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1.
N Engl J Med ; 381(10): 923-932, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31483963

RESUMO

BACKGROUND: Pulmonary alveolar proteinosis is a disease characterized by abnormal accumulation of surfactant in the alveoli. Most cases are autoimmune and are associated with an autoantibody against granulocyte-macrophage colony-stimulating factor (GM-CSF) that prevents clearing of pulmonary surfactant by alveolar macrophages. An open-label, phase 2 study showed some therapeutic efficacy of inhaled recombinant human GM-CSF in patients with severe pulmonary alveolar proteinosis; however, the efficacy in patients with mild-to-moderate disease remains unclear. METHODS: We conducted a double-blind, placebo-controlled trial of daily inhaled recombinant human GM-CSF (sargramostim), at a dose of 125 µg twice daily for 7 days, every other week for 24 weeks, or placebo in 64 patients with autoimmune pulmonary alveolar proteinosis who had a partial pressure of arterial oxygen (Pao2) while breathing ambient air of less than 70 mm Hg (or <75 mm Hg in symptomatic patients). Patients with severe pulmonary alveolar proteinosis (Pao2 <50 mm Hg) were excluded to avoid possible exacerbation of the disease in patients who were assigned to receive placebo. The primary end point was the change in the alveolar-arterial oxygen gradient between baseline and week 25. RESULTS: The change in the mean (±SD) alveolar-arterial oxygen gradient was significantly better in the GM-CSF group (33 patients) than in the placebo group (30 patients) (mean change from baseline, -4.50±9.03 mm Hg vs. 0.17±10.50 mm Hg; P = 0.02). The change between baseline and week 25 in the density of the lung field on computed tomography was also better in the GM-CSF group (between-group difference, -36.08 Hounsfield units; 95% confidence interval, -61.58 to -6.99, calculated with the use of the Mann-Whitney U test and the Hodges-Lehmann estimate of confidence intervals for pseudo-medians). Serious adverse events developed in 6 patients in the GM-CSF group and in 3 patients in the placebo group. CONCLUSIONS: In this randomized, controlled trial, inhaled recombinant human GM-CSF was associated with a modest salutary effect on the laboratory outcome of arterial oxygen tension, and no clinical benefits were noted. (Funded by the Japan Agency for Medical Research and Development and the Ministry of Health, Labor, and Welfare of Japan; PAGE ClinicalTrials.gov number, NCT02835742; Japan Medical Association Center for Clinical Trials number, JMA-IIA00205.).


Assuntos
Doenças Autoimunes/tratamento farmacológico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/uso terapêutico , Fatores Imunológicos/uso terapêutico , Proteinose Alveolar Pulmonar/tratamento farmacológico , Administração por Inalação , Adulto , Idoso , Autoanticorpos/sangue , Doenças Autoimunes/diagnóstico por imagem , Método Duplo-Cego , Esquema de Medicação , Feminino , Fator Estimulador de Colônias de Granulócitos e Macrófagos/administração & dosagem , Fator Estimulador de Colônias de Granulócitos e Macrófagos/efeitos adversos , Fator Estimulador de Colônias de Granulócitos e Macrófagos/imunologia , Humanos , Fatores Imunológicos/administração & dosagem , Fatores Imunológicos/efeitos adversos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Proteinose Alveolar Pulmonar/diagnóstico por imagem , Proteinose Alveolar Pulmonar/imunologia , Capacidade de Difusão Pulmonar , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos , Proteínas Recombinantes/uso terapêutico , Fumar/efeitos adversos , Tomografia Computadorizada por Raios X , Teste de Caminhada
3.
Braz Oral Res ; 33: e090, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31531553

RESUMO

The aim of this study was to investigate the impact of smoking on gingival inflammation in a representative sample of 1,650 adults from Santiago (Chile), Porto Alegre (Brazil), and Tucumán (Argentina). A questionnaire was administered to participants to gather demographic and behavioral characteristics, including smoking habits. The participants were clinically examined to obtain gingival index (GI), gingival bleeding index (GBI), visible plaque index (VPI), and calculus presence values. Gingival inflammation was defined as a mean GI > 0.5. Heavy smokers presented significantly lower levels of gingival inflammation, as reflected by both GI and GBI, than both light and moderate smokers, despite their having increased amounts of plaque and calculus. Being 50 years old or older [odds ratio (OR), 1.93], a VPI ≥ 30% (OR, 28.1), and self-reported diabetes (OR, 2.79) were positively associated with detection of gingival inflammation. In conclusion, the occurrence of clinically detectable gingival inflammation was lower in heavy smokers than light and moderate smokers. Older age, diabetes, and visible plaque emerged as risk indicators of gingivitis. Plaque and gingival indices are significantly associated regardless of the smoking status.


