Weight Gain after Smoking Cessation

Both overweight or obesity and cigarette smoking are relevant risk factors for public health. Cigarette smoking is associated with lower body weight while smoking cessation is associated with weight gain. Most smokers who quit experience a weight gain, particularly within one year, and it may persist up to 8 years after smoking cessation. However, only a minority of quitters gain excessive weight. Some individual characteristics have been found to be associated with excessive weight gain after smoking cessation while methodological problems may affect estimates of weight gain observed in different studies. Main mechanisms to explain weight gain after smoking cessation include increased energy intake, decreased resting metabolic rate, and decreased physical activity. The health benefits of smoking cessation far exceed any health risks that may result from smoking cessation-induced body weight gain. As weight gain may be a barrier against quitting smoking or a reason to restart smoking, behavioural and pharmacological methods have been evaluated to control weight gain after smoking cessation. Physicians should apply efficient strategies to promote smoking cessation on their weight-concerned smoking patient. This review briefly addresses some issues on the relationship between smoking cessation and weight gain, with regard to the size of the problem, mechanisms, health risks and control strategies

Predicting cognitive decline in patients with hypoxaemic COPD

AbstractThe objective was to identify predictors of cognitive decline in patients with hypoxaemic COPD on continuous oxygen therapy.Eighty-four consecutive ambulatory hypoxaemic COPD patients in stable clinical conditions were prospectively studied over the course of 2 yr. Baseline multidimensional assessment included respiratory function tests, blood gas analysis, Mini Mental Status (MMS) test, Geriatric Depression Scale (GDS), Activities of Daily Living (ADLs) and Charlson's index of comorbidity. Reassessments were made 1 yr and 2 yr thereafter. Sequential changes in MMS, GDS and ADLs were assessed by Friedman's ANOVA by rank test.Forty patients completed the study (group A), while 44 died or were lost to follow-up (group B). Group B was characterized by more severe respiratory function impairment and worse performances on ADLs and GDS. In group A, MMS deteriorated from baseline to the 1 yr and 2 yr reassessments (27 ± 2·9 vs. 25·8 ± 4·1 and 25·4 ± 4, P<0·005), whereas GDS and ADLs did not change significantly; the 23 patients experiencing a decline of MMS had baseline lower percentage predicted FVC (52·3 ± 17·1 vs. 66·9 ± 13·4, P<0·03) and FEV1 (27·2 ± 8·6 vs. 44 ± 26·8, P<0·02) values and better affective status (GDS score: 11·9 ± 7·7 vs. 16·5 ± 5·6, P<0·04). Two-year changes in MMS and in GDS scores were inversely correlated (Spearman's ρ = −0·32, P = 0·04).Cognitive decline is faster in the presence of severe bronchial obstruction and parallels the worsening of the affective status in COPD patients on oxygen therapy. The onset of depression rather than baseline depressive symptoms seems to be a risk factor for cognitive decline

The global burden of chronic respiratory diseases

Key points Currently, the serious consequences of chronic diseases and their risk factors are not fully recognised by the international health community. In the period of 1990–2020, COPD deaths are expected to increase from 2.2 to 4.7 million worldwide. Reducing chronic disease death rates by an additional 2% annually would avert 36 million deaths by 2015. The abatement of the main risk factors for respiratory diseases, in particular tobacco smoking, environmental tobacco smoke, indoor biomass fuels, outdoor air pollution and unhealthy diet, can achieve huge health benefits. Educational aims To define the burden of chronic respiratory diseases all over the world. To underline the importance of chronic diseases recognition by the international health community. To provide details about the burden of chronic obstructive pulmonary disease (COPD): the predicted third cause of death by 2020. Summary Currently, the serious consequences of chronic diseases and their risk factors are not fully recognised by the international health community. Moreover, chronic diseases are not only a problem of the ageing population in developed countries. In fact, it has been estimated that 80% of mortality for chronic diseases occurred in low-income and middleincome countries in 2005. Thus, the World Health Organization (WHO) Dept of Chronic Diseases and Health Promotion has suggested a new Millennium Development Goal for the next few years: to reduce chronic disease death rates by an additional 2% annually, in order to avert 36 million deaths by 2015

Do GOLD stages of COPD severity really correspond to differences in health status?

The purpose of this study was to assess whether different stages of chronic obstructive pulmonary disease (COPD) severity defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria correlate with meaningful differences in health status. A total of 381 COPD patients, aged 73+/-6 yrs, were classified in the five GOLD stages. Disease-specific (St George Respiratory Questionnaire (SGRQ)) and generic indexes of health status were measured in all patients. Multivariate analysis of covariance or Kruskal Wallis tests were used to compare health status indexes across the spectrum of GOLD stages of COPD severity. GOLD stages of COPD severity significantly differed in SGRQ components and Barthel's index, but not in the indexes assessing cognitive and affective status and quality of sleep. The largest variation in health status was observed at the transition from stage IIa to stage IIb, while there were no other significant differences between consecutive stages. Both female sex and comorbidity were associated with a greater impact of COPD on the health status. In conclusion, the upper limit of stage IIb (forced expiratory volume in one second of 49%) marks a threshold for dramatic worsening of health status. Progression of chronic obstructive pulmonary disease severity from stage 0 to stage IIa does not correspond to any meaningful difference in health status

Repeatability of the ISAAC video questionnaire and its accuracy against a clinical diagnosis of asthma

