Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional en estudiantes universitarios: adaptación y validación / Resistance to Peer Pressure for Cigarette Smoking in University Students: Scale Adaptation and Validation / Escala de resistência à pressão dos pares para o consumo de cigarros em universitários: adaptação e validação

Introducción: la influencia o presión de pares que fuman es uno de los principales factores por los que los estudiantes universitarios inician el consumo del cigarro convencional; sin embargo, no se ha encontrado un instrumento que evalúe este fenómeno. Por lo tanto, el objetivo fue adaptar y validar la Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional. Materiales y métodos: participaron 237 estudiantes universitarios del estado de Nuevo León (México), de 18 a 24 años. Se realizó análisis factorial exploratorio, análisis de confiabilidad, correlación de Spearman y prueba de Kruskal-Wallis. Resultados: el 63.3 % de los estudiantes fueron mujeres y la media de edad fue de 19.66 años. Se identificaron dos factores con un total de 13 ítems. Se obtuvo un alfa de Cronbach de 0.81. Se encontraron diferencias estadísticamente significativas entre los distintos tipos de consumidores de cigarro convencional y los puntajes de la escala de resistencia a la presión de pares (H[4] = 23.85; p < 0.001). Conclusiones: la nueva versión de la Escala de Resistencia a la Presión de Pares para el Consumo de Cigarro Convencional evidenció adecuadas propiedades psicométricas para evaluar la presión que ejercen los pares en estudiantes universitarios para el consumo de cigarro convencional

Introduction: Influence or peer pressure is one of the leading factors in developing cigarette smoking habits in university students; however, no effective strategy to assess this phenomenon has been developed yet. This study aimed to adapt and validate the peer pressure resistance scale to conventional cigarette consumption. Materials and methods: A total of 237 university students from the Nuevo León State (Mexico), aged 18­24 years, were enrolled. Exploratory factor and reliability analyses, the Spearman correlation, and the Kruskal­Wallis test were performed. Results: 63.3% of the students were women, and the mean age was 19.66 years. The exploratory analysis extracted two factors with a total of 13 items. A Cronbach's Alpha of 0.81 was found. Statistically significant differences were found between the different types of conventional cigarette users and peer pressure resistance scale scores [H(4) = 23.85; p < .001] were found. Conclusions: The peer pressure resistance scale showed appropriate psychometric properties for assessing the peer pressure to smoke conventional cigarettes in university students.

Introdução: a influência ou pressão dos pares que fumam é um dos principais fatores que levam os universitários a começarem a fumar cigarros convencionais, porém não foi encontrado nenhum instrumento para avaliar esse fenômeno. Portanto, o objetivo do trabalho foi adaptar e validar a escala de resistência à pressão dos pares para o consumo de cigarro convencional. Materiais e métodos: participaram 237 estudantes universitários do estado de Nuevo León, México, de 18 a 24 anos. Foram realizadas análise fatorial exploratória, análise de confiabilidade, correlação de Spearman e teste de Kruskal-Wallis. Resultados: 63,3% dos alunos eram mulheres e a média de idade foi de 19,66 anos. Dois fatores foram identificados com um total de 13 itens. Obteve-se um alfa de Cronbach de 0,81. Diferenças estatisticamente significativas foram encontradas entre os diferentes tipos de usuários de cigarros convencionais e as pontuações na escala de resistência à pressão dos pares (H(4) = 23,85; p < 0,001). Conclusões: a nova versão da escala de resistência à pressão dos pares para o consumo de cigarros convencionais apresentou propriedades psicométricas adequadas para avaliar a pressão exercida pelos pares sobre os universitários para o consumo de cigarros convencionais

Effects of Exposure to Incense Smoke Associated with Impaired Lung Function and Respiratory Disease: A Systematic Review

The community uses incense (bakhour) through ceremonies, traditional health practices, and aromatherapy. Nevertheless, evidence from experiments and studies of populations suggests that a habit of burning incense makes the lungs work less well. The study investigated the relationship between exposure to incense smoke and impaired lung function and respiratory diseases. Data tracing was carried out systematically following PRISMA guidelines from January to April 2022 and registered in the PROSPERO database. The articles select-ed in this review were cross-sectional, cohort, observational, and experimental studies based on the criteria: (1) animals or humans exposed to incense smoke; (2) exposure to incense smoke which was carried out in-doors or outdoors; (3) the selected articles which were included in the original type of article; (4) the publica-tion year between 2016-2021 and the selected articles entered into reputable journals (Scopus and Web of Science). JBI guidelines and synthesis guidelines without meta-analysis (SWiM) to determine the level of evi-dence and minimize bias and interpretation of results. This study describes respiratory symptoms or diseases, home use of incense, and lung function measurement. Six articles were included; 6 (100%) reported using in-cense indoors, and 5 (83%) reported using incense outside the home. Respiratory symptoms and diseases caused by exposure to incense sticks are 5 (83%) shortness of breath, 6 (100%) wheezing, asthma, and in-flammation of the lungs, 2 (33%) chronic obstructive pulmonary disease, and 4 (67%) allergic rhinitis. In-cense smoke particles decrease lung function based on FVC, FEV, PEFR, and FEF values of 25-75%. The results indicate that smoking incense adversely affects lung function and leads to respiratory diseases. The communi-ty and related parties can minimize and conduct education and prevention related to simultaneous incense exposure in the community to reduce the burden of diseases and disorders due to respiratory incense smoke in areas that use it daily.

