-
1.
The effects of preoperative alcohol, tobacco, and psychological stress on postoperative complications: a prospective observational study.
Myoga, Y, Manabe, H, Osaki, Y
BMC anesthesiology. 2021;(1):245
Abstract
BACKGROUND Postoperative complications occur frequently, despite progress in anesthetic pharmacology and surgical techniques. Although habits, such as alcohol and tobacco use, and mental health have been studied individually as modifying factors, few studies have examined the relationship between multiple lifestyle choices and postoperative complications in patients undergoing surgery. Hence, this study aimed to investigate the associations between unhealthy lifestyle choices and postoperative complications. METHODS We included 730 patients who underwent surgery in our department between March 2015 and April 2016. Participants completed preoperative questionnaires, including the Alcohol Use Disorders Identification Test, Fagerström Test for Nicotine Dependence, and tests for psychological stress (6-item Kessler Psychological Distress Scale; Hospital Anxiety and Depression Scale). Multivariable logistic analysis was used to analyze the association of preoperative drug dependence and psychological stress with postoperative complications. RESULTS Of the 721 cases analyzed, 461 (64%) were women. The median age of patients was 62 years (interquartile range: 48-71). At the time of surgical decision-making, 429 out of 710 respondents (60%) had a drinking habit, and 144 out of 693 respondents (21%) had a smoking habit during the preceding year. Seventy-nine patients had developed complications. Multivariable analysis revealed that old age (p = 0.020), psychological stress (p = 0.041), and longer anesthesia time (p < 0.001) were significantly associated with postoperative complications. Drinking or smoking variables were not associated with postoperative complications. CONCLUSIONS Preoperative psychological stress, as evaluated with the 6-item Kessler Psychological Distress Scale, is associated with the risk of postoperative complications.
-
2.
Increased cardiovascular risk and reduced quality of life are highly prevalent among individuals with hepatitis C.
McPherson, S, Gosrani, S, Hogg, S, Patel, P, Wetten, A, Welton, R, Hallsworth, K, Campbell, M
BMJ open gastroenterology. 2020;(1)
Abstract
OBJECTIVE Hepatitis C virus (HCV) infection is common. Although treatment is effective, with oral antivirals curing >95% of patients, most individuals have comorbidities that persist long term. Therefore, our aim was to determine the prevalence of potentially modifiable health problems in patients with HCV and develop an HCV care bundle to identify and target comorbidities. DESIGN Cross-sectional, observational single-centre study that recruited consecutive patients with HCV from our viral hepatitis clinics. Data were collected on cardiovascular (CV) risk factors, lifestyle behaviours, anthropometry and health-related quality of life (HRQoL). QRISK 3 was used to predict 10-year CV event risk. RESULTS 100 patients were recruited (67% male, 93% white, median age 52 years (range 24-80); 71% were treated for HCV; 34% had cirrhosis; 14% had diabetes; 61% had hypertension; 31% had metabolic syndrome; and 54% were smokers). The median 10-year CV event risk was 8.3% (range 0.3%-63%). 45% had a predicted 10-year CV event risk of >10%. Only 10% of individuals were treated with statins and 27% with antihypertensives. 92% had a predicted 'heart age' greater than their chronological age (median difference +7 (-4 to +26) years). HRQoL was reduced in all SF36v2 domains in the cohort. Factors independently associated with HRQoL included cirrhosis, metabolic syndrome, history of mental health disorder, sedentary behaviour and HCV viraemia. CONCLUSION A large proportion of patients with HCV presented with increased risk of CV events, and rates of smoking and sedentary behaviour were high, while prescribing of primary prophylaxis was infrequent. HRQoL was also reduced in the cohort. A 'care bundle' was developed to provide a structured approach to treating potentially modifiable health problems.
-
3.
Impact of Dietary Habit, Iodine Supplementation and Smoking Habit on Urinary Iodine Concentration During Pregnancy in a Catalonia Population.
