The effect of clonidine on the cessation of cigarette smoking

The effect of clonidine on smoking cessation was studied by randomly assigning 186 smokers in a double-blind fashion to either placebo or clonidine. Abstinence from smoking was reported more frequently by subjects receiving clonidine, but the difference was statistically significant only at the end of the first week (34.4% vs 21.5%; p less than 0.05). Bothersome side effects were common and resulted in the early discontinuation of the study medication by 23 of the subjects taking clonidine and eight taking placebo (p less than 0.05). Although this study did not demonstrate a significant effect of clonidine on smoking cessation, a beneficial trend was detected and therefore further trials with transcutaneous delivery of this agent in combination with behavior modification techniques are warranted.     

The effect of cigarette smoking on salivation and esophageal acid clearance

To further define the influence of cigarette smoking on the pathophysiology of gastroesophageal reflux disease, studies were done to evaluate acid clearance in the esophagus and the salivary titratable base secretion of chronic smokers as compared to those of nonsmokers, and to ascertain the acute effects of smoking on these variables. Eight nonsmoking volunteers and 16 cigarette smokers without symptoms of gastroesophageal reflux disease were studied. All studies were initiated after a 6-hour fast, with the smokers also having refrained from smoking. Of the 16 smokers half smoked three cigarettes in the course of the experiments and half did not smoke. The immediate effects of cigarette smoking were a prolongation of the acid clearance time and a diminution of the secretion of salivary titratable base. However, both of these effects were overshadowed by greater baseline differences between the populations of smokers and nonsmokers. As a population the smokers had only 60% of the titratable base secretion of nonsmokers and acid clearance times that were 50% longer than those of nonsmokers. These effects were presumably long-lasting effects of cigarette smoking, although the duration of the effect was not defined. The observed differences in acid clearance are most likely the result of diminished salivary base secretion, since good correlation existed between these parameters.     

Effect of cigarette smoking on levels of bioavailable testosterone in healthy men

The effect of smoking on androgen levels is important given the recent interest in the link between low levels of androgens and the development of cardiovascular disease. Numerous studies examining the effects of cigarette smoking on the levels of total and free testosterone have reported conflicting findings, but there has been no accurate assessment of the effects of cigarette smoking on the levels of bioavailable testosterone [not bound to sex hormone-binding globulin (SHBG)]. We attempted to determine whether smoking affects the level of bioavailable testosterone. We undertook a case-control study of 25 healthy male smokers and 25 healthy never-smokers, matched by age and body mass index. Early morning levels of total, free and bioavailable testosterone, 17beta-oestradiol, SHBG and cotinine were determined and compared between the two groups. Levels of total (18.5+/-4.6 nM versus 15.1+/-4.9 nM, P=0.01) and free testosterone (462+/-91 pM versus 402+/-93 pM, P=0.03) were found to be higher in smokers compared with non-smokers respectively, as was SHBG (34.1+/-12.8 versus 28.1+/-9.0 nM, P=0.06). There were no significant differences in the levels of bioavailable testosterone (3.78+/-1.59 versus 3.51+/-1.26 nM, P=0.49) or 17beta-oestradiol (44.5+/-11.4 versus 42.3+/-11.5 pM, P=0.50) between smokers and non-smokers respectively. These data suggest that cigarette smoking has no significant effect on the biologically active fraction of testosterone, but may influence the levels of total and free testosterone through changes in the levels of SHBG.     

The effect of HIV/AIDS disease progression on spirituality and self-transcendence in a multicultural population.

This study examined the relationship of sociodemographic and clinical factors with spirituality and self-transcendence in people with HIV/AIDS. It involved 420 HIV/AIDS patients from an HIV clinic who were predominantly Hispanic (79%) and male (82%), with a mean age of 39 years. Subjects completed spirituality, self-transcendence, health status, and depression scales. Medical charts were reviewed to obtain demographics, current therapies, depression diagnosis, CD4 cells (sometimes called T-cells), and viral load levels. Self-transcendence was related to levels of energy (p < .05) and acculturation (p < .05). Spirituality was related to levels of energy (p < .001) and pain (p < .02). Neither disease progression nor severity was related to self-transcendence or spirituality. The findings suggest the concept of self-transcendence may not be culturally meaningful to Hispanic patients. The development of valid and reliable tools specific for this population is important for future research.     

