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Vámos O, Kulcsár N, Mikecs B, Kelemen K, Kaán R, Abafalvi L, Dinya E, Vág J, Hermann P, Kispélyi B. Acute effects of traditional and electronic cigarettes on palatal blood flow in smokers: A cross-over pilot study. J Oral Biol Craniofac Res 2024; 14:152-157. [PMID: 38333089 PMCID: PMC10850968 DOI: 10.1016/j.jobcr.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
Background Smoking is a significant health hazard and contributes to cardiovascular and pulmonary diseases. It can increase postoperative complications during oral and maxillofacial surgery due to its topical effect on the oral mucosa. New alternatives to traditional tobacco products are gaining popularity, in particular, electronic cigarettes. Objectives This pilot study investigated the acute effects of nicotine-containing and nicotine-free electronic cigarettes on palatal blood flow (PBF), and compared their effects to traditional cigarettes. Materials and methods 14 medically healthy volunteers (8 males, 6 females, age: 34.7 ± 7.0) were recruited for the study. All patients (N = 14) were requested to smoke nicotine-containing (ECN) and nicotine-free electronic cigarettes (EC0) and a mouthpiece (end of a traditional cigarette) as a control sham smoking blind test (BT). EC users did not smoke a traditional cigarette (TC), resulting in 10 people in the TC group. Palatal blood flow was measured by Laser Speckle Contrast Imager before, immediately after, and 15 min after the exposures. Exhaled carbon monoxide (eCO) and carboxyhemoglobin (COHb) were measured before and immediately after smoking with a piCO+ Smokerlyzer machine. Results In all groups, no significant differences were observed in the changes of palatal blood flow between time points. Exhaled carbon monoxide and carboxyhemoglobin were significantly higher in the traditional cigarette (TC) group compared to the nicotine-containing electronic cigarette (ECN) and nicotine-free electronic cigarette (EC0) groups, both before and after the exposure (p < 0.05). Conclusion Acute use of either traditional or electronic cigarettes may have minimal impact on palatal blood flow, but additional studies are required to clarify their impact on the mucosa.
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Affiliation(s)
- Orsolya Vámos
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Norbert Kulcsár
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Barbara Mikecs
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Kata Kelemen
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Réka Kaán
- Department of Oral Health Sciences, KU Leuven, Oude Markt 13, 3000, Leuven, Belgium
| | - Lilla Abafalvi
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Elek Dinya
- Institute of Digital Health Sciences, Faculty of Public Services, Semmelweis University, Üllői Road 26, Budapest, H-1085, Hungary
| | - János Vág
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
| | - Barbara Kispélyi
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi Street 47, Budapest, H-1088, Hungary
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Morgan M, Farra YM, Vergara-Anglim A, Bellini C, Oakes JM, Shefelbine SJ. E-cigarette aerosol exposure effect on bone biomechanical properties in murine models. J Biomech 2024; 162:111879. [PMID: 38043496 PMCID: PMC10836423 DOI: 10.1016/j.jbiomech.2023.111879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 10/11/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
Numerous studies have shown the detrimental health effects of tobacco smoking on bone volume and strength in human and animal models. Little is known regarding the impacts of e-cigarettes, a form of smoke-less nicotine intake, despite their growing population of users. This study uses murine models to evaluate the effects of exposure to e-cigarette aerosols (JUUL) on bone structure and strength through micro-CT imaging and mechanical testing. JUUL mice had more trabecular bone in thickness and volume, yet lower ultimate stress and modulus values in the cortical bone than the control mice. These outcomes suggest that, although vaping can result in a higher bone volume, this bone is weaker than average. E-cigarettes should be examined more closely regarding adolescence and long-term consequences on skeletal health.
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Affiliation(s)
- Meagan Morgan
- Department of Bioengineering, Northeastern University, Boston, MA, USA
| | - Yasmeen M Farra
- Department of Bioengineering, Northeastern University, Boston, MA, USA
| | | | - Chiara Bellini
- Department of Bioengineering, Northeastern University, Boston, MA, USA
| | - Jessica M Oakes
- Department of Bioengineering, Northeastern University, Boston, MA, USA
| | - Sandra J Shefelbine
- Department of Mechanical and Industrial Engineering, Boston, MA, USA; Department of Bioengineering, Northeastern University, Boston, MA, USA.
