Brinkman Index Research Articles

Morphological Differences in the Abdominal Aorta Between Subjects With and Without Type 2 Diabetes.

Aim Chronic hyperglycemia is a well-known risk factor for the development of many macrovascular complications, but hyperglycemia may be reportedly protective against abdominal aneurysms. Materials and methods In this study, we evaluated morphological differences in the abdominal aorta between subjects with and without type 2 diabetes mellitus (T2DM) without abdominal aortic aneurysm and evaluated the correlation between imaging findings of computed tomography (CT) and diabetes-related parameters. Results The abdominal aortic diameter was significantly smaller in subjects with T2DM compared to non-diabetes mellitus (NDM) subjects (p=0.026). Abdominal aortic wall thickness assessed by contrast-enhanced CT was significantly greater in subjects with T2DM compared to NDM subjects (p=0.011). There was a significant single correlation between abdominal aortic diameter and age, gender, Brinkman index, HbA1c, and mean/max intima-media thickness (IMT). Multiple regression analysis showed that HbA1c was an independent negative factor affecting abdominal aortic diameter (t=-3.28, p=0.0036). And Brinkmann index was an independent factor affecting aortic wall thickness (t=2.23, p=0.034). Conclusion This study revealed the imaging characteristics of smaller abdominal aortic diameter and larger wall thickness in T2DM subjects compared to NDM subjects. The abdominal aortic wall thickening was significantly correlated with cervical IMT. Therefore, close examination for other diabetes-related macrovascular complications should be aggressively considered when these findings are present.

588. EFFICACY OF INTRAOPERATIVE RECURRENT LARYNGEAL NERVE MONITORING DURING MINIMALLY INVASIVE ESOPHAGECTOMY FOR ESOPHAGEAL CANCER: A NATIONWIDE INPATIENT COHORT STUDY

Abstract Background Lymphadenectomy around the recurrent laryngeal nerve (RLN) is an essential part of curative surgery for esophageal cancer. The rate of lymph node metastasis around the RLN is extremely high, and postoperative RLN palsy could lead to a poor prognosis in patients with esophageal cancer. Although several single-center studies have shown that intraoperative nerve monitoring (IONM) can avoid RLN palsy, this has not been confirmed in a large-scale multicenter study. This study was performed to evaluate whether intraoperative nerve monitoring IONM can reduce postoperative RLN palsy during minimally invasive esophagectomy (MIE) for esophageal cancer using a national database. Methods We retrieved data of patients with esophageal cancer who underwent MIE involving thoracoscopic or robotic esophagectomy with IONM (502 patients) and without IONM (4,353 patients) at 348 hospitals from April 2020 to March 2022 from the Diagnosis Procedure Combination database in Japan. We compared the frequency of postoperative RLN palsy and respiratory complications between the IONM (+) group and IONM (−) group using propensity score-matching (PSM) analysis. The propensity score was estimated using multivariable logistic regression models including age, sex, Body Mass Index, Brinkman index, Activities of Daily Living, comorbidities at admission, clinical TNM classification, approach of MIE, and hospital case volume with reference to previous studies of IONM. Results After PSM, the standardized bias was <10% for all covariates, which indicated improved balance in the covariates between the matched pairs. With 1-to-1 matching, 501 pairs (1,002 cases) were created between the IONM (+) and (−) groups. The postoperative RLN palsy rate was significantly lower in the IONM (+) than (−) group (odds ratio, 0.24; 95% confidence interval [CI], 0.13–0.46). The respiratory complication rate was also significantly lower in the IONM (+) than (−) group (odds ratio, 0.66; 95% CI, 0.45–0.97). The anesthesia time was significantly longer in the IONM (+) group (regression coefficient, 60.1 minutes; 95% CI, 44.2–76.9). The length of postoperative hospitalization tended to be shorter in the IONM (+) than (−) group (regression coefficient, −1.39 days; 95% CI, −3.91 to 1.14). Conclusion This nationwide cohort study showed that IONM during MIE for esophageal cancer can reduce postoperative RLN palsy and respiratory complications.

