RESUMEN

Introdução: O câncer de pulmão é uma doença grave, sendo a segunda maior causa de morte em todo o mundo, entretanto, em alguns países desenvolvidos, tornou-se já a primeira causa de morte. Cerca de 90% dos casos de neoplasia pulmonares são causados pela inalação da fumaça do cigarro. Objetivo: Correlacionar a prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, além de demonstrar a associação destes com sexo e faixa etária. Métodos: Estudo de caráter ecológico acerca da prevalência de tabagismo e morbimortalidade por câncer de pulmão nos estados brasileiros, nos períodos de 2013 e 2019, dividida por sexo e faixa etária. Foram utilizados bancos de coleta de dados como o Tabnet e Pesquisa Nacional de Saúde. Resultados: As maiores taxas de mortalidade e internações hospitalares foram do público masculino, em 2013, com taxa de 2,7 e 10, respectivamente, e em 2019 com 3,3 e 11,9, respectivamente. Ademais, a maior prevalência de tabagismo foi encontrada nos homens; entretanto seu índice tem caído, enquanto a quantidade de mulheres tabagistas tem aumentado. A Região Sul demonstrou maiores números de mortalidade em ambos os períodos estudados, com taxas de 4,9 e 5,8 por 100 mil habitantes, e morbidade hospitalar com 19,9 e 23,5 por 100 mil habitantes. Já a Região Norte se configurou com as menores prevalências: em 2013 apresentou taxa de óbito por câncer de pulmão de 1,0 e morbidade hospitalar de 3,5/100 mil habitantes, em 2019 apresentou taxa de mortalidade de 4,6 e internações de 1,6/100 mil habitantes. Os coeficientes de correlação de morbidade hospitalar e prevalência de tabagismo foram R2=0,0628, r=0,251 e p=0,042, enquanto os de mortalidade e prevalência de tabagismo foram R2=0,0337, r=0,183 e p=0,140. Conclusões: Na presente pesquisa, pode-se inferir que houve associação positiva na comparação entre taxa de morbidade hospitalar e prevalência de tabagismo; em contrapartida, não foi possível observar associação positiva na correlação da taxa de mortalidade por câncer de pulmão e prevalência de tabagismo.

Introduction: Lung cancer is a serious disease, being the second leading cause of death worldwide. Moreover, in some developed countries, it has already become the leading cause of death. About 90% of lung cancer cases are caused by cigarette smoking. Objective: To correlate the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states, and to demonstrate their association with sex and age group as well. Methods: An ecological study on the prevalence of smoking and lung cancer morbidity and mortality in Brazilian states between 2013 and 2019, divided by sex and age group. The data collection databases Tabnet and National Health Survey were used. Results: The highest rates of mortality and hospital admissions were among men, in 2013 with a rate of 2.7 and 10, respectively, and in 2019 with 3.3 and 11.9, respectively. In addition, the highest prevalence of smoking was found in men, but this rate has fallen, while the number of women smokers has increased. The South region showed higher mortality rates in both periods studied, with rates of 4.9 and 5.8 per 100,000 inhabitants, and hospital morbidity with 19.9 and 23.5 per 100,000 inhabitants. The North region had the lowest prevalence, where in 2013, it had a death rate from lung cancer of 1.0 and hospital morbidity of 3.5/100 thousand inhabitants, and where in 2019, it had a mortality rate of 4.6 and hospitalizations of 1.6/100 thousand inhabitants. The correlation coefficients for hospital morbidity and smoking prevalence were R2=0.0628, r=0.251 and p=0.042, while for mortality and smoking prevalence, these were R2=0.0337, r=0.183 and p=0.140. Conclusions: In the present study, it can be inferred that there was a positive association between hospital morbidity rate and prevalence of smoking, while it was not possible to observe a correlation between lung cancer mortality rate and prevalence of smoking.