Existence of SARS-Cov-2 in the Peritoneal Fluid / Existência de SARS-Cov-2 no líquido peritoneal

Abstract Objective To determine the existence of SARS-CoV-2 in the peritoneal fluid to assess the risk of exposure through surgical smoke and aerosolization threatening healthcare workers during abdominal surgery. Background SARS-CoV-2 is a respiratory virus and possible ways of viral transmission are respiratory droplets, close contact, and fecal-oral route. Surgeries pose risk for healthcare workers due to the close contact with patients. Aerosolized particles may be inhaled via the leaked CO2 during laparoscopic procedures and surgical smoke produced by electrocautery. Methods All the data of 8 patients, who were tested positive for COVID-19, were collected between August 31, 2020 and April 30, 2021. Recorded clinicopathologic data included age, symptoms, radiological and laboratory findings, antiviral treatment before surgery, type of surgery and existence of the virus in the peritoneal fluid. Nasopharyngeal swab RT-PCR was used for the diagnosis. COVID-19 existence in the peritoneal fluid was determined by RT-PCR test as well. Results All 8 COVID-19 positive patients were pregnant, and surgeries were cesarean sections. 1 of the 8 patients was febrile during surgery. Also only 1 patient had pulmonary radiological findings specifically indicating COVID-19 infection. Laboratory findings were as follows: 4 of 8 had lymphopenia and all had elevated D-dimer levels. Peritoneal and amniotic fluid samples of all patients were negative for SARS-CoV-2. Conclusion SARS-CoV-2 exposure due to aerosolization or surgical fumes does not seem to be likely, provided the necessary precautions are taken.

Resumo Objetivo Determinar a existência de SARS-CoV-2 no fluido peritoneal para avaliar o risco de exposição através da fumaça cirúrgica e aerossolização que ameaçam os profissionais de saúde durante a cirurgia abdominal. Contexto O SARS-CoV-2 é um vírus respiratório e as possíveis formas de transmissão viral são gotículas respiratórias, contato próximo e rota fecal-oral. As cirurgias representam risco para os profissionais de saúde devido ao contato próximo com os pacientes. As partículas aerossolizadas podem ser inaladas através do CO2 vazado durante os procedimentos laparoscópicos e a fumaça cirúrgica produzida pela eletrocauterização. Métodos Todos os dados de 8 pacientes, que foram testados positivos para COVID-19, foram coletados entre 31 de agosto de 2020 e 30 de abril de 2021. Dados clinicopatológicos registrados incluíam idade, sintomas, achados radiológicos e laboratoriais, tratamento antiviral antes da cirurgia, tipo de cirurgia e existência do vírus no fluido peritoneal. O diagnóstico foi feito através do swab nasofaríngeo RT-PCR. A existência de COVID-19 no fluido peritoneal foi determinada pelo teste de RT-PCR também. Resultados Todas as 8 pacientes positivas para COVID-19 estavam grávidas, e as cirurgias eram cesarianas. 1 das 8 pacientes estava com febre durante a cirurgia. Também apenas 1 paciente tinha achados radiológicos pulmonares especificamente indicando infecção por COVID-19. Os achados laboratoriais foram os seguintes: 4 de 8 tinham linfopenia e todas apresentavam níveis elevados de D-dímero. Amostras de fluido peritoneal e líquido amniótico de todas as pacientes foram negativas para SARS-CoV-2. Conclusão A exposição ao SARS-CoV-2 devido à aerossolização ou fumaças cirúrgicas não parece ser provável, desde que sejam tomadas as precauções necessárias.

Calculating the risk of fire in community pharmacies. Gustav-Purt method

Introduction: Fire is a chemical reaction of combustion, based on the strongly exothermic "oxidation-reduction" phenomena that produce a big detachment of light and heat.Its effects are, generally, harmful, producing personal injuries due to smoke, toxic gasses, and extremely hot temperatures; and damaged materials and buildings. Fire is produced when the three following factors simultaneously coexist in time and space: Fuel; a comburent agent, usually the oxygen in the air; and heat, which contributes the necessary energy to actuate the reaction. Besides, it is necessary, for the production of the flame, the existence of a chain reaction. Method: The Gustav-Purt Method, which aim is to calculate the potential risk in a determinate building and of the means to fight fires should be implemented. Results: After the calculation of the distinct factors, the conclusion that the risk of fire in a pharmacy is high is reached. Discussion: Therefore, strict inspection by sanitary authorities to avert the danger of the fire is necessary.

Introducción: El fuego es una reacción química de combustión, basado en los fenómenos de oxidación-reducción fuertemente exotérmica que se manifiesta por desprender gran cantidad de luz y calor. Sus efectos son generalmente perjudiciales, produciendo daños personales por el humo, gases tóxicos y temperaturas extremas, causando grandes daños a instalaciones y bienes. El fuego se produce cuándo existen simultáneamente en el tiempo y en un mismo lugar los tres factores siguientes: Combustible, Agente Comburente, normalmente el oxígeno del aire y Calor, que contribuye con la energía necesaria para activar la reacción. Además, es necesario, para la producción de la llama, la existencia de reacciones de cadena. Método: El método de Gustav Purt, tiene por objetivo calcular el riesgo potencial existente en un edificio determinado y qué medios de lucha contra incendios son necesarios implementar. Resultados: Tras el cálculo de los distintos factores, se llega a la conclusión que el riesgo de incendio en una farmacia es elevado. Discusión: Por consiguiente, es necesario la estricta inspección de las autoridades sanitarias de la Administración para evitar el peligro del fuego.

Challenges of Second-hand Smoke: Are We Asking the Right Questions?

Second-hand tobacco smoke as defined by WHO is the smoke emitted by a smoker or released from a burnt cigarette or any tobacco product. It is highly prevalent all over the globe but its serious health implications are often neglected by the public and the scientific community alike. Second-hand smoke has everlasting impact on all the body’s major organs, especially among the vulnerable population of children, pregnant ladies, people with chronic diseases and senior citizens. Although India started its war against this menace earlier than other counties, all its efforts remain bootless as its approach and implementation have a wide range of lacunae. This review aims to give a big picture of second-hand smoke, highlighting its pathophysiological changes in the body, socioeconomic impact, various strategies, and the gap that prevents these strategies from finding a favorable result in India. It becomes all the more important to reduce its impact owing to the increase in prevalence among youth reducing their vitality, derailing the society and the nation. It is recommended that the health authorities approach this health problem with utmost seriousness as a laid-back approach could welcome this silent killer’s known and unknown repercussions

Auditory and visual reaction times among children of chronic smokers and non-smokers: A comparative study