Smoking Habit and Coffee Consumption with Gastritis Incidence Rate at Productive Ages

Gastritis is a disease caused by an inflammation of the mucous and submucosal lining of the stomach. Several studies show that there is an influence of smoking habit and coffee consumption on gastritis incidence rate. The study was to determine the correlation between smoking habit and coffee consumption toward gastritis at productive ages. The research is an analytical observational study with a cross-sectional design conducted in Makale Health Center, South Sulawesi, in February 2020. Required data was gathered by conducting guided interviews using a questionnaire that includes age range, sex, and education level. Brinkman Index was used to measure smoking habits, coffee consumption, and gastritis questionnaire. Data was analyzed using a chi-square test with a significance level of p=0.05. From a total of 115 respondents, there are 69.6% included in the age range of 26–35 years old, 58.3% have mild smoking habits, 56.5% have severe coffee consumption, and 85.2% are suffering from gastritis. There is a relation between smoking habit (p=0.029) and coffee consumption (p=0.003) with gastritis (p<0.05). The conclusion is that there is a relationship between smoking habits, coffee consumption, and gastritis incidence.

Proportions of Hypertension in Stable COPD Patients at the National Respiratory Center Persahabatan Hospital

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of these deaths are related to cardiovascular disease. This is due to systemic inflammation that causes increased vascular stiffness and hypertension. These comorbidities lead to poor quality of life, low exercise tolerance, and an increased risk of hospitalization. This study aims to report the proportion of hypertension among stable COPD patients in the Indonesian population.Methods: This cross-sectional study was conducted at the National Respiratory Center Persahabatan Hospital between February and March 2023. Stable COPD patients admitted to the Asthma and COPD Polyclinic who met the criteria were enrolled. Clinical information, vital signs, spirometry results, and DLCO measurements were collected.Results: There were 84 subjects participating in this study. The result of this study shows a 60.7% proportion of hypertension in stable COPD patients. Hypertension has a significant correlation with pulmonary functional values (P=0.021), severity degree of clinical COPD (P=0.004), Brinkman index (P=0.008), and age (P=0.0001). However, hypertension association with COPD duration (P=0.505) and DLCO (P=0.122) were not significant.Conclusion: The hypertension proportion in stable COPD Indonesian patients is 60.7%. Hypertension shows a significant association with pulmonary function values, severity degree of clinical COPD, Brinkman index, and age.

Gambaran Tingkat Aktivitas Fisik Dan Tingkat Kebiasaan Merokok Pada Mahasiswa Kedokteran Universitas Tarumanagara Angkatan 2021-2022

Smoking and lack of physical activity are major public health problems, especially among medical students. The aim of this research is to determine the level of physical activity and level of smoking habits among medical students at Tarumanagara University class of 2021-2022. This research is a descriptive observational type and the design used is cross-sectional. Sampling was carried out using non-random sampling, consecutive sampling type. Data collection regarding gender, age, weight, height, physical activity level and level of smoking habits was carried out by carrying out direct measurements and questionnaires to research subject respondents who met the inclusion criteria from the period February-March 2024. The questionnaire was used to measure activity levels physically using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Measuring the level of smoking habits using the Brinkman index questionnaire. The research results showed that the age range of respondents in this study was 18-23 years with a mean of 20.03 years. Respondents who smoked were 38 (62.3%) students and 23 (37.7%) students who did not smoke. The description of the low level of physical activity of Tarumanagara University Medical students was 32 (52.5%) students, 20 (32.8%) students with moderate physical activity and 9 (14.8%) with high physical activity. The level of smoking habits among Tarumanagara University Medical students was low at 59 (96.7%) students and 2 (3.3%) had moderate levels of smoking.

Association between dietary variety status and sarcopenia as defined by the Asian Working Group for Sarcopenia 2019 consensus in older outpatients at a hospital specializing in geriatric medicine: A cross‑sectional study with baseline data of prospective cohort study (JUSTICE‑TOKYO study).

