Lens opacity in patients with hypercholesterolemia and ischaemic heart disease

Lens opacity studies were performed using an electronic Lens Opacity Meter (Interzeag Opacity Lensmeter 701) in a population (n = 321) with ischaemic heart disease. These patients are participating in a trial targetting at the reduction of mortality and incidence of myocardial infarction using a cholesterol-lowering drug, simvastatin. A separate study to evaluate the reliability of the method showed good reproducibility. Repeated measurements after a short time-interval (2–10 days) gave statistically lower opacity values either due to a change in lens transparency or perhaps a change in pigment and cell dispersion in the acqueous caused by repeated mydriasis. Lens opacity values showed a highly significant positive correlation to age. Serum cholesterol, systolic blood pressure and smoking habits showed no significant correlations to the levels of lens opacity when adjustments for age were made.Abbreviations HMG-CoA hydroxy-methylglutarylcoenzyme A - 4S Scandinavian Simvastatin Survival Study - LOM lens opacity meter     

4409名学生心理健康状况及家庭环境与吸烟行为分析

目的:探讨中学生心理行为特征和心理健康状况及家庭心理环境与中学生吸烟行为的关系.方法:以苏州市4409名初中、高中、职业中学的学生为对象,采用SCL-90、家庭环境量表和自编问题进行问卷调查.结果:反叛性、冒险性强,倾向早熟、毅力差、顺从敏感性高是吸烟的危险因素,而情感调节性和认同敏感性与吸烟无关;吸烟组与对照组SCL-90在总分、阳性项目数、躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性方面的评分均高于对照组,且有统计学意义(P＜0.01);吸烟组在FES-CV中的亲密度、情感表达、知识性、道德宗教观、组织性平均分明显低于对照组(P＜0.01),而在FES-CV的矛盾性的平均分则明显高于对照组(P＜0.01).结论:中学生行为的反叛性、冒险性、早熟性、毅力性和不良心理健康水平是中学生吸烟的危险因素;同时不良家庭关系也是中学生吸烟的危险因素,一个亲密、融洽的家庭环境可能会减少中学生吸烟,而一个矛盾的家庭则可能会增加中学生吸烟.     

Relationship between maternal glycaemia and birth weight in glucose-tolerant women from different ethnic groups in New Zealand.

AIM: The aim of this study was to compare the population attributable fraction(PAF) for a large baby (> or =4 kg) due to glycaemia, weight and smoking in glucose-tolerant women from different ethnic groups. METHODS: A retrospective review of screening for gestational diabetes (GDM)and associated birth weight was undertaken in New Zealand European (n= 529), Maori (n= 540) and Pacific (n= 916) women. The proportion with a large baby was compared by 1-h post 50-g glucose challenge test tertile and maternal weight tertile. RESULTS: Large babies were more common from Pacific and European than Maori women (24.3%, 18.8%, 8.9%, respectively; P<0.001). Birth weight increased significantly with increasing glucose among Pacific women (P<0.001) even after adjusting for maternal weight and other confounders. The risk of having a large baby was 2.56 (1.82-3.60)-fold greater in women in the highest maternal weight tertile (> or =84 kg), with a significantly greater PAF in Pacific women(27.2%, 12.9%, 16.4%, respectively; P<0.001). The odds ratio (OR) of having a large baby increased with even mildly elevated maternal 1-h glucose concentrations [OR for 5.6-6.2 mmol/l: 1.54 (1.11-2.14); for > or =6.3 mmol/l: 2.06 (1.50-2.82)], with no ethnic differences in PAF (11.1-11.8%, 16.7-18.7%, respectively). Smoking and being Maori were associated with smaller babies. CONCLUSIONS: Increased maternal weight and glycaemia are associated with a greater proportion of large babies among glucose-tolerant women. Growth of Pacific babies may be more sensitive to a higher maternal glucose when the mother is obese.     

