scholarly journals Mixed evidence for the compression of morbidity hypothesis for smoking elimination—a systematic literature review

2020 ◽  
Author(s):  
Charlotte M Dieteren ◽  
Timor Faber ◽  
Job van Exel ◽  
Werner B F Brouwer ◽  
Johan P Mackenbach ◽  
...  
Keyword(s):  
Smoking Status ◽  
Absolute Number ◽  
Health Expectancy ◽  
Current Evidence ◽  
Compression Of Morbidity ◽  
Healthy Life Years ◽  
Life Years ◽  
Relative Compression ◽  
The Absolute ◽  
Never Smokers

Abstract Background There is debate around the composition of life years gained from smoking elimination. The aim of this study was to conduct a systematic review of the literature to synthesize existing evidence on the effect of smoking status on health expectancy and to examine whether smoking elimination leads to compression of morbidity. Methods Five databases were systematically searched for peer-reviewed articles. Studies that presented quantitative estimates of health expectancy for smokers and non-/never-smokers were eligible for inclusion. Studies were searched, selected and reviewed by two reviewers who extracted the relevant data and assessed the risk of bias of the included articles independently. Results The search identified 2491 unique records, whereof 20 articles were eligible for inclusion (including 26 cohorts). The indicators used to measure health included disability/activity limitations (n=9), health-related quality of life (EQ-5D) (n=2), weighted disabilities (n=1), self-rated health (n=9), chronic diseases (n=6), cardiovascular diseases (n=4) and cognitive impairment (n=1). Available evidence showed consistently that non-/never-smokers experience more healthy life years throughout their lives than smokers. Findings were inconsistent on the effect of smoking on the absolute number of unhealthy life years. Findings concerning the time proportionally spent unhealthy were less heterogeneous: nearly all included articles reported that non-/never-smokers experience relatively less unhealthy life years (e.g. relative compression of morbidity). Conclusions Support for the relative compression of morbidity due to smoking elimination was evident. Further research is needed into the absolute compression of morbidity hypothesis since current evidence is mixed, and methodology of studies needs to be harmonized.

scholarly journals Gender and regional differentials in health expectancy in Greece

2013 ◽  
Vol 2 (2) ◽  
pp. 12 ◽  
Author(s):  
Christos Bagavos
Keyword(s):  
Health Status ◽  
Population Health ◽  
National Level ◽  
Good Health ◽  
National Health Survey ◽  
Health Policies ◽  
Health Expectancy ◽  
Healthy Life ◽  
Healthy Life Years ◽  
Life Years

<em>Background</em>. Differentials and inequalities in heath status are closely related to the implementation and the sustainability of public health policies. The paper investigates differences in health expectancy as an indicator of population health among regions and between genders.<em></em><br /><em>Design and Methods</em>. Based on activity limitation, we compute Healthy Life Years indicator by applying the prevalence-based Sullivan method. The analysis is based on data from the National Health Survey conducted in Greece in 2009 by the Hellenic Statistical Authority, carried out on a multistage probability sample of 6172 individuals.<br /><em>Results</em>. The results show that men are more likely than women to live a greater part of their life in good health. When regions are considered (NUTS_1 and NUTS_2 levels), the resulting diversities in healthy life years are more pronounced than those in life expectancy.<br /><em>Conclusions</em>. The paper provides additional insights about health status discrepancies among Greek geographic regions and between genders. The results indicate that men are more likely to report to be in good health than women, and the differences by gender are more pronounced at regional than at national level. This empirical evidence can be used for monitoring both, the population health status and the undesired differentials in health expectancy, and may therefore be a useful tool for health policies aiming at reducing heath inequalities among individuals.<br />

The Issue of Sustainability in Third World Food Production (The Distinguishedl Lecture)

