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BACKGROUND: The immune system is recognized to have therapeutic potential to destroy cancer cells. Soluble T-cell immunoglobulin mucin domain-3 (sTIM-3) and its ligand galectin 9 (Gal-9) cause suppression of cytokine production, cell cycle arrest and cell death. sTIM-3 and Gal-9 levels may have prognostic implications in non-small-cell lung cancer (NSCLC) patients. METHODS: This prospective cohort study was performed at Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Pernambuco, Brazil. Fifty-eight patients were diagnosed with advanced NSCLC from January 2019 to January 2020. RESULTS: The age median was of 64.0 years. Soluble galectin-9 (sGal-9) levels in the smokers compared to nonsmoker patients (p < 0.0001). By using the receiver operating characteristic curve, we found that a baseline of 1694 pg/mL (cutoff). sGAL9 with specificity (72.2%), sensitivity (83.2%) and area under the curve = 0.8497 (p < 0.0004). Until 18.2 months, 46.8% and 72.9% were alive in the sGAL9low and sGAL9high groups, respectively (log-rank test; p = 0.02). The median survival was 15.9 months for sGAL9low (≤1694 pg/mL). CONCLUSION: This study indicated an association of tobacco with the release of circulating sGal-9 levels and the accuracy of sGal-9 as a potential biomarker predictive of survival time in advanced NSCLC patients. Furthermore, sGal-9 has may be a potential therapeutic target in the advanced NSCLC.

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Objective: This study aimed to assess a bidirectional relationship between tobacco consumption and quality of life among Chilean teachers. Participants and methods: A total sample of 647 Chilean teachers was included in a cross-sectional study (71.8% female). Teachers completed a socio-demographic questionnaire, tobacco consumption habits, and the SF-36 questionnaire to assess quality of life. Logistic regression models were employed for statistical analysis of quality of life (physical component summary; mental component summary), and tobacco consumption habits, adjusted for socio-demographic characteristics. Results: A total of 34.2% of teachers were smokers, with the majority (68.7%) being under 45 years old. Smoking teachers demonstrated lower quality of life scores, particularly mental health and emotional problems dimensions, and mental component summary (p < 0.05) versus nonsmoking teachers. Teachers with tobacco consumption had a higher risk of low mental component summary (OR: 1.74; p < 0.001), and those with low mental component summary were more likely to be smokers (OR: 1.77; p < 0.002). Conclusion: These findings indicate that tobacco consumption adversely affects the quality of life of Chilean teachers, especially their mental health. Psychological support should be provided to help teachers cope with work stress and tobacco consumption.

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INTRODUCTION: This study evaluated the effects of cigarette smoke inhalation (CSI) on apical periodontitis (AP) induced in rats by histometric, immunohistochemical, and microtomographic analysis. METHODS: A total of 32 male Wistar rats were divided into 4 experimental groups (n = 8): control, CSI, AP, and CSI + AP. Rats in the CSI and CSI + AP groups inhaled cigarette smoke by remaining inside a smoking chamber for 8 minutes 3 times a day for 50 days. After 20 days of smoke inhalation, rats in the AP and CSI + AP groups had the pulp of their first right lower molar exposed to induce AP. Blood was collected on day 50 to evaluate nicotine and serum cotinine levels. The animals' mandibles were removed for histologic processing to evaluate bone resorption by histometric, immunohistochemical (receptor activator of nuclear factor kappa B ligand/osteoprotegerin), and microtomographic analysis. The Student t test was applied. RESULTS: Histometric analysis showed a larger area of bone resorption (P < .05) and microtomographic analysis found greater resorption volume (P < .001) for the CSI + AP group compared with the AP group. The CSI + AP group presented a high RANKL immunostaining pattern compared with the AP group (P < .001). CONCLUSIONS: CSI increased bone resorption caused by AP.

