Active or Passive Exposure to Tobacco Smoking and Allergic Rhinitis, Allergic Dermatitis, and Food Allergy in Adults and Children: A Systematic Review and Meta-Analysis

Background: Allergic rhinitis, allergic dermatitis, and food allergy are extremely common diseases, especially among children, and are frequently associated to each other and to asthma. Smoking is a potential risk factor for these conditions, but so far, results from individual studies have been conflicting. The objective of this study was to examine the evidence for an association between active smoking (AS) or passive exposure to secondhand smoke and allergic conditions. Methods and Findings: We retrieved studies published in any language up to June 30th, 2013 by systematically searching Medline, Embase, the five regional bibliographic databases of the World Health Organization, and ISI-Proceedings databases, by manually examining the references of the original articles and reviews retrieved, and by establishing personal contact with clinical researchers. We included cohort, case-control, and cross-sectional studies reporting odds ratio (OR) or relative risk (RR) estimates and confidence intervals of smoking and allergic conditions, first among the general population and then among children. We retrieved 97 studies on allergic rhinitis, 91 on allergic dermatitis, and eight on food allergy published in 139 different articles. When all studies were analyzed together (showing random effects model results and pooled ORs expressed as RR), allergic rhinitis was not associated with active smoking (pooled RR, 1.02 [95% CI 0.92–1.15]), but was associated with passive smoking (pooled RR 1.10 [95% CI 1.06–1.15]). Allergic dermatitis was associated with both active (pooled RR, 1.21 [95% CI 1.14–1.29]) and passive smoking (pooled RR, 1.07 [95% CI 1.03–1.12]). In children and adolescent, allergic rhinitis was associated with active (pooled RR, 1.40 (95% CI 1.24–1.59) and passive smoking (pooled RR, 1.09 [95% CI 1.04–1.14]). Allergic dermatitis was associated with active (pooled RR, 1.36 [95% CI 1.17–1.46]) and passive smoking (pooled RR, 1.06 [95% CI 1.01–1.11]). Food allergy was associated with SHS (1.43 [1.12–1.83]) when cohort studies only were examined, but not when all studies were combined. The findings are limited by the potential for confounding and bias given that most of the individual studies used a cross-sectional design. Furthermore, the studies showed a high degree of heterogeneity and the exposure and outcome measures were assessed by self-report, which may increase the potential for misclassification. Conclusions: We observed very modest associations between smoking and some allergic diseases among adults. Among children and adolescents, both active and passive exposure to SHS were associated with a modest increased risk for allergic diseases, and passive smoking was associated with an increased risk for food allergy. Additional studies with detailed measurement of exposure and better case definition are needed to further explore the role of smoking in allergic diseases. Please see later in the article for the Editors' Summar

Lung cancer as an index of tobacco exposure: association with non-lung cancer mortality

Objetivo Valorar el papel del tabaquismo, empleando como proxy la mortalidad por cáncer de pulmón, en la mortalidad por otros cánceres (excluyendo el de estómago). Métodos Análisis de series temporales de mortalidad por cáncer en los hombres españoles (1970-2003) para valorar la posible asociación entre cáncer de pulmón y los cánceres «no pulmón-no estómago» (NPNE). Para evitar el efecto de posibles autocorrelaciones se aplicó la regresión Prais-Winsten. Resultados Las tasas anuales de mortalidad por cánceres NPNE están linealmente relacionadas con la mortalidad por cáncer de pulmón en el período 1970-2003, con una pendiente de la recta de 1,07, intervalo de confianza del 95% de 0,98-1,17 y R2 de 0,97. Conclusiones Las variaciones de las tasas de mortalidad por cánceres NPNE pueden ser modeladas en función de los cambios en las tasas de mortalidad por cáncer de pulmón en el período estudiado. Los resultados presentados parecen mostrar una posible asociación entre el tabaquismo y los cánceres NPNEObjective:To assess the possible role of tobacco smoke in non-lung cancer (excluding stomach cancer)using changes in lung cancer mortality rates as a proxy for tobacco exposure.Methods:A time series analysis of cancer mortality was performed to evaluate the possible associationbetween changes in mortality rates for lung cancer and for non-lung, non-stomach cancer (NLNS) from1970 to 2003 in Spanish males. To avoid problems with autocorrelation, Prais-Winsten regression wasapplied.Results:Changes in NLNS cancer death rates showed a parallel trend with lung cancer death rates in thestudy period, with an adjusted slope of 1.07, 95% CI of 0.98-1.17, and R2of 0.97.Conclusion:Variation in NLNS cancer death rates can be accurately modelled as a function of changes inlung cancer death rates for the study period, suggesting a possible association between tobaccoexposure and NLNS cancersS