1992 ◽  
Vol 31 (4I) ◽  
pp. 511-534
Author(s):  
Winfried Von Urff
Keyword(s):  
Developing Countries ◽  
Population Growth ◽  
Food Production ◽  
Third World ◽  
Total Population ◽  
Absolute Number ◽  
Comprehensive Analysis ◽  
World Food ◽  
The Absolute ◽  
The Difference

In spite of the fact that food production in developing countries doubled over the last 25 years undernutrition is still widely spread. At the beginning of the eighties, according to FAO, 335 to 494 million people in developing countries suffered from serious undernutrition the difference being due to different concepts to determine undernutrition on which scientist were unable to find a consensus.) Unfortunately there is no recent comprehensive analysis of the food situation comparable to those of previous World Food Surveys but it can be taken for sure that the absolute number of undernourished has increased. According to unofficial FAO sources a figure of 870 million was estimated for 1990 (22 percent of the total population in developing countries) using the same concept that led to the figure of 494 million in 1979-81 (23 percent of the total population in developing countries) which means that most probably the number of undernourished increased at a rate slightly less than population growth.

scholarly journals Associations between smoking and blood-group, and the risk of dyslipidaemia amongst French women

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
C. J. MacDonald ◽  
A. L. Madika ◽  
G. Severi ◽  
A. Fournier ◽  
M. C. Boutron-Ruault
Keyword(s):  
Blood Group ◽  
Smoking Status ◽  
Effect Modification ◽  
Blood Groups ◽  
Cross Sectional ◽  
Increased Risk ◽  
Cardio Vascular Disease ◽  
Never Smokers ◽  
Cardio Vascular ◽  
Incident Cases

AbstractDyslipidaemia is a major risk factor for cardio-vascular disease, as it promotes atherosclerosis. While cross-sectional studies have identified higher serum cholesterol amongst individuals with the A blood group, there is less evidence from prospective studies whether this translates into a higher risk of dyslipidaemia that requires treatment, nor if this genetic factor interacts with smoking status. This study aimed to prospectively determine potential associations between smoking, ABO blood groups, and risk of incident dyslipidaemia requiring treatment, and to assess associations over strata of blood ABO group. We assessed associations between blood ABO group, smoking and dyslipidaemia in 74,206 women participating in the E3N cohort. We included women who did not have cardiovascular disease at baseline. Logistic regression was used to determine associations between ABO group, smoking and prevalent dyslipidaemia at baseline. Cox proportional hazard models were then used to determine if blood ABO group and smoking were associated with the risk of incident dyslipidaemia, amongst women free of dyslipidaemia at baseline. At baseline 28,281 women with prevalent dyslipidaemia were identified. Compared to the O-blood group, the non-O blood group was associated higher odds of with prevalent dyslipidaemia (ORnon-O = 1.09 [1.06: 1.13]). Amongst the women free of dyslipidaemia at baseline, 6041 incident cases of treated dyslipidaemia were identified during 454,951 person-years of follow-up. The non-O blood groups were associated with an increased risk of dyslipidaemia when compared to the O-group (HRnon-O = 1.16 [1.11: 1.22]), specifically the A blood-group (HRA = 1.18 [1.12: 1.25]). Current smokers were associated with an increased risk of incident dyslipidaemia (HR smokers = 1.27 [1.16: 1.37]), compared to never-smokers. No evidence for effect modification between smoking and ABO blood group was observed (p-effect modification = 0.45), although the highest risk was observed among AB blood group women who smoked (HR = 1.76 [1.22: 2.55]). In conclusion, the non-O blood groups, specifically the A group were associated with an increased risk of dyslipidaemia. Current smokers were associated with a 30% increased risk of dyslipidaemia. These results could aid in personalised approaches to the prevention of cardiovascular risk-factors.

