Effects of acute tobacco abstinence in adolescent smokers compared with nonsmokers

PURPOSE: Abstinence effects such as nicotine withdrawal and mood changes contribute to the maintenance of cigarette smoking in adult smokers, and emerging reports on adolescent smokers suggest they may experience similar subjective effects when deprived. This study aimed to prospectively document tobacco abstinence-induced changes during the first 48 hours of abstinence in adolescent smokers compared with nonsmokers, to distinguish effects distinct from typical adolescent lability. METHODS: Fifty-seven adolescent smokers and 44 adolescent nonsmokers were assessed during a 48-hour inpatient session. Characteristic nicotine withdrawal symptoms, cravings for cigarettes, and mood symptoms were measured at 13 time points following initiation of abstinence. RESULTS: The only abstinence-related effects observed were changes in craving for tobacco and feelings of anger. Tobacco craving increased and peaked quickly following initiation of abstinence and displayed a slight decrease toward the end of the 48-hour abstinence period, while anger symptoms peaked after a more prolonged abstinence. Overall, smokers' symptoms and cravings were positively associated with amount of daily smoking but not with reports of dependence or biological measures of extent of use. CONCLUSIONS: We observed that among adolescent smokers, the primary effects associated with abstinence from cigarettes are relatively minimal, and include a heightened and persistent craving to smoke and increases in anger. Although smokers had greater negative mood symptoms compared with nonsmokers, the presence and severity of most of these symptoms appear to be minimally altered by abstinence and not associated with dependency or biological indicators of amount of tobacco use.     

Alcohol hangover effects on measures of affect the morning after a normal night's drinking

AIM: To investigate the effects of students' usual levels of alcohol consumption on aspects of mood and anxiety the following morning. METHODS: Students were recruited who consumed their usual quantity of any type of alcoholic beverage in their chosen company and then completed assessments of the effects the following day. The timing of drinking was restricted to the period between 22:00 and 02:00 h the night before testing as these are the most popular hours for consuming alcohol in the population under investigation. The testing included an assessment of mood and anxiety; testing was also performed after an evening of abstinence (no hangover condition), following a counterbalanced repeated measure design, with time of testing and order of testing as 'between participant' factors. Forty-eight student social drinkers (33 women, 15 men) aged between 18 and 43 years were tested, with a 1 week interval between test sessions. RESULTS: Males reported consuming on average 14.7 units and females 10.5 units the night before testing. On the morning after alcohol consumption, ratings of alertness and tranquility were lower than the ratings the morning following an evening of abstinence at both 11:00 and 13:00 h and the post intoxication physical symptoms, emotional symptoms and symptoms of fatigue persisted throughout the morning. CONCLUSION: Heavy alcohol consumption lowers mood, disrupts sleep, increases anxiety and produces physical symptoms, emotional symptoms and symptoms of fatigue throughout the next morning.     

Adverse effects of a liberal diagnosis of 'food intolerance'

Signs and symptoms of food intolerance in young children are manifold and non-specific. When confronted with a patient with a sign or symptom that can be caused by food intolerance, the physician can take two approaches. One approach is aimed at not missing food intolerance (liberal approach), the other at not overdiagnosing food intolerance (restricted approach). Each approach has its own pros and cons. The main disadvantage of the restricted approach is that food intolerance may not be recognized straightaway. However, this is hardly ever harmful to the patient. The disadvantages of the liberal approach are more numerous and more serious. They include the excessive use of expensive hypoallergenic formulae, unjustified focus on food intolerance as the cause of numerous harmless and self-limiting symptoms in young children, increased risk of poor growth, and insufficient attention for any of the true cause of the patient's symptoms. Therefore, when confronted with a young child with signs and symptoms that could be caused by food intolerance, other causes should be considered prior to focusing on the food intolerance.     

