CYP2B6 and bupropion's smoking-cessation pharmacology: the role of hydroxybupropion.

Bupropion is indicated to promote smoking cessation. Animal studies suggest that the pharmacologic activity of bupropion can be mediated by its major metabolite, hydroxybupropion. We measured plasma bupropion and its metabolite levels in a double-blind, placebo controlled, randomized smoking-cessation trial. Among the treatment-adherent individuals, higher hydroxybupropion concentrations (per µg/ml) resulted in better smoking-cessation outcomes (week 3, 7, and 26 odds ratio (OR) = 2.82, 2.96, and 2.37, respectively, P = 0.005-0.040); this was not observed with bupropion levels (OR = 1.00-1.03, P = 0.59-0.90). Genetic variation in CYP2B6, the enzyme that metabolizes bupropion to hydroxybupropion, was identified as a significant source of variability in hydroxybupropion formation. Our data indicate that hydroxybupropion contributes to the pharmacologic effects of bupropion for smoking cessation, and that variability in response to bupropion treatment is related to variability in CYP2B6-mediated hydroxybupropion formation. These findings suggest that dosing of bupropion to achieve a hydroxybupropion level of 0.7 µg/ml or increasing bupropion dose for CYP2B6 slow metabolizers could improve bupropion's cessation outcomes.

Economic costs of motorcycle injury among crash-involved commercial motorcyclists in Oyo State, Nigeria.

OBJECTIVE: This study presents the costs of injury from road crashes sustained by commercial motorcyclists in Oyo state, Nigeria. METHODS: Across-sectional survey of 373 commercial motorcyclists selected using a multi-stage sampling technique was conducted. Information on injury costs for 44 (11.8%) of them who were reportedly involved in a road crash in the 12-month preceding the survey are presented. RESULTS: The mean age of the 44 crash-involved motorcyclists was 33.6 +/- 9.1 years. Daily income ranged from N300.00 ($2.31) - N1, 500.00 ($11.54). Thirty-three (75.0%) of those involved in crashes sustained injuries and 7 (21.2%) of them were admitted. Common injuries sustained were bruises (75.8%), fractures (12.1%), cuts (6.1%) and burns (6.1%). Median number of days away from work was 14 (range: 1 - 150). Median number of days on admission was 60 (range 7 - 90). The median cost of treatment was N2, 000.00 ($15.38), range: N20.00 (about 16 cents) - N25, 000.00 ($192.31) and this was paid by the injured motorcyclist alone in about 47% of cases. Median productivity costs lost was N7, 000.00 ($53.85), range N300 ($2.31) - N72, 000.00 ($553.85). CONCLUSION: The study showed that the costs of injuries were considerable. Efforts to prevent road crashes must be intensified to reduce the ensuing economic losses.

A comparative study of HIV/AIDS knowledge and attitudes of hearing-impaired and non-hearing-impaired secondary school students in Ibadan.

OBJECTIVE: This study was conducted to compare HIV/AIDS knowledge and attitudes of hearing-impaired and non-hearing-impaired secondary school students in Ibadan, South-Western Nigeria. METHOD: A cross-sectional survey of all the hearing impaired students and an equal number of non-hearing-impaired students enrolled in a half way school in Ibadan was conducted. Four non-hearing-impaired students did not complete the survey and their responses were excluded from the final analysis. Data was analysed using the Statistical Package for the Social Sciences (version 11.0). RESULTS: Seventy-eight hearing-impaired and non 74 non-hearing impaired students completed the survey. Thirty (38.5%) hearing-impaired and 67 (90.5%) and non-hearing-impaired students knew that HIV could be transmitted via semen, vaginal fluid and blood, (p < 0.001). HIV/AIDS knowledge scores were calculated giving minimum and maximum scores of 0 and 15 respectively. Mean knowledge score for hearing-impaired students was 4.7(±2.1) compared with 8.7(±2.3) among non-hearing-impaired students (t-test=11.307, p < 0.001). Generally, the students' attitudes to HIV/AIDS prevention and PLWHA were not favorable with only hearing-impaired and 44 (59.5%) non-hearing-impaired students agreeing that it would be alright for them to be in the same class with someone who had AIDS. CONCLUSIONS: The study showed that the hearing-impaired students had poorer knowledge and attitudes to HIV/AIDS compared with their non-hearing-impaired counterparts. There is a pressing need for development of HIV/AIDS education programmes specially designed to meet the needs of hearing impaired students.

Sexual practices of deaf and hearing secondary school students in ibadan, Nigeria.

BACKGROUND: Adolescents and young people with disabilities generally face various forms of discrimination. Inspite of this, they have to deal with similar reproductive health issues encountered by their abled peers. This situation is made worse by misconceptions that they are not sexually active. OBJECTIVE: The objective was to compare the sexual practices of the hearing impaired students with their non-hearing impaired counterparts. METHOD: A cross-sectional survey was conducted. All consenting deaf students and an equal number of hearing students attending a half way school in Ibadan participated. Four of the hearing students did not complete the survey and their responses were excluded from the final analysis. RESULTS: A total of 78 deaf students and 74 hearing students with mean ages of 17.1 (S.D. ± 3.0) and 15.8 (S.D. ± 1.9) years respectively participated. Twenty-six (33.3%) deaf and 36 (48.6%) hearing students had ever had sexual intercourse (p = 0.055). Median ages at sexual debut were 16 and 14 years for the deaf and hearing students respectively. The number of sexual partners ever had ranged from 1 to 8 among the deaf and 1 to 6 among the hearing students. Four (15.4%) deaf and 23 (63.9%) hearing students reported that they used a condom the last time they had sexual intercourse. CONCLUSION: The study revealed that hearing-impaired students like their hearing counterparts were sexually active however deaf students were more likely to engage in unsafe sex. There is therefore a pressing need for comprehensive sexuality education for deaf students in the study area.

Perception of cigarette smoking and advertisement among senior secondary school students in Ibadan, Southwestern Nigeria.

BACKGROUND: Cigarette smoking among youths is increasingly a public health concern. OBJECTIVE: This study sought to determine the prevalence of smoking among secondary school students and to assess their perception of smoking and cigarette advertisement. METHODS: A cross sectional study was conducted among 1,223 senior secondary school students in Ibadan, Southwest Nigeria. RESULTS: The prevalence of smoking among this population was 41 (3.4%) with 115 (9.4%) reporting that they had ever smoked. Mean age of smoking initiation was 14.2 years. Smoking was greater among males than females and in higher secondary school classes. Only 700 (57%) of students knew that smoking was harmful to their health and 477 (39%) reported that they had been taught about the harmful effects of smoking in the school teaching programme. Twenty-six percent of students had an item with a cigarette brand name on it and 19% had been offered a free cigarette by a cigarette representative. One hundred and twenty-two (10%) of the students indicated that they will smoke when they leave school. CONCLUSION: Although the prevalence of smoking among students was low, exposure to cigarette advertisements may encourage them to smoke.