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Former Smokers (former + smoker)
Selected AbstractsSmoking and venous thromboembolism: a Danish follow-up studyJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 8 2009M. T. SEVERINSEN Summary.,Background: Large-scale prospective studies are needed to assess whether smoking is associated with venous thromboembolism (VTE) (i.e. deep venous thrombosis and pulmonary embolism) independently of established risk factors. Objective: To investigate the association between smoking and the risk of VTE among middle-aged men and women. Methods: From 1993 to 1997, 27 178 men and 29 875 women, aged 50,64 years and born in Denmark, were recruited into the Danish prospective study ,Diet, Cancer and Health'. During follow-up, VTE cases were identified in the Danish National Patient Registry. Medical records were reviewed and only verified VTE cases were included in the study. Baseline data on smoking and potential confounders were included in gender stratified Cox proportional hazard models to asses the association between smoking and the risk of VTE. The analyses were adjusted for alcohol intake, body mass index, physical activity, and in women also for use of hormone replacement therapy. Results: During follow-up, 641 incident cases of VTE were verified. We found a positive association between current smoking and VTE, with a hazard ratio of 1.52 (95% CI, 1.15,2.00) for smoking women and 1.32 (95% CI, 1.00,1.74) for smoking men, and a positive dose-response relationship. Former smokers had the same hazard as never smokers. Conclusions: Smoking was an independent risk factor for VTE among middle-aged men and women. Former smokers have the same risk of VTE as never smokers, indicating acute effects of smoking, and underscoring the potential benefits of smoking cessation. [source] Do the Transtheoretical Model processes of change, decisional balance and temptation predict stage movement?ADDICTION, Issue 5 2009Evidence from smoking cessation in adolescents ABSTRACT Aims To examine the effects of processes of change (POC) on forward stage movement directly, indirectly through decisional balance and temptation, and total effects as a test of the key hypothesis of the Transtheoretical Model (TTM). Design Prospective cohort study. Setting United Kingdom. Participants A total of 1160 adolescents aged 13,14 years who were current or former smokers at baseline. Measurements Stage was assessed with the standard algorithm three times, once every 3 months. On each occasion the POC, decisional balance and temptation were measured with the standard questionnaires. Path analysis was used to examine the direct, indirectly mediated and total contribution of POC and the other constructs to stage movement 3 months later. Findings Four of the 24 analyses showed evidence that the theoretically appropriate POC predicted stage transition, with statistically significant total effects. Effect sizes were small. When the POC were summarized to experiential and behavioural process means, one transition from pre-contemplation was predicted by experiential processes and, contrary to the TTM, one transition predicted by behavioural processes. There was slightly more evidence that decisional balance (attitudes towards smoking) and temptation (ability to resist the urge to smoke) was associated with stage transition. Conclusions POC use was not associated generally with stage transition and evidence that effects, if missed, must be modest, giving no support to the central tenet of the TTM. [source] Tobacco smoking and dental periapical conditionEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 2 2004Jan Bergström The relation between smoking and apical periodontitis has been little studied to date. The aim of the present study was to investigate whether tobacco smoking might be associated with the prevalence or severity of periapical lesions. A total of 247 individuals, 81 current smokers, 63 former smokers, and 103 non-smokers participated in the study. The periapical condition was expressed as the number and percentage of radiographically detectable lesions and, in addition, as a severity index. The overall prevalence of apical periodontitis was 52% and the overall prevalence of endodontic treatment 58%. There was no significant influence of smoking on the prevalence of either apical periodontitis or endodontic treatment. The mean number (percentage) of periapical lesions per person was 1.9 (6%) in current smokers, 1.5 (4%) in former smokers, and 1.0 (3%) in non-smokers. Controlling for age, the association between smoking and periapical lesions was not statistically significant. The mean periapical severity index including all teeth, or teeth affected by periapical lesions alone, did not significantly differ between smoking groups. It is concluded that the present observations do not lend support to the assumption that tobacco smoking is associated with apical periodontitis. [source] Smoking after the age of 65 years: a qualitative exploration of older current and former smokers' views on smoking, stopping smoking, and