Sex-specific parameters of ascending aorta, descending aorta and pulmonary trunk by computed tomographic angiography with impact of age, hypertension, smoking and diabetes / Parámetros específicos de la parte ascendente de la aorta, parte descendente de la aorta y tronco pulmonar analizados mediante angiografía por tomografía computadorizada relacionados con el sexo, impacto de la edad, hipertensión, tabaquismo y diabetes

This study aims at establishing whether transverse diameter (TD) and cross sectional-area (CSA) of the ascending aorta (AA), descending aorta (DA) and pulmonary trunk (PT) measured by computerized tomographic angiography (CTA) altered by sex, age, hypertension, smoking and diabetes. CTA examinations of the TD and CSA of the AA, DA and PT of 100 patients aged 49.5±16.9 years (range 16­78 years) selected between January 2009 to May 2011 from those referred to Radiology Department, Jordan University Hospital, Faculty of Medicine, University of Jordan, Amman, Jordan for advanced evaluation. Measurements were made in the axial plane at the upper border of the six thoracic vertebrae. Patients were divided into three age groups. Significance of differences in parameters between age groups was calculated. Assessment ratios were considered. It was found that parameters of the three arteries were significantly larger in men than in women (P= < 0.05) and increased with age. Hypertension increased diameters of AA and DA in both genders (P= 0.001) and of PT in men (P= 0.01). Smoking significantly decreased parameters of PT in men (P= 0.01). Diabetes increased parameters of the three arteries in both genders, significantly increased parameters of PT in men (P= <0.05) and parameters of DA in women (P= <0.05). It is concluded that studied parameters were larger in men and increased with age of our patients. Distinctive differences in measurements appeared in hypertensive, smokers, and diabetic patients.

El objetivo fue determinar si el sexo, edad, hipertensión, tabaquismo y la diabetes alteran el diámetro transversal (DT) y área transversal (AT) de la parte ascendente de la aorta (AA), parte descendente de la aorta (AD) y tronco pulmonar (TP), medidos por angiografía por tomografía computadorizada (ATC). Exámenes de ATC de 100 pacientes de 49,5±16,9 años (rango 16­78 años) fueron seleccionados entre enero del año 2009 a mayo del año 2011 por el Departamento de Radiología, Hospital de la Universidad de Jordania, Facultad de Medicina de la Universidad de Jordania, Amman, Jordania para una evaluación avanzada del DT y AT de la AA, AD y TP. Las mediciones se realizaron en el plano axial en el margen superior de las seis vértebras torácicas. Los pacientes fueron divididos en tres grupos según edad. Se determinó la existencia de significancia estadística de los diferentes parámetros entre los grupos etarios. La evaluación de las razones también fueron consideradas. Se encontró que los parámetros de las tres arterias fueron significativamente mayores en los hombres que en las mujeres (p= <0,05) y que aumentaron con la edad. La hipertensión aumentó los diámetros de la AA y AD en ambos sexos (p= 0,001) y del TP en los hombres (p= 0,01). En fumadores disminuyeron significativamente los parámetros del TP en los hombres (p= 0,01). La diabetes aumentó los parámetros de las tres arterias en ambos sexos. Ademas, aumentaron significativamente los parámetros del TP en los hombres (p= <0,05) y los parámetros de la AD en las mujeres (p = <0,05). Se concluye que los parámetros estudiados eran mayores en los hombres y aumentaron con la edad de nuestros pacientes. Diferencias distintivas en las mediciones aparecieron en hipertensos, fumadores y pacientes diabéticos.

