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1.
Circulation: Cardiovascular Quality and Outcomes ; 15, 2022.
Article in English | EMBASE | ID: covidwho-1938112

ABSTRACT

Objectives: We aimed to evaluate the association of body mass index (BMI) with in-hospital mortality and cardiorespiratory outcomes in patients admitted with COVID-19 infection. Methods: This data was collected from an academic tertiary referral center in upstate New York. Retrospective cohort analysis was conducted on patients admitted with COVID-19 infection (n=194). BMI was calculated and patients were stratified into two categories: 'healthy' (BMI=18.5-24.5) and 'overweight' (BMI>25). Cardiorespiratory outcomes were classified as in-hospital mortality, need for vasopressors, mechanical ventilation, and hemodialysis. Transthoracic echocardiography was performed to evaluate for left ventricular (LV) ejection fraction, right ventricular (RV) systolic function and RV dilation. Cardiovascular (CV) risk factors such as history of COPD, Diabetes, HTN, CAD and cigarette smoking were analyzed. LDH, troponin, CRP and ferritin levels were also noted. Results: Out of 194 patients, 68% were overweight with a mean BMI of 29.8 +/-9.5 kg/m2 and a mean age of 66 +/-16, 75% of females and 63% of males were overweight. Mortality rate was 31% in overweight patients compared to 17% in healthy subset (p<0.04). The rate of need for mechanical ventilation was higher in overweight group as well (34% vs. 17%, p<0.02). There was no significant difference between the cohorts in terms of vasopressor and hemodialysis requirement (p=0.09 and 0.2 respectively). RV systolic function was depressed in 21% of overweight cohort vs. 8% of healthy patients (p<0.02) while RV dilatation was seen in 15% of overweight patients compared with 5% of healthy patients (p<0.03). There was no significant difference in LV ejection fraction between the groups. LDH was more frequently elevated in overweight cohort with a mean level of 346 +/-185 IU/L (p<0.01). No significant difference in rest of the laboratory analysis or CV risk factors were found. Conclusion: Elevated BMI (>25) is associated with a statistically significant increase in in-hospital mortality, need for mechanical ventilation, right ventricular abnormalities, and LDH levels in patients hospitalized with COVID-19 infection.

2.
Front Neuroendocrinol ; 67: 101016, 2022 Jul 20.
Article in English | MEDLINE | ID: covidwho-1937319

ABSTRACT

Incidents of strokes are increased in young women relative to young men, suggesting that oral contraceptive (OC) use is one of the causes of stroke among young women. Long-term exposures to the varying combinations of estrogen and progestogen found in OCs affect blood clotting, lipid and lipoprotein metabolism, endothelial function, and de novo synthesis of neurosteroids, especially brain-derived 17ß-estradiol. The latter is essential for neuroprotection, memory, sexual differentiation, synaptic transmission, and behavior. Deleterious effects of OCs may be exacerbated due to comorbidities like polycystic ovary syndrome, sickle cell anemia, COVID-19, exposures to endocrine disrupting chemicals, and conventional or electronic cigarette smoking. The goal of the current review is to revisit the available literature regarding the impact of OC use on stroke, to explain possible underlying mechanisms, and to identify gaps in our understanding to promote future research to reduce and cure stroke in OC users.

