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1.
Pan Afr Med J ; 33: 136, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565115

RESUMO

Introduction: Shisha consumption is a growing public health issue all over the globe and public health awareness about its deleterious health consequences is still not sufficiently raised. Methods: In this location-based study of nightclubs in Ibadan, Nigeria, 633 patrons of selected nightclubs were interviewed in order to obtain information on prevalence, correlates and predictors of shisha smoking. Results: The overall prevalence of shisha smoking was 7.1%. The age of initiation into shisha smoking was lower among women, p = 0.03, but men were significantly more likely to be more frequent users, daily or weekly users, p < 0.001 and also to be current cigarette smokers, p = 0.03. There was no significant gender variability in the stage of readiness to quit. Regression analysis showed that after adjusting for age, the predictors of shisha smoking were: cigarette smoking, OR = 4.83, 95% CI (1.49-15.70) and more than 12 years of education, OR = 7.55, 95% CI (1.88 - 30.37), while being a rural dweller was a protective factor, OR = 0.05, 95% CI (0.01-0.20). Conclusion: Shisha smoking has emerged as a prevalent public health issue in Nigeria. There is a need for an immediate response from policy providers towards shisha smoking intervention in Nigeria.


Assuntos
Fumar Cigarros/epidemiologia , Abandono do Hábito de Fumar/psicologia , Cachimbos de Água/estatística & dados numéricos , Fumar/epidemiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Proteção , Análise de Regressão , Fatores de Risco , Fatores Sexuais
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(8): 971-975, 2019 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-31484263

RESUMO

Objective: To investigate the associations between smoking and literacy on health among 4-6 grade primary school students. Methods: A questionnaire survey was conducted to research on health literacy and smoking among 4-6 grade pupils in Shandong province, through a multi-stage stratified cluster random sampling method. Sociodemographic characteristics, health literacy level and smoking rate were collected from respondents. Binary logistic regression analysis was used to evaluate the association of smoking and health literacy. Results: A total of 9 240 questionnaires were distributed, with the rate of valid response as 99.7%. The current smoking rate of the students was 2.6%, on higher in boys (3.1%) than in girls (2.0%). 60.8% of 4-6 grade students were found to have adequate health literacy level. Levels of literacy health in both boy and girl school students appeared 56.7% and 64.9%, respectively. Results indicated that health literacy in smokers (14.4%) was lower than that in non-smokers (62.0%). Results from the binary logistic regression analysis showed that the independent influencing factors would include grade, father's education level, economic situation of the family, self-assessment on the school record and literacy on health (P<0.01). After controlling the other independent variables, the smoking rate was 8.62 (1/0.116) times in students with low literacy level on health, than those with high literacy level. Conclusions: Literacy on health was significantly associated with smoking in the 4-6 grade pupils of Shandong province.


Assuntos
Alfabetização em Saúde , Fumar/epidemiologia , Estudantes/psicologia , Criança , Feminino , Humanos , Masculino , Instituições Acadêmicas , Inquéritos e Questionários
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.
Harefuah ; 158(9): 583-586, 2019 Sep.
Artigo em Hebraico | MEDLINE | ID: mdl-31507109

RESUMO

AIMS: This study aimed to examine a possible association between BMI levels, smoking and socio-economic status and the existence of fibromyalgia. BACKGROUND: Obesity is a worldwide epidemic with devastating impacts on the public's health. There are several indications that obesity might also be involved in the pathogenesis of chronic pain syndromes such as fibromyalgia. METHODS: Patients who were diagnosed with fibromyalgia were compared to population-based controls, matched in age and gender (by a ratio of 1:5). Body mass indices, smoking status and socioeconomic strata were retrieved from computerized medical records of the Clalit Health Services database. Body mass index was classified in WHO categories of underweight, normal, overweight and obese (<18.5, 18.5-<25, 25.0-<30, ≥30.0 kg/m2); χ2, t-tests, and logistic regression models were used to compare the study groups and assess the association between obesity and fibromyalgia. RESULTS: The study included 14,296 patients with fibromyalgia and 71,324 controls. Among patients with fibromyalgia the average BMI (body mass index) was higher than that of the controls 29.1± 6.2 vs. 28.0± 6.01, p<0.001) with every increment of 1 unit of the BMI score, there was an increment of 2.7% of the odds of having coexistent fibromyalgia. The chances of having fibromyalgia was 56% higher among subjects with obesity compared to individuals of normal weight. The data revealed that patients with fibromyalgia smoke more and belong to lower socioeconomic levels. CONCLUSIONS: Our findings demonstrate that obesity is significantly associated with a higher proportion of fibromyalgia. This finding underlines the role that obesity plays in inflammation and chronic pain.


