RESUMO
BACKGROUND: Smoking cessation therapies include counseling, psychological management and pharmacological therapy. Varenicline is the most effective and safe medication available. AIM: To study risk factors for the failure of pharmacological smoking cessation therapy with varenicline. PATIENTS AND METHODS: Retrospective analysis of 281 patients aged 45 ± 11 years (65% males) with a mean consumption of 31 ± 22 packs/year. They completed a smoking cessation program comprising psychological support and use of varenicline in a private clinic. Patients were followed with telephonic interviews during one year. A complete abstinence during one year was considered as a success of the program. RESULTS: The success rate of the program was 53.4%. The factors associated with failure were a high tobacco dependence rate determined with the Fageström test (Odds ratio (OR) 2.47, 95% confidence intervals (CI) 1.16-5.26, p = 0.02). An instruction level of more than 12 years was associated with a lower failure rate (OR 0.38 95% CI 0.18-0.82). CONCLUSIONS: A high tobacco dependence rate and a lower education were associated with a higher failure rate of this smoking cessation program.
Assuntos
Agonistas Nicotínicos/uso terapêutico , Avaliação de Programas e Projetos de Saúde , Abandono do Hábito de Fumar/métodos , Fumar/tratamento farmacológico , Vareniclina/uso terapêutico , Adulto , Idade de Início , Idoso , Escolaridade , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/normas , Fumar/efeitos adversos , Fumar/psicologia , Abandono do Hábito de Fumar/psicologia , Resultado do TratamentoRESUMO
Background: Smoking cessation therapies include counseling, psychological management and pharmacological therapy. Varenicline is the most effective and safe medication available. Aim: To study risk factors for the failure of pharmacological smoking cessation therapy with varenicline. Patients and Methods: Retrospective analysis of 281 patients aged 45 ± 11 years (65% males) with a mean consumption of 31 ± 22 packs/year. They completed a smoking cessation program comprising psychological support and use of varenicline in a private clinic. Patients were followed with telephonic interviews during one year. A complete abstinence during one year was considered as a success of the program. Results: The success rate of the program was 53.4%. The factors associated with failure were a high tobacco dependence rate determined with the Fageström test (Odds ratio (OR) 2.47, 95% confidence intervals (CI) 1.16-5.26, p = 0.02). An instruction level of more than 12 years was associated with a lower failure rate (OR 0.38 95% CI 0.18-0.82). Conclusions: A high tobacco dependence rate and a lower education were associated with a higher failure rate of this smoking cessation program.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Avaliação de Programas e Projetos de Saúde , Fumar/tratamento farmacológico , Abandono do Hábito de Fumar/métodos , Agonistas Nicotínicos/uso terapêutico , Vareniclina/uso terapêutico , Fumar/efeitos adversos , Fumar/psicologia , Métodos Epidemiológicos , Resultado do Tratamento , Abandono do Hábito de Fumar/psicologia , Idade de Início , Escolaridade , Programas Nacionais de Saúde/normasRESUMO
BACKGROUND: Therapies to quit smoking are based on counseling, psychological therapy (PT), nicotine replacement therapy, bupropion or varenidine. AIM: To report the results of a multidisciplinary program to quit smoking. MATERIAL AND METHODS: Patients aged l8 years or more, motivated to quit smoking were admitted in a program based in counseling and PT, with or without pharmacological therapy. They were assessed by telephone during one year of follow up. Patients with unstable psychiatric diseases were excluded. Results were considered as "successful" when patients maintained abstinence during the year of follow up. A logistic regression analysis was done to identify factors associated with treatment success. RESULTS: Between 2005 and 2011, 198 patients aged 45 ± 11 years (56% males), who smoked 31.5 ± 20.6 packages/year, were treated. Of these, 155 (78%) were treated with varenidine, 26 (13%) with bupropion and 17 (9%>) did not receive pharmacological therapy. One hundred sixty eight patients completed the year of follow up. In 82 (49%>), treatment was successful and was negatively associated with a history of depression (odds ratio = 4 (95% confidence intervals 1.23-38.33). The main side effeets associated to varenidine and bupropion were nausea in 37 and 23%o, sleep disorders in 20 and 19%o and headache in 12 and 0%>, respectively. CONCLUSIONS: A multidisciplinary program to quit smoking achieved a 49%> of abstinence during a year of follow up.
