Lasing Effect in Symmetrical van der Waals Heterostructured Metasurfaces Due to Lattice-Induced Multipole Coupling

New practical ways to reach the lasing effect in symmetrical metasurfaces have been developed and theoretically demonstrated. Our approach is based on excitation of the resonance of an octupole quasi-trapped mode (OQTM) in heterostructured symmetrical metasurfaces composed of monolithic disk-shaped van der Waals meta-atoms featured by thin photoluminescent layers and placed on a substrate. We revealed that the coincidence of the photoluminescence spectrum maximum of these layers with the wavelength of high-quality OQTM resonance leads to the lasing effect. Based on the solution of laser rate equations and direct full-wave simulation, it was shown that lasing is normally oriented to the metasurface plane and occurs from the entire area of metasurface consisting of MoS2/hBN/MoTe2 disks with line width of generated emission of only about 1.4 nm near the wavelength 1140 nm. This opens up new practical possibilities for creating surface emitting laser devices in subwavelength material systems.

All-Plasmonic Switching Effect in the Graphene Nanostructures Containing Quantum Emitters

Nonlinear plasmonic effects in perspective 2D materials containing low-dimensional quantum emitters can be a basis of a novel technological platform for the fabrication of fast all-plasmonic triggers, transistors, and sensors. This article considers the conditions for achieving a strong coupling between the surface plasmon-polariton (SPP) and quantum emitter taking into account the modification of local density of optical states in graphene waveguide. In the condition of strong coupling, nonlinear interaction between two SPP modes propagating along the graphene waveguide integrated with a stub nanoresonator loaded with core-shell semiconductor nanowires (NWs) was investigated. Using the 2D full-wave electromagnetic simulation, we studied the different transmittance regimes of the stub with NW for both the strong pump SPP and weak signal SPP tuned to interband and intraband transition in NW, respectively. We solved the practical problem of parameters optimization of graphene waveguide and semiconductor nanostructures and found such a regime of NW-SPP interaction that corresponds to the destructive interference with the signal SPP transmittance through the stub less than 7 % in the case for pump SPP to be turned off. In contrast, the turning on the pump SPP leads to a transition to constructive interference in the stub and enhancement of signal SPP transmittance to 93 % . In our model, the effect of plasmonic switching occurs with a rate of 50 GHz at wavelength 8 µ m for signal SPP localized inside 20 nm graphene stub loaded with core-shell InAs/ZnS NW.

[Combined treatment of colorectal cancer followed by metastatic liver injury]

AIM

To increase the effectiveness of treatment of colorectal cancer followed by metastatic liver lesion.

MATERIAL AND METHODS

This study included 319 patients with colorectal cancer and metastatic liver lesion Gennari grade I, II, and III for the period from 2002 to 2017. All patients received combined treatment. 107 patients underwent liver resections: right-sided hemihepatectomy - 10, advanced right-sided hemihepatectomy - 7, left-sided hemihepatectomy - 9, triple segmentectomy - 33, bisegmentectomy - 29, segmentectomy - 19 cases. Radiofrequency ablation of liver metastases was performed in 105 patients. Cool tip device with a power of 200 W was used for destruction. Fifty-seven patients underwent microwave destruction of liver tumor (AveCure MWG 881, 34 W). Transarterial chemoembolization by doxorubicin and HepaSpheres 150-250 ng was applied in 34 patients.

RESULTS

Annual, 2-, 3- and 5-year survival was 83.1%, 73.5%, 60.2% and 24.6%, respectively after liver resection. RFA of liver metastases was followed by annual, 2- and 3-year survival near 73.5%, 53.3% and 32.1%, respectively. In case of MWA of liver metastases annual survival was 78.5%, 2-year - 63.3%, 3-year - 58.3%.

CONCLUSION

Chemotherapy combined with targeted therapy, radiofrequency and microwave ablation is able to increase resectability up to 35-40% in patients with colorectal cancer followed by liver metastases. Minimally invasive procedures (RFA, MWA) reduce surgical risk in critically ill patients.

Role of vascular endothelial growth factor in non‑small cell lung cancer pathogenesis

The angiogenesis is an important process in the pathogenesis of malignancies. It is regulated by various growth factors, with the vascular endothelial growth factor (VEGF) playing the central role. The aim of the present study was to evaluate possible associations of functional VEGF -2578C>A, -634G>C, and +936C>T polymorphisms with the risk for occurrence and progression of non-small cell lung cancer (NSCLC) in patients living in Republic of Belarus.