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Introducción: Las enfermedades crónicas no transmisibles (ECNT), como el cáncer, enfermedades cardiovasculares y respiratorias, son la epidemia del siglo XXI, siendo el tabaquismo un factor de riesgo común. Objetivo: Caracterizar a los pacientes tabáquicos de la Unidad de Tratamientos Intermedios (UTI) del Instituto Nacional del Tórax. Material y Método: Estudio observacional, analítico y descriptivo. Se evaluaron 150 ingresos consecutivos a la UTI desde el 01 de septiembre al 01 de diciembre de 2022. Resultados: La prevalencia de tabaquismo fue de un 56%, incluyendo exfumadores. La media de edad fue de 64 años. La exposición a humo de segunda mano resultó significativa con un 41,7% en fumadores activos. Las asociaciones con hipertensión arterial, EPOC y cáncer pulmonar resultaron significativas. Un 20,2% de los pacientes con cáncer pulmonar tenían tabaquismo activo. No fueron significativos los días de estadía en la unidad, hospitalaria general ni fallecimientos. Conclusiones: En nuestra cohorte la prevalencia de tabaquismo fue más alta que la nacional y se confirmó su vínculo con las ECNT. Identificamos que la exposición de segunda mano fue significativa, por lo que los esfuerzos para el cese del tabaquismo deben ir enfocados tanto al paciente como su entorno cercano. A pesar que algunos pacientes tenían el diagnóstico de cáncer pulmonar, un porcentaje no menor seguía fumando, por lo que es relevante incorporar a este grupo de pacientes a programas especializados para reducir morbilidad. Con nuestro estudio reafirmamos la importancia de continuar con los esfuerzos nacionales por reducir el tabaquismo como acción preventiva de las ECNT y sus complicaciones.

Introduction: Chronic non-communicable diseases (NCDs), such as cancer, cardiovascular and respiratory diseases, are the epidemic of the 21st century, smoking being a common risk factor. Objective: To characterize smoking patients in the Intermediate Treatment Unit (ICU) of the Chilean National Thorax Institute. Material and Method: Observational, analytical and descriptive study. 150 consecutive admissions to the ICU were evaluated from September 1 to December 1, 2022. Results: The prevalence of smoking was 56%, including former smokers. The average age was 64 years-old. Exposure to secondhand smoke was significant with 41.7% in active smokers. The associations with high blood pressure, COPD and lung cancer were significant. 20.2% of patients with lung cancer were active smokers. The days of stay in the unit, general hospital stay, or deaths were not significant. Conclusions: In our cohort the prevalence of smoking was higher than the national average and its link with NCDs is confirmed. We identified that secondhand exposure was significant, so efforts to stop smoking must be focused on both the patient and their immediate environment. Although some patients had a diagnosis of lung cancer, a significant percentage continued to smoke, making it important to incorporate this group of patients into specialized programs to reduce morbidity. With our study we reaffirm the importance of continuing national efforts to reduce smoking as a preventive action for NCDs and their complications.

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OBJECTIVE: To evaluate the effects of cigarette smoke inhalation on the immune-inflammatory profile of experimental apical periodontitis in rats. METHODOLOGY: In total, 32 male Wistar rats were divided into four groups (n = 8): AP-induced apical periodontitis; S-cigarette smoke inhalation; APS-induced AP and cigarette smoke inhalation; and C (control)-neither AP nor cigarette smoke inhalation. To induce cigarette smoke inhalation, the animals were kept in a chamber filled with tobacco smoke for 8 min thrice a day for 50 days. AP was induced 20 days after inhalation initiation by exposing their coronary pulp to their oral environment for 30 days. After animals were euthanized, their right hemimaxillae were removed for histopathological, semi-quantitative and immunohistochemical (F4/80, CD206 and iNOS) analyses. RESULTS: Quantitative data showed a moderate number of inflammatory infiltrates in AP and an intense number in APS (p < .05). Comparing F4/80+ cells showed no statistically significant differences among groups, but we found more CD206+ cells in AP than in C and S (p > .05). INOS+ immunostaining showed a significant increase in AP and APS, when compared with C and S (p < .05). APS had more iNOS+ cells than AP (p < .05). CONCLUSION: Cigarette smoke inhalation worsened AP, leading to a predominantly pro- inflammatory profile in our experimental model.

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Objetivo: A periodontite é uma doença infecto-inflamatória que acomete os tecidos de inserção periodontal, e ser fumante representa um risco modificável significativo para todos os graus da doença. Ainda, indivíduos fumantes apresentam uma resposta inflamatória alterada quando comparados a não fumantes. Nesse contexto, o objetivo deste estudo foi reportar um relato de caso de tratamento periodontal de paciente fumante pesado. Relato de caso: O paciente DRS, sexo masculino, 22 anos, foi encaminhado à Faculdade de Odontologia da Universidade Federal de Pelotas (UFPel) com a queixa principal de necessidade de "realização de uma limpeza dentária". Na anamnese, relatou fumar 20 cigarros ao dia, há 7 anos (7 maços-ano). Na consulta inicial, foi encontrado índice de placa visível (IPV) de 100% e índice de sangramento gengival (ISG) de 66,67%. Foi encontrado cálculo supragengival como fator retentivo de placa (FRP) em 46,30% dos sítios. Estabeleceu-se o diagnóstico de periodontite estágio III localizado grau C. Os exames periodontais foram realizados por um único pesquisador calibrado e optou-se pelo tratamento periodontal não cirúrgico. Ao exame de 12 meses, o paciente apresentou IPV de 23,45% e ISG de 22,83%. Houve ausência de FRP. De uma forma geral, foi possível constatar a diminuição significativa das bolsas periodontais, bem como o ganho significativo de inserção clínica periodontal. Considerações finais: Dessa forma, é possível concluir a efetividade da terapia periodontal não cirúrgica, aliada à manutenção periodontal e instruções de higiene para o tratamento de periodontite estágio III, grau C, em paciente fumante.(AU)

