Masculinity of smokers and the masculinity of cigarette images.

It was hypothesized that the more masculine a smoker's personality, the more masculine the image of the smoker's regular brand of cigarette. The masculinity of 40 male and 40 female college-age smokers was measured with the Fe scale (CPI) and Mf scale (MMPI). Ss then stated their regular brand of cigarette and rated the masculinity of 13 top-selling cigarettes, including their own. Both groups had low but statistically significant positive correlations between their masculinity, on the Fe scale, and the rated masculinity of their cigarette. The results are interpreted as providing moderate support for the belief that product preference is a predictable interaction between the consumer's personality and the product's image. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Matched and mismatched interventions with young adult smokers: Testing a stage theory.

This experiment tested the transtheoretical model (J. O. Prochaska & C. C. DiClemente, 1983) of smoking cessation by matching or mismatching interventions to smokers in a particular stage. The interventions were tested against a no-intervention condition with 92 college-aged daily smokers in the precontemplation stage of change. The stage-matched intervention asked smokers to think more about quitting smoking; the stage-mismatched intervention provided action-oriented activities typically used for those ready to quit smoking. The results failed to support the value of matching interventions to a smoker's stage of change. Instead, more smokers who received the action intervention tried to quit smoking. Matching interventions to an individual's current stage may be less important than the transtheoretical model suggests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two-year results after lung volume reduction surgery in alpha1-antitrypsin deficiency versus smoker's emphysema

Lung volume reduction surgery (LVRS) improves exercise capacity and relieves dyspnoea in patients with smoker's emphysema (SE). It is unclear, however, whether LVRS similarly improves lung function in alpha1-antitrypsin-deficiency emphysema (alpha1 E). To address this question, this study prospectively compared the intermediate-term functional outcome in 12 consecutive patients with advanced alpha1E and 18 patients with SE who underwent bilateral LVRS. Before surgery there were no statistically significant differences between the two groups in the six-minute walking distance, dyspnoea score, respiratory mechanics or lung function data, except for the forced expiratory volume in one second, which was lower in the deficient group (24 versus 31% of the predicted value; p<0.05). In both groups, bilateral LRVS produced significant improvements in dyspnoea, the six-minute walking distance, lung function and respiratory mechanics. In the alpha1E group, the functional data, with the exception of the six-minute walking distance, returned to baseline at 6-12 months postoperation and showed further deterioration at 24 months. The functional status of the SE group remained significantly improved over this period. In conclusion, the functional improvements resulting from bilateral lung volume reduction surgery are sustained for at least 2 yrs in most patients with smoker's emphysema, but this type of surgery offers only short-term benefits for most patients with alpha1E.     

Smoking and attention: a review and reformulation of the stimulus-filter hypothesis

An accumulation of evidence suggests that smoking may be reinforcing, in part, due to nicotine's capacity to enhance attentional processing. Correspondingly, the stimulus-filter model of nicotine reinforcement asserts that nicotine facilitates cognitive performance by acting as a stimulus-barrier, thereby screening irrelevant and annoying stimuli from the smoker's awareness. A review of the available data suggests that while nicotine does appear to reliably enhance sustained, divided, and focused attention, the stimulus-filter model falls short of adequately explaining the findings. An alternative, attention, allocation model of nicotine reinforcement is reviewed, the tenets of which suggest that nicotine differentially augments attentional processing via its propensity to: (a) induce attentional narrowing, and (b) increase perceptual processing capacity. The motivational implications of the model, including smokers' use of nicotine to dampen stress, are discussed.     

Nicotine's role in smoking: An analysis of nicotine regulation.