MATERIALS AND METHODS

A total of 202 patients (147 males and 55 females) diagnosed as having the NSCLC. The control group consisted of 336 individuals (245 males and 91 females) without an oncopathology. The total DNA was isolated from peripheral blood. We investigated the single nucleotide polymorphisms of VEGF (rs 2010963), (rs 699947), (rs 3025039). The genotyping was performed by PCR-RFLP analysis.

RESULTS

Our results revealed a marginally significant association of the -2578CC genotype (p=0.002) with a greater degree of tumor spread (Т2-Т4). Heterozygous genotypes -2578СА and +936СT carriers were included into the follow-up group significantly more often (р=0.021 and р=0.012, respectively). Our study demonstrate that VEGF -2578A/C and +936C/T polymorphisms are among the factors determining the individual peculiarities of NSCLC course in this population and can be used for clarifying the prognosis of the disease.

[Management of urological patients with HIV infection]

The analysis of urological care for HIV infected patients treated in Moscow city clinical hospital N 47 covers 12-year trends in hospitalization of HIV-infected urological patients, their nosological distribution, statistics of surgical outcomes. The highest efficacy of empiric antibacterial therapy of acute pyelonephritis in HIV-infected patients was seen in combined administration of fluorofloxacin of the second generation (ofloxacin) and nitroimidasol (metronidasol). Specific features of pharmacokinetics and interaction of antiretroviral drugs with medicines used in urological practice are analysed.

[The new MRI pulse sequence: experience in emergency neuroradiology]

The new pulse sequence (PS) has been obtained on MRI tomography Ellipse, B=0,15 and Biospec 70/30, B=7 T. The new pulse images of the brain combine features of FLAIR and its sensitivity to magnetic field heterogeneity. We named its PS as the T2 Fluid Attenuation Gradient Echo (T2 FLAGE). The T2 FLAGE characteristics of tissue contrast as well as its efficacy in detection of ICH have been assessed in 57 patients with acute stroke and in 16 experimental rats. The analysis of tissue contrast of lesions and normal brain structure has revealed the greater visibility of T2 FLAGE images compared to FLAIR. At the same time, the images sensitivity of magnetic field heterogeneity is retained. The ROC-analysis has shown that T2 FLAGE images are more effective in differential diagnosis of stroke type compared to FLAIR.

[Improvement of MRI effectiveness in the detection of intracerebral hematoma. Double inversion recovery]

A study aimed at developing the pulse consequence, the double inversion recovery (DIR), using low field magnetic tomography, and assessing its effectiveness in the detection of intracerebral hematoma. The research has been conducted at "Ellipse" MR tomograph. The new pulse sequence has been created by the modification of the regular FLAIR, its technical parameters were as follows: the first TI - 90 ms, the second TI - 1300 ms, TR - 4665 ms, echo - 3. Twenty-seven patients have been enrolled in the study. The tissue contrast coefficients on FLAIR and DIR images have been compared. It has been shown that the contrast coefficient of normal brain structures and brain lesions on the DIR images in regard to the white matter are significantly higher than on the FLAIR images. Results of the study revealed that the dynamics of MR symptoms of intracerebral hematoma is faster on the DIR images compared to the FLAIR ones. This finding can be used for detection of intracerebral hematoma in difficult clinical cases.

[Comparative assessment of MR-semiotics of acutest intracerebral hematomas in low- and extra high-field frequency magnetic resonance tomography]

An objective of the study was to compare sensitivity of low- and extra high-field frequency magnetic resonance (MR) tomography of acutest intracerebral hematomas (ICH) and to assess differences between symptoms in obtained images. A study was conducted using experimental ICH in rats (n=6). Hematomas were formed by two injections of autologic blood into the brain. MR-devices "Bio Spec 70/30" with magnetic field strength of 7 T and "Ellipse-150" with magnetic field strength of 0,15 T were used in the study. MR-tomography was carried out 3-5 h after the injections. Both MR-devices revealed the presence of pathological lesion in all animals. Extra highfield frequency MR-tomography showed the specific signs of ICH caused by the paramagnetic effect of deoxyhemoglobin in T2 and T2*-weighted images (WI) and low frequency MR-tomography - in T2*-WI only. The comparable sensitivity of low- and extra high-field frequency MR-devices in acutest ICH was established.

Tobacco sales in pharmacies: time to quit

OBJECTIVE

To assess the pharmacy profession's perceptions of tobacco sales in US pharmacies and explore whether a policy prohibiting sales of tobacco in pharmacies would alter adult consumer shopping behaviour.

