Search

Background: An increase in the prevalence of lung cancer that is not smoking-related has been noticed in recent years. Unfortunately, these patients are not included in low dose computer tomography (LDCT) screening programs and are not actually considered in early diagnosis. Therefore, improved early diagnosis methods are urgently needed for non-smokers. It is necessary to establish a prediction model for non-smoking individuals at intermediate to high risk of developing lung cancer (LC) and develop a tool to address the significant gap in evaluating pulmonary nodules in non-smokers. Methods: We retrospectively investigated 1121 patients with pulmonary nodules, who underwent LDCT examinations between September 2019 and March 2023. Five artificial intelligence (AI) algorithms were used to build two kinds of models and identify which one was better at diagnosing non-smoking pulmonary nodules patients. In the first model, we assigned 554 non-smoking individuals to a training cohort and 150 non-smoking patients to an independent validation cohort. The second model included 971 patients for the training set and 150 non-smoking patients for an independent validation set. All LDCT images of participants were obtained for AI analysis. AI of LDCT scans, liquid biopsy, and clinical characteristics were collected for model building. Results: Among LC patients, 58,4% were non-smokers. Non-smoking patients had a high incidence of LC (71.4%), and women showed a significant excess risk compared with non-smoking men in terms of LC risk. Furthermore, our results indicated that the model built using random forest (RF) method, which integrates clinical characteristics (age, extra-thoracic cancer history, gender), radiological characteristics of pulmonary nodules (nodule diameter, nodule count, upper lobe location, malignant sign at the nodule edge, subsolid status), the artificial intelligence analysis of LDCT data, and liquid biopsy achieved the best diagnostic performance in the independent external non-smokers validation cohort (sensitivity 92%, specificity 97%, area under the curve [AUC] = 0.99). Conclusions: These results could significantly improve early non-smoker LC diagnosis and treatment for non-smoker patients with malignant nodules. The established multi-omics model is a noninvasive prediction tool for non-smoking malignant pulmonary nodule diagnosis. Validation revealed that these models exhibited excellent discrimination and calibration capacities, especially the first model built using the RF method, suggesting their clinical utility in the early screening and diagnosis of non-smoking LC. [ABSTRACT FROM AUTHOR]

Abstract Background Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disorder in China, impacting a significant proportion of individuals aged > 40 years. In China, the prevalence of and risk factors for COPD among non-smokers remain largely unexplored. In this study, we aimed to determine the prevalence of COPD in non-smokers within the Chinese population and identify potential risk factors associated with COPD in non-smokers. Methods Web of Science, PubMed, Embase, Chinese WanFang, Chinese China National Knowledge Infrastructure, and Weipu databases from inception to August 5, 2024, were searched. Studies reporting the percentage of never-smokers among those diagnosed with COPD and investigations exploring the risk factors associated with COPD in never-smokers in China were examined. Summary proportions and odds ratios (OR), along with their corresponding 95% confidence intervals (95% CI), were measured. Results In total, 112 investigations with 491,812 participants were included. The percentage of never-smokers in people with COPD was 41.1% (95% CI: 37.5–44.6%). The prevalence of never-smokers among males diagnosed with COPD was 22.3% (95% CI: 18.8–25.7%), which differed from that among women (81.3%, 95% CI: 75.3–87.2%). The results showed an association between the utilization of biomass fuel and the occurrence of COPD in never-smokers (OR: 1.25, 95% CI: 1.06–1.44). Among never-smokers, the data showed a close association between being underweight (OR: 1.89, 95% CI: 1.78–2.00), tuberculosis history (OR: 1.71, 95% CI: 1.53–1.88) and COPD. Never-smokers living in rural areas or those with low educational status were more susceptible to COPD. Conclusion This review confirmed the highly different proportions of never-smokers among male and female patients with COPD. Trial registration PROSPERO: CRD42023420786.

Introduction The purpose of this study was to examine the prevalence, clinical characteristics, and changing trends of non-smokers with lung cancer (LC) based on data from a population-wide cancer registry in northern China. Methods The study used LC incidence and follow-up data from 2010 to 2019 from the Cancer Registry System of Tianjin city, which included 82769 cases. Trends in the incidence and proportion of non-smokers with LC were examined by joinpoint regression analysis. Life table and Cox survival analyses were used to calculate the survival rates and compare the death hazard ratios (HRs) in different groups, respectively. Results Among the 82769 new diagnosis cases of LC during 2010 to 2019, there were 34589 (41.8%) current smokers, 14913 (18.0%) ex-smokers, 28123 (34.0%) non-smokers, and 5144 (6.2%) unknowns. The proportion of non-smokers changed slightly from 2010 (35.36%) to 2019 (36.87%) (annual percentage change, APC= -0.01%, p>0.05). This proportion declined in men (2010 vs 2019; 22.06% vs 20.66%) and increased in women (2010 vs 2019; 53.02% vs 62.35%), and in the 0–44 years age group it showed an upward trend from 2015 to 2019 (APC=4.82%, 95% CI: 1.8–7.9). Compared with smokers with LC, non-smokers with LC were predominantly females (64.15% vs 27.26%), had a predominantly adenocarcinoma histological subtypes (76.71% vs 42.22%), and had a 20% lower risk of death than smokers (HR=0.80; 95% CI: 0.78–0.81). Conclusions The proportion of non-smokers with LC was relatively high in northern China, with an increasing trend in the proportion of females and younger age groups. Non-smokers with LC had different epidemiological and clinical characteristics compared with smokers with LC.

Background: The process of laryngoscopy and tracheal intubation is potent stressful stimuli that cause sympathetic activation, which is transient. Some of the modalities for attenuation of laryngoscopic and intubation response have been found to be less effective in smokers than in non-smokers. In view of this, the present study was performed to compare the effectiveness of dexmedetomidine in male smoker and non-smoker patients. Aims and Objectives: The aim of this study was to compare the effectiveness of dexmedetomidine in suppressing sympathoadrenal pressor response due to laryngoscopy and endotracheal intubation between smokers and non-smokers. Materials and Methods: This was a hospital-based non-randomized controlled study. Sixty patients were divided into two groups: 30 patients with no history of smoking (Group NS) and 30 patients with a smoking history (Group S). Both groups were received dexmedetomidine 0.75 mcg/kg over 10 min intravenous infusion. Hemodynamic parameters and Ramsay sedation score were measured at perioperative period. Results: Group S patients showed a significant rise in heart rate (HR), systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and rate pressure product (RRP) during the immediate post-intubation period, but Group NS showed a decrease in HR, SBP, DBP, MAP and RRP throughout the post-intubation period. Conclusion: Single dose of 0.75 mcg/kg IV dexmedetomidine given over a period of 10 min before the induction of anesthesia is completely effective in attenuating the hemodynamic responses associated with laryngoscopy and intubation in non-smokers, but it is not efficient in smokers.

