ASH Daily News for 31 July 2019



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UK

  • Study: Cigarette smoke makes MRSA superbug bacterium more drug-resistant
  • Study: NHS ‘health checks’ reduce cardiovascular disease risk

International

  • Switzerland: Swiss minister scraps sponsorship deal with Philip Morris after criticism
  • USA: Smoking may interfere with treatment for lung abnormalities
  • USA: Study claims that unlisted chemicals in Juul e-cigarettes may irritate throats of users

UK

Study: Cigarette smoke makes MRSA superbug bacterium more drug-resistant

New research from the University of Bath has found that cigarette smoke can make MRSA bacterial strains more resistant to antibiotics. In addition, cigarette smoke exposure has been found to make some strains of Staphylococcus aureus more invasive and persistent, although the effect is not universal across all strains tested.

The researchers believe the stress cigarette smoke causes to S. aureus sparks an emergency ‘SOS’ response, which increases the rate of mutation in microbial DNA, resulting in hardy and persistent variants better able to resist antibiotics. Previous studies had attributed smokers’ increased susceptibility to infection to the damaging effects of smoke on the immune system, but this study shows that it may also be changing the DNA and characteristics of pathogenic microbes as well.

Researcher Dr Maisem Laabei said: “We expected some effects, but we didn’t anticipate smoke would affect drug-resistance to this degree. We recognise that exposure in a lab is different to inhaled smoke over a long time, but it seems reasonable to hypothesise, based on our research and others’ that stressful conditions imposed by smoking induce responses in microbial cells leading to adaptation to harsh conditions, with the net effect of increasing virulence and/or potential for infection.”

Source: Science Daily, 30 July 2019

Scientific Reports. Cigarette smoke exposure redirects Staphylococcus aureus to a virulence profile associated with persistent infection. July 2019

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Study: NHS health checks reduce cardiovascular disease risk

A new study has found that attending a health check as part of the NHS Health Check programme is associated with increased risk management interventions and decreased risk factors for cardiovascular disease in the six years afterwards. The programme, introduced in 2009, was designed to spot early signs of stroke, kidney disease, heart disease, dementia and type two diabetes in adults aged 40-74. One previous review had found that the programme did not decrease morbidity or mortality among participants.

In the new study, researchers studied data from 127,891 participants who completed the health check between 2010 and 2016, as well as data from 322,910 matched controls over six years’ follow-up. The authors found that health check participants had slightly lower baseline body mass index (BMI), blood pressure (SBP) and fewer were smokers (21% in health check participants vs. 27% in controls). Health check participants were five times more likely to receive weight management advice, three times more likely to receive smoking cessation advice, and their use of statins was 24% higher.

Six years after taking part in health checks, people who had a health check had net reductions in body mass index, systolic blood pressure, and smoking status.

Source: Medical Xpress, 30 July 2019

PLOS Medicine. Health checks and cardiovascular risk factor values over six years’ follow-up: Matched cohort study using electronic health records in England. July 2019

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International

Switzerland: Swiss minister scraps sponsorship deal with Philip Morris after criticism

Switzerland has scrapped a 1.8 million Swiss franc (£1.5 million) sponsorship deal with Philip Morris International for the country’s pavilion at Expo 2020 in Dubai after being widely criticised for taking tobacco money to promote its image abroad. Foreign Minister Ignazio Cassis made the decision to cancel the deal so as “not to undermine the primary objective of the Swiss presence in Dubai, which is to convey a positive image of Switzerland”, according to the foreign ministry on Tuesday.

The World Health Organisation (WHO) had criticised the deal for violating agreements it had struck over Expo sponsorships. Eight Swiss universities offering health education also told Cassis, a medical doctor, in a letter last week that taking money from a cigarette maker contradicted ethical principles. Cassis has ordered revisions to the ministry’s sponsorship policy by the end of the year to prevent similar situations from re-occurring.

Source: Reuters, 30 July 2019

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USA: Smoking may interfere with treatment for lung abnormalities

A new study has found that treatment for blood vessel abnormalities in the lungs is less likely to be successful if patients are smokers. The study assessed how smoking affects the persistence of PAVMs (pulmonary arteriovenous malformations), which are abnormal connections between arteries and veins in the lungs. When these abnormalities become symptomatic, treatment involves embolisation, where a catheter is used to insert a small coil to block the PAVM. The procedure is highly effective, but PAVMs persist in some patients.

The five-year persistence rate was 26% in patients who were smokers at the time of the procedure, compared with 13% in non-smokers. PAVM persistence occurred in more than a third of smokers with more than 20 pack years, compared with 12.2% of non-smokers. If the findings are confirmed in larger studies, the researchers believe better advice can be given to patients with hereditary hemorrhagic telangiectasia, which is associated with the occurrence of PAVMs.

Source: UPI, 30 July 2019

Radiology. Smoking Significantly Impacts Persistence Rates in Embolized Pulmonary Arteriovenous Malformations in Patients with Hereditary Hemorrhagic Telangiectasia. July 2019

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USA: Study claims that unlisted chemicals in Juul e-cigarettes may irritate throats of users

Research from the American Journal of Preventive Medicine has found that when a vanilla-flavouring chemical (found in Juul pods) mixes with nicotine and other flavours during vaping, a chemical reaction forms which irritates air passageways. While the chemical vanillin used for vanilla flavouring in many e-cigarettes is subject to regulation, researchers say the way it mixes with other chemicals is a separate concern.

“People often assume that these e-liquids are a final product once they are mixed,” Hanno Erythropel, a researcher at Yale University and study lead author, said in a news release. “But the reactions create new molecules in the e-liquids, and it doesn’t just happen in e-liquids from small vape shops, but also in those from the biggest manufacturers in the U.S.”

Juul spokesperson Ted Kwong, however, disputed the findings as unrealistic because a user “would have to consume at least seven Juul pods, and likely much more, in a single day” to reach the exposure levels seen in the study.

“The researchers created a risk assessment model based on an occupational environmental standard for ambient air, which, as applied to analyses of vapour products, assumes a person would inhale only aerosolised vapour for eight hours per day, five days per week, for decades,” Kwong told UPI. “The result was to create a false equivalence and a measurement of exposure that would never be found in the real world.”

Source: UPI, 30 July 2019

American Journal of Preventive Medicine. Flavorant–Solvent Reaction Products and Menthol in JUUL E-Cigarettes and Aerosol. July 2019

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