SUBJECTS AND DESIGN

In California, surveys were administered to 1168 licensed pharmacists and 1518 pharmacy students, and telephone interviews were conducted with 988 adult consumers.

RESULTS

Most (58.1%) licensed pharmacists were strongly against sales of tobacco in pharmacies, 23.6% were against it, 16.7% were neutral, 1.2% were in favour of it, and 0.4% were strongly in favour of it. Pharmacists who were current tobacco users were more likely to be in favour of tobacco sales in pharmacies than were pharmacists who were current non-users (p < 0.005). Similar statistics were observed for pharmacy students. Most consumers (72.3%) disagreed with the statement, "I am in favour of tobacco products being sold in drugstores"; 82.6% stated that if the drugstore where they most commonly shopped were to stop selling tobacco products, they would shop there just as often, 14.2% would shop there more often, and 3.2% would shop there less often.

CONCLUSION

Little professional or public support exists for tobacco sales in pharmacies.

[Doppler technologies in combined diagnosis of acute pyelonephritis]

We studied diagnostic potentialities of conventional clinical, device, x-ray and ultrasonic methods including current Doppler technology in differentiation of serous and purulent stages of acute pyelonephritis (AP) in 50 patients (mean age 25.5 +/- 5.5 years). Energetic dopplerangiography (EDA) showed the highest diagnostic significance. EDA was highly informative in renal carbuncle and total purulent destruction of the kidney and low informative in serous and apostematous AP, renal abscess. Conventional ultrasonic, x-ray, clinical and device investigations as well as impulse dopplerography and color Doppler mapping of blood flow are of secondary importance in AP.

[Using energetic Doppler-angiography in combined diagnostics of prostatic abscess]

Diagnostic possibilities of conventional clinical-laboratory, physical methods, seroscale echography and energetic dopplerangiography (EDA) were compared in 32 patients with prostatic abscess (PA). Nonspecific symptoms hamper conventional PA diagnosis. PA is detected, as a rule, at transrectal ultrasonic investigation (TUI) which is effective in formed PA (sensitivity 100%) but is low effective in early PA (sensitivity 50%). Minimal size of PA detectable by TUI is 7 mm (mean 12 +/- 1.2 mm). EDA improves diagnostic potential of TUI in infiltrative PA (sensitivity 91.7%). In established PA, EDA confirms TUI findings. Transabdominal ultrasonography has insufficient resolution and must be used for PA screening.

[Xenogenous islets of Langerhans transplantation of insular cells without immunosuppressive therapy in the treatment of insulin-dependent diabetes]

Results of experimental and clinical xenotransplantation without immunosuppressive therapy in the treatment of insulin-dependent diabetes are summarized. Morphologic study demonstrated possibility of long-term preservation of macroencapsular xenogeneous culture of the insular cells in the blood of the recipients without immunosuppressive therapy. Thirteen patients with diabetes underwent surgery according to the developed method. Laboratory and clinical examinations demonstrated an increasing level of C-peptide, immunoreactive insulin, a decrease of fructozamine and insulin demand to 70-85%. It is concluded that intravascular xenotransplantation is an effective procedure, and it may be regarded as alternative to allotransplantation.

Youth and tobacco

Youth around the world take up smoking and use tobacco products at high rates. Young people may not grasp the long-term consequences of tobacco use, although tobacco consumption and exposure has been shown to have significant negative health effects. Youth use a variety of tobacco products that are smoked, chewed, or sniffed, including machine-manufactured cigarettes, cigars, bidis, kreteks, sticks, and snuff. Prevention efforts have focused on countering those aspects that are believed to contribute to smoking uptake, such as tobacco industry advertising and promotion, and access to tobacco. There are many aspects of tobacco promotion through the media that have been more difficult to control, however, such as product placement within popular cinema movies. Once a youth has taken up tobacco, he or she is more likely than an adult to become addicted and should be offered treatment for tobacco cessation. Although there is not yet sufficient evidence to prove efficacy, the same treatments are suggested for youth as are recommended for adults, including nicotine replacement products. Given the severity of the tobacco epidemic worldwide and the devastating health effects on an individual and population basis, there are currently many efforts to curtail the tobacco problem, including the World Health Organization (WHO) sponsored Framework Convention on Tobacco Control. It is through comprehensive and collaborative efforts such as this that the global hazard of tobacco is most likely to be overcome.