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Pescatore SM, DeShazo SJ, Lindeman RW. Non-Tobacco Nicotine dependence associated with increased Postoperative Complications following Intramedullary Nailing for Intertrochanteric Femur Fractures. JOURNAL OF SURGERY AND RESEARCH 2024; 7:229-236. [PMID: 38993265 PMCID: PMC11238609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
Objectives Nicotine usage is known to increase postoperative complications; however, studies show that the general population believes that non-tobacco nicotine delivery devices are a safer option compared to tobacco-based nicotine products. This study evaluates postoperative complications between non-tobacco nicotine dependent and non-nicotine dependent patients for intramedullary nailing in intertrochanteric femur fractures. Methods Utilizing the TriNetX database, we retrospectively examined postoperative outcomes in patients aged 18 to 90 who underwent intramedullary nailing for intertrochanteric femur fractures between November 21, 2013, and November 21, 2023. Two cohorts were analyzed: Cohort A comprised nicotine-dependent patients without tobacco product usage (e.g. cigarettes or chewing tobacco) and Cohort B consisted of patients without any nicotine dependence. Propensity matching was performed for BMI, type 2 diabetes, alcohol/substance abuse, socioeconomic status, and demographic factors. Outcomes assessed included mortality, sepsis, pneumonia, revision, dehiscence, pulmonary embolism, nonunion, and deep vein thrombosis within 1 day to 6 months post-treatment. Results A total of 2,041 non-tobacco nicotine dependent patients were matched with 22,872 non-nicotine dependent patients. Non-tobacco nicotine dependent patients experienced higher associated risk for numerous postoperative complications compared to non-nicotine dependent patients including increased risk for mortality within 6 months postoperatively (RR 1.386, 10.7% vs 7.7%, P = 0.001), sepsis (RR 1.459, 4.4% vs 3.0%, P = 0.027), and pneumonia (RR 1.751, 5.8% vs 3.3%, P = 0.001). Conclusions Non-tobacco nicotine dependence increases postoperative complications for patients undergoing intramedullary nailing for intertrochanteric femur fractures. Our findings support the need for development of perioperative nicotine cessation guidelines for non-tobacco nicotine users. Level of evidence Level III, Prognostic.
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Affiliation(s)
- Sabrina M Pescatore
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Sterling J DeShazo
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Robert W Lindeman
- Department of Orthopedic Surgery and Rehabilitation, University of Texas Medical Branch, Galveston, Texas, USA
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Tsai YL, Wang HP, Wu DW, Huang JC, Wu PY, Chen SC. Low Lung Function Is Associated with Low Baseline Calcaneus Ultrasound T-Score but a Slow Decline in T-Score in a Taiwanese Follow-Up Population with No History of Smoking, Bronchitis, Emphysema, or Asthma. J Pers Med 2023; 13:jpm13050795. [PMID: 37240965 DOI: 10.3390/jpm13050795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023] Open
Abstract
Osteoporosis is a common disease, and the prevalence is increasing in patients with chronic respiratory diseases, with important implications with regard to fractures, hospitalization, and death. Due to inconsistent data and a lack of large cohort follow-up studies on the association between lung function and osteoporosis, the aim of this study was to investigate this issue. We enrolled and followed for a median of 4 years a total of 9059 participants with no history of smoking, bronchitis, emphysema, or asthma from the Taiwan Biobank. Spirometry data, including forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC), were used to assess lung function. Changes in the calcaneus ultrasound T-score (ΔT-score) were calculated as follow-up T-score-baseline T-score. A ΔT-score ≤ -3 (median value of ΔT-score) meant a fast decline in T-score. Multivariable analysis showed that lower values of FEV1 (β, 0.127, p < 0.001), FVC (β, 0.203, p < 0.001), and FEV1/FVC (β, 0.002, p = 0.013) were significantly associated with a low baseline T-score. In addition, after follow-up, higher values of FEV1 (odds ratio (OR), 1.146, p = 0.001), FVC (OR, 1.110, p = 0.042), and FEV1/FVC (OR, 1.004, p = 0.002) were significantly associated with ΔT-score ≤ -3. FEV1/FVC < 70% (OR, 0.838, p < 0.001) was significantly associated with ΔT-score ≤ -3. In conclusion, lower FEV1, FVC, and FEV1/FVC were associated with a low baseline T-score, and higher FEV1, FVC, and FEV1/FVC were associated with a rapid decline in T-score in follow-up. This suggests that lung disease may be associated with bone mineral density in the Taiwanese population with no history of smoking, bronchitis, emphysema, or asthma. Further research is needed to establish causality.
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Affiliation(s)
- Yu-Lin Tsai
- Department of Post Baccalaureate Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hao-Ping Wang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Da-Wei Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Jiun-Chi Huang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Pei-Yu Wu
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Soo J, Easwaran M, Erickson‐DiRenzo E. Impact of Electronic Cigarettes on the Upper Aerodigestive Tract: A Comprehensive Review for Otolaryngology Providers. OTO Open 2023; 7:e25. [PMID: 36998560 PMCID: PMC10046796 DOI: 10.1002/oto2.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/18/2022] [Accepted: 12/02/2022] [Indexed: 02/19/2023] Open
Abstract
Objective The use and effects of electronic (e)-cigarettes (e-cigs) are particularly relevant for otolaryngology providers as tobacco plays a major role in benign and malignant diseases of the upper aerodigestive tract. This review aims to (1) summarize the recent policies regarding e-cigs and important patterns of use and (2) serve as a comprehensive resource for clinical providers on the known biologic and clinical effects of e-cigs on the upper aerodigestive tract. Data Sources PubMed/MEDLINE. Review Methods We conducted a narrative review on (1) general information on e-cig use and informative findings in the lower respiratory system and a comprehensive review on (2) the effects of e-cigs on cell and animal models and the clinical implications of these products on human health as is relevant to otolaryngology. Conclusions Although e-cigs are likely less harmful than conventional cigarettes, preliminary research on e-cigs suggest several deleterious effects including in the upper aerodigestive tract. Due to this, there has been increased interest in restricting e-cig usage, particularly among the adolescent population, and caution in recommending e-cigs to current smokers. Implications for Practice Chronic e-cig use is likely to have clinical implications. It is critical for otolaryngology providers to be aware of the rapidly changing regulations and use patterns regarding e-cigs and how e-cigs influence human health, particularly with regards to the upper aerodigestive tract, to accurately council patients regarding potential risks and benefits of use.
