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2.
Medicine (Baltimore) ; 100(2): e23997, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33466141

RESUMEN

ABSTRACT: There are reports that the use of regional anesthesia (RA) may be associated with better perioperative surgical stress response in cancer patients compared with general anesthetics (GA). However, the role of anesthesia on the magnitude of the postoperative systemic inflammatory response (SIR) in colorectal cancer patients, within an enhanced recovery pathway (ERP), is not clear.The aim of the present study was to examine the effect of anesthesia, within an enhanced recovery pathway, on the magnitude of the postoperative SIR in patients undergoing elective surgery for colorectal cancer.Database of 507 patients who underwent elective open or laparoscopic colorectal cancer surgery between 2015 and 2019 at a single center was studied. The anesthetic technique used was categorized into either GA or GA + RA using a prospective proforma. The relationship between each anesthetic technique and perioperative clinicopathological characteristics was examined using binary logistic regression analysis.The majority of patients were male (54%), younger than 65 years (41%), either normal or overweight (64%), and were nonsmokers (47%). Also, the majority of patients underwent open surgery (60%) and received mainly general + regional anesthetic technique (80%). On univariate analysis, GA + RA was associated with a lower day 4 CRP (≤150/>150 mg/L) concentration. On day 4, postoperative CRP was associated with anesthetic technique [odds ratio (OR) 0.58; confidence interval (CI) 0.31-1.07; P = .086], age (OR 0.70; CI 0.50-0.98; P = .043), sex (OR 1.15; CI 0.95-2.52; P = .074), smoking (OR 1.57; CI 1.13-2.19; P = .006), preoperative mGPS (OR 1.55; CI 1.15-2.10; P = .004), and preoperative dexamethasone (OR 0.70; CI 0.47-1.03; P = .072). On multivariate analysis, day 4 postoperative CRP was independently associated with anesthetic technique (OR 0.56; CI 0.32-0.97; P = .039), age (OR 0.74; CI 0.55-0.99; P = .045), smoking (OR 1.58; CI 1.18-2.12; P = .002), preoperative mGPS (OR 1.41; CI 1.08-1.84; P = .012), and preoperative dexamethasone (OR 0.68; CI 0.50-0.92; P = .014).There was a modest but an independent association between RA and a lower magnitude of the postoperative SIR. Future work is warranted with multicenter RCT to precisely clarify the relationship between anesthesia and the magnitude of the postoperative SIR.


Asunto(s)
Anestesia/efectos adversos , Anestesia/métodos , Neoplasias Colorrectales/cirugía , Complicaciones Posoperatorias/epidemiología , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología , Factores de Edad , Anciano , Proteína C-Reactiva/biosíntesis , Procedimientos Quirúrgicos Electivos/efectos adversos , Procedimientos Quirúrgicos Electivos/métodos , Femenino , Humanos , Laparoscopía/efectos adversos , Laparoscopía/métodos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores Sexuales , Fumar Tabaco/epidemiología
3.
Rev Saude Publica ; 54: 134, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33331528