[Indirect electrochemical blood oxidation in the prophylaxis of suppurative-inflammatory complications after transurethral resection of the prostate]

To investigate efficiency of indirect electrochemical blood oxidation in prophylaxis of infectious complications, 28 patients were treated with 0.06% hypochlorite solution (2 infusions, 2-3 days before TURP). These patients belonged to a high-risk group of infectious complications (80% of them had chronic prostatitis, 8 patients had bladder stones, 8 had undergone cystostomy). The results demonstrated that the complication rate in the above prepared patients fell four times as compared to the control group and the postoperati hospital stay was reduced by 3 days.

Nicotine dependence, withdrawal symptoms, and adolescents' readiness to quit smoking

The purpose of this study was to characterize nicotine dependence and nicotine withdrawal symptoms among adolescent smokers and to investigate associations between these key factors and adolescents' readiness to quit smoking. A total of 5624 high school students participated in a school-based survey. Of 1111 adolescents who were current or former smokers, the following stage-of-change distribution for smoking cessation was observed: precontemplation, 52.5%; contemplation, 16.0%; preparation, 7.5%; action, 13.2%; and maintenance, 10.8%. Among current smokers, 18.1% were substantially dependent on nicotine, 45.2% had moderate dependence, and 36.7% had no dependence. Higher proportions of current smokers than successful quitters reported withdrawal symptoms with their most recent quit attempts. Precontemplators exhibited significantly higher mean nicotine dependence scores than did students in the contemplation or preparation stages (F(2,837) = 12.03; p < 0.0001). A similar trend was observed for withdrawal-symptom scores across the stages of change. The nicotine dependence and withdrawal-symptom scores were significantly correlated (r = 0.44, p < 0.001). Nicotine dependence and nicotine withdrawal appear to interfere with adolescents' abilities and readiness to quit smoking, suggesting a potential role for nicotine replacement therapy in the treatment of tobacco use and dependence among adolescents.

[Differential diagnostic value of prostate-specific antigen in prostatic hyperplasia]

Diagnostic value of prostate specific antigen (PSA) was studied in 163 patients with prostatic hyperplasia. As PSA is not a cancer-specific test, it is recommended to obtain biopsy in patients with prostatic hyperplasia and PSA > 4 ng/ml to diagnose prostatic cancer early. Methods raising PSA specificity for differential diagnosis of prostatic hyperplasia are not absolutely reliable.

Validation of the modified Fagerström tolerance questionnaire with salivary cotinine among adolescents

This study was conducted to gain evidence of validity for a nicotine dependence measure for adolescent smokers. We hypothesized that the individual item responses and the total Fagerström Tolerance Questionnaire (FTQ) score would be positively correlated with cotinine values. We examined the relationship between a seven-item modified FTQ and saliva continine among 131 adolescent volunteers in a smoking cessation program. As anticipated, the total FTQ score was related to saliva cotinine (r = .40, p < .01), as were six of the seven individual FTQ items (p < .05). Our findings provide preliminary evidence that the modified FTQ scale is valid and applicable to adolescent smokers.

Smoking and diabetes: readiness for change and provider advice

Smoking is a serious health risk, particularly for people with diabetes. This study was designed to examine important aspects of smoking in a large group of individuals with diabetes. A survey was mailed to 2,056 individuals with diabetes. The variables examined were the stages of change for smoking, prevalence of quitting advice given by health care providers, and the patterns of readiness for change. The majority (57.8%) of current smokers were in the precontemplation stage. Comparisons on the stage of change indicated that more individuals with Type 2 diabetes have quit while there are more current smokers among those with Type 1 diabetes. Comparisons on current smokers indicated no differences on stage of change across the Type 1 and Type 2 groups, across three subgroups of individuals with Type 2 diabetes, or across duration of diabetes. Those who reported that they were given cessation advice were further along in the stages of change. These results suggest that the majority of individuals with diabetes who smoke are in the precontemplation stage of change and provider advice is important in moving smokers toward change. The current findings underscore the importance of assessing stage of change and providing stage-matched interventions when working with smokers with diabetes.

Spit tobacco intervention in dental practice: recommendations for clinicians

To address ST use effectively, awareness needs to be raised regarding its harmful affects and addictive nature. Clinicians can and should take a leadership role in the control of ST by addressing ST use with patients. The recommendations provide clinicians with practical tools and strategies for intervention with ST users and potential users. Although many of these strategies require training and time, it should be emphasized that even minimal intervention can be effective in combating ST use.

