Lung function, smoking and survival in severe alpha1-antitrypsin deficiency, PiZZ

Lung function, smoking, age and mortality data in 158 adult severe alpha₁-antitrypsin deficient, PiZZ individuals, followed from 1963 to 1982 were analyzed. Low initial FEV₁ value was significantly associated with increased mortality (p < 0.005). A 3 yr mortality rate of 40% was found in individuals whose initial FEV₁ values were less than 30% of that predicted. In contrast, the corresponding 3-yr mortality among those whose initial FEV₁ values were between 30 and 65% of that predicted was only 7%. Smokers were found to have significantly lower FEV₁ levels (p = 0.008) and higher mortality (p < 0.005) than non-smokers. The difference between current and ex-smokers in mortality and FEV₁ level were not statistically significant (p = 0.9 and p>0.25, respectively). Cross-sectional analysis of the initial FEV₁ values indicated a significant decline (p < 0.005) of FEV₁ with increasing age. This decline was greater among smokers than non-smokers. Longitudinal analysis of FEV₁ rates of decline in 80 cases with follow-up FEV₁ measurements failed to detect any significant differences between smokers and non-smokers, but was performed late in the disease process. The application of these results to the planning of studies on replacement therapy, smoking intervention strategy and longitudinal follow-up is discussed.     

Adolescents becoming smokers: the roles of stress and coping methods

Purpose: To examine the relationship of stress and coping methods to smoking status (never-smoker, experimenter, and current smoker) among an inner-city, clinic-based, adolescent population, as well as to examine the prevalence of smoking and related behaviors in this population using a cross-sectional survey.

Methods: A self-administered questionnaire that included the Perceived Stress Scale (PSS), negative life events (LES), and a coping measures scale was used with 954 clinic patients aged 12–21 years. Demographic characteristics were compared using analysis of variance and Chi-square test. The Kruskal-Wallis analysis of variance was used to compare the values of each scale among smoking-status groups. Logistic regression analysis was used to determine the relationship of smoking status to PSS, LES, and coping methods.

Results: The overall prevalence of smoking in this population was 26%. The age of onset was 13.3 years for current smokers vs. 15.5 for experimenters (p < .01). Perceived stress and negative life events, adjusting for demographic variables, were highest among current smokers, less so in experimenters, and lowest in the never-smokers (p < .001). Stepwise logistic regression analysis showed that negative life events, perceived stress, greater use of the negative coping methods of anger and helplessness, and less use of the positive coping methods of parental support and cognitive coping were significantly and independently related to smoking status.

Conclusions: One in four inner-city youth report smoking. Higher levels of stress and greater use of negative coping methods were found in current smokers than in experimenters and never-smokers.     

Differential parental communication with adolescents who are disabled and their healthy siblings

Purpose: To examine the levels of parental communication and differential conversational styles with adolescents who are disabled and their healthy siblings, to better understand why the adolescent who is disabled has a higher risk of psychosocial problems during the transition into adulthood.

Methods: Families who had a disabled adolescent and at least one other adolescent who was not disabled were videorecorded during dinner at home. Twenty adolescents (12 girls and 8 boys) and their families participated. Analyses were conducted on the 392 interactions.

Results: Not only did the healthy adolescents participate in family interactions at higher frequencies than the adolescents who were disabled F(1, 383) = 14.00, p < .001, but the interactions were also more meaningful with healthy adolescents, F(2, 383) = 5.25, p < .01. Furthermore, healthy siblings had significantly greater conversational control than did their siblings with disabilities, χ² [1] = 14.36, p < .001. Parents responded more negatively when adolescents who were disabled initiated a topic in comparison with their response to the healthy siblings, F(2, 69) = 5.44, p < .01. Finally, adolescents with disabilities were ignored more often than their healthy siblings, z = −3.75, p < .001, and they did not monopolize the conversation as often as did their healthy siblings, z = −3.91, p < .001.

Conclusion: These results suggest that adolescents who are disabled may be at a disadvantage when engaged in family interactions in contrast with their healthy siblings.     