RESUMEN

OBJECTIVE: This study aims to investigate the prevalence of adolescents and young adults who were victims of sexual violence at some point in their lives and to compare the presence of depressive and anxious symptoms, quality of life, and use of alcohol, tobacco, and illegal drugs among this population and those who were not abused. METHODS: Validated questionnaires and instruments were applied in a group of university students to assess: sexual profile and behavior, socioeconomic status, presence or not of sexual violence (Questionnaire on Exposure to Traumatizing Events), depressive (Beck Depression Inventory) and anxious symptoms (Beck Anxiety Inventory), quality of life (World Health Organization's Quality of Life Assessment) and the use or abuse of tobacco, alcohol, and illegal drugs (Smoking, Alcohol, and Substance Involvement Screening Test). RESULTS: Out of the 858 students who participated, 71 (8.3%) were victims of sexual violence, 52 girls (73.2%). In the victims of violence group there were more students who already had the first sexual intercourse (p = 0.029), students who already had become pregnant (p = 0.001), students with higher scores for depressive (p < 0.001) and anxious symptoms (p = 0.001), students with worse quality of life (p < 0.001), and who used more tobacco (p = 0.008) and marijuana (p = 0.025) as well as abused hypnotics or sedatives (p = 0.048) than in the non-victim group. CONCLUSION: The abuses are presented in several forms and affect, even in long term, the survivors' life. The sexual violence theme should be addressed and widely discussed in all spheres of society in order to mobilize, to sensitize, and provide society with knowledge, demystifying this subject and drawing attention to this important social issue.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Trastornos Relacionados con Alcohol/psicología , Ansiedad/psicología , Depresión/psicología , Calidad de Vida/psicología , Delitos Sexuales/psicología , Estudiantes/psicología , Trastornos Relacionados con Sustancias/psicología , Fumar Tabaco/psicología , Adolescente , Trastornos Relacionados con Alcohol/epidemiología , Ansiedad/epidemiología , Brasil/epidemiología , Niño , Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/estadística & datos numéricos , Depresión/epidemiología , Femenino , Humanos , Drogas Ilícitas , Masculino , Embarazo , Delitos Sexuales/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Encuestas y Cuestionarios , Fumar Tabaco/epidemiología , Adulto Joven
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
6.
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
7.
PLoS One ; 15(9): e0238320, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32911529

RESUMEN

AIM: In view of the current context of poverty and socio-economic inequalities and the high and rising burdens of HIV infection and non-communicable diseases in South Africa, this study aims to describe the distribution of adverse life events (ALEs) by age and gender, and examine the socio-demographic characteristics, psychosocial coping mechanisms, risky lifestyle behaviours and family burden of HIV-related ill-health associated with ALEs in 25-74-year-old black residents of Cape Town. MATERIALS AND METHODS: In a random cross-sectional sample, 12 ALEs, tobacco and alcohol use, sense of coherence (SOC), locus of control (LOC) and impact of HIV in the family were determined by administered questionnaires. Data analyses included descriptive statistics adjusted for the realised sample. Multivariable linear regression models assessed the independent associations of increasing number of ALEs. RESULTS: Among 1099 participants, mean lifetime score of ALE categories examined was 6.1 ±2.1 (range 0-12) with men reporting significantly higher number of events compared with women (p<0.001). The most frequent ALE was the death of a loved one (88.5%) followed by a major financial crisis (81.2%) with no trend across gender or age group. In the multivariable linear regression model, increasing ALEs were significantly associated with male gender, unemployment, having spent >50% of life in urban areas, >7 years of education, problematic alcohol use and poorer psychosocial coping mechanisms defined by low SOC and LOC. All four variables pertaining to HIV-related burden of ill-health in the family were significantly associated with increasing ALEs. CONCLUSIONS: Considering that lower SOC and LOC and problem drinking were significantly linked to ALEs, policymakers need to formulate strategies that improve coping mechanisms and promote problem-solving behaviours, target the high burden of alcohol misuse and address unemployment.


Asunto(s)
Adaptación Psicológica , Experiencias Adversas de la Infancia/estadística & datos numéricos , Consumo de Bebidas Alcohólicas/epidemiología , Infecciones por VIH/complicaciones , Acontecimientos que Cambian la Vida , Fumar Tabaco/epidemiología , Población Urbana/estadística & datos numéricos , Adulto , Grupo de Ascendencia Continental Africana , Anciano , Estudios Transversales , Femenino , VIH/aislamiento & purificación , Infecciones por VIH/psicología , Infecciones por VIH/virología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sudáfrica/epidemiología
8.
Med Hypotheses ; 143: 110153, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32763662

RESUMEN

Reports from various countries suggest that tobacco smoking might protect from SARS-CoV-2 infection, since the prevalence of smoking in COVID-19 hospitalized patients is lower than in the respective general population. Apart from nicotine or other chemicals contained in tobacco smoke, we propose that a single-stranded RNA virus that infects tobacco leaves, tobacco mosaic virus (TMV), might be implicated in this effect. TMV, though non-pathogenic, is found in smokers' airways, and stimulates adaptive and innate immunity, with release of specific antibodies and interferons. The latter may have preventive and/or therapeutic effects against COVID-19. If confirmed by epidemiological and interventional studies, this might lead to the use of TMV as an immunological adjuvant against SARS-CoV-2 infection and COVID-19 disease.


