Do the socioeconomic context and the European geographical area modify parental influences on smoking experimentation among adolescents?

Adolescent smoking is a major public health problem. While the socioeconomic status (SES) of the neighbourhood and that of the family are known to play a role in smoking onset and progression, it is not clear whether it modifies the association between parental influences and adolescent behaviour. The purpose of this study is to investigate family correlates of adolescent smoking experimentation and to explore the modifying role of socioeconomic context and European geographical area in a sample of European adolescents. This is a secondary analysis of the baseline survey of the European Drug Addiction Prevention (EU-Dap) trial which took place in seven European countries and involved 7079 students. School SES was used as indicator of socioeconomic context. European countries were aggregated in two geographical areas: North-Central and South. The associations between parental, family factors, and adolescents smoking experimentation were analysed through multilevel mixed-effect logistic regression models, stratified by school SES and European geographical area. Parental smoking, permissiveness towards tobacco, family conflicts, problematic relationships, low connectedness, and low parental control were significantly associated with adolescent smoking experimentation. Paternal smoking was a stronger correlate of adolescent smoking in low SES schools, while maternal smoking in high SES schools. Parental permissiveness was a stronger correlate in low SES schools. Family conflicts and low parental control were correlates only in low SES schools. The associations did not substantially differ between European geographical areas, with the exception of parental smoking that was a stronger correlate in the North, and parental control that was a correlate only in the South of Europe. To reduce inequalities in tobacco-related outcomes, prevention efforts in low socioeconomic contexts appear to be a public health priority. Parental smoking, permissiveness, family relationships, and connectedness should be addressed in preventive programs.

     

Mesenchymal stromal cell secretome in liver failure: Perspectives on COVID-19 infection treatment

Due to their immunomodulatory potential and release of trophic factors that promote healing, mesenchymal stromal cells (MSCs) are considered important players in tissue homeostasis and regeneration. MSCs have been widely used in clinical trials to treat multiple conditions associated with inflammation and tissue damage. Recent evidence suggests that most of the MSC therapeutic effects are derived from their secretome, including the extracellular vesicles, representing a promising approach in regenerative medicine application to treat organ failure as a result of inflammation/fibrosis. The recent outbreak of respiratory syndrome coronavirus, caused by the newly identified agent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has forced scientists worldwide to use all available instruments to fight the infection, including the inflammatory cascade caused by this pandemic disease. The use of MSCs is a valid approach to combat organ inflammation in different compartments. In addition to the lungs, which are considered the main inflammatory target for this virus, other organs are compromised by the infection. In particular, the liver is involved in the inflammatory response to SARS-CoV-2 infection, which causes organ failure, leading to death in coronavirus disease 2019 (COVID-19) patients. We herein summarize the current implications derived from the use of MSCs and their soluble derivatives in COVID-19 treatment, and emphasize the potential of MSC-based therapy in this clinical setting.     

Use of ventilation bag for the respiratory support during magnetic resonance imaging in Arnold-Chiari ventilated patients,a case report

Context: Magnetic Resonance Imaging (MRI) is an essential diagnostic tool for neuroimaging tissues such as the spinal cord. Unfortunately, the use of MRI may be limited in ventilated patients, who cannot maintain the supine position in spontaneous breathing for the whole duration of the exam (i.e. neuro-muscular patients with diaphragm involvement). The use of MRI-compatible ventilator during MRI could be a solution but they are not universally available. Furthermore, their performances are not up to those of the conventional ones and they are not always compatible with Non Invasive Ventilation (NIV).

Findings: This case report describes an easy and low-cost solution to ventilate a patient non-invasively during the MRI procedure. The patient in this case was a 45-yr-old man, wheelchair-dependent and chronically ventilated in NIV with a forced vital capacity in supine position of 370?ml (10% of predicted normal), affected by Arnold-Chiari Syndrome, and in need of a MRI diagnostic control.

Conclusion: The technique proposed, that does not affect the MRI images quality, consists in ventilating the patient using a simple nonmetallic Ventilation Bag, operated by a Respiratory Therapist. This has been proven a useful and economical solution for ventilatory support during MRI for a respiratory-dependent patient with Arnold-Chiari Syndrome.     

