Nicotine dependence and psychological distress: outcomes and clinical implications in smoking cessation

Nicotine dependence is characteristically a chronic and relapsing disease. Although 75%–85% of smokers would like to quit, and one-third make at least three serious lifetime attempts, less than 50% of smokers succeed in stopping before the age of 60. Relevant and complex factors contributing to sustained cigarette consumption, and strongly implicated in the clinical management of smokers, are the level of nicotine dependence and psychological distress. In this review of the literature, these two factors will be examined in detail to show how they may affect smoking cessation outcome and to encourage clinicians to assess patients so they can offer tailored support in quitting smoking

Depressive, anxious, withdrawal symptoms, and craving as possible predictors of abstinence maintenance in smokers attending a 12-week quitting program

BACKGROUND INFORMATION: Depressive, anxious, withdrawal symptoms, and craving might affect differently the probability to maintain abstinence after quitting smoking. OBJECTIVE: The objective of this study was to assess depressive, anxious, nicotine withdrawal symptoms, and craving in a sample of smokers attending a smoking cessation program over a period of 12 weeks. METHODS: A naturalistic study was conducted in which 78 smokers were consecutively recruited for a 12 week evaluation program. Socio-demographic data and clinical information were collected, rating scales were used to assess anxious and depressive symptoms, nicotine dependence, withdrawal symptoms, and craving. RESULTS: Of the 78 recruited smokers, 17 remained abstinent and 61 reverted to smoking during the period of 12 weeks. The probability of maintaining abstinence was increased when low depressive symptoms or low craving occurred during the cessation program. CONCLUSION: The present results strengthen the importance of assessing depressive symptoms and craving over the follow-up of a physician-assisted smoking cessation program to detect abstaining smokers at risk to relapse

Epidemiology of chronic obstructive pulmonary disease: Health effects of air pollution

Abstract:  COPD is one of the leading causes of morbidity and mortality in the industrialized and the developing countries. According to the prediction of the World Health Organization, COPD will become the third leading cause of mortality and the fifth cause of disability in 2020 worldwide. In epidemiology, distinct phenotypic entities converge on the term COPD, so that prevalence and mortality data may be inclusive of chronic bronchitis, emphysema and asthma; moreover, the assessment of prevalence rates may change considerably according to the diagnostic tools used. Thus, a considerable problem is to estimate the real prevalence of COPD in the general population. COPD is determined by the action of a number of various risk factors, among which, the most important is cigarette smoking. However, during the last few decades, evidence from epidemiological studies finding consistent associations between air pollution and various outcomes (respiratory symptoms, reduced lung function, chronic bronchitis and mortality), has suggested that outdoor air pollution is a contributing cause of morbidity and mortality. In conclusion, epidemiological studies suggest that air pollution plays a remarkable role in the exacerbation and in the pathogenesis of chronic respiratory diseases. Thus, respiratory physicians, as well as public health professionals, should advocate for a cleaner environment

Life gain in Italian smokers who quit

This study aims to estimate the number of life years gained with quitting smoking in Italian smokers of both sexes, by number of cigarettes smoked per day (cig/day) and age at cessation. All-cause mortality tables by age, sex and smoking status were computed, based on Italian smoking data, and the survival curves of former and current smokers were compared. The more cig/day a man/woman smokes, and the younger his/her age of quitting smoking, the more years of life he/she gains with cessation. In fact, cessation at age 30, 40, 50, or 60 years gained, respectively, about 7, 7, 6, or 5, and 5, 5, 4, or 3 years of life, respectively, for men and women that smoked 10-19 cig/day. The gain in life years was higher for heavy smokers (9 years for >20 cig/day) and lower for light smokers (4 years for 1-9 cig/day). Consistently with prospective studies conducted worldwide, quitting smoking increases life expectancy regardless of age, gender and number of cig/day. The estimates of the number of years of life that could be gained by quitting smoking, when computed specifically for a single smoker, could be used by physicians and health professionals to promote a quit attempt. © 2014 by the authors; licensee MDPI, Basel, Switzerland

Using Local Ecological Knowledge of Fishers to Reconstruct Abundance Trends of Elasmobranch Populations in the Strait of Sicily

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The impact of introducing tyrosine kinase inhibitors on chronic myeloid leukemia survival: a population-based study

