1,721,118 research outputs found
Treatment of tobacco addiction and the cardiovascular specialist
No full textPurpose of review Tobacco smoking is the leading cause of avoidable deaths worldwide, and half of these deaths are due to cardiovascular disease (CVD). Physicians specialized in the management of CVD play a key role in ensuring that all smokers with cardiovascular disorders are offered best evidence support to help them quit smoking. This review summarizes recent findings on smoking as a risk factor for CVD, effects of smoking cessation on the prognosis of CVD patients, interactions between drug treatment for CVD and smoking, effective interventions to promote quitting in CVD patients and policy issues regarding tobacco control. Recent findings Smoking cessation following an acute cardiovascular event yields a substantial reduction in morbidity and mortality. Recent declines in CVD mortality were mainly a result of risk factor modification rather than improvement of medical treatments for CVD. The latter are also less effective in smokers than in nonsmokers, and smokers are at high risk of medication nonadherence. Effective interventions to support quit attempts in smokers with CVD are available. Cardiovascular specialists should encourage policy-makers to take appropriate tobacco control action. Summary Cardiovascular specialists are in a unique position to promote cardiovascular health at the individual as well as at a population level.Pfizer; Johnson Johnso
Intracellular pH and K-ATP channel activity in dorsal vagal neurons of juvenile rats in situ during metabolic disturbances
No full textIntracellular pH (pH(i)) is an important factor for understanding cellular processes associated with the response of central neurons to metabolic disturbances such as anoxia or ischemia. In the present study, pH(i) was fluorometrically measured in 2' 7' -bis(carboxyethyl)-5(6)-carboxyfluorescin (BCECF)-filled, voltage-clamped dorsal vagal neurons (DVN) of brainstem slices from rats during metabolic disturbances activating ATP-sensitive K+ (K-ATP) channels. Chemical anoxia induced by cyanide, rotenone or p-trifluoroinethoxy-phenylhydrazone (FCCP) decreased pH(i) by >0.4 pH units. Untreated neurons with normal pH(i) baseline (7.2) responded to glucose-free superfusate after a delay of 7-16 min with a progressive fall of pH(i). In contrast, pHi increased by >0.2 pH units after similar to 10 min in cells that had a mean pH(i) of 6.8 due to incomplete recovery from a CN- induced acid load prior to glucose depletion. Metabolic arrest, induced by cyanide in glucose-free solution after 30 min preincubation in glucose-free saline, caused a progressive glutamate-mediated inward current with no change of pH(i). Upon metabolic arrest, depolarization-evoked pH(i) decreases ( similar to 0.2 pH units) were abolished, whereas glucose-free superfusate slightly delayed their recovery without major effects on amplitude. The glucose-dependent pH(i) fall coincided with activation of the K-ATP channel-mediated outward current, while K-ATP currents due to anoxia or metabolic arrest could reach their maximum in the absence of a major pH(i) change. The results indicate that the anoxic pH(i) decrease is due to enhanced glycolysis and lactate formation with often no obvious effect on K-ATP channel activity. The origin of glucose-dependent acidosis and its relation to K-ATP channel activity remain to be determined. (C) 2004 Elsevier B.V. All rights reserved
Misleading information on smoking in German medical textbooks
No full textBackground and objective: Smoking is a major risk factor for coronary heart disease and lung cancer. While nicotine causes addiction, heart and lung diseases are caused by other substances contained in tobacco smoke. This study assessed whether these facts are adequately portrayed in German medical textbooks. Methods: The sections on cardiovascular and lung cancer risk factors in 28 German textbooks of internal medicine, available in two bookstores as well as the library of Gottingen University (Germany), were scanned for the words "smoking" and "nicotine" as risk factors for coronary artery disease and lung cancer. Results: In 12 of the 25 textbooks covering cardiovascular disease, smoking was mentioned as a risk factor for coronary artery disease; another 12 textbooks listed nicotine or nicotine addiction. In one textbook both terms were used. While smoking was referred to in all 21 textbooks that also discussed risk factors for lung cancer, nicotine was not mentioned in this context. Conclusion: Many German textbooks of internal medicine contain misleading terms for the health effects of smoking, which may influence the thoughts and possibly also the behaviour of their readers. The use of the words "smoking" and "nicotine" as synonymous within the context of cardiovascular risk factors, suggesting a causal relationship between nicotine and coronary heart disease, is incorrect and should be removed from the specialist medical literature
Effect of a Short Smoking Cessation Training Session on Smoking Cessation Behavior and Its Determinants Among General Practitioner Trainees in England
No full textPharmacotherapy for Smoking Cessation Current Advances and Research Topics