smoking cessation resources and servicesHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2006Susan Kerr BA MSc PhD RN HV Abstract The aim of this study was to explore older current/former smokers' views on smoking, stopping smoking, and smoking cessation resources and services. Despite the fact that older smokers have been identified as a priority group, there is currently a dearth of age-related smoking cessation research to guide practice. The study adopted a qualitative approach and used the health belief model as a conceptual framework. Twenty current and former smokers aged , 65 years were recruited through general practices and a forum for older adults in the West of Scotland. Data were collected using a semistructured interview schedule. The audio-taped interviews were transcribed and then analysed using content analysis procedures. Current smokers reported many positive associations with smoking, which often prevented a smoking cessation attempt. The majority were aware that smoking had damaged their health; however, some were not convinced of the association. A common view was that ,the damage was done', and therefore, there was little point in attempting to stop smoking. When suggesting a cessation attempt, while some health professionals provided good levels of support, others were reported as providing very little. Some of the participants reported that they had never been advised to stop smoking. Knowledge of local smoking cessation services was generally poor. Finally, concern was voiced regarding the perceived health risks of using nicotine replacement therapy. The main reasons why the former smokers had stopped smoking were health-related. Many had received little help and support from health professionals when attempting to stop smoking. Most of the former smokers believed that stopping smoking in later life had been beneficial to their health. In conclusion, members of the primary care team have a key role to play in encouraging older people to stop smoking. In order to function effectively, it is essential that they take account of older smokers' health beliefs and that issues, such as knowledge of smoking cessation resources, are addressed. [source] Cigarette pack and advertising displays at point of purchase: community demand for restrictionsINTERNATIONAL JOURNAL OF CONSUMER STUDIES, Issue 6 2008Jacqueline A. Hickling Abstract Tobacco promotion influences tobacco consumption. Traditional forms of tobacco promotion have been heavily restricted in response to the harmful effects of tobacco. Tobacco displays at the point of purchase are increasingly important as a means of communicating brand imagery for the tobacco industry, especially when advertising is restricted at these points. Previous research has demonstrated that children exposed to tobacco advertising at the point of purchase have inflated perceptions of availability, use and popularity of tobacco. Internationally, laws are being debated and implemented to prohibit or restrict the display of tobacco at the point of purchase or put tobacco out of sight. Such measures would reduce tobacco product exposure and, hence, tobacco marketing among youth and the community. In South Australia, a ban on all cigarette advertising at the point of purchase was introduced in 2005. This study was designed to assess community support for restrictions on cigarette displays and advertising at the point of purchase. A telephone survey was conducted with a random sample of 2026 South Australian adults (aged 18 years and over) in July 2005. Overall, 63% of the community approved of a hypothetical total ban on cigarette displays at the point of purchase, with over three-quarters believing this should happen in the next 12 months. A further 24% believed that cigarette displays should be restricted and 82% would approve of a ban on displays in stores that sell confectionary. Only 7% of adult smokers reported making their decision about the brand of cigarettes to buy at the point of purchase and 90% made their decision before they even entered the shop. The results strengthen arguments that cigarette displays are not necessary to maintain brand loyalty or to encourage brand switching of established smokers. Instead, the results make arguments more credible that cigarette displays normalize and promote smoking among young people and may also promote unplanned purchase or increased consumption among less frequent smokers or former smokers. Placing cigarettes out of sight would be unlikely to impact on brand choice for most smokers, who have already made up their mind before they enter the store. [source] Nurses' Tobacco-Related Knowledge, Attitudes, and Practice in Four Major Cities in ChinaJOURNAL OF NURSING SCHOLARSHIP, Issue 1 2007Sophia S.C. Chan Purpose: To (a) identify Chinese nurses' tobacco-related knowledge, attitude, and practice (KAP), including perception of competency in smoking-cessation interventions; (b) identify barriers and facilitators to smoking cessation interventions to patients; and (c) assess the learning needs and smoking status of nurses. Design: A