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PubMed1997

Factors influencing psychosocial development of preschool children in a rural area of Haryana, India.

In a cross-sectional survey, 3746 children aged less than 6 years residing in 47 randomly selected villages of district Ambala (India), were studied to find out the environmental risk factors influencing psychosocial development. A culture appropriate test battery comprising 67 test items was administered, and psychosocial development score of each child was computed by scoring each test item passed as 1 and failed as 0. At each age level children having score in lower quartile were categorised as having slow psychosocial development and those in upper quartile were labelled as having accelerated development. Logistic regression revealed that per capita income, education of mother, nutritional status of the child, number of rooms and environmental hygiene in the house, presence of a high school within easy travel distance, availability of a caretaker when mother is busy, child attending a nursery (anganwadi), households having access to newspaper, child having toys or toy substitutes, TV, books, story telling by the mother were found to have a significant association with psychosocial development of preschool children. The risk factors identified in this survey can be used for screening families at risk in rural communities and for selection of interventions for promotion of psychosocial development of children.

Analysis of Variance↗
PubMedDate not supplied

Dietary protein and blood pressure.

OBJECTIVE: - To review published and presented data on the relationship between dietary protein and blood pressure in humans and animals. DATA SOURCES: - Bibliographies from review articles and books on diet and blood pressure that had references to dietary protein. The bibliographies were supplemented with computerized MEDLINE search restricted to English language and abstracts presented at epidemiologic meetings. STUDY SELECTION: - Observational and intervention studies in humans and experimental studies in animals. DATA EXTRACTION: - In human studies, systolic or diastolic blood pressure were outcome measures, and dietary protein was measured by dietary assessment methods or by urine collections. In animal studies, blood pressure and related physiological effects were outcome measures, and experimental treatment included protein or amino acids. DATA SYNTHESIS: - Historically, dietary protein has been thought to raise blood pressure; however, studies conducted in Japan raised the possibility of an inverse relationship. Data analyses from subsequent observational studies in the United States and elsewhere have provided evidence of an inverse relationship between protein and blood pressure. However, intervention studies have mostly found no significant effects of protein on blood pressure. Few animal studies have specifically examined the effects of increased dietary protein on blood pressure. CONCLUSIONS: - Because of insufficient data and limitations in previous investigations, better controlled and adequately powered human studies are needed to assess the effect of dietary protein on blood pressure. In addition, more research using animal models, in which experimental conditions are highly controlled and detailed mechanistic studies can be performed, is needed to help provide experimental support for or against the protein-blood pressure hypothesis.

Animals↗
PubMed2005

Insulin and oral agents for managing cystic fibrosis-related diabetes.

BACKGROUND: Insulin therapy is recommended by the Cystic Fibrosis Foundation when cystic fibrosis-related diabetes has been diagnosed. Diagnosis is based on an elevated fasting blood glucose level greater than 6.94 mmol/liter (125 mg/deciliter) or symptomatic diabetes for random glucose levels greater than 11.11 mmol/liter (200 mg/deciliter). OBJECTIVES: To examine the evidence that, when treated with agents for managing diabetes, people with cystic fibrosis improve their sugar metabolic control resulting in beneficial impact on lung function and the ability to maintain optimal weight. SEARCH STRATEGY: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also handsearched abstracts from pulmonary and North American Cystic Fibrosis Conference symposia. Date of the most recent search of the Group's Trials Register: December 2004. SELECTION CRITERIA: Randomized controlled trials comparing all methods of diabetes therapy for one month or longer in people with cystic fibrosis. DATA COLLECTION AND ANALYSIS: No studies were found which were eligible for inclusion in this review. MAIN RESULTS: Six references to four studies were identified by the searches, but none were eligible for inclusion in the review as they were not randomized controlled trials. AUTHORS' CONCLUSIONS: While some cystic fibrosis centers use oral medications to help control diabetes, a condition which complicates the course of cystic fibrosis, insulin therapy is the recommended and most widely used treatment method. Lung function has been reported to improve with the use of insulin, but this has not been correlated to the degree in which sugar metabolism has been affected. While the Cystic Fibrosis Foundation recommends insulin therapy be used in managing diabetes, this systematic review identifies the need for a multicentre randomized controlled trial assessing both the efficacy of insulin or other insulin-releasing or insulin-sensitizing medications and their possible adverse effects in managing cystic fibrosis-related diabetes.