scholarly journals AB0588 INFECTION AGGRAVATED DECREASE OF THE LEVEL OF TH17 AND TREG CELLS AND LOW-DOSE IL-2 REBALANCED TH17/TREG IN THE PERIPHERAL BLOOD OF PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1591.3-1591
Author(s):  
Y. Liang ◽  
H. Y. Wen ◽  
Y. Duan ◽  
Y. Liu ◽  
Z. Yu ◽  
...  
Keyword(s):  
T Cells ◽  
Low Dose ◽  
Lymphocyte Subsets ◽  
Absolute Number ◽  
Treg Cells ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Infection Group ◽  
The Absolute ◽  
Organ Infection

Background:Idiopathic inflammatory myopathies (IIM) are featured by a series of clinical presentation such as proximal muscle weakness, increased serum levels of creatine kinase and other muscle enzymes and involvement of other organs and systems[1, 2], which results in high morbidity and early mortality[3]. We have known the changes of the level of Th17 and Treg cells in IIM in previous studies[4-6]. However, whether infection affects lymphocyte subsets or not and whether the effect of low-dose interleukin-2 (IL-2) can be influenced by the use of immunosuppressants or not are still unclear.Objectives:The study aimed to explore the changes of lymphocyte subsets in patients of IIM with or without important organ infection, and the restoration of Th17/Treg after receiving low-dose IL-2.Methods:A total of 118 IIM patients were enrolled and classified into infection group and non-infection group based on the important organ infection. Of them, 48 cases were treated with low dose IL-2 (5.0*105IU for 5 days). The absolute number of peripheral total T, B, CD4+T, CD8+T, NK, Th1, Th2, Th17 and Treg cell subsets were analyzed by flow cytometry combined with absolute counting beads. Clinical data, laboratory examinations and the levels of peripheral lymphocyte subsets were analyzed retrospectively.Results:In these patients, especially in the infection group, the absolute number of T, CD4+T, CD8+T, NK, Th1, Th2, Th17 and Treg cells were significantly decreased as compared with that in the healthy controls, which were significantly increased by low dose IL-2 (especially Treg cells) treatment. The levels of ESR, LDH and HBDH and the ratio of Th17/Treg were significantly lower than those before IL-2 treatment (Z=-2.237, -2.083, -2.140, -3.663,P=0.025, 0.037, 0.032, 0.000). The 48 cases who received IL-2 treatment were divided into 2 groups according to whether they used immunosuppressants. There was no significant difference in the absolute number of T, B, CD4+T, CD8+T, Th1, Th2, Th17 and Treg cells, the proportion of Th17 and Treg cells and the ratio of Th17/Treg between the 2 groups (P>0.05).Conclusion:Global decrease in lymphocyte subsets was found in IIM patients, especially those who had important organ infection. A significant re-balance of Th17/Treg was observed after receiving treatment with low-dose IL-2. Furthermore, the restoration of lymphocyte subsets showed similar degree after treatment with or without immunosuppressants. Low-dose IL-2 may become a potential therapy for IIM patients. The mechanism of lymphocyte decrease in IIM is required further to study.References:[1]Clark K E N, Isenberg D A. A review of inflammatory idiopathic myopathy focusing on polymyositis[J]. European Journal of Neurology, 2017.[2]Tieu J, Lundberg IE, Limaye V. Idiopathic inflammatory myositis. Best Pract Res Clin Rheumatol. 2016. 30(1): 149-68.[3]Mandel DE, Malemud CJ, Askari AD. Idiopathic Inflammatory Myopathies: A Review of the Classification and Impact of Pathogenesis. Int J Mol Sci. 2017. 18(5).[4]Zhang SX, Wang J, Sun HH, et al. Circulating regulatory T cells were absolutely decreased in dermatomyositis/polymyositis patients and restored by low-dose IL-2. Ann Rheum Dis. 2019 .[5]Espinosa-Ortega F, Gómez-Martin D, Santana-De Anda K, Romo-Tena J, Villaseñor-Ovies P, Alcocer-Varela J. Quantitative T cell subsets profile in peripheral blood from patients with idiopathic inflammatory myopathies: tilting the balance towards proinflammatory and pro-apoptotic subsets. Clin Exp Immunol. 2015. 179(3): 520-8.[6]Feng M, Guo H, Zhang C, et al. Absolute reduction of regulatory T cells and regulatory effect of short-term and low-dose IL-2 in polymyositis or dermatomyositis. Int Immunopharmacol. 2019. 77: 105912.Acknowledgments:Thanks for the support of my teachers, classmates and my family.Disclosure of Interests:None declared