cross-sectional survey was conducted in four major cities (Beijing, Shanghai, Guangzhou, and Chongqing) in China from November to December 2003. Methods: 2,888 registered nurses working in hospitals affiliated with five university schools of nursing in these cities were invited to complete a questionnaire. An instrument used to assess tobacco-related KAP in Hong Kong was translated into Chinese and pilot tested to ensure reliability and validity. Findings: 2,179 questionnaires were returned and after exclusion of the grossly incomplete questionnaires, 1,690 were included in the present analysis. Only 2% of participants were current and 1% were former smokers; most had not received training for smoking-cessation interventions as part of their nursing education program. Two-thirds recognized smoking as a leading cause of preventable death and that smoking cessation was the most cost effective intervention, but only a third routinely assisted patients' quit attempts. Nurses who received training reported greater competence in providing smoking-cessation intervention, and more frequent practice of cessation interventions. Conclusions: Chinese nurses had some knowledge about the health effects of tobacco use, but seldom practiced smoking-cessation interventions. Those who had prior training had greater competence and more practice. Including tobacco control, especially smoking cessation, in nursing curricula in China has the potential to save millions of lives. [source] Relationship between smoking status and periodontal conditions: findings from national databases in JapanJOURNAL OF PERIODONTAL RESEARCH, Issue 6 2006M. Ojima Background and Objective:, The association between cigarette smoking and periodontitis was examined employing two nationally representative samples of adults in Japan. Material and Methods:, Data were derived from the Survey of Dental Diseases (SDD) and the National Nutrition Survey (NNS) in 1999. In the SDD, periodontal conditions were evaluated by calibrated dentists utilizing the Community Periodontal Index (CPI), whereas in the NNS, participants were interviewed on the basis of smoking status by enumerators. Among 6805 records electronically linked via a household identification code, 4828 records of individuals aged 20 yr or older were analyzed. Results:, The prevalence of periodontal disease varied significantly by smoking status (p < 0.0001): 39.3%, 49.5% and 47.3% (CPI , 3), and 7.9%, 11.7% and 12.4% (a more severe form of periodontitis, CPI = 4), for nonsmokers, former smokers and current smokers, respectively. In adults aged ,,40 yr (n = 3493), logistic regression models revealed greater probabilities (approximately 1.4 times higher) of periodontitis [CPI , 3, odds ratio = 1.38 (1.12,1.71), p = 0.0024] and a more severe form of periodontitis [odds ratio = 1.40 (1.04,1.89), p = 0.0288] in current smokers compared with nonsmokers, following adjustment for possible confounding factors. Conclusion:, Based on the findings of this study and other numerous reports, cigarette smoking leads to deterioration of periodontal conditions in Japanese adults. [source] Relationship of smoking and smoking cessation with number of teeth present: JPHC Oral Health Study,ORAL DISEASES, Issue 1 2009T Yanagisawa Background:, Smoking is associated with the number of teeth. The purpose of this study was to determine the relationship of number of teeth with smoking and smoking cessation. Methods:, Subjects included 547 males aged between 55 and 75 years. Oral examinations were conducted in 2005. Smoking status information was collected from questionnaire surveys conducted in 1990, 1995, 2000, and 2005. The relationship between having more than eight missing teeth and smoking status was estimated with adjusted odds ratio. Results:, Comparing with never smokers, odds ratios of having more than eight missing teeth among current and former smokers were 1.96 and 1.86, respectively. The odds ratios in those who had stopped smoking for ,10 years was 3.02, and for those who had ceased smoking for 11,20 years was 2.66. In those who stopped smoking for 21 years or more, there was no increase in the odds ratio. Conclusion:, Smoking had a positive association with the number of missing teeth and smoking cessation is beneficial for maintaining teeth. The odds of having more than eight missing teeth in those who had never smoked was equal to that of individuals who reported that they had stopped smoking for 21 years or more. [source] Prevalence and risk of asthma symptoms among firefighters in São Paulo, Brazil: A population-based studyAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009Marcos Ribeiro MD Abstract The firefighters are at increased risk of respiratory disease as a result of exposure to smoke and dust. The aim of this study was to determine the prevalence and risk associated with respiratory symptoms among city firefighters in São Paulo, Brazil. Methods A cross-sectional study utilizing the European Community Respiratory Health Survey (ECRHS) questionnaire was administered to firefighters and police officers, in order to evaluate