Identification of current smokers among renal transplant recipients.

TL;DR: In this paper, the authors examined smoking and engagement in other modifiable behavioral risk factors and human papillomavirus status in patients with head and neck cancer in order to facilitate identification and foster development of targeted interventions in high-risk patients.

TL;DR: The NicAlert® add-on test strategy had excellent diagnostic test performance for identifying current smokers who are expected to have a high risk of perioperative complications.

TL;DR: Plasma and urine cotinine can serve as an alternative to self-report and were dose-dependently associated with poor late outcomes in RTR and dose dependency with mortality and graft failure.

TL;DR: In this paper, the authors explore the non-standardized psychosocial approach to organ transplant listing and explore the factors that are relevant to the standardization of the decision-making process.

Abstract: "The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure" provides a new guideline for hypertension prevention and management. The following are the key messages(1) In persons older than 50 years, systolic blood pressure (BP) of more than 140 mm Hg is a much more important cardiovascular disease (CVD) risk factor than diastolic BP; (2) The risk of CVD, beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg; individuals who are normotensive at 55 years of age have a 90% lifetime risk for developing hypertension; (3) Individuals with a systolic BP of 120 to 139 mm Hg or a diastolic BP of 80 to 89 mm Hg should be considered as prehypertensive and require health-promoting lifestyle modifications to prevent CVD; (4) Thiazide-type diuretics should be used in drug treatment for most patients with uncomplicated hypertension, either alone or combined with drugs from other classes. Certain high-risk conditions are compelling indications for the initial use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); (5) Most patients with hypertension will require 2 or more antihypertensive medications to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg for patients with diabetes or chronic kidney disease); (6) If BP is more than 20/10 mm Hg above goal BP, consideration should be given to initiating therapy with 2 agents, 1 of which usually should be a thiazide-type diuretic; and (7) The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated. Motivation improves when patients have positive experiences with and trust in the clinician. Empathy builds trust and is a potent motivator. Finally, in presenting these guidelines, the committee recognizes that the responsible physician's judgment remains paramount.

TL;DR: It is concluded that cotinine is the measure of choice, but for most clinical applications carbon monoxide provides an acceptable degree of discrimination and is considerably cheaper and simpler to apply.

TL;DR: A biomarker is desirable in quantitating systemic exposure both in smokers and nonsmokers to constituents of tobacco smoke to reflect exposure to toxic constituents of smoke that are of concern.

Abstract: PRIMARY CARE CLINICIANS, TObacco dependence treatment specialists, and health care administrators, insurers, and purchasers now have an unprecedented opportunity to reduce tobacco use rates in the United States and consequently the burden of illness, death, and economic cost resulting from tobacco use. This opportunity is the result of an unusual confluence of circumstances: 70% of smokers now want to quit smoking completely, and 46% try to quit each year; more than 70% of smokers visit a health care setting each year; and effective treatments now exist. Indeed, these circumstances challenge clinicians and health care delivery systems to fulfill the mandate of an unspoken contract regarding health care—to provide patients with effective interventions that will prevent needless illness and death. Both clinicians and health care delivery systems are at risk of breaking this fundamental contract. Currently, neither ensures that smokers consistently receive effective tobacco interventions. Therefore, most smokers trying to quit do so on their own, without the benefit of highly effective treatments. The health care system’s neglect of the tobacco user exacts costs that sum to thousands of lives and billions of dollars in added health care expenditures each year. Panel, Staff, and Consortium Representatives and Financial Disclosures are listed at the end of this article. Corresponding Author and Reprints: Michael C. Fiore, MD, MPH, University of Wisconsin Medical School, Center for Tobacco Research and Intervention, 1930 Monroe St, Suite 200, Madison, WI 53711 (e-mail: mcf@ctri. medicine.wisc.edu). Objective To summarize the recently published US Public Health Service report Treating Tobacco Use and Dependence: A Clinical Practice Guideline, which provides recommendations for brief clinical interventions, intensive clinical interventions, and system changes to promote the treatment of tobacco dependence.