Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes: results from five pooled cohorts.

BACKGROUND: Smoking and nicotine exposure increase insulin resistance and the risk of type 2 diabetes. Swedish smokeless tobacco (snus) is high in nicotine, and its use is prevalent in Scandinavian countries, but few studies have investigated snus use in relation to diabetes risk. OBJECTIVE: To explore the association between snus use and risk of type 2 diabetes using pooled data from five cohorts. METHODS: Analyses were based on prospective studies conducted between 1990 and 2013 including 54 531 never-smoking men and 2441 incident cases of type 2 diabetes identified through screening, self-reporting and hospital and prescription registries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed and adjusted for age, body mass index, educational level, alcohol consumption and physical activity. RESULTS: Compared to never users, the HR of type 2 diabetes was 1.15 (95% CI: 1.00-1.32) in current users of snus. In individuals consuming 5-6 boxes per week, the HR was 1.42 (95% CI: 1.07-1.87); in those consuming ≥7 boxes per week, the HR was 1.68 (95% CI: 1.17-2.41). Each additional box of snus consumed per week yielded an HR of 1.08 (95% CI: 1.01-1.16). CONCLUSION: Our findings indicate that high consumption of snus is a risk factor for type 2 diabetes. The risk was similar to that in smokers, implying that smokers will not reduce their risk of type 2 diabetes by changing to snus use. The results also support the notion that nicotine increases the risk of type 2 diabetes.

Cadmium concentrations in shrimp (Penaeus semisulcatus and Penaeus monodon) caught from the coastal areas in Southern Iran.

This study was undertaken to determine the concentration of cadmium in two shrimp species, namely, Penaeus semisulcatus and Penaeus monodon caught from the coastal areas in southern Iran. Cadmium concentration was determined by graphite furnace atomic absorption spectrophotometry in 91 shrimp samples after nitric acid/perchloric acid digestion. Accuracy of the analysis was checked by various methods including the use of reference material. The mean ± SD of cadmium concentrations in shrimp samples were 0.128 ± 0.144 (µg/g). The cadmium concentrations ranged from 0.010 to 0.96 µg/g of the muscle tissues of shrimp. Higher cadmium concentration in shrimp samples was found in summer (significant p < 0.05). The results show that the mean concentration of cadmium in shrimp is lower than the maximum allowed levels according to International standards, although the concentration of cadmium in only one sample was more than the amount recommended by Food and Agriculture Organization. Therefore, no risk to the consumer arises from the cadmium contents of the shrimp caught in these areas.

The complexity of obesity in U.K. adolescents: relationships with quantity and type of technology, sleep duration and quality, academic performance and aspiration.

BACKGROUND: Contemporary technology and multiple device use may link to increased body mass index (BMI). The sleep-obesity relationship is inconsistent in adolescents. Sleep duration and quality may have crucial connections to obesity development, particularly in adolescents where sleep alterations are common. Elevated BMI in adolescents may influence academic performance and aspiration, but data are limited. OBJECTIVES: The objectives of this study was to assess the linear associations between BMI z-score and (i) quantity/type of technology used; (ii) sleep quantity/quality and (iii) academic performance/aspiration. METHODS: Consenting adolescents (n = 624; 64.9% girls, aged 11-18 years) were recruited. The Schools Sleep Habits Survey and Technology Use Questionnaire were administered. Objective measures of height/weight were obtained. RESULTS: Quantity of technology was positively associated with BMI z-score ß = 0.10, P < 0.01. Those who always engaged in video gaming had significantly higher BMI z-score vs. never-users, ß = 1.00, P < 0.001. Weekday sleep duration and sleep onset latency were related to BMI z-score, ß = -0.24, P < 0.001 and ß = 0.01, P < 0.001, respectively. An inverse linear association was observed between BMI z-score and academic performance, ß = -0.68, P < 0.001. CONCLUSIONS: If confirmed prospectively, reducing bedtime use of technology and improving sleep hygiene in adolescents could be an achievable intervention for attenuating obesity with potentially positive effects on academic performance.

Concomitant carotid endarterectomy and coronary artery bypass grafting versus staged carotid stenting followed by coronary artery bypass grafting.

AIM: Significant carotid stenosis (>or=70%) in patients undergoing coronary artery bypass grafting (CABG) can increase the risk of perioperative cerebral vascular accident (CVA). In this study, we compared the results of two common operative strategies: concomitant carotid endarterectomy and CABG versus carotid stenting and CABG. METHODS: This cohort study was conducted from January 2001 to September 2006. Significant carotid artery stenosis was detected in patients who were candidates for CABG at the Tehran Heart Center. The stenosis was detected by carotid Doppler screening and was confirmed by magnetic resonance angiography. Reluctant patients or those with previous major CVA, significant bilateral carotid stenosis and intracranial lesions were excluded. Patients were divided into 2 groups. Group A underwent concomitant carotid endarterectomy and CABG (n=19), while carotid stenting and CABG were done in group B (n=28). RESULTS: The mean age in group A was 67.37+/-7.09 years and 65.57+/-8.13 years in group B. The mean hospital stay (days) was 18.68+/-7.95 in group A and 26.35+/-77.04 in group B (P=0.01). The median charge was dollars 252.79 in group A and dollars 2206.66 in group B (P <0.0001). There was a significant difference in frequency of hypotension and bradycardia between the 2 groups (P <0.05). There were 2 cases of in-hospital mortality in each group (10.5% and 7.1%, respectively). Two postoperative strokes occurred in group A and 3 in group B (10.5% and 10.7%, respectively). CONCLUSION: Concomitant carotid endarterectomy and CABG is as safe as carotid stenting and CABG, with fewer neurologic events and less hypotension, bradycardia, cost and shorter hospital stay.