Administration, Oral↗
PubMed2006

Azapirones for generalized anxiety disorder.

BACKGROUND: Azapirones are a group of drugs that work at the 5-HT1A receptor and are used to treat patients suffering from generalized anxiety disorder (GAD). However, several studies have shown conflicting results. Whether azapirones are useful as first line treatment in general anxiety disorders still needs to be answered. OBJECTIVES: To assess the efficacy and the acceptability of azapirones for the treatment of GAD. SEARCH STRATEGY: Initially the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR) and The Cochrane Central Register of Controlled Trials (CENTRAL) were searched, incorporating results of group searches of MEDLINE (1966 to June 2005), EMBASE (1980 to June 2005), CINAHL (1982 to June 2005), PsycLIT (1974 to June 2005), PSYNDEX (1977 to June 2005), and LILACS (1982 to June 2005). Subsequently the revised Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (CCDANCTR-Studies and CCDANCTR-References) were searched on 21-10-2005. Reference lists of relevant papers and major text books of anxiety disorder were examined. Authors, other experts in the field and pharmaceutical companies were contacted for knowledge of suitable trials, published or unpublished. Specialist journals concerning azapirones were handsearched. SELECTION CRITERIA: Randomized controlled trials of azapirones, including buspirone versus placebo and/or other medication and/or psychological treatment, were included. Participants were males and females of all ages with a diagnosis of generalized anxiety disorder. DATA COLLECTION AND ANALYSIS: Data were extracted from the original reports independently by CC, MA and MT. The main outcomes studied were related to the objectives stated above. Data were analysed for generalized anxiety disorder versus placebo, versus other medication and versus psychological treatment separately. Data were analysed using Review Manager Version 4.2.7. MAIN RESULTS: Thirty six trials were included in the review, reporting on 5908 participants randomly allocated to azapirones and/or placebo, benzodiazepines, antidepressants, psychotherapy or kava kava. Azapirones, including buspirone, were superior to placebo in treating GAD. The calculated number needed to treat for azapirones using the Clinical Global Impression scale was 4.4 (95% confidence interval (CI) 2.16 to 15.4). Azapirones may be less effective than benzodiazepines and we were unable to conclude if azapirones were superior to antidepressants, kava kava or psychotherapy. Azapirones appeared to be well tolerated. Fewer participants stopped taking benzodiazepines compared to azapirones. The length of studies ranged from four to nine weeks, with one study lasting 14 weeks. AUTHORS' CONCLUSIONS: Azapirones appeared to be useful in the treatment of GAD, particularly for those participants who had not been on a benzodiazepine. Azapirones may not be superior to benzodiazepines and do not appear as acceptable as benzodiazepines. Side effects appeared mild and non serious in the azapirone treated group. Longer term studies are needed to show that azapirones are effective in treating GAD, which is a chronic long-term illness.

Anti-Anxiety Agents↗
PubMed2003

Specific dermatoses of pregnancy: an evidence-based systematic review.

OBJECTIVE: We conducted an evidence-based systematic analysis of the literature on specific dermatoses of pregnancy. STUDY DESIGN: The bibliographic databases MEDLINE and EMBASE were screened for studies and reports in all languages about herpes gestationis, pruritic urticarial papules and plaques of pregnancy, pruritic folliculitis of pregnancy, and prurigo of pregnancy from January 1962 to January 2002. As main index terms, including analogs and derivatives, we used the names of specific dermatoses of pregnancy. Intrahepatic cholestasis of pregnancy, not a primary dermatosis, was included herein because this disorder is associated with pregnancy and its secondary skin manifestations must be differentiated from specific dermatoses of pregnancy. Other sources were abstract books of symposia and congresses, theses, textbooks, monographs, reviews, editorials, letters to the editor, free or rapid communications, and the reference lists from all the articles that were retrieved. All articles selected for inclusion in this review were evaluated critically with regard to their impact factor and evidence-based contribution to this field, as measured by their citation index and impact factor of the journal in which they were published. Approximately 39% of articles met the selection criteria. RESULTS: The clinical features and prognosis of the specific dermatoses of pregnancy have been delineated through a number of retrospective and cohort studies. The molecular biologic and immunogenetic properties of herpes gestationis, pruritic urticarial papules and plaques of pregnancy, and intrahepatic cholestasis of pregnancy have been further clarified. A meta-analysis in this review reveals a higher prevalence of multiple gestation pregnancy (11.7%) among patients with pruritic urticarial papules and plaques of pregnancy. Several investigations have unraveled the fetal complications in intrahepatic cholestasis of pregnancy and herpes gestationis. New treatment modalities in intrahepatic cholestasis of pregnancy (cholestyramine, ursodeoxycholic acid) and herpes gestationis (cyclosporin, intravenous immunoglobulin, and tetracyclines postpartum) have shown promise and warrant further evaluation. CONCLUSION: During the past few decades, a significant amount of new data has provided new insights into the classification, pathogenesis, treatment, prognosis, and fetal risks that are associated with the specific dermatoses of pregnancy.

