Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 15.848
Filtrar
1.
Geneva; World Health Organization; 2020.
em Inglês | WHO IRIS | ID: who-330485
2.
RECIIS (Online) ; 13(4): 935-951, out.-dez. 2019. ilus
Artigo em Português | LILACS | ID: biblio-1047680

RESUMO

Este artigo é resultado do trabalho de pesquisa sobre a produção das campanhas antitabagistas de governo e sobre a forma com que foram apropriados pela população. Nosso objetivo foi avaliar como essas campanhas foram pensadas em relação aos princípios de comunicação e saúde pressupostos pelo Sistema Único de Saúde. A expectativa foi problematizar a questão numa perspectiva interdisciplinar. Analisamos documentos a partir dos preceitos teóricos e metodológicos da Semiologia dos Discursos Sociais. Concluiu-se que foram criadas campanhas alarmistas, pautadas na imputação do medo e na vigília moral, que acabaram por se distanciar da ideia de uma comunicação em saúde pública dialógica, informativa e participativa.


This article is the result of a research on the use of the concept of aversion in the production of government anti-smoking campaigns and how they were appropriated by the population. Our objective was to evaluate how these campaigns were conceived in relation to the principles of communication and health presupposed by the Unified Health System. The expectation was to problematize the issue from an interdisciplinary perspective. We analyze documents from the theoretical and methodological precepts of Semiology of Social Discourses. It was concluded that alarmist campaigns were created, based on the imputation of fear and on moral vigilance, which eventually distanced these actions from the principles of communication in dialogic, informative and participatory public health.


Este artículo es el resultado del trabajo de investigación sobre la utilización del concepto de aversión en la producción de las campañas antitabaco de gobierno y sobre la forma en que fueron apropiados por la población. Nuestro objetivo fue evaluar cómo estas campañas fueron pensadas en relación a los principios de comunicación y salud presupuestados por el Sistema Único de Salud. La expectativa fue problematizar la cuestión desde una perspectiva interdisciplinaria. Analizamos documentos a partir de los preceptos teóricos y metodológicos de la Semiología de los Discursos Sociales. Se concluyó que se crearon campañas alarmistas, pautadas en la imputación del miedo y en la vigilia moral, que acabaron por distanciarse de la idea de una comunicación en salud pública dialógica, informativa y participativa.


Assuntos
Humanos , Tabagismo , Meios de Comunicação , Publicidade como Assunto , Promoção da Saúde , Estilo de Vida , Propaganda , Política Pública , Sistema Único de Saúde , Saúde , Comercialização de Produtos Derivados do Tabaco , Fumar Cigarros , Prevenção do Hábito de Fumar/história , Neoplasias
3.
Orv Hetil ; 160(52): 2047-2053, 2019 Dec.
Artigo em Húngaro | MEDLINE | ID: mdl-31868011

RESUMO

Introduction: The harmful effects represent an important public health problem in tha world. Aim: Our aim is to report and compare the results of screenings performed in Hungary's Comprehensive Health Screening Program 2010-2020-2030 (MÁESZ) with international data. Method: During the 9-year continuous screening, we analyzed the data of 71 922 women and 60 934 men in the 18-80-year-old population and examined the occurrence of regular daily smokers. Data were collected with the help of special screening data sheets. Results: 24.4% of males and 24.2% of females smoked regularly during the 9-year screening period. Between 2012 and 2015, smoking prevalence showed a temporary significant decline, then, from 2016, it started to increase again. The downturn coincided with the opening of national tobacco stores. In men, the proportion of smokers was significantly higher in young adults (18-25 years) than in women. Later in life, the difference leveled off and even between 46-55 years, the prevalence of smoking was greater in women. There is a difference in smoking patterns between the two genders, which is probably related to marriage and motherhood in women. After 56 years, the proportion of smokers in both genders decreased rapidly. The prevalence of smoking in Hungary in all age groups significantly exceeds the European and world average. Transient increases in middle-aged women have also been reported in European surveys. Conclusion: Compared to 2010, the proportion of smokers has decreased in Hungary, but a new surge observed after 2015 is not a positive phenomenon. We find the high proportion of smoking women worrying. Orv Hetil. 2019; 160(52): 2047-2053.


