Efficacy of a nicotine nasal spray in smoking cessation: a placebo-controlled, double-blind trial

Laboratory trials have demonstrated the efficacy of nicotine replacement in smoking cessation bur absolute success races are low. For many, nicotine gum is hard to use and transdermal nicotine is slow-acting and passive. A new, faster-acting nicotine nasal spray (NNS) can provide easily self-administered relief from cigarette withdrawal. The NNS was tested for safely and efficacy in smoking cessation. Two hundred and fifty-five smokers were randomized to NNS or a piperine placebo. Drug use was limited to 8–32 doses/day for 6 months. Subjects were tested while smoking and at post-cessation daily (week 1) with follow-up at weeks 2, 3, 6 and at 3 months, 6 months and 1 year. Continuous abstinence analyses (CO ≤8 ppm.; no slips) showed that NNS significantly enhanced success rates over placebo overall (p < 0.001) and at all test intervals. Differences at key intervals between active and placebo were: 63% vs. 40% (day 5), 51% vs. 30% (week 3), 43% vs. 20% (6 weeks), 34% vs. 13% (3 months), 25% vs. 10% (6 months) and 18% vs. 8% (1 year). Side effects were common but tolerable. Cotinine measures showed that replacement of nicotine approximated 30% of smoking levels. Hazard functions revealed relapse risks peaked at day 1, day 5 and 3 weeks for strict abstinence. It is concluded NNS is safe, efficacious and a viable alternative treatment for smoking cessation.     

The Role of Glucagon,Catecholamines and Cortisol in Counterregulation of Insulin-induced Hypoglycemia in Normal Man

ABSTRACT To study the response of glucose counterregulation to insulin-induced hypoglycemia, six normals were given a 4-hour infusion of insulin (2.4 U/h) ± somatostatin (50 μg/h). Supplementary glucagon (1.5 or 3.0 ng/kg/min) was given in additional experiments. In a separate study, glucagon was supplemented for 4 hours as a constant rate infusion (3.25 ng/kg/min) or at rates stepwise increasing from 1.5 to 5.0 ng/kg/min. Insulin decreased blood glucose by 1.5 mmol/1 and simultaneous suppression of glucagon resulted in a more pronounced hypoglycemia enhancing the adrenaline and Cortisol responses. The hyperglycemic effect of glucagon substitution (3 ng/kg/min) faded out after about 2 hours, whereafter exaggerated adrenaline and Cortisol responses to hypoglycemia were seen. A comparison between the effects of steady state hyperglucagonemia and gradually appearing hyperglucagonemia on the counterregulation of hypoglycemia revealed no significant differencies in glucose, adrenaline and Cortisol responses to insulin. It is concluded that the glycemic effect of glucagon is transient in the hypoglycemic state. When the hepatic responsiveness to this hormone is decreased during hypoglycemia, adrenaline becomes the essential protective factor.     

Craving for Cigarettes

The urge to smoke is by far the most commonly reported subjective response to cigarette withdrawal. It is worse in smokers with higher nicotine intake and can be reduced by a nicotine substitute. Although it may occur at any time during abstinence, it can be increased by stress and boredom and reduced when the smoker is kept occupied. Craving for cigarettes probably has multiple causation arising partly out of the perceived benefits of smoking and negative consequences of not smoking and partly as a direct result of loss of nicotine. Whatever its root causes it would be expected to involve general psychological processes such as associative learning and attribution. This paper draws together the threads of pharmacological and psychological levels of explanation for cigarette craving in an attempt to provide a clearer understanding of this phenomenon.     

Dual-photon absorptiometry of mandibles: in vitro test of a new method

A new method for non-invasive in vivo measurement of changes in bone mineral content (BMC) of mandibles, comprising two-dimensional dual-photon absorptiometry (GT45), has been developed and tested in vitro on mandibular specimens. The analysis showed that: 1) in vitro precision and accuracy of the methods are high, 2) effect of fat and soft tissue on photon attenuation is slight when scanning jaws and forearm bones, 3) BMC in units (U/cm²) in standard area, comprising mandibular base and body in left molar region, is representative for BMC in total mandibular base and body, 4) cortical bone constitutes the main part of measured BMC in mandibles, and 5) BMC of molar region is highly correlated to cortical bone mass in mm³/mm² subperiosteal surface of standard locality anterior to and below mental foramen, measured by histomorphometry. GT45 seems suitable for in vivo estimation of BMC changes in edentulous jaws and in mandibular base and body of dentate mandibles in longitudinal and cross-sectional studies. The radiation dose is negligible.     

Plaque inhibition by guanidino propyl piperazine (CKO 569A)

The plaque inhibiting effect of the antibacterial substance, guanidino propyl piperazine (CKO 569A) has been analyzed in a clinical study of 10 adults. Plaque formation was enhanced by three daily rinses with 15% sucrose. Normal hygiene was performed. The effects of a twice daily mouthwash of 30 s duration with 0.2, 0.1 and 0.05% CKO 569A, 0.05% chlorhexidine and a placebo on plaque formation were compared through a registration of plaque scores. Each solution was tested over a period of 5 days. As a result of this study it could be concluded that in humans CKO 569A is an effective inhibitor of plaque, and that lingual plaque scores appear to be a good indicator of plaque inhibiting activity.     

Sex and age differences in bone morphology of mandibles

abstract — Histomorphometric analysis of mandibular specimens has been performed in order to demonstrate possible sex and age differences in percent bone mass and bone activity in the mandible. The material consisted of 32 autopsy specimens from the right premolar region of the mandibular body in subjects with sudden unexpected death and without known bone disease. The subjects were divided in a young group (20–43 years of age) and an old group (60–90 years of age); each group consisted of eight females and eight males. Microradiograms of buccolingual ground sections of 100 μm were used. Quantitation of (1) percent bone area of cortical and trabecular bone and (2) total bone surface/bone area and resorption surfaces/total bone surface in trabecular bone, were done by electronic point-counting. The analysis did not reveal any significant sex or age differences in the trabecular bone with respect to percent bone mass, trabecular coarseness and bone activity. In the buccal and lingual cortices a significant age difference was demonstrated, but there was no sex difference in percent bone mass. Cortical porosity in mandibles clearly increases with increasing age, but seems to be independent of sex.