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1.
An. Fac. Cienc. Méd. (Asunción) ; 54(3): 61-66, Dec. 2021.
Article in Spanish | LILACS | ID: biblio-1352909

ABSTRACT

El tabaquismo es una importante causa de enfermedad y muerte debido a neoplasias, enfermedades cardiovasculares y pulmonares, provocando además disminución de la productividad y aumento de la pobreza. La telemedicina es una de las innovaciones principales en los servicios de salud, especialmente en el contexto de la pandemia de COVID19 que dificulta la atención presencial. Se ha evidenciado en los pacientes, un grado de satisfacción elevado, un aspecto importante al momento de valorar la calidad de la atención médica prestada y justificar las innovaciones


Smoking is an important cause of illness and death due to neoplasms, cardiovascular and pulmonary diseases, also causing a decrease in productivity and an increase in poverty. Telemedicine is one of the main innovations in health services, especially in the context of the COVID19 pandemic that makes face-to-face care difficult. A high degree of patient satisfaction has been evidenced, an important aspect when assessing the quality of medical care provided and justifying innovations


Subject(s)
Tobacco Use Disorder , Telemedicine , Patients , Pulmonary Medicine , Smoking , Patient Satisfaction , Efficiency
3.
Cambios rev. méd ; 20(1): 74-79, 30 junio 2021.
Article in Spanish | LILACS | ID: biblio-1292925

ABSTRACT

INTRODUCCIÓN. Para el tratamiento farmacoterapéutico de enfermedades respi-ratorias, el uso de herramientas para abordar la vía inhalatoria es de elección por su mayor eficacia y menos efectos secundarios; registrar su adhesión y prevalencia es importante. OBJETIVO. Determinar el nivel y la prevalencia de adhesión al uso de inhaladores en pacientes con Asma y Enfermedad Pulmonar Obstructiva Cróni-ca. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 215 y muestra de 121 Historias Clínicas. Se aplicó el Test de Adhesión a Inhaladores, que consistió en dos cuestionarios complementarios: el de 10 ítems, que valoró el nivel de adhesión, y el de 12 que identificó el tipo de incumplimiento en pacientes de Consulta Externa de la Unidad Técnica de Neumología del Hospital de Especialidades Carlos Andrade Marín, periodo julio 2018 - enero 2019. La tabulación y análisis de datos se realizó con el programa Excel. RESULTADOS. La prevalencia de mala adhesión en asmáticos fue de 83,33% y en Enfermedad Pulmonar Obstructiva Crónica 13,33%. En cuanto al sexo, la prevalencia de mala adhesión fue de 15,28% en hombres y de 40,82% en mujeres, con una p<0,05. No se encontró diferencia significativa respecto a los niveles de instrucción. CONCLUSIÓN. La prevalencia de mala adhesión al uso de inhaladores en pacientes con Asma y Enfermedad Pulmonar Obstructiva Crónica fue alta sobre todo en los asmáticos.


INTRODUCTION. For respiratory diseases and their pharmacotherapeutic treatment, the use of tools to address the inhalation route is chosen due to its greater efficacy and fewer secondary effects; then record the adherence and prevalence is important. OBJECTIVE. To determine both level and prevalence of adherence to the use of inhalers in patients with Asthma and Chronic Obstructive Pulmonary Disease. MATE-RIALS AND METHODS. Cross-sectional analytical study. Population of 215 and sam-ple of 121 patients. The Inhaler Adherence Test was applied, which consisted of two complementary questionnaires: a 10-item questionnaire, which assessed the level of adherence, and a 12-item questionnaire that identified the type of non-compliance in patients of the Pneumology Technical Unit of the Hospital de Especialidades Carlos Andrade Marín, period July 2018 - January 2019. The tabulation and data analysis was performed with Microsoft Excel program. RESULTS. The prevalence of poor ad-herence in asthmatics was 83.33% and in Chronic Obstructive Pulmonary Disease was 13.3%. Regarding gender, the prevalence of poor adherence was 15.28% in men and 40.82% in women, with a p <0.05. No significant differences were found regarding the levels of instruction. CONCLUSION. The prevalence of poor adherence to the use of inhalers in patients with Asthma and Chronic Obstructive Pulmonary Disease was high, especially in asthmatics