Assuntos
Gengivite/epidemiologia , Gengivite/etiologia , Fumar/efeitos adversos , Fumar/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Estudos Transversais , Índice de Placa Dentária , Feminino , Hemorragia Gengival/epidemiologia , Hemorragia Gengival/etiologia , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Prevalência , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , América do Sul/epidemiologia , Estatísticas não Paramétricas , Inquéritos e Questionários , Adulto Jovem
4.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 145-151, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538461

RESUMO

Nonsyndromic cleft lip with or without cleft palate is the most common craniofacial anomaly affecting around 1 in 700 live births worldwide. Clefts of the human face can be classified anatomically as cleft palate only (CPO), cleft lip only (CLO), cleft lip and palate (CLP) or a combined group of cleft lip with or without cleft palate (CL/P), based on different in embryologic development. These malformations have some genetic origin, in fact several association studies have been performed to obtain important information about the candidate genes; but more important are gene-environment interactions that play an increasing role in its etiology. Epidemiological studies have shown how environmental factors (alcohol, smoking, drugs), as well as possible gene-environment interactions, play an important role in the onset of the malformation. On the contrary, folic acid intake seems to have a protective effect. In this review, we analyze the role of environmental factors related to onset of cleft.


Assuntos
Fenda Labial/etiologia , Fissura Palatina/etiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Fenda Labial/genética , Fissura Palatina/genética , Ácido Fólico/administração & dosagem , Interação Gene-Ambiente , Humanos , Fumar/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/complicações
5.
Niger J Clin Pract ; 22(9): 1208-1212, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489855

RESUMO

Background: The upper aerodigestive tract (UAT) includes the nose and paranasal sinuses, oral cavity, pharynx, larynx, and salivary glands. Cancers of the UAT constitute approximately 4% of all malignancies. In this study, the varied nature of the UAT cancers was studied to find out their incidence, etiology, and clinicopathological correlations. Materials and Methods: This prospective, observational, and clinicopathological study was conducted on 100 patients who were presented at outdoor in the Department of ENT, Government Medical College/Rajindra Hospital, Patiala, Punjab, India, from October 2016 to October 2018. Proven cases of UAT cancers were taken up and reviewed to gather data on multiple clinicopathological variables, such as age, sex, predisposing factors, and site of pathology. Histopathological differentiation was noted after conducting a biopsy. Results: Most patients of UAT cancers were in the age group of 40-70 years. Maximum incidence was among males (82%) compared to females (28%). The most common predisposing factor was alcohol + smoking (28%), followed by alcohol + chewing tobacco (25%). The most common symptom in the oral cavity was ulcer and odynophagia (38%) each. In oropharyngeal cancers, dysphagia (92%) was the most common symptom. In laryngeal cancers, dyspnea (68%) and hoarseness of voice (32%) were the most common. The most common site involved in UAT cancers was the oral cavity (31%), followed by oropharynx (28%), larynx (22%), hypopharynx (7%), and salivary gland (5%). The most common histopathological type was squamous cell carcinoma (SCC) (90%). Most of the ulceroproliferative and exophytic growth was moderately differentiated SCC on histopathology. Conclusion: Studies are essential for education and awareness aimed at reducing exposure to habit-forming substances.


Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Laríngeas/patologia , Neoplasias Bucais/patologia , Neoplasias Otorrinolaringológicas/patologia , Fumar/efeitos adversos , Fumar Tabaco/efeitos adversos , Tabaco sem Fumaça/efeitos adversos , Adulto , Idoso , Carcinoma de Células Escamosas/epidemiologia , Causalidade , Feminino , Humanos , Incidência , Índia/epidemiologia , Neoplasias Laríngeas/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/epidemiologia , Neoplasias Otorrinolaringológicas/epidemiologia , Estudos Prospectivos , Distribuição por Sexo
6.
Artigo em Chinês | MEDLINE | ID: mdl-31495115

RESUMO

Objective: To investigate the detection of thyroid nodules and related risk factors in nuclear power workers, and to provide scientific evidence for thyroid protection of nuclear power workers. Methods: In December 2018, select 295 workers of a nuclear power production enterprise and 238 administrative staff of it, and select 250 staff members of a thermal power generation enterprise 70 kilometers away from the nuclear power station to conduct thyroid ultrasound examination and questionnaire survey for single factor. Analysis and further multivariate logistic regression analysis were used to study the risk factors of thyroid nodules in the population. Results: Women and smoking history were independent risk factors for the increased incidence of thyroid nodules in the study population; three shifts work pattern was an independent risk factor for the increased prevalence of thyroid nodules in nuclear power workers (P<0.05) , and other factors such as the history of nuclear exposure had no significant correlation with thyroid nodules (P>0.05) . Conclusion: Nuclear exposure has little effect on the prevalence of thyroid nodules in nuclear power workers.


Assuntos
Centrais Nucleares , Exposição Ocupacional , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia , Feminino , Humanos , Prevalência , Fatores de Risco , Jornada de Trabalho em Turnos , Fumar/efeitos adversos
7.
Vasc Health Risk Manag ; 15: 159-174, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31417268

RESUMO

While tobacco cigarette (TC) smoking has continued to drop to all-time lows, the use of electronic cigarettes (ECs), introduced in the US in 2007, has been rising dramatically, especially among youth. In EC emissions, nicotine is the major biologically active element, while levels of carcinogens and harmful combustion products that typify TC smoke are very low or even undetectable. TCs cause cardiovascular harm by activation of inflammatory pathways and oxidative damage, leading to atherogenesis and thrombosis, as well as through sympathetic activation triggering ischemia and arrhythmia. While ECs are generally believed to be safer than TCs, there remain many uncertainties regarding the overall cardiovascular health effects of EC usage. In this review, we discuss the various components of EC smoke and review the potential mechanisms of cardiovascular injury caused by EC use. We also discuss the controversy regarding the increasing epidemic of youth EC use weighed against the use of ECs as a smoking-cessation aid.


Assuntos
Doenças Cardiovasculares/induzido quimicamente , Sistemas Eletrônicos de Liberação de Nicotina , Nicotina/administração & dosagem , Agonistas Nicotínicos/administração & dosagem , Abandono do Hábito de Fumar/métodos , Fumar/efeitos adversos , Vaping , Administração por Inalação , Fatores Etários , Animais , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Humanos , Nicotina/efeitos adversos , Agonistas Nicotínicos/efeitos adversos , Medição de Risco , Fatores de Risco , Fumar/epidemiologia , Resultado do Tratamento , Vaping/efeitos adversos
8.
Pan Afr Med J ; 33: 74, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448036

RESUMO

Myocardial infarction (MI) is a major cause of cardiovascular mortality. Inferior MI accounts for 30-50% of infarctions but it is associated with a favorable prognosis compared to anterior infarct. This study aimed to study the epidemiological, clinical, electrical, echocardiographic, angiographic features of inferior MI, as well as its complications and its therapeutic approaches. Over a period of 3 years, we admitted 720 patients with STEMI, of whom 103 with inferior STEMI, reflecting a rate of 14.3%. There was a clear male predominance, with an average age of 58 years (men) and 62 years (women). Smoking was the main risk factor for cardiovascular disease (57.28% of patients were smokers). Right ventricular infarction was found in 11.65% of cases. Half of these patients had hemodynamic instability. Third-degree atrioventricular block was diagnosed in 12.6% of patients. Therapeutic approach was based on thrombolysis (7 patients) and coronary angiogram (42 patients). Inferior MI was caused by right coronary lesion in 53% of cases and circumflex artery occlusion in 47% of cases. Right coronary is responsible for right ventricular infarction in 100% of cases. Coronary angioplasty was performed in 18 patients after coronary angiogram. Eleven patients underwent transluminal coronary angioplasty in the right coronary while 2 patients underwent transluminal coronary angioplasty in the circumflex artery. Early mortality at 30 days was 1.94%. In the right ventricular infarction group mortality rate was about 17%.