Consumo de tabaco, alcohol, drogas y su relación con los intentos de suicidio en población asistida en la guardia de un hospital general polivalente / Smoking, Alcohol and Drugs Consumption, and their relationships with suicide attempts in a population assisted in the Ward of a general polyvalent hospital

El problema del consumo de tabaco, alcohol y drogas y los intentos de suicidio son dos afecciones de autodestrucción, la primera con una intencionalidad tal vez inconciente y la otra voluntariamente ejecutada.Objetivo: analizar el consumo de sustancias psicoactivas en pacientes que ingresan en la guardia de un Hospital General polivalente con el diagnóstico de intento de suicidio y definir el perfil de la conducta suicidaMaterial y métodos: se realizaron dos fichas epidemiológicas administradas por profesionales de la guardia y por el Servicio de Psiquiatría del Hospital Posadas, contenían datos generales sobre el intento de suicidio y frecuencia del consumo de sustancias inmediatamente antes del intento de suicidio y en el mes anterior, a 200 pacientes ingresados a la guardia entre junio y diciembre de 2009.Resultados: se encontró una asociación entre el consumo de alcohol, marihuana y cocaína en los varones, y de alcohol y sedantes en las mujeres.

The issue of smoking, alcohol and drugs consumption, as well as suicide attempts constitute two self-destructive affections. The first one is related with an intentionality which is probably unconscious, and the second one, with an intentionality deliberately executed. Purpose: to analyze the consumption of psychoactive substances in patients who are admitted to the ward of a General, polyvalent Hospital with a suicide attempt diagnosis, and to define the profile of the suicidal behavior. Material and methods: two epidemiologic forms administered by professionals from the ward and by the Psychiatry Service of Hospital Posadas, containing general information on the suicide attempt and the frequency of consumption of substances immediately before the suicide attempt and in the previous month, to 200 patients admitted to the ward between June and December 2009. Results: a relationship was found between alcohol, marihuana and cocaine consumption in men and between alcohol and sedatives in women.

Capacidad respiratoria, niveles de vitamina C y malonilaldehído en estudiantes de bioanálisis fumadores y no fumadores / Respiratory capacity, vitamin C and malonilaldehyde levels in smokers and non smokers students of bioanalysis

Diversos autores señalan las implicaciones de fumar en la alteración de la capacidad respiratoria y del sistema oxida ción/an - tioxidación y la importancia de la detección de las mismas para contribuir en la prevención de diversas patologías. La presente investigación plantea evaluar la capacidad respiratoria y los niveles de vitamina C (VC) y malonilaldehído (MDA) de fumadores y no fumadores. Participaron 50 estudiantes de Bioanálisis de ambos sexos, clasificados según la Organización Mundial de la Salud en fumadores diarios (FD), fumadores ocasionales (FO) y no fumadores (NF). Los parámetros evaluados fueron: volumen espiratorio forzado en el primer segundo (VEF1) y la capacidad vital forzada (CVF), niveles de VC y MDA. Los resultados presentados como X +/- DS y porcentajes y analizados por ANOVA, fueron: El 69,2% y 84,6% de los estudiantes (FD, FO) presentaron valores normales de CVF y VEF, sin diferencias estadísticamente significativas con los NF. Los niveles de VC (mg/dl.) fueron 1,19 ± 0,30 (NF) con 1,12 ± 0,09 (FO) sin diferencias significativas entre ellos y el MDA (µm/l) mostró un aumento estadísticamente significativo (p < 0,05) en los F.O. (1,56 ± 0,5) con respecto a los NF (0,99 ± 0,60). Se concluye que los valores de MDA mostraron un aumento significativo en los FO, que se corresponden con manifestaciones de estrés oxidativo. Sin embargo, los niveles de vitamina C, aunque se mostraron más bajos en el grupo FO, no evidenciaron diferencias significativas al igual que los índices espirométricos.

Several authors have shown the implications of smoking in the alteration of respiratory capacity and oxidation / antioxidation system and the importance of screening them for help in preventing various diseases. In the present investigation was to assess respiratory capacity and vitamin C (VC) and malondialdehyde (MDA) levels of smokers and non smokers. Partici - pated 50 bioanalysis students both sexes, classified by the World Health Organization in daily smokers (DF), occasional smokers (OF) and non-smokers (NF). The evaluated parameters were: forced expiratory volume in first second (FEV1) and forced vital capacity (FVC), levels of VC and malonilaldehyde. Results presented as X ± SD and percentages and statistically analyzed by ANOVA, were 69,2% and 84,6% of students (DF, OF) had normal values of FVC and FEV, respectively, without differences significant height. VC levels (mg/dl) Were 1.19 ± 0.30 (NF) with 1.12 ± 0.09 (OF) without significant differences between them and the MDA (ìm/l) showed a statistically significant increase (p<0.05) their values in OF (1.56 ± 0.5) with res pect to NF (0.99 ± 0.60). We conclude that the values of MDA showed a significant increase in OF, which correspond to manifestations of oxidative stress. However, vitamin C levels, though were lower in FO group, showed no significant differences as well as spirometry.