their respiratory symptoms. Results Complete respiratory data were obtained from 1,235 firefighters and 1,839 police officers. Among the firefighters, there were 55.5% never-smokers, 22.4% current smokers and 18.2% former smokers (P,<,0.05). Among the police officers, there were 63.4%, 18.6%, and 9.6% who were never-smokers, current smokers and former smokers (P,<,0.05), respectively. Compared to police, firefighters experienced an increase in wheezing [OR,=,1.63 (95% CI: 1.43,1.87)], wheezing with breathlessness [OR,=,1.34 (95% CI: 1.10,1.64)], wheezing without a cold [OR,=,1.60 (95% CI: 1.32,1.95)], waking with tightness in the chest [OR,=,1.20 (95% CI: 1.02,1.42)], and rhinitis [OR,=,1.12 (95% CI: 1.03,1.22)]. The prevalence of adult-onset asthma in never-smokers was 9.3% and 6.7% for firefighters and police officers [OR,=,1.23 (95% CI: 1.01,1.56)]. An independent association was observed between years employed, smoking, history of rhinitis, and work as a firefighter and respiratory and nasal symptoms. We observed a high prevalence of asthma-like symptoms in firefighters who presented respiratory symptoms beginning immediately after firefighting. Conclusion These results suggest that the prevalence of respiratory symptoms and asthma in firefighters is higher than those in police officers. Work-as a firefighter, rhinitis and years employed were risk factors for respiratory symptoms of asthma. Am. J. Ind. Med. 52:261-269, 2009. © 2008 Wiley-Liss, Inc. [source] Smoking and acute urinary retention: The Olmsted County study of urinary symptoms and health status among menTHE PROSTATE, Issue 7 2009Aruna V. Sarma PhD Abstract BACKGROUND Previous reports have suggested an inverse relationship between smoking and surgery for benign prostatic hyperplasia (BPH). We hypothesized that acute urinary retention (AUR), an adverse outcome of this disease and indication for surgical treatment, may be related to smoking. METHODS Study subjects were randomly selected from Olmsted County men aged 40,79 identified through the Rochester Epidemiology Project. Of the 3,854 eligible men, 2,089 (54%) completed a questionnaire that included the American Urological Association Symptom Score and assessed smoking status. Community medical records were examined for occurrence of AUR with documented catheterization in the subsequent 10 years and occurrence of BPH surgery. Proportional hazard models were used to assess the relationship between baseline smoking status and subsequent retention. RESULTS In the 18,307 person-years of follow-up, 114 men had AUR. When compared to 727 never-smokers, there was a trend among the 336 current smokers to be at lower risk (Relative risk (RR),=,0.62, 95% Confidence Interval (CI),=,0.33, 1.18) whereas the 1,026 former smokers were at similar risk to non-smokers (RR,=,1.0, 95%CI,=,0.67, 1.46). Among men with moderate-severe symptoms at baseline, current smokers were at lower risk of retention compared to non-smokers (RR,=,0.65, 95%CI,=,0.22, 1.91) but the association approached the null among those with none-mild symptoms (RR,=,0.91, 95% CI,=,0.40, 2.06). CONCLUSIONS Community-dwelling men who currently smoke may be at a modestly reduced risk of AUR. The magnitude of this association is sufficiently small that it seems unlikely that this explains a sizable proportion of the inverse association between smoking and surgically treated BPH. Prostate 69: 699,705, 2009. © 2009 Wiley-Liss, Inc. [source] Smoking and risk for amyotrophic lateral sclerosis: Analysis of the EPIC cohort,ANNALS OF NEUROLOGY, Issue 4 2009Valentina Gallo MD Objective Cigarette smoking has been reported as "probable" risk factor for Amyotrophic Lateral Sclerosis (ALS), a poorly understood disease in terms of aetiology. The extensive longitudinal data of the European Prospective Investigation into Cancer and Nutrition (EPIC) were used to evaluate age-specific mortality rates from ALS and the role of cigarette smoking on the risk of dying from ALS. Methods A total of 517,890 healthy subjects were included, resulting in 4,591,325 person-years. ALS cases were ascertained through death certificates. Cox hazard models were built to investigate the role of smoking on the risk of ALS, using packs/years and smoking duration to study dose-response. Results A total of 118 subjects died from ALS, resulting in a crude mortality rate of 2.69 per 100,000/year. Current smokers at recruitment had an almost two-fold increased risk of dying from ALS compared to never smokers (HR = 1.89, 95% C.I. 1.14,3.14), while former smokers at the time of enrolment had a 50% increased risk (HR = 1.48, 95% C.I. 0.94,2.32). The number of years spent smoking increased the risk of ALS (p for trend = 0.002). Those who smoked more than 33 years had more than a two-fold increased risk of ALS compared with never smokers (HR = 2.16, 95% C.I. 1.33,3.53). Conversely, the number of years since quitting smoking was associated with a decreased risk of ALS compared with continuing smoking. Interpretation These results strongly support the hypothesis of a role of cigarette smoking in aetiology of ALS. We