National Jewish Health

About: National Jewish Health is a healthcare organization based out in Denver, Colorado, United States. It is known for research contribution in the topics: Asthma & T cell. The organization has 883 authors who have published 833 publications receiving 79201 citations. The organization is also known as: National Jewish Medical and Research Center.

Addressing Heavy Drinking in Smoking Cessation Treatment: A Randomized Clinical Trial.

Abstract: The positive association between cigarette smoking and alcohol use has been well documented (eg, Chiolero, Wietlisbach, Ruffieux, Paccaud, & Cornuz, 2006; Dawson, 2000; Falk, Yi, & Hiller-Sturmhofel, 2006; Friedman, Tekawa, Klatsky, Sidney, & Armstrong, 1991) Almost 20% of current smokers consume five or more drinks on one occasion at least once per month, compared to about 65% of nonsmokers (Dawson, 2000) The combined negative effects of excessive drinking and smoking on health outcomes are substantial For example, smoking and heavy drinking combine to produce especially negative consequences on brain morphology and function (Durazzo, Cardenas, Studholme, Weiner, & Meyerhoff, 2007; Meyerhoff et al, 2006), and smoking negates the cardioprotective effects of regular drinking (Ebbert, Janney, Sellers, Folsom, & Cerhan, 2005; Schroder, Marrugat, Elosua, & Covas, 2002) Furthermore, a multiplicative effect operates when smoking is combined with heavy drinking, conferring markedly greater risk for oral, pharyngeal, laryngeal, and esophageal cancers relative to just smoking, just drinking, or neither smoking nor drinking (Pelucchi, Gallus, Garavello, Bosetti, & La Vecchia, 2006) Greater alcohol use is associated with decreased odds of smoking cessation (Hymowitz et al, 1997; Osler, Prescott, Godtfredsen, Hein, & Schnohr, 1999; Sorlie & Kannel, 1990; Zimmerman, Warheit, Ulbrich, & Buhl Auth, 1990) and is a strong prospective predictor of smoking relapse among self-quitters (Garvey, Bliss, Hitchcock, Heinold, & Rosner, 1992; Ockene et al, 2000) Current alcohol use (Humfleet, Munoz, Sees, Reus, & Hall, 1999; Sherman, Wang, & Nguyen, 1996; Smith, Kraemer, Miller, Debusk, & Taylor, 1999) and current binge drinking (Murray, Istvan, Voelker, Rigdon, & Wallace, 1995) at the start of a smoking cessation treatment and use of alcohol after treatment (Humfleet et al, 1999) are negatively associated with abstinence, although there has been an exception (Hughes & Oliveto, 1993) In treatment samples, approximately one quarter of smoking lapses occur in contexts involving alcohol use (Baer & Lichtenstein, 1988; Borland, 1990; Shiffman, 1982) A number of recent clinical trials have examined smoking cessation interventions initiated during alcoholism treatment Results have indicated that these interventions do not harm treatment outcome and may even be associated with better drinking outcomes (Prochaska, Delucchi, & Hall, 2004), though there have been exceptions (eg, Joseph, Willenbring, Nugent, & Nelson, 2004) However, relatively little attention has been devoted to smokers who drink heavily but are not alcohol dependent The US Department of Health and Human Services guidelines for treating tobacco dependence recommend that smokers reduce or avoid drinking alcohol as much as possible when making a quit attempt (Fiore, Bailey, Cohen, & et al, 2000) However, clinicians currently have little guidance as to how to address heavy drinking in smoking cessation treatment as no empirical studies have been published to date in this area Brief motivationally-focused behavioral interventions have been shown to reduce drinking (McCrady, 2000; Moyer, Finney, Swearingen, & Vergun, 2002; Whitlock, Polen, Green, Orleans, & Klein, 2004) among drinkers who are not seeking treatment for alcohol problems and especially among those with less severe alcohol problems (Moyer et al, 2002) Incorporating brief interventions into smoking cessation treatment for nondependent heavy drinkers may be efficacious both in reducing drinking and in improving smoking cessation outcomes Towards this end, the aim of the current study was to test the efficacy of a smoking cessation treatment that incorporated a brief alcohol intervention, which focused on the risks of smoking relapse associated with drinking and the negative effects of continued heavy drinking This randomized clinical trial involved 236 non-alcohol dependent, heavy drinking smokers who were recruited from the community and were seeking smoking cessation treatment Participants were randomized to either standard smoking cessation treatment (ST), which included provision of the nicotine patch, or an equivalent standard treatment that also incorporated a brief alcohol intervention (ST-BI) Treatment conditions were matched on amount of contact time and participants were followed for 26 weeks after their smoking quit date We hypothesized that ST-BI, compared to ST, would result in higher rates of point prevalence smoking abstinence at 2, 8, 16, and 26 weeks after quit date and a lower number of alcoholic drinks consumed per week In addition, we hypothesized that ST-BI, relative to ST, would result in lower rates of initial lapses to smoking that involved alcohol use during treatment Finally, we examined two potential moderators of treatment effects on smoking: level of drinking prior to treatment and intention to change drinking These analyses were considered exploratory as there are theoretical reasons to expect either stronger or weaker effects of ST-BI at higher levels of each variable For pretreatment drinking, the emphasis of ST-BI on alcohol use might be especially relevant for relatively heavier drinkers; on the other hand, asking these very heavy drinkers to change both drinking and smoking simultaneously might prove overly difficult For intention to change drinking, ST-BI might be relatively more effective for those who intend to change drinking because it reinforces the expectations of such smokers that changing alcohol use may facilitate smoking cessation; on the other hand, ST-BI could be less effective for these smokers because the information in ST-BI is redundant with their intentions

