Clinical laboratory testing for smoking toxicity: implications for early identification of respiratory diseases

Smoking toxicity has short and long term clinical effects and also leads to organ damage. However, clinical assessment in the context of early identification of smoke toxicity by evidence-base pathology is yet to be practiced. The present study was aimed to assess the knowledge and practice of health practitioners regarding clinical laboratory testing of smoking toxicity, with a view to generate a debate on why and how to test. In this pilot study, various health practitioners and students were asked via interviews about laboratory testing of smoking toxicity. There is considerable dismissal of ‘why’ to test and up 57% responded that it was unnecessary. However, there is general opinion that laboratory routine tests can be used to identify toxicity. It appears that there is a gap between knowledge and practice of clinical laboratory testing of cigarette toxicity. Students and health practitioners have the knowledge on smoke toxicity but this requires articulation into evidence-base pathology for early identification and intervention of subclinical pathology in smoking toxicity, especially before noticeable organ damage

Evaluation of oxidative stress and whole blood viscosity for clinical laboratory testing of smoking toxicity

Background: There are no clearly established clinical biochemical markers for cigarette smoking despite the knowledge that cigarette smoking is a risk factor for various diseases, especially cardiovascular complications of respiratory pathologies. However, there are reports of significant increases in blood viscosity and oxidative stress among smokers. The main objective of the study was to ascertain the association of toxicity from cigarette smoking on whole blood viscosity in our data.Methods: This study analysed the archived clinical data of 20 cigarette smokers and 20 apparently healthy individuals.Results: The data show that on average, oxidative stress levels are relatively the same between groups, while whole blood viscosity is statistically significantly lower in non-smokers compared to smokers.Conclusions: This report suggests that oxidative stress induced whole blood hyper-viscosity could be a valid biomarker for laboratory testing of smoking toxicity among cigarette smokers

Hemorheological parameters better classify metabolic syndrome than novel cardiovascular risk factors and peripheral vascular disease marker

The present study compares the association of Metabolic Syndrome (MetS) with hemorheological parameters, oxidative stress, inflammation and peripheral arterial disease markers. 100 participants were recruited and participants were divided into three groups on the basis of absence or presence of MetS and its components. Odds ratio for correctly predicting MetS was highest for erythrocyte aggregation followed by erythrocyte deformability. ROC curve analysis demonstrated that all the hemorheological components significantly classified MetS participants. Area Under Curve was higher for the hemorheological parameters (erythrocyte aggregation and erythrocyte deformability) than for the oxidative stress, inflammation and peripheral arterial disease markers. The possibilities of the hemorheological components to be identified as better cardiovascular risk markers due to their strong association with MetS cannot be precluded from the present findings

The association of asthma education centre characteristics on hospitalizations and emergency department visits in Ontario: a population-based study

Abstract Background International guidelines recommend patient education as an essential component of optimal asthma management. Since 1990 hospital-based asthma education centres (AECs) have been established in Ontario, Canada. It is unknown whether patient outcomes are related to the level of services provided. Methods Using linked, population-based health administrative and hospital survey data we analyzed a population of patients aged 2 to 55 years with a hospitalization for asthma (N = 12 029) or a high acuity asthma emergency department (ED) visit (N = 63 025) between April 2004 and March 2007 and followed for three years. Administrative data documenting individuals’ attendance at AECs were not available. Poisson models were used to test the association of potential access to various AEC service models (outpatient service availability and in-hospital services) with asthma readmissions, ED visits or death within 6 to 36 months following the index admission or ED visit. Results Fifty three of 163 acute care hospitals had an AEC (N = 36) or had access by referral (N = 17). All AECs documented use with guideline-based recommendations for AE programs. ED patients having access to an AEC that offered full-time, extended hours had reduced rates of adverse outcomes (adjusted relative rate [aRR] 0.78, 95% confidence interval [CI] 0.69, 0.90) compared to those with no AEC access. Hospitalized patients with access to asthma education during hospitalization had reduced rates of adverse events (aRR 0.87, 95% CI 0.75, 1.00) compared to those with no inhospital AEC access. Conclusion Although compliant with asthma guideline-based program elements, on a population basis access to asthma education centres is associated only with a modest benefit for some admitted and ED patients and depends on the level of access to services provided. Review of both services provided and strategies to address potential barriers to care are necessary

Les étrangers et l'habitat populaire. Aperçu sur l'évolution mulhousienne de 1962 à 2010.

Communication présentée par Pierre VIDAL, urbaniste et membre de l’atelier Logements du CCPM. Dans sa recherche d’une meilleure connaissance de l’histoire locale de l’habitat populaire, l’atelier « Logement ouvrier, social, populaire » du Conseil Consultatif du Patrimoine Mulhousien (CCPM) n’explore pas seulement des aspects matériels et architecturaux  de l’habitation, mais aborde aussi des  dimensions humaines et sociologiques liées à leurs occupants. Parmi ceux-ci, migrants et immigrés ont..

Cardiovascular disease risk factors in a Nigerian population with impaired fasting blood glucose level and diabetes mellitus

Abstract Background Diabetes is a risk factor for cardiovascular diseases (CVDs) and there are reports of increasing prevalence of prediabetes in Nigeria. This study therefore characterised CVDs risk factors in subjects with impaired fasting glucose (IFG) and diabetes. Methods Data from 4 population-based cross-sectional studies on 2447 apparently healthy individuals from 18 - 89\ua0years were analysed. Anthropometric, blood pressure and biochemical parameters were collected and classified. Individuals with IFG (prediabetes) and diabetes were merged each for positive cases of dyslipidaemia, high blood pressure (HBP) or obesity. Optimal Discriminant and Hierarchical Optimal Classification Tree Analysis (HO-CTA) were employed. Results Overall prevalence of IFG and diabetes were 5.8% (CI: 4.9 \u2013 6.7%) and 3.1% (CI: 2.4 \u2013 3.8%), respectively. IFG co-morbidity with dyslipidaemia (5.0%; CI: 4.1 \u2013 5.8%) was the highest followed by overweight/obese (3.1%; CI: 2.5 \u2013 3.8%) and HBP (1.8%; CI: 1.3 \u2013 2.4%). The predicted age of IFG or diabetes and their co-morbidity with other CVD risk factors were between 40 \u2013 45\ua0years. Elevated blood level of total cholesterol was the most predictive co-morbid risk factor among IFG and diabetes subjects. Hypertriglyceridaemia was an important risk factor among IFG-normocholesterolaemic-overweight/obese individuals. Conclusion The higher prevalence of co-morbidity of CVD risk factors with IFG than in diabetes plus the similar age of co-morbidity between IFG and diabetes highlights the need for risk assessment models for prediabetes and education of individuals at risk about factors that mitigate development of diabetes and CVDs