450 research outputs found
Fumo, malattie respiratorie e terapie per smettere di fumare
No full textIl fumo di tabacco è la principale causa di morte
prematura e prevenibile: continua ad uccidere circa
6 milioni di persone ogni anno, inclusi 600.000
non fumatori esposti al fumo passivo, e si stima che
il numero delle morti causate dal fumo potrebbe
ammontare a 8,3 milioni nell’anno 2030 [http://
www.who.int/tobacco/en/].
In Italia è attribuibile al fumo di tabacco un
numero di decessi variabile tra 70.000 e 83.000
ogni anno, circa 220 morti al giorno (http://www.
ministerosalute.it).
L’Organizzazione Mondiale della Sanità (OMS)
ha implementato e incoraggiato la Convenzione
Quadro per il Controllo del Tabacco (WHO Framework
Convention on Tobacco Control, FCTC).
La FCTC è il primo trattato internazionale per la
tutela della salute pubblica che stabilisce obiettivi
e principi giuridicamente vincolanti che i firmatari
sono tenuti a rispettare; hanno formalmente
aderito 172 Paesi corrispondenti all’87% della
popolazione mondiale (http://www.who.int/fctc/
reporting/en/).
Nonostante l’impatto epidemiologico ed economico
legato alla patologia fumo-correlata sia
considerato uno dei maggiori problemi sanitari
del pianeta, l’attenzione al problema del fumo, il
riconoscimento e la diagnosi della dipendenza da
tabacco e il trattamento del tabagismo sono ancoralontani dalla pratica clinica degli operatori sanitari
medici e non medici, compresi coloro che operano
in ambito pneumologico.
L’obiettivo di questo capitolo è quello di fornire
elementi di base per la conoscenza delle dimensioni
dell’epidemia da tabacco, dei danni sulla salute
causati e correlati all’abitudine al fumo, dei benefici
conseguenti alla sua cessazione, dei meccanismi
pato-fisiologici e sociali del tabagismo e del trattamento
della malattia fumo. Attenzione verrà rivolta
alle problematiche connesse alla patologia respiratoria
e al trattamento in ambito pneumologico. A
causa della vastità delle conoscenze scientifiche, la
trattazione che segue è necessariamente sintetica e
propone al suo interno strumenti e riferimenti fruibili
per l’approfondimento dei molteplici aspetti
del problema
Short dual antiplatelet therapy: how, when and why
No full textDual antiplatelet therapy (DAPT) is a cornerstone of antithrombotic treatment in patients undergoing percutaneous coronary intervention. The optimal duration of DAPT, i.e. the minimal period needed to ensure the best safety and efficacy, to prevent ischemic complications, including stent thrombosis, has been extensively explored in multiple randomized controlled trials over the last years. Accumulating evidence is supporting a clinical approach where there is a prevailing role of the risk of bleeding: in patients at high bleeding risk (HBR) it is generally advisable to reduce the duration of DAPT irrespective of their risk of thrombosis. In addition, among HBR patients, (i) new recommendations prefer direct oral anticoagulants (DOAC) over vitamin K antagonists in DOAC-eligible patients with atrial fibrillation and coronary artery disease; (ii) measures to minimize bleedings while on DAPT should be pursued, including de-escalation of P2Y12 receptor inhibitor therapy; and (iii) new studies are testing reversal strategies for short DAPT regimens, with early discontinuation of aspirin. In the present review, we discuss the rationale and decision-making considerations to reduce safely DAPT duration in HBR patients
Smoking cessation as a therapeutic and preventive intervention: A meeting report
No full textIn November 2000, a meeting took place on "Smoking cessation as a therapeutic and preventive intervention". The venue of the meeting was Venice, in the old Monastery of the Isola San Giorgio, and it was jointly organised by the Italian Association of Hospital Pulmonologists (AIPO) and the European Section of the Society for Research on Nicotine and Tobacco (SRNT-Europe). The meeting was also sponsored by the European Respiratory Society (ERS). The importance of the topic cannot be underestimated. According to the World Health Organisation (WHO) tobacco smoking is the most important cause of preventable death in the industrialised world. When tobacco smoking constitutes a repetitive and compulsive behaviour, for instance when a person continues smoking when suffering from a smoking related disease, it is due to tobacco dependence, which both WHO and the American Psychiatric Association classify as a disease. Tobacco smoking is not only a disease in itself but can also cause other diseases, such as chronic obstructive lung disease, lung cancer and cardiovascular disease, and can worsen pre-existent disease, e.g. asthma. In the WHO European region, according to WHO estimates, tobacco smoking causes at least 1,200,000 death each year (14% of all deaths). So far, a preventive strategy based on protection of children and adolescents from initiation has not worked in decreasing the prevalence among young generations. Even with the best educational programs success is partial and ephemeral. Smoking cessation with behavioural and pharmacological aid is a well established therapeutic intervention, supported by strong scientific evidence. But smoking cessation can also be a preventive intervention, because it can reduce the prevalence of smokers in a community. Obviously, smoking cessation is to be used together with all other interventions recognised as effective in tobacco control (cigarette and tobacco product pricing, regulatory approaches, smoking bans, health education)
Epidemiology of chronic obstructive pulmonary disease: Health effects of air pollution
No full textCOPD 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. © 2006 The Authors
The global burden of chronic respiratory diseases
No full textCurrently, the serious consequences of chronic diseases and their risk factors are not fully
recognised by the international health community. Moreover, chronic diseases are not
only a problem of the ageing population in developed countries. In fact, it has been estimated
that 80% of mortality for chronic diseases occurred in low-income and middleincome
countries in 2005. Thus, the World Health Organization (WHO) Dept of Chronic
Diseases and Health Promotion has suggested a new Millennium Development Goal for
the next few years: to reduce chronic disease death rates by an additional 2% annually,
in order to avert 36 million deaths by 2015
Serum Antibodies Anti-Benzo(a)Pyrene Diol Epoxide-DNA Adducts (BPDE-DNA) and Tobacco Smoking May Predict Respiratory Outcomes in a General Population Follow-Up
No full text- …