Introducción: El cáncer de pulmón es una enfermedad grave, siendo la segunda causa de muerte en todo el mundo, sin embargo, en algunos países desarrollados, ya se ha convertido en la primera causa de muerte. Alrededor del 90% de los casos de neoplasias pulmonares están causados por la inhalación del humo del cigarrillo. Objetivo: Correlacionar la prevalencia de tabaquismo y la morbimortalidad por cáncer de pulmón en los estados brasileños, además de demostrar la asociación de estos con el género y el grupo de edad. Métodos: estudio ecológico sobre la prevalencia de tabaquismo y morbimortalidad por cáncer de pulmón en los estados brasileños, dentro de los períodos 2013 y 2019, divididos por sexo y grupo de edad. Se utilizaron bancos de recogida de datos como Tabnet y la Encuesta Nacional de Salud. Resultados: las mayores tasas de mortalidad e ingresos hospitalarios se dieron en el público masculino, en 2013 con una tasa de 2,7 y 10, respectivamente, y en 2019 con 3,3 y 11,9, respectivamente. Además, la mayor prevalencia del tabaquismo se encontró en los hombres, sin embargo, su tasa ha disminuido, mientras que la cantidad de mujeres fumadoras ha aumentado. La región Sur presentó cifras más altas de mortalidad en ambos periodos estudiados, con tasas de 4,9 y 5,8 por 100.000 habitantes, y de morbilidad hospitalaria con 19,9 y 23,5 por 100.000 habitantes. Mientras que la región Norte se configuró con las prevalencias más bajas, en 2013 presentó una tasa de mortalidad por cáncer de pulmón de 1,0 y una morbilidad hospitalaria de 3,5/100.000 habitantes, en 2019 presentó una tasa de mortalidad de 4,6 y hospitalizaciones de 1,6/100.000 habitantes. Los coeficientes de correlación para la morbilidad hospitalaria y la prevalencia del tabaquismo fueron R2=0,0628, r=0,251 y p=0,042, mientras que para la mortalidad y la prevalencia del tabaquismo fueron R2=0,0337, r=0,183 y p=0,140. Conclusiones: En la presente investigación se puede inferir que existe una asociación positiva en la comparación entre la tasa de morbilidad hospitalaria y la prevalencia de tabagismo, en contrapartida, no fue posible observar una asociación positiva en la correlación de la tasa de mortalidad por cáncer de pulmón y la prevalencia de tabagismo.

Asunto(s)

RESUMEN

BACKGROUND:  E-cigarettes are the most-used tobacco product among US adolescents and are associated with nicotine addiction. This qualitative investigation aimed to understand adolescents' experiences and perceptions with nicotine addiction, and related influences of addiction, to inform product regulation, health communication, and cessation resource development. METHODS:  Between May 2020 and December 2021, in-depth, semi-structured individual interviews were conducted with 47 California (United States) adolescents ages 13-17 who reported recent tobacco use (primarily e-cigarette use). The topic of addiction both arose organically and followed specific interviewer questions. Researchers used thematic analysis techniques to identify unifying themes related to addiction. RESULTS:  Adolescents described e-cigarette addiction in ways that reflected a loss of control over their routines and activities and as physical symptoms, including reward and withdrawal. While some viewed addiction risk as a reason not to vape, others perceived it possible to use e-cigarettes and avoid or manage addiction. Specific characteristics of e-cigarette devices, particularly disposable nicotine-salt products, including flavors, "cool" designs, concealable size and odor, low price, and ease-of-use, were seen as enhancing addiction risk. Quit attempts were difficult and usually unsupported by adults or formal cessation aids. CONCLUSIONS:  For many adolescents, addiction is a major component of their experience with e-cigarettes, often in ways that disrupt their routines and reduce their quality of life. Tobacco control or regulation could target e-cigarette product characteristics to decrease potential for addiction among adolescents. Needed are youth-targeted public communication about nicotine addiction and adolescent-tailored, evidence-based cessation support.

RESUMEN

Background: Research on individual differences in brain structural features of internet gaming disorder (IGD) and established addictions such as tobacco use disorder (TUD) is currently limited. This study utilized normative modeling to analyze the cortical thickness (CT) development patterns of male patients with IGD and TUD, aiming to provide further insights into whether IGD qualifies as an addiction. Methods: Surface-based brain morphometry (SBM) was used to calculate CT from T1-weighted magnetic resonance imaging data of 804 male participants (665 healthy individuals, 68 IGD and 71 TUD). Gaussian process regression was employed to generate normative models of CT development. Deviation maps were produced to depict deviations of IGD and TUD participants from the typical developmental patterns. Results: Both addiction groups exhibited widespread cortical thinning, particularly in regions such as the bilateral temporal pole and medial orbitofrontal cortex. The TUD group demonstrated a higher degree of individualization and limited spatial overlap compared to the IGD group. Opposite trends in CT changes were observed between the two groups in the bilateral pericalcarine cortex and pars triangularis. Conclusions: These findings regarding the similarities and differences between IGD and TUD provide support for the idea that IGD shares common features with substance-related addictions and contribute to a deeper understanding of the neural mechanisms underlying IGD.

