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Biomedical subjects

J Slade

Publications and source records attributed to J Slade.

At least 55 records · Page 3Linked to original sources

Epidemiology of tobacco use and dependence.

Knowledge of the epidemiology of tobacco use and dependence can be used to guide research initiatives, intervention programs, and policy decisions. Both the reduction in the prevalence of smoking among US adults and black adolescents and the decline in per capita consumption are encouraging. These changes have probably been influenced by factors operating at the individual (e.g., school-based prevention programs and cessation programs) and environmental (e.g., mass media educational strategies, the presence of smoke-free laws and policies, and the price of tobacco products) levels (for a discussion of these factors, see, e.g., refs. 2, 48, 52, 183, and 184). The lack of progress among adolescents, especially whites and males, and the high risk for experimenters of developing tobacco dependence present cause for great concern (48, 183-186). In addition to those discussed above, several areas of research can be recommended. 1. Better understanding of the clustering of tobacco use with the use of other drugs, other risk behaviors, and other psychiatric disorders could better illuminate the causal processes involved, as well as the special features of the interventions needed to prevent and treat tobacco dependence. 2. To better understand population needs, trend analyses of prevalence, initiation, and cessation should, whenever possible, incorporate standardized measures of these other risk factors. Future research should compare the effect of socioeconomic status variables on measures of smoking behavior among racial/ethnic groups in the United States. 3. For reasons that may be genetic, environmental, or both, some persons do not progress beyond initial experimentation with tobacco use (2, 48, 183, 187-192), but about one-third to one-half of those who experiment with cigarettes become regular users (48, 193, 194). Factors, both individual and environmental, that can influence the susceptibility of individuals to tobacco dependence need further attention. 4. To estimate their sensitivity and specificity, comparisons of the National Household Survey on Drug Abuse indicators of dependence with DSM-based criteria are needed. Public health action continues to be warranted to reduce the substantial morbidity and mortality caused by tobacco use (195). A paradigm for such action has been recommended and involves preventing the onset of use, treating tobacco dependence, protecting non-smokers from exposure to secondhand smoke, promoting nonsmoking messages while limiting the effect of tobacco advertising and promotion on young people, increasing the real (inflation-adjusted) price of tobacco products, and regulating tobacco products (186).

Adolescent↗

Quantitative study of synaptophysin immunoreactivity of cerebral cortex and spinal cord in motor neuron disease.

Synaptophysin immunoreactivity can be quantified by image analysis to evaluate loss of presynaptic terminals in human neurodegenerative diseases. The extent and regional distribution of such loss is reported in motor neuron disease (MND). Autopsy samples of spinal cord and cerebral cortex were examined from 28 cases of MND and 28 age and sex matched controls. The MND group included individuals with amyotrophic lateral sclerosis (17[ALS]), and progressive muscular atrophy (11[PMA]). In the spinal cord, there was significant reduction of presynaptic terminals in the lateral ventral horn (15%) in both the ALS (p < 0.01) and PMA (p < 0.05) groups. Perisomatic synaptophysin profiles on lower motor neurons are preserved late in the disease and are not related to corticospinal innervation. Less marked presynaptic loss was demonstrable more widely in the medial ventral, intermediate and dorsal spinal grey matter (10%) in both ALS (p = 0.03) and PMA (p = 0.05). In the cerebral cortex no synaptic loss was demonstrated in motor or anterior cingulate regions in any of the MND cases. Spinal degeneration in MND is associated with loss of presynaptic terminals in all grey matter regions. It is most marked in the limb motor neuron area and is independent of corticospinal tract degeneration. The cerebral pathology of ALS is not associated with significant loss of presynaptic terminals in the cortical areas studied.

Adult↗

Nicotine addiction counseling for chemically dependent patients.

A total of 771 professionals employed in alcohol treatment programs in Nebraska were surveyed to determine whether their personal alcohol and tobacco use status or characteristics of their treatment programs were related to whether they provided nicotine addiction counseling. About a third of respondents agreed that clients in active treatment should be urged to quit smoking. Compared with respondents who had never smoked, current smokers were one-half to one-third as likely to provide such counseling. Greater knowledge of the effects of nicotine addiction and employment in programs that provided nicotine addiction education or treatment increased the odds of counselors' providing nicotine counseling. Counselors' alcohol use status was not associated with nicotine counseling practices.

Adult↗

Parvalbumin and calbindin D-28k in the human motor system and in motor neuron disease.

