Surgery is unlikely to be enough for a patient to stop smoking 24 h prior to hospital admission / É improvável que a cirurgia seja suficiente para que o paciente pare de fumar 24 horas antes da internação hospitalar

Abstract Introduction The need for surgery can be a decisive factor for long-term smoking cessation. On the other hand, situations that precipitate stress could precipitate smoking relapse. The authors decided to study the impact of a surgery on the patient's effort to cease smoking for, at least, 24 h before hospital admission and possible relapse on the last 24 h before hospital admission for ex-smokers. Methods Smoker, ex-smokers and non-smokers adults, either from pre-anesthetic clinic or recently hospital admitted for scheduled elective surgeries that were, at most, 6 h inside the hospital buildings were included in the study. The patients answered a questionnaire at the ward or at the entrance of the operating room (Admitted group) or at the beginning of the first pre-anesthetic consultation (Clinic group) and performed CO measurements. Results 241 patients were included, being 52 ex-smokers and 109 never smokers and 80 non-smokers. Smokers had higher levels of expired carbon monoxide than non-smokers and ex-smokers (9.97 ± 6.50 vs. 2.26 ± 1.65 vs. 2.98 ± 2.69; p = 0.02). Among the smokers, the Clinic group had CO levels not statistically different of those on the Admitted group (10.93 ± 7.5 vs. 8.65 ± 4.56; p = 0.21). The ex-smokers presented with no significant differences for the carbon monoxide levels between the Clinic and Admitted groups (2.9 ± 2.3 vs. 2.82 ± 2.15; p = 0.45). Conclusion A medical condition, such as a surgery, without proper assistance is unlikely to be enough for a patient to stop smoking for, at least, 24 h prior to admission. The proximity of a surgery was not associated with smoking relapse 24 h before the procedure.

Resumo Introdução A necessidade de cirurgia pode ser um fator decisivo para a cessação do tabagismo em longo prazo. Por outro lado, situações que precipitam o estresse podem precipitar a recaída do tabagismo. Decidimos avaliar o impacto de uma cirurgia no esforço do paciente para deixar de fumar durante pelo menos 24 horas antes da internação hospitalar e a possível recaída nas últimas 24 horas anteriores à internação em ex-fumantes. Métodos Fumantes, ex-fumantes e não fumantes adultos, quer de clínica pré-anestésica ou recentemente internados para cirurgias eletivas programadas que ficariam, no máximo, seis horas dentro das unidades hospitalares, foram incluídos no estudo. Os pacientes responderam um questionário na enfermaria ou na entrada da sala de operação (Grupo Internação) ou no início da primeira consulta pré-anestesia (Grupo Clínico) e fizeram mensurações dos níveis de CO. Resultados No total, 241 pacientes foram incluídos: 52 ex-fumantes, 109 que nunca fumaram e 80 não fumantes. Os fumantes apresentaram níveis mais elevados de monóxido de carbono expirado que os não fumantes e ex-fumantes (9,97 ± 6,50 vs. 2,26 ± 1,65 vs. 2,98 ± 2,69;p = 0,02). Entre os fumantes, o Grupo Clínico apresentou níveis de CO não estatisticamente diferentes daqueles do Grupo Internação (10,93 ± 7,5 vs. 8,65 ± 4,56; p = 0,21). Os ex-fumantes não apresentaram diferenças significativas entre os grupos Clínico e Internação para os níveis de monóxido de carbono (2,9 ± 2,3 vs. 2,82 ± 2,15; p = 0,45). Conclusão É improvável que uma condição médica, como uma cirurgia, sem assistência adequada seja suficiente para que um paciente pare de fumar, pelo menos, 24 horas antes da internação. A proximidade de uma cirurgia não foi associada à recaída do tabagismo nas 24 horas anteriores ao procedimento.

[Surgery is unlikely to be enough for a patient to stop smoking 24h prior to hospital admission]. / É improvável que a cirurgia seja suficiente para que o paciente pare de fumar 24 horas antes da internação hospitalar.

