Smoker motivations and predictors of smoking cessation: lessons from an inpatient smoking cessation programme.

INTRODUCTION: Our study aimed to review the quit rates of smokers from our inpatient smoking cessation programme in relation to habits and sociodemographic factors, and also to explore the potential usefulness of electronic cigarettes (ECs) by reviewing smoking motivations. METHODS: This was a retrospective study of patients recruited into our inpatient smoking cessation programme from June 2008 to June 2015. Sociodemographic factors and information on smoking habits were collected using a counsellor-administered questionnaire. Patients were given intensive counselling followed by a phone interview at one, three and six months to assess smoking status. RESULTS: A total of 2,722 patients were enrolled. 27.6% of patients were abstinent at six months' follow-up. Patients who quit smoking were older, married, initiated smoking at a later age and had lower Fagerström Test for Nicotine Dependence scores. There was a trend towards successful quitting in those with higher education levels and Chinese ethnicity, but this was not statistically significant. Patients who planned to quit cold turkey and those who quit because of social pressures were more successful. Of the smoking motivations, only nicotine dependence was an independent predictor of smoking cessation. CONCLUSION: Smoking motivations such as habitual use and psychological dependence did not influence quit rates and therefore do not support the use of ECs. Instead, a cold turkey method of quitting was shown in our study to contribute to cessation success. We recommend an increased focus on the use of pharmacologic aids as well as involvement of peer/spousal support to aid in such quit attempts.

Smoker motivations and predictors of smoking cessation: lessons from an inpatient smoking cessation programme

INTRODUCTION@#Our study aimed to review the quit rates of smokers from our inpatient smoking cessation programme in relation to habits and sociodemographic factors, and also to explore the potential usefulness of electronic cigarettes (ECs) by reviewing smoking motivations.@*METHODS@#This was a retrospective study of patients recruited into our inpatient smoking cessation programme from June 2008 to June 2015. Sociodemographic factors and information on smoking habits were collected using a counsellor-administered questionnaire. Patients were given intensive counselling followed by a phone interview at one, three and six months to assess smoking status.@*RESULTS@#A total of 2,722 patients were enrolled. 27.6% of patients were abstinent at six months' follow-up. Patients who quit smoking were older, married, initiated smoking at a later age and had lower Fagerström Test for Nicotine Dependence scores. There was a trend towards successful quitting in those with higher education levels and Chinese ethnicity, but this was not statistically significant. Patients who planned to quit cold turkey and those who quit because of social pressures were more successful. Of the smoking motivations, only nicotine dependence was an independent predictor of smoking cessation.@*CONCLUSION@#Smoking motivations such as habitual use and psychological dependence did not influence quit rates and therefore do not support the use of ECs. Instead, a cold turkey method of quitting was shown in our study to contribute to cessation success. We recommend an increased focus on the use of pharmacologic aids as well as involvement of peer/spousal support to aid in such quit attempts.

Multicenter validation of a shortened gastric-emptying protocol.

UNLABELLED: Gastric emptying scintigraphy is considered to be the gold standard for detection of gastroparesis and other disorders of gastric motility; Society of Nuclear Medicine and Molecular Imaging guidelines are predicated on imaging over a period of 4 h, which is inconvenient for patients. Bonta et al. introduced 2-h criteria, which served to shorten the protocol in most patients, with negligible loss of accuracy. We have evaluated the Bonta criteria in a larger multicenter trial encompassing 4 academic institutions. METHODS: Retrospective data from 4 academic medical centers were aggregated; 431 patients were included, 105 (24.4%) of whom demonstrated delayed gastric emptying defined by 4-h gastric retention of more than 10%. Bonta criteria (retention > 65% is considered abnormal and < 45% normal; otherwise, proceed to complete examination) were applied to the 2-h data. Sensitivity, specificity, accuracy, and resource use for the Bonta method were calculated. Results based on standard 4-h solid gastric emptying, performed according to current Society of Nuclear Medicine and Molecular Imaging guidelines, served as the gold standard. RESULTS: Retention of 10% or less was achieved by 6, 77, 215, and 326 patients at 1, 2, 3, and 4 h, respectively. At 2 h, 261 of 431 patients (60.6%) had gastric retention of less than 45%, which according to Bonta would be classified as normal; 62 (14.4%) had gastric retention of more than 65%, which would be classified as delayed emptying; and 108 (25.1%) had intermediate values requiring further imaging through 4 h. The Bonta criteria yielded a sensitivity, specificity, and accuracy of 92.4%, 96.9%, and 95.8%, respectively, superior to any single cutoff point applied to the 2-h values. The criteria resulted in false-negative results in 8 (1.9%) patients, 6 of whom were borderline-positive at 4 h (gastric retention of 11%-14%). Using the Bonta criteria, 74.9% of studies would be terminated by 2 h, decreasing total camera use by 15.7%, from 1,768 to 1,490 images, and the average study duration would be reduced by 20.6%, from 3.1 to 2.5 h. CONCLUSION: In a multicenter cohort, use of the Bonta criteria shortened the duration of studies in most patients, resulting in an effective compromise between reduced resource use, improved patient convenience, and preserved accuracy.