Assuntos
Fumar/epidemiologia , Tabagismo/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Hungria/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Fatores Sexuais , Fumar/tendências , Abandono do Hábito de Fumar , Tabaco sem Fumaça , Adulto Jovem
4.
MMWR Morb Mortal Wkly Rep ; 68(45): 1013-1019, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31725711

RESUMO

Cigarette smoking is the leading cause of preventable disease and death in the United States (1). The prevalence of adult cigarette smoking has declined in recent years to 14.0% in 2017 (2). However, an array of new tobacco products, including e-cigarettes, has entered the U.S. market (3). To assess recent national estimates of tobacco product use among U.S. adults aged ≥18 years, CDC, the Food and Drug Administration (FDA), and the National Cancer Institute analyzed data from the 2018 National Health Interview Survey (NHIS). In 2018, an estimated 49.1 million U.S. adults (19.7%) reported currently using any tobacco product, including cigarettes (13.7%), cigars (3.9%), e-cigarettes (3.2%), smokeless tobacco (2.4%), and pipes* (1.0%). Most tobacco product users (83.8%) reported using combustible products (cigarettes, cigars, or pipes), and 18.8% reported using two or more tobacco products. The prevalence of any current tobacco product use was higher in males; adults aged ≤65 years; non-Hispanic American Indian/Alaska Natives; those with a General Educational Development certificate (GED); those with an annual household income <$35,000; lesbian, gay, or bisexual adults; uninsured adults; those with a disability or limitation; and those with serious psychological distress. The prevalence of e-cigarette and smokeless tobacco use increased during 2017-2018. During 2009-2018, there were significant increases in all three cigarette cessation indicators (quit attempts, recent cessation, and quit ratio). Implementing comprehensive population-based interventions in coordination with regulation of the manufacturing, marketing, and distribution of all tobacco products can reduce tobacco-related disease and death in the United States (1,4).


Assuntos
Abandono do Hábito de Fumar/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Tabagismo/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Tabagismo/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
5.
Enferm. clín. (Ed. impr.) ; 29(5): 280-290, sept.-oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184152

RESUMO

Objetivo: Los objetivos de este trabajo han sido determinar el estado ponderal y los hábitos de alimentación y de consumo de alcohol y tabaco en estudiantes universitarios, determinar la asociación de estas variables con la autopercepción negativa de sus hábitos alimentarios, así como analizar el riesgo de desarrollar algún tipo de trastorno de la conducta alimentaria (TCA). Método: Se llevó a cabo un estudio transversal en 422 estudiantes universitarios. Los parámetros analizados fueron: estado nutricional, hábitos alimentarios, consumo alcohol/tabaco y conductas de TCA. Se aplicó regresión logística para identificar factores asociados a una percepción negativa de los hábitos alimentarios. Resultados: El 5% de la población presentaba peso insuficiente, el 16% sobrepeso y el 4% obesidad. El 55% no realizaba las cinco comidas/día. Los alimentos recomendados de ingesta diaria se consumían por debajo de las recomendaciones, mientras que embutidos/carnes grasas, bollería industrial, carnes magras y pescados se consumían en exceso. Percibieron sus hábitos alimentarios como buenos/muy buenos el 63%. El consumo de alcohol/tabaco predominaba los fines de semana. Las chicas mostraron mayor preocupación por su imagen (80,6% vs. 33%) y miedo a engordar (52,5% vs. 23,9%). Casi el 30% presentó una percepción distorsionada de su imagen corporal. Encontramos un riesgo del 12,8% de anorexia nerviosa atípica y del 4,7% de bulimia nerviosa atípica. Conclusiones: Los estudiantes universitarios presentan un estilo de vida poco saludable, principalmente debido a hábitos alimentarios alejados de las recomendaciones. Más del 17% presentan riesgo de desarrollar TCA atípico. Esta información puede resultar de interés para desarrollar acciones preventivas


Objective: The objectives of this paper were to determine weight status, eating, and alcohol drinking and smoking habits of university students, to determine the association between these variables with negative self-perception of their eating habits and to assess the risk of developing eating disorders. Method: A cross-sectional study was carried out on 422 university students. The parameters analyzed were: nutritional status, eating habits, alcohol/ tobacco consumption, and risk of eating disorder. Logistic regression was applied to identify factors associated with a negative perception of eating habits. Results: Out of the whole population that was analyzed, 5% were underweight, 16% overweight and 4% obese. Fifty-five percent of the sample analyzed did not consume five meals a day. The recommended foods for daily consumption were consumed below recommendations, while sausages/fatty meats, industrial pastries, lean meats, and fish were over-consumed. Overall, the population perceived their eating habits as good/very good (63%). Alcohol and tobacco consumption predominated at weekends. The girls were more image-conscious (80.6% vs. 66%) and fearful of gaining weight (52.5% vs. 23.9%). Almost 30% had a distorted perception of body image. There was a 12.8% risk of atypical anorexia nervosa and 4.7% of atypical bulimia nervosa. Conclusions: College students led unhealthy lifestyles, mainly due to eating habits that do not conform to the establish recommendations. More than 17% are at risk of developing an atypical eating disorder. This information may be of interest in developing preventive actions


