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Associations of self-reported smoking, cotinine levels and epigenetic smoking indicators with oxidative stress among older adults: a population-based study.

April 24, 2017 - 6:48am

Associations of self-reported smoking, cotinine levels and epigenetic smoking indicators with oxidative stress among older adults: a population-based study.

Eur J Epidemiol. 2017 Apr 22;:

Authors: Gao X, Gào X, Zhang Y, Breitling LP, Schöttker B, Brenner H

Abstract
Tobacco smoking and oxidative stress (OS) are both related to a wide spectrum of adverse age-related health outcomes, but their association is not yet well-established. We examined the associations of self-reported smoking indicators, serum cotinine levels and smoking-related DNA methylation biomarkers with two urinary proxy markers of OS, 8-isoprostane (8-iso) and 8-hydroxy-2'-deoxyguanosine (8-oxodG), in two independent subsets of older adults recruited in Germany (discovery set: n = 978, validation set: n = 531). We obtained DNA methylation profiles in whole blood samples by Illumina Human Methylation450K Beadchip and measured the urinary levels of both OS markers using commercial ELISA kits. After controlling for potential confounders, current smoking, cumulative smoking exposure (pack-years) and serum cotinine levels (ng/ml) were strongly associated with 8-iso levels (p values <0.0001, 0.004 and 0.001, respectively). Of 151 previously identified smoking-related CpG sites, 71 loci were associated with 8-iso levels after correction for multiple testing (FDR < 0.05) in the validation phase and were designated as loci related to 8-iso levels defined OS. In addition, serum cotinine levels, cumulative smoking exposure and a smoking index (SI) based on the 71 identified loci manifested monotonic associations with 8-iso levels. However, we did not observe any associations between these smoking indicators and 8-oxodG levels. In conclusion, this study suggests that smoking-related epigenetic alterations are closely correlated with smoking-induced OS. The identified CpG sites could potentially be prognostic epigenetic markers of OS and OS-related health outcomes. Our findings and the underlying mechanisms should be followed up in further, preferably longitudinal studies.

PMID: 28434075 [PubMed - as supplied by publisher]

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Association Between Environmental Tobacco Smoke Exposure and the Occurrence of EGFR Mutations and ALK Rearrangements in Never-smokers With Non-Small-cell Lung Cancer: Analyses From a Prospective Multinational ETS Registry.

April 24, 2017 - 6:48am

Association Between Environmental Tobacco Smoke Exposure and the Occurrence of EGFR Mutations and ALK Rearrangements in Never-smokers With Non-Small-cell Lung Cancer: Analyses From a Prospective Multinational ETS Registry.

Clin Lung Cancer. 2017 Jan 19;:

Authors: Soo RA, Kubo A, Ando M, Kawaguchi T, Ahn MJ, Ou SI

Abstract
BACKGROUND: Molecular studies have demonstrated actionable driver oncogene alterations are more frequent in never-smokers with non-small-cell lung cancer (NSCLC). The etiology of these driver oncogenes in patients with NSCLC remains unknown, and environmental tobacco smoke (ETS) is a potential cause in these cases.
MATERIALS AND METHODS: We assembled clinical and genetic information for never-smoker patients with NSCLC accrued in Japan, Korea, Singapore, and the United States. To determine an association between cumulative ETS and activating EGFR mutations or ALK rearrangements, the Mantel extension test was used. Multivariate analysis on activating EGFR and ALK gene rearrangements was performed using the generalized linear mixed model with nations as a random effect.
RESULTS: From July 2007 to December 2012, 498 never-smokers with pathologically proven NSCLC were registered and tested for the association between ETS and EGFR and ALK status. EGFR mutations were more frequent in the ever-ETS cohort (58.4%) compared with the never-ETS cohort (39.6%), and the incidence of EGFR mutations was significantly associated with the increment of cumulative ETS (cETS) in female never-smokers (P = .033), whereas the incidence of ALK rearrangements was not significantly different between the ever-ETS and never-ETS cohorts. Odds ratio for EGFR mutations for each 10-year increment in cETS was 1.091 and 0.89 for female and male never-smokers (P = .031 and P = .263, respectively).
CONCLUSION: Increased ETS exposure was closely associated with EGFR mutations in female never-smokers with NSCLC in the expanded multinational cohort. However, the association of ETS and ALK rearrangements in never-smokers with NSCLC was not significant.

PMID: 28433570 [PubMed - as supplied by publisher]

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Cigarette smoke extract counteracts atheroprotective effects of high laminar flow on endothelial function.

April 23, 2017 - 6:36am

Cigarette smoke extract counteracts atheroprotective effects of high laminar flow on endothelial function.

