Evaluation of a Dedicated Tobacco Cessation Support Service for Thoracic Cancer Center Patients.

CONTEXT: Cancer patients' continued tobacco use results in poorer therapeutic outcomes including decreased quality of life and survival. OBJECTIVE: To assess reach and impact of a free, opt-out, telephone-based tobacco cessation program for thoracic cancer center patients. DESIGN: Observational study. SETTING: Comprehensive Cancer Center in Western New York. PARTICIPANTS: Current or recent (within past 30 days) tobacco-using thoracic cancer center patients referred to a tobacco cessation support service between October 2010 and October 2012 at a Comprehensive Cancer Center (n = 942/1313 referrals were eligible for cessation support). INTERVENTION: A free, opt-out, telephone-based cessation service that was implemented as standard of care. Cessation specialists had patient-guided conversations that assessed readiness to quit; methods used in the past provided cessation strategies and worked to set up a quit date. There was an average of 35.9 days between referral and first contact. MAIN OUTCOME MEASURES: Program reach (referral and participation rates) and impact (as self-reported cessation outcomes measured twice after referral). RESULTS: Of 942 patients, 730 (77.5%) referred to and called by a tobacco cessation service participated in at least 1 cessation support call, of which 440 of 730 (60.3%) were called for follow-up and 89.5% (394/440) participated. In total, 20.2% (69/342) of current smokers at referral reported at least 7-day abstinence at follow-up. Among current smokers at referral and first contact, being married (odds ratio [OR] = 2.05; 95% confidence interval [CI], 1.01-4.18) and having a lower Eastern Cooperative Oncology Group (ECOG) performance score (OR = 4.05; 95% CI, 1.58-10.39) were associated with quitting at follow-up, after controlling for demographic, clinical, and health behavior characteristics. CONCLUSIONS: Our results demonstrate that 78% of thoracic cancer center patients, if contacted, participated at least once in this cessation support service; for current smokers at referral and first contact, being married and having a lower ECOG performance score were associated with self-reported quitting at follow-up. Other organizations may find our results useful while implementing a systematic way to identify tobacco-using patients as part of routine care and to improve available cessation support services.

Anomalías congénitas / Congenital anomalies

Las anomalías congénitas en conjunto con la restricción del crecimiento intrauterino dan cuenta del 50 a 60 por ciento de la mortalidad fetal. En este artículo se describen las malformaciones congénitas más importantes divididas por sistemas, la mayoría son diagnosticables a través del ultrasonido; sin embargo, hay un grupo de ellas que no son posibles de diagnosticar, otras que se desarrollan tardíamente en el embarazo y finalmente existen casos en que el examen ultrasonográfico puede sugerir una anormalidad inexistente. También se profundiza en la incidencia, etiología y factores de riesgo de las malformaciones congénitas, se describe la importancia y características del diagnóstico prenatal y de la prevención por medio de la suplementación de ácido fólico en la dieta.

Congenital anomalies in conjunction with intrauterine growth restriction account for 50-60 percent of fetal mortality. This article describes major birth defects by systems; most can be diagnosed by ultrasound while others cannot. Some anomalies develop later in pregnancy and in some cases sonographic examination may suggest the presence of a nonexistent abnormality. Incidence, etiology and risk factors of congenital malformations are described, as well as the importance and characteristics of prenatal diagnosis and prevention through folic acid supplementation in the diet.

Radiographic findings of screening chest films in Priest Hospital.

OBJECTIVE: To study radiographic findings in abnormal chest films from screening programs as part of a Sustained and Holistic Health Care in Priests and Novices in Commemoration of His Majesty the King's 60 Years Accession to the Throne MATERIAL AND METHOD: A retrospective, descriptive study of chest x-ray findings in phase l of the screening of chest film program was performed between February 2006 and June 2006. RESULTS: One thousand one hundred twenty two cases participated in phase l of the screening program. Nine hundred and three cases had a chest x-ray. One hundred thirty one cases had abnormal chest film from radiographic reports. The age range was 17-92 years, with mean age of 42.69 years. The abnormalities found were classified into abnormal heart size in 34 cases (25.95%), pulmonary lesions in 80 cases (61.07%), pleural lesions in 7 cases (5.34%) and other abnormality in 10 cases (7.64%). CONCLUSION: The result of abnormality that was detected from chest films, frontal PA view, was about 14.51%. However, the authors cannot assume that the cases that have a normal chest film are the healthy group. Therefore, a physical and laboratory examinations are a useful combination to classify cases in healthy, asymptomatic, or symptomatic group. In the asymptomatic cases, the results are useful for early detection and treatment. The early diagnosis can improve the result of the treatment and quality of life. This study will be useful for other epidemiology and clinical study.

Rehabilitation in neuromuscular disorders and thoracic wall deformities.

The causes of neuromuscular disorders and thoracic wall deformities are often incurable, but there are a wide range of supportive treatments that have been introduced with the aim of improving the patient's quality of ife. There are very few studies evaluating these and as a result it is still uncertain what role they have. This review analyses the outcomes of and possible indications for these therapies. The importance of recognizing the needs of each individual patient is emphasized and the use of pulmonary rehabilitation programmes with a standard combination of treatments should be reconsidered.