RESUMO
The role of tobacco in the etiology of upper aerodigestive tract carcinomas is well established. Smoking decreases the effectiveness of cancer therapy and increases the risk of all treatment modalities. Smoking adversely affects the general health of the cancer survivor and places the patient at risk of developing additional primary tumors. The smoking habits of head and neck cancer patients were evaluated using a questionnaire administered at two tertiary head and neck cancer centers. Demographic factors, level of exposure, tumor stage and location, treatment modalities, concomitant alcohol use, and cessation methods were examined. Results demonstrate a high rate of smoking cessation at the time of cancer diagnosis. Significant demographic factors were not identified. Physical barriers to continued smoking because of cancer treatment as well as counseling at the time of tumor diagnosis were the most effective deterrents to continued tobacco use. Heavy alcohol use was a negative predictor of smoking cessation. Pharmacologic aids alone were found to be of no value. This study demonstrates the difficulties with smoking cessation in head and neck cancer patients, and emphasizes the importance of intervention by the otolaryngologist-head and neck surgeon.
Assuntos
Atitude Frente a Saúde , Neoplasias de Cabeça e Pescoço/terapia , Abandono do Hábito de Fumar , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Aconselhamento , Demografia , Feminino , Previsões , Neoplasias de Cabeça e Pescoço/etiologia , Neoplasias de Cabeça e Pescoço/patologia , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estadiamento de Neoplasias , Neoplasias Primárias Múltiplas/etiologia , Segunda Neoplasia Primária/etiologia , Nicotina/administração & dosagem , Nicotina/uso terapêutico , Análise de Regressão , Fatores de Risco , Fumar/efeitos adversos , Fumar/psicologia , Prevenção do Hábito de Fumar , Inquéritos e QuestionáriosRESUMO
Previous studies have consistently demonstrated that fetal rabbit excisional wounds exposed to amniotic fluid do not heal in utero. This study examines fetal wounds covered to exclude amniotic fluid. Full-thickness excisional wounds were created on fetal rabbits on day 25 of gestation. The following three treatment groups were examined: uncovered (n = 19 live); covered, a silicone cover was sutured over the wound (n = 14 live); and donut, a silicone cover containing a 2-mm central hole was sutured over the wound (n = 6 live). Fetuses were returned to the uterus and harvested by cesarean section 72 hr postoperatively. Fetal (covered) wounds excluded from amniotic fluid contracted and reepithelialized up to confluence. Sixteen of 19 uncovered wounds expanded, 3 were unchanged; minimal reepithelialization was present in all wounds. Partially (donut) covered wounds exhibited an intermediate response. This study shows that excisional wounds in the rabbit fetus respond to injury by contracting and reepithelializing when excluded from amniotic fluid.