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Respiratory Tract Diseases , Asthma , Nebulizers and Vaporizers , Pulmonary Medicine , Pulmonary Disease, Chronic Obstructive , Treatment Adherence and Compliance , Respiratory Therapy , Bronchodilator Agents , Medication Therapy Management , Medication Adherence , Dry Powder Inhalers
4.
Article in English | WPRIM | ID: wpr-887531

ABSTRACT

INTRODUCTION@#Non-cystic fibrosis bronchiectasis (NCFB) is a highly heterogenous disease. We describe the clinical characteristics of NCFB patients and evaluate the performance of Bronchiectasis Severity Index (BSI) in predicting mortality.@*METHODS@#Patients attending the bronchiectasis clinic between August 2015 and April 2020 with radiologically proven bronchiectasis on computed tomography were recruited. Clinical characteristics, spirometry, radiology, microbiology and clinical course over a median period of 2.4 years is presented.@*RESULTS@#A total of 168 patients were enrolled in this prospective cohort study. They were predominantly women (67.8%), Chinese (87.5%) and never-smokers (76.9%). Median age of diagnosis was 64 years (interquartile range 56-71) and the most common aetiology was "idiopathic" bronchiectasis (44.6%). Thirty-nine percent had normal spirometries. Compared to female patients, there were more smokers among the male patients (53.8% versus 8.5%, @*CONCLUSION@#The NCFB cohort in Singapore has unique characteristics with sex differences. Over half the patients had a history of haemoptysis. The BSI score is a useful predictor of mortality in our population.


Subject(s)
Aged , Bronchiectasis/epidemiology , Cohort Studies , Female , Fibrosis , Humans , Male , Middle Aged , Prospective Studies , Pulmonary Medicine , Severity of Illness Index , Singapore/epidemiology
7.
J. bras. pneumol ; 47(1): e20200406, 2021. tab, graf
Article in English | LILACS | ID: biblio-1154685

ABSTRACT

ABSTRACT Chronic unexplained dyspnea and exercise intolerance represent common, distressing symptoms in outpatients. Clinical history taking and physical examination are the mainstays for diagnostic evaluation. However, the cause of dyspnea may remain elusive even after comprehensive diagnostic evaluation-basic laboratory analyses; chest imaging; pulmonary function testing; and cardiac testing. At that point (and frequently before), patients are usually referred to a pulmonologist, who is expected to be the main physician to solve this conundrum. In this context, cardiopulmonary exercise testing (CPET), to assess physiological and sensory responses from rest to peak exercise, provides a unique opportunity to unmask the mechanisms of the underlying dyspnea and their interactions with a broad spectrum of disorders. However, CPET is underused in clinical practice, possibly due to operational issues (equipment costs, limited availability, and poor remuneration) and limited medical education regarding the method. To counter the latter shortcoming, we aspire to provide a pragmatic strategy for interpreting CPET results. Clustering findings of exercise response allows the characterization of patterns that permit the clinician to narrow the list of possible diagnoses rather than pinpointing a specific etiology. We present a proposal for a diagnostic workup and some illustrative cases assessed by CPET. Given that airway hyperresponsiveness and pulmonary vascular disorders, which are within the purview of pulmonology, are common causes of chronic unexplained dyspnea, we also aim to describe the role of bronchial challenge tests and the diagnostic reasoning for investigating the pulmonary circulation in this context.


