Impacto do tabagismo passivo nos sintomas da asma na infância / Impact of passive smoking on childhood asthma symptoms

Objetivo: Caracterizar a população asmática pediátrica e avaliar as repercussões do tabagismo passivo nos sintomas da asma na infância. Métodos: A amostra é composta de 384 pacientes, entre 2 e 14 anos, com diagnóstico de asma, acompanhados no ambulatório de pneumologia pediátrica do Hospital de Clínicas da Universidade Federal do Paraná. A avaliação ocorreu por meio de uma ficha de dados, aplicada em forma de entrevista aos responsáveis ou à criança participante. Resultados: A exposição ao tabagismo passivo esteve presente em 55% das crianças. Aglomeração domiciliar, menor renda familiar, menor nível de escolaridade materna e paterna foram vistos significativamente no grupo exposto. A população exposta mostrou maior frequência de asma classificada como moderada, maior uso de corticoide inalatório e maior frequência de sintomas diurnos (presentes pelo menos uma vez na semana em 60% dos pacientes). Conclusão: Foi alta a prevalência de crianças asmáticas expostas ao tabagismo passivo. Condição socioeconômica baixa foi confirmada no grupo exposto. Asma de gravidade moderada, maior uso de corticoides inalados e maior frequência de sintomas diurnos foram vistos no grupo de expostos. Este estudo confirma a necessidade imediata de adoção de medidas efetivas no combate ao tabagismo passivo como estratégia imprescindível para o controle da asma na infância.

Objective: To characterize the pediatric asthmatic population and to evaluate the repercussions of passive smoking on childhood asthma symptoms. Methods: The sample consisted of 384 patients, aged 2 to 14 years, diagnosed with asthma, who were followed up at the pediatric pulmonology outpatient clinic of the Hospital de Clínicas of the Federal University of Paraná. The evaluation was carried out by means of a data sheet, administered in the form of an interview to the legal guardians or to the participating child. Results: Exposure to passive smoking was present in 55% of the children. Household agglomeration, lower family income, and lower level of maternal and paternal schooling were seen in the exposed group. The exposed population showed a higher frequency of asthma classified as moderate, greater use of inhaled corticosteroids, and greater frequency of diurnal symptoms (present at least once a week in 60% of patients). Conclusion: The prevalence of asthmatic children exposed to passive smoking was high. Low socioeconomic condition was confirmed in the exposed group. Asthma of moderate severity, greater use of inhaled corticosteroids, and greater frequency of diurnal symptoms were seen in the exposed group. This study confirms the immediate need to adopt effective measures to combat passive smoking as an essential strategy for the control of childhood asthma.

Effect of second-hand cigarette smoke exposure on neonatal birth weight and prematurity among pregnant patients in secondary hospitals in Manila: A prospective cohort study / Philippine Journal of Obstetrics and Gynecology

Background@#Smoking is a known risk factor for many maternal and perinatal morbidities. Regrettably, as many as 69.8% of mothers, though not active smokers themselves, are exposed to second-hand cigarette smoke (SHS). No level of SHS exposure is safe. Due to the potential harmful effects to the mother and her unborn child, it is important to establish the effect of SHS exposure on neonatal outcome among our pregnant patients. @*Objective@#To determining the effect of second hand cigarette smoke exposure on neonatal outcomes. @*Methods@#Participants are patients with low risk singleton pregnancies who were going for prenatal check up and eventually delivered in secondary hospitals in Manila. Descriptive statistics was used to summarize the demographic and clinical characteristics of the patients. Null hypotheses were rejected at 0.05 ?-level of significance. The computer software STATA 13.1 was used for data analysis. @*Results@#The husband was the most identified source of second-hand smoke. Maternal weight was also higher among the exposed group. The most significant effect of SHS exposure among newborns was a 103 grams difference in mean birth weight. There was no difference in pediatric aging, birth length, and anthropometric measurements. @*Conclusion@#The prevalence of smoking in Philippines remains high at 23.8% among adult population, majority being male adults. Exposure to second-hand smoke during pregnancy was noted to be as high as 69.8%. The most common source of second-hand smoke is the husband, and thus, he should be one of the targets of preventive strategies in second-hand smoke exposure.