Importance of myeloid dendritic cells in persistent airway disease after repeated allergen exposure.

Abstract: Rationale: There is conflicting information about the development and resolution of airway inflammation and airway hyperresponsiveness (AHR) after repeated airway exposure to allergen in sensitized mice.Methods: Sensitized BALB/c and C57BL/6 mice were exposed to repeated allergen challenge on 3, 7, or 11 occasions. Airway function in response to inhaled methacholine was monitored; bronchoalveolar lavage fluid inflammatory cells were counted; and goblet cell metaplasia, peribronchial fibrosis, and smooth muscle hypertrophy were quantitated on tissue sections. Bone marrow–derived dendritic cells were generated after differentiation of bone marrow cells in the presence of growth factors.Results: Sensitization to ovalbumin (OVA) in alum, followed by three airway exposures to OVA, induced lung eosinophilia, goblet cell metaplasia, mild peribronchial fibrosis, and peribronchial smooth muscle hypertrophy; increased levels of interleukin (IL)-4, IL-5, IL-13, granulocyte-macrophage colony–stimulating factor, trans...

Physical activity, health status and risk of hospitalization in patients with severe chronic obstructive pulmonary disease.

Abstract: Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and 70% of the cost of COPD is due to hospitalizations. Self-reported daily physical activity an

Timing of Initial Exposure to Cereal Grains and the Risk of Wheat Allergy

Abstract: OBJECTIVE.Early exposure to solid foods in infancy has been associated with the development of allergy. The aim of this study was to examine the association between cereal-grain exposures (wheat, barley, rye, oats) in the infant diet and development of wheat allergy. METHODS.A total of 1612 children were enrolled at birth and followed to the mean age of 4.7 years. Questionnaire data and dietary exposures were obtained at 3, 6, 9, 15, and 24 months and annually thereafter. The main outcome measure was parent report of wheat allergy. Children with celiac disease autoimmunity detected by tissue transglutaminase autoantibodies were excluded. Wheat-specific immunoglobulin E levels on children reported to have wheat allergy were obtained. RESULTS.Sixteen children (1%) reported wheat allergy. Children who were first exposed to cereals after 6 months of age had an increased risk of wheat allergy compared with children first exposed to cereals before 6 months of age (after controlling for confounders including a family history of allergic disorders and history of food allergy before 6 months of age). All 4 children with detectable wheat-specific immunoglobulin E were first exposed to cereal grains after 6 months. A first-degree relative with asthma, eczema, or hives was also independently associated with an increased risk of wheat-allergy development. CONCLUSIONS.Delaying initial exposure to cereal grains until after 6 months may increase the risk of developing wheat allergy. These results do not support delaying

Impact of Race on Asthma Treatment Failures in the Asthma Clinical Research Network

Abstract: Rationale: Recent studies suggest that people with asthma of different racial backgrounds may respond differently to various therapiesObjectives: To use data from well-characterized participants in prior Asthma Clinical Research Network (ACRN) trials to determine whether racial differences affected asthma treatment failuresMethods: We analyzed baseline phenotypes and treatment failure rates (worsening asthma resulting in systemic corticosteroid use, hospitalization, emergency department visit, prolonged decrease in peak expiratory flow, increase in albuterol use, or safety concerns) in subjects participating in 10 ACRN trials (1993–2003) Self-declared race was reported in each trial and treatment failure rates were stratified by raceMeasurements and Main Results: A total of 1,200 unique subjects (whites = 795 [66%]; African Americans = 233 [19%]; others = 172 [14%]; mean age = 32) were included in the analyses At baseline, African Americans had fewer asthma symptoms (P < 0001) and less average daily