哮喘患儿肺功能测定及临床意义研究

目的 观察哮喘患儿第1秒用力呼气量(FEV₁)、用力肺活量(FVC)、FEV₁/FVC水平,并分析其与细胞因子和免疫功能的相关性。方法 选取2015年8月-2018年8月在淮安市第一人民医院接受治疗的100例哮喘患儿为哮喘组,同时选取同期在本院接受体检的100例非哮喘患儿为对照组。观察两组患儿FEV₁、FVC、FEV₁/FVC水平、细胞因子和免疫功能的差异,分析哮喘患儿FEV₁、FVC、FEV₁/FVC水平、细胞因子和免疫功能的相关性。结果 哮喘组患儿的FEV₁、FVC、FEV₁/FVC、CD3+、CD4+、CD8+水平分别为78.47±2.13、80.23±2.76、75.68±1.05,61.09±2.43、43.15±3.02、21.83±2.27,低于对照组(t=-40.376、-37.674、-56.508、-11.175、-14.530、-34.348,P<0.001);哮喘组患儿的IL-4、IL-5、IL-13水平分别为156.63±10.14、55.26±3.45、57.54±4.16,高于对照组(t=69.519、61.958、64.306,P<0.05);哮喘患儿的FEV₁、FVC、FEV₁/FVC水平与细胞因子(IL-4、IL-5、IL-13)水平呈负相关(r=-0.552~-0.358),与免疫功能指标(CD3+,CD4+,CD8+)呈正相关(r=0.398~0.514)。结论 哮喘患儿FEV₁、FVC、FEV₁/FVC水平较低,且与细胞因子和免疫功能密切相关。     

Scientific abstracts at the society for adolescent medicine meetings:: A 3-decade comparison

Purpose: The purpose of this study was to review abstracts accepted for presentation at the annual national meeting of the Society for Adolescent Medicine (SAM) over the past 3 decades for subject content and research design.

Methods: Retrospective review was conducted of research abstracts for 3 years, selected at random, for the 1990s and then matched at 10-year intervals for the previous 2 decades. The major categories for subject content were: medical, psychosocial, health services, and miscellaneous; for research design categories were: retrospective, observational, experimental, and miscellaneous. Subsequent publication was also assessed.

Results: The most notable change over the 3 decades in subject content was a shift from medical topics (58% to 19%) to psychosocial topics [20% to 52% (p < .001)] of abstracts, the latter largely accounted for by increases in topics pertaining to high-risk behaviors. There was a substantial decrease in abstracts concerning medical aspects of chronic illness (p < .001), well-adolescent care, growth and development, and psychosocial aspects of chronic illness (p < .02). Regarding research design, the proportion of retrospective studies decreased over the 3 decades (p < .02); the most prevalent design was observational, with an increase in studies using established databases (p < .02). Less than 15% represented an experimental design. Studies using qualitative analysis appeared for the first time in the 1990s. The percentage of presentations which eventuated in published reports increased from 35% to 63% over the 3 decades (p < .02).

Conclusion: A significant shift occurred in subject con- tent of scientific abstracts from a medical to a psychosocial emphasis. The proportion of retrospective designs decreased, and qualitative analyses emerged. The likelihood of later publication of the studies increased.     

Interruption of pregnancy with vaginal suppositories containing 16,16-dimethyl-trans-delta 2-prostaglandin E1 methyl ester.

A newly synthesized Prostaglandin E₁ analogue, 16,16-dimethyl-trans-Δ²-Prostaglandin E₁ methyl ester, has been shown to be effective in termination of 1st and second trimester pregnancy following vaginal administration. Suppositories, each containing 1 mg Prostaglandin E₁ derivative, were administered five times to each of fifty pregnant women of five to twenty gestational weeks at three-hourly intervals. The procedure was clinically effective in 86% of the patients resulting in 56% complete and 30% incomplete abortions. The cervix of all patients was dilated up to 7 mm in diameter at the second insertion of the suppository. Vaginal bleeding and lower abdominal pain not requiring sedation were observed in all patients. Diarrhea (42%), vomiting (6%), and fever (4%) were the most common side effects. The Karyopyknotic Index of the vaginal smear increased significantly (p < 0.01) twelve hours after the initial insertion. The superficial cells of the cervix gradually degenerated during the termination procedure.     