hypothesize that this could occur through lipid peroxidation via formaldehyde exposure. Ann Neurol 2009;65:378,385. [source] Predictors of Hospital Admission for Chronic Obstructive Pulmonary Disease Exacerbations in Canadian Emergency DepartmentsACADEMIC EMERGENCY MEDICINE, Issue 4 2009Brian H. Rowe MD, CCFP(EM) Abstract Objectives:, The objective was to examine predictors of hospital admission among adults presenting to Canadian emergency departments (EDs) for acute exacerbations of chronic obstructive pulmonary disease (COPD). Current acute treatment approaches and outcomes 2 weeks after the ED visit are also described. Methods:, Subjects, aged ,35 years presenting with COPD exacerbations to 16 EDs across Canada, underwent a structured in-ED interview and a telephone interview 2 weeks later. Results:, Of 501 study patients, 247 (49.3%; 95% confidence interval [CI] = 44.9% to 53.6%) were admitted. Admitted patients were older, were more often former smokers, and had more admissions for COPD during the past 2 years. They also reported more days of activity limitation and use of inhaled beta2 -agonists in the previous 24 hours. Canadian Triage and Acuity Scale (CTAS), respiratory rate (RR), and airflow obstruction were more severe in the hospitalized group. Most of the patients received inhaled beta2 -agonists, anticholinergics, oral corticosteroids (CS), and antibiotics; hospitalized patients received more aggressive treatments. The median ED length of stay (LOS) of admitted patients was 13.1 hours (interquartile range [IQR] = 7.4-23.0) compared to 5.6 hours (IQR = 4.2-8.4) in discharged patients. Admission was associated with at least two COPD admissions in the past 2 years (odds ratio [OR] = 2.10; 95% CI = 1.24 to 3.56), receiving oral CS for COPD (OR = 1.72; 95% CI = 1.08 to 2.74), having a CTAS score of 1,2 (OR = 2.04; 95% CI = 1.33 to 3.12), and receiving adjunct ED treatments (OR = 3.95; 95% CI = 2.45 to 6.35). Use of EDs for usual COPD care was associated with a reduced risk of admission (OR = 0.43; 95% CI = 0.28 to 0.66). Conclusions:, Exacerbations of COPD in Canadian EDs result in prolonged ED stays and approximately 50% hospitalization despite aggressive acute treatment approaches. Historical, severity, and treatment-related factors were strongly associated with hospital admission. Validation of these results should be completed prior to widespread use. [source] Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesityBRITISH JOURNAL OF DERMATOLOGY, Issue 4 2009K. Sartorius Summary Background, Hidradenitis suppurativa (HS) is a long-standing disease with abscess and often fistula formation, predominantly in the axillae and groins. The disease is difficult to treat and has a severe impact on quality of life. A clinically relevant system for scoring disease severity is lacking in HS. Objectives, To evaluate the modified Hidradenitis Suppurativa Score (HSS) and to study the impact of body mass index (BMI) and smoking habits on disease severity. Methods, Two hundred and fifty-one consecutive patients with HS referred to a clinic with special interest in the disease were included, of whom 115 were scored. Points were given for regions involved, types of lesion (nodules, fistulas), total area involved and whether lesions were separated by normal skin. Background characteristics included BMI and smoking habits. Two hundred and forty-six patients completed the Dermatology Life Quality Index (DLQI). Results, The median (interquartile range, IQR) HSS for all patients was 38 (18,66): women 38 (18,71) and men 37 (19,51). Median (IQR) HSS for smokers was 41 (22,75·5), former smokers 27 (16,53) and nonsmokers 22 (10,57). Median (IQR) HSS for patients with BMI < 25 kg m,2 was 32 (12,54), BMI 25,30 kg m,2 44 (22,56) and BMI , 30 kg m,2 50 (18,86). Mean ± SD DLQI for the whole group of patients was 10·3 ± 7·5, median 9, and showed no significant differences between the groups studied. There was a significant positive correlation of fair degree between HSS and DLQI. There were significant differences in HSS between nonsmokers and smokers as well as between women of normal weight compared with obese women. Conclusions, The modified HSS is simple and practical and it extracts important clinical information. A connection between disease severity and BMI as well as smoking habits in patients with HS is presented. The results suggest that the HSS may be a relevant outcome measure in future therapeutic trials in HS. [source] A single nucleotide polymorphism in the alcohol dehydrogenase 7 gene (alanine to glycine substitution at amino acid 92) is associated with the risk of squamous cell carcinoma of the head and neckCANCER, Issue 12 2010Sheng Wei MD Abstract BACKGROUND: The authors conducted a hospital-based study of 1110 patients with squamous cell carcinoma of the head and neck (SCCHN) and a control group of 1129 patients to replicate the associations reported by a recent, large European study between 2 potentially functional single nucleotide polymorphisms (SNPs) of the alcohol dehydrogenase (ADH) genes, a substitution in ADH1B at amino acid 