ABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Tobacco Smoke Pollution/prevention & control , Smoking/therapy , Tobacco Use Cessation/methods , Smoking Prevention , Occupational Health/legislation & jurisprudence , Psychotherapy, Group/trends , Nicotine/therapeutic use , Tobacco Use Disorder/therapy , Bupropion/therapeutic use , Occupational Risks , Risk Factors , Patch Tests/methodsABSTRACT
No disponible
Subject(s)
Humans , Tobacco Use Disorder , Bupropion , Tobacco Use Cessation , Nicotinic Agonists , Dopamine Uptake Inhibitors , Nicotine , Behavior TherapyABSTRACT
Primary pulmonary lymphoma is a rare entity usually formed of B-type cells, usually low-grade and composed of mucosal- or bronchial-associated lymphoid tissue. High-grade primary pulmonary lymphomas usually occur in immunodeficient patients who mostly present with respiratory and nonspecific symptoms. A chest x-ray may show a pulmonary mass or atelectasis and pleural effusion. In such cases, the prognosis is worse than for low-grade pulmonary lymphomas; survival is 8 to 10 years and there is a higher probability of local progression or metastasis. We report the case of an immunocompetent 76-year-old patient who had a pulmonary mass with cavitation secondary to a large B-cell primary pulmonary lymphoma. After the fourth session of chemotherapy the pulmonary mass was reduced in size and an aspergilloma was seen to have developed in the residual cavity. A review of the literature revealed this case to be anecdotal as it is extremely infrequent for a primary pulmonary lymphoma to present in the form of a single mass with cavitation and with few symptoms.
Subject(s)
Lung Neoplasms/pathology , Lymphoma, B-Cell, Marginal Zone/pathology , Aged , Antineoplastic Agents/therapeutic use , Bronchoscopy , Humans , Lung/pathology , Lung Neoplasms/therapy , Lymphoma, B-Cell, Marginal Zone/therapy , Male , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
UNLABELLED: Smoking and depression are related. Bupropion, the first non-nicotinic drug that is an effective treatment in smoking cessation, is a tricyclic antidepressant that inhibits neuronal uptake of serotonin, dopamine and norepinephrine in the thalamic nuclei. OBJECTIVE: To assess if certain personality factors (anxiety or depression) might predict the efficacy of bupropion for smoking cessation. METHOD: The study was carried out in two smoking cessation clinics in Madrid and Barcelona. Fifty patients (21 men) declaring the desire to quit smoking were enrolled. Their mean age was 43.6 years (SD 8.75). The patients were treated with 300 mg of bupropion per day for one month and expired CO was monitored for 6 months. Personality factors were assessed on a hospital anxiety and depression scale (HADS). We evaluated whether there was a significant difference in HADS scores for patients who were still not smoking after 6 months and those who had not managed to quit. RESULTS: The 50 patients were smokers of a mean 39 packs per year (SD 17.82) and had mean scores of 7.4 (SD 4.15) for anxiety and 5.8 (SD 3.93) for depression. Four patients (8%) were unable to complete the study. After one month, 28% of the patients smoked, after 3 months 56% smoked and after 6 months 58% still smoked. The patients who smoked during the first month had higher depression scores than did the non-smokers (p = 0.03). After 3 and 6 months the patients who had managed to continue not smoking were those who had higher anxiety scores than did those who still smoked (p = 0.0052 at 3 months and p = 0.017 at 6 months). CONCLUSION: Patients who responded better to treatment with bupropion after 6 months of follow-up were those with higher anxiety scores on the HADS. Depression levels influenced outcome only during the first month.
Subject(s)
Antidepressive Agents, Second-Generation/therapeutic use , Anxiety/complications , Bupropion/therapeutic use , Depression/complications , Smoking Cessation , Adolescent , Adult , Aged , Antidepressive Agents, Second-Generation/administration & dosage , Anxiety/diagnosis , Anxiety/drug therapy , Bupropion/administration & dosage , Depression/diagnosis , Depression/drug therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prognosis , Time FactorsABSTRACT
Existe una relación entre tabaquismo y enfermedad depresiva. Bupropión es el primer fármaco no nicotínico eficaz en la deshabituación tabáquica. Se trata de un antidepresivo que inhibe la recaptación neuronal de la serotonina, la dopamina y la noradrenalina en los nucleos talámicos. OBJETIVO: Valorar si existen algunas variables dentro del área de la personalidad (ansiedad o depresión) que pudiesen servir como índices predictivos en el tratamiento deshabituador con bupropión. MÉTODO: Estudio realizado en dos consultas de tabaquismo (Madrid y Barcelona). Se incluyó a 50 pacientes (21 varones) con una edad media de 43,6 años (desviación estándar [DE], 8,75) que manifestaban la voluntad en querer dejar de fumar. Fueron tratados con 300 mg/día de bupropión durante un mes y seguidos durante 6 meses con controles de CO espirado. Las variables de personalidad fueron evaluadas con el test de HADS, test psicométrico que puntúa trastornos de personalidad ansiosodepresivos. Se valoró si existía alguna diferencia significativa en los valores de puntuación del HADS entre los pacientes que seguían sin fumar a los 6 meses y los que no. RESULTADOS: Los 50 pacientes incluidos eran fumadores con una media de 39 paquetes/año (DE, 17,82) y con un valor medio de ansiedad de 7,4 (DE, 4,15) y de depresión de 5,8 (DE, 3,93). Un total de 4 pacientes (8 per cent) no pudo completar el estudio. Al primer mes de tratamiento un 28 per cent de los pacientes fumaba, al tercer mes era un 56 per cent de fumadores y a los 6 meses un 58 per cent de los pacientes incluidos seguía fumando. Al analizar las variables de personalidad, observamos que los pacientes que durante el primer mes fumaban tenían unas puntuaciones más elevadas de depresión que los no fumadores (p = 0,03). Al tercero y el sexto mes los pacientes que siguen sin fumar presentan unas puntuaciones más elevadas de ansiedad que la de aquellos pacientes que siguen fumando (p = 0,0052 a los 3 meses y p = 0,017 a los 6 meses). CONCLUSIÓN: Los pacientes que responden mejor al tratamiento con bupropión y después de 6 meses de seguimiento son aquellos que tienen niveles de ansiedad más elevados según el HADS test. Los niveles de depresión sólo influyen negativamente durante el primer mes (AU)
Subject(s)
Middle Aged , Adolescent , Aged , Adult , Male , Female , Humans , Tobacco Use Cessation , Time Factors , Bupropion , Antidepressive Agents, Second-Generation , Prognosis , Anxiety , Depression , Follow-Up StudiesABSTRACT
Smoking cessation is a first-line treatment for patients with bronchial and pulmonary diseases. Various strategies have been developed to help patients quit. Bupropion, a drug initially developed as an antidepressant, has recently been shown to have effects that increase the ability of a smoker to quit. This descriptive study, enrolling 86 patients who volunteered for a smoking cessation program, assesses the use of 300 mg of bupropion over a 4-week period combined with 12 weeks of nicotine patch application at doses that were lowered every 4 weeks. Abstinence was achieved by 69% of patients after 6 months of follow-up and no significant side effects were described. The percentage decreased to 58.6% after one year of follow-up. No significant differences were found between success in quitting in this study and either the number of prior attempts to quit or concomitant respiratory disease. We conclude that bupropion combined with transdermal nicotine is a good option to aid patients to achieve smoking cessation.
Subject(s)
Bupropion/therapeutic use , Nicotine/administration & dosage , Smoking Cessation/methods , Administration, Cutaneous , Female , Humans , Male , Middle AgedABSTRACT
El abandono del consumo de tabaco es una medida terapéutica de primer orden para todos los pacientes afectados de bronconeumopatías. A lo largo del tiempo, van apareciendo diferentes estrategias para ayudar a nuestros pacientes a dejar su hábito tabáquico. El bupropión es un fármaco que fue desarrollado inicialmente como agente antidepresivo; recientemente se ha descrito la acción por la cual aumenta la capacidad del fumador de abstenerse de fumar. Estudio descriptivo que valora a un grupo de 86 pacientes que voluntariamente quiso someterse a un programa de deshabituación tabáquica utilizando como tratamiento 300 mg de bupropión durante 4 semanas, asociado a los parches de nicotina, dosis decrecientes cada 4 semanas, durante 12 semanas. Los resultados obtenidos fueron que un 69 por ciento de nuestros pacientes consiguió abstenerse de fumar después de 6 meses de seguimiento, sin describirse efectos secundarios significativos. Este porcentaje disminuyó al 58,6 por ciento al cabo de un año de seguimiento. Al analizar si existía alguna relación entre el número de veces que el paciente había intentado previamente dejar de fumar y el éxito en este intento, no se observaron diferencias significativas. Tampoco se encontraron al valorar si existía enfermedad pulmonar concomitante y abandono tabáquico. Concluimos afirmando que la asociación de bupropión y nicotina transdérmica es una buena alternativa para ayudar a nuestros pacientes a dejar de fumar. (AU)
Subject(s)
Middle Aged , Male , Female , Humans , Bupropion , Tobacco Use Cessation , Nicotine , Administration, CutaneousABSTRACT
Quitting smoking is a first-line treatment for patients with bronchial diseases. Continued smoking worsens the clinical course of chronic broncho-pulmonary diseases and increases the number of exacerbations. Specialists commonly insist on the need to quit smoking. This study sought to determine whether a percentage of patients seen in a respiratory medicine clinic continued to smoke while denying doing so. One hundred twenty-five subjects were studied consecutively. At a regular visit they were first asked about smoking; later, without prior warning, exhaled carbon monoxide (CO) was measured by co-oximetry. If CO was over 10 ppm, the subject was considered to have been smoking. We defined a patient as a "liar" if he or she denied smoking but had a reading of CO in exhaled air over 10. Of the 125 cases studied, 21 (17%) smoked while denying doing so. Among men the percentage was 21%, and among ex-smokers, the figure was 27%. The highest value, 34%, was found among patients with chronic obstructive pulmonary disease (COPD). We conclude, therefore, that a substantial proportion of patients lies to their physicians. A third of COPD patients, who are particularly sensitive to the toxic effects of smoking, try to mislead their doctors.