From early to late adolescence: alcohol use and anger relationships

Purpose: To evaluate the longitudinal relationship of alcohol use in early adolescence to anger in late adolescence.

Methods: Data were collected in Indianapolis, Indiana, from 1987 to 1993 as part of a large drug abuse prevention trial. Fifty percent of the 1201 students were female, 75%, white, and 69%, low socioeconomic status, who were surveyed in grades 6/7, 9/10, and 11/12. Subjects were asked four anger-related questions: “When I have a problem, I get mad at people,” “When I have a problem, I do bad things or cause trouble,” “When I have a problem, I say or do nasty things,” and “I am a hotheaded person.” Two additional items asked subjects to report the number of alcoholic drinks consumed and frequency of drunkenness in the past 30 days. Odds ratios (OR) were used to assess the predictive relationship of alcohol use in early adolescence to anger in late adolescence.

Results: Early use of alcohol increased the odds of later anger. Specifically, alcohol use in the past month in grade 6/7 increased the odds in grade 11/12 of saying or doing nasty things (OR = 8.23, p < .01), self-reported hotheadedness (OR = 9.72, p < .01), and high anger on a composite anger scale (OR = 4.84, p < .05). Drunkenness in the past month in grade 6/7 increased the odds of self-reported hotheadedness (OR = 6.17, p < .05) and high anger on the anger scale (OR = 3.20, p < .05) in grade 9/10 and doing something bad to cause trouble in grade 11/12 (OR = 24.97, p < .01). For subjects in grade 9/10, alcohol use in the past month increased the odds in grade 11/12 of doing something bad to cause trouble (OR = 2.79, p < .05), saying or doing nasty things (OR = 2.02, p < .05), and self-reported hotheadedness (OR = 2.51, p < .05).

Conclusions: The present study showed that alcohol use in early adolescence was associated with increased anger, both in middle and late adolescence, controlling for gender, age, and socioeconomic status. The findings suggest that alcohol and drug prevention programs delivered in early adolescence may have the capacity to prevent risk for later anger and related violent behavior.     

Determinants of adolescents’ satisfaction with health care providers and intentions to keep follow-up appointments

Objective: To better understand the determinants of adolescents' satisfaction with their health care providers and to examine the relationship among satisfaction, intention to return for follow-up, and appointment-keeping behavior.

Methods: One hundred and twenty-four adolescent patients attending a university-based general adolescent medicine clinic were surveyed prior to the visit about their attitudes regarding provider behavior. After the visit, subjects completed a questionnaire on provider behavior during the visit, satisfaction with the visit, and intention to keep their follow-up appointment.

Results: Multivariate regression analysis revealed that pre-visit attitudes about providers' style of behavior predicted satisfaction (β = 0.252; p < 0.01). After controlling for pre-visit attitudes, perceptions about providers' style of behavior proved to be a strong predictor of visit satisfaction (β = 0.512; p < 0.01). Visit satisfaction was associated with intention to keep scheduled follow-up appointments (r = 0.327; p < 0.01). However, subjects with greater intention to return were not more likely to keep their follow-up appointments.

Conclusion: Provider behavior is an important determinant of adolescents' satisfaction with their health care.     

Alcohol consumption and blood pressure: a comparison of native Japanese to American men

