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At least 19 recordsLinked to original sources
PubMed1977

Chronic oxygen therapy.

Chronic low flow oxygen is useful therapy for patients with chronic obstructive lung disease who are crippled by hypoxemia despite optimal programs of usual respiratory care. Patients should be considered for chronic oxygen therapy who have (a) a resting Pao2 less than 55 mm Hg while breathing room air; or (b) profound tissue hypoxemia measured by mixed venous Pao2 and suggested by symptoms such as cor pulmonale and congestive heart failure; or (c) pulmonary hypertension or polycythemia even though daytime Pao2 is greater than 55 mm Hg. Arterial blood must be obtained to demonstrate hypoxemia and assess the benefits of oxygen therapy. Patients on chronic oxygen must remain under close medical supervision. There are no absolute contraindications to chronic oxygen therapy, other than refusal of the patient to quit smoking. Complications of therapy appear to be negligible. The exciting suggestion of improved prognosis in patients with chronic obstructive lung disease on oxygen therapy and the possibility of delaying the long-term sequelae of chronic respiratory failure bear careful watching in the future.

Acidosis, Respiratory↗
PubMed1991

Levels and determinants of early neonatal mortality in Natal, northeastern Brazil: results of a surveillance and case-control study.

An institution-based surveillance and nested case-control study was conducted in Natal, Northeastern Brazil to estimate the level and determinants of early neonatal mortality. The early neonatal mortality rate was 25.5 per 1000 live-birth, 75% of early neonatal deaths were premature low birthweight infants, and the mortality rates were 591 and 318 per 1000 respectively, for preterm small for gestational age (PT-SGA) and preterm appropriate for gestational age (PT-AGA) infants. Mortality was 50 per 1000 for term low birthweight, and 8.6 for term normal birthweight AGA infants. In addition to prematurity and low birthweight, the main risk factors associated with early neonatal death were maternal smoking, complications during pregnancy or intrapartum, and inadequate antenatal care. The associations were weaker for prepregnancy factors such as single marital status or low maternal body weight, and no significant associations were observed with socioeconomic status. These findings suggest that in this population, efforts to reduce early neonatal death should focus on improved maternal care and the prevention of prematurity.

Brazil↗
PubMed1990

[Long-term prognosis after recovery from acute myocardial infarction].

754 cases of acute myocardial infarction survivors were followed up for 28 days to 14 years, the missing rate was 1.86%. The factors influencing long-term prognosis were analyzed. Single factor analysis revealed sex, occupation, age, amount of cigarette smoked, history of stroke, and COPD, complications of heart failure, and arrhythmia, stroke and COPD, heart rate higher than 110/min, lung rales, frequency of infarction, quit smoking after infarction exerted significant influence on over all and cardiac death rate. Multiple factors Cox model analysis revealed quit smoking, complications of stroke heart failure, arrhythmia and occupation were the independent predicting factors for over-all causes of death. Frequency of myocardial infarction, quit smoking, amount of cigarette smoked, occupation, stroke were the independent prognostic factors of cardiac death.

Adult↗
PubMed1989

Smoking behaviour, knowledge and opinion of medical students.

On the basis of a questionnaire on smoking behaviour, knowledge and attitudes administered to medical students in the University of Malaya in July 1987, the prevalence of smoking was found to be low (10%) among medical students. Smokers and non-smokers were equally well informed about common smoking complications. Most students, irrespective of smoking status, felt that they would as future doctors, often advise sick smokers against smoking. In contrast, less than half would do so for healthy smokers who do not themselves raise the question of smoking. The students' personal smoking behaviour also influenced their view of their professional role. Appropriate values, attitudes and a preventive approach towards smoking need to be further developed in the medical students' thinking and behaviour.

Adult↗
PubMed1989

Percutaneous transluminal angioplasty for innominate artery stenosis and total occlusion of subclavian artery in Takayasu's-type arteritis.

Previous reports describe high success rates achieved by dilating subclavian artery stenoses. Attempts at angioplasty for total occlusions have been uniformly unsuccessful. No previous case successfully recanalizing total subclavian artery occlusion was found after an extensive literature search. Modified guidewire technique facilitated safe crossing of the occlusion.

Adult↗
PubMed1987

Maternal smoking: greater effect on males, fetal tobacco syndrome?

