Biomedical subjects

Eduardo Farinaro

Publications and source records attributed to Eduardo Farinaro.

16 recordsLinked to original sources

PubMed2006

Effects of selenium supplementation on cardiovascular disease incidence and mortality: secondary analyses in a randomized clinical trial.

Despite the documented antioxidant and chemopreventive properties of selenium, studies of selenium intake and supplementation and cardiovascular disease have yielded inconsistent findings. The authors examined the effect of selenium supplementation (200 microg daily) on cardiovascular disease incidence and mortality through the entire blinded phase of the Nutritional Prevention of Cancer Trial (1983-1996) among participants who were free of cardiovascular disease at baseline (randomized to selenium: n = 504; randomized to placebo: n = 500). Selenium supplementation was not significantly associated with any of the cardiovascular disease endpoints during 7.6 years of follow-up (all cardiovascular disease: hazard ratio (HR) = 1.03, 95% confidence interval (CI): 0.78, 1.37; myocardial infarction: HR = 0.94, 95% CI: 0.61, 1.44; stroke: HR = 1.02, 95% CI: 0.63, 1.65; all cardiovascular disease mortality: HR = 1.22, 95% CI: 0.76, 1.95). The lack of significant association with cardiovascular disease endpoints was also confirmed when analyses were further stratified by tertiles of baseline plasma selenium concentrations. These findings indicate no overall effect of selenium supplementation on the primary prevention of cardiovascular disease in this population.

Cardiovascular Diseases↗

PubMed2006

Abnormalities of renal sodium handling in the metabolic syndrome. Results of the Olivetti Heart Study.

OBJECTIVE: The mechanisms underlying high blood pressure in the framework of metabolic syndrome (MS) are not clarified: we thus analyzed the relationship of MS and its components to renal tubular sodium handling among participants of the Olivetti Heart Study, an epidemiological investigation of a representative sample of adult white male population in southern Italy. METHODS: Proximal (FPRNa) and distal (FDRNa) fractional sodium reabsorption were estimated by the clearance of exogenous lithium in 702 participants aged 25-75 years examined in 1994-1995. Blood pressure and relevant anthropometric and biochemical variables were also measured. The diagnosis of MS was based on modified National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATP III) criteria. RESULTS: FPRNa, but not FDRNa, was directly associated with body mass index (BMI), waist circumference, diastolic pressure, serum triglyceride and uric acid, independently of age and of antihypertensive treatment. After adjustment for age, FPRNa, but not FDRNa, was significantly greater in individuals with MS, as compared to those without [77.6% (95% confidence interval = 76.7-80.1) versus 74.4% (73.7-75.1), P < 0.001]. A similar difference was observed after the exclusion of participants on current antihypertensive treatment (P = 0.018). In untreated individuals, a significant interaction was observed between obesity and insulin resistance as related to FPRNa (P = 0.002): the highest age-adjusted levels of FPRNa were detected in obese hypertensive and obese insulin-resistant participants. CONCLUSION: In this sample of an adult male population, MS was associated with an increased rate of FPRNa. This finding is relevant to the pathophysiology of MS and possibly to the prevention of its cardiovascular and renal consequences.

Adult↗

PubMed2006

Alcohol drinking pattern and subjective health in a population-based study.

AIMS: Some patterns of alcohol consumption (e.g. binge drinking, drinking outside of meals) have been associated with detrimental effects on health outcomes. Subjective health provides a global assessment of health status and is a strong predictor of total mortality; however, little is known about its relationship with alcohol drinking pattern. The association between several drinking patterns (i.e. drinking intensity and frequency, frequency of intoxication, drinking outside of meals, and beverage type) and subjective health was examined in a random sample of 3586 women and men. DESIGN: A population-based cross-sectional study. METHODS: Subjective health was assessed using the physical and mental health component summaries of the Short Form-36 health survey questionnaire. Alcohol consumption refers to the 30 days before the interview. Analysis of covariance compared gender-specific mean scores across alcohol drinking patterns. FINDINGS: Overall, non-current drinkers reported poorer physical and mental health than life-time abstainers and current drinkers, while no consistent differences were found between life-time abstainers and current drinkers. In female current drinkers, daily drinking, beer and mixed beverage consumption were associated with better mental health. In male current drinkers, moderate alcohol consumption (2-2.9 drinks per day), wine and mixed beverage consumption were associated with better physical health. Intoxication and liquor consumption were associated with poorer mental health in women and poorer physical health in men. No consistent associations were found for drinking outside meals. CONCLUSIONS: Aspects of drinking pattern may affect subjective health differentially in women and men. Overall, intoxication and liquor drinking are associated with poorer self-perceived health status than regular, moderate consumption of other alcoholic beverages.

