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OBJECTIVES: Considering the increase in regenerative dental treatments, autologous fibrin membranes (ARMs) have been widely used in tissue engineering, favoring the regeneration of hard and soft tissues, accelerating angiogenesis and promoting cell differentiation and migration. This study proposed evaluate the differences in clinical characteristics and levels of the growth factors BMP-2, IGF, PDGF and VEGF between smokers and nonsmokers were evaluated according to the guidelines of the US Preventive Service Task Force (USPSTF). MATERIALS AND METHODS: Fourteen smokers and 14 nonsmokers were selected. After processing, the samples were allowed to rest in tubes for 5 min for the organization of the matrix and completion of the fibrin clot. Only the yellow portion and the buffy coat were removed and stored. Four clots were obtained from each donor and used to quantify the release of the growth factors BMP2, PDGF, IGF and VEGF. In addition, histological analyses were performed, and clinical characteristics were evaluated. RESULTS: The data were tabulated and subjected to statistical analysis with a significance level of 5%. In both groups, the membranes remained intact throughout the analysis period, indicating similar structural behavior. Histological evaluation of the membranes obtained from the participants revealed the presence of more homogeneous fibrin membranes in the nonsmoker group and many leukocytes bordering the entire fibrin clot. In the smoker group, heterogeneous fibrin clots, sometimes malformed, and fewer leukocytes in the region of the buffy coat and bordering the entire fibrin were observed. CONCLUSIONS: Smokers had significantly lower levels of VEGF, PDGF and BMP-2 (pg/ml in 1 µg total protein) than smokers did (p < 0.05), and there was no significant difference in IGF levels (p > 0.05) between the groups. There was also no statistically significant difference in membrane size between smokers and nonsmokers (mm, p > 0.05). CLINICAL RELEVANCE: Smoking may interfere with the formation of the fibrin mesh and consequently affects the quality and regenerative capacity in in smoking patients.

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Within-country differences in the prevalence of tobacco consumption may be expected in Mozambique, as determinants of tobacco use vary considerably countrywide. We compared the daily use of smoked and smokeless tobacco in 2005 and 2014/2015 across Mozambican regions. Two surveys were conducted in Mozambique, in 2005 and 2014/2015, with representative samples of the adult population, following the World Health Organization's STEPwise Approach to NCD Risk Factor Surveillance. Prevalence estimates were computed for daily use of different types of tobacco, stratified by regions. Data from the 2014/2015 survey were compared to those from the 2005 survey, after direct age-standardization. During the 10-year period, a significant reduction was observed in the prevalence of daily tobacco smoking among women in the Northern and men in the Southern provinces, due to the decrease in the consumption of hand-rolled cigarettes among Northern women (from 9.6% to 2.3%), and manufactured cigarettes among Southern men (from 23.7% to 11.8%). In Center and Northern regions, nonsignificant increases were observed in the consumption of manufactured cigarettes among men. The consumption of smokeless tobacco among Southern women decreased (from 3.1% to 1%). There was a decrease in the daily consumption of hand-rolled cigarettes among women in the North and of manufactured cigarettes among men in the South, as well as a potential trend towards residual smokeless tobacco consumption. However, the results suggest increases in the daily consumption of manufactured cigarettes among men in the Center and Northern regions.

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BACKGROUND: The impact of ankyloglossia (tongue-tie) on breastfeeding outcomes may be overestimated and surgical treatment in newborns remains a controversial topic. The aim of the present study was to assess and quantify the impact of ankyloglossia in newborns on breastfeeding self-efficacy at 14 days of life. METHODS: A birth cohort study was conducted involving mothers and newborns soon after childbirth at a public hospital in the city of Canoas, southern Brazil. At the hospital, the lingual frenum of newborns were clinically examined and classified using the Bristol Tongue Assessment Tool. For every newborn with defined or suspected ankyloglossia, two newborns without ankyloglossia were co-enrolled for the study. At 14 days of the children's lives, the mothers were interviewed at home to collect data on breastfeeding self-efficacy using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Poisson regression with robust variance was conducted to quantify differences in the Breastfeeding Self-Efficacy scores between exposed and nonexposed newborns after adjusting for maternal sociodemographic variables (mother's completed years of schooling, mother's age, family structure, progenitor status of child, mother's smoking status), the gestational variables (number of prenatal appointments, gestational age, comorbidities, type of childbirth), and child related variables (sex, birth weight, birth length) as confounders. RESULTS: The final sample was composed of 31 children with ankyloglossia (exposed) and 57 without ankyloglossia (nonexposed). No significant differences were found in the BSEF-SF scores between the 31 children with ankyloglossia (mean BSEF-SF scores: 56.0; median BSEF-SF scores: 60; 95% CI: 51.9-60.1) and the 57 children without ankyloglossia (mean BSEF-SF scores: 59.6; median BSEF-SF scores: 60; 95% CI: 57.5-61.7). The Poisson regression analysis showed no significant difference in the BSEF-SF scores between newborns with ankyloglossia and those without ankyloglossia (Ratio = 0.95; 95% CI: 0.88-1.02; p = 0.139). CONCLUSION: Ankyloglossia at birth exerted no clinically relevant impact on breastfeeding self-efficacy in children at 14 days of life.