We compared the cross-sectional association of alcohol consumption with blood pressure in 810 Japanese men (JM) living in Tokyo and 946 white men (WM) living in New York. Mean systolic (JM and WM, p < 0.001) and diastolic blood pressure (JM, p < 0.002; WM, p < 0.001) were associated with alcohol consumption in both groups. Compared to abstainers, the heaviest drinkers had the highest systolic (JM, p = 0.001; WM, p < 0.01) and diastolic (JM, p < 0.002; WM, p < 0.05) blood pressures. The relation of blood pressure to alcohol intake was J-shaped in the Americans, but linear in the Japanese. Exploratory analyses revealed that the J-shape may have been due to under-reporting of heavy alcohol ingestion by American abstainers. When abstainers were excluded, the relationships were similar in both the American and Japanese. The positive association between blood pressure and alcohol consumption persisted after adjustment for age, cigarette smoking, use of antihypertensive medications, body mass index, heart rate, abdominal skinfold thickness, hematocrit, fasting blood glucose, serum uric acid levels and urinary sodium/potassium ratio. Alcohol use was also related to prevalence of hypertension. These findings confirm the presence of an independent association between alcohol intake and blood pressure in both JM and WM and suggest that, despite differences in the metabolism of alcohol, the relation of alcohol consumption to blood pressure is similar in both nationalities.     

Quality-of-life following thoracotomy for lung cancer

Contrary to the issues of perioperative morbidity and survival following surgery for lung cancer, little attention has been given to quality-of-life. To address this, quality-of-life was assessed preoperatively and 1, 3, 6 and 9 months postoperatively in a cohort of 117 consecutive subjects who underwent thoracotomy with a certain or presumptive diagnosis of lung cancer. Those with cancer (n = 91) confirmed at thoracotomy were contrasted to those without (n = 26). Moderate to severe dyspnea, reported in 14% preoperatively, increased to 34% at 1 and 3 months (p < 0.005) but returned to approximately 10% at 6 and 9 months. Similarly, activities of daily living were impaired in 11% preoperatively; this disability increased to 21% at 1 month (p < 0.005), and returned to baseline at 6 and 9 months. Those with cancer compared to those without a postoperative diagnosis of cancer had similar quality-of-life preoperatively but deteriorated more in the postoperative period. This study demonstrates that important deterioration in quality-of-life occurs during the first 3 months postoperatively in those with a final diagnosis of cancer but improvement back to baseline can be expected thereafter.     

Weight change in adolescents who used hormonal contraception

Purpose: (a) To compare weight change at 1 year between adolescents 13–19 years old who were using either depot medroxyprogesterone acetate (DMPA) or oral contraceptives (OC), and (b) to determine if age, baseline body mass index (BMI), race/ethnicity, or weight gain at 3 months predicted which subjects would gain excessive weight.

Method: The setting was a Planned Parenthood Teen Clinic with chart review of variables of interest. Excessive weight was defined as weight gain > 10%.

Results: Baseline variables were similar in the two groups, except that DMPA users (n = 44) had a greater mean BMI (t test, p = .05) than OC users (n = 86). Mean (standard deviation) and median weight gains at 1 year were 3.0 (4.5) and 2.4 kg in the DMPA users and 1.3 (3.9) and 1.5 kg in the OC users (difference in medians not significant, Wilcoxon rank sum test, p = .10). Fifty-six percent of DMPA and 70% of OC users lost weight or gained < 5% of their baseline weight (p = .17, Fisher exact test); 25% of DMPA users and 7% of OC users gained > 10% of their baseline weight (p = .006). Age, baseline BMI, or race/ethnicity did not affect the likelihood that either group would gain > 5% or > 10% of their baseline weight. Of adolescents who gained > 5% of baseline weight at 3 months, 13 of 14 (93%) gained even more weight at 12 months.

Conclusions: The majority of adolescents who used hormonal contraception for 1 year lost weight or gained < 5% of baseline weight. DMPA users were more likely than OC users to gain > 10%. Subjects who gained > 5% of baseline weight at 3 months were at high risk (93%) of gaining even more weight by 1 year.     

