Hemotherapy services in the Brazil are regulated according to the RDC-153. In general, smokers presented HT and Hb levels inside of the reference values to blood donations. Considering that reference values are in ample zone, this work studied the quality of blood utilized to donation in relations to hematologic parameters and two blood enzyme activities, PBG-synthase and cholinesterase. Besides, we also investigated the sensitivity of these enzymes to nicotine in vitro. These experiments may be explanatory as regard possible use of these enzymes as biomarkers to this agent since they are sensitive to oxidant and insecticides compounds respectivily. For in vivo experiments, thirty blood samples were divided in three groups according to smoke habit from donators: NF - non smoker, F10 - smoker of 10±5 cigarettes/day and F20 - smoker of 20 or more cigarettes/day. For in vitro, only samples from not smoker donators were used. The results demonstrated that HT and Hb levels in the F20 group were significantly higher than others. The COHb levels were significantly higher in the both smoker groups, F10 and F20, than control group (NF). In relation to PBG-synthase and cholinesterase, smoke habit did not alter their activities. The F20 group presented a short decrease in PBG-synthase activity and in reactivation index. The cholinesterase activity from F20 group was higher (18%) than other groups, but not significantly. The in vitro results demonstrated that to PBG-synthase, only concentrations higher than 10 mM were able to inhibit the its activity, and the mechanism involved in these inhibition seems to be not related to oxidative effects since the DTT was not able to recover the activity. Total blood AChE is much more sensitive to nicotine than the plasma ChE, since the IC50 for these activities were 3 and 22 mM of nicotine, respectively. Taking as a whole, these results show the low sensitivity of these enzymes to smoke and to nicotine. However, it is need to consider that all experiments were conducted with substrate concentration at levels of saturation and this is not a physiologic condition. This fact is important mainly in relation to blood AChE since the competitive component is involved in this inhibition; thus, the endogenous inhibition can occur even when this not appear in the in vitro assays. Then, according to these data, we suggest more attention as to quality of human blood utilized in the hemoterapy services in the Brazil. / Os serviços de Hemoterapia no Brasil são regulados de acordo com a RDC- 153/2004. Em geral, os fumantes apresentam HT e níveis de Hb dentro dos valores de referência para a doação de sangue. Considerando que os valores de referência estão em uma faixa muito ampla, este trabalho estudou a qualidade do sangue utilizada para a doação em relação a alguns parâmetros hematológicos e em relação à atividade das enzimas sangüíneas, PBG-sintase e colinesterase. Além disto, também se investigou a sensibilidade destas enzimas à nicotina in vitro. Este estudo pode ajudar a esclarecer o possível uso destas enzimas como biomarcadores a este agente desde que as mesmas são sensíveis a compostos oxidantes e inseticidas, respectivamente. Para os experimentos in vivo, trinta amostras de sangue foram divididas em três grupos de acordo com o hábito de fumar dos doadores: NF - não fumante, F10 fumante de 10±5 cigarros/dia e F20 - fumante de 20 ou mais cigarros/dia. Para os experimentos in vitro, somente as amostras de doadores não fumantes foram usadas. Os resultados demonstraram que os níveis de HT e de Hb do grupo F20 foram significativamente mais elevados do que os dos outros grupos. Os níveis de COHb foram significativamente mais elevados em ambos os grupos de fumantes (F10 e F20) do que no grupo controle (NF). Com relação à PBG-sintase e a colinesterase, o hábito do fumar não alterou suas atividades. O grupo F20 apresentou uma pequena diminuição na atividade de PBG-sintase e no índice de reativação. A atividade da colinesterase do grupo F20 foi mais elevada (18%) do que a dos outros grupos, mas não significativamente. Os resultados in vitro demonstraram que para a PBG-sintase, somente as concentrações maiores que 10 mM foram capazes de inibir sua atividade, e o mecanismo envolvido nesta inibição parece não estar relacionado a efeitos oxidantes, uma vez que o DTT não recuperou a atividade. A AChE sangüínea foi mais sensível a nicotina que a colinesterase plasmática, uma vez que as IC50 para suas atividades foram 3 e 22 mM de nicotina, respectivamente. Tomando os resultados em conjunto, verificou-se que estas enzimas apresentam baixa sensibilidade ao tabagismo e a nicotina. Entretanto, é necessário considerar que todos os ensaios enzimáticos foram conduzidos com concentrações saturantes de substrato, o que não é uma condição fisiológica normal. Este fato é importante principalmente com relação a AChE de sangue, desde que a inibição por nicotina envolve um componente competitivo; assim, a inibição endógena pode ocorrer mesmo sem ser aparente nos testes in vitro. Estes resultados sugerem que mais atenção deve ser dispensada quanto à qualidade do sangue utilizado nos serviços hemoterapia no Brasil.