The Impact of Age and Gender on Hematopoietic Stem Cells and Immune Contexture of the Bone Marrow Microenvironment

2020 ◽  
pp. 1-6
Author(s):  
Rebar N. Mohammed
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Hematopoietic Stem Cells ◽  
Immune Cells ◽  
Absolute Number ◽  
Cell Number ◽  
Hematopoietic Stem ◽  
The Absolute ◽  
And Gender ◽  
The Impact

Hematopoietic stem cells (HSCs) are a rare population of cells that reside mainly in the bone marrow and are capable of generating and fulfilling the entire hematopoietic system upon differentiation. Thirty-six healthy donors, attending the HSCT center to donate their bone marrow, were categorized according to their age into child (0–12 years), adolescence (13–18 years), and adult (19–59 years) groups, and gender into male and female groups. Then, the absolute number of HSCs and mature immune cells in their harvested bone marrow was investigated. Here, we report that the absolute cell number can vary considerably based on the age of the healthy donor, and the number of both HSCs and immune cells declines with advancing age. The gender of the donor (male or female) did not have any impact on the number of the HSCs and immune cells in the bone marrow. In conclusion, since the number of HSCs plays a pivotal role in the clinical outcome of allogeneic HSC transplantations, identifying a younger donor regardless the gender is critical.

Risk Factors for Olfactory and Gustatory Dysfunctions in Patients with SARS-CoV-2 Infection

2021 ◽  
pp. 1-8
Author(s):  
Francesca Galluzzi ◽  
Veronica Rossi ◽  
Cristina Bosetti ◽  
Werner Garavello
Keyword(s):  
Risk Factors ◽  
Smoking Status ◽  
Inverse Association ◽  
Current Smoking ◽  
Logistic Regression Models ◽  
Respiratory Allergies ◽  
History Of ◽  
Never Smokers ◽  
Smell Loss ◽  
Relevant Covariates

<b><i>Introduction:</i></b> Smell and taste loss are characteristic symptoms of SARS-CoV-2 infection. The aim of this study is to investigate the prevalence and risk factors associated with olfactory and gustatory dysfunctions in coronavirus disease (COVID-19) patients. <b><i>Methods:</i></b> We conducted an observational, retrospective study on 376 patients with documented SARS-CoV-2 infection admitted to the San Gerardo Hospital in Monza, Italy, from March to July 2020. All patients answered a phone questionnaire providing information on age, sex, smoking status, and clinical characteristics. Adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated through logistic regression models including relevant covariates. <b><i>Results:</i></b> The prevalence of olfactory and gustatory dysfunctions in COVID-19 patients was 33.5 and 35.6%, respectively. Olfactory dysfunctions were significantly directly associated with current smoking and history of allergy, the multivariable ORs being 6.53 (95% CI 1.16–36.86) for current smokers versus never smokers, and 1.89 (95% CI 1.05–3.39) for those with an allergy compared to those without any allergy. Respiratory allergy in particular was significantly associated with olfactory dysfunctions (multivariable OR 2.30, 95% CI 1.02–5.17). Significant inverse associations were observed for patients aged 60 years or more (multivariable OR 0.33, 95% CI 0.19–0.57) and hospitalization (multivariable OR 0.22, 95% CI 0.06–0.89). Considering gustatory dysfunctions, after allowance of other variables a significant direct association was found for respiratory allergies (OR 2.24, 95% CI 1.03–4.86), and an inverse association was found only for hospitalization (OR 0.21, 95% CI 0.06–0.76). <b><i>Conclusion:</i></b> Our study indicates that current smoking and history of allergy (particularly respiratory) significantly increase the risk for smell loss in COVID-19 patients; the latter is also significantly associated to taste loss. Hospitalization has an inverse association with the risk of olfactory and gustatory dysfunctions, suggesting that these may be symptoms characteristics of less severe SARS-CoV-2 infection.