Assuntos
Benzazepinas/uso terapêutico , Bupropiona/uso terapêutico , Terapia Cognitivo-Comportamental , Agonistas Nicotínicos/uso terapêutico , Equipe de Assistência ao Paciente , Quinoxalinas/uso terapêutico , Abandono do Hábito de Fumar/métodos , Fumar/terapia , Adolescente , Adulto , Idoso , Benzazepinas/efeitos adversos , Bupropiona/efeitos adversos , Terapia Combinada/métodos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agonistas Nicotínicos/efeitos adversos , Avaliação de Programas e Projetos de Saúde , Quinoxalinas/efeitos adversos , Fatores Socioeconômicos , Resultado do Tratamento , Vareniclina , Adulto JovemRESUMO
Background: Therapies to quit smoking are based on counseling, psychological therapy (PT), nicotine replacement therapy, bupropion or varenidine. Aim: To report the results of a multidisciplinary program to quit smoking Material and Methods: Patients agedl8years or more, motivated to quit smoking were admitted in a program based in counseling and PT, with or without pharmacological therapy. They were assessed by telephone during one year offollow up. Patients with unstable psychiatric diseases were excluded. Results were considered as "successful" when patients maintained abstinence during the year offollow up. A logistic regression analysis was done to identify factors associated with treatment success. Results: Between 2005 and 2011, 198 patients aged 45 ± 11 years (56% males), who smoked 31.5 ± 20.6 packages/year, were treated. Ofthese, 155 (78%) were treated with varenidine, 26 (13%) with bupropion and 17 (9%>) did not receive pharmacological therapy. One hundred sixty eightpatients completed the year offollow up. In 82 (49%>), treatment was successful and was negatively associated with a history of depression (odds ratio = 4 (95% confidence intervals 1.23-38.33). The main side effeets associated to varenidine and bupropion were nausea in 37 and 23%o, sleep disorders in 20 and 19%o and headache in 12 and 0%>, respectively Conclusions: A multidisciplinary program to quit smoking achieved a 49%> of abstinence during a year offollow up.
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Benzazepinas/uso terapêutico , Bupropiona/uso terapêutico , Terapia Cognitivo-Comportamental , Agonistas Nicotínicos/uso terapêutico , Equipe de Assistência ao Paciente , Quinoxalinas/uso terapêutico , Abandono do Hábito de Fumar/métodos , Fumar/terapia , Benzazepinas/efeitos adversos , Bupropiona/efeitos adversos , Terapia Combinada/métodos , Estudos Transversais , Agonistas Nicotínicos/efeitos adversos , Avaliação de Programas e Projetos de Saúde , Quinoxalinas/efeitos adversos , Fatores Socioeconômicos , Resultado do TratamentoRESUMO
BACKGROUND: Lipoaspiration is one of the most frequently performed aesthetic surgical procedures worldwide. The use of tumescent solution containing lidocaine to infiltrate subcutaneous fat before surgery has been accepted as the standard of care for these procedures. Its objective is to diminish postoperative analgesic necessities and secondary blood loss, but its role in hematocrit reduction is not clear at this time. This study aimed to measure the effect of subcutaneous lidocaine infiltration on blood loss secondary to corporal liposuction. METHODS: A prospective, randomized, double-masked clinical trial was performed. Between November 2005 and July 2007, 70 consecutive female patients submitted to corporal liposuction as a single surgery were included in the study. All the patients were randomly assigned to two groups. The study group received tumescent solution containing lidocaine and epinephrine, whereas the control group received tumescent solution containing only epinephrine. Hematocrit was measured preoperatively, then 2 to 4, 12, and 24 h postoperatively. RESULTS: The comparison between the two groups did not show significant statistical differences with respect to age, body mass index, infiltrated volume, aspirated fat volume, surgical time, hospital stay, preoperative hematocrit, or comparison of the areas lipoaspirated. The mean hematocrit reduction in the study group was 10.8% +/- 2.9% compared with 8.8% +/- 2.6% in the control group (P = 0.004). CONCLUSION: The use of lidocaine in the tumescent solution for subcutaneous fat infiltration significantly increases postoperative anemia compared with the results obtained when epinephrine infiltration alone is used.