337例致病菌阳性腹泻病例调查分析

目的了解医院肠道门诊致病菌腹泻病例的流行病学特征及其流行菌株,为感染性腹泻防治提供依据。方法在一、二级医院肠道门诊对因腹泻就诊,经病原学监测结果为肠道致病菌感染的病例,进行临床症状、可疑食物史调查,并对病原学检测结果进行分析。结果 337例患者就诊前的平均腹泻次数为5.87次;所有患者均有不同程度的大便性状改变,稀便、水样便最多,分别占病例总数的74.48%和21.07%;不同致病菌所引起的大便性状改变不同;副溶所致腹泻占80%以上;可疑饮食史主要是海水产品、肉及肉制品、淡水产品及果蔬类。结论腹泻病的临床症状、病原学及可疑饮食史对此病的诊治、预防有着非常重要的意义,要加强食源性疾病网和食品污染物监测网"两网"监测。     

Vitek—AMS技术在食物中毒实验诊断上的初步应用

用Vitek——自动微生物诊检仪(Vitek——AMS)的革兰氏阴性菌鉴定卡(GNI)来测定食品中肠道致病菌的方法,已在世界先进国家广泛使用,并被AOAC列为法定分析法。本文报导了用60型Vitek——AMS对一起食物中毒可疑食品的检测。诊断确认中毒系鼠伤寒沙门氏菌和奇异变形杆菌污染烧鸡所致。与部颁方法检测结果一致,并与流行病学、卫生学调查及临床症状相符,可作为食物中毒病因学判断依据。作者引用此诊检技术在食物中毒实验诊断上作了初步尝试并为食品微生物的快速检测开辟了新的途径。     

Diagnosis of food allergies in children

Due to the aspecific nature of their symptoms, food allergies cannot be diagnosed reliably based on the patient's symptoms alone. Many parents believe that their child is allergic to one or more types of food; however, this can be confirmed in only 20% of cases. A food allergy cannot be demonstrated by laboratory diagnostic tests because these tests detect sensitisation, rather than allergy. Many children who are sensitized to a certain type of food can tolerate the food without problems. The most commonly used type of diagnostic test for food allergies is open elimination and provocation, which, in the Netherlands, is primarily conducted in child healthcare clinics. This type of diagnostic test, however, is associated with a high rate (> 50%) of false-positive results. The most reliable way to diagnose a food allergy is to conduct a double-blind, placebo-controlled food provocation. This test is only available at a few centres in the Netherlands. Food allergies occur in 2.5% of children but are more often regarded incorrectly as the cause of symptoms in young children. Therefore, a critical attitude is warranted when parents suspect that their child is allergic to one or more types of food.     

对903例人群食物不耐受相关症状调查分析

目的对903例人群食物不耐受相关症状及其影响凶素进行分析。方法用酶联免疫方法（ELISA）检测人血清中14种食物过敏原特异性IgG抗体。同时采用食物不耐受检测健康状况评估表收集食物不耐受阳性情况、饮食习惯等方面资料。采用SPSSFORWINDOWS13．0软件对相关资料进行频数分析、卡方检验、Mann—Whitney检验等。以P〈0．05为差异有统计学意义。结果食物不耐受发牛频率前五位依次是：蟹（254例,占28．13％）、蛋清／蛋黄（244例,占27．02％）、牛奶（118例,占13．07％）、大豆（108例,占11．96％）。不同患者可出现1种到8种食物不耐受。食物不耐受者症状出现频率依次为神经系统（55．89％）、消化道（45．69％）、心血管系统症状（15．64％）。脑力劳动者发生食物不耐受低于体力劳动者（P〈0．05）。结论人群对食物不耐受最常见的食物为：蟹、蛋清／蛋黄和牛奶。不耐受的症状可表现在多个系统。多见于体力劳动者。     

Neuropeptide Y suppresses ethanol drinking in ethanol-abstinent, but not non-ethanol-abstinent, Wistar rats

In outbred rats, increases in brain neuropeptide Y (NPY) activity suppress ethanol consumption in a variety of access conditions, but only following a history of ethanol dependence. NPY reliably suppresses ethanol drinking in alcohol-preferring rats, and this effect is augmented following a period of ethanol abstinence. The purpose of this experiment was to examine the effects of NPY on two-bottle choice ethanol drinking and feeding in Wistar rats that had undergone chronic ethanol vapor exposure, cycles of ethanol abstinence, or both. Ethanol-drinking Wistar rats were given 6 weeks of access to 15% (vol/vol) ethanol and water followed by either: two cycles of 1 week ethanol vapor exposure and 2 weeks with no ethanol; two cycles of 1 week ethanol bottle availability and 2 weeks with no ethanol; or 2 weeks of ethanol vapor exposure. Rats were infused intracerebroventricularly with one of four NPY doses (0.0, 2.5, 5.0, or 10.0 μg) following the ethanol exposure patterns described above, and tested for ethanol drinking and feeding in a two-bottle choice situation. NPY dose dependently increased food intake regardless of ethanol exposure history, but suppressed ethanol drinking only in rats that underwent cycles of ethanol access and ethanol abstinence. These results support the notion that dysregulation of brain NPY systems during chronic intermittent ethanol exposure is important in the motivational drive for subsequent relapse to ethanol drinking.     

