Factors Influencing Tobacco Smoking and Cessation Among People Living with HIV: A Systematic Review and Meta-analysis.

Tobacco smoking is highly prevalent among people living with HIV (PLWH), yet there is a lack of data on smoking behaviours and effective treatments in this population. Understanding factors influencing tobacco smoking and cessation is crucial to guide the design of effective interventions. This systematic review and meta-analysis of studies conducted in both high-income (HICs) and low- and middle-income countries (LMICs) synthesised existing evidence on associated factors of smoking and cessation behaviour among PLWH. Male gender, substance use, and loneliness were positively associated with current smoking and negatively associated with smoking abstinence. The association of depression with current smoking and lower abstinence rates were observed only in HICs. The review did not identify randomised controlled trials conducted in LMICs. Findings indicate the need to integrate smoking cessation interventions with mental health and substance use services, provide greater social support, and address other comorbid conditions as part of a comprehensive approach to treating tobacco use in this population. Consistent support from health providers trained to provide advice and treatment options is also an important component of treatment for PLWH engaged in care, especially in LMICs.

Pouch-Related Symptoms and Quality of Life in Patients with Ileal Pouch-Anal Anastomosis.

BACKGROUND: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become the standard surgical treatment for the majority of patients with inflammatory bowel disease (IBD) who require colectomy. We evaluated the prevalence of pouch-related symptoms among the Crohn's and Colitis Foundation of America Partners cohort and the effect of pouch-related symptoms on Patient-Reported Outcome Measurement Information System measures. METHODS: We performed analyses nested in the Crohn's and Colitis Foundation of America Partners cohort. We used bivariate analyses to compare demographics and medication use among patients with ulcerative colitis or indeterminate colitis and pouch-related symptoms and those with IPAA without symptoms. We also compared Patient-Reported Outcome Measurement Information System domains (measured in T-scores) and short IBD questionnaire quality of life scales between symptomatic pouch patients (over the past 6 mo) and those without symptoms. RESULTS: Among 243 patients reporting a history of IPAA, 199 (82%) reported a history of pouch symptoms. Patients with recent pouch symptoms demonstrated higher mean T-scores in pain interference (53.0 versus 45.3; P < 0.001), depression (51.0 versus 46.4; P = 0.002), and fatigue (56.3 versus 47.0; P < 0.001). Symptomatic pouch patients reported lower mean scores in social role satisfaction (47.4 versus 54.6) and short IBD questionnaire (4.8 versus 5.8) (both P < 0.001). These differences were all clinically meaningful. CONCLUSIONS: In a large sample of patients with IBD, nearly all patients with IPAA reported a history of pouch symptoms. Patients experiencing symptoms within the 6 months before the survey assessment demonstrated clinically meaningful decrements in patient-reported outcomes in multiple domains of physical and psychosocial functioning.

[Long-term results of lung cancer surgery in octogenarians]. / Résultats à long terme de la chirurgie de résection pulmonaire pour cancer chez l'octogénaire.

INTRODUCTION: This retrospective study was undertaken to evaluate late results of lung cancer surgery in octogenerians. METHODS: All patients 80years old or more who underwent a lung resection for cancer from 2000 to 2010 at Lyon University Hospital were included. No patients were treated with video-assisted surgery. Wedge resections were excluded. RESULTS: Sixty-three patients (42 men, 21 women) were operated. The median age was 82years. Operative mortality was 4.7%. The rate of perioperative complications was 49%. The late survival was 34% at 5years. Five-year survival by nodal involvement was N0, 36%; N1, 29%; N2 20%, P<0.05. Patients with a squamous cell carcinoma (24) had a better long-term survival than patients with an adenocarcinoma (30), 33% and 25% respectively at 5years, P<0.05. The rate of recurrence was 33.9%. CONCLUSIONS: Surgical treatment of lung cancer in selected population of octogenerians is associated with satisfactory early and long-term results. Survival is influenced by nodal involvement and by the pathologic type of the cancer.