Calbindin D-28k and parvalbumin are neuronal calcium binding proteins of interest in relation to neurodegenerative diseases. Expression of calbindin and parvalbumin may be one of the determinants of selective vulnerability in these disorders. The distribution of these proteins was surveyed in the normal human motor system and in motor neuron disease (MND) using immunocytochemistry in formalin fixed post-mortem tissues. CNS tissues from 14 MND patients (mean age 61.2 years, mean post-mortem delay 24.6 h) and seven controls (mean age 62.6 years, mean post-mortem delay 25.3 h) were studied. Preliminary studies on the effects of fixation were performed. In normal cases upper and lower motor neurons showed absent expression of both proteins. Several neuronal groups characteristically spared in MND showed varying patterns of immunoreactivity: oculomotor neurons showed parvalbumin staining of the perikaryon; the thoracic preganglionic sympathetic neurons showed calbindin staining in perikarya. Onuf's nucleus showed calbindin staining in the neuropil only. In motor neuron disease a loss of ventral horn interneurons and calbindin immunoreactive processes was observed with no other disease related changes in the spinal cord, brain-stem, or motor cortex. These findings are consistent with the hypothesis that the distribution of these proteins is one determinant of selective vulnerability to the neurodegenerative processes in MND acting via disturbance of neuronal calcium homeostasis.

Amyotrophic Lateral Sclerosis↗

Adolescent Nicotine Use and Dependence.

Because regular, compulsive smoking usually begins in childhood or adolescence, pediatricians and other clinicians with adolescent patients have a unique opportunity to treat and prevent nicotine addiction before it causes lasting harm or death. The author examines the pharmacology, toxicity, and natural history of nicotine addiction as well as its relationship to other drug problems and methods of clinical management.

Journal Article↗

Nicotine dependence: intervention strategies for the physician.

Nicotine dependence is the most common serious medical problem in primary care. Its complications are common and far reaching, both for the person addicted to tobacco and for other people in the environment. Nicotine dependence is highly treatable.

Administration, Cutaneous↗

Adult-onset motor neuron disease and infantile Werdnig-Hoffmann disease (spinal muscular atrophy type 1) in the same family.

We describe a family in which infantile Werdnig-Hoffmann disease and adult-onset progressive muscular atrophy both occurred. The possibility of these two diseases developing within the same family by chance is unlikely, and several genetic hypotheses may be put forward to explain the association. We suggest that the molecular pathogenesis of these two subtypes of lower motor neuron degeneration may be linked. The genetic defect in the childhood spinal muscular atrophies has been mapped to chromosome 5q in close proximity to the microtubule-associated protein 1B locus. The association of diseases within this family suggests that chromosome 5q should also be studied in relation to adult-onset familial motor neuron disease.

Aged↗

Lower motor neuron degeneration and familial predisposition to colonic neoplasia in two adult siblings.

A previously unreported association between a familial predisposition to colonic neoplasia and familial adult onset lower motor neuron (LMN) degeneration is reported. Two brothers presented at the ages of 53 and 44 years with multiple colonic adenomata and invasive colonic carcinoma respectively. Subsequently both developed a virtually identical pattern of motor neuron disease of progressive muscular atrophy type. At presentation both had LMN weakness affecting predominantly the upper limb and neck muscles. The disease progressed rapidly to involve the lower limb and bulbar musculature and both brothers died after a 15 month course. Necropsy was performed on one brother and showed pathological changes confined to the LMNs with no evidence of involvement of the pyramidal tracts or motor cortex. The combination of these diseases in two brothers may be of importance in the search for genes responsible for familial motor neuron disorders. It is suggested that a genomic search should be directed initially to the vicinity of known colon neoplasia genes, particularly 5q, 17q and 18q.

Adenocarcinoma↗

Development of smoke-free chemical dependency units.

Until recently, the country's chemical dependency units (CDUs) have not addressed nicotine dependence in a meaningful way for their patients. Most CDUs have accepted exemptions to the smoke-free hospital requirements enacted around the country. Twenty-nine CDU's have been identified which have developed progressive smoke-free policies and begun to treat nicotine dependence in the substance abuser. These CDUs cite three factors--concern for the smoker's health, concern for the health effects of involuntary smoking, and the strong opinion of a key leader--as motivations to implement these policies. Because of the significant resistance to these policies, the strong opinion of a key leader was considered one of the most important factors. Once the policy was in place, these CDUs were surprised that the programs ran so smoothly, including normal census counts. The CDUs used a variety of interventions to help smokers quit. There is considerable need to develop effective interventions suitable for CDUs in the treatment of nicotine dependence.

Health Policy↗

Nicotine addiction.

Addiction to nicotine is the most common serious condition in medicine today. This chemical dependency has produced the largest epidemic of disease in this century, an epidemic that is beginning to wane in the United States but which is accelerating in the Third World. Widespread cultural acceptance of tobacco and the malignant fostering of use by cigarette merchants has perpetuated the epidemic. Nicotine regularly causes addiction in its users. This condition is best viewed as a chronic disease with remissions and exacerbations. It is highly amenable to treatment, and primary-care physicians are ideally situated to manage this fascinating condition. Physicians have a larger role to play, as well, in the many opportunities that exist to prevent this condition in the young and to protect non-smokers from tobacco smoke pollution.

Humans↗