Assuntos
Fibromialgia/epidemiologia , Obesidade/epidemiologia , Fumar/epidemiologia , Índice de Massa Corporal , Humanos , Sobrepeso , Fatores Socioeconômicos
5.
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
6.
Medicine (Baltimore) ; 98(34): e16816, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31441853

RESUMO

The erythrocyte sedimentation rate (ESR) is a routine test for inflammation. Few studies have investigated the potential influence of lifestyle factors and common metabolic abnormalities on the ESR. This study investigates the influence of demographic factors, alcohol consumption, smoking, physical activity, obesity, and metabolic syndrome on the ESR in adults.This cross-sectional study covered 1472 individuals (44.5% males; age range, 18-91 years) randomly selected from the population of a Spanish municipality. The ESR was measured using a standardized method. We assessed habitual alcohol consumption in standard drinking units, along with tobacco smoking, regular physical exercise (by questionnaire), body mass index, and variables defining metabolic syndrome. Multivariate analyses were performed, including mean corpuscular volume and hemoglobin concentration in the models.The ESR was higher in females than in males, and increased steadily with age. Median ESR of females was 2-fold higher than that of males, and median ESR of individuals aged >65 years was 2-fold higher than that of individuals in the youngest category (ages 18-35 years). Body mass index, presence of metabolic syndrome, and smoking were independently and positively associated with higher ESR values. Light alcohol drinkers and individuals with high regular physical activity displayed lower ESR values than did alcohol abstainers and individuals with low physical activity, respectively.ESR varies greatly with age and sex, and corresponding reference values are proposed. Lifestyle factors (physical activity, smoking, and alcohol consumption) and common metabolic abnormalities (obesity and related metabolic syndrome) may also influence ESR values.


Assuntos
Sedimentação Sanguínea , Comportamentos Relacionados com a Saúde , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Exercício , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Fatores de Risco , Fatores Sexuais , Fumar/epidemiologia , Fatores Socioeconômicos , Espanha/epidemiologia , Adulto Jovem
7.
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
8.
Medicine (Baltimore) ; 98(31): e16686, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374053

RESUMO

This study provided the baseline for establishing policies for community health promotion programs to propose the clusters of multiple health risk factors and identify the risks of laryngeal disorders according to the clusters by using the national level survey representing the South Korean population. This study targeted 5941 people who completed the 5th Korean National Health and Nutrition Examination Survey. The independent variables were age, sex, smoking, high-risk drinking, education level, occupation, household income, and self-reported voice problems. The identify cluster relationship with laryngeal disorders by conducting 2-way cluster analysis and multinomial logit analysis. The prevalence of laryngeal disorder was 6.7%. The results of analysis, 3 clusters were automatically extracted. Multinomial logistic regression analysis showed that sociodemographic factors, health risk behaviors, and health status clusters were significantly related to the risk of laryngeal disorders. The males who were smoking, high-risk drinking, college graduate and above, high income, and non-manual workers had a higher risk of laryngeal disorders than females who were non-smokers, non-drinkers, 60 years old and older, economically inactive, and high school graduate. The results of this study suggested that it may be effective to classify population according to sociodemographic and health behaviors and develop health education materials and health promotion program accordingly in order to prevent laryngeal disorders.