Impacto da cirurgia de revascularização do miocárdio na cessação do tabagismo / Impact of coronary artery bypass graft surgery in smoking cessation

FUNDAMENTO: Tabagismo é um importante fator de risco modificável para doença cardiovascular. Poucos estudos têm investigado a frequência da cessação de fumar entre pacientes submetidos à doença cardíaca. OBJETIVOS: Determinar a frequência da cessação de fumar em pacientes submetidos à cirurgia de revascularização do miocárdio. MÉTODOS: Estudo de coorte, de 203 pacientes consecutivos, maiores de 18 anos, submetidos à cirurgia de revascularização do miocárdio no período de janeiro 2006 a março de 2007, quando foram entrevistados em relação ao uso de cigarros no período pré e pós-operatório. Fumantes foram estratificados de acordo com o grau de dependência com o uso do Teste de Dependência de Fagerstrõm. Os pacientes foram seguidos durante 60 e 90 dias para avaliar uso de cigarros. RESULTADOS: A média de idade do grupo foi de 62 ± 10 anos, e 134 (66 por cento) eram homens. Antes da cirurgia, 146 (71,9 por cento) pacientes eram fumantes. Um número significativo de pacientes parou de fumar no período pós-operatório: 136 (93,15 por cento) e 137 (93,84 por cento), aos 60 e 90 dias, respectivamente, pararam de fumar depois da cirurgia. CONCLUSÃO: Cirurgia de revascularização do miocárdio é um importante determinador para cessação de fumar.

BACKGROUND: Tobacco use is an important modifiable risk factor for cardiovascular disease. Few studies have investigated the frequency of smoking cessation among patients submitted to heart surgery. OBJECTIVE: To determine the frequency of smoking cessation in patients submitted to coronary artery bypass graft surgery. METHODS: In this cohort study, 203 consecutive patients, aged above 18, submitted to coronary artery bypass graft surgery in the period from January 2006 to March 2007, were interviewed in relation to the use of cigarettes in the pre- and postoperative period. Smokers were stratified according to the levels of nicotine dependence with the use of Fagerstrõm Nicotine Dependence Test. They were followed as outpatients during 60 and 90 days for the occurrence of smoking. RESULTS: The mean age of the group was 62 ± 10 years, and 134 (66 percent) were male. Before surgery, 146 (71.9 percent) patients were smokers. A significant number of patients stopped smoking in the postoperative period: 136 (93.15 percent) and 137 (93.84 percent) on days 60 and 90, respectively, remained not smoking after surgery. CONCLUSION: Coronary artery bypass graft surgery is an important determinant of smoking cessation.

El tabaco como factor de riesgo cardiovascular / Smoking as a cardiovascular risk factor

El cigarrillo es considerado un factor de riesgo para la saludque afecta a más de 1 300 millones de fumadores y a otrosvarios millones de personas que están expuestas frecuentementeal humo del tabaco ambiental. Más de cinco millones fallecenal año por enfermedades ocasionadas por fumar. Además, losestudios epidemiológicos demuestran que el tabaquismo tienerelación importante con la morbimortalidad cardiovascular.Varios componentes tóxicos del tabaco, participansignificativamente en las distintas etapas de la aterogénesis:desde la disfunción endotelial, hasta la trombosis y su expresiónclínica aguda. Estudios experimentales y clínicos recientesdemuestran que no existe una relación linear entre exposicióny consumo de cigarrillos, con el riesgo cardiovascular. Aúnno se conocen con certeza los mecanismos exactos porlos que el humo del tabaco se relaciona con la disfuncióncardiovascular, sin embargo, hay suficientes evidencias de larelación de componentes tóxicos del tabaco con la inflamación,con modificaciones lipídicas y con trombosis. Se plantea lahipótesis del estrés oxidativo, como potencial responsabledel inicio y desarrollo de las enfermedades cardiovasculares.

