ABSTRACT
Introducción: El tabaco es la primera causa de morbimortalidad prevenible en el mundo. En Chile la prevalencia de consumo es 40,6 por ciento, la mayor a nivel continental. El consejo breve o consejería breve (CB) es una intervención simple, efectiva y de bajo costo para el cese de consumo de tabaco, que Atención Primaria en Salud (APS) ha demostrado disminuir en la prevalencia de tabaquismo. Existe escasa información sobre la utilización de CB en APS en Chile. Métodos: Estudio transversal de metodología cuantitativa. Se encuestó a 604 pacientes pertenecientes a 2 centros APS de Santiago, tras haber recibido atención clínica. Los datos fueron analizados con SPSS 21 y calculadora web Graph Pad. Resultados: La prevalencia de tabaquismo entre los encuestados fue de 32,5por ciento, de ellos, el 78,6 por ciento reportó deseo de dejar de fumar. Al 43,7 por ciento de los encuestados se le preguntó respecto al consumo de tabaco en la atención reciente, y del total de fumadores, a 37,1 por ciento se les aconsejó dejar de fumar. Los pacientes fumadores calificaron la recepción de CB como "indiferente", "agradable" o "muy agradable" en un 94,9 por ciento, y en un 90,5 por ciento, entre aquellos que no desean dejar de fumar. Conclusión: El tabaquismo es un problema escasamente abordado en las atenciones clínicas APS, lo que contrasta con la alta prevalencia de consumo nacional y de los pacientes consultantes. La mayoría de los fumadores desea dejar de fumar, y la minoría considera "desagradable" o "muy desagradable" ser aconsejada para cesar el consumo, aun en aquellos fumadores que no quieren dejar de fumar.(AU)
Introduction: Smoking is the leading cause of preventable morbidity and mortality worldwide. In Chile smoking prevalence is 40.6 percent, the highest on the continent. Brief advice or brief counseling (BC) is a simple, effective and inexpensive intervention for tobacco consumption cessation, that has been shown decrease smoking prevalence in Primary Health Care (PHC). There is little information on the use of BC in PHC in Chile. Methods: Cross-sectional study of quantitative methodology. 604 patients were surveyed from 2 PHC centers of Santiago, after receiving clinical care. Data was analyzed with SPSS 21 and Graph Pad web calculator. Results: The smoking prevalence among respondents was 32.5 percent, 78.6 percent of them expressed desire to quit 43.7 percent of respondents were asked about consumption of tobacco in a recent consultation, and a total 36.9 percent of smokers were advised to quit. Smokers patients rated reciving CB as "indifferent", "pleasant" or "very pleasant" in 94,9 percent and 90,5 percent among those who did not want to quit. Conclusion: Smoking is a problem rarely addressed in PHC, this contrasts with the high prevalence of domestic consumption and consulting patients. Most smokers want to quit and only a minority considered "unpleasant" or "very unpleasant" being advised to cease consumption, even in those smokers who do not want to quit.(AU)
Subject(s)
Humans , Male , Female , Nicotiana , Counseling , Primary Health Care , Chile , Tobacco Use CessationABSTRACT
Most people with schizophrenia continue their treatment within their families. This can lead to a deterioration of the life quality of their caregivers, by compromising economic and social aspects, as well as their physical and mental health. Evidence shows that psychosocial interventions can alleviate this burden of care. In Chile, the Ministry of Health recommends the inclusion of psychosocial interventions in the treatment of schizophrenia patients but does not propose any specific programs. The purpose of this research is to examine the effect of the program Profamille on the severity of burden of care and psychological symptoms of caregivers of patients with schizophrenia. Subjects and Methods: Open, non-controlled clinical trial. The program was carried out in rehabilitation centers in three Chilean cities for a period of five months. Participants included 51 caregivers of people with schizophrenia with at least one year of evolution and ambulatory treatment. The program consisted of 10 biweekly, 2.5 hours long sessions led by a clinical psychologist and a psychiatric resident. Self-evaluation scales were used to assess the results. Results: The program dropout rate was 31 percent. Mean scores showed significant differences in the scales of depression and anxiety, pre and post program, with a moderate effect size. There were no differences in the scale of burden of care. Discussion: The Profamille program shows ease of implementation, cost-effectiveness, and a potential favorable effect. Further examination of this program with medium and long term follow-up is suggested...
