RESUMO
With highly active antiretroviral therapy, HIV infection has become a treatable chronic disease. However, modifiable risk factors such as cigarette smoking continue to impact the morbidity and mortality of people with HIV (PWH). We assessed the prevalence and factors associated with cigarette smoking and motivation to quit among PWH in Western Jamaica. A cross-sectional study was conducted in which 392 adults seeking HIV care at health facilities in Western Jamaica completed an interviewer-administered questionnaire. Current smoking prevalence among participants was 17.4%. Current smoking was significantly associated with being male (OR = 2.99), non-Christian/non-Rastafarian (OR = 2.34), living or working with another smoker (aOR =1.86), being moderate to severely depressed (OR = 3.24), having an alcohol drinking problem (OR = 1.84), and never being asked by a healthcare provider if they smoked (OR = 3.24). Among the PWH who currently smoke, 36.7% are moderately to highly dependent on nicotine. One-third of people who smoke (33.8%) started smoking for the first time after HIV diagnosis, while 66.2% initiated smoking before; 88% were willing to quit smoking. These findings provide baseline information for designing and implementing a comprehensive smoking cessation program that considers the needs of PWH in Jamaica, with the potential of becoming a replicable model for other HIV-specialized healthcare settings in the Caribbean.
Assuntos
Fumar Cigarros , Infecções por HIV , Humanos , Jamaica/epidemiologia , Masculino , Feminino , Estudos Transversais , Adulto , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Prevalência , Fumar Cigarros/epidemiologia , Fumar Cigarros/psicologia , Fatores de Risco , Pessoa de Meia-Idade , Inquéritos e Questionários , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Motivação , Adulto Jovem , Fumar/epidemiologia , Fumar/psicologiaRESUMO
A canine patient, 13-year-old mixed breed male, 24kg, was seen at a private clinic in the city of Guayaquil, Ecuador. The main reason for consultation was the evaluation of a mass in the right knee and neck that had previously been cytologically diagnosed of neoplastic origin by another team of veterinarians through fine needle puncture and cytology. The contacts were asymptomatic. At the time of the consultation, a detailed exploration and complementary methods were performed that included hematological and urinary exams, mass cytology, serological test, chest radiography and biopsy for further histopathological study. The final diagnosis was a cutaneous granuloma due to microfilariae of Acanthocheilonema spp. and its subsequent surgical and medical treatment with excellent results. The canine heartworm is a cosmopolitan disease caused by nematodes of the genus Dirofilaria, with D. immitis being the best-known species. Less frequently, the species Acanthocheilonema spp., found in this patient, is also reported in Americas, with little knowledge about it. This is the first report of its kind hoping that it will serve as a basis for future studies.
Foi atendido, em uma clínica particular, na cidade de Guaiaquil, Equador, um paciente canino, sem raça definida, de 13 anos de idade, macho, não castrado, de 24kg. O motivo da consulta foi a avaliação de uma massa em região de articulação de joelho direito e de pescoço, que havia sido previamente diagnosticada como de origem neoplásica por outra equipe de médicos veterinários, mediante punção por agulha fina e citologia. Os contactantes eram assintomáticos. No momento da consulta, realizaram-se detalhadas avaliações clínica e complementar, que incluíram exames hematológicos, urinálise, citologia da massa, teste sorológico, radiografia torácica e biopsia para posterior estudo histopatológico. O diagnóstico final foi granuloma cutâneo por microfilária de Acanthocheilonema spp., para o qual os tratamentos clínico e cirúrgico apresentaram excelentes resultados. A dirofilariose é uma enfermidade cosmopolita causada por nematódeos do gênero Dirofilaria, sendo a espécie D. immitis a mais conhecida. Em menor frequência, a espécie Acanthocheilonema spp. encontrada neste paciente é também relatada na América, existindo pouco conhecimento a seu respeito. Este é o primeiro relato de caso sobre este tema e espera-se que sirva como base para futuros estudos.