ABSTRACT
Introduction:While smoking remains one of the leading causes of death in Mexico, uptake of evidence-based cessation therapy remains low. Widespread use of mobile devices and internet in Mexico has created new avenues for providing access to cessation treatment.Methods:We assessed the feasibility and acceptability of "Vive Sin Tabaco ¡Decídete!" (English: Live without Tobacco . Decide!), a web-based, informed decision-making tool designed to help Mexican smokers develop a quit plan and take advantage of cessation resources. We invited 164 smokers in two primary care clinics. Measures included physical, situational, and psychological nicotine dependence, interest in using pharmacotherapy and counseling, smoking status at 3 months, and satisfaction with the program.Results:Most participants were light smokers and reported low-to-moderate nicotine dependence. Immediately after using ¡Vive Sin Tabaco ¡Decídete!, the majority were interested in quitting, set a quit date, and reported interest in using pharmacotherapy and cessation counseling. Follow-up rate at 3 months was 81.5%; seven-day point prevalence abstinence was 19.1% using intention-to-treat analysis.Conclusion:Integration of e-Health tools in primary healthcare settings has the potential to improve knowledge about cessation treatments among smokers and integrate smoking cessation into routine of care.
Subject(s)
Computers, Handheld , Decision Support Techniques , Smoking Cessation/methods , Telemedicine/methods , Adolescent , Adult , Aged , Aged, 80 and over , Counseling/methods , Decision Making , Feasibility Studies , Female , Humans , Male , Mexico , Middle Aged , Primary Health Care , Smoking Cessation Agents/therapeutic use , Tobacco Use Disorder/drug therapy , Tobacco Use Disorder/epidemiology , Young AdultABSTRACT
ABSTRACTObjectives:To assess the association between cardiovascular health and cognitive function among Mexican older adults. DESIGN: Nationally representative cross-sectional survey. SETTING: Households in Mexico. PARTICIPANTS: Individuals aged 50 years and older (n = 1,492) from the Mexico-SAGE project Wave 1. MEASUREMENTS: A continuous and a categorical index of cardiovascular health was calculated based on exercise, smoking, body mass index, and blood pressure ranging from 0 to 4. Cognitive function was obtained by averaging the standardized scores (z scores) of five psychometric tests. Associations were conducted using linear regression. RESULTS: The continuous index of cardiovascular health was not associated with cognitive function. Using the categorical index, participants with the best levels of cardiovascular (score of 4) health performed better on global cognitive function than groups with lower cardiovascular health (scores of 0, 0.41 SD; 1, 0.39 SD; and 2, 0.56 SD). The association was moderated by age, reaching significance only among those 50-64 years old. CONCLUSIONS: If longitudinal research confirms these findings, results would suggest that dementia-related policies in Mexico need to focus on achieving optimal levels of cardiovascular health, especially in midlife.
Subject(s)
Aging , Blood Pressure/physiology , Cardiovascular Diseases/psychology , Cognition/physiology , Exercise/physiology , Health Status , Healthy Lifestyle , Aged , Aged, 80 and over , Aging/physiology , Aging/psychology , Body Mass Index , Cross-Sectional Studies , Female , Humans , Male , Mexico , Middle Aged , Smoking/adverse effects , World Health OrganizationABSTRACT
BACKGROUND: The research of light (≤10 cigarettes per day) and non-daily smokers in developing countries including Brazil is scarce despite the high prevalence of these groups among smokers and health risks associated to low-level smoking. OBJECTIVE: To describe health and smoking characteristics of Brazilian adult light and non-daily smokers. METHODS: We analyzed data from the 2013 Brazilian National Health Research survey (n=48,282). RESULTS: The prevalence of current manufactured cigarette smoking in the total sample was 12.4%. Among these smokers, 12.8% were non-daily smokers (NDS), 47.4% were light smokers (LS) and 39.8% were moderate/heavy smokers (MHS). Bivariate analysis showed that non-daily smoking was associated with higher odds of poor self-rated health, binge drinking and lung diseases compared to never smokers (ORs=1.2; 5.9 and 1.9). Light smoking was associated with higher odds of poor self-rated health, binge drinking, depression, use of sleeping pills and lung diseases (ORs=1.3; 4.3; 1.4; 1.2 and 2.0). After controlling for sex and age, non-daily smoking was associated with lung disease (OR=2.2) and light smoking with depression and lung diseases (ORs=1.3 and 1.8). Smoking levels were associated with living with same-level smokers in bivariate and multivariate analyses. CONCLUSION: A large proportion of smokers in Brazil are light and non-daily smokers, carrying substantial health risks related to tobacco use. Longitudinal research is needed to provide further evidence of associations found in this study. Public health policies must take the different smoking patterns into consideration to effectively target all smokers and reduce the harmful consequences of tobacco worldwide.
