Urinary cotinine in narguila or chicha tobacco smokers

Urinary levels of nicotine metabolites were measured in nonsmokers and of tobacco either as cigarettes or as the middle eastern water pipes [narguila]. Levels of urinary cotinine were similar for the smokers of cigarettes [median 30 cigarettes per day] and narguila [median 2 pipes per day, or around 40 grams of tobacco]. Use of water pipes may remove a small amount of nicotine, but smokers appear to titrate dose to effect. It is unlikely that narguila smoking confers any less risk

epidemic of hyperthyroidism following salt iodination in Lebanon

Salt iodination, in Lebanon, started partially in late 1992, and was implemented in a uniform manner by January 1995. following salt iodination, an epidemic of iodine-induced thyrotoxicosis occurred as noted by the author, in his private clinic. The number of thyrotoxic patients increased sharply by 2 to 6 folds, and the yearly incidence rose from a baseline of 0.02% up to 0.07%. the younger patients have predominantly Graves disease [32% of the cases], while 17% have solitary thyroid nodules, and 44% of the cases were elderly subjects with multinodular goiter. The patholgenwsis and possible causes of this epidemic are discussed