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Background: Thyroid eye disease (TED) is the most prevalent extrathyroidal manifestation of Graves' disease (GD). Emerging evidence suggests a relationship between elevated total and low-density lipoprotein (LDL) cholesterol levels and TED. This study aimed to investigate this correlation in the Brazilian population by analyzing data from two tertiary care centers. Methods: Data were collected from GD patients treated with methimazole between 1999 and 2021, excluding those receiving other treatments. Laboratory results and information on smoking habits, statin use and medications affecting lipid profiles during the euthyroid state were analyzed. Results: Smoking and elevated LDL cholesterol levels were significantly associated with TED activity and severity. Logistic regression revealed correlations between higher LDL cholesterol, total cholesterol and increased clinical activity score (P < 0.01, OR: 1.012, 95% CI: 1.003-1.021; P < 0.01, OR: 1.010, 95% CI: 1.002-1.018). These were also associated with more severe disease forms as defined by EUGOGO (P < 0.01, OR: 1.015, 95% CI: 1.006-1.024; P < 0.005, OR: 1.011, 95% CI: 1.004-1.019). Multiple regression confirmed that TED activity was significantly correlated with LDL cholesterol (P < 0.01) and smoking status (P < 0.01). Disease severity was associated with reduced HDL cholesterol (P < 0.05, OR: 0.973, 95% CI: 0.948-0.999), elevated LDL cholesterol (P < 0.005, OR: 1.013, 95% CI: 1.004-1.023) and active smoking (P < 0.05, OR: 2.881, 95% CI: 1.190-6.971). Conclusion: Elevated LDL cholesterol may serve as a potential indicator of TED. Further research is needed to determine whether lipid-lowering interventions could reduce TED risk or improve its management.

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OBJECTIVES: To examine prevalence trends in the use of smoked tobacco products in 11 South American (SA) countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Suriname, Uruguay, and Venezuela) and their association with country-specific socio-demographic index (SDI) over 30 years. DATA AND METHODS: The estimates of SDI and smoked tobacco prevalence stratified by age, sex, and country were extracted from the Global Burden of Disease Study (1990-2019) on individuals aged 15+. The annual percentage changes (APCs) of trends in country-specific prevalence of smoked tobacco were evaluated using Joinpoint regression. Correlation analysis was also used to explore the association between country-specific prevalence of smoked tobacco and their SDIs, a measure of developmental status considering income per capita, educational attainment, and total fertility rate. RESULTS: While all SA countries showed an overall decline in smoked tobacco use prevalence between 1990 and 2019 (APCs between -0.52%-and -4.73%; p < 0.05), Bolivia and Ecuador showed a significant increasing trend (APCs of 0.34% and 0.20%). Country-specific SDI was strongly and significantly correlated (rs = -0.99 to -0.85) with smoking prevalence in SA countries, except for Ecuador and Bolivia (rs = 0.16 and 0.36, respectively). CONCLUSION: In recent decades, most SA countries have experienced a significant reduction in the prevalence of smoked tobacco use, except Ecuador and Bolivia, where smoking rates have risen, showing a direct correlation with SDI. These findings can contribute to the design and implementation of strategies and policies for tobacco prevention and control in the SA region especially within the two affected countries - Ecuador and Bolivia.