Objective: Periodontitis is an infect-inflammatory diseases that affects the periodontal attachment tissues, and being smoker represents a significant modifiable risk for all degrees of the disease. Moreover, smokers have an altered inflammatory response when compared to non-smokers. Therefore, the aim of this study was to report a case report of periodontal treatment of a heavy smoker. Case report: A patient DRS, male, 22 years old, was referred to the School of Dentistry of the Federal University of Pelotas (UFPel) with the main complaint of the need to "perform a dental cleaning". During the anamnesis, he reported smoking 20 cigarettes a day for 7 years (7 pack-years). In the initial appointment, a visible plaque index (VPI) of 100% and a gingival bleeding index (GBI) of 66.67% were found. Supragingival calculus was found as a plaque retentive factor (PRF) in 46.30% of the sites. The diagnosis of periodontitis stage III localized grade C was established. Periodontal examinations were performed by a single calibrated researcher and non-surgical periodontal treatment was chosen. At the 12-month appointment, the patient had an VPI of 23.45% and an GBI of 22.83%. There was absence of PRF. In general, it was possible to observe a significant decrease in periodontal pockets, as well as a significant gain in periodontal clinical attachment. Final considerations: Thus, it is possible to conclude the effectiveness of non-surgical periodontal therapy, combined with periodontal maintenance and hygiene instructions for the treatment of periodontitis stage III localized grade C in a smoker.(AU)

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The objective of this study was to analyze evidence of the clinical and microbiological benefits of antimicrobial photodynamic therapy (aPDT) adjunctive to scaling and root planing (SRP) in smokers with periodontitis. Randomized clinical trials (RCTs) were included, through an electronic search in PubMed/MEDLINE, LILACS, Web of Science, and the Cochrane Library for articles published in English until December 2022. The quality of the studies was assessed using the JADAD scale and the risk of bias was estimated using the Cochrane Collaboration assessment tool. Of the 175 relevant articles, eight RCTs were included. Of these, seven reported clinical results and five microbiological results, with a follow-up time of 3-6 months. A meta-analysis was performed for the probing depth (PD) reduction and clinical attachment level (CAL) gain at 3 and 6 months. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were counted for the PD and CAL. The overall effect for the PD reduction at 3 and 6 months (WMD = -0.80, 95% CI = -1.44 to -0.17, p = 0.01; WMD = -1.35, 95% CI = -2.23 to -0.46, p = 0.003) was in favor of aPDT. The CAL gain (WMD = 0.79, 95% CI = -1.24 to -0.35, p = 0.0005) was statistically significant at 6 months, in favor of aPDT. In these RCTs, aPDT was unable to demonstrate efficacy in reducing the microbial species associated with periodontitis. aPDT as an adjuvant to SRP improves the PD reduction and CAL gain more effectively than only SRP. RCTs are needed to establish standardized protocols with longer follow-up times in order to provide more results on aPDT adjunctive to SRP in smokers with periodontitis.

