Background: Patients who have suffered an acute ischemic stroke (AIS) and are smokers may have a better outcome following thrombolytic therapy when compared with non-smokers. While this finding is controversial, data on baseline clinical risk factors to predict treatment efficacy of thrombolytic therapy using ambulatory status in patients who suffered AIS and are smokers is not common. Methods: Between 2010 and 2016, retrospective data on patients who have suffered an AIS and received recombinant tissue plasminogen activator (rtPA) were obtained from Greenville health system registry. Assessment of clinical risk factors and the likelihood of an improvement in post-stroke ambulation among smokers and non-smokers was carried out using multivariate logistic regression. Results: Of 1001 patients, 70.8% were smokers and 29.2% non-smokers. Among the smokers and non-smokers, 74.6% and 84.6% improvement in ambulation respectively at discharge. The odds of improved ambulation decrease among smokers as age group increases compared to those below 50 [(60–69 years, aOR, 0.30, 95% C.I, 0.108–0.850, p < 0.05), (70–79 years aOR, 0.27, 95% C.I, 0.096–0.734, p < 0.05), (80+ years aOR, 0.16, 95% C.I, 0.057–0.430, P < 0.01). Patients with National Institute of Health Stroke Scale Score (NIHSS) score > 7 (reference <7) were 91% less likely to have improved ambulation among smokers and non-smokers (aOR, 0.09, 95% C.I, 0.055–0.155, P = 0.01), and (aOR, 0.08, 95% C.I, 0.027–0.214, P = 0.01) respectively. Atrial fibrillation was an independent predictor of decreased improvement in ambulation only among smokers (aOR, 0.58, 95% C.I, 0.356–0.928 P < 0.05). Conclusion: Our findings suggest that elderly smokers with atrial fibrillation would benefit more from aggressive management of atrial fibrillation than non-smokers.

No description available.

BACKGROUND: Although prior studies have established the association of asthma with smoking and obesity, literature on difference-in-differences analyses involving sexual identity is sparse. Therefore, this study aimed to examine the between and within sexual identity-group differences in asthma prevalence among individuals who smoke and are obese. METHODS: We aggregated the 2017-2019 National Survey on Drug Use and Health data on adults ( = 128,319) to perform weighted multivariable logistic regression analysis and marginal estimates and marginsplot to determine asthma prevalence by sexual identity and the status of smoking and obesity. RESULTS: About 66% of the study population reported having asthma. Among the individuals with asthma, 42% were obese, 10% were daily cigarette smokers, and 6% identified as bisexual persons. Lesbian/gay daily smokers (86%) or former smokers (75%) had a higher probability of having asthma than bisexual (daily smokers = 78% vs former smokers = 72%) and heterosexual (daily smokers = 68% vs former smokers = 65%) persons. Within each sexual identity subgroup, daily smokers (68-86%) had the highest probability of asthma. Obese bisexual (73%) or lesbian/gay (72%) persons had higher probabilities of having asthma than heterosexual persons (69%). Obese (73%) or overweight (72%) bisexual (compared to normal weight = 70% or underweight = 51%) and obese (69%) or overweight (65%) heterosexual (compared to normal weight = 62% or underweight = 57%) persons had the highest probabilities of having asthma within their groups, whereas overweight persons (overweight = 81% vs underweight = 79%, normal weight = 78%, and obese = 72%) had the highest probabilities within lesbian/gay persons. CONCLUSIONS: Smoking and obesity show heightened odds for asthma, with significant odds for sexual minorities in asthma diagnosis relative to heterosexuals. These findings provide formative information for future longitudinal and experimental studies to explore these mechanisms of asthma risks among sexual and gender minorities.

Cigarette smoke contains sufficient carbon monoxide to induce maternal and fetal hypoxia. Hypoxia is a known teratogen, and consequently maternal smoking has been the focus of many studies on adverse birth outcomes, including cleft lip and palate. Current literature of epidemiological studies on smoking and clefts suggests a modest but statistically significant increase in risk of clefting associated with maternal smoking. A biological condition that may also contribute to hypoxia is anemia. Data from the Utah Child and Family Health Study was used to assess the effects of hypoxia-inducing conditions, maternal smoking, anemia, and their interaction, on the risk of having a child with a cleft. Smoking during the first trimester and hemoglobin levels ofless than 12.0 g/dL were the defined risk exposures and logistic regression modeling was used to test the hypotheses. Smoking during the first trimester of pregnancy was associated with increased risk of clefting; however, anemia did not appear to be associated with clefting in this population, and there was also no apparent additional increase in risk for those mothers who both smoked and were anemic. Prospects for future studies include using populations that have higher rates of anemia and smoking to gain more statistical power, and using more sensitive measures of red blood cell health other than hemoglobin. From a public health perspective, evidence from this study would suggest that efforts to promote smoking cessation in women of child-bearing years is of considerable importance.

