ABSTRACT
OBJECTIVE: Worldwide, tobacco smoke is still the leading cause of preventable morbidity and mortality. Many smokers develop chronic smoking-related conditions that require emergency department (ED) visits. However, best practices for ED smoking cessation counselling are still unclear. METHODS: A randomized controlled trial was conducted to determine whether an "ask, advise, and refer" approach increases 12-month, 30-day quit rates in the stable adult ED smoking population compared to usual care. Patients in the intervention group were referred to a community counselling service that offers a quitline, a text-based program, and a Web-based program. Longitudinal intention-to-treat analyses were performed. RESULTS: From November 2011 to March 2013, 1,295 patients were enrolled from one academic tertiary care ED. Six hundred thirty-five were allocated to usual care, and 660 were allocated to intervention. Follow-up data were available for 70% of all patients at 12 months. There was no statistically significant difference in 12-month, 30-day quit rates between the two groups. However, there was a trend towards higher 7-day quit attempts, 7-day quit rates, and 30-day quit rates at 3, 6, and 12 months in the intervention group. CONCLUSION: In this study, there was a trend towards increased smoking cessation following referral to a community counselling service. There was no statistically significant difference. However, if ED smoking cessation efforts were to provide even a small positive effect, such an intervention may have a significant public health impact given the extensive reach of emergency physicians.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Patient Participation/statistics & numerical data , Smoking Cessation/methods , Smoking Cessation/statistics & numerical data , Smoking/therapy , Adult , Age Factors , British Columbia , Counseling/statistics & numerical data , Female , Hospitals, Teaching , Humans , Male , Prognosis , Referral and Consultation/statistics & numerical data , Risk Factors , Sex Factors , Smoking/adverse effects , Smoking/epidemiology , Smoking Prevention/methods , Tertiary Care Centers , Treatment Outcome , Urban Population , Young AdultABSTRACT
INTRODUCTION: Aluminum phosphide (ALP), as an effective pesticide and a substance used for protecting rice during storage, has become one of the commonest causes of poisoning and even suicide in developing countries including Iran and India. The authors aimed to study the efficacy of sweet almond oil as an antidote in ALP toxicity. METHODS: The present experimental study was conducted over 35 rats. The animals were divided into four groups: one group as the control group and three other groups which received ALP alone or ALP and sweet almond oil with different time intervals. In addition to estimating the survival rate of the animals, plasma cholinesterase activity as a possible factor affected in ALP poisoning was evaluated. RESULTS: Treatment by intragastric irrigation of sweet almond oil resulted in significant reduction of mortality. Moreover, mean plasma cholinesterase levels were inhibited in groups receiving ALP. CONCLUSION: Oral sweet almond oil, if especially used immediately after poisoning with ALP, improves the survival rate.
Subject(s)
Aluminum Compounds/toxicity , Antidotes/pharmacology , Cholinesterases/blood , Pesticides/toxicity , Phosphines/toxicity , Plant Oils/pharmacology , Animals , Female , Male , Rats , Rats, WistarABSTRACT
BACKGROUND: Aluminium phosphide (AlP) is used as a fumigant. It produces phosphine gas which is a mitochondrial poison. Although this poisoning has been repeatedly reported in literature with a high mortality rate, there is no known antidote for AlP intoxication. In the present study, we studied the effects of hyperbaric oxygenation (HBO) on the survival time of AlP intoxicated rats. METHODS: Intoxicated rats with AlP (11.5 mg/kg, oral gavage) were placed in hyperbaric oxygenation with different concentrations of compressed air and oxygen. RESULTS: All the animals exposed to AlP died within 5 days. The mean survival times of rats exposed to AlP without any intervention, treated with hyperbaric condition by compressed air, and treated with hyperbaric condition by pure O2 were 91 ± 1, 262 ± 8, and 276 ± 6 minutes, respectively. In analysis of survival times, there was a significant difference between Group 2 which received AlP and the groups which underwent intervention (Groups 2 and 3, p < 0.001; Groups 2 and 4, p < 0.001). CONCLUSIONS: Hyperbaric oxygenation may probably improve the survival time of the intoxicated rats with aluminium phosphide, but it may not decrease the mortality rate.