Assuntos
Comportamentos de Risco à Saúde , Doenças da Laringe/epidemiologia , Fatores Socioeconômicos , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Análise por Conglomerados , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , República da Coreia/epidemiologia , Fatores de Risco , Distribuição por Sexo , Fumar/epidemiologia
9.
Medicine (Baltimore) ; 98(31): e16701, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374062

RESUMO

The purpose of this study was to investigate the incidence and risk factors of head and neck cancer in living donor liver transplant (LDLT) recipients.This is a retrospective cohort study. A case-matched (1:4) comparison between recipients with and without developed head and neck cancer after LDLT was conducted. The differences between 2 groups were analyzed.The incidence of head and neck malignancy in our cohort was 9 of 453 (1.98%). Their cumulative survival rate was below 60% at 24 months after the diagnosis of head and neck cancer, and no recipients lived for more than 2 years after being diagnosed with stage IV cancer. In the case-control study, univariate analysis revealed that alcohol consumption (odds ratio [OR] = 8.75, 95% confidence interval [CI]: 1.55-49.56) and smoking (OR = 6.71, 95% CI: 1.20- 37.44) were factors associated with the incidence of head and neck cancer after LDLT.In the conclusion, recipients with head and neck cancer after LDLT may have a rather poor prognosis, especially those who are initially diagnosed with advanced-stage disease. Alcohol consumption and smoking may be the predisposing factors to head and neck cancer in LDLT recipients.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Neoplasias de Cabeça e Pescoço/mortalidade , Transplante de Fígado/efeitos adversos , Transplantados/estatística & dados numéricos , Alcoolismo/complicações , Alcoolismo/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fumar/epidemiologia
10.
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
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(7): 775-778, 2019 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-31357797

RESUMO

Objective: To evaluate the implementation effect of the Beijing Tobacco Control Regulation. Methods: An observational study was conducted in a multi-stage randomly selected sample of 93 restaurants in Dongcheng and Chaoyang districts, Beijing. Undercover visits to the restaurants were paid by investigators at lunch or dinner time. The incidence of smoking behavior and the posters of no-smoking signs were observed, waiters were interviewed about awareness of the regulation, and comparisons with the baseline data of 6 months before and 1 month after regulation implementation were made. Results: The pasting rate of no-smoking signs was 76.3%. The awareness of the regulation in the waiters surveyed was high. The incidence rate of smoking in restaurants (29.0%) was lower than that before the regulation implementation (36.7%), but it was significantly higher than that one month after regulation implementation (14.8%). No active interventions from the restaurant staff were observed when smoking occurred. The incidence of smoking in restaurants within commercial buildings (3.3%) was significantly lower than that in non-commercial buildings (41.3%), the difference was significant (P<0.05). Conclusions: The effect of the regulation weakened 3 years after implementation compared with that in 1 month after the implementation. The enforcement degree of the regulation was conflicted with pasting rate of no-smoking signs and the regulation awareness level in waiters in restaurants in Dongcheng and Chaoyang districts.


Assuntos
Restaurantes/organização & administração , Prevenção do Hábito de Fumar/organização & administração , Fumar/legislação & jurisprudência , Conscientização , Pequim/epidemiologia , Humanos , Fumar/epidemiologia , Fatores de Tempo
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(7): 810-814, 2019 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-31357804

RESUMO

Objective: To explore the relationship between selenium and the risk for oral cancer. Methods: We performed a case-control study in 325 cases of newly diagnosed primary oral cancer from the First Affiliated Hospital of Fujian Medical University and 650 controls from the same hospital and community. Unconditional logistic regression and stratification analyses were used to explore the association between selenium and oral cancer. Adjusted OR and corresponding 95%CI were calculated. The analyses on multiple interactions between selenium and smoking or drinking status, and fruit or fish intake frequencies were conducted. Results: The level of serum selenium was 112.42 (80.98-145.06) µg/L in the case group, which was lower than 164.85 (144.44-188.53) µg/L in control group, the difference was statistical significant (P<0.01). There was a negative correlation between serum selenium level and the risk for oral cancer regardless of smoking and drinking status, and fruits and fish intake frequencies (P<0.05). There were multiple interactions between serum selenium level and smoking or drinking status, and fruit and fish intakes. Conclusions: The high level of serum selenium is a protective factor for the incidence of oral cancer, and serum selenium has multiple interactions with smoking or drinking status, and fruit and fish intakes. Therefore, reducing tobacco use and alcohol consumption and increasing the intakes of fruit and fish can reduce the risk for oral cancer to some extent.


