Serum thiocyanate, smoking habits and smoking cessation trial in patients with peripheral atherosclerosis

The smoking habits in patients with atherosclerosis in the lower limbs and the effect of advising them to stop smoking was studied by means of self-declaration of the number of cigarettes smoked per day and determination of serum thiocyanate. Ninety-six per cent of males and 70 per cent of the females were smokers or ex-smokers. The number of years of smoking was about 40 for the smokers of both sexes and the male ex-smokers and 23 for the female ex-smokers. The number of cigarettes smoked per day reported by the patients was less than that reported by the smokers in a reference population. The serum thiocyanate levels confirmed the smoking status of the non-smokers and showed that about one-sixth of the ex-smokers had smoked in the last month prior to the study, and that the smokers on the average were heavy smokers smoking much more than the self-reported number of cigarettes. The effect of advising the patients to quit smoking was very disappointing. A maximum of 15 per cent of the smokers stopped smoking while some of the ex-smokers resumed smoking.     

Nurses' opportunistic interventions with patients in relation to smoking

AIM: This paper reports a study exploring nurses' provision of opportunistic health education on smoking for hospital patients. BACKGROUND: Smoking cessation guidelines recommend assessment of patients' smoking habits and provision of smoking cessation advice when possible, and highlight the importance of the role of nurses in health promotion and health education. In the past, nurses have been criticized for lack of knowledge, skills and confidence in relation to health education and the perception that it is additional to, rather than integrated with, nursing care. METHODS: A qualitative case study design was selected to explore the health education practice of 12 nurses working in acute wards in three general hospitals in Scotland. Data were collected in 2000 through non-participant observation, semi-structured interviews and the use of a radio-microphone to record nurse-patient interactions. The data analysis was guided by four key elements of health education practice: 'the teachable moment', 'readiness to learn', 'the provision of health information' and 'oral communication'. FINDINGS: Smoking was part of the nurses' agenda, as most recognized opportunities to introduce health education on smoking during nursing care, suggesting a tentative move towards the integration of health education with nursing care. Evidence from patients' interactions indicated ample opportunity for nurses to provide smoking-related health information. However, the content of nurses' interactions on smoking was variable, with some limited by poor communication skills and inadequate knowledge of smoking and smoking cessation. The context of the interactions was also important in understanding some of the restrictions on conversational progress. CONCLUSIONS: Nurses require the knowledge and skills to perform a health education role, and the inclusion of smoking cessation guidelines in nursing curricula would contribute to this. Where patients are in hospitals for short periods of time, opportunistic health education on smoking needs to be introduced as the basis for more specialist intervention.     

不同戒烟时间与正在吸烟AMI患者溶栓再通前后炎症因子表达的差异

目的：探讨不同戒烟时间AMI和正在吸烟AMI患者溶栓再通前、后IL-1、TNF—α和IL-10表达的差异。方法：AMI患者80例,根据患者吸烟状态将患者分为不吸烟AMI组、吸烟〈5年AMI组、戒烟≤5年AMI组和戒烟〉5年AMI组,每组均20例．采用重组链激酶静脉溶栓,分别于溶栓治疗前、溶栓治疗再通后12h和24h采集静脉血,观察IL-1、IL-10和TNF-α的变化。结果：各组IL-1、TNF—Q和IL-10溶栓治疗前后在不同时间点的变化均具有统计学意义（P〈0．01）。吸烟〈5年AMI组和戒烟≤5年AMI组溶栓治疗后,随时间延长,3种炎症因子逐渐升高,但不吸烟组和戒烟〉5年组溶栓后12h和24hIL-1、TNF—α和IL-10的差异无统计学意义（P〉0．05）。溶栓治疗前、溶栓后12h和溶栓后24h,3种炎症因子表达水平吸烟〈5年AMI组和戒烟〉5年AMI组均高于不吸烟组,吸烟〈5年AMI组高于戒烟〉5年AMI组,差异有统计学意义（均P〈0．01）;但不吸烟AMI组和和戒烟〉5年AMI组,吸烟〈5年AMI组和戒烟≤5年AMI组的差异无统计学差异（P〉0．05）。结论：吸烟可上调AMI患者溶栓再通后炎症因子的表达,加重和延长缺血再灌注损伤,损伤时间可达24h,戒烟〉5年可下调3种炎症因子的表达,减轻缺血再灌注损伤。     