Redox Biol. 2017 Apr 07;12:776-786

Authors: Giebe S, Cockcroft N, Hewitt K, Brux M, Hofmann A, Morawietz H, Brunssen C

Abstract
Tobacco smoking and hemodynamic forces are key stimuli in the development of endothelial dysfunction and atherosclerosis. High laminar flow has an atheroprotective effect on the endothelium and leads to a reduced response of endothelial cells to cardiovascular risk factors compared to regions with disturbed or low laminar flow. We hypothesize that the atheroprotective effect of high laminar flow could delay the development of endothelial dysfunction caused by cigarette smoking. Primary human endothelial cells were stimulated with increasing dosages of aqueous cigarette smoke extract (CSEaq). CSEaq reduced cell viability in a dose-dependent manner. The main mediator of cellular adaption to oxidative stress, nuclear factor erythroid 2-related factor 2 (NRF2) and its target genes heme oxygenase (decycling) 1 (HMOX1) or NAD(P)H quinone dehydrogenase 1 (NQO1) were strongly increased by CSEaq in a dose-dependent manner. High laminar flow induced elongation of endothelial cells in the direction of flow, activated the AKT/eNOS pathway, increased eNOS expression, phosphorylation and NO release. These increases were inhibited by CSEaq. Pro-inflammatory adhesion molecules intercellular adhesion molecule-1 (ICAM1), vascular cell adhesion molecule-1 (VCAM1), selectin E (SELE) and chemokine (C-C motif) ligand 2 (CCL2/MCP-1) were increased by CSEaq. Low laminar flow induced VCAM1 and SELE compared to high laminar flow. High laminar flow improved endothelial wound healing. This protective effect was inhibited by CSEaq in a dose-dependent manner through the AKT/eNOS pathway. Low as well as high laminar flow decreased adhesion of monocytes to endothelial cells. Whereas, monocyte adhesion was increased by CSEaq under low laminar flow, this was not evident under high laminar flow. This study shows the activation of major atherosclerotic key parameters by CSEaq. Within this process, high laminar flow is likely to reduce the harmful effects of CSEaq to a certain degree. The identified molecular mechanisms might be useful for development of alternative therapy concepts.

PMID: 28432984 [PubMed - as supplied by publisher]

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Management of Dyslipidemias in Europe and the USA: Same Evidence, Different Conclusions? Can We Find Common Ground?

April 23, 2017 - 6:36am
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Management of Dyslipidemias in Europe and the USA: Same Evidence, Different Conclusions? Can We Find Common Ground?

Curr Cardiol Rep. 2017 Jun;19(6):49

Authors: Graham IM, Catapano AL

Abstract
PURPOSE OF REVIEW: An examination of the current ACC/AHA and ESC/EAS Guidelines on the management of dyslipidemias for common ground and differences.
RECENT FINDINGS: There is much common ground. Both note that ASCVD is, in most people, the product of a number of risk factors, notably tobacco exposure, hyperlipidemia, hypertension, inactivity, overweight and diabetes. They stress that risk calculators can help in the assessment of risk in apparently healthy persons. Persons with established ASCVD and many with diabetes or renal impairment are at high to very high risk and warrant intensive risk factor advice. The ACC/AHA Guidelines favor the universal use of statins in all high-risk subjects. In contrast, the ESC/EAS Guidelines favor a goal approach based on total risk and baseline LDL cholesterol level. Perhaps the most important challenges are to stress similarities rather than differences and to simplify communications with both healthcare professionals and the public. Subjects with established vascular disease and renal impairment and many with diabetes are at high to very high risk and need intensive risk factor management. A risk chart or calculator is recommended to assess total risk in apparently healthy persons. The higher the risk, the more intense the risk factor management.

PMID: 28432660 [PubMed - in process]

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Expression of CphB- and CphE-type cyanophycinases in cyanophycin-producing tobacco and comparison of their ability to degrade cyanophycin in plant and plant extracts.

April 23, 2017 - 6:36am
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Expression of CphB- and CphE-type cyanophycinases in cyanophycin-producing tobacco and comparison of their ability to degrade cyanophycin in plant and plant extracts.