Asunto(s)
Betacoronavirus/inmunología , Infecciones por Coronavirus/inmunología , Modelos Inmunológicos , Pandemias , Neumonía Viral/inmunología , Fumadores , Virus del Mosaico del Tabaco/inmunología , Productos de Tabaco/virología , Fumar Tabaco , Animales , Anticuerpos Antivirales/biosíntesis , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Resistencia a la Enfermedad , Humanos , Interferones/biosíntesis , Ratones , Neumonía Viral/epidemiología , Neumonía Viral/virología , Sistema Respiratorio/inmunología , Sistema Respiratorio/virología , Virus del Mosaico del Tabaco/aislamiento & purificación , Fumar Tabaco/epidemiología , Receptores Toll-Like/inmunología
9.
J Environ Public Health ; 2020: 7654360, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32724320

RESUMEN

Purpose: To analyze the determinants of tobacco smoking addiction in rural areas. Methods: A cross-sectional study was conducted on February 2020. The self-administered questionnaire (α = 0.908) and Perceived Stress Scale-10 were used as tobacco smoking determinants and the WHO ASSIST questionnaire V3.0 to determine its addiction risk. Their correlations were analyzed by Spearman's rank-order approach using the SPSS version 23.0. Results: Among 75 male respondents that participated in this study, those on low, moderate, and high addiction risk were 45 (60.00%), 23 (30.67%), and 7 (9.33%), respectively, and significantly correlated with the research questionnaire that consisted three parts: 1. awareness toward the health risk; 2. social control; 3. mass media role in tobacco smoking (p=0.014, 0.004, and 0.009 respectively), but there was no significant correlation with the stress level (p=0.287). Conclusion: Increased awareness toward the health risk, good social control, and mass media reporting the danger of tobacco smoking is significantly in correlation with the decreased addiction in rural areas. However, the high perceived stress has no correlation with its increase.


Asunto(s)
Población Rural/estadística & datos numéricos , Fumar Tabaco/epidemiología , Adolescente , Adulto , Anciano , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Encuestas y Cuestionarios , Fumar Tabaco/prevención & control , Adulto Joven
10.
J Environ Public Health ; 2020: 7391587, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32655649

RESUMEN

Objectives: Our objective in this study was to identify the risk factors for cigarette, e-cigarette, and IQOS use among adolescents in Taiwan, with a particular focus on socioeconomic status, smoking status of parents and peers, cigarette promotions, and anti-tobacco campaigns. Methods: Data were obtained from the 2018 version of the annual cross-sectional Taiwan Global Youth Tobacco Survey, which is used to monitor tobacco use among Taiwanese adolescents in junior and senior high schools. The dependent variables in the study were "current cigarette smoking," "current use of e-cigarettes," and "current use of IQOS devices" (i.e., during the 30 days prior to survey completion). Independent variables included gender, school grade, monthly income/allowance, educational level of parents, smoking status of parents, smoking status of close friends, access to free cigarettes, exposure to cigarette advertisements, and attendance at anti-tobacco courses. Logistic regression was used in the identification of factors correlated with the current use of cigarettes, e-cigarettes, or IQOS. Results: We determined that 5.65% of the adolescents in the study were currently using cigarettes, 2.74% were currently using e-cigarettes, and 2.33% were currently using IQOS. Our analysis revealed a number of factors that have a bearing on smoking behavior, including gender, monthly allowance, educational level of parents, smoking status of parents and close friends, access to free cigarettes, and exposure to cigarette advertisements. Conclusions: The tobacco product that was most widely used by adolescents was cigarettes, followed by e-cigarettes and IQOS. The socioeconomic status, smoking status of parents/close friends, and access to cigarettes were all identified as important factors related to the current use of cigarettes, e-cigarettes, and IQOS by adolescents.