Background: Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disorder in China, impacting a significant proportion of individuals aged > 40 years. In China, the prevalence of and risk factors for COPD among non-smokers remain largely unexplored. In this study, we aimed to determine the prevalence of COPD in non-smokers within the Chinese population and identify potential risk factors associated with COPD in non-smokers. Methods: Web of Science, PubMed, Embase, Chinese WanFang, Chinese China National Knowledge Infrastructure, and Weipu databases from inception to August 5, 2024, were searched. Studies reporting the percentage of never-smokers among those diagnosed with COPD and investigations exploring the risk factors associated with COPD in never-smokers in China were examined. Summary proportions and odds ratios (OR), along with their corresponding 95% confidence intervals (95% CI), were measured. Results: In total, 112 investigations with 491,812 participants were included. The percentage of never-smokers in people with COPD was 41.1% (95% CI: 37.5–44.6%). The prevalence of never-smokers among males diagnosed with COPD was 22.3% (95% CI: 18.8–25.7%), which differed from that among women (81.3%, 95% CI: 75.3–87.2%). The results showed an association between the utilization of biomass fuel and the occurrence of COPD in never-smokers (OR: 1.25, 95% CI: 1.06–1.44). Among never-smokers, the data showed a close association between being underweight (OR: 1.89, 95% CI: 1.78–2.00), tuberculosis history (OR: 1.71, 95% CI: 1.53–1.88) and COPD. Never-smokers living in rural areas or those with low educational status were more susceptible to COPD. Conclusion: This review confirmed the highly different proportions of never-smokers among male and female patients with COPD. Trial registration: PROSPERO: CRD42023420786. [ABSTRACT FROM AUTHOR]

Background: The process of laryngoscopy and tracheal intubation is potent stressful stimuli that cause sympathetic activation, which is transient. Some of the modalities for attenuation of laryngoscopic and intubation response have been found to be less effective in smokers than in non-smokers. In view of this, the present study was performed to compare the effectiveness of dexmedetomidine in male smoker and non-smoker patients. Aims and Objectives: The aim of this study was to compare the effectiveness of dexmedetomidine in suppressing sympathoadrenal pressor response due to laryngoscopy and endotracheal intubation between smokers and non-smokers. Materials and Methods: This was a hospital-based non-randomized controlled study. Sixty patients were divided into two groups: 30 patients with no history of smoking (Group NS) and 30 patients with a smoking history (Group S). Both groups were received dexmedetomidine 0.75 mcg/kg over 10 min intravenous infusion. Hemodynamic parameters and Ramsay sedation score were measured at perioperative period. Results: Group S patients showed a significant rise in heart rate (HR), systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and rate pressure product (RRP) during the immediate post-intubation period, but Group NS showed a decrease in HR, SBP, DBP, MAP and RRP throughout the post-intubation period. Conclusion: Single dose of 0.75 mcg/kg IV dexmedetomidine given over a period of 10 min before the induction of anesthesia is completely effective in attenuating the hemodynamic responses associated with laryngoscopy and intubation in non-smokers, but it is not efficient in smokers. [ABSTRACT FROM AUTHOR]

INTRODUCTION The purpose of this study was to examine the prevalence, clinical characteristics, and changing trends of non-smokers with lung cancer (LC) based on data from a population-wide cancer registry in northern China. METHODS The study used LC incidence and follow-up data from 2010 to 2019 from the Cancer Registry System of Tianjin city, which included 82769 cases. Trends in the incidence and proportion of non-smokers with LC were examined by joinpoint regression analysis. Life table and Cox survival analyses were used to calculate the survival rates and compare the death hazard ratios (HRs) in different groups, respectively. RESULTS Among the 82769 new diagnosis cases of LC during 2010 to 2019, there were 34589 (41.8%) current smokers, 14913 (18.0%) ex-smokers, 28123 (34.0%) non-smokers, and 5144 (6.2%) unknowns. The proportion of non-smokers changed slightly from 2010 (35.36%) to 2019 (36.87%) (annual percentage change, APC= -0.01%, p>0.05). This proportion declined in men (2010 vs 2019; 22.06% vs 20.66%) and increased in women (2010 vs 2019; 53.02% vs 62.35%), and in the 0--44 years age group it showed an upward trend from 2015 to 2019 (APC=4.82%, 95% CI: 1.8--7.9). Compared with smokers with LC, non-smokers with LC were predominantly females (64.15% vs 27.26%), had a predominantly adenocarcinoma histological subtypes (76.71% vs 42.22%), and had a 20% lower risk of death than smokers (HR=0.80; 95% CI: 0.78--0.81). CONCLUSIONS The proportion of non-smokers with LC was relatively high in northern China, with an increasing trend in the proportion of females and younger age groups. Non-smokers with LC had different epidemiological and clinical characteristics compared with smokers with LC. [ABSTRACT FROM AUTHOR]

Pulmonary blastoma (PB) is an exceedingly rare and aggressive malignant lung neoplasm that has distinct biphasic morphology. In this report, we document rare manifestations and molecular alterations in PB. A 59-year-old non-smoker female, presented with cough and hemoptysis for 4 months. The high-resolution computed tomography chest scan showed a 3.5x2.7 cm mass in the basal segment of the left lung. Positron emission tomography and computed tomography revealed a fluorodeoxyglucose avid lobulated mass in the superior segment of the lower lobe of the left lung. On core biopsy, the diagnosis of pleomorphic carcinoma in a background of adenocarcinoma was made. A definite diagnosis of pulmonary blastoma was established on the left lung lobectomy specimen based on morphological and immunohistochemical findings. Post-surgical biopsy from the scalp swelling showed metastatic deposits. On Next Generation Sequencing (NGS), in addition to conventional CTNNB1 gene mutation, new pathogenic MYCN and ATM gene mutations were detected. Post-chemotherapy, the patient was doing well after 10 months of close follow-up. PB exhibited rare associations in the form of non-smoker status, scalp metastasis, and MYCN and ATM gene mutations on NGS in addition to conventional CTNNB1 gene mutation. Large cohort studies are required to discover the incidence, significance and therapeutic implications of these co-existing pathogenic molecular alterations in PB.

