Objetivo: Descrever características demográficas e clínicas de fumantes que procuraram atendimentoem centro especializado na cessação de tabagismo. Métodos: Foram analisadas, retrospectivamente,as informações disponíveis em ficha clínica padronizada preenchida no momento do primeiro atendimento, de fumantes que procuraram o Ambulatório de Apoio ao Tabagista do Centro de Saúde Escola daFaculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, no período de 18 meses.Resultados: O serviço foi procurado no período por 186 fumantes (135 mulheres), com idade de 50±12anos. A maioria (59%) veio encaminhada de outros ambulatórios médicos, e o consumo apenas decigarros industrializados foi relatado por 96%. A idade de início do consumo regular de cigarros foi de18±7 anos. Experiências prévias frustradas de abandono foram relatadas por 83% dos fumantes, e onúmero médio de tentativas efetuadas foi de 3±2. A maioria dos atendidos (66%) exibia dependência ànicotina de grau alto ou muito alto, com escore médio do teste de Fargeström de 6±2. Co-morbidadesfísicas foram relatadas em 62% e psiquiátricas em 24% dos casos, particularmente depressão (17%).Conclusões: Os dados obtidos servem como embasamento de algumas necessidades a serem supridas por novos serviços de cessação do tabagismo a serem instalados em municípios de porte médiodo Brasil e exterior.
Women carrying germline BRCA1/2 deleterious mutations are an extreme risk population for developing breast cancer, with a cumulative life-time risk of 56-80%. Prophylactic bilateral mastectomy provides a valid option for reducing the risk of breast cancer by nearly 90 %. Although it greatly affects the quality of life, breast prophylactic surgery in BRCA1/2 mutation carriers have increased in Europe and in US over the last decade.The major breast cancer prevention trials using tamoxifen and raloxifen showed an approximately 50% risk reduction in high risk women. The contralateral risk reduction in current adjuvant trials comparing aromatase inhibitors (AI) to tamoxifen therapies reveals a higher preventive efficacy of AI after menopause. Two ongoing randomized studies using exemestane (MAP3) or anastrozole (IBIS2) are assessing the risk reduction of breast cancer in menopausal women but none are designed for BRCA1/2 carriers.The French federation of cancer centres, "FNCLCC" (Federation Nationale des Centres de Lutte Contre le Cancer) has developed a randomized phase III study to determine the efficacy of the aromatase inhibitor letrozole to reduce the incidence of invasive breast cancer in post menopausal BRCA1/2 carriers. The ONCO-03 (LIBER) study is a double-blind, letrozole versus placebo, controlled study involving 28 centres in France. The study opened for recruitment in march 2008. The study design, procedures and first analysis of patients enrolment are presented.Based on the known preclinical and clinical profile of AI, a greater reduction in breast cancer incidence with fewer side effects is hypothesized with this class of agents than with tamoxifen or raloxifen. For postmenopausal women bearing a BRCA1/2 genetic predisposition, prevention of breast cancer risk by letrozole could provide a precious alternative to bilateral mastectomy. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1048.
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