3.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927700

ABSTRACT

Introduction: Eosinophilic lung diseases (ELD) are a group of conditions that are characterized by pulmonary eosinophilia. Acute eosinophilic pneumonia (AEP) may be idiopathic in many patients, however, changes in smoking habits and drug use can trigger the disease. Case: A 24-year-old female presented to the emergency room with dyspnea for 1 week. She also had productive cough, fever of 38.7C (101.7F) and chest tightness. Although she had been vaping for the past year she switched to heavy cigar smoking 3 weeks prior to admission. Vital signs on presentation were blood pressure 127/72 mmHg, heart rate 122 beats/min, respiratory rate 28/min, oral temperature 37.4°C (99.4°F) and oxygen saturation 88% on room air. Lung exam revealed mild rhonchi. Blood work showed leukocytosis 29.13 x 103/mcL (N:4-12 x 103/mcL) with neutrophilia 26.6 x 103/mcL (N: 1.60-7.71 x 103/mcL), mild lymphopenia 1.07 x 103/mcL and a normal metabolic panel. SARS-CoV-2 PCR was negative 3 times. CT chest revealed consolidative opacities involving the right lung more than left and small bilateral pleural effusions. The patient was provided supplemental oxygen via nasal cannula and started on ceftriaxone and azithromycin for community acquired pneumonia. She rapidly declined requiring endotracheal intubation for invasive mechanical ventilation. Antibiotic coverage was broadened to vancomycin, piperacillin-tazobactam, doxycycline and levofloxacin. Further negative work up included viral pathogen panel, respiratory cultures, HIV screening, fungal antibodies, urine pneumococcal and legionella antigens, ANA and ANCA, and serum next-generation sequencing. She developed peripheral eosinophilia on hospital day 2 which peaked at 3.29 x 103/mcL (N: 0.0-0.40 x 103/mcL) on day 6. Bronchoscopy revealed no organisms on gram stain and there was no alveolar hemorrhage. Cell count from bronchoalveolar lavage (BAL) was not available. She was started on methylprednisone 60 mg every 6 hours IV for presumed AEP with marked improvement over the next 48 hours. She was discharged home shortly thereafter on an 8 week steroid taper. Discussion: AEP has been associated with new onset or resumption of cigarette smoking. Our patient had an acute onset febrile illness rapidly progressing to hypoxic respiratory failure, initial peripheral neutrophilic leukocytosis with subsequent peripheral eosinophilia, patchy bilateral ground glass and consolidative opacities with small pleural effusions, and immediate response to steroids. Prognosis is excellent if the disease is recognized and treated promptly. Conclusion: AEP is a rare cause of acute respiratory failure that can be confidently diagnosed with careful history, a constellation of symptoms and signs, and BAL eosinophilia (>20-25%).

4.
Neurology ; 98(18 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1925196

ABSTRACT

Objective: NA Background: COVID-19 infection has been associated with a state of hypercoagulability. The hypercoagulability typically presents as a Deep Venous thrombus or Pulmonary Embolism but rarely can manifest as CVST even after recovery from the original COVID-19 infection. Case Report: 27-year-old Caucasian female who had a COVID-19 infection 2 weeks prior, presented with 4 days of persistent headaches associated with nausea and vomiting. Patient also had episodes of rightward gaze without loss of awareness. No prior history of seizures. NIHStrokeScale was 0. CT head showed a hyper density within the sylvian fissure and the sulci of the right temporal and right lateral frontal lobes suggestive of subarachnoid hemorrhage(SAH);CTA head showed cerebral venous sinus thrombosis(CVST) involving straight sinus, most of vein of Gale, right transverse and right sigmoid sinuses that was also seen on MR venogram. MRI brain showed illdefined edema in a distribution concerning for venous infarct due to CVST. CTA chest also showed multiple bilateral pulmonary emboli. EEG showed focal slowing in the right hemisphere and no epileptiform discharges. Patient was started on heparin and transitioned to Dabigatran on discharge. Past medical history was remarkable for Wolf-Parkinson-White syndrome (s/p ablation), obesity and depression. Patient has no personal or family history of hypercoagulability or malignancy. Patient reported birth control use which she stopped 3 weeks prior to this presentation. Patient stopped cigarette smoking 5 years ago. Patient has a healthy 2.5-year-old son and has no history of miscarriages. Patient was not vaccinated for COVID. Results: NA Conclusions: This is a case of CVST without major classical predisposing factors for CVST however patient had recent COVID-19 infection which should be considered as a potential risk factor for CVST. Considering MR venogram of the head in patients presenting with persistent post-COVID headaches can help identify this potential life threating condition in a timely manner.

