Thalidomide-induced neuropathy and genetic differences in drug metabolism

A pharmacogenetic predisposition to thalidomide-induced neuropathy has been investigated. Differences of drug metabolism were examined in 16 patients with severe orogenital ulceration, who were treated with thalidomide (200 mg/day) for 0.3–5.0 years. Eight had evidence of early peripheral neuropathy according to nerve conduction studies. Rates of C-hydroxylation, N-acetylation, and conjugation reactions with sulphate, glucuronide and glycine, were tested with the probe compounds debrisoquine, sulphadimidine, paracetamol and aspirin, respectively. Urinary drug metabolites were analysed by high pressure liquid chromatography. Results were compared with 16 healthy age- and sex-matched volunteers.Of the patients 6.25% and 13.3% of the controls had a poor Debrisoquine Hydroxylator Ratio (DMR); none of the patients with neuropathy had a poor DMR as compared to 12.5% without neuropathy. Of the patients 40.0% and 35.7% of the controls were slow acetylators; 28.6% with neuropathy were slow acetylators as opposed to 50% without neuropathy. Similarly, there were no significant differences in rates of conjugation between groups. All unaffected patients were active smokers, whereas only two of those with neuropathy smoked. Cumulative dose or duration of therapy were unrelated to risk of neuropathy.In conclusion, changes of nerve conductivity are a frequent and unpredictable adverse effect of thalidomide (200 mg/day), although smoking may have a protective action against their development. Nerve conduction studies are required before and during treatment, irrespective of the prescribed dose.     

PSYCHOSOCIAL PROFILE OF PREGNANT ADOLESCENTS IN A LARGE AUSTRALIAN REGIONAL AREA

A psychosocial profile was developed of 122 pregnant adolescents attending a public hospital antenatal clinic in a large regional Australian area. Participants completed the Rosenberg Self-Esteem Scale and the Support Behaviours Inventory and were interviewed to obtain psychosocial and demographic information. Results revealed that those who were most likely to have either or a combination of poor self-esteem, lack of social support, be unemployed or smoke, were more likely to be living alone or with friends, not have a partner or have a partner for a shorter period, have a partner who was older, have previous children, have not planned their pregnancy and have less education. The degree of social support was significantly associated with self-esteem. Over half of the sample smoked, and over half were unemployed. These results underscore the importance of addressing psychosocial factors in the implementation of care for the pregnant adolescent.     

Relationship between Cigarette Dose and Perceived Risk of Lung Cancer

BACKGROUND: Most people are aware that smoking cigarettes increases the risk of ill health, in particular of lung cancer. The precise way in which they relate amount of exposure to smoke and level of health risk has not, however, been determined. METHODS: A convenience sample of 155 French adolescents and adults ages 15 to 75 rated the risk of "smoker's cancer"--the popular term for lung cancer--in 24 scenarios depicting eight levels of daily cigarette consumption of three concentrations of nicotine. The data were analyzed according to functional measurement methodology to ascertain the forms of the relationship between exposure and perceived risk. RESULTS: All subjects perceived that the risk of smoker's cancer increased as smoking increased. Yet at high levels of consumption, additional cigarettes were generally judged to result in decreasing increments of risk, regardless of the nicotine content of the cigarettes and the sex and smoking status of the participants. Adolescents, however, were more likely than adults to perceive a linear, rather than a negatively accelerated, relationship. CONCLUSIONS: The actual form of the relationship between the dose of cigarette smoke and risk of lung cancer is either linear or positively accelerated. Public health educators and physicians should be aware that, at least in France, many people, particularly adults, incorrectly perceive this relationship as negatively accelerated.     

Health education pamphlets about smoking—their benefit to smokers and non-smokers

The aim of this present study was to compare the use by smokers and non-smokers of pamphlets about smoking as delivered from different settings. The study was a nation-wide cross-sectional survey of 1924 randomly selected, Danish men and women, aged 14–77 y, who had answered a mailed questionnaire in 1994. Of these 71% also participated in a telephone interview enquiring about the use of health education material, smoking status and socio-demographic variables, 39% of readers of household-delivered anti-smoking pamphlets reported having gained information from them and 22% reported having made changes in their own smoking behaviour such as avoiding smoking in the presence of non-smokers. In general practice settings, these percentages were higher among smokers. Smokers who were thinking of stopping smoking in the near future were in addition more likely to take and to read smoking related health education materials from other places. Non-smokers received (3–49%) and read pamphlets about smoking as frequently as did smokers who did not intend to quit. In conclusion, written health education material was well received by readers, but, when distributed in a more open setting it needs to be targeted towards smokers who are considering stopping smoking. In general practice, smokers not thinking of stopping were open to health education, and pamphlets used in this setting should also target this group. Non-smokers contribute indirectly to smokers quitting by providing support to smokers and pamphlets for non-smokers need to be more targeted towards this social role.     