The effect of bupropion sustained-release on cigarette craving after smoking cessation

BACKGROUND: Most (>50%) smokers who attempt to stop smoking relapse within the first year of abstinence. The effect of continued use of pharmacotherapy for smoking cessation on relapse rates is unknown. Bupropion sustained-release (SR) is the first non-nicotine-based therapy that is effective for achieving abstinence from smoking. OBJECTIVE: This analysis explored the factors involved in relapse to smoking in patients who had successfully stopped smoking using bupropion SR. These patients were participants in a double-blind, placebo-controlled trial of bupropion SR for the prevention of relapse to smoking. METHODS: Participants who had stopped smoking with 7 weeks of open-label bupropion SR were randomly assigned to receive double-blind treatment with either bupropion SR or placebo for 45 weeks. The primary efficacy outcome of the main study was the rate of relapse to smoking. The analyses presented here examine the levels of reported cigarette craving and, in those participants who returned to smoking, the reasons associated with relapse, using patient-completed questionnaires. RESULTS: Craving was cited most frequently as a factor contributing to relapse in those participants receiving placebo (cited by 49.2% of relapsers) but significantly less frequently by participants receiving bupropion SR (cited by 22.4% of relapsers) (P < 0.05). Results from patients' diaries showed no differences between bupropion SR and placebo in terms of "craving in the past 24 hours" but significantly lower scores for "craving right now" for bupropion SR at weeks 11 and 12 (P < 0.05). Results at scheduled visits showed that "craving in the past 24 hours" was significantly less with bupropion SR compared with placebo at weeks 12, 20, and 48, and "craving right now" was significantly less with bupropion SR compared with placebo at weeks 12, 16, 20, 24, 48, and 52 (P < 0.05). CONCLUSIONS: Craving continues to be a significant concern for individuals even after they have successfully stopped smoking. Bupropion SR appears to reduce reported cravings, which may contribute to the overall reduction in the rate of relapse observed with this pharmacotherapy.     

The effect of G-CSF on lymphocyte subsets and CD34+ cells in allogeneic stem cell transplantation.

The effect of granulocyte colony-stimulating factor (G-CSF) on peripheral blood lymphocytes (PBL) and CD34+ cell frequency in the apheresis product has been determined in 25 healthy stem cell donors. Peripheral blood mononuclear cells (PBMNC) were collected after five days of G-CSF 10 microg/kg/day s.c., which was well tolerated. The median number of leukocytes increased eight-fold over that of pretreatment levels. Collection of PBMNC lasted a median of two (range, 1-3) days. The mean mononuclear cell (MNC) count and total lymphocyte percentage were 6.69 x 10(8)/kg and 59.08%, respectively, and the frequency of CD34+ cell expression was 2.1% in the apheresis product. The frequency of CD3+, CD4+, CD25+, NK and CD122+ cell expressions in mobilized PBMNC and PBL showed no significant difference. However, the frequency of CD8+, CD8+28+, CD3+DR+, CD19+, CD20+ and CD22+ B cells expression in the apheresis product increased significantly compared to steady-state PBL. In contrast, the frequency of the CD11 a+ and CD8+38+ cell expressions in the apheresis product was decreased compared to the steady-state PBL. The mean yield of CD34+ and CD3+ cells were 13.6 x 10(6) and 2.69 x 10(8)/kg of recipient body weight (RBW), respectively. Following allograft all patients engrafted with >0.5 x 10(9)/l neutrophil and < or = 20 x 10(9)/l platelets on a median of day 13 and 12, respectively. Nine patients had grade II-IV acute GVHD and chronic GVHD occurred in eight patients. Four patients died due to transplant-related complications. There was one late engraftment failure which occurred on the fifth month. Thirteen patients are still alive. In conclusion, these results indicate that administration of G-CSF at 10 microg/kg/day in normal donors alters the lymphocyte subsets and there are significant differences in the lymphocyte contents of the recipients before apheresis and in apheresis product.     

