Vladan Sekulić, Milena P. Rajić, Marina Vlajković, Slobodan Ilić, Miloš Stević, Ivana Mišić and Milan Božinović
Presently, there is very little data on the impact of nicotine and other components of tobacco smoking on the outcome of radioiodine therapy (RIT) in Graves’ disease (GD). Thus, this study was aimed to analyze a possible impact of cigarette smoking on the effect of radioiodine therapy in the patients with Graves’ disease.
The study included 31 patients (16 smokers and 15 non-smokers) with GD, aged from 22 to 73 years, who were treated with a single dose of iodine-131 sodium iodide (131I-NaI) and subjected to a 12-month follow-up, thereafter. Patients were treated with antithyroid drugs (ATDs) before RIT and described very intense stressful events occurring prior to diagnosing Graves’ hyperthyroidism. A successful response to RIT was defined as euthyroidism and subclinical or clinical hypothyroidism, while an unsuccessful response was defined as persistent hyperthyroidism.
Comparison of age (47.4±9.41 vs. 49.5±13.8 years, p=0.628) at the time of RIT, applied activity of 131I-NaI (372±78.4 vs. 363±43.7 MBq, p=0.675), and duration of ATDs therapy (3.47±3.33 vs. 4.94±5.62 years, p=0.387) between smokers and non-smokers showed no significant difference. The cumulative incidence of successful response to therapy in smokers and non-smokers was 31.2 vs. 46.7% (p<0.05), 50.0 vs. 60.0% (p>0.05), 56.2 vs. 60.0% (p>0.05), and 56.2 vs. 66.7% (p>0.05) after 3, 6, 9 and 12 months, respectively.
The results showed that cigarette smoking has no impact on the effect of radioiodine therapy after twelve-month period in patients who had experienced stressful events before the occurrence of Graves’ disease. However, patients with smoking habits achieved successful response later than non-smokers.
Ovim istraživanjem željelo se odrediti veličinu i analizirati čimbenike koji utječu na kašnjenje u otkrivanju i započinjanju liječenja tuberkuloze. Oboljeli od plućne tuberkuloze detaljno su intervjuirani o rizičnom načinu života, različitim demografskim, socioekonomskim i zdravstvenim obilježjima te je izračunano vrijeme od početka simptoma do početka liječenja. Medijan i 75. percentil navedenog vremena iznosili su 68 i 120 dana. Unutar mjesec dana od početka simptoma liječiti se počelo 16,7 % bolesnika, u drugome mjesecu 23,8 %, 23,3 % u trećem mjesecu, 12,9 % u četvrtome mjesecu, dok je 23,3 % ispitanika liječenje započelo više od četiri mjeseca nakon početka simptoma. Uporaba droga bila je povezana s vremenom dužim od medijana, što se smatralo dugim kašnjenjem (p=0,021) u otkrivanju i liječenju tuberkuloze. Najniži stupanj obrazovanja (p=0,021), minimalan (p=0,039) te minimalni do prosječni mjesečni obiteljski prihod (p=0,020), pušenje (p=0,050) i komorbiditet (p=0,048) pokazali su se značajnima kad je promatran 75. percentil izmjerenog vremena, što se smatralo ekstremnim kašnjenjem. U multiplome modelu uporaba droga ostala je značajno povezana s dugim kašnjenjem, a najniži stupanj obrazovanja (p=0,033), sadašnje (p=0,017) i bivše (p=0,045) pušačke navike s ekstremnim kašnjenjem. U uvjetima smanjivanja incidencije tuberkuloze kašnjenje u otkrivanju i liječenju tuberkuloze može se smanjiti zdravstvenim prosvjećivanjem opće populacije ne samo o tuberkulozi nego i općenito o zdravlju te stavovima i navikama glede prevencije i ranog liječenja. Istodobno se mora povećati i znanje o tuberkulozi te dijagnostičke sposobnosti zdravstvenih radnika.
Ana Mrkaić, Suzana Branković, Pavle Randjelović, Milica Veljković, Ivan Pavlović and Mirjana Radenković
Smoking has many harmful effects on human body. It is well known that smoking is one of the most important risk factors for cardiovascular diseases. Though the ingredients from cigarette smoke stimulate the release of vasoconstrictor and reduce the release of vasodilator substances, the goal of this study was to investigate the acute effects of smoking on arterial blood pressure, heart rate and blood vessel flow.
The investigation was conducted on forty healthy volunteers divided into two groups of twenty non-smokers (control group), and twenty smokers (experimental group). The group of smokers was examined before and after smoking four cigarettes during one hour. Blood pressure and electrocardiograph (ECG) were measured by common methods. Brecht’s and Boucke’s methods of plethysmography were used to evaluate the peripheral circulation.
