Registration and management of smoking behaviour in patients with coronary heart disease. The EUROASPIRE survey.

AIMS: To establish to what extent smoking status and its management is recorded in coronary patients' medical records, and to investigate their motivation to change smoking behaviour. METHODS: In EUROASPIRE, a survey on secondary prevention in 21 hospitals in the Czech Republic, Finland, France, Germany, Hungary, Italy, the Netherlands, Slovenia and Spain, data were collected from records of 4863 consecutive patients =<70 years of age, with previous (>6 months) admission for coronary bypass operation, angioplasty, myocardial infarction or ischaemia. Of these, 3569 patients were interviewed 1.6 years following their index hospitalization. RESULTS: Of the 82% of patients whose pre-hospitalization smoking behaviour was known, 34% were smokers. Documentation was significantly better in younger patients, in males and patients requiring angioplasty or bypass operation. In only 35% of 1364 smokers was the smoking habit recorded again after discharge from hospital At the time of the interview, 554 of the interviewed patients were still smoking. In over 90% of the smokers, advice to quit smoking was reported at interview. A positive relationship was found between receiving advice and seeking help to stop smoking, between receiving advice to stop smoking and attempting to stop, as well as between seeking help and attempting to stop. CONCLUSION: In almost 20% of coronary patients, smoking habits are not documented in medical records, and in only 35% of the smoking patients is smoking status documented at the follow-up. After a cardiac event requiring hospitalization as many as 50% of patients continue their smoking habit and so there is further potential to reduce the risk of recurrent coronary disease. Advice to stop smoking motivates patients to seek help and to attempt to stop smoking. Physicians repeated advice to stop smoking is important and smoking status should always be documented at follow-up.

[Outcome of radiotherapy of intrapelvic prostate carcinoma. Observations in 158 consecutive cases]. / Wat met de radiotherapie van het intrapelviene prostaatcarcinoom? Observaties bij 158 consecutieve gevallen.

Survival figures of 158 consecutive patients with carcinoma of the prostate without evidence of extrapelvic spread and treated by radiotherapy with curative intent, were calculated for 3 different clinical T-stages. Patients with subclinical malignancy (incidental finding at surgery for benign disease with less than adequate removal of all cancerous foci; or cases with positive margins after operation for overt malignancy), denoted a survival curve which was fully identical with that of an age-matched control population. Of cases with palpable but still intracapsular cancer (T2), 78% survived for 5 y and 42% for 10 y. Transcapsular cases (T3/T4) showed figures of 48% and 19% after 5 and 10 y, respectively. An important increase of the relative mortality risk, from 2 to 6, 5, was found for T3/T4 patients with decreasing age, for which phenomenon we have, as yet, no valid explanation. The significance of these various figures is briefly discussed. The authors are inclined to believe that there are indications from their own results and from those in the literature that some type of local or locoregional treatment may be of value at least in early cases (T1/T2), but that, even if so, conclusive proof will result only from large, comparative trials.