Smoking is considered a risk factor in the health of more than1 300 million smokers and another several million peoplewho have frequent exposure to environmental tobacco smoke.Over five million people die each year from diseases causedby smoking. In addition, epidemiological studies show thatsmoking has a significant relationship with cardiovascularmorbidity and mortality. Several toxic constituents of tobaccoparticipate significantly in the different stages of atherogenesis:from endothelial dysfunction to thrombosis and acute clinicalexpression. Recent experimental and clinical studies show thatthere is no linear relationship between exposure and cigarettesmoking with cardiovascular risk. As yet unknown with certaintyare the exact mechanisms by which tobacco smoke is related tocardiovascular dysfunction, however, there is sufficient evidenceabout the relationship of toxic constituents of tobacco smokewith inflammation and modified lipids and thrombosis. It ishypothesized that oxidative stress is potentially responsiblefor the initiation and development of cardiovascular disease.

Prevalência dos fatores de risco cardiovasculares nos pacientesatendidos no ambulatório de geriatria da UNESC / Prevalence of Cardiovascular Risk Factors in Elderly Patients – South Brazil

Objetivo: Conhecer a prevalência de fatores de risco cardiovasculares nos pacientes atendidos no Ambulatóriode Geriatria da Universidade do Extremo Sul Catarinense (UNESC) entre os anos de 2005 e 2007. Método: Foi realizado um estudo transversal, documental,descritivo, retrospectivo, de abordagem quantitativa, onde foram analisados 120 prontuários de pacientes idosos que foram atendidos entre o período demarço de 2005 e setembro de 2007, no Ambulatório de Geriatria da UNESC. As variáveis coletadas foram: idade, sexo e raça, presença de hipertensão arterial e diabete melito, níveis de HDL-c, LDL-c, colesterol total e triglicerídeo, valor do IMC, presença de história familiarpara doenças cardiovasculares, e prática de atividade física regular.Resultados: A prevalência dos fatores de risco analisados foi de: sedentarismo 80%, história familiar positiva para DAC 76,7%, HAS 72,5%, obesidade 37,5%,DM 26,7%, tabagismo 6,7%, alterações nos níveis de HDL-c 19,8%, LDL-c 34,2%, colesterol total 27% e triglicerídeos 18,8%. Conclusões: A prevalência dos fatores de risco paraDAC na população de idosos atendidos no Ambulatório de Geriatria da UNESC é, de maneira geral, elevada, e as categorias associadas como fator de risco foram: mulheres, raça negra e a faixa etária entre 60 e 69 anos.Dentre os fatores de risco modificáveis, o sedentarismo foi o que apresentou a maior prevalência, seguido pela presença de história familiar positiva para DAC, HAS, obesidade, dislipidemia, DM, e, por fim, tabagismo.

Aim: To know the prevalence of cardiovascular risk factors in patients investigated in Geriatric Ambulatoryfrom Extreme South of Santa Catarina University (UNESC) between 2005 and 2007. Methods: It was realized a descriptive, retrospective, transversal study, where it was analyzed 120 records of elderly patients followed between March 2005 and September 2007, in Geriatric Ambulatory of UNESC.The collected variables were: age, sex, race, blood hypertension, and diabetes mellitus (DM); HDL-c, LDL-c, totalcholesterol and triglycerides levels; BMI value, familial history of cardiovascular disease and regular physical activity practice. Results: The prevalence of cardiovascular risk factors was: sedentarism 80%, familial history of cardiovascular disease 76,7%, blood hypertension 72,5%, obesity 37,5%, DM 26,7%, smoking 6,7%, HDL-c levelslow 19,8%, LDL-c 34,2%, total cholesterol 27% and triglycerides18,8%. Conclusions: The prevalence of cardiovascular risk factors in this population is high, and categories associated with these risk factors were women, black people and age between 60-69 years old. Among risk factorsthat can be modified, the sedentarism was the most prevalent, followed by familial history of cardiovascular disease, blood hypertension, obesity, dyslipidemia, DM and smoking.

