Impact of sidestream whole smoke solutions on the outcome of wound repair and related angiogenesis

Evaluating the Influence of Side Stream Cigarette Smoke at an Early Stage of Non-Alcoholic Steatohepatitis Progression in Mice

Side stream cigarette smoke (SSCS) is known to be as harmful and hazardous to human health as is active smoking. In this study, we investigated the relationship between the exposure to SSCS and its stimulatory and subacute effects on the progression of non-alcoholic steatohepatitis (NASH). A methionine and choline-deficient plus high fat (MCDHF) diet was administered to C57BL/6 mice for 6 weeks. During the first three weeks of MCDHF diet feeding, each diet group was exposed to SSCS (0, 20, 40 μg/L) or fresh air for 2 hrs per day and 5 days per week. Additional experiments were performed by increasing the concentration (0, 30, 60 μg/L) and exposure time (6 hours per day) of SSCS. According to histopathologic analysis and serum levels of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST), there were no differences in hepatic fat deposition, fibrosis, apoptosis or liver damage in MCDHF-fed mice based on SSCS exposure. There were also no differences in the expression of inflammation-, oxidative stress- or fibrosis-related genes between MCDHF-fed mice with or without SSCS exposure. Therefore, it is concluded that SSCS with current exposure amounts does not have additive detrimental effects on the early stage of NASH.

Pharyngocutaneous Fistula after Total Laryngectomy: Risk Factors with Emphasis on Previous Radiotherapy and Heavy Smoking

Objective

In this retrospective cohort study, we aimed to determine the incidence of pharyngocutaneous fistula (PCF) after total laryngectomy (TL) and to define the possible predictors for PCF formation.

Methods

The medical records of 198 patients with laryngeal squamous cell carcinoma who underwent TL were reviewed. After the exclusion of patients with history of free flap reconstruction, previous laryngeal surgery, and previous radiotherapy (RT) for other primary cancers, the risk factors for PCF were analyzed in 183 patients who were included in the study.

Results

The overall incidence of PCF was 20.2%. A history of heavy smoking and previous RT were detected as independent risk factors in both univariate (p=0.004 and p=0.007, respectively) and multivariate (p=0.005) analyses. Preoperative tracheotomy (PT) longer than 14 days was a risk factor for PCF among patients with PT in the univariate analysis (p=0.031). Overall three- and five-year survival rates were statistically indifferent between the PCF and non-PCF groups (p>0.05). However, the overall five-year survival rate was lesser in the persistent PCF group (47%) than in the non-persistent PCF group (83%) (p=0.038).

Conclusion

Heavy smoking and previous RT are independent risk factors for PCF, and the persistence of PCF decreases survival rates. Preventable measures should be taken to decrease the incidence and persistence of this complication of TL in the management of patients with possible risk factors.

Tobacco exposure and complications in conservative laryngeal surgery

Smoking is an important risk factor in the development of head and neck cancer. However, little is known about its effects on postoperative complications in head and neck cancer surgery. We performed a retrospective analysis on 535 consecutive laryngeal cancer patients submitted to open partial laryngectomy at the Otolaryngology-Head and Neck Surgery Department of Florence University to evaluate a possible correlation between smoking and surgical complications. Patients were grouped in non smokers and smokers and evaluated for airway, swallowing, local and fistula complications by multivariate analysis: 507 (95%) patients were smokers, 69% presented supraglottic, 30% glottic and 1% transglottic cancer. The most common operation was supraglottic horizontal laryngectomy in 58%, followed by supracricoid partial laryngectomy in 27% and frontolateral hemilaryngectomy in 15% of cases. The incidence of overall complications was 30%, airway complications representing the most frequent (14%), followed by swallowing (7%), local (6%) and fistula complications (3%). Smokers developed more local complications (p = 0.05, univariate, p = 0.04, multivariate analysis) and pharyngocutaneous fistula (p = 0.01, univariate, p = 0.03, multivariate analysis).