Food allergies: immunological reactions to food

Allergic reactions to food are mediated by the immune system, can be consistently reproduced, and cause a change in the target organ. An estimated 0.3% to 20% of infants are affected. The incidence decreases with age to about 1% to 3% in adults. Development of food allergies depends on heredity, intestinal permeability, immune responsiveness, and exposure to food. Common symptoms include gastrointestinal, skin, or respiratory disturbances that occur from seconds to several hours after food ingestion. Although the skin-prick test is the most reliable diagnostic test, positive results must be followed by a trial elimination diet and food challenge to determine whether symptoms appear after food ingestion. Food allergies are treated by the elimination of the offending foods from the diet. Breast feeding is usually recommended to reduce the incidence of allergic disease in infants. The dietitian's expertise is particularly valuable in assessing the nutritional status of the allergic person, assuring nutritional adequacy during treatment and maintenance, and participating in research to address the many unresolved issues surrounding food allergies.     

1起金黄色葡萄球菌引起某幼儿园儿童食物中毒调查

目的 为预防食物中毒发生,提高突发公共卫生事件处置能力。方法 采用现场流行病学和卫生学调查,结合实验室检测结果进行分析。结果 所有病例均进食当天分发的蛋糕,临床症状基本相同,在8份患者肛拭子、2份患者洗胃液和4份蛋糕中均检出A型金黄色葡萄球菌肠毒素。结论 该事件是1起由金黄色葡萄球菌污染引起的食物中毒事件。     

Double-blind, placebo-controlled cow's milk challenge in children with alleged cow's milk allergies, performed in a general hospital: diagnosis rejected in two-thirds of the children

OBJECTIVE: To present the results of double-blind, placebo-controlled food challenges with cow's milk in a general hospital. DESIGN: Retrospective chart review with a prospective protocol. METHOD: Food challenges were performed between 1 December 2003 and 31 March 2005, consisting of 2 challenges separated by 1 week conducted in the out-patient hospital ward. Signs and symptoms that occurred during the food challenge and following reintroduction of cow's milk (if performed) were recorded. RESULTS: Food challenge was conducted in 43 children (23 boys and 20 girls) with a median age of 14 months. The challenge was not performed completely in 2 children. No anaphylactic reactions occurred. In all 41 patients a diagnosis ofcow's milk allergy had been made prior to referral to the paediatrician, based on symptoms, open elimination and challenge results. This diagnosis was rejected in 28 children (68%), based on negative results from the double-blind food challenge. Symptoms occurred during the placebo challenge in 10 children (24%), 8 of whom experienced symptoms identical to the presenting symptoms. After reintroduction of cow's milk, 2 recurrences of presenting symptoms were noted (possible late reactions). CONCLUSIONS: Food challenge was conducted safely and effectively in a general hospital. Two-thirds of cases of cow's milk allergy diagnosed before referral were rejected based on the food challenge results. Many reactions attributed to cow's milk allergy did not appear to be caused by cow's milk allergy.     

一起聚餐引起的食物中毒流行病学调查

目的调查食物中毒家庭成员聚餐情况,证实食物中毒存在及查找危险因素。方法采用问卷调查方式对12例聚餐者进行调查和访谈,同时结合临床症状,应用SPSS16.0软件对调查资料进行分析,查找引起食物中毒的危险因素。结果12人聚餐后8人发病。病例组与非病例组在是否食用土豆块上有统计学意义,且有量的方向趋势,存在等级方向性。结论确认本次事件是一起由食用土豆块引起的食物中毒。     