Selected AIDS beliefs, behaviors and informational needs of homosexual/bisexual men with AIDS or ARC

Due to the current absence of curative therapies, patients with AIDS or ARC (AIDS-Related Complex) rely on information to provide them with a sense of control over their lives [Institute of Medicine, National Academy of Sciences, Confronting AIDS: Directions for Public Health, Health Care and Research (1986)]. The purpose of this study was to describe AIDS beliefs, behaviors and informational needs of patients with AIDS or AIDS-related complex 7 years into the epidemic. Data were collected once using a modified version of the AIDS Beliefs and Behaviors Questionnaire (ABBQ) developed by McKusick et al. [Am. J. Public Hlth. 75, 493-496 (1985)] and Moran et al. [Oncol. Nurs. Forum (1988)]. Study results showed that 90% of outpatients (N = 30) at an internationally recognized AIDS medical center wanted more information about building their immune systems. Surprisingly few patients (10%) wanted explicit information about safe sexual behaviors, although 4 years into the epidemic, this information was a central concern [Moran, Unpublished Masters thesis (1986)]. Results suggests that nurses need to take a more active role in monitoring and addressing patients' changing informational needs.     

吸烟对大鼠尿液中若干促石、抑石成分的影响研究

目的：了解吸烟对Wistar大鼠尿液生化指标的影响。方法：健康雄性Wistar大鼠168只，分成吸烟5支/d组、吸烟10支/d组和空白对照组，均饮用超纯净水，观察第0、10、20、30、40、50、60天时，各组大鼠尿草酸、枸橼酸、钙、钠水平。结果：随吸烟时间的延长，大鼠尿枸橼酸水平逐渐降低。结论：吸烟能够降低成石抑制物的排泄水平。     

Obstructive sleep apnoea, cigarette smoking and serum testosterone levels in a male sleep clinic cohort

This study evaluated the impact of obstructive sleep apnoea (OSA) and smoking on total serum testosterone levels in 96 men (mean age 43.3 years; range 25 - 60 years) attending a sleep clinic. Fifty-five men (57.3%) had OSA, defined as an apnoea-hypopnoea index of > or = 15 events/h, recorded during overnight polysomnography, and 42 (43.8%) were current smokers. Mean serum total testosterone levels were significantly lower in OSA subjects (3.4 ng/ml) than in non-OSA subjects (3.9 ng/ml), whereas no significant difference was observed between current smokers and nonsmokers. In a multiple linear regression analysis, serum testosterone was negatively correlated with body mass index and the apnoea-hypopnoea index, but not with age and pack-years of smoking. Our results support previous observations regarding testosterone levels in men with OSA, but, contrary to some earlier reports, there was no positive relationship between smoking and total testosterone in the present cohort.     

Maternal cigarette smoking, breast-feeding, and respiratory tract infections in infancy. A population-based cohort study.

This population-based study comprised 192 mothers and their infants; 58 mothers were smokers and 134 non-smokers. At the 18-month infant check-up at the child health clinic, mothers were questioned about the length of the breast-feeding period, both exclusively breast-feeding and overall breast-feeding time. The numbers of antibiotic-treated respiratory tract infections (RTIs) during the first year of life were noted during a scrutiny of records at the district physician's surgery and child health clinic of the Health Centre, and at the paediatric and ENT departments of the Central Hospital. We were unable to find any connection between the duration of breast-feeding and the number of antibiotic-treated RTIs in the infants. This applied to both exclusively breast-feeding period and overall breast-feeding period. Further, it was shown that infants of smokers were affected by RTIs more often than those of non-smokers, the incidence figures being 1.16 vs. 0.76 antibiotic courses per infant and year, respectively. Moreover, infants of smokers were breast-fed for a shorter period than those of non-smokers, the mean values being 3.3 vs. 4.3 months, respectively, for the period of exclusively breast-feeding, and 5.0 vs. 7.2 months, respectively, for the overall breast-feeding period.     

The health consequences of cigarette smoking. Pulmonary diseases.

Cigarette smoking has significant detrimental effects on both the structure and function of the lung; it is the single most important risk factor for the development of COPD. Uncertainty remains concerning the mechanisms by which smokers develop obstructive lung disease. It is speculated, however, that an imbalance between proteolytic and antiproteolytic forces in the lung or an increase in heightened airways responsiveness is responsible. Population-based studies have documented lower levels of FEV1, accelerated loss of ventilatory function, and increased respiratory symptoms and infections among smokers compared with nonsmokers. Data from both prospective and retrospective studies have consistently shown increased mortality from COPD, pneumonia, and influenza among cigarette smokers compared with nonsmokers.     

