Smoking and inadequate housing: results from an Australian national survey.

OBJECTIVES: To examine the effect of: (a) the smoking status of the household; and (b) the amount spent on smoking by the household on inadequate housing. STUDY DESIGN: This was a cross-sectional study using data from the first wave of the Household Income and Labour Dynamics in Australia survey. METHODS: A total of 7673 households were eligible for analysis. The outcome, inadequate housing, was derived from a questionnaire item asking respondents about the adequacy of their housing with respect to their housing needs in general. A house was defined as a smoking household if at least one member smoked. Amongst smoking households, the total amount spent on smoking per week was calculated. Other factors included in the analyses were education, occupation and age of the head of the household, household size, household disposable income and housing tenure. RESULTS: There was evidence for an unadjusted association between being a smoking household and having inadequate housing [odds ratio (OR) 1.64, 95% confidence interval (CI) 1.32-2.03, P<0.001]; however, after adjusting for indicators of socio-economic status and age, evidence for the association became much weaker (OR 1.15, 95% CI 0.90-1.47, P=0.262). For smoking households, there was little evidence for an association between inadequate housing and the amount spent on smoking by the household, either unadjusted or adjusted. CONCLUSIONS: It appears that antismoking policies will not enhance housing adequacy, which is predominantly affected by indicators of socio-economic status.

Cardiac manifestations in oxidative phosphorylation disorders of childhood.

OBJECTIVE: To determine the frequency, type, and severity of cardiac involvement in pediatric patients with oxidative phosphorylation (OXPHOS) disorders. STUDY DESIGN: Retrospective review of clinical and laboratory records of all patients with definitive OXPHOS disorders diagnosed and treated at the Royal Children's Hospital in Melbourne between 1984 and 2005. RESULTS: Of a total of 89 patients (male:female ratio 1.5:1) 29 (33%) had cardiac involvement: 9 as presenting symptoms, 9 developing on follow-up, and 11 with subclinical cardiac findings. Leigh or Leigh-like syndrome and complex I and combined complex I, III, and IV deficiencies were the most common clinical and laboratory diagnoses, respectively. Clinically symptomatic patients had hypertrophic cardiomyopathy (5 patients), dilated cardiomyopathy (4 patients), combined ventricular hypertrophy and systolic dysfunction (3 patients), and left ventricular noncompaction (3 patients) at first assessment. A change in the type of cardiomyopathy was noted on follow-up in 2 patients. Conduction and rhythm abnormalities were present in 7 symptomatic patients. CONCLUSIONS: Cardiac assessment in children with OXPHOS disorders may reveal subclinical abnormalities of cardiac function. Patients who present with primary cardiac features have a poor prognosis. OXPHOS disorders should be considered in the differential diagnosis of children presenting with otherwise unexplained cardiomyopathy.

Thyroid disease, a risk factor for optic neuropathy mimicking normal-tension glaucoma.

The aethiology and pathogenesis of normal-tension glaucoma (NTG) is unknown but increasing evidence suggests multiple mechanisms of damage. Six out of 25 NTG patients (24%) had thyroid disease. The mean age of these patients was 66.5 +/- 9 years and of those without thyroid disease 60.7 +/- 9.6 years. The thyroid group was more hyperopic. The difference in mean intraocular pressure was not significant, but in the thyroid group the mean diurnal IOP variations were significantly smaller. The pattern VEP results indicated a correlation between optic neuropathy and prolonged latency of the P100 component in the group with thyroid disease and a correlation between optic neuropathy and lowered N80-P100 amplitudes in the group without. For one patient with hypothyroidism the delayed latency in the worse eye was normalized after thyroxine substitution. Due to overlapping the absolute values of P100 and the N80-P100 peak-peak amplitudes in pattern VEP cannot be used for differential diagnosis. These findings indicate that thyroid disease either causes optic neuropathy mimicking glaucomatous damage or is a risk factor for glaucoma.