Changes in Smoking Prevalence and Number of Cigarettes Smoked Per Day Following the Implementation of a Comprehensive Tobacco Control Plan in New York City

The New York City (NYC) Health Department has implemented a comprehensive tobacco control plan since 2002, and there was a 27% decline in adult smoking prevalence in NYC from 2002 to 2008. There are conflicting reports in the literature on whether residual smoker populations have a larger or smaller share of “hardcore” smokers. Changes in daily consumption and daily and nondaily smoking prevalence, common components used to define hardcore smokers, were evaluated in the context of the smoking prevalence decline. Using the NYC Community Health Survey, an annual random digit dial, cross-sectional survey that samples approximately 10,000 adults, the prevalence of current heavy daily, light daily, and nondaily smokers among NYC adults was compared between 2002 and 2008. A five-level categorical cigarettes per day (CPD) variable was also used to compare the population of smokers between the 2 years. From 2002 to 2008, significant declines were seen in the prevalence of daily smoking, heavy daily smoking, and nondaily smoking. Among daily smokers, there is also evidence of population declines in all but the lowest smoking category (one to five CPD). The mean CPD among daily smokers declined significantly, from 14.6 to 12.5. After an overall decline in smoking since 2002, the remaining smokers may be less nicotine dependent, based on changes in daily consumption and daily and nondaily smoking prevalence. These findings suggest the need to increase media and cessation efforts targeted towards lighter smokers.     

Systemic inflammatory diseases and silicone breast prostheses: report of a case of adult still disease and review of the literature

There has been a debate about the possibility of a link between silicone breast implants and the onset of systemic connective tissue diseases (eg, scleroderma, systemic lupus erythematosus, rheumatoid arthritis) and other inflammatory pathologies, such as silicone implant associated syndrome and adult Still disease. We report a case of adult Still disease in a patient with a silicone gel breast implant. The disease regressed with steroidal treatment, and the patient is now no longer steroid-dependent, although the implant is still in place.     

Effect of HAART on SEN virus infected HIV positive patients

Since it has been demonstrated that concomitant infections could influence the outcome of antiviral treatment, we investigated whether the presence of SENV infection may interfere with highly active antiretroviral therapy (HAART) in HIV+ coinfected patients. In spite of persistent fluctuations in SENV-A positivity we could not find any correlation between SENV-DNA and the immunological and virologic parameters found in the patients, suggesting SENV has no apparent clinical relevance during highly active antiretroviral therapy.     

Cushing’s syndrome as a cause of secondary obesity and metabolic syndrome: a case report

We describe the case of a woman affected by morbid obesity associated to type 2 diabetes mellitus (T2DM), hyperlipidaemia and hypertension, configuring a picture of metabolic syndrome (MS). Hormonal investigations revealed that her MS was secondary to the presence of a cortisol-producing left adrenal adenoma. After monolateral adrenalectomy, the MS subsided. Excessive and sustained hypercortisolism gives rise to the entire spectrum of MS. As some clinical manifestations of MS and Cushing’s syndrome (CS) overlap, it is important to consider CS as a possible cause of secondary MS, in order to avoid a delay in diagnosis and proper treatment, which exposes the patient to an increased risk of morbidity and mortality.