Nicotine regulation refers to a smoker's maintenance of a characteristic level of nicotine in the body. It implies that changes in smoking behavior (i.e., compensation) will accompany either increases or decreases in nicotine availability. Research on regulation has been inconclusive because of (a) a failure to distinguish between regulation and compensation, (b) the use of indirect rather than direct measures of nicotine exposure, and (c) a number of methodological problems. The present review addresses these issues by (a) clarifying definitional ambiguities, (b) presenting a classification strategy that differentiates the indirect and direct evidence for regulation, (c) quantifying the direct evidence, and (d) discussing measurement and methodological problems. (76 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Independent responsiveness of frog liver low-density lipoprotein receptor and HMGCoA reductase to estrogen treatment

We examined the mutagenicity of cigarette smoker's urine in 32 healthy male cigarette smoker and 37 healthy male non-smoker. Twenty-four-hour urine specimens were subjected to blue rayon extraction which selectively adsorb polycyclic compounds, after which the elutions were fractionated by carboxymethyl cellulose column chromatography for removing antimutagenic compounds. The mutagens were measured by using an S9-mediated Salmonella mutagenicity test on strain TA98. Compared with those with non-smokers, smokers' urine showed a significantly higher urinary level of mutagens in the acid-elutable and in the sum of all chromatography fractions. A similar tendency was also seen in the alkali-elutable fraction. The subjects were classified into three groups according to the number of smoked cigarettes. Heavy smokers, who smoked more than 20 cigarettes per day, showed a significantly higher urinary level of mutagens than both non-smokers and light smokers especially in the acid-elutable and in the sum of all chromatography fractions. Our findings suggest that smokers are exposed to a great amount of polycyclic carcinogens and mutagens by cigarette smoking. These results also suggest that urinary level of mutagens measured by using blue rayon extraction combined with carboxymethyl cellulose chromatography could be a good index for estimating the exposure to carcinogens and mutagens such as polycyclic compounds.     

Decrease in bladder cell micronucleus prevalence after intervention to lower the concentration of arsenic in drinking water

Epidemiological studies performed in Taiwan, Argentina, and Chile suggest that ingestion of arsenic (As) may cause bladder cancer. Because of these findings, we previously investigated the relationship between As ingestion and genetic damage to the urothelium in two cross-sectional biomarker studies, one in Nevada and one in Chile. In both studies, we found that increased levels of micronucleated cells (MNCs) in exfoliated bladder cells were associated with elevated concentrations of As in drinking water, suggesting that As induces genetic damage to bladder cells. To further investigate this relationship, we conducted an intervention study in a subset of highly exposed men (n = 34) from the cross-sectional study in Chile. Subjects whose usual source of water contained about 600 micrograms/liter As were supplied with water lower in As (45 micrograms/liter) for 8 weeks, allowing ample opportunity for renewal and exfoliation of bladder epithelial cells. Mean urinary As levels decreased during the intervention from 742 to 225 micrograms/liter. Bladder MNC prevalence also decreased from 2.63 MNCs/1000 cells preintervention to 1.79 MNCs/1000 cells postintervention (P < 0.05). When the analysis was limited to individuals previously having subcytotoxic urinary As levels (< 700 micrograms/liter), the change between pre- and postintervention MNC was more pronounced: the level decreased from 3.54 to 1.47 MNCs/1000 cells, respectively (P = 0.002). Among smokers, MNC prevalences decreased from 4.45 MNCs/1000 cells preintervention to 1.44 MNCs/1000 cells postintervention (P = 0.002). Among nonsmokers, the decrease was much smaller: 2.04 MNCs/1000 cells preintervention to 1.90 MNCs/1000 cells postintervention (P = 0.25), suggesting that smoker's bladder cells could be more susceptible to genotoxic damage caused by As. The reduction in bladder MNC prevalence with reduction in As intake provides further evidence that As is genotoxic to bladder cells.     