AbstractThe objective of the study was to evaluate the performance of the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire in terms of repeatability and accuracy against a clinical diagnosis of asthma achieved according to the National Heart, Lung and Blood Institute (NHLBI) algorithm.Two hundred and forty-one subjects, aged 13–14 years from two secondary schools in Rome, Italy, were enrolled. Video and written ISAAC questionnaires were completed twice, 3 months apart, by 194 and 190 adolescents, respectively. Two months later, 106 subjects were visited by two physicians blinded to the results of questionnaires.Sixteen subjects were classified as having clinical asthma (CA) at the clinical visit, and eight of them as having clinical active asthma (CAA) on the basis of at least one positive outcome of the NHLBI algorithm. The repeatability of video questionnaire was similar to that of the written questionnaire for items on exercise wheeze and nocturnal cough and, to a lesser degree, for items concerning any wheeze in the past. The video questionnaire showed a worse performance than the written questionnaire for items on asthma attack: K-value (95% CL)=0·59 (0·37–0·80) for video scene no. 5 and K-value (95% CL)=0·86 (0·74–0·98) for written question no. 6. The overall accuracy of the video questionnaire, estimated as a positive answer to any video scene, was lower in terms of sensitivity than that of any written question when CA was used as a gold standard (0·50 vs. 0·81, P=0·025) and increased with respect to CAA (0·75vs. 0·87, P=0·317). The specificity of any video scene was better than that of any written question, independently from the gold standard used.In conclusion, the video questionnaire showed a fairly good accuracy, although slightly lower than that of the written questionnaire and provided sufficiently reliable results. However, samples of subjects from different geographic areas and cultures should be studied in order to conclusively define the performance of the ISAAC video questionnaire

Antimicrobial activity of some essential oils against methicillin-susceptible and methicillin-resistant staphylococcus pseudintermedius-associated pyoderma in dogs

This study aimed to test in vitro the antimicrobial activity of 11 essential oils (EOs) against four methicillin-resistant Staphylococcus pseudintermedius (MRSP) and four methicillin-susceptible S. pseudintermedius (MSSP) clinical isolates. The obtained findings demonstrated a clear in vitro efficacy of some tested EOs against both MRSP and MSSP strains. Particularly, modal minimum inhibitory concentration (MIC) values ranging from 1:2048 v/v for Melissa officinalis against an MSSP strain to 1:256 v/v for Cymbopogon citratus against all MRSP strains were observed. The best results, highlighting a modal MIC value of 1:1024 v/v for all tested isolates, was provided by Cinnamomum zeylanicum. Intriguingly, Cinnamomum zeylanicum showed, in many cases, a correspondence between minimum bactericidal concentration (MBC) and MIC values, indicating that the inhibiting dose is also often bactericidal. Moreover, a mild antibacterial and bactericidal activity against both MRSP and MSSP isolates was detected for the other tested EOs. Considering the zoonotic potential of S. pseudintermedius and the increased dissemination of multidrug-resistant strains, the employment of EOs could be useful for the treatment of canine pyoderma. Since antibiotic resistance has become the most urgent issue, from the perspective of the One Health initiative, alternative therapeutic approaches are desirable to limit the use of antibiotics or to improve the efficacy of conventional therapies

Helichrysum araxinum Takht. ex Kirp. grown in Italy: Volatiloma composition and in vitro antimicrobial activity

In the present work the composition of biogenic volatile organic compounds (BVOCs) and the essential oil (EO) of Helichrysum araxinum Takht. ex Kirp. aerial parts, together with the antimicrobial activity, were investigated. The results showed the prevalence of sesquiterpene hydrocarbons in both spontaneous emissions as well as in the EO. The main compounds of BVOCs were γ-curcumene (10.7%), γ-muurolene (9.2%), and β-selinene (8.5%). This latter constituent also showed a similar amount in the EO and represented the most abundant compounds together with α-selinene (8.0%). It is Interesting to note the same percentage of monoterpene hydrocarbons (MHs) in both the aroma profile and the EO (18.0%) with the same most abundant compounds: β-pinene (6.3% in BVOCs vs. 5.1% in EO, respectively) and limonene (4.5% in VOCs vs. 4.9% in EO, respectively). With regard to the antimycotic activity, the EO showed to be inactive against the tested strains, while a moderate antibacterial activity was shown against Staphylococcus isolates

Salvia spp. Essential oils against the arboviruses vector aedes albopictus (diptera: Culicidae): Bioactivity, composition, and sensorial profile—stage 1

Mosquito-borne arboviruses diseases cause a substantial public health burden within their expanding range. To date, their control relies on synthetic insecticides and repellents aimed to control the competent mosquito vectors. However, their use is hampered by their high economic, environmental, and human health impacts. Natural products may represent a valid eco-friendly alternative to chemical pesticides to control mosquitoes, and mosquito-borne parasitic diseases. The aim of this work was to combine the chemical and sensorial profiles with the bioactivity data of Salvia spp. essential oils (EOs) to select the most suitable EO to be used as a repellent and insecticide against the invasive mosquito Aedes albopictus (Diptera: Culicidae), vector of pathogens and parasites, and to describe the EOs smell profile. To do this, the EOs of four Salvia species, namely S. dolomitica, S. dorisiana, S. sclarea, and S. somalensis were extracted, chemically analyzed and tested for their bioactivity as larvicides and repellents against Ae. albopictus. Then, the smell profiles of the EOs were described by a panel of assessors. The LC50 of the EOs ranged from 71.08 to 559.77 µL L−1 for S. dorisiana and S. sclarea, respectively. S. sclarea EO showed the highest repellence among the tested EOs against Ae. albopictus females (RD95 = 12.65 nL cm−2), while the most long-lasting, at the dose of 20 nL cm−2, was S. dorisiana (Complete Protection Time = 43.28 ± 3.43 min). S. sclarea EO showed the best smell profile, while S. dolomitica EO the worst one with a high number of off-flavors. Overall, all the EOs, with the exception of the S. dolomitica one, were indicated as suitable for “environmental protection”, while S. dorisiana and S. sclarea were indicated as suitable also for “Body care”