Pulmonary blastoma (PB) is an exceedingly rare and aggressive malignant lung neoplasm that has distinct biphasic morphology. In this report, we document rare manifestations and molecular alterations in PB. A 59-year-old non-smoker female, presented with cough and hemoptysis for 4 months. The high-resolution computed tomography chest scan showed a 3.5x2.7 cm mass in the basal segment of the left lung. Positron emission tomography and computed tomography revealed a fluorodeoxyglucose avid lobulated mass in the superior segment of the lower lobe of the left lung. On core biopsy, the diagnosis of pleomorphic carcinoma in a background of adenocarcinoma was made. A definite diagnosis of pulmonary blastoma was established on the left lung lobectomy specimen based on morphological and immunohistochemical findings. Post-surgical biopsy from the scalp swelling showed metastatic deposits. On Next Generation Sequencing (NGS), in addition to conventional CTNNB1 gene mutation, new pathogenic MYCN and ATM gene mutations were detected. Post-chemotherapy, the patient was doing well after 10 months of close follow-up. PB exhibited rare associations in the form of non-smoker status, scalp metastasis, and MYCN and ATM gene mutations on NGS in addition to conventional CTNNB1 gene mutation. Large cohort studies are required to discover the incidence, significance and therapeutic implications of these co-existing pathogenic molecular alterations in PB. [ABSTRACT FROM AUTHOR]

Copyright of Eastern Mediterranean Health Journal is the property of World Health Organization and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Oral squamous cell carcinoma is the most common type of oral cancer with multi-factorial causes. Chronic irritation of oral mucosa from ill-fitting dentures has often been mentioned as a contributing factor in the development of oral cancer. There is a unique category of non-smoking non-drinking (NSND) patients reported with carcinoma which usually occurs in women. In contrast to this, our report includes a male patient who is an NSND patient. This case report includes a rare occurrence of carcinoma induced by ill-fitting prosthesis.

Simple Summary: Lung cancer is one of the biggest public health issues due to its high prevalence and mortality. Currently, increasing consideration is given to the incidence of lung cancer in the individuals with no lifetime history of tobacco smoking. However, up-to-date data on the characteristics of a group of non-smokers with lung cancer are limited. The current literature also contains gaps in the differences in the clinical course of lung cancer in smokers and non-smokers. This study aimed to investigate the differences in tumor characteristics, survival rates, and comorbidities between a group of smokers and a group of non-smokers with lung cancer. The presented results may be used in clinical practice and in shaping future lung cancer prevention programs. Changes in smoking trends and changes in lifestyle, together with worldwide data regarding the incidence of lung cancer in the group of patients with no previous history of smoking, leads to consideration of the differences in the course of the disease, the time of cancer diagnosis, the survival rate, and the occurrence of comorbidities in this group of patients. This study aimed to determine the occurrence of non-smokers among patients undergoing anatomical resection of the lung tissue due to lung carcinoma and to investigate the differences between the course of lung cancer, survival, and the comorbidities in the groups of patients with lung cancer depending on the history of tobacco smoking. The study included a cohort of 923 patients who underwent radical anatomical resection of the lung tissue with lung primary adenocarcinoma or squamous cell carcinoma. The Chi2 Pearson's test, the t-test, the Mann–Whitney U test, the Kaplan–Meier method, the Log-rank test with Mantel correction, and the Cox proportional hazard model were used for data analysis. We observed a significantly higher mean age of smoking patients compared to the mean age of non-smoking patients. The coexistence of former neoplastic diseases was significantly more frequent in the group of non-smokers compared to the group of smoking patients. We did not observe differences depending on smoking status in the tumor stage, grade, vascular and pleural involvement status in the diagnostic reports. We did not observe differences in the survival between smokers vs. non-smokers, however, we revealed better survival in the non-smoker women group compared to the non-smoker men group. In conclusion, 22.11% of the patients undergoing radical anatomical resection of the lung tissue due to lung cancers were non-smokers. More research on survival depending on genetic differences and postoperative treatment between smokers and non-smokers is necessary. [ABSTRACT FROM AUTHOR]

Abstract Background Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants that may contribute to the etiology of obesity. However, it is unclear whether PAHs from environmental sources are associated with regional body fat distribution, and whether the association varies across racial/ethnic groups who may have differential PAH exposure patterns. Objectives To examine correlations between PAHs and body fat distribution, and potential racial/ethnic differences among U.S. adults. Methods Ten PAHs were measured in spot urine samples from 2691 non-smoking adults (age ≥ 20 years) in the NHANES 2001–2016. Dual-energy X-ray absorptiometry was used to measure fat mass percent (FM%). Partial Pearson correlation coefficients (r) with multivariable adjustment were used to assess PAH-FM% associations. Results In the total population, 1-naphthalene, 3-fluorene, and 1-pyrene were inversely correlated with total FM% or trunk FM% (adjusted r ranged: − 0.06 to − 0.08), while 2-naphthalene, 9-fluorene, and 4-phenanthrene were positively correlated with the FM% measurements (r: 0.07–0.11). PAH levels are highest among non-Hispanic Blacks, followed by Hispanics and Whites and some of the correlations were different by these races/ethnicities. Among non-Hispanic Whites, no PAH was correlated with FM%. In contrast, 9-fluorene was positively correlated with total FM% (r = 0.20) and trunk FM% (r = 0.22) among Blacks, and 4-phenanthrene was positively correlated with total FM% (r = 0.23) and trunk FM% (r = 0.24) among Hispanics (P-interaction: 0.010–0.025). Discussion In this US adult population, certain PAHs are significantly associated with higher body fat contents among non-Hispanic Blacks and Hispanics but not non-Hispanic Whites, suggesting that minority groups might be particularly susceptible to PAH’s obesogenic effects or the effects of other factors that determine the PAH exposure levels. Alternatively, differences in body composition may contribute to differential PAH metabolism in minority groups. Future studies are warranted to explore the racial/ethnic disparity in PAH exposures, drivers of these exposure differences, and mechanisms through which PAHs may influence body composition by races/ethnicities.

