RESUMO
One-third of smokers primarily use menthol cigarettes and usage of these cigarettes leads to elevated serum nicotine levels and more difficulty quitting in standard treatment programmes. Previous brain imaging studies demonstrate that smoking (without regard to cigarette type) leads to up-regulation of ß(2)*-containing nicotinic acetylcholine receptors (nAChRs). We sought to determine if menthol cigarette usage results in greater nAChR up-regulation than non-menthol cigarette usage. Altogether, 114 participants (22 menthol cigarette smokers, 41 non-menthol cigarette smokers and 51 non-smokers) underwent positron emission tomography scanning using the α(4)ß(2)* nAChR radioligand 2-[(18)F]fluoro-A-85380 (2-FA). In comparing menthol to non-menthol cigarette smokers, an overall test of 2-FA total volume of distribution values revealed a significant between-group difference, resulting from menthol smokers having 9-28% higher α(4)ß(2)* nAChR densities than non-menthol smokers across regions. In comparing the entire group of smokers to non-smokers, an overall test revealed a significant between-group difference, resulting from smokers having higher α(4)ß(2)* nAChR levels in all regions studied (36-42%) other than thalamus (3%). Study results demonstrate that menthol smokers have greater up-regulation of nAChRs than non-menthol smokers. This difference is presumably related to higher nicotine exposure in menthol smokers, although other mechanisms for menthol influencing receptor density are possible. These results provide additional information about the severity of menthol cigarette use and may help explain why these smokers have more trouble quitting in standard treatment programmes.
Assuntos
Encéfalo/diagnóstico por imagem , Mentol/administração & dosagem , Receptores Nicotínicos/metabolismo , Fumar/sangue , Fumar/patologia , Regulação para Cima/efeitos dos fármacos , Adulto , Análise de Variância , Azetidinas/farmacologia , Encéfalo/efeitos dos fármacos , Mapeamento Encefálico , Feminino , Radioisótopos de Flúor , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de PósitronsRESUMO
Recognizing the symptoms and signs of torture and documenting their cause may be key to providing effective health care for refugees from countries where torture is known to have occurred. Generalist or primary care physicians are in a unique position to establish a trust relationship with patients, to identify potential signs and symptoms of torture, and encourage patients to talk about their experiences. With knowledge about, understanding of, and sensitivity toward torture survivors, physicians can help these patients regain their health and a sense of well-being.