Cholestasis, Intrahepatic↗
PubMed2006

The influence of high-efficiency particulate air filtration on mortality and fungal infection among highly immunosuppressed patients: a systematic review.

BACKGROUND: Patients with hematological malignancies who are treated with intensive chemotherapy or who receive bone marrow transplants are exposed to an increased risk of developing nosocomial fungal infections. The aim of this systematic review was to compare the effectiveness of high-efficiency particulate air (HEPA) filtration with that of non-HEPA filtration in decreasing the rates of mortality and fungal infection among patients with diagnosed hematological malignancies and neutropenia or among patients with bone marrow transplants. METHODS: Articles identified in a Medline search, guidelines, and books, as well as the bibliographies of review articles, monographs, and the articles identified by Medline, were researched. Randomized trials and observational studies comparing HEPA filtration with conventional room ventilation were selected for inclusion in the present review. RESULTS: Sixteen trials (9 with death as an outcome and 10 with fungal infection as an outcome) that compared HEPA filtration with non-HEPA filtration were selected for meta-analyses. We discovered no significant advantages of HEPA filtration in the prevention of death among patients with hematological malignancies with severe neutropenia in randomized controlled trials (RCTs; relative risk [RR], 0.86 [95% confidence interval {CI}, 0.65-1.14]) and in studies of a lower standard (non-RCTs; RR, 0.87 [95% CI, 0.60-1.25]). CONCLUSIONS: The placement in protected areas of patients with hematological malignancies with severe neutropenia or patients with bone marrow transplants appears to be beneficial, but no definitive conclusion could be drawn from the data available.

Air Microbiology↗
PubMed2003

Use of schizophrenia as a metaphor in US newspapers.

Research has identified misleading and stigmatizing popular beliefs about schizophrenia, but little is known about media images corresponding to these beliefs. Building on Susan Sontag's exploration of cancer in the 1978 book Illness as Metaphor, the authors hypothesize that "schizophrenia" is now more commonly misused. A total of 1740 newspaper articles from 1996 or 1997 that mentioned schizophrenia or cancer were randomly selected and then coded for contextual and metaphorical use. Only 1 percent of articles that mentioned cancer used that illness in a metaphorical way, compared with 28 percent of the articles that mentioned schizophrenia. Results differed by newspaper but not by region. The authors suggest that these inaccurate metaphors in the media contribute to the ongoing stigma and misunderstandings of psychotic illnesses.

Humans↗
PubMed2002

A methodological report from the Malmö Diet and Cancer study: development and evaluation of altered routines in dietary data processing.

BACKGROUND: In the Malmö Diet and Cancer study, information on dietary habits was obtained through a modified diet history method, combining a 7-day menu book for cooked meals and a diet questionnaire for foods with low day-to-day variation. Half way through the baseline data collection, a change of interview routines was implemented in order to reduce interview time. METHODS: Changes concentrated on portion-size estimation and recipe coding of mixed dishes reported in the menu book. All method development and tests were carefully monitored, based on experiential knowledge, and supplemented with empirical data. A post hoc evaluation study using "real world" data compared observed means of selected dietary variables before and after the alteration of routines handling dietary data, controlling for potential confounders. RESULTS: These tests suggested that simplified coding rules and standard portion-sizes could be used on a limited number of foods, without distortions of the group mean nutrient intakes, or the participants' ranking. The post hoc evaluation suggested that mean intakes of energy-adjusted fat were higher after the change in routines. The impact appeared greater in women than in men. CONCLUSIONS: Future descriptive studies should consider selecting subsets assessed with either method version to avoid distortion of observed mean intakes. The impact in analytical studies may be small, because method version and diet assistant explained less than 1 percent of total variation. The distribution of cases and non-cases across method versions should be monitored.