Transgenic Res. 2017 Apr 21;:

Authors: Ponndorf D, Broer I, Nausch H

Abstract
Increasing the arginine (Arg) content in plants used as feed or food is of interest, since the supplementation of food with conditionally essential Arg has been shown to have nutritional benefits. An increase was achieved by the expression of the Arg-rich bacterial storage component, cyanophycin (CGP), in the chloroplast of transgenic plants. CGP is stable in plants and its degradation into β-aspartic acid (Asp)-Arg dipeptides, is solely catalyzed by bacterial cyanophycinases (CGPase). Dipeptides can be absorbed by animals even more efficiently than free amino acids (Matthews and Adibi 1976; Wenzel et al. 2001). The simultaneous production of CGP and CGPase in plants could be a source of β-Asp-Arg dipeptides if CGP degradation can be prevented in planta or if dipeptides are stable in the plants. We have shown for the first time that it is possible to co-express CGP and CGPase in the same plant without substrate degradation in planta by transient expression of the cyanobacterial CGPase CPHB (either in the plastid or cytosol), and the non-cyanobacterial CGPase CPHE (cytosol) in CGP-producing Nicotiana tabacum plants. We compared their ability to degrade CGP in planta and in crude plant extracts. No CGP degradation appeared prior to cell homogenization independent of the CGPase produced. In crude plant extracts, only cytosolic CPHE led to a fast degradation of CGP. CPHE also showed higher stability and in vitro activity compared to both CPHB variants. This work is the next step to increase Arg in forage plants using a stable, Arg-rich storage protein.

PMID: 28432544 [PubMed - as supplied by publisher]

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Depressive Symptoms and Tobacco Use: Does Religious Orientation Play a Protective Role?

April 23, 2017 - 6:36am
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Depressive Symptoms and Tobacco Use: Does Religious Orientation Play a Protective Role?

J Relig Health. 2017 Apr 21;:

Authors: Parenteau SC

Abstract
Many studies have established an association between depression and smoking. The main objective of this study was to determine whether religious orientation moderates the relationship between depressive symptoms and tobacco use. This study utilized a cross-sectional data collection strategy to examine the relationship among depressive symptoms, religious orientation, and tobacco use among undergraduate students (N = 349) at a midsize southeastern university. Participants completed a demographic questionnaire, the Center for Epidemiologic Studies Depression Scale, the Extrinsic/Intrinsic Religious Orientation Scale-Revised and the Drinking and Drug Habits Questionnaire. Analyses using hierarchical linear regression indicate a significant interaction effect (depressive symptoms × extrinsic religious orientation) on tobacco use. Additional moderation analyses reveal a significant interaction effect between depressive symptoms and the extrinsic-personal religious orientation on tobacco use. Results suggest that having an extrinsic religious orientation, and specifically, the extrinsic-personal subtype, can protect against the effects of depressive symptoms. In this regard, individuals who turn to religion for solace or comfort may be less likely to engage in tobacco use when experiencing depressive symptoms. Limitations, future directions, and implications are discussed.

PMID: 28432499 [PubMed - as supplied by publisher]

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Smokeless tobacco products harbor diverse bacterial microbiota that differ across products and brands.

April 23, 2017 - 6:36am
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Smokeless tobacco products harbor diverse bacterial microbiota that differ across products and brands.

Appl Microbiol Biotechnol. 2017 Apr 22;:

Authors: Smyth EM, Kulkarni P, Claye E, Stanfill S, Tyx R, Maddox C, Mongodin EF, Sapkota AR

Abstract
Smokeless tobacco products contain numerous chemical compounds, including known human carcinogens. Other smokeless tobacco constituents, including bacteria, may also contribute to adverse health effects among smokeless tobacco users. However, there is a lack of data regarding the microbial constituents of smokeless tobacco. Our goal was to characterize the bacterial microbiota of different smokeless tobacco products and evaluate differences across product types and brands. DNA was extracted from 15 brands of smokeless tobacco products (including dry snuff, moist snuff, snus, and Swedish snus) and 6 handmade products (e.g., toombak) using an enzymatic and mechanical lysis approach. Bacterial community profiling was performed using PCR amplification of the V1-V2 hypervariable region of the 16S rRNA gene, followed by 454 pyrosequencing of the resulting amplicons and sequence analysis using the QIIME package. Total viable counts were also determined to estimate the number of viable bacteria present in each product. Average total viable counts ranged from 0 to 9.35 × 10(7) CFU g(-1). Analysis of the 16S rRNA gene sequences revealed high bacterial diversity across the majority of products tested: dry snuff products where characterized by the highest diversity indices compared to other products. The most dominant bacterial phyla across all products were Firmicutes, Proteobacteria, Actinobacteria, and Bacteroidetes. Significant differences in both bacterial community composition and in silico predicted gene content were observed between smokeless tobacco product types and between brands of specific smokeless tobacco products. These data are useful in order to comprehensively address potential health risks associated with the use of smokeless tobacco products.

PMID: 28432442 [PubMed - as supplied by publisher]

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Policy coherence, integration, and proportionality in tobacco control: Should tobacco sales be limited to government outlets?

April 23, 2017 - 6:36am
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Policy coherence, integration, and proportionality in tobacco control: Should tobacco sales be limited to government outlets?