Diretrizes para cessação do tabagismo: 2008 / Smoking cessation guidelines: 2008

Estas diretrizes constituem uma ferramenta atualizada e abrangente para auxiliar o profissional de saúde na abordagem do tabagista, recomendando atitudes baseadas em evidências clínicas como a melhor forma de conduzir cada caso. De forma reduzida e mais objetiva possível, o texto final foi agrupado em dois grandes itens: Avaliação e Tratamento. Os dois itens apresentam comentários e níveis de recomendação das referências utilizadas, bem como algumas propostas de abordagem, como por exemplo, redução de danos, em situações específicas ainda pouco exploradas, como recaídas, tabagismo passivo, tabagismo na categoria médica e uso de tabaco em ambientes específicos.

These guidelines are an up-to-date and comprehensive tool to aid health professionals in treating smokers, recommending measures and strategies for managing each case based on clinical evidence. Written in a simplified and objective manner, the text is divided into two principal sections: Evaluation and Treatment. The sections both present comments on and levels of evidence represented by the references cited, as well as some proposals for the reduction of damage and for intervening in specific and still poorly explored situations, such as relapse, passive smoking, physician smoking, and tobacco use in specific environments.

Enfermedad pulmonar difusa asociada al consumo de tabaco / Smoking related interstitial lung disease: case report

The relationship between cigarette smoke and interstitial lung diseases (ILD) is not clear. Respiratory bronchiolitis (RB), usually found as an incidental histologic abnormality in otherwise asymptomatic smokers, is characterized by the accumulation of cytoplasmic golden-brown-pigmented macrophages within respiratory bronchioles. A small proportion of smokers have a more exaggerated response that, in addition to the bronchiole-centered lesions, provokes interstitial and air spaces inflammation and fibrosis extending to the nearby alveoli. This set of histologic changes is called RB-ILD, and it results in clinical symptoms. Desquamative interstitial pneumonia (DIP) is characterized by panlobular involvement, diffuse mild-to-moderate interstitial fibrosis, and massive alveolar filling with macrophages. It is well known that the histopathologic patterns of RB-IID and DIP may overlap, and that the key features for differentiating these disorders are the distribution and the extent of the lesions: bronchiolocentric in RB-IID and diffuse in DIP. It has been proposed that RB, RB-IID and DIP may be different components of the same histopathologic disease spectrum, representing various degrees of severity of the same process caused by chronic smoking, although this is still controversial. To illustrate the problem, we present the clinical case of a heavy-smoker patient with progressive dyspnea and radiographic pulmonary infiltrates suggesting of smoking related interstitial lung disease.

La enfermedad pulmonar difusa asociada al consumo de tabaco no ha sido claramente definida, la bronquiolitis respiratoria (RB) es un hallazgo morfológico frecuente en fumadores asintomáticos, se caracteriza por la acumulación de macrófagos pigmentados en los bronquiolos respiratorios. Sólo una pequeña proporción de los sujetos fumadores presenta una respuesta inflamatoria exagerada que compromete el intersticio y espacio alveolar, lo cual corresponde a la bronquiolitis respiratoria asociada a enfermedad pulmonar difusa (RBIID), que se manifiesta por disnea de esfuerzos y tos. La neumonía intersticial descamativa (DIP) se caracteriza por compromiso panlobular, fibrosis intersticial discreta e infiltración masiva del espacio aéreo por macrófagos. El patrón histopatológico de RBIID y DIP se pueden sobreponer, siendo los principales elementos diferenciadores entre ambas entidades, la distribución y extensión de las lesiones: compromiso bronquiolo-céntrico en RBIID y difuso en DIP. Se ha planteado que la RB, RBIID y DIP pueden constituir diferentes fases de una misma enfermedad asociada al consumo de tabaco, lo cual aún es motivo de controversia. Con el propósito de ilustrar este problema, se presenta el caso clínico de un paciente fumador que consultó por disnea progresiva, tos e infiltrados pulmonares bilaterales sugerentes de enfermedad pulmonar difusa asociada al tabaquismo.