Torres, MT, Vila, L, Manresa, JM, Casamitjana, R, Prieto, G, Toran, P, Falguera, G, Francés, L, The Iodegest Study Group,
Nutrients. 2020;(9)
Abstract
(1) Background: The nutritional status of women during pregnancy can have a considerable effect on maternal and fetal health, and on the perinatal outcome. Aim: to assess the changes occurring in dietary iodine intake, potassium iodide supplementation, and smoking habit, and the impact of these changes on the urinary iodine concentration (UIC) during pregnancy in a population of women in Catalonia (Spain). (2) Methods: Between 2009-2011, an observational study included a cohort of women whose pregnancies were monitored in the public health system in the Central and North Metropolitan areas of Catalonia. Women received individual educational counseling, a dietary questionnaire was completed, and a urine sample was collected for iodine determination at each trimester visit. (3) Results: 633 (67.9%) women answered the questionnaire at all 3 visits. The percentage of women with a desirable UIC (≥150 μg/L) increased from the first to the second trimester and remained stable in the third (57.3%, 68.9%, 68%; p < 0.001). Analysis of the relationship between UIC≥150 μg/L and the women's dietary habits showed that the percentage with UIC ≥150 μg/L increased with greater consumption of milk in the first trimester, and the same was true for iodized salt use in all three trimesters and iodine supplementation in all three. (4) Conclusion: During pregnancy, increased intake of milk, iodized salt, and iodine supplements were associated with an increase in the UIC.
-
4.
Maternal arterial blood gas values during delivery: Effect of mode of delivery, maternal characteristics, obstetric interventions and correlation to fetal umbilical cord blood.
Zaigham, M, Helfer, S, Kristensen, KH, Isberg, PE, Wiberg, N
Acta obstetricia et gynecologica Scandinavica. 2020;(12):1674-1681
-
-
Free full text
-
Abstract
INTRODUCTION Obstetricians routinely use biochemical parameters from non-pregnant women to assess the condition of the laboring mother. However, it is well known that pregnancy leads to significant physiological changes in most organ systems. The aim of this study was to determine normal values for maternal arterial blood gases during vaginal deliveries as compared with control values from planned cesarean sections. We also wanted to elucidate the effect of various maternal characteristics, mode of delivery and obstetric interventions on blood gas values. MATERIAL AND METHODS We carried out a randomly selected, prospective-observational cohort study of 250 women undergoing vaginal delivery and 58 women undergoing planned cesarean section at the Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden. RESULTS We found significant differences for gestational age, parity, umbilical venous blood pH, pCO2 and lactate values between the two study groups (P < .005). Significantly lower pH, pCO2 , pO2 and sO2 were found in mothers delivering vaginally. Higher base deficit, hemoglobin, bilirubin, potassium, glucose and lactate were found in vaginal deliveries than in planned cesarean sections (P < .02). Maternal body mass index (BMI), smoking and hypertension were not significantly correlated to acid base parameters in women with vaginal deliveries. On the other hand, multiple regression showed significant associations for the use of epidural anesthesia on maternal pH (P < .05) and pO2 (P < .01); and synthetic oxytocin on pCO2 (P = .08), glucose (P < .00) and lactate (P < .02) levels in maternal arterial blood. Maternal arterial pH, pCO2 and lactate values correlated significantly to values in venous umbilical cord blood (P < .000). CONCLUSIONS Maternal arterial blood gas parameters varied significantly according to mode of delivery, the use of epidural anesthesia and synthetic oxytocin.
-
5.
The major causes and risk factors of total and cause-specific mortality during 5.4-year follow-up: the Shanghai Changfeng Study.
Wu, L, Lin, H, Hu, Y, Zhu, C, Ma, H, Gao, J, Wu, J, Shen, H, Jiang, W, Zhao, N, et al
European journal of epidemiology. 2019;(10):939-949
-
-
Free full text
-
Abstract
To investigate the major causes and predictive factors of death in a middle-aged and elderly Chinese population. A total of 6591 residents aged ≥ 45 years from Shanghai Changfeng community were followed up for an average of 5.4 years. The causes of death were coded according to the 10th Revision of International Classification of Diseases. The mortality rate was calculated by person-years of follow up and age-standardized according to the 2010 Chinese census data. Multivariable-adjusted Cox proportional hazards model was performed to investigate the predictors of all-cause and cause-specific mortality. During the total follow-up of 35,739 person-years, 370 deaths were documented (157 from malignant neoplasms, 70 from heart diseases, 68 from cerebrovascular diseases, 75 from other causes). The age-standardized all-cause mortality rate was 798.2 per 100,000 person-years (927.9 among men and 716.7 among women). Results from multivariable analyses showed that aging, diabetes, and osteoporosis at baseline were independent predictors of all-cause mortality, with hazard ratios (HR) of 1.11 (95% CI 1.10-1.13), 1.91 (1.51-2.42), and 1.71 (1.24-2.35), respectively. The population attributable risk percent of diabetes and osteoporosis was 19.7% and 11.7%, respectively. Cigarette smoking was associated with a higher risk of all-cause mortality in men (HR and 95%CI 1.44, 1.01-2.06). In women, diabetes and osteoporosis were related to a higher risk of cardiovascular mortality (3.27, 1.82-5.88 and 1.89, 1.04-3.46, respectively). While in men, osteoporosis was related to a higher risk of malignant neoplasms mortality (2.39, 1.07-5.33). Malignant neoplasms, heart diseases, and cerebrovascular diseases are the leading causes of death. Aging, smoking, underweight, diabetes, and osteoporosis are independent predictors of premature death among middle-aged and elderly Chinese community population. Moreover, there may have been some differences in the causes and predictors of premature death between men and women.