Background: Tobacco consumption is the primary cause for cancers in men and women in India. Second hand smoking also has toxins in the similar concentration affecting children in particular leading to many health-related conditions including neurological disorders. The present study was done with the hypothesis that passive smoking in children causes delay in their reaction time when compared to the children of non-smokers which indicates cognition deficit. Aims and Objectives: The objectives of the study are as follows: (1) Comparison of the visual simple reaction time (VSRT) and visual choice reaction time (VCRT) among the children of chronic smokers and non-smokers and (2) to compare the auditory simple reaction time (ASRT) and auditory choice reaction time (ACRT) among the children of chronic smokers and non-smokers. Materials and Methods: This was a cross-sectional study. After obtaining necessary permission and consents, 30 children aged between 8 and 14 years with exposure to passive smoking as cases and 30 children of non-smoking parents as controls were included in the study. Audio-visual reaction timer was used. Results: Student’s “t” test was used for analysis. Mean value of VSRT showed 248.3 ms among controls and 277.7 ms in cases; VCRT among controls was 277.4 ms and 309.1 ms in cases (P < 0.05). Means of ASRT in controls was 213 ms and 250.4 in cases; ACRT in controls was 244 ms and among cases was 272.4 ms (P < 0.05). Conclusion: Significant delay in VSRT, VCRT, and ASRT was seen among the children exposed to tobacco smoke. ACRT also showed delayed response but not statistically significant.

Osseointegration of implants with superhydrophilic surfaces in rats with high serum levels of nicotine

Abstract This study aimed to evaluate the effect of nicotine administration on the osseointegration of a superhydrophilic implants surface on rat tibiae. Thirty-two rats were used and divided into 2 groups according to the administration or not of nicotine: HH - Installation of implants with superhydrophilic surfaces in healthy animals; and HN - Installation of implants with superhydrophilic surfaces in animals subjected to nicotine administration. The animals were euthanized 15 and 45 days after implant placement (n = 8). Osseointegration was assessed by means of biomechanical analyses (removal torque), microcomputed tomography (volume of bone around the implants- %BV/TV), and histomorphometry (bone-implant contact -%BIC and the bone area between implant threads -%BBT). The animals subject to the nicotine administration presented lower removal torque than the control animals at the 45-day period (21.88 ± 2.80 Ncm vs. 17.88 ± 2.10 Ncm). The implants placed in the control rats presented higher %BIC (54.26 ± 6.59% vs. 39.25 ± 4.46%) and %BBT (50.57 ± 5.28% vs. 32.25 ± 5.24%) than the implants placed in nicotine animals at 15-day period. The nicotine administration reduces the osseointegration at 15 days, however, the superhydrophilic surface equalized the osseointegration in nicotine-exposed animals compared with healthy animals after 45 days of implant placement.

Resumo O objetivo deste estudo foi avaliar o efeito da administração de nicotina na osseointegração de implantes com superfície modificada por jateamento de oxidos e ataque ácido instalados em tíbia de ratos. Foram utilizados 32 ratos que foram divididos em 2 grupos de acordo com a administração ou não de nicotina: HH - Instalação de implantes com superfícies superhidrofílicas em animais sadios; e HN - Instalação de implantes com superfícies superhidrofílicas em animais submetidos à administração de nicotina. Os animais foram eutanasiados 15 e 45 dias após a colocação do implante (n = 8). A osseointegração foi avaliada por meio de análises biomecânicas (torque de remoção), microtomografia (volume de osso ao redor dos implantes - %BV/TV) e histomorfometrica (contato osso-implante -%BIC e área óssea entre roscas do implante -%BBT). Os animais submetidos à administração de nicotina apresentaram menor torque de remoção do que os animais controle no período de 45 dias (21,88 ± 2,80 Ncm vs. 17,88 ± 2,10 Ncm). Os implantes colocados nos ratos controle apresentaram maiores %BIC (54,26 ± 6,59% vs. 39,25 ± 4,46%) e %BBT (50,57 ± 5,28% vs. 32,25 ± 5,24%) do que os implantes colocados nos animais submetidos a administração de nicotina no período de 15 dias. A administração de nicotina prejudicou a osseointegração no período de 15 dias. Entretanto, a superfície superhidrofílica equalizou a osseointegração em animais expostos à nicotina em comparação com animais saudáveis após 45 dias da colocação do implante.

Associação entre doenças respiratórias e fumo passivo domiciliar em crianças de 6 a 10 anos atendidas pela atenção primária em Araguaína/TO / Association between respiratory diseases and passive smoking at home in children from the age of 6 to 10 years old assisted by the primary healthcare in Araguaína, Tocantins / Asociación entre enfermedades respiratorias y tabaco pasivo en hogares con niños entre 6 y 10 años atendidos por atención primaria en Araguaína-TO

Introdução: O tabagismo é definido como a dependência física e psicológica de tabaco, e o fumo passivo consiste na inalação da fumaça de derivados do tabaco por não fumantes. As crianças são especialmente vulneráveis à exposição à fumaça do tabaco. Objetivo: Identificar a associação entre fumo passivo domiciliar e morbidade respiratória em pré-escolares de seis a dez anos, por meio de coleta de dados na Atenção Primária à Saúde em Araguaína/TO. Métodos: Estudo de perfil descritivo, com corte transversal de caráter quantitativo, conduzido em três unidades básicas de saúde. Foi determinada uma amostra de 72 entrevistados, selecionados de forma aleatória em meio às unidades básicas. Os resultados foram colhidos de questionários respondidos por familiares ou responsáveis das crianças. Resultados: O teste de Odds Ratio (OR) obteve o resultado de 3,06, com intervalo de confiança de 95% ­ IC95% 1,16 ­ 8,11 e p<0,05, revelando assim a existência de correlação entre o desenvolvimento de doenças respiratórias e o fumo passivo domiciliar em crianças de seis a dez anos. A prevalência do tabagismo passivo domiciliar foi de 44,4%, expondo à fumaça do cigarro as crianças, que manifestam sintomas como tosse seca, chiado no peito, respiração rápida, dor e secreção no ouvido. Conclusões: Foi comprovada a associação entre tabagismo passivo domiciliar e morbidade respiratória entre crianças de seis a dez anos. Não se obteve a conexão entre o tabagismo passivo e o aumento do número de internações por causa respiratória.

