Foster care young people have an increased overall risk for the development of chronic health conditions.Smoking is a major risk factor for many conditions with inflammatory component. We performed a cross-sectional pilot study to assess the correlation between tobacco consumption status and inflammatory profile among adolescents living with foster parents in the central region of Romania. A number of 35 teenagers aged 10-18 were enrolled. Blood samples were collected by venipuncture for complete blood count (CBC), fibrinogen, Interleukin-6 (IL 6), C reactive protein (CRP). Exhaled CO was measured and urine samples were collected in the same session for cotinine assessment. Of the 123 teenagers initially enrolled, 35 completed the entire study protocol. Urinary cotinine accurately reflected smoker status. Smoking did not affect hemoglobin levels or other hematological parameters in foster care teenagers. The value of C-reactive protein was higher in smokers. Plasma fibrinogen correlated with the daily number of cigarettes. Interleukin-6 did not correlate with the smoker status or the daily number of cigarettes consumed. Our study highlights the existence of an inflammatory response to smoking in foster care adolescents, a social category otherwise predisposed to various addictive behaviors.
Background: There are a multitude of factors that influence smoking status, and minors from the social protection system are a vulnerable category in terms of smoking. Methods: The objective of this research was to assess the degree of smoking dependence and to identify potential predictors of smoking status in foster care teenagers. Smoker status was confirmed by dosing CO in the exhaled air, and the degree of dependence was assessed using the Fagerström score. We performed a multivariate logistic regression analysis. Results: From the 275 foster care minors, 22.5% were current smokers. Exhaled CO was not influenced by general demographic factors, was associated with the frequency of smoking, and was positively correlated with the estimated number of cigarettes consumed daily and with the Fagerström score. The calculated probability of being a smoker was less than 20.4% in 75% of nonsmokers, whereas 75% of actual smokers had a predicted probability higher than 30.3%. Conclusions: In addition to age, gender, social environment, previous exposure to secondhand smoking, and residential type of foster care system, the expressed opinions regarding the health effects of tobacco use were associated with smoking in foster care teenagers.
BackgroundThe efficacy of anti TNFblockers in active ankylosing spondylitis (AS) is widely accepted. In Europe, high costs related to biological treatment lead to significant differences regarding the patient's accessibility to treatment depending on the level of economic development of different countries. In Romania, according to the national reimbursement protocol, a patient is eligible for treatment with TNF blockers if the disease is active despite using at least two non-steroidal anti-inflammatory drugs and sulfasalazine (for peripheral arthritis).ObjectivesThe aim of the study is to assess the accessibility of patients with AS to biological therapy in Romania, depending on their area of residence and socio- economical indicators for each region.MethodsA cross-sectional study was performed in 41 counties and Bucharest. Data were collected from the Romanian Registry of Rheumatic Diseases and the socio- economic indicators from the yearbook of the National Institute for Statistics.ResultsData were gathered for 2013 AS patients treated with biologics. The mean age was 45.46 yrs (±12.07), 78% were male, 71% live in urban residences and the mean disease duration was 11.53 yrs. 74% (n=1498) of patients had access to biologics in their county of residence, while 26% (n=524) of patients had to travel for treatment to another county. Compared to the group treated inside their county of residence, those treated outside, originated from areas with a lower gross domestic product per capita (5701.77 € compared to 8722.44 €; p<0.001; t test) and with high deficit of physicians (1.28 physicians/ 1000 inhabitants, comparated to 2.63 physicians/ 1000 inhabitants; p<0.001; t test). The urban habitat was associated with a higher accessibility to biologics (75.9%) inside their county of residence compared to patients living in rural areas (69.2%) (p=0.002, χ2 test); so the latter have to travel in order to being cared by a rheumatologist. The patients' age had a great influence on the accessibility to biologics: the patients treated outside of their county of residence were younger than those treated inside (44.1 yrs compared to 45.9 yrs; p=0.003, t test). On a national scale, the majority of AS patients treated outside their county of residence (86%; 449); were treated in Bucharest (the capital city); so the majority of patients treated with biologics in Bucharest are originating from other counties (60%; n=449/751).ConclusionsIn Romania, although there is a national protocol for biological therapy in AS, applied in the same way in every region of the country, the accessibility to biologic therapy varies a lot, mostly due to differences in the socio- economic status of each area of residence.Disclosure of InterestNone declared
Inadvertent intravascular injection of local anesthetics (LA) during regional anesthesia causes Local Anesthetic Systemic Toxicity (LAST). Theories of lipid rescue in the case of LAST proved that the administration of lipids in LAST has beneficial effects. One possible mechanism of action is based on the lipophilic properties of LA which allow plasma-free LA to be bound by the molecules of Lipid Emulsion (LE). The association LA–LE is shuttled towards organs such as liver and the kidneys, and the half-life of LA is shortened. The main objective of this experimental study was to assess the possible cardio-prophylactic effect of LE administration before the induction of LAST by intravenous administration of Ropivacaine. This was an experimental, interventional, prospective, and non-randomized study. The subjects were divided into groups and received, under general anesthesia, LE 20% first 0.3–0.4 mL, followed by 0.1 mL Ropivacaine 2 mg/mL, or Ropivacaine alone. At the end of the experiment, the subjects were sacrificed, and tissue samples of kidney, heart and liver were harvested for histopathological examination. LE, when administered as prophylaxis in Ropivacaine-induced LAST, had protective cardiac effects in rats. The LE known side effects were not produced if the substance was administered in the low doses used for LAST prophylaxis.
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