RESUMO
This paper reports the effects of a multi-community drug prevention trial on the use of cigarettes, alcohol, and marijuana in early adolescents and their parents, effects on parent prevention practices, and the relationship of family health behaviors to adolescent cigarette and alcohol use. Annual self-report surveys were administered to a population-based sample of 6/7th grade students from all schools in a 15 community area (n = 5008). Students were also administered an expired air (CO) measure of cigarette smoking to increase the accuracy of self-reported smoking and drug use. A sub-sample of parents were also surveyed at one year follow-up (n = 620). Logistic regression analyses of student data indicated that program groups were increasing in monthly drug use prevalence rates at an average of half the rates of control groups at one year follow-up (3.4 vs 14.5% for cigarette use, 4.2 vs 9.6% for alcohol use (greater than 1 drink), 3.5 vs 7.6% for marijuana use); effects were similar for weekly use rates, and have been maintained at two year follow-up. Analyses of parent data at one year follow-up indicated that the odds of program group parents rating drug prevention practices and personal involvement in prevention programs as extremely important, discussing prevention with their children, and exercising regularly were higher compared to control group parents; and perceived child use of cigarettes and marijuana, and self-use of alcohol in the last week was lower (odds ratios averaged across prevention ratings for each substance = 1.85, 1.72, 1.37, 1.53; for use items .34, .73, .59; P less than .10-- .002).
Assuntos
Comportamento do Adolescente , Doenças Cardiovasculares/prevenção & controle , Comportamentos Relacionados com a Saúde , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Consumo de Bebidas Alcoólicas , Humanos , Fumar Maconha/prevenção & controle , Relações Pais-Filho , Análise de Regressão , Fatores de Risco , Prevenção do Hábito de FumarRESUMO
A series of eight hundred and eighteen patients with histologically-confirmed multisystem sarcoidosis was analysed; within this series were 53 (6 per cent) patients with sarcoidosis of the upper respiratory tract (SURT). Two-thirds presented with predominantly upper respiratory tract symptoms when the systemic disorder was minimal or unrecognized. Women were affected twice as often as men. SURT is commonly associated with lupus pernio and other manifestations of chronic fibrotic sarcoidosis, and it follows the same indolent course. When granulomas are found on biopsy of the upper respiratory tract, there should be a management plan to determine whether they are due to multisystem sarcoidosis or other granulomatous disorders including tuberculosis, Wegener's granulomatosis and leprosy. About one-half of patients with SURT will need oral steroids, either alone or in combination with topical steroids or chloroquine.
Assuntos
Doenças Respiratórias/diagnóstico , Sarcoidose/diagnóstico , Adolescente , Corticosteroides/uso terapêutico , Adulto , Idoso , Criança , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osso Nasal , Mucosa Nasal , Doenças Respiratórias/tratamento farmacológico , Sarcoidose/tratamento farmacológicoRESUMO
Meningeal infection with Candida remains rare. We report its occurrence in a healthy man following mastoid exploration for chronic suppurative middle ear disease. The infective agent proved to be C tropicalis, which has only been isolated from CSF in two previous cases of Candida meningitis.
Assuntos
Candidíase/microbiologia , Meningite/microbiologia , Candida/patogenicidade , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média Supurativa/cirurgia , Complicações Pós-Operatórias/microbiologiaRESUMO
In a series of 34 patients with sarcoidosis affecting the upper respiratory tract and nose, 26 had lupus pernio (LP) and 17 had sarcoidosis of the upper respiratory tract (SURT). In nine patients these features coexisted. A patient presenting with SURT carried a 50% risk of developing LP although one feature could be present without the other. Both were disorders of women of the child-bearing years of life. SURT, like LP, was an indicator of chronic fibrotic sarcoidosis, developing insidiously and progressing indolently over the years. It was complicated by ulceration, septal perforation, and LP. Three patients had nasal septal perforations, in two instances following submucous resection. This operation is contraindicated in patients with active sarcoidosis, particularly when granulomas are found on nasal biopsy. The Kveim-Siltzbach skin test was positive in all patients with SURT, making it invaluable in the differential diagnosis of granuloma of the nasal cavity.