Introduction: Oral Squamous Cell Carcinomas (OSCC) are mostly related to tobacco consumption eventually associated to alcohol (Smoker/Drinker patients: SD), but 25-30% of the patients have no identified risk factors (Non-Smoker/Non-Drinker patients: NSND). We hypothesized that these patients have distinguishable immune profiles that could be useful for prognosis. Materials and Methods: Cells present in immune tumor microenvironment (TME) and blood from 87 OSCC HPV-negative patients were analyzed using a multiparameter flow cytometry assay, in a prospective case-control study. Cytokine levels in tumor supernatants and blood were determined by a cytometric bead array (CBA) assay. Results: Normal gingiva and blood from healthy donors (HD) were used as controls. A significant increase of granulocytes (p<0.05 for blood), of monocytes-macrophages (p<0.01 for blood) and of CD4+ T cells expressing CD45RO and CCR6 (p<0.001 for blood; p<0.0001 for TME) as well as higher levels of IL-6 (p<0.01 for sera, p<0.05 for tumor supernatant) were observed in SD patients as compared to NSND OSCC patients and HD. High percentages of CD4+ T cells expressing CD45RO and CCR6 cells in tumor tissue (p=0.05) and blood (p=0.05) of SD OSCC patients were also associated with a poorer prognosis while a high percentage of regulatory T cells (Treg) in tumor tissue was associated with a more favorable prognostic factor (p=0.05). Also, a higher percentage of blood CD8+ T lymphocytes among CD45+ cells in NSND patients was associated with a better disease-free survival (p=0.004). Conclusion: Granulocytes, monocytes-macrophages, and CD4+ T cells expressing CD45RO and CCR6 in blood and TME as well as serum IL-6 can therefore distinguish OSCC SD and NSND patients. Quantifying the proportion of CD4+ T cells expressing CD45RO and CCR6 and of Treg in SD patients and CD8+ T cells in NSND patients could help defining the prognostic of OSCC patients. [ABSTRACT FROM AUTHOR]

The presence of multiple tracheal and bronchial diverticula is a rare condition. We present a case of a 22‐years old non‐smoker male with a history of pulmonary tuberculosis, having multiple tracheal and bronchial diverticula along with other common sequelae such as stenosed and collapsed upper lobe bronchi. [ABSTRACT FROM AUTHOR]

A meta‐analysis was performed to evaluate the preoperative smoking and smoke cessation on wound healing and infection in post‐surgery subjects. A systematic literature search up to January 2022 incorporated 11 trials involving 218 567 subjects after post‐surgery at the beginning of the study; 176 670 were smoke cessation or non‐smokers, and 41 897 were smokers. Statistical tools like the dichotomous method were used within a random or fixed‐influence model to establish the odds ratio (OR) with 95% confidence intervals (CIs) to evaluate the influence of preoperative smoking and smoke cessation on wound healing and infection in post‐surgery subjects. Smoke cessation or non‐smokers had significantly lower postoperative wound healing problems (OR, 0.59; 95% confidence interval, 0.43‐0.82, P <.001), and surgical site wound infection (OR, 0.74; 95% CI, 0.63‐0.87, P <.001) compared with smokers in post‐surgery subjects. Smoke cessation or non‐smokers had significantly lower postoperative wound healing problems, and surgical site wound infection compared with smokers in post‐surgery subjects. Furthermore, evidence is needed to confirm the outcomes. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is a significant public health issue characterized by gradually worsening airflow limitation. It is a leading cause of mortality and morbidity worldwide, yet research on COPD patients who have never smoked is limited. This study aims to document the demographic, symptomatic, and therapeutic characteristics of COPD patients receiving outpatient pulmonary care in Hungary, focusing on smoking history, and evaluate their distribution according to the GOLD A/B/E classification., Methods: The study recorded demographic data, symptom severity, occurrence of severe and moderate exacerbations, treatment, comorbidities, quality of life, and COVID-19 vaccination status among COPD patients from November 2021 to January 2023. A total of 6974 patients were categorized into current smokers, former smokers, and never smokers., Results: Patients had an average age of 67.2±8.9 years, with 48.2% male and 51.8% female. Of participants, 86.1% had a smoking history, while 13.9% had never smoked. COPD patients who had never smoked showed significantly better quality of life (CAT: 15.2±7.6 vs 15.8±6.9; p=0.006), oxygen saturation (SpO 2 %: 96.7±2.3 vs 95.8±2.4; p<0.001), higher body mass index (BMI: 29.4±5.9 vs 27.1±6.3; p<0.001), and better lung function (FEV 1 ref%: 67.9±20.7 vs 58.9±18.1; p<0.001) compared to smokers. However, non-smoking COPD patients had a higher frequency of comorbidities (3.5±2.2 vs 2.9±2.1; p<0.05). These differences may arise from complex genetic and environmental interactions., Conclusion: COPD patients who have never smoked exhibited better quality of life, nutritional status, and lung function compared to smokers, indicating the need for tailored treatment approaches. Further long-term studies are essential to validate these differences in quality of life and lung function between smoking and non-smoking COPD patients., Competing Interests: Dr Balazs Santa and Dr Alpar Horvath are employees of Chiesi Hungary Kft, during the conduct of the study. The authors declare no conflicts of interest. Financial funding did not influence the presentation of this data., (© 2024 Fekete et al.)

IntroductionOral Squamous Cell Carcinomas (OSCC) are mostly related to tobacco consumption eventually associated to alcohol (Smoker/Drinker patients: SD), but 25-30% of the patients have no identified risk factors (Non-Smoker/Non-Drinker patients: NSND). We hypothesized that these patients have distinguishable immune profiles that could be useful for prognosis.Materials and MethodsCells present in immune tumor microenvironment (TME) and blood from 87 OSCC HPV-negative patients were analyzed using a multiparameter flow cytometry assay, in a prospective case-control study. Cytokine levels in tumor supernatants and blood were determined by a cytometric bead array (CBA) assay.ResultsNormal gingiva and blood from healthy donors (HD) were used as controls. A significant increase of granulocytes (p