No full textPromoting smoking cessation is among the key medical interventions aimed at reducing worldwide morbidity and mortality in this century. Both behavioural counselling and pharmacotherapy have been shown to significantly increase long-term abstinence rates, and combining the two treatment modalities is recommended. This article provides an update on pharmacotherapy for smoking cessation in the general population. Current first-line agents used to support quit attempts are nicotine replacement therapy (NRT), bupropion and varenicline. Research suggests that abstinence rates can be increased by combining different forms of NRT or simultaneously administering NRT and non-nicotine medications. New treatments targeting the nicotinic acetylcholine receptor as well as other pathophysiological pathways involved in nicotine addiction are being developed, with nicotine vaccines now being tested in phase III clinical trials. Among the numerous research topics currently addressed, pharmacogenetics and tailoring therapy to specific groups of smokers look most promising. However, substantial progress is unlikely to be made unless social gradients impeding effective treatment of all smokers are overcome. In addition, public smoking bans and reimbursement of medication costs are crucial in reducing the future burden of disease caused by smoking on a global level.Pfizer; GlaxoSmithKlin
The Most Successful Method for Failing to Quit Smoking Is Unassisted Cessation
No full textCancer Research UK [14135, ]; Department of Healt
Pharmacotherapy for Smoking Cessation Current Advances and Research Topics
No full textPromoting smoking cessation is among the key medical interventions aimed at reducing worldwide morbidity and mortality in this century. Both behavioural counselling and pharmacotherapy have been shown to significantly increase long-term abstinence rates, and combining the two treatment modalities is recommended. This article provides an update on pharmacotherapy for smoking cessation in the general population. Current first-line agents used to support quit attempts are nicotine replacement therapy (NRT), bupropion and varenicline. Research suggests that abstinence rates can be increased by combining different forms of NRT or simultaneously administering NRT and non-nicotine medications. New treatments targeting the nicotinic acetylcholine receptor as well as other pathophysiological pathways involved in nicotine addiction are being developed, with nicotine vaccines now being tested in phase III clinical trials. Among the numerous research topics currently addressed, pharmacogenetics and tailoring therapy to specific groups of smokers look most promising. However, substantial progress is unlikely to be made unless social gradients impeding effective treatment of all smokers are overcome. In addition, public smoking bans and reimbursement of medication costs are crucial in reducing the future burden of disease caused by smoking on a global level.Pfizer; GlaxoSmithKlin
Answer to the commentary about compliance to assumptions and choice of the model in item response theory
No full textA systematic review of factors influencing student ratings in undergraduate medical education course evaluations
Full text linkBackground: Student ratings are a popular source of course evaluations in undergraduate medical education. Data on the reliability and validity of such ratings have mostly been derived from studies unrelated to medical education. Since medical education differs considerably from other higher education settings, an analysis of factors influencing overall student ratings with a specific focus on medical education was needed. Methods: For the purpose of this systematic review, online databases (PubMed, PsycInfo and Web of Science) were searched up to August 1st, 2013. Original research articles on the use of student ratings in course evaluations in undergraduate medical education were eligible for inclusion. Included studies considered the format of evaluation tools and assessed the association of independent and dependent (i.e., overall course ratings) variables. Inclusion and exclusion criteria were checked by two independent reviewers, and results were synthesised in a narrative review. Results: Twenty-five studies met the inclusion criteria. Qualitative research (2 studies) indicated that overall course ratings are mainly influenced by student satisfaction with teaching and exam difficulty rather than objective determinants of high quality teaching. Quantitative research (23 studies) yielded various influencing factors related to four categories: student characteristics, exposure to teaching, satisfaction with examinations and the evaluation process itself. Female gender, greater initial interest in course content, higher exam scores and higher satisfaction with exams were associated with more positive overall course ratings. Conclusions: Due to the heterogeneity and methodological limitations of included studies, results must be interpreted with caution. Medical educators need to be aware of various influences on student ratings when developing data collection instruments and interpreting evaluation results. More research into the reliability and validity of overall course ratings as typically used in the evaluation of undergraduate medical education is warranted
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