A significant problem in assessing the relative relevance of nicotine and tar yield for compensatory smoking after switching from high to low yield cigarettes is that nicotine and tar yield are highly intercorrelated across conventional cigarettes and that the tar/nicotine ratios vary only within a modest range. A better differentiation between the impacts of nicotine and tar yield was expected by comparing in a laboratory experiment a new low nicotine/medium tar cigarette ("Next") with conventional low nicotine/low tar (ultra-light) cigarettes and with medium nicotine/medium tar cigarettes with respect to nicotine absorption and physiological effects. Twelve females, habitually smoking medium type cigarettes (> or = 0.7 mg nicotine) participated in the study. Neither the number of cigarettes smoked under field conditions nor the puffing behavior during the laboratory experiment differed between the three types of cigarettes. In the laboratory, Next produced only very small increases in plasma nicotine and changes in cardiovascular or EEG measures, whereas the effects of the medium cigarettes were in the expected range and those of the ultra-light cigarettes about halfway in between. The nicotine absorption/nicotine yield and the CO absorption/CO yield ratios were similar for Next and the habitual cigarettes, but about twofold higher for the ultra-light cigarettes. This suggests that gustatory and olfactory sensations, which are supposed to be more dependent on tar than on nicotine yield, may play a greater role for the regulation of smoking behavior than hitherto believed.
In a modified "subject-paced" rather than fixed rate version of a rapid information processing (RIP) task, the presentation rate of the stimuli is continuously adapted to the individual performance level. Thus, this modified task version probably assesses a continuous "speed function" rather than mere "vigilance". In order to compare the two task versions more directly, we carried out a study which assessed the effects of a regular nicotine cigarette and the nearly nicotine-free cigarette NEXT on both task versions under the same experimental conditions. The dominant alpha frequency pointed to a greater arousal evoked by the subject-paced RIP version compared with the fixed rate version. With the fixed rate version, smoking nicotine cigarettes reduced reaction times, whereas with the subject-paced version, processing rate was improved. Additionally, smoking NEXT decreased craving less than smoking the regular cigarettes. It was concluded that the two task versions are sensitive to different cognitive functions. Whereas the subject-paced version was more sensitive to effects on the speed of processing, the fixed rate version was more sensitive to effects on reaction time.
In a field study heart rate, activity, cigarette consumption, craving for cigarettes, saliva cotinine and subjective ratings were assessed in 12 female subjects, smoking medium tadmedium nicotine cigarettes (TN). The habituated cigarettes were compared with a nearly nicotine-free/medium tar (0.08 mgl9.3 mg) cigarette (Tn) and with abstinence. Two recording periods of 3 days each were conducted in two consecutive weeks. Heart rate was highest with the TN cigarettes, 8 bpm lower on abstinence days and in between with the Tn cigarettes. A characteristic increase in heart rate and activity before cigarette lighting appeared with the TN and the Tn cigarettes and with button pressing indicating smoking desire on abstinence days. This response is attributed to an anticipative activation preceding lighting a cigarette. Subjective ratings assessing the craving to smoke differed between abstinence and the smoking condition but not between the two cigarette types, whereas saliva cotinine was significantly higher with the W t h a n with the Tn cigarettes or abstinence. Cigarette consumption was similar with both cigarette types, but taste and strength were rated better for the TN than the Tn cigarettes.It is concluded that heart rate and saliva cotinine depend on the amount of nicotine absorbed, whereas subjective craving is reduced by smoking independently of the actual nicotine yield of the cigarette.
Background and aimsMalnutrition is very common in patients with heart failure (HF) and is associated with a worse clinical outcome. The Controlling Nutritional Status (CONUT) score is an easily derived index for the evaluation of malnutrition. This study aimed to evaluate the association between the CONUT score and the prognosis in patients with HF.Methods and resultsElectronic databases were searched for potential studies from inception up to February 15, 2022. Observational cohort studies included adult participants with HF, and reported the associations between the CONUT score and the adjusted relative risk (RR) of all-cause mortality, and patients with composite major adverse cardiac outcomes (MACEs) were included. We finally included 18 studies comprising 12,532 participants with HF for analysis. The median age of the patients was 70.5 years old, and 35.4% were women. After a median follow-up duration of 32.5 months, patients with HF with a higher CONUT score were associated with a higher risk of all-cause mortality (per 1 increment of the CONUT score: RR, 1.21, 95% CI, 1.13–1.29, I2 = 68%, P for heterogeneity = 0.002) and MACEs (per 1 increment of the CONUT score: RR, 1.14, 95% CI, 1.06–1.23, I2 = 81%, P for heterogeneity <0.0001) after adjusting for other prognostic factors. When the CONUT score was divided into the normal nutritional status and malnourished status, malnourished patients with HF were associated with increased risks of all-cause death (RR, 1.61, 95% CI, 1.40–1.85, I2 = 17%, P for heterogeneity = 0.29) and MACEs (RR, 2.12, 95% CI, 1.49–3.02, I2 = 87%, P for heterogeneity <0.0001), compared with those with normal nutritional status.ConclusionsThe CONUT score is associated with the clinical outcomes in patients with HF, and can be used as a screening tool of nutritional status in HF to improve prognosis.
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