Functional T lymphocyte immune deficiency in a population of homosexual men who do not exhibit symptoms of acquired immune deficiency syndrome.

To determine whether healthy homosexual men are immunologically impaired, peripheral blood leukocytes (PBL) from 20 male homosexuals were compared prospectively with PBL from 14 age-matched male heterosexual donors with respect to: (a) the capacity of their PBL to generate functional T cell immune responses in vitro; and (b) the content of total T cells and T cell subsets in their peripheral blood. The homosexual donors studied indicated moderate sexual life styles in that all but one of the donors had less than five current sexual partners. The percentages of OKT3+, OKT4+, and OKT8+ T cells were similar to those of heterosexual controls. T cell function was assessed by measuring cytotoxic T cell responses to influenza virus and to allogeneic cells. Approximately one-third of the homosexual donors consistently exhibited weak cytotoxic T lymphocyte (CTL) responses to influenza virus, whereas all of the heterosexual donors generated strong CTL responses to influenza. There was no correlation between the strength of CTL responsiveness to influenza virus and the strength of CTL responses to allogeneic cells. These results suggest that the influenza-specific CTL response may be a sensitive indicator of immunologic defects in asymptomatic homosexuals. If acquired immune deficiency syndrome results from an infectious agent, it remains to be seen if such immunosuppression predisposes to the infection, or if it reflects early consequences of infection.     

The effects of cigarette smoking on male fertility

Cigarette smoking, one of the main causes of preventable morbidity and mortality, has a multitude of well-known side effects. The relationship between cigarette smoking and infertility has been studied for decades; however, large-scale, population-wide prospective studies are lacking. The majority of the current literature is in the form of retrospective studies focused on the effects of smoking on semen analyses. This article discusses the results of these studies and reviews the postulated mechanisms. The effects of smoking on assisted reproduction and in vitro fertilization outcomes are noted. The consequences of smoking while pregnant on future fertility as well as the outcomes of second-hand smoke are analyzed. The current evidence suggests that men should be advised to abstain from smoking in order to improve reproductive outcomes.     

Effects of intravenous cocaine and cigarette smoking on luteinizing hormone,testosterone, and prolactin in men

Cocaine and nicotine have a number of similar behavioral and neurobiological effects. This study compared the acute effects of cocaine and cigarette smoking on luteinizing hormone (LH), testosterone (T), and prolactin. Twenty-four men who met American Psychiatric Association Diagnostic and Statistical Manual criteria for cocaine abuse or nicotine dependence were given intravenous cocaine (0.4 mg/kg) or placebo-cocaine, or smoked a low or high nicotine cigarette under controlled conditions. Placebo-cocaine or low nicotine cigarette smoking did not change LH, T, or prolactin. Peak plasma levels of 254 +/- 18 ng cocaine/ml and 22.6 +/- 3.4 ng nicotine/ml were measured at 8 and 14 min, respectively. LH increased significantly after both i.v. cocaine and high nicotine cigarette smoking (P < 0.01). These LH increases were significantly correlated with increases in cocaine and nicotine plasma levels (P < 0.001-0.003), and high nicotine cigarette smoking stimulated significantly greater increases in LH release than i.v. cocaine (P < 0.05). Testosterone levels did not change significantly after either cocaine or after high nicotine cigarette smoking. After i.v. cocaine, prolactin decreased significantly and remained below baseline levels throughout the sampling period (P < 0.05-0.01). After high nicotine cigarette smoking, prolactin increased to hyperpro-lactinemic levels within 6 min and remained significantly above baseline levels for 42 min (P < 0.05-0.03). The rapid increases in LH and reports of subjective "high" after both i.v. cocaine and high nicotine cigarette smoking illustrate the similarities between these drugs and suggest a possible contribution of LH to their abuse-related effects.     

