/etiología , Fumar Tabaco/efectos adversos , Estudios de Cohortes , Femenino , Tasa de Filtración Glomerular/fisiología , Humanos , Masculino , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Factores de Riesgo
10.
PLoS One ; 15(8): e0236657, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32760089

RESUMEN

Crohn's disease is a pathological condition of the gastro-intestinal tract, causing severe transmural inflammation in the ileum and/or colon. Cigarette smoking is one of the best known environmental risk factors for the development of Crohn's disease. Nevertheless, very little is known about the effect of prolonged cigarette smoke exposure on inflammatory modulators in the gut. We examined the effect of cigarette smoke on cytokine profiles in the healthy and inflamed gut of human subjects and in the trinitrobenzene sulphonic acid mouse model, which mimics distal Crohn-like colitis. In addition, the effect of cigarette smoke on epithelial expression of transient receptor potential channels and their concurrent increase with cigarette smoke-augmented cytokine production was investigated. Active smoking was associated with increased IL-8 transcription in ileum of controls (p < 0,001; n = 18-20/group). In the ileum, TRPV1 mRNA levels were decreased in never smoking Crohn's disease patients compared to healthy subjects (p <0,001; n = 20/group). In the colon, TRPV1 mRNA levels were decreased (p = 0,046) in smoking healthy controls (n = 20/group). Likewise, healthy mice chronically exposed to cigarette smoke (n = 10/group) showed elevated ileal Cxcl2 (p = 0,0075) and colonic Kc mRNA levels (p = 0,0186), whereas TRPV1 mRNA and protein levels were elevated in the ileum (p = 0,0315). Although cigarette smoke exposure prior to trinitrobenzene sulphonic acid administration did not alter disease activity, increased pro-inflammatory cytokine production was observed in the distal colon (Kc: p = 0,0273; Cxcl2: p = 0,104; Il1-ß: p = 0,0796), in parallel with the increase of Trpv1 mRNA (p < 0,001). We infer that CS affects pro-inflammatory cytokine expression in healthy and inflamed gut, and that the simultaneous modulation of TRPV1 may point to a potential involvement of TRPV1 in cigarette smoke-induced production of inflammatory mediators.


Asunto(s)
Colon/metabolismo , Enfermedad de Crohn/metabolismo , Íleon/metabolismo , Canales Catiónicos TRPV/metabolismo , Fumar Tabaco/efectos adversos , Adulto , Anciano , Animales , Células CACO-2 , Colon/patología , Enfermedad de Crohn/inducido químicamente , Enfermedad de Crohn/patología , Citocinas/metabolismo , Modelos Animales de Enfermedad , Femenino , Células HT29 , Humanos , Íleon/patología , Inflamación/metabolismo , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patología , Masculino , Ratones , Ratones Endogámicos C57BL , Persona de Mediana Edad , Investigación en Medicina Traslacional , Ácido Trinitrobencenosulfónico
11.
PLoS One ; 15(8): e0236435, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32760090

RESUMEN

BACKGROUND: Obesity is a major health problem in low and middle income countries (LMICs) and is associated with miscarriage. This study aims to examine the association between obesity and miscarriage among reproductive age women (15-49 years) in Nepal. METHODS: The combined 19160 cross-sectional pregnancy data from the Nepal Demographic and Health Survey (NDHS) for the years 2001, 2006, 2011 and 2016 was utilized. Miscarriage was defined as a spontaneous loss of pregnancy that occurred before the foetus reached 7 months of gestational age. Logistic regression analyses that adjusted for clustering, stratification and sampling weights were used to examine the association between obesity and miscarriage among women of reproductive age. RESULTS: The odds of miscarriage were 1.45 times higher (Adjusted odds ratio (AOR) = 1.45; 95%Cl: 1.06, 1.98, P = 0.021) among women with obesity. Women who did not use contraception, younger (15-19 years), and older women (35 years or more) were significantly more likely to have miscarriage. Women who smoked tobacco reported higher odds of miscarriage than women who did not smoke tobacco (AOR = 1.27; 95%Cl: 1.07,1.50, P = 0.006). Stratification of maternal smoking status by maternal Body Mass Index (BMI), after adjusting for contraception, mother age and year of survey revealed that tobacco smoking and obesity are associated with miscarriage (AOR = 1.46; 95%Cl: 1.05,2.04, P = 0.025). CONCLUSIONS: Findings from this study show that obesity and tobacco smoking are associated with miscarriage. Smoking cessation, pregnancy planning and counselling on healthy weight for women of reproductive age in Nepal may help promote healthy behaviours and decrease the likelihood of miscarriage.