To the best of our knowledge, little is known about the association between dietary variety status and sarcopenia in university-affiliated geriatric hospital in elderly. The present study aimed to investigate, in a multidisciplinary setting, the prevalence of sarcopenia and association between dietary variety status and sarcopenia in older outpatients at Juntendo Tokyo Koto Geriatric Medical Center (Tokyo, Japan). Between October 2020 and December 2021, a cross-sectional study of outpatients aged ≥65 years [458 male (44%) and 584 female (56%); mean age, 78.2±6.1 years] was conducted to assess prevalence of sarcopenia, according to Asian Working Group for Sarcopenia 2019 criteria, and the relationship between dietary variety status and sarcopenia. Patient profile, comorbidities, drug use, neuropsychological data, abdominal symptoms, pulmonary function and dietary variety status were collected. Of 1,042 subjects, there were 223 (21.4%) with [142 male (63.7%) and 81 female (36.3%); mean age, 80.6±6.3 years] and 819 (78.6%) without sarcopenia [316 male (38.6%) and 503 female (61.4%); mean age, 77.6±5.8]. In multivariate analysis, older age, male sex, low body mass index, high Brinkman Index and phase angle, low quality of life, history of daycare use, diabetes mellitus, osteoporosis and low Mini-Mental State Examination and Dietary Variety Score were related to sarcopenia. The prevalence of sarcopenia was higher in than in community-dwelling individuals. Dietary variety status was associated with sarcopenia.

Dipeptidyl peptidase 4-positive cancer-associated fibroblasts enhance lung adenocarcinoma growth

Cancer-associated fibroblasts (CAFs) are a heterogeneous population of fibroblasts with various features in the cancer stroma and have been reported to influence cancer progression through cell–cell interactions in various types of malignancies, including lung adenocarcinoma (LUAD). Dipeptidyl peptidase 4 (DPP4) is a transmembrane protein with serine protease activity and is involved in the progression of tumors, metabolic diseases, and autoimmune diseases. In the present study, we focused on the role of DPP4-positive CAFs in LUAD. Immunohistochemistry revealed that 38 of 89 LUAD patients showed DPP4 expression in the fibrous stroma, and patients harboring DPP4-positive CAFs were more often male, had a higher Brinkman index, and had a higher Ki-67 labeling index of tumor cells than those with DPP4-negative CAFs. DPP4-positivity was associated with the expression of other CAF markers, α-SMA, periostin, and podoplanin, as well as a cellular senescence marker, p16. In the in vitro study, conditioned media collected from pulmonary fibroblast (OUS-11, HPF, and HPF-C)-induced overexpression of DPP4 significantly promoted the proliferation of LUAD cells (A549 and PC-9) and increased the expression levels of MCP-1, IL-8, IL-6, and GCSF in the media compared to those in controls. In addition, OUS-11 overexpression in DPP4 overexpression increased periostin expression. In conclusion, DPP4-positive CAFs could promote lung adenocarcinoma cell growth by producing soluble factors, and DPP4 inhibition may inhibit cancer progression.

Effect of Degree of Smoking Based on Brinkman Index on Hemoglobin Levels in Adults

Cigarette consumption is the main cause of death in the world because it affects various physiological conditions in the body. Various ingredients in cigarette smoke such as tar, nicotine, carbon monoxide, and others can cause health problems, especially in the O2 transportation system. Hemoglobin is a protein in red blood cells that carries oxygen from the lungs to all tissues. The carbon monoxide contained in cigarette smoke is competitive with O2 in binding to hemoglobin so that the oxygen distributed to the tissues is reduced. The body will compensate for peripheral hypoxia that occurs by increasing hemoglobin levels in the body so that oxygen transport to the tissues can be maintained. Research regarding the relationship between the degree of smoking and hemoglobin levels is still controversial. Analytical research with cross-sectional design. A total of 184 respondents were taken using purposive sampling and it was found that the majority (94%) were men who worked as security officers, cleaners, parking attendants, or technicians. Based on the Brinkman Index, 73.9% of respondents were classified as light smokers, only 1.6% were classified as heavy smokers and 50.5% of respondents had low hemoglobin levels. Analysis showed that the majority of respondents in the light smoker group had normal hemoglobin levels (58.1%), while moderate and heavy smokers had lower hemoglobin levels. In statistical analysis, a significant p-value (0.001) was found between the degree of smoking and hemoglobin levels.

