Smoking cessation after 12 months with multi-component therapy.

Smoking is one of the most important causes of morbidity and mortality in developed countries. One of the priorities of public health programmes is the reduction of its prevalence, which would involve millions of people quitting smoking, but cessation programs often have modest results, especially within certain population groups. The aim of this study was to analyze the variables determining the success of a multicomponent therapy programme for smoking cessation. We conducted the study in the Smoking Addiction Unit at the Hospital of Manresa, with 314 patients (91.4% of whom had medium or high-level dependency). We observed that higher educational level, not living with a smoker, following a multimodal programme or smoking cessation with psychological therapy, and pharmacological treatment are relevant factors for quitting smoking. Abstinence rates are not associated with other factors, such as sex, age, smoking behaviour characteristics or psychiatric history. The combination of pharmacological and psychological treatment increased success rates in multicomponent therapy. Psychological therapy only also obtained positive results, though somewhat more modest.

Diagnostic accuracy of tumour markers in serous effusions: a validation study.

The utility of tumour markers (TM) in the differential diagnosis of cancer in serous effusion (fluid effusion (FE)) has been the subject of controversy. The aim of this study was to prospectively validate our previous study and to assess whether the addition of adenosine deaminase (ADA), C-reactive protein (CRP) or percentage of polymorphonuclear cells (%PN) allows the identification of false positives. In this study, carcinoembryonic antigen, cancer antigen 15-3, cancer antigen 19-9, ADA, CRP and %PN in FE were determined in 347 patients with 391 effusions. Effusions were considered as malignant effusion when at least one TM in serum exceeded the cutoff and the ratio FE/S was higher than 1.2. Also, cases with values of ADA, CRP and %PN above the established cutoffs in serous effusion were considered as potential false positives. The combined sensitivity and specificity of the three TM was 76.2 % (95 % confidence intervals (CI) 67.8-83.3 %) and 97.0 % (95 % CI 94.1-98.7), respectively. Subanalysis of the 318 cases with previous criteria and negative ADA, CRP and %PN obtained sensitivities of 78.4 % (95 % CI 69.4-85.6) and a specificity of 100 % (95 % CI 98.2-100). The results obtained validate our previous study and are improved with the addition of ADA, CRP and %PN. TM in serous effusions and serum could be useful for the diagnostic assessment of patients with serous effusions.

Abstinencia a los 12 meses de un programa multicomponente para dejar de fumar / Smoking cessation after 12 months with multi-component therapy

El tabaquismo es una de las causas de morbimortalidad más importantes en los países desarrollados. Uno de los objetivos prioritarios de los programas de salud pública es la disminución de su prevalencia lo que implica que millones de personas dejen de fumar, sin embargo los programas de cesación a menudo tienen resultados discretos, especialmente con algunos grupos de población. El objetivo de este estudio fue analizar la eficacia de un tratamiento de cesación tabáquica multicomponente realizado en una unidad de tabaquismo hospitalaria. Fue realizado en la Unidad de Tabaquismo del Hospital de Manresa, e incluyó 314 pacientes (91,4% presentaban un nivel de dependencia medio o alto). Se observó que el nivel de estudios, no convivir con fumadores, seguir la terapia multicomponente y utilizar tratamiento farmacológico son factores relevantes en el éxito al dejar de fumar. La tasa de abstinencia no se asocia con otras características como el sexo, la edad, las características del hábito tabáquico o el presentar antecedentes psiquiátricos. La combinación del tratamiento farmacológico y psicológico aumentó las tasas de éxito en la terapia multicomponente. La terapia psicológica única también obtuvo resultados positivos aunque más modestos

Smoking is one of the most important causes of morbidity and mortality in developed countries. One of the priorities of public health programs is the reduction of its prevalence, which means millions of people quit smoking, but cessation programs often have modest results, especially within some population groups. The aim of this study was to analyze the variables determining the success of a multicomponent therapy program for smoking cessation. We conducted the study in the Tobacco Unit of the Hospital of Manresa, with 314 patients (91.4% have a medium or high level dependency). We observed that education and not living with a smoker, following a multimodal program for smoking cessation with psychological therapy and pharmacological treatment are relevant factors to quit. The abstinence rate is not associated with other factors such as sex, age, and the characteristics of the smoking behavior or psychiatric history. The combination of pharmacological and psychological treatment increased success rates in multicomponent therapy. Psychological therapy only also obtained positive, through more modest results