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Articles Jae Sook Koh, PhD et al
From the Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
BACKGROUND Despite the obvious relation between smoking and facial wrinkling, grossly undetectable wrinkling and the consequences of smoking on the face have been poorly studied.
OBJECTIVE: To assess the risk factor of cigarette smoking on the development of premature facial wrinkling.
METHODS: One hundred and twenty-three nonsmokers, 160 current smokers, and 67 past smokers, aged 20–69 years, were studied. Cigarette smoking status, weight changes, average sun exposure time (recreational and occupational) in 1 month, and past medical and facial cosmetic surgery were quantified by self-questionnaire. Computerized image analysis of silicone skin replicas was used in addition to clinical visual measurement, and a severity score based on predetermined criteria was assigned to each patient.
RESULTS: Current smokers have a higher degree of facial wrinkling than nonsmokers and past smokers. Past smokers who smoked heavily at a younger age show less facial wrinkling than current smokers. In the analysis, which was adjusted for age group, the relative risk of moderate to severe wrinkling for current smokers compared with nonsmokers was 2.72 (confidence interval, CI: 1.32–3.21, P < 0.05). In current smokers, the relative risks associated with more than 19 pack-years and 11–19 pack-years of smoking compared with nonsmokers were 2.93 (CI: 1.14–4.1, P < 0.05) and 1.75 (CI: 1.54–3.67, P < 0.05), respectively. On image analysis of facial skin replicas, the mean values of Ra (arithmetic average roughness), Rz (average roughness), and Rt (distance between the highest and lowest values) of current smokers were higher than those of nonsmokers and past smokers in all age groups. This indicates a strong correlation between cigarette smoking and skin wrinkling. In addition, microscopic superficial wrinkling (Ra and Rt) was noted in current smokers in the younger age group (20–39 years).
Conclusions
This study suggests that attention should be paid to smoking-associated facial wrinkling (not evident from a visual assessment) in young people and added to the list of disorders seemingly caused by smoking.
Association between smoking and erectile dysfunction: A population-based study
Gades NM et al.
Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
The association between smoking and erectile dysfunction was evaluated in a cohort of 2,115 Caucasian men, aged 40-79 years, randomly selected from Olmsted County, Minnesota. Smoking status was assessed by questionnaire; during the fourth biennial examination, erectile dysfunction was assessed with the Brief Male Sexual Function Inventory. Of the 1,329 men with a regular sexual partner, 173 were current smokers, 836 had previously smoked, and 203 reported erectile dysfunction. Compared with former and never smokers, current smokers in their forties had the greatest relative odds of erectile dysfunction, 2.74 (95% confidence interval (CI): 0.44, 16.89), compared with 1.38 (95% CI: 0.51, 3.74), 1.70 (95% CI: 0.82, 3.51), and 0.77 (95% CI: 0.27, 2.21) for men in their fifties, sixties, and seventies, respectively.
Compared with men who never smoked, men who smoked at some time had a greater likelihood of erectile dysfunction (age-adjusted odds ratio = 1.42, 95% CI: 1.00, 2.02), and there was a dose response. Although the causal pathway underlying this association is not clear, this study contributes to the growing literature describing an association between smoking and erectile dysfunction.
PMID: 15692078 [PubMed - indexed for MEDLINE]
Park K et al.
Department of Urology, Seoul National University Hospital, 28 Chongno-Gu, Yongon-Dong, Seoul, Korea.
OBJECTIVE: To assess the clinical efficacy of sildenafil and the potential predictors of poor response to sildenafil in elderly patients with erectile dysfunction
PATIENTS AND METHODS: The study included 162 patients (aged > or = 60 years) treated with sildenafil for at least 8 weeks; all patients were evaluated with a history, physical examination, measurement of total testosterone and a pharmacological erection test. Sexual function before and 8 weeks after treatment was assessed using the self-administered International Index of Erectile Function (IIEF). Treatment was considered successful when the patient attained a higher grade on the erectile function (EF) domain score, and an affirmative response to the overall assessment question. Factors influencing treatment outcome were evaluated by univariate and multivariate statistical analysis.