5.
Int J Environ Res Public Health ; 19(13)2022 Jun 26.
Article in English | MEDLINE | ID: covidwho-1911373

ABSTRACT

COVID-19 has changed people's routines and imposed new ways of living. This study investigated variations in lifestyles (namely, physical activity, diet, alcohol consumption, and cigarette smoking) between the prepandemic and the pandemic period in a sample of older adults with hypertension. Moreover, it investigated predictors of adherence to government restrictions during the first lockdown period, evidencing the role of relevant sociodemographic indicators and lifestyle changes. A sample of 105 older Italian adults (M_age = 70 years; SD = 5.83) with hypertension was enrolled from a previous longitudinal study and interviewed on the phone between May and August 2020. Updated information about sociodemographic indicators and lifestyle changes was collected. Adherence to restrictions was explored through several questions regarding compliance with home confinement, facemask use, and the observance of social distancing. Results evidenced that only 33% of the respondents abided by all the national restrictions. During the first pandemic peak, considerable changes in lifestyles occurred, particularly regarding physical activity, which diminished in 70% of the sample. Women, unemployed/retired people, and individuals who decreased their amount of physical activity reported higher adherence to rules. Maintaining a healthy lifestyle over time is essential for disease prevention. Therefore, it is essential to continue to inform the population about the importance of a healthy lifestyle, and it is necessary to provide guidelines to maintain and promote it even during housebound periods.


Subject(s)
COVID-19 , Hypertension , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Female , Humans , Hypertension/epidemiology , Life Style , SARS-CoV-2
6.
American Journal of Public Health ; 112(7):1009-1010, 2022.
Article in English | ProQuest Central | ID: covidwho-1905462

ABSTRACT

Driven by targeted marketing, high nicotine content, and the availability of flavors appealing to youths,1 past 30-day use surged among high school students from 1.5% in 2011 to 27.5% in 2019.2 To curb youth access and use, the US Food and Drug Administration (FDA) issued an enforcement policy against any flavored, cartridge-based e-cigarettes with tobacco and menthol flavor exemptions in February 2020. Because of the concern of the comparability of the August 2020 data collected during the pandemic, Hammond etal. did not assess the potential impact of the policy on the accessibility of vaping devices or e-cigarette use prevalence. Studies that exploited the variation in the comprehensiveness of flavor restrictions between state and local jurisdictions indicated a reduction in flavored and total e-cigarette sales associated with more stringent flavor restrictions.9 However, other studies have raised an important concern that reducing youth access to flavored e-cigarettes may motivate substitution of e-cigarettes with traditional cigarettes.10 Moreover, flavor is also a primary driver of e-cigarette initiation among adult cigarette smokers and may be critical for adult smokers who are otherwise unable to quit cigarette smoking to switch to a potentially safer alternative.

7.
American Journal of Public Health ; 112(7):999-1000, 2022.
Article in English | ProQuest Central | ID: covidwho-1904878

ABSTRACT

Over the past decade, the landscape ofyouth e-cigarette use has been dynamic.1,2 E-cigarettes have been the most commonly used tobacco product among US youths since 2014,1 and in 2019, current (past30-day) e-cigarette use prevalence reached a peak among middle-school (10.5%) and high-school (27.5%) students.3 During 2020 to 2021, the COVID-19 pandemic resulted in virtual learning for students, which impacted youth access to e-cigarettes, including from social sources;in 2020, before COVID-19 was declared a pandemic, more than half of youths who currently used e-cigarettes reported getting their e-cigarettes from a friend.3 Nonetheless, in 2021, more than 2 million US middle- and high-school students used e-cigarettes.2 POLICIES TO REDUCE YOUTH E-CIGARETTE USE Flavors remain a major driver ofyouth e-cigarette use.2 A majority of youths who currently use e-cigarettes report flavors are a reason they used the products, and, in 2021,84.7% of youths who used e-cigarettes reported using a flavored product2;the most commonly used flavor types among youths were fruit (71.6%), followed by candy, desserts, or other sweets (34.1 %);mint (30.2%);and menthol (28.8%).2 Public health concerns over youth e-cigarette use have fueled the adoption of policies focused on flavored e-cigarettes. [...]as of February 2022, seven statesand more than 300communities have enacted restrictions on the sale of at least some flavored e-cigarettes;many of these laws include mentholflavored products.4 Research suggests these local laws are associated with reduced availability, marketing, and sales of restricted products.5 However, there is variation inthe specificproducts, flavors, and store types covered by these laws.4 FACTORS THAT DIMINISH POLICY IMPACT Noncomprehensive policies, such as those that exempt certain flavors, can lead to shifts in behaviors by consumers that might diminish the policy's intended effects.5 For example, following the January 2020 national restriction on the sale of certain flavored cartridge-based e-cigarettes (excluding menthol and tobacco), increases occurred in US sales of mentholflavored e-cigarettes and disposable e-cigarettes, the latter of which were still available for sale with fruit, candy, mint, and other flavors.6 Disposable e-cigarette use increased among US youths during 2019 to 2020, and in 2020, among youths who used flavored e-cigarettes, menthol use was 34.3% among those who used disposable e-cigarettes and 48.4% among those who used prefilled cartridges or pods.3 Actions by manufacturers can diminish the impact of flavored e-cigarette restrictions. CORRESPONDENCE Correspondence should be sent to Brian A. King, PhD, MPH, Office on Smoking and Health, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS S107-7, Atlanta, GA 30341 (e-mail: baking@cdc.gov).