48 from arginine to histidine (R48H) (reference SNP number [rs]1229984; guanine to adenine [G,A]) and a substitution in ADH7 at amino acid 92 from alanine to glycine (A92G) (rs1573496; cytosine to guanine [C,G]), and the risk of squamous cell carcinoma of the head and neck (SCCHN). METHODS: Multivariate logistic regression was used to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). False-positive report probabilities (FPRPs) also were calculated for significant findings. RESULTS: The ADH7 A92G GG and combined CG + GG genotypes were associated with a decreased risk of SCCHN (GG: adjusted OR, 0.32; 95% CI, 0.13-0.82; CG + GG: adjusted OR, 0.74; 95% CI, 0.59-0.94; FPRP, .098) compared with the CC genotype. This association was also evident in subgroups of older patients (aged >57 years), men, former smokers, patients with oral cancer, and patients with N) lymph node status (P < .05 for all); however, such associations were not observed for the ADH1B R48H SNP. CONCLUSIONS: The current results support the ADH7 A92G SNP as a marker for the risk of SCCHN in non-Hispanic white populations. Cancer 2010. © 2010 American Cancer Society. [source] Beta-carotene in multivitamins and the possible risk of lung cancer among smokers versus former smokersCANCER, Issue 1 2008A meta-analysis, evaluation of national brands Abstract BACKGROUND Some studies have suggested that beta-carotene supplementation may increase the risk of lung cancer, particularly among smokers or former smokers. Beta-carotene, a provitamin A, is available in multivitamins. In the current study, the authors investigated the risk of lung cancer associated with beta-carotene in smokers or former smokers and surveyed the beta-carotene content in national brand multivitamins. METHODS The authors systemically reviewed the published literature using a search of the MEDLINE database and performed a meta-analysis of large randomized trials that reported on the effect of beta-carotene supplementation on the incidence of lung cancer among smokers or former smokers. A sample of multivitamins was evaluated for their beta-carotene content and the suggested daily dosage. RESULTS Four studies contributing 109,394 subjects were available for analysis. The average daily beta-carotene dosage in these trials ranged from 20 to 30 mg daily. Among current smokers, beta-carotene supplementation was found to be significantly associated with an increased risk of lung cancer (odds ratio [OR], 1.24; 95% confidence interval [95% CI], 1.10,1.39). Among former smokers, there was no significant increase noted (OR, 1.10; 95% CI, 0.84,1.45). In a sample of 47 common multivitamins, beta-carotene was present in 70% of the identified formulas. The median dosage of beta-carotene was 0.3 mg (range, 0,17.2 mg) daily. The beta-carotene content was found to be significantly higher among multivitamins sold to improve visual health than among other multivitamins, with a median daily dosage of 3 mg (range, 0,24 mg). CONCLUSIONS High-dose beta-carotene supplementation appears to increase the risk of lung cancer among current smokers. Although beta-carotene was prevalent in multivitamins, high-dose beta-carotene was observed among multivitamin formulas sold to promote visual health. Cancer 2008. © 2008 American Cancer Society. [source] Genetic variants in cell cycle control pathway confer susceptibility to bladder cancerCANCER, Issue 11 2008Yuanqing Ye PhD Abstract BACKGROUND Cell cycle checkpoint regulation is crucial for the prevention of carcinogenesis in mammalian cells. METHODS To test the hypothesis that common sequence variants in the cell cycle control pathway may affect bladder cancer susceptibility, the effects of a panel of 10 potential functional single nucleotide polymorphisms (SNPs) from 7 cell cycle control genes, P53, P21, P27, CDK4, CDK6, CCND1, and STK15, were evaluated on bladder cancer risk in a case-control study of 696 bladder cancer cases and 629 healthy controls. RESULTS Overall, on individual SNP analysis only individuals with the p53 intron 3 16-bp duplication polymorphism variant allele had a significantly reduced bladder cancer risk (odds ratio [OR] = 0.74, 95% confidence interval [CI], 0.56,0.96). This effect was more evident in former smokers and younger subjects. We then applied the Classification and Regression Tree (CART) statistical approach to explore the high-order gene-gene and gene-smoking interactions. In the CART analysis, smoking status was identified as the most influential factor for bladder cancer susceptibility. The final decision tree by CART contained 6 terminal nodes. Compared with the second-lowest risk group the ORs for terminal nodes 1 and 3 to 6 ranged from 0.46 to 6.30. CONCLUSIONS These results suggest that cell cycle genetic polymorphisms may affect bladder cancer predisposition through modulation of host genome stability and confirm the importance of studying gene-gene and gene-environment interactions in bladder cancer risk assessment. Cancer 2008. © 2008 American Cancer Society. [source] Age and comorbidity impact surgical therapy in older bladder carcinoma