-
6.
Modeling Associations between Chemosensation, Liking for Fats and Sweets, Dietary Behaviors and Body Mass Index in Chronic Smokers.
Larsen, BA, Litt, MD, Huedo-Medina, TB, Duffy, VB
Nutrients. 2019;(2)
Abstract
Chronic smokers have a greater risk for altered chemosensation, unhealthy dietary patterns, and excessive adiposity. In an observational study of chronic smokers, we modeled relationships between chemosensation, fat/carbohydrate liking, smoking-associated dietary behaviors, and body mass index (BMI). Also tested in the model was liking for sweet electronic cigarette juice (e-juice). Smokers (n = 135, 37 ± 11 years) were measured for: Taste genetics (intensity of 6-n-propylthiouracil-PROP); taste (NaCl and quinine intensities) and olfactory (odor identification) function; liking for cherry e-juice; and weight/height to calculate BMI. Smokers survey-reported their food liking and use of smoking for appetite/weight control. Structural equation models tested direct and indirect relationships between chemosensation, fat/carbohydrate liking, dietary behaviors, and BMI. In good-fitting models, taste intensity was linked to BMI variation through fat/carbohydrate liking (greater PROP intensity→greater NaCl intensity→greater food liking→higher BMI). Olfactory function tended to predict sweet e-juice liking, which, in turn, partially mediated the food liking and BMI association. The path between smoking-associated dietary behaviors and BMI was direct and independent of chemosensation or liking. These findings indicate that taste associates with BMI in chronic smokers through liking of fats/carbohydrates. Future research should determine if vaping sweet e-juice could improve diet quality and adiposity for smokers.
-
7.
Examining Associations between Perinatal and Postnatal Risk Factors for Childhood Obesity Using Sibling Comparisons.
Hawkins, SS, Baum, CF, Rifas-Shiman, SL, Oken, E, Taveras, EM
Childhood obesity (Print). 2019;(4):254-261
-
-
Free full text
-
Abstract
Background: One of the major criticisms of observational studies examining risk factors for childhood obesity is unmeasured confounding. We examined the associations between breastfeeding initiation, cesarean delivery, prenatal smoking, and gestational diabetes mellitus (GDM) with childhood obesity using both a traditional observational approach and a sibling-pair design with family fixed effects. Methods: We used data from the Linked the Collecting Electronic Nutrition Trajectory Data Using e-Records of Youth (CENTURY) Study, a clinical database created through the linkage of well-child visits with children's birth certificates, with obesity measured at 2 (N = 55,058) and 5 (N = 43,894) years of age. We conducted three sets of regression models: (1) full sample to examine the adjusted association between each risk factor and obesity with clustering by family; (2) rerun only among siblings with clustering by family; and (3) fixed effects analysis among siblings. Results: Across risk factors, 30%-39% of children had siblings. In the full sample, breastfeeding initiation was associated with a lower BMI z-score, while cesarean delivery and smoking during pregnancy were associated with a higher BMI z-score. Effect sizes were consistent in models with siblings only. However, in the fixed effects models, the coefficients attenuated and were no longer significant for each of these risk factors. We found no association between GDM and child BMI z-score in any of the models. Results were consistent for childhood obesity as a dichotomous measure and at 5 years of age. Conclusions: Our findings suggest that unmeasured genetic, environmental, and familial factors are likely confounding associations between breastfeeding, cesarean delivery, prenatal smoking, and GDM with childhood obesity in observational studies.
-
8.
Increased eryptosis in smokers is associated with the antioxidant status and C-reactive protein levels.