Asunto(s)
Fumar Tabaco/epidemiología , Dispositivos para Dejar de Fumar Tabaco/estadística & datos numéricos , Vapeo/epidemiología , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Factores de Riesgo , Taiwán/epidemiología , Fumar Tabaco/psicología , Vapeo/psicología
11.
PLoS One ; 15(6): e0233861, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32520979

RESUMEN

OBJECTIVES: The primary objective of the present study was to compare the prevalence and patterns of second-hand smoke (SHS) exposure in the home, workplace, public places, and at all three places amongst the non-smoker respondents between the two rounds of Global Adult Tobacco Survey (GATS) in India. The secondary objectives were to assess the differences in various factors associated with SHS exposure among non-smokers. STUDY DESIGN: This secondary data analysis incorporated data generated from the previous two rounds of the cross-sectional, nationally representative GATS India, which covered 69,296 and 74,037 individuals aged 15 years and above. Exposure to the SHS at home, workplace, and public places amongst the non-smokers were the primary outcome variables. Standard definitions of the surveys were used. RESULTS: The overall weighted prevalence of exposure to SHS amongst the non-smokers inside the home and public places reduced. In contrast, the prevalence in the workplace increased marginally in round II compared to I. The proportion of adults who were exposed to SHS at all three places did not change much in two rounds of surveys. A decrease in the knowledge of the respondents exposed to SHS at home and public places was observed about the harmful effects of smoking in round II. Age, gender, occupation, place, and region of respondents were found to be significant determinants of SHS exposure at all the three places on multinomial logistic regression analysis. CONCLUSIONS: The study calls for focused interventions in India and stringent implementation of anti-tobacco legislation, especially in the workplaces for reducing the exposure to SHS amongst the non-smokers and to produce encouraging and motivating results by next round of the survey.


Asunto(s)
Exposición a Riesgos Ambientales/estadística & datos numéricos , No Fumadores , Contaminación por Humo de Tabaco/estadística & datos numéricos , Fumar Tabaco/epidemiología , Adolescente , Adulto , Estudios Transversales , Análisis de Datos , Exposición a Riesgos Ambientales/prevención & control , Femenino , Vivienda , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Instalaciones Privadas , Instalaciones Públicas , Encuestas y Cuestionarios , Contaminación por Humo de Tabaco/prevención & control , Fumar Tabaco/prevención & control , Lugar de Trabajo , Adulto Joven
12.
JAMA Netw Open ; 3(6): e203826, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32501490

RESUMEN

Importance: Several states have banned sales of flavored e-cigarettes, but evidence on the association between vaping flavors and subsequent smoking initiation and cessation is limited. Objective: To evaluate whether new uptake of flavored e-cigarettes is more strongly associated with subsequent smoking initiation and cessation than uptake of unflavored e-cigarettes, separately for youths (12-17 years), emerging adults (18-24 years), and prime-age adults (25-54 years). Design, Setting, and Participants: This cohort study conducted secondary data analyses of longitudinal survey data from waves 1 to 4 of the Population Assessment of Tobacco and Health Study (collected from 2013 to 2018). The analytic sample was limited to 17 929 respondents aged 12 to 54 years at wave 1 who completed at least 3 consecutive waves of the survey and did not use e-cigarettes at baseline. Data were collected from 2013 to 2018 and analyzed in February 2020. Exposures: Flavored vs unflavored e-cigarette use reported in wave 2 of the Population Assessment of Tobacco and Health Study. Main Outcomes and Measures: Binary indicators captured wave 3 smoking among 7311 youths and 4634 emerging adults who did not smoke at baseline (ie, initiation) and not smoking at wave 3 among 1503 emerging adults and 4481 prime-age adults who smoked at baseline (ie, cessation). Smoking status was based on having smoked in the past 30 days for youths and established smoking (ie, current smoking among those who smoked at least 100 cigarettes in their lifetime) for emerging and prime-age adults. Results: The youths who did not smoke at baseline, emerging adults who smoked at baseline, and prime-age adults who smoked at baseline consisted of 51.4% to 58.0% male participants and 66.9% to 77.0% white individuals. Vaping uptake was positively associated with smoking initiation in youth (adjusted odds ratio [AOR], 6.75; 95% CI, 3.93-11.57; P < .001) and in emerging adults (AOR, 3.20; 95% CI, 1.70-6.02; P < .001). Vaping uptake was associated with cessation in adults (AOR, 1.34; 95% CI, 1.02-1.75; P = .03). Vaping nontobacco flavors was no more associated with youth smoking initiation than vaping tobacco-flavors (AOR in youth, 0.66; 95% CI, 0.16-2.76; P = .56) but was associated with increased adult smoking cessation (AOR in adults, 2.28; 95% CI, 1.04-5.01; P = .04). Conclusions and Relevance: In this study, adults who began vaping nontobacco-flavored e-cigarettes were more likely to quit smoking than those who vaped tobacco flavors. More research is needed to establish the relationship between e-cigarette flavors and smoking and to guide related policy.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Aromatizantes , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar Tabaco/epidemiología , Vapeo/epidemiología , Adolescente , Adulto , Factores de Edad , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estados Unidos , Adulto Joven
13.
Int J Mol Sci ; 21(11)2020 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-32486196