patients,,CANCER, Issue 8 2005A population-based study Abstract BACKGROUND Bladder carcinoma often occurs in older patients who also may have other comorbid conditions that could influence the administration of surgical therapy. The current study was conducted to describe the distribution of comorbid conditions in patients with bladder carcinoma and ascertain whether these conditions, as grouped by the American Society of Anesthesiologists physical status classification, affected the choice of surgical therapy. METHODS The authors examined six population-based cancer registries from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program in 1992. A total of 820 individuals age 55 years and older was found. A random sample of newly diagnosed bladder carcinoma patients were stratified according to registry, age group (ages 55,64 yrs, ages 65,74 yrs, and age 75 yrs and older), and gender. Data regarding comorbid conditions were abstracted from the medical records and merged with routinely collected cancer registry data. The main outcome measures were the prevalence and distribution of comorbid conditions, American Society of Anesthesiologists physical status classification, and the receipt of cystectomy in patients with muscle invasion. RESULTS Hypertension, chronic pulmonary disease, arthritis, and heart disease were found to affect at least 15% of the study population. Approximately 38% of patients were current or former smokers. Greater than 90% of patients with superficial disease were treated with transurethral resection alone. Among those patients with muscle invasion, only 55% of those ages 55,59 years underwent cystectomy; this percentage dropped to 4% in patients age 85 years and older. Among patients with an American Society of Anesthesiologists physical status classification of 0,2, the cystectomy rate ranged from 53% in those ages 55,59 years to 9% in those age 85 years and older. CONCLUSIONS There were no significant treatment differences noted with regard to age among patients with superficial disease. Among those patients with muscle invasion, those age 75 years and older were less likely to undergo radical cystectomy (14%) compared with patients ages 55,64 years (48%) and those ages 65,74 years (43%). Patient age may contribute to treatment decisions in patients with muscle-invasive disease, even when comorbidity is taken into account. Cancer 2005. © 2005 American Cancer Society. [source] Safety and efficacy of carotid stenting in the very elderly,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 5 2010Arthur Grant MD Abstract Background: Carotid artery stenting (CAS) has emerged as an alternative to carotid endarterectomy (CEA) in patients at high risk for complications from surgery. The very elderly (,80-year-old) are one subgroup of patients identified as being at increased risk for carotid surgery. However, there is concern that the very elderly are also at increased risk for complications of CAS. A stroke and death rate of 12% was reported in very elderly patients during the roll-in phase of Carotid Revascularization Endarterectomy versus Stent Trial (CREST). We are reporting on a large clinical series of CAS with independent neurological assessment in the very elderly. Methods: Between 1994 and 2008, a consecutive series of 418 CAS patients (,80-year-old) were treated at four high-volume centers with extensive CAS experience. Independent neurologic assessment was performed after CAS procedures. Thirty-day follow-up information was available in 389 patients. Results: The average age was 83.2 ± 2.8 years. Most patients were male (63.2%), and the target lesion carotid stenosis was asymptomatic in two-thirds (68.2%) of patients. The majority of patients treated with CAS had a history of coronary artery disease (74.4%), hypertension (87.8%), and dyslipidemia (71.1%). One third (30.1%) were diabetic and more than half (56.5%) were current or former smokers. Embolic protection devices (EPD) were used in 78.7% of cases with the CAS procedure being performed before EPD availability being the most common reason for not using them. The overall 30-day incidence of stroke and death was 2.8% (11/389). The cumulative incidence of major cardiovascular events (stroke, death, or myocardial infarction) during that time period was 3.3% (13/389). Conclusions: This large series of CAS with independent neurologic assessment is convincing evidence that the very elderly (,80 years) can safely undergo CAS with stroke and death rates comparable to younger patients. The key to obtaining these excellent results is that CAS be performed by high volume, experienced operators who exercise restraint regarding patient selection. © 2009 Wiley-Liss, Inc. [source] Glutathione cycle in stable chronic obstructive pulmonary diseaseCELL BIOCHEMISTRY AND FUNCTION, Issue 6 2010Biljak, Vanja Radi Abstract Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation and oxidant/antioxidant imbalance. Glutathione is the most abundant cellular low-molecular weight thiol and the glutathione redox cycle is the fundamental component of the cellular antioxidant