RESUMEN

PURPOSE: To examine adolescents' perspectives regarding external and internal influences of the e-cigarette initiation process. DESIGN: Semi-structured, in-depth qualitative interviews. SETTING: California, remote videoconference. PARTICIPANTS: Adolescents ages 13-17 who currently or previously used e-cigarettes (n = 47). METHOD: Interviews occurred from May 2020-February 2021. Two researchers coded transcripts based on a codebook developed inductively. Coded excerpts were reviewed to identify encompassing themes related to adolescent e-cigarette initiation. RESULTS: Adolescents were often near e-cigarette use by peers, family members, and others, creating ample opportunities to try e-cigarettes in response to curiosity, peer pressure, and desires to cope with stress or belong to a group. Adverse first experiences were common (eg, throat irritation, nausea), but many adolescents vaped again or continued to use regularly in attempts to cement friendships or alleviate symptoms of stress and anxiety. Specific characteristics of e-cigarette devices, including low-cost, concealability, and variety in designs and flavors facilitated initiation, continued use, and nicotine dependence. CONCLUSIONS: Adolescents progress to e-cigarette use via a multistage process, starting where social expectations and opportunity converge. While individual circumstances vary, many continue to vape as a perceived coping tool for emotional issues, to gain social belonging, or influenced by e-cigarette characteristics that contribute to ongoing use and dependence. Efforts to deter use should address the devices themselves and the social forces driving youth interest in them.

RESUMEN

BACKGROUND: Studies have demonstrated the potential of repetitive transcranial magnetic stimulation (rTMS) to decrease smoking cravings in individuals with tobacco use disorder (TUD). However, the neural features underlying the effects of rTMS treatment, especially the dynamic attributes of brain networks associated with the treatment, remain unclear. METHODS: Using dynamic functional connectivity analysis, this study first explored the differences in dynamic functional network features between 60 subjects with TUD and 64 nonsmoking healthy controls (HCs). Then, the left dorsolateral prefrontal cortex (DLPFC) was targeted for a five-day course of rTMS treatment in the 60 subjects with TUD (active rTMS in 42 subjects and sham treatment in 18 subjects). We explored the effect of rTMS on the dynamic network features associated with rTMS by comparing the actively treated group and the sham group. RESULTS: Compared to nonsmokers, TUD subjects exhibited an increased integration coefficient between the frontoparietal network (FPN) and the basal ganglia network (BGN) and a reduced integration coefficient between the medial frontal network (MFN) and the FPN. Analysis of variance revealed that rTMS treatment reduced the integration coefficient between the FPN and BGN and improved the recruitment coefficient of the FPN. LIMITATIONS: This study involved a limited sample of young male smokers, and the findings may not generalize to older smokers or female smokers with an extensive history of smoking. CONCLUSION: rTMS treatment of the left DLPFC exhibited significant effectiveness in restructuring the neural circuits associated with TUD while significantly mitigating smoking cravings.

Asunto(s)

RESUMEN

BACKGROUND: There are no clinical practice guidelines addressing the treatment of tobacco-cannabis co-use and a dearth of studies to inform treatment for co-use. This narrative review aims to (1) summarize promising intervention components used in published co-use treatment studies, (2) describe key gaps and emerging issues in co-use, and (3) provide recommendations and considerations in the development and evaluation of co-use interventions. METHODS: We conducted a literature search in June 2024 across several databases to update previous reviews on tobacco-cannabis co-use treatment. We found 9 published intervention studies that specifically addressed treatment for both substances. Data from these studies were manually extracted and summarized. RESULTS: Most of the 9 included studies (1) focused on acceptability and/or feasibility, (2) provided both psychosocial/behavioral and pharmacotherapy intervention components, (3) were conducted in adults, and (4) were delivered in-person, with some having digital asynchronous components, for a 5-to-12-week duration. The most common psychosocial/behavioral strategies used were Cognitive Behavioral Therapy, Motivational Interviewing, and Contingency Management; while the most common pharmacotherapy was Nicotine Replacement Therapy. There was no evidence of compensatory use of tobacco or cannabis when providing simultaneous treatment for both substances. CONCLUSIONS: The literature to date provides support for well-integrated multi-component interventions of psychosocial/behavioral and pharmacotherapy strategies for co-use treatment. This review reinforces an urgent need for treatments targeting tobacco and cannabis co-use. Future interventions should address key gaps, including co-use of vaporized products among youth and young adults, tailored interventions for priority populations, and digital applications to increase reach and advance health equity.