Semantic Reference Model in Medical Time Series

The analysis of time series databases is very important in the area of medicine. Most of the approaches that address this problem are based on numerical algorithms that calculate distances, clusters, index trees, etc. However, a domain-dependent analyis sometimes needs to be conducted to search for the symblic rather than numerical characteristics of the time series. This paper focuses on our work on the discovery of reference models in time series of isokinetics data and a technique that transforms the numerical time series into symblic series. We briefly describe the algorithm used to create reference models for population groups an its application in the real world. Then, we describe a method based on extracting semantic information from a numerical series. This symbolic information helps users to effciently analyze and compare time series in the same or similar way as a domain expert would

Prevalence and caries-related risk factors in schoolchildren of 12-and 15-year-old: a cross-sectional study

Background: To assess the prevalence and severity of caries in 12- and 15-year-old schoolchildren, and to analyse the related risk factors. Methods: We conducted a cross-sectional study on a random sample of 1843 schoolchildren aged 12 and 15 from Galicia (northwest of Spain). Self-administered questionnaire and dental clinical examination were performed to obtain information about oral health habits, dental caries and oral hygiene. A logistic regression model including dental-caries-related variables was generated for each age group. Results: The respective findings for 12- and 15-years-old were as follows: decayed, missing, filled teeth index both for permanent and temporary dentition (DMFT/dmft) of 0.89 (95% CI, 0.87–0.91) and 1.38 (95% CI, 1.33–1.43), respectively; caries prevalence 39.6% (95% CI, 36.3–42.9) and 51.7% (95% CI, 48.0–55.4), respectively. In the 12-yearold group, individuals who occasionally, never or hardly ever brushed their teeth had higher values of caries (OR = 1.83, 95% CI 1.07–3.15, and OR = 9.14, 95% CI1.63–51.17, respectively). Also, the presence of plaque on more than 1/3 gingival was statistically associated with an increase of caries (OR = 2.03; 95% CI, 1.11–3.70), and living in a rural environment was a risk factor (OR = 1.3; 95% CI,1.02–1.80). In the 15-year-old group, higher caries risk was found when brushing was performed once a day (OR = 1.61; 95% CI,1.03–2.50), and among individuals who visited private clinics (OR = 1.77; 95% CI, 1.17–2.66), while electric toothbrush was associated with a lower caries risk (OR = 0.50; 95% CI, 0.29–0.86). Conclusions: This study revealed that risk factors of dental caries showed differences in schoolchildren of 12- and 15-year-old. Strongest evidence related to caries in 12-year-old group were found in frequency of toothbrushing and dental plaque. In 15-year old group, electric toothbrush, time since the last visit to the dentist and type of dental care (public/private) had a stronger association with dental caries. Caries prevalence and mean DMFT/dmft increased from 12- to 15-year-old, in spite of improvement in oral hygiene at the age of 15This study was authorised and funded by the Galician Regional Health Administration (Consellería de Sanidade, Dirección Xeral de Innovación e Xestión da Saúde Publica, Xunta de Galicia), as coordinated by the Preventive Medicine and Public Health Department of Santiago de Compostela UniversityS

