High Incidence Of Smoking Research Articles

Knowledge, Attitude, and Barriers toward Smoking Cessation Counseling: A Cross-Sectional Study among Clinical Dental Students in Indonesia

Abstract Objectives The World Health Organization has promoted the integration of smoking cessation programs into normal dental treatment since they have significant positive effects on oral health. However, there are stillmany barriers including a lack of knowledge about the smoking cessation counseling (SCC). The high incidence of smoking is an important health challenge in Indonesia. This study determined the relationships between sociodemographic factors and knowledge about the effects of smoking on oral health, as well as knowledge of, attitudes about, and barriers to SCC among clinical dental students in Indonesia. Materials and Methods This was a cross-sectional study utilizing a questionnaire involving clinical dental students throughout Indonesia. Clinical dental students from 32 dental schools in Indonesia were invited to participate in the study. Twenty-seven dental schools agreed to participate in the study and the estimated sample size was 416 participants. The questionnaire included sociodemographic data, smoking status, knowledge about the effects of smoking on oral health, and knowledge of, attitudes about, and barriers to SCC. Statistical Analysis Mann–Whitney U and Kruskal–Wallis tests were used to determine differences in knowledge about the effects of smoking on oral health and the knowledge of, attitudes about, and barriers to SCC among clinical dental students' sociodemographic factors and smoking status. The Spearman's correlation analysis was used to determine the correlation between knowledge of, attitudes about, and barriers to SCC. Results A total of 614 students participated in the study. Significant differences were found in students' knowledge regarding the effects of smoking based on smoking status, SCC based on educational stages, attitudes based on sex and smoking status, and barriers based on sex (p < 0.05). Significant relationships were found between students' knowledge of the effects of smoking and of SCC (r = 0.226), knowledge of the effects of smoking and attitudes about SCC (r = 0.110), knowledge of and attitudes about SCC (r = 0.162), knowledge of and barriers to SCC (r = –0.17), as well as attitudes about and barriers to SCC (i = –0.224). Conclusion Clinical dental students' knowledge regarding SCC are lacking, but they have positive attitude regarding SCC. It is necessary to improve education quality in every dental educational institution related to SCC.

Carbon monoxide and carboxyhemoglobin contents in exhaled air and blood pressure levels with diff erent nicotine delivery pathways

Aim. To assess the content of CO and COHb in exhaled air and the level of blood pressure (BP) in the working-age population of Yuzhno-Sakhalinsk when using various means of nicotine delivery.Materials and methods. The study participants (n = 503) were surveyed using a questionnaire. The BP and oxygen saturation parameters were assessed. The content of CO and COHb content in exhaled air was measured using a smokerlyzer. Statistical processing was performed using nonparametric methods.Results. The study group was dominated by males (58.3%). A high incidence of smoking was observed among females, with up to 42% in the general group and 48.8% in the group of consumers of alternative nicotine delivery systems (ANDS). A correlation between the content of CO and COHb and the smoking experience of more than 10 years was established, regardless of the means of nicotine delivery. Arterial hypertension was registered among 39.8% of the surveyed participants, with a higher frequency in cigarette smokers (28.8%, p = 0.02). This was associated with a greater proportion of individuals (62%) with a long smoking experience of more than 10 years (p = 0.003). A weak direct correlation was established between an increase in blood pressure and the content of CO and COHb (p < 0.001).Conclusion. The share of females as active consumers of tobacco products has grown, particularly in the form of ANDS. Among smokers, the average high level of CO and COHb prevails, which correlates with the smoking experience of more than 10 years and does not depend on the means of nicotine delivery. A direct relationship between the intensity of smoking and the risk of hypertension was established.

Risk and Time Preferences, Subjective Social Status, and Smoking Behaviors.

Objectives: In the context of rapidly developing economies, socioeconomic changes bring about increased inequality, lower perceived social status, stress, and depression, all of which contribute to the high incidence of smoking. In this study, we investigate the linkages between social status and smoking behaviors. Methods: Using data from Indonesia, we use regression analysis to study the roles of socioeconomic factors and individual risk and time preferences in determining smoking behaviors. Results: We find that both objective and perceived social status matter, but the role of perceived social status is orders of magnitude larger than that of objective social status measures, such as income or education. Conclusions: Whereas traditional policies focused on income or education can be effective in reducing smoking, our results suggest that much more can be achieved through policies that target inequality and socioeconomic stress.