Assuntos
Neoplasias Bucais/epidemiologia , Selênio/sangue , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos de Casos e Controles , China/epidemiologia , Dieta/estatística & dados numéricos , Humanos , Neoplasias Bucais/sangue , Fatores de Proteção , Fatores de Risco , Fumar/epidemiologia
13.
MMWR Morb Mortal Wkly Rep ; 68(28): 621-626, 2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31318853

RESUMO

From 1965 to 2017, the prevalence of cigarette smoking among U.S. adults aged ≥18 years decreased from 42.4% to 14.0%, in part because of increases in smoking cessation (1,2). Increasing smoking cessation can reduce smoking-related disease, death, and health care expenditures (3). Increases in cessation are driven in large part by increases in quit attempts (4). Healthy People 2020 objective 4.1 calls for increasing the proportion of U.S. adult cigarette smokers who made a past-year quit attempt to ≥80% (5). To assess state-specific trends in the prevalence of past-year quit attempts among adult cigarette smokers, CDC analyzed data from the 2011-2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys for all 50 states, the District of Columbia (DC), Guam, and Puerto Rico. During 2011-2017, quit attempt prevalence increased in four states (Kansas, Louisiana, Virginia, and West Virginia), declined in two states (New York and Tennessee), and did not significantly change in the remaining 44 states, DC, and two territories. In 2017, the prevalence of past-year quit attempts ranged from 58.6% in Wisconsin to 72.3% in Guam, with a median of 65.4%. In 2017, older smokers were less likely than younger smokers to make a quit attempt in most states. Implementation of comprehensive state tobacco control programs and evidence-based tobacco control interventions, including barrier-free access to cessation treatments, can increase the number of smokers who make quit attempts and succeed in quitting (2,3).


Assuntos
Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/psicologia , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fumar/epidemiologia , Estados Unidos/epidemiologia , Adulto Jovem
14.
Medicine (Baltimore) ; 98(30): e16573, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348288

RESUMO

RATIONALE: Previous studies have suggested that increased levels of advanced glycation end products (AGEs) and soluble receptor for AGE (sRAGE) are associated with diabetes-related complications. However, there is little evidence on the association between long-term levels of AGEs and sRAGE and progression of diabetes-related complications. PATIENT CONCERNS: A 64-year-old man had poorly controlled type 2 diabetes, obesity, smoking, hypertension, and dyslipidemia. He had many risk factors for diabetes-related complications. DIAGNOSIS: Despite poor glycemic control over 15 years, the patient did not exhibit diabetes-related complications. INTERVENTIONS: We examined serum AGEs (CEL and MG-H1) and sRAGE levels in this patient over the past 10 years. OUTCOMES: The patient maintained low serum AGEs and sRAGE levels. LESSONS: AGEs and sRAGE levels may be associated with long-term development of diabetes-related complications.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Produtos Finais de Glicação Avançada/sangue , Receptor para Produtos Finais de Glicação Avançada/sangue , Glicemia , Progressão da Doença , Dislipidemias/complicações , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Fumar/epidemiologia
15.
Medicine (Baltimore) ; 98(30): e16611, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348309

RESUMO

Although unilateral primary aldosteronism (PA) is the most common surgically correctable cause of hypertension, the cure rate varies widely. The predicting factors related to uncured hypertension are not completely established. This study was designed to determine predicting factors associated with resolution of hypertension after adrenalectomy for PA.The records of unilateral PA patients who had undergone retroperitoneal laparoscopic adrenalectomy were retrospectively reviewed from January 2010 to December 2017 in a single center. Patient demographics and preoperative factors were analyzed, including age, sex, smoking history, family history of hypertension, the presence of diabetes, body mass index (BMI), systolic blood pressure, diastolic blood pressure, biochemical results and tumor characteristics. Univariate and multivariate Logistic regression analysis were used for statistical assessment.126 patients with unilateral PA were enrolled, and the mean age at the time of surgery was 54.2 years. Of these patients, 74 (58.7%) were women, and the mean BMI and duration of hypertension were 26 kg/m and 61 months, respectively. Hypertension was cured in 46% patients, of the patients with uncured hypertension, 91% had improved control of hypertension. In univariate analysis, age (P = .03), BMI (P = .01), duration of hypertension >5 years (P = .03), preoperative antihypertensive agents>2 (P = .02), contralateral abnormalities (P = .03) were the main factors related to uncured hypertension after adrenalectomy. In multivariate regression analysis, uncured hypertension was independently associated with obesity (25.00-29.99: odds ratio [OR], 2.97, P < .02; ≥30: OR, 6.42, P < .01), duration of hypertension >5 years (OR, 6.25, P < .01), preoperative antihypertensive agents >2 (OR, 5.30, P < .001), and contralateral adrenal abnormalities (OR, 8.38, P < .01).The hypertension cure rate of unilateral adrenalectomy in PA is not high. Obesity, duration of hypertension >5 years, preoperative antihypertensive agents >2 and contralateral adrenal abnormalities were independently associated with uncured hypertension.