Journal Article↗
PubMed1992

The effect of prenatal diagnosis on the incidence of Down syndrome livebirths in the Singapore General Hospital.

During a 3-year-period between January 1988 and December 1990, there were 12 Down Syndrome (DS) livebirths out of 13,794 livebirths at the Department of Obstetrics and Gynaecology, Singapore General Hospital, giving an incidence of 1 in 1,150 livebirths or 0.87 per thousand. There were 1569 mothers who were 35 years or older at the expected date of delivery (EDD) and 5 of these 12 DS livebirths were from these older mothers. Although only 11.5% of all mothers were 35 years or more, as a group, these older mothers contributed to 42% of the DS livebirths. There were 5 DS fetuses diagnosed prenatally and 4 were aborted electively. The fifth DS fetus which was diagnosed prenatally was allowed to continue to term because of the mother's religious objection to an induced abortion. The failure to offer prenatal diagnosis and selective procreation to all mothers 35 years or older had resulted in 4 unnecessary DS births, reducing our DS detection rate by a factor of 33%. All these 4 cases were booked late for antenatal care.

Adult↗
PubMed1993

Is personal continuity of care compatible with free choice of doctor? Patients' views on seeing the same doctor.

While much has been written about the benefits of personal continuity of care there has been little research about the views of patients. In this cross sectional study 111 patients from three group practices (one of which ran a personal list system) were interviewed at home within a week of consulting a general practitioner. Patients were selected randomly from a systematic series of consulting sessions and a semi-structured interview was administered. Patients receiving more personal continuity of care were likely to be older, to have booked their most recent appointment further in advance, to desire personal continuity of care, to have an external health locus of control and to have a lower extroversion score. In the practice with a personal list, patients had a high level of continuity of care, were satisfied and showed little interest in having a choice of doctor. In the combined list practices patients valued their choice of doctor but often could not exercise it enough and they were more critical. They made more suggestions for change than those in the practice with a personal list system, mostly about receptionists and appointments. It is concluded that most patients like to see the same doctor, but they may not be willing to wait two days for this if there is a quicker option. It may be difficult to deliver both personal continuity of care and choice in group practice.

Attitude to Health↗
PubMed1998

Freud's presentation of 'the psychoanalytic mode of thought' in Totem and taboo and his technical papers.

Freud considered 'the psychoanalytic mode of thought' to be an instrument of research. In 'Totem and Taboo', he demonstrated his mode of thinking by applying it to the data of contemporary studies of totemism. While taking the reader along the paths of his selection and weighing of information, he also applied clinical discoveries about mental life in reconstructing 'primitive psychological situations' in the distant past. In the technical papers that appeared concurrently with his book, he applied to the clinical situation the ideas on transference, narcissism, primitive mental mechanisms and unconscious communication that he had explored in 'Totem and Taboo'. In this paper, the author presents material showing the structure of Freud's exposition as a model of analytic exploration. Some of the principles of mental organisation mentioned by Freud are discussed. Examples are given of the close parallels between 'Totem and Taboo' and two technical papers. The author suggests that 'Totem and Taboo' is an important step in Freud's development of his theory of object relations and his ideas about the intersubjectivity of unconscious mental life.

Cultural Evolution↗
PubMed1998

Cancer risk assessment: conceptual considerations for clinical practice.

PURPOSE/OBJECTIVES: To review current information on the types and components of risk assessment and associated considerations for clinical practice and education. DATA SOURCES: Published articles, book chapters, and clinical experience. DATA SYNTHESIS: Cancer risk assessment is a clinical process that is integral to cancer screening. Cancer risk assessment includes obtaining information about cancer risk factors and selecting the best means to communicate this information to individual patients. Ethical, psychosocial, and clinical factors are considerations. A comprehensive tool to provide consistency in documenting risk factors as part of a comprehensive cancer risk assessment is included. CONCLUSIONS: Nurses can conduct and interpret cancer risk assessments. Consideration of conceptual issues of risk assessment may enhance this process. IMPLICATIONS FOR NURSING PRACTICE: When implementing cancer risk assessments into cancer screening programs, nurses need to consider the purpose of conducting the risk assessment, how the information will be interpreted to the population being served, and the potential impact on an individual patient.