Asunto(s)

RESUMEN

BACKGROUND: Internet gaming disorder (IGD) and tobacco use disorder (TUD) are two major addiction disorders that result in substantial financial loss. Identifying the similarities and differences between these two disorders is important to understand substance addiction and behavioral addiction. The current study was designed to compare these two disorders utilizing dynamic analysis. METHOD: Resting-state data were collected from 35 individuals with IGD, 35 individuals with TUD and 35 healthy controls (HCs). Dynamic coactivation pattern analysis was employed to decipher their dynamic patterns. RESULTS: IGD participants showed decreased coactivation patterns within the default mode network (DMN) and between the DMN and the salience network (SN). The SN showed reduced coactivation patterns with the executive control network (ECN) and DMN, and the ECN showed decreased coactivation patterns with the DMN. In the TUD group, the DMN exhibited decreased coactivation patterns with the SN, the SN exhibited reduced coactivation patterns with the DMN and ECN, and the ECN showed decreased coactivation patterns with the DMN and within the ECN. Furthermore, the triple network model was fitted to the dynamic properties of the two addiction disorders. Decoding analysis results indicated that addiction-related memory and memory retrieval displayed similar dysfunctions in both addictions. CONCLUSION: The dynamic characteristics of IGD and TUD suggest that there are similarities in the dynamic features between the SN and DMN and differences in the dynamic features between the DMN and ECN. Our results revealed that the two addiction disorders have dissociable brain mechanisms, indicating that future studies should consider these two addiction disorders as having two separate mechanisms to achieve precise treatment for their individualized targets.

Asunto(s)

RESUMEN

OBJECTIVES: Smoking remains the leading cause of preventable disease. However, smokers have shown poor compliance with smoking cessation clinics. Smartphone applications present a promising opportunity to improve this compliance. This study aimed to explore the relationship between nicotine dependence, smartphone usage patterns, and anticipated compliance with a smoking cessation application among smokers, with the goal of informing future development of such applications. METHODS: A total of 53 current smokers were surveyed using a questionnaire. Nicotine dependence was assessed using the Fagerstrom Test for Nicotine Dependence (FTND). Variables included the number of hours spent using a phone, willingness to quit smoking, number of previous quit attempts, desired number of text messages about smoking cessation, expected duration of application usage, and FTND scores. Kendall's partial correlation, adjusted for age, was employed for the analysis. RESULTS: The amount of time smokers spent on their mobile devices was negatively correlated with the number of smoking cessation text messages they wanted to receive (τ coefficient = -0.210, p = 0.026) and the duration they intended to use the cessation application (τ coefficient = -0.260, p = 0.006). Conversely, the number of desired text messages was positively correlated with the intended duration of application usage (τ coefficient = 0.366, p = 0.00012). CONCLUSIONS: Smokers who spent more time on their mobile devices tended to prefer using the cessation application for shorter periods, whereas those who desired more text messages about smoking cessation were more inclined to use the application for longer durations.

RESUMEN

Smoking is a significant risk factor for the development of many cancers. In addition, after a cancer dia-gnosis, it also has an adverse effect on survival, the course and effectiveness of cancer treatment and quality of life, and increases the likelihood of a number of other complications. Treating tobacco dependence reduces the risk of their occurrence or the extent of their consequences. A working group of authors from professional groups (the Section of Supportive Treatment and Care and the Section of Preventive Oncology of the Czech Society of Oncology of the Czech Medical Association of J. E. Purkyne, the Society for the Treatment of Tobacco Dependence, Czech Nurses Association, Working Group for the Prevention and Treatment of Tobacco Dependence of the Czech Medical Association J. E. P. and the Society for Treatment of Tobacco Dependence) prepared a simple basic scheme of intervention in contact with smokers in routine practice based on recommendations of professional societies, outcomes of studies, scientific literature and proven practice. A smoke-free environment, the importance of zero exposure to tobacco smoke, smoking cessation recommendations for smokers, relapse prevention for ex-smokers and the offer of tobacco dependence treatment should be a natural part of cancer care at least in the form of a brief DIK (abbreviation for "question - intervention - contact" in the Czech language) intervention. It is important to record smoking status, including exposure to second-hand smoke, in all patients, and to empathically repeat interventions in smokers (active and passive), including relapse prevention. This ap-proach contributes to abstinence in cancer patients and thus to higher efficacy of cancer treatment, longer survival and reduction of other risks.