Review Article: Normal science? Texts for teaching the sociology of health and illness

Ellen Annandale, The Sociology of Health and Medicine
Rob Baggott, Health and Health Care in Britain
David Field and Steve Taylor (eds), Sociological Perspectives on Health,Illness and Health Care
John Germov (ed), Second Opinion: an Introduction to Health Sociology
Ron Iphofen and Fiona Poland, Sociology in Practice for Health CareProfessionals
Lesley Mackay, Keith Soothill and Kath Melia (eds), Classic Texts inHealth Care
Alan Petersen and Charles Waddell (eds), Health Matters: a Sociology ofIllness, Prevention and Care     

郑州市4123名中学生吸烟状况调查

目的：了解郑州市中学生吸烟状况。方法：采用问卷法对６所中学４１２３名学生进行吸烟状况调查。结果：中学生总吸烟率为４５１６％（１８６２／４１２３）。其中,高中组吸烟率（５０４９％）高于初中组（３９４９％）,男生吸烟率（７０１９％）明显高于女生（３１５％）,且中学生吸烟的严重性随年龄的增加而增加;父母的文化程度、周围人群的吸烟情况与学生吸烟率有密切关系。结论：中学生吸烟问题较重,为保护中学生的身心健康应大力开展卫生宣教。     

低剂量γ-射线及香烟对仔鼠发育和反射行为的影响

母鼠暴露于低剂量γ－射线（照射源６０Ｃｏ,剂量为０、０．２５、０．５、１．０ＧＹ）及香烟烟雾水溶物（浓度为０、０．５、１．０、１．５、２．０支／只）,可使子代小鼠发育（开眼、张耳、生毛、出牙）及反射行为（平面翻正、空中翻正、视觉定向、听觉惊愕）出现不同程度的延迟。并且低剂量γ－射线与香烟烟雾水溶物还有极显著的协同效应。     

研究中学男生吸烟与其他危害健康问题的相互作用

目的：研究吸烟青少年与其他危害健康行为情绪的关系。方法：采用无记名问卷调查1358名中学男生吸烟状况以及其他危害行为,同时评定了焦虑、抑郁症状。结果：中学男生近一个月吸烟率、每日吸烟率分别为14．9％和5．8％,成瘾学生3．8％。Logistic回归分析表明,饮酒、打架斗殴、携带防身刀具、不健康的控制体重行为、学习成绩落后,以及抑郁症状与吸烟有影响。结论：吸烟行为与其他危害健康行为互为关联。     

烟草凝集物对家兔胚泡乳酸脱氢酶及过氧化脂质的影响

为探讨吸烟对胚泡发育的影响,观察了烟草凝集物对孕７天兔胚泡的过氧化脂质和乳酸脱氢酶的影响,结果表明,体外培养４ｈ时ＬＰＯ水平比２ｈ显示升高,４ｈＬＤＨ与２ｈＬＤＨ相比差异不显著。ＬＤＨ活力与ＣＳＣ剂量不相关,但ＬＰＯ有随ＣＳＣ剂量增加上升的趋势,其ｒ值接近Ｐ＝０．０５的显著性水平。提示ＣＳＣ有促进脂质过氧化反应的趋势。     

Manipulation of cigarette craving through rapid smoking: efficacy and effects on smoking behavior

Craving is thought to play an important role in maintaining regular smoking patterns in current smokers, and in leading to relapse in smokers attempting to quit. Within the scientific community however, the concept is surrounded by controversy. In an effort to 1) identify interventions that can reliably influence cigarette cravings, and 2) assess the relationship between cigarette craving and smoking behavior, effects of aversive rapid smoking (up to nine cigarettes with puffs taken every 6 s) on self-reported craving and subsequent smoking behavior were compared to effects of self-paced smoking or no smoking. Subjects (n = 14) engaged in a rapid, self-paced or no smoking procedure at the start of three separate sessions. Craving levels, measured repeatedly during the next 3 h of no smoking, were significantly lower after rapid smoking than after either self-paced or no smoking. Measures of subsequent smoking behavior (latency to first cigarette, number of cigarettes, number of puffs) did not differ systematically across conditions. Thus, craving was reliably suppressed by aversive rapid smoking, but craving scores did not predict actual smoking behavior. Received: 2 April 1998/Final version: 7 August 1998