Protein Programmed Death-Ligand 1 Expression in Non-Small Cell Lung Cancer (NSCLC) and Its Correlation to Smoking Status in North Sumatera Population

Tobacco smoking is associated to the increase risk of lung cancer, and smoking could also trigger the tumour proportion score from programmed death ligand (PD-L1). This study aims to identify the correlation of non-small cell lung cancer (NSCLC) with the PD-L1 expression and smoking profile on the North Sumatra Population. Lung cancer is a significant health issue worldwide, where it is the leading cause of death in men. In Indonesia, lung cancer ranks second in terms of incidence overall and first in men. The 5-year prevalence of lung cancer in Indonesia is 10.85 per 100,000 population. The case fatality rate (CFR) for lung cancer in Indonesia is 86.91%. This research implemented a descriptive study with cross-sectional design. 100 of patients with lung cancer were recruited, however; only 52 patients were diagnosed with NSCLC based on histopathological results. Subsequently, 35 samples were included in accordance to inclusion criteria. Staining on Ventana 22C3 platform was performed in Dharmais Cancer Hospital, and tumour proportion score was assessed by two experts of Pathologist. This study was carried out from August 2019 to September 2020. Results: Characteristics of patients with NSCLC to the PD-L1 expression were found more in male patients with percentage of 88.6%, whereas the most common type of cancer is adenocarcinoma, accounting for 97.14% of cases with mild degree smoking index for 45.7% (Brinkman index) and IV-stage of clinical status for 68.6%. The tumour proportion score with 1-49% was 51.4% with high expression of PD-L1 (positive) for 74.28%, while lower expression of PD-L1 accounted for 45%. There is a correlation between PD-L1 expression and smoking status in NSCLC patients, with p-value of 0.037 (<0.05).

The correlation between smoking cumulative dose based on Brinkman Index with peak expiratory flow rate.

Indonesia is the country with the highest prevalence of smokers above 15 years old according to WHO, with a percentage of 76.2%. Smoking-induced lung damage is characterized by inflammation, leading to the destruction of lung parenchyma and airway obstruction, ultimately worsening lung function parameters. This study aims to find correlation between cumulative dose of smoking based on Brinkman index (BI) with Peak Expiratory Flow Rate (PEFR). This is a cross-sectional correlative study conducted on January-March 2020. Data were collected through history taking and PEFR measured with a peak flowmeter by taking the average of three peak flowmeter measurements, each separated by a 2-min interval. Inclusion criteria include male active smokers, aged 30 to 40 years, who have had a smoking history for at least 1 year. Exclusion criteria are as follows: uses e-cigarretes for smoking, has a history of chronic lung diseases such as tuberculosis, pneumonia, post-COVID-19 syndrome, asthma, and has not smoked in the last 28 days. A total of 48 male smokers are included in this study. The mean age of participants was 35.91 years, with a history of smoking of 18.12 years, and 12.5 cigarettes smoked daily. Patients included in this study had BI classified as mild (47.91%), moderate (47.91%), and severe (4.16%). PEFR in patients was classified into green (10.41%), yellow (83.33%), and red (6.25%). Analysis showed significant negative correlation between BI and PEFR (r = -0.721; p < 0.001) suggesting that increasing Brinkman Index may lead to a decrease in PEFR. Higher BI correlates with a decrease in PEFR. PEFR may prove to be useful in early detection of reduced pulmonary function. Further trials conducted on larger sample sizes and evaluating other lung function parameters are recommended.

Metabolic Tumor Volume as Significant Predictor for Chemotherapy Containing PD-L1 Blocker in Extensive Stage Small Cell Lung Cancer.

Chemo-immunotherapy, including the programmed death ligand 1 (PD-L1) antibody, is an effective treatment for patients with extensive-stage small-cell lung cancer (ES-SCLC). However, no biomarker has been established for the prediction of chemo-immunotherapy. Therefore, we investigated the potential of 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) as a predictive marker. Forty-six patients with ES-SCLC who received 18F-FDG-PET immediately before combined platinum-based chemotherapy with PD-L1 blockade as a first-line treatment were eligible, and the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) on 18F-FDG uptake were evaluated. PD-L1 and tumor infiltrative lymphocytes (TILs) were immunohistochemically analyzed in 36 of the 46 patients. A high MTV was significantly associated with poor performance status and low albumin levels, and there was a significant association between low albumin and high TLG. Univariate analysis identified sex, Brinkman index, and MTV as significant predictors of progression-free survival (PFS), and sex, SUVmax, MTV, and TLG as significant factors of overall survival (OS). Multivariate analysis revealed that sex, Brinkman index, and MTV were independent prognostic factors for PFS, and sex, SUVmax, MTV, and TLG were significant predictors of OS. SUVmax was significantly higher in patients with positive PD-L1 expression than in those with negative expression but was not significantly different between positive and negative TILs. Moreover, the levels of MTV and TLG were not closely associated with the levels of PD-L1 and TILs. MTV or TLG metabolic tumor activity is suitable for the prediction of chemo-immunotherapy outcomes in patients with ES-SCLC.