Assuntos
Humanos , Estudantes de Ciências da Saúde , Saúde do Estudante , Estilo de Vida , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Estado Nutricional , Estudos Transversais , Modelos Logísticos , Comportamento Alimentar , Alcoolismo/epidemiologia , Tabagismo/epidemiologia , Autoimagem , Anorexia/epidemiologia
6.
Metas enferm ; 22(8): 14-20, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184994

RESUMO

Objetivo: analizar el consumo de distintas sustancias adictivas en jóvenes universitarios de la Comunidad Valenciana en función de distintas características sociodemográficas y académicas. Método: estudio descriptivo transversal realizado en 2016 en ocho universidades valencianas (n= 26.529). El grupo de investigación NECOPSED de la Universidad CEU Cardenal Herrera diseñó un cuestionario ad hoc a través de un grupo focal en el que se incluyeron variables sociodemográficas (sexo, edad), académicas (titulación, curso) y de frecuencia de consumo de sustancias (de 1 nunca a 7 consumo diario), entre otras, que se administró en aulas seleccionadas por conveniencia. Se realizaron análisis uni y bivariantes. Resultados: en la muestra (n= 520) hubo un 61,2% de mujeres y la media de edad fue de 20,73 años. Las drogas más consumidas fueron alcohol (= 4,91), tabaco (= 3,17) y el cannabis (= 2,06). Se encontró un mayor consumo de todas las sustancias en los hombres, así como un aumento del mismo paralelo a la edad, con superioridad estadísticamente significativa en varias de ellas (p≤ 0,05). No hubo diferencias entre estudiantes de titulaciones relacionadas con la salud y el resto (p> 0,05). Conclusión: las sustancias más consumidas son el alcohol, el tabaco y el cannabis. El consumo de sustancias se asoció con el sexo y la edad, pero no con la titulación académica


Objective: to analyze the use of different addictive substances in young university students from the Valencian Community, according to different sociodemographical and academic characteristics. Method: a descriptive cross-sectional study conducted in 2016 in eight Valencian universities (n= 26.529). The NECOPSED Research Team from the Universidad CEU Cardenal Herrera designed an ad hoc questionnaire through a focus group, including the following variables: sociodemographical (gender, age), academic (career, year), and frequency of substance use (from 1= never to 7= daily use), among others, which was administered in classrooms selected by convenience. Univariate and bivariate analyses were conducted. Results: the sample (n= 520) included 61.2% of women, and the mean age was 20.73 years. The most common drugs used were alcohol (= 4.91), tobacco (= 3.17) and cannabis (= 2.06). A higher use of all substances was found in men, as well as an increase parallel to age, with statistically significant superiority in some of them (p≤ 0.05). There were no differences between students from careers associated with health and the rest (p> 0.05). Conclusion: the substances more used were alcohol, tobacco and cannabis. Substance use was associated with gender and age, but not with academic grade


Assuntos
Humanos , Masculino , Feminino , Adulto , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Abuso de Maconha/prevenção & controle , Tabagismo/prevenção & controle , Alcoolismo/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estudos Transversais , Inquéritos e Questionários
8.
BMC Public Health ; 19(1): 1249, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510968

RESUMO

BACKGROUND: The consumption of tobacco products has evolved to include more complex combinations of different products. We investigated the tobacco habits of a representative population of young Finnish male conscripts in order to evaluate the prevalence of dual use of cigarettes and snus as well as the transition from one tobacco product to another. In addition, we evaluated the correlation between the level of education and the use of cigarettes and snus. METHODS: A questionnaire-based survey was carried out in three out of 17 garrisons among conscripts during their first week of service in 2014. A total of 1971 male conscripts were selected by simple random sampling of the 9013 males in the selected garrisons. Of them 1916 participated and filled in the questionnaire. The response rate was 97.2%. The questionnaire consisted of 25 questions including age, gender, basic education, use of tobacco products as well as questions assessing nicotine dependency. RESULTS: The amount of dual users of cigarettes and snus was 21%. There was a higher probability of dual use of cigarettes and snus among smokers compared to snus users (p < 0.001). One third (35%) of former smokers reported daily snus use and over 40% of the former snus users smoked daily. One third (34%) of the participants reported snus usage and 14% of the study subjects used snus daily. 40% of the study population were smokers and over 25% smoked daily. Of the participants with basic educational background 57% smoked daily (p < 0.001), however, no association between snus and level of education was found (p = 0.69). CONCLUSIONS: This study provides better understanding of the complex tobacco habits of young adult males. The simultaneous usage of multiple tobacco products as well as the high tendency to transition from one tobacco product to another should be taken into consideration when planning cessation interventions in health care settings and tobacco control policies at societal levels.