Asunto(s)

RESUMEN

INTRODUCTION: Varenicline helps people who smoke quit at rates 2-3 times greater than placebo. Currently in the U.S., varenicline is not available over the counter (OTC). In this study, we assessed the safety and efficacy of 1mg and 0.5mg varenicline as an OTC medication for smoking cessation in comparison to placebo. METHODS: This randomized, double-blind, placebo-controlled study was performed at two clinical sites in the United States of n=313 people. The treatment period was 12 weeks. During the COVID pandemic, the protocol was modified to allow remote participation; verification of smoking status was via breath carbon monoxide levels for in-person visits and mailed urine cotinine kits for the remote participants. RESULTS: There was no difference in biologically confirmed continuous abstinence by condition between Weeks 8-12; however, the odds of biologically confirmed point prevalence abstinence were higher for those in the 1mg b.i.d. condition than for those in the placebo condition at Week 12 (OR 3.39; 95% CI 1.49, 7.71), and were higher for those assigned to the 1.0mg b.i.d. condition than the 0.5mg b.i.d. condition at Week 12 (OR 2.37; 95% CI 1.11, 5.05). Adverse events were modest, and as expected (vivid dreams and nausea in the medication conditions). CONCLUSIONS: The results are suggestive that varenicline is safe and effective as an OTC medication.

RESUMEN

Background/Objectives: Despite the availability of effective pharmacotherapy and evidence-based treatments, a substantial proportion of smokers do not seek treatment. This study aims to explore the cognitive distortions associated with not seeking evidence-based smoking cessation treatment and to identify cognitive barriers. Methods: The research conducted in Istanbul between October and December 2017 employs a cross-sectional design and includes two groups: a treatment-seeking group comprising 156 patients diagnosed with tobacco use disorder and a non-treatment seeking group of 78 patients with tobacco use disorder who had never sought professional help for smoking cessation. A comprehensive data collection process was used, including sociodemographic information, cognitive distortion assessment using the cognitive distortions scale, a smoking-related cognitive distortions interview and the Fagerström Test for Nicotine Dependence. Results: While no significant sociodemographic differences were observed between the treatment-seeking and non-treatment-seeking groups, the study found that higher nicotine dependence was associated with a higher likelihood of seeking treatment. The treatment-seeking group displayed significantly higher levels of "all-or-nothing thinking" cognitive distortions related to smoking and smoking cessation. Conversely, the non-treatment-seeking group exhibited elevated levels of cognitive distortions such as "labeling", "mental filtering", "should statements" and "minimizing the positive" regarding receiving smoking cessation treatment. Conclusions: Understanding the cognitive distortions associated with treatment-seeking behavior for tobacco use disorder is crucial for developing targeted public-based interventions, public service announcements for tobacco use prevention and encouraging individuals to seek evidence-based treatment. Addressing these cognitive distortions can also potentially enhance the effectiveness of smoking cessation programs and reduce the global burden of tobacco-related diseases and mortality.

RESUMEN

Substance use disorders affect the mental activities of an individual's brain and behavior, leading to a loss of control over their substance use, such as drugs, alcohol, and medication. However, these disorders are treatable. This case report presents and discusses the management of a 39-year-old Hispanic male with a complex medical background and a history of substance use. The patient, who resided with his mother in the Bronx, was admitted to the Outpatient Program (OPD) at the Life Recovery Center (LRC) Addiction Treatment Center for concurrent alcohol and tobacco use disorders. The patient had a history of anemia after bariatric surgery 10 years ago and no significant psychiatric history. Therefore, a comprehensive approach was required for the patient's treatment. The case further highlights the patient's presentation, treatment options, medication, and outcomes, which are essential for managing substance use disorders in individuals with complex medical backgrounds.