Epidemiological profile of lung cancer in a Nepalese population: A single-institution review.

e13087 Background: Lung cancer is one of the common cancers worldwide, and is the commonest cancer in Nepal, with an incidence of 16%. There is a high incidence of smoking in Nepal, being highest in the mountain region in the north and lowest in the tarai region in the south. Smoking kills around 15,000 people per year. The prevalence of smoking in the urban population of Kathmandu over the age of 15 has been estimated at 64.6% in men and 14.2% in women. Nepal has diverse population with various ethnicities and different cultures. The aim of this study was to determine the relation of smoking, epidemiology of lung cancer and distribution of lung cancer in various ethnicities of Nepal. Methods: All patients attending National Hospital and Cancer Research Center in Kathmandu who were diagnosed with lung cancer between January 2012 and December 2018 were enrolled in the study. Informed consent was taken before enrollment and data was collected by the nursing staffs prospectively using a preset questionnaire for interviewing patients. Results: Data was collected from 250 patients over the seven years with histologically proven lung cancer. About 85.6 % of patients were male and 80% of them were smokers. 50% of men and 30 % of the women were smokers. Most common age to start smoking was in 11-20 years group (60%). 58% of patients were from Kathmandu valley, and 42% of patients from outside the valley. 38% of male were literate and 16% were illiterate where as 13.6% of female were literate and 32.4% were illiterate. Among the various ethnic groups, 44% were Newars, 20% Mongols, 18% in Chhetris and 18% Brahmins. The incidence of lung cancer was highest (57.6%) in the age 61-80 years age group. 14.4% of the patients had family history of cancer M = 8.6% and F = 6.0%). Squamous cell carcinoma was the highest (51.2%) followed by small cell carcinoma (22%) and adenocarcinoma (26.8%). Carcinoma of right lung was frequent (62%) compared to the left lung (38%). Local cigarette were used by 82.5% of the smokers and 54.5% of them used filtered cigarettes. 40% practiced relighting the butt ends. Conclusions: The study shows that smoking is a single major contributing factor observed in lung cancer in Nepal across various age groups as well as diverse ethnic groups. Given the high incidence of smoking starting before the age of 20, there is an urgent need for organized mass anti-smoking campaigns, especially in schools targeting the younger age group. Need of awareness against the smoking and the cause of lung cancer needs to emphasized to reduce the burden of the lung cancer.

When is a patient high risk for resection? A changing paradigm with minimally invasive lung surgery.

e20059 Background: The predicted post-operative forced expiratory volume after 1 second (FEV1) and the diffusing capacity of the lung for carbon monoxide (DLCO) are predictors of postoperative complications and survival. Despite the benefits of minimally invasive surgery in patients with marginal lung function current practice guidelines advocates non-surgical approach for treatment from evidence derived from patients undergoing thoracotomy. It is necessary to define what should be minimum acceptable lung function for resection in the era of minimally invasive surgery. Methods: Single institution retrospective study of 61 patients with pre-operative predicted FEV1 and DLCO < 60% that underwent lung resection for pulmonary lung nodules suspected to be malignant between January 2017 to June 2018. Patient demographic and clinical data were collected and the 30-day or in-hospital morbidity and mortality were assessed. Results: 28 (46%) patients with pre-operative predicted FEV1 < 60% and 33 (54%) with DLCO < 60% were reviewed. 10 patients had both FEV1 and DLCO < 60%. There were 12 patients (28% in FEV1, 12% in DLCO group) who had < 40% of pre-operative predicted values. 15 (65%) of FEV1 group and 15 (45%) of DLCO group had anatomic lung resections with either a lobectomy or a segmentectomy. 24 (39%) of cases were done robotically and the remaining with VATS. 80% of patients had cancer in their final pathology. Patients were 68± 7 years old, 34 (56%) were male. Significant baseline clinical findings include high incidence of smoking (82% in FEV1, 97% in DLCO group), HTN (71% in FEV1, 81% in DLCO group), COPD (61% in FEV1, 48% in DLCO group), CAD (25% in FEV1, 30% in DLCO group), and a total of 2 patients suffered previous CVD. Most common complications included persistent air leak > 5 days (21% in FEV1 and DLCO group) and arrhythmia (14% in FEV1, 15% in DLCO group). Of those with an air leak, 50% in the FEV1 group and 29% in the DLCO group had predicted values < 40%. Three patients developed pneumothorax post chest tube removal necessitating chest tube replacement, all of whom had predicted values < 40%. One patient developed acute DVT and PE and another patient required mechanical ventilation for > 48 hours. There were no 30-day mortalities. Conclusions: Lung resection using minimally invasive technique had low rates of 30-day morbidity in patients with reduced pulmonary function. Majority of complications observed were minor. Minimally invasive lung resection is possible and may be extended to selected patients with pre-operative predicted DLCO or FEV1 < 40% suspected of malignancy.