一起由斯坦利沙门氏菌引起食物中毒事件的实验室检测

目的对一起食物中毒事件病原菌进行检测和分析,确定食物中毒原因,并了解病原菌耐药情况。方法根据流行病调查和临床表现,选择疑似的病原菌,按照GB4789.4-2010[1]、WS271-2007[2]、B-K琼脂扩散法[3]对采集的样品进行病原菌分离、鉴定及进行耐药性检测。结果共采集8份样品(2份肛拭物,6份剩余食物),除1份剩余食物外均检出斯坦利沙门氏菌,检出的7株斯坦利沙门氏菌对16种抗生素未见耐药情况。结论本起食物中毒是由斯坦利沙门氏菌引起,检出的斯坦利沙门氏菌未出现耐药情况。     

一起扁毛霜农药引起食物中毒的调查报告

目的查明引起此次食物中毒的原因,有针对性的采取预防措施。方法对就餐者、食物加工者及引起食物中毒的危险因素进行调查,采集可疑中毒物样品及剩余食物进行检测鉴定。结果就餐的5人全部发病,症状相似,潜伏期2～5 min,进食多者发病快、病情重,未进食者未发病。经调查,加入食物中的调料为有机磷农药扁毛霜。结论该起事件是由扁毛霜农药引起的食物中毒。     

Effects of disordered eating and obesity on weight, craving, and food intake during ad libitum smoking and abstinence

Although there is empirical support for the association between smoking, disordered eating, and subsequent weight gain upon smoking cessation, there have been no prospective studies to track changes in eating patterns during smoking abstinence and explore underlying biobehavioral processes. To help fill these gaps, we recruited four groups of women (N=48, 12/group) based on presence vs. absence of obesity and on low vs. high risk of severe dieting and/or binge-eating to participate in a laboratory study of eating in the context of ad libitum smoking and smoking abstinence. Participants [mean age 31.3 years; Fagerstrom Test of Nicotine Dependence (FTND) 4.3; smoking rate 18.7 cigarettes/day] completed two sessions: one after ad libitum smoking, the other after 2 days' smoking abstinence, in counterbalanced order. After a half-day's restricted eating, participants watched a video, with measured amounts of preselected preferred food available throughout. Cigarettes were available during the ad libitum smoking session. High-risk women weighed more after 2 days' abstinence than during the ad libitum smoking condition, whereas low-risk women did not differ across conditions. Nicotine craving changed significantly more in anticipation of nicotine deprivation for high-BMI women than their low-BMI counterparts. Caloric intake was marginally attenuated during abstinence for low-BMI compared with high-BMI participants (P<.10), an effect primarily accounted for by differences in protein intake (P<.10). These findings suggest that low-BMI women may be less prone to weight gain during early abstinence, possibly because they compensate for metabolic changes induced by nicotine washout by eating less. Craving increases experienced by high-BMI women during abstinence under conditions of food deprivation may contribute to difficulty quitting in these women.     

Food allergy: nuts and tree nuts

Nuts are a well-defined cause of food allergy, which affect approximately 1 % of the general population in the UK and the USA. There do appear to be differences in the frequency of nut allergy between different countries because of different dietary habits and cooking procedures. For example, in the USA and France, peanuts are one of the most frequent causes of food allergy, but in other countries, it seems to be less common. Genetic factors, in particular, appear to play a role in the development of peanut allergy. While the majority of nut allergens are seed storage proteins, other nut allergens are profilins and pathogenesis-related protein homologues, considered as panallergens because of their widespread distribution in plants. The presence of specific IgE antibodies to several nuts is a common clinical finding, but the clinical relevance of this cross-reactivity is usually limited. Allergic reactions to nuts appear to be particularly severe, sometimes even life-threatening, and fatal reactions following their ingestion have been documented. Food allergy is diagnosed by identifying an underlying immunological mechanism (i.e. allergic testing), and establishing a causal relationship between food ingestion and symptoms (i.e. oral challenges). In natural history investigations carried out in peanut-allergic children, approximately 20 % of the cases outgrew their allergy or developed oral tolerance. The treatment of nut allergies should include patient and family education about avoiding all presentations of the food and the potential for a severe reaction caused by accidental ingestion. Patients and families should be instructed how to recognise early symptoms of an allergic reaction and how to treat severe anaphylaxis promptly.     