8.
American Journal of Public Health ; 112(7):1011-1013, 2022.
Article in English | ProQuest Central | ID: covidwho-1904764

ABSTRACT

First-generation e-cigarettes were visually more like traditional tobacco cigarettes but lacked choice in flavors, whereas newer versions have evolved, looking less like their predecessors and gaining flavor alternatives. Equally, however, choice of flavors plays an important role in potentially supporting adults who use e-cigarettes as a smoking cessation aid.4 It has therefore been a challenge for policymakers in different jurisdictions to balance actions that reduce pathways of harm for young people's health and actions that minimize disruption of smoking cessation efforts among adults, a choice often made within a limited supply of evidence. [...]comparing findings from different countries can present challenges given the international divergence in e-cigarette use, which likely reflects differences in the regulatory landscape over the past decade.7 For example, Hammond et al. highlighted that, unlike in the United States and Canada, cartridge and pod e-cigarettes remain less prevalent than refillable tank devices among youth and adult vapers in the United Kingdom. Since 2016, there has been a plateauing of e-cigarette use in the United Kingdom, in contrast to the large growth seen in the United States during this period.8 European Union legislation such as the Tobacco Products Directive likely delayed the entry of products such asJUUL into UK markets as a result of the restrictions on e-liquids with a nicotine strength of more than 20 milligrams per milliliter. [...]our later research showed that the proliferation of e-cigarette use in the United Kingdom likely contributed to hardening attitudes toward smoking amongyoung people.10 In contrast to the United States, the majority of users of nicotine-based vaping products in the United Kingdom are adults.11 After implementation of the Tobacco Products Directive, e-cigarette flavor remained an important reason for e-cigarette experimentation among young people in the United Kingdom.3 Attraction to flavors continues to be a strong reason in more recent Englandbased surveys.11 Efforts to address vaping flavor enticement among young people may thus take different forms moving forward, with North America highlighting the role of nicotine-based products and England focusing more attention on the role of non-nicotine products.

9.
American Journal of Public Health ; 112(7):995-998, 2022.
Article in English | ProQuest Central | ID: covidwho-1904609

ABSTRACT

Putatively, flavorings afford adult cigarette smokers options to switch to vaping.1 But the flavorings are also perceived to be attractive to people who have never smoked cigarettes, with particular concern about nicotine initiation by underage youths.2 In particular, the flavor and type of device on which nicotine use is initiated may influence later nicotine dependence in young adults.3 In the United States, three broad classes of vaping device are common: (1) single-unit disposable devices roughly equivalent to a pack of cigarettes;(2) homemade devices with, for example, customizable nicotine liquid tanks, batteries, and mouthpieces;and (3) devices with a rechargeable battery and replaceable cartridges containing nicotine liquid. Creating complicated relationships, and further limiting possible benefits to smoking cessation in the public health audience's eyes, Altria (formerly Philip Morris) purchased a major stake in JUUL in 2018. In addition to stay-at-home mandates, fear of contracting the respiratory illness was noted to increase motivation to quit cigarette smoking.8 Interestingly, e-cigarette users also reported greater quit attempts (41 %) than did cigarette smokers (26%) because of COVID-19 fears.9 In addition, various state and local prohibitions against public vaping and fluctuations in product cost have also occurred. Because of changes in sampling necessitated by the COVID-19 pandemic, data quality in large population-based surveys remains an area of active investigation, including potential discontinuities that could limit comparisons overtime. [...]we note that one or two time points since the Guidance was released may not portend sustained changes in behavior.