RESUMEN

The recently discovered novel coronavirus, SARS-CoV-2 (COVID-19 virus), has brought the whole world to standstill with critical challenges, affecting both health and economic sectors worldwide. Although initially, this pandemic was associated with causing severe pulmonary and respiratory disorders, recent case studies reported the association of cerebrovascular-neurological dysfunction in COVID-19 patients, which is also life-threatening. Several SARS-CoV-2 positive case studies have been reported where there are mild or no symptoms of this virus. However, a selection of patients are suffering from large artery ischemic strokes. Although the pathophysiology of the SARS-CoV-2 virus affecting the cerebrovascular system has not been elucidated yet, researchers have identified several pathogenic mechanisms, including a role for the ACE2 receptor. Therefore, it is extremely crucial to identify the risk factors related to the progression and adverse outcome of cerebrovascular-neurological dysfunction in COVID-19 patients. Since many articles have reported the effect of smoking (tobacco and cannabis) and vaping in cerebrovascular and neurological systems, and considering that smokers are more prone to viral and bacterial infection compared to non-smokers, it is high time to explore the probable correlation of smoking in COVID-19 patients. Herein, we have reviewed the possible role of smoking and vaping on cerebrovascular and neurological dysfunction in COVID-19 patients, along with potential pathogenic mechanisms associated with it.


Asunto(s)
Trastornos Cerebrovasculares/epidemiología , Infecciones por Coronavirus/epidemiología , Enfermedades del Sistema Nervioso/epidemiología , Neumonía Viral/epidemiología , Fumar Tabaco/epidemiología , Vapeo/epidemiología , Humanos , Pandemias
14.
PLoS One ; 15(6): e0234561, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32555596

RESUMEN

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) has been associated with an increased risk of tobacco smoking, and more difficulties with smoking cessation compared to non-ADHD individuals. Women with ADHD may therefore show elevated rates of smoking during pregnancy. AIMS: To examine the association between ADHD and smoking habits among pregnant women in Sweden and Norway. METHODS: Women pregnant for the first time were identified in Sweden (n = 622,037), and Norway (n = 293,383), of which 1.2% (n = 7,444), and 1.7% (n = 4,951) were defined as having ADHD, respectively. Data on smoking habits were collected early and late in pregnancy. RESULTS: In Sweden, ADHD was associated with an increased risk of smoking early in pregnancy, adjusted risk ratio (adjRR) 2.69 (95% confidence interval, 2.58-2.81), and late in pregnancy, adjRR 2.95 (2.80-3.10). Similar findings were observed in the Norwegian data, early in pregnancy, adjRR 2.31 (2.21-2.40), and late in pregnancy, adjRR 2.56 (2.42-2.70). Women with ADHD were more likely to continue smoking during pregnancy, compared to women without ADHD, both in Sweden adjRR 1.13 (1.10-1.17), and in Norway, adjRR 1.16 (1.12-1.20). Having a sibling diagnosed with ADHD was associated with an increased risk of smoking early and late in pregnancy, in both Sweden and Norway. CONCLUSIONS: Women with ADHD are considerably more likely to smoke early and late in (their first) pregnancy and are less likely to stop smoking between the two time points. Smoking, early and late in pregnancy, co-aggregates in families with ADHD. Smoking prevention and intervention programs should be targeted towards women with ADHD, specifically during their childbearing years, to ensure better mother and child outcomes.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Fumar Tabaco/epidemiología , Estudios de Cohortes , Femenino , Humanos , Noruega/epidemiología , Embarazo , Primer Trimestre del Embarazo , Tercer Trimestre del Embarazo , Factores de Riesgo , Hermanos , Cese del Hábito de Fumar , Suecia/epidemiología
15.
BMC Public Health ; 20(1): 702, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32414354