Assuntos
Fumar Cigarros/epidemiologia , Comportamentos Relacionados com a Saúde , Abandono do Hábito de Fumar/estatística & dados numéricos , Tabagismo/epidemiologia , Tabaco sem Fumaça/estatística & dados numéricos , Adolescente , Finlândia/epidemiologia , Humanos , Masculino , Produtos do Tabaco/estatística & dados numéricos , Adulto Jovem
9.
Psychol Addict Behav ; 33(6): 561-566, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31512887

RESUMO

While most tobacco users want to quit using tobacco, only a small minority succeed in quitting. Affective attitudes might influence health-related intentions and behavior. Emotional attachment to tobacco brands is an aspect of such affective attitudes. The aim of this study is to investigate emotional attachment to the personal snus or cigarette pack, as well as associations with quitting plans, among snus users and smokers. A sample of 1,450 smokers and 1,423 snus users (16-83 years, mean age 41 years, 41% women) was recruited from a web panel and weighted according to national statistics on smoking and snus use. Positive package-related feelings loaded on a single component in principal component analysis. Multinomial adjusted regressions were performed for smokers and snus users, with quitting plans as the dependent variable (no quitting plan, plan to quit within 6 months, plan to quit later) and emotional attachment as an independent variable. Smokers and snus users often endorsed statements expressing positive feelings related to buying and using their choice of tobacco brand, with endorsements ranging from 17% to 73%. Adjusted multinomial regressions showed that emotional attachment was associated with lower likelihood of planning to quit smoking within the next 6 months (adjusted odds ratio [AOR] = 0.68, p < .001) and lower likelihood of planning to quit snus use within the next 6 months (AOR = 0.54, p < .001) or later (AOR = 0.81, p < .01). Emotional attachment to tobacco brands is negatively associated with quitting plans among smokers and snus users. Policies to reduce brand attachment might lead to increased quitting plans and potentially increased quit attempts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Associação , Emoções , Motivação , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Tabagismo/psicologia , Tabaco sem Fumaça , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Razão de Chances , Tabagismo/reabilitação , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-31547229

RESUMO

There were high smoking rates among young male college students in Korea. We aimed to investigate the prevalence of and factors affecting abstinence from smoking following smoking cessation service attendance in this population. Data were collected between 1 August 2015 and 20 August 2018. Participants were administered more than nine face-to-face and telephone counseling sessions by trained tobacco cessation specialists for six months. Follow-up assessments were conducted at 4, 6, and 12 weeks, and 6 months after the quit date. A total of 3978 male college student smokers were enrolled; their mean age was 23.17 (±3.45) years. Almost one-third of the participants (64.9%) reported that they had attempted to quit during the past year. The number of cigarettes smoked per day, CO ppm, and Fagerström Test of Nicotine Dependence score at the baseline were negatively associated with abstinence, while motivational variables-importance, confidence, and readiness-were positively associated with abstinence. Our results suggest that provision of visiting smoking cessation services can be an active intervention platform for college student smokers who need professional assistance or support. Active and accessible support should be provided to such people. Visiting a smoking cessation service may result in increased long-term abstinence rates in such students.


Assuntos
Fumantes/psicologia , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/psicologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Fumar Tabaco/psicologia , Tabagismo/psicologia , Adulto , Humanos , Masculino , República da Coreia , Estudos Retrospectivos , Adulto Jovem
12.
Adv Mind Body Med ; 33(2): 12-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31476134

RESUMO

Objective: The purpose of this study was to examine whether the Life-Change Stop Smoking Program (tobacco dependence treatment program with Stress Management/Mindfulness Training) was more effective in achieving 6 mo of smoking abstinence among a high-risk group, such as US veterans at the Loma Linda Veterans Affairs (VA) Medical Center, compared with the VA's conventional stop smoking program. The effects of participants' initial stress level and depression risk on achieving abstinence were also assessed. Methods: Through examination of medical records and confirmation of exhaled air carbon monoxide level, abstinence status from smoking was determined at the 6-mo follow-up of the Life-Change Stop Smoking program (study group) participants and the Break the Chains program (comparison group, age and gender matched) participants. The 6-mo abstinence rates of the study group and comparison group were analzyed. Results: The statistically significant level of difference (χ2 [P < .001], regression [P = .0000]) in 6-mo abstinence rates between groups was observed. Conclusion: The stop smoking program with Stress Management/Mindfulness Training was effective (64.6% in study group, 40.1% in comparison group, P < .001) in achieving 6 mo of smoking abstinence for the high-risk group.