Abstract 5573: Loss of glutathione S-transferase omega 2 promotes immunosuppressive tumor microenvironment by the induction of PD-L1 expression in lung adenocarcinoma

Abstract Glutathione S-transferase omega 2 (GSTO2) is known as one of important regulators for the glutathione redox balance. We recently reported that GSTO2 is exclusively expressed in airway basal cells, Clara cells, and type II alveolar cells, which have self-renewal capacity in the lungs; however, its expression was completely lost in lung squamous cell carcinoma (LSCC) (Cancer Science, 2022). In this study, we examined the expression of GSTO2 in lung adenocarcinoma (LAC), another type of lung cancer, and analyzed the relationship between GSTO2 expression and clinicopathological features. We enrolled 139 patients who were diagnosed with LAC and underwent surgery, and immunohistochemically evaluated the expression of GSTO2 using formalin-fixed, paraffin-embedded sections of surgical specimens. Fifty eight of 139 lung adenocarcinoma samples exhibited GSTO2 expression, while remaining 81 cases did not. The expression of GSTO2 in LAC samples was significantly associated with never or light (Brinkman Index &amp;lt; 400) smoking history (P=0.0027) and histological subtypes (lepidic 77%; acinar 44%; papillary 22%; micropapillary 16.7%; solid 9.6%; P&amp;lt;0.0001). There were no significant differences between the groups with respect to pN, pM, EGFR mutation, ALK fusion, and ROS-1 fusion. However, GSTO2 expression in LAC significantly associated with pT1 (P&amp;lt;0.0001), early stage (P&amp;lt;0.0001), and absence of PD-L1 expression (P=0.0027). Moreover, patients with GSTO2-negative LAC had a significantly lower disease-free survival rate than those with GSTO2-positve LAC (P=0.028). To examine whether GSTO2 expression affects PD-L1 expression, we prepared GSTO2-transfected and mock-transfected lung adenocarcinoma cell lines (A549 and PC-9). In both cell lines, mRNA level of PD-L1 was significantly reduced in GSTO2-transfectants. Because Jang RH et al reported that vimentin, reflecting to acquire mesenchymal traits in epithelial-mesenchymal transition (EMT), regulates the PD-L1 expression, we next examined whether GSTO2 overexpression affects the expression of EMT related molecules. There was no difference in a mRNA level of E-cadherin, while the mRNA expression of vimentin and SLUG, a transcriptional inducer of EMT, were significantly suppressed in GSTO2-transfected PC-9. In both cell lines, protein expression of vimentin was also significantly reduced in GSTO2-transfectants. The present study shed light on a novel function of GSTO2 as a PD-L1 regulator, which may contribute to prevention of tumor immune escape. Citation Format: Ryusuke Sumiya, Hiroto Hatano, Teruki Hagiwara, Satoshi Nagasaka, Kazuhiko Yamada, Norihiro Kokudo, Hiromu Suzuki, Yuki I. Kawamura. Loss of glutathione S-transferase omega 2 promotes immunosuppressive tumor microenvironment by the induction of PD-L1 expression in lung adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5573.

Physical Activity and Smoking Habits are Closely Related to Cardiovascular Endurance in Farmers

In 2019, there were 523 million cases of cardiovascular disease which caused the deaths of 18.6 million people. In this manner, some major issue should be considered, high cardiovascular endurance, for example. Relatively, high cardiovascular endurance can reduce the incidence of cardiovascular disease by 40% to 70%. Objective to nalyzing the relationship between physical activity and smoking habits among farmers in Pandan Wangi Village. The method used is quantitative research with cross-sectional design involving 108 respondents. The respondents were selected by a simple random sampling technique. Data in this study were collected using GPAQ for physical activity variables, Brinkman index questionnaire for smoking variables, and Harvard step test for cardiovascular endurance variables. Meanwhile, Spearman rank test was used in the data analysis. The research shows that the characteristics of respondents were dominated by male (64.8%) within 36-45 years old age range group (52.8%). In addition, most of the respondents were non-smoker category (62.0%), had a high level of physical activity (52.8%), and a very good level of cardiovascular endurance (27.8%). Bivariate analysis shows that there is a significant relationship between physical activity (p-value = 0.005) and smoking behavior (p-value = 0.047) on cardiovascular endurance among farmers in Pandan Wangi Village. There is a significant relationship between physical activity and smoking habits on cardiovascular endurance among farmers in Pandan Wangi Village.