10.
Tobacco Control ; 31(2):387-393, 2022.
Article in English | ProQuest Central | ID: covidwho-1891901

ABSTRACT

Correspondence to Stan Shatenstein, Deputy News Editor, Tobacco Control, Montreal, Quebec, Canada;shatensteins@sympatico.ca For the past 30 years, Tobacco Control (TC) has been one of few leading scientific journals to include editorial cartoons in its pages. Tobacco Industry and Tobacco Control Smoking and the Movies Long before Jurassic Park IV could be imagined, smoking had made a notable comeback in films like Avatar, where growing tobacco would have been near impossible or an extraordinary waste of precious agricultural land, and in the original Jurassic Park, Samuel L Jackson recalls that director Steven Spielberg gave him ‘the worst-tasting fake cigarettes ever’, knowing that Jackson had quit smoking and did not want to suffer a relapse in real life. Lawsuits In 2005, the Supreme Court of Canada unanimously upheld British Columbia’s Tobacco Damages and Health Care Costs Recovery Act, making it possible for the province to continue to seek redress from the tobacco industry.

11.
Topics in Antiviral Medicine ; 30(1 SUPPL):380-381, 2022.
Article in English | EMBASE | ID: covidwho-1880503

ABSTRACT

Background: The COVID-19 pandemic disrupted the normal delivery of HIV care, altered social support networks, and caused economic insecurity. People with HIV (PWH) are vulnerable to such disruptions, particularly if they have a history of substance use. We describe engagement in care and adherence to antiretroviral therapy (ART) for PWH during the pandemic. Methods: From May 2020 to February 2021, 773 PWH enrolled in 6 existing cohorts completed 1495 surveys about substance use and engagement in HIV care during the COVID-19 pandemic. We described the prevalence and correlates of having missed a visit with an HIV provider in the past month and having missed a dose of ART in the past week. Results: Thirteen percent of people missed an HIV visit in the past month. Missing a visit was associated with unstable housing, food insecurity, anxiety, low resiliency, disruptions to mental health care, and substance use including cigarette smoking, hazardous alcohol use, cocaine, and cannabis use. Nineteen percent of people reported missing at least one dose of ART in the week prior to their survey. Missing a dose of ART was associated with being a man, low resiliency, disruptions to mental health care, cigarette smoking, hazardous alcohol use, cocaine, and cannabis use, and experiencing disruptions to substance use treatment. Conclusion: Social determinants of health, substance use, and disruptions to mental health and substance use treatment were associated with poorer engagement in HIV care. Close attention to continuity of care during times of social disruption is especially critical for PWH.

12.
Pakistan Journal of Medical and Health Sciences ; 16(4):12-14, 2022.
Article in English | EMBASE | ID: covidwho-1856768

ABSTRACT

Aim: To assess the respiratory outcomes twelve weeks after the management with non-invasive positive pressure ventilation (NIPPV) in patients recovered from severe corona virus disease 2019 (COVID-19). Methodology: The cross-sectional analytical study was conducted in the Department of Pulmonology, Sir Ganga Ram Hospital Lahore between October 2020 and March 2021. Total 124 patients visiting the hospital twelve weeks after recovery from COVID-19 were enrolled using convenience sampling. After excluding patients with a history of previous respiratory symptoms before the development of COVID-19, data from 87 patients who required oxygen >15 L/minute and NIPPV support were subjected to final analysis. Results: The proportion of middle-aged adults was 52.9%, males 64.4% and smokers 49.4%. Twelve weeks after treatment with NIPPV, O2 saturation <97.0% at rest was found in 97.7% patients, PR >100 at rest in 16.1% patients, severe dyspnea in 65.5% patients, O2 dependency >5 L/min in 2.3% patients, severe CXR abnormalities in 20.7% patients and lung fibrosis in 27.6% patients. The distribution of SpO2, PR, and dyspnea status twelve weeks after recovery from severe COVID-19 were not significantly different between NIPPV duration groups (p-value >0.05). However, the number of patients with O2 dependency, severe CXR abnormality, and lung fibrosis were significantly different between NIPPV duration groups (all p-values <0.05). Conclusion: Oxygen desaturation, severe dyspnea and severe CXR abnormalities twelve weeks after the treatment with NIPPV were common among patients recovered from COVID-19. Severe CXR abnormality, lung fibrosis, and O2 dependency were significantly associated with prolonged duration of NIPPV.