Submitted by Maike Costa (maiksebas@gmail.com) on 2016-01-06T14:43:21Z No. of bitstreams: 1 arquivototal.pdf: 1657736 bytes, checksum: 37cf08fcfbfe5530d575a79e23561391 (MD5) / Made available in DSpace on 2016-01-06T14:43:21Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1657736 bytes, checksum: 37cf08fcfbfe5530d575a79e23561391 (MD5) Previous issue date: 2015-10-14 / This master thesis analysis the constitution of the smoker subject in anti-smoking campaigns present in the cigarette packs. We also aims to verify how occur the governmentality that focus on the body of this subject and his discursive construction in anti-smoking campaigns, in the statements molded over the syncretic materiality of cigarette packs. We anchor us in the Discourse Analysis and its resonance in Brasil, with emphasis on Michel Foucault’s contributions, beyond the Historical Semiology of the picture, anchored on Jean-Jacques Courtine’s presuppositions. Methodologically, we cut out a corpus consisting of eighteen statements inside of the archive that constructs the smoker subject in cigarette packs and distributed them in three statements series, which are: Smoking and the risks of illness and death to the smoker subject; The risks of the passive smoking to health; and Smoking and sexual impotence. We use Foucault’s archegenealogy theory, that allows us excavate from the history the conditions of the emergency of the anti-smoking discourse, the interdiction of the cigarettes advertising and the transformations in the statements positions of the smoker subject in our society. In our analysis, we resort to nine cigarettes advertising, molded over between 1930 and 1990. Such advertising are in a memory domain of statements about smoking, what allows us to relation them to our corpus. We concluded that the government of the population is legitimated by knowledge and institutions, such as the medical knowledge and the legal institutions, that procure the anti-smoking discourse and control its way of circulation. The publishing of research about the harm of smoking to health shows that the smoke is a factor of risk for countless illness, making the body of the smoker subject stop of being associated with vitality, virility, beauty and glamour and started to be discoursed as an abnormal body, morbid, sexually impotent, that represents threat to all the population, since he causes illness and death of others individual with the passive smoking. / Esta dissertação analisa a constituição do sujeito fumante em campanhas antitabagistas nas embalagens de cigarro. Pretendemos também verificar como ocorre a governamentalidade que incide sobre o corpo desse sujeito e sua construção discursiva em campanhas de prevenção ao tabagismo, a partir de enunciados que circulam na materialidade sincrética das embalagens de cigarro. Ancoramo-nos na Análise do Discurso e suas ressonâncias no Brasil, com ênfase nas contribuições de Michel Foucault, além da Semiologia Histórica da imagem, que toma como base os pressupostos de Jean-Jacques Courtine. Metodologicamente, recortamos um corpus de 18 enunciados no interior do arquivo que constitui o sujeito fumante em embalagens de cigarro e os distribuímos em três séries enunciativas, quais sejam: Tabagismo e os riscos de doença e morte para o sujeito fumante; Os riscos do tabagismo passivo à saúde; e Tabagismo e impotência sexual. Utilizamos o aporte da arquegenealogia de Foucault, que nos permite escavar da história as condições de emergência do discurso antitabagista, a interdição das propagandas de cigarro e as transformações nas posições enunciativas do sujeito fumante em nossa sociedade. Em nossas análises, recorremos a nove propagandas de cigarro, veiculadas entre os anos de 1930 e 1990. Tais propagandas estão em um domínio de memória dos enunciados sobre o tabagismo, o que nos possibilita correlacioná-las ao nosso corpus. Concluímos que o governo da população é legitimado por saberes e instituições, tais como o saber médico e as instituições jurídicas, que agenciam o discurso antitabagista e controlam o seu modo de circulação. A divulgação de pesquisas científicas sobre os males do tabagismo à saúde mostrou que o fumo é um fator de risco para inúmeras doenças. Em decorrência disso, o corpo do fumante deixa de ser associado à vitalidade, virilidade, beleza e ao glamour, e passa a ser discursivizado como um corpo anormal, mórbido, sexualmente impotente e que representa uma ameaça para toda a população, pois causa o adoecimento e morte de outros indivíduos com o fumo passivo.

