[Prevalence of tobacco use and associated factors among women in Parana State, Brazil]

This study aimed to estimate the prevalence of tobacco use and to describe the demographic profile of female smokers in Parana State, Brazil. The study used a cross-sectional population-based design with cluster sampling (n = 2,153) of women 18 years or older in seven cities. Prevalence of smoking was 13.4%, ranging from 10% in Cascavel to 19% in Irati. According to multivariate analysis, city of residence, marital status, and schooling were significantly associated with tobacco use. Women in Irati (OR = 2.08; 95%CI: 1.22-3.54) were more likely to smoke than those in Cambe. Married women and widows were less likely to smoke (OR = 0.47; 95%CI: 0.30-0.73 and OR = 0.43; 95%CI: 0.22-0.87) than single women. Women living with a partner (but not married) were more likely to smoke than single women (OR = 2.49; 95%CI: 1.12-5.53), and women with university degrees were less likely to smoke than those with eight years of school or less (OR = 0.41; 95%CI: 0.22-0.87). The results confirm the need for tobacco control programs that take gender and regional differences into account

Circulating irisin levels in functional hypothalamic amenorrhea: a new bone damage index? A pilot study.

Purpose: Patients with functional hypothalamic amenorrhea (FHA) could commonly have bone damage, often preceded by metabolic alterations due to a relative energy deficit state. To date, there are no markers capable of predicting osteopenia before it is manifested on DXA. Irisin is a myokine that promotes the differentiation of osteoblastic cells and appears to be inversely correlated with the incidence of bone fragility and fractures in postmenopausal women. The aim of this study was to measure irisin levels in FHA patients and to correlate it with bone density parameters. Methods: Thirty-two patients with FHA and 19 matched controls underwent the same clinical and laboratory evaluation. Results: Irisin and body mass index (BMI) were significantly lower in the case group than in healthy controls (2.03 ± 0.12 vs. 2.42 ± 0.09 p < 0.05 and 19.43 ± 2.26 vs. 22.72 ± 0.67 p < 0.05, respectively). Additionally, total body mass density (BMD g/cm2) was significantly lower in the case group than in the healthy controls (1.09 ± 0.08 vs. 1.14 ± 0.05, p < 0.05), without signs of osteopenia. Conclusions: The FHA group showed lower irisin levels associated with significantly reduced BMD parameters that did not reach the severity of osteopenia. Therefore, we could speculate that irisin could predict DXA results in assessing modifications of body composition parameters. Future research is warranted to study these parameters in a larger population to confirm our results, so that irisin could be used as a predictor and screening method for bone deprivation. Furthermore, irisin is strictly related to energy metabolism and could be an indirect marker of nutritional status in FHA patients, identifying earlier states of energy deficit. Keywords: Amenorrhea; Body composition; Bone diseases; Energy metabolism; Osteoporosis

Abdominal drainage after elective colorectal surgery: propensity score-matched retrospective analysis of an Italian cohort

background: In italy, surgeons continue to drain the abdominal cavity in more than 50 per cent of patients after colorectal resection. the aim of this study was to evaluate the impact of abdominal drain placement on early adverse events in patients undergoing elective colorectal surgery. methods: a database was retrospectively analysed through a 1:1 propensity score-matching model including 21 covariates. the primary endpoint was the postoperative duration of stay, and the secondary endpoints were surgical site infections, infectious morbidity rate defined as surgical site infections plus pulmonary infections plus urinary infections, anastomotic leakage, overall morbidity rate, major morbidity rate, reoperation and mortality rates. the results of multiple logistic regression analyses were presented as odds ratios (OR) and 95 per cent c.i. results: a total of 6157 patients were analysed to produce two well-balanced groups of 1802 patients: group (A), no abdominal drain(s) and group (B), abdominal drain(s). group a versus group B showed a significantly lower risk of postoperative duration of stay >6 days (OR 0.60; 95 per cent c.i. 0.51-0.70; P < 0.001). a mean postoperative duration of stay difference of 0.86 days was detected between groups. no difference was recorded between the two groups for all the other endpoints. conclusion: this study confirms that placement of abdominal drain(s) after elective colorectal surgery is associated with a non-clinically significant longer (0.86 days) postoperative duration of stay but has no impact on any other secondary outcomes, confirming that abdominal drains should not be used routinely in colorectal surgery