Cigarette smoking and acne in adolescents: results from a cross-sectional study

BACKGROUND: Previous studies on the association between smoking and acne have reported conflicting results. OBJECTIVE: To investigate the association between smoking and acne among school-going adolescents. METHODS: A cross-sectional study was conducted. Smoking was defined as smoking > 3 cigarettes daily for 6 months or more. We defined acne as having > 20 retentional and/or inflammatory facial acne lesions. Multivariate (proportional) logistic regression models were used to adjust for confounding variables. RESULTS: Of the 594 participants, 36.2% had acne. Acne sufferers were less likely to smoke (18.1 vs. 23.7%, P = 0.10). In girls, smoking was significantly associated with lower prevalence of acne (adjusted OR = 0.41, 95% CI = 0.13, 0.82). Smoking, daily cigarette consumption and duration of smoking appeared to be protective in the development of inflammatory acne in girls. No significant associations between acne and smoking variables were detected among boys. Limitations: although this study suggests a significant negative association between smoking and inflammatory acne in girls, it does not prove causality. This association did show a trend for linear relationship. Because of the unexpected differences between boys and girls, sample size may have affected our results. CONCLUSION: The anti-inflammatory effects of smoking may inhibit the development of papulopustular acne in girls more than in boys. However, smoking should not be considered a therapeutic option for acne. Additional studies that consider possible differences across age, gender and type of acne are needed to clarify the association between smoking and acne.     

Selection and the effect of prenatal smoking

There is a debate about the extent to which the effect of prenatal smoking on infant health outcomes is causal. Poor outcomes could be attributable to mother characteristics, which are correlated with smoking. I examine the importance of selection on the effect of prenatal smoking by using three British cohorts where the mothers' knowledge about the harms of prenatal smoking varied substantially. I find that the effect of smoking on the probability of a low birth weight birth conditional on gestation is slightly more than twice as large in 2000 compared with 1958, implying that selection could explain as much as 50% of the current association between smoking and birth outcomes. Copyright © 2009 John Wiley & Sons, Ltd.     

Association of passive smoking with increased coronary heart disease risk is not explained by elevation of leucocyte count

The increased risk of coronary heart disease in cigarette smokersmay be due at least partly to an elevation of the leucocytecount Chronic passive smoking has also been found to be associatedwith an increased risk of coronary heart disease, but its effecton the leucocyte count has not been reported. In this study250 male factory employees aged 20–64 years were interviewedon smoking behaviour and exposure to environmental tobacco smoke,and blood counts were determined. Urinary cotinine was measureby radio-immunoassay and corrected for urinary creatinine concentrations.Mean leucocyte count was significantly higher among smokerscompared with non-smokers (8,666 compared to 6, 900; p<0.001).On the basis of smoking history, passive smokers had leucocytecounts similar to non-smokers. These findings were confirmedwhen leucocyte counts were compared with urine cotinine to creatinineratios. The association of haematocrlt and haemoglobin withsmoking was similar to that of leucocyte count These findingssuggest that any association of passive smoking with coronaryheart disease is not through an elevation of leucocyte count.     

Recurrent wheezing in relation to environmental risk factors in infancy

Clinical course and environmental factors were recorded in a prospective study of 276 unselected infants followed from birth to the age of 18 months. The study was performed with a questionnaire at the age of 6 and 12 months and a physical examination at 18 months. Fifty-nine (21%) of the children had greater than or equal to 2 episodes of wheezing before they were 18 months old. A total of 58 (21%) of the children belonged to the lowest social class V, 182 (66%) were daily exposed to passive tobacco smoking at home and/or in daycare, 164 (59%) were breastfed greater than or equal to 3 months, 192 (70%) were in daycare, 62 (22%) lived in flats and 167 (61%) were in daily contact with furred pets at home and/or in daycare. In social class V a preponderance of children were exposed to passive tobacco smoking, a majority were living in flats and a minority were breastfed greater than or equal to 3 months. Linear logistic regression analysis was used for the purpose of assessing the causal effect of environmental risk factors on the risk of recurrent episodes of wheezing before the age of 18 months. The study demonstrated that male sex and daily exposure to passive tobacco smoking were significant risk factors with estimated odds ratios 1.9 and 2.4, respectively. Maternal tobacco smoking seemed to be associated with the highest risk. There was a tendency--though not significant--indicating that breastfeeding greater than or equal to 3 months had a protective effect.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of environmental and clinical factors on lung function and respiratory symptoms in adolescents with α1-antitrypsin deficiency

