Objective:This study aimed to compare the effectiveness of two cognitive behavioral therapy-based smoking cessation interventions initiated during hospitalization and to evaluate the factors related to relapse after discharge. Methods:This was a prospective randomized study involving 90 smokers hospitalized in a university hospital. We collected data related to sociodemographic characteristics, reasons for admission, smoking-related diseases, smoking history, the degree of nicotine dependence (ND), and the level of craving. Patients were divided into two treatment groups: brief intervention (BrInter, n = 45); and intensive intervention with presentation of an educational video (InInterV, n=45). To assess relapse, all patients were assessed by telephone interview in the first, third, and sixth months after discharge. Abstinence was confirmed by measurement of exhaled carbon monoxide (eCO). Results:Of the 90 patients evaluated, 55 (61.1%) were male. The mean age was 51.1 ± 12.2 years. The degree of ND was elevated in 39 (43.4%), and withdrawal symptoms were present in 53 (58.9%). The mean eCO at baseline was 4.8 ± 4.5 ppm. The eCO correlated positively with the degree of ND (r = 0.244; p = 0.02) and negatively with the number of smoke-free days (r = −0.284; p = 0.006). There were no differences between the groups in terms of the variables related to socioeconomic status, smoking history, or hospitalization. Of the 81 patients evaluated at 6 months, 33 (40.7%) remained abstinent (9 and 24 BrInter and InInterV group patients, respectively; p = 0.001), and 48 (59.3%) had relapsed (31 and 17 BrInter and InInterV group patients, respectively; p= 0.001). Moderate or intense craving was a significant independent risk factor for relapse, with a relative risk of 4.0 (95% CI: 1.5-10.7; p < 0.00001). Conclusions:The inclusion of an educational video proved effective in reducing relapse rates. Craving is a significant risk factor for relapse.

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Introduction: Silicosis is a fibrotic lung disease resulting from the inhalation of crystalline silica and can be classified as simple or complicated according to the International Labour Organization criteria. Furthermore, individuals exposed to crystalline silica also have a higher risk for the development of tuberculosis (Tb).The contribution of inflammatory cytokines to the risk of silicosis and Tb in different populations has previously been reported. Since genetic background might be related to susceptibility to silicosis and Tb, the study of polymorphisms within IL-1α, IL-1β, and tumor necrosis factor protein-coding genes may contribute to elucidating the genetic basis of these diseases.Methods: Single nucleotide polymorphisms (SNPs) were genotyped by polymerase chain reaction using restriction fragment length polymorphism or by Taqman methodology, in a sample of 102 silica-exposed patients from Brazil.Results: No significant associations were observed between the SNPs studied and the severity of silicosis. However, significant associations were found between Tb and the C allele (odds ratio [OR] = 1.93, 95% confidence interval [CI], 1.01-3.73) and the CC genotype (OR = 2.34, 95% CI, 1.04-5.31) of IL1A −899C>T. The IL1B +3954C>T polymorphism also showed an association with Tb (T allele dominant model OR = 2.38, 95% CI, 1.04-5.41). Conclusion:These preliminary results demonstrate that the IL1A and IL1B gene variations may contribute to some extent to susceptibility to Tb, but not silicosis.However, additional studies are still needed to confirm these results.