Adolescent↗
PubMedDate not supplied

Research methodology and applied statistics. Part 2: the literature search.

This paper presents a basic methodology for an effective and efficient retrieval and recording of written materials in a subject area. The purpose of the literature review is examined and the criteria for selection of materials for inclusion are outlined. The methodology then describes the role of the librarian, various types of information resources, how to choose appropriate indexing and abstracting services, and a simple efficient method of recording the items found. The importance and use of Medical Subject Headings for research in physiotherapy is emphasized. A survey of types of book materials and how to locate them is followed by a detailed description of the most useful indexing and abstracting services available, in particular, the publications of the National Library of Medicine, notably Index Medicus, as well as Excerpta Medica and the Science Citation Index. A discussion of on-line search services, their coverage and availability in Canada, concludes the review of information sources. Finally, guidelines for selecting and summarizing the materials located and comments on the literary style for a review are supplied.

Documentation↗
PubMed1986

Problem-oriented drug monographs developed for physicians in Northern Ireland.

Monographs prepared by a drug information pharmacist at a government hospital in Northern Ireland were evaluated by hospital and community physicians. The monographs related drug information to both the primary medical problem (e.g., angina) and secondary problems of individual patients (e.g., renal or hepatic dysfunction). The pharmacokinetic and pharmacodynamic properties of various agents in a drug group were compared. The initial monograph about beta blockers was evaluated by 13 pharmacists in government hospitals. The monograph was then revised and two additional monographs were written on the use of benzodiazepines in anxiety and insomnia and the use of organic nitrates in cardiovascular disease. The three monographs were distributed to 122 hospital physicians and 67 community physicians for evaluation of the information and the manner in which it was presented. Questionnaires were returned by 46% of the hospital physicians and 39% of the community physicians. Almost 50% of the responding prescribers said the monographs gave them new information. The lack of cost information in the monographs was cited as a problem by 25% of respondents. The most frequently suggested topics for additional monographs were antibiotics, analgesics, nonsteroidal anti-inflammatory agents, bronchodilators, and antidepressants. Physicians considered the monographs a useful source of education about selection of appropriate drug therapy.

Adrenergic beta-Antagonists↗
PubMed2001

Single versus combination intravenous antibiotic therapy for people with cystic fibrosis.

BACKGROUND: Choice of antibiotic, and the use of single or combined therapy are controversial areas in the treatment of respiratory infection in Cystic Fibrosis (CF). Advantages of combination therapy include wider range of modes of action, possible synergy and reduction of resistant organisms; advantages of monotherapy include lower cost, ease of administration and reduction of drug related toxicity. Current evidence does not provide a clear answer and therefore the use of intravenous antibiotic therapy in CF requires further evaluation. OBJECTIVES: To assess the effectiveness of single compared to combination intravenous antibiotic therapy in the treatment of patients with CF. SEARCH STRATEGY: The Cochrane CF and Genetic Disorders Group Specialised Register of Controlled Trials and the abstract books of the three major CF conferences were searched to identify randomised controlled trials. The register was compiled by conducting detailed computer searches of Medline from 1966-present and Embase 1974-1995. SELECTION CRITERIA: Randomised controlled trials comparing a single intravenous antibiotic with a combination of that antibiotic plus a second antibiotic in patients with CF. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality and extracted data. MAIN RESULTS: A total of nine studies including 386 patients compared a single agent to a combination of the same antibiotic and one other. There was a wide variation in the individual antibiotics used in each study. In total, the studies included eight comparisons of a beta-lactam antibiotic (penicillin-related or third generation cephalosporin) with a beta-lactam-aminoglycoside combination and three comparisons of an aminoglycoside with a beta-lactam-aminoglycoside combination. These two groups of studies were analysed as separate subgroups. There was considerable heterogeneity amongst these trials which led to difficulties in performing the review and interpreting the results. The meta-analysis did not demonstrate any significant differences between monotherapy and combination therapy, in terms of lung function, symptom scores and adverse effects. Single therapy was associated with an increase in the number of patients with resistant strains of Ps. aeruginosa at two to eight weeks follow-up. This is an important preliminary finding which needs further clarification with a good quality long-term study. These results should be interpreted with caution. All but two of the included trials were published between 1977 and 1988; these were single centre studies with flaws in the randomisation process and small sample size. Overall, the methodological quality was poor. REVIEWER'S CONCLUSIONS: The results of this systematic review of monotherapy versus combination therapy for pulmonary exacerbations in CF are inconclusive. The review raises important methodological issues. There is a need for a randomised controlled trial which needs to be well designed in terms of adequate randomisation allocation, blinding, power and long-term follow up. Results need to be standardised to a consistent method of reporting, in order to validate the pooling of results from multiple studies.

