Objective :The aim of the present case–control study was to compare the quality-of-life (QOL) and physical-activity (PA) data of exclusive-narghile-smokers (ENS) with age- and tobacco quantity matched exclusive-cigarette-smokers (ECS).

Methods : Males aged ⩾ 20 years who are ENS or ECS for more than 10 years were recruited to participate in this case–control study. Amounts of used tobacco (narghile-years (NY), pack-years (PY)) were determined. QOL (symptoms, activity, impacts and total scores) and PA (daily, sporting, leisure and PA scores) data were collected according the Saint-George’s-respiratory and the Voorrips PA questionnaires. Student t-test and Chi-2 test were used to compare the profiles of the two groups. Pearson correlation-coefficient (r) was used for evaluating the relationship between used quantity of tobacco and PA and QOL data.

Results : Two age (44 ± 9 vs. 45 ± 14 years) and quantity of used tobacco (30 ± 32 NY vs. 37 ± 34 PY) matched groups (63 ENS and 54 ECS) were compared. Compared to the ENS group, the ECS group has a worse QOL with significantly higher activities, impact and total scores (respectively, 22 ± 22 vs. 32 ± 25; 11 ± 12 vs. 23 ± 24 and 18 ± 14 vs. 28 ± 20), has significantly lower sporting and PA scores (respectively, 12 ± 8 vs. 8 ± 6 and 17 ± 8 vs. 14 ± 7). There were clear negative dose–effect relationships between sporting (r = −0.39), leisure (r = −0.38) or PA (r = −0.46) scores and quantity of used cigarettes. However, no significant relationship was found between quantity of used narghile and QOL or PA data.

Conclusion : Chronic exclusive narghile-use is less detrimental to PA and QOL than chronic exclusive cigarette smoking.

This study investigated the outcomes after lower dose SBRT (BED < 90 Gy) in 46 patients with stage I NSCLC, who were aged ≥70 years or in reduced general condition. Local control rates at 1, 2, and 3 years were 100, 95, and 95 %, respectively. Rates of freedom from distant progression were 83, 63, and 54 %, and survival rates were 77, 57, and 36 %, respectively. Seventeen patients died during the follow-up, 11 (65 %) from distant progression of NSCLC, and six (35 %) from non-malignant causes. No patient developed radiation-induced pneumonitis. Thus, SBRT with BED <90 Gy resulted in excellent local control and appears to be a reasonable option for stage I NSCLC in elderly patients and those with a poor performance status. (Source: Lung)

Clinical trials have provided some evidence of a favorable effect of inhaled corticosteroids on the frequency of exacerbations and on the quality of life of patients with chronic obstructive pulmonary disease (COPD). In contrast, ICS have little or no impact on lung function decline and on mortality.
STATE OF THE ART :Inhaled corticosteroids are recommended only in a minority of COPD patients, those with severe disease and repeated exacerbations and probably those with the COPD and asthma overlap syndrome. However, surveys indicate that these drugs are inappropriately prescribed in a large population of patients with COPD. Overtreatment with inhaled corticosteroids exposes these patients to an increased risk of potentially severe side-effects such as pneumonia, osteoporosis, and oropharyngeal candidiasis. Moreover, it represents a major waste of health-care spending.

CONCLUSION: Primary care physicians as well as pulmonologists should be better aware of the benefits as well as the side-effects and costs of inhaled corticosteroids.

In COPD, the risk attributable to smoking is very variable according to published studies. A significant number shows that the risk of COPD in non-smokers is far from negligible. The links between COPD and pollution of the interior environment vary between developed and developing countries.
State of the art

In developing countries, numerous studies have shown a link between COPD and exposure to substances derived from the combustion of biomass fuels, particularly in women where the exposure is the greatest. Nevertheless, a cause and effect relationship has not always been demonstrated. In developed countries, there is no evidence of a role of exposure to domestic interior pollution in the genesis of COPD and interior pollutants such as NO2 and particulates seem only to aggravate already existing COPD.
Conclusion : Further studies are necessary to evaluate their role in COPD and explore the underlying mechanisms. Irritative phenomena could be involved.