J Public Health Policy. 2017 Apr 21;:

Authors: Smith EA, McDaniel PA, Hiilamo H, Malone RE

Abstract
Multiple factors, including marijuana decriminalization/legalization, tobacco endgame discourse, and alcohol industry pressures, suggest that the retail regulatory environment for psychoactive or addictive substances is a dynamic one in which new options may be considered. In most countries, the regulation of tobacco, marijuana, and alcohol is neither coherent, nor integrated, nor proportional to the potential harms caused by these substances. We review the possible consequences of restricting tobacco sales to outlets run by government-operated alcohol retail monopolies, as well as the likely obstacles to such a policy. Such a move would allow governments more options for regulating tobacco sales, and increase coherence, integration, and proportionality of substance regulation. It might also serve as an incremental step toward an endgame goal of eliminating sales of commercial combustible tobacco.

PMID: 28432335 [PubMed - as supplied by publisher]

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Tobacco retail availability and risk of relapse among smokers who make a quit attempt: a population-based cohort study.

April 23, 2017 - 6:36am
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Tobacco retail availability and risk of relapse among smokers who make a quit attempt: a population-based cohort study.

Tob Control. 2017 Apr 21;:

Authors: Chaiton MO, Mecredy G, Cohen J

Abstract
INTRODUCTION: The availability of tobacco is thought to influence smoking behaviour, but there are few longitudinal studies examining if the location and number of tobacco outlets has a prospective impact on smoking cessation.
METHODS: The Ontario Tobacco Survey, a population-representative sample of Ontario adult smokers who were followed every 6 months for up to 3 years, was linked with tobacco outlet location data from the Ontario Ministry of Health. Proximity (distance), threshold (at least one outlet within 500 m) and density (number of outlets within 500 m) with respect to a smokers' home were calculated among urban and suburban current smokers (n=2414). Quit attempts and risk of relapse were assessed using logistic regression and survival analysis, adjusted for neighbourhood effects and individual characteristics.
RESULTS: Increased density of tobacco outlets was associated with decreased odds of making a quit attempt (OR: 0.54; 95% CI 0.35 to 0.85) in high-income neighbourhoods, but not in lower income ones. There was an increased risk of relapse among those who had at least one store within 500 m (HR: 1.41 (95% CI 1.06 to 1.88). Otherwise, there was no association of proximity with quit attempts or relapse.
CONCLUSIONS: The existence of a tobacco retail outlet within walking distance from home was associated with difficulty in succeeding in a quit attempt, while the increased density of stores was associated with decreased attempts in higher income neighbourhoods. The availability of tobacco may influence tobacco use through multiple mechanisms.

PMID: 28432213 [PubMed - as supplied by publisher]

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Into the black: Marlboro brand architecture, packaging and marketing communication of relative harm.

April 23, 2017 - 6:36am
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Into the black: Marlboro brand architecture, packaging and marketing communication of relative harm.

Tob Control. 2017 Apr 21;:

Authors: Dewhirst T

PMID: 28432212 [PubMed - as supplied by publisher]

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Recruiting and retaining youth and young adults: challenges and opportunities in survey research for tobacco control.

April 23, 2017 - 6:36am
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Recruiting and retaining youth and young adults: challenges and opportunities in survey research for tobacco control.

Tob Control. 2017 Apr 21;:

Authors: Cantrell J, Hair EC, Smith A, Bennett M, Rath JM, Thomas RK, Fahimi M, Dennis JM, Vallone D

Abstract
INTRODUCTION: Evaluation studies of population-based tobacco control interventions often rely on large-scale survey data from numerous respondents across many geographic areas to provide evidence of their effectiveness. Significant challenges for survey research have emerged with the evolving communications landscape, particularly for surveying hard-to-reach populations such as youth and young adults. This study combines the comprehensive coverage of an address-based sampling (ABS) frame with the timeliness of online data collection to develop a nationally representative longitudinal cohort of young people aged 15-21.
METHODS: We constructed an ABS frame, partially supplemented with auxiliary data, to recruit this hard-to-reach sample. Branded and tested mail-based recruitment materials were designed to bring respondents online for screening, consent and surveying. Once enrolled, respondents completed online surveys every 6 months via computer, tablet or smartphone. Numerous strategies were utilized to enhance retention and representativeness RESULTS: Results detail sample performance, representativeness and retention rates as well as device utilization trends for survey completion among youth and young adult respondents. Panel development efforts resulted in a large, nationally representative sample with high retention rates.
CONCLUSIONS: This study is among the first to employ this hybrid ABS-to-online methodology to recruit and retain youth and young adults in a probability-based online cohort panel. The approach is particularly valuable for conducting research among younger populations as it capitalizes on their increasing access to and comfort with digital communication. We discuss challenges and opportunities of panel recruitment and retention methods in an effort to provide valuable information for tobacco control researchers seeking to obtain representative, population-based samples of youth and young adults in the U.S. as well as across the globe.

