Orientador: Dionei Ramos / Resumo: Introdução: O tabagismo, bem como a abstinência deste, traz uma série de mudanças físicas e psicológicas. Na literatura a escala The Mood And Physical Symptoms Scale (MPSS) e a Wisconsin Smoking Withdrawal Scale (WSWS) são semelhantes e avaliam sintomas da abstinência do tabagismo, porém somente a WSWS é validada para o Brasil, sendo necessária a validação transcultural da MPSS. Além disso, é necessário verificar em momentos diferentes da abstinência, a responsividade das duas escalas a fim de quantificar corretamente os sintomas relacionados à Síndrome de Abstinência Tabagística (SAT). Objetivos: Verificar se MPSS é um instrumento válido e reprodutível para avaliar a presença de sintomas da SAT em tabagistas brasileiros e, determinar a diferença mínima clinicamente importante (DMI) da MPSS e WSWS após cessação. Métodos: Para a validação, 112 tabagistas responderam a escala MPSS e (WSWS) da seguinte forma: basal (avaliador 1 – MPSS e WSWS), após 30 minutos (avaliador 2 - MPSS) e após 15 dias (avaliador 1 - MPSS). Para a DMI foram avaliados 33 tabagistas após 24 horas e terceira semana após a cessação do tabagismo. Para reprodutibilidade na aplicação, e reaplicação da MPSS, o coeficiente de correlação intraclasse (CCI) foi utilizado, assim como o teste de Wilcoxon, para verificar se houve diferença entre as aplicações. A consistência interna da escala foi avaliada por meio do coeficiente alfa de Cronbach. A validade de constructo da MPSS em relação a WSWS foi avaliada por meio... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Smoking, as well as this abstinence, brings a series of physical and psychological changes. In the literature, The Mood and Physical Symptoms Scale (MPSS) and The Wisconsin Smoking Withdrawal Scale (WSWS) are similar and evaluate smoking cessation symptoms, but only the WSWS is validated for Brazil, requiring cross-cultural validation of the MPSS. In addition, it is necessary to verify at different times of abstinence the responsiveness of the two scales in order to correctly quantify the symptoms related to the Smoking Abstinence Syndrome (SAS). Aim: Verify if MPSS scale is a valid and reproducible instrument to evaluate the presence of SAT symptoms in Brazilian smokers and to determine the Minimal Detectable Change (MDC) of MPSS and WSWS after cessation of smoking. Methods: For validation, 112 smokers answered to the MPSS and WSWS as follows: baseline (appraiser 1 - MPSS and WSWS), after 30 minutes (appraiser 2 - MPSS) and after 15 days evaluator 1 - MPSS). For MDC, 33 smokers were assessed after 24 hours and third week after cessation of smoking. For reproducibility in the application and reapplication of the MPSS, the intraclass correlation coefficient (ICC) was used and the Wilcoxon test, to verify if there was a difference between the applications. The internal consistency of the scale was evaluated using the Cronbach alpha coefficient. The construct validity of the MPSS in relation to the WSWS was evaluated by means of the Spearman correlation coefficient... (Complete abstract click electronic access below) / Mestre

O cigarro é considerado pela Organização Mundial de Saúde como o maior agente de poluição ambiental doméstica atualmente. Muitos estudos têm analisado os efeitos do tabagismo passivo em seres humanos, mas pouco tem sido estudado em animais domésticos, assim como crianças, são os mais afetados pelo tabagismo passivo. O presente estudo busca correlacionar o exposição ao fumo passivo com a incidência de mutagênese através do teste da presença de micronúcleos nas células epiteliais da mucosa oral de cães expostos. Paralelamente, foi estudada a possível correlação desde dado com o nível de dependência à nicotina do proprietário, avaliada pelo teste de Fagerstrom. Para a avaliação da mutagênese, esfregaços da mucosa oral foram colhidos de 48 cães, 23 fumantes passivos e 25 não expostos. O número de micronúcleos por celula foi avaliado em todas as amostras. Os dados mostram que a incidência de micronúcleos foi estatisticamente maior nos animais fumantes passivos comparado com o controle (p < 0,001). Além disso, nos animais dos proprietários com escore 8 (dependência de nicotina muito alta) no Teste de Fagerstrom, a quantidade de micronúcleos foi significativamente maior do que nos animais de proprietários com escore 6 (alta dependência). Da mesma forma, nos cães de proprietários com escore 6 a incidência de micronúcleos