La mayoría de las personas enfermas de esquizofrenia, continúan su tratamiento a cargo de sus familias. Esto lleva al deterioro en la calidad de vida de sus cuidadores, comprometiendo aspectos económicos, sociales y de salud física y mental. La evidencia muestra que las intervenciones psicosociales, pueden aliviar esta sobrecarga. En Chile, el Ministerio de Salud, recomienda incluirlas en el tratamiento de la esquizofrenia, sin proponer programas específicos. El propósito de esta investigación, es conocer el efecto del programa Profamille, en el grado de sobrecarga y sintomatologia depresiva y ansiosa de familiares de personas con esquizofrenia. Sujetos y Método: Ensayo clínico abierto, no controlado, de tipo pre-post. El Programa consistió en 10 sesiones bisemanales, de 2 horas y media de duración, dirigidas por un psicólogo clínico y un residente de psiquiatría, en centros de rehabilitación de la quinta región. Participaron 51 cuidadores de personas con diagnóstico de esquizofrenia, con al menos, un año de evolución y en tratamiento ambulatorio. El efecto del Programa fue medido con las Escalas de Sobrecarga de Zarit, Depresión de Zungy Conde y Ansiedad de Zung. Resultados: El porcentaje de abandono del programa fue un 31 por ciento. Las medias de los puntajes pre y post programa, muestran diferencias significativas en las escalas de depresión y ansiedad, con un tamaño de efecto moderado, no así en la escala de sobrecarga. Discusión: Por su costo-efectividad, facilidad de implementación y potencial efecto favorable, se recomiendan más ensayos con este programa con seguimientos de mediano y largo plazo...
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Caregivers/education , Caregivers/psychology , Patient Education as Topic , Schizophrenia , Family Health , Family Therapy , Health Education , Program Evaluation , WorkloadABSTRACT
The present study examined the cross-talk between prostanoids and nitric oxide [NO] in human gastric biopsies during Helicobacter pylori infection. A pool of 1 or 2 biopsies per patient [11 H. pylori positive and 9 H. pylori negative] were incubated in the medium with/without drugs, 1400W and NS-398, inhibitors of inducible nitric oxide synthase [iNOS] and Cyclooxygenase 2 [COX-2], respectively. Levels of NO and prostaglandin E[2] [PGE[2], predominant products of activity of NOS and COX enzymes, were measured in the medium whereas the expressions of iNOS and COX protein, examined by Western blotting, were measured in the biopsies. The 11 patients with H. pylori infection showed a marked expression of COX-2 and iNOS proteins and high levels of PGE[2] and NO, as a consequence of iNOS and COX-2 activation, while proteins were absent and the level of nitrite and PGE[2] was low in the 9 noninfected patients. The COX-2 inhibitor decreased both NO and PGE[2]. The iNOS-specific inhibitor decreased NO but did not have any effect on the increase in gastric mucosal PGE[2]. Both inhibitors had no effect on the protein level of these two enzymes. The data showed that COX-2 inhibitor might modulate the iNOS pathway, suggesting that COX-2 activity and /or its products may be related to the functional activation of iNOS but not to the expression of iNOS protein
Subject(s)
Humans , Male , Female , Helicobacter Infections , Gastritis , Prostaglandin-Endoperoxide Synthases , Cyclooxygenase 2 , Dinoprostone , Receptor Cross-Talk , Gastric MucosaABSTRACT
Since nitric oxide [NO] plays an important role in regulating vascular tone and changes in the plasma concentration of the end product of NO [nitrite/nitrate] have been observed during exercise, we studied the influence of acute exercise on nitrite/nitrate plasma levels in a group of semiprofessional football players and in younger and older sedentary subjects. The subjects exercised for 10 min on a cycle ergometer and blood samples were obtained at rest and immediately after exercise. Plasma samples were analysed for nitrite/nitrate. The acute physical exercise induced a significant increase in nitrite/nitrate plasma levels both in sedentary and in active subjects. No difference was evident between the younger and older subjects, both in the basal level and after exercise, indicating that the changes could not be due to age. The higher basal plasma level of nitrite/nitrate observed in the active subjects compared with sedentary groups indicates that the state of physical conditioning had an effect on resting NO concentration. It seems that either acute exercise, even for a short time, or training can induce an increase in circulating NO