Barriers to care among persons living with HIV/AIDS in urban and rural areas

Phenols constitute an important toxic component of the main stream (MS) of cigarette smoke. The content of volatile fraction of that group of compounds in MS depends on the tobacco type and conditions in which cigarettes are smoked, as well as on the filters applied. The purpose of the research was to determine the content of volatile in steam phenols in the MS of selected brands of cigarettes produces in Poland, as well as imported ones, and the assessment of the toxicity of doses of the phenols that smokers were exposed to. Cigarettes conditioned in constant humidity were smoked in standard conditions in the simulator of smoking, designed by the authors, while MS was absorbed in Zaitcev washers, filled with methanol. The absorbed phenols were distilled in steam and extracted with ethyl acetate. Then the phenols were separated by the method of overpressure thin-layer chromatography on DC Alufolien Polyamid 11F254 Merck chromatoplates, in the developing system chloroform-methanol 99:1 v/v, were induced with sodium diazofluoroborate, and after eultuion the separated phenol, and o-cresol were determined, as well as the non-separated mixture of p- and m-cresols, by the spectrophotometric method. The determined contents of phenols in MS were assessed regarding their toxicity applying the criteria of environmental exposure. When calculating the results, the efficiencies of the applied in the analytical procedures processes of absorption, distillation and extraction of the investigated phenols previously determined experimentally, were taken into consideration. The content of determined compounds in the brands of the cigarettes examined was in the case of phenols, changing within the range from 41.25 +/- 1.15 to 7.60 +/- 0.93 (the average of 20.31 +/- 9.61 micrograms per cigarette); in the case oo-cresol it was within the range from 28.16 +/- 0.95 to 5.72 +/- 0.53 (the average of 11.56 +/- 6.7), while for the non-separated p- and m-cresols the range was from 21.12 +/- 0.5 to 7.31 +/- 0.45 (the average amounted to 11.48 +/- 4.98 micrograms per cigarette The conclusions of the study were the brands of cigarettes significantly influences the content of the phenols examined in the cigarette smoke the phenols determined coexist in the MS of examined cigarettes in similar proportions the doses of phenols inhaled by a smoker during a day with the MS of examined brands of cigarettes participate essentially in the toxicity of the cigarette smoke and smoking 20 cigarettes a day causes the smoker's organism to be exposed to incomparably larger doses of phenols than those from unpolluted atmospheric air.     

The Association says no to Mandatory Continuing Education

Mandatory Continuing Education (MCE) for nurses is a compulsory requirement for nurses to participate in continuing education in order to continue practising as a nurse. Should MCE be introduced, the most likely method of enforcing that requirement would be for it to be linked to a nurses' authority to practice, that is, it would be necessary to demonstrate the required MCE before annual registration would be renewed and a current practising certificate issued.     

Is tubal sterilization associated with an increased risk of subsequent hysterectomy but a decreased risk of ovarian cancer? A review of recent literature

Recent epidemiologic studies have suggested that tubal sterilization (TS) may lead to an increased incidence of subsequent hysterectomy but a decreased risk of ovarian cancer. This review evaluates the nature and magnitude of these two relationships, which should be of great concern and interest to women, clinicians and the administrators of family planning programs. The positive relationship between TS and subsequent hysterectomy is more likely to be of a motivational rather than biological nature, and a considerable number of unnecessary hysterectomies after TS could be avoided by changing the attitudes of physicians and women. The inverse relationship between TS and ovarian cancer appears causal, although the exact biological mechanisms remain to be clarified. Theoretically, this non-contraceptive beneficial effect of TS could be used as a primary preventive measure to curb the incidence of the highly fatal ovarian cancer. However, a number of medical, ethical, and economic questions attending use of a generally irreversible contraceptive procedure as a preventive measure must first be answered. The issue of whether TS is associated with any long-term sequelae, and, if so, whether the association is of a cause-and-effect nature or a by-product of time passage and aging of the woman, should be addressed by well-designed studies.     

Predictable exodontia in general practice

Exodontia that is carefully and skillfully done by general dentists is a valuable service to patients. The majority of patients would rather have their family dentist perform necessary extractions or other minor surgery procedures than be referred outside the office. Most teeth that need to be extracted could be removed by a generalist if that person has developed the expertise to do not only relatively easy extractions, but also that percentage that is inevitably more difficult--requiring "surgical" removal. To be successful with exodontia, the dentist must have the ability to select cases within his or her level of comfort and ability, have a working knowledge of sound surgical principles, be able to apply a variety of patient management techniques, and then be prepared to handle whatever complications may arise. This article has presented ideas that should be integrated into the operator's own systematic approach to extractions. It is one of many resources to help the general dentist provide a higher level of surgical treatment.     