foi estatisticamente maior que nos cães de proprietários com escore 3. Concluiu-se que existe uma associação entre a dependência da nicotina do proprietário e a frequência de alterações citogenéticas no cão exposto ao fumo passivo. Além das implicações para a saúde do animal, as observações do presente estudo podem contribuir para um estímulo à cessação do tabagismo em proprietários de animais domésticos / Cigarette smoking is considered by WHO as the major domestic air pollution agent. Many studies have addressed passive smoking and human beings but little has been studied about domestic animals. Domestic animals as well as children are dramatically affected by passive smoking. The present work tries to correlate passive smoking and micronucleus incidence in oral mucosa smears of pet dogs. In addition we studied a possible correlation between micronucleus incidence and owner´s nicotine dependence. With this purpose, owners were submitted to Fagerström questionnaire to address nicotine dependence. In the same way, oral mucosa smears were collected from 48 animals, 23 passive smokers and 25 not exposed to passive smoking. Micronucleus counts were performed in all samples at light microscopy. We observed a statistically significant difference (p < 0,001) between the two groups with an increased incidence of micronucleus formation in the passive smokers group compared to controls. Moreover, in the animals whose owners were at score 8 (very high nicotine dependence) on the Fagerstrom Test, the number of micronuclei was significantly higher than in animals with owners of score 6 (high dependency). Likewise, in dogs whose owners had a score 6 the incidence of micronuclei was statistically higher than in dogs whose owners had a score 3. It was concluded that there is an association between nicotine dependence of owners and frequency of cytogenetic alterations in dogs exposed to secondhand smoke. Besides ambient health impacts, the observations of the present study may contribute in helping dog owners quit smoking

The purpose of this study was to determine whether an educational tobacco intervention impacted college students' perceptions relative to tobacco, self-efficacy, and perceived stress levels. The Health Belief Model (HBM) provided a theoretical framework to distinguish differences relative to tobacco between groups. Both the control (N=155) and intervention (N=184) group consisted of a convenience sample of students from a 2000-level health course. A pre- and post-test questionnaire was administered to both groups which included questions regarding demographics, tobacco use, HBM, self-efficacy, and perceived stress. Data analysis included frequency counts, confirmatory factor analysis, Cronbach's alpha, and two-way ANOVA. Two-way ANOVA results indicated statistically significant differences for the Health Belief Model questions (p=0.002) and self-efficacy items (p=0.03). No statistical significance was found regarding perceived stress. These findings provide evidence an educational tobacco intervention administered at the college level can have a significant impact on students. / by Kelley E. Rhoads. / Thesis (M.S.)--Florida Atlantic University, 2012. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2012. Mode of access: World Wide Web.

Introdução: O comprimento telomérico é estudado em vários processos da relação saúdedoença, tais quais estresse oxidativo, processo inflamatório e estresse crônico e parece ser modulado por fatores genéticos e ambientais, além de estar associado a doenças como aterosclerose, doença de Alzheimer, insuficiência cardíaca e disqueratose congênita. Nosso estudo buscou entender a relação entre os telômeros de recém-nascidos e a gestação sob condições adversas. Objetivo: avaliar o impacto da exposição a diferentes ambientes intrauterinos sobre o comprimento de telômeros dos recém-nascidos. Métodos: o comprimento telomérico foi avaliado através do método de qPCR (Razão T/S) de células da mucosa oral de uma amostra conveniência de 239 pares de mãe e recémnascido, divididos nos seguintes grupos de mães: diabéticas (DM) (n=39), hipertensas (HAS) (n=16), tabagistas (n=52), controle (n=99) e mães que tiveram filhos pequenos para a idade gestacional (PIG) (n=33). Resultados: Em todos os grupos observamos uma correlação fraca entre o comprimento telomérico da mãe e da criança (r= 0,229) (p<0,001). Não houve diferença significativa no comprimento telomérico