scholarly journals Self-reported and cotinine-verified smoking and increased risk of incident hearing loss

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Woncheol Lee ◽  
Yoosoo Chang ◽  
Hocheol Shin ◽  
Seungho Ryu
Keyword(s):  
Smoking Status ◽  
Objective Measure ◽  
Self Report ◽  
Urinary Cotinine ◽  
Increased Risk ◽  
Former Smokers ◽  
Never Smokers ◽  
Time Varying Covariates ◽  
New Onset

AbstractWe examined the associations of smoking status and urinary cotinine levels, an objective measure of smoking, with the development of new-onset HL. This cohort study was performed in 293,991 Korean adults free of HL who underwent a comprehensive screening examination and were followed for up to 8.8 years. HL was defined as a pure-tone average of thresholds at 0.5, 1.0, and 2.0 kHz ≥ 25 dB in both ears. During a median follow-up of 4.9 years, 2286 participants developed new-onset bilateral HL. Self-reported smoking status was associated with an increased risk of new-onset bilateral HL. Multivariable-adjusted HRs (95% CIs) for incident HL comparing former smokers and current smokers to never-smokers were 1.14 (1.004–1.30) and 1.40 (1.21–1.61), respectively. Number of cigarettes, pack-years, and urinary cotinine levels were consistently associated with incident HL. These associations were similarly observed when introducing changes in smoking status, urinary cotinine, and other confounders during follow-up as time-varying covariates. In this large cohort of young and middle-aged men and women, smoking status based on both self-report and urinary cotinine level were independently associated with an increased incidence of bilateral HL. Our findings indicate smoking is an independent risk factor for HL.

Abstract P259: Smoking Increases Risks of Death and Stroke in Both Men and Women. Absolute Risk Difference of Stroke is Likely to be Larger in Women

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Masaki Ohsawa ◽  
Kuniaki Ogasawara ◽  
Shinichi Omama ◽  
Kozo Tanno ◽  
Kazuyoshi Itai ◽  
...  
Keyword(s):  
Smoking Status ◽  
Absolute Risk ◽  
Incidence Rates ◽  
Risk Difference ◽  
Current Smoker ◽  
Men And Women ◽  
Risk Of Death ◽  
Adjusted Rate ◽  
Never Smokers ◽  
Rate Ratios

Background: Smoking is an important risk factor for cardiovascular disease, however, to what extent smoking increases excessive deaths and strokes in a general population has not been sufficiently examined especially in women. Methods: A total of 10,382 female and male participants aged 65 years or older were divided into two groups according to smoking status (current smoker; never smoker). Past smokers were excluded. Main outcomes were all-cause death and incident stroke. Age-adjusted mortality and incidence rates were estimated in the groups using Poisson’s regression analysis. Age-adjusted rate ratios (RR) and excess events (EE per 1000 person-years) attributable to smoking were determined using the rate in never smokers as a reference. Results: There were 1410 deaths and 735 strokes during the 9.0-year observation period (90,099 person-years). Smoking contributed to a 2.3-fold higher risk of death in women and 1.8-fold higher risk in men. It contributed to 12 excess deaths per 1000 person-years in both men and women. The rate ratio and excessive events of stroke were likely to be higher in women than those in men (RR: 2.6 vs. 1.6; EE: 9.3 vs 5.0, see table). Conclusion: Smoking significantly increases risks of death and stroke not only in men but also in women. Absolute risk difference of stroke attributable to smoking is likely to be larger in women than in men.

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