1/2. Psychiatric aspects of head and neck cancer surgery.Psychiatric problems of patients with head and neck cancer include reactions to disfiguring illness and treatment; adjustment to alterations of speech, eating, and other functions, including sex; changes in body image; alcohol and tobacco addiction; pain; organic brain syndromes; and dealing with terminal illness. Although speech is often compromised, head and neck patients can communicate and psychiatric work is possible. The consultation-liaison psychiatrist can provide considerable assistance by utilizing psychodynamic, behavioral, and pharmacologic modes of treatment and by working with family members and staff.- - - - - - - - - - ranking = 1keywords = alcohol (Clic here for more details about this article) |
2/2. nicotine absorption and dependence in unlicensed lozenges available over the counter.AIM: To demonstrate the nicotine absorption and dependence potential from unlicensed nicotine containing lozenges. DESIGN: A single case report of dependence on nicotine lozenges, plus measurements of nicotine levels before and after consumption of eight nicotine lozenges over 2 hours in volunteers. SETTING: Hospital Smokers' Clinic. PARTICIPANTS: One male patient suffering from schizophrenia who had consumed 150 "Stoppers" lozenges per day for the previous 5 years, plus seven non-smoker volunteers. MEASUREMENTS: blood nicotine concentration. FINDINGS: The patient's low expired carbon monoxide level (5 p.p.m.) and high plasma nicotine (32 ng/ml) and cotinine levels (947 ng/ml) were consistent with very heavy lozenge consumption. The non-smoker volunteers obtained nicotine concentrations of around 11 ng/ml by consuming eight Stoppers lozenges over 2 hours. Other brands of nicotine lozenges produced lower initial levels, but also produced delayed intestinal absorption and vomiting after food consumption. CONCLUSION: nicotine lozenges are a potential aid to smoking cessation but their safety, efficacy and abuse potential remain to be properly evaluated.- - - - - - - - - - ranking = 0.50971979080777keywords = abuse (Clic here for more details about this article) |