Background: Polycyclic aromatic hydrocarbons (PAHs) are environmental pollutants that may contribute to the etiology of obesity. However, it is unclear whether PAHs from environmental sources are associated with regional body fat distribution, and whether the association varies across racial/ethnic groups who may have differential PAH exposure patterns. Objectives: To examine correlations between PAHs and body fat distribution, and potential racial/ethnic differences among U.S. adults. Methods: Ten PAHs were measured in spot urine samples from 2691 non-smoking adults (age ≥ 20 years) in the NHANES 2001–2016. Dual-energy X-ray absorptiometry was used to measure fat mass percent (FM%). Partial Pearson correlation coefficients (r) with multivariable adjustment were used to assess PAH-FM% associations. Results: In the total population, 1-naphthalene, 3-fluorene, and 1-pyrene were inversely correlated with total FM% or trunk FM% (adjusted r ranged: − 0.06 to − 0.08), while 2-naphthalene, 9-fluorene, and 4-phenanthrene were positively correlated with the FM% measurements (r: 0.07–0.11). PAH levels are highest among non-Hispanic Blacks, followed by Hispanics and Whites and some of the correlations were different by these races/ethnicities. Among non-Hispanic Whites, no PAH was correlated with FM%. In contrast, 9-fluorene was positively correlated with total FM% (r = 0.20) and trunk FM% (r = 0.22) among Blacks, and 4-phenanthrene was positively correlated with total FM% (r = 0.23) and trunk FM% (r = 0.24) among Hispanics (P-interaction: 0.010–0.025). Discussion: In this US adult population, certain PAHs are significantly associated with higher body fat contents among non-Hispanic Blacks and Hispanics but not non-Hispanic Whites, suggesting that minority groups might be particularly susceptible to PAH's obesogenic effects or the effects of other factors that determine the PAH exposure levels. Alternatively, differences in body composition may contribute to differential PAH metabolism in minority groups. Future studies are warranted to explore the racial/ethnic disparity in PAH exposures, drivers of these exposure differences, and mechanisms through which PAHs may influence body composition by races/ethnicities. [ABSTRACT FROM AUTHOR]

ObjectivesThis study aimed to identify the potential risk factors for small airway dysfunction (SAD) in non-smokers with chronic cough.MethodsNon-smokers with chronic cough who underwent lung function tests at Xiangya Hospital from May 2019 to May 2020 were enrolled, and divided into the derivation and validation cohorts based on their hospital admission time. SAD was determined based on the presence of at least two of the following three indicators of lung function being less than 65% of predicted: maximal mid-expiratory flow, forced expiratory flow at 50% of forced vital capacity (FVC), and forced expiratory flow at 75% of FVC. Clinical data of these patients were collected. Risk factors for SAD were identified by logistic regression analysis in the derivation cohort and further confirmed in the validation cohort.ResultsIn total, 316 patients (152 in the non-SAD group and 164 in the SAD group) were included in the derivation cohort. Compared with the non-SAD group, the SAD group had a higher proportion of female patients (82.3 vs. 59.2%, P < 0.001), was more commonly exposed to second-hand smoke (SHS) (61.6 vs. 27.6%, P < 0.001), and tended to be older (median age, 45.5 vs. 40.0 years old, P = 0.004). The median FVC, forced expiratory volume in one second (FEV1) % pred, FEV1/FVC ratio, and peak expiratory flow (PEF) % pred were slightly lower in the SAD group. Multivariable logistic analysis showed that exposure to SHS was an independent risk factor (OR 4.166 [95% CI 2.090–8.302], P < 0.001) for SAD in non-smokers with chronic cough after adjusting for related variables. In the validation cohort (n = 146), patients with SHS exposure had a relative risk of 1.976 (95% CI 1.246–3.135, P = 0.004) for SAD compared to those without SHS exposure. Multivariable logistic analysis consistently confirmed that exposure to SHS was an independent risk factor (OR 3.041 [95% CI 1.458–6.344], P = 0.003) for SAD in non-smokers.ConclusionsExposure to SHS is independently associated with a higher risk of SAD in non-smokers with chronic cough. Reduction in SHS exposure may ameliorate lung function, thus lowering the risk of irreversible airway obstruction.

Background: Coronary Artery Disease (CAD) is a major cause of mortality in most countries. Many risk factors such as high blood pressure, hyperlipidemia, diabetes, age, sex, obesity, smoking, and family history play a role in CAD. The aim of this study was to evaluate the concentration of Total Sialic Acid (TSA) and Lipid Profiles (LP) with the Severity of the Vessel in patients with non-smoker and diabetic CAD, so that by measuring these parameters, effective help for diagnosis and prevention for healthy people Prone to CAD, and also control the treatment of patients. Methods: In this study, 200 individual including 160 patient and 40 control group were considered. All patient groups were non-smokers and diabetic. Patients were divided into 4 groups according to the results of angiography: Patients with Normal angiography (n = 40) with one eclipse (n = 40), patients with double stenosis (n = 40) and patients with eclipse Three vessels (n = 40). The control group was chosen from people who had no history of CAD and other diseases. The lipid profile was measured by standard methods and serum total sialic acid was measured by ELISA method. Results: There was no significant difference between the two groups in age and sex, but there was a significant difference in family history (p

According to previous studies, an impaired pulmonary function is associated with arterial stiffness (AS). The pulse pressure (PP) is an important predictor of AS, but the association of an impaired pulmonary function with the PP is unclear. Therefore, this study assessed the associations between the PP and the predicted forced vital capacity (predicted FVC) and predicted forced expiratory volume in one second (predicted FEV1) in Korean non-smoking adults. The data obtained from 6,857 adults during the 2013∼2015 Korean National Health and Nutrition Examination Survey were analyzed. After adjusting for the related variables, the ORs of restrictive pulmonary disease (RPD, the predicted FVC＜80.0% with FEV1/FVC≥70.0%) using the normal PP group (PP≤60 mmHg) as a reference group was significant for the high PP group (PP＞60 mmHg; 1.337 [95% confidence interval (CI), 1.049∼1.703]). In addition, the ORs of obstructive pulmonary disease (OPD, FEV1/FVC＜70.0%) using the normal PP group as a reference group were significant for the high PP group (1.339 [95% CI, 1.093∼1.642]). In conclusion, a high PP is positively associated with both RPD and OPD in Korean non-smoking adults.

Abstract Background Kartagener syndrome, an autosomal recessive disorder with a triad of chronic sinusitis, bronchiectasis, and situs inversus, is characterized by recurrent respiratory tract infections and chronic inflammation of the lung. Information on comorbidities other than infections in patients with Kartagener syndrome is currently limited. Case presentation A 39-year-old, non-smoking female was diagnosed with Kartagener syndrome and admitted to Saitama Medical Center, Jichi Medical University, Japan. Computed tomography revealed an endobronchial massive shadow at the ostial site of the right upper lobe bronchus with atelectasis of the right upper lobe. The mass was surgically resected and pathologically diagnosed as mucoepidermoid carcinoma. The lesion had no vascular invasions and no metastases to the lungs or lymph nodes. The surgical margin was negative for carcinoma. Following surgery, the patient has been in good condition. Conclusions The present case showed different clinicopathological characteristics from those previously reported in cases of Kartagener syndrome complicated by carcinoma. To the best of our knowledge, this is the first reported case of a young, non-smoking female with comorbid Kartagener syndrome and pulmonary mucoepidermoid carcinoma. This case report may provide a new perspective on the complications of Kartagener syndrome.