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is one of the main causes of morbidity and mortality in adults over 40 years old, characterized by airflow limitation and inflammation, with several systemic manifestations. Its main comorbidity is cardiovascular disease, which is responsible for a high impact on the prognosis and mortality of patients with this disease. The objective of this research was to compare smokers with and without COPD, required for suspicion of myocardial ischemia. Methods: The study population consisted of individuals submitted to Physical Stress Echocardiography (EEEF) for the diagnosis of myocardial ischemia, clinically investigated and submitted to pulmonary function examination to diagnose COPD. A total of 267 smokers were enrolled in a G1 group: those with a diagnosis of COPD with 121 participants (45%), 63.6% with mild COPD, according to GOLD criteria (2017); And group G2: without COPD with 146 participants (55%).Results: The presence of myocardial ischemia was significantly different between the groups (p<0.001), independently of the variables common to smokers and the classification of the disease. Statistically important was also the presence of comorbidities in the G1 group (osteoporosis, depression and neoplasms). It is concluded that in individuals with suspected myocardial ischemia, the investigation of COPD is fundamental, since its presence is statistically higher in smokers with COPD criteria, even in the initial phase. / Introdução: A Doença Pulmonar Obstrutiva Crônica (DPOC) é uma das principais causas de morbimortalidade no adulto acima de 40 anos, sendo caracterizada por limitação do fluxo aéreo e inflamação, com diversas manifestações sistêmicas. Sua principal comorbidade é a doença cardiovascular, responsável por alto impacto no prognóstico e mortalidade do portador dessa doença. O objetivo desta pesquisa foi comparar indivíduos tabagistas com e sem DPOC, requeridos por suspeita de isquemia miocárdica. Métodos: A população do estudo foi composta por indivíduos submetidos à Ecocardiografia sob Estresse pelo Esforço Físico (EEEF) para diagnóstico de isquemia miocárdica, investigados clinicamente e submetidos a exame de função pulmonar para diagnóstico da DPOC. Foram avaliados 267 tabagistas reunidos em grupo G1: os que preenchiam diagnóstico de DPOC com 121 participantes (45%), sendo 63,6% portadores da DPOC leve, segundo critério do GOLD (2017); e grupo G2: sem DPOC com 146 participantes (55%). Resultados: A presença de isquemia miocárdica foi significativamente diferente entre os grupos (p<0,001), independentemente das variáveis comuns aos tabagistas e da classificação da doença. Estatisticamente importante também foi a presença das comorbidades no grupo G1 (osteoporose, depressão e neoplasias). Conclui-se que em indivíduos com suspeita de isquemia miocárdica, a investigação da DPOC é fundamental, pois sua presença é estatisticamente maior nos tabagistas com critérios da DPOC, mesmo em fase inicial. / Aracaju, SE