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PURPOSE: This scoping review aimed to map research on factors associated with obstructive sleep apnoea (OSA) in children and adolescents undergoing overnight polysomnography (PSG) and questionnaire-based diagnostic assessments. METHODS: Searches were conducted in three electronic databases up to May 2023, including nine observational studies, including 3482 individuals. RESULTS: Among the included studies, nine reported on sex, six on obesity, five on tonsillar hypertrophy, three on mouth breathing, two on allergic rhinitis, and three on smoking exposure. The sample comprised 3482 children, with subsets analyzed for sex (n = 3482), obesity (n = 2752), and tonsillar hypertrophy (n = 794). Meta-analysis demonstrated a significantly higher prevalence of OSA in males compared to females [P < 0.0001; I2 = 49 %], with a pooled relative risk (RR) of 1.15 (95 % confidence interval [CI]: 1.07-1.23). Associations were found between obesity and OSA [RR: 1.42; 95 % CI: 1.20-1.68; P = 0.02; I2 = 61 %], and tonsillar size and OSA [RR: 1.61; 95 % CI: 1.35-1.92; P = 0.06; I2 = 60 %]. CONCLUSION: Considering the study's limitations, these findings underscore the importance of considering sex, obesity, and tonsillar size when evaluating OSA in children and adolescents.

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OBJECTIVE: Silicosis is a pneumoconiosis characterized by fibrosis of the lung parenchyma caused by the inhalation of silica particles. Silica dust inhalation is associated with inflammation and induction of oxidative stress in the lungs. This oxidative stress affects telomeres, which are short tandem DNA repeats that cap the end of linear chromosomes. We aimed to determine whether telomere length (TL) correlates with silicosis or severity of silicosis in silica-exposed workers in Brazil. METHODS: We included 200 men in southeastern Brazil: 100 with silicosis and 100 who had not been exposed to silica. We extracted DNA from buccal cells and assessed TL by multiplex quantitative polymerase chain reaction. RESULTS: The median TL was significantly shorter in the patients with silicosis than in the unexposed controls (p < 0.0001), although it did not differ between the patients with simple silicosis and those with complicated silicosis (p = 0.961). We also found that, in patients with silicosis, TL was influenced by smoking (p = 0.034) and by a history of personal protective equipment use in the workplace (p = 0.002). CONCLUSIONS: Silica exposure appears to have an impact on TL, which was found to be shorter in patients with silicosis than in unexposed controls. Further studies are needed in order to confirm the impact that oxidative stress caused by silica inhalation has on telomeres.

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OBJECTIVE: To assess the relationship between smoking exposure and organ damage accrual measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for Systemic Lupus Erythematosus score (SLICC-SDI) in consecutive patients with systemic lupus erythematosus (SLE) from Argentina. METHODS: 623 consecutive SLE patients (fulfilling ≥4, 1997 ACR criteria) were included in this cross-sectional study. Sociodemographic and disease related variables including SLICC-SDI score and smoking status were collected. Patients currently smoking were considered "smokers", and "non-smokers" those who never smoked and former smokers. SLICC-SDI was divided into two categories: <3 and ≥3 was defined as severe damage. RESULTS: Six hundred and 23 patients were included in the analysis, 89% women. Eighty-four per cent were non-smokers and 16 % were current smokers 83 percent of patients had SLICC-SDI <3 and 17 % had SLICC-SDI ≥3. Twenty one percent of patients with SLICC-SDI ≥3 and 15% with <3 SLICC-SDI were current smokers (p 0.081). In the multiple regression analysis, current smoking (OR 1.82, CI 95% 1.01-3.31, p 0.046), older age (OR 1.04, CI 95% 1.00-1.05, p 0.034), disease duration (OR 1.03, CI 95% 1.00-1.07, p 0.021) and cyclophosphamide exposure (OR 2.97, CI 95% 1.49-5.88, p 0.002) were related to SLICC-SDI ≥3. CONCLUSION: In our sample of patients, current smoking, older age, disease duration and cyclophosphamide were related to severe damage (SLICC-SDI ≥3).

