ABSTRACT
BACKGROUND: Although there is a very high comorbidity between tobacco dependence and other addictive disorders, there are only few studies examining the implementation and outcomes of a tobacco cessation program in patients with addictive diseases. Therefore, the aim of this study is to investigate to what extent a standardized tobacco cessation program leads to improvements regarding psychological/physical parameters in patients with addiction undergoing therapy and whether there is a reduction in tobacco consumption. METHODS: The study took place in a therapeutic community specialized in addiction therapy. A total sample of 56 participants were non-randomly assigned to an intervention group (IG; n = 31) and a treatment as usual group (TAUG; n = 25). The IG participated in a 6-week tobacco cessation program, while the TAUG received no additional treatment. Both groups were assessed for changes in primary outcomes (tobacco dependence, smoked cigarettes per day (CPD), and general substance-related craving) and secondary outcomes (heart rate variability (HRV): root mean square of successive differences, self-efficacy, and comorbid psychiatric symptoms) at two measurement time points (pre- and post-treatment/6 weeks). RESULTS: We observed significant improvements in self-efficacy (F(1,53) = 5.86; p < .05; ηp2 = .11) and decreased CPD in the IG (ß = 1.16, ρ < .05), while no significant changes were observed in the TAUG. No significant interaction effects were observed in psychiatric symptoms, general substance-related craving, and HRV. CONCLUSIONS: The results highlight the potential benefit of an additional tobacco cessation program as part of a general addiction treatment. Although no improvements in the physiological domain were observed, there were significant improvements regarding self-efficacy and CPD in the IG compared to the TAUG. Randomized controlled trials on larger samples would be an important next step. TRIAL REGISTRATION: ISRCTN15684371.
Subject(s)
Tobacco Use Cessation , Humans , Male , Pilot Projects , Female , Middle Aged , Adult , Treatment Outcome , Tobacco Use Cessation/methods , Tobacco Use Cessation/psychology , Tobacco Use Disorder/rehabilitation , Tobacco Use Disorder/psychology , Tobacco Use Disorder/therapyABSTRACT
Previous studies have reported results on 24-hour ambulatory blood pressure (ABP) in Europe and Japan, but no data exists from South America. In this study, we conducted a population survey to identify reference values and to compare ambulatory blood pressure with clinic, home, and self-measured values. A random sample of 2650 adults was selected among 190 000 people covered by our prepaid healthcare institution. Clinic (physician and nurse) and home (nurse) blood pressure measurements were performed 3 times each, with semiautomatic electronic equipment. Self-measurements were performed by the subjects manually activating the ambulatory device. We analyzed 1573 individuals who were not receiving antihypertensive therapy from 1921 participants. Self-measurement was available in a subgroup of 577 participants younger than the whole sample. Normal ambulatory blood pressure limits were estimated as those that best correlated with 140/90 mm Hg at clinic. Estimated values were 125/80 mm Hg for 24-hour ambulatory (range: 122 to 128 and 77 to 83 mm Hg) and 129/84 mm Hg for daytime ambulatory (range: 127 to 132 and 81 to 86) blood pressure, depending on gender and age. Ambulatory and clinic blood pressures increased with age. The age-dependent increase in ABP was similar in women and men. Average blood pressure at clinic was 124/79 mm Hg by physician and 123/78 mm Hg by nurse. Nurse measurement at home was 125/78 mm Hg, daytime ambulatory was 121/77 mm Hg, and 24-hour ambulatory was 118/74 mm Hg. The values of the subgroup with self-measurement were physician 119/77 mm Hg; nurse at clinic 118/77 mm Hg; nurse at home 121/78 mm Hg; self-measured 115/72 mm Hg; daytime ambulatory 119/77 mm Hg; and 24-hour ambulatory 115/73 mm Hg. This study shows that a 24-hour ABP average value of 125/80 mm Hg and a daytime ABP average value of 129/84 mm Hg are suitable upper limits for normality. Higher limits would yield an artificially higher prevalence of white coat hypertension. Most subjects showed higher blood pressure levels when measurements were performed by healthcare personnel at a clinic or at home than when self-measured at home.
Subject(s)
Blood Pressure Monitoring, Ambulatory , Blood Pressure , Hypertension/physiopathology , Adult , Age Factors , Aged , Aged, 80 and over , Blood Pressure Monitoring, Ambulatory/methods , Female , Humans , Hypertension/diagnosis , Male , Middle Aged , Reference ValuesABSTRACT
Se expuso el protocolo utilizado en nuestros servicios para la administaración de estreptoquinasa en el curso del infarto agudo de miocardio por via sistémica. Se analizaron los criterios de reperfusión. Posteriormente fue analizada una serie de 20 pacientes sometidos al tratamiento, 14 de los cuales mostraron criterios de reperfusión. Quince pacientes se sometieron a coronariografía, de los que 9 mostraron el vaso involucrado en el infarto permeable. Se destaca la importancia del tratamiento precoz y la necessidad de una correcta anticoagulación. Las complicaciones no fueron significativas, a excepción de un probable hematoma retroperitoneal que no pudo ser confirmado