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Affiliation(s)
- Joanne Soo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Meena Easwaran
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Elizabeth Erickson‐DiRenzo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
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Lippi L, Folli A, Curci C, D’Abrosca F, Moalli S, Mezian K, de Sire A, Invernizzi M. Osteosarcopenia in Patients with Chronic Obstructive Pulmonary Diseases: Which Pathophysiologic Implications for Rehabilitation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114314. [PMID: 36361194 PMCID: PMC9657186 DOI: 10.3390/ijerph192114314] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 10/28/2022] [Accepted: 10/30/2022] [Indexed: 05/10/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a burdensome condition affecting a growing number of people worldwide, frequently related to major comorbidities and functional impairment. In these patients, several factors might have a role in promoting both bone and muscle loss, including systemic inflammation, corticosteroid therapies, sedentary behaviours, deconditioning, malnutrition, smoking habits, and alcohol consumption. On the other hand, bone and muscle tissues share several linkages from functional, embryological, and biochemical points of view. Osteosarcopenia has been recently defined by the coexistence of osteoporosis and sarcopenia, but the precise mechanisms underpinning osteosarcopenia in patients with COPD are still unknown. In this scenario, a deeper understanding of the molecular basis of osteosarcopenia might guide clinicians in a personalized approach integrating skeletal muscle health with the pulmonary rehabilitation framework in COPD. Taken together, our results summarized the currently available evidence about the multilevel interactions between osteosarcopenia and COPD to pave the way for a comprehensive approach targeting the most common risk factors of these pathological conditions. Further studies are needed to clarify the role of modern clinical strategies and telemedicine solutions to optimize healthcare delivery in patients with COPD, including osteopenia, osteoporosis, and sarcopenia screening in these subjects.
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Affiliation(s)
- Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Arianna Folli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Claudio Curci
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantova, Italy
| | - Francesco D’Abrosca
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Kamal Mezian
- Department of Rehabilitation Medicine, First Faculty of Medicine, Charles University and General University Hospital, 12800 Prague, Czech Republic
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy
- Department of Rehabilitation and Sports Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, 15006 Prague, Czech Republic
- Correspondence: ; Tel.: +390961369768
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Nicholson T, Davis L, Davis ET, Newton Ede M, Scott A, Jones SW. e-Cigarette Vapour Condensate Reduces Viability and Impairs Function of Human Osteoblasts, in Part, via a Nicotine Dependent Mechanism. TOXICS 2022; 10:506. [PMID: 36136470 PMCID: PMC9504563 DOI: 10.3390/toxics10090506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 06/16/2023]
Abstract
Cigarette consumption negatively impacts bone quality and is a risk-factor for the development of multiple bone associated disorders, due to the highly vascularised structure of bone being exposed to systemic factors. However, the impact on bone to electronic cigarette (e-cigarette) use, which contains high doses of nicotine and other compounds including flavouring chemicals, metal particulates and carbonyls, is poorly understood. Here, we present the first evidence demonstrating the impact of e-cigarette vapour condensate (replicating changes in e-cigarette liquid chemical structure that occur upon device usage), on human primary osteoblast viability and function. 24 h exposure of osteoblasts to e-cigarette vapour condensate, generated from either second or third generation devices, significantly reduced osteoblast viability in a dose dependent manner, with condensate generated from the more powerful third generation device having greater toxicity. This effect was mediated in-part by nicotine, since exposure to nicotine-free condensate of an equal concentration had a less toxic effect. The detrimental effect of e-cigarette vapour condensate on osteoblast viability was rescued by co-treatment with the antioxidant N-Acetyl-L-cysteine (NAC), indicating toxicity may also be driven by reactive species generated upon device usage. Finally, non-toxic doses of either second or third generation condensate significantly blunted osteoblast osteoprotegerin secretion after 24 h, which was sustained for up to 7 days. In summary we demonstrate that e-cigarette vapour condensate, generated from commonly used second and third generation devices, can significantly reduce osteoblast viability and impair osteoblast function, at physiologically relevant doses. These data highlight the need for further investigation to inform users of the potential risks of e-cigarette use on bone health, including, accelerating bone associated disease progression, impacting skeletal development in younger users and to advise patients following orthopaedic surgery, dental surgery, or injury to maximise bone healing.
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Affiliation(s)
- Thomas Nicholson
- Institute of Inflammation and Ageing, MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Lauren Davis
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Edward T. Davis
- Royal Orthopaedic Hospital, Bristol Road South, Birmingham B15 2TT, UK
| | | | - Aaron Scott
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Simon W. Jones
- Institute of Inflammation and Ageing, MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
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