Abstract Introduction Using the modified Theory of Planned Behaviour (mTPB), different indicators of therapeutic success were studied to understand pro-abstinence behavioural orientation during an ...18-year after-care period following a 3-month intensive alcoholism treatment. The indicators were: perceived needs satisfaction (NS), normative differential (ND), perceived alcohol utility (UT), beliefs about treatment programme benefits (BE) and behavioural intentions (BI). Methods The sample of 167 patients who consecutively started an intensive alcoholism treatment programme has been followed-up for 18 years, using standardised ailed instruments at the end of the treatment, and in the years 4-5, 9 and 18 of follow-up. The last data collection was completed by 32 subjects in 2010. The analysis followed the standard explore-analyse-explore approach. After the initial descriptive exploration of data, multivariate analysis of variance (MANOVA) in SPSS statistical package was set to explore between-groups and within-groups differences over time. Results At the between-group level, BI remained stable at the same level as at the end of the treatment programme, whereas BE and UT robustly changed over time and levelled off after 10 years of follow-up. NS and ND show a trend of pro-abstinent orientation and level off after 10 years of follow-up, although the trend is not significant. The same results were confirmed by the within-subject level. Conclusions Studied constructs stabilised after ten years of follow-up, apart from BI. The latter suggests that BI level needed for completion of an intensive treatment programme suffices for the maintenance of abstinence when accompanied by the change in perception of alcohol usefulness.
El delirium tremens (DT) en adultos mayores, como consecuencia de dejar de beber alcohol, plantea verdaderos desafíos tanto en el diagnóstico como en el tratamiento. Para diagnosticarlo, se parte de ...los síntomas que presenta la persona, como cambios en su estado mental, desorientación, agitación y alteraciones en su capacidad cognitiva. Es esencial diferenciar el DT de otras condiciones médicas que puedan tener síntomas parecidos, lo que demanda un cuidadoso proceso de diagnóstico diferencial para descartar otras causas.
En cuanto al tratamiento, se hace énfasis en estabilizar al paciente médicamente y prevenir complicaciones graves. En la mayoría de los casos, es necesario hospitalizar al paciente para administrar tratamientos médicos, como benzodiazepinas, que ayudan a controlar los síntomas agudos. La duración del tratamiento varía según la gravedad de los síntomas y cómo responde cada paciente a la medicación que recibe.
La frecuencia del DT en adultos mayores varía dependiendo de varios factores, incluyendo su historial de consumo de alcohol y las condiciones médicas previas que puedan tener. Sin embargo, debido a la dificultad que a menudo conlleva su diagnóstico y a las posibles complicaciones, se considera una condición médica grave que necesita atención inmediata y específica por parte del personal médico.
Resumo Este estudo teve por objetivo comparar o perfil de mortalidade por causas externas entre Adventistas do Sétimo Dia e população geral do Espírito Santo no período de 2003 a 2009. Realizou-se ...busca dos Adventistas no banco nominal do Sistema de Informação sobre Mortalidade de posse das informações dos Adventistas fornecidas pelas sedes administrativas da instituição. Os óbitos por causas externas ocorridos no período estudado foram então separados em dois grupos: Adventistas e população geral. Os Adventistas apresentaram menor mortalidade proporcional por causas externas (10%) que a população geral (19%), sendo o sexo masculino o principal responsável por essa diferença. Em ambos os grupos os óbitos predominaram na faixa de 20 a 29 anos. As mortes por causas acidentais foram mais expressivas entre os Adventistas (68,08%) enquanto as mortes por causas intencionais relacionadas às agressões e lesões autoprovocadas foram mais significativas na população geral (53,67% de todas as mortes). A razão de mortalidade padronizada para as causas externas foi 41,3, sendo assim ser Adventista reduziu a mortalidade em 58,7%. Acredita-se que o benefício dos Adventistas verificado em relação à mortalidade por causas externas possa estar relacionado à recomendação de abstinência do consumo de álcool por esse grupo.