Asunto(s)
Aborto Espontáneo , Obesidad , Fumar Tabaco/efectos adversos , Aborto Espontáneo/epidemiología , Aborto Espontáneo/etiología , Adulto , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Estilo de Vida Saludable , Humanos , Edad Materna , Persona de Mediana Edad , Nepal/epidemiología , Obesidad/complicaciones , Obesidad/epidemiología , Embarazo , Factores de Riesgo , Adulto Joven
12.
PLoS One ; 15(8): e0236559, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32817636

RESUMEN

Chronic obstructive pulmonary disease (COPD) poses a significant but heterogeneous burden to individuals and healthcare systems. Policymakers develop targeted policies to minimize this burden but need personalized tools to evaluate novel interventions and target them to subpopulations most likely to benefit. We developed a platform to identify subgroups that are at increased risk of emergency department visits, hospitalizations and mortality and to provide stratified patient input in economic evaluations of COPD interventions. We relied on administrative and survey data from Ontario, Canada and applied a combination of microsimulation and multi-state modeling methods. We illustrated the functionality of the platform by quantifying outcomes across smoking status (current, former, never smokers) and by estimating the effect of smoking cessation on resource use and survival, by comparing outcomes of hypothetical cohorts of smokers who quit at diagnosis and smokers that continued to smoke post diagnosis. The cumulative incidence of all-cause mortality was 37.9% (95% CI: 34.9, 41.4) for never smokers, 34.7% (95% CI: 32.1, 36.9) for current smokers, and 46.4% (95% CI: 43.6, 49.0) for former smokers, at 14 years. Over 14 years, smokers who did not quit at diagnosis had 16.3% (95% CI: 9.6, 38.4%) more COPD-related emergency department visits than smokers who quit at diagnosis. In summary, we combined methods from clinical and economic modeling to create a novel tool that policymakers and health economists can use to inform future COPD policy decisions and quantify the effect of modifying COPD risk factors on resource utilization and morality.


Asunto(s)
Aceptación de la Atención de Salud/estadística & datos numéricos , Formulación de Políticas , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar Tabaco/efectos adversos , Anciano , Análisis Costo-Beneficio , Femenino , Recursos en Salud/economía , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Modelos Teóricos , No Fumadores/estadística & datos numéricos , Ontario , Estudios Retrospectivos , Factores de Riesgo , Fumadores/estadística & datos numéricos
15.
PLoS One ; 15(6): e0234516, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32559253

RESUMEN

The prevalence of metabolic syndrome is increased worldwide. Tobacco smoking increases the risk of developing metabolic syndrome. Waterpipe tobacco smoking has become a global trend of tobacco consumption and is as common as cigarette smoking. In this study, the effect of waterpipe tobacco smoke (WTS) on the development of metabolic syndrome in rats was evaluated. Adult Wistar rats were exposed for 19 weeks to either fresh air (control) or WTS for 1 hour daily/ 5 days per week (WTS). Central obesity, systolic blood pressure, lipid profile, glucose hemostasis and levels of leptin and adiponectin were evaluated. The WTS exposure increased body weight, abdominal circumference, systolic blood pressure and fasting glucose compared to control animals (P<0.05), consistent with inducing metabolic syndrome. The retroperitoneal fat, lipid profile and levels of insulin, leptin and adiponectin were not affected by WTS exposure (P>0.05). In conclusion, exposure to WTS has detrimental health effects leading to the development of metabolic syndrome in experimental animals.


Asunto(s)
Síndrome Metabólico/metabolismo , Efectos Tardíos de la Exposición Prenatal/metabolismo , Fumar Tabaco/efectos adversos , Tabaco para Pipas de Agua/efectos adversos , Animales , Modelos Animales de Enfermedad , Femenino , Humanos , Síndrome Metabólico/inducido químicamente , Síndrome Metabólico/fisiopatología , Estrés Oxidativo/efectos de los fármacos , Embarazo , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/fisiopatología , Ratas , Pipas de Agua
16.
Acta Biomed ; 91(2): 106-112, 2020 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-32420934