13.
American Journal of Public Health ; 112(5):728-730, 2022.
Article in English | ProQuest Central | ID: covidwho-1842772

ABSTRACT

Local and state public health officials, who before the pandemic mainly worked behind the scenes to protect the public's health, were quickly thrust into the spotlight alongside their governors, mayors, and county commissioners to explain public health mitigation efforts such as business and school closures, mandatory mask orders, and social distancing recommendations. Before COVID-19, state and territorial health officials faced opposition from members of the public for supporting efforts to ban youth vaping and the sale of flavored e-cigarettes, for failing to support (and in some states for supporting) the use of cannabis for medical or recreational use, for enforcing vaccination requirements for school entry, or for supporting taxes on sugar-sweetened beverages. A VIEW FROM THE FIELD As the executive director of the Association of State and Territorial Health Officials (ASTHO), I have seen firsthand the stress, strain, and cognitive dissonance that results from the denigration and defamation of our public health leaders. By November 2021, almost every state legislature has seen the introduction of a bill to weaken or remove the emergency powers of governors and/or local or state health officials.11 Successful efforts to reduce the power of public health authorities are a Pyrrhic victory: knee-jerk reactions that incite one's political base but with potentially deadly consequences for all of us when health officials' hands are tied in new outbreaks.

14.
International Journal of Environmental Research and Public Health ; 19(9):5563, 2022.
Article in English | ProQuest Central | ID: covidwho-1837367

ABSTRACT

An increasing number of tobacco products are entering the market, offering a variety of options to attain desired nicotine intake. However, little is known about the effect of this diverse marketplace on the experiences and nicotine exposure among tobacco users. A mixed-methods study examined experiences with tobacco products among individuals with relatively lower or higher levels of biomarkers of nicotine exposure. Semi-structured interviews were conducted with younger and older adults to examine tobacco use behaviors, addiction to tobacco products, and nicotine effects. Younger and older adults provided similar narratives about addiction and nicotine effects, which were similar across age groups, product types (i.e., ENDS, combustible cigarettes, or oral tobacco products), and having lower or higher nicotine exposure. Some individuals with higher nicotine exposure who switched from combustible cigarettes to another product (e.g., ENDS) found similar or greater access and perceived addiction to nicotine. Adults with higher and lower levels of nicotine exposure provided narratives consistent with features of nicotine addiction, regardless of age and products used. Availability of multiple tobacco products may be associated with greater access and exposure to nicotine. Addiction may occur at low levels of use and with non-cigarette products.

15.
International Journal of Environmental Research and Public Health ; 19(9):5036, 2022.
Article in English | ProQuest Central | ID: covidwho-1837115

ABSTRACT

Background: Tobacco smoke has been associated with negative health outcomes, including those with chronic respiratory illnesses, such as asthma. This study aimed to assess the relationship between exposure to environmental tobacco smoke (ETS), as well as tobacco use (cigarette and electronic cigarettes), on asthma severity among adults with current asthma, with stratification by sex to understand potential biological sex differences. Methods: The study population consisted of Californian adults 18 years or older with self-reported physician/health care diagnosis of asthma and still having current asthma from 2020 California Health Interview Survey. All descriptive statistics and analyses were sex-stratified and survey-weighted. Crosstabulations were used to understand the association between asthma attack and ETS or firsthand smoke exposure, while binary logistic regression models were used to assess the effect of ETS exposure, current smoking status, and control variables on asthma attack in the past 12 months, with a sub-analysis among non-smoking adults with asthma. Results: Among the primary variable of interest, 35% of males and 30% of females reported ETS exposure in the past 12 months, while 13% of males and 6% of females reported being a current smoker. Past year asthma attack was reported among 43% and 55% of males and females, respectively. Among males, after adjusting for all control variables, asthma attack was significantly higher among those with ETS exposure (OR: 1.75, 95% CI: 1.01–3.02) and among current smokers (OR: 3.82, 95% CI: 1.49, 9.81). Male non-smokers with ETS exposure had a 109% higher odds of asthma attack, compared to non-exposure individuals. Conclusion: Using a population-based survey, our results highlight the ongoing burden of tobacco use and exposure particularly among males with current asthma, further corroborate the literature on the relationship between tobacco and asthma, and highlight putative sex-specific outcomes.