There were no differences in measured systolic and diastolic blood pressure and recorded ECG between non-smokers and smokers, neither between smokers before and after smoking. However, heart rate was increased by 29.57% after smoking in comparison to the value before smoking.
Evaluation of plethysmographic parameters showed that amplitude was significantly decreased. Parameters of peripheral resistance were very increased: ductility was decreased by over 20%.
It can be concluded that acute smoking does not significantly affect the level of blood pressure, although it increases heart rate. The shape of plethysmograms showed decreased systolic filling and decreased diameters of blood vessels.
Mirjana Bećarević, Duško Mirković and Nada Majkić-Singh
Hyperhomocysteinemia and Smoking in Primary Antiphospholipid Syndrome
The thrombotic tendency in antiphospholipid syndrome (APS) shares several pathways with atherosclerosis. Atherothrombosis (atherosclerosis superimposed with thromboses) is influenced by nonmodifiable and some modifiable risk factors (smoking, obesity, physical inactivity, alcohol abuse, hyperhomocysteinemia). Therefore, we investigated the association among clinical and serological features of patients with primary APS and potentially modifiable risk factors for the development of atherothrombosis. Also, we compared the analyzed parameters with those in control subjects. Homocysteine concentrations were detected by HPLC (high performance liquid chromatography), while antiphospholipid antibodies were detected by ELISA. Smokers had elevated levels of homocysteine (χ2 = 6.22, p < 0.05). Independently of patients' age, the association between increased levels of homocysteine and history of myocardial infarctions was found (χ2 = 4.61, p < 0.05). Hyperhomocysteinemia and smoking are the most important modifiable risk factors for atherothrombosis in primary APS.
Goran Dimitrov, Elena Džikova, Gligor Dimitrov, Gjorgji Babushku and Vesna Antovska
The high incidence of premalignant lesions of the cervix in our country and worldwide was the primary aim for conducting this study so as to establish whether HPV16, smoking and coitarche (first intercourse) are significant factors in the developmental stages of cervical dysplasia in the case of which the conization is a surgical treatment of choice.
In the period of three years, one hundred and thirty-six women from the Republic of Macedonia with histologically confirmed CIN were examined as well as 50 control cases with normal cytology and colposcopic findings. The aforesaid epidemiologic factors examined in this study were obtained through special questionnaires. The resulting material was statistically processed to determine whether these factors are risk factors for development of higher stages of cervical dysplasia.
The obtained statistical analysis showed that HPV16, smoking and coitarche under the age of 18 are very important factors in the development of higher stages of CIN where conization is indicated as a treatment of choice.
Our study demonstrated that coitarche under the age of 18, smoking and infection with HPV16 as the most common high risk HPV in our country are the most important factors in causing and development of high grade CIN, where conization is necessary as a treatment of choice. Thus, socially-based organized screening can be of great benefit in early diagnosis and adequate treatment of this highly prevalent disease.
Katerina Damevska, Lence Neloska, Gjeorgji Gocev and Marija Mihova
Previous studies have shown a higher prevalence of cardiometabolic diseases among patients with psoriasis compared to non-psoriatics. However, little attention has been paid to the effects of systemic antipsoriatic drugs. The aim of this study was to investigate the association between psoriasis and these comorbidities, comparing untreated patients with psoriasis and population-based control non-psoriatic patients. A hospital-based case-control study included 122 patients with plaque-type psoriasis and 122 age- and gender-matched controls. Patients who ever received systemic antipsoriatic drugs were excluded. There were no significant differences between psoriatic patients and controls regarding the prevalence of hypertension (p=0.311), coronary heart disease (p=0.480), diabetes (p=0.641), myocardial infarction (p=0.71), stroke (2.4% vs. 2.4%, p=1.00) and metabolic syndrome (p=0.764). The prevalence of hypertriglyceridemia in patients with psoriasis and controls was 41.8% and 28.7%, respectively (OR 1.78, 95% CI 1.04-3.04, p=0.032). Furthermore, significant differences were observed in mean triglyceride levels (p=0.013). Smoking was significantly more often reported in psoriatic patients compared to controls. Patients with psoriasis also had a higher mean BMI (26.24, SD 4.42) compared with controls (24.73, SD 3.86), p=0.005. Psoriasis showed a statistically significant association with BMI obesity classification [χ2(4)=11.560, p=0.02]. The prevalence of cardiovascular and metabolic comorbidities was not significantly higher in patients with plaquetype psoriasis who were never treated with systemic antipsoriatic drugs, compared to population-based non-psoriatic controls. Our data suggest that systemic antipsoriatic drugs may play an important role in the development of these comorbidities. However, this study confirms that untreated psoriasis patients have three major modifiable increased cardiovascular risk factors, such as smoking, obesity and hypertriglyceridemia.