Cigarette smoking in a multiethnic population of youth: methods and baseline findings

BACKGROUND

To expand upon recent research studies that have identified dramatic ethnic differences in adolescent cigarette smoking, this study was designed to characterize smoking among a multiethnic population of adolescents and to identify significant factors that may protect against smoking initiation.

METHODS

During the first 2 years, this mixed cross-sectional, longitudinal study recruited and collected baseline data from a volunteer sample of 1,441 Houston-area public school students in the 5th, 8th, or 12th grade. A wide range of new and established predictors of smoking behavior was assessed, and their associations with ever smoking and susceptibility to smoking were assessed within ethnicity (white, N = 537; African-American, N = 454; and Hispanic, N = 297).

RESULTS

Consistent with previous studies, white students smoked in substantially higher proportions than African-American students, with Hispanic adolescents in-between. Simultaneously adjusting for other variables, the odds of ever smoking (OR = 0.47, P < 0.01) and susceptibility to smoking (OR = 0.64, P < 0.01) were significantly lower among African-American adolescents when compared with whites; odds ratios for Hispanics and whites did not differ. Across all three ethnicities, the most important predictor of both ever smoking and susceptibility to smoking was the smoking status of the three best friends. Several ethnicity-specific variables also were identified.

CONCLUSIONS

In concordance with previous investigations, cigarette smoking prevalence differs by ethnicity, and the factors associated with ever smoking and susceptibility to smoking differ among white, African-American, and Hispanic adolescents. The results of this study may be used to develop theory-based, culturally appropriate smoking intervention programs for adolescents.

Stages of acquisition and cessation for adolescent smoking: an empirical integration

Adolescent cigarette smoking acquisition and cessation were integrated into a single nine-stages-of-change continuum using the transtheoretical model of change framework. Findings in a high school student sample (n > 700) showed that a few of the never smokers were planning to try smoking, and half of the current smokers were contemplating quitting. More than half of former smokers were long-term quitters. The high pros of smoking scores assessing coping benefits of cigarettes were related to smoking acquisition and the high con (disadvantages) scores to long-term abstinence. Never smokers were most tempted to try smoking when they anticipated that smoking would help reduce negative and increase positive mood. Current and former smokers were tempted due to peer cigarette offers and negative mood. These temptations were significantly reduced among ex-smokers.

Computer-based smoking cessation interventions in adolescents: description, feasibility, and six-month follow-up findings

The impact of adolescent smoking cessation clinics has been disappointing due to low participation rates, high attrition, and low quit rates. This paper describes two computerized self-help adolescent smoking cessation intervention programs: 1) a program utilizing the expert system which is based on the transtheoretical model of change and 2) a popular action-oriented smoking cessation clinic program for teens which was modified for computer presentation. High participation rates in the program among 132 smokers demonstrate the high feasibility and acceptability of the programs. Quit rates of up to 20% were observed during the intervention, and an additional 30% made unsuccessful quit attempt(s). The 6-month follow-up findings indicated that adolescents were poorly prepared to maintain abstinence.

Promoting smoking cessation among cancer patients: a behavioral model

The smoking cessation clinical practice guideline recently published by the Agency for Health Care Policy and Research (AHCPR) summarizes current knowledge on smoking cessation treatments. Among its recommendations, the guideline encourages physicians to motivate patients who indicate that they are not yet ready to quit smoking. Because medical training typically emphasizes pharmacologic rather than behavioral treatment, we believe that physicians caring for cancer patients may benefit from more extensive instruction in motivating patients to quit smoking. This article describes how a contemporary theoretical approach, the transtheoretical model of change, can be used to promote behavioral change. Multiple studies, primarily in the field of smoking cessation, provide strong empiric support for use of this model in clinical practice. The model consists of five stages of smoking cessation that describe different levels of readiness to quit: precontemplation, contemplation, preparation, action, and maintenance. A diagnostic tool is presented, and specific smoking cessation counseling strategies are suggested for each stage of change. Implications for the use of the model by physicians who counsel and treat smokers are discussed.

Transitions out of high school: time of increased cancer risk?

BACKGROUND

The effectiveness of lifestyle behavior interventions with children to reduce chronic disease risks in adulthood assumes stability in the lifestyle behaviors across time. The transition out of high school is a time when many changes occur in social roles, e.g., changing schools, leaving the parents' home, changing peers, finding employment, getting married, and becoming a parent. Cancer risk behaviors may increase as a result of some of these social role changes.

METHODS

Concepts relevant to the stability or change in lifestyle behaviors through the transition out of high school are presented. Literature concerning diet, smoking, smokeless tobacco, alcohol, physical activity, sexual practices, and sun exposure behaviors through the transition is reviewed.