Outcomes of Locking-Plate Fixation for Hindfoot Fusion Procedures in 15 Patients

Tibiotalocalcaneal arthrodesis is a salvage procedure for various end-stage foot and ankle pathologic entities. Several factors are known to influence the union rate after these procedures, including construct rigidity. The data on locked plates as a fixation technique have been inconclusive, with variable union rates reported. One recent study suggested that locking plates can lead to high nonunion rates owing to excessive rigidity. The purpose of the present study was to retrospectively examine the outcomes of locking plate fixation. We retrospectively reviewed the cases of 15 patients (7 [46.7%] male, 8 [53.3%] female) who underwent tibiotalocalcaneal, tibiocalcaneal, or tibiotalar arthrodesis fixed with a locking plate from January 2013 to January 2014. The average age was 52.19 ± 5.8 years. The mean follow-up period was 17 ± 5.3 months. We examined the overall union rates and the effects of smoking, diabetes, and rheumatologic status on the union rate. Of the 15 cases, 11 (73.3%) did not achieve union. The mean time to failure was 10 ± 5.3 months. Age, gender, smoking, diabetes, use of augmentation screws outside the plate, and operating surgeon did not have an effect on the failure rate (p > .50). In addition, gender, smoking, and diabetes did not predict for nonunion. The high failure rate of rigid locking plate fixation reported might be attributable to the high incidence of smoking and diabetic comorbidities in our study. However, excessive construct rigidity might play an important role. Larger studies are needed to establish more reliable union rates with the use of locking plates in foot and ankle fusion.

Smoking, alcohol, and substance use and rates of quitting during pregnancy: is it hard to quit?

BackgroundAlcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant.AimThe aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy.MethodThis study was conducted on pregnant females in Sakarya, Turkey. A total of 1,082 consecutively presenting females who agreed to participate in the study were evaluated. The study team prepared a sociodemographic data form and adapted the “Introduction” section, derived from the Addiction Profile Index, to cover substance use during pregnancy.ResultsThe substances most frequently used by pregnant females in their previous pregnancies and current pregnancies were cigarettes/tobacco products (11% and 11.8%, respectively), alcohol (0.6% and 0.4%, respectively), and rarely, synthetic cannabinoids (0.3% and 0.2%, respectively). Daily tobacco smokers continued to smoke during pregnancy, with a rate of 42.5%. Based on research into predictors of smoking (cigarettes) in pregnancy, a correlation was found between lifetime smoking and smoking during a previous pregnancy. A similar link was found with respect to alcohol.ConclusionCigarettes are the most frequently used substance in pregnancy, and to a lesser extent, alcohol and synthetic cannabinoids, also considered to be risky substances. A high incidence of smoking regularly during pregnancy was found in daily smokers. It is recommended that physicians should sensitively ask pregnant females presenting at clinics about all forms of substance use, including alcohol and synthetic cannabinoids, and to include such questions in their routine enquiries.

Sudden unexpected infant death in Jordan and the home environment.