Introduction: smoking is defined as the physical and psychological dependence of tobacco, passive smoke consists of inhaling the smoke and tobacco derivatives by non-smokers. Children are especially vulnerable to exposure to tobacco smoke. Objective: identify the association between passive smoking at home and respiratory tract morbidity in pre-school children from the age of 6 to 10 years old, utilizing data gathering in Primary Healthcare units from Araguaína ­ TO. Methods: cross-sectional descriptive research with quantitative character conducted within three Basic Healthcare Units. A sample comprised of 72 interviewed subjects was determined, selected in random fashion at the healthcare units. Results: The Odds Ratio test obtained the result of OR 3.06, with 95%CI 1.16­8.11 and p<0.05, thus evidencing the existence of a correlation between the development of respiratory diseases and the secondhand smoke in children aged 6 to 10 years. The prevalence of passive smoking at home was 44,4%, exposing, this way, the children to cigarette smoke, leading to the manifestation of symptoms such as dry cough, wheezing, fast breathing, pain, and auricular secretions. Conclusions: the association between passive smoking at home and respiratory tract morbidity in children from the age of 6 to 10 years old was proved. No connection between passive smoking and the increase of respiratory tract-related hospitalizations was obtained.

Introducción: El tabaquismo se define como la dependencia física y psicológica al tabaco, el humo de segunda mano consiste en la inhalación del humo del tabaco por parte de los no fumadores. Los niños son especialmente vulnerables a la exposición al humo del tabaco. Objetivo: Identificar la asociación entre el humo de segunda mano en el hogar y la morbilidad respiratoria en niños preescolares de 6 a 10 años, a través de la recolección de datos en la Atención Primaria de Salud en Araguaína-TO. Métodos: estudio descriptivo de perfil, de corte transversal cuantitativo, realizado en tres unidades básicas de salud. Se determinó una muestra de 72 entrevistados, seleccionados aleatoriamente entre las unidades básicas. Resultados: la prueba de Odds Ratio obtuvo el resultado de OR 3.06, con IC95% 1,16­8,11 y p<0,05, evidenciando así la existencia de una correlación entre el desarrollo de enfermedades respiratorias y el humo de segunda mano en niños de 6 a 10 años. La prevalencia de tabaquismo pasivo en el hogar fue del 44,4%, exponiendo así a los niños al humo del cigarrillo, manifestando síntomas como tos seca, sibilancias, respiración acelerada, dolor y secreción en el oído. Conclusiones: se comprobó la asociación entre el tabaquismo pasivo en el hogar y la morbilidad respiratoria en niños de 6 a 10 años. No hubo relación entre el tabaquismo pasivo y el aumento del número de hospitalizaciones por causas respiratorias.

Effect of Euphorbia helioscopia Aqueous Extract on Chronic Obstructive Pulmonary Disease and Precancerous Lesion-associated Proteins of Lung Tissues in Mice Induced by Cigarette Smoke / 中国实验方剂学杂志

ObjectiveTo investigate the protective effect and mechanism of Euphorbia helioscopia aqueous extract （EHE） on mice with chronic obstructive pulmonary disease （COPD） and its influence on precancerous lesion-associated proteins in lung tissues induced by cigarette smoke （CS）. MethodThe COPD model was induced by CS in 60 mice and the model mice were randomly divided into control group， model group， positive drug group （dexamethasone， 2 mg·kg-1）， and low-， medium-， and high-dose EHE groups （1.875， 3.75， 7.5 g·kg-1）. The high-performance liquid chromatography （HPLC） method was used to determine the related components in EHE. The changes in end-expiratory pause （EEP）， airway resistance （Penh）， expiratory flow at 50% vital capacity （EF50）， and other pulmonary function indexes were detected by the spirometer. The levels of inflammatory factors， such as interleukin （IL）-2， IL-5， IL-18， IL-17A， and IL-27 in bronchoalveolar lavage fluid （BALF） of mice were detected by high-throughput liquid protein chip technology. Hematoxylin-eosin （HE） staining was used to detect the pathological changes in lung tissues in mice. The content of malondialdehyde （MDA）， myeloperoxidase （MPO）， and glutathione peroxidase （GSH-Px） in lung tissues was determined by the colorimetric method. The mRNA relative expression of tumor necrosis factor-α （TNF-α）， transforming growth factor-β （TGF-β）， matrix metalloproteinase-2 （MMP-2）， matrix metalloproteinase-9 （MMP-9）， and matrix metalloproteinase-12 （MMP-12） was detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. Immunohistochemistry （IHC） was used to detect the expression of tumor protein （P53） and cell proliferation-associated antigen （Ki67） in lung tissues， and Western blot was used to detect the relative expression of tumor suppressor protein （P16）， DNA （cytosine-5）-methyltransferase 1 （DNMT1）， and fragile histidine triad （FHIT） in lung tissues. ResultThe results showed that the main compounds in EHE included phenols （gallic acid and protocatechuic acid） and flavonoids （such as hyperoside， rutin， myricetin， naringenin， quercetin， luteolin， kaempferol， and licorice chalcone A）， among which gallic acid and rutin were the highest in content. Compared with normal group， model group showed increased levels of EEP， EF50， and Penh （P<0.05）， and showed increased MDA and MPO levels （P<0.01） and decreased GSH-Px （P<0.01）， and the model group displayed increased levels of IL-2， IL-5， IL-18， IL-17A， IL-27， TNF-α， TGF-β， MMP-2， MMP-9， and MMP-12 （P<0.05）. And the model group exhibited up-regulated expression of P53， Ki67， and FHIT in lung tissues （P<0.01） and down-regulated expression of DNMT1 and P16 （P<0.01）. Compared with model group， the EHE groups showed decreased EEP and EF50 levels （P<0.05）. The pathological injury of lung tissues in mice of the model group was observed under HE staining， and the pathological injury of basal cell hyperplasia of lung tissues was gradually improved after treatment with EHE. The EHE groups showed reduced levels of MDA and MPO （P<0.01） and increased GSH-Px （P<0.01）. The EHE groups displayed decreased levels of IL-2， IL-5， IL-18， IL-17A， IL-27， TNF-α， TGF-β， MMP-2， MMP-9， and MMP-12 （P<0.05）. And the EHE groups showed down-regulated Ki67 and FHIT in lung tissues （P<0.05） and up-regulated expression of P53 and DNMT1 （P<0.05）. ConclusionEHE can protect mice from COPD and inhibit precancerous lesions， and the mechanism may be related to the inhibition of inflammation and oxidative stress response， regulation of protease and antiprotease imbalance， and regulation of epithelial cell growth.