16.
Tobacco Control ; 31(3):399-401, 2022.
Article in English | ProQuest Central | ID: covidwho-1832558

ABSTRACT

Despite some tobacco control success in China, likely as a result of completing MPOWER’s policies of monitoring tobacco use, introducing prevention policies and introducing mass media policies, the Global Adult Tobacco Survey (GATS) found that smoking cessation attempts have actually decreased from 36.4% of smokers in 2010 to 19.8% in 2018. [...]China faces significant tobacco-related disease burdens and direct and indirect economic costs, which have been estimated to be between USD$9 billion to USD$57.5 billion per year. Letters urging the Attorney General not to approve the Brookline bylaw were submitted by the Business Retail Association of Brookline and by the New England Convenience Store and Energy Marketers Association, while letters urging approval of the measure were submitted by Action on Smoking and Health and by PHAI. On 14 September, 2021, several Brookline tobacco retailers filed a lawsuit in Massachusetts Superior Court challenging the bylaw on the basis that despite the approval by the state attorney general, it is pre-empted under state law, and that it violated the Massachusetts Constitution’s guarantee of equal protection under the law by discriminating against anyone born on or after 1 January, 2000.

17.
Journal of Heart and Lung Transplantation ; 41(4):S295, 2022.
Article in English | EMBASE | ID: covidwho-1796810

ABSTRACT

Introduction: Acute pericarditis is frequently encountered in the immediate post-operative period following lung transplant, however when seen following recovery it is often in the context of infection. We present a case of a patient 12 years out from lung transplant who presented with findings compatible with acute pericarditis, ultimately diagnosed with acute cellular rejection (ACR). Case Report: A 60 year old man 12 years post bilateral lung transplant for smoking related COPD with CLAD, stage I, BOS phenotype and prior history of probable antibody-mediated rejection (AMR), presented to the emergency department with acute onset dyspnea (<24h), pleurisy, and a leukocytosis. CT angiogram of his chest revealed no evidence of pulmonary embolism, but new bilateral ground glass and consolidative opacities. Infectious studies, including COVID-19, were negative. Multiple EKGs demonstrated diffuse ST elevations without reciprocal changes. Serial high sensitivity troponin assays were negative, and transthoracic echocardiogram did not reveal any findings compatible with myocardial injury. Once ischemia was excluded he underwent bronchoscopy with biopsies, which demonstrated A2 ACR. Screening for donor specific antibodies indicated new C1q-binding class II HLA antibodies. He was treated for acute pericarditis with colchicine and prednisone. He also received high dose methylprednisolone for ACR, as well as IVIG and rituximab for possible AMR. His chest pain and pleurisy dramatically improved after the first dose of methylprednisolone. The initial insult was thought to be an interruption of immunosuppression coupled with cigarette use. This case represents a novel presentation of ACR with concurrent findings of acute pericarditis. Symptoms of pericarditis and rejection can overlap and this case highlights that the two entities can present simultaneously.

18.
Front Public Health ; 10: 796687, 2022.
Article in English | MEDLINE | ID: covidwho-1775997

ABSTRACT

Background: Substance use indicated the use of psychoactive substances such as alcohol, cigarettes, khat, and illegal drugs. Substance use has varying impacts on the health and socio-economics of countries, and is a major public health concern globally. Currently, substance use is a common public health problem among Ethiopian youth mainly in the city of Jimma. Therefore, this study aimed to assess the magnitude of Cigarette smoking, alcohol drinking, khat chewing, and associated factors among the youth of Jimma town in 2019. Methods: A community-based cross-sectional study was conducted among youth of Jimma town from March 2019 to April 2019. A simple random sampling technique was used to select 423 study participants. Data were collected using a structured interviewer-administered questionnaire. The collected data were entered into EPI data manager version 4.4.1 and transported to SPSS version 23 for data cleaning and analyses. The disruptive study was carried out to determine the prevalence of cigarette smoking, alcohol consumption, and khat chewing. Binary and multivariable analyses were carried out to identify factories associated with cigarette smoking, alcohol consumption, and khat chewing. Finally, adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to determine the presence and strength of association. Results: The current prevalence of cigarette use, alcohol use, and khat use was 16.0, 30.6, and 45.7%, respectively. Factors associated with current smoking use were substance use by siblings, subjective norm factors, and perceived benefits of substance use. Factors associated with current alcohol consumption were youth who highly perceived substance use as important. Factors associated with current khat use were male, substance use by siblings, out-of-school youth, and subjective norms. Concussion: The study findings indicated that the prevalence of khat, alcohol, and cigarettes was high among the youth of the city of Jimma. To reduce the prevalence of khat, alcohol, and cigarettes among youth, coordinated efforts from the youth, the government, health professionals, and the community at large are needed.