Adult↗

PubMed2006

[Attitudes and behaviors toward cardiological procedures: results from a multicenter study in Italy].

BACKGROUND: In Italy, cardiovascular diseases represent an important cause of disability in the elderly. Therefore, it is necessary to provide effective and appropriate diagnostic and therapeutic procedures to all the interested subjects. The aim of our study was to estimate attitudes and behaviors of health personnel and representatives of citizen associations toward the following procedures: thrombolysis, coronary artery bypass, pacemaker implantation, and aortic valve replacement. METHODS: Within an Italian multicenter study on the relation between age and treatment of cardiovascular diseases, a questionnaire was administered to a stratified sample of medical doctors (cardiologists, heart surgeons, geriatrics, internists), general practitioners in order to show any existing discrimination in care access as regards age, sex and race of patients. RESULTS: The sample included 283 subjects (73.8% men, median age 47 years). In 53% age was a discriminating factor in the distribution of the therapeutic procedures, with higher statistically significant percentages reported by geriatrics and internists (62.5 and 58.6%, respectively) and lower ones by cardiologists and heart surgeons (48.2 and 41.5%, respectively) (chi2 = 29.592, p < 0.0001). The influence of the shortest expectancy of life in the elderly is the reason for discrimination in 19.6% of the participants. Race and gender do not represent a discriminating factor for 81 and 92.1% of responders, respectively. CONCLUSIONS: The results of our study highlight the presence of different attitudes among health personnel about the distribution of cardiological procedures as regards patients' age, in particular when > 75 years old. An easier access should be given to these patients and this may represent the objective of research aimed at developing better treatments for elderly people.

Attitude of Health Personnel↗

PubMed2005

Components of the metabolic syndrome and carotid atherosclerosis: role of elevated blood pressure.

Elevated blood pressure is among the factors that contribute to the metabolic syndrome (MetS). It is not known whether subjects with MetS and elevated blood pressure are at the same cardiovascular risk as subjects with MetS but without elevated blood pressure. To clarify this point, we have evaluated the prevalence of carotid atherosclerosis in subjects with MetS with or without elevated blood pressure. A large population was examined (842 women and 1011 men). Blood pressure, lipids, glucose, and waist were measured by routine methods. Carotid atherosclerosis was evaluated by echo Doppler examination. The prevalence of MetS was 24.4% in women and 28.7% in men. The prevalence of carotid atherosclerosis was 35.1% in women and 37.3% in men (p=NS), and increased with increasing number of MetS components. Age, smoking, and systolic blood pressure (SBP) were associated with the presence of carotid atherosclerosis (logistic model), whereas age, high-density lipoprotein cholesterol, and SBP were associated with the extent of atherosclerosis (linear model). When comparing subjects with an equal number of MetS components, the prevalence of carotid atherosclerosis was significantly higher in subjects with elevated blood pressure than in those without. No difference in carotid atherosclerosis prevalence was found in subjects bearing or not bearing components of the syndrome other than elevated blood pressure. The present findings demonstrate that subjects with MetS and elevated blood pressure have increased carotid atherosclerosis compared with subjects with MetS but without elevated blood pressure. The diagnosis of MetS per se might not adequately identify subjects at elevated cardiovascular risk.

Adult↗

PubMed2005

Long-term follow-up of psychological distress following earthquake experiences among working Italian males: a cross-sectional analysis.

This report details relationships between earthquake exposures in 1980 and 1983 to 1984 and psychological distress reported in 1994. Participants are 555 Italian male factory workers from Naples, Italy. Those men who experienced damage from the 1980 quake reported higher levels of psychological distress (across several dimensions of the Symptom Checklist) than those without damage; additionally, 30% of these men reported symptoms of posttraumatic stress disorder (PTSD). While men evacuated as a result of the 1983 to 1984 Bradyseism earthquakes did not report higher distress levels (Symptom Checklist) than their nonevacuated colleagues, they did report more PTSD-like symptoms than those not evacuated. Financial loss from the Bradyseism quakes was associated with higher distress across all measures (seven Symptom Checklist dimensions and presence of PTSD symptoms). Additionally, social network disruptions following 1983 to 1984 evacuation were associated with greater distress (not all measures). These findings suggest that psychological distress from natural disasters may be very long lasting.