The prevalence of obstructive sleep apnea in Japanese asthma patients.

Obstructive sleep apnea (OSA) occurs more commonly in asthma patients than in the general population because these conditions share some comorbidities. In Japan, the prevalence of OSA in the general population is reported to be approximately 20%; however, few reports have described the prevalence of OSA in asthma patients. Furthermore, the characteristics of Japanese patients with OSA and asthma are not clear. Adult asthma patients were recruited from the outpatient departments of our institution between August 31, 2017, and March 31, 2019. In all included patients, the presence and severity of OSA were evaluated by the Epworth Sleepiness Scale (ESS) and a home sleep test (HST) using portable polysomnography (PSG). The rate of coexisting OSA in asthma patients and the characteristics of those patients according to the severity of OSA were investigated. Fifty-three patients were included. OSA was detected in 36 (67.9%) patients (mild, n = 15; moderate, n = 14; and severe, n = 7). Patients with OSA had significantly higher body mass index, Brinkman index, apnea-hypopnea index (AHI), and 3% oxygen desaturation index (ODI) values in comparison to those without OSA, while the percentage of the predicted value of forced vital capacity (%FVC) and lowest SpO2 levels were significantly lower. As the severity of OSA increased, age, brain natriuretic peptide level, AHI, and 3%ODI increased, and in contrast, FVC, %FVC, forced expiratory volume in one second (FEV1), percentage of the predicted value of FEV1 (%FEV1), Epworth Sleepiness Scale (ESS), 3%ODI, and lowest SpO2 levels decreased. In particular, the fact that the ESS value was inversely correlated with the severity of OSA in our patients was different from the general characteristics of OSA. Moreover, the AHI value was negatively correlated with FVC, %FVC, FEV1, and %FEV1. BMI was the only independent factor for the presence of OSA, and for asthma severity (FEV1, % of predicted), there was a weak correlation with smoking history. This is the first report to investigate the prevalence of OSA in Japanese asthma patients, using an HST. This study suggests that an HST should be performed in addition to the sleep interview for asthma patients with refractory disease, a low pulmonary function, advanced age, and high BMI because the more severe the OSA, the lower the ESS value may be.

Interleukin-6 (IL-6) as a Marker of Endothelial Dysfunction Confirmed Using Flow Mediated Dilatation in Active Smoker

Background: The pro-inflammatory cytokine interleukin-6 (IL-6) is thought to be the catalyst for endothelial dysfunction caused by smoking. Flow-mediated dilatation (FMD) is a non-invasive method to identify the development of blood vessel endothelial dysfunction at an early stage. However, several studies have not sufficiently explained how smoking and IL-6 interact. Objective: This study focuses on the role of Interleukin-6 (IL-6) in the process of endothelial dysfunction confirmed using non-invasive modalities such as Flow Mediated Dilatation (FMD) in smokers related to the risk of cardiovascular disease in the future with the hope of providing insight in education to smokers to quit smoking. Material and Methods: In this study, we gathered 116 male participants, of which 56 were nonsmokers, and 60 were smokers, and we used IL-6 and FMD testing. SPSS for Windows version 23 will be used to analyze the data. Result: According to the analysis of laboratory tests, the average IL-6 level in light smokers was 67.7±3.2 and in moderate smokers it was 95.111.0; with a p-value of 0.009, indicating a significant difference among the groups. The average FMD in the smoking group was 5.4±0.4% (p-value 0.000), whereas the average FMD in the non-smoker samples was 10.9±0.9%. We also looked at the average FMD among light and moderate smokers based on Brinkman Index, which was 5.5±0.4% and 5.00.4%, with a p-value of 0.780, indicating no significant difference between the groups Conclusion: Compared to non-smokers, this study demonstrates a correlation between IL-6 and smoking activity. However, there was no statistically significant difference between the prevalence of endothelial dysfunction and the degree of smoking dependence in this investigation.