Assuntos
Angioplastia Coronária com Balão/métodos , Angiografia Coronária/métodos , Infarto Miocárdico de Parede Inferior/epidemiologia , Idoso , Bloqueio Atrioventricular/epidemiologia , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Infarto Miocárdico de Parede Inferior/fisiopatologia , Infarto Miocárdico de Parede Inferior/terapia , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia
9.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 33(9): 862-865;869, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31446706

RESUMO

Objective:To explore the relationship between smoking and the severity of OSA. Method:There were 719 patients included in the study, who were accompanied by snoring, daytime sleepiness and other symptoms. Laboratory-based polysomnographic variables (including AHI, oxygen desaturation index and microarousal index, etc.), and anthropometric measurements (including weight, neck circumference, waist circumference, hip circumference etc.) were collected for all participants. The severity of OSA was determined by AHI. No OSA was defined as AHI<5, mild OSA as AHI of 5 to 15,moderate OSA as AHI of >15 to 30, and severe OSA as AHI of >30. Smoking severity was determined by the smoking index (SI). Light smoke was defined as SI<200, moderate smoke was as SI 200 to 400, and severe smoke as SI>400. Result:There were 138 cases of non-OSA and 581 cases of OSA. There were 381 non-smokers, 279 smokers and 59 quit smokers. The smoking rate of OSA group was significantly higher than that of non-OSA group (41.5% vs. 27.5%,P<0.01). After excluding 59 quit smokers, the remaining 660 subjects were divided into four groups according to the severity of smoking, then each group was further divided into four groups according to OSA severity. Unadjusted analysis showed that OSA severity positively correlated with smoking severity (r=0.203,P<0.01). The positive correlation remained significant after further adjustment for age, BMI and waist-hip ratio. In addition, logistic regression analysis showed that compared to non-smokers, the odd ratios for OSA in moderate smokers were 1.72 (95%CI 1.08-2.75) and in severe smokers were 2.68 (95%CI 1.61-4.46), after adjustment for age, BMI and waist-hip ratio. Conclusion:The severity of smoking significantly correlated with the severity of OSA. There was increased risk of OSA in patients with severe smoke. The correlation was independent of some confounders such as age and obesity.


Assuntos
Apneia Obstrutiva do Sono/diagnóstico , Fumar/efeitos adversos , Humanos , Polissonografia , Índice de Gravidade de Doença , Ronco
10.
J Stroke Cerebrovasc Dis ; 28(9): 2496-2505, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31279697

RESUMO

BACKGROUND: Nicotine may have neuroprotective effects on the injured brain through modulation of the cholinergic anti-inflammatory pathway. AIMS: This study aimed to evaluate the relationship between cigarette smoking and outcomes in patients with spontaneous intracerebral hemorrhage (ICH). METHODS: This was a retrospective review of consecutive ICH patients enrolled in the ICH Outcomes Project from 2009 to 2017. Patients with age ≥18 years and baseline modified Rankin Scale (mRS) score 0-2 were included. Smoking patterns were categorized as recent smoker (≤30 days prior to ICH) and not recent smoker (>30 days prior to ICH). Not recent smokers were further categorized into former smokers and nonsmokers. The primary outcome was good outcome (90-day mRS ≤ 2). Secondary outcomes were excellent outcome (90-day mRS 0-1), 90-day Barthel Index, and in-hospital and 90-day mortality. RESULTS: The study cohort comprised 545 patients, including 60 recent smokers and 485 not recent smokers. Recent smokers had higher rates of good (35% versus 23%; odds ratio [OR] = 1.787, P = .047) and excellent (25% versus 13%; OR = 2.220, P = .015) outcomes compared to not recent smokers. These differences were not significant after baseline adjustments. Recent smokers had higher rates of good (36% versus 24%; OR = 1.732, P = .063) and excellent (25% versus 13%; OR = 2.203, P = .018) outcomes compared to nonsmokers. These differences were not significant after baseline adjustments. A 90-day Barthel Index, in-hospital, and 90-day mortality were comparable between recent and not recent smokers, recent and nonsmokers, and former and nonsmokers. CONCLUSIONS: Despite potential neuroprotective effects of nicotine found in cigarettes, these may be outweighed by the detrimental effects of cigarette smoking on health outcomes.