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BACKGROUND: Hypovitaminosis D raised a significant public health concern due to its potential association with various diseases, including Oral Squamous Cell Carcinoma (OSCC). The objective of this study was to compare serum 25(OH)D3 levels between individuals with and without OSCC, and by subgroups based on their smoking habits. MATERIAL AND METHODS: A case-control study was conducted utilizing progressive multicenter recruitment, involving 46 patients with Oral Squamous Cell Carcinoma (OSCC) and 65 controls. Serum levels of 25(OH)D3 were evaluated via electrochemiluminescence. Patients were categorized according to their vitamin D levels into sufficiency, mild deficiency, moderate deficiency, and severe deficiency. Comparative analyses of serum 25(OH)D3 levels were performed between OSCC patients and controls, as well as among subgroups based on their smoking habits. Group comparisons were made with the Mann-Whitney test, and subgroup analyses used the Kruskal-Wallis test. Significance was set at p < 0.05 Results: 91% of participants, including both OSCC patients and controls, exhibited some degree of 25(OH)D3 deficiency. Among them, 71.7% of OSCC patients and 50.7% of controls had serum levels characterized by moderate to severe deficiencies. Patients with OSCC showed lower levels of 25(OH)D3, with medians of 20.2 ng/ml (IQR 9.48), compared to controls, with medians of 24.8 ng/ml (IQR 9.13) (p=0.002). Furthermore, when comparing the medians among the four study groups (smoking and non-smoking controls and smoking and non-smoking patients with OSCC), a significant difference was observed between non-smoking control patients with 25.04 ng/ml (IQR = 9.71) and smoking OSCC patients with 19.65 ng/ml (IQR = 12.14) (p < 0.05). CONCLUSIONS: Individuals with oral squamous cell carcinoma (OSCC) exhibited lower serum levels of vitamin D (25(OH)D3) compared to controls, suggesting a potential link between vitamin deficiency and the development of this type of cancer. Vitamin D supplementation could serve as a preventive and therapeutic strategy.

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BACKGROUND: This split-mouth, double-masked, randomized clinical trial aimed at evaluating the impact of different macro geometries and nano topographical modifications on peri-implant bone repair in smokers. METHODS: Thirty-two patients who smoked at least ten cigarettes/day, with the need of a single maxillary or mandibular implant bilaterally, received two implants randomly assigned to DA - Dual Acid-Etched implants (n = 32); HCAN - healing chambers and activated nano surface (n = 32). Implant stability quotient (ISQ) was evaluated 07, 30, 60, 90, and 120 days after implant placement. Levels of bone and angiogenic markers were quantified in the peri-implant fluid after 07, 15, 30, 90, and 120 days of implant insertion. HCAN implants have a higher ISQ than DA implants at 60 days (p < 0.05). RESULTS: PLGF levels were lower for HCAN implants than for DA implants at 07-day period (p < 0.05). Besides, HCAN implants presented higher levels of OPG at 30 days and OPN, BMP-9, FGF-1, PLGF, and VEGF at 90 days, compared to DA implants (p < 0.05). The levels of EGF were higher for HCAN implants at 15, 90, and 120 days compared with DA implants (p < 0.05). HCAN implants also showed lower levels of TNF-α at 07 days in comparison to DA implants (p < 0.05) but had higher levels of DKK1 at 30 days, while DA implants presented higher levels of this marker at 90 days (p < 0.05). CONCLUSION: Macro geometry and nano topographical modifications positively modulated the bone and angiogenic factors, resulting in higher production of these markers during early peri-implant bone healing and having a positive effect on implant stabilization in smokers. TRIAL REGISTRATION: RBR-10gjvcyt; date of registration: 06/12/2023 (Retrospectively registered).

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BACKGROUND: Mesh salvage using negative pressure wound therapy (NPWT) in cases of mesh infection following hernia repair has emerged as an alternative to early mesh removal. However, the factors related to the success or failure of mesh salvage with NPWT remain unclear. METHODS: This retrospective cohort study included 61 patients with mesh infections after hernia repair treated with NPWT between 2018 and 2024. We analyzed demographic, clinical, and surgical variables, as well as the bacterial spectrum and antimicrobial susceptibility. A binary logistic regression model was used to identify factors associated with NPWT failure, defined as the need for mesh removal. RESULTS: Mesh salvage was successful in 80.3% of cases. Active smoking was significantly associated with NPWT failure (OR = 7.82, CI 95% 1.05-64.8; p = 0.044). Other factors, such as age, body mass index, Charlson comorbidity index, mesh type, and mesh position, were not significantly related to failure. Most infections were caused by Staphylococcus aureus (24.6%) and Escherichia coli (22.9%). CONCLUSIONS: NPWT is an effective method for salvaging infected meshes, with a high success rate. Active smoking was identified as a risk factor for NPWT failure, highlighting the need for early identification of patients who may benefit from alternative approaches. Further studies are required to develop predictive models for NPWT success in mesh salvage.