Le cancer broncho-pulmonaire du non-fumeur est considéré comme une entité à part du fait de ses particularités épidémiologiques. Il est en outre un excellent modèle pour l'étude des facteurs de risque de cancer bronchique autres que le tabagisme actif. Il n'existe que très peu de données non-asiatiques concernant cette entité d'intérêt. Le bio-observatoire national des cancers bronchiques de non-fumeurs (BioCAST I IFCT-1002) est une étude épidémiologique multicentrique prospective. Son objectif principal est de décrire une population de patient strictement non-fumeur (moins de 100 cigarettes au cours de la vie) atteint de cancer bronchique, notamment sur le plan de leur profil moléculaire somatique et de leur exposition aux facteurs de risque. Les objectifs secondaires étaient d'étudier si l'exposition aux différents facteurs de risque pouvait influencer le profil moléculaire ; et d'utiliser cette cohorte particulière (grande fréquence et diversité de mutations somatiques attendue) afin de développer un test multiplex pour le diagnostic non-invasif du profil moléculaire somatique tumoral à partir d'ADN circulant. Au total, 384 patients non-fumeurs atteints de cancer broncho-pulmonaire ont été inclus dans cette cohorte. Deux-tiers d'entre eux étaient exposés au tabagisme passif, et il s'agissait essentiellement d'une exposition domestique touchant les femmes. Inversement, 35% des hommes étaient exposés de manière certaine à au moins un cancérogène professionnel, contre 8% des femmes. Au total, 72% des patients présentait une anomalie moléculaire, essentiellement au niveau de l'EGFR (51% de l'ensemble de la cohorte). Le genre, ou l'exposition à différents facteurs de risque (tabagisme passif, exposition professionnelle, exposition hormonale chez les femmes) n'affectait pas de manière significative et cliniquement pertinente le profil mutationnel, avec les limites liée à de faibles effectifs dans certains groupes et aux expositions multiples. Seule l'exposition professionnelle à l'amiante et / ou à la silice semble avoir pour effet de diminuer la fréquence des mutations de l'EGFR / Lung cancer in never smokers (LCINS) is considered as a separate entity given its epidemiological specificities. It is also a very interesting template to assess alternative risk factors for lung cancers than tobacco smoking. However, there is very little non-Asian data about this particular topic. The BioCAST / IFCT1002 study is a prospective, nationwide, and multi-centric epidemiological study. Its main objective was to describe a French population of lung cancers in lifelong never smokers (less than 100 cigarette during all lifetime); with a special focus on molecular somatic profile and risk-factors exposure. Secondary objectives were to assess the interaction between risk-factor exposure and molecular profile; and to use this particular cohort to develop a multiplex test for non-invasive diagnosis of tumor mutations in circulating free DNA. Overall, 384 patients were recruited in the cohort. Two-third were exposed to passive smoking (mainly women and in domestic setting). By contrast, 35% of men were definitely exposed to occupational carcinogens versus 8% of women. Finally, 72% were found with a somatic mutation, mainly in the EGFR gene (51% of the whole population). Gender or exposure to risk factors such as passive smoking, occupational exposure, or hormonal status in women, were not significantly associated with a specific and/or clinically meaningful molecular profile in tumor. These findings should be interpreted with caution given that some subgroups were small and/or with many simultaneous exposures. However, exposure to asbestos and/or silica was significantly associated to a decreased risk for EGFR mutation. On the pilot study (n=106), circulating free DNA was associated with tumor burden. The multiplex diagnosis (12 amplicons on 5 genes) by next-generation sequencing was feasible and gave encouraging results in stage 4 patients (67% sensitivity, 73% concordance rate). LCINS is an interesting entity for the study of non-tobacco-related cancer risk factors; or to optimize liquid biopsy strategy