Acupuncture: past, present, and future.

During the past 40 years, acupuncture, a therapeutic technique of oriental medicine, has become more and more popular, evolving into one of the most utilized forms of complementary integrative medicine interventions in the United States. In fact, more than 10 million acupuncture treatments are administered annually in the United States alone.(1) Its rise in popularity, particularly in the West, can be attributed in part to its effectiveness for pain relief and in part to the fact that scientific studies have begun to prove its efficacy.

Treatment of multiple sclerosis with chinese scalp acupuncture.

Chinese scalp acupuncture is a contemporary acupuncture technique with just 40 years of history. It integrates traditional Chinese needling methods with Western medical knowledge of the cerebral cortex and has been proven to be a very effective technique for treating multiple sclerosis (MS) and other central nervous system disorders. A 65-year-old male patient who had had MS for 20 years was treated with Chinese scalp acupuncture. The motor area, sensory area, foot motor and sensory area, balance area, hearing and dizziness area, and tremor area were stimulated once a week for 10 weeks, then once a month for six sessions. After the 16 treatments, the patient showed remarkable improvements. He was able to stand and walk without any problems. The numbness and tingling in his limbs did not bother him anymore. He had more energy and had not experienced incontinence of urine or dizziness after the first treatment. He was able to return to work full time. At this writing, the patient has been in remission for 26 months. This case demonstrates that Chinese scalp acupuncture can be a very effective treatment for patients with MS. Chinese scalp acupuncture holds the potential to expand treatment options for MS in both conventional and complementary or integrative therapies. It can not only relieve symptoms, increase the patient's quality of life, and slow and reverse the progression of physical disability but also reduce the number of relapses and help patients with multiple sclerosis to remain in remission.

La acupuntura china del cuero cabelludo es una técnica de acupuntura contemporánea con apenas 40 años de historia. Integra los métodos de colocación de agujas chinos tradicionales con el conocimiento médico occidental de la corteza cerebral y ha demostrado ser una técnica muy eficaz para el tratamiento de la esclerosis múltiple y otros trastornos del sistema nervioso central. Un paciente de 65 años que llevaba sufriendo esclerosis múltiple (EM) durante 20 años recibió tratamiento con este tipo de acupuntura. Durante 10 semanas, una vez por semana, se estimularon las áreas motora, sensorial, motora y sensorial del pie, del equilibrio, de la audición y el mareo, y del temblor y, a partir de entonces, una vez al mes durante seis sesiones. Después de los 16 tratamientos, el paciente mostró una notable mejoría. Pudo hablar y caminar sin problemas. El entumecimiento y el hormigueo en las extremidades dejó de molestarle. Tenía más energía y no había sufrido incontinencia urinaria ni mareos después del primer tratamiento. Pudo volver a trabajar a tiempo completo. En el momento de escribir este texto, el paciente llevaba 26 meses en remisión. Este caso demuestra que la acupuntura china del cuero cabelludo puede ser un tratamiento muy eficaz para los pacientes con EM y puede ampliar las opciones de tratamiento para la EM en los tratamientos tanto convencionales como complementarios o integradores. No solo puede aliviar los síntomas, aumentar la calidad de vida del paciente y retardar e invertir la progresión de la discapacidad física, sino que también reduce el número de recaídas y ayuda a los pacientes con esclerosis múltiple a permanecer en remisión.

Effectiveness Guidance Document (EGD) for acupuncture research - a consensus document for conducting trials.

BACKGROUND: There is a need for more Comparative Effectiveness Research (CER) to strengthen the evidence base for clinical and policy decision-making. Effectiveness Guidance Documents (EGD) are targeted to clinical researchers. The aim of this EGD is to provide specific recommendations for the design of prospective acupuncture studies to support optimal use of resources for generating evidence that will inform stakeholder decision-making. METHODS: Document development based on multiple systematic consensus procedures (written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders including patients, clinicians and payers were involved. RESULTS: Recommendations focused mainly on randomized studies and were developed for the following areas: overall research strategy, treatment protocol, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication. CONCLUSION: The present EGD, based on an international consensus developed with multiple stakeholder involvement, provides the first systematic methodological guidance for future CER on acupuncture.