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OBJECTIVE: Sublingual varicose veins are variations of normality that appear more prominent during aging. The systematic review aim to investigate sublingual varicose veins frequency in patients exposed to systemic and environmental exposed factors linked to cardiovascular diseases. METHODS: This systematic review was based on the PECO strategy, and the PubMed, Web of Science, Scopus, Embase and Grey Literature library were searched for publications examining the association between sublingual varicose veins and systemic and environmental exposed factors linked to cardiovascular diseases, such as hypertension, diabetes, smoking, and leg varices. A meta-analysis was conducted using random-effects models. This review included 11 studies with a total of 2,272 patients with sublingual varicosity and systemic exposed factors linked to cardiovascular diseases. The quality assessment was improved by Newcastle and Ottawa Scales (NOS). RESULTS: Consistent results were observed across all systemic and environmental exposed factors linked to cardiovascular diseases subgroups. We found association between sublingual varicose veins and hypertension [p = 0.0002; 95%IC2.90 [1.66-5.06]; I2 91%); diabetics (p = 0.009; 95%IC 3.19 [1.34 - 7.62]; I2 84%); tobacco abuse (p = 0.002; 95%IC 1.97 [1.29 - 3.01]; I2 82%) and leg varicosity (p = 0.03; 95%IC 2.63 [1.08 - 6.44]; I2 95%). Seven articles received score 7, indicating good quality and four articles received moderate quality. CONCLUSION: Patients exposed to exposed factors that affect blood vessels showed a higher prevalence of sublingual varicose veins. These findings emphasize the importance of recognizing oral signs underlying systemic diseases. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42023397166.

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OBJECTIVES: To assess work history, occupational exposure, smoking, and biomass fuel use in a Mexican IgG4-related disease (IgG4-RD) cohort. METHODS: We conducted a cross-sectional study among patients with IgG4-RD. A standardised questionnaire was used to collect data on occupational, smoking, and biomass fuel exposure. The International Standard Classification of Occupations (ISCO88) categorised patients into white-collar (ISCO88 groups 0-5) and blue-collar (ISCO88 groups 6-9) work. RESULTS: We included 95 patients, with a mean age of 53.8±15.8 years, and 50.5% were male. Seventy-eight (82.1%) had paid work: 63 (66.3%) in white-collar and 15 (15.8%) in blue-collar occupations. Of those who had no paid work, 13 (13.7%) did household work and 4 (4.2%) were students. White-collar jobs were more common than blue-collar jobs, both including (66.3% vs. 29.5%) and excluding (66.3% vs. 15.8%) unpaid household work. Pancreatobiliary involvement was not more frequent among blue-collar workers. Occupational exposure was reported by 31.6% of patients. White-collar workers had more lung involvement (29% vs. 7.1%, p=0.02) and less biomass exposure (19% vs. 64.3%, p<0.001). Occupational exposures were associated with the proliferative phenotype (OR 3.5, 95% CI 1.08-11.36). History of smoking was linked to increased lung involvement (OR 3.2, 95% CI 1.1-9.4), while biomass exposure was associated with the Mikulicz/systemic phenotype (OR 2.6, 95% CI 1.03-6.9). CONCLUSIONS: This study shows that there are different patterns of occupational exposure among Mexican IgG4-RD patients, with fewer blue-collar jobs compared to other cohorts. Smoking and biomass fuel exposure may be more significant risk factors for IgG4-RD in this population, warranting further investigation.

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BACKGROUND: Diabesity is a condition characterized by the coexistence of type 02 diabetes and obesity. The causes are multifactorial, resulting from a complex interaction of genetic and behavioral factors. Among the behavioral factors, there are physical inactivity, inadequate eating habits and excessive consumption of alcohol and tobacco. OBJECTIVE: To investigate the clustering of physical inactivity and other risk factors and the association between risk factor combinations and the presence of diabesity in quilombola adults. METHODS: Cross-sectional study involving a sample of 332 middle-aged and older adults (≥ 50 years) selected among participants in the "Epidemiological Profile of Quilombolas in Bahia" study. Data were collected by interview and anthropometric assessment. Descriptive statistics, cluster analysis, and multinomial logistic regression procedures were used for data analysis. RESULTS: The highest prevalence of clustering was identified for the combinations of regular alcohol consumption in the absence of the other factors (O/E=14.2; 95%CI 0.87-1.15), followed by regular alcohol and tobacco consumption (O/E=10.3; 95%CI 0.64-0.95) and regular consumption of alcohol, tobacco and foods high in sugar and fat (O/E=6.8; 95%CI= 1.31-1.75). Unadjusted analysis revealed an association between physical inactivity in the absence of the other factors (OR=0.82; 95%CI 0.78-0.86) and diabesity. CONCLUSION: Alcohol consumption was the most prevalent factor among the largest combinations evaluated. Furthermore, the presence of physical inactivity without the other behaviors analyzed and the absence of all behaviors were associated with diabesity only in unadjusted analysis.

