The economic impact of smoke-free laws on sales in bars and restaurants in Argentina

We studied the impact of the recent smoke-free laws on the sales in bars and restaurants, in the city of Buenos Aires and in three provinces of Argentina. Using a quasi-experimental design and a difference-in-differences estimation procedure we found that the smoke-free laws did not have a statistically significant negative effect on sales in bars and restaurants in the city of Buenos Aires and in the provinces of Córdoba, Santa Fe and Tucumán. Moreover, in the case of Buenos Aires, the smoke-free legislation could have induced an increase in the sales in bars and restaurants.     

The economic impact of a smoke-free bylaw on restaurant and bar sales in Ottawa, Canada

AIMS: On 1 August 2001, the City of Ottawa (Canada's Capital) implemented a smoke-free bylaw that completely prohibited smoking in work-places and public places, including restaurants and bars, with no exemption for separately ventilated smoking rooms. This paper evaluates the effects of this bylaw on restaurant and bar sales. DATA AND MEASURES: We used retail sales tax data from March 1998 to June 2002 to construct two outcome measures: the ratio of licensed restaurant and bar sales to total retail sales and the ratio of unlicensed restaurant sales to total retail sales. Restaurant and bar sales were subtracted from total retail sales in the denominator of these measures. DESIGN AND ANALYSIS: We employed an interrupted time-series design. Autoregressive integrated moving average (ARIMA) intervention analysis was used to test for three possible impacts that the bylaw might have on the sales of restaurants and bars. We repeated the analysis using regression with autoregressive moving average (ARMA) errors method to triangulate our results. FINDINGS: Outcome measures showed declining trends at baseline before the bylaw went into effect. Results from ARIMA intervention and regression analyses did not support the hypotheses that the smoke-free bylaw had an impact that resulted in (1) abrupt permanent, (2) gradual permanent or (3) abrupt temporary changes in restaurant and bar sales. CONCLUSIONS: While a large body of research has found no significant adverse impact of smoke-free legislation on restaurant and bar sales in the United States, Australia and elsewhere, our study confirms these results in a northern region with a bilingual population, which has important implications for impending policy in Europe and other areas.     

Cardiovascular aging in health

Major focuses of geriatric medicine are cardiovascular diseases with increases in prevalence in older people and how aging might modify the risk factors, clinical manifestations, treatment strategies, and prognoses of these diseases. Quantitative information on age-associated alterations in cardiovascular structure and function in health is essential to define and target the specific characteristics of the cardiovascular aging process that render it the major risk factor for cardiovascular diseases. Such information also is required to differentiate among the limitations of elderly individuals that relate to disease and limitations that may fall within expected normal limits. Differences in cardiovascular function between older and younger individuals have been described extensively in the literature, but confusion often arises in the interpretation of these differences because of a failure to acknowledge or to control for interactions among age, disease, and lifestyle. The Baltimore Longitudinal Study on Aging has made an effort to characterize the effects of aging on multiple aspects of cardiovascular structure and function. The concepts that have evolved from this and other studies are discussed.     

Impact of smoke-free workplace legislation on exposures and health: possibilities for prevention.

The aims of this study were to review experiences with national or statewide smoke-free workplace legislation and data on the occurrence of environmental tobacco smoke (ETS) exposure at work, to present the best estimates for health effects related to workplace ETS exposure, and to calculate corresponding population attributable fractions (PAFs) for respiratory and cardiovascular diseases for 14 European countries and the USA. Systematic searches of the Medline database were carried out, with a cut-off date of November 2005. PAFs for the main outcomes were calculated from the best disease-specific effect estimates and country-specific prevalences of work ETS exposure. Significant numbers of workers are exposed to ETS at work, i.e. approximately 7.5 million workers in 15 European Union countries and 24.6 million in the USA. Workplace ETS exposure is causally linked to lung cancer and coronary heart disease, and is related to an increased risk of asthma in adults and reduced birthweight in newborns. Relatively strong evidence links ETS exposure to chronic obstructive pulmonary disease and stroke. PAFs in Europe and the USA showed that, at current workplace ETS exposure prevalences, the public health impact is substantial. Experience of national and statewide smoke-free workplace legislation from different countries shows that such legislation leads to significant reductions in employees' environmental tobacco smoke exposure at work, as well as improvements in respiratory and cardiac health.     

Cardiovascular effects of coxibs

A new class of drugs, the selective cyclooxygenase-2 (COX-2) inhibitors, or coxibs, have recently been marketed as an alternative to conventional nonsteroidal anti-inflammatory drugs (NSAIDs) on the basis of a lower risk of gastrointestinal side effects. The recent withdrawal of rofecoxib, along with safety concerns about other COX-2 selective inhibitors raises important questions about the cardiovascular toxicity of these drugs. Recently some concerns arose even for a possible cardiotoxicity of nonselective nonsteroidal anti-inflammatory drugs. From data available so far, it seems that coxibs still remain a rational choice for patients with low cardiovascular risk and high gastrointestinal risk. Long-term studies with a cardiovascular endpoint involving both selective and nonselective anti-inflammatory drugs are warranted.     

Cardiovascular effects of SERM

Raloxifene has an estrogenic effect on the cardio-vascular system. In vascular endothelium, both clinical and basic studies show that raloxifene induces the synthesis and release of nitric oxide. In vascular smooth muscle, basic study shows that raloxifene attenuates the PDGF-induced cell proliferation by both induction of apoptosis and arrest of the cell cycle. We now await the results of currently ongoing prospective large scale randomized control trial, Raloxifene Use of The Heart.     

Cardiovascular effects of doping

Cardiovascular effects of doping drugs are numerous, with different mechanisms: vasoconstriction of amphetamines, erythropoietin and cocaine; sodium water retention of anabolic steroids and corticosteroids; elevation in blood viscosity of erythropoietin, perflurocarbon emulsion, recombinant hemoglobin and anabolic steroids; sympathetic nervous system activation of amphetamines, beta 2 agonists and clenbuterol; lipids profile disorder of anabolic steroids. Physical activity consequences, particularly bradycardia and dehydration, are worsening. Thrombosis and arrythmogenic effects, with possibility of sudden death, are the severe immediate events. Hypertension and coronary diseases are medium-term effects; acute myocardial infarction is frequent. Heart failure can be secondary to cardiac muscle direct fibrosis, like with anabolic steroids. These cardiovascular effects are serious and it is necessary to early detect the doping drugs use in sporstmen; all prescribing physician should be aware of existing drugs and their clinical events.     

Cardiovascular effects of leukotrienes

Summary Leukotrienes have been shown to signif. icantly influence coronary vascular resistance, infarct size, pulmonary vascular resistance, bronchial tone, and renal vascular resistance either directly or indirectly. There is a notable dirth of data on human pathophysiologic conditions. With the advent of specific inhibitors of the synthesis and action of leukotrienes and, more importantly, of methods on the in-vivo synthesis of these potentially important mediators, these gaps in our understanding will be closed.