Cotinine excretion (tobacco smoke biomarker) of smokers and non-smokers: comparison of GC/MS and RIA results

With a validated GC/MS method, the tobacco smoke biomarker cotinine has been estimated in urine for 148 non-smokers (male; 43±13 years; median 5.0 μg/g creatinine; 95^th percentile 104 μg/g) and 96 smokers (male; 39±12 years; 1002 μg/g; 2993 μg/g). For a subgroup of 50 persons, the GC/MS results were compared with those by a commercially available radio immunoassay. Both methods identified the same persons as non-smokers and smokers, respectively, and were closely related. For smokers, the relationship was distinctly closer than for the non-smokers (r=0.90, p<0.001, n=14 vs. r=0.41, p<0.02, n=36). The RIA values were 2.4times (smokers) and 2.9times (non-smokers) higher than the GC/MS results. This was probably caused by the cross reactivity of the RIA antibodies against other urinary nicotine metabolites, e.g. trans-3′-hydroxycotinine, and has to be taken into account to correctly compare results of studies obtained with different analytical techniques and for choosing cut-off points to discriminate between active smokers and non-smokers or between non-smokers with higher or lower exposure to environmental tobacco smoke.     

Does elementary school alcohol, tobacco, and marijuana use increase middle school risk?

Purpose: To assess whether alcohol, tobacco, and other drug (ATOD) use in elementary school may have serious implications for continued ATOD use in middle school and beyond.

Methods: Longitudinal analyses were conducted on questionnaire data from 331 middle school students who had previously provided ATOD-use data during elementary school. Non-school personnel administered questionnaires in three participating school districts in three different states. The sample of students was ethnically and geographically diverse, including students from a range of low socioeconomic status backgrounds living in rural, urban or inner-city environments.

Results: Middle school alcohol use was almost three times as likely to occur if alcohol use had occurred in elementary school (OR = 2.94, p < .001). Elementary school use of tobacco and marijuana also greatly increased the likelihood of middle school use (OR = 5.35, p < .001 and OR = 4.25, p < .05, respectively).

Conclusions: Early use of ATOD is associated with greatly increased odds of later use, which has important implications for the timing of drug prevention programs. Preventive interventions designed for use in pediatric practice settings should commence no later than elementary school, during the middle childhood years.     

Presence of an interaction between smoking and being overweight increases risks of hypertension, diabetes, and cardiovascular disease in outpatients with mood disorders

Objective

We aimed to evaluate the hypothesis that the presence of an interaction between smoking and being overweight increases the risks of lifestyle-related diseases (hypertension, diabetes mellitus, dyslipidemia, and cardiovascular disease) in outpatients with mood disorders.

Methods

In this cross-sectional survey, using data from 213 outpatients with mood disorders (95 men, 118 women), we calculated the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for each of hypertension, diabetes, dyslipedemia, and cardiovascular disease, using a binary logistic regression model; we then calculated the adjusted OR values for smokers and non-smokers with body mass indexes (BMIs) of <25 or ≥25 kg/m². Next, we examined the data for the presence of an interaction between smoking and being overweight, using three measures of additive interaction: relative excess risk due to the interaction (RERI), attributable proportion due to the interaction (AP), and the synergy index (S).

Results

Smokers with BMI <25 kg/m² had a significantly lower risk of hypertension (OR 0.27, 95% CI 0.09–0.81) than non-smokers with BMI <25 kg/m² (reference group). Compared with the reference group, overweight non-smokers had a significantly higher risk (2.82, 1.34–6.19) of hypertension, and overweight smokers had a higher risk (4.43, 1.28–15.26) of hypertension and very high risks of diabetes (8.24, 2.47–27.42) and cardiovascular disease (13.12, 1.95–88.41). The highest RERI was derived from the relation with cardiovascular disease. The highest AP and S were derived from the relation with type 2 diabetes. There was no interaction of smoking and being overweight with dyslipidemia.

Conclusion

The presence of an interaction between smoking and being overweight exacerbates the risks of hypertension, diabetes, and cardiovascular disease in outpatients with mood disorders.     