FUNDAMENTO: A diabesidade é uma condição caracterizada pela coexistência de diabetes tipo 02 e obesidade. As causas são multifatoriais, resultantes de uma complexa interação de fatores genéticos e comportamentais. Entre os fatores comportamentais, destacam-se a inatividade física, os hábitos alimentares inadequados e o consumo excessivo de álcool e tabaco. OBJETIVO: Investigar o agrupamento (clustering) da inatividade física e outros fatores de risco e a associação entre as combinações de fatores de risco e a presença de diabesidade em adultos quilombolas. MÉTODOS: Trata-se de estudo transversal com amostra composta por 332 adultos de meia idade e idosos (idade ≥ 50 anos), selecionados entre os participantes do estudo "Perfil epidemiológico dos quilombolas baianos". Os dados foram obtidos por meio de entrevistas e avaliação antropométrica. Para a análise dos dados, foram utilizadas estatísticas descritivas, análise de cluster e procedimentos de regressão logística multinominal. RESULTADO: A maior prevalência de agrupamento foi identificada para as combinações de consumo regular de álcool sem a presença dos demais fatores (O/E=14,2; IC95%= 0,87-1,15), seguido de consumo regular de álcool e tabaco (O/E=10,3; IC95%= 0,64-0,95) e consumo regular de álcool, tabaco e alimentos ricos em açúcar e gorduras (O/E=6,8; IC95%= 1,31-1,75). Na análise bruta, foram observadas associações entre inatividade física sem a presença dos demais fatores (OR= 0,82 IC95%= 0,78-0,86) e diabesidade. CONCLUSÃO: O consumo de álcool foi o fator mais prevalente nas maiores combinações avaliadas. Além disso, inatividade física, sem os outros comportamentos analisados, e a ausência de todos os comportamentos associaram-se à diabesidade apenas na análise bruta.

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INTRODUCTION: Since the onset of the COVID-19 pandemic, cases of COVID-19-associated pulmonary aspergillosis (CAPA) have been described. Possible risk factors for the development of this condition have been proposed, although evidence in Latin American populations is limited. The objectives were to identify risk factors for the development of CAPA and describe the characteristics of this infection. MATERIALS AND METHODS: A retrospective case-control study was conducted. The population consisted of adult patients with severe COVID-19, hospitalized in ICU and who had undergone diagnostic tests for invasive pulmonary aspergillosis. RESULTS: Seventy-five patients were evaluated, 21 in the case group and 54 in the control group. 64% were male, with an average age of 62.7 years. It was found that a history of diabetes (OR 3.3, CI 1.09-9.95, p=0.03), smoking (OR 3.47, CI 1.20-10, p=0.02), coronary artery disease (OR 5, CI 1.24-20.08, p=0.02), and a Charlson score equal to or greater than 5 (OR 1.27, CI 1-1.60, p=0.013) could be associated with the development of CAPA. Most cases were considered as possible CAPA (87.5%). The time between orotracheal intubation to the diagnosis of CAPA was 11.5 days. Fever was the most common symptom (90%), and only 24% of patients had compatible radiographic findings. Mortality in the case group was 61.9%. DISCUSSION: A history of diabetes, smoking, coronary artery disease, and a Charlson score equal to or greater than 5 may increase the risk of developing CAPA.