RESULTS

Most lifestyle behaviors display increasing cancer risk around the transition out of high school. Different levels of change were associated with different pathways through the transition. Inconsistent findings were obtained in the pattern of co-occurrence of these behaviors.

CONCLUSION

Priority research includes establishing the pattern of co-occurrence of lifestyle behaviors through the transition, identifying the pattern of tracking of each behavior through the transition, and identifying the primary influences on the group values and tracking of the behaviors. Longitudinal research is needed to control for preexisting differences between pathways through the transition.

[Pharmacology and pharmacy on the INTERNET]

The article is devoted to the information on pharmacology and pharmacy which can be found in Internet. It contains Internet addresses of departments and faculties of pharmacology and pharmacy, manuals and textbooks, tests, scientific societies. The article also includes some information about discussion groups and grants.

Precision blackbody sources for radiometric standards

The precision blackbody sources developed at the All-Russian Institute for Optical and Physical Measurements (Moscow, Russia) and their characteristics are analyzed. The precision high-temperature graphite blackbody BB22p, large-area high-temperature pyrolytic graphite blackbody BB3200pg, middle-temperature graphite blackbody BB2000, low-temperature blackbody BB300, and gallium fixed-point blackbody BB29gl and their characteristics are described.

[The transurethral microwave thermotherapy of benign prostatic hyperplasia]

The authors have treated benign prostatic hyperplasia (BPH) in 50 patients aged 54-89 years (mean age 67.5 years) including 10 patients with cystostoma. The patients were exposed to transurethral microwave thermotherapy (TUMT) performed on the prostcare unit. Only 1 session (60 min at 45 degrees C) was conducted. Inflammatory complications of TUMT occurred in 4(8%) patients. A 1.5-year follow-up covered 45 patients. A subjective response was obtained in 86% of patients. An objective response by urination rate and prostatic size 3 months after TUMT was reached in 80 and 90% of patients, respectively; 1.5 years after in 48, 34 and 47%, respectively. TUMT is recommended in uncomplicated BPH as an alternative to chemotherapy or surgical treatment (in patients with cystostoma and serious intercurrent diseases).

Diabetes self-management. Self-reported recommendations and patterns in a large population

OBJECTIVE

Diabetes self-management is the cornerstone of overall diabetes management. Yet many questions concerning self-management remain unanswered. The current study was designed to examine several questions about diabetes self-management: 1) What do individuals report being told to do? 2) What are their self-reported levels and patterns of self-care? 3) Are there differences on self-reported self-management recommendations and levels across various subgroups?

RESEARCH DESIGN AND METHODS

Mailed surveys were returned by 2,056 individuals (73.4% response rate). Of the total, 13.8% had IDDM and the remainder had NIDDM, with 65% of the NIDDM group using insulin.

RESULTS

The levels and patterns of self-management were consistent with those found in previous studies, i.e., individuals most regularly followed their prescribed medication regimen and least regularly followed recommendations for lifestyle changes of diet and exercise. There were significant differences on reported self-management recommendations across different subgroups. Comparisons on level of self-management across diabetes type revealed significant differences for diet and glucose testing. Differences were also found on self-management levels for a number of individual characteristics, including age, working status, and type of insurance, along with knowledge of the Diabetes Control and Complications Trial findings.

CONCLUSIONS

These findings provide important information on perceived self-management recommendations and the specific self-management levels and patterns in individuals with diabetes. The current findings may help health professionals better understand the levels and correlates of diabetes self-management and direct future research.

Smoking cessation. 2: Components of effective intervention

Smoking cessation treatment is an essential component of comprehensive healthcare, but many healthcare providers lack formal training and are hesitant to provide such intervention. The recently published US Agency for Health Care Policy and Research (AHCPR) Smoking Cessation Clinical Practice Guideline provided empirically based recommendations to address these issues. The most effective components of smoking cessation include the use of nicotine replacement therapy, provider support and encouragement, and training in such skills as problem solving and coping. Methods of using these recommendations are illustrated, and sample scripts are offered to serve as references for providers from various disciplines who conduct smoking cessation interventions.

Respiratory response to cigarette smoking among adolescent smokers: a pilot study

BACKGROUND

Because cigarette smoking affects the respiratory system earlier than many other systems of the human body, an attempt was made to identify objective and subjective respiratory problems among adolescent smokers.

