In this single-center study, cytisine was more effective than placebo for smoking cessation. The lower price of cytisine as compared with that of other pharmacotherapies for smoking cessation may make it an affordable treatment to advance smoking cessation globally.

GlanceLG, Wissler R, Mukamel DB, et al. Perioperative outcomes among patients with the modified metabolic syndrome who are undergoing noncardiac surgery.T his single-center, randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of cytisine compared with placebo in aiding smoking cessation. Participants, who received a minimal amount of counseling during the investigation, were randomly selected to receive cytosine or matching placebo for 25 days. The primary outcome measure was sustained, biochemically verified smoking abstinence for 12 months after the end of treatment. Of 1542 adult smokers screened, 740 were enrolled and 370 were randomly assigned to each study group.The rate of 12-month abstinence was 8.4% (31 participants) in the cytisine group compared with 2.4% (9 participants) in the placebo group (difference, 6.0 percentage points; 95% confidence interval, 2.7Y9.2; P = 0.001). The 7-day point prevalence for abstinence at the 12-month follow-up was 13.2% in the cytisine group versus 7.3% in the placebo group (P = 0.01) Gastrointestinal adverse events were reported more frequently, however, in the cytisine group. The investigators concluded that cytosine was more effective than placebo for smoking cessation. The lower price of cytosine compared with other drug therapies for smoking cessation may render it an affordable treatment to promote smoking cessation globally.C igarette smoking increases the risk of perioperative cardiac, pulmonary, and wound complications, and abstinence from smoking in this period can reduce complication rates.

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Infection with cytomegalovirus (CMV) remains a major problem in kidney transplant recipients, resulting in serious infectious complications and occasionally mortality. Accumulating evidence indicates that natural killer cell immunoglobulin-like receptors (KIRs) and their ligands affect the susceptibility to various diseases, including viral infections (e.g., CMV infection). We investigated whether KIR genes and their ligands affect the occurrence of CMV infection in a group of 138 kidney transplant recipients who were observed for 720 days posttransplantation. We typed the recipients for the presence of KIR genes (human leukocyte antigen C1 [HLA-C1], HLA-C2, HLA-A, HLA-B, and HLA-DR1) by polymerase chain reaction with sequence-specific primers. The multivariate analysis revealed that the lack of KIR2DS2 (p = 0.035), the presence of KIR2DL3 (p = 0.075), and the presence of KIR2DL2–HLA-C1 (p = 0.044) were risk factors for posttransplant CMV infection. We also found that a lower estimated glomerular filtration rate (p = 0.036), an earlier time of antiviral prophylaxis initiation (p = 0.025), lymphocytopenia (p = 0.012), and pretransplant serostatus (donor-positive/recipient-negative; p = 0.042) were independent risk factors for posttransplant CMV infection. In conclusion, our findings confirm that the KIR/HLA genotype plays a significant role in anti-CMV immunity and suggest the contribution of both environmental and genetic factors to the incidence of CMV infection after kidney transplantation.