Rökning är en av de vanligaste riskfaktorerna för hjärtkärlsjukdom i Sverige. Det finns ett flertal vetenskapligt underbyggda metoder för att sluta röka. Rådgivning och motiverande samtal kring rökavvänjning, samt nikotinersättningsmedel är väl utarbetade metoder. Syftet är att undersöka vilket stöd till rökfrihet som rökande patienter får på avdelning 10 på UMAS. Metoden är en enkätstudie och resultatet presenteras genom kvantitativ data. Urvalet består av de patienter som befann sig på avdelningen (n = 75) de två veckor som studien genomfördes. Urvalet är ett icke slumpmässigt, ett konsekutivt, urval. Resultatet av studien visar att ett stort antal patienter inte tillfrågas i fall de är rökare. Det är också vanligare att män tillfrågas i fall de röker än kvinnor. Bland rökande patienter var nikotinersättningsmedel den vanligaste metoden som erbjudits för att vara rökfri. Vidare visar resultatet att flera av de patienter som svarat att de inte är rökare, tidigare har rökt. Då materialet som ligger till underlag för studiens resultat är litet bör slutsatserna av studien betraktas med försiktighet. Av samma anledning kan inte heller resultatet av studien anses vara generaliserbart för populationen och bör därför inte överföras på annan verksamhet. / Smoking is one of the most common risk factors for heart and vascular diseases in Sweden. There are many scientifically proven methods to quit smoking. Among the well established ones are counselling and Motivational Interviewing together with different nicotine replacement therapies. The aim of this study was to investigate the support smoking patients are given not to smoke at ward 10 at UMAS. The chosen method is a survey study and the result is presented as quantitative data. The respondents are patients who were present at the ward (n = 75) during the two weeks when data was collected. It is a non-probability sample, a consecutive selection. The result shows that a large number of patients are not asked if they smoke. It is also more common to ask men than women if they smoke. Among the smoking patients nicotine replacement therapy is the most frequent method offered to stay off smoking. Further on the result shows that several of the patients who answered that they did not smoke were previous smokers. Considering the size of data collected the conclusions made in the study should be looked upon tentatively. For the same reason there is no possibility to generalize the result and convert it on to other areas.

Det finns ett starkt samband mellan cigarrettrökning och förekomst av parodontit. Parodontit är dosberoende och minskning av cigarrettrökning eller tobaksstopp har potential att förhindra utveckling av parodontit samt fortsatt progression av redan existerande parodontit. / <p>Inget</p>

一、研究目的：自從菸酒開放自由進口後，國內市場競爭更加劇烈，而反菸團體的活 動，消費者對健康意識的警悟，以及潛在消費人口結構的改變，都造成業者在經營上 的挑戰，本研究目的在試擬業者行銷策略。 二、文獻：本研究應用消費行為理論，生活型態理論，市場區隔理論，產品定位理論 及相關文獻。 三、研究方式：本研究採用問卷方式來收集初級資料，採用因素分析法，集群分析法 ，多元尺度法，區別分析法，卡方檢定與變異數分析法。 四、研究內容：根據問卷資料萃取生活型態構面，並進行市場區隔，並對不同特徵消 費群在人口統計變項，評估準則，消費行為上加以剖析其差異性。並針對吸菸者對品 牌與屬性的知覺與偏好態度作產品定位分析，以了解競爭態勢，與品牌理想點分析。 五、研究結果：本研究共區隔四個消費群簇，此四群在人口統計變項，消費行為，生 活型態構面與評估準則上均有顯著性的差異。第群訴求重點在於低價格。第二群訴求 重點在於翩翩紳士風度，第群訴求重點在於男子氣概，反抗權威的形象，第四群訴求 重點在於低尼古丁，低焦油含量。