Avaliação de danos cardiovasculares segundo framingham entre tabagistas internados numa instituição particular / Evaluation according to framingham of cardiovascular damages among smoker patients of a private institution

Pesquisa tipo survey que analisou a vulnerabilidade de fumantes internados numa instituição particular para eventos cardiovasculares. Consultamos prontuários e 125 participantes preencheram impresso entre outubro edezembro de 2004, dos quais 44% eram fumantes passivos, 39,2% não eram fumantes, 13,6% eram fumantesativos e 3,2%, fumantes ativos e passivos. Entre os abstêmios, categorizados segundo a classificação deProchaska e DiClemente, 48,8% estavam em manutenção, 41,5% em contemplação e 9,7% não pretendiammudar hábitos. Entre 21 fumantes, 71,4% consumiam dez a 30 cigarros/dia; a tragada foi de média a profunda entre 76,2%; a dependência foi de média a muito alta entre 42,8%, e a exposição passiva ao tabaco deu-se nafaixa etária de 01 a 30 anos para 74,5% dos participantes. O risco de eventos cardiovasculares ficou assimcaracterizado: 60% tinham baixo risco; 15,5%, médio risco; 19%, alto risco; e 5,5% não responderam a todas asquestões. Sendo o tabagismo um dos fatores de vulnerabilidade para morbimortalidades cardiovasculares, ações que promovam sua interrupção são relevantes.

This survey type research aimed at analyzing the vulnerability of active/passive smokers of a private institution. Medical records were analyzed, and a total of 125 (100%) individuals filled out forms from October to December 2004. Among them 39.2% stated not to have contact with smokers; 13.6% were active smokers and 3.2% were active/passive smokers. Among 41 abstemious-smoker participants, according to Prochaska and DiClementetaxonomy 48.8% were in maintenance; 41.5% in contemplation and 9.7% did not intend to change habits. Amongst 21 smokers, 71.4% smoked 10 to 30 cigarettes a day and their smoke intake ranged from medium to high, in a percentage of 76.2%. Tobacco addiction ranged from average to high for 42.8% of them, and the passive exposition to tobacco ranged from 1 to 30 years for 74.5% of the participants. The risk of coronary events amongst 104 participants was low for 60%, high for 19% and medium for 15.5%. Taking into consideration that smoking is a high-risk factor for cardiovascular disease; the results ha shown the necessity of its interruption as a means of reducing risk of death.

Percepciones conocimientos actitudes: sobre el tabaco y su uso: en docentes y empleados de una escuela de ciencias de la salud / Insights knowledge and attitudes: on tobacco and in use: in a teaching staff and employees of a school of health sciences

Se espera que las Escuelas de Ciencias de la Salud contribuyan, más intensamente, en el control de la epidemia del tabaquismo. Este estudio investigó sobre el consumo de tabaco en docentes y empleados del Decanato de Medicina de la Universidad Centroccidental Lisandro Alvarado, Barquisimeto, Venezuela. Fue un estudio transversal, aplicando una encuesta autoadministrada, anónima, exploró la prevalencia de tabaquismo, percepciones, conocimientos y actitudes, acerca del tabaquismo y sus efectos sobre la salud. Todo el personal fue invitado a participar. Los resultados se presentan en porcentajes y odd ratio (IC:95 por ciento). 63,5 por ciento de las encuestas distribuidas, fueron respondidas, (68,5 por ciento docentes y 31,5 por ciento empleados). La edad promedio fue 45,6 años en docentes y 37,9 años en el otro grupo. 50,7 por ciento de los docentes fueron mujeres y 53,8 por ciento en los empleados. La tasa de fumadores fue en los docentes 8 por ciento y en los empleados 19,8 por ciento. Intentaron dejar de fumar 73 por ciento y 54,5 por ciento respectivamente. Los factores más importantes para consumir tabaco fueron: fumar en casa sin problema, percepción de que a la familia no le importa si el o ella fuma, tener amigos o pareja que fumen y la percepción de que fumar da sensación de relax e imagen sensual positiva. El estudio aporta evidencias importantes para el diseño y evaluación de programas de promoción de salud para la comunidad universitaria. Este estudio puede considerarse un paso inicial hacia un sistema de vigilancia epidemiológica en tabaquismo.