RESUMEN

OBJECTIVE: Pharmacotherapy is commonly used during quit attempts and has shown an increase in the likelihood of achieving abstinence. However, with established pharmacotherapies, abstinence rates following a quit attempt remain low, and relapse is common. This review aims to investigate the efficacy and harm profiles of current and emerging pharmacotherapies. METHODS: Literature review of current and emerging pharmacotherapies for smoking cessation and tobacco use disorder. RESULTS: Emerging pharmacotherapies include new formulations of existing therapies, drug repurposing and some new treatments. New treatments are welcome and may incorporate different mechanisms of action or different safety and tolerability profiles compared to existing treatments. However, emerging pharmacotherapies have yet to demonstrate greater efficacy compared to existing treatments. The emergence of Electronic Nicotine Delivery Systems (ENDS) or 'vaping' is a feature of the current debate around tobacco use disorder. ENDS appear to facilitate switching but not quitting and are controversial as a harm minimisation strategy. LIMITATIONS: Studies included a broad range of therapies and trial designs that should be compared with their differences taken into consideration. CONCLUSION: Strategies to successfully quit smoking vary between individuals and may extend beyond pharmacotherapy and involve complex psychosocial factors and pathways.

Asunto(s)

RESUMEN

Previous researches of tobacco use disorder (TUD) has overlooked the hierarchy of cortical functions and single modality design separated the relationship between macroscopic neuroimaging aberrance and microscopic molecular basis. At present, intrinsic timescale gradient of TUD and its molecular features are not fully understood. Our study recruited 146 male subjects, including 44 heavy smokers, 50 light smokers and 52 non-smokers, then obtained their rs-fMRI data and clinical scales related to smoking. Intrinsic neural timescale (INT) method was performed to describe how long neural information was stored in a brain region by calculating the autocorrelation function (ACF) of each voxel to examine the difference in the ability of information integration among the three groups. Then, correlation analyses were conducted to explore the relationship between INT abnormalities and clinical scales of smokers. Finally, cross-modal JuSpace toolbox was used to investigate the association between INT aberrance and the expression of specific receptor/transporters. Compared to healthy controls, TUD subjects displayed decreased INT in control network (CN), default mode network (DMN), sensorimotor areas and visual cortex, and such trend of decreasing INT was more pronounced in heavy smokers. Moreover, various neurotransmitters (including dopaminergic, acetylcholine and µ-opioid receptors) were involved in the molecular mechanism of timescale decreasing and differed in heavy and light smokers. These findings supplied novel insights into the brain functional aberrance in TUD from an intrinsic neural dynamic perspective and confirm INT was a potential neurobiological marker. And also established the connection between macroscopic imaging aberrance and microscopic molecular changes in TUD.

Asunto(s)

RESUMEN

OBJECTIVES: The study aimed to evaluate the cost-effectiveness of the Pare de Fumar Conosco software compared with the standard of care adopted in Brazil for the treatment of smoking cessation. METHODS: In the cohort of smokers with multiple chronic conditions, we developed an decision tree model for the benefit measures of smoking cessation. We adopted the perspectives of the Brazilian Unified Health System and the service provider. Resources and costs were measured by primary and secondary sources and effectiveness by a randomized clinical trial. The incremental cost-effectiveness ratio (ICER) was calculated, followed by deterministic and probabilistic sensitivity analyses and deterministic and probabilistic sensitivity analyses. No willingness to pay threshold was adopted. RESULTS: The software had a lower cost and greater effectiveness than its comparator. The ICER was dominant in all of the benefits examined (-R$2 585 178.29 to -R$325 001.20). The cost of the standard of care followed by that of the electronic tool affected the ICER of the benefit measures. In all probabilistic analyses, the software was superior to the standard of care (53.6%-82.5%). CONCLUSION: The Pare de Fumar Conosco software is a technology that results in cost savings in treating smoking cessation.