The aim of this study was to evaluate maternal common practice for infant sleep care and the home environment, in order to explore the major risk factors associated with sudden unexpected infant death in Jordan. Data were collected via semi-structured questionnaire interview to investigate the sociodemographic features, infant sleep practices and home environments. The sample included 604 mothers with infants <1 year old. Descriptive statistics were generated. Sleep practices were identified as leading factors in unexpected infant death. They included infant head covering (84%), heavy bedding with multiple quilts (81%) or blankets (67%), and co-bedding (66%). Environmental risk factors included high incidence of smoking, exposure to toxic solid fuel heaters during winter and inadequate room ventilation. Factors leading to unexpected infant death were high in Jordan. Unsafe infant sleeping practices and poor environmental factors put infants at high risk of sudden death. Lack of awareness of risk factors increases the risk.

The Relationship Between Smoking and Other Drug Use Among Sexual Minority Youth

This article examines cross-sectional data from 283 lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth who responded to survey questions about health risk behaviors. Responses from online, anonymous self-report questionnaires examining smoking (lifetime prevalence [72%] and past-month [42%]) and illicit drug use (cocaine, marijuana, inhalants, heroin, methamphetamines, ecstasy, and painkillers with no prescription) among sexual minority youth and young adults ages 13 to 22 are examined. Results indicate that youth who had ever tried smoking were more likely to use cocaine, painkillers, marijuana, and inhalants than youth who have never tried smoking. As a result of the high incidence of smoking as well as the high incidence of illicit drug use for sexual minority youth and young adults, implications are suggested for preventative and interceptive approaches targeting this population.

Optimal management of the elderly patient with head and neck cancer: Issues regarding surgery, irradiation and chemotherapy.

Head and neck cancer (HNC) represents the sixth most common malignancy and accounts for approximately 6% of new cancer cases annually worldwide. As life expectancy constantly increases, the onset of HNC in patients older than 65 years of age at diagnosis is not rare and up to one fourth of cases occurs in patients older that 70 years at age. Because elderly cancer patients are severely under-represented in clinical trials, there is a clear need to address the particular aspects of this specific patient group, especially in the context of novel multidisciplinary therapeutic approaches. The frailty of elderly patients with HNC is attributed to the high incidence of smoking and alcohol abuse in this malignancy and the presence of substantial cardiovascular, respiratory or metabolic comorbidities. In the current work, I provide an overview of current and emerging treatment approaches, in elderly patients with HNC. In particular, I discuss modern surgical approaches that improve radical excision rates while preserving functionality, the incorporation of modern radiotherapeutic techniques and the introduction of novel chemotherapeutic combinations and molecular targeted agents in an effort to reduce toxicity without compromising efficacy. Finally, there is an urgent need to increase accrual and active participation of elderly patients with HNC in clinical trials, including biomarker evaluation in biopsy specimens towards an individualized therapeutic approach.

Prevalence of Chronic Obstructive Pulmonary Disease in the Canary Islands

IntroductionThe prevalence of chronic obstructive pulmonary disease (COPD) varies significantly among the different geographical areas reported. In Spain, two epidemiological studies have shown a prevalence of 9–10% in the population aged over 40. However, neither of these studies included the Canary Islands, which are of interest due to their climatic conditions and high incidence of smoking. Materials and methodsA random group of 1353 subjects aged between 40 and 70years was selected from a sample population of 596478 individuals. Participants completed a questionnaire and then performed spirometry with bronchodilator testing if obstruction was observed. COPD was diagnosed when the post-bronchodilator FEV1/FVC ratio was less than 0.70. ResultsThe prevalence of COPD was 7.3% (95%CI: 5.5–9.5) and was higher in males than in females (8.7% vs 6.3%, P=.134). The incidence of smoking was 29.4% (95%CI: 25.4–33.1) and was also higher in males than in females (35.1% vs 25.4%, P<.001). The prevalence of COPD stratified by severity of obstruction, according to the GOLD criteria, was 16% in group I, 69.9% in group II, 10.4% in group III and 3.3% in group IV. 71.6% of the subjects were underdiagnosed and 63.5% undertreated. ConclusionsDespite having one of the highest rates of smoking in Spain, the prevalence of COPD in the Canary Islands is lower than in most of the Spanish regions studied.