entre os grupos DM, HAS, PIG, Tabaco e Controle. Entretanto, dentro do grupo Tabaco houve diferença significativa numa relação dose-resposta inversa, de maior consumo de cigarro e comprimento telomérico menor, tanto para a mãe (p=0,020) quanto para o recém-nascido (p=0,033). Conclusão: os achados deste estudo sugerem que o uso do tabaco na gestação pode exercer influência negativa sobre o comprimento dos telômeros tanto da mãe quanto do seu filho. / Background: Telomere lenght has been studied in several health-disease processes, such as oxidative stress, inflammatory process and chronic stress. It seems to be influenced by genetic and environmental issues, and it is associated with diseases such as atherosclerosis, Alzheimer's disease, heart failure and congenital dyskeratosis. Our study searched to understand the relationship between newborns telomeres and adverse intrauterine conditions. Objective: to evaluate the impact of exposure to different intrauterine environments on the telomere length of newborns. Methods: the telomere length was evaluated by qPCR (T/S ratio) on oral mucosa cells of a convenience sample of 239 pairs of mother and newborn, divided according to the following groups of mothers: diabetic (DM) (n = 39), hypertensive (HAS) (n = 16), tobacco (n = 52), controls (n = 99) and mothers who had small children for gestational age (SGA) (n = 33). Results: In all groups we observed a weak correlation between the telomere of the mother and the son (r= 0.229) (p <0.001). There was no significant difference in telomere size between DM, HAS, SGAG, Tobacco and Control groups. However, in the Tobacco group there was a significant difference in an inverse dose-response relationship: higher cigarette consumption and lower telomere length, both for the mother (p = 0.020) and for the newborn (p = 0.033). Conclusion: the findings of this study suggest that tobacco use during gestation may induce a negative influence on the telomere length of both the mother and her child.

A proposta desse estudo de 24 meses foi identificar os preditores da cessação de tabagismo em um estudo de coorte em fumantes com periodontite crônica, atendidos em um programa antitabágico multidisciplinar. Dos 286 participantes triados, 116 foram incluídos no estudo e receberam tratamento periodontal não cirúrgico e terapia de cessação de tabagismo, que consistia em palestras, terapia cognitiva comportamental e farmacoterapia de acordo com as necessidades individuais. Durante o início do tratamento periodontal, os dentistas motivavam os participantes do estudo para parar de fumar, usando técnicas de entrevista motivacional. Além disso, aconselhamento e apoio a cessação do tabagismo também foram fornecidos pelos dentistas, durante as sessões de manutenção periodontal aos 3, 6, 12 e 24 meses de estudo. Tabagismo foi avaliado através de um questionário estruturado, e era validado pelas medidas de Monóxido de Carbono (CO) expirado. O teste de Fagerström para a Dependência do Cigarro foi utilizado para aferir a dependência. Dos 61 indivíduos que permaneceram até o final do estudo, 31, 21 e 18 declararam que não eram fumantes após 3, 12 e 24 meses, respectivamente. Foram utilizados teste de associação, teste de comparação de média e regressão logística univariada para identificar os preditores de cessação de tabagismo. Cessação de tabagismo após 24 meses esteve associada com gênero masculino (odds ratio [OR] = 3,77, intervalo de confiança [IC] 95% = 1,16-12,30), nível de CO no início do estudo < 10ppm (OR = 5,81, IC 95% 1,76 - 19,23), não conviver ou trabalhar com fumante (OR = 7,38, IC 95% 1,76 - 30,98) e uma média menor no teste de Fagerström (OR = 5,36, IC 95% 1,55 - 20,43). Pode ser concluído que cessação de tabagismo foi associada com variáveis demográficas, histórico de tabagismo e dependência do cigarro. / The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis attending a multidisciplinary smoking cessation program. Among the 286 screened subjects, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Tests for association tests, tests for comparison of means and univariate logistic regression analysis were used to identify predictors of smoking cessation. Among the 61 individuals that remained up to the 24-months examination, 31, 21 and 18 declared that were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with male gender (odds ratio [OR] = 3.77, confidence interval [CI] 95% = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, CI 95% 1.76 - 19.23), not living or working with another smoker (OR = 7.38, CI 95% 1.76 - 30.98) and lower mean Fagerström test score (OR = 5.63, CI 95% 1.55 - 20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