Immunoregulatory subsets of the T helper and T suppressor cell populations in homosexual men with chronic unexplained lymphadenopathy

Unexplained, generalized lymphadenopathy in homosexual men, which can be a prodrome to the acquired immunodeficiency syndrome, is associated with impaired cell-mediated immunity, a low ratio of T helper-inducer to T suppressor-cytotoxic cells (defined by the T4 and T8 monoclonal antibodies), and hypergammaglobulinemia. We performed double-marker studies on T cells by using a panel of monoclonal antibodies (Ia, T17, TQ1, and Leu-8), which reportedly detect activation or functional subsets of the T4 and T8 T cell populations. The T4:TQ1- or T4:Leu-8- subset, which is the major helper subset for B cell responses, is normally represented in lymphadenopathy patients. A depression in the reciprocal subset, T4:TQ1+ or T4:Leu-8+, accounts for the T4 T cell defect. Similarly, the TQ1 and Leu-8 markers delineate the abnormality of T8 T cells: the T8:TQ1- or T8:Leu-8- subset is elevated, whereas the T8:TQ1+ or T8:Leu-8+ subset is normally represented. We found no evidence of excessive activation of T4 T cells by using the T17 or Ia monoclonal antibodies. We did find an overall increase in Ia-positive T cells; however, this was due to increased T8:Ia+ cells. In functional studies, immunoglobulin production induced by pokeweed was subnormal. Most lymphadenopathy patients had normal T helper cell function when combined with normal B cells. The dampened pokeweed responses could be partially explained by depression of the T4:TQ1+ (or T4:Leu-8+) subset (which has minor help-associated function) and/or greater than expected suppression. However, subnormal pokeweed responses could not be totally explained by immunoregulatory T cell abnormalities because we also found an intrinsic defect in the B cell responses of lymphadenopathy patients.     

乌司他丁对重度脓毒症患者淋巴细胞亚群的影响

目的探讨乌司他丁对重度脓毒症患者淋巴细胞计数及各亚群比例变化的影响。方法观察重度脓毒症患者的APECHEⅡ评分及SOEA评分,以及淋巴细胞计数和各亚群细胞比例的变化情况。结果经治疗患者较高的APECHEⅡ评分及SOEA评分水平降低,淋巴细胞计数回升,比例改善,以乌司他丁组改善更明显。革兰氏阳性细菌感染患者表现出更明显而持久的淋巴细胞亚群改变。结论重度脓毒症患者淋巴细胞计数下降且各亚群比例异常,乌司他丁有助于纠正该异常。     

Effect of cigarette smoking on postural muscle tremor.

In a study of the effect of smoking on postural reflexes--specifically postural muscle tremor--in man, amplitude of postural muscle tremor, when tested in 30 subjects, was increased to a significant degree immediately following the smoking of one cigarette. Tremor amplitude continued to be significantly increased one-half hour after smoking ceased. There was no significant change in the frequency of tremor. Measurement was made using a piezo crystal accelerometer attached to the third fingers of both hands. Effects were recorded with a Sanborn Twin Viso Recorder. The findings, that smoking does affect postural reflexes, have implications for the formulation of nursing therapies, particularly in areas such as rehabilitation nursing, where the use of postural reflexes is the primary mode of intervention.     

Racial differences in serum immunoglobulin levels: Relationship to cigarette smoking,t-cell subsets,and soluble interleukin-2 receptors

To investigate the influence of race, cigarette smoking, and immunologic parameters on serum immunoglobulins, we analyzed serum IgG, IgA, and IgM levels in 455 healthy adults. The study population ranged in age from 20 to 69 years, including 282 whites and 173 blacks, 181 never-smokers, 93 ex-smokers, and 181 current smokers. Race and smoking were independently associated with alterations in serum IgG levels. Blacks had significantly higher IgG levels than whites (1,587 vs. 1,209 mg/dl; P<0.001), and never smokers had significantly higher levels than current smokers (1,426 vs. 1,287 vs. mg/dl; P<0.001). IgA and IgM levels were unrelated to race or smoking. Serum IgG was also found to be directly related to the proportion of HLA-DR⁺ cells and the level of soluble interleukin-2 receptors (sIL-2R) and inversely related to the proportion of CD4⁺ cells. Investigation of this racial heterogeneity may provide insights into the pathogenesis of immunologic diseases that exhibit unexplained racial variation.©1995 wiley-Liss, inc.