Assuntos
Encéfalo/fisiopatologia , Hemorragia Cerebral/fisiopatologia , não Fumantes , Fumantes , Fumar/efeitos adversos , Adulto , Idoso , Encéfalo/efeitos dos fármacos , Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/mortalidade , Bases de Dados Factuais , Avaliação da Deficiência , Feminino , Nível de Saúde , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuroprotetores/administração & dosagem , Fármacos Neuroprotetores/efeitos adversos , Nicotina/administração & dosagem , Nicotina/efeitos adversos , Agonistas Nicotínicos/administração & dosagem , Agonistas Nicotínicos/efeitos adversos , Valor Preditivo dos Testes , Prognóstico , Fatores de Proteção , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fumar/mortalidade , Abandono do Hábito de Fumar , Fatores de Tempo
11.
J Stroke Cerebrovasc Dis ; 28(9): 2414-2420, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31301986

RESUMO

BACKGROUND: Stroke is a highly prevalent disease with consequent mortality and morbidity. Few community based studies have been conducted only in upper Egypt to estimate prevalence of stroke. OBJECTIVES: This study was designed to find out the prevalence of stroke in Fayoum Governorate & to study some associated risk factors. METHODS: through this community based cross-sectional study 4784 participants aged more than or equal to 18 years old were enrolled. A multi-stage random sample technique was followed to choose the study sample. A predesigned interviewer-administered structured questionnaire was used. Suspected stroke case by screening questionnaire was referred to the neurologist. RESULTS: The Crude prevalence of stroke was 16 out of 1000 with confidence interval of proportion (12.6%-19.7%). The age adjusted local (Fayoum 2017 census) prevalence rate was 7.97 out of 1000, age adjusted prevalence rate (Egypt population 2017) was 1.05 out of 1000. Age-adjusted World Health Organization standard world population prevalence rate was 1.69 out of 1000. The crude prevalence of ischemic stroke was significantly higher than hemorrhagic stroke 11.9 versus 3.9 out of 1000 population. The most prevalent risk factor was smoking among males, followed by obesity then hypertension. The prevalence of stroke was significantly higher among participants affected with hypertension, diabetes, heart diseases, obesity, and smoking. Logistic regression analysis showed that having hypertension, diabetes, heart diseases, atrial fibrillation, obesity, and smoking were reported risk factors of stroke. CONCLUSIONS: The prevalence of stroke in Fayoum governorate was 1.6%. Hypertension, diabetes, heart diseases, obesity, and smoking were reported risk factors of stroke.


Assuntos
Acidente Vascular Cerebral/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Doenças Cardiovasculares/epidemiologia , Comorbidade , Estudos Transversais , Diabetes Mellitus/epidemiologia , Egito/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fumar/efeitos adversos , Fumar/epidemiologia , Acidente Vascular Cerebral/diagnóstico , Adulto Jovem
12.
Rev Assoc Med Bras (1992) ; 65(6): 864-869, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340318

RESUMO

OBJECTIVE: This study aims to verify the association between risk factors for the onset of SUI and transobturator suburethral sling surgical treatment outcomes. PATIENTS AND METHODS: A retrospective study was conducted with 57 patients operated by the Pelvic Floor Surgery Service. Demographic data were compiled from the sample, the body mass index (BMI) was calculated, and the patients were divided according to the response to the surgical treatment. RESULTS: A total of 77.2% of the sample was cured or improved after surgical treatment. Out of the total sample, 75.4% of the women were postmenopausal, and 73.7% denied current or past smoking. The median age was 61 years, the median number of births was 4.0, the median BMI was 28.6 kg/m2, and 50.9% of the sample was classified as pre-obese. BMI, menopausal status, age, smoking, and sexual activity were not factors associated with the surgical outcome. However, parity equal to or greater than 5 was associated with worse postoperative results (p = 0.004). CONCLUSIONS: among risk factors associated with the emergence of SUI, only parity greater than 4 showed a negative impact on transobturator sling surgery outcomes.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Modelos Logísticos , Menopausa/fisiologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Paridade/fisiologia , Estudos Retrospectivos , Fatores de Risco , Comportamento Sexual/fisiologia , Fumar/efeitos adversos , Resultado do Tratamento
14.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 33(6): 736-742, 2019 Jun 15.
Artigo em Chinês | MEDLINE | ID: mdl-31198003