Submitted by admin tede (tede@pucgoias.edu.br) on 2016-09-08T17:44:05Z No. of bitstreams: 1 ANA LÚCIA MUNARO TACCA.pdf: 3214178 bytes, checksum: 58c28e17365eb1264fc070c8b52bf41f (MD5) / Made available in DSpace on 2016-09-08T17:44:05Z (GMT). No. of bitstreams: 1 ANA LÚCIA MUNARO TACCA.pdf: 3214178 bytes, checksum: 58c28e17365eb1264fc070c8b52bf41f (MD5) Previous issue date: 2016-03-10 / The main risk factor for cervical cancer is infection with the Human Papillomavirus (HPV). However, other risk factors are required for the development of cervical cancer, among them, smoking and genetic susceptibility have been proven relevant. Enzymes named Glutathione-S-Transferase (GST) are responsible for the metabolism of tobacco carcinogens and the genes encoding these enzymes are highly polymorphic. The objective of this study was to compare the frequencies of GSTM1 and GSTT1 null polymorphisms in women with cervical cancer and in women with no history of cancer, as well as the possible associations between such genetic polymorphisms, cigarette smoking and the prognosis of cervical cancer. The series consisted of 135 patients with cervical cancer and 100 participants without cancer. Genotypes were investigated by means of polymerase chain reaction (PCR). The results were compared using the Chi-square test or Fisher's exact test, and survival analysis by Kaplan-Meier tests and Log-rank. Among the cases, the frequency for GSTM1 gene null polymorphism was 22,2%, and for the GSTT1 gene, it was 48,5%. Among the controls, the frequency of the GSTM1 gene null polymorphism was 45.0%, while for the GSTT1 gene null polymorphism it was 56.0%. Important association was demonstrated between smoking and cervical cancer (p= 0.0062; OR = 2.16). The results showed that the GSTM1 and GSTT1 null genotypes were not associated with cervical cancer in the population studied. In addition, GSTM1 genotype was significantly associated to a better prognosis of the tumors, decreasing the risk of metastasis (p= 0.014; OR = 3.45). The overall survival rate for the group was 78.5% and, when stratified by genotypes studied, survival was higher in patients with positive genotypes, indicating a higher risk of death in the presence of dual nullity (p= 0.031; RR = 2.458). / O principal fator de risco para o câncer do colo uterino é a infecção pelo Papilomavírus humano (HPV), porém, sabe-se que outros fatores são necessários para o desenvolvimento do câncer. Dentre os fatores estudados, destacam-se o tabagismo e os fatores de suscetibilidade genética. As enzimas denominadas Glutationas-S-Transferase (GST) são responsáveis pela metabolização dos carcinógenos do tabaco e os genes que codificam essas enzimas são altamente polimórficos. O principal objetivo deste estudo foi comparar as frequências dos polimorfismos nulos de GSTT1 e GSTM1 em mulheres com câncer de colo uterino e em mulheres sem história de câncer, bem como as possíveis associações entre os polimorfismos genéticos, o tabagismo e o prognóstico dos tumores de colo uterino. A casuística consistiu de 135 pacientes com câncer e 100 participantes sem câncer. Os genótipos foram investigados por meio de reação em cadeia da polimerase (PCR). Os resultados foram comparados pelo teste Chi-quadrado ou teste exato de Fisher e as análises de sobrevida pelos testes de Kaplan-Meier e comparadas por Log-rank. Entre os casos, a frequência do polimorfismo nulo para o gene GSTM1 foi de 22,2% e para o gene GSTT1 foi de 48,5%. Entre os controles, a frequência do polimorfismo nulo no gene GSTM1 foi de 45,0%, enquanto para o gene GSTT1 nulo foi de 56,0%. Importante relação entre o hábito tabagista e o câncer do colo uterino foi observada (p=0,0062; OR=2,16). Os resultados demonstraram que os genótipos nulos de GSTM1 e GSTT1 não conferiram risco para o câncer cervical na população estudada. Além disso, o genótipo GSTM1 presente esteve associado significativamente ao melhor prognóstico dos tumores, diminuindo o risco de metástases (p=0,014; OR=3,45). A sobrevida global foi de 78,5% e, quando estratificada pelos genótipos estudados, foi superior em pacientes com genótipos positivos, indicando maior risco de óbito na presença de dupla nulidade (p=0,031; RR=2,458).