Schools of health science are expected to contribute to a greaten extent in the process of curbing the tobacco epidemic. This study explores issues concerning tobacco among faculty members and employees at the Lisandro Alvarado School of Medicine (LA-SM) in Barquisimeto-Lara State, Venezuela. This is a crooss sectional self-administrated anonymous survey that explores prevalence of: Tobacco use, attitudes, beliefs, knowledge about tobacco use and how tobacco affects health. All faculty members and employees were invited to participate, only 63.5% answered. Results are showing in percentages and odds ratio (OR-95% CL). Participation: 68.5% faculty members and 31.5% of employees of the universe, mean age: 45.6 faculty members; employees 37.9%. Female gender: 50.7% faculty members and 53.8% employees. Current smokers: 8% faculty members and 19.8% employees. Ever attempted to quit: 71.4% faculty members; 62.5% employees. Desire to quit: 73% faculty members and 54.5% employees. The most important factors associated with CM: being abble to smoke at home without trouble, perception that the family doesn't care if he/she smokes, having friends or lover that smokes and having a positive sociological perception of smoking (feeling of "relax") but also; pleasure, anhance of sensual positive self-imaging. The results of this study provide the pertaining evidence for the desing and evaluation of health promotion programs targeted this university community. This should see as the first step toward and epidemiological surveillance system.

Uso de varenicline no tratamento do tabagismo: relato de dois casos / Use of varenicline in smoking cessation: two case reports

O objetivo deste trabalho foi antecipar informações sobre uma droga que está sendo lançada no combate ao tabagismo, auxiliando aqueles que desejam parar de fumar. O varenicline atua no sistema nervoso central, ligando-se ao receptor nicotínico alfa4beta2 e proporcionando redução do prazer que o cigarro provoca. É um mecanismo de ação novo, que nenhum psicofármaco atinge. Os estudos têm mostrado superioridade do varenicline em manter taxas mais altas e prolongadas de abstinência, quando comparado à bupropiona e placebo. Caso 1: Homem, 51 anos, mais de 30 anos de tabagismo. Nunca atingiu abstinência superior a algumas semanas. Utilizou varenicline na dose preconizada e, na 12ª semana, quando podia interromper, resolveu manter o fármaco até completar 24 semanas de tratamento. Está abstinente há 8 meses. Caso 2 Mulher, 48 anos, 30 anos de dependência do tabaco. Há 21 anos, parou espontaneamente na gestação da única filha e, após 6 meses, recaiu. Usou varenicline por 12 semanas associado à terapia cognitivo-comportamental. Há 7 meses, está abstinente. Os tratamentos disponíveis até o momento são incipientes em promover altos índices de abstinência no primeiro ano. Portanto, a abordagem engloba um conjunto de estratégias, como disponibilizar drogas de primeira linha, além de medidas e projetos que apóiem não só o parar de fumar, mas o continuar abstinente. O tratamento do tabagismo requer investimento público; do contrário, drogas como o varenicline vão beneficiar apenas uma pequena parcela da população.