Cigarette Smoke Induces Gefitinib Resistance in NSCLC Cells via ROS/Sirt3/SOD2 Pathway / 中国肺癌杂志

BACKGROUND@#Epidermal growth factor receptor (EGFR) gene mutations are the most common driver mutations in non-small cell lung cancer (NSCLC). To prolong the survival of the patients, EGFR tyrosine kinase inhibitors (TKIs) resistance in NSCLC is a major challenge that needs to be addressed urgently, and this study focuses on investigating the mechanism of cigarette smoke (CS) induced Gefitinib resistance in NSCLC.@*METHODS@#PC-9 and A549 cells were cultured in vitro and treated with 1 µmol/L Gefitinib for 4 h and 10% cigarette smoke extract (CSE) for 48 h. Western blot was used to detect Sirtuin 3 (Sirt3) and superoxide dismutase 2 (SOD2) protein expressions; DCFH-DA probe was used to detect intracellular reactive oxygen species (ROS); CCK-8 kit was used to detect cell activity, and EdU was used to detect cell proliferation ability. Sirt3 overexpression plasmid (OV-Sirt3) was transfected in PC-9 and A549 cells and treated with 1 µmol/L Gefitinib for 4 h and 10% CSE for 48 h after N-acetylcysteine (NAC) action. The expressions of Sirt3 and SOD2 were detected by Western blot; the ROS level in the cells was detected by DCFH-DA probe, and the cell activity was detected by CCK-8.@*RESULTS@#CSE induced an increase in the 50% inhibitory concentration (IC50) of both PC-9 and A549 cells to Gefitinib (P<0.01) and enhanced the proliferation of PC-9 and A549 cells, suggesting that CS induced Gefitinib resistance in NSCLC. ROS was involved in CSE-induced Gefitinib resistance (P<0.05). CSE induced low expressions of Sirt3 and SOD2 (P<0.01), and Sirt3/SOD2 was associated with poor prognosis in lung cancer patients (P<0.05). OV-Sirt3 in PC-9 and A549 cells reversed CSE-induced Gefitinib resistance (P<0.05) and significantly reduced ROS production. NAC reversed CSE-induced Gefitinib resistance in PC-9 and A549 cells (P<0.05).@*CONCLUSIONS@#The ROS/Sirt3/SOD2 pathway is involved in CS-induced Gefitinib resistance in NSCLC.

The Association between Exposure to Second-Hand Smoke and Disease in the Chinese Population: A Systematic Review and Meta-Analysis / 生物医学与环境科学（英文）

OBJECTIVE@#To analyze the association between exposure to second-hand smoke (SHS) and 23 diseases, categorized into four classifications, among the Chinese population.@*METHODS@#We searched the literature up to June 30, 2021, and eligible studies were identified according to the PECOS format: Participants and Competitors (Chinese population), Exposure (SHS), Outcomes (Disease or Death), and Study design (Case-control or Cohort).@*RESULTS@#In total, 53 studies were selected. The odds ratio (OR) for all types of cancer was 1.79 (1.56-2.05), and for individual cancers was 1.92 (1.42-2.59) for lung cancer, 1.57 (1.40-1.76) for breast cancer, 1.52 (1.12-2.05) for bladder cancer, and 1.37 (1.08-1.73) for liver cancer. The OR for circulatory system diseases was 1.92 (1.29-2.85), with a value of 2.29 (1.26-4.159) for stroke. The OR of respiratory system diseases was 1.76 (1.13-2.74), with a value of 1.82 (1.07-3.11) for childhood asthma. The original ORs were also shown for other diseases. Subgroup analyses were performed for lung and breast cancer. The ORs varied according to time period and were significant during exposure in the household; For lung cancer, the OR was significant in women.@*CONCLUSION@#The effect of SHS exposure in China was similar to that in Western countries, but its definition and characterization require further clarification. Studies on the association between SHS exposure and certain diseases with high incidence rates are insufficient.

High COVID-19 morbidity and mortality risk among smoked drug users in Brazil

Abstract In much of the West, including Brazil, drug use has increased since social distancing began in response to the pandemic. Use of smoked and modified drugs, and their impacts on health, may contribute to aggravate the effects of the pandemic. However, studies on the relationship between use of smoked drugs and the new coronavirus are still scarce and have not received enough attention in global health recommendations. This paper aims to briefly review the relationship between use of smoked drugs and acute respiratory syndrome coronavirus 2 [SARS-CoV-2]. Recent studies also suggest that drug consumption increases the risk of contamination by SARS-CoV-2 and leads to worse prognosis, particularly consumption of drugs that affect lung function. Use of smoked drugs, especially tobacco, is strongly associated with lung diseases that are risk factors for contamination by SARS-CoV-2. It is essential to develop strategies based on specific characteristics of drug users and for mental health professionals to be included in strategic teams. It is also necessary to invest in information campaigns regarding risks and prevention of harm caused by smoked drugs as well as to design strategies that facilitate access to psychosocial treatment during the pandemic.

Impacto do uso de produtos de tabaco aquecido (HTP) na qualidade do ar em ambientes fechados / Impact of the use of heated tobacco products (HTP) on indoor air quality

Resumo Introdução: Os produtos de tabaco aquecido (HTP) têm ganhado popularidade nos últimos anos. No entanto, tem-se questionado sobre os danos que provocam na saúde, em especial aos impactos decorrentes da exposição a suas emissões. O objetivo deste estudo é avaliar o impacto do uso de HTPs em ambientes internos/fechados na qualidade do ar e/ou na saúde das pessoas expostas passivamente, por meio de uma revisão sistemática de estudos originais. Métodos: Realizou-se busca bibliográfica nas bases de dados Medical Literature Analysis and Retrieval Sistem (MEDLINE), Excerpta Medica Database (EMBASE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e SCOPUS. As etapas de seleção, extração dos dados e avaliação do risco de viés dos estudos foi realizada em dupla, de forma independente, e as divergências foram resolvidas por consenso. Resultados: Foram selecionados 21 estudos, incluídos nesta revisão. Os resultados indicam que os produtos de tabaco aquecido são fonte de poluição ambiental decorrente da emissão de material particulado. Conclusão: Os produtos de tabaco aquecido produzem emissões que podem expor as pessoas às substâncias tóxicas emitidas no ambiente fechado, assim como outros produtos de tabaco.