Introducción: La evidencia sobre factores de riesgo para el desarrollo de aspergilosis pulmonar asociada a COVID-19 (CAPA), en poblaciones de Latinoamérica, es escasa. Los objetivos del presente estudio fueron identificar factores de riesgo para el desarrollo de CAPA en pacientes con COVID-19 grave y describir las características de la infección. Materiales y métodos: Estudio retrospectivo de casos y controles. La población incluyó pacientes adultos, con COVID-19 grave, sometidos a pruebas diagnósticas para CAPA. Resultados: Se evaluaron 75 pacientes, 21 casos y 54 controles (relación 1:2.6). El promedio de edad fue 62.7 años. El antecedente de diabetes (OR 3.3 IC 1.09 - 9.95, p=0.03), tabaquismo (OR 3.47 IC 1.20-10, p=0.02), enfermedad coronaria (OR 5 IC 1.24-20.08, p=0.02) y score de Charlson ≥ 5 (OR 1.27, IC 1- 1.60, p=0.013) podrían asociarse al desarrollo de CAPA. El 87.5% de los casos se consideraron como CAPA posible. El tiempo entre la intubación orotraqueal y el diagnóstico de CAPA fue de 11.5 días. El síntoma más frecuente fue la fiebre (90%) y solo el 24% de los pacientes presentó hallazgos radiológicos compatibles con aspergilosis. La mortalidad en el grupo de casos fue de 61.9%. Discusión: El antecedente de diabetes, tabaquismo, enfermedad coronaria y score de Charlson igual o mayor a 5 podría aumentar el riesgo de desarrollar CAPA en pacientes con COVID-19 grave.

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INTRODUCTION: The objective was to analyze the prevalence of classic CVRFs in specialist doctors and establish if there are differences by sex, age and specialty. MATERIALS AND METHODS: Observational, cross-sectional study carried out through an anonymous selfadministered survey of specialist doctors throughout the country. Sociodemographic and CVRF data were collected by self-report. Excess weight was considered if the body mass index (BMI) was ≥ 25. Records without weight and/or height were excluded. RESULTS: A total of 2925 specialist doctors participated, 67.5% women and 84% between 40 and 60 years old. The prevalence of SBO was 75%. The most prevalent conventional risk factors were family history (AHF) 57%, excess weight (53%), sedentary lifestyle (44%), followed by dyslipidemia 21%, smoking 16.5%, hypertension 16% and diabetes 4%. Men had significantly more CVRF than women except for smoking and sedentary lifestyle, which were similar in both sexes. DISCUSSION: Specialist physicians have a high prevalence of modifiable CRFs, which are also associated with AHF, present in more than half of the physicians. The prevalence is higher in men, intensivists and those over 60 years of age.

Introducción: El objetivo de este análisis fue evaluar la prevalencia de los factores de riesgo cardiovascular (FRCV) clásicos en médicos especialistas y establecer si existen diferencias por sexo, edad y especialidad. Materiales y métodos: Estudio observacional, de corte transversal mediante una encuesta anónima autoadministrada realizada a médicos especialistas de todo el país. Se recabaron datos sociodemográficos y de síndrome de burnout (SBO) y FRCV por autorreporte. Se consideró exceso de peso si el índice de masa corporal (IMC) era ≥ a 25. Se excluyeron los registros sin peso y/o altura. Resultados: Participaron 2925 médicos especialistas, 67.5% mujeres y 84% tenía entre 40 y 60 años. La prevalencia de SBO fue del 75%. Los factores de riesgo convencionales más prevalentes fueron los antecedentes heredofamiliares (AHF) 57%, el exceso de peso (53%), el sedentarismo (44%), seguidos por dislipemia 21%, tabaquismo 16.5%, hipertensión 16% y diabetes 4%. Los varones tuvieron significativamente más FRCV que las mujeres a excepción del tabaquismo y el sedentarismo que fueron similares en ambos sexos. Discusión: Los médicos especialistas presentan una prevalencia importante de FRCV modificables, que se asocian también al AHF, presente en más de la mitad de los médicos. Estos factores afectan más a los varones, los intensivistas y a los mayores de 60 años.