We tested the recently proposed criteria for a Fetal Tobacco Syndrome (FTS) on a sample of 925 primiparous black women (including 204 smokers) and their neonates. The proposed FTS criteria included proportional growth retardation (ponderal index greater than 2.26, birth weight less than 2,500 g) in term neonates. Only 19 neonates (2%) in our study fulfilled the FTS morphometric criteria, and of these only 8 had smoking mothers. Nonetheless, the negative effect of maternal smoking on fetal growth (birth weight and length) as reported from earlier investigations was clearly evident in our own data (P less than .01). Separate analysis by fetal sex revealed that the negative effect of maternal smoking upon fetal growth is more pronounced among males than females. We concluded that fetal sex should be taken into account in studies of maternal smoking effects. As for evidence for the existence of the FTS, it remains to be proven.

Adolescent↗
PubMed1987

Evaluation of platelet function in pregnancy. Comparative studies in non-smokers and smokers.

We have evaluated the possible role of platelet functional abnormalities as a contributory cause of thrombosis during pregnancy and to the increased fetal mortality and morbidity among women who smoke. Fifty-three pregnant women were enrolled and evaluated on two separate prenatal visits held between the 20th and 36th week of pregnancy and, when possible, post partum. Smoking status was evaluated by personal statement and alveolar carbon monoxide levels. Women in the smoking group deliberately avoided cigarettes for at least 20 minutes before sampling. Plasma levels of beta-thromboglobulin, thromboxane B2, and 6-Keto PGF1 alpha were evaluated. A significant increase in 6-Keto PGF1 alpha was noted among smoking women as pregnancy advanced. 6-Keto PGF1 alpha levels decreased among non-smoking women while beta-thromboglobulin increased significantly between the 20th and 33rd week of pregnancy in non-smokers. Platelet aggregation, both in platelet rich plasma and in whole blood (by impedance aggregometry), was evaluated by five different parameters and four different aggregating agents. Significant differences between the non-smoking and smoking pregnant women were noted for selected age cohorts and aggregating agents. An increase in platelet reactivity among smokers was observed in whole blood by impedance aggregometry with adenosine diphosphate and in two age cohorts using platelet rich plasma. In two groups in which aggregation was significantly accelerated among non-smokers, epinephrine was used as the aggregating agent.

6-Ketoprostaglandin F1 alpha↗
PubMed1981

Maternal smoking and elevation of catecholamines and metabolites in the amniotic fluid.

To assess the effect of maternal smoking on fetal adrenergic activity, simultaneous measurements in amniotic fluid of the parent catecholamines, dopamine (DA), norepinephrine (NE), and epinephrine (E), as well as the specific intraneuronal deaminated metabolites of DA, 3,4-dihydroxyphenylacetic acid (DOPAC), and of NE, 3,4-dihydroxyphenylglycol (DOPEG), were made by radioenzymatic assay. In the second trimester, a significant (p less than 0.002) and selective elevation of the mean DOPEG concentration was noted in the amniotic fluid of smokers (N = 8) as compared to nonsmokers (N = 36). In the third trimester, significant elevations were found in the mean amniotic fluid concentration of E (p less than 0.0002) and NE (p less than 0.0005), as well as DOPEG (p less than 0.0002), of smokers (n = 12) when compared to nonsmokers (N = 12). There were no significant differences in amniotic fluid concentrations of DA and its deaminated metabolite DOPAC. Since compartmentalization of catecholamines exist between the maternal and fetal circulations, the elevated levels of NE, E, and DOPEG in the amniotic fluid of smokers suggests fetal adrenergic activation as a result of fetal hypoxia and/or by a direct effect of nicotine on the fetal adrenergic system.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1987

Caffeine-cigarette interaction on fetal growth.

The influence of caffeine and cigarette consumption on fetal growth during pregnancy was studied retrospectively in 913 newborn infants. Analysis of variance was adjusted for length of gestation and sex. A significant caffeine-cigarette interaction was found on birth weight (F = 85.4, p less than 0.01). Among women smoking 15 cigarettes or more per day, birth weight was 206 gm (+/- 57.7 gm) lighter for babies whose mothers consumed 300 mg or more of caffeine per day. Head circumference and length of the newborns were affected only by cigarette smoking. Another caffeine-cigarette interaction was observed on placental weight (F = 15.0, p less than 0.01). Among women who consumed less than 300 mg of caffeine daily, placental weight increased with cigarette consumption. However, it diminished (p less than 0.05) among women smoking 15 cigarettes or more per day if they consumed 300 mg or more of caffeine daily. This is the first time that such interactions were found to influence birth and placental weights, indicating that the concomitant consumption of caffeine and cigarette constitutes a higher risk for the developing fetus.

Birth Weight↗
PubMed1988

Lung cancer and smoking in Shanghai.

