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Biomedical subjects

P Hajek

Publications and source records attributed to P Hajek.

At least 19 recordsLinked to original sources
PubMed1992

Randomised controlled trial of nasal nicotine spray in smoking cessation.

Studies with nicotine chewing gum and nicotine skin patches indicate that nicotine replacement can help people to give up smoking. The rapidity with which nicotine is absorbed when given as a nasal spray suggests that it might be effective for those for whom the other means of replacement are too slow. The efficacy and safety of a nasal nicotine spray as an adjunct to group treatment for stopping smoking were assessed in a randomised, double-blind, placebo-controlled trial in which 227 cigarette smokers attending the Maudsley Hospital Smokers Clinic received 4 weeks of supportive group treatment plus active nicotine (0.5 mg per shot) or placebo nasal spray. The main end-point was biochemically validated complete abstinence from smoking from the third week of group treatment until the 12-month follow-up. Side-effects were assessed by self-reports and, where necessary, by physical examination. Of subjects assigned to active treatment 26% (n = 30) were validated abstinent throughout the year, compared with 10% (n = 11) of those assigned to placebo (relative abstinence rate 2.6, 95% CI 1.5-4.5, p less than 0.001). The advantage of the active spray was greatest in the heaviest smokers. Plasma nicotine concentrations from the spray were typically between one-half and three-quarters of baseline smoking levels. Tobacco-withdrawal symptoms, craving for cigarettes, and weight gain in abstinent subjects were reduced by the active spray. Minor irritant side-effects were frequent in both active and placebo sprays, but only 2 subjects had the spray discontinued as a result. No serious adverse effects were encountered. Nasal nicotine spray combined with supportive group treatment is an effective aid to smoking cessation.

Administration, Intranasal↗
PubMed1991

Effect of buspirone on cigarette withdrawal symptoms and short-term abstinence rates in a smokers clinic.

This paper reports on a double blind trial of the effect of buspirone, 15 mg per day, on cigarette withdrawal symptoms and ability of smokers to maintain abstinence during treatment. A total of 61 smokers were randomly assigned to active or placebo conditions. They were maintained on their drug for 2 weeks prior to attempting abstinence and then for a further 4 weeks of abstinence. Subjects attended weekly group sessions of a psychological treatment programme. There was no evidence that the side effects in the active drug group were worse than those in the placebo group. Although there was no significant difference between active and placebo conditions on withdrawal symptoms, smokers in the active drug condition were more than twice as likely to maintain abstinence for the duration of the study than those in the placebo condition (47% versus 16%, chi square = 5.3, P less than 0.025). The results provide preliminary evidence for short-term efficacy of buspirone as an aid to smoking cessation at a low dose. They also provide evidence of a dissociation between withdrawal symptoms and successful abstinence.

Adult↗
PubMed1991

Magnetic resonance in lesions of the parotid gland.

In a prospective study the relevance of magnetic resonance (MR) for the diagnoses of tumors of the parotid gland has been evaluated. Due to the excellent soft tissue contrast and also the possibility of imaging in various planes and sections and to the high resolution achieved by surface coils, it was possible to visualize the lesions and the surrounding anatomy in great detail. MR combines the advantages of ultrasound and computed tomography and is indicated if a tumor cannot be defined sharply by using ultrasound or CT.

Adipose Tissue↗
PubMed1991

Dream of absent-minded transgression: an empirical study of a cognitive withdrawal symptom.

Among 293 smokers abstinent for between 1 and 4 weeks, 33% reported having at least 1 dream about smoking. In most dreams, subjects caught themselves smoking and felt strong negative emotions, such as panic and guilt. Dreams about smoking were the result of tobacco withdrawal, as 97% of subjects did not have them while smoking, and their occurrence was significantly related to the duration of abstinence. They were rated as more vivid than the usual dreams and were as common as most major tobacco withdrawal symptoms. In subjects abstinent for 1 year, 63% recalled having dreams about smoking. They had on average 5 of them, and about a quarter occurred after the 6th month of abstinence. Having dreams about smoking was prospectively positively related to maintenance of abstinence. An explanation of this finding based on the association of smoking in dreams with aversive emotions is offered.

Adult↗
PubMed1991

Individual differences in difficulty quitting smoking.