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Introdução: o uso do tabaco em suas diferentes formas continua a ser uma das principais causas de morte evitáveis no Brasil. Com uma história de sucesso notável, o Brasil alcançou uma das maiores reduções significativas na prevalência do tabagismo desde 1990. No entanto, é preocupante que a taxa de declínio do consumo de tabaco tenha diminuído nos últimos anos, conforme sugerem as pesquisas. Objetivos: o presente estudo teve como objetivo comparar os resultados de três pesquisas domiciliares realizadas pelo Instituto Brasileiro de Geografia e Estatística (IBGE). Métodos: foi realizada a comparação da prevalência do uso de tabaco entre entrevistados com 18 anos ou mais, assim como foi avaliada a porcentagem de mudanças na prevalência entre 2008, 2013 e 2019, usando dados de três pesquisas: The Global Tobacco Adult Survey, do ano de 2008, e a Pesquisa Nacional de Saúde do Brasil, dos anos de 2013 e 2019. Além disso, analisamos a prevalência no Brasil e seus estados de acordo com idade, gênero, nível educacional e raça. Resultados: a prevalência do tabagismo ativo diminuiu 19% entre 2008 e 2013, passando de 18,2% (IC 95%: 17,7;18,7%), em 2008, para 14,7% (IC 95%: 14,2;15,2%), em 2013. No entanto, em 2019, a prevalência foi de 12,6% (IC 95%: 12,2;13,0%), revelando uma redução de 14,3%. O tabagismo foi maior entre a população com baixo nível de escolaridade, status de renda mais baixo e raça/cor da pele preta e parda. Conclusão: a prevalência do tabagismo diminuiu no Brasil nas últimas três décadas. No entanto, recentemente, houve uma redução na intensidade da queda, exigindo atenção e análise cuidadosa das estratégias de prevenção e abandono do tabagismo.(AU)

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BACKGROUND AND OBJECTIVE: Leucocyte- and platelet-rich fibrin has been developed to stimulate wound healing response. However, it is currently unknown whether smoking affects the biological responses elicited by leucocyte- and platelet-rich fibrin on periodontal ligament-derived mesenchymal stromal cells. This study analyzes the kinetics of biomolecule release from leucocyte- and platelet-rich fibrin derived from smokers and nonsmokers and their effect on periodontal ligament cell proliferation and migration as essential biological activities during wound healing. METHODS: Biomolecules present in leucocyte- and platelet-rich fibrin exudates and conditioned media collected from smokers and nonsmokers were analyzed by Luminex arrays. Periodontal ligament-derived mesenchymal stromal cell obtained from one nonsmoker were treated with leucocyte- and platelet-rich fibrin exudates or leucocyte- and platelet-rich fibrin conditioned media derived from both smokers and nonsmokers. The parameters evaluated included cell proliferation, determined by Ki67 immunostaining and migration assessed using transwell assays. Also, cells were treated with nicotine in the presence of fetal bovine serum 10% or leucocyte- and platelet-rich fibrin conditioned media. RESULTS: A similar biomolecular profile was detected in leucocyte- and platelet-rich fibrin exudates and leucocyte- and platelet-rich fibrin conditioned media from smokers and nonsmokers, stimulating (periodontal ligament-derived mesenchymal stromal cell) proliferation, and migration to a comparable degree. Nicotine reduced cell proliferation and migration of periodontal cells; however, this effect was recovered in the presence of leucocyte- and platelet-rich fibrin conditioned media. CONCLUSION: Leucocyte- and platelet-rich fibrin derived from smokers could be an autologous source of biomolecules to stimulate cell biological activities involved in wound healing in smokers who have difficulties in ceasing this habit. Clinical trials are required to evaluate the impact of leucocyte- and platelet-rich fibrin on healing responses in smokers.

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OBJECTIVES: Perform a systematic review to evaluate the influence of smoking on the effectiveness of tooth whitening (TW) and to analyze whether tooth sensitivity is different between smokers and non-smokers. MATERIALS AND METHODS: A systematic review modeled according to the PRISMA guidelines was conducted. PubMed, Embase, Web of Science, Cochrane, Scopus, and OpenGrey databases were searched for related clinical trials. The population, exposure, comparison, outcomes (PECO) was individuals who had TW performed, smoking individuals, non-smoking individuals, and effectiveness of TW, respectively. Risk of bias was assessed with the ROBINS-I tool, and data from included studies were extracted by two researchers independently. The certainty of the evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. RESULTS: Five studies were selected for qualitative analysis. The ROBINS-I tool classified 3 studies as having a moderate risk of bias, one study as having a serious risk of bias, and one with a critical risk. GRADE performed only for color change results and showed a low certainty of evidence. Limited evidence suggests that effectiveness of TW between smokers and non-smokers is similar. The tooth sensitivity also does not seem to be influenced by smoking. Due to the heterogeneity of the data, a meta-analysis could not be performed. CONCLUSIONS: Effectiveness of TW between smokers and non-smokers is comparable. The tooth sensitivity also does not seem to be influenced by smoking. CLINICAL RELEVANCE: The effectiveness of bleaching among smokers and non-smokers appears to be similar. Tooth sensitivity during TW also appears not to be influenced by smoking.

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