Accuracy of the college alumnus physical activity questionnaire

The validity and reproducibility of the Physical Activity Index from the College Alumnus Questionnaire (PAI-CAQ) were determined in 78 men and women (21–59 yr) with a broad range of physical activity habits. The PAI-CAQ was computed as the sum of energy expended in stair climbing, walking, and sports and recreational physical activity recalled from the past week. Data were validated against measures of cardiorespiratory fitness, body fatness, motion detection, and physical activity records. All physical activity was recorded by participants for six 48-hour periods. Each day of the week, including weekends, were represented at least twice in the physical activity records. Age-adjusted correlation coefficients between like activities on the College Alumnus Questionnaire and physical activity records ranged from 0.25 to 0.65 in men and 0.28 to 0.86 in women. Correlations between the PAI-CAQ and validation criteria that reflected total and heavy-intensity physical activities were higher (r = 0.34–0.69, p < 0.05) than for lighter-intensity physical activities and motion detection expressed in MET-min·d⁻¹ and kcal·d⁻¹ (r < 0.35, p > 0.05). Test-retest reproducibility was higher over 1 month (r = 0.72) than over 8 and 9 months (r = 0.34 and 0.43) (p < 0.05). Energy expended in walking and stair climbing was underestimated on the College Alumnus Questionnaire, resulting in lower PAI-CAQ scores, as compared to the physical activity records.     

Primary care physicians’ screening of adolescent patients: a survey of California physicians

Purpose: To determine how often primary care physicians screen adolescents for important risk factors and to determine how rates of screening vary by physicians' specialty and practice setting, patients' age, and type of risk factor.

Methods: A stratified random sample of 343 California physicians who are Board certified in pediatrics, family practice, or internal medicine, and physicians in these specialties who specialized in adolescent medicine were surveyed about their screening practices using a mailed questionnaire. Subjects were asked the percentage of routine comprehensive physical examination during which they personally queried or screened each age group of adolescents (11-14 years old and 15-18 years old) for each of the following risk factors: high blood pressure, alcohol use, cigarette use, sexual activity, and drug use.

Results: The frequency with which primary care physicians reported actually screening younger and older adolescents for the various risks were approximately: 93% and 96% for high blood pressure, 70% and 84% for alcohol use, 74% and 82% for drug use, 67% and 83% for sexual activity, and 76% and 86% for smoking, respectively. For all risk factors, providers screened older adolescents more frequently than younger adolescents (p < 0.01). Finally, screening rates varied by specialty (p < 0.01) but not by practice setting.

Conclusions: This study found that California physicians frequently screen adolescents for a variety of risk factors. However, the reported rates may not be consistent with published guidelines. Interventions may need to be developed which focus on improving primary care physicians' adolescent-specific screening practices.     

Parenting style and adolescent smoking

Purpose: To investigate whether parenting style is an independent risk factor of smoking initiation and experimentation among adolescents, and whether there is a relationship between parenting style and readiness to quit, or nicotine dependence among smokers.

Methods: The 84-item Health and Smoking Questionnaire, which assesses demographics, smoking status and smoking history, perceptions of risk and risk reduction, risk factors for tobacco use, and parenting style, was administered to 816 adolescents in grades 7 to 12 (mean age, 15.1 years) of whom 22.6% (n = 182) were smokers. Parenting style was measured by the brief, nonretrospective version of the Family of Origin Scale (FOS). Higher scores on the FOS indicated more positive perceived parenting style with high levels of intimacy and autonomy, characteristics of healthy parent-child relationships. Data were analyzed using a model-building approach to logistic regression with demographic and other psychosocial variables in the first two steps, and with parenting style as the last step.

Results: Results from two logistic regression models indicate that although parenting style is not a significant risk factor for smoking experimentation [odds ratio (OR) = .998; confidence interval (CI) = .977–1.019; p = .820], it is a significant independent risk factor for smoking initiation (OR = .950; CI = .930–.970; p = .000). Smokers who were more ready to quit had higher parenting style scores than those who were not ready to quit, and smokers who had made a serious quit attempt (an indicator of nicotine addiction) had higher parenting style scores than those who had not made a quit attempt. Moreover, nonsmokers who reported they would smoke a cigarette if their best friend offered had significantly lower parenting style scores than those who reported they would not smoke a cigarette.

Conclusions: Additional research on parenting style and its impact on adolescent smoking with a more economically and ethnically diverse sample is warranted. If future research confirms the strength of the relationship between parenting style and adolescent smoking, teaching positive parenting, including facilitating intimate yet autonomous relationships, may be considered as part of smoking prevention and cessation programs.     