RESUMEN

BACKGROUND: Few studies have investigated factors associated with smoking behaviors. In this population-based study, we investigated demographics and medical comorbid diseases to establish a prediction model for smoking behaviors by using the National Health Interview Survey (NHIS) and National Health Insurance Research Database (NHIRD). METHODS: We enrolled individuals aged ≥40 years who had participated in the NHIS in 2001, 2005, and 2009. We identified the smoking behaviors of the study participants in the NHIS. Smoking behaviors were divided into ever smokers (current smokers and ex-smokers) and nonsmokers (never smokers).We defined medical comorbid disorders of the study participants by using medical claim data from the NHIRD. We used multivariable logistic regression models to calculate the adjusted odds ratio and 95% confidence interval for variables associated with smoking. The significant variables in the multivariable model were included in the receiver operating characteristic curves (ROC) to predict the sensitivity and specificity of the model. RESULTS: In total, 26,375 participants (12,779 men and 13,596 women) were included in the analysis. The prevalence of smoking was 39.29%. The mean ages of the 16,012 nonsmokers were higher than those of the 10,363 smokers (57.86 ± 12.92 years vs. 53.59 ± 10.82 years). Men outnumbered women among smokers (68.18% vs. 31.82%). Male sex, young age and middle age, being insured categories, residence in suburban areas, and chronic obstructive pulmonary disease (COPD) were independent factors associated with smoking. The area under the ROC curve of these significant factors to predict smoking behaviors was 71.63%. CONCLUSION: Sex, age, insured categories, residence in suburban areas, and COPD were associated with smoking in people.


Asunto(s)
Estado de Salud , Fumadores/estadística & datos numéricos , Fumar Tabaco/epidemiología , Adulto , Factores de Edad , Anciano , Comorbilidad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Curva ROC , Características de la Residencia , Factores Sexuales
16.
BMC Public Health ; 20(1): 677, 2020 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-32404138

