829 resultados para Young adults--Tobacco use.
Resumo:
To investigate a recently developed lymphadenopathy can be simple or complex. The medical history, presence or not of symptoms, the general physical examination, and the localization and characteristics of the adenopathy, most often lead to a diagnosis and therapy when indicated. Among young adults, the etiology is either infectious or reactive, rarely tumoral, as opposed to elderly persons. The most important step is to look at signs of severity (or non banality) such as an increased size, hard consistency, supra-clavicular location, an immunocompromised host, a history of Tb exposition. If present, these signs will trigger a biopsy with cyto- or histopathological examination mostly to rule out a malignant tumor. This article reviews the practical steps of an investigation of an isolated adenopathy in an adult patient.
Resumo:
Suicide by self-poisoning is rather common around the world. This paper presents an exceptional complex suicide in which nicotine was applied in the form of self-made patches soaked with an extraction from fine-cut tobacco. In addition, the 51-year-old suicide victim took a lethal dose of diphenhydramine. Toxicological analysis also revealed the presence of tetrazepam in subtherapeutic concentrations. The scene of death suggested an autoerotic accident at first, as the body was tied with tapes, cables and handcuffs. As a result of the entire investigations, the fatality had to be classified as a suicidal intoxication by nicotine and diphenhydramine.
Resumo:
La anorexia nerviosa es un trastorno de la conducta alimentaria que se caracteriza por unapérdida de peso superior al saludablemente recomendado, conductas para perder peso y evitarel aumento de peso, miedo a la obesidad y distorsión de la imagen corporal. Tanto la incidenciacomo la prevalencia de este tipo de trastornos ha aumentado considerablemente en las últimasdécadas, son varios los estudios que afirman que hay una estrecha relación entre la influencia delos factores socioculturales y el grado de distorsión de la imagen corporal en este tipo depacientes.El objetivo de este estudio es analizar la influencia que ejercen los medios de comunicación ylos grupos sociales en la distorsión de la imagen corporal de pacientes con anorexia nerviosa.Para lograr este objetivo se realizará un estudio fenomenológico con pacientes de 16 a 21 añosque se visiten en un hospital de día de trastornos de la conducta alimentaria. Los datos serecogerán mediante de una entrevista semiestructurada basada en los ítems del cuestionario deinfluencia de los modelos estéticos corporales (CIMEC). El análisis de los datos obtenidos serápor edición, transcribiendo la entrevista, identificando los segmentos significativos paraposteriormente poderlos analizar.En relación con las consideraciones finales, es un estudio que dentro de la subjetividad podríaser realmente útil para conocer desde el punto de vista del paciente cómo influyen los medios decomunicación y las relaciones sociales en la anorexia nerviosa, permitiendo la propuesta deacciones futuras que ayuden a estos adolescentes y adultos jóvenes a hacer frente a la presiónque ejerce la sociedad.
Resumo:
Background: Bone health is a concern when treating early stage breast cancer patients with adjuvant aromatase inhibitors. Early detection of patients (pts) at risk of osteoporosis and fractures may be helpful for starting preventive therapies and selecting the most appropriate endocrine therapy schedule. We present statistical models describing the evolution of lumbar and hip bone mineral density (BMD) in pts treated with tamoxifen (T), letrozole (L) and sequences of T and L. Methods: Available dual-energy x-ray absorptiometry exams (DXA) of pts treated in trial BIG 1-98 were retrospectively collected from Swiss centers. Treatment arms: A) T for 5 years, B) L for 5 years, C) 2 years of T followed by 3 years of L and, D) 2 years of L followed by 3 years of T. Pts without DXA were used as a control for detecting selection biases. Patients randomized to arm A were subsequently allowed an unplanned switch from T to L. Allowing for variations between DXA machines and centres, two repeated measures models, using a covariance structure that allow for different times between DXA, were used to estimate changes in hip and lumbar BMD (g/cm2) from trial randomization. Prospectively defined covariates, considered as fixed effects in the multivariable models in an intention to treat analysis, at the time of trial randomization were: age, height, weight, hysterectomy, race, known osteoporosis, tobacco use, prior bone fracture, prior hormone replacement therapy (HRT), bisphosphonate use and previous neo-/adjuvant chemotherapy (ChT). Similarly, the T-scores for lumbar and hip BMD measurements were modeled using a per-protocol approach (allowing for treatment switch in arm A), specifically studying the effect of each therapy upon T-score percentage. Results: A total of 247 out of 546 pts had between 1 and 5 DXA; a total of 576 DXA were collected. Number of DXA measurements per arm were; arm A 133, B 137, C 141 and D 135. The median follow-up time was 5.8 years. Significant factors positively correlated with lumbar and hip BMD in the multivariate analysis were weight, previous HRT use, neo-/adjuvant ChT, hysterectomy and height. Significant negatively correlated factors in the models were osteoporosis, treatment arm (B/C/D vs. A), time since endocrine therapy start, age and smoking (current vs. never).Modeling the T-score percentage, differences from T to L were -4.199% (p = 0.036) and -4.907% (p = 0.025) for the hip and lumbar measurements respectively, before any treatment switch occurred. Conclusions: Our statistical models describe the lumbar and hip BMD evolution for pts treated with L and/or T. The results of both localisations confirm that, contrary to expectation, the sequential schedules do not seem less detrimental for the BMD than L monotherapy. The estimated difference in BMD T-score percent is at least 4% from T to L.