RESUMO A dispneia crônica inexplicada e a intolerância ao exercício representam sintomas comuns e angustiantes em pacientes ambulatoriais. O histórico clínico e o exame físico são as bases da avaliação diagnóstica. No entanto, a causa da dispneia pode permanecer inexplicada mesmo após uma avaliação diagnóstica abrangente - análises laboratoriais básicas, exames de imagem do tórax, testes de função pulmonar e testes cardíacos. Nesse momento (e frequentemente antes), os pacientes geralmente são encaminhados a um pneumologista, o qual se espera que seja o principal médico para a resolução desse enigma. Nesse contexto, o teste de exercício cardiopulmonar (TECP), para avaliação de respostas fisiológicas e sensoriais do repouso ao pico do exercício, proporciona uma oportunidade única de desvendar os mecanismos subjacentes à dispneia e as interações desses mecanismos com um amplo espectro de distúrbios. No entanto, o TECP é subutilizado na prática clínica, possivelmente por questões operacionais (custos dos equipamentos, disponibilidade limitada e baixa remuneração) e limitação da formação médica em relação ao método. Para enfrentar esta última deficiência, almejamos fornecer uma estratégia pragmática para a interpretação dos resultados do TECP. O agrupamento dos achados da resposta ao exercício permite a caracterização de padrões que possibilitam ao clínico restringir a lista de possíveis diagnósticos, em vez de apontar uma etiologia específica. Apresentamos uma proposta de avaliação diagnóstica e alguns casos ilustrativos avaliados por TECP. Como a hiper-responsividade das vias aéreas e os distúrbios vasculares pulmonares, que são da competência da pneumologia, são causas comuns de dispneia crônica inexplicada, também objetivamos descrever o papel dos testes de broncoprovocação e o raciocínio diagnóstico para a investigação da circulação pulmonar nesse contexto.


Subject(s)
Humans , Pulmonary Medicine , Lung Diseases/diagnosis , Respiratory Function Tests , Exercise Tolerance , Dyspnea/diagnosis , Dyspnea/etiology , Exercise Test
8.
Cienc. tecnol. salud ; 7(3): 442-460, 26 de noviembre 2020. ^c27 cmilus
Article in Spanish | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1141473

ABSTRACT

En las últimas décadas, la terapia de plasma rico en plaquetas (PRP) ha despertado mucha atención en el área de la medicina regenerativa, siendo aplicada a diferentes patologías sistémicas y localizadas. El PRP proporciona diversos factores de crecimiento y proteínas que pueden estimular al proceso de regeneración celular, representa un factor importante para su uso clínico generalizado, en diferentes tejidos en donde el suministro de sangre es lento o limitado y apoya la recuperación, cicatrización, activación biológica de células de defensa, estabilización en la regeneración celular y tisular, teniendo uso clínico en casi todas las especialidades médicas. Esta revisión tiene como objetivo presentar las bases teóricas para la potencial aplicación del PRP y sus factores de crecimiento en tratamientos que buscan una terapia regenerativa por bioestimulación de la aplicación autóloga, en patologías para las cuales aún no existe tratamiento específico. Se revisaron artículos de los últimos 10 años en los buscadores y bases de datos Google Scholar, PubMed y Scopus y se seleccionaron aquellos que pueden ayudar a entender la aplicación de PRP en diversos procesos de regeneración, con miras a utilizarse como un tratamiento alternativo y complementario a pacientes con COVID-19. Se encontró abundante literatura experimental y clínica en el uso de PRP autóloga, en diversos procesos de regeneración, inclusive en neumología e infectología, por lo que amerita comprobar su efecto con protocolos establecidos, en patologías respiratorias severas como apoyo biológico autólogo para activar la respuesta biológica innata de tipo celular.


Platelet-rich plasma (PRP) therapy has generated much attention in recent decades in regenerative medicine, being applied to different systemic and localized pathologies. PRP provides various growth factors and proteins that can stimulate the cell regeneration process. It is an important factor for its clinical use in different tissues where blood supply is slow or limited, and supports the recovery, healing, activation of defense cells, cellular stabilization, and tissue regeneration, having clinical use in almost all medical specialties. Articles from the last 10 years in Google Scholar, PubMed and Scopus were reviewed and selected those that can help to understand the application of PRP in various regeneration processes, with a view to use as an alternative and complementary treatment for patients with Covid-19. It was found that there is abundant experimental and clinical literature on the use of autologous PRP in various regeneration processes, including pneumology and infectious diseases. It worth evaluating its effect in severe respiratory diseases as an autologous biological support to activate the innate cellular response.