Aminoglycosides↗
PubMed2005

["Morphobreast": patient's data bank management for objective selection of implant's volume in hypotrophic breasts].

Good selection of mammary implant volume is essential to satisfy patient's real desire of breast augmentation. The authors have developed a data processing called "Morphosein": it is an active press-i-book, allowing recording and exploitation of basic morphologic datas before and after operating procedure. They use Filemaker Pro as basic software and database, which is fed with personnal patients. This tool allows a comparative research on patients having a similar morphologic and on results obtained with different types of implants. These datas, store since 4 years, give to the authors' objective informations to help the patient's choice.

Adult↗
PubMed2003

Control of occupational asthma and allergy in the detergent industry.

OBJECTIVE: To provide an overview of how a comprehensive preclinical, clinical, and industrial hygiene program has been successfully used to control allergy and asthma to enzymes used in the detergent industry. DATA SOURCES: The author performed a PubMed and ToxLine search of English-language articles with the keywords enzymes, occupational allergy, occupational asthma, detergent, and detergent industry from January 1, 1995, to January 1, 2002. Scientific meeting abstracts, books, and industry association papers on allergy and asthma in the detergent industry were also reviewed. In addition, the practical experience of one major detergent company was included in the review. STUDY SELECTION: All published work on this topic was reviewed, and the work that discussed the key highlights of control of occupational allergy and asthma to enzymes used in the detergent industry was selected for this review. RESULTS: The detergent industry has developed guidelines for the safety assessment of enzymes, control of exposure to enzymes, and medical surveillance of enzyme-exposed workers. Because of these guidelines, occupational allergy and asthma to enzymes used in the detergent industry have become uncommon events. Cases of disease have been documented in some manufacturing sites that have had poor adherence to the guidelines. Those manufacturing sites that have adhered to the guidelines have had few cases of allergy and asthma to enzymes among exposed workers. A review of medical data from these sites has shown that workers who have developed IgE antibody to enzymes can continue to work with enzymes and remain symptom free. CONCLUSIONS: Occupational allergy and asthma to enzymes used in the detergent industry have been successfully controlled via the use of preclinical, clinical, and industrial hygiene safety programs designed to minimize sensitization to enzymes and development of disease. The basic principles of these programs can be applied to other industries where occupational allergy and asthma to proteins are common.

Asthma↗
PubMed1997

Review of the evidence that pH is a determinant of nicotine dosage from oral use of smokeless tobacco.

OBJECTIVE: To determine whether manipulation of the pH of moist-snuff products by manufacturers could control the delivery of nicotine. DATA SOURCES: Medline database 1966-97 using the following subject headings and keywords: nicotine, absorption, mouth mucosa, skin, hydrogen-ion concentration, smokeless tobacco, biological transport, and membranes; computer database of the tobacco bibliography maintained by the US Centers for Disease Control and Prevention's Office on Smoking and Health; bibliographies of pertinent journal articles, books, and governmental reports; personal communications with experts in nicotine pharmacology and addiction; and Brown & Williamson Tobacco Corporation documents in the Tobacco Control Archives of the University of California, San Francisco. STUDY SELECTION: Included all relevant animal studies, in-vitro studies, nicotine replacement therapy trials, and human observational studies. DATA SYNTHESIS: We found that the effects of pH on drug absorption have been well established in animal models for nicotine and many other acidic or basic compounds. Increased alkalinity promotes the absorption of nicotine and increases its physiological effects. Human studies, which are more limited, confirm these processes. For example, nicotine absorption is directly related to the pH when nicotine is delivered in either tobacco smoke or nicotine polacrilex gum. CONCLUSIONS: Although other factors could influence the rate of nicotine absorption from oral tobacco, manipulating tobacco pH appears to be the primary means by which the speed of nicotine absorption is determined in moist-snuff products.

Administration, Oral↗