defence system. Concentration of total glutathione and catalytic activities of glutathione peroxidase and glutathione reductase were determined in peripheral blood of patients (n,=,109) and healthy subjects (n,=,51). Concentration of total glutathione in patients was not changed in comparison to healthy controls. However, we found statistically significant difference between patients with moderate and severe disease stages. Glutathione reductase activity was increased, while glutathione proxidase activity was decreased in the patients with COPD, when compared to healthy controls. We found no significant difference in glutathione peroxidase and glutathione reductase activities between stages. Patients who smoked had lower concentration of total glutathione compared with former smokers and never-smoking patients. Lung function parameters were inversely associated with glutathione level. Evidence is presented for differential modulation of glutathione peroxidase and glutathione reductase activities in peripheral blood of patients with stable COPD. We suppose that in addition to glutathione biosynthesis, glutathione reductase-dependent regulation of the glutathione redox state is vital for protection against oxidative stress. Copyright © 2010 John Wiley & Sons, Ltd. [source] Leptin, soluble interleukin-6 receptor, C-reactive protein and soluble vascular cell adhesion molecule-1 levels in human coronary atherosclerotic plaqueCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 3 2006M. Karaduman Summary The aim of the present study was to explore the relationship between tissue levels of leptin, soluble interleukin-6 receptor (sIL-6R), high-sensitive-C-reactive protein (hs-CRP) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in atherosclerotic plaques, and traditional risk factors. Coronary artery specimens were obtained from 35 consecutive patients (26 men and nine women) who underwent coronary artery bypass grafting procedure. The mean tissue levels of leptin, hs-CRP and sIL-6R were significantly higher in patients with diabetes mellitus than without diabetes mellitus. When patients were classified according to the smoking status, the mean tissue levels of leptin, hs-CRP and sIL-6R were significantly higher in current smokers than both former smokers and non-smokers. In addition, the mean tissue levels of leptin and sIL-6R were significantly higher in former smokers than non-smokers. There was a positive association between leptin and hs-CRP, sIL-6R and plasma glucose in all patients. Plasma HDL levels were associated negatively with atherosclerotic tissue levels of leptin. Tissue levels of sIL-6R were associated significantly in a positive manner with leptin, hs-CRP and plasma glucose, while tissue levels of hs-CRP were associated with both leptin and sIL-6R. In conclusion, it is attractive to speculate that hs-CRP, sIL-6R and leptin could act synergistically in course of local inflammatory activity and those molecules may not be just markers of inflammation and cardiovascular risk but are also likely to play a pathogenic role in atheromatous plaque. In addition, atherosclerotic tissue levels of CRP, sIL-6R and leptin were significantly higher in current smokers and patients with diabetes. [source] Significant inverse relationship between serum free T4 concentration and body mass index in euthyroid subjects: differences between smokers and nonsmokersCLINICAL ENDOCRINOLOGY, Issue 4 2008Ashley E. Makepeace Summary Objective, There are conflicting data regarding the relationship between thyroid function and body mass index (BMI) in euthyroid subjects, and it is uncertain whether tobacco smoking modifies this relationship. The objective of this study was to examine the relationships between thyroid function, BMI and smoking in euthyroid subjects. Design, Linear regression models were used to examine the relationships between serum free T4, serum TSH, BMI and smoking in a cross-sectional, community-based sample of 1853 euthyroid subjects in Busselton, Western Australia. Results, There was a significant negative relationship between free T4 and BMI: after adjustment for age and sex, each 1 pmol/l increase in free T4 was associated with a decrease in BMI of 0·12 kg/m2 (95% CI 0·06, 0·18; P < 0·001). The mean BMI ± SD of subjects in the highest quintile of free T4 concentration was 24·4 ± 3·5 kg/m2, compared with 26·1 ± 3·8 kg/m2 for the lowest quintile. The relationship between free T4 and BMI was statistically significant (adjusted for age and sex) in subjects who had never smoked (P = 0·001) and former smokers (P = 0·011), but not in current smokers (P = 0·77). There was no significant relationship between TSH and BMI: after adjustment for age and sex, each 1 mU/l increase in TSH was associated with an increase in BMI of 0·08 kg/m2 (95% CI ,0·16, 0·32; P = 0·53). Conclusions, In euthyroid subjects, small differences in free T4 are associated with differences in BMI. This relationship is not present in current smokers. We speculate that this may be relevant to weight changes associated with smoking cessation. [source] | |||||||||||||