Incidence of hidradenitis suppurativa among tobacco smokers: a population-based retrospective analysis in the U.S.A.

BACKGROUND: The relationship between tobacco use and hidradenitis suppurativa (HS) is controversial. OBJECTIVES: To determine the incidence of HS among tobacco smokers. METHODS: Retrospective cohort analysis identifying incident HS cases among adult tobacco smokers and nonsmokers sampled from a demographically heterogeneous population-based sample of over 50 million unique patients across all census regions in the U.S.A. RESULTS: We identified 3 924 310 tobacco smokers, which included 7860 patients newly diagnosed with HS. Tobacco smokers diagnosed with HS were most commonly aged 18-39 years (3795 of 7860; 48·3%), women (5640 of 7860; 71·8%), white (5200 of 7860; 66·2%) and those with body mass index (BMI) ≥ 30 (5690 of 7860; 72·4%). Overall incidence of HS was 0·20% (7860 of 3 924 310) among tobacco smokers and 0·11% (8430 of 8 027 790) among nonsmokers (P < 0·001). Incidence was greatest among tobacco smokers who were aged 30-39 years (0·35%), women (0·28%), African Americans (0·46%) and those with BMI ≥ 30 (0·33%). The overall adjusted odds of developing HS was 1·90 (95% confidence interval 1·84-1·96) among tobacco smokers, compared with nonsmokers (P < 0·001). HS incidence among tobacco smokers remained increased within each demographic subgroup. CONCLUSIONS: Incidence of HS appears to be doubled among tobacco smokers. These findings may support evidence-based counselling efforts for the cessation of smoking in populations at risk for HS.

Prevalence of hidradenitis suppurativa among patients with Down syndrome: a population-based cross-sectional analysis.

BACKGROUND: Hidradenitis suppurativa (HS) has been linked to Down syndrome (DS). OBJECTIVES: To determine whether patients with DS have a higher prevalence of HS, and whether the diagnosis of HS occurs at an earlier age for these patients. METHODS: A cross-sectional analysis was performed for a population sample of 11 936 patients with DS and 16 813 290 patients without DS. The primary outcome was the diagnosis of HS. Systemized Nomenclature of Medicine-Clinical Terms were used to identify patients with DS and HS. We used logistic regression models and significant interaction terms to evaluate the relationship between DS and HS. We also compared the proportion of incident HS cases within 5-year age groups to determine whether patients with DS had received an earlier diagnosis of HS. RESULTS: Prevalence of HS among patients with DS was 2·1%, compared with 0·3% for patients without DS (P < 0·001). HS prevalence was greatest among patients with DS who were aged 18-29 years. After controlling for age, sex and obesity, there was no difference in the prevalence of HS between female and male patients with DS or between white and nonwhite patients with DS. Compared with patients without DS, patients with DS had increased odds of HS in unadjusted [odds ratio (OR) 7·84, 95% confidence interval (CI) 6·93-8·88] and adjusted (OR 5·24, 95% CI 4·62-5·94) analyses. HS was diagnosed by the age of 29 years in 81·8% of patients with DS, compared with 34·0% of patients without DS (P < 0·001). CONCLUSIONS: HS is strongly associated with DS across demographic subgroups and may present earlier in life for these patients.

Exogenous melatonin modifies the circadian rhythm but does not increase the level of some immune parameters in the chicken.

The effect of daily injection of the pineal hormone melatonin and naltrexone, an opioid antagonist, on the circadian rhythm and the level of immune parameters (plaque forming cell [PFC] number, serum agglutinin titer, lymphoid gland weight, total white blood cells (WBC) and their fraction number, and serum lysozyme [LZ] content) was examined in White Leghorn cockerels and female BALB/c mice kept in LD 12:12. Animals were immunized ip with sheep red blood cells (SRBC) to stimulate their immune system. Subcutaneous injections of melatonin, naltrexone, or both drugs together were made 2 hr before the end of light, for 4 or 5 days, beginning on the day of immunization. The day following the fifth injection, chickens were sacrificed over a 24 hr period every 4 hr (experiment I) or twice daily, i.e., at the beginning of light and dark phases (experiment II). Mice were killed on the day following the fourth injection at the beginning of light, and splenic PFC number was determined (experiment III). In experiment I, the existence of the diurnal rhythm was evaluated by cosinor analysis. Melatonin injections entrained the circadian rhythm in anti-SRBC serum agglutinins, but it did not influence circadian rhythmicity in other parameters examined. The circadian rhythm in total WBC number and their fractions was entrained by naltrexone treatment. Melatonin injections did not affect either the diurnal mean of parameters examined or the weight of lymphoid organs. Splenic PFC number in chickens was diminished by both melatonin and naltrexone injections, whereas in mice it was increased by melatonin, and naltrexone antagonized that effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholecystokinin-8 and vasoactive intestinal polypeptide stimulate exocrine pancreatic secretion via duodenally mediated mechanisms in the conscious pig.

The effects of local and peripheral administration of cholecystokinin-8 (CCK-8) and vasoactive intestinal polypeptide (VIP) on basal pancreatic secretion were investigated in conscious pigs. Five pigs (20 +/- 2 kg, mean +/- S.E.M.) were chronically fitted with a T-shaped cannula in the duodenum, and catheters in the pancreatic duct, jugular vein, and right gastroepiploic artery. The arterial catheter was inserted against the bloodstream with its tip opposite the duodenal branch(es) of the right gastroepiploic artery, so that all injected peptides would reach the duodenal arterial circulation excluding the pancreas. Pancreatic secretion during basal conditions (i.e. after an overnight fast) exhibited a characteristic cyclic pattern (cycle duration, 70 +/- 4.2 min). Secretion volume oscillated between 0.2 +/- 0.04 and 4.0 +/- 0.9 ml kg-1 h-1 (P < 0.001), trypsin output between 9.6 +/- 1.9 and 29.1 +/- 4.1 U kg-1 h-1 (P < 0.001) and protein output between 0.36 +/- 0.08 and 9.2 +/- 1.7 mg kg-1 h-1 (P < 0.001). Infusion into the jugular vein for 1 min, during the trough of pancreatic secretion, of either CCK-8 (15 pmol kg-1 min-1) or VIP (7 pmol kg-1 min-1) did not stimulate pancreatic secretion. However, local infusion of an identical dose of CCK-8 or VIP into the duodenal arterial circulation increased the volume, protein output and trypsin output of the pancreatic juice (P < 0.05 to < 0.001). These results indicate that CCK-8 and VIP can stimulate the exocrine pancreas by a duodenally mediated mechanism.

Treatment of Parkinson's disease with aporphines. Possible role of growth hormone.

To avoid the main drawbacks of prolonged treatment with levodopa (involuntary movements and the "on-off" phenomenon), we administered apomorphine by mouth to 14 patients with Parkinson's disease. This treatment caused azotemia, which we circumvented by switching to N-propylnoraporpine, whose nephrotoxic dose (80 mg six times per day) was larger than its therapeutic dose (10 to 15 mg six times per day). Slowly increasing doses induced significant improvement (P less than 0.005) in all 24 patients studied, transitory mental aberrations in seven, and release of growth hormone in three patients tested. In patients previously on prolonged levodopa administration, the dyskinesia and "on-off" phenomenon were almost identical with N-propylnoraporphine, but both drawbacks were reduced or abolished in six patients by coadministration of alpha-methyldopa hydrazine plus levodopa. This coadministration seemed to abolish tachyphylaxis. We conclude that N-propylnoraporphine is very useful in the treatment of Parkinson's disease.