Objective: Silicosis is a pneumoconiosis characterized by fibrosis of the lung parenchyma caused by inhalation of silica particles. Genetic factors might play a role in the severity silicosis. We sought to evaluate the influence of polymorphisms in the ACE, FAS, FASLG, NOS2, IL1RN, FAM13A, TGFB1, and TNF genes on the severity of silicosis. Methods: Nine polymorphisms were genotyped by PCR in a sample of 143 patients with silicosis in the state of Rio de Janeiro, Brazil. Results: Fifty-seven patients (40%) were classified as having simple silicosis and 86 (60%) were classified as having complicated silicosis. The TT genotype of rs1800469 in the TGFB1 gene showed a protective effect for complicated silicosis (OR = 0.35; 95% CI, 0.14-0.92; p = 0.028) when compared with the other two genotypes (CC+CT). The polymorphic T allele of rs763110 in the FASLG gene (OR = 0.56; 95% CI, 0.31-0.99; p = 0.047), as well as a dominant model for the T allele (TT+CT: OR = 0.37; 95% CI, 0.15-0.96; p = 0.037), also showed a protective effect. When patients with simple silicosis despite having been exposed to silica for a longer time (> 44,229 hours) were compared with patients with complicated silicosis despite having been exposed to silica for a shorter time, the T allele of rs763110 in the FASLG gene (OR = 0.20; 95% CI, 0.08-0.48; p < 0.0001), as well as dominant and recessive models (OR = 0.06; 95% CI, 0.00-0.49; p = 0.01 and OR = 0.22; 95% CI, 0.06-0.77; p = 0.014, respectively), showed a protective effect against the severity of silicosis. Conclusions: It appears that rs1800469 polymorphisms in the TGFB1 gene and rs763110 polymorphisms in the FASLG gene are involved in the severity of silicosis. Given the lack of studies relating genetic polymorphisms to the severity of silicosis, these results should be replicated in other populations.

Introdução:  Estudos têm demonstrado a ocorrência de piores desfechos em pacientes fumantes infectados pelo SARS-CoV-2 quando comparados aos não fumantes. O objetivo do presente estudo foi oferecer, de forma remota, atendimento e auxílio à cessação do tabagismo aos pacientes frente à pandemia da COVID-19. Métodos: Realizadas ligações telefônicas para 88 pacientes inscritos na lista de espera do Programa de tratamento do tabagismo do Hospital Universitário Antônio Pedro. Elaborado roteiro de entrevista telefônica contendo dados sociodemográficos, história tabágica, teste de Fagerstrom, interesse e possibilidade de participação em sessões de  grupos online. Elaborada e disponibilizada aos pacientes uma cartilha contendo orientações para cessação do tabagismo. Foram selecionados pacientes que tinham possibilidade de participar de grupos online. Para avaliar o sucesso terapêutico, os pacientes deveriam participar de pelo menos quatro das seis sessões de terapia cognitivo-comportamental, de forma remota, realizadas nas plataformas Zoom Meeting e Google Meet. Os participantes que pararam de fumar durante ou ao término das sessões de grupo foram considerados de sucesso imediato. Resultados: O estudo incluiu 56 pacientes, sendo 42 do sexo feminino, com média de idade de 58 anos, carga tabágica média 46 maços/ano. A maioria possuía grau elevado de dependência à nicotina. Dos 56 pacientes, 49 (87,5%) manifestaram interesse de receber a cartilha enquanto aguardavam na fila de espera, 52 (92,8%) tinham conhecimento  que o tabagismo é fator de risco e agravamento da COVID-19, 44 (78,6%) relataram interesse e condições de participar remotamente das sessões online, sendo que, destes, dezesseis foram inicialmente convidados para compor o primeiro grupo on-line. Dos doze pacientes que completaram no mínimo quatro sessões, oito pararam de fumar. Conclusão: É imprescindível oferecer apoio e tratamento aos pacientes tabagistas durante a pandemia da COVID-19, uma vez que eles fazem parte do grupo de risco. O acesso remoto vem ao encontro da necessidade do momento, já que esses pacientes devem evitar aglomerações e espaços públicos coletivos.

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Silicosis is a pneumoconiosis characterized by fibrosis of the lung parenchyma caused by the inhalation of silica dust. Tuberculosis is an important and frequent infectious complication of silicosis, called silicotuberculosis. The risk of pulmonary tuberculosis in patients with silicosis is up to 40 times higher when compared to the general population. As the radiological findings are similar in both diseases, the diagnosis of silicotuberculosis is not always simple. We describe the case of a patient with silicosis associated with clinical and radiological findings compatible with tuberculosis.

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