Conflicts Of Interest In Research On Electronic Cigarettes

INTRODUCTION The tobacco control community has raised some concerns about whether studies on electronic cigarettes (e-cigarettes) published in scientific journals hide conflicts of interest (COI) and whether such reports are biased. This study assessed potential COI in the e-cigarette scientific literature. METHODS Cross-sectional study was conducted on e-cigarette publications indexed in PubMed up to August 2014. We extracted information about the authors (affiliations, location, etc.), publication characteristics (type, topic, subject, etc.), results and conclusions, presence of a COI statement, and funding by and/or financial ties to pharmaceutical, tobacco, and/or e-cigarette companies. An algorithm to determine the COI disclosure status was created based on the information in the publication. Prevalence ratios (PRs) and confidence intervals (CIs) were calculated to identify associations with COI disclosure, controlling for several independent variables. RESULTS Of the 404 publications included in the analysis, 37.1% (n=150) had no COI disclosure statement, 38.6% declared no COI, 13.4% declared potential COI with pharmaceutical companies, 3.0% with tobacco companies, and 10.6% with e-cigarette companies. The conclusions in publications with COI, which were mainly tied to pharmaceutical companies, were more likely to be favourable to e-cigarette use (PR=2.23; 95% CI: 1.43-3.46). Publications that supported the use of e-cigarettes for both harm reduction (PR= 1.81; 95% CI: 1.14-2.89) and smoking cessation (PR= 2.02; 95% CI: 1.26-3.23) were more likely to have conclusions that were favourable to e-cigarettes. CONCLUSIONS One-third of the publications reporting studies on e-cigarettes did not have a COI disclosure statement, and this proportion was even higher in news articles, editorials and other types of publications. Papers with conclusions that were favourable to e-cigarette use were more likely to have COI. Journal editors and reviewers should consider evaluating publications, including funding sources, to determine whether the results and conclusions may be biased

Tobacco consumption and premenstrual syndrome: A case-control study

Objective : To assess whether tobacco smoking is associated with Premenstrual Syndrome (PMS) and its most severe form, Premenstrual Dysphoric Disorder (PMDD). Design : Case-control study with incident cases using the Spanish public healthcare system. Setting 3 major public hospitals and one family counseling and planning center. Population : Women consulting for troubles related to menstruation and for other motives such as screening for uterine cancer, contraception counseling or desire for pregnancy. Methods : Logistic regression. Main outcome measures : Odds Ratios of PMS and PMDD. Results : 285 incident PMS cases and 285 age-matched controls on the one hand, and 88 incident PMDD cases and 176 controls on the other hand participated in the study. The odds of premenstrual disorders was higher in current smokers compared with never smokers: Odds Ratio (OR) = 1.78, 95% Confidence Interval (CI): 1.20–2.63 for PMS and OR = 2.92, 95%CI: 1.55–5.50 for PMDD. For PMS, women who smoke 1 to 5 cigarettes/day presented an OR = 2.82, 95%CI: 1.57–5.06 and those who smoke more than 15 cigarettes/day an OR = 2.52, 95%CI: 0.99–6.40. Compared to non-smokers, current and ex-smokers who smoked < 3 pack-years presented an OR = 1.79, 95%CI: 1.04–3.08 for PMS, and an OR = 3.06, 95%CI: 1.27–7.35 for PMDD. Smokers of 3 to 8 pack-years presented an OR = 2.34, 95%CI: 1.33–4.13 for PMS and OR = 3.56, 95%CI: 1.55–8.17 for PMDD. These results were confirmed by the exposure-effect curve obtained from a cubic spline model. Conclusions : This study shows that smokers are more likely to develop PMS and PMDD.The authors received no specific funding for this work. The Department of Preventive Medicine of the University of Santiago de Compostela receives funding from the Regional Ministry of Education, Universities and Vocational Training (Consellería de Educación, Universidades y Formación Profesional), Santiago de Compostela, Spain. (Grant ED431C 2018/20)S