Attanzio, A, Frazzitta, A, Vasto, S, Tesoriere, L, Pintaudi, AM, Livrea, MA, Cilla, A, Allegra, M
Toxicology. 2019;:43-48
Abstract
Cigarette smoking has been linked with oxidative stress and inflammation. In turn, eryptosis, the suicidal erythrocyte death similar to apoptosis that can be triggered by oxidative stress, has been associated with chronic inflammatory diseases including atherosclerosis. However, the link between smoking and eryptosis has not been explored so far. The aim of the present study was to determine the level of eryptotic erythrocytes in healthy male smokers (n = 21) compared to non-smokers (n = 21) and assess its relationship with systemic inflammation (CRP) as well as with antioxidant defense (GSH) and their resistance to ex-vivo induced hemolysis. Smoking caused an increase in phosphatidylserine translocation outside the erythrocyte membrane (hallmark of eryptosis), significantly correlated to the plasma level of CRP (r = 0.546) and GSH concentration in erythrocytes (r=-0.475). With respect to non-smokers, smokers show a marginal increase of total leucocytes and erythrocyte volume, no modifications of the RBC resistance to oxidative stress-induced hemolysis and hematological and lipid parameters unvaried. We conclude that the inflammatory status (high CRP levels) and RBC oxidative stress (low GSH levels) caused by cigarette smoking are associated with an increase of eryptotic erythrocytes, a yet unknown relationship potentially involved with atherosclerosis and cardiovascular disease in smokers.
-
9.
Tuberculosis and other chronic morbidity profile of sewage workers of Delhi.
Chandra, K, Arora, VK
The Indian journal of tuberculosis. 2019;(1):144-149
Abstract
BACKGROUND Sewage management is hazardous due to chronic exposure to chemical gases, bioaerosols and micro-organisms through inhalation; accidental oral intake and penetration through skin or mucous membranes through injuries or breech in personal protective equipment. While there has been some research on isolated infections and multisystem symptom profiling of sewage workers, there is little research on the burden of chronic illnesses like Tuberculosis and Non Communicable Diseases (NCDs). METHODS A cross sectional observational study was conducted on chronic comorbidity profile of sewage workers with more than five years of occupational experience and employed in three contiguous districts of NCT of Delhi. RESULTS The study sample consisted of 104 sewage workers with mean age of 50.71 (±8.43) years, an average of 7.35 (±3.75) years of formal education and an average occupational exposure to sewage work of 21.28 (±10.54) years. 21.15% sewage workers had Tuberculosis and 92.31% had at least one of the chronic respiratory diseases (COPD, Asthma or ACOS). 85.6% of participants were smokers. The most common NCD was Hypertension (67.3%) followed by Dyslipidaemia (50%) and Diabetes Mellitus (43.3%). There was clustering of NCDs with 53.85% subjects having three or more chronic disorders. Less than 5% of study participants were free from all the investigated chronic diseases. CONCLUSION The sewage workers have an adverse chronic morbidity profile for both Tuberculosis and NCDs. There is an urgent need for epidemiological research and targeted screening and public health intervention for Tuberculosis and other NCDs in sewage workers as an occupational group.
-
10.
Association between smoking and serum uric acid in Korean population: Data from the seventh Korea national health and nutrition examination survey 2016.
Kim, SK, Choe, JY
Medicine. 2019;(7):e14507
-
-
Free full text
-
Abstract
The aim of this study was to identify any association between serum uric acid and smoking status using data from the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-1) 2016 of the Korean population.This study used a cross-sectional design and analyzed 5609 subjects aged ≥ 19 years among 8150 participants enrolled in the KNHANES VII-1 2016. Smoking status was classified into current smokers, never smokers, and ex-smokers. Hyperuricemia was defined as > 7.0 mg/dL for men and > 6.0 mg/dL of serum uric acid for women. Association between smoking and serum uric acid/hyperuricemia was assessed by Pearson's or Spearman's correlation analyses and multivariate logistic regression analysis showing odds ratio (OR) and 95% confidence interval (CI).A significant difference in serum uric acid according to smoking status was identified in female (P < .001) but not in male subjects (P = .069). In female subjects, current smokers and ex-smokers showed higher serum uric acid than never smokers (P < 0.001 of both). Serum uric acid was associated with smoking status in female but not male subjects (r = 0.057, P = .001 and r = 0.025, P = .220, respectively). There was significant difference of smoking status between female subjects with and without hyperuricemia (P < .001). Current smokers had 2.7 times higher likely to have hyperuricemia in female, compared to never smokers (OR 2.674, 95% CI 1.578 - 4.531, P < .001).This study revealed that smoking was closely associated with serum uric acid in female but not in male subjects in Korean population.