Background Chronic myeloid leukemia is associated with a BCR/ABL oncoprotein inhibited by imatinib mesylate, the first tyrosine kinase inhibitor. Although experimental studies have clearly demonstrated the efficacy of imatinib, up-to-date data on its effectiveness at the population level are limited. Our study aims to assess the change in disease-specific survival for chronic myeloid leukemia after introducing tyrosine kinase inhibitors in first-line treatment. Methods This study analyzed data from two population-based cancer registries in Italy. Disease-specific survival for chronic myeloid leukemia cases diagnosed before and after the introduction of tyrosine kinase inhibitors (February 2002) were calculated up to 10 years. Hazard ratios were calculated using Cox regression models adjusted for sex, age at diagnosis and residency. An interrupted time series analysis was also performed. Results Between 1996 and 2012, 357 new cases of chronic myeloid leukemia were diagnosed (standardized incidence rate of 1.2 per 100,000 residents), quite constant throughout the period. The interrupted time series analysis showed a gain of 40.4% in 5 years of disease-specific survival for chronic myeloid leukemia (from 47.3, 95%CI 38.5\u201355.5% to 80.8%, 95%CI 74.5\u201385.8%) after the introduction of tyrosine kinase inhibitors. The hazard ratio was 0.36 (95%CI 0.25\u20130.52) for cases diagnosed after tyrosine kinase inhibitor introduction, with differences per age at diagnosis: 74yo 0.41 (95%CI 0.23\u20130.73). An improvement in survival (hazard ratio 0.66, 95%CI 0.36\u20131.20) was also observed in cases diagnosed before, and alive at, tyrosine kinase inhibitors introduction. Conclusions Tyrosine kinase inhibitors increased disease-specific survival both for new and prevalent chronic myeloid leukemia cases. The effectiveness was similar to that observed in trials only in patients ages 65 years or younger

Respiratory symptoms/diseases and environmental tobacco smoke (ETS) in never smoker Italian women

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Progetto ARGA (Allergopatie Respiratorie: studio di monitoraggio delle linee guida GINA e ARIA): studio osservazionale tra i Medici di Medicina Generale del territorio nazionale.

non presenteBackground: le linee guida (LG) internazionali GINA (Global Initiative for Asthma) ed ARIA (Allergic Rhinitis and its Impact on Asthma) per la gestione dell\u27asma e RA non sono sufficientemente applicate nella pratica clinica. Obiettivi: valutare il grado di applicabilit? delle LG ed il loro impatto sulla qualit? della vita del paziente in Medicina Generale. Metodi: studio osservazionale prospettico; 168 Medici di Medicina Generale (MMG) (71 del gruppo A (+ corso sulle LG) e 97 del gruppo B (- corso)) sono stati selezionati per arruolare i pazienti con diagnosi di asma/RA. Sia il MMG sia il paziente hanno compilato il questionario sulle Allergopatie Respiratorie e la scheda per la rilevazione delle Reazioni Avverse da Farmaci. Il follow-up verr? eseguito dopo 12 mesi

Pirfenidone for Idiopathic Pulmonary Fibrosis and Beyond

Pirfenidone (PFD) slows the progression of idiopathic pulmonary fibrosis (IPF) by inhibiting the exaggerated fibrotic response and possibly through additional mechanisms, such as anti-inflammatory effects. PFD has also been evaluated in other fibrosing lung diseases. Myocardial fibrosis is a common feature of several heart diseases and the progressive deposition of extracellular matrix due to a persistent injury to cardiomyocytes may trigger a vicious cycle that leads to persistent structural and functional alterations of the myocardium. No primarily antifibrotic medications are used to treat patients with heart failure. There is some evidence that PFD has antifibrotic actions in various animal models of cardiac disease and a phase II trial on patients with heart failure and preserved ejection fraction has yielded positive results. This review summarises the evidence about the possible mechanisms of IPF and modulation by PFD, the main results about IPF or non-IPF interstitial pneumonias and also data about PFD as a potential protective cardiac drug

Integrating the care of the complex COPD patient

The European Seminars in Respiratory Medicine has represented an outstanding series updating new science in respiratory disease from the 1990\u2019s up to the early beginning of this 21st century [1,2]. Its aim is to update issues and current science, focusing on the multidisciplinary approach to patients with respiratory disease. As such, it represents a unique opportunity for specialists in Respiratory Medicine involved in Basic and Clinical Research to discuss topical and debated problems in medical care, at a top level forum guided by an expert panel of authors. The structure of the seminar is based on the following pillars: \u2022 Attendance at the Seminars is strictly limited: selection of participants is based, in order of priority, on scientific curriculum, age (younger specialists are privileged), and early receipt of the application form. \u2022 Each topic is allotted considerable time for presentation and discussion. The first section is devoted to a series of presentations (with adequate time allocated for discussion) by an expert panel of researchers and clinicians. In the second section involves discussions of controversial issues, in a smaller audience format encouraging interaction between the panel and audience. \u2022 \u201cMeet the expert\u201d seminars discuss topical subjects in more depth, utilizing an interactive tutorial