RESUMEN

BACKGROUND: While the prevalence of post-disaster musculoskeletal pain has been documented, its associated disaster-related factors have not been investigated. This study was to investigate the association of lifestyle factors associated with musculoskeletal pain after the Great East Japan Earthquake. METHODS: We conducted a cross-sectional study of 34,919 participants, aged 40-89 years, without any major disabilities at about 1 year after the disaster. The participants were asked about their musculoskeletal pain (low back and limb pain) and lifestyle factors: use of evacuation shelters or temporary housing at any point of time, job loss after the disaster, decreased income after the disaster, current smoking status, current drinking status, lack of sleep, regular exercise, and participation in recreational or community activities. Furthermore, psychological factors, such as traumatic reactions, psychological distress, and uncomfortable symptoms, affecting musculoskeletal pain were assessed. We used multinomial logistic regression analysis to calculate odds ratios of each lifestyle factor for prevalent and prevalent plus exacerbated musculoskeletal pain. RESULTS: Musculoskeletal pain prevalence was 32.8%: 27.6% for prevalent and 5.2% for prevalent plus exacerbated musculoskeletal pain. Multivariable adjusted odds ratios and 95% confidence intervals of lifestyle factors associated with prevalent and prevalent plus exacerbated musculoskeletal pain were as follows: shelter use (prevalent: 1.02, 0.96-1.08; exacerbated: 1.44, 1.29-1.60), job loss (prevalent: 1.03, 0.96-1.10; exacerbated: 1.30, 1.16-1.47), decreased income (prevalent: 1.13, 1.05-1.21; exacerbated: 1.29, 1.14-1.45), current heavy drinking (prevalent: 1.33, 1.21-1.47; exacerbated: 1.38, 1.14-1.68), insomnia (prevalent: 1.22, 1.15-1.29; exacerbated: 1.50, 1.36-1.65), exercising almost daily (prevalent: 0.83, 0.77-0.91; exacerbated: 0.80, 0.68-0.95), and participating in community activities often (prevalent: 0.83, 0.75-0.92; exacerbated: 0.76, 0.61-0.95). CONCLUSIONS: Prevalent and exacerbated musculoskeletal pain were inversely associated with exercising almost daily and participating in recreational or community activities sometimes or often, and positively associated with decreased income, current heavy drinking, and insomnia. Besides, the use of evacuation shelters or temporary housing/job loss was positively associated only with exacerbated musculoskeletal pain. These results suggest that post-disaster lifestyle factors are potentially associated with musculoskeletal pain. To achieve better post-disaster pain management, further studies are needed to confirm the consistency of these results in other disasters and to highlight the underlying causative mechanisms.


Asunto(s)
Desastres , Terremotos , Accidente Nuclear de Fukushima , Estilo de Vida , Dolor Musculoesquelético/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/epidemiología , Estudios Transversales , Dieta , Ejercicio Físico , Femenino , Encuestas Epidemiológicas , Vivienda , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Sueño , Fumar Tabaco/epidemiología
17.
Dev Cell ; 53(5): 514-529.e3, 2020 06 08.
Artículo en Inglés | MEDLINE | ID: mdl-32425701

RESUMEN

The factors mediating fatal SARS-CoV-2 infections are poorly understood. Here, we show that cigarette smoke causes a dose-dependent upregulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 receptor, in rodent and human lungs. Using single-cell sequencing data, we demonstrate that ACE2 is expressed in a subset of secretory cells in the respiratory tract. Chronic smoke exposure triggers the expansion of this cell population and a concomitant increase in ACE2 expression. In contrast, quitting smoking decreases the abundance of these secretory cells and reduces ACE2 levels. Finally, we demonstrate that ACE2 expression is responsive to inflammatory signaling and can be upregulated by viral infections or interferon treatment. Taken together, these results may partially explain why smokers are particularly susceptible to severe SARS-CoV-2 infections. Furthermore, our work identifies ACE2 as an interferon-stimulated gene in lung cells, suggesting that SARS-CoV-2 infections could create positive feedback loops that increase ACE2 levels and facilitate viral dissemination.


Asunto(s)
Células Epiteliales Alveolares/metabolismo , Infecciones por Coronavirus/epidemiología , Interferones/metabolismo , Peptidil-Dipeptidasa A/genética , Neumonía Viral/epidemiología , Mucosa Respiratoria/metabolismo , Contaminación por Humo de Tabaco/efectos adversos , Fumar Tabaco/genética , Adulto , Anciano , Animales , Células CACO-2 , Células Cultivadas , Femenino , Células HCT116 , Humanos , Interferones/genética , Masculino , Ratones , Persona de Mediana Edad , Pandemias , Peptidil-Dipeptidasa A/metabolismo , ARN Mensajero/genética , ARN Mensajero/metabolismo , RNA-Seq , Ratas , Transducción de Señal , Análisis de la Célula Individual , Fumar Tabaco/epidemiología , Fumar Tabaco/metabolismo , Regulación hacia Arriba
18.
Medicine (Baltimore) ; 99(19): e20119, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32384489