本論文採問卷方式進行研究，研究對象為吸煙者。問卷共分四大部份，分別是一般化 生活型態、與吸煙有關之特殊化生活型態、吸煙動機和人口統計變項，目的在研究吸 煙者的香煙使用量、生活型態、吸煙動機、人口變項之間的相互關係，並試圖依生活 型態與吸煙動機將吸煙者加以區隔。 本論文共約五萬字，分成七章。第一章為緒論，包括六小節，分別說明台灣香煙消費 之概況、研究動機、研究目的、研究對象和研究之觀念架構。 第二章為理論與文獻探討，包括三個小節，分別探討非營利事業行銷、吸煙動機、吸 煙者之生活型態與人格等方面的理論。 第三章為研究方法，有五個小節，分別是研究程序、研究假設、研究母體與抽樣設計 、問卷回數與樣本描述。 第四章至第六章為研究結果，分別說明因素分析、假設檢 定、集群分析的結果。 最後一章是結論與建議，包括研究結論、對戒煙運動之行銷策略的建議、研究限制、 彌後研究之建議等四小節。

La morbi-mortalité élevée des carcinomes épidermoïdes de la cavité orale (CECO), qui peuvent se développer à partir de lésions orales à potentiel malin (LOPM), rend indispensable le développement de nouvelles stratégies thérapeutiques. Le décryptage de l’hétérogénéité moléculaire aux différentes étapes de la carcinogénèse orale pourrait permettre de personnaliser les stratégies thérapeutiques de prévention et de traitement de ces cancers. Notre objectif était de caractériser l’hétérogénéité transcriptomique des LOPM et des CECO.Nous avons d’abord défini des signatures transcriptomiques associées aux changements histologiques de la carcinogénèse orale observés dans le modèle murin induit par le 4-NQO, montrant la pertinence de l’analyse de la dynamique temporelle du transcriptome pour améliorer la prévention des CECO. Cependant, ce modèle ne représentant qu’un sous-groupe particulier des CECO, nous avons ensuite étudié l’hétérogénéité inter-lésionnelle des LOPM en identifiant deux sous-types transcriptomiques principaux nommés « classical » et « immunological », qui sont caractérisés par différents biomarqueurs de risque de CECO.Au stade invasif, nous avons également étudié l’hétérogénéité transcriptomique des CECO HPV-négatifs entre les patients non-fumeurs non-buveurs (NFNB) et les patients fumeurs buveurs (FB). Le microenvironnement immunitaire était la principale différence biologique entre NFNB et FB, suggérant un bénéfice accru des immunothérapies chez les NFNB. Le profil transcriptomique de réponse antivirale observé dans les CECO des NFNB pourrait être en faveur de leur origine virale. En conclusion, l’hétérogénéité transcriptomique des LOPM et CECO suggère de personnaliser les stratégies thérapeutiques des patients porteurs de ces lésions / Oral squamous cell carcinomas (OSCC), which may develop from oral premalignant lesions (OPL), are associated with a substantial morbidity and mortality. A better understanding of the molecular heterogeneity at different steps of oral carcinogenesis may help to refine prevention and treatment strategies of patients suffering from OPL and OSCC. Our goal was to decipher transcriptomic hetereogeneity of OPL as well as OSCC. Using the 4-NQO murine model of oral carcinogenesis, we first identified transcriptomic signatures that characterized the dynamics of gene expression changes through different stages of disease progression, and that could be relevant for refining prevention strategies. Because this model represents only a subgroup of patients suffering from OSCC, we then investigated inter-OPL molecular heterogeneity. We identified two distinct gene expression subtypes, which were named classical and immunological and were characterized by different biomarkers of cancer risk. At invasive steps, we investigated transcriptomic heterogeneity between HPV-negative OSCC from never-smoker never-drinker (NSND) and smoker drinker (SD) patients. The immune microenvironment was the main biological difference between OSCC from NSND and SD, suggesting higher clinical benefit of immunotherapies in OSCC from NSND. The antiviral gene expression profile of OSCC from NSND could suggest a viral origin.In conclusion, we investigated transcriptomic heterogeneity of OPL as well as OSCC, that could help to refine their prevention and treatment strategies