Subject(s)
Substance-Related Disorders , Adolescent , Cross-Sectional Studies , Ethiopia/epidemiology , Humans , Male , Risk Factors , Substance-Related Disorders/epidemiology , Universities
19.
J Community Health ; 47(4): 588-597, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1763425

ABSTRACT

The Covid-19 pandemic is related to increased alcohol consumption and smoking. These behaviors may be related to several sociodemographic, behavioral and mental health factors. Thus, the aim of this study was to assess the association between alcohol consumption and cigarette smoking with sociodemographic, behavioral and mental health characteristics. This study used data from two population-based studies conducted in two cities from Southern Brazil amid the Covid-19 pandemic. Individuals aged 18 years or older were included and selected using a multistage sampling procedure. Alcohol consumption and smoking and changes in such consumption during the Covid-19 pandemic were evaluated. Sociodemographic, behavioral, pandemic-related, and mental health variables were also included. A hierarchical model was used to conduct the adjusted analyses, and Poisson regression with robust adjustment was used for variance. A total of 2170 individuals were studied. The prevalence of alcohol consumption and smoking were 9.3% and 14.2%, respectively. The rates of increase in alcohol consumption and smoking during the Covid-pandemic were about 20% and 30%, respectively. They were higher among those with depressive symptoms, feeling of sadness and self-reported stress. Those with poor diet quality had higher prevalence of alcohol consumption (PR: 1.82) and were 1.58 times more likely to smoke. The findings may help stakeholders in health and political systems to better understand the consequences of the Covid-19 pandemic and develop strategies to mitigate these consequences in Brazil and elsewhere.


Subject(s)
COVID-19 , Alcohol Drinking/epidemiology , Alcohol Drinking/psychology , COVID-19/epidemiology , Humans , Mental Health , Pandemics , Smoking/epidemiology
20.
Open Forum Infectious Diseases ; 8(SUPPL 1):S280-S281, 2021.
Article in English | EMBASE | ID: covidwho-1746641

ABSTRACT

Background. Diabetes is emerging as one of the complications of coronavirus disease 2019 (COVID-19), but this is hard to be revealed with cross-sectional studies since it is also known as the major predisposing factor for high-risk COVID-19. Therefore, this study aimed to estimate the risk of new-onset diabetes after COVID-19 through a population follow-up study. Methods. All COVID-19 confirmed cases in Korea from January 20 to June 4, 2020, were matched with national health insurance data and their health screening data, both provided by the National Health Insurance Service of Korea. Controls were selected as the people who received the PCR test for COVID-19 and showed negative results in the same period and followed up until July 19, 2020. We selected the outcome as the diagnosis of diabetes according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10, E10 - E14). People who were diagnosed with diabetes in the past five years were excluded from both groups. After performing a log-rank test between groups, adjusted incidence rate and hazard ratio were estimated using Cox proportional hazard modeling. Demographic characteristics (age, sex, region, family histories of hypertension/diabetes, and income) and underlying health conditions such as hypertension, dyslipidemia, heart disease, alcohol consumption, cigarette smoking, and BMI were adjusted. Proportional assumptions were tested by the zph test and the sensitivity analysis by excluding each factor in turn and comparing results. Results. A total of 6,247 COVID-19 patients and 143,594 controls without diabetes in the past were included for the analysis. The number of new-onset diabetes were 759 (12.15%) in COVID-19 patients and 3,465 (2.41%) in controls (P < 0.01). The adjusted incidence of diabetes was 15.34 (95% confidence interval, CI: 14.10 - 16.66) and 11.18 (95% CI: 10.67 - 11.72) per 100 person-year, respectively, with the mean follow-up time as 46.31 (standard deviation: 16.37) days. The adjusted hazard ratio of diabetes in COVID-19 cases was 2.97 (95% CI: 2.44 - 3.63). Conclusion. Since COVID-19 patients showed a higher incidence of new-onset diabetes in a short-time follow-up, we should consider diabetes as one of the possible complications of COVID-19.

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