Assuntos
Adrenalectomia/estatística & dados numéricos , Hiperaldosteronismo/cirurgia , Hipertensão/epidemiologia , Adulto , Fatores Etários , Idoso , Pressão Sanguínea , Índice de Massa Corporal , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hiperaldosteronismo/complicações , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Fatores Sexuais , Fumar/epidemiologia , Fatores Socioeconômicos
16.
Pan Afr Med J ; 32: 156, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308861

RESUMO

Introduction: Tobacco is one of the leading preventable cause of death worldwide. Tobacco consumption among teenagers is a major public health problem, especially in developing countries. Younger smokers are more liable to smoking complications. The objectives were to evaluate the prevalence of smoking among male secondary school students in the Northern Borders region, KSA. Methods: A cross-sectional study was conducted in Arar city. Four schools were chosen randomly from 21 secondary schools. A total of 240 students responded to the pre-designed questionnaire. The questionnaire included questions on demographic factors, smoking behavior and knowledge about smoking hazards. Results: Prevalence of current smoking among male secondary school students is 40.8%. Cigarette smoking was the most common type (67.3%) followed by Shish smoking (22.4%). Few students (2.1%) reported other forms of smoking, example (Hashish). Of the studied group, 39.8% smoke on a daily basis with 29.6% of them smoke more than five cigarettes per day. Conclusion: Smoking is a prevalent habit among teenagers. Special concern should be directed to smoking cessation campaigns with behavioral, legal and economic interventions.


Assuntos
Fumar Cigarros/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Estudos Transversais , Humanos , Masculino , Prevalência , Arábia Saudita/epidemiologia , Instituições Acadêmicas , Abandono do Hábito de Fumar/métodos , Inquéritos e Questionários
17.
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
18.
BMC Public Health ; 19(1): 742, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196124

RESUMO

BACKGROUND: Smoking prevention programmes that reach adolescents before they experiment with tobacco may reduce the prevalence of tobacco use. ASSIST is a school-based, peer-led smoking prevention programme that encourages the diffusion of non-smoking norms among secondary school students (aged 12-13), and was shown in a randomised control trial (conducted 2001-2004) to reduce the prevalence of weekly smoking. This paper presents findings from a process evaluation of the implementation of ASSIST in Scotland in 2014-2017. It examines acceptability and fidelity of implementation and explores the context of message diffusion between peers. METHODS: Mixed method implementation study with students (n = 61), school staff (n = 41), trainers (n = 31) and policy and commissioning leads (n = 17), structured observations (n = 42) and student surveys (n = 2130). RESULTS: ASSIST was delivered with a high degree of fidelity to the licensed manual with all elements of the programme implemented. Student survey findings indicated that the frequency of conversations about smoking increased over the ASSIST delivery period (18% at baseline, 26% at follow-up), but student recollection of conversations about smoking with peer supporters was low (9%). The delivery context of ASSIST was important when considering perceptions of message diffusion. In the study schools, survey findings showed that 0.9% (n = 19) of participants were regular smokers (at least once a week), with nine out of ten (89.9%, n = 1880) saying they had never smoked. This very low prevalence may have affected when and with whom conversations took place. Study participants indicated that there were wider benefits of taking part in ASSIST for: peer supporters (i.e. personal and communication skills); schools (an externally delivered health promotion programme that required minimal resource from schools); and communities (via communication about the risks of smoking to wider social networks). CONCLUSIONS: ASSIST in Scotland was delivered with a high degree of fidelity to the licensed programme and was acceptable from the perspective of schools, students and trainers. Targeting ASSIST in deprived areas with higher youth smoking prevalence or in other countries where youth smoking rates are rising or higher than in Scotland may be particularly relevant for the future delivery.