Association between smoking and central sensitization pain: a web-based cross-sectional study.

This study aimed to investigate whether smoking is an independent risk factor for central sensitization syndrome (CSS) in individuals with pain as measured by the Central Sensitization Inventory (CSI). In 2020, we conducted an Internet survey targeting 2000 ordinary residents of Japan (aged 20-69years) who had pain symptoms from October to November 2020. A multiple regression analysis was performed on the association between smoking status (nonsmokers and current smokers; Brinkman index) and CSI values. Moreover, compared to nonsmokers, the relative risk (RR) of the CSI cut-off score of 40 points or higher among current smokers was calculated using a modified Poisson regression model. Covariates included age, sex, body mass index, marital status, equivalized income, exercise habits, history of hypertension, history of hyperlipidemia, history of diabetes, pain chronicity, and Pain Catastrophizing Scale score. This study analyzed 1,822 individuals (1,041 men and 781 women). Among those experiencing pain, current smoking was associated with the increase in CSI values (β = 0.07). The Brinkman index was also significantly associated with the increase in CSI values (β = 0.06). Current smoking also increased the risk of being over the CSI cut-off score, with a relative risk (RR) of 1.29 (95% confidence intervals, 1.04-1.60). Younger age, being women, experiencing chronic pain, and higher pain catastrophizing thinking were also significantly associated with increased CSS severity, independent of smoking status. Smoking is an independent risk factor for CSS. This indicates that smoking may be an important factor in the management of central pain disorders.

Does intensity-modulated radiation therapy by helical tomotherapy for prostate cancer increase the subsequent risk of bladder cancer? A propensity score-matched analysis.

This study aimed to evaluate the risk of bladder cancer after intensity-modulated radiation therapy (IMRT) using helical tomotherapy for prostate cancer in comparison to the risk post-radical prostatectomy (RP) using propensity score-matched analysis and to assess the risk factors for bladder cancer. This retrospective study included 2067 patients with non-metastatic prostate cancer treated at our institution between June 2007 and December 2016. Of these, 1547 patients were treated with IMRT and 520 underwent RP. The propensity scores were calculated using age, National Comprehensive Cancer Network risk classification, prostate volume, Brinkman index, and follow-up time as matched covariates. A propensity score-matched patient cohort (n = 718; IMRT: 359, RP: 359) was created, and the risk of bladder cancer after treatment was compared. In total, bladder cancer was detected in 33 patients. Five patients in the IMRT group and one in the RP group died of bladder cancer. In the propensity score-matched analysis, the 5-year bladder cancer-free survival rate was significantly lower in the IMRT group than in the RP group (91.7% and 96.2%, respectively; p < 0.001). Multivariate analysis revealed that IMRT and the Brinkman index were the risk factors for bladder cancer in this cohort (odds ratio = 5.085, 95% confidence interval = 1.436-18.008, p = 0.012 and odds ratio = 1.001, 95% confidence interval = 1.000-1.001, p = 0.010, respectively). IMRT for prostate cancer using helical tomotherapy increases the subsequent risk of bladder cancer compared with RP and is an independent risk factor for bladder cancer similar to smoking.

Correlation of Smoking Intensity Scores and Total Serum Immunoglobulin E Level in Adult Male Smokers

Background: Exposure to cigarette smoke causes an increase in the T-helper 2 immune response and elevates the formation of IgE by B cells and activation of eosinophils. Objectives: This study aims to determine the correlation between smoking intensity scores measured using the Brinkman Index and total serum Immunoglobulin E level. Methods: The study used an analytical cross-sectional design in a population of adult male smokers according to inclusion and exclusion criteria. This study evaluated the smoking intensity score on total serum Immunoglobulin E expression with control for age, gender, history of atopy, infection, and use of corticosteroids. Serum total IgE levels were examined by immunoradiometric assay using venous blood samples. Data were analyzed using correlation tests and multivariate analysis, linear regression tests with p &lt;0.05 which was significant. Results: The study included 95 samples with a mean sample age of 31.38 ± 1.98 years. The mean Brinkman Index was 103.74 ± 74.47 with a mean total serum IgE level of 247.58 ± 354.58 kU/L. Of the total sample, there were 47 samples (49.5%) who were obese and 26 samples (27.4%) consumed alcohol. The correlation between the Brinkman index and IgE level based on the Spearman correlation test was obtained with a p-value &lt;0.001. Multivariate linear regression analysis showed that the B coefficient value of the Brinkman Index was 0.880 with a p-value of &lt;0.001. Meanwhile, no significant relationship was found between confounding variables and total serum IgE levels. Conclusion: The study found a strong correlation between total serum IgE levels in adult male smokers and the Brinkman Index. The higher the Brinkman Index, the higher the total serum IgE level.