Laryngeal cancer is the most common head and neck cancer. There might be many risk factors for laryngeal cancer. Smoking, especially cigarette smoking and alcohol are indisputable risk factors. The authors of this paper assessed the presumed risk factors in order to identify possible aetiological agents of the disease.
A hospital-based case-control study was conducted. The study group consisted of 108 histologically verified laryngeal cancer patients and 108 hospital controls matched by sex, age (±3 years) and place of residence. Laryngeal cancer patients and controls were interviewed during their hospital stay using a structured questionnaire. According to multiple logistic regression analysis six variables were independently related to laryngeal cancer: hard liquor consumption (Odd Ratio/OR/=2.93, Confidence Interval/CI/95% = 1.17 to 7.31), consumption more than 2 alcoholic drinks per day (OR=4.96, CI 95% = 2.04 to 12.04), cigarette smoking for more than 40 years (OR=4.32, CI 95% = 1.69 to 11.06), smoking more than 30 cigarettes per day (OR=4.24, CI 95% = 1.75 to 10.27), coffee consumption more than 5 cups per day (OR=4.52, CI 95% = 1.01 to 20.12) and carbonated beverage consumption (OR=0.38, CI 95%=0.16 to 0.92). The great majority of laryngeal cancers could be prevented by eliminating tobacco smoking and alcohol consumption.
Agima Ljaljević, Elvir Zvrko and Marija Stojiljković
Tobacco Use Among Youth: Findings from the Global Youth Tobacco Survey in Montenegro
Smoking is a burning healthcare and economy issue, especially in underdeveloped countries. The aim of this study was to determine the number of smokers among elementary school students in Montenegro and to assess the correlates of tobacco use. The study was done in 2003 using the World Health Organization Global Youth Tobacco Survey. Our data showed that children as young as ten years smoked. There were 3.6 % permanent smokers and one in three students (30.6 %) experimented with smoking. More than two thirds who smoked agreed that they should quit smoking, and three fourths tried to quit. This study has also shown that children talk too little about smoking in schools and are exposed to passive smoking at home and elsewhere. Activities to solve the elementary school smoking problem should include preventive programs to be introduced into regular school curricula because this is the only way to address the issue properly. In addition, legislation prohibiting indoor tobacco smoking should be implemented rigorously to protect children from passive smoking in public places.
Jordan Minov, Jovanka KaradžInska-Bislimovska, Kristin Vasilevska, Snežana Risteska-Kuc and Sašo Stoleski
Exposure to Environmental Tobacco Smoke in the Workplace in Macedonia: Where Are We Now?
To assess the prevalence and the level of exposure to environmental tobacco smoke (ETS) in the workplace after the enactment of the law restricting indoor smoking in Macedonia, we performed a cross-sectional, self-administered questionnaire study including 372 never-smoking workers recruited from six workplaces. We found a high prevalence of workers exposed to ETS in the workplace (27.4 %) with no significant difference between particular occupation groups. We found no significant difference in the prevalence of passive smokers in the workplace between this study and our study conducted before the law was enacted (31.5 % vs. 27.4 %, P=0.324). The prevalence of workers exposed to ETS for less than three hours a day was significantly lower than of passive smokers with longer exposure (28.4 % vs. 71.6 %, P=0.038). The prevalence of workers exposed to ETS from less than 10 cigarettes smoked by coworkers per day was lower than the prevalence of workers with higher exposure, but statistical significance was not reached (37.9 % vs. 62.1 %, P=0.087). Our findings indicate a high prevalence and a high level of exposure to ETS in the workplace, which calls for stricter adherence to smoking-free legislation or even the total ban of smoking in the workplace.
Mehrdad Rajaei, Shapour Omidvari and Mostafa Saadat
No studies have yet investigated the influence of smoking on age at diagnosis of breast cancer. Therefore, the present study was carried out. This study consisted of 605 females with pathologically confirmed primary adenocarcinoma of the breast and 438 healthy females matched by age. Among our participants, 86 (14.2%) patients and 62 (14.1%) control subjects, respectively, were smokers. Based on a Cox regression model, evidence suggested that smoking status influenced the age at diagnosis of breast cancer (HR=0.78, 95% CI: 0.62-0.99, P=0.040). After stratification of the patients according to their menopausal status, the same results were obtained. The present study indicated that non-smokers have a lower age at diagnosis in comparison with patients who smoke.