PMID: 28432211 [PubMed - as supplied by publisher]

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A randomised controlled trial of a complex intervention to reduce children&#039;s exposure to secondhand smoke in the home.

April 23, 2017 - 6:36am
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A randomised controlled trial of a complex intervention to reduce children's exposure to secondhand smoke in the home.

Tob Control. 2017 Apr 21;:

Authors: Ratschen E, Thorley R, Jones L, Opazo Breton M, Cook J, McNeill A, Britton J, Coleman T, Lewis S

Abstract
OBJECTIVES: Exposing children to secondhand tobacco smoke (SHS) causes significant harm and occurs predominantly through smoking by caregivers in the family home. We report a trial of a complex intervention designed to reduce secondhand smoke exposure of children whose primary caregiver feels unable or unwilling to quit smoking.
DESIGN: An open-label, parallel, randomised controlled trial.
SETTING: Deprived communities in Nottingham City and County, England PARTICIPANTS: Caregivers resident in Nottingham City and County in England who were at least 18 years old, the main caregiver of a child aged under 5 years living in their household, and reported that they were smoking tobacco inside their home.
INTERVENTIONS: We compared a complex intervention combining personalised feedback on home air quality, behavioural support and nicotine replacement therapy for temporary abstinence with usual care.
MAIN OUTCOMES: The primary outcome was change in air quality in the home, measured as average 16-24 hours levels of particulate matter of <2.5 µm diameter (PM2.5), between baseline and 12 weeks. Secondary outcomes included changes in maximum PM2.5, proportion of time PM2.5 exceeded WHO recommended levels of maximum exposure of 25 µg/mg(3), child salivary cotinine, caregivers' cigarette consumption, nicotine dependence, determination to stop smoking, quit attempts and quitting altogether during the intervention.
RESULTS: Geometric mean PM2.5 decreased significantly more (by 35.2%; 95% CI 12.7% to 51.9%) in intervention than in usual care households, as did the proportion of time PM2.5 exceeded 25 µg/mg(3), child salivary cotinine concentrations, caregivers' cigarette consumption in the home, nicotine dependence, determination to quit and likelihood of having made a quit attempt.
CONCLUSIONS: By reducing exposure to SHS in the homes of children who live with smokers unable or unwilling to quit, this intervention offers huge potential to reduce children's' tobacco-related harm.
TRIAL REGISTRATION NUMBER: ISRCTN81701383.This trial was funded by the UK National Institute for Health Research (NIHR): RP-PG-0608-10020.

PMID: 28432210 [PubMed - as supplied by publisher]

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Understanding the Relationship of Cigarette Smoking Trajectories Through Adolescence and Weight Status in Young Adulthood in the United States.

April 23, 2017 - 6:36am
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Understanding the Relationship of Cigarette Smoking Trajectories Through Adolescence and Weight Status in Young Adulthood in the United States.

J Adolesc Health. 2017 Apr 18;:

Authors: Patel M, Kaufman A, Hunt Y, Nebeling L

Abstract
PURPOSE: Adolescent cigarette smoking has steadily declined since 1999, whereas adolescent obesity rates have quadrupled since the 1980s. Few studies address the longitudinal relationship of smoking and weight in youth and young adulthood. This study examines the relationship of smoking trajectories beginning in adolescence on weight status in young adulthood in a nationally representative longitudinal sample.
METHODS: The study sample was drawn from the National Longitudinal Study of Adolescent to Adult Health Waves I-IV (N = 13,361). Four trajectories were generated through repeated-measures latent class analyses using current cigarette smoking status in Waves I-IV and age of initiation: nonsmokers (44%), early establishers (23%), late establishers (21%), and former smokers (12%). Wave IV weight status included self-reported body mass index (BMI) and measured waist circumference. Bivariate analyses addressed associations between smoking trajectory and BMI at each wave. Multivariate linear regression models tested the relationship of smoking trajectory and weight status at Wave IV.
RESULTS: In bivariate analyses, early and late establishers had a significantly lower BMI at Wave III and all smoking trajectories had a significantly lower BMI at Wave IV versus nonsmokers. All smoking trajectories had a significantly lower BMI than nonsmokers (early establishers: β = -1.27, confidence interval [CI]: -1.56 to -.98]; late establishers: β = -.84, CI: -1.16 to -.52; and former smokers: β = -.63, CI: -.93 to -.34; p < .05) in an adjusted multivariable regression model.
CONCLUSIONS: This study reveals that weight status increased over time for all trajectories; thus smoking does not mitigate obesity risk. These results have implications for both research and interventions to help youth and young adults avoid both smoking and obesity.