RESUMEN

BACKGROUND: A growing number of epidemiological studies have suggested a possible association between long-chain omega-3 polyunsaturated fatty acid (PUFA) intake and the risk of cancers, but the results have been inconsistent. We aimed to conduct a meta-analysis to assess the association of omega-3 PUFA consumption with digestive system cancers. METHODS: Relevant observational studies were identified through a comprehensive search of PubMed, Embase, and the Web of Science through December 2019 and by reviewing the references of the retrieved articles. The relative risks (RRs) of digestive system cancers associated with omega-3 PUFA intake were estimated using a random-effect model and were stratified by region, sex, study design, type of omega-3 PUFAs, smoking status, alcohol consumption, BMI, and physical activity. RESULTS: Twenty-five studies (8 case-control studies and 17 cohort studies) involving 1,247,271 participants and 23,173 patients with digestive system cancers were included in this analysis. The risk of digestive system cancers decreased by 17% in individuals who consumed omega-3 PUFAs (RR = 0.83, 95% confidence interval (CI), 0.76-0.91). The risk estimates of digestive system cancers varied by cancer sites, study location, study design, type of omega-3 PUFAs, and other confounders (smoking, alcohol consumption, body mass index, and physical activity). Visual inspection of funnel plots and the Begg's and Egger's tests revealed no evidence of publication bias. CONCLUSION: The findings show that omega-3 PUFAs should be as a healthy dietary component for the prevention of digestive system cancers. Cancer incidence decreases with increasing omega-3 PUFAs intake for most digestive system cancer sites. The relation between omega-3 PUFAs and digestive system cancers RR is similar among different populations.


Asunto(s)
Neoplasias del Sistema Digestivo/epidemiología , Ácidos Grasos Omega-3/administración & dosificación , Consumo de Bebidas Alcohólicas/epidemiología , Índice de Masa Corporal , Neoplasias del Sistema Digestivo/prevención & control , Ejercicio Físico , Humanos , Incidencia , Estudios Observacionales como Asunto , Estudios Prospectivos , Características de la Residencia , Factores de Riesgo , Factores Sexuales , Fumar Tabaco/epidemiología
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.
BMC Public Health ; 20(1): 734, 2020 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-32434482

RESUMEN

BACKGROUND: Tobacco use is a leading cause of preventable diseases and death for all individuals, even more so for people living with HIV (PLWH), due to their status of chronic inflammation. To date, in Italy no study was performed to compare smoking habits in PLWH and the general population. We aimed to investigate smoking habits in PLWH, as compared to the general population. METHODS: Multi-center cross-sectional study. Smoking habits were compared between PLWH and the general population. PLWH were enrolled in the STOPSHIV Study. The comparison group from the general population was derived from a survey performed by the National Statistics Institute (ISTAT), with a stratified random sampling procedure matching 2:1 general population subjects with PLWH by age class, sex, and macro-area of residence. RESULTS: The total sample consisted of 1087 PLWH (age 47.9 ± 10.8 years, male 73.5%) and 2218 comparable subjects from the general population. Prevalence of current smokers was 51.6% vs 25.9% (p < 0.001); quitting smoking rate was 27.1% vs. 50.1% (p < 0.001) and the mean number of cigarettes smoked per day was 15.8 vs. 11.9 (p < 0.001), respectively for PLWH and the general population. Smoking and heavy smoking rates amongst PLWH were significantly higher even in subjects who reported diabetes, hypertension and extreme obesity (p < 0.001). Logistic regressions showed that PLWH were more likely current smokers (adjusted Odds Ratio, aOR = 3.11; 95% Confidence Interval (CI) =2.62-3.71; p < 0.001) and heavy smokers (> 20 cigarettes per day) (aOR = 4.84; 95% CI = 3.74-6.27; p < 0.001). PLWH were less likely to have quitted smoking (aOR = 0.36; 95% CI = 0.29-0.46; p < 0.001). CONCLUSION: HIV-infected patients showed a higher rate of current smokers, a larger number of cigarettes smoked and a lower quitting rate than the general population. Our findings emphasize the need for smoking cessation strategies targeting HIV persons.


Asunto(s)
Infecciones por VIH , Fumar Tabaco/epidemiología , Adulto , Estudios Transversales , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Fumadores , Fumar/epidemiología , Cese del Hábito de Fumar , Encuestas y Cuestionarios
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