Second-hand smoke (SHS; ie, exposure to smoking of friends and spouses in the household) reduces the likelihood of smoking cessation in noncancer populations. We assessed whether SHS is associated ...with cessation rates in lung cancer survivors.
Patients with lung cancer were recruited from Princess Margaret Cancer Centre, Toronto, ON, Canada. Multivariable logistic regression and Cox proportional hazard models evaluated the association of sociodemographics, clinicopathologic variables, and SHS with either smoking cessation or time to quitting.
In all, 721 patients completed baseline and follow-up questionnaires with a mean follow-up time of 54 months. Of the 242 current smokers at diagnosis, 136 (56%) had quit 1 year after diagnosis. Exposure to smoking at home (adjusted odds ratio aOR, 6.18; 95% CI, 2.83 to 13.5; P < .001), spousal smoking (aOR, 6.01; 95% CI, 2.63 to 13.8; P < .001), and peer smoking (aOR, 2.49; 95% CI, 1.33 to 4.66; P = .0043) were each associated with decreased rates of cessation. Individuals exposed to smoking in all three settings had the lowest chances of quitting (aOR, 9.57; 95% CI, 2.50 to 36.64; P < .001). Results were similar in time-to-quitting analysis, in which 68% of patients who eventually quit did so within 6 months after cancer diagnosis. Subgroup analysis revealed similar associations across early- and late-stage patients and between sexes.
SHS is an important factor associated with smoking cessation in lung cancer survivors of all stages and should be a key consideration when developing smoking cessation programs for patients with lung cancer.
Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow's triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower ...extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy.
This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely.
Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.
Abstract Introduction Human papillomavirus (HPV) is a risk and prognostic factor for oropharyngeal cancer (OPC). Determining whether the incidence of HPV-associated OPC is rising informs health ...policy. Methods HPV status was ascribed using p16 immunohistochemistry in 683/1474 OPC patients identified from the Princess Margaret Hospital's Cancer Registry (from 2000 to 2010). Missing p16 data was estimated using multiple ( n = 100) imputation (MI) and validated using an independent OPC cohort ( n = 214). Non-OPC head and neck squamous cell carcinoma (HNSCC) ( n = 3262) were also used for time-trend comparison. Regression was used to compare HNSCC subsets and time-trends. The c -index was used to measure the predictive ability of MI. Results The incidence of OPC rose from 23.3% of all HNSCC in 2000 to 31.2% in 2010 ( p = 0.002). In the subset of OPC tested for p16, there was no change in p16 positivity over time ( p = 0.9). However, p16 testing became more frequent over time ( p < 0.0001), but was nonetheless biased, favouring never-smokers OR 1.87 (95% CI 1.29–2.70) and tumors of the tonsil OR 2.30 (1.52–3.47) or base-of-tongue OR 1.72 (1.10–2.70). These same factors were also associated with p16-positivity ORs 3.22 (1.27–8.16), 7.26 (3.50–15.1), 5.83 (2.70–12.7), respectively. Following MI and normalization, the proportion of OPC that was p16-associated rose from 39.8% in 2000 to 65.0% in 2010, p = 0.002, fully explaining the rise in OPC in our patient population. Conclusion The rise in HNSCC referrals seen from 2000 to 2010 at our institution was driven primarily by p16-associated OPC. MI was necessary to derive reliable conclusions when cases with missing data are considerable.
This study was designed to determine the immunoglobulin-E (IgE) levels in patients with wound infections caused by different bacterial species. Fifty fife samples were collected from patients ...suffering from wounds, including pus swabs and blood samples for both sexes, who attended Al- salam teaching Hospital and some outpatient clinics in Mosul City, with patients aged (8-50) years. During the time period of September 2022 to the end of March 2023. The data is entered into a questionnaire for the individuals that are the study's subject. To perform required laboratory tests, samples were sent to the lab.That detected (7.27%) include 4 patients were negative growth, and (92.72%) include 51 patients were positive growth.(87.27%) of samples had only one species isolated from each sample, while (12.72%) include 7 patients were mixed cultures isolated from the total swabs. Staphylococcus aureus and Escherichia coli represented the highest rates among bacterial isolates at (33.33%)include 18 patients and (20.37%)include 11 patients respectively; pseudomonas aeroginosa and staphylococcus epidermidis were at (14.81%)inclued 8 patients, while a lower percentage of (10%) inclued 5 patients was for Klebsiella pneumonia. Antibiotic-resistant bacteria included isolates of Staphylococcus aureus, E. coli, Staphylococcus epidermidis, pseudomonas aeroginosa, and K. pneumoniae. Antibiotics included (Clindamycin (10 g/disc), Cefixime (5g/disc), Imipenem (10 g/disc), and Amoxicillin/Clavulanicacid (20/10 μg/disc). The largest percentage of gram-positive and gram-negative bacteria was in the age groups (21-30) years then (41–50) years, while the lowest percentage rate was in the age group (1–10) years. IgE showed the highest level (P≤0.05) reached at mean ±S.D (0.315±0.023ng/ml) with Pseudomonas aeroginosa infection and the lowest level (P≤0.135) at (0.141±0.072) with Staphylococcus epidermidies, compared with the control group where mean±S.D was(0.178±0.056).