This essay comments on the main approaches to studying individual differences in ability to quit smoking, and suggests complementing them with a concept of 'difficulty of quitting'. Several areas of research into determinants of ability to quit smoking are discussed, including measures of dependence, reactivity to nicotine, severity of withdrawal symptoms, endurance of discomfort, and psychological well being. A number of correlates of inability to quit may have a common denominator in stress and neuroticism. If these are the primary obstacles to quitting, changes in the composition of the smoking population and in the image of smoking can be expected which could lead to smoking losing some of its appeal for potential new recruits.

Adaptation, Psychological↗
PubMed1990

Effect of glucose tablets on craving for cigarettes.

Clients attending a smokers clinic were randomly allocated to two groups to assess the effects of glucose tablets in reducing craving for cigarettes. Smokers who had already been abstinent for 1 week were eligible to take part in the study. All subjects completed rating relating to urge to smoke and craving. Then subjects in one group were given packets of dextrose tablets and those in the other group were given packets of tablets containing sorbitol (a low calorie sweetener). Ratings of urges to smoke and craving were taken after 1 week, during which time the subjects had been asked to chew their tablets ad lib. Eight out of ten smokers in each group maintained abstinence. The remaining two smokers either did not abstain or did not turn up for the second measurement session. There was a significant reduction in ratings of urges to smoke and craving in the glucose group compared with the sorbitol group. These results support a theory postulating a link between glucoregulation and cigarette craving. If the results are replicated and it is shown that the reduction in craving translates into improved abstinence rates, oral glucose could be of assistance to smokers wishing to give up.

Female↗
PubMed1990

What do opiate addicts and cigarette smokers mean by "craving"? A pilot study.

There is general agreement that the term 'craving' requires clarification. This present report presents a pilot study in which groups of opiate addicts and cigarette smokers completed a brief rating scale to describe the frequency and intensity with which they had certain feelings while craving for their own drug of dependence. Craving was reported as being a dysphoric state and opiate addicts described more frequent and more intense dysphoric feeling while craving. Despite the difference in mean scores there were some similarities in the overall profile of scores in the two groups. Implications of these findings are discussed.

Adult↗
PubMed1989

Effect of smoke-free cigarettes on 24 h cigarette withdrawal: a double-blind placebo-controlled study.

In a double-blind randomised trial, 40 cigarette smokers used either nicotine-containing or placebo smoke-free cigarettes during 24 h abstinence from smoking. Subjects in the nicotine group experienced smaller increases in irritability and difficulty concentrating and fewer urges to smoke than those who received placebo. Nicotine smoke-free cigarettes were rated as more satisfying, more helpful and more effective in relieving craving than placebo. After 24 h use nicotine smoke-free cigarettes provided average blood nicotine levels of 6.3 ng/ml, i.e., 29.2% of smoking levels. The most frequent side effects were irritation of the throat and coughing. Overall, side effects were rated as not serious. Although the smoke-free cigarette in its present form is not very efficient in delivering nicotine, it was effective in alleviating initial tobacco withdrawal. It is possible that by providing both nicotine and "behavioural" replacement it may be particularly useful in the first stages of stopping smoking. The product is worth further investigation.

Adult↗
PubMed1989

Time course of cigarette withdrawal symptoms while using nicotine gum.

Ratings of withdrawal symptoms were provided at weekly intervals by 147 smokers clinic clients who managed complete abstinence for 4 weeks. The ratings followed a similar temporal pattern regardless of amount of nicotine gum used. Irritability, depression, difficulty concentrating and restlessness peaked in the 1st week or two and returned to baseline by week 4. Hunger was more persistent. Craving was reported to be the most troublesome withdrawal symptom at first, although by the 4th week hunger was cited almost as often. Across all subjects, evenings were cited most often as the worst time of day for craving but among heavier smokers and those who used more nicotine gum mornings were considered worst.

Female↗
PubMed1989

Severity of withdrawal symptoms as a predictor of outcome of an attempt to quit smoking.

In 227 smokers' clinic clients who managed at least one week of abstinence, ratings of withdrawal symptoms were used to predict subsequent return to smoking. Depression, time spent with urges to smoke, and difficulty not smoking during the first week of abstinence were significantly associated with lapse back to smoking during the second week. Depression and difficulty not smoking during the second week significantly predicted smoking status during the third week. No withdrawal symptoms during the third week were associated with a return to smoking during the fourth week. The predictive power of withdrawal symptoms was over and above that of smoke intake and dependence. The findings provide some support for the view that reduction of withdrawal symptoms may be a worthwhile target in programmes for helping smokers to quit.