Esta investigação, levada a efeito no período de 15 de maio de 1978 a 14 de maio de 1979, no Município de Ribeirão Preto, permitiu estudar características do hábito de fumar da gestante, bem como controlar algumas variáveis, a fim de se verificar a possível associaçao entre o hábito de fumar na gestante e o dano ao seu concepto, caracterizado pelo baixo peso ao nascer. Verificou-se que o baixo peso ao nascer está proporcionalmente mais presente em recém-nascidos de mães fumantes do que em recém-nascidos de não-fumantes, tendo sido controladas, em análises separadas, para o mesmo conjunto de dados, as variáveis idade da mãe, escolaridade da mãe, renda média mensal por pessoa da família, duração da gestação, hábito de fumar do pai para recém-nascidos masculino e feminino. Há evidência de associação para mães que continuam fumando durante a gestação e o baixo peso ao nascer do seu concepto. As porcentagens de óbitos neonatais e neonatais precoces foram um pouco maiores entre os filhos de fumantes comparados com filhos de mães não fumantes durante a gestação. Observou-se que uma pequena porcentagem de mulheres fumantes (15,9 por cento) deixou de fumar durante a gestação, e uma porcentagem bem menor de não fumantes (0,4 por cento) passou a fumar durante a gestação. / The presente investigation, carried out from May 15th 1978 to May 14th 1979, in the município of Ribeirão Preto, made it possible to study some characteristics of pregnant women\'s smoking habits as well as control some variables in order to verify whether or not there is an association between the pregnant woman\'s smoking habit and damage to her conceptus, the latter being measured through low birth weight. It was verified that low birth weight is proportionaly more present in newborns from smoking mothers rather than in newborns from non smoking mothers; for the some set of data, in separate analyses, the variables mother\'s age, mother\'s education level, average family monthly income and gestation\'s duration father\'s smoking were controlled, for each newborn\'s sex. This association was shown for mothers that kept smoking during pregnancy. The percentages of neonatal deaths and early neonatal deaths were a little higher for children of mothers that smoked during the pregnancy. It was observed that a small percentage of smoking women (15,9 per cent) stopped smoking during pregnancy and a much smaller percentage of non smoking women (0,4 per cent) started smoking during pregnancy.

O tabagismo é um problema de saúde pública em todo o mundo. Entre as mulheres, devido ao aumento da prevalência comparada aos homens, o tabagismo feminino tem merecido atenção. Para o enfrentamento, é necessário entender o fenômeno e criar estratégias mais adequadas que incluam aspectos emocionais e sociais da dependência do tabagismo. Este estudo buscou descrever os esquemas cognitivos, sintomas de ansiedade e depressão de 112 mulheres que procuraram tratamento para cessação do tabagismo e sua relação com o insucesso do tratamento. A coleta de dados incluiu roteiro de entrevista estruturada e escalas validadas para a população brasileira que têm o objetivo de avaliar os esquemas cognitivos, sintomas de ansiedade e de depressão, e aspectos da dependência do cigarro. O conhecimento de fatores emocionais envolvidos no tabagismo e sua cessação podem ser úteis às ações de apoio à mudança comportamental do fumante. Objetivo: Descrever o perfil psicológico de mulheres que buscam cessação do tabagismo quanto aos esquemas cognitivos, sintomas de ansiedade e depressão antes e depois do tratamento com Terapia Cognitivo- Comportamental em grupo, e analisar fatores que contribuem para o desfecho de cessação. O desenho do estudo foi longitudinal e transversal. Para avaliar os esquemas cognitivos, o Questionário de Esquemas de Young em sua forma curta foi utilizado. Os grupos de terapia cognitivo-comportamental foram realizados concomitantes ao cuidado usual por médicos do estudo. Esses profissionais foram treinados no protocolo do estudo e o seguimento foi realizado por telefone por um membro do estudo independente e cego. Resultados: Os resultados forneceram evidências de que esquemas cognitivos tiveram relação significativa com os sintomas de depressão e ansiedade, com a adesão e os resultados do tratamento (cessação do tabagismo) / Cigarette smoking is a major public health problem worldwide. Among women, due to increased prevalence compared to men, the female smoking has deserved attention. To face, it is necessary to understand the phenomenon and create more appropriate strategies that include emotional and social aspects of smoking dependence. This study aimed to describe the cognitive schemes, symptoms of anxiety and depression of 112 women who sought treatment for smoking cessation and its relationship to treatment failure. Data collection included structured interview and validated scales for the Brazilian population who have to evaluate the cognitive schemes, symptoms of anxiety and depression and aspects of tobacco dependence. Knowledge of emotional factors involved in smoking and its cessation may be helpful to actions to support behavioral change of the smoker. Objective: To describe the psychological profile of women seeking smoking cessation regarding cognitive schemes, symptoms of anxiety and depression before and after treatment with cognitive-behavioral therapy in groups and analyze factors that contribute to the outcome of cessation . Method: The layout of the study was longitudinal and transversal. To assess the cognitive schemes, the Young Schema Questionnaire in its short form was used. The Cognitive Behavioral Therapy groups were conducted at the same time as the medical care and were applied by psychologists and medical doctors. These professionals were trained in the study protocol and the follow-up was conducted by telephone by the same independent and blind evaluator. Results: Our results provided evidence that the cognitive schemas of those women who sought treatment for quitting smoking showed a significant relation to the symptoms of depression and anxiety, with the adherence and the results of the treatment (quitting smoking), and with the positive impact of Cognitive Behavioral Therapy in decreasing schemas scores. It was also evident that the overall time throughout which the individual had smoked correlated to smaller rates of being able to quit smoking

吸煙是引起骨質疏鬆症的因素之一。臨床研究清楚表明吸煙者的骨密度降低，但其他干擾因素可能掩蓋了吸煙對骨頭的不良效果。使用動物模型用以研究吸煙和骨質疏鬆症之間是否有直接的因果關係與它潛在的機制是有必要的。為此，我們使用年輕和雌激素耗盡的小鼠作被動吸煙模型以及小鼠成骨細胞和破骨細胞株來作研究。 / 年輕的Balb/c小鼠暴露於2%或4% (v/v)的香煙煙霧中，代表中度和重度吸煙的人。骨代謝生物標誌物明顯增加，4%吸煙組在14週後股骨的微觀結構4%顯著下降，這相等於人類吸煙12年。此外，雌性Balb/c小鼠進行4%吸煙和/或卵巢切除術(OVX)。吸煙+OVX組增加血清中骨轉換指標水平。4%吸煙組的股骨生長板較薄。μ-CT數據進一步表明，相對骨體積(BV / TV)和結構模型指數(SMI)在吸煙組有顯著影響，而且在吸煙+ OVX組上有更大程度的影響。 / 在細胞研究中使用氯仿(CSE)和乙醇的香煙提取物(ESE)。CSE抑制小鼠細胞株RAW 264.7形成破骨細胞，並刺激小鼠成骨細胞株的分化和功能。這個與體內研究矛盾的結果暗示直接從煙霧中提取的化學成分並不是引起骨質疏鬆的元兇。影響骨代謝的很可能是其他從煙霧中生成的活性代謝物和一些吸煙引起的內源性激素物質。在吸煙引起的骨質流失中，這些代謝物或內源性物質可能是非常重要的。 / 有見及此，4%吸煙小鼠的血清用以研究其對成骨細胞和破骨細胞活動的影響。吸煙小鼠血清顯著降低在成骨細胞中鹼性磷酸酶(ALP)活性和鈣沉積，一些成骨細胞標記基因和蛋白表達均下降，而且 Wnt/β-catenin信號通路下調。此外，吸煙小鼠血清顯著增加形成破骨細胞的數量，組織蛋白酶K的基因和蛋白表達增加，在NF-κB和p-38 MAPK信號傳導途徑的信號分子表達增加。 / 總而言之，大量吸煙可能影響年輕小鼠和雌激素耗竭小鼠的骨代謝和微結構，通過類似的行動機制，人類也可能有同樣的骨疾病風險。這項研究揭示了吸煙導致的骨質疏鬆症在青少年和絶經後婦女的發病機制。這也給我們線索如何預防和治療與吸煙有關的骨骼疾病。這項研究還傳達了一個明確的信息：在年輕時應開始應控制吸煙。 / Cigarette smoking is one of the risk factors for osteoporosis. Clinical studies clearly showed that smokers have lower bone mineral density, but other confounding factors could mask the adverse actions of smoking on bones. Animal models are warranted to study the direct causal relationship between cigarette smoking and osteoporosis, and also the underlying mechanisms. In this regard, we used a mouse passive smoking model in both young and estrogen depleted mice, and the mouse osteoblast and osteoclast cell lines. / Young Balb/c mice were exposed to 2 or 4% (v/v) of cigarette smoke, similar to moderate or heavy smoking respectively in humans. Biomarkers for bone turnover were increased and bone microstructure of femur was significantly deteriorated after 4% smoking for 14 weeks which is similar to cigarette smoking for 12 years in humans. Furthermore, the effects of heavy smoking on ovariectomized mice were also investigated. Female Balb/c mice were subjected to 4% cigarette smoking and/or ovariectomy (OVX). Cigarette smoking together with OVX further increased the levels of bone turnover markers in serum. Femur growth plate was thinner in the 4% smoking group when compared to those in the SHAM- and OVX-operated groups. Micro-CT data further indicated that the relative bone volume (BV/TV) and structural model index (SMI) were significantly affected in the smoking groups, and to a greater extent in the 4% smoking + OVX group. / Chloroform (CSE) and ethanol smoke extracts (ESE) were used in cell studies. CSE suppressed the formation of osteoclasts, and stimulated the differentiation and function of mouse osteoblasts. These findings are contradictory to those found in in vivo study implying that chemical components directly extracted from cigarette smoke are not the culprits in causing bone disorder in animals. It is likely that other active metabolites from cigarette smoke and some endogenous hormonal substances released by cigarette smoking could affect bone metabolism. These active metabolites together with the endogenous bone hormones are perhaps crucial in smoking-induced bone loss in the body. / In view of this hypothesis, sera from 4% smoking mice were used to investigate their effects on osteoblast and osteoclast activities. It was found that the alkaline phosphatase (ALP) activity and calcium deposition in osteoblast were reduced significantly by the sera from smoking mice. Gene and protein expressions of some osteoblast markers were also decreased. The downregulation of Wnt/β-catenin signaling pathway was observed after the treatment with the serum obtained from the 4% smoking group. Moreover, the number of osteoclasts being formed was increased significantly by the smoking mouse serum. Cathepsin K gene and protein expressions were also induced. The increased expressions of the signaling molecules including NF-κB and p-38 MAPK were also observed. / In conclusion, heavy cigarette smoking could deteriorate bone metabolism and microstructures in young female and also estrogen depleted mice. The same kind of risk in bone disease may also apply to humans through similar mechanisms of action. This study sheds light in understanding the pathogenesis of smoking-induced bone disorders in teenagers and also postmenopausal women. It also gives us clues how to prevent and treat smoking related bone diseases. This study also conveys a clear message that cigarette smoking control should be started in young ages. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Chan, Lok Yi Ruby. / Thesis (Ph.D.) Chinese University of Hong Kong, 2014. / Includes bibliographical references (leaves 182-207). / Abstracts also in Chinese. / Chan, Lok Yi Ruby.

There is increasing evidence that psychological stress and associated mood disorders are linked with, and can adversely affect the course of inflammatory bowel disease (IBD). Stress is perceived to be relieved by smokers, and this, like a lack of knowledge about its adverse effects, and nicotine dependence, could contribute to continued smoking by patients with Crohn’s disease (CD). Stress has previously been shown to influence disease course in patients with inactive ulcerative colitis (UC) but its influence in acute severe UC is not known. Emerging trial evidence supports the suggestion that psychologically-orientated therapy may ameliorate IBD-associated mood disorders, but there is no strong data yet to indicate that stress management has a beneficial effect on the activity or course of IBD. In addition gut-focussed hypnotherapy has been successfully used in the setting of functional bowel disorders. The 4 main hypotheses tested in thesis are: 1. In patients with IBD: (1) poor knowledge of the effects of smoking on their disease and/or (2) high nicotine dependence explain the higher prevalence of smoking in CD than UC 2. Anxiety, depression and stress are more common and worsen outcome in patients with acute severe UC. 3. Stress management in the form of psychotherapy given by a counsellor has a beneficial effect on the activity and course of IBD. 4. Gut-focussed hypnotherapy reduces the relapse rate in patients with UC. The major findings are as follows: 1. Despite more patients with CD being smokers, they were better informed about the effects of smoking on their own disease than UC patients. Nicotine dependence was no higher in patients with CD than UC. In IBD patients as a whole, nicotine dependence was lower than in smokers’ clinic clients and comparable to that of the general population, suggesting that most IBD patients could be weaned off smoking successfully in the IBD clinic.