PMID: 28431973 [PubMed - as supplied by publisher]

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Addressing Unmet Maternal Health Needs at a Pediatric Specialty Infant Care Clinic.

April 23, 2017 - 6:36am
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Addressing Unmet Maternal Health Needs at a Pediatric Specialty Infant Care Clinic.

Womens Health Issues. 2017 Apr 18;:

Authors: Zerden ML, Falkovich A, McClain EK, Verbiest S, Warner DD, Wereszczak JK, Stuebe A

Abstract
OBJECTIVE: The objective of this intervention was to evaluate the feasibility of screening mothers of medically fragile infants in the domains of 1) depression, 2) tobacco exposure, and 3) family planning at a post-neonatal intensive care unit (NICU) developmental pediatric visit. Additionally, we sought to estimate the percentage who met criteria for further evaluation in the three domains assessed.
METHODS: A cross-sectional questionnaire was administered to 100 caregivers of medically fragile infants at a specialty, post-NICU clinic visit. Participants' responses in three domains were evaluated and appropriate referrals were provided. Analysis was then restricted to the 87 biological mothers who completed the screening. Study staff contacted the mothers 2 months later to determine whether services had been accessed and to assess overall satisfaction with the screening within the pediatric visit. Qualitative interviews were conducted with pediatric clinic staff.
RESULTS: Screening questionnaires were completed by 87 biological mothers. Twenty-two mothers (25%) met referral criteria. Pediatric clinic staff and providers were comfortable administering the screening instrument, and there was minimal disruption to clinic flow.
CONCLUSIONS: Mothers of medically fragile infants are likely to have unmet health care needs that can be identified at a specialty pediatric clinic visit. A screening and referral intervention can be implemented with minimal interruption in pediatric clinic flow and is acceptable to mothers and pediatric providers.

PMID: 28431902 [PubMed - as supplied by publisher]

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Primary Repair of Traumatic Distal Biceps Ruptures in a Military Population: Clinical Outcomes of Single- Versus 2-Incision Technique.

April 23, 2017 - 6:36am
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Primary Repair of Traumatic Distal Biceps Ruptures in a Military Population: Clinical Outcomes of Single- Versus 2-Incision Technique.

Arthroscopy. 2017 Apr 18;:

Authors: Waterman BR, Navarro-Figueroa L, Owens BD

Abstract
PURPOSE: To determine the success of distal biceps repair in a high-demand military population and to comparatively evaluate the perioperative risk profile, functional results, and adverse patient outcomes of a single- versus 2-incision technique within this high-risk group.
METHODS: Between 2007-2013, all military service members undergoing primary surgical repair for distal biceps rupture through the Military Health System were isolated. Patients with allograft tendon reconstruction, revision procedures, nonmilitary status, and/or follow-up of less than 24 month were excluded. Demographic data (age, limb dominance) and surgical variables (time to surgery, surgical technique) were extracted, and rates of perioperative complications, rerupture, reoperation, revision, and inability to return to preinjury function were recorded. Logistic regression analysis was performed to evaluate for prognostic risk factors, whereas the Fisher exact test was used for comparative analysis.
RESULTS: A total of 290 patients met the inclusion criteria, including 44 (15.2%) with a delayed presentation; all patients were men, with an average age of 38.9 years (range, 20-61 years). A single-incision technique was performed in 75.4% (n = 214) versus a 2-incision technique in 24.6% (n = 70), and a cortical button was the predominant fixation construct (73.4%). Reruptures occurred in 7 patients (2.4%), and 3 individuals (1.0%) had significant elbow dysfunction postoperatively. When we compared the overall complication rates, the 2-incision technique (7.1%, n = 5) was not significantly different from the single-incision repair (16.4%, n = 35; P = .0732). Tobacco use was significantly associated with risk of rerupture (odds ratio, 4.86; P = .0423) or combined surgical and clinical failures (odds ratio, 5.64; P = .0091), whereas age, limb dominance, time to surgery, fixation construct, and surgical technique were not statistically significant (P > .05).
CONCLUSIONS: Among active patients, a single-volar incision technique and a 2-incision technique showed similar complication profiles. Rerupture and persistent elbow dysfunction were uncommon, but adverse outcomes were significantly more likely among patients who used tobacco. Anatomic distal biceps repair is a safe surgical procedure with excellent clinical outcomes and a 96.6% rate of return to preoperative military function without restrictions.
LEVEL OF EVIDENCE: Level III, retrospective comparative study.

PMID: 28431883 [PubMed - as supplied by publisher]

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Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study.

April 23, 2017 - 6:36am
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Monitoring quality and coverage of harm reduction services for people who use drugs: a consensus study.

