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1.
Rev. méd. Chile ; 141(3): 345-352, mar. 2013. ilus
Artículo en Español | LILACS | ID: lil-677343

RESUMEN

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.


Asunto(s)
Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Benzazepinas/uso terapéutico , Bupropión/uso terapéutico , Terapia Cognitivo-Conductual , Agonistas Nicotínicos/uso terapéutico , Grupo de Atención al Paciente , Quinoxalinas/uso terapéutico , Cese del Hábito de Fumar/métodos , Fumar/terapia , Benzazepinas/efectos adversos , Bupropión/efectos adversos , Terapia Combinada/métodos , Estudios Transversales , Agonistas Nicotínicos/efectos adversos , Evaluación de Programas y Proyectos de Salud , Quinoxalinas/efectos adversos , Factores Socioeconómicos , Resultado del Tratamiento
2.
Rev. méd. Chile ; 136(10): 1272-1280, Oct. 2008. tab
Artículo en Español | LILACS | ID: lil-503894

RESUMEN

Background: The association between Lung Cancer and smoking is well documented. However there is less information about the estimation of its attributable fraction and population burden. Aim: To estímate the attributable risk and population attributable risk of smoking among Lung Cancer patients attended in Public Health Services at Santiago. Material and methods: A case control study matched by age was carried out. Crude and adjusted attributable and population attributable risks were estimated, controlling for potential confounders and interaction variables. Results: Mean age for cases was 63 years for women and 67 years for men. Lung Cancer patients had a higher smoking prevalence than controls (64.5 percent and 39.7 percent respectively among women; 95.8 and 67.1 respectively among men p <0.01). Heavy smoker proportion was 4 times higher among patients that smoked 5 to 10 years more (women and men respectively, p <0.01) and 3 times more cigarettes per day (p <0.01). Attributable risk for women was 64.4 percent and 90.4 percent for men. Population attributable fraction was 41.9 percent and 86.3 percent for women and men, respectively. Projecting these estimates to the Chilean population, approximately 1975 new cases per year of Lung Cancer caused by smoking will be diagnosed. Conclusions: Attributable risks of smoking for Lung Cancer are high and significant, even when they are adjusted by confounding variables.


Asunto(s)
Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pulmonares/epidemiología , Fumar/epidemiología , Edad de Inicio , Estudios de Casos y Controles , Chile/epidemiología , Intervalos de Confianza , Neoplasias Pulmonares/etiología , Prevalencia , Medición de Riesgo , Factores de Riesgo , Distribución por Sexo , Fumar/efectos adversos , Organización Mundial de la Salud
3.
Rev. méd. Chile ; 136(10): 1281-1287, Oct. 2008. tab
Artículo en Español | LILACS | ID: lil-503895

RESUMEN

Background: Tobaceo is the fourth cause of the global burden of disease, accounting for 79.9 million loss of disability-adjusted Ufe years (DALYs) in 2001. In 2002, tobacco-attributable mortality in Chile represented 17 percent of total mortality. Aim: To estimate the direct cost of tobaceo in Ischemic Heart Disease, Chronic Obstructive Pulmonary Disease and Lung Cáncer, explore patients' disposition to answer a health related expenses questionnaire, valídate the instruments used and determine an adequate sample size for an upcoming study. Material and methods: Socio-demographic and health care related variables were investigated among patients attending two publie hospitais for ischemic heart disease, chronic obstructive pulmonary disease and lung cancer, in a cross-sectional study. Costs were estimated using the national publie health insurance price list and market pnces. Tobacco-attributable fraction was then applied to calcúlate the tobacco-attributable cost ofeach disease. Results: The instruments used were validated. The group of lung cáncer patients was smaller due to increased mortality prior to interview. Lung cancer generated the largest total and attríbutable direct costs. The costs in patients with ischemic heart disease were significantly lower Conclusions: There were some difficulties in the application of the questionnaire to register medication use. The sample size needed in a larger study was calculated for each of the three diseases. We recommend that a definitive study addresses tobacco-attributable direct costs related to chronic obstructive pulmonary disease.


Asunto(s)
Anciano , Femenino , Humanos , Masculino , Gastos en Salud/estadística & datos numéricos , Neoplasias Pulmonares/economía , Isquemia Miocárdica/economía , Enfermedad Pulmonar Obstructiva Crónica/economía , Fumar/economía , Chile/epidemiología , Estudios Transversales , Costos de Hospital/estadística & datos numéricos , Neoplasias Pulmonares/mortalidad , Isquemia Miocárdica/epidemiología , Proyectos Piloto , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Años de Vida Ajustados por Calidad de Vida , Encuestas y Cuestionarios , Tamaño de la Muestra , Fumar/epidemiología
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