A practical guide for perioperative smoking cessation

Background: To assess the effect of preoperative smoking cessation on postoperative complications in patients undergoing herniorrhaphy.
Materials and Methods: This prospective study was conducted on 163 consecutive patients, undergoing herniorrhaphy. Demographic characteristics and postoperative complications were compared between smokers (group A), patients who reduced smoking by 50% (group B), and patients who completely quit smoking (group C).
Results: The mean age of the patients was 42.9 (SD=10.3) years. Group A (n=77), group B (n=27), and group C (n=59) were not significantly different in terms of age, body mass index (BMI), medical history, laboratory data, smoking habit, type of hernia, type of anesthesia, the American Society of Anesthesiologists (ASA) class, repair method, surgery approach, and duration surgery (P>0.05 for all). However, significant differences were observed between group B and group A, group C and group A, and group C and group B regarding postoperative complications, such as wound healing complications and length of hospital stay (LOS) (P<0.05 for all).
Conclusion: Decreased preoperative smoking is associated with the reduced risk of respiratory, cardiovascular, and wound healing complications and decreased LOS in patients undergoing herniorrhaphy.

http://www.tanaffosjournal.ir/article_245206_48a3d5c8d3e8bb2e6a75139769d01213.pdf

Preoperative Smoking Cessation and its Association with Postoperative Complications and Length of Hospital Stay in Patients Undergoing Herniorrhaphy

Abstract Cigarette smoking is associated with pulmonary and cardiovascular disease and confers increased postoperative morbidity and mortality. Smoking cessation in the weeks before surgery can mitigate these risks, and surgeons should screen patients for smoking before a scheduled operation so that appropriate smoking cessation education and resources can be given. Interventions that combine nicotine replacement therapy, pharmacotherapy, and counseling are effective to achieve durable smoking cessation. When trying to stop smoking in the preoperative period, surgical patients experience much higher than average cessation rates compared with the general population, indicating that the time around surgery is ripe for motivating and sustaining behavior change. This chapter summarizes the impact of smoking on postoperative outcomes in abdominal and colorectal surgery, the benefits of smoking cessation, and the impact of interventions aimed to reduce smoking before surgery.

Smoking Cessation for Preoperative Optimization

Smoking and tobacco use are the most used psychoactive substances globally, with an estimated population of more than one billion users across the world. It is a significant public health problem and is associated with a multitude of adverse health consequences, particularly in the elderly population, such as various types of neoplasms, cardiovascular and respiratory illnesses, delayed wound healing, and cognitive deficits. It has been seen that the adverse consequences are reduced in past smokers/tobacco users who have eventually become abstinent as compared to active smokers/users. Effective treatment strategies are available to assist individuals in quitting smoking or tobacco use. It is especially important in the elderly as their mobility is reduced, and so is their motivation to quit, mainly due to the longer duration of tobacco use and insufficient knowledge about its adverse effects than the younger population. It is worthwhile to understand the impact and the measures of assessment and treatment to improve the health outcomes in the elderly. This review intends to present clinically relevant aspects of smoking and tobacco use in the elderly, including epidemiology, predictors and risk factors, adverse impact on physical health, and assessment and management of tobacco use and smoking.

Smoking and tobacco use cessation in the elderly

Background Preoperative smoking is an easily modifiable risk factor and has associations with increased postoperative morbidity and mortality. It is important to clarify these risks for specific procedures to provide improved and evidence-based quality of care. The purpose of the present study aims to identify the associations between preoperative smoking and 30-day postoperative outcomes in patients undergoing total hip arthroplasty. Methods We used R statistics to conduct a multivariable logistic regression analysis followed by a propensity score matching analysis to explore the association between preoperative smoking and postoperative outcomes. Results A final cohort of 67,897 patients who underwent total hip arthroplasty was selected for analysis. After adjusting for potential confounders, the odds of postoperative pulmonary complications (odds ratio [OR], 1.352; 95% confidence interval [95% CI], 1.075-1.700; P = .01), infectious complications (OR, 1.310; 95% CI, 1.094-1.567; P = .003), and extended hospital stay (OR, 1.17; 95% CI, 1.099-1.251; P Conclusions After controlling for potential confounding variables, our multivariable regression analysis revealed a significant increase in pulmonary and infectious complications as well as significantly longer hospital stays in our smoking population. When using a propensity score matching analysis, an increase in infectious complications as well as extended hospital stay was observed. Given the concerning prevalence of smoking in the United States, our data provide updated information toward a growing mass of literature supporting smoking cessation before surgical operations.