Harm Reduct J. 2017 Apr 22;14(1):19

Authors: Wiessing L, Ferri M, Běláčková V, Carrieri P, Friedman SR, Folch C, Dolan K, Galvin B, Vickerman P, Lazarus JV, Mravčík V, Kretzschmar M, Sypsa V, Sarasa-Renedo A, Uusküla A, Paraskevis D, Mendão L, Rossi D, van Gelder N, Mitcheson L, Paoli L, Gomez CD, Milhet M, Dascalu N, Knight J, Hay G, Kalamara E, Simon R, EUBEST working group, Comiskey C, Rossi C, Griffiths P

Abstract
BACKGROUND AND AIMS: Despite advances in our knowledge of effective services for people who use drugs over the last decades globally, coverage remains poor in most countries, while quality is often unknown. This paper aims to discuss the historical development of successful epidemiological indicators and to present a framework for extending them with additional indicators of coverage and quality of harm reduction services, for monitoring and evaluation at international, national or subnational levels. The ultimate aim is to improve these services in order to reduce health and social problems among people who use drugs, such as human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection, crime and legal problems, overdose (death) and other morbidity and mortality.
METHODS AND RESULTS: The framework was developed collaboratively using consensus methods involving nominal group meetings, review of existing quality standards, repeated email commenting rounds and qualitative analysis of opinions/experiences from a broad range of professionals/experts, including members of civil society and organisations representing people who use drugs. Twelve priority candidate indicators are proposed for opioid agonist therapy (OAT), needle and syringe programmes (NSP) and generic cross-cutting aspects of harm reduction (and potentially other drug) services. Under the specific OAT indicators, priority indicators included 'coverage', 'waiting list time', 'dosage' and 'availability in prisons'. For the specific NSP indicators, the priority indicators included 'coverage', 'number of needles/syringes distributed/collected', 'provision of other drug use paraphernalia' and 'availability in prisons'. Among the generic or cross-cutting indicators the priority indicators were 'infectious diseases counselling and care', 'take away naloxone', 'information on safe use/sex' and 'condoms'. We discuss conditions for the successful development of the suggested indicators and constraints (e.g. funding, ideology). We propose conducting a pilot study to test the feasibility and applicability of the proposed indicators before their scaling up and routine implementation, to evaluate their effectiveness in comparing service coverage and quality across countries.
CONCLUSIONS: The establishment of an improved set of validated and internationally agreed upon best practice indicators for monitoring harm reduction service will provide a structural basis for public health and epidemiological studies and support evidence and human rights-based health policies, services and interventions.

PMID: 28431584 [PubMed - in process]

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Water-pipe smoke condensate increases the internalization of Mycobacterium Bovis of type II alveolar epithelial cells (A549).

April 23, 2017 - 6:36am
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Water-pipe smoke condensate increases the internalization of Mycobacterium Bovis of type II alveolar epithelial cells (A549).

BMC Pulm Med. 2017 Apr 21;17(1):68

Authors: Mortaz E, Alipoor SD, Movassaghi M, Varahram M, Ghorbani J, Folkerts G, Garssen J, Adcock IM

Abstract
BACKGROUND: Tuberculosis (TB) is a major global health problem, and there is an association between tobacco smoke and TB. Water pipe smoking has become an increasing problem not only in Middle Eastern countries but also globally because users consider it as safer than cigarettes. The presence of high levels of toxic substances in water-pipe smoke may be a predisposing factor that enhances the incidence of pulmonary disorders. For example, uncontrolled macropinocytosis in alveolar epithelial cells following exposure to water-pipe smoke may predispose subjects to pulmonary infection. Here, we studied the effects of water-pipe condense (WPC) on the internalization of Mycobacterium Bovis BCG by macropinocytosis in the alveolar epithelial cell line A549.
METHODS: A549 cells were exposed to WPC (4 mg/ml) for 24, 48, 72 and 96 h. Cell viability was studied using the methyl thiazolyldipenyl-tetrazolium bromide (MTT) reduction assay and proliferation by bromodeoxyUridine (BrdU) incorporation. Cells were exposed to FITC-Dextran (1 mg/ml) (as a control) and FITC-BCG (MOI = 10) for 20 min at 37 °C before cells were collected and the uptake of BCG-FITC determined by flow cytometry. Similar experiments were performed at 4 °C as a control. The Rho-associated protein kinase (ROCK) inhibitor Y-27632 (1 μM) was used to assess the mechanism by which WPC enhanced BCG uptake.
RESULTS: WPC (4 mg/ml) increased the uptake of BCG-FITC after 72 (1.3 ± 0.1 fold, p < 0.05) and 96 (1.4 ± 0.05 fold, p < 0.05) hours. No effect on BCG-FITC uptake was observed at 24 or 48 h. WPC also significantly increased the uptake of FITC-Dextran (2.9 ± 0.3 fold, p < 0.05) after 24 h. WPC significantly decreased cell viability after 24 (84 ± 2%, p < 0.05), 48 (78±, 3%, p < 0.05), 72 (64 ± 2%, p < 0.05) and 96 h (45 ± 2%, p < 0.05). Y-27632 completely attenuated the increased uptake of BCG by WPC. Cell proliferation showed a decreasing trend in a time-dependent manner with WPC exposure.
CONCLUSION: WPC exposure increased epithelial cell endocytosis activity and death as well as enhancing their capacity for macropinocytosis. Our in vitro data indicates possible harmful effects of WPC on the ability of lung epithelial cells to phagocytose mycobacterium.

