Leaving work to smoke

Work-place smoking bans have not only reduced work-day cigarette consumption but also been associated with going outside to smoke during working hours. We examined the extent of "exiled smoking", estimated how much work-day cigarette consumption can be attributed to it, and examined proximal predictors of both these two variables. Some 794 smokers from 42 medium-sized work-places were surveyed as the baseline for an intervention study. A self-completed questionnaire assessed smoking behaviour on work and non-working days, leaving work to smoke, and beliefs and opinions about smoking and smoking bans. Multiple regressions were used to examine predictors of leaving work to smoke, and of the amount smoked when doing so. Smokers reported consuming an average of 5.4 cigarettes during work breaks, 3.5 of which were associated with deliberately seeking opportunities to smoke; 39% reported leaving work to smoke one or more times per day during non-break periods. Indices of addiction were significant predictors of both leaving work to smoke and of cigarette consumption while doing so. Leaving work to smoke is in part an activity of addicted smokers, presumably to maintain blood nicotine levels. There is the potential to further reduce rates of cigarette consumption associated with work-place smoking bans if this "exiled smoking" can be reduced. This may be easier to achieve in light smokers.     

Tobacco health warnings and smoking-related cognitions and behaviours

Aims. To explore whether the introduction onto cigarette packs of new larger, more prominent health warnings in black on white would lead to an increase in: noticing warnings, thoughts about the effects of smoking, and consequent behaviours of not smoking a planned cigarette and/or prematurely stubbing out one already lit. In addition evidence was sought linking these effect to smoking cessation. Design. Two national cross-sectional surveys of broadly representative samples of smokers: one about 2 weeks before the mandated introduction date of the warnings, and a follow-up 6 months later, pan-way through implementation. A longitudinal subsample of smokers from the initial baseline survey was resurveyed at follow-up. Setting. In Australia, new health warnings and strengthened contents labelling of cigarette packets were mandated for cigarettes manufactured from 1 January 1995. Participants. Broadly representative samples of Australian smokers: 510 at baseline, and 512 at follow-up. Two hundred and forty-three of the baseline sample were also resurveyed. Measurements. Self-report on effects of warnings and smoking cessation activity. Findings. In the cross-sectional sample at follow-Up, 66% of smokers reported at least sometimes noticing the health warnings when taking out a cigarette (compared with 37% at baseline), and 14% reported they had refrained from smoking on at least one occasion as a result (compared with 7% at baseline). Not smoking as a result of noticing the (old) warnings at baseline was predictive of quitting at follow-up. Frequency of stubbing out cigarettes before they were finished as a result of thinking about smoking-related harm was not affected by the new warnings, but was predictive of making quit attempts. Conclusions. The new health warnings were more potent at stimulating both thoughts about negative effects of smoking and the appropriate consequent action of not smoking the planned cigarette. This is important as spontaneous rejection of cigarettes predicted subsequent cessation.     

Cardiovascular Evaluation in Turner Syndrome: Utility of MR Imaging

Forty patients with karyotypidy proven Turner syndrome were prospectively studied using magnetic resonance imaging (MRI) and echocardiography in order to determine the frequency of cardiovascular anomalies and to assess the utility of both imaging modalities as methods for cardiovascular evaluation in Turner syndrome. Cardiovascular anomalies were found in 45% of patients A high absolute prevalence of bicuspid aortic valve (175%) and aortic coarctation (12.5%) were observed relative to comparable series. Of clinically significant abnormalities, three of five aortic coarctations and four of five ascending aortic dilatations were solely MRI detected and not evident at echocardiographic examination. MRI is thus seen as a valuable adjunct to echocardiography in the cardiovascular evaluation of Turner syndrome patients. The usefulness of MIU primarily relates to its ability to provide excellent visualisation of the entire thoracic aorta where a large proportion of clinically significant anomalies Occur in Turner syndrome.     

Noncontact Mapping Guided Ablation of Right Ventricular Outflow Tract Ectopy in a Patient with Interruption of the Inferior Vena Cava and Azygos Continuation

A 58‐year‐old woman with symptomatic multiple monomorphic premature ventricular beats of a right ventricular outflow tract origin was referred for ablation. An inferior vena cava interruption with azygos continuation was discovered during catheter placement. This case describes positioning of the noncontact mapping array and successful radiofrequency ablation in this challenging anatomy. (PACE 2013; 36:e129–e131)     

Trypanosoma cruzi infection in mice enhances the membrane expression of low-affinity Fc receptors for IgG and the release of their soluble forms

The membrane expression of low-affinity Fc receptors for IgG (FcγRII/III) on cells and the number of FcγRII/III(+) cells were studied by flow cytometry, using the 2-4G2 MoAb, in mice infected by Trypanosoma cruzi. Cells from spleen, mesenteric lymph nodes and peritoneum were collected on days 10, 20, 30 and 40 post infection (p.i.). The in vivo serum level of soluble FcγRII/III, as well as its in vitro release by cells from infected mice were studied. Parasitaemia and IgG1, IgG2a and IgG2b T. cruzi-specific antibody titres were also recorded. Both the expression of FcγR on cell membrane and the absolute number of FcγR(+) cells increased in spleen and in mesenteric lymph nodes, but not in peritoneum. The modifications in spleen occurred in the early and late parasitaemic phase of infection, i.e., before and after detection of T. cruzi-specific antibodies (from day 10 to 40 p.i.). In mesenteric lymph nodes, the variations were observed only in the early acute infection, when antibodies were not yet detectable at significant levels (on days 10 and 20 p.i.). Higher levels of soluble FcγR were detected in sera and in culture supernatants of spleen and lymph node cells from day 20 to 40 p.i. These results show that T. cruzi infection in mice upregulates the expression and the release of FcγRII/III, in the acute phase of infection, before as well as after the rise of antibody response.     

The path to Australia''s tobacco health warnings

Australia introduced new health warnings and contents labelling on cigarettes and other tobacco products from January 1995. The changes were based on recommendations emerging from research commissioned for that purpose. The research demonstrated the need for changes, that changes could increase the noticeability of the warnings and contribute to an increase in relevant knowledge, and that the changes were acceptable to the public. The tobacco industry fought the changes and some modifications resulted, but new stronger warnings with elaborations on the back of the pack, an information number to call and elaborated contents labelling have been implemented.