4株EPEC(O111:K58)的分离鉴定及血清学试验

[目的]探讨引起食物中毒的致病性大肠埃希菌（EPEC）Olll：K58的分离鉴定及血清学试验。[方法]依据GB／T4789．6—2003对4份食物中毒患者肛拭或粪便进行培养分离，经染色镜检，生化反应，血清学试验作出鉴定，并对该起食物中毒进行流行病学调查。[结果]从食物中毒患者的3份肛拭和1份粪便均检出并确证为致病性大肠杆菌EPEC（Olll：K58）；并确定导致食物中毒的病因是由致病性大肠肝菌EPEC（Olll：K58）引起。[结论]致病性大肠埃希菌引起的食物中毒可达到快速检验和鉴定。     

Effects of long-term abstinence on psychological functioning: A prospective longitudinal analysis comparing alcohol-dependent patients and healthy volunteers

Using a prospective longitudinal design, differences between abstinent alcohol-dependent patients (n = 15) and abstinent healthy volunteers (n = 11) were determined with respect to their psychological functioning and alcohol consumption patterns following abstinence. Results showed no differences in alcohol consumption. In 20% of the patients and 9% of the controls more than 10% of protocols indicated alcohol intake, and in 27% of the patients and 27% of the controls less than 10% of protocols indicated alcohol intake. Total abstinence was reported by 53% of the patients and by 64% of the controls. For patients, validation of self-reported alcohol consumption was carried out via biological markers. Patients and controls differed in terms of: increased sleep, euphoria, concentration, initiative, anxiety, negative and positive craving, pessimistic thoughts, autonomic disturbances, and humour. A gradual normalization back to baseline levels was observed for some symptoms. These results suggest that affective/mood states may be unstable for alcoholics, and further, that these symptoms may be related to the protracted withdrawal syndrome or may represent residual symptomatology.     

Self-reported long-term smoking cessation in patients with respiratory disease: prediction of success and perception of health effects

Smoking status of 372 patients with respiratory disease, who had been advised to quit smoking by a respiratory specialist, was assessed six months after the advice. A multiple logistic regression model was developed for prediction of successful abstinence. The patients were again followed four to seven years later. Questionnaires were returned by 160 patients (43.0%). Of the remaining patients, 27 (7.3%) had died, 12 (3.2%) refused to participate, 53 (14.2%) had no current address available and 120 (32.3%) did not return questionnaires mailed to them. Among the respondents, 31.9% reported at least one year of abstinence from cigarettes, 63.1% were still smoking and 5.0% had quit smoking for periods of less than one year. While the original logistic model was not very useful for predicting long-term success (69.7% accuracy of classification), a model that included, as predictors, six-month smoking status and reasons for smoking other than addiction, was more useful (78.9% accuracy). At follow-up, successful abstainers reported improvement in their respiratory condition but no differences were found in reported symptoms or emotional well-being when they were compared to those who continued to smoke. Treatment implications of these results are discussed and include offers of alternative treatments if short-term abstinence is not achieved following physician advice.     

32例食物蛋白过敏与婴儿呕吐的相关性研究

【目的】 检测以呕吐为主要表现的婴儿血清食物特异性IgG,以探讨牛奶不耐受与呕吐的关系。 【方法】 收集2008年9月～2010年2月在唐都医院儿科门诊及住院的32例3月~1岁婴儿,全部满足下例条件:1)主要症状除频繁呕吐外,部分伴腹泻、血便、湿疹、生长缓慢;2)上消化道内镜提示胃、十二指肠有粘膜病变;3)食物不耐受检测对一种或一种以上食物蛋白不耐受;4)食物归避试验或激发试验阳性;其中男20例,女12例;对研究对象进行血常规、24 h食管PH值监测、胃镜检查、食物不耐受检测、食物归避试验; 【结果】 食物特异性IgG检测对食物不耐受引起之婴儿呕吐的病因诊断有积极临床意义,特别注意胃镜下黏膜糜烂或十二指肠增生为主的呕吐婴儿,应考虑完善食物不耐受检测,以免延误诊断和治疗。 【结论】 食物蛋白过敏是引起婴儿呕吐的原因之一,尤其是对频繁呕吐患儿治疗效果不佳时应考虑食物过敏。