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Guo L, An Y, Huang X, Liu W, Chen F, Fan Y, Gao S, Han L, Wang K. A Mendelian randomization study on the causal effects of cigarette smoking on liver fibrosis and cirrhosis. Front Med (Lausanne) 2024; 11:1390049. [PMID: 38841575 PMCID: PMC11150551 DOI: 10.3389/fmed.2024.1390049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Liver fibrosis significantly impacts public health globally. Untreated liver fibrosis eventually results in cirrhosis. Cigarette smoking is the main etiologic factor for various diseases. However, the causal effects of cigarette smoking on liver fibrosis and cirrhosis have yet to be fully elucidated. Methods In this study, Mendelian randomization (MR) analysis was performed to assess the association between cigarette smoking, liver fibrosis, and cirrhosis. Single-nucleotide polymorphisms (SNPs) were selected as instrumental variables from a genome-wide association study (GWAS) of European ancestry. Patients were divided into six exposure categories as follows: "ever smoked," "pack years of smoking," "age of smoking initiation," "smoking status: never," "smoking status: current," and "smoking status: previous." The outcomes of this study included liver fibrosis and cirrhosis. MR-Egger, weighted median, inverse variance weighted, simple mode, and weighted mode were selected as the analysis methods. Cochran's Q and the MR-PRESSO tests were conducted to measure heterogeneity. The MR-Egger method was performed to evaluate horizontal pleiotropy, while the "leave-one-out" analysis was performed for sensitivity testing. Results The results of this study showed that having a smoking history increases the risk of liver fibrosis and cirrhosis ["ever smoked": odds ratio (OR) = 5.704, 95% CI: 1.166-27.910, p = 0.032; "smoking status: previous": OR = 99.783, 95% CI: 2.969-3.353e+03, p = 0.010]. A negative correlation was observed between patients who never smoked and liver fibrosis and cirrhosis ("smoking status: never": OR = 0.171, 95% CI: 0.041-0.719, p = 0.016). However, there were no significant associations between "smoking status: current," "pack years of smoking," and "age of smoking initiation" and liver fibrosis and cirrhosis. Cigarette smoking did not have a significant horizontal pleiotropic effect on liver fibrosis and cirrhosis. The "Leave-one-out" sensitivity analysis indicated that the results were stable. Conclusion The study confirmed the causal effects of cigarette smoking on liver fibrosis and cirrhosis.
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Affiliation(s)
- Liwei Guo
- Medical Integration and Practice Center, Shandong University, Jinan, Shandong, China
- Department of Epidemiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Yong An
- Department of Epidemiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Xu Huang
- Department of Epidemiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Wenhua Liu
- Department of Epidemiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Fangfang Chen
- Department of Respiratory, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Institute of Respiratory Diseases, Jinan, Shandong, China
| | - Yuchen Fan
- Department of Hepatology, Qilu Hospital, Shandong University, Jinan, Shandong, China
- Institute of Hepatology, Shandong University, Jinan, Shandong, China
| | - Shuai Gao
- Department of Hepatology, Qilu Hospital, Shandong University, Jinan, Shandong, China
- Institute of Hepatology, Shandong University, Jinan, Shandong, China
| | - Liyan Han
- Department of Hepatology, Qilu Hospital, Shandong University, Jinan, Shandong, China
- Institute of Hepatology, Shandong University, Jinan, Shandong, China
| | - Kai Wang
- Medical Integration and Practice Center, Shandong University, Jinan, Shandong, China
- Department of Hepatology, Qilu Hospital, Shandong University, Jinan, Shandong, China
- Institute of Hepatology, Shandong University, Jinan, Shandong, China
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Lessa SM, Tietzmann DC, Amantéa SL. Factors associated with respiratory morbidity in the first year of life. J Pediatr (Rio J) 2023; 99:635-640. [PMID: 37353206 PMCID: PMC10594016 DOI: 10.1016/j.jped.2023.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/25/2023] Open
Abstract
OBJECTIVES To investigate the association between socioeconomic and nutritional factors with respiratory morbidity in the first year of life in different regions of Brazil. METHODOLOGY A nested case-control study within a randomized field trial was conducted in three capital cities (Porto Alegre, Manaus, and Salvador), representing different macro-regions of the country. Cases were defined as children with a reported previous diagnosis of asthma, bronchiolitis, or pneumonia. Corresponding controls were matched by age and sex in a 2:1 ratio, selected consecutively from the original cohort, resulting in a sample of 222 children. Bivariate analyses were performed to assess the association between sociodemographic and nutritional variables with respiratory morbidity outcomes, calculating odds ratios (OR) and their respective confidence intervals (95% CI). Values of p < 0.05 were considered significant. Potential confounding factors were adjusted through multivariate analysis (logistic regression). RESULTS Maternal smoking and breastfeeding for less than six months showed a significant association and increased risk of respiratory disease (OR=2.12 and 2.05, respectively). Children born in the Southern region of Brazil also demonstrated a higher association and risk of respiratory morbidity. The consumption of ultra-processed foods did not show a significant association or increased risk of respiratory disease. CONCLUSIONS Maternal smoking, breastfeeding for less than six months, and being born in the Southern region of Brazil are risk factors for the development of respiratory morbidity in the first year of life. The consumption of ultra-processed foods does not appear to pose a risk, but it was prevalent in more than 80% of the population, limiting its discriminatory power of analysis.