RESUMEN

INTRODUCTION: COVID-19 pandemic burst onto the international scene as a new disease not affecting patients uniformly; hence it has risen many questions yet to be clarified. The aim of this study was to outline the main issues that led tobacco smoking being discussed as a potential risk factor associated with COVID-19. METHODS: articles from MEDLINE and pre-prints published from January to April 2020 were identified. RESULTS: data from China showed that men had more severe outcomes of COVID-19 than women. Since smoking prevalence is very high among Chinese men in comparison to women, it was hypothesized that smoking could be a risk factor for poor prognosis. This was also supported by the higher prevalence of comorbidities, many of which are tobacco-related diseases, in patients with severe COVID-19, who were also more likely to have a smoking history. A meta-analysis confirmed these results reporting an OR=2.25 (95% CI: 1.49-3.39) for developing severe Covid-19 among patients with a smoking history. Some authors, noticing that reported smoking prevalence among hospitalized patients was substantially below smoking prevalence in the corresponding populations, speculated a protective role of nicotine. However, it is likely that low prevalence among hospitalized patients are partially due to many smokers misclassified as nonsmokers. Tobacco smoking seems to cause a dose-dependent upregulation of the angiotensin-converting- enzyme-2 (ACE2), the virus cellular entry receptor, which could explain the higher risk of severe COVID-19 in smokers. CONCLUSIONS: There is need for further independent studies to clarify the role of smoking on COVID-19 incidence, progression and mortality.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Fumar Tabaco/efectos adversos , Anciano , Anciano de 80 o más Años , Comorbilidad , Infecciones por Coronavirus/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/etiología , Prevalencia , Pronóstico , Factores de Riesgo
17.
Environ Toxicol Pharmacol ; 78: 103411, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32422280

RESUMEN

The effects of obesity and smoking in the coronavirus disease 2019 (COVID-19) pandemic remain controversial. Angiotensin converting enzyme 2 (ACE2), a component of the renin-angiotensin system (RAS), is the human cell receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. ACE2 expression increases on lung alveolar epithelial cells and adipose tissue due to obesity, smoking and air pollution. A significant relationship exists between air pollution and SARS-CoV-2 infection, as more severe COVID-19 symptoms occur in smokers; comorbid conditions due to obesity or excess ectopic fat accumulation as underlying risk factors for severe COVID-19 strongly encourage the virus/ACE2 receptor-ligand interaction concept. Indeed, obesity, air pollution and smoking associated risk factors share underlying pathophysiologies that are related to the Renin-Angiotensin-System in SARS-CoV-2 infection. The aim of this review is to emphasize the mechanism of receptor-ligand interaction and its impact on the enhanced risk of death due to SARS-CoV-2 infection.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Obesidad/complicaciones , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Factores de Riesgo , Fumar Tabaco/efectos adversos , Humanos , Pandemias , Peptidil-Dipeptidasa A/genética , Sistema Renina-Angiotensina
18.
Neurology ; 94(20): e2132-e2138, 2020 05 19.
Artículo en Inglés | MEDLINE | ID: mdl-32371450

RESUMEN

OBJECTIVE: To investigate the causal relevance of current tobacco smoking for the risk of Parkinson disease (PD). METHODS: We compared the risks of death from PD with smoking habits in 30,000 male doctors in the British Doctors cohort study in 1951 and in survivors who had been resurveyed periodically for 5 decades. Cause-specific mortality was monitored for 65 years and included 283 deaths from PD. The relative risks (RRs) of PD (and 95% confidence intervals [CIs]) were estimated using Cox models for smoking habits (smoking status, amount smoked, and years since quitting) at baseline or updated habits at resurvey. RESULTS: The prevalence of current smoking declined progressively during follow-up from 67% to 8% between 1951 and 1998. The crude rates of PD death were lower in current smokers than in never smokers at baseline (30 vs 46/100,000 persons-years). After adjustment for age at risk, current smokers at baseline had a 30% lower risk of PD (RR 0.71; 95% CI 0.60-0.84), and continuing smokers classified using updated smoking habits at resurvey had a 40% lower risk (RR 0.60; 95% CI 0.46-0.77) of PD compared with never smokers. The risks of PD were inversely associated with the amount of tobacco smoked. The protective effect of current smoking vs never smoking for PD was attenuated by increasing duration since quitting smoking. CONCLUSIONS: In contrast to previous suggestions, the present report demonstrates a causally protective effect of current smoking on the risk of PD, which may provide insights into the etiology of PD.