RESUMO

Objective: To investigate the influence of endoplasmic reticulum stress (ERS) on smoking-induced nucleus pulposus cells apoptosis and inflammatory response. Methods: Between October 2016 and October 2018, 25 patients with cervical disc herniation receiving discectomy were collected and divided into smoking group (14 cases) and non-smoking group (11 cases). The baseline data of age, gender, herniated segment, and Pfirrmann grading showed no significant difference between the two groups ( P>0.05). The obtained nucelus pulposus tissues were harvested to observe the cell apoptosis via detecting the apoptosis-related proteins (Caspase-3 and PRAP) by TUNEL staining and Western blot test. The nucleus pulposus cells were isolated and cultured with enzyme digestion, of which the third generation cells were used in follow-up experiments. Then, the expressions of inflammatory factors [interleukin 1ß (IL-1ß) and tumor necrosis factor α (TNF-α)] were detected by ELISA; the nuclear translocation of P65 was monitored by cell immunofluorescence staining. Furthermore, ERS-related proteins (GRP78 and CHOP) were detected by Western blot; and endoplasmic reticulum ultrastructure was observed under transmission electron microscope. To verify the regulatory effect of ERS, cells were pretreated by ERS specific inhibitor (4-PBA), then cell apoptosis and inflammatory response were tested. Results: The nucleus pulposus tissue observation showed that the cell apoptotic rate and the expressions of apoptosis-related proteins (Caspase-3 and PARP) were obviously higher in smoking group than in non-smoking group ( P<0.05). The nucleus pulposus cells observation indicated that the expressions of the inflammatory factors (IL-1ß and TNF-α) and the ERS-related proteins (GRP78 and CHOP) were also higher in smoking group than in non-smoking group ( P<0.05). The results of cell immunofluorescence staining further confirmed that smoking stimulated nuclear translocation of P65 in nucleus pulposus cells. The ERS injury was much more serious in smoking group than in non-smoking group. Furthermore, after 4-PBA inhibiting ERS, the expressions of GRP78, CHOP, IL-1ß, TNF-α, and P65 were significantly decreased ( P<0.05), and flow cytometry results showed that cell apoptotic rate in smoking group was decreased, showing significant difference compared with the non-smoking group ( P<0.05). Conclusion: Somking can stimulate cell apoptosis and inflammatory response in nucleus pulposus cells via ESR pathway. Suppressing ESR may be a novel target to suspend smoking-induced intervertebral disc degeneration.


Assuntos
Estresse do Retículo Endoplasmático , Inflamação , Degeneração do Disco Intervertebral , Núcleo Pulposo , Fumar , Apoptose , Humanos , Interleucina-1beta , Fumar/efeitos adversos
15.
Diving Hyperb Med ; 49(2): 107-111, 2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31177516

RESUMO

INTRODUCTION: Approximately 77% of professional divers leave the industry within five years of entry, for reasons that are uncertain. One possibility is that attrition is due to ill-health. The health of New Zealand occupational divers is surveyed by a comprehensive medical examination every five years and by a health questionnaire in the intervening years. Divers are thereby confirmed 'fit' annually. The aim of this study was to determine if divers quit the industry due to a health problem not identified by this health surveillance system. METHOD: 601 divers who had left the industry within five years of entry medical examination ('quitters') were identified from a computerised database. One hundred and thirty-six who could be contacted were questioned about their principal reason for quitting. Comparison was made between the health data of all those defined as 'quitters' and a group of 436 'stayers' who have remained active in the industry for over 10 years. RESULTS: Health was the principal reason for abandoning a diving career for only 2.9% of quitters. The overwhelming majority (97.1%) quit because of dissatisfaction with aspects of the work, such as remuneration and reliability of employment. Besides gender, the only significant difference between the health data of quitters and stayers was that smoking was four times more prevalent among quitters. CONCLUSIONS: The key determinant of early attrition from the New Zealand professional diver workforce is industry-related rather than health-related. The current New Zealand diver health surveillance system detects the medical problems that cause divers to quit the industry.