Prevalencia de enfermedad pulmonar obstructiva crónica en las Islas Canarias

IntroductionThe prevalence of chronic obstructive pulmonary disease (COPD) varies significantly among the different geographical areas reported. In Spain, two epidemiological studies have shown a prevalence of 9-10% in the population aged over 40. However, neither of these studies included the Canary Islands, which are of interest due to their climatic conditions and high incidence of smoking. Materials and methodsA random group of 1,353 subjects aged between 40 and 70years was selected from a sample population of 596,478 individuals. Participants completed a questionnaire and then performed spirometry with bronchodilator testing if obstruction was observed. COPD was diagnosed when the post-bronchodilator FEV1/FVC ratio was less than 0.70. ResultsThe prevalence of COPD was 7.3% (95%CI: 5.5-9.5) and was higher in males than in females (8.7% vs. 6.3%, P=.134). The incidence of smoking was 29.4% (95%CI: 25.4-33.1) and was also higher in males than in females (35.1% vs 25.4%, P<.001). The prevalence of COPD stratified by severity of obstruction, according to the GOLD criteria, was 16% in groupi, 69.9% in groupii, 10.4% in groupiii and 3.3% in groupiv. 71.6% of the subjects were underdiagnosed and 63.5% undertreated. ConclusionsDespite having one of the highest rates of smoking in Spain, the prevalence of COPD in the Canary Islands is lower than in most of the Spanish regions studied.

Acute myocardial infarction: Clinical features and outcomes in young adults in Singapore

To investigate the clinical features and in-hospital outcomes of young adults with acute myocardial infarction (AMI) in Singapore. Between January 2005 to September 2010, 333 consecutive patients aged ≤ 45 years old were diagnosed to have AMI at our institution. As Singapore is a multi-ethnic society, we also analysed whether ethnic differences exist between the three dominant ethnic groups, Malay, Chinese and Indian with regards to the clinical features. Clinical data was collected retrospectively on demographic characteristics, presenting signs and symptoms, blood investigation, angiographic findings and in-hospital clinical outcomes. The mean age at presentation was 40.2 ± 4.0 years with male predominance (94%). The majority of patients were Chinese (51%) followed by Indians (31%) and Malays (18%). The most common risk factor was smoking (74%) followed by hypertension (28.5%) and hyperlipidemia (20.0%). 37% of patients were obese. The majority of patients had single vessel disease (46%) on coronary angiography. The mean total cholesterol, low-density lipoprotein and high-density lipoprotein levels were 5.6 ± 1.2 mmol/L, 3.8 ± 1.1 mmol/L and 0.93 ± 0.25 mmol/L respectively. The mean left ventricular function was 44% ± 10% with the incidence of heart failure 3% and cardiogenic shock 4.5%. Overall in-hospital mortality was low with 4 deaths (1.2%). For ethnic subgroup analysis, Indians have a 3-fold risk of developing premature AMI when compared to other ethnic groups. Young AMI patients in Singapore are characterized by male predominance, high incidence of smoking and obesity. Overall in-hospital clinical outcomes are favourable. Among the 3 ethnic groups, Indians have the highest risk of developing premature AMI.

Pregnancy in imprisoned women

BackgroundImprisoned women are a socially disadvantaged group at greater risk of poorer obstetric and perinatal outcome compared with the general population. Despite an increased incidence of smoking, alcohol and substance...

Effects of nicotine on depressive-like behavior and hippocampal volume of female WKY rats