Assuntos
Atenção Plena , Abandono do Hábito de Fumar , Tabagismo , Veteranos , Humanos , Fumar , Abandono do Hábito de Fumar/métodos , Tabagismo/terapia , Veteranos/psicologia
13.
BMC Public Health ; 19(1): 1211, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477072

RESUMO

BACKGROUND: The American Cancer Society discourages the dual use of electronic cigarettes (ECs) and cigarettes because such use has not resulted in reduced exposures to the harmful effects of smoking. American Indian (AI) people have the highest prevalence of smoking and of EC use in the United States, but very little is known about dual EC and cigarette use in AI communities. METHODS: In 2016, 375 adult AI in Oklahoma who smoked cigarettes completed a survey about EC use (vaping). We describe vaping patterns, nicotine dependence, and reasons for EC use among the subset of 44 (12%) current dual EC users. To differentiate habitual EC users from occasional or merely curious users, we defined dual use as using ECs on some days or every day in the past 30 days. RESULTS: About one-third of dual users vaped ten or more times daily. About two-thirds used a tank product. Eleven percent used ECs without nicotine and another 9% were unsure of the nicotine content. A minority (40%) enjoyed vaping more than smoking, and most (76%) would smoke first on days they did both. Thirty-one percent vaped within 5 min of waking and another 24% within 30 min. Although the two-item heaviness of use index did not differ significantly between smoking and vaping, the ten-item Penn State Dependence Index (PSDI) suggested greater dependence on smoking than vaping (11.02 vs. 6.42, respectively; p < .0001). The most common reasons for vaping were to reduce smoking (79%), enjoyment of flavors (78%), and ability to vape where smoking is not allowed (73%). Perceptions of less harm to others (69%) or to self were the next most common (65%). Fewer than half used ECs to reduce stress, for affordability, or because others used them. CONCLUSIONS: Nearly 20% of dual users used ECs either without nicotine or without knowing if the product contained nicotine. The PSDI indicated greater dependence on smoking than vaping. Reasons for vaping were nearly equal between smoking reduction and enjoying flavors. Understanding patterns of dual use will inform future efforts to address nicotine dependence for AI communities with high prevalence of smoking.


Assuntos
Fumar Cigarros/etnologia , Índios Norte-Americanos/psicologia , Tabagismo/etnologia , Vaping/etnologia , Adulto , Feminino , Aromatizantes , Humanos , Índios Norte-Americanos/estatística & dados numéricos , Masculino , Prevalência , Abandono do Hábito de Fumar/etnologia , Inquéritos e Questionários , Estados Unidos/epidemiologia
14.
Rev. Hosp. Ital. B. Aires (2004) ; 39(3): 94-97, sept. 2019. ilus.
Artigo em Espanhol | LILACS | ID: biblio-1048277

RESUMO

Las fístulas arteriovenosas durales medulares son malformaciones vasculares adquiridas que constituyen una causa muy infrecuente de mielopatía progresiva (5-10 casos por millón de habitantes por año). La resonancia magnética es el estudio por imágenes de elección para su diagnóstico. A continuación presentamos el caso de una paciente femenina de 89 años, que consultó a la guardia de nuestra institución por un cuadro de paraparesia moderada asociada a parestesias e incontinencia urinaria posterior a esfuerzo físico. Se le diagnosticó una fístula arteriovenosa dural medular como causante de su cuadro. (AU)


Spinal dural arteriovenous fistulas (SDAVF) are acquired spinal vascular malformations and a rare cause of progressive myelopathy (5-10 new cases per year and per 1 million inhabitants). Magnetic resonance imaging is the diagnosis modality of choice. We present a case of a 89-year-old female patient who consulted the emergency department of our institution because of paraparesis and lower extremities paresthesias associated with urinary incontinence post physical effort. With the final diagnosis of spinal dural arteriovenous fistula, as a cause of the clinical symptoms. (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Fístula Arteriovenosa/diagnóstico por imagem , Dura-Máter/anormalidades , Parestesia , Fibrilação Atrial/complicações , Doenças da Medula Espinal/diagnóstico por imagem , Tabagismo/complicações , Incontinência Urinária , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/epidemiologia , Dor Lombar/complicações , Aneurisma da Aorta Abdominal/complicações , Paraparesia , Incontinência Fecal , Hipertensão/complicações , Hipestesia , Disfunção Erétil , Anticoagulantes/uso terapêutico
15.
Int. arch. otorhinolaryngol. (Impr.) ; 23(3): 299-304, July-Sept. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1040025