The treatment of Parkinson's disease: current concepts and rationale

The recent advances in the treatment of Parkinson's disease have made for significant improvements in the quality of life and mortality rate of those who suffer from this neurodegenerative disease. At the same time, the number of options and the complexity of multi-drug regimens have posed a great challenge for the clinician caring for the patient with Parkinson's disease. Though there are still many questions to be answered in regard to the potential neuroprotective effects of several medications, a few general rational treatment plans can be outlined. In patients requiring treatment in the early stages of the disease, especially with a predominance of tremor, anticholinergics or amantadine should be considered initially. At this point, it would be reasonable to add selegiline for both therapeutic and possible neuroprotective effects. As a patient becomes more affected by the disease and additional therapy is necessary, starting either a dopamine agonist or levodopa would be a rational choice. Continuation of selegiline and, possibly, amantadine for neuroprotective reasons should be contemplated. Titration in levodopa therapy (with controlled-release or standard levodopa) to higher levels should prompt addition of a dopamine receptor agonist if one has not been started previously. Conversely, if a patient is receiving only a dopamine receptor agonist and is becoming progressively disabled, levodopa should be added to the regimen. Fluctuations in motor abilities may be improved further by the use of a COMT inhibitor. Patients with uncontrollable motor fluctuations should be considered for surgery. Undoubtedly, the coming years will bring more treatment options and more evidence on which sequences and combinations of therapies are the most beneficial. Differences in efficacy and adverse effects for each patient must be taken into consideration when outlining and carrying out a treatment plan. By using a rational approach to the treatment of Parkinson's disease, with the above guidelines in mind, the patient should be able to enjoy a good quality of life and level of function for many years.     

Defining empirically supported therapies.

A scheme is proposed for determining when a psychological treatment for a specific problem or disorder may be considered to be established in efficacy or to be possibly efficacious. The importance of independent replication before a treatment is established in efficacy is emphasized, and a number of factors are elaborated that should be weighed in evaluating whether studies supporting a treatment's efficacy are sound. It is suggested that, in evaluating the benefits of a given treatment, the greatest weight should be given to efficacy trials but that these trials should be followed by research on effectiveness in clinical settings and with various populations and by cost-effectiveness research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapy of congestive heart failure in elderly persons

LVEF should be measured in all elderly persons with CHF Underlying causes and precipitating causes of CHF should be treated. Persons with CHF associated with abnormal LVEF should be treated with a low sodium diet, diuretics, and ACE inhibitors. If CHF persists, digoxin should be added. If CHF still persists, isosorbide dinitrate plus hydralazine should be added. If CHF still persists, a beta blocker should also be added. However, calcium channel blockers should not be used. Persons with CHF associated with normal LVEF should be treated with a low sodium diet, diuretics, and ACE inhibitors. If CHF persists, a beta blocker, isosorbide dinitrate plus hydralazine, or a calcium channel blocker should be added to the therapeutic regimen. If sinus rhythm is present, digoxin should not be used. Persons with CHF and abnormal or normal LVEF unable to tolerate ACE inhibitors should be treated with losartan.     

Return from the tropics: relevant diagnosis and rational therapy

Gastrointestinal disorders, particularly diarrhoea, are the main reason to consult a physician after travelling to the tropics. Although mostly of infectious origin specific pathogens frequently cannot be demonstrated. As the majority of acute diarrhoeal episodes resolve without any specific therapy, bacterological and parasitological investigations should initially be ordered with reserve and economically. Fever after a stay in the tropics has to be always a matter of concern as it could be the expression of a potentially dangerous infection, e.g. falciparum malaria. The primary objective must be the exclusion of potentially life-threatening infections requiring a specific treatment. Numerous asymptomatic travellers returning from the tropics want their physicians to exclude an inapparent exotic infection. The value of such check-ups can be questioned, and there are just a few rational investigations in this particular context.     