INTRODUCTION: The need for surgery can be a decisive factor for long-term smoking cessation. On the other hand, situations that precipitate stress could precipitate smoking relapse. The authors decided to study the impact of a surgery on the patient's effort to cease smoking for, at least, 24h before hospital admission and possible relapse on the last 24h before hospital admission for ex-smokers. METHODS: Smoker, ex-smokers and non-smokers adults, either from pre-anesthetic clinic or recently hospital admitted for scheduled elective surgeries that were, at most, 6h inside the hospital buildings were included in the study. The patients answered a questionnaire at the ward or at the entrance of the operating room (Admitted group) or at the beginning of the first pre-anesthetic consultation (Clinic group) and performed CO measurements. RESULTS: 241 patients were included, being 52 ex-smokers and 109 never smokers and 80 non-smokers. Smokers had higher levels of expired carbon monoxide than non-smokers and ex-smokers (9.97±6.50 vs. 2.26±1.65 vs. 2.98±2.69; p=0.02). Among the smokers, the Clinic group had CO levels not statistically different of those on the Admitted group (10.93±7.5 vs. 8.65±4.56; p=0.21). The ex-smokers presented with no significant differences for the carbon monoxide levels between the Clinic and Admitted groups (2.9±2.3 vs. 2.82±2.15; p=0.45). CONCLUSION: A medical condition, such as a surgery, without proper assistance is unlikely to be enough for a patient to stop smoking for, at least, 24h prior to admission. The proximity of a surgery was not associated with smoking relapse 24h before the procedure.

Radiographic evaluation of Gustafson's criteria for the purpose of forensic age diagnostics.

The main criteria used in dental age estimation in living young individuals are mineralisation and eruption of the third molars. In order to further diversify the spectrum of characteristics after completion of third molar development, tests were undertaken to determine whether the characteristics studied by Gustafson can be ascertained with the required forensic certainty with the aid of the orthopantomogram and whether the evaluation of these could render forensic odontological age diagnoses possible beyond the 18th year of life. For this purpose, 1,299 conventionally produced orthopantomograms of 650 female and 649 male Germans aged from 15 to 40 years were studied. The characteristics of secondary dentin formation, cementum apposition, periodontal recession and attrition were evaluated in all the mandibular premolars. The correlation of the individual characteristics with chronological age was studied with the aid of a multiple regression analysis in which chronological age formed the dependent variable. Depending on the tooth studied, the R values amounted to 0.65 to 0.73; the standard error of estimate was 5.3 to 5.7 years. Basically, the regression equations calculated can be recommended for age estimation in living individuals, although it should be borne in mind that the applicability of the new method presented is limited by the quality of the X-ray images.

Thrombin-mediated hepatocellular carcinoma cell migration: cooperative action via proteinase-activated receptors 1 and 4.

Proteinase-activated receptor-1 (PAR(1)), a thrombin receptor and the prototype of a newly discovered G-protein-coupled receptor subfamily, plays an important role in tumor development and progression. In this study, we documented the expression of the thrombin receptors PAR(1), PAR(3), and PAR(4) in permanent hepatocellular carcinoma (HCC) cell lines and primary HCC cell cultures. Stimulation of HCC cells with thrombin and the PAR(1)-selective activating peptide, TFLLRN-NH(2), increased transmembrane migration across a collagen barrier. This effect was blocked by the PAR(1) antagonist SCH 79797, confirming that the PAR(1) thrombin receptor subtype is involved in regulating hepatoma cell migration. In addition, the PAR(4)-selective agonist, AYPGKF-NH(2), also stimulated HCC cell migration whilst the PAR(4) antagonist, trans-cinnamoyl-YPGKF-NH(2), attenuated the effect of thrombin on HCC cell migration. PAR(1)- and PAR(4)-triggered HCC cell migration was blocked by inhibiting a number of key mediators of signal transduction, including G proteins of the G(i)/G(o) family, matrix metalloproteinases, ERK/MAPKinase, cyclic AMP-dependent protein kinase, Src tyrosine kinase, and the EGF receptor kinase. Our data point to a cooperative PAR(1)/PAR(4) signaling network that contributes to thrombin-mediated tumor cell migration. We suggest that a combined inhibition of coagulation cascade serine proteinases, the two PARs and their complex signaling pathways may provide a new strategy for treating hepatocellular carcinoma.