METHODS

Two studies based on a pulmonary function test (PFT), respiratory symptom assessment, and other smoking-related variables were undertaken. Study 1 involved cigarette smokers (N = 18, 22% males, mean age 18.7 years) from a freshman college class who participated in an acute smoking experiment that involved performing a PFT before and after smoking a single cigarette. Study 2 was performed on a combined group of vocational-technical high school students and freshman college students (N = 44, 48% males, mean age 17.8 years) where PFT parameters, respiratory symptoms, and smoking-related health vulnerability were assessed among smokers vs nonsmokers.

RESULTS

In Study 1, the average reduction across PFT parameters was 4.4% and the mean estimated lung age increased from 27.15 to 29.84 years. In Study 2, a consistent trend toward reduction of PFT values among smokers vs nonsmokers was observed; the mean forced expiratory volume in 1 sec/forced vital capacity ratio (90.51% vs 94.59%), peak expiratory flow rate (80.32% vs 92.06%), and flow rate of 50% of forced vital capacity (88.39% vs 102.81%) differed significantly. Significant differences in respiratory symptoms were also observed among smokers vs nonsmokers.

CONCLUSIONS

The beginning of respiratory health disorders can be identified among adolescent smokers. These findings might provide important clues on how to improve outcomes from health care provider-based adolescent smoking cessation counseling.

Measuring nicotine dependence among high-risk adolescent smokers

In the present study we tested our hypothesis that because of the higher prevalence and greater intensity of cigarette smoking among vocational-technical students (N = 110; 51.8% males; mean age 17 years), adolescents might demonstrate the nicotine dependence patterns comparable to those measured in a similar fashion in a group of adult smokers (N = 173; 50% males; mean age 42 years). A modified version of the Fagerström Tolerance Questionnaire (FTQ) utilized in the adolescent sample was coded to make it comparable to the original FTQ used in the adult sample. The tests of item structure and internal consistency of the modified FTQ for adolescents were satisfactory; the overall mean FTQ score correlated significantly with the intensity and duration of smoking. Although the FTQ values were generally lower in the adolescent sample, 20% of students had an overall FTQ score of 6 and above, indicating substantial nicotine dependence (compared to 49% in adults). Reasons for failure of the existing adolescent smoking cessation programs as well as the rationale for adding a nicotine replacement option to the behavioral smoking cessation treatment for a subset of high-risk nicotine-dependent adolescents are discussed.

Spectral effective emissivities of nonisothermal cavities calculated by the Monte Carlo method

An algorithm based on the Monte Carlo method is described that permits the precise calculation of radiant emission characteristics of nonisothermal blackbody cavities for use as standard sources in radiometry, photometry, and radiation thermometry. The algorithm is realized for convex axisymmetric specular-diffuse cavities formed by three conical surfaces. The numerical experiments provide estimates of normal effective emissivities of cylindrical blackbody cavities with flat or conical bottoms for various axisymmetric temperature distributions on the cavity walls.

Effects of a statewide antismoking campaign on mass media messages and smoking beliefs

BACKGROUND. In 1985, The Minnesota Legislature initiated a long-term and broad-based program to deter adolescent tobacco use. The initiative was funded by higher taxes on tobacco products and combined school-based programming, mass-media campaigns, and local community grants. The Minnesota-Wisconsin Adolescent Tobacco-Use Research Project was designed to evaluate this effort by monitoring adolescent tobacco use and related factors in Minnesota and Wisconsin from 1986 to 1990. The results presented in this paper indicate that the Minnesota initiative dramatically increased Minnesota schoolchildren's reported exposure to the anti-smoking messages in the mass media but had little effect on smoking-related beliefs or smoking behaviors. CONCLUSIONS. These results, together with the findings from other recent studies, suggest that even dramatic increases in exposure to anti-tobacco messages in the mass-media, in the absence of a substantial and sustained school-based tobacco prevention measures, may be insufficient to generate reductions in adolescent tobacco use.

Three approaches to adolescent smoking detection: a comparison of "expert" assessment, anonymous self-report, and co measurement

A new method designed to assess adolescent smoking was recently developed and applied by researchers in the former Soviet Union. As originally applied in Lithuania and Russia, two official student leaders from each class were chosen to estimate smoking prevalence rates for their class, and so the method became labeled as the "expert assessment." Their findings suggested that this "expert assessment" method agreed quite well with school-wide prevalence estimates based on a survey of the entire school population. The purpose of the present study was to determine whether student representatives, selected at random and coached to accurately summarize the smoking habits of their classmates, could provide accurate estimates of the smoking prevalence rate in their school. To accomplish this purpose, estimates from the student representatives were compared to those from an anonymous survey and from measurement of carbon monoxide in expired air. The results indicated that the self-report and carbon monoxide data were in close agreement, while the student representatives substantially overestimated the prevalence of smoking in their school, in spite of the coaching provided according to the "expert assessment" protocol. Additional research on alternative methods to select student representatives, such as those based on a sociometric analysis, may yet result in a low-cost method to assess schoolwide levels of smoking in adolescent populations.