The Association of Preoperative Smoking With Postoperative Outcomes in Patients Undergoing Total Hip Arthroplasty.

Postoperative pulmonary complications (PPCs) include respiratory infection, respiratory failure, pleural effusion, atelectasis, pneumothorax, bronchospasm and aspiration pneumonia. The occurrence of PPCs is associated with poorer outcomes in surgical patients, including prolonged hospital stay and increased mortality after surgery. Many studies have investigated the association between preoperative smoking and PPCs; however, the optimal duration of preoperative smoking cessation is still unclear. It is generally believed that stopping smoking before surgery helps to reduce the occurrence of PPCs, and that a longer duration of smoking cessation is associated with a lower risk of PPCs. The purpose of the study was to determine the duration of preoperative smoking cessation that was not associated with increased risk of PPCs in elderly patients who underwent noncardiac, nonneurologic surgery.

Impact of prior smoking cessation on postoperative pulmonary complications in the elderly: secondary analysis of a prospective cohort study.

In nuclear astrophysics, the nuclides 151 Eu and 153 Eu are both in the path of the s-process, and their (n, γ ) cross sections are important input parameters for the calculation of the nuclear astrophysics network. According to the EXFOR

Measurement of the nat Eu( n , γ ) cross section up to 500 keV at the CSNS Back-n facility, and the stellar 151 , 153 Eu( n , γ ) cross section at s-process temperatures

Metabolic activation and cytotoxicity of metaxalone mediated by cytochrome P450 enzymes and sulfotransferases.


 Therapeutic antibodies have ushered in a new age of cancer immunotherapy. Historically, these therapies have targeted a limited subset of soluble and cell surface tumor-associated antigens (TAAs). T cell receptors (TCRs) on cytotoxic CD8+ T cells recognize peptide antigens bound to major histocompatibility class I (MHC-I) proteins, called HLA-A/B/C in humans. By this pathway, antigen is regularly sampled from the intracellular peptidome, processed, and presented to cytotoxic T cells. Expanding TCR-based recognition of soluble, intracellular TAAs presented on the surface of malignant cells by this mechanism is a propitious therapeutic strategy. Here we describe a novel platform for generating T cell receptor mimic (TCRm) antibodies using our humanized immunoglobulin (RenMabTM) mice engineered to express HLA. TCRm antibodies have the same binding properties as endogenous TCRs and recognize processed, HLA-bound peptides including intracellular tumor-associated antigens, viral oncoproteins, and cancer-testis antigen (CTA). TCRm antibodies bind peptide-HLA with high specificity and up to nanomolar affinity. Our optimized immunization protocols and high-throughput screening methods allow for one-step TCRm antibody generation. TCRm antibodies can also be used to assemble bispecific T cell engaging antibodies (BiTEs) to enhance tumor targeting of cytotoxic T cells. Biocytogen’s TCRm antibodies are a flexible and powerful tool for cancer immunotherapy. By enabling TCR-mediated recognition of an unrestricted repertoire of cancer neoantigens, TCRm antibodies may find broad clinical application.
 Citation Format: Jun Du, Taolin Liu, Wanbo Tang, Yue Zhang, Limin Zhao, Xin Jiao, Chao Sun, Pengfei Du, Yuqi Zhang, Baihong Liu, Qingcong Lin, Yi Yang. Targeting intracellular tumor antigens using fully human TCR mimic antibodies derived from HLA transgenic RenMiceTM [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2752.

Abstract 2752: Targeting intracellular tumor antigens using fully human TCR mimic antibodies derived from HLA transgenic RenMiceTM

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Impact of prior smoking cessation on postoperative pulmonary complications in the elderly: secondary analysis of a prospective cohort study.

Measurement of the nat Eu( n , γ ) cross section up to 500 keV at the CSNS Back-n facility, and the stellar 151 , 153 Eu( n , γ ) cross section at s-process temperatures

Metabolic activation and cytotoxicity of metaxalone mediated by cytochrome P450 enzymes and sulfotransferases.

Abstract 2752: Targeting intracellular tumor antigens using fully human TCR mimic antibodies derived from HLA transgenic RenMiceTM