Guidelines for the design and conduct of clinical trials on dentine hypersensitivity

Clinical trials on dentine hypersensitivity have been numerous and protocols varied. To date there is little consensus as to the conduct of studies on this poorly-understood yet common and painful dental condition. A committee of interested persons from academia and industry was convened to discuss the subject of clinical trials on dentine hypersensitivity and a consensus report is presented. A double-blind randomized parallel groups design is recommended, although cross-over designs may be used for the preliminary screening of agents. Subjects may have multiple sites scored. Sample size will be determined by estimating the variability in the study population, the effect to be detected and the power of the statistical test to be used. Subject selection is based on a clinical diagnosis of dentine hypersensitivity, excluding those with conflicting characteristics such as currently-active medical or dental therapy. The vestibular surfaces of incisors, cuspids and bicuspids are preferred as sites to be tested. A range of sensitivity levels should be included. Tactile, cold and evaporative air stimuli should be applied. Negative and benchmark controls should be incorporated. Most trials should last 8 weeks. Sensitivity may be assessed either in terms of the stimulus intensity required to evoke pain or the subjective evaluation of pain produced by a stimulus using a visual analog or other appropriate scale. The subject's overall assessment may be determined by questionnaire. Outcomes should be expressed in terms of clinically significant changes in symptoms. Follow-up evaluation is required to determine the persistence of changes. At least 2 independent trials should be conducted before a product receives approval.     

Establishing a high-school-based training room clinic

Being a team physician can be a time-consuming commitment. The team physician is responsible for all aspects of the athlete's care and has the final say in all medical matters related to athletic participation. Primary care physicians are well suited to be team physicians. The training room is an outstanding way to increase physician availability to adolescents and underserved population. Setting up a training room must be planned in advance, including funding, supplies and liability. Most legal problems can be avoided with a contract and proper documentation. The school-based training room provides the physician with an excellent opportunity for community service and can be a very rewarding experience.     

Possible methods of creating a functional neoglottis and of constructing a functionally adequate neolarynx

The intention of the following report is to present a concept for constructing a substitute glottis (neoglottis). The concept evolved over the years on the basis of anatomic studies and in the course of plastic reconstructions on patients. It is based on pedicled grafting of a voluntarily controllable--and hence trainable--musculature that might be transplanted into the larynx attached to a neurovascular pedicle. A rima glottidis might be imitated that could be opened and closed from a neutral position. During sleep the neoglottis would be in a relaxed, spasm-free position. A sensitive and tactile stimulus response ought to be possible, as should variations of the state of tension of the substitute vocal muscles.     

The varicocele and male infertility

Varicocele is accepted as a common cause of male subfertility, even though many men with varicocele appear to have normal fertility. The pathophysiology of the varicocele effect on fertility remains unclear, but the association of varicocele with decreased testicular size, abnormal testicular histology, and abnormal semen parameters is clearly established. Because a small varicocele may impair fertility, it must be diligently sought, and the Doppler stethoscope may be helpful in establishing the diagnosis when a venous thrill is equivocal during the Valsalva maneuver in a standing patient. Abnormal semen parameters should be demonstrated in subfertile males with varicocele prior to advising varicocelectomy. Decreased sperm motility or a "stress pattern" in the semen should be documented; however a decreased sperm count may or may not be present. Various surgical approaches are available. When suprainguinal approaches have been used, failures have been shown to be attributable to secondarily incompetent cremasteric system veins. When high inguinal approaches are used, unsuccessful operations are probably secondary to a failure to identify one of the several venous tributaries that may be present at this level. The surgeon's approach should be based on available data, and his patients should be informed that failures are possible with any method of varicocelectomy until experience indicates otherwise. In most series, improvement in semen quality and pregnancy rates have been reported in a significant percentage of patients undergoing varicocelectomy for infertility. However, prior to subjection of the patient to varicocelectomy, the wife of the varicocele patient should be thoroughly studied (and treated when indicated).     

The use of thermal analysis techniques for the validation of phase transformation models

In the study of the phase transformation of steel several methods can be used to obtain information about the behaviour of steel during heating and cooling. In this research several conventional methods, e.g. dilatometry, were studied together with an in-situ thermal analysis method (ISTA). This method, which can be applied to any cooling curve, enables us to draw conclusions as to the transformation behaviour of the steel. Using a continuous annealing simulator (Casim) a range of cooling rates can be investigated with the resulting mechanical properties. It will be demonstrated that ISTA can be performed on the results of a variety of experimental techniques and therefore under very different experimental conditions. It is possible to investigate transformation behaviour and mechanical properties on a single test piece. Using the pressurized air cooling of the Casim proves to be a good compromise between the possibilities of determining the mechanical properties and flexibility in cooling conditions of the specimens.