Strange lump

[Fred & Hanneke]

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[Dr Vicky]

If it is a lipoma (fatty lump), there is nothing to worry about. It is unlikely to go away,and may enlarge with time, but I would suggest you get it checked out if it starts being painful, becomes rapidly larger, or is otherwise concerning you.

[Anthony Buckley]

THE GENETIC FACTOR IN SMOKING

For many smokers, the habit and the chemical addiction are all that need to be relinquished. The majority of ex-smokers therefore find it relatively easy to stop and are understandably baffled and distressed that so many others seem unable to stop.
Schizophrenia probably provides the strongest evidence yet that, for some, a third and infinitely more-powerful factor exists: ie that smoking can be 'medication'. Various studies have shown that between 88-95% of sufferers smoke because, the researchers found, it ameliorates psychotic symptoms. The research below shows that tobacco can indeed be a medication which helps in schizophrenia and some forms of depression. Smokers await DNA tests and an alternative medication to tobacco.

** Cigarette smoking protects against schizophrenia **
Researchers and clinicians have long been puzzled by the high incidence of
cigarette smoking among people with schizophrenia. A study of more than
50,000 Swedes has turned up some interesting findings. People who smoked
between the ages of 18 and 20 had a statistically lower chance of developing
schizophrenia than those who didn't smoke. The more cigarettes smoked, the
lower the chance of developing the disorder. ... further investigation may
lead to important insights regarding the etiology of schizophrenia at a
molecular level," they write. American Journal of Psychiatry, 160,
2216-2221. http://ajp.psychiatryonline.org/cgi/content/abstract/160/12/2216?etoc

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Am J Psychiatry 160:2216-2221, December 2003
© 2003 American Psychiatric Association

Investigating the Association Between Cigarette Smoking and Schizophrenia in
a Cohort Study

Stanley Zammit, M.R.C.Psych., Peter Allebeck, M.D., Christina Dalman, M.D.,
Ingvar Lundberg, M.D., Tomas Hemmingsson, Ph.D., and Glyn Lewis, Ph.D.

"…there is evidence to suggest that smoking may improve symptoms in people
with this disorder".
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Some Smokers Use Nicotine to "Self-Medicate for Depression"---
by Caryn Lerman, Ph.D.

Behavioral research has established that cigarette smoking by people with
depression can be a form of self- medication, using the mood-altering
properties of nicotine to relieve -- at least temporarily -- depressive
symptoms. New research, appearing in the January edition of the journal
Health Psychology, published by the American Psychological Association
(APA), suggests that depressed people -- and nondepressed people -- who
smoke to improve their mood may do so because of differences in their
genetic make-up, differences that may be important to the effectiveness of
future treatments for depression and nicotine dependency.
..Additionally, smokers are more likely than nonsmokers to report depressive
symptoms and such symptoms predict relapse following attempts to quit
smoking. "In fact," they point out, "the likelihood of quitting smoking is
about 40 percent lower among depressed smokers compared with the likelihood
among nondepressed smokers." The researchers' study was designed to
determine if genes involved in the brain's reward mechanisms play a role in
this phenomenon.
... With additional research, they add, "genotyping may become a useful
strategy for designing and targeting pharmacologic therapies to subgroups of
depressed smokers most likely to benefit from them."
5/29/98
http://wwx.shpm.con/articles/atd/selfmed.html

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Smoke signal
15:53 24 October 00
A simple genetic test could help doctors tailor anti-smoking treatments to
patients' needs, making it easier for them to quit.
The test allowed an Oxford University team to successfully predict which
smokers would respond well to nicotine patches, and which wouldn't.
.... Nicotine stimulates the production of dopamine in the nucleus
accumbens, the brain's "pleasure centre".
People with these mutations metabolise dopamine more quickly. They would
therefore benefit from anti-smoking treatments that are designed to boost
dopamine levels. But they are less likely to respond well to
nicotine-replacement therapies, such as nicotine patches, says the team.
John Stapleton of the National Addiction Centre in London finds the work
interesting, but warns: "They are only looking at a few genes and there are
potentially dozens involved. This is only part of the story."

Tailored treatment
The team found that a person's genotype affects not only whether they are
likely to smoke or not, but how many cigarettes they consume.
Between 30 and 40 per cent of people have mutations in genes that code for
two enzymes involved in dopamine metabolism: dopamine-hydroxylase and
monoamine oxidase. Heavy smokers are two to three times as likely to have
mutations in these genes as non-smokers, says Robert Walton, one of the
Oxford researchers.
People with these mutations need to smoke more to maintain normal dopamine
levels, so should be targeted with dopamine-boosting drugs...

Walton hopes the DNA test could be widely available in two to three years'...
More at: Pharmacogenetics (vol 10, p 483)
Emma Young

http://wwx.mindful-things.con/newsletter_archive/03-12_08_newsletter.html