Association of cigarette smoking with diabetic retinopathy

OBJECTIVE: To determine whether cigarette smoking is associated with the incidence and progression of diabetic retinopathy. RESEARCH DESIGN AND METHODS: Younger-onset diabetic subjects who had been diagnosed at less than 30 yr of age and taking insulin (n = 1210) and a random sample of older-onset diabetic subjects diagnosed at greater than or equal to 30 yr of age (n = 1780) were selected. Baseline examinations were conducted on 996 younger- and 1370 older-onset subjects. Incidence of retinopathy was based on 138 younger-onset and 154 older-onset insulin-taking subjects and 321 older-onset non-insulin-taking subjects who were free of retinopathy at baseline. Progression of retinopathy was based on 530 younger-onset and 418 older-onset insulin-taking subjects and 486 older-onset non-insulin-taking subjects with less than proliferative diabetic retinopathy at baseline. RESULTS: Baseline smoking history was categorized by status (nonsmoker, ex-smoker, current smoker) and pack-years smoked while diabetic. Retinopathy was documented by stereoscopic fundus photography. In univariate analyses, the only significant association was between pack-years and progression to proliferative diabetic retinopathy in older-onset insulin-taking subjects (P less than 0.01). After controlling for known risk factors for the incidence and progression of retinopathy, pack-years smoked was borderline significant (P = 0.052) in predicting incidence of retinopathy in younger-onset subjects. Smoking was not associated with incidence in older-onset subjects or with progression or progression to proliferative diabetic retinopathy in any of the groups. CONCLUSIONS: Smoking is not likely to be an important risk factor for diabetic retinopathy.     

吸烟成瘾青少年大脑自发活动变化

目的 观察吸烟成瘾青少年大脑自发活动变化。方法 前瞻性招募吸烟成瘾(吸烟组)与非吸烟成瘾(对照组)在校男大学生各42名,基于静态分数低频振幅(sfALFF)和动态分数低频振幅(dfALFF)方法观察组间大脑局部自发神经活动差异,采用Pearson相关性分析观察吸烟组sfALFF值、dfALFF值与尼古丁依赖测试(FTND)评分、烟龄和吸烟频率的相关性。结果 相比对照组,吸烟组左侧距状裂周围皮层、右侧额下回三角部sfALFF值,左侧眶部额中回、左侧颞中回、左侧海马、左侧额下回三角部及右侧楔叶dfALFF值升高,而左侧颞下回、右侧枕中回、右侧顶下缘角回及左侧额中回sfALFF值降低。吸烟组左侧额下回三角部dfALFF值与吸烟频率呈正相关(r=0.286,P=0.033),左侧额中回sfALFF值与FTND评分呈负相关(r=-0.352,P=0.011)。结论 吸烟成瘾青少年大脑局部自发神经活动存在异常,并与FTND评分和吸烟频率具有相关性。     

Effects of cigarette smoking on short-term variability of blood pressure in smoking and non smoking healthy volunteers

The present trial was planned to study the effects of smoking on short-term variability of blood pressure and on haemodynamic parameters after an overnight cessation and after one day of repeated smoking in healthy cigarette smoking volunteers, compared to a control group of non-smokers who were not asked to smoke. 40 healthy male volunteers, 20 smokers and 20 non-smokers, participated in an open study with two period of measurements over a single day (morning and afternoon). Blood pressure and heart rate were measured using standard and finger recordings over 6 min before and 10 min after smoking one cigarette (in smokers only). During the two periods, smokers were asked to smoke 4 cm of a cigarette containing 1 mg of nicotine in 2 min, and a blood sample was taken for a plasma nicotine assay. In the smoking group, smoking the first cigarette of the day caused a significant increase of systolic blood pressure (+7%), diastolic blood pressure (+10%) and heart rate (+25%). The blood pressure variability in the frequency range of the Mayer waves (66-129 mHz) was increased after an overnight cessation of smoking in the smoking group in comparison to the non-smokers, and decreased significantly after the first cigarette of the day (7.1 +/- 4.0 to 3.2 +/- 1.8 mmHg2; P < 0.01). The changes observed in the afternoon after continuous smoking were significantly less important (3.8 +/- 1.9 to 3.2 +/- 1.9 mmHg2; NS). In the non-smoking group, the different parameters remained stable between the different measurements. These results suggest that an overnight cessation of smoking in smoking subjects is associated with a increase in sympathetic activity to the vascular system in the morning, which is released by smoking the first cigarette. This effect of smoking is reduced in the afternoon after a continuous nicotinic impregnation.     