Abstract Introduction: Heated tobacco products (HTP) have gained popularity in recent years. However, questions have been raised about the damage they cause to health, especially the impacts resulting from exposure to their emissions. This study aims to evaluate the impact of the use of HTPs indoors on air quality and/or the health of passively exposed people, through a systematic review of original studies. Methods: A bibliographic search was carried out in the Medical Literature Analysis and Retrieval System (MEDLINE), Excerpta Medica Database (EMBASE), Latin American and Caribbean Health Sciences (LILACS) and SCOPUS databases. Results: 21 studies were selected and included in this review. The results indicate that heated tobacco products are a source of environmental pollution due to the emission of particulate matter. The stages of selection, data extraction and risk of bias assessment of the studies were performed in pairs, independently, and disagreements were resolved by consensus. Conclusion: Heated tobacco products produce emissions that can expose people to toxic substances emitted indoors, just like other tobacco products.

HeLP: Development of occupational protection mask against surgical smoke / HeLP: Desarrollo de máscara de protección ocupacional contra el humo quirúrgico / HeLP: Desenvolvimento de máscara de proteção ocupacional contra a fumaça cirúrgica

ABSTRACT Objectives: to describe a technological innovation in the development of an individual, ergonomic, sustainable and effective occupational respiratory protection mask for workers exposed to surgical smoke. Methods: applied, exploratory, quantitative research, using design methods and tools: Sense Intent, Know Context, Know People, Frame Insights, Explore Concepts, Frame Solutions, Realize Offerings, in addition to the Product Development Process tools. It was developed from March 2019 to December 2021. Results: from the prototyping mold, it became possible to represent the abstract to the physical, where all the concepts created in the methodological steps were implemented and the necessary adjustments were made to create the model as a technological innovation, which will have the concept for product commercialization. Conclusions: a mask for protection against surgical smoke (HeLP) was developed, from the design step to the prototype development, being a technological innovation.

RESUMEN Objetivos: describir una innovación tecnológica en el desarrollo de una máscara de protección respiratoria ocupacional individual, ergonómica, sostenible y eficaz para trabajadores expuestos al humo quirúrgico. Métodos: investigación exploratoria aplicada con un enfoque cuantitativo, utilizando métodos y herramientas de diseño: Sense Intent, Know Context, Know People, Frame Insights, Explore Concepts, Frame Solutions, Realize Offers, además de las herramientas del Proceso de Desarrollo de Producto. Fue desarrollado de marzo de 2019 a diciembre de 2021. Resultados: a partir del molde de prototipado, se logró representar lo abstracto a lo físico donde implementó los conceptos creados en las etapas metodológicas y realizó los ajustes necesarios para la creación del modelo como innovación tecnológica en el cual tendrá el concepto para la comercialización del producto. Conclusiones: se desarrolló una máscara de protección contra el humo quirúrgico (HeLP), desde la etapa de diseño hasta el desarrollo del prototipo, configurando una innovación tecnológica.

RESUMO Objetivos: descrever uma inovação tecnológica do desenvolvimento de máscara de proteção ocupacional respiratória individual, ergonômica, sustentável e eficaz para trabalhadores expostos à fumaça cirúrgica. Métodos: pesquisa aplicada, exploratória com abordagem quantitativa, empregando métodos e ferramentas em design: Sense Intent, Know Context, Know People, Frame Insights, Explore Concepts, Frame Solutions, Realize Offerings, além das ferramentas do Processo de Desenvolvimento de Produtos. Foi desenvolvida no período de março de 2019 a dezembro de 2021. Resultados: a partir do molde da prototipagem, tornou-se possível a representação do abstrato para o físico, onde implementou os conceitos criados nas etapas metodológicas e realizou os ajustes necessários para a criação do modelo como uma inovação tecnológica em que terá o conceito para a comercialização do produto. Conclusões: foi desenvolvida uma máscara de proteção contra a fumaça cirúrgica (HeLP), desde a etapa de projeto até o desenvolvimento do protótipo, configurando-se uma inovação tecnológica.

Máscara n95: percepções dos trabalhadores do centro cirúrgico / Máscara n95: percepciones de los trabajadores del centro quirúrgico / N95 mask: perceptions of surgical center workers

Objetivo: identificar as percepções dos trabalhadores do centro cirúrgico quanto ao uso da máscara N95 como Equipamento de Proteção Individual em relação à fumaça cirúrgica. Método: pesquisa qualitativa mediante entrevistas áudio-gravadas, com nove trabalhadores do Centro Cirúrgico de um hospital no norte do Paraná, Brasil. Questionou-se: qual a percepção dos trabalhadores expostos à fumaça cirúrgica em relação ao uso das máscaras N95? Foi utilizada a técnica de análise de conteúdo. Resultados: o estudo revela a fragilidade do conhecimento dos profissionais sobre a utilização da máscara N95 e sobre os riscos que estão expostos durante sua jornada de trabalho, quando expostos à fumaça cirúrgica. Assim como o desconforto pelo uso da máscara. Conclusão: sugere-se capacitação aos profissionais da saúde expostos à fumaça cirúrgica, onde possa ser esclarecido sobre o uso de Equipamento de Proteção Individual de forma correta e sua importância na prevenção para o desenvolvimento de doenças ocupacionais.