The observed high incidence of smoking amongst depressed individuals has led to the hypothesis of 'self medication" with nicotine in some of these patients. The inbred Wistar-Kyoto (WKY) rats exhibit depressive-like characteristics as evidenced by exaggerated immobility in the forced swim test (FST). One aim of this study was to investigate whether nicotine may have an antidepressant-like effect in these animals. Moreover, because of human postmortem studies indicating a reduction of the hippocampus volume in depressed patients, it was of interest to determine whether such an anatomical anomaly may also be manifested in WKY rats and whether it would be affected by chronic nicotine treatment. Adult female WKY and their control Wistar rats were administered nicotine consecutively (0.2 mg/kg, i.p., once or twice daily for 14 days) and their activity in an open field, as well as their immobility in FST were assessed either 15 min or 18 h after the last injection. Another set of animals was treated twice daily with 0.2 mg/kg nicotine for 14 days and sacrificed on day 15 for stereological evaluation of the hippocampal volume. When tested 15 min after the last injection, once or twice daily nicotine exacerbated the immobility in the FST in WKY rats only. When tested 18 h after the last injection, only twice daily nicotine treatment resulted in less immobility in the FST in WKY rats. Open field locomotor activity was not affected by any nicotine regimen. WKY rats had significantly less hippocampal volume (approximately 20%) than Wistar rats which was not altered by nicotine. These findings further validate the use of WKY rats as an animal model of human depression and signify the importance of inherent genetic differences in final behavioral outcome of nicotine.

Clinical Features of Patients with Detached Ciliary Tufts in Semen/Klinische Merkmale von Patienten mit abgetrennten Cilia-Büscheln im Sperma

Cilia in the male genital tract are found on the epithelium of the ductuli efferentes, epididymis and vas deferens. Detached ciliary tufts (DCTs) were observed in semen of 13 men and this paper deals with the clinical features of these patients. There was a high incidence of smoking (73%), diminished testicular volume in 64%, a high number with previous urological surgery and trauma and an increased percentage of cytoplasmic droplets. It is postulated that DCTs originate from the epididymal ephithelium. DCTs are possibly shedded as part of epididymal involvement which occurs as a result of testicular pathology caused by several agents.

A review of Inuit oncology patients treated at The Ottawa Hospital Cancer Centre

6610 Background: Nunavut, Canada's largest territory (1.9 million kms2), is roughly 3 times the size of Texas, but is sparsely populated with only 27,000 residents. Its demographics are unique, with a median age of 22, 85% are Inuit, and 85% speak Inuktitut. No oncology services are available within the territory. Residents must travel to cancer centers in Ottawa, Winnipeg, or Edmonton. The Ottawa Hospital Cancer Centre (TOHCC) is responsible for all oncology consultations for the Baffin region of Nunavut (distance 2,100-2,700km), where half of Nunavut's population reside (population 14,000). Methods: Consecutive Nunavut patients seen in consultation at TOHCC from January 2002 to August 2007 were identified. Chart review was undertaken; extracting demographic information, ethnicity, diagnosis, stage, treatment, outcome, complications of care, and use of translation services. Results: 113 cancer patients of Inuit descent were identified. The average age at diagnosis was 57 years, (50%M, 50%F). Fifty-four percent were actively smoking at the time of diagnosis. Previous tuberculosis (TB) infection was reported by 40%, while only 1 case of TB reactivation while on therapy was identified. An Inuktitut/English interpreter was required by 73%. Oncologic services at TOHCC included surgery (39%), radiation (64%), and chemotherapy (58%). Lung cancer was the most common (n=55), with the following histological distribution: squamous (n=25), small cell (n=7), adenocarcinoma (n=3), and unspecified non-small cell (n=20). A rare case of Kaposi's sarcoma was identified in an HIV negative patient. No cases of prostate cancer were identified. The incidences of specific cancers among Inuit patients as compared to the Canadian population are as listed in the table. Conclusions: Cancer in the Inuit population differs radically from the rest of the Canadian population. Causes for the variation may include high incidence of smoking, young population, high parity and breastfeeding rates. A comparison of incidence rates for specific cancers Cancer Type Incidence in this Inuit population (n=113) Incidence in a Canadian Population*(n=150,000) Lung 55 (49%) 15% Colorectal 24 (21%) 14% Breast 10 (8.8%) 15% Nasopharyngeal 9 (8.0%) 0 Cervical 5 (4.4%) 1% Prostate 0 15% Other types 10 (9%) - * Canadian Cancer Statistics 2007, Toronto, Canada (ISSN 0835–2976) No significant financial relationships to disclose.