Subject(s)
Binge Drinking/epidemiology , Depression/epidemiology , Health Status , Lung Diseases/epidemiology , Smoking/epidemiology , Adolescent , Adult , Brazil/epidemiology , Comorbidity , Female , Health Surveys , Humans , Male , Middle Aged , Prevalence , Young AdultABSTRACT
Objetivo: Conocer la enorme aportación de Bichat como iniciador del método anatomoclínico, hecho que, al considerar a la lesión anatómica como el fundamento del saber clínico, permitió el tránsito de la medicina hacia una disciplina verdaderamente científica. A partir de Bichat, el fundamento de la enfermedad deja de ser lejano o abstracto y se convierte en un fundamento muy concreto. Diseño: Ensayo histórico (10 referencias). Resultado: Bichat abordó el estudio del tejido desde un punto de vista puramente sensorial haciendo caer la teoría fibrilarista vigente desde el siglo XVI y dando un sentido nuevo y definitivo al término tejido. Fue capaz de identificar, describir y clasificar 21 tipos diferentes de tejidos, mismos que señaló como estructuras elementales de los diferentes órganos. De acuerdo con el concepto de ''anatomía general'', Bichat consideraba los órganos como estructuras formadas por varios tejidos que podían enfermar independientemente (pues ellos serían el asiento del proceso morboso) y no como un todo indivisible. Bichat vio al tejido como una estructura continua y fundamental de todo el organismo y dirigió su atención hacia él y no hacia los órganos aislados como había indicado Giovanni Batista Morgagni. Conclusión: Gracias a los avances conseguidos a través del método anatomoclínico, la medicina francesa se colocó a la cabeza de la medicina mundial al comenzar el siglo XIX y pudo conservar ese sitio por lo menos durante un siglo.
Objective: To know the great contribution made by Bichat as a pioneer of the anatomoclinical methods, by considering the anatomical lesion as the foundation of the clinical knowledge, it was possible to make the transition from medicine to a truly scientific discipline. Starting with Bichat, the foundation of disease stops being distant and abstract and becomes a very concrete concept. Design: Historical assay (10 references). Result: Bichat was the first to introduce the notion of tissues as distinct entities, approaching their study from a purely sensorial point of view, leading to the fall of the fibrilarist theory in force since the XVI century. He was able to identify, describe, and classify 21 tissues, which he pointed out as elemental structures of the diverse organs. According to the concept of ''general anatomy'', Bichat considered organs as structures formed by several tissues that could become diseased independently (since they were the site of the morbid process) and not as an indivisible whole. Bichat saw the tissue as a continuous and fundamental structure of the whole organism and addressed his attention to it and not toward the isolated organs, as had been indicated by Giovanni Batista Morgagni. Conclusion: Thanks to the advances achieved by the anatomoclinical methods, French medicine became the leader of worldwide medicine at the beginning of the XIX century and was able to keep that place for at least one century.
ABSTRACT
Objetivo: Presentar un caso típico de páncreas anular en el adulto, revisar la literatura al respecto y exponer la patogenia, el cuadro clínico y radiografíco y las opciones de tratamiento quirúrgico de esta afección. Sede: Servicio de Cirugía General. Hospital General Regional: #6 del IMSS Cd. Madero, Tamaulipas. Diseño: Reporte de un caso. Operación efectuada: Duodeno-duodenoanastomosis latero-lateral. Conclusión: El páncreas anular, aunque raro, se manifiesta con la misma frecuencia en el niño y en el adulto; el cirujano general debe estar familiarizado con los métodos de tratamiento quirúrgico de esta patología