Subject(s)
Humans , Therapeutics , Regenerative Medicine , Platelet-Rich Plasma , Pulmonary Medicine , Communicable Diseases , Coronavirus Infections
9.
Medisan ; 24(5) tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1135206

ABSTRACT

Introducción: Los biomarcadores son sustancias biológicas o bioquímicas que aparecen como respuesta del organismo ante ciertos tipos de tumores y que reflejan la etapa y el grado de estos. Objetivo: Determinar la asociación de los marcadores tumorales con los procesos respiratorios crónicos. Métodos: Se realizó un estudio descriptivo y transversal de 306 pacientes diagnosticados con enfermedades respiratorias crónicas, atendidos en las consultas comunitarias de neumología de la provincia de Santiago de Cuba, de enero del 2014 a diciembre del 2018. Resultados: En la serie predominaron el sexo masculino y las edades de 60 a 69 años, así como las enfermedades intersticiales, la bronquitis crónica y la enfermedad pulmonar obstructiva crónica. De igual modo, resultaron importantes los estudios radiológicos para la detección de procesos neoplásicos, sobre todo el empleo de la tomografía axial computarizada. Por otra parte, los marcadores que presentaron valores alterados fueron el CYFRA 21.1 y el CA 72.4, de manera que se demostró su asociación con los procesos respiratorios crónicos. Conclusiones: Los biomarcadores tumorales son una herramienta útil en el seguimiento de pacientes con neoplasias malignas, pero también muestran valores alterados ante la presencia de varias enfermedades respiratorias crónicas sin que ello represente la existencia de un proceso maligno.


Introduction: Biomarkers are biological or biochemical substances which emerge as a response of the organism on certain types of tumors and which reflect the stage or degree of them. Objective: To determine the association of tumoral markers with the chronic respiratory events. Methods: A descriptive and cross-sectional study of 306 patients diagnosed with chonic respiratory diseases and assisted at the Pneumology community outpàtients from Santiago de Cuba province was carried out from January, 2014 to December, 2018. Results: Male sex and ages between 60 o 69 years as well as interstitial diseases, chronic bronchitis and the chronic obstructive pulmonary disease predominated in the series. Likewise, radiological studies were also important for detecting neoplasic processes, mainly with the use of the axial computerized tomography. On the other side, markers presenting altered values were the CYFRA 21.1 y el CA 72.4, so that its association with the chronic respiratory processes. Conclusions: Tumoral biomarkers are an usefull tool in the follow-up of patients with malignant neoplasies, but also they show altered values in the presence of different chronic respiratory diseases, which doesn´t mean there is a malignant process.


Subject(s)
Respiratory Tract Diseases/diagnosis , Biomarkers, Tumor , Secondary Care , Pulmonary Medicine
10.
Rev. am. med. respir ; 20(3): 267-269, sept. 2020. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1123089

ABSTRACT

Los avances en los tratamientos médicos y las mejoras en la calidad de la atención logran que un número creciente de adolescentes con enfermedades crónicas lleguen a la adultez y requieran la atención de médicos especialistas de adultos1-3. El pasaje de un centro asistencial pediátrico a otro de adultos es un proceso complejo que puede traer aparejado dificultades para todos los actores intervinientes. .