Nicotine and nicotinic system in hypoglutamatergic models of schizophrenia

Schizophrenia is a complex neuropsychiatric disorder with devastating consequences. It is characterized by thought fragmentation, hallucination and delusion, collectively referred to as positive symptoms. In addition, mood changes or affective disorders, referred to as negative symptoms, as well as cognitive impairments can be manifested in these patients. Arguably, modeling such a disorder in its entirety in animals might not be feasible. Despite this limitation, various models with significant construct, predictive and some face validity have been developed. One such model, based on hypoglutamatergic hypothesis of schizophrenia, makes use of administering NMDA receptor antagonists and evaluating behavioral paradigms such as sensorimotor gating. Because of very high incidence of smoking among schizophrenic patients, it has been postulated that some of these patients may actually be self medicating with tobacco's nicotine. Research on nicotinic-glutamatergic interactions using various animal models has yielded conflicting results. In this review, some of these models and possible confounding factors are discussed. Overall, a therapeutic potential for nicotinic agonists in schizophrenia can be suggested. Moreover, it is evident that various experimental paradigms or models of schizophrenia symptoms need to be combined to provide a wider spectrum of the behavioral phenotype, as each model has its inherent limitations.

Combined effects of systemic alcohol and nicotine on dopamine release in the nucleus accumbens shell

This study was undertaken to determine whether simultaneous administration of both alcohol and nicotine systemically would result in an additive dopamine release in the nucleus accumbens (NACC). Moreover, to also investigate whether nicotinic receptors may be mediating these effects of alcohol and nicotine, the effects of mecamylamine, a nicotinic receptor antagonist was also evaluated. Microdialysis was applied to measure the dopamine overflow in the shell region of NACC. All drugs were administered intraperitoneally. The doses of alcohol ranged from 0.5-2.0 g/kg, and nicotine and mecamylamine 0.25-1.0 mg/kg. An additive effect of combined alcohol and nicotine on dopamine release was obtained. This effect of alcohol and nicotine was dose-dependently blocked by mecamylamine pre-treatment. These findings further support the hypothesis that an additive effect of alcohol and nicotine on the mesolimbic 'reward pathway' may contribute to the high incidence of smoking in alcoholics. Furthermore, nicotinic antagonists can block such effects of combined alcohol and nicotine.

A retrospective analysis of epidemiology and treatment patterns for gastric cancer at a tertiary health care center in India

4086 Background: Gastric cancer is the second most common gastrointestinal cancer in our hospital based cancer registry. This retrospective analysis aims at studying the epidemiology and treatment patterns for gastric cancer at our hospital, which is a tertiary care cancer center for the state of Andhra Pradesh in south India. Methods: A retrospective analysis of the case records of 125 consecutive patients with gastric cancer who presented to our department between Jan 2004 and Dec 2005 were analysed. Data regarding epidemiology, stages at diagnosis and treatment plans were collected. Patients with early gastric cancer received 5FU based chemoradiation or chemotherapy only. Palliative chemotherapy included 5FU/cisplatin based regimens. Results: A total of 125 patients were analysed. The median age was 61years (range 18–82 years). 71% were males and 29% females. Being a tertiary care center, 92% were referred with a confirmed diagnosis on endoscopic biopsy. 30% were smokers, 11% consumed alcohol, 40% had both habits while 29% had neither. The most common part of the stomach involved was the antro-pyloric region (44%) followed by the body (30%), GE junction/cardia (20%) while 6% had diffuse involvement including linitis plastica. At diagnosis, 35% were early stage, 56% metastatic and 8% locally advanced tumors. 90% patients who had surgery for early stage disease had T2,3 tumors. One third had inadequate nodal staging.70% of patients who had curative resections underwent adjuvant chemoradiation and 30% had chemotherapy only. Of all patients with metastatic disease, 65% palliative chemotherapy while 45% opted for best supportive care. Conclusions: The distribution of tumors within the stomach is similar to Japanese data, which may reflect the common etiological factors like high salt diet. The fact that one third of patients had inadequate nodal dissection stresses the relevance of adjuvant chamoradiotherapy protocols. The high incidence of smoking as a contributory factor in the etiology reflects the need for aggressive anti tobacco legislation. The study reiterates the need for inexpensive and novel therapies for palliation of symptoms in patients with advanced disease and widens the scope for collaborative clinical trials. No significant financial relationships to disclose.