Assuntos
Grupo Associado , Serviços de Saúde Escolar/organização & administração , Prevenção do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar/organização & administração , Estudantes/psicologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde , Instituições Acadêmicas , Escócia/epidemiologia , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Inquéritos e Questionários
19.
Rev Assoc Med Bras (1992) ; 65(5): 603-610, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166435

RESUMO

OBJECTIVE: To investigate the profile of motivations for smoking among inpatients at a hospital in southern Brazil. METHODS: A survey study involving hospitalized smokers. The Modified Reasons for Smoking Scale (MRFSS) and its domains were analyzed according to gender and dependence degree. RESULTS: The sample consisted of 85 adults (mean age 53 years), low schooling/family income, and well-adjusted in terms of gender (male= 52.9%) and clinical (48%) or surgical (47%) specialty. Most were in Action as the motivational stage (68%), with elevated smoking exposure (median = 39 years/packs) and dependence degree of nicotine (56.4%). The highest domains of the MRFSS were: Smoking Pleasure (4.34 ± 1.2), Relaxation/Tension Reduction (4.24 ± 1.2) and Dependence (3.8±1.4). Significantly, women presented higher scores, in domain Relaxation/Tension Reduction (4.7±0.9). In those with elevated nicotine dependence, higher scores were observed in the Automatism/Habit and Stimulation domains. CONCLUSIONS: Smoking Pleasure and Relaxation/Tension Reduction, especially in women and Automatism, in those more dependents, are factors that should be more highlighted in future strategies for smoking cessation in inpatients.


Assuntos
Pacientes Internados/estatística & dados numéricos , Motivação , Fumar/epidemiologia , Adulto , Fatores Etários , Idoso , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Assunção de Riscos , Fumar/psicologia , Abandono do Hábito de Fumar , Fatores Socioeconômicos , Estatísticas não Paramétricas , Inquéritos e Questionários , Fatores de Tempo
20.
BMJ ; 365: l2287, 2019 06 19.
Artigo em Inglês | MEDLINE | ID: mdl-31217191

RESUMO

OBJECTIVE: To evaluate the impact of the WHO Framework Convention on Tobacco Control (FCTC) on global cigarette consumption. DESIGN: Two quasi-experimental impact evaluations, using interrupted time series analysis (ITS) and in-sample forecast event modelling. SETTING AND POPULATION: 71 countries for which verified national estimates of cigarette consumption from 1970 to 2015 were available, representing over 95% of the world's cigarette consumption and 85% of the world's population. MAIN OUTCOME MEASURES: The FCTC is an international treaty adopted in 2003 that aims to reduce harmful tobacco consumption and is legally binding on the 181 countries that have ratified it. Main outcomes were annual national estimates of cigarette consumption per adult from 71 countries since 1970, allowing global, regional, and country comparisons of consumption levels and trends before and after 2003, with counterfactual control groups modelled using pre-intervention linear time trends (for ITS) and in-sample forecasts (for event modelling). RESULTS: No significant change was found in the rate at which global cigarette consumption had been decreasing after the FCTC's adoption in 2003, using either ITS or event modelling. Results were robust after realigning data to the year FCTC negotiations commenced (1999), or to the year when the FCTC first became legally binding in each country. By contrast to global consumption, high income and European countries showed a decrease in annual consumption by over 1000 cigarettes per adult after 2003, whereas low and middle income and Asian countries showed an increased annual consumption by over 500 cigarettes per adult when compared with a counterfactual event model. CONCLUSIONS: This study finds no evidence to indicate that global progress in reducing cigarette consumption has been accelerated by the FCTC treaty mechanism. This null finding, combined with regional differences, should caution against complacency in the global tobacco control community, motivate greater implementation of proven tobacco control policies, encourage assertive responses to tobacco industry activities, and inform the design of more effective health treaties.


Assuntos
Saúde Global , Cooperação Internacional , Prevenção do Hábito de Fumar/legislação & jurisprudência , Prevenção do Hábito de Fumar/tendências , Fumar/epidemiologia , Epidemias , Previsões , Política de Saúde , Humanos , Análise de Séries Temporais Interrompida , Produtos do Tabaco , Organização Mundial da Saúde
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