Association Between Exposure to Environmental Tobacco Smoke at the Workplace and Risk for Developing a Colorectal Adenoma: A Cross-Sectional Study

PURPOSE: A colorectal adenoma (CRA) is a well-defined precursor to colorectal cancer (CRC). Additionally, smoking is a potent risk factor for developing a CRA, as well as CRC. However, the association between exposure to environmental tobacco smoke (ETS) and the risk for developing a CRA has not yet been fully evaluated in epidemiologic studies. We performed a cross-sectional analysis on the association between exposure to ETS at the workplace and the risk for developing a CRA. METHODS: The study was conducted on subjects who had undergone a colonoscopy at a health promotion center from January 2012 to December 2012. After descriptive analyses, overall and subgroup analyses by smoking status were performed by using a multivariate logistic regression. RESULTS: Among the 1,129 participants, 300 (26.6%) were diagnosed as having CRAs. Exposure to ETS was found to be associated with CRAs in all subjects (fully adjusted odds ratio [OR], 1.95; 95% confidence interval [CI], 1.08-2.44; P = 0.001). In the subgroup analysis, exposure to ETS in former smokers increased the risk for developing a CRA (fully adjusted OR, 4.44; 95% CI, 2.07-9.51; P < 0.001). CONCLUSION: Exposure to occupational ETS at the workplace, independent of the other factors, was associated with increased risk for developing a CRA in all subjects and in former smokers. Further retrospective studies with large sample sizes may be necessary to clarify the causal effect of this relationship.

Respuesta cardiaca al estrés tóxico por exposición pasiva combinada al humo de cigarrillo y al etanol / Cardiac stress toxic response to combined passive smoke cigarette exposition plus ethanol

El estrés oxidativo ha sido considerado por muchos investigadores como la principal causa de daño tisular generado por el consumo de alcohol en combinación con nicotina. Sin embargo, se desconoce si existe una potenciación de la inducción de Hsps como respuesta al daño celular en el caso de fumadores involuntarios que consumen etanol, y si los sistemas de citoprotección endógena, específicamente la proteína anti-estrés Hsp70, tienen alguna participación. En tal sentido, en este trabajo se determinó la presencia de las Hsp70 y su correspondencia con la respuesta subcelular cardiaca en el estrés tóxico individual y combinado de etanol y exposición pasiva al humo del cigarrillo (EPHC) en ratas. Se utilizaron 60 ratas hembras Sprague-Dawley (80- 100gr), divididas aleatoriamente en cuatro grupos: grupo control; grupo etanol (2 g/kg p.c. 50%, vía oral); grupo humo (exposición pasiva al humo de 8 cigarrillos) y grupo combinado (etanol-humo). Los tratamientos se suministraron diariamente en dosis única, durante 15 días continuos. Seguidamente, posterior al sacrificio de los animales se tomaron muestras de la pared ventricular izquierda del corazón para el estudio bioquímico y subcelular. Los resultados mostraron un paralelismo entre la mayor acumulación de Hsp70 y el menor daño subcelular en el tejido cardiaco. El tratamiento combinado de alcohol y EPHC promovió la respuesta al estrés en el corazón, a través de un proceso de coinducción, resultando en mayor acumulación de Hsp70. Se sugiere un papel cardioprotector de las Hsp70.

Many researchers have considered oxidative stress as the main cause of tisular damage induced by alcohol and nicotine together. Oxidative stress is associated to the induction of stress proteins. However, in the case of passive smoke, it is unknown whether the stress proteins are induced and what kind of role they could have. In this regard, this work determined Hsp70 and their relationship to subcellular heart response in individual and combined ethanol and passive smoke cigarette exposition in rats. 60 female Sprague-Dawley (80-100g) rats, were randomized into four group: control; ethanol (2 g/kg c.w. 50%, oral route); passive smoke of 8 cigarettes and ethanol/smoke group. Single dose daily treatment was given during 15 days. Once therats were killed, samples for biochemical and subcellular analysis were made from left ventricular wall. Results showed a strong relationship between bigger accumulation of Hsp70 and smaller cardiac cellular damage. Ethanol plus passive smoke treatment promoted the stress response by co-induction and an increased Hsp70 accumulation was induced. It is suggested a cardiac protective role for Hsp70.