Three-row versus two-row circular staplers for left-sided colorectal anastomosis: a propensity score-matched analysis of the iCral 2 and 3 prospective cohorts

Background: Since most anastomoses after left-sided colorectal resections are performed with a circular stapler, any technological change in stapling devices may influence the incidence of anastomotic adverse events. The aim of the present study was to analyze the effect of a three-row circular stapler on anastomotic leakage and related morbidity after left-sided colorectal resections. Materials and methods: A circular stapled anastomosis was performed in 4255 (50.9%) out of 8359 patients enrolled in two prospective multicenter studies in Italy, and, after exclusion criteria to reduce heterogeneity, 2799 (65.8%) cases were retrospectively analyzed through a 1:1 propensity score-matching model including 20 covariates relative to patient characteristics, to surgery and to perioperative management. Two well-balanced groups of 425 patients each were obtained: group (A) – true population of interest, anastomosis performed with a three-row circular stapler; group (B) – control population, anastomosis performed with a two-row circular stapler. The target of inferences was the average treatment effect in the treated (ATT). The primary endpoints were overall and major anastomotic leakage and overall anastomotic bleeding; the secondary endpoints were overall and major morbidity and mortality rates. The results of multiple logistic regression analyses for the outcomes, including the 20 covariates selected for matching, were presented as odds ratios (OR) and 95% confidence intervals (95% CI). Results: Group A versus group B showed a significantly lower risk of overall anastomotic leakage (2.1 vs. 6.1%; OR 0.33; 95% CI 0.15–0.73; P = 0.006), major anastomotic leakage (2.1 vs. 5.2%; OR 0.39; 95% CI 0.17–0.87; P = 0.022), and major morbidity (3.5 vs. 6.6% events; OR 0.47; 95% CI 0.24–0.91; P = 0.026). Conclusion: The use of three-row circular staplers independently reduced the risk of anastomotic leakage and related morbidity after left-sided colorectal resection. Twenty-five patients were required to avoid one leakage

Características do uso de produtos derivados do tabaco entre universitários do curso de Odontologia em uma Universidade de Curitiba

Resumo Introdução Profissionais da saúde, incluindo dentistas, são referências de comportamento e exercem grande influência sobre a população que assistem. Objetivo Este estudo teve como objetivos investigar a prevalência do uso de produtos derivados do tabaco entre universitários de Odontologia, analisar fatores associados à ocorrência do uso e quais são os produtos mais utilizados. Material e método Realizou-se um estudo transversal descritivo por meio de um questionário online no ano de 2012. A estatística descritiva gerou um perfil da amostra e aplicou-se o teste Qui-quadrado para análise de associação entre variáveis, seguido da análise multivariada de regressão logística com as variáveis que se mostraram significativas. Resultado A prevalência de uso de produtos derivados de tabaco foi de 24,92%. O narguilé mostrou-se o produto de maior uso (66,23%), seguido do cigarro industrializado (54,55%). Os fatores associados ao uso de produtos de tabaco foram ‘morar sozinho’ (p=0,012; OR=2,13; IC=1,17-3,85), ‘conviver com alguém que fuma’ (p=0,000; OR=3,22; IC=1,75-5,91) e ‘permanecer próximo às pessoas enquanto elas fumam’ (p=0,000; OR=6,96; IC=2,37-20,45). Conclusão Este estudo provê informação importante para desenvolvimento de programas de sensibilização e capacitação dos profissionais de saúde por instituições de ensino superior em relação ao uso de produtos derivados de tabaco

Prevalência do uso de produtos derivados do tabaco e fatores associados em mulheres no Paraná, Brasil