Adult↗

PubMed2004

Relationship of alcohol drinking pattern to risk of hypertension: a population-based study.

Epidemiological studies have demonstrated a positive relationship between heavy alcohol use and hypertension, but few studies have directly addressed the role of drinking pattern. This study was designed to investigate the association of current alcohol consumption and aspects of drinking pattern with hypertension risk in a sample of 2609 white men and women from western New York, aged 35 to 80 years, and free from other cardiovascular diseases. Hypertension was defined by systolic blood pressure > or =140 mm Hg or diastolic blood pressure > or =90 mm Hg or use of antihypertensive medication. Odds ratios (95% confidence intervals) were computed after adjustment for several covariates. Compared with lifetime abstainers, participants reporting drinking on a daily basis (1.75 [1.13 to 2.72]) or mostly without food (1.64 [1.08 to 2.51]) exhibited significantly higher risk of hypertension. When analyses were restricted to current drinkers, daily drinkers and participants consuming alcohol without food exhibited a significantly higher risk of hypertension compared with those drinking less than weekly (1.65 [1.18 to 2.30]) and those drinking mostly with food (1.49 [1.10 to 2.00]), respectively. After additional adjustment for the amount of alcohol consumed in the past 30 days, the results were follows: 0.90 (0.58 to 1.41) for daily drinkers and 1.41 (1.04 to 1.91) for drinkers without food. For predominant beverage preference, no consistent association with hypertension risk was found across the various types of beverages considered (beer, wine, and liquor). In conclusion, drinking outside meals appears to have a significant effect on hypertension risk independent of the amount of alcohol consumed.

Adult↗

PubMed2004

Wall shear stress is associated with intima-media thickness and carotid atherosclerosis in subjects at low coronary heart disease risk.

BACKGROUND AND PURPOSE: Systemic and local coronary heart disease (CHD) risk factors participate in atherogenesis. The role of wall shear stress, a major local risk factor, remains to be elucidated. METHODS: Two hundred thirty-four subjects were carefully characterized for the presence of hypertension, hyperlipidemia, diabetes mellitus, obesity, and cigarette smoking and were divided into low- and high-risk groups. They underwent echo-Doppler examination of the carotid arteries. Atherosclerotic plaques and stenoses were detected, intima-media thickness (IMT) was measured, and wall shear stress was calculated. RESULTS: One hundred eight subjects were classified as low-risk individuals. The prevalence of carotid atherosclerosis in this group was 18.5%. Wall shear stress was 24.23+/-7.21 dyne/cm(2) in individuals without atherosclerosis and 16.89+/-5.48 in those with atherosclerosis (P<0.000). In multiple regression analyses, wall shear stress, body mass index, and HDL cholesterol were inversely associated and total cholesterol was directly associated with the presence of atherosclerosis; only wall shear stress was associated with IMT. In the high-risk group the prevalence of atherosclerosis was 45.2%. Wall shear stress was 20.44+/-6.82 dyne/cm(2) in subjects without atherosclerosis and 17.84+/-6.88 dyne/cm(2) in those with atherosclerosis (P=0.037). Age was the only variable associated with both carotid atherosclerosis and IMT. CONCLUSIONS: In subjects traditionally considered at low CHD risk, intima-media thickening and carotid atherosclerosis are significantly associated with low wall shear stress. In contrast, in subjects at high CHD risk, the contribution of wall shear stress seems to be masked, and age becomes the only factor significantly associated with both carotid atherosclerosis and IMT.

Age Factors↗

PubMed2004

Body fat distribution, relative weight, and liver enzyme levels: a population-based study.