Asunto(s)

RESUMEN

OBJECTIVE: This study aimed to evaluate the clinical efficacy and safety of administering intermittent theta burst stimulation (iTBS) to the medial prefrontal cortex for tobacco use disorder. METHODS: A randomized sham-controlled trial was conducted, with 38 participants receiving 28 sessions of active (n=25) or sham (n=13) iTBS (2 sessions/day, 600 pulses/session, 110% resting motor threshold, AFz target) along with smoking cessation education (Forever Free © booklets) over 14 visits. Primary outcomes included self-reported cigarette consumption and abstinence, verified by urinary cotinine tests. Secondary outcomes included symptoms of tobacco use disorder, negative mood, and safety/tolerability. RESULTS: Both active and sham groups reported reduced cigarette consumption (ß = -0.12, p = 0.015), cigarette craving (ß = -0.16, p = 0.002), and tobacco withdrawal symptoms (ß = -0.05, p < 0.001). However, there were no significant time x group interaction effects for any measure. Similarly, the two groups had no significant differences in urinary cotinine-verified abstinence. Adverse events occurred with similar frequency in both groups. CONCLUSION: There were no differences in cigarette consumption between the active and sham iTBS groups, both groups decreased cigarette consumption similarly. Further research is needed to compare iTBS to standard high-frequency rTMS and explore the potential differences in efficacy. Despite limitations, this study contributes to experimental design considerations for TMS as a novel intervention for tobacco and other substance use disorders, emphasizing the need for a more comprehensive understanding of the stimulation parameters and target sites.

Asunto(s)

RESUMEN

Introducción. La obesidad abdominal es considerada un factor de riesgo de enfermedad cardiovascular y diabetes. El consumo excesivo episódico de alcohol y la inactividad física también son factores de riesgo comportamentales asociados a enfermedades no transmisibles. Objetivo: Analizar la asociación entre la obesidad abdominal, el consumo de alcohol y la inactividad física en universitarios panameños. Materiales y métodos: Estudio transversal analítico realizado en 374 estudiantes universitarios panameños en el periodo abril ­ diciembre de 2021. Se implementó el cuestionario para la vigilancia de factores de riesgo de enfermedades no transmisibles de la Organización Mundial de la Salud y se evaluó la circunferencia de cintura. La obesidad abdominal se estableció con una circunferencia de cintura ≥80 cm en mujeres y ≥90 cm en hombres. Se realizaron análisis descriptivos, bivariados y múltiples usando modelos de regresión logística para determinar la asociación entre las variables del estudio. Las pruebas U Mann-Whitney y Chi cuadrado fueron utilizadas para analizar diferencias por sexo. Resultados: Una tercera parte de los universitarios participantes presentaron obesidad abdominal. Las mujeres reportaron mayores niveles de inactividad física (<0,0001) y conducta sedentaria (p=0,0010) que los hombres. Después de ajustar por sexo, edad y nivel socioeconómico, la obesidad abdominal estuvo asociada con la inactividad física (OR: 1,762, IC 95%: 1,040 ­ 2,985, p=0,035) y el consumo excesivo episódico de alcohol (OR 1,114, IC: 1,015 ­ 1,223, p=0,023). Conclusiones: Los universitarios panameños que reportaron bajos niveles de actividad física y consumo excesivo episódico de alcohol tuvieron una mayor probabilidad de registrar obesidad abdominal(AU)

Introduction. Abdominal obesity is considered a risk factor for cardiovascular disease and diabetes. Episodic excessive consumption of alcohol and physical inactivity are behavioral risk factors associated with non-communicable diseases. Objective: To analyze the association between abdominal obesity, alcohol consumption and physical inactivity in Panamanian university students. Materials and methods: Analytical cross-sectional study conducted on 374 Panamanian university students in the period April ­ December 2021. The questionnaire for the surveillance of risk factors for non-communicable diseases of the World Health Organization was implemented and waist circumference was evaluated. Abdominal obesity was established with a waist circumference ≥80 cm in women and ≥90 cm in men. Descriptive, bivariate, and multiple analyzes were performed using logistic regression models to determine the association between the study variables. The Mann-Whitney U and Chi square tests were used to analyze differences by sex. Results: A third of the participating university students had abdominal obesity. Women reported higher levels of physical inactivity (<0,0001) and sedentary behavior (p=0,0010) than men. After adjusting for sex, age and socioeconomic status, abdominal obesity was associated with physical inactivity (OR: 1,762, 95% CI: 1,040 ­ 2,985, p=0,035) and episodic heavy alcohol consumption (OR 1,114, CI: 1,015 ­ 1,223, p=0,023). Conclusions: Students who reported low levels of physical inactivity and binge drinking were more likely to have abdominal obesity(AU)