Objetivo: identificar las percepciones de los trabajadores del centro quirúrgico en cuanto al uso de la máscara N95 como Equipo de Protección Individual en relación al humo quirúrgico. Método: investigación cualitativa mediante entrevistas audio-grabadas, con nueve trabajadores del Centro Quirúrgico de un hospital en el norte de Paraná, Brasil. Se preguntó: ¿cuál es la percepción de los trabajadores expuestos al humo quirúrgico con respecto al uso de las máscaras N95? Se utilizó la técnica de análisis de contenido. Resultados: el estudio revela la fragilidad del conocimiento de los profesionales sobre la utilización de la máscara N95 y sobre los riesgos que están expuestos durante su jornada de trabajo, cuando están expuestos al humo quirúrgico. Así como la incomodidad por el uso de la máscara. Conclusión: se sugiere capacitación a los profesionales de la salud expuestos a humo quirúrgico, donde pueda ser esclarecido sobre el uso de Equipo de Protección Individual de forma correcta y su importancia en la prevención para el desarrollo de enfermedades ocupacionales.

Objective: to identify the perceptions of surgical center workers regarding the use of the N95 mask as Personal Protection Equipment in relation to surgical smoke. Method: qualitative research through audio-recorded interviews with nine workers from the Surgical Center of a hospital in northern Paraná, Brazil. It was questioned: what is the perception of workers exposed to surgical smoke in relation to the use of N95 masks? The technique of content analysis was used. Results: the study reveals the fragility of professionals' knowledge about the use of the N95 mask and the risks they are exposed during their working day, when exposed to surgical smoke. As well as discomfort from wearing the mask. Conclusion: training for health professionals exposed to surgical smoke is suggested, where it can be clarified about the use of Personal Protective Equipment correctly and its importance in preventing the development of occupational diseases.

Impact of Smoke-Free Legislation on Acute Myocardial Infarction and Subtypes of Stroke Incidence in Shenzhen, China, 2012-2016: An Interrupted Time Series Analysis / 生物医学与环境科学（英文）

OBJECTIVE@#This study assesses the impact of smoke-free legislation on the incidence rate for acute myocardial infarction (AMI) and stroke in Shenzhen.@*METHODS@#Data on ischemic ( n = 72,945) and hemorrhagic ( n = 18,659) stroke and AMI ( n = 17,431) incidence covering about 12 million people in Shenzhen from 2012 to 2016 were used. Immediate and gradual changes in incidence rates were analyzed using segmented Poisson regression.@*RESULTS@#Following the smoke-free legislation, a 9% (95% CI: 3%-15%) immediate reduction was observed in AMI incidence, especially in men (8%, 95% CI: 1%-14%) and in those aged 65 years and older (17%, 95% CI: 9%-25%). The gradual annual benefits were observed only in hemorrhagic and ischemic stroke incidence, with a 7% (95% CI: 2%-11%) and 6% (95% CI: 4%-8%) decrease per year, respectively. This health effect extended gradually to the 50-64 age group. In addition, neither the immediate nor gradual decrease in stroke and AMI incidence rates did not show statistical significance among the 35-49 age group ( P > 0.05).@*CONCLUSION@#Smoke-free legislation was enforced well in Shenzhen, which would generate good experiences for other cities to enact and enforce smoke-free laws. This study also provided more evidence of the health benefits of smoke-free laws on stroke and AMI.

Effects of moxa smoke through olfactory pathway on learning and memory ability in rapid aging mice / 中国针灸

OBJECTIVE@#To observe the effects of moxa smoke through olfactory pathway on learning and memory ability in rapid aging (SAMP8) mice, and to explore the action pathway of moxa smoke.@*METHODS@#Forty-eight six-month-old male SAMP8 mice were randomly divided into a model group, an olfactory dysfunction group, a moxa smoke group and an olfactory dysfunction + moxa smoke group, with 12 mice in each group. Twelve age-matched male SAMR1 mice were used as the blank group. The olfactory dysfunction model was induced in the olfactory dysfunction group and the olfactory dysfunction + moxa smoke group by intraperitoneal injection of 3-methylindole (3-MI) with 300 mg/kg, and the moxa smoke group and the olfactory dysfunction + moxa smoke group were intervened with moxa smoke at a concentration of 10-15 mg/m3 for 30 min per day, with a total of 6 interventions per week. After 6 weeks, the emotion and cognitive function of mice was tested by open field test and Morris water maze test, and the neuronal morphology in the CAI area of the hippocampus was observed by HE staining. The contents of neurotransmitters (glutamic acid [Glu], gamma-aminobutyric acid [GABA], dopamine [DA], and 5-hydroxytryptamine [5-HT]) in hippocampal tissue of mice were detected by ELISA.@*RESULTS@#The mice in the blank group, the model group and the moxa smoke group could find the buried food pellets within 300 s, while the mice in the olfactory dysfunction group and the olfactory dysfunction + moxa smoke group took more than 300 s to find them. Compared with the blank group, the model group had increased vertical and horizontal movements (P<0.05) and reduced central area residence time (P<0.05) in the open field test, prolonged mean escape latency on days 1-4 (P<0.05), and decreased search time, swimming distance and swimming distance ratio in the target quadrant of the Morris water maze test, and decreased GABA, DA and 5-HT contents (P<0.05, P<0.01) and increased Glu content (P<0.05) in hippocampal tissue. Compared with the model group, the olfactory dysfunction group had increased vertical movements (P<0.05), reduced central area residence time (P<0.05), and increased DA content in hippocampal tissue (P<0.05); the olfactory dysfunction + moxa smoke group had shortened mean escape latency on days 3 and 4 of the Morris water maze test (P<0.05) and increased DA content in hippocampal tissue (P<0.05); the moxa smoke group had prolonged search time in the target quadrant (P<0.05) and increased swimming distance ratio, and increased DA and 5-HT contents in hippocampal tissue (P<0.05, P<0.01) and decreased Glu content in hippocampal tissue (P<0.05). Compared with the olfactory dysfunction group, the olfactory dysfunction + moxa smoke group showed a shortened mean escape latency on day 4 of the Morris water maze test (P<0.05). Compared with the moxa smoke group, the olfactory dysfunction + moxa smoke group had a decreased 5-HT content in the hippocampus (P<0.05). Compared with the blank group, the model group showed a reduced number of neurons in the CA1 area of the hippocampus with a disordered arrangement; the olfactory dysfunction group had similar neuronal morphology in the CA1 area of the hippocampus to the model group. Compared with the model group, the moxa smoke group had an increased number of neurons in the CA1 area of the hippocampus that were more densely packed. Compared with the moxa smoke group, the olfactory dysfunction + moxa smoke group had a reduced number of neurons in the CA1 area of the hippocampus, with the extent between that of the moxa smoke group and the olfactory dysfunction group.@*CONCLUSION@#The moxa smoke could regulate the contents of neurotransmitters Glu, DA and 5-HT in hippocampal tissue through olfactory pathway to improve the learning and memory ability of SAMP8 mice, and the olfactory is not the only effective pathway.