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Affiliation(s)
- Samantha M Lessa
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Departamento de Pediatria, Porto Alegre, RS, Brazil.
| | - Daniela C Tietzmann
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Departamento de Nutrição, Porto Alegre, RS, Brazil
| | - Sérgio L Amantéa
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Departamento de Pediatria, Porto Alegre, RS, Brazil
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Hapsari BDA, Melita M, Ismail AR, Djatmika FNT. A large primary lung abscess due to Klebsiella oxytoca: How critical the combination between early antibiotic therapy and bronchoscopy? NARRA J 2023; 3:e169. [PMID: 38450261 PMCID: PMC10916413 DOI: 10.52225/narra.v3i2.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/13/2023] [Indexed: 03/08/2024]
Abstract
Lung abscess is a microbial infection that can cause necrosis of the lung tissue and formation of cavities. Antibiotics and bronchoscopy are needed in the management of large lung abscess to prevent further complications. However, some of the cases have poor clinical improvement. The aim of this case report was to describe a patient with large lung abscess who had well responded to antibiotic therapy combined with bronchoscopy drainage. We reported a 55-year-old man with a lung abscess presented with initial symptom of acute productive cough for two weeks. Chest computed tomography (CT) scan with contrast of patient indicated a massive abscess on the right lung segment with a size of 10.9 × 10.41 × 8 cm. Laboratory examination showed leukocytosis. Bronchoscopy was performed as a diagnostic and therapeutic procedure. Antibiotic resistance test was conducted from bronchoalveolar lavage sample to determine the most suitable antibiotics for the patient. The culture yielded a positive for Klebsiella oxytoca that was resistant to ampicillin and cefazolin. The bacterium was sensitive to piperacillin-tazobactam, aztreonam, ceftazidime, ceftriaxone, ertapenem, cefepime, nitrofurantoin, meropenem, amikacin, gentamicin, ciprofloxacin, tigecycline, trimethoprim- sulfamethoxazole, and levofloxacin. Levofloxacin 750 mg injection was given for 14 days followed with oral levofloxacin 500 mg once a day for four weeks and bronchoscopy to stop the microbial infection process in the lung tissues. Lung abscess reduced significantly and the patient was followed until recovered. In conclusion, early combination therapy of adequate antibiotics and bronchoscopy is effective in treating a massive lung abscess caused by Klebsiella oxytoca.
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Affiliation(s)
- Brigitta DA. Hapsari
- Department of Pulmonology and Respiratory Medicine Faculty of Medicine, Universitas Sebelas Maret, Surakarta,Indonesia
| | - Melita Melita
- Department of Pulmonology and Respiratory Medicine Faculty of Medicine, Universitas Sebelas Maret, Surakarta,Indonesia
| | - Affan R. Ismail
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
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Marques GÁ, de Oliveira PD, Montzel M, Menezes AMB, Malta DC, Sardinha LMV, Wehrmeister FC. Treatments used by chronic obstructive pulmonary disease patients in Brazil: National Survey of Health, 2013. Rev Saude Publica 2023; 56:119. [PMID: 36629710 PMCID: PMC9749731 DOI: 10.11606/s1518-8787.2022056004090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 01/18/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of treatments used for the management of chronic obstructive pulmonary disease (COPD) in the Brazilian adult population. METHODS A population-based cross-sectional study with data from the 2013 Brazilian National Survey of Health, including individuals aged 40 years or older, with a self-reported medical diagnosis of COPD, chronic bronchitis and/or emphysema, who were asked about treatments used for disease management. RESULTS A total of 60,202 adults were interviewed, of which 636 were 40 years of age or older and had reported a medical diagnosis of COPD, emphysema, or chronic bronchitis. Less than half (49.4%) of the diagnosed population reported using some type of treatment, with differences regarding the macro-region of the country (South 53.8% - Northeast 41.2%, p = 0.007). Pharmacological treatment was the most reported, and emphysema patients had the highest proportion of those undergoing more than one type of treatment. Among the individuals who reported having only chronic bronchitis, 55.1% (95%CI: 48.7-61.4) used medication, 4.7% (95%CI: 2.6-8.3) underwent physical therapy, and 6.0% (95%CI: 3.6-9.9) oxygen therapy. On the other hand, among the emphysema patients, 44.1% (95%CI: 36.8-51.7) underwent drug treatment, 8.8% (95%CI: 5.4-14.2) physical therapy, and 10.0% (95%CI: 6.3-15.6) oxygen therapy. CONCLUSION The prevalence of treatments for COPD management was below ideal in 2013. The pharmacological treatment was the main type of treatment, followed by oxygen therapy and physical therapy.