Abdominal pain in a 70-year-old Danish population An epidemiological study of the prevalence and importance of abdominal pain

In order to assess the prevalence and importance of abdominal pain in the elderly, an epidemiological study of a 70-year-old Danish population was carried out. Seventy two percent of 1119 randomly selected persons answered a questionnaire concerning abdominal pain. One year prevalence of abdominal pain was 28% among women and 17% among men (p < 0.01). Among those with abdominal pain no significant sex difference was found as regards location, severity, frequency, or medicine consumption. Eleven percent of the men and 19% of the women had abdominal pain which they considered to be of importance to their well-being in terms of frequency, severity, or need of medicine (sex difference: χ² = 10.18, DF = 2, p < 0.01). Participants who had no abdominal pain judged their general health to be better than those who had experienced abdominal pain (p < 0.01).

It is concluded that abdominal pain is frequent in a 70 year old population and influences the well-being of the subjects. Further studies are needed to evaluate whether subjects with abdominal pain have a poorer prognosis than subjects without.     

Anti-haemolysin IgG1 to IgG2 ratios correlate with haemolysin neutralization titres and lung lesion scores in Actinobacillus pleuropneumoniae infected pigs

Currently available porcine Actinobacillus pleuropneumoniae bacterins afford only minimal protection by decreasing mortality but not morbidity. To evaluate a possible role of IgG subclasses in protection, IgG1 and IgG2 responses to A. pleuropneumoniae haemolysin (HLY) were examined in piglets exposed to a low dose (10⁵ c.f.u. ml⁻¹) of A. pleuropneumoniae CM5 (LD) given by aerosol (which affords complete protection) or bacterin-vaccinated piglets (no protection). Only the LD group developed HLY neutralizing antibody. These animals produced both IgG1 and IgG2-associated antibody in response to HLY, and there was a positive correlation (r = 0.6) between IgG1 anti-HLY antibody and neutralizing titres. Anti-HLY IgG1 antibody was negatively correlated with pneumonic scores at necropsy (r = −0.67, p≤0.005). These results suggest that immunization procedures that bias anti-HLY antibody to IgG1 may be more efficacious than those inducing IgG2.     

The Associations Between Smoking Habits and Serum Triglyceride or Hemoglobin A1c Levels Differ According to Visceral Fat Accumulation

Background

Whether smokers and former smokers have worse lipid profiles or glucose levels than non-smokers remains unclear.

Methods

The subjects were 1152 Japanese males aged 42 to 81 years. The subjects were divided according to their smoking habits (nonsmokers, former smokers, and current smokers) and their visceral fat area (VFA) (<100 cm² and ≥100 cm²).

Results

The serum triglyceride (TG) levels of 835 males were assessed. In the VFA ≥100 cm² group, a significantly greater proportion of current smokers (47.3%) exhibited TG levels of ≥150 mg/dL compared with former smokers (36.4%) and non-smokers (18.8%). The difference in TG level distribution between former smokers and non-smokers was also significant. However, among the subjects with VFA of <100 cm², the TG levels of the three smoking habit groups did not differ. The serum hemoglobin A1c (HbA1c) levels of 877 males were also assessed. In the VFA <100 cm² group, significantly higher proportions of current smokers (17.9%) and former smokers (14.9%) demonstrated HbA1c levels of ≥5.6% compared with non-smokers (6.3%). In contrast, in the VFA ≥100 cm² group, significantly fewer former smokers displayed HbA1c levels of ≥5.6% compared with non-smokers and current smokers. Furthermore, the interaction between smoking habits and VFA was associated with the subjects’ TG and HbA1c concentrations, and the associations of TG and HbA1c concentrations and smoking habits varied according to VFA.

Conclusions

Both smoking habits and VFA exhibited associations with TG and HbA1c concentrations. The associations between smoking habits and these parameters differed according to VFA.Key words: smoking habits, visceral fat, interaction, serum triglycerides, hemoglobin A1c