Comparison of smoking conventional cigarettes and using heated tobacco products on the olfactory and gustatory function in healthy young adults: A cross-sectional study.

Smoking has a negative impact on the chemosensory function. The aim of the study was to evaluate the effects of smoking experience and type of tobacco products on gustatory and olfactory function. This study included 30 conventional cigarette smokers, 30 heated tobacco products (HTPs) users, and 30 non-smokers. Olfactory function was assessed with a 'Sniffin' Sticks Screening 12 Test' while the taste function was assessed with 'taste strips' for the basic tastes of sweet, sour, salty, and bitter. The lifetime exposure to smoking was calculated using the Brinkman index (BI). Conventional cigarette smokers demonstrated decreased olfactory function in comparison to non-smokers (median: 10 vs 11; p=0.001) but HTPs users did not differ between those two groups. Overall gustatory function was lower in conventional cigarette smokers (median: 9.5) and HTPs users (median: 10) than in non-smokers (median: 14; p<0.001). A difference was detected in the sour, salty and bitter taste but without significant difference between HTPs users and conventional cigarette smokers. Negative linear correlations were found between the BI and olfactory function, overall gustatory function, sour, salty, and bitter taste (r= -0.317 - -0.585; p≤0.002). In multiple linear regression, BI was the only predictor of olfactory dysfunction when controlling for the effect of tobacco products, age, and gender accounting for 11% of variance (p=0.024, R2=0.123). For gustatory dysfunction, BI was the strongest predictor followed by gender and tobacco products accounting for 11%, 5%, and 4% (p<0.001, R2=0.259). Olfactory and gustatory function are adversely associated with smoking, more depending on BI than tobacco product.

Preventing Pneumonia in High-risk Patients After Esophageal Cancer Surgery: Mini-tracheostomy and Tazobactam/Piperacillin.

We evaluated the usefulness of prophylactic mini-tracheostomy (PMT) and perioperative administration of tazobactam/piperacillin (TAZ/PIPC) in high-risk patients after esophagectomy. We retrospectively studied 89 consecutive high-risk patients who underwent esophagectomy for esophageal cancer between January 2013 and December 2021. We defined patients with two or more of the following factors as high risk: age ≥70 years, performance status ≥1, respiratory dysfunction, liver dysfunction, cardiac dysfunction, renal dysfunction, diabetes mellitus, albumin <3.5 g/dl, and Brinkman index >600. Standard management was administered to the first 50 patients (standard group). PMT and TAZ/PIPC were administered to the next 39 patients (combination group). Patient characteristics and short-term outcomes were compared before and after propensity-score matching. Before propensity-score matching, 24-hour urine creatinine clearance, retrosternal route, 3-field lymph node dissection, and open abdominal approach were more common, postoperative pneumonia (13% vs. 36%, p=0.045) and complications of grade ≥3b (2.6% vs. 22%, p=0.01) were less frequent, and the postoperative hospital stay was shorter (median: 23 vs. 28 days, p=0.022) in the combination group than in the standard group. In propensity-score matching, patient characteristics, except for 24-h creatinine clearance and reconstructive route, were matched for 23 paired patients. Postoperative pneumonia (8.7% vs. 39%, p=0.035) and complications of grade ≥3b (0% vs. 26%, p=0.022) were less frequent and postoperative hospital stay was shorter (median: 22 vs. 25 days, p=0.021) in the combination group than in the standard group. PMT with TAZ/PIPC can potentially prevent postoperative pneumonia in high-risk patients after esophagectomy.