Assembly of four diverse heterocyclic libraries enabled by Prins cyclization, Au-catalyzed enyne cycloisomerization, and automated amide synthesis.

We describe a unified synthetic strategy for efficient assembly of four new heterocyclic libraries. The synthesis began by creating a range of structurally diverse pyrrolidinones or piperidinones. Such compounds were obtained in a simple one-flask operation starting with readily available amines, ketoesters, and unsaturated anhydrides. The use of tetrahydropyran-containing ketoesters, which were rapidly assembled by our Prins cyclization protocol, enabled efficient fusion of pyran and piperidinone cores. A newly developed Au(I)-catalyzed cycloisomerization of alkyne-containing enamides further expanded heterocyclic diversity by providing rapid entry into a wide range of bicyclic and tricyclic dienamides. The final stage of the process entailed diversification of each of the initially produced carboxylic acids using a fully automated platform for amide synthesis, which delivered 1872 compounds in high diastereomeric and chemical purity.

Chinese scalp acupuncture for cerebral palsy in a child diagnosed with stroke in utero.

A 6-year-old patient with cerebral palsy was treated with Chinese scalp acupuncture. The Speech I, Speech II, Motor, Foot motor and sensory, and Balance areas were stimulated once a week, then every other week for 15 sessions. His dysarthria, ataxia, and weakness of legs, arms, and hands showed significant improvement from each scalp acupuncture treatment, and after 15 sessions, the patient had recovered completely. This case report demonstrates that Chinese scalp acupuncture can satisfactorily treat a child with cerebral palsy. More research and clinical trials are needed so that the potential of scalp acupuncture to treat cerebral palsy can be fully explored and utilized.

Se aplicó acupuntura china en el cuero cabelludo para tratar a un paciente de 6 años de edad que sufría de parálisis cerebral. Una vez a la semana se estimularon el Habla I, Habla II, la función motora, la función motora del pie y funciones sensoriales, y las áreas que regulan el equilibrio. Luego, se repitió el procedimiento cada dos semanas durante 15 sesiones. La disartria, ataxia y debilidad en las piernas, brazos y manos que padecía el paciente mostró una mejoría considerable luego de recibir este tipo de tratamiento con acupuntura. Transcurridas las 15 sesiones, el paciente se había recuperado por completo. El análisis de este caso demuestra que esta técnica de acupuntura china puede ser efectiva en el tratamiento de los niños que sufren parálisis cerebral. Se necesitarán realizar más investigaciones y ensayos clínicos para que los beneficios potenciales de la acupuntura en el cuero cabelludo, como técnica de tratamiento de la parálisis cerebral, sea plenamente analizada y aplicada.

Review of clinical applications of scalp acupuncture for paralysis: an excerpt from chinese scalp acupuncture.

Chinese scalp acupuncture is a contemporary acupuncture technique integrating traditional Chinese needling methods with Western medical knowledge of representative areas of the cerebral cortex. It has been proven to be a most effective technique for treating acute and chronic central nervous system disorders. Scalp acupuncture often produces remarkable results with just a few needles and usually brings about immediate improvement, sometimes taking only several seconds to a minute. Acupuncture, a therapeutic technique of Oriental Medicine, can be traced back more than 2500 years. Throughout its long history, acupuncture has evolved as its own unique traditional medicine. By embracing newly developed knowledge and technology, the profession continues to create additional methods of treatment. Techniques such as electrical and laser acupuncture and even new acupuncture points are currently being developed. We believe scalp acupuncture, which integrates Western medicine with Traditional Chinese Medicine, to be the most significant development that Chinese acupuncture has made in the past 60 years.

Creation and manipulation of common functional groups en route to a skeletally diverse chemical library.

We have developed an efficient strategy to a skeletally diverse chemical library, which entailed a sequence of enyne cycloisomerization, [4 + 2] cycloaddition, alkene dihydroxylation, and diol carbamylation. Using this approach, only 16 readily available building blocks were needed to produce a representative 191-member library, which displayed broad distribution of molecular shapes and excellent physicochemical properties. This library further enabled identification of a small molecule, which effectively suppressed glycolytic production of ATP and lactate in CHO-K1 cell line, representing a potential lead for the development of a new class of glycolytic inhibitors.