Asunto(s)

RESUMEN

BACKGROUND: Lung cancer screening with annual low-dose computed tomography (LDCT) in high-risk patients with exposure to smoking reduces lung cancer-related mortality, yet the screening rate of eligible adults is low. As hospitalization is an opportune moment to engage patients in their overall health, it may be an opportunity to improve rates of lung cancer screening. Prior to implementing a hospital-based lung cancer screening referral program, this study assesses the association between hospitalization and completion of lung cancer screening. METHODS: A retrospective cohort study of evaluated completion of at least one LDCT from 2014 to 2021 using electronic health record data using hospitalization as the primary exposure. Patients aged 55-80 who received care from a university-based internal medicine clinic and reported cigarette use were included. Univariate analysis and logistic regression evaluated the association of hospitalization and completion of LDCT. Cox proportional hazard model examined the time relationship between hospitalization and LDCT. RESULTS: Of the 1935 current smokers identified, 47% had at least one hospitalization, and 21% completed a LDCT during the study period. While a higher proportion of patients with a hospitalization had a LDCT (24%) compared to patients without a hospitalization (18%, p<0.001), there was no association between hospitalization and completion of a LDCT after adjusting for potentially confounding covariates (95%CI 0.680 - 1.149). There was an association between hospitalization time to event and LDCT completion, with hospitalized patients having a lower probability of competing LDCT compared to non-hospitalized patients (HR 0.747; 95% CI 0.611 - 0.914). CONCLUSIONS: In a cohort of patients at risk for lung cancer and established within a primary care clinic, only 1 in 4 patients who had been hospitalized completed lung cancer screening with LDCT. Hospitalization events were associated with a lower probability of LDCT completion. Hospitalization is a missed opportunity to refer at-risk patients to lung cancer screening.

Asunto(s)

RESUMEN

Nicotine use disorder remains a major public health emergency despite years of trumpeting the consequences of smoking. This is likely due to the complex interplay of genetics and nicotine exposure across the lifespan of these individuals. Genetics influence all aspects of life, including complex disorders such as nicotine use disorder. This review first highlights the critical neurocircuitry underlying nicotine dependence and withdrawal, and then describes the cellular signaling mechanisms involved. Finally, current genetic, genomic, and transcriptomic evidence for new drug development of smoking cessation aids is discussed, with a focus on the Neuregulin 3 Signaling Pathway.

Asunto(s)

RESUMEN

Purpose It has been suggested that compassion may decrease as students progress through their health care education and into clinical practice. The purpose of this pilot study was to determine whether an immersive curriculum thread of tobacco use disorder (TUD) cessation methodology, including behavioral techniques and communication skills, was associated with any change in dental hygiene and dental students perceived levels of compassion.Methods Dental hygiene (DH) and dental (DS) students (n=300) who had experienced an immersive TUD curriculum from West Virginia University were invited to complete the Sussex-Oxford Compassion Scale-Toward Others (SOC-O) online survey during the academic years 2022-2023. Possible scores on the SOC-O ranged from 20 (no or low compassion) to 100 (high compassion). The SOC-O scores for students who did not have clinical experience and limited TUD content (first- and second-year DH and DS students) were compared with SOC-O scores of students who had clinically applied the immersive tobacco cessation curriculum thread (third and fourth year DH and DS students) using t-tests.Results A total of seventy DH and DS students completed the SOC-O survey for a response rate of 23.3%. The overall mean SOC-O score was 83.0 for participants who lacked clinical experience (DH1, DH2, DS1, DS2) and 85.8 for participants with clinical experience using the TUD content (DH3, DH4, DS3, DS4) (p >0.05). For the SOC-O subscale analysis, both groups were similar in the recognition of suffering, universality of suffering, empathy/compassion for a person suffering, tolerance of uncomfortable feelings, and action/motivation to act to alleviate suffering.Conclusion A high level of perceived compassion among dental hygiene and dental students was associated with an immersive behavioral sciences curriculum thread for the assessment/treatment of TUD. Perceived levels of compassion were maintained for participants with and without clinical experience. Additional focus on compassion philosophy research within educational methodology is needed to maintain and improve compassion outcomes in the health care professions.

Asunto(s)