Individuals identified in the Swedish neonatal α₁-antitrypsin (AAT) screening study were followed prospectively from their first to their eighteenth year of life. The aim of this study was to analyse the effect of environmental factors, i.e. active and passive smoking, and of clinical factors on lung function and the occurrence of respiratory symptoms in AAT-deficient adolescents. The study group consisted of 88 protease inhibitor (Pi)ZZ and 40 PiSZ adolescents. Medical history including respiratory symptoms, and active and passive smoking were recorded at each follow-up up to the age of 18 y. Lung function tests were performed at the present check-up. At the age of 18 y, both forced expiratory volume in one second (FEV₁) and FEV₁/vital capacity (VC) were significantly lower in the smoking than in the non-smoking subgroup, and significantly more smokers than non-smokers reported the presence of phlegm. The mean FEV₁/VC ratio was lower for those presently exposed to parental smoking. Multiple linear regression analysis indicated that clinical liver disease in early life, active smoking and parental smoking were independent determinants of FEV₁/VC. The results suggest that marginal deviations in lung function and the symptom of phlegm among AAT-deficient adolescents occur characteristically early in the subgroup of smokers. Parental smoking may contribute to decreased lung function     

Perioperative respiratory events in smokers and nonsmokers undergoing general anaesthesia

Background: The prevalence of respiratory diseases in smokers and nonsmokers and the incidence of perioperative respiratory events (PREs) were investigated for patients undergoing general anaesthesia. The aim was to quantify well-known problems and to identify possible new associations between smoking and PREs.
Methods: From July 1992 to December 1994, risk factors, demographic data, and PREs were documented by an automatically readable anaesthetic record (ARAR). PREs were used as defined by the German Society of Anaesthesiology and Intensive Care.
Results: Of 26 961 subsequent anaesthesias in adults, 7122 (26.4%) were performed in smokers with a prevalence of chronic bronchitis of 23.3% (4.8% in nonsmokers). 1573 PREs occurred in 1397 (5.2%) of all anaesthetics. 459 events concerned intubation problems and problems in technical airway management. 1114 specific respiratory events (SPREs) like re-intubation, laryngospasm, bronchospasm, aspiration, hy-poventilation/hypoxaemia and others had a total incidence of 5.5% in smokers and 3.1% in nonsmokers. The relative risk (RR) of SPREs was 1.8 in all smokers, 2.3 in young (16–39 years) smokers, and 6.3 in obese young smokers. The RR of perioperative bronchospasm was 25.7 in young smokers with chronic bronchitis.
Conclusion: The impact of smoking on perioperative respiratory problems should make anaesthetists take this widespread preoperative condition seriously, particularly in young adults. The presented method of incident reporting (based on a national classification) could contribute to future research in anaesthetic epidemiology.     

Up-regulation of nicotinic acetylcholine receptors following chronic exposure of rats to mainstream cigarette smoke or α4β2 receptors to nicotine

Smokers are reported to have a higher density of central nicotinic acetylcholine receptors (nAChRs) that non-smokers at autopsy. Whether this increased receptor density is a response to smoking or a result of genetic variability is not known. While sub-chronic treatment of rats and mice with nicotine results in upregulation of central nAChRs, changes in receptor density in response to cigarette smoke have not been studied previously. In this study, male Sprague-Dawley rats were exposed nose-only for 13 weeks to mainstream cigarette smoke followed by assessment of [³H]nicotine binding in five brain regions of smoke- and sham-exposed animals. In smoke-exposed animals, there was a significant increase in nAChR density in the cortex, striatum, and cerebellum (35, 25, and 31% increases, respectively), while there was no significant change in receptor density in the thalamus and hippocampus. Smoke exposure did not alter markedly the affinity of the receptor for nicotine in these brain regions. Furthermore, up-regulation of nAChRs did not alter the biphasic binding properties by which nicotine binds to its receptor. There were no changes in the association (fast phase) or isomerization (slow phase) rate constants, and the percent contribution of slow and fast phase binding to nAChRs was not altered in the up-regulated receptor population compared with control. Similar results were observed following chronic nicotine exposure of cultured cortical cells from fetal rat brain or cells transfected with the α4β2 nAChR subtype. These results show that the up-regulation following smoke exposure in the rat is phenomenologically similar to that observed in vitro. These data provide preliminary evidence for a relationship between cigarette smoking and nAChR up-regulation in vivo and suggest that similar mechanisms of upregulation may underlie chronic smoke exposure of live animals and nicotine exposure of artificially expressed α4β2 receptors in vitro.