Effect of zinc and probiotics supplementation on IL-6 and tissue neutrophil levels in rats exposed to cigarette smoke

@#Introduction: Cigarette smoke exposure can cause inflammation, inducing the release of acute phase cytokines, such as IL-6, that will then trigger the recruitment of neutrophils, which are mostly phagocytic cells. Zinc and probiotics are known to have beneficial effects against inflammation. This study was conducted to investigate the effect of zinc and probiotics supplementation on IL-6 and tissue neutrophil levels in rats exposed to cigarette smoke. Methods: In a randomised, experimental study with post-test control group design, thirty 2 to 3-month-old male Wistar rats, each weighing 180-220 g, were divided into five groups: control group without treatment (C); exposed to cigarette smoke [C (-)]; exposed to cigarette smoke and received zinc (Z); exposed to cigarette smoke and received probiotics (P); and exposed to cigarette smoke and received a combination of zinc and probiotics (ZP). Results: Mean tissue neutrophil levels in Z, P, and ZP groups were 43.43±2.01, 34.67±1.32,and 29.77±5.05 cells, respectively. There were significant differences between supplementation intake and tissue neutrophil levels in each group compared to C (-) group (p<0.05). Meanwhile, only IL-6 level in the ZP group (6.02 pg/mL) decreased significantly compared to C (-) group (10.61 pg/mL). Conclusion: These results suggest that a combination of zinc and probiotics have an anti-inflammatory effect as measured by IL-6 and neutrophil levels.

Attitude Towards Anti-smoking Measures and Its Associated Factors Among Adults in Sub-urban Area, in Kuala Terengganu, Terengganu, Malaysia

@#Introduction: General population across different countries have shown an overall support for anti-smoking measures that vary significantly by certain population parameters. However, characteristics of the public attitude in a community who has been exposed to prolonged awareness campaigns and smoke-free area legislation is unclear. Consequently, we investigate residents who reside next to Batu Buruk beach in Kuala Terengganu city which has been gazetted as a smoke-free area since 2017. Methods: The cross-sectional study involves self-administered validated questionnaires. Multiple linear regression with forward method was applied to identify significant factors associated with the attitude towards anti-smoking measures. Results: A total of 295 residents participated. Most of them were Malays (96.6%), married (64.4%), attained up to the secondary school level (45.4%) and employed (59.7%). The mean value of the total attitude scores was 181.86 (range: 70-200). Multivariate analyses revealed those having higher monthly income had a higher total attitude scores (adjusted b: 6.91, 95% CI: 2.15, 11.66), while current daily smokers had a lower total attitude scores towards anti-smoking measures than non-smokers (adjusted b: -23.30, 95% CI: -29.55, -17.05). These findings highlight comparatively stronger and more consistent support for anti-smoking measures that may vindicate high-stake investment and legislation against smoking. Conclusion: The novel evidence may also better-inform the strategy to expand the initiatives further through profiling the target population with heightened emphasis on the economic standing and prevalence of current daily smokers. Future research may adopt experimental design to establish causality relationship between predictors and outcomes revealed in this community.

Dendrobium Polysaccharides Mitigate CSE-induced Inflammatory Damage of Human Bronchial Epithelial Cells via TLR4/NF-κB Pathway / 中国实验方剂学杂志

ObjectiveTo observe the effects of Dendrobium polysaccharides on the secretion of inflammatory cytokines and Toll-like receptor 4 （TLR4）/nuclear factor （NF）-κB pathway in 16HBE cells exposed to cigarette smoke extract （CSE）. MethodThe 16HBE cells were classified into the control， CSE， and CSE+ Dendrobium polysaccharides （100， 200， 400 mg·L-1） groups. The cell-counting kit-8 （CCK-8） assay was employed to measure the cell viability， and a microscope was used to observe the cell morphology. The enzyme-linked immunosorbent assay was employed to measure the levels of interleukin （IL）-8， IL-1β， IL-4， IL-13， and transforming growth factor （TGF）-β in cell culture supernatants. Real-time PCR was carried out to determine the mRNA levels of Toll-like receptor 4 （TLR4）， nuclear factor-κB （NF-κB）， and IL-4. Western blot was employed to determine the protein levels of interleukin-4 receptor （IL-4R）， TLR4， myeloid differentiation primary response protein 88 （MyD88）， NF-κB， phosphorylated nuclear factor-κB （p-NF-κB）， and nucleoproteins nuclear factor-κB （NEs-NF-κB）. The immunofluorescence assay was employed to measure the nuclear translocation of NF-κB. ResultCompared with the control group， the CSE group showed elevated levels of IL-8， IL-1β， IL-4， IL-13， and TGF-β in the cell culture supernatants （P<0.05， P<0.01）， up-regulated expression levels of TLR4， MyD88， NF-κB， p-NF-κB， NEs-NF-κB， and IL-4 （P<0.01）， and significant nuclear translocation of NF-κB. Compared with the CSE group， Dendrobium polysaccharides increased the cell survival rate， recovered the cell activity， lowered the levels of IL-8， IL-1β， IL-4， IL-13， and TGF-β， down-regulated the expression of TLR4， MyD88， NF-κB， p-NF-κB， NEs-NF-κB， and IL-4 （P<0.05， P<0.01）， and reduced the nuclear translocation of NF-κB. ConclusionDendrobium polysaccharides showed significant protective effects on the 16HBE cells exposed to CSE by inhibiting the TLR4/NF-κB signaling pathway.