Indiana University-Purdue University Indianapolis (IUPUI) / The smoking rate of low-income pregnant women is almost 4 times the rate for higher-income women. A better understanding of smoking within the low-income population is needed. The purpose of this dissertation was to study smoking and related factors for pregnant and postpartum women living in poverty. The first component used Rodger’s evolutionary concept analysis method and uncovered three attributes, four antecedents, and three consequences for smoking cessation. The second (N = 1,554) and third (N = 71,944) components were a secondary data analysis of first-pregnancy Medicaid-eligible women enrolled in the Nurse-Family Partnership program from 2011-2016. The second component explored patterns of smoking and depression and their associations. Eight distinct patterns of smoking and depression were found. Smokers were more likely than nonsmokers to have depressive symptoms at the end of pregnancy (OR = 1.37 [1.04, 1.81] and 12 months post-delivery (OR = 1.93 [1.47, 2.51]. The third component investigated covariates present during early pregnancy and their relationships with smoking status and sought to find best fitting predictive models. Multivariable logistic regression showed cigarette use in the 3 months prior to pregnancy and at program intake were significant predictors for smoking status at the end of pregnancy and 12 months post-delivery. Interactive Matrix Language, Structured Query Language, and iterations of logistic regression identified 5 covariates (high school education, cigarette use prior to pregnancy, smoking status at pregnancy baseline, depression, and self-mastery) for the best fitting model at the end of pregnancy and three additional covariates (post-secondary education, marital status, and race) for the 12 months post-delivery model. The area under the receiver operator characteristic curve was 0.9681 for the end of pregnancy model and 0.9269 for 12 months post-delivery model, indicating excellent prediction ability of the models. Results can be integrated in smoking prevention education, screening, and cessation intervention programs.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18160号 / 医博第3880号 / 新制||医||1003(附属図書館) / 31018 / 京都大学大学院医学研究科医学専攻 / (主査)教授 三森 経世, 教授 生田 宏一, 教授 宮地 良樹 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Background and study aims: It has been suggested that smoking may be associated with microscopic colitis (MC) in some studies; however, there are conflicting results in the current literature with many of these studies having significant limitations. Our study aims to offer a meta-analysis evaluating the association between MC, including both its subtypes, and smoking. Patients and methods: A systemic review was conducted in PUBMED, Embase, PubMed Central, and ScienceDirect databases from inception through December 2019. Effect estimates from the individual studies were extracted and combined using the random effect, generic inverse variance method of DerSimonian and Laird and a pooled odds ratio (OR) was calculated. Forest plots were generated, and publication bias was assessed for using conventional techniques. Results: Eight observation studies with a total of 1461 patients with MC were included in this study, 383 of whom were active smokers (26.2%). Current smoking was significantly associated with MC (OR 3.58, 95% CI, 2.51–5.11), lymphocytic colitis (LC) (OR 3.64, 95% CI, 2.46–5.38), and collagenous colitis (CC) (OR 4.43, 95% CI, 2.68–7.32). Gender-specific subgroup analysis showed a significant association with smoking was found for CC in men (OR 4.53, 95% CI, 1.59–12.85), CC in women (OR 3.27, 95% CI, 2.35–4.54), LC in women (OR 2.27, 95% CI, 1.27–4.06) and MC in women (OR 2.93, 95% CI, 2.09–4.10). We found no publication bias as assessed by the funnel plots and Egger's regression asymmetry test. Conclusion: Our meta-analysis found a statistically significant association between smoking and both subtypes of MC.

No description available.

No description available.

This thesis is concerned with the use of some of the newer techniques in a study of some of the effects of cigarette smoking on gastric secretion and gastric motility in normal subjects and in patients with active duodenal ulcers.