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Affiliation(s)
- Gabriela Ávila Marques
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Paula Duarte de Oliveira
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Marina Montzel
- Universidade Federal de PelotasFaculdade de MedicinaDepartamento de Medicina SocialPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
| | - Ana Maria Baptista Menezes
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
| | - Deborah Carvalho Malta
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno-Infantil e Saúde PúblicaBelo HorizonteMGBrasil Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno-Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | | | - Fernando César Wehrmeister
- Universidade Federal de PelotasFaculdade de MedicinaPrograma de Pós-Graduação em EpidemiologiaPelotasRSBrasil Universidade Federal de Pelotas. Faculdade de Medicina. Programa de Pós-Graduação em Epidemiologia. Pelotas, RS, Brasil
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Abstract
OBJECTIVE This study aimed to develop a Transtheoretical-Model-based and WhatsApp-text-message-supported smoking cessation program for pregnant women and to evaluate its effectiveness. METHODS This study is a pretest-posttest designed, randomized controlled and quasi-experimental intervention research. The study was conducted on 50 pregnant women, 25 of them in the intervention group and 25 of them in the control group. A theory-based motivational individual counseling initiative has been applied to the intervention group, and WhatsApp text messages have been sent 3 days a week, in accordance with the stages of change to support the interviews. RESULTS In the final follow-up, 60% of pregnant women in the intervention group and 36% of pregnant women in the control group quit smoking. All participants indicated they would recommend the WhatsApp-text-message-supported smoking cessation program. Transtheoretical-Model-based and WhatsApp-text-message-supported smoking cessation programs were found to be effective in reducing nicotine dependency scores and carbon monoxide levels of pregnant women and quitting smoking. PRACTICE IMPLICATIONS The smoking cessation program used in the research may be applied by midwives or nurses trained on the subject to help pregnant women quit smoking.
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de Lima Tavares Toscano L, Silva AS, de França ACL, de Sousa BRV, de Almeida Filho EJB, da Silveira Costa M, Marques ATB, da Silva DF, de Farias Sena K, Cerqueira GS, da Conceição Rodrigues Gonçalves M. A single dose of purple grape juice improves physical performance and antioxidant activity in runners: a randomized, crossover, double-blind, placebo study. Eur J Nutr 2020; 59:2997-3007. [PMID: 31732851 PMCID: PMC7755635 DOI: 10.1007/s00394-019-02139-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the effects of a single dose of juice on physical performance, oxidative stress, inflammation and muscle damage in runners. METHODS Fourteen recreational male runners (39 ± 9 years, VO2peak = 55.9 ± 6.5 ml/kg/min) performed two running tests to exhaustion at 80% of VO2max after ingesting grape juice or a placebo drink (10 ml/kg/day) randomly. Blood samples were taken before and 2 h after supplementation and immediately after running to analyze total antioxidant capacity (TAC), malondialdehyde (MDA), alpha-1 acid glycoprotein (A1GPA), high-sensitivity C-reactive protein (hs-CRP), creatine kinase (CK) and lactate dehydrogenase (LDH). RESULTS The participants ran for an average of 59.2 ± 27.8 min until exhaustion in the placebo group and for 68.4 ± 29.7 min until exhaustion in the grape juice intake group, which was a significantly longer time (p = 0.008). This improvement in physical performance was accompanied by a 43.6% increase in TAC (p = 0.000) at the post-exercise timepoint compared to the level at baseline. MDA, A1GPA, hs-CRP, CK, and LDH did not exhibit changes. In contrast, no significant change in any variable was observed after consuming the placebo drink. CONCLUSION The single-dose intake of purple grape juice demonstrated an ergogenic effect in recreational runners by increasing run time to exhaustion and increasing antioxidant activity.