RESUMO

Abstract Introduction Epidemiological studies focused on prognostic factors associated with laryngeal cancer in the Brazilian population are poorly reported in the literature. Objective To evaluate the influence of certain risk factors on the survival rates of patients with squamous cell carcinoma (SCC) of the larynx. Methods This retrospective study was conducted on adult patients who were admitted to the outpatient clinic of the head and neck department in a tertiary care hospital. Evaluation of the influence of risk factors on the survival rates of patients registered in the hospital with laryngeal SCC was performed based on age, sex, initial stage, time of evolution, habits, educational levels and relapse and death. Overall survival (OS), disease-free survival (DFS) and clinical-demographic data were analyzed using the Kaplan-Meier method, Log-rank test and Cox regression. Results A total of 107 patients with a mean age of 59.8 years (range 19-81) were included in this study. Stages III and IV were associated with decreased DFS (p = 0.02) and OS (p = 0.02). Smoking patients had a greater period of disease evolution than non-smoking patients (p = 0.003). Alcohol consumption in smokers increased the risk of death by 2.8 (p = 0.002) compared with non-drinking smokers. Male patients presented lower DFS average when compared with female patients (p = 0.04). Conclusion Our study confirms that male gender, smoking habit combined with alcohol consumption, and advanced stages were strongly associated with poor prognosis.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Laríngeas/epidemiologia , Prognóstico , Tabagismo , Brasil , Consumo de Bebidas Alcoólicas , Análise de Sobrevida , Epidemiologia Descritiva , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária
16.
Int. arch. otorhinolaryngol. (Impr.) ; 23(3): 305-310, July-Sept. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1040015

RESUMO

Abstract Introduction Suspension laryngoscopy (SL) is a commonly performed procedure among otolaryngologists. Several studies have shown that adverse effects occur regularly with SL. Objective To evaluate the postoperative complications of SL, and to determine if protecting the dentition and the oral mucosa and limiting suspension times decrease the overall incidence of oral cavity and pharyngeal complications of SL. Methods All of the cases of SL performed by 1 surgeon from November 2008 through September 2014 were retrospectively reviewed. A consistent technique for dental and mucosal protection was utilized, and suspension times were strictly limited to 30 consecutiveminutes. The incidence of postoperative complications was calculated and analyzed with respect to gender, smoking status, dentition, laryngoscope type, and suspension system. Results A total of 213 consecutive SL cases were reviewed, including 174 patients (94 male, 80 female). The overall postoperative complication rate was of 3.8%. Four patients experienced tongue-related complications, two experienced oral mucosal alterations, one had a dental injury, and one experienced a minor facial burn. The complication incidence was greater with the Zeitels system(12.5%) compared with the Lewy suspension system (3.3%), although it was not significant (p = 0.4). Likewise, the association of complications with other patient factors was not statistically significant. Conclusion Only 8 out of 213 cases in the present series experienced complications, which is significantly less than the complication rates observed in other reports. Consistent and conscientious protection of the dentition and of the oral mucosa and limiting suspension times to 30 minutes are factors unique to our series that appear to reduce complications in endolaryngeal surgery.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Complicações Pós-Operatórias , Laringoscopia/efeitos adversos , Laringoscopia/métodos , Tabagismo , Odontopatias/prevenção & controle , Fatores Sexuais , Estudos Retrospectivos , Laringoscópios , Doenças da Boca/prevenção & controle
17.
Indian J Med Res ; 149(4): 489-496, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31411172

RESUMO

Background & objectives: Substance use disorders are a major public health concern in Punjab. However, reliable estimates of prevalence of substance use disorders are not available for the State. The present study reports estimates of prevalence of substance use disorders in Punjab, conducted as part of National Mental Health Survey, India. Methods: Using multistage stratified random cluster sampling, 2895 individuals from 719 households of 60 clusters (from 4 districts of Punjab) were interviewed. Mini International Neuropsychiatric Interview and Fagerstrom nicotine dependence scale were used to assess substance use disorders. Results: The sample comprised almost equal numbers of males and females. Nearly 80 per cent had less than or equal to high school education, and 70 per cent were married. The weighted prevalence of alcohol and other substance use disorders was 7.9 and 2.48 per cent, respectively. The prevalence of tobacco dependence was 5.5 per cent; 35 per cent households had one person with substance use disorder. The prevalence was highest in the productive age group (30-39 yr), urban metro and less educated persons. The prevalence of alcohol and other substance use disorders was much higher in Punjab as compared to other States where survey was done. Tobacco dependence was lowest in Punjab. Majority (87%) of the persons with substance use disorders did not suffer from any other mental disorder. Treatment gap was 80 per cent. Interpretation & conclusions: Punjab has a high burden of substance use disorders. The estimates will help clinicians and policymakers to plan the strategies against the menace of substance use disorders effectively.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Psicóticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tabagismo/epidemiologia , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Índia/epidemiologia , Masculino , Transtornos Mentais/patologia , Pessoa de Meia-Idade , Transtornos Psicóticos/patologia , Transtornos Relacionados ao Uso de Substâncias/patologia , Inquéritos e Questionários , Tabagismo/patologia , Adulto Jovem
18.
BMC Res Notes ; 12(1): 473, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370907