The study analyzed the importance of smoking in the appearance of acute coronary events (ACE) on a sample of 865 subjects. For smoking assessment, the status of smoker, duration and frequency of smoking were monitored. Compared to other risk factors, smoking does not show complete reversibility of the possibility of SCA occurrence by cessation of smoking, especially if exposure to cigarette smoke has been for a long time.

OBJECTIVE: The most important risk factor for chronic obstructive pulmonary disease (COPD) is smoking. However, more than 25% of patients do not have a history of smoking. The intent of this study is to identify characteristics of COPD patients that are non-smokers. MATERIAL AND METHODS: The records of patients with COPD were retrospectively reviewed. Smoking history, comorbidities, exacerbations, biomass, and environmental tobacco smoke (ETS) exposures were identified. Also, age, gender, pulmonary function test (PFT) values, modified Medical Research Council (mMRC) dyspnea scores were recorded. Non-smokers exposed to any of the COPD risk factors above were grouped and the data were analyzed to determine the specific characteristics of COPD that applied to them. RESULTS: A total of 706 COPD patients were analyzed with a mean age of 67.2 ± 9.4. Of these patients, 93 (13.2%) were female and 613 (86.8%) were male. Of the 706 patients, 128 (18.1%) were non-smokers. The percentage of male patients having COPD was significantly lower in the non-smoker group (P< .001). However, biomass, ETS exposure in childhood, and a history of previous respiratory infection were significantly higher in the non-smoker group (P < .001). The mean body mass index (BMI) was greater in non-smokers than smokers. CONCLUSION: Non-smokers with COPD have more biomass, ETS exposure, and infection history in childhood. They also have less impairment of airflow limitation, better symptom scores, and greater BMIs. Smoking history can be used to determine a different phenotype. [ABSTRACT FROM AUTHOR]

Abstract We describe the case of a 29‐year‐old female non‐smoker who was treated with steroid therapy for a subacute exacerbation of multisystem Langerhans cell histiocytosis (MS‐LCH) with worsening lung, skin, and oral mucosal lesions. The patient developed pneumonia, and computed tomography (CT) showed multiple thin‐walled cavities. Transbronchial lung cryobiopsy (TBLC) specimens revealed Langerhans cells, which were positive for CD1a and S‐100 expression. Similar histological findings were detected in the submandibular gland, skin, and tooth. On the basis of these findings, the patient was diagnosed with MS‐LCH and subsequently treated with steroid therapy. From the literature review, case reports of non‐smokers with pulmonary lesions that worsened and required treatment are rare. Almost all cases recurred and needed additional treatment. This case study contributes to our understanding of the potential role of steroid therapy in MS‐LCH treatment. Additionally, TBLC is a novel, potentially safer, diagnostic tool that has not been previously described for LCH.

Background: Apart from several well documented risk factors; oxidative stress may play an important role in the pathogenesis of myocardial infarction. Our study has been designed to investigate the pro-oxidant status in AMI patients who have no previous history of diabetes, hypertension and habit of smoking. Aims and Objectives: To measure the level of serum thiobarbituric acid reactive substances(TBARS) to assess the extent of oxidative damage in recently diagnosed cases of AMI and to look for any correlation between this stress marker and some of the lipid profile markers. Materials and Methods: A cross sectional study was conducted in a tertiary care hospital with 50 non-diabetic, non-hypertensive, non-smoker AMI patients of either sex as Cases and 50 age and sex matched healthy Controls. The biochemical parameters were measured by validated techniques. Results: Level of serum TBARS (4.78 ± 1.06 nmol/ml) has significantly increased (p

Background: Kartagener syndrome, an autosomal recessive disorder with a triad of chronic sinusitis, bronchiectasis, and situs inversus, is characterized by recurrent respiratory tract infections and chronic inflammation of the lung. Information on comorbidities other than infections in patients with Kartagener syndrome is currently limited.Case Presentation: A 39-year-old, non-smoking female was diagnosed with Kartagener syndrome and admitted to Saitama Medical Center, Jichi Medical University, Japan. Computed tomography revealed an endobronchial massive shadow at the ostial site of the right upper lobe bronchus with atelectasis of the right upper lobe. The mass was surgically resected and pathologically diagnosed as mucoepidermoid carcinoma. The lesion had no vascular invasions and no metastases to the lungs or lymph nodes. The surgical margin was negative for carcinoma. Following surgery, the patient has been in good condition.Conclusions: The present case showed different clinicopathological characteristics from those previously reported in cases of Kartagener syndrome complicated by carcinoma. To the best of our knowledge, this is the first reported case of a young, non-smoking female with comorbid Kartagener syndrome and pulmonary mucoepidermoid carcinoma. This case report may provide a new perspective on the complications of Kartagener syndrome. [ABSTRACT FROM AUTHOR]

The study analyzed the importance of smoking in the appearance of acute coronary events (ACE) on a sample of 865 subjects. For smoking assessment, the status of smoker, duration and frequency of smoking were monitored. Compared to other risk factors, smoking does not show complete reversibility of the possibility of SCA occurrence by cessation of smoking, especially if exposure to cigarette smoke has been for a long time. [ABSTRACT FROM AUTHOR]

Yoonki Hong,1 Wonjun Ji,2 Soojeong An,3 Seon-Sook Han,1 Seung-Joon Lee,1 Woo Jin Kim1 1Department of Internal Medicine, Environmental Health Center, Kangwon National University Hospital, Chuncheon, South Korea, 2Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, 3Department of Statistics, Kangwon National University, Chuncheon, South Korea Background: There is growing evidence about sex-related phenotypes of COPD. However, the sex differences in COPD mainly result from smokers. This study evaluated the sex differences in nonsmoking patients with COPD, focusing on structural changes in the lungs in airway diseases and emphysema. Methods: Ninety-seven nonsmoking patients, defined as having

Background: There are several prognostic factors in patients with Chronic Obstructive Pulmonary Disease (COPD) that include Forced expiratory volume in one second (FEV1), Body Mass Index (BMI), dyspnea severity, exercise capacity and Pulmonary Hypertension (PH). PH is one of the most important factors. PH pathogenesis in patients with COPD has not been clarified thoroughly and factors such as alveolar hypoxemia, polycythemia, acidosis and pulmonary vessels obstruction have been suggested. The authors assessed some of these contributing factors in smoker and non-smoker patients with COPD. Materials and Methods: This comparative-descriptive study included COPD patients suspected to have cor pulmonale without exacerbation in the last four weeks. Echocardiographic evaluation of Pulmonary Arterial Pressure (PAP) was done and Pulmonary Hypertension (PH) was defined as systolic Pulmonary Arterial Pressure (PAP) greater than 40 mmHg. Complete Blood Count (CBC) and Arterial Blood Gas (ABG) were also studied in all patients. Results: Echocardiography was done for 142 patients who were suspected to have PH and 110 patients had measurable PAP. All of the patients were in stage II - IV of COPD according to GOLD criteria. 90 patients had PH of which 47 were smokers and 43 were non-smokers. In smoker patients, significant correlation between PAP and PaO2 was seen (r=-0.291, p-value=0.047). But in non-smoker patients, this correlation was absent. A significant correlation between PAP and FEV1 (r=-0.341, P value=0.025) was seen in non-smoker patients. This correlation was absent in smoker patients. There was no correlation between PAP and hemoglobin, hemoglobin and FEV, and also PaO2 and FEV1 in smoker and non-smoker COPD patients. Conclusion: In non-smoker patients with COPD, degree of pulmonary parenchymal lesions and bronchial obliteration plays a more important role than hypoxia in the pathogenesis of pulmonary hypertension. [ABSTRACT FROM AUTHOR]

Background: Apart from several well documented risk factors; oxidative stress may play an important role in the pathogenesis of myocardial infarction. Our study has been designed to investigate the pro-oxidant status in AMI patients who have no previous history of diabetes, hypertension and habit of smoking. Aims and Objectives: To measure the level of serum thiobarbituric acid reactive substances(TBARS) to assess the extent of oxidative damage in recently diagnosed cases of AMI and to look for any correlation between this stress marker and some of the lipid profile markers. Materials and Methods: A cross sectional study was conducted in a tertiary care hospital with 50 non-diabetic, non-hypertensive, non-smoker AMI patients of either sex as Cases and 50 age and sex matched healthy Controls. The biochemical parameters were measured by validated techniques. Results: Level of serum TBARS (4.78 ± 1.06 nmol/ml) has significantly increased (p<0.001) in cases with respect to control group(2.19±0.41 nmol/ml); a positive correlation between serum TBARS and LDL; a negative correlation between serum TBARS and HDL in cases. Conclusion: Our study indicates an increased oxidative stress in AMI patients even in absence of some high risk factors which are oxidative stress inducers by themselves. This evidence suggests that oxidative stress itself may play an important role in the pathogenesis of myocardial infarction. So, the oxidative stress marker may have the importance in early diagnosis of AMI. It also suggests the potential appropriateness of antioxidant therapy in the prevention of AMI. [ABSTRACT FROM AUTHOR]

Objective: This study assessed the association of metabolic syndrome and metabolic syndrome score with the predicted forced vital capacity and predicted forced expiratory volume in 1 s (predicted forced expiratory volume in 1 s) values in Korean non-smoking adults. Methods: We analysed data obtained from 6684 adults during the 2013–2015 Korean National Health and Nutrition Examination Survey. Results: After adjustment for related variables, metabolic syndrome (p < 0.001) and metabolic syndrome score (p < 0.001) were found to be inversely associated with the predicted forced vital capacity and forced expiratory volume in 1 s values. The odds ratios of restrictive pulmonary disease (the predicted forced vital capacity < 80.0% with forced expiratory volume in 1 s/FVC ⩾ 70.0%) by metabolic syndrome score with metabolic syndrome score 0 as a reference group showed no significance for metabolic syndrome score 1 [1.061 (95% confidence interval, 0.755–1.490)] and metabolic syndrome score 2 [1.247 (95% confidence interval, 0.890–1.747)], but showed significant for metabolic syndrome score 3 [1.433 (95% confidence interval, 1.010–2.033)] and metabolic syndrome score ⩾ 4 [1.760 (95% confidence interval, 1.216–2.550)]. In addition, the odds ratio of restrictive pulmonary disease of the metabolic syndrome [1.360 (95% confidence interval, 1.118–1.655)] was significantly higher than those of non-metabolic syndrome. Conclusion: Metabolic syndrome and metabolic syndrome score were inversely associated with the predicted forced vital capacity and forced expiratory volume in 1 s values in Korean non-smoking adults. In addition, metabolic syndrome and metabolic syndrome score were positively associated with the restrictive pulmonary disease. [ABSTRACT FROM AUTHOR]

The increases in air pollution over the metropolitan cities are a threat to human health and environment. An attempt has been made to evaluate the health consequences of indoor air pollution induced by Beam Rolling Mills Factory at Ahwaz (Iran). A questionnaire was prepared to obtain information on health of 481 workers, out of which 200 each were selected from exposed and non-exposed category by stratified randomized method. Fisher exact test and chi-square test were used to calculate the values. The study concludes that more than 80% of the workers have high exposure risk to diseases. Analysis of the health impacts reveals that exposed workers are more prone to various diseases as compared to the non-exposed workers. It is also observed that exposure to air pollutants might be the causative factor for various diseases among the smokers but also nonsmoking workers. The analysis also reveals that there is higher relative risk in occupational fatigue and cardio-vascular disease. Further, the study found that percentage of workers having various diseases is much higher in the indoor environment as compared to the outdoor environment

Patients with smoking-independent lung cancer mainly consist of females, yet the molecular background of this epidemiological feature, other than epidermal growth factor receptor (EGFR) mutation, remains unclear. Several studies have revealed the association between female hormone‑associated factors and the prognosis of lung cancer, however the data remain inconsistent. The present study focused on the expression of estrogen receptor (ER)α in order to elucidate this association in smoking‑independent lung cancer. Immunohistochemistry staining (IHC) of aromatase, ERα and ERβ was performed against formalin‑treated tissues from 38 patients who had never‑smoked who underwent complete surgical resection between 2012 and 2013. Among them, adequate RNA of the tumor and adjacent normal lung cancer was extracted from 31 matching deep frozen samples. Considering the IHC results, reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) was performed to measure the expression level of 2 different exons of ERα, exon 6 and exon 7, which are part of the ligand binding domain of ERα, using the Taqman gene expression assay. Extra‑nuclear expression of ERα using IHC demonstrated a statistically significant association with pathological invasiveness. RT‑qPCR results exhibited a decreased expression of ERα exon 7 in invasive tumor tissues, compared with their adjacent normal tissues. This is consistent with the findings of previous in vitro studies indicating that extra‑nuclear ERα were exon 7 splicing variants. No difference was observed in ERα exon 7 expression between normal and tumor tissues in non‑invasive lung cancer tissues. When considering the EGFR mutation status, EGFR wild‑type lung cancers exhibited decreased ERα exon 7 expression levels compared with EGFR mutated lung cancers. Extra‑nuclear expression of ERα, which may represent exon 7 splicing variants of ERα, showed statistical association with pathological invasiveness in smoking‑independent lung cancer. The post‑translational splicing mechanism of ERα may be involved in the acquired invasiveness of smoking independent lung cancer. [ABSTRACT FROM AUTHOR]