Incidence and Risk Factors for Hepatitis C Virus Infection among Illicit Drug Users in Italy

So far, only three small outdated studies have investigated hepatitis C virus (HCV) incidence and risk factors among illicit drug users (DUs) in Italy. Thus, during 2007–2010, we conducted a prospective cohort study among DUs attending 17 Italian rehabilitation centers serving urban areas. Two hundred eighty-four HCV-uninfected DUs were prospectively followed by interview and anti-HCV antibody and RNA testing every 6 months. Incidence was calculated using the person-years method. Infection predictors were assessed by time-dependent Cox analysis. Participants were mostly male (83.4%), under opioid substitution therapy (OST) (78.9%), non-injecting DUs (67.9%), and with a mean age of 30.8. Ninety-one of 224 DUs initially under OST interrupted treatment during the follow-up. Overall HCV incidence was 5.83/100 person-years at risk (PYAR) [95% confidence intervals (CI), 3.63–9.38]. The incidence did not significantly differ according the participants’ sociodemographic characteristics or the degree of urbanization of the towns involved in the study. The incidence was higher for DUs under than for those not under OST (6.23 vs 4.50/100 PYAR; p = 0.681). Incidence was also higher for those with than for those without OST interruption (7.17 vs 5.04/100 PYAR; p = 0.55). However, all these differences were non-significant. At last follow-up visit, a significant decrease in frequency of sharing equipment for preparation/using drugs (by injection or not) was observed by analyzing either the whole cohort or DUs under OST only. Anti-HCV seroconversion resulted independently associated with sharing drug preparation/use equipment, backloading, having a HCV-positive sexual partner, or household and (marginally) intravenous injection. In this study, HCV incidence was non-negligible and OST seemed to lack effectiveness in reducing it. In Italy, implementation of combined harm reduction interventions and antiviral treatment of chronically infected DUs would be needed.     

Temporomandibular disorders and orthognathic surgery

The relations between temporomandibular dysfunctions (TMDs) and maxillomandibular malformations requiring orthognathic surgery for correction have been the object of different studies in medical literature. The authors have performed a bibliographic revision on this issue to show the state of the art. This study, an analysis of the literature of the last 20 years, is chronologically presented. It analyzes the prevalence of TMD in patients with different types of maxillomandibular deformities undergoing orthognathic surgery and the TMD changes that occurred after an orthognathic surgical treatment. Medical studies reported in literature show a high variation of results related both to the prevalence of TMD in patients with maxillomandibular deformities and to the changes ensuing from an orthognathic surgical treatment. It has been difficult to compare the different studies because of the different methods used to individuate TMD signs and symptoms in the groups of patients analyzed, as well as the different types of orthognathic surgery performed and the specific TMD treatments used when required. It is concluded that despite the different results provided by the various studies, a certain prevalence of TMD is always present in patients with maxillomandibular deformity. This can be assumed to be within a correlation between dysgnathia and TMDs, and it asserts the necessity to treat patients who have maxillomandibular deformities and TMD by performing a specific treatment of TMD.     

Cigarette smoking,snuff use and alcohol drinking: coexisting risk behaviours for oral health in young males

OBJECTIVES: The use of oral moist snuff (snus) is widespread among Swedish men, but little is known about the use in adolescents. The aim of this study was to describe patterns of snuff dipping, smoking and alcohol drinking in a sample (n = 6287) of 9th grade male students participating in a census survey in the Stockholm region. RESULTS: About 20% of the sample reported use of snus, and more than two-thirds of snus users were also cigarette smokers. Among current nonusers of tobacco (66% of the sample), 14% reported frequent binge drinking, in contrast to 49% among current exclusive cigarette smokers, 60% among exclusive snus users and 69% among users of both cigarettes and snus. The estimated mean annual consumption of alcohol was 5-10 times higher among tobacco users than among nonusers, with users of snus consuming more alcohol than smokers. Compared to non- or minimal drinkers, heavy alcohol drinkers had a disproportionately higher risk to report snus use, after adjustment for smoking behaviour (OR = 16.7, 95% CI 12.9-21.7). When the analysis was restricted to users of only one type of tobacco, heavy drinkers were twice as likely to report snus, rather than cigarette, use. CONCLUSIONS: Both tobacco use and alcohol drinking have been independently associated with a variety of pathological oral conditions in adults. These behaviours coexist in early adolescence. Their effect on oral health need to be investigated in prospective studies and should be of concern to the dental professionals.