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Affiliation(s)
- Lydiane de Lima Tavares Toscano
- Programa de Pós-graduação em Ciências da Nutrição, Universidade Federal da Paraíba (UFPB), João Pessoa, Paraíba, Brazil
- Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba (UFPB), Centro de Ciências da Saúde, Campus I, Cidade Universitária, João Pessoa, Paraíba, CEP 58059-900, Brazil
| | - Alexandre Sérgio Silva
- Programa de Pós-graduação em Ciências da Nutrição, Universidade Federal da Paraíba (UFPB), João Pessoa, Paraíba, Brazil.
- Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba (UFPB), Centro de Ciências da Saúde, Campus I, Cidade Universitária, João Pessoa, Paraíba, CEP 58059-900, Brazil.
| | - Ana Carla Lima de França
- Programa de Pós-graduação em Ciências da Nutrição, Universidade Federal da Paraíba (UFPB), João Pessoa, Paraíba, Brazil
- Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba (UFPB), Centro de Ciências da Saúde, Campus I, Cidade Universitária, João Pessoa, Paraíba, CEP 58059-900, Brazil
| | - Bruno Rafael Virgínio de Sousa
- Programa de Pós-graduação em Ciências da Nutrição, Universidade Federal da Paraíba (UFPB), João Pessoa, Paraíba, Brazil
- Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba (UFPB), Centro de Ciências da Saúde, Campus I, Cidade Universitária, João Pessoa, Paraíba, CEP 58059-900, Brazil
| | - Eder Jackson Bezerra de Almeida Filho
- Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba (UFPB), Centro de Ciências da Saúde, Campus I, Cidade Universitária, João Pessoa, Paraíba, CEP 58059-900, Brazil
| | - Matheus da Silveira Costa
- Programa de Pós-graduação em Ciências da Nutrição, Universidade Federal da Paraíba (UFPB), João Pessoa, Paraíba, Brazil
- Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba (UFPB), Centro de Ciências da Saúde, Campus I, Cidade Universitária, João Pessoa, Paraíba, CEP 58059-900, Brazil
| | | | | | - Klécia de Farias Sena
- Laboratório de Estudos do Treinamento Físico Aplicado ao Desempenho e a Saúde, Departamento de Educação Física, Universidade Federal da Paraíba (UFPB), Centro de Ciências da Saúde, Campus I, Cidade Universitária, João Pessoa, Paraíba, CEP 58059-900, Brazil
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Ruszkiewicz JA, Zhang Z, Gonçalves FM, Tizabi Y, Zelikoff JT, Aschner M. Neurotoxicity of e-cigarettes. Food Chem Toxicol 2020; 138:111245. [PMID: 32145355 PMCID: PMC7089837 DOI: 10.1016/j.fct.2020.111245] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 02/29/2020] [Accepted: 03/03/2020] [Indexed: 02/07/2023]
Abstract
It appears that electronic cigarettes (EC) are a less harmful alternative to conventional cigarette (CC) smoking, as they generate substantially lower levels of harmful carcinogens and other toxic compounds. Thus, switching from CC to EC may be beneficial for smokers. However, recent accounts of EC- or vaping-associated lung injury (EVALI) has raised concerns regarding their adverse health effects. Additionally, the increasing popularity of EC among vulnerable populations, such as adolescents and pregnant women, calls for further EC safety evaluation. In this state-of-the-art review, we provide an update on recent findings regarding the neurological effects induced by EC exposure. Moreover, we discuss possible neurotoxic effects of nicotine and numerous other chemicals which are inherent both to e-liquids and EC aerosols. We conclude that in recognizing pertinent issues associated with EC usage, both government and scientific researchers must address this public health issue with utmost urgency.
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Affiliation(s)
- Joanna A Ruszkiewicz
- Molecular Toxicology Group, Department of Biology, University of Konstanz, Konstanz, Germany
| | - Ziyan Zhang
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Filipe Marques Gonçalves
- Biochemistry Graduate Program, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Yousef Tizabi
- Department of Pharmacology, Howard University College of Medicine, Washington DC, United States
| | - Judith T Zelikoff
- Department of Environmental Medicine, New York University School of Medicine, Manhattan, NY, United States
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States.
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Baldi BG. Revisiting 2019, setting goals for 2020, and reflecting upon open science. ACTA ACUST UNITED AC 2020; 46:e20190431. [PMID: 32130349 PMCID: PMC7462685 DOI: 10.1590/1806-3713/e20190431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Bruno Guedes Baldi
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas Faculdade de Medicina, Universidade de São Paulo - HCFMUSP - São Paulo (SP) Brasil.,. Editor-Chefe do Jornal Brasileiro de Pneumologia - JBP - Brasília (DF) Brasil
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