Langerhans cell histiocytosis (LCH) is a rare disease of unknown cause, which encompasses a set of disorders of multiple organs with various clinical presentations that share the common characteristic of sizeable Langerhans cell infiltration. The clinical spectrum of LCH ranges from solitary bone lesions to involvement of other organs. Lung involvement in LCH may be part of a multisystem disease, which almost exclusively occurs in adult smokers, while it is overlooked or misdiagnosed in the majority of non-smokers. High-resolution computed tomography (HRCT) of the chest is crucial for diagnosis; however, the treatment and prognosis of this disease have not been clearly determined. We herein present the case of a non-smoking adult patient who presented with lower limb pain and was diagnosed via biopsy with LCH with multisystem involvement, including the bone and lungs. Lytic lesions in the corpus of the sacroiliac joint, sacrum, acetabulum and femoral head by a soft tissue mass were observed on diagnostic CT. In addition, chest HRCT revealed multiple cysts in the bilateral lungs, predominantly in the upper lobes. The final diagnosis of LCH was confirmed by histopathological examination and immunohistochemical staining for CD1a and S-100. Corticosteroid treatment alleviated lower limb pain and improved the patient's quality of life; thus, corticosteroids may be considered as a potential treatment option for patients with LCH. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study was to determine the prevalence of COPD among non-smoking adults, and to investigate the risk factors that affect disease occurrence. Methods The data from the 5th Korea national health and nutrition examination survey (KNHNES) has been used, and 5,489 non-smoking adults aged between 40 to 79 years with diagnosable FEV1/FVC were selected therefrom as the subjects of this study. Results The prevalence of COPD in non-smokers was observed to be 6.9%. The development of the COPD showed statistically significant difference among groups; males showed about 2.54 times (95% CI: 1.410∼146.612) higher rates compared to females, subjects aged 70–79 showed about 3.08 times (95% CI: 1.823∼11.437) higher rates compared to those aged 40–49, subjects whose education level was elementary school or less showed about 5.36 times (95% CI: 1.341∼21.393) higher rates compared to those who are college or more, and subjects who are middle school showed about 4.72 times (95% CI: 1.374∼16.217) higher rates compared to the college or more. Conclusion It is confirmed that development of the COPD in non-smokers reach significance. For the prevention of the disease, there is a need to identify COPD-related risk factors in males and the elderly and provide appropriate nursing intervention, and to develop health-related education programs for those with low educational background to take in order to promote the improvement of lung health. [ABSTRACT FROM AUTHOR]

Objectives: To identify any association between implementing smoking regulation policies and workers' urine cotinine concentration levels in Korea. Methods: From the first stage of the Korean National Environmental Health Survey conducted by the National Institute of Environmental Research from 2009 to 2011, 2,475 non-smoking workers selected. We analyzed the trend in the changes of cotinine concentration in urine using the general linear model and linear regression, in various jobs as categorized by the National Center for Health Statistics (NCHS) and Korea Standard Classification of Occupations (KSCO). Results: The urine cotinine concentration tended to decrease every year (2.91 ng/ml in 2009, 2.12 ng/ml in 2010, and 1.31 ng/ml in 2011), showing a decreasing trend (P < 0.001). The total subjects' decreased cotinine concentration in urine between 2009 and 2011 was 2.72 ng/ml (54.1 % relative decrease). The changes in each subgroup's urine cotinine concentration ranged from 1.59 to 6.03 ng/ml (33.2 to 77.5 %). All groups except for the managerial group (n = 49), which had a small sample size, had statistically significant negative regression coefficients (p < 0.05). The ranges of the decrease in urine cotinine were 2.75 ng/ml (53.6 %) for males and 2.72 ng/ml (54.9 %) for females. The negative slope in urine cotinine level was statistically significantly greater in men than women. The changes in urine cotinine by occupation as classified by the NCHS occupational categories ranged from 2.43 to 3.36 ng/ml (46.6 to 61.5 % relative decrease). The negative slopes in urine cotinine levels of the white-collar and farm workers were statistically significantly greater than those of the service workers and blue-collar workers. The change by occupation as classified by the KSCO ranged from 1.59 to 6.03 ng/ml (a 33.2 to 77.5 % relative decrease). The negative slopes in urine cotinine levels of the professionals and related workers and clerks were statistically significantly greater than those of the service workers and plant and machine operators and assemblers. Conclusions: The cotinine concentration in urine among non-smoking worker groups tended to decline from 2009 to 2011. Such a result may be an indirect indicator of the effectiveness of smoking regulation policies including the revision of the National Health Promotion Act. [ABSTRACT FROM AUTHOR]

Background: Smoking is a crucial problem for public health affecting smokers and also, their second-hand smokers. Objectives: To compare the respiratory muscle strength among smoker group, second-hand smoker group, and non-smoker group. Materials and methods: One hundred and twenty males and females, aged between 20-40 years old, were recruited and divided into three groups. Vital signs and respiratory muscle strength were measured in all subjects. Respiratory muscle strength was measured by respiratory pressure meter for three times with one minute resting period. The highest value was selected for data analysis. Results: Result of the study demonstrated that maximal inspiratory and expiratory pressure were not significantly different among three groups (p

This case report highlights delay in the diagnosis of adenoma carcinoma of the lung in a female patient who has never smoked. It took three months to reach the diagnosis of stage IV lung carcinoma despite the presence of symptoms and an abnormal chest radiograph finding from the beginning. The clinical characteristics and predictors of missed opportunities for an early diagnosis of lung cancer are discussed. In this case, patient and doctor factors contributed to the delay in diagnosis. Thus, early suspicions of lung cancer in a woman with the presence of respiratory symptoms despite being a non-smoker are important in primary care setting. [ABSTRACT FROM AUTHOR]