Regional body fat distribution may represent an independent risk factor for several conditions, especially metabolic and cardiovascular diseases; recent findings have shown that abdominal fat accumulation can be an independent predictor of hepatic steatosis. Very few studies, mostly using selected clinical samples, have focused on the relationship between indices of abdominal visceral fat accumulation and the most commonly used biochemical liver tests, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT). The aim of the present study was to evaluate the relation between central fat accumulation, as assessed by abdominal height, relative weight, as determined by body mass index (BMI), and liver function tests (ALT, AST, and GGT) in a random sample of 2,704 residents of Erie and Niagara Counties in New York State, 35-80 years of age and free from known hepatic disease. Multiple linear regression models were used, with liver enzymes as dependent variables with abdominal height and BMI as independent variables, and the inclusion of several covariates (age, race, education, smoking status, pack-years of smoking, drinking status, and total ounces of ethanol in the past 30 days). Abdominal height was consistently a better correlate of ALT and GGT levels than BMI in both sexes. In addition, abdominal height was the most powerful independent predictor of ALT in both sexes as well as of GGT among women. In conclusion, these findings support a role for central adiposity independent from BMI in predicting increased levels of hepatic enzymes, likely as a result of unrecognized fatty liver.

Abdomen↗

PubMed2004

Lack of association between polymorphism in the beta2-adrenergic receptor gene, hypertension, and obesity in the Olivetti heart study.

OBJECTIVE: Several case-control studies have explored the possible association between polymorphism in the beta2 adrenoreceptor gene (beta2AR), hypertension, and obesity--the focus being in particular on the Arg16Gly and Gln27Glu substitutions, which appear to modify the extracellular part of the beta2AR with possible functional modification. However, controversial results have been obtained. DESIGN AND METHODS: The analysis refers to 993 middle-age men characterized for Arg16Gly and Gln27Glu polymorphism of the beta2AR. In this general population sample there were 563 overweight, 160 obese, and 405 hypertensive individuals, of whom 171 were receiving antihypertensive therapy. RESULTS: The genotype frequencies for codon 16 were: GlyGly = 38%; ArGly = 45%; ArgArg = 17%. The frequencies for codon 27 were: GlnGln = 50%; GlnGlu = 39%; GluGlu = 11%. Codon 16 and codon 27 polymorphisms were in linkage disequilibrium. No differences were detected in body mass index and blood pressure across different genotypes. Likewise, no association was detected between either of the two polymorphisms and being overweight (codon 27: chi2 = 0.1, codon 16: chi2 = 1.4), obesity (codon 27: chi2 = 0.1, codon 16: chi2 = 1.7) and hypertension (codon 27: chi2 = 2.7, codon 16: chi2 = 1.9). The odds ratio (with 95% confidence intervals) for overweight, obesity, and hypertension were not different between genotypes. Likewise, no difference in the anthropometric indices of fat distribution, fasting blood glucose, serum insulin, triglycerides, uric acid, and HOMA index could be detected between groups. CONCLUSIONS: In summary, in this large unselected sample of adult white men, genetic variation in the beta2AR was not associated with blood pressure or with overweight, obesity, and fat distribution.

Body Mass Index↗

PubMed2004

Differential effects of alcohol drinking pattern on liver enzymes in men and women.

BACKGROUND: Increasing evidence suggests that drinking pattern may have powerful implications for health; however, very few studies have focused on the association between drinking pattern and risk of alcoholic liver damage. This study was aimed at examining the association of gamma-glutamyltransferase (GGT), aspartate aminotransferase, and alanine aminotransferase with current alcohol consumption and with some aspects of drinking pattern (e.g., drinking frequency during the week and in relation to food consumption). METHODS: A cross-sectional analysis was conducted of a random sample of 2943 white residents of Erie and Niagara Counties in New York State who were 35 to 80 years of age and free from known hepatic disease. RESULTS: The most significant associations were found for GGT; in both sexes, average levels were significantly higher in current and former drinkers compared with lifetime abstainers. In analyses based on quartiles of alcohol consumption, only participants in the two top quartiles showed significantly elevated enzymes compared with both lifetime abstainers and participants in other quartiles. For drinking pattern, there was evidence of sex-specific associations. In men, daily drinkers showed the highest levels of GGT, whereas in women, the highest level of GGT was observed in weekend drinkers. Women (but not men) who consumed alcohol without food exhibited higher levels of GGT compared with women who consumed alcoholic beverages in relation to food. CONCLUSIONS: These findings support the hypothesis that, in addition to amount, drinking pattern may affect liver function and that differences exist between sexes with regard to the effect of drinking pattern on liver function and potential liver damage.

Adult↗

PubMed2004

Greater hepatic vulnerability after alcohol intake in African Americans compared with Caucasians: a population-based study.

AIMS OF THE STUDY: In the last 40 years, African Americans have experienced higher age-adjusted liver cirrhosis mortality rates than whites. Alcohol use has been hypothesized to be the likely determinant of this disparity in liver disease mortality. This study was aimed at evaluating racial variations in common biomarkers of liver injury, such as gamma-glutamyltransferase (GGT), aspartate amino transferase (AST) and alanine amino transferase (ALT), by categories of drinking status and levels of current alcohol use. METHODS: A cross-sectional analysis of a general population sample of 3304 residents of Erie and Niagara counties in New York State, 35-80 years of age and free from known hepatic disease, stratified by racial group (African-American and white). RESULTS: Concentrations of GGT were higher for African-Americans than for whites in all categories of drinking status (lifetime abstainers, former and current drinkers) after adjustment for potential confounders (age, sex, education, smoking, and body mass index). However, differences in enzyme mean values between the two racial groups were consistently larger among current drinkers than for either lifetime abstainers or former drinkers. In analyses based on tertiles of alcohol consumption in the last 30 days, differences in GGT mean values between the two races tended to amplify with increasing amounts of consumption. CONCLUSIONS: These findings seem to support the hypothesis of greater sensitivity to alcohol-induced hepatotoxicity among African-Americans than for whites.

Adult↗

PubMed2003

Genetic variation in the renin-angiotensin system and abdominal adiposity in men: the Olivetti Prospective Heart Study.

BACKGROUND: The renin-angiotensin system is involved in adipocyte growth and differentiation and possibly in adipose tissue metabolism. OBJECTIVE: To investigate the association of polymorphism in the angiotensin-converting enzyme (ACE) I/D gene, angiotensinogen M235T gene, and angiotensin II type 1 receptor A1166C gene with body mass index, body fat pattern, and obesity-associated hypertension. DESIGN: Cross-sectional longitudinal study. SETTING: The Olivetti factories in Marcianise and Pozzuoli, suburbs of Naples, Italy. PARTICIPANTS: 959 adult men, 25 to 75 years of age. MEASUREMENTS: Renin-angiotensin system polymorphism, anthropometric indexes, blood pressure, and serum glucose and insulin levels. RESULTS: No association was detected between angiotensinogen or angiotensin II type 1 receptor gene polymorphism and anthropometric indexes or blood pressure. For ACE I/D polymorphism, significant age-genotype interaction was detected on cross-sectional observation; the relation of body mass index, waist circumference, and diastolic blood pressure to age was significantly greater in persons with the DD genotype than in those with the ID or II genotype. Overweight and abdominal adiposity were more common in men with the DD genotype, particularly among older participants (51.1% vs. 36.5% and 33.1% vs. 22.0%, respectively). Odds ratios were 1.82 (95% CI, 1.16 to 2.87) for overweight and 1.76 (CI, 1.06 to 2.90) for abdominal adiposity. Among 314 untreated men first examined 20 years earlier, those with the DD genotype had greater age-adjusted weight gain (1.45 kg [CI, 0.12 to 2.78 kg]) and change in diastolic blood pressure (2.83 mm Hg [CI, 0.39 to 5.28 mm Hg]). The relative risk for overweight was 2.34 (CI, 1.32 to 4.15) among participants with the DD genotype versus those with the ID or II genotype. CONCLUSIONS: The ACE I/D polymorphism was a significant predictor of overweight and abdominal adiposity in men. DD homozygosity was associated with larger increases in body weight and blood pressure in aging persons, as well as with higher incidence of overweight.

Abdomen↗

PubMed2003

Plasma leptin and blood pressure in men: graded association independent of body mass and fat pattern.

OBJECTIVE: The role of leptin in the association between body mass, central adiposity, and blood pressure (BP) is controversial. This study evaluated the relationship between leptin and BP in relation to body mass index (BMI) and fat distribution in a large sample of untreated male adults. RESEARCH METHODS AND PROCEDURES: The study population was made up of 457 untreated male employees of the Olivetti factory in Naples. Plasma leptin, complete anthropometry, BP, and relevant biochemical variables were measured. RESULTS: Log-transformed plasma leptin levels were directly associated with BMI (r = 0.661, p < 0.001) and waist circumference (r = 0.630; p < 0.001). Leptin also correlated with systolic (r = 0.258) and diastolic (r = 0.277) BP (p < 0.001). The association between leptin and BP was maintained after accounting for age, BMI (or waist circumference), log-insulin, and serum creatinine (p < 0.01); this association was stronger than that with BMI. Logistic regression analysis showed that an increased prevalence of hypertension (BP >or= 140 and/or 90 mm Hg) was associated with high plasma leptin levels when controlling for age and waist circumference (odds ratio, 1.99; 95%CI, 1.06 to 3.72) or for age and BMI (odds ratio, 1.92; 95%CI, 1.02 to 3.61). DISCUSSION: A graded positive relationship between plasma leptin levels and BP was observed in this sample of untreated male adults. This association was independent of age, BMI, abdominal adiposity, and fasting plasma insulin. Moreover, elevated plasma leptin concentrations were associated with greater probability of hypertension, again independently of potential confounders.

Adipose Tissue↗

PubMed2002

The relationship of waist circumference to blood pressure: the Olivetti Heart Study.

BACKGROUND: The association between overweight, high blood pressure (BP), and insulin resistance is well established, but the role of body fat distribution in this association has yet to be fully elucidated. The aim of this study was to investigate the role of central adiposity in the association between overweight, high BP, and insulin resistance. METHODS: A total of 1,079 men participated in the follow-up of the Olivetti Heart Study from 1994 to 1995. The present analysis includes 768 men, after the exclusion of 184 participants on pharmacological treatment for hypertension. In 65 men fasting blood glucose was >7 mmol/L; in 48, age was below or above 2 standard deviations from the mean of the population; and in 14 the data set was incomplete. Anthropometric indices of adiposity, metabolic variables (including fasting serum insulin and homeostasis model assessment [HOMA] index of insulin sensitivity), and BP were measured. RESULTS: In univariate analysis, waist circumference was the anthropometric index that best correlated with BP (P < .001). In multiple regression analysis, waist circumference remained the strongest independent predictor of BP after adjustment for confounders. Significant increase of systolic (P value for trend analysis < .001) and diastolic (P < .001) pressure, heart rate (P = .003), fasting and postload serum insulin (P < .001), and HOMA index of insulin sensitivity (P < .001) were observed across age-adjusted quintiles of waist circumference. Greater degrees of central adiposity were associated with higher prevalence of elevated BP values and insulin resistance (P value < .001, chi2 for linear trend). CONCLUSIONS: In middle-aged men, a central distribution of body fat is associated with increased BP, independently of body mass index and insulin resistance, thus suggesting a key role of central adiposity in the full expression of the "metabolic syndrome."

Abdomen↗

PubMedDate not supplied

Transient decrease of exhaled nitric oxide after acute exposure to passive smoke in healthy subjects.

Nitric oxide (NO) is produced and detected in the exhalate from the respiratory tract where it plays important regulatory functions. Exhaled nitric oxide (eNO) concentrations are reduced in active cigarette smokers between cigarettes and in nonsmoking subjects during short-term exposure to environmental tobacco smoke. In this study, the authors evaluated eNO before and after an acute exposure to environmental tobacco smoke in healthy, nonsmoking subjects (n = 12). Baseline eNO levels were measured by chemiluminescence at baseline (1 hr before exposure), shortly after the end of exposure, and 10 and 30 min after the end of exposure. Mean room air NO concentration increased from 3 ppb to 4 ppm (range, 560 ppb-8.5 ppm) during the exposure period. Carboxyhemoglobin levels were assessed before and after the exposure with spectrophotometry. All subjects had decreased eNO with exposure to environmental tobacco smoke (mean +/- standard error of the mean: 16.65 +/- 1.35 ppb to 13.86 +/- 1.33 ppb; p < .001). These concentrations remained significantly decreased at 10 min and recovered within 30 min. No modifications in airway resistance or increase in carboxyhemoglobin levels were observed. Exposure to environmental tobacco smoke transiently--but consistently--decreased eNO concentration in healthy, nonsmoking subjects, suggesting that second-hand smoke can directly affect NO in the airway environment.

Acute Disease↗