Assuntos
Mergulho , Fumar/epidemiologia , Mergulho/psicologia , Mergulho/estatística & dados numéricos , Emprego , Feminino , Humanos , Masculino , Nova Zelândia , Reprodutibilidade dos Testes , Fumar/efeitos adversos , Inquéritos e Questionários
16.
Rev Infirm ; 68(252): 32-34, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31208597

RESUMO

Raising awareness of the harmful effects of smoking on health and supporting smokers who wish to quit are important public health challenges. The involvement of nurses in these specific healthcare actions targeting the motivation to change seems to be a promising approach as revealed by a study summarised in this article.


Assuntos
Prática Avançada de Enfermagem , Prática Privada/organização & administração , Abandono do Hábito de Fumar/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Motivação , Pesquisa em Avaliação de Enfermagem , Fumar/efeitos adversos , Fumar/psicologia
17.
Rev Fac Cien Med Univ Nac Cordoba ; 76(2): 79-85, 2019 06 19.
Artigo em Espanhol | MEDLINE | ID: mdl-31216161

RESUMO

Background: High blood pressure is a category of blood pressure, poorly studied in young adults and is associated with other cardiovascular risk factors. Objective: To estimate the prevalence of high blood pressure and other cardiovascular risk factors in university students of the National University of Asunción-Paraguay. Methods: Cross-sectional study in first-year university students of careers related to health at the National University of Asunción. High blood pressure was considered at a systolic blood pressure of 120-129 mmHg and / or diastolic blood pressure of ?80 mmHg. The anthropometric, lipid and metabolic variables were measured and the smoking and alcohol habit were determined. Results: 284 university students were included in the analysis (mean age [± SD] 19.4 ± 2.1 years, 73.2% were women). The overall prevalence of high blood pressure was 25.5%; (95% CI: 20.5-30.5%) (Men 40%, Women 29%). High blood pressure was associated with increased abdominal circumference (OR: 1.031, 95% CI: 1.005-1.058, p = 0.024); low HDL-C (OR: 1.355, 95% CI 1.054-1.743, p = 0.018); obesity, OR: 2,124; 95% CI: 1.334-3.941; p = 0.007) and DM2 (OR: 4.431, 95% CI: 3,642-7,963, p = <0.001). The prevalence of other cardiovascular risk factors more frequent were alcohol consumption, overweight and obesity. More than 70% of college students have one or more cardiovascular risk factors. Conclusions: high prevalence of high blood pressure and is associated with other cardiovascular risk factors.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Hipertensão/diagnóstico , Obesidade/complicações , Fumar/efeitos adversos , Adolescente , Adulto , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Paraguai/epidemiologia , Prevalência , Fatores de Risco , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adulto Jovem
18.
MMWR Morb Mortal Wkly Rep ; 68(24): 533-538, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31220055

RESUMO

Cigarette smoking is the leading cause of chronic obstructive pulmonary disease (COPD) in the United States; however, an estimated one fourth of adults with COPD have never smoked (1). CDC analyzed state-specific Behavioral Risk Factor Surveillance System (BRFSS) data from 2017, which indicated that, overall among U.S. adults, 6.2% (age-adjusted) reported having been told by a health care professional that they had COPD. The age-adjusted prevalence of COPD was 15.2% among current cigarette smokers, 7.6% among former smokers, and 2.8% among adults who had never smoked. Higher prevalences of COPD were observed in southeastern and Appalachian states, regardless of smoking status of respondents. Whereas the strong positive correlation between state prevalence of COPD and state prevalence of current smoking was expected among current and former smokers, a similar relationship among adults who had never smoked suggests secondhand smoke exposure as a potential risk factor for COPD. Continued promotion of smoke-free environments might reduce COPD among both those who smoke and those who do not.


