Diretrizes para Cessação do Tabagismo

Universidade Federal do Rio de Janeiro Hospital Universitário Clementino Fraga FilhoUniversidade Federal de Pelotas Faculdade de MedicinaUniversidade Federal da Bahia Faculdade de MedicinaUniversidade Federal de Pernambuco Faculdade de MedicinaUniversidade de Brasília Faculdade de MedicinaSecretaria de Estado de Saúde Coordenador do Controle do TabagismoUniversidade Federal de São Paulo (UNIFESP) Faculdade de MedicinaUniversidade Federal do Rio de Janeiro Faculdade de MedicinaUniversidade Federal do Mato Grosso Faculdade de Ciências MédicasMinistério da Saúde Instituto Nacional do CâncerPontifícia Universidade Católica Hospital Universitário Faculdade de MedicinaUNESP Faculdade de Medicina de BotucatuSecretaria de Estado de Saúde do Paraná Programa Estadual de Controle de TabagismoUniversidade Católica do Rio Grande do Sul Faculdade de MedicinaUNIVAG Faculdade de OdontologiaUniversidade Federal de Minas Gerais Faculdade de MedicinaUniversidade Federal do Rio Grande Faculdade de MedicinaHospital de Messejana Ambulatório de Apoio ao TabagistaHospital do Servidor Público Estadual de São PauloUniversidade Federal do Mato Grosso do SulUNIFESP, Faculdade de MedicinaSciEL

Atualização na abordagem do tabagismo em pacientes com doenças respiratórias

O tabagismo é o maior responsável pelas doenças respiratórias (DR). Os efeitos nocivos do tabaco sobre o aparelho respiratório se iniciam ainda intraútero e influenciam as respostas imunológicas ao longo da infância e vida adulta. Os tabagistas com DR possuem peculiaridades que podem dificultar a cessação tabágica, tais como maior grau de dependência e de abstinência de nicotina; níveis mais elevados de monóxido de carbono exalado; motivação e autoeficácia baixas; maior preocupação com ganho ponderal; e elevada prevalência de ansiedade e depressão. Além disso, requerem tratamento mais intensivo e prolongado. É necessário esclarecer sempre o paciente sobre o fato de que parar de fumar será a única medida que irá reduzir a progressão das DR e melhorar sua qualidade de vida, independentemente do tempo e da gravidade da doença. Os médicos devem sempre oferecer o tratamento de cessação tabágica. O tratamento ambulatorial ou hospitalar deve ser multidisciplinar, baseado em intervenções comportamentais e farmacoterapia, sendo eficaz e custo-efetivo, dobrando as chances de sucesso.Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with “healthy” smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success

Update on the approach to smoking in patients with respiratory diseases.

Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with ?healthy? smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success

Aspergillus niger causando traqueobronquite e aspergilose pulmonar invasiva em transplantado de pulmão: relato de caso

Submitted by Cristina Damasceno ([email protected]) on 2012-10-16T17:30:06Z No. of bitstreams: 1 Aspergillus niger causing tracheobronchitis and invasive pulmonary aspergillosis in a lung transplant recipient case report.pdf: 77599 bytes, checksum: bc980eddd1dd3c8affcbb9e70e8f3eea (MD5)Approved for entry into archive by Gabriela Silva da Rosa([email protected]) on 2012-10-16T17:56:50Z (GMT) No. of bitstreams: 1 Aspergillus niger causing tracheobronchitis and invasive pulmonary aspergillosis in a lung transplant recipient case report.pdf: 77599 bytes, checksum: bc980eddd1dd3c8affcbb9e70e8f3eea (MD5)Made available in DSpace on 2012-10-16T17:56:50Z (GMT). No. of bitstreams: 1 Aspergillus niger causing tracheobronchitis and invasive pulmonary aspergillosis in a lung transplant recipient case report.pdf: 77599 bytes, checksum: bc980eddd1dd3c8affcbb9e70e8f3eea (MD5) Previous issue date: 2008A case of invasive aspergillosis caused by Aspergillus niger in a lung transplant recipient is described. The patient presented hyperglycemia starting postoperatively, with other complications such as cytomegalovirus infection. The associated predisposing factors and other implications are discussed. Aspergillus niger seems to be a fungal species of low virulence that requires the presence of a severely immunosuppressed host to cause invasive disease.Descreve-se um caso de aspergilose invasiva causada por Aspergillus niger em um paciente transplantado de pulmão com quadros hiperglicêmicos desde o pós-operatório e outras complicações como infecção por citomegalovírus. Os fatores predisponentes associados e outras implicações são discutidos. Aspergillus niger parece ser uma espécie fúngica de baixa virulência, necessitando a presença de um hospedeiro gravemente imunodeprimido para causar doença invasiva

Aspergillus niger causando traqueobronquite e aspergilose pulmonar invasiva em transplantado de pulmão : relato de caso

Descreve-se um caso de aspergilose invasiva causada por Aspergillus niger em um paciente transplantado de pulmão com quadros hiperglicêmicos desde o pós-operatório e outras complicações como infecção por citomegalovírus. Os fatores predisponentes associados e outras implicações são discutidos. Aspergillus niger parece ser uma espécie fúngica de baixa virulência, necessitando a presença de um hospedeiro gravemente imunodeprimido para causar doença invasiva.A case of invasive aspergillosis caused by Aspergillus niger in a lung transplant recipient is described. The patient presented hyperglycemia starting postoperatively, with other complications such as cytomegalovirus infection. The associated predisposing factors and other implications are discussed. Aspergillus niger seems to be a fungal species of low virulence that requires the presence of a severely immunosuppressed host to cause invasive disease

Smoking control: challenges and achievements

ABSTRACT Smoking is the most preventable and controllable health risk. Therefore, all health care professionals should give their utmost attention to and be more focused on the problem of smoking. Tobacco is a highly profitable product, because of its large-scale production and great number of consumers. Smoking control policies and treatment resources for smoking cessation have advanced in recent years, showing highly satisfactory results, particularly in Brazil. However, there is yet a long way to go before smoking can be considered a controlled disease from a public health standpoint. We can already perceive that the behavior of our society regarding smoking is changing, albeit slowly. Therefore, pulmonologists have a very promising area in which to work with their patients and the general population. We must act with greater impetus in support of health care policies and social living standards that directly contribute to improving health and quality of life. In this respect, pulmonologists can play a greater role as they get more involved in treating smokers, strengthening anti-smoking laws, and demanding health care policies related to lung diseases