Alcohol outlet density and alcohol consumption in Galician youth

Objetivo: Valorar la influencia que la densidad de los puntos de venta y los de venta y consumo de alcohol ejercen sobre los patrones de consumo de 1os/las jóvenes preuniversitarios/as de Galicia. Métodos: Se ha llevado a cabo un análisis transversal de la cohorte de estudiantes de la Universidad de Santiago de Compostela (Cohorte Compostela 2016). Se calcularon las prevalencias de consumo para cada uno de los municipios de procedencia de los/1as estudiantes de primer ciclo durante el año anterior a1 ingreso. Se valoró la asociación del consumo de riesgo de alcohol (CRA) y consumo intensivo de alcohol (CIA) con un modelo logístico, considerando como variables independientes la población del municipio, la densidad de locales de venta, la densidad de locales de venta y consumo de alcohol, y la densidad de ambos tipos de locales en el municipio. Resultados: La prevalencia de CRA fue del 60,5% (intervalo de confianza del 95% [IC95%]: 58,4-62,5) y la de CIA de 28,5% (IC95%: 26,7-30,2). Se observó una gran variabilidad según el municipio de procedencia. El modelo logístico multivariante mostró que los municipios con una densidad de 8,42-9,34 de ambos tipos de locales por mil habitantes presentaban mayor riesgo de CRA (odds Rátios [OR]:1.39; lC9S%: 4,09-1,78) y de CIA (OR= 4 ,29; lC95%: 1,01-i ,66). Conclusión: Estos datos sugieren la importancia de incluir la información del entorno al estudiar el consumo de alcohol. Conocer mejor el entorno podría ayudar a plantear políticas que fomenten en la población conductas más saludables.Objective: To assess the influence that alcohol outlet density, off- and on-alcohol premises, and alcohol consumption wield on the consumption patterns of young pre-university students in Galicia (Spain). Method: A cross-sectional analysis of a cohort of students of the University of Santiago de Compostela (Compostela Cohort 2016) was carried out. Consumption prevalence were calculated for each of the municipalities from the first-cycle students’ home residence during the year prior to admission. The association with risky alcohol consumption (RC) and binge-drinking (BD) was assessed with a logistic model considering as independent variables the municipality population, alcohol outlet density of off- premises, density of off- and on- premises and total density of both types of premises in the municipality. Results: The prevalence of RC was 60.5% (95% confidence interval [95%CI]: 58.4-62.5) and the BD was 28.5% (95%CI: 26.7-30.2). A great variability was observed according to the municipality of provenance. The multivariate logistic model showed municipalities with a density of 8.42-9.34 of both types of premises per thousand inhabitants presented a higher risk of RC (odds ratio [OR]: 1,39; 95%CI: 1.09-1.78) and BD (OR: 1.29; 95%CI: 1.01-1.66). Conclusion: These data suggest the importance of including environmental information when studying alcohol consumption. Knowing our environment better could help plan policies that encourage healthier behaviour in the population.Este trabajo ha sido financiado por el Plan Nacional sobre Drogas (2005/PN014) y el Fondo de Investigación Sanitaria (PI15/00165). C. Carbia está becada con el programa FPU (FPU13/04569) del Ministerio de EducaciónS

Estimation of environmental tobacco smoke exposure: review of questionnaires used in Spain

Introducción En los últimos años, las encuestas de salud y los estudios epidemiológicos sobre el tabaquismo han incorporado preguntas sobre la exposición al humo ambiental de tabaco, aunque no existe un cuestionario estandarizado. Métodos Entre enero y mayo de 2008 se revisaron las encuestas que contenían preguntas sobre exposición a tabaquismo pasivo realizadas en España desde las administraciones públicas, las sociedades científicas y organismos de investigación. Se han revisado los literales, que se han clasificado según tipo de estudio, población diana, ámbito geográfico y lugar de exposición. Resultados Se identificaron 27 encuestas que incluían tabaquismo pasivo. La mayoría correspondían a encuestas de salud (81,5%) e iban dirigidas a población general (70,4%). El ámbito geográfico más común era el autonómico (48,1%) y el lugar de exposición más común el hogar (88,9%). Discusión Los resultados muestran una enorme variabilidad en las preguntas utilizadas. Es necesario homogeneizar las preguntas sobre exposición al tabaquismo pasivo si queremos comparar los resultados.Introduction In the last few years, health surveys and epidemiological studies on smoking have introduced questions on environmental tobacco smoke (ETS) exposure. However, a standardized questionnaire is lacking. Methods Between January and May 2008, we reviewed surveys containing items on ETS exposure carried out in Spain by public administrations, scientific societies and research institutes. The wording of the questions was reviewed and classified according to the study type, target population, geographical setting and place of exposure. Results We identified 27 surveys that included questions on passive smoking. Most were health surveys (81.5%) and were aimed at the general population (70.4%). The most frequent geographical setting consisted of autonomous regions (48.1%) and the most common place of exposure was the home (88.9%) Discussion The results show wide variability in the questions used. Questionnaire items on ETS exposure should be homogenized to allow comparison of the results of surveys.S

Anti‑inflammatory drugs and uterine cervical cancer cells: Antineoplastic effect of meclofenamic acid

Uterine cervical cancer (UCC) is one of the main causes of cancer-associated mortality in women. Inflammation has been identified as an important component of this neoplasia; in this context, anti-inflammatory drugs represent possible prophylactic and/or therapeutic alternatives that require further investigation. Anti-inflammatory drugs are common and each one may exhibit a different antineoplastic effect. As a result, the present study investigated different anti-inflammatory models of UCC in vitro and in vivo. Celecoxib, sulindac, nimesulide, dexamethasone, meclofenamic acid, flufenamic acid and mefenamic acid were tested in UCC HeLa, VIPA, INBL and SiHa cell lines. The cytotoxicity of the drugs was evaluated in vitro. Celecoxib, sulindac, nimesulide, mefenamic acid and flufenamic acid presented with slight to moderate toxicity (10–40% of cell death corresponding to 100 µM) in certain cell lines, while meclofenamic acid exhibited significant cytotoxicity in all essayed cell lines (50–90% of cell death corresponding to 100 µM). The meclofenamic acid was tested in murine models (immunodeficient and immunocompetent) of UCC, which manifested a significant reduction in tumor growth and increased mouse survival. It was demonstrated that of the evaluated anti-inflammatory drugs, meclofenamic acid was the most cytotoxic, with a significant antitumor effect in murine models. Subsequent studies are necessary to evaluate the clinical utility of this drug

Mortality Attributable to Environmental Tobacco Smoke Exposure in Spain in 2020

Introduction and objectives: Exposure to environmental tobacco smoke (ETS) is associated with increased mortality and morbidity. The objective of this study was to estimate the impact of ETS exposure in Spain on mortality in 2020 in the population aged 35 years and over. Methods: A method of estimating attributable mortality (AM) based on the prevalence of ETS exposure was applied. Prevalence data were obtained from a representative study conducted in Spain and the relative risks were derived from a meta-analysis. AM point estimates are presented along with 95% confidence intervals (95% CI), calculated using a bootstrap naive procedure. AM, both overall and by smoking habit, was estimated for each combination of sex, age group, and cause of death (lung cancer and ischemic heart disease). A sensitivity analysis was performed. Results: A total of 747 (95% CI 676–825) deaths were attributable to ETS exposure, of which 279 (95% CI 256–306) were caused by lung cancer, and 468 (95% CI 417–523) by ischemic heart disease. Three quarters (75.1%) of AM occurred in men and 60.9% in non-smokers. When chronic obstructive pulmonary disease and cerebrovascular disease are included, the burden of AM is estimated at 2242 deaths. Conclusions: ETS exposure is associated with 1.5% of all deaths from lung cancer and ischemic heart disease in the population aged 35 and over. These data underline the need for health authorities to focus on reducing exposure to ETS in all settings and environmentsInstituto de Salud Carlos III (ISCIII), reference: PI22/00727, co-funded by the European UnionS