Adult↗
PubMed1989

[Gd-DTPA in the MR diagnosis of pituitary adenomas].

25 patients with surgically (n = 14) and/or biochemically (n = 20) confirmed pituitary adenomas were examined on a 1.5 T superconducting MR system by means of multislice spin-echo technique, 3 mm thick sections and a 256 x 256 matrix. T1-weighted sagittal and coronal sections were obtained before and after administration of Gd-DTPA (0.1 mmol./kg. BW). 13 microadenomas and 12 macroadenomas were found. In unenhanced T1-weighted images 48% of the adenomas were isointense, 48% were hypointense and 4% were hyperintense. 58% of the adenomas enhanced to a lesser degree, 15% enhanced to a higher degree than the normal pituitary gland. 12% showed equal enhancement and 15% showed hypointense and hyperintense areas simultaneously. In 3 patients (12%) there was evidence of adenoma only in the enhanced images. The delineation of the adenoma from the cavernous sinus was possible in 95% of the enhanced, but only in 25% of the native scans.

Adenoma↗
PubMed1989

Withdrawal-oriented therapy for smokers.

The treatment approach of the Maudsley Hospital Smokers Clinic is described. It stems from the notion that smokers seeking help are dependent on nicotine, and that withdrawal discomfort is a major block to their success in quitting. Accordingly, therapy focuses on helping clients overcome nicotine deprivation. It uses nicotine replacement and a special format of group treatment. Details are given of preparation of clients, use of nicotine chewing gum, use of group-oriented groupwork, use of information about withdrawal, and training in withdrawal-oriented therapy. Data are presented concerning characteristics of the clientele, treatment adherence, and treatment results. A number of controversial issues are addressed, such as the optimal duration of treatment, timing of the quit date, the value of educational input, and the value of individualization of treatment goals.

Adult↗
PubMed1989

Breath holding and success in stopping smoking: what does breath holding measure?

Breath-holding endurance has recently been shown to predict the outcome of an attempt at stopping smoking. This could reflect a relationship between breath-holding endurance and the endurance of discomfort associated with cigarette withdrawal. However, it is not clear whether breath holding measures any such general trait. To see if it is related to another test of endurance, its correlation with maintained grip was examined. The two variables were closely related and remained so after differences in strength were partialled out. Breath holding appears to be a valid measure of endurance of physical discomfort.

Adult↗
PubMed1988

Long-term use of nicotine chewing gum. Occurrence, determinants, and effect on weight gain.

Among 538 clients of a Smokers Clinic who were treated with 2-mg nicotine chewing gum, 34 (6.3%) were still using the gum at one-year follow-up. This group represented 25% of lapse-free abstainers. At one-year follow-up, long-term gum users were using an average of 6.8 pieces of gum per day. Long-term gum users were similar to treatment failures in cigarette consumption and tobacco dependence, while "gum-free" successes were significantly lighter and less-dependent smokers. Long-term gum users used more gum during the four weeks of treatment than treatment failures, who in turn used more than the gum-free successes. It is suggested that for many the long-term use of gum was an essential ingredient of their success. Long-term gum users gained significantly less weight than other long-term treatment successes.

Adult↗
PubMed1988

Craniopagus twins: neuroradiological findings (CT, angiography, MRI).

A pair of craniopagus twins was examined with CT, angiography and MRI, to preoperatively assess their cerebral anatomy and blood flow. Angiography revealed a common venous sinus and a venous cross-flow from one brain to the other. This common sinus was also identified in magnetic resonance images. The significance of accurately evaluating the veins and sinuses in craniopagus twins is stressed.

Brain↗
PubMed1988

Fibrous metaphyseal defects--determination of their origin and natural history using a radiomorphological study.

The radiomorphological appearance of fibrous metaphyseal defects (FMDs) is demonstrated by long-term follow-up studies. A characteristic radiomorphological course rather than a typical single appearance can be established. These findings correlate well with the duration of these tumor-like lesions; therefore, the radiological findings allow conclusions to be made about the age of a fibrous metaphyseal defect. In addition, the characteristic locations of FMDs will be explained in respect of their origins at insertions of tendons and ligaments.

Adolescent↗