PMID: 28431548 [PubMed - in process]

Categories: Tobacco News Feed

tobacco; +32 new citations

April 22, 2017 - 6:29am

32 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

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Categories: Tobacco News Feed

Decreased Central Nervous System Grey Matter Volume (GMV) in Smokers Affects Cognitive Abilities: A Systematic Review.

April 21, 2017 - 6:18am

Decreased Central Nervous System Grey Matter Volume (GMV) in Smokers Affects Cognitive Abilities: A Systematic Review.

Med Sci Monit. 2017 Apr 20;23:1907-1915

Authors: Vňuková M, Ptáček R, Raboch J, Stefano GB

Abstract
Although cigarette smoking is a leading cause of preventable mortality, tobacco is consumed by approximately 22% of the adult population worldwide. Smoking is also a risk factor for cardiovascular disease, affects brain processing, and is a recognized risk factor for Alzheimer disease (AD). Tobacco toxins (e.g., nicotine at high levels) inhaled in smoke may cause disorders resulting in preclinical brain changes. Researchers suggest that there are differences in brain volume between smokers and non-smokers. This review examines these differences in brain grey matter volume (GMV). In March/April 2015, MedLine, Embase, and PsycINFO were searched using the terms: "grey matter" AND "voxel-based" AND "smoking" AND "cigarette". The 4 studies analyzed found brain GMV decreases in smokers compared to non-smokers. Furthermore, sex-specific differences were found; while the thalamus and cerebellum were affected in both sexes, decreased GMV in the olfactory gyrus was found only in male smokers. Age-group differences were also found, and these may suggest pre-existing abnormalities that lead to nicotine dependence in younger individuals. Only 1 study found a positive correlation between number of pack-years smoked and GMV. Smoking decreases GMV in most brain areas. This decrease may be responsible for the cognitive impairment and difficulties with emotional regulation found in smokers compared with non-smokers.

PMID: 28426638 [PubMed - in process]

Categories: Tobacco News Feed

Frailty in HIV infected people: a new risk factor for bone mineral density loss.

April 21, 2017 - 6:18am

Frailty in HIV infected people: a new risk factor for bone mineral density loss.

AIDS. 2017 Apr 19;:

Authors: Bregigeon S, Galinier A, Zaegel-Faucher O, Cano CE, Obry V, Laroche H, Trijau S, Saout A, Poizot-Martin I

Abstract
OBJECTIVE: This study aims to assess the association between bone mineral density (BMD) and frailty in a cohort of HIV-infected patients.
DESIGN: A cross-sectional study in an HIV outpatient unit where nearly 1,000 patients are monitored.
METHODS: Subjects undergoing bone densitometry were proposed an evaluation of frailty using criteria of the Cardiovascular Health Study (CHS) and the Study of Osteoporotic Fractures (SOF). Frailty markers (FM) were weight-loss, self-reported exhaustion, physical activity, grip strength, chair stands, and slow gait. Patients' characteristics were collected from an electronic medical record. Associations of frailty with BMD and osteoporosis were tested using multivariate linear and logit regression models, respectively.
RESULTS: 175 HIV infected patients, 121(69.14%) male, were analyzed. Prevalence of FM, osteopenia and osteoporosis were comparable among genders. Despite a younger age, spinal and femoral neck BMD were lower in female (P < 0.05). Linear regression model adjusting by age, duration of HIV follow-up, body mass index, smoking status, osteoarthritis, osteoporosis treatment and the age at menopause showed a negative association of spinal and femoral BMD with frailty according to SOF criteria in female (P < 0.05). In male, SOF-defined frailty was associated with osteoporosis (OR 28.79; 95%IC 2.15-386.4) in a model adjusting for age, duration of HIV follow-up, CD4 nadir, CD4 T cell count, tobacco consumption, exposure to TDF and protease inhibitors. No significant associations were found between BMD and CHS-defined frailty.
CONCLUSION: Our study shows that frailty according to SOF criteria is associated with low spinal BMD values in female and osteoporosis in male HIV-infected patients.

PMID: 28426535 [PubMed - as supplied by publisher]

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