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OBJECTIVE: In this study, the localization of tumor necrosis factor alpha (TNF-α) and interleukin (IL) -6 in the umbilical cord tissue of pregnant women with preeclampsia who smoke and in those who do not smoke was investigated using immunohistochemical methods. METHODS: The sample groups consisted of a control group, cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia. Histological and immunohistochemical methods were applied to the tissue samples. RESULTS: It was determined that there were varying degrees of edemato s change in the layers of arteries and veins in the preeclampsia and the cigarette smokers with preeclampsia groups, with a statistically significant level of difference in thickness compared to the other groups. In addition, different levels of TNF α and IL-6 immunoreactivity were detected in the umbilical cord tissue across all the groups. In the preeclampsia group, TNF-α immunoreactivity was found to increase in the arterial muscle layer. Moreover, IL-6 immunoreactivity was found to decrease in the arterial endothelium and muscle layers in the cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia groups and increase in the venous endothelium and muscle layers. In addition, immunoreactivity increased in the amniotic epithelium in the cigarette smokers with preeclampsia group. DISCUSSION: In conclusion, the differences in cytokine levels between the cigarette smokers, preeclampsia, and cigarette smokers with preeclampsia groups were thought to be caused by responses of the maternal immune system and histopathological changes in the umbilical cord tissue.

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OBJECTIVE: To estimate the prevalence and to evaluate trends and disparities in the occurrence of smoking among pregnant women living in the municipality of Rio Grande (RS), in the extreme south of Brazil, between 2007 and 2019. METHODS: All pregnant women living in this municipality who had a child in one of the local hospitals between January 1st and December 31st in the years 2007, 2010, 2013, 2016, and 2019 were included in the study. The interviews took place within 48 hours after childbirth. A pregnant woman was considered a smoker if she smoked at least one cigarette per day for 30 consecutive days in any of the pregnancy trimesters. The respective Pearson's χ2 test was used to estimate the proportions and the trend. RESULTS: The mean prevalence of smoking in the studied period was 17.7% (95%CI 17.0-18.3), dropping from 23.4 (95%CI 21.7-25.0) in 2007 to 12.4% (95%CI 11.1-13.9) in 2019. This decrease occurred in all categories of the studied variables (p>0.001). The greatest disparities in the decrease were observed between the extreme groups for income (75.0 versus 34.4%) and level of education (51.0 versus 32.1%) and living or not with a partner (50.7 versus 27.7%). CONCLUSION: There was a sharp and uneven drop in the prevalence of smoking over these 13 years. Pregnant women at higher risk of complications during pregnancy and childbirth were at a clear disadvantage compared to others. Reducing the prevalence of smoking depends on prioritizing interventions among pregnant women with greater social vulnerability.

RESUMO

This study investigates the changing epidemiological profile of tongue squamous cell carcinoma (SCC) to young patients, highlighting its rising incidence among non-traditional risk groups. A retrospective descriptive study was conducted, covering data from medical records between 2000 and 2012. Patients were categorised into two age groups (≤ 40 years; 41-50 years). Sociodemographic and clinicopathological characteristics were evaluated. A total of 108 patients participated, mostly aged 41-50. Alcohol consumption (43.3%) surpassed smoking. Majority (56.7%) aged ≤ 40 never smoked. Lateral tongue border was most affected, with stages III and IV prevalent. Patients aged ≤ 40 were mostly eligible for surgery (44%). Survival tied to staging and surgery; age had no significant impact. Young squamous cell carcinoma patients often lacked traditional risk factors like smoking, underwent surgery, and typically had disease-free margins. The study underscores the importance of broad external policies for early diagnosis, beyond just traditional risk groups.

RESUMO

OBJECTIVE: To analyze the association of household composition with risk behaviors in Brazilian adolescents. METHODS: Cross-sectional study, with a nationally representative sample of Brazilian adolescents (n=159,245) aged 13 to 17, enrolled and regularly attending the 7th to 9th year of elementary school and the 1st to 3rd year of high school, participants in the National Survey of School Health in 2019. The risk behaviors were: insufficient physical activity, sedentary behavior, alcohol consumption, smoking, poorer diet quality, skipping breakfast and not having meals with parents/guardians. In the analyses, the sampling weights and study design were considered, stratified by the type of school (public or private) and estimated using Poisson regression models. RESULTS: Adolescents, from public and private schools, who lived in single-parent households or where parents were absent, had a higher prevalence of alcohol consumption, smoking, poorer diet quality, skipping breakfast and not eating meals with parents/guardians, compared to those who lived with both parents. Additionally, adolescents from public schools showed a higher prevalence of sedentary behavior than those from single-parent households. Adolescents from private schools had a higher prevalence of sedentary behavior among those who lived only with their mother and a higher prevalence of insufficient physical activity among those who lived without either parent. CONCLUSION: Brazilian adolescents, from public and private schools, who lived in single-parent households or without parents, showed higher prevalence of risk behaviors.