现役士兵吸烟及其吸烟心理状况调查

目的探讨现役士兵吸烟现状,了解吸烟心理,为部队开展控烟和健康教育工作提供依据。方法采用自拟一般情况调查问卷和Russell吸烟原因问卷对160名士兵进行调查分析。结果士兵吸烟率为60．26％,城市籍士兵吸烟率显著高于农村籍（P〈0．01）。100％的士兵都认为吸烟有害健康,其中95．5％对吸烟的危害有一定深度的认识,愿意戒烟者71．28％,无所谓10．64％,不愿意18．09％;感觉戒烟不困难22．34％,有些困难但能克服35．11％,很困难42．55％。士兵、一级士官、二级以上士官Russell吸烟原因问卷的心理意象、手口活动、享乐、镇静、刺激、瘾各因子分经方差分析均有显著性差异（P〈0．05）。结论士兵吸烟率较高,不同级别士兵的吸烟心理有所不同,对士兵开展控烟工作势在必行。     

Acute kidney injury associated with smoking synthetic cannabinoid

Context and objectives. Synthetic cannabinoids are illegal drugs of abuse known to cause adverse neurologic and sympathomimetic effects. They are an emerging health risk: 11% of high school seniors reported smoking them during the previous 12 months. We describe the epidemiology of a toxicologic syndrome of acute kidney injury associated with synthetic cannabinoids, review the toxicologic and public health investigation of the cluster, and describe clinical implications of the cluster investigation. Materials and methods. Case series of nine patients affected by the toxicologic syndrome in Oregon and southwestern Washington during May–October 2012. Cases were defined as acute kidney injury (creatinine > 1.3 mg/dL) among persons aged 13–40 years without known renal disease who reported smoking synthetic cannabinoids. Toxicology laboratories used liquid chromatography and time-of-flight mass spectrometry to test clinical and product specimens for synthetic cannabinoids, their metabolites, and known nephrotoxins. Public health alerts informed clinicians, law enforcement, and the community about the cluster and the need to be alert for toxidromes associated with emerging drugs of abuse. Results. Patients were males aged 15–27 years (median, 18 years), with intense nausea and flank or abdominal pain, and included two sets of siblings. Peak creatinine levels were 2.6–17.7 mg/dL (median, 6.6 mg/dL). All patients were hospitalized; one required dialysis; none died. No alternate causes of acute kidney injury or nephrotoxins were identified. Patients reported easily purchasing synthetic cannabinoids at convenience, tobacco, and adult bookstores. One clinical and 2 product samples contained evidence of a novel synthetic cannabinoid, XLR-11 ([1-(5-fluoropentyl)-1H-indol-3-yl](2,2,3,3-tetramethylcyclopropyl)methanone). Discussion and conclusion. Whether caused by direct toxicity, genetic predisposition, or an as-yet unidentified nephrotoxin, this association between synthetic cannabinoid exposure and acute kidney injury reinforces the need for vigilance to detect new toxicologic syndromes associated with emerging drugs of abuse. Liquid chromatography and time-of-flight mass spectrometry are useful tools in determining the active ingredients in these evolving products and evaluating them for toxic contaminants.     

Helping patients with Crohn's disease to stop smoking

Evidence shows that Crohn's disease in cigarette smokers runs a more aggressive course. Two nurses worked in collaboration to identify smokers with Crohn's disease in order to offer pharmacological and psychological support in quitting the habit. This paper provides the results of a pilot study on a smoking-cessation course targeted specifically at such patients.     

Nursing undergraduate students and their relationship with smoking

This study was designed to investigate: the prevalence of smokers among the UNIFESP nursing undergraduate students; some initial usage features; the smokers' dependence degree on nicotine. In order to compare the ratio of some variables, Pearson's Square Chi test was applied. The number of smokers among the nursing undergraduate students in the sample was 23 (8.2%) and 167 (59.9%) said they had never smoked a cigarette. Smokers' average age was 19.5 years old, and there is a significant difference between genders and only 2 (9.1%) smoking students may show a more severe discomfort while attempting to stop smoking, as showed the Fagerstr?m's Test.