RESULTS: The overall efficacy with sildenafil was 47% (76/162). On univariate analysis, uncontrolled diabetes, current smoking, hypogonadism (<3 microg/L testosterone) and low pretreatment EF domain score (<17) were selected as predictors of a poor response. On multivariate logistic regression, a low pretreatment EF domain score was the strongest independent prognostic factor for a poor response (odds ratio 2.25, 95% confidence interval, 1.45-7.33), and this was followed by hypogonadism (1.89, 1.12-3.16) and current smoking (1.34, 1.04-3.52).
CONCLUSION: In a real clinical setting, sildenafil was effective for about half of the elderly men. The baseline EF domain score, hypogonadism and current smoking were significantly associated with failure of sildenafil.
These results suggest that modifying reversible risk factors, e.g. stopping smoking and replacing testosterone, would be beneficial in augmenting the efficacy of sildenafil in elderly men.
PMID: 15679795 [PubMed - indexed for MEDLINE]
Bunyavejchevin S et al.
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.
OBJECTIVES:To assess the risk factors of ectopic pregnancy in Thai women. SETTING: Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University.
MATERIAL AND METHOD:From 1999 to 2000, 208 cases of ectopic pregnancy and 781 controls (postpartum women) were included in the study. The women were interviewed by trained research interviewers using a standardized questionnaire. Detailed information regarding age at first intercourse, number of sexual partners, history of changing partners within 6 months, previous obstetric history, history of spontaneous and criminal abortion, history of pelvic inflammatory disease, smoking, history of endometriosis and history of previous ectopic pregnancy was collected
RESULTS: By multivariate analysis, 5 variables remained as strong and independent risk factors for ectopic pregnancy: the number of sexual partners > or = 2 (OR = 3.02, 95% CI (1.75-5.23), vaginal delivery > or = 1 (OR = 0.005, 95% CI (0.002-0.0015), history of pelvic inflamatory disease (OR = 3.17, 95% CI (1.40-7.19), smoking (OR = 2.49, 95% CI (1.36-4.55), infertility (OR = 2.74, 95% CI (1.35-5.54)).
CONCLUSION: Problems of multiple sexual partners, pelvic inflammatory disease, smoking and infertility were the main risk factors of ectopic pregnancy in Thai women.
PMID: 12930019 [PubMed - indexed for MEDLINE]
Mirone, V. et al
Clinica Urologica Federico II, Università degli Studi di Napoli, Naples, Italy.
OBJECTIVES: We analysed the role of smoking on the risk of erectile dysfunction (ED) using data from a cross-sectional study on prevalence and risk factors for ED in the general population in Italy.
METHODS: A total of 2010 men aged more than 18 years were randomly identified and interviewed by 143 general practitioners among their registered patients. Patients were asked "about their ability to achieve and maintain an erection sufficient for satisfactory sexual performance." If they were dissatisfied, they were defined as having ED.
RESULTS: In comparison with never smokers, current smokers had an odds ratio (OR) of ED of 1.7 (95% confidence interval (CI), 1.2-2.4) and ex-smokers of 1.6 (95% CI, 1.1-2.3). The association between smoking and ED risk was present in subjects without a history of any cardiovascular disease, cardiopathy, hypertension, diabetes and neuropathy, but not in those with a history of these conditions. For example, the ORs of ED in smokers, in comparison with never smokers, were respectively 2.4, 2.0 and 1.7 in men with no history of any cardiovascular disease, diabetes and neuropathy, but respectively 1.0, 1.0 and 1.2 in those with a history of the conditions.
CONCLUSIONS: This study shows that the risk of ED is influenced by smoking and that the duration of the habit increases the risk. Further, it highlights the potential interaction of smoking with medical history on ED risk.
PMID: 12180231 [PubMed - indexed for MEDLINE]
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