A case series of nicotine nasal spray in the treatment of tobacco dependence among patients with schizophrenia

A retrospective case series of 12 smokers with schizophrenia or schizoaffective disorder who had not successfully quit smoking with previous treatments for tobacco dependence were treated with nicotine nasal spray. All but one patient (92 percent) tolerated the nasal spray well, and nine (75 percent) used it at maximal doses for prolonged periods. After treatment five patients (42 percent) were abstinent from smoking for more than 90 days, and four patients (33 percent) substantially reduced the amount that they smoked. Ten patients (83 percent) used the spray in combination with other medications, and all received psychosocial support. Nicotine nasal spray was found to be well tolerated.     

The prevalence of overweight and obesity in British Columbian Aboriginal adults

Overweight and obesity among Aboriginal populations has been a growing challenge within Canada. This investigation aimed to identify the prevalence of overweight and obesity within British Columbian adult Aboriginal populations including both on and off reserve individuals through direct measurement. Further, this study stratified the variations in these rates according to age, gender and geographic region. Weight, height and waist circumference (WC) were measured via standardized procedures, and body mass index (BMI) was calculated. The mean body composition indicators were above recommended for men (BMI = 30.3 ± 5.6 kg m^?2; WC = 104.2 ± 14.7 cm) and women (BMI = 30.9 ± 7.2 kg m^?2; WC = 99.3 ± 17.1 cm), respectively. Rates of obesity for men and women were similar, 48.4% and 48.7%, respectively, and showed significant increases with age. Abdominal obesity (AO) was significantly greater among female participants, 69.0% compared with 52.7% in men, while both genders also demonstrated significant increases in AO with age. Both obesity and AO rates were found to be significantly greater in the Northern and Interior regions of the province in comparison to the Vancouver/Lower Mainland region. Alarmingly high rates of obesity and AO were observed in this population in men and women at every age and geographic region.     

The place of premedication in pediatric practice

Behind the multiple arguments for and against the use of premedication, sedative drugs in children is a noble principle that of minimizing psychological trauma related to anesthesia and surgery. However, several confounding factors make it very difficult to reach didactic evidence-based conclusions. One of the key confounding issues is that the nature of expectations and responses for both parent and child vary greatly in different environments around the world. Studies applicable to one culture and to one hospital system (albeit multicultural) may not apply elsewhere. Moreover, the study of hospital-related distress begins at the start of the patient's journey and ends long after hospital discharge; it cannot be focused completely on just the moment of anesthetic induction. Taking an example from actual practice experience, the trauma caused by the actual giving of a premedication to a child who absolutely does not want it and may struggle may not be recorded in a study but could form a significant component of overall effect and later psychological pathology. Clearly, attitudes by health professionals and parents to the practice of routine pediatric premedication, vary considerably, often provoking strong opinions. In this pro–con article we highlight two very different approaches to premedication. It is hoped that this helps the reader to critically re-evaluate a practice, which was universal historically and now in many centers is more selective.     

The effectiveness of community based physical activity interventions with Aboriginal peoples

Though historically rare, Aboriginal individuals continue to experience greater levels of cardiovascular disease than the general Canadian population. Increasing evidence indicates rising sedentary behaviors from the traditional healthy and active lifestyles of this population.

Objective

This investigation aimed to examine the health benefits of a community-based physical activity intervention for Aboriginal Canadians.

Methods

From 2007–2010, 273 participants from the province of British Columbia, Canada were recruited through 21 Aboriginal communities representing male and females of wide ranging ages and health statuses. Participants attended identical testing of body composition, blood pressure, total and high density lipoprotein cholesterols, and physical activity behavior pre-and post-training. Participants completed one of three self-selected 13 week interventions: walking (n = 149), walk/running (n = 86), or running (n = 27).

Results

Improvements in health measures were observed for both male and female participants of all age groups and all three training programs. Male and female participants' improvements included waist circumference: 2.7 cm and 2.2 cm, total cholesterol: 0.18 mmol/L and 0.12 mmol/L, and systolic blood pressure: 2.6 mm Hg and 1.5 mm Hg, respectively.

Conclusions

The self-selected intensities program was successful in improving health status and physical activity for Aboriginal adults of all ages, genders and activity programs.     

The integration of tobacco dependence treatment and tobacco-free standards into residential addictions treatment in New Jersey

New Jersey was the first state to implement a licensure standard for all residential addiction treatment programs to assess and treat tobacco dependence in the context of entirely tobacco-free facilities (including grounds). A program evaluation of the first year of the policy (2001–2002) assessed the impact on programs, clients, and staff. At 1-year follow-up, all 30 residential programs surveyed provided some tobacco dependence treatment and 50% had tobacco-free grounds. Eighty-five percent of the programs accepted the state's offer to provide free NRT, reaching more than 2,326 clients. Seventy-seven percent of all clients were smokers, and 65% of the smokers reported they wanted to stop or cut down tobacco use. Forty-one percent of the smokers reported that they did not use any tobacco during their entire residential stay. There was no increase in irregular discharges, or reduction in proportion of smokers among those entering residential treatment, compared with prior years. Licensure standards regulation can be an effective mechanism for increasing the quantity and quality of tobacco dependence treatment in residential addictions programs.     

Hypertonic saline reduces metalloproteinase expression in liver during pancreatitis

• 1 We recently demonstrated that hypertonic saline reduces inflammation and mortality in acute pancreatitis. The present study investigated the effects of hypertonic saline in metalloproteinase (MMP) regulation and pancreatitis‐associated hepatic injury.
• 2 Wistar rats were divided into four groups: (i) control, not subjected to insult or treatment; (ii) no treatment (NT), induction of pancreatitis (retrograde infusion of 2.5% sodium taurocholate (1.0 mL/kg)), but no further treatment; (iii) normal saline (NS), induction of pancreatitis and treatment with normal saline (0.9% NaCl, 34 mL/kg, i.v. bolus, 1 h after the induction of pancreatitis); and (iv) hypertonic saline (HS), induction of pancreatitis and treatment with hypertonic saline (7.5% NaCl, 4 mL/kg administered over a period of 5 min, 1 h after the induction of pancreatitis). In all four groups, 4, 12 and 24 h after the induction of pancreatitis, liver tissue samples were assayed to determine levels of MMP‐2, MMP‐9, 47 kDa heat shock protein (HSP47) and collagen (Type I and III).
• 3 Compared with the control group, MMP‐9 expression and activity was increased twofold in the NS and NT groups 4 and 12 h after the induction of pancreatitis, but remained at basal levels in the HS group. In contrast, MMP‐2 expression was increased twofold 12 h after the induction of pancreatitis only in the NS group, whereas the expression of HSP47 was increased 4 h after the induction of pancreatitis in the NS and NT groups. Greater extracellular matrix remodelling occurred in the NS and NT groups compared with the HS group, probably as a result of the hepatic wound‐healing response to repeated injury. However, the collagen content in hepatic tissue remained at basal levels in the HS group.
• 4 In conclusion, the results of the present study indicate that hypertonic saline is hepatoprotective and reduces hepatic remodelling, maintaining the integrity of the hepatic extracellular matrix during pancreatitis. Hypertonic saline‐mediated regulation of MMP expression may have clinical relevance in pancreatitis‐associated liver injury.

     

Allergic contact sensitization to the glycidyl ester of hexahydrophthalic acid in a cutting oil

Allergic contact dermatitis is reported in 5 machine operatives working with a cutting oil containing an epoxy compound used as a stabilizer. Positive patch test reactions to this compound were obtained in all 5 men and were negative in 25 controls.