A case-control study involving interviews with 733 male and 672 female incident lung cancer patients and 1495 population-based controls revealed that cigarette smoking is the dominant cause of lung cancer among men in urban Shanghai. All of the principal cell types were affected, with clear trends of rising risk with increasing intensity and duration of smoking. Far fewer women smoked cigarettes, but the overall risk patterns resembled those among males. Among women, however, smoking accounted for only about one-quarter of all lung cancers and less than 10% of lung adenocarcinomas. The findings lay to rest any doubts about the health hazards of smoking Chinese cigarettes, although smoking is not responsible for the high rates of adenocarcinoma reported among Chinese women.

Adenocarcinoma↗
PubMed1976

Factors associated with spontaneous pre-term birth.

Factors associated with spontaneous pre-term birth in 283 singleton pregnancies were compared with those present in a total population of 16 994 women at risk studied in the First British Perinatal Mortality Survey. It was shown that the risk of spontaneous pre-term birth was related to low maternal age, low maternal weight, maternal smoking, low social class, illegitimacy, threatened abortion, and a previous history of antepartum haemorrhage, perinatal loss, or low birth weight livebirths.

Birth Weight↗
PubMed1984

Effects of maternal cigarette smoking on fetal trunk movements, fetal breathing movements and the fetal heart rate.

The acute effect of maternal cigarette smoking was studied in 10 patients between 37 and 40 weeks gestation. There was a significant reduction in the percentage of time the fetus spent moving during the first 16 min of smoking (P less than 0.02). No significant changes were seen in the proportion of time the fetus spent breathing or the number of times the fetus changed from high or intermediate to low heart period variability. There were significant reductions in the number of accelerations (P less than 0.01), beat-to-beat variation (P less than 0.01) and root-mean-square of the deviation around the mean (P less than 0.02).

Adult↗
PubMed1988

Cigarette smoking as risk factor for late fetal and early neonatal death.

Risk factors for late fetal death and early neonatal mortality were examined in a population based prospective study. Practically all Swedish births between 1983 and 1985 were included, 281,808 births in all. The overall rates of late fetal death and early neonatal mortality were 3.5 and 3.1 per 1000, respectively. About 30% of the pregnant women were recorded as being daily smokers. Logistic regression analyses showed significant relative risks for late fetal death for high maternal age (1.4), nulliparity (1.4), multiparity (greater than or equal to 2) (1.3), smoking (1.4), and multiple births (2.8). Significant relative risks for early neonatal mortality were found for multiple births (4.9) and smoking (1.2). Smokers aged under 35 faced a relative risk of late fetal death ranging from 1.1 to 1.6, while the risk for late fetal death was doubled if the mothers were aged 35 years or more and smoked. In countries like Sweden, where maternal cigarette smoking is prevalent, smoking may be the most important preventable risk factor for late fetal death.

Female↗
PubMed1988

Smoking during pregnancy and the perinatal cadmium burden.

The association between maternal smoking and both morphometric birth parameters and the perinatal cadmium burden were studied. The cadmium concentrations were measured by atomic absorption spectrometry in 100 samples of maternal whole blood (MB) and in 93 samples of umbilical cord blood (CB). In the group of nonsmokers, significantly higher birth weight and decreased relative placental weight were noted as compared to the group of smokers who smoked more than 6 cigarettes a day (p less than 0.05). In both maternal and cord blood samples, the measured Cd levels were found to be significantly higher in smokers than in the nonsmoking subjects (for MB and CB p less than 0.01 and p less than 0.01 respectively). The average number of cigarettes smoked daily by the women had little effect on the levels of the metal. The Cd-MB strongly correlated with the Cd-CB (p less than 0.001). The cadmium values determined in MB and CB did not significantly affect any of the studied fetoplacental parameters. The reported findings give support for placental permeability to cadmium in humans and confirm that smoking during pregnancy leads to elevated Cd concentrations in both the mother and the fetus.

Adult↗
PubMed1989

The value of ultrasonic placental grading: no correlation with intrauterine growth retardation or with maternal smoking.

In a prospective study the usefulness of placental grading in detecting IUGR has been evaluated. Those who were echoscopically examined within one week before delivery were taken into the study (n = 137). Changes in placental tissue increased clearly as pregnancy progressed and in 42% (57/137) the placentae reached Grade III. Increasing placental grading is associated with normal maturation of the placenta. Post partum examination of the placenta correlated well with the echoscopic picture (accuracy = 80.5%). No relationship was found in an unselected group between Grade III and IUGR at term. When a Grade III placenta was first seen before 36 weeks, in three out of five cases a growth retarded neonate was born. The effects of maternal smoking habits during pregnancy on birth weight and placenta were examined. There were no significant differences in mean placental weight, placental ratio and placental grading as the amount of cigarettes increased. The mean birth weight and birth weight percentile decreased significantly when the mother smoked more than 10 cigarettes per day.

Female↗