Tobacco smoking in Moscow school students

A cross-sectional study on tobacco smoking prevalence and related socio-psychological parameters in Moscow school students aged 10-17 was performed. Data from an anonymous self-report (n = 4802) on smoking prevalence was confirmed by special technique--expert assessment. Widespread smoking was found: among male 5th graders (the youngest group) 14.4% are smokers (those who smoked at least 1 cigarette over the past 3 months); among male 10th graders (oldest group) 53.2% smoke; among females these figures were 0.8% for the youngest students and 28.2% for the oldest ones. A significant difference in awareness of smoking health hazards and attitudes towards the habit was shown among school students with various smoking statuses. Complaints about cough and shortness of breath after light physical stress were significantly more prevalent in regular smokers as compared to non-smokers. The possible causal role of some psychological factors in early formation of smoking habit is discussed.

[Treatment of moist gangrene of the foot in patients with diabetes mellitus]

The authors generalized their experience in the treatment of 159 patients aged 21 to 84 with diabetes mellitus and pyonecrotic lesions of the lower limbs. On the basis of the results of rheovasography, aortoarteriography, and roentgenography of the foot bones they concluded that to prognosticate the possibility of preserving the supporting function of the limb, not only the level and extent of the gangrene but also the state of the main and the collateral blood flow in the limb and the spread of bone destruction in the foot must be taken into account. Pathogenetic nonoperative treatment including antibacterial therapy, transfusion of hemo- and rheomodulators, and the use of hemosorption made it possible to convert moist to dry gangrene in 86.8% of patients, expand the indications for "minor" amputations, and reduce the number of high amputations from 56.2 to 35.8% and the total mortality from 10.2 to 4.4%.

Comparison of smoking prevalence in school students sampled from the United States of America and the Union of Soviet Socialist Republics

To assess the smoking prevalence among adolescents in the USA and the USSR, students in Moscow and Minneapolis were surveyed by common protocol and identically trained staff. Smoking habits were measured by a self-report questionnaire and an expired air sample of carbon monoxide (CO). Significant gender differences were found between the two national groups. Among girls in the USA, there was a significantly higher rate of weekly smoking as compared to girls in the USSR. Among boys in the USSR as compared to those in the USA, there was a significantly higher rate of ever smokers and daily smokers, but also of ex-smokers. These gender differences may reflect cultural differences in smoking patterns between the two countries. Cigarette smoking is clearly a public health problem in both countries with its onset in adolescence.

[The potentials of sympathectomy in treating lesions of the lower extremities in diabetics]

Investigations of the system of general and regional hemostasis in patients with diabetes mellitus and the IVth degree of ischemia of lower extremities have established the development of chronic hypercoagulation-thrombotic forms of disseminated intravascular blood coagulability. Prophylactics of thrombotic complications allows to avoid high amputations in 80% of the patients, to make only necrectomies, small amputations and dermoplasty.

[Clinico-roentgenologic characteristics of postoperative osteitis of the pubic bones]

The paper is concerned with clinicoroentgenological analysis of postoperative osteitis of the pubic bones (OPB) in 29 patients with urological diseases. The development of OPB follows operative complications, mainly of pyoinflammatory type. Clinically OPB develops as a pyoinfectious process. X-ray signs present a picture of inert osteomyelitis of the pelvic bones, caused by low virulent urinary infection. Its characteristic feature is superficial spreading of osseous destruction to a large extent with the affection of the adjacent of the pelvic joints. The probable routes of infection dissemination are venous (in injury of the pelvic plexus veins) and by continuity (as a result of urinary pelvic cellulitis).

[Laparoscopy in the diagnosis of acute appendicitis in children]

Based upon an analysis of results of 1210 operations and 160 laparoscopies in children for "acute appendicitis" the authors make a conclusion that about 20% of children were subjected to unnecessary appendectomies. Laparoscopy allows to make the correct diagnosis in the absolute majority of children with obscure clinical picture of acute appendicitis and to choose a rational medical treatment.