•Non-smoking, non-drinking elderly females are a distinct subgroup of oral SCC patients.•Disease specific survival is up to 30% lower than all other oral SCC patients (P < 0.001)•Disease specific ...survival is up to 25% lower than age matched controls (P = 0.006)•NSND patients have higher rates of recurrent and persistent disease (42.9% vs 27.6%, p = 0.005)
Objectives
To examine differences in survival and clinical outcomes of elderly patients without traditional risk factors presenting with oral squamous cell carcinoma.Materials & methods
Retrospective review of 287 consecutive patients divided into 2 treatment period cohorts treated for oral SCC between the 1st Jan 2007 and 31st Dec 2012. Patients were classified as either smoker-drinkers (SD) or non-smoking, non-drinking (NSND). Only patients with oral sub-site primaries according to ICD-10 were included. Carcinomas of the lip, tonsil, base of tongue and oro-pharyngeal subsites were excluded.Results
Of the study population (N = 287), 24.4% were NSND and 9.75% were NSND elderly (older than 70 years) females. >50% of tumours arose from the oral tongue in NSND patients (p = 0.022) and there was a higher rate of recurrent and persistent disease (42.9% vs 27.6%, p = 0.005). Disease specific survival at 5 years was significantly reduced when NSND elderly females were compared to all other patients (p < 0.001) as well as age matched controls (p = 0.006). This effect was verified independently in each cohort.ConclusionsThe results of this study suggest that NSND elderly females are a distinct patient population with poorer disease specific survival outcomes.
Background: Currently in developed countries
there is an increase in the consumption of roll
your own tobacco, which is associated with a higher
proportion of users of this form of tobacco who
wish ...to make an attempt to quit. The objective of
this study was to analyze the effectiveness of tobacco
cessation interventions based on the type of
tobacco consumed.
Methods: Longitudinal study of a cohort of
641 smokers recruited between 2015 and 2018 in
a health area of Galicia included in smoking cessation
programs, based on psychological counseling
and pharmacological treatment. The characteristics
and success of the intervention were evaluated in
two groups: roll your own tobacco smokers (RYO)
and manufactured tobacco smokers (MT). A logistic
regression was performed to determine the
probability of success in smoking cessation. The
risk measure was the odds ratio (OR) with its 95%
confidence interval.
Results: RYO users started at a younger age and
had a lower sociocultural stratum than MT users.
Interventions to quit smoking in RYO users were associated
with less abstinence at 4 weeks (52% MT vs
38% LT) (OR: 0.5; 95% CI 0.35-0.99; p=0.045;) and
at 3 months (42% TM vs 30% TL) (OR:0.6; 95% CI
0.33-0.98; p=0.04).
Conclusions: Smoking cessation programs are
less effective in short-term RYO users. There are no
differences in long-term abstinence between the two
groups.
Fundamentos: Actualmente en los países desarrollados
existe un aumento del consumo de tabaco
de liar lo que se asocia a una mayor proporción de
usuarios de esta forma de tabaco que desean realizar
un intento de abandono. El objetivo de este estudio
fue analizar la efectividad de las intervenciones
de cesación tabáquica en función del tipo de tabaco
consumido.
Métodos: Estudio longitudinal de una cohorte
de 641 fumadores reclutados entre 2015 y 2018 en
un área sanitaria de Galicia incluidos en programas
de deshabituación tabáquica, basados en el asesoramiento
psicológico y en el tratamiento farmacológico.
Se evaluaron las características y el éxito de
la intervención en dos grupos: fumadores de tabaco
de liar (TL) y fumadores de tabaco manufacturado
(TM). Se realizó una regresión logística para determinar
la probabilidad de éxito en la cesación tabáquica.
La medida de riesgo fue el odds ratio (OR)
con su intervalo de confianza al 95%.
Resultados: Los consumidores de TL se iniciaron
a una edad más temprana y tenían un estrato
sociocultural más bajo que los consumidores de
TM. Las intervenciones para abandonar el tabaco
en los consumidores de TL se asociaron a una menor
abstinencia a las 4 semanas (52%TM vs 38%
TL) (OR: 0,5; 95%IC 0,35-0,99; p=0,045;) y a los 3
meses (42%TM vs 30%TL) (OR:0,6; 95%IC 0,33-
0,98; p=0,04).
Conclusiones: Los programas de cesación tabáquica
son menos efectivas en los consumidores de
TL a corto plazo. No se observan diferencias en la
abstinencia a largo plazo entre ambos grupos.
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