O objetivo deste estudo foi avaliar a prevalência do uso de produtos derivados do tabaco e o perfil demográfico de mulheres fumantes no Paraná, Brasil. Foi um estudo transversal de base populacional com amostragem por cluster envolvendo 2.153 mulheres com 18 anos de idade ou mais em sete cidades. A prevalência do uso do tabaco fumado foi de 13,4% variando de 10% (Cascavel) a 19% (Irati). Na análise multivariada, cidade, estado civil e escolaridade foram significativamente associados ao uso do tabaco. Mulheres em Irati (OR = 2,08; IC95%: 1,22-3,54) foram mais propensas a serem fumantes que mulheres em Cambé. As casadas ou viúvas foram menos propensas a serem fumantes (OR = 0,47; IC95%: 0,30-0,73 e OR = 0,43; IC95%: 0,22-0,87) que as solteiras. Mulheres em união estável foram mais propensas a serem fumantes que as solteiras (OR = 2,49; IC95%: 1,12-5,53) e mulheres com curso superior foram menos propensas a serem fumantes que as com primeiro grau ou menos (OR = 0,41; IC95%: 0,22-0,87). Estes resultados confirmam a necessidade de programas de controle do tabaco que levem em consideração as questões de gênero e regiões

Malattia oncologica e telenursing. nuove prospettive infermieristiche

A livello internazionale si è osservato un florido sviluppo della tecnologia digitale nel settore sanitario, anche in risposta alla pandemia, con impatto positivo in termini di qualità delle cure, soddisfazione dei pazienti e outcomes clinici. Pur essendo noto che il contributo infermieristico nel percorso diagnostico-terapeutico dei pazienti oncologici migliora gli outcomes di cura, la diffusione del telenursing è ancora scarsa in Italia e sostanzialmente limitata a triage e follow-up telefonico. Lo sviluppo e l’implementazione di strumenti e interventi infermieristici nell’assistenza e nel monitoraggio da remoto sono fondamentali nella promozione della salute e della continuità delle cure dei pazienti oncologic

Increased fibulin-1 plasma levels in polycystic ovary syndrome (PCOS) patients: possible contribution to the link between PCOS and cardiovascular risk

Purpose: To investigate a possible relation between fibulin-1 plasma levels and PCOS. Design: ELISA quantitative determination of human fibulin-1. Methods: 50 women with PCOS and 40 control patients who attended the Unit of Human Reproductive Pathophysiology, Universit\ue0 Cattolica del Sacro Cuore, Rome, were enrolled. Ultrasonographic pelvic examinations, hormonal profile assays, oral tolerance test OGTT, lipid profile and ELISA quantitative determination of human fibulin-1 were performed. Results: Fibulin-1 levels were found to be statistically significantly higher in PCOS patients than in matched control women. No statistically significant positive correlation was found between fibulin-1 and AUCi, HOMA-IR, total cholesterol, LDL, AMH, androstenedione and FAI, whereas a statistically significant positive correlation was found between fibulin-1 and 17OHP (p = 0.016) in the PCOS group. However, multivariable linear regression analysis showed that 17 OH P did not independently predict fibulin-1 levels (p = 0.089). Conclusions: Our data could contribute to explain the hypothesized increased cardiovascular risk and vascular damage in patients with PCOS. A better understanding of the cellular and molecular mechanisms involved in cardiometabolic disorders associated with PCOS is mandatory to identify new therapeutic strategies to eventually prevent the progression of cardiovascular diseases in these patients

Guidance for Product Category Rule Development

This guidance document is a response to an internationally recognized need for additional instruction on the development of rules specific to a category of products for making claims based on a life cycle assessment (LCA). The purpose is to supplement existing standards for LCA-based claims that require the development of product category rules (PCRs) or their equivalents. The aim is that PCRs can be developed in a consistent manner and used to support claims based on multiple standards. The scope of the Guidance is global. The Guidance embodies the efforts of individuals with expertise in LCA and LCA-based product claims from more over 40 organizations in 13 countries and regions under the name of The Product Category Rule Guidance Development Initiative. The Initiative received no financial support from any standard or other product claim program and this Guidance reflects no bias toward any particular standard or program. The Guidance is intended to be a living document and we hope that it will continue to improve as the application of product claims based on LCA expands and diversifies.JRC.H.8-Sustainability Assessmen