Subject(s)
Humans , Pulmonary Medicine , Therapeutics , Chronic Disease
11.
Acta méd. colomb ; 45(3): 41-46, jul.-set. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1130699

ABSTRACT

Resumen Objetivo: realizar el análisis bibliométrico de COVID-19 durante diciembre de 2019 a 30 de junio de 2020. Métodos: revisión bibliométrica del total de la literatura y de lo relacionado con COVID-19 en las bases Pubmed, Scopus y Lilacs durante el periodo diciembre de 2019 a 30 junio de 2020. Se clasificaron los artículos por categorías (objetivo, país, especialidad) y se compararon con la literatura del año anterior. Resultados: se encontraron 27 373, 16 944 y 1083 publicaciones acerca de COVID-19 en Pubmed, Scopus y Lilacs respectivamente. La principal especialidad médica por búsqueda fue neumología. De acuerdo con el objetivo, el más encontrado fue tratamiento (50.0%). El país con más publicaciones fue Estados Unidos (28.9%) en Pubmed y Scopus. En el lapso COVID-19 las publicaciones de la enfermedad representan 0.06 del total. Conclusiones: existe un volumen importante de publicaciones relacionadas con COVID-19 en periodo de estudio, equivalente a 6% de las publicaciones totales, lo cual es significativo para una sola enfermedad.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1879).


Abstract Objective: to perform a bibliometric analysis of COVID-19 from December 2019 to June 30, 2020. Methods: a bibliometric review of all the literature and COVID-19 related material in the PubMed, Scopus and Lilacs databases from December 2019 to June 30, 2020. Articles were classified by categories (objective, country, specialty) and compared to the previous year's literature. Results: a total of 27,373, 16,944 and 1,083 publications on COVID-19 were found in PubMed, Scopus and Lilacs, respectively. The main medical specialty by search was pulmonology. The most frequently found objective was treatment (50.0%). The country with most publications was the United States (28.9%) on PubMed and Scopus. During the COVID-19 span, publications on the disease represented 0.06 of the total. Conclusions: there was a significant volume of COVID-19 related publications during the study period, equivalent to 6% of the total publications, which is significant for a single disease.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1879).


Subject(s)
COVID-19 , Pulmonary Medicine , Bibliometrics , PubMed , Literature
12.
Cuad. Hosp. Clín ; 61(1): [24], jul. 2020. ilus.
Article in Spanish | LILACS, LIBOCS | ID: biblio-1118878

ABSTRACT

PREGUNTA DE INVESTIGACIÓN: ¿Qué identifica a los integrantes del equipo de salud que proporcionan atención humanizada en la unidad de terapia Intermedia del servicio de neumología en el Hospital del Tórax de la ciudad de La Paz? OBJETIVO: conocer las vivencias de las personas que enfrentan una situación de hospitalización en la unidad de terapia intermedia en el servicio de neumología del Hospital del Tórax de la ciudad de La Paz, para distinguir que identifica a los integrantes del equipo de salud que les proporcionan atención humanizada. MATERIAL Y MÉTODOS: diseño cualitativo, análisis hermenéutico. RESULTADOS: el descubrimiento más significativo fue que los integrantes del equipo de salud que proporcionan atención humanizada y demuestran mayor disposición de ayuda al prójimo, son los que en su experiencia de vida tuvieron la necesidad de atravesar por una situación similar al estar en el rol de beneficiarios (al ser atendidos o acompañar en el proceso de recuperación a otra persona) y conocieron de cerca esta situación en la que se espera recibir una atención humanizada que no siempre se encuentra. CONCLUSIONES: la concepción de atención humanizada no solo se reduce a la amabilidad, se debe considerar al ser humano de manera integral y como parte de este trato integral implícitamente también se comprende el proporcionar excelencia técnica para atender al ser humano y no solo a la enfermedad. A veces desde una perspectiva excesivamente biomédica se descuida el aspecto psicosocial del que nadie, sano o enfermo, puede desprenderse.


RESEARCH QUESTION: ¿What identifies the members of the health team that provide humanized care in the intermediate therapy unit of the pneumology service at the Hospital of the Thorax in the city of La Paz? OBJECTIVE: to know the experiences of people facing a hospitalization situation in the intermediate therapy unit in the peumology service of the Hospital del Tórax in the city of La Paz, in order to distinguish that it identifies the members of the health team that provide them with humanized care. MATERIAL AND METHODS: qualitative design, hermeneutical analysis. RESULTS: the most significant discovery was that the members of the health team that provