Uygar UTKU, Serkan YILMAZ, Onur KARAKAYALI

Evaluation of Cerebral Blood Flow Alterations and Acute Neuronal Damage due to Water-Pipe Smoking

Background: Although water-pipe smoking is a great public health problem, data regarding the acute and chronic effects and the degree of toxin exposure are limited. While water pipe-related malignancy, pulmonary, infectious, cardiac effects, infertility, and biological effects have been described in a meta-analysis, there are no studies in the literature about its neurologic effects.Aims: To evaluate water pipe-related acute neurological effects and cerebral blood flow through transcranial Doppler ultrasonography and serum S100 calcium binding protein calcium binding protein level measurements.Study Design: Prospective observational study.Methods: Vital signs and baseline carboxyhemoglobin and S100 calcium binding protein levels, cerebral flood changes with transcranial Doppler ultrasound were evaluated and recorded before and after water-pipe smoking.Results: The mean age of the 31 volunteers was 30.61 (±5.67) years, and 24 of them (77.42%) were male. A statistically significant difference was determined in heart rate, oxygen saturation, systolic and diastolic arterial pressure values before and after water-pipe smoking (p

PDF

___

WHO Study Group on Tobacco Product Regulation (TobReg). Advisory note. Waterpipe tobacco smoking: health effects, research needs and recommended actions by regulators. Geneva: World Health Organization; 2005.
Primack BA, Fertman CI, Rice KR, Adachi-Mjia AM, Fine MJ. Waterpipe and cigarette smoking among college athletes in the United States. J Adolesc Health 2010;46:45-51.
Shihadeh A, Saleh R. Polycyclic aromatic hydrocarbons, carbon monoxide, “tar”, and nicotine in the mainstream smoke aerosol of the narghile water pipe. Food Chem Toxicol 2005;43:655-61.
Knishkowy B, Amitai Y. Water-Pipe (narghile) smoking: an emerging health risk behavior. Pediatrics 2005;116:113-9.
Arngrim N, Schytz HW, Britze J, Vestergaard MB, Sander M, Olsen KS, et al. Carbon monoxide inhalation induces headache in a human headache model. Cephalalgia 2018;38:697-706.
Hullin T, Aboab J, Desseaux K, Chevret S, Annane D. Correlation between clinical severity and different non-invasive measurements of carbon monoxide concentration: A population study. PLOS ONE 2017;12:1-9.
Park E, Ahn J, Min YG, Jung YS, Kim K, Lee J, et al. The usefulness of the serum s100b protein for predicting delayed neurological sequelae in acute carbon monoxide poisoning. Clin Toxicol (Phila) 2012;50:183-8.
Kleindienst A, Ross Bullock M. A Critical Analysis of the Role of the Neurotrophic Protein S100B in Acute Brain Injury. J Neurotrauma 2006;23:1185-200.
Bathala L, Mehndiratta MM, Sharma VK. Transcranial doppler: Technique and common findings (Part 1). Ann Indian Acad Neurol 2013;16:174-9.
Kadhum M, Jaffery A, Haq A, Bacon J, Madden B. Measuring the acute cardiovascular effects of shisha smoking: a cross-sectional study. JRSM Open 2014;5:2054270414531127. 
Shaikh RB, Vijayaraghavan N, Sulaiman AS, Kazi S, Shafi MS. The acute effects of waterpipe smoking on the cardiovascular and respiratory systems. J Prev Med Hyg 2008;49:101-7.
Eissenberg T, Shihadeh A. Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure. Am J Prev Med 2009;37:518-23.
Shafagoj YA, Mohammed FI. Levels of maximum end-expiratory carbon monoxide and certain cardiovascular parameters following hubble-bubble smoking. Saudi Med J 2002;23:953-8.
Zahran FM, Ardawi MS, Al-Fayez SF. Carboxyhemoglobin concentrations in smokers of sheesha and cigarettes in Saudi Arabia. Br Med J (Clin Res Ed) 1985;291:1768-70.
Al-Moamary MS, Al-Shammary AS, Al-Shimemeri AA, Ali MM, Al-Jahdali HH, Awada AA. Complications of carbon monoxide poisoning. Saudi Med J 2000;21:361-3.
Levant A, Cabot C, Genestal M, et al. Acute CO poisoning after smoking narghile. Presented at the 22e Journe´e de Tabacologie; Paris 2006.
Yıldırım F, Çevik Y, Emektar E, Çorbacıoğlu ŞK, Katırcı Y. Evaluating ECG and carboxyhemoglobin changes due to smoking narghile. Inhal Toxicol 2016;28:546-9.
Ashurst JV, Urguhart M, Cook MD. Carbon Monoxide Poisoning Secondary to Hookah Smoking. J Am Osteopath Assoc 2012;112:686-8.
Turkmen S, Eryigit U, Sahin A, Yeniocak S, Turedi S. Carbon monoxide poisoning associated with water pipe smoking. Clin Toxicol (Phila) 2011;49:7:697-8.
Kochanowicz J, Lewko J, Rutkowski R, Turek G, Sieskiewicz A, Lyson T, et al. Influence of smoking cigarettes on cerebral blood flow parameters. Biol Res Nurs 2015;17:8-12.
McDonald DA. The numerical analysis of circulatory wave-forms. In: McDonald DA, editör. Blood flow in arteries. 1974:146-73.
Roher AE, Debbins JP, Malek-Ahmadi M, Chen K, Pipe JG, Maze S, et al. Cerebral blood flow in Alzheimer’s disease. Vasc Health Risk Manag 2012;8:599-611.
Haimoto H, Hosoda S, Kato K. Differential distribution of immunoreactive S100-alpha and S100-beta proteins in normal nonner- vous human tissues. Lab Invest 1987;57:489-98.
Mussack T, Biberthaler P, Kanz G, Wiedemann E, Gippner-Steppert C, Mutschler WI, et al. Serum S-100B and interleukin-8 as predictive markers for comparative neurologic outcome analysis of patients after cardiac arrest and severe traumatic brain injury. Crit Care Med 2002;30:2669-74.
Yilmaz S, Karakayali O, Kale E, Akdogan A. Could serum S100B be a predictor of neuronal damage and clinical poor outcomes associated with the use of synthetic cannabinoids? S100B to predict neuronal damage of SC in the ED. Am J Emerg Med 2018;36:435-41.
Hårdemark HG, Ericsson N, Kotwica Z, Rundström G, Mendel-Hartvig I, Olsson Y, et al. S-100 protein and neuron-specific enolase in CSF after experimental traumatic or focal ischemic brain damage. J Neurosurg 1989;71:727-31. Vos PE, Jacobs B, Andriessen TM, Lamers KJ, Borm GF, Beems T, et al. GFAB and S100B are biomarkers of traumatic brain injury. An observational cohort study. Neurology 2010;75:1786-93.
Golbidi S, Li H, Laher I. Oxidative Stress: A Unifying Mechanism for Cell Damage Induced by Noise, (Water-Pipe) Smoking, and Emotional Stress-Therapeutic Strategies Targeting Redox Imbalance. Antioxid Redox Signal 2018;28:741-59.