The objective of this study was to provide information about a new drug to help people quit smoking. Varenicline acts on the central nervous system and binds to the alpha4beta2 nicotine receptor, reducing the sensation of pleasure caused by smoking. Its mechanism of action is unique, different from any other psychotropic. Studies have shown that, when compared with bupropion and placebo, varenicline is more effective in maintaining smoking abstinence and for longer periods of time. Case 1: A 51-year-old male patient who has been smoking for more than 30 years. He has never been more than a few weeks without smoking. He used the recommended dose of varenicline and, although he could have stopped after 12 weeks, preferred to follow the treatment for 24 weeks. He has been abstinent for 8 months. Case 2: 48-year-old female who has been tobacco dependent for 30 years. She quit during the pregnancy of her daughter 21 years ago, but started again 6 months later. She used varenicline for 12 weeks associated with cognitive-behavioral therapy. She has been abstinent for 7 months. Currently available treatments still have limited effectiveness in assuring high abstinence rates over the first year. Therefore, our approach includes several strategies, such as administration of first-line drugs, besides measures and projects that not only help patients quit smoking, but also remain abstinent. Anti-smoking treatments require large investments from the government. Otherwise, new drugs, such as varenicline, will only benefit a few segments of the population.

Dependência de tabaco e comorbidade psiquiátrica / Tobacco dependence and psychiatric comorbity

A incidência e a prevalência de doencas mentais são maiores nos fumantes do que no restante da populacão. O tratamento da dependência da nicotina nestes pacientes é difícil. Este estudo tem por objetivo promover uma revisão da associacão entre o tabagismo e as doencas psiquiátricas. MÉTODO: Foi realizada uma revisão seletiva da literatura sobre o tema. Os autores apresentam artigos sobre a associacão entre tabagismo e depressão, pânico, esquizofrenia, transtorno de déficit de atencão e hiperatividade (TDAH), doenca de Alzheimer e abuso de substâncias. RESULTADOS: O tabagismo tem íntima relacão com outros transtornos psiquiátricas, especialmente com depressão, esquizofrenia, TDAH e abuso de drogas. Fumar é associado a um maior risco de crises de pânico e são necessários novos estudos de coorte para verificar a hipótese de uma relacão inversa entre o consumo de nicotina e desenvolvimento de doenca de Alzheimer. CONCLUSAO: Há crescente evidência da relacão entre o tabagismo e comorbidades psiquiátricas. Outros estudos da associacão entre comorbidades psiquiátricas e tabagismo são necessários para melhor compreensão desta relacão complexa.

Chromosome damage in passive smoker female

Current epidemiological data associates passive smoking with health hazards which not only affects the passive smoker but also affects the offsprings of passive smoker females. To determine the effect of cigarette smoke on the chromosomes of passive smoker females who were still in the childbearing age, the micronucleus [MN] frequency in 20 passive smoker females [spouse smoker] who had been exposed to cigarette smoke for at least 5 years was compared to the MN frequency in 20 control subjects [females with non-smoking spouse] all in the age group 31-39 years. The MN frequency among passive smoker female group ranged from 16-27 MN/500 cytokinesis blocked [CB] binucleated cell, with a mean of 21.1 +/- 3.7, while the MN frequency among the control group ranged from 3-11 MN/500 CB binucleated cell, with a mean of 8 +/- 1.7. The difference is statistically significant [t=14.2, p<0.01]. Applying the correlation coefficient test between age and MN frequency, a weak positive though non significant correlation was found between age and MN frequency in the passive smoker female group [R=0.11, p=0.630] while an intermediate positive but still non significant correlation was found between age and MN frequency in the control [R=0.26, p=0.27]. There was a positive correlation between the duration of exposure to cigarette smoke and the MN frequency, but this was statistically non significant [R=0.33, p=0.125]. The results emphasize that mothers especially in the childbearing age should not be exposed to cigarette smoke to avoid its deleterious effects on their health thus preventing any harmful effect the smoke can have on their offsprings

Fumar o no fumar: ¿Cual es el problema? / To smoke or not smoke: what is the problem?

El trabajo es una selección selectiva de la investigación conductual y farmacológica realizada sobre el hábito de fumar. Se examinan la mayoría de las implicaciones teóricas oriundas de la investigación anterior y reciente relacionadas con la iniciación, mantenimiento y terapia del hábito de fumar, incluyendo algunos estudios sobre suspensión y abandono del hábito