Asunto(s)
Enfermedad de Parkinson/epidemiología , Médicos/estadística & datos numéricos , Fumar/efectos adversos , Fumar Tabaco/efectos adversos , Adulto , Factores de Edad , Anciano , Estudios de Cohortes , Grupos Étnicos , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/etiología , Factores de Riesgo , Fumar/epidemiología , Cese del Hábito de Fumar , Factores de Tiempo
19.
Rev Mal Respir ; 37(6): 479-487, 2020 Jun.
Artículo en Francés | MEDLINE | ID: mdl-32381378

RESUMEN

Nicotine is the specific psychoactive substance of tobacco while tetrahydrocannabinol (THC) is the specific component of cannabis. The inhalation technique of cannabis is different from that of tobacco smoking: the volume of puffs is larger, inhalation is deeper, and pulmonary retention time is longer. Cannabis addiction is difficult to evaluate, both products often being smoked concomitantly. The principle physical side effects of cannabis affect organs and functions in a similar way to tobacco: pulmonary, cardiovascular, endocrine and stomatological. Gastrointestinal complications such as cannabinoid hyperemesis are specific to cannabis. Some psychological effects of THC may be acute (altered time and space perception, sensory disability, decreased vigilance, mood and dissociative disorders, hallucinations and delirium, impaired learning and memory, impaired cognitive and motor performance, panic attacks and anxiety) or chronic (lack of motivation, disorganisation of thoughts, increase in frequency and severity of schizophrenic crises). Cannabis can also be implicated in traffic and workplace accidents. Synthetic cannabinoids have increased psychotropic and somatic effects due to a greater affinity for brain cannabinoid receptors.


Asunto(s)
Cannabis/fisiología , Tabaco/fisiología , Encéfalo/efectos de los fármacos , Encéfalo/metabolismo , Cannabinoides/farmacología , Cannabis/química , Humanos , Abuso de Marihuana/complicaciones , Abuso de Marihuana/epidemiología , Fumar Marihuana/efectos adversos , Fumar Marihuana/epidemiología , Psicotrópicos/farmacología , Receptores de Cannabinoides/efectos de los fármacos , Receptores de Cannabinoides/metabolismo , Transducción de Señal/efectos de los fármacos , Transducción de Señal/fisiología , Tabaco/química , Fumar Tabaco/efectos adversos , Fumar Tabaco/epidemiología
20.
PLoS One ; 15(5): e0233749, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32469973

RESUMEN

INTRODUCTION: Smoking is hazardous to health and places a heavy economic burden on individuals and their families. Clearly, smoking in China is prevalent since China is the largest consumer of tobacco in the world. Chinese smoking and nonsmoking households were compared in terms of the incidence and intensity of Catastrophic Health Expenditures (CHEs). The factors associated with catastrophic health expenditures were analyzed. METHODS: Data for this study were collected from two waves of panel data in 2011 and 2013 from the national China Health and Retirement Longitudinal Study (CHARLS). A total of 8073 households with at least one member aged above 45 were identified each year. Catastrophic health expenditure was measured by the ratio of a household's out-of-pocket healthcare payments (OOP) to the household's Capacity to Pay (CTP). A panel logit random-effects model was used to examine correlates with catastrophic health expenditure. RESULTS: The incidence of catastrophic health expenditures for Chinese households with members aged 45 and above in 2011 and 2013 were 12.99% and 15.56%, respectively. The mean gaps (MGs) were 3.16% and 4.88%, respectively, and the mean positive gaps (MPGs) were 24.36% and 31.40%, respectively. The incidences of catastrophic health expenditures were 17.41% and 20.03% in former smoking households, 12.10% and 15.09% in current smoking households, and 12.72% and 13.64% in nonsmoking households. In the panel logit regression model analysis, former smoking households (OR = 1.444, P<0.001) were more prone to catastrophic health expenditures than nonsmoking households. Risk factors for catastrophic health expenditures included members with chronic diseases (OR = 4.359, P<0.001), hospitalized patients (OR = 8.60, P<0.001), elderly people aged above 65 (OR = 1.577, P<0.001), or persons with disabilities (OR = 1.275, P<0.001). Protective factors for catastrophic health expenditures included being in an urban household, having a larger family size, and having a higher household income. CONCLUSIONS: The incidence of catastrophic health expenditures in Chinese households is relatively high. Smoking is one of the primary risk factors for catastrophic health expenditures. Stronger interventions against smoking should be made in time to reduce the occurrence of health issues caused by smoking and the financial losses for individuals, families and society.


Asunto(s)
Enfermedad Catastrófica/economía , Financiación Personal/economía , Gastos en Salud/estadística & datos numéricos , Fumar Tabaco , Anciano , China , Composición Familiar , Humanos , Estudios Longitudinales , Persona de Mediana Edad , No Fumadores , Factores de Riesgo , Fumadores , Fumar Tabaco/efectos adversos , Fumar Tabaco/economía
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