Assuntos
Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fumar/epidemiologia , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fumar/efeitos adversos , Estados Unidos/epidemiologia , Adulto Jovem
19.
J Stroke Cerebrovasc Dis ; 28(8): 2232-2241, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31178360

RESUMO

BACKGROUND: TIAregistry.org is an international cohort of patients with transient ischemic attack (TIA) or minor stroke within 7 days before enrollment in the registry. Main analyses of 1-year follow-up data have been reported.5 We conducted subanalysis on the baseline and 1-year follow-up data of Japanese patients. METHODS: The patients were classified into 2 groups based on Japanese ethnicity, Japanese (345) and non-Japanese (3238), and their baseline data and 1-year event rates were compared. We also determined risk factors and predictors of 1-year stroke. RESULTS: Current smoking, regular alcohol drinking, intracranial arterial stenosis, and small vessel occlusion; and hypertension, dyslipidemia, coronary artery disease, and extracranial arterial stenosis were more and less common among Japanese patients, respectively. Stroke risk was higher and TIA risk was lower at 1-year follow-up among Japanese patients. The baseline risk factors for recurrent stroke were diabetes, alcohol drinking, and large artery atherosclerosis. Independent predictors of 1-year stroke risk were prior congestive heart failure and alcohol consumption. CONCLUSIONS: The two populations of patients featured differences in risk factors, stroke subtypes, and outcome events. Predictors of recurrent stroke among Japanese patients included congestive heart failure and regular alcohol drinking. Strategies to attenuate residual risk of stroke aside from adherence to current guidelines should take our Japanese-patient specific findings into account.


Assuntos
Grupo com Ancestrais do Continente Asiático , Disparidades nos Níveis de Saúde , Ataque Isquêmico Transitório/etnologia , Estilo de Vida/etnologia , Acidente Vascular Cerebral/etnologia , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/etnologia , Comorbidade , Feminino , Humanos , Ataque Isquêmico Transitório/diagnóstico , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Recidiva , Sistema de Registros , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fumar/efeitos adversos , Fumar/etnologia , Acidente Vascular Cerebral/diagnóstico , Fatores de Tempo
20.
Hautarzt ; 70(8): 581-593, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31172201

RESUMO

BACKGROUND: Foot mycoses, including onychomycoses, are worldwide infectious diseases. As part of a regional survey using randomly selected residents of in Mecklenburg-Western Pomerania, we investigated the impact of dietary habits, the presence of most frequent autoimmune diseases and current smoking on fungal skin infections in order to reveal potential new risk factors to elucidate potential preventive interventions. OBJECTIVES: The identification of potential new factors that influence the development of mycosis was performed in order to derive possible preventive measures. METHODS: In the Study of Health in Pomerania (SHIP) in Mecklengburg-Western Pomerania, 2523 inhabitants were examined for mycotic lesions and asked about nutritional habits, the presence of atopic dermatitis, allergic rhinitis, psoriasis and smoking habits. RESULTS: In all, 8% of probands were diagnosed with mycosis, 6.5% onychomycosis, 3.7% tinea pedis and 0.2% tinea corporis. Psoriasis, allergic rhinitis and atopic dermatitis and frequent consumption of cooked potatoes, oatmeal and corn flakes, cereals, pasta and rice were significantly associated with tinea pedis. Onychomycosis was positively associated with consumption of cooked potatoes. Cigarette consumption proved protective for tinea pedis and dermatophyte colonization. CONCLUSIONS: The autoimmune disorders psoriasis and atopic dermatitis and allergic rhinitis seem to predispose to foot mycosis. Recalcitrant mycosis should raise the question of diets high in carbohydrates. Nicotine abuse seems to protect against skin mycosis and colonization.


Assuntos
Dermatite Atópica/complicações , Comportamento Alimentar , Onicomicose/complicações , Psoríase/complicações , Rinite Alérgica/complicações , Fumar/efeitos adversos , Tinha dos Pés/complicações , Doenças Autoimunes , Dermatite Atópica/epidemiologia , Alemanha/epidemiologia , Humanos , Incidência , Onicomicose/epidemiologia , Psoríase/epidemiologia , Rinite Alérgica/epidemiologia , Tinha dos Pés/epidemiologia
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