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Background: There is limited population-based evidence on long-term smoking relapse rates after 1 year of abstinence. We estimate the incidence of relapse and evaluate demographic, health, socioeconomic characteristics, and episodic events associated with an increased probability of relapse., Methods: Smoking relapse is studied using a subsample of individuals in the annual British Household Panel Survey, between 1991 and 2006, who reported not being a smoker for at least 1 year (two consecutive surveys) after previously reporting smoking (n = 1,578). A random-effects panel logit regression was used to examine the association between smoking relapse and length of abstinence, demographic, socioeconomic, and health variables., Results: Data were available on individuals for a mean of 5.2 years after the initial 1-year smoking abstinence. We estimated that 37.1% (34.0%-40.5%; 95% CI) of the sample would relapse within 10 years. Increased length of abstinence, increased age, being married, being educated to degree level, and a high frequency of General Practitioner (GP) visits were significantly associated with a lower risk of relapse. Conversely, higher relapse rates were significantly associated with mental health problems and having a partner who started smoking., Conclusions: A significant proportion of smokers relapse after more than 1 year of abstinence. This study sheds light on factors associated with long-term relapse. This can form the basis for designing public health interventions to prolong abstinence and targeting interventions at former smokers at the highest risk of relapse.

Objective: To determine the long-term response to serial sacroiliac joint (SIJ) corticosteroid injections. Design. Retrospective practice audit., Setting and Patients: Tertiary care spine center. Review of charts of all patients in a single practice who underwent diagnostic and therapeutic fluoroscopically guided SIJ injections with combined local anesthetic, long-acting corticosteroid, and contrast., Measures: Response was evaluated at 1 hour and again at follow-up clinic visits. Response to injection was graded as positive if there was > or =50% relief of the targeted pain during the local anesthetic phase and at least 2 weeks of > or =50% relief afterward. If pain recurred, patients had to have been sufficiently satisfied with the relief to request repeat injection., Results: There were 164 patients; 5 had incomplete records, 4 had <2 year follow-up. Of the 155 patients, 120 (77%) were positive responders; 45 were men and 75 were women; and the mean age was 48 (27-91) years. Sixty-nine had prior lumbar surgery. Mean duration of follow-up was 44 months (26-101). Two were lost to follow-up. The 118 positive responders received a mean of 2.7 injections per patient. Forty patients required 1 injection only, 29 required two, 22 required three, and 27 required four or more. The mean duration of response for those receiving >1 injection was 9.3 months per injection (1-58). There were no adverse events., Conclusions: SIJ corticosteroid injections appear to be an effective palliative treatment for selected patients with SIJ pain. Most patients whose pain is responsive to SIJ steroid injections improved sufficiently and remained well after 1 to 3 injections, but some required frequent injections on a long-term basis.

There is paucity of medical literature on the use of lamotrigine in elderly patients who have behavior problems and diverse psychiatric syndromes. This article is a retrospective case series summarizing the authors' experience with this medication. In a 20-patient case series from an institutional review board-approved retrospective chart review, the tolerability and efficacy of lamotrigine was evaluated for the management of agitated and aggressive behaviors in nursing home patients with a range of psychiatric and medical diagnoses. Nineteen of the elderly nursing home patients tolerated lamotrigine treatment, and 18 showed modest clinical improvement. These results support the authors' belief that controlled clinical investigations of this medication should be performed.

Trichospirura leptostoma is a spirurid nematode that inhabits the pancreatic ducts of the common marmoset, Callithrix jacchus, and other New World primates. This parasite was diagnosed in members of this species at the Marmoset Research Center in Oak Ridge, Tennessee colony after their importation from multiple colonies outside the United States. Animals with few parasites in the pancreas had few tissue changes, whereas those with many parasites had moderate to severe fibrosis replacing exocrine tissue. Trichospirura leptostoma can cause chronic pancreatitis, resulting in subclinical to clinical pancreatic insufficiency and secondary malnutrition. Clinical signs of pancreatic insufficiency in affected marmosets included weight loss (despite good appetite) and increased fecal volume. Because earlier reports did not mention treatments, experimental therapeutic regimens were attempted to eliminate infections from the marmosets. In the clinical studies, different doses and treatment periods with ivermectin and fenbendazole were evaluated for therapeutic efficacy. Fenbendazole given daily at a dosage of 50 mg/kg of body weight by gavage for 14 days was the most effective treatment (PI 0.052). Control of the cockroach vector, as well as treatment of infected animals, is needed to prevent Trichospirura leptostoma-induced disease.