RESUMO

OBJECTIVE: Current literature suggests there may be a relationship between sex hormones, which dramatically increase during pregnancy, and nicotine use behaviors. We hypothesized that higher progesterone and progesterone:estradiol ratio (P/E2) would be associated with less smoking-related symptomatology (SRS), better mood and fewer cigarettes smoked per day (CPD) during ad libitum smoking and following overnight abstinence in pregnant women. Associations between SRS, mood, smoking behavior and sex hormones were estimated using multiple linear regression with adjustment for CPD and pregnancy trimester. RESULTS: There were 35 second trimester and 42 third trimester participants. Participants mean age was 26.2 (SD: 4.1), they smoked 11.3 CPD (SD: 4.4) and the mean nicotine dependence score was 4.94 (SD: 1.98). There were no statistically significant associations between progesterone levels, estradiol levels, or the P/E2 ratio and SRS or mood measures during ad libitum smoking or following overnight abstinence in this sample of pregnant women. Similarly, there were no associations between sex hormone levels and number of CPD smoked during the ad libitum period. Contrary to our hypothesis, we found no significant associations between sex hormones and SRS, mood or smoking behavior in this sample of pregnant women. Trial registration ClinicalTrials.gov (NCT01811225), December 6, 2012.


Assuntos
Fumantes/psicologia , Fumar/psicologia , Tabagismo/psicologia , Adulto , Afeto/fisiologia , Estudos Transversais , Estradiol/sangue , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Modelos Lineares , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Progesterona/sangue , Fumar/sangue , Tabagismo/sangue
19.
Cochrane Database Syst Rev ; 8: CD009164, 2019 08 16.
Artigo em Inglês | MEDLINE | ID: mdl-31425618

RESUMO

BACKGROUND: Pharmacological treatments for tobacco dependence, such as nicotine replacement therapy (NRT), have been shown to be safe and effective interventions for smoking cessation. Higher levels of adherence to these medications increase the likelihood of sustained smoking cessation, but many smokers use them at a lower dose and for less time than is optimal. It is important to determine the effectiveness of interventions designed specifically to increase medication adherence. Such interventions may address motivation to use medication, such as influencing beliefs about the value of taking medications, or provide support to overcome problems with maintaining adherence. OBJECTIVES: To assess the effectiveness of interventions aiming to increase adherence to medications for smoking cessation on medication adherence and smoking abstinence compared with a control group typically receiving standard care. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialized Register, and clinical trial registries (ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform) to the 3 September 2018. We also conducted forward and backward citation searches. SELECTION CRITERIA: Randomised, cluster-randomised or quasi-randomised studies in which adults using active pharmacological treatment for smoking cessation were allocated to an intervention arm where there was a principal focus on increasing adherence to medications for tobacco dependence, or a control arm providing standard care. Dependent on setting, standard care may have comprised minimal support or varying degrees of behavioural support. Included studies used a measure that allowed assessment of the degree of medication adherence. DATA COLLECTION AND ANALYSIS: Two authors independently screened studies for eligibility, extracted data for included studies and assessed risk of bias. For continuous outcome measures, we calculated effect sizes as standardised mean differences (SMDs). For dichotomous outcome measures, we calculated effect sizes as risk ratios (RRs). In meta-analyses for adherence outcomes, we combined dichotomous and continuous data using the generic inverse variance method and reported pooled effect sizes as SMDs; for abstinence outcomes, we reported and pooled dichotomous outcomes. We obtained pooled effect sizes with 95% confidence intervals (CIs) using random-effects models. We conducted subgroup analyses to assess whether the primary focus of the adherence treatment ('practicalities' versus 'perceptions' versus both), the delivery approach (participant versus clinician-centred) or the medication type were associated with effectiveness. MAIN RESULTS: We identified two new studies, giving a total of 10 studies, involving 3655 participants. The medication adherence interventions studied were all provided in addition to standard behavioural support.They typically provided further information on the rationale for, and emphasised the importance of, adherence to medication or supported the development of strategies to overcome problems with maintaining adherence (or both). Seven studies targeted adherence to NRT, two to bupropion and one to varenicline. Most studies were judged to be at high or unclear risk of bias, with four of these studies judged at high risk of attrition or detection bias. Only one study was judged to be at low risk of bias.Meta-analysis of all 10 included studies (12 comparisons) provided moderate-certainty evidence that adherence interventions led to small improvements in adherence (i.e. the mean amount of medication consumed; SMD 0.10, 95% CI 0.03 to 0.18; I² = 6%; n = 3655), limited by risk of bias. Subgroup analyses for the primary outcome identified no significant subgroup effects, with effect sizes for subgroups imprecisely estimated. However, there was a very weak indication that interventions focused on the 'practicalities' of adhering to treatment (i.e. capabilities, resources, levels of support or skills) may be effective (SMD 0.21, 95% CI 0.03 to 0.38; I² = 39%; n = 1752), whereas interventions focused on treatment 'perceptions' (i.e. beliefs, cognitions, concerns and preferences; SMD 0.10, 95% CI -0.03 to 0.24; I² = 0%; n = 839) or on both (SMD 0.04, 95% CI -0.08 to 0.16; I² = 0%; n = 1064), may not be effective. Participant-centred interventions may be effective (SMD 0.12, 95% CI 0.02 to 0.23; I² = 20%; n = 2791), whereas those that are clinician-centred may not (SMD 0.09, 95% CI -0.05 to 0.23; I² = 0%; n = 864).Five studies assessed short-term smoking abstinence (five comparisons), while an overlapping set of five studies (seven comparisons) assessed long-term smoking abstinence of six months or more. Meta-analyses resulted in low-certainty evidence that adherence interventions may slightly increase short-term smoking cessation rates (RR 1.08, 95% CI 0.96 to 1.21; I² = 0%; n = 1795) and long-term smoking cessation rates (RR 1.16, 95% CI 0.96 to 1.40; I² = 48%; n = 3593). In both cases, the evidence was limited by risk of bias and imprecision, with CIs encompassing minimal harm as well as moderate benefit, and a high likelihood that further evidence will change the estimate of the effect. There was no evidence that interventions to increase adherence to medication led to any adverse events. Studies did not report on factors plausibly associated with increases in adherence, such as self-efficacy, understanding of and attitudes toward treatment, and motivation and intentions to quit. AUTHORS' CONCLUSIONS: In people who are stopping smoking and receiving behavioural support, there is moderate-certainty evidence that enhanced behavioural support focusing on adherence to smoking cessation medications can modestly improve adherence. There is only low-certainty evidence that this may slightly improve the likelihood of cessation in the shorter or longer-term. Interventions to increase adherence can aim to address the practicalities of taking medication, change perceptions about medication, such as reasons to take it or concerns about doing so, or both. However, there is currently insufficient evidence to confirm which approach is more effective. There is no evidence on whether such interventions are effective for people who are stopping smoking without standard behavioural support.


Assuntos
Adesão à Medicação/estatística & dados numéricos , Agonistas Nicotínicos/uso terapêutico , Abandono do Hábito de Fumar/métodos , Dispositivos para o Abandono do Uso de Tabaco , Tabagismo/tratamento farmacológico , Benzazepinas/uso terapêutico , Bupropiona/uso terapêutico , Quimioterapia Combinada/métodos , Humanos , Nortriptilina/uso terapêutico , Quinoxalinas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Prevenção do Hábito de Fumar
20.
Artigo em Inglês | MEDLINE | ID: mdl-31450707

RESUMO

Stress is robustly associated with tobacco smoking and relapse. African Americans experience greater difficulty quitting compared to whites, yet no studies have examined race differences in physiological stress biomarkers during a quit attempt. This pilot study compared cortisol levels among treatment-seeking African American and white smokers, and relapse rates. Adult smokers (N = 115; n = 72 African American, n = 43 White) received eight sessions of group cognitive behavioral therapy plus transdermal nicotine patches. Assessments included demographics, salivary cortisol (collected at session 1, the end-of-therapy [EOT], and one-month post-therapy), and carbon monoxide-verified smoking relapse. Overall, cortisol levels declined over the course of the day at baseline, the EOT, and the one-month follow-up. African Americans exhibited lower cortisol levels compared to Whites at baseline and the EOT, but not at the one-month follow-up. In addition, African American smokers exhibited flatter slopes compared to Whites at each time point. Relapse rates were greater among African Americans at the EOT and one-month follow-up. The attenuated cortisol pattern observed in African Americans may indicate hypothalamic-pituitary-adrenal axis (HPA) exhaustion and aid our understanding of tobacco-related disparities. There is a need to focus on stress mechanisms and specific intervention approaches in order to eliminate racial/ethnic differences.


Assuntos
Fumantes/psicologia , Abandono do Hábito de Fumar , Estresse Fisiológico , Fumar Tabaco , Tabagismo , Adulto , Terapia Cognitivo-Comportamental , Grupos de Populações Continentais , Grupos Étnicos , Feminino , Humanos , Hidrocortisona/sangue , Masculino , Pessoa de Meia-Idade , Recidiva , Abandono do Hábito de Fumar/etnologia , Abandono do Hábito de Fumar/psicologia , Fumar Tabaco/sangue , Fumar Tabaco/etnologia , Fumar Tabaco/psicologia , Fumar Tabaco/terapia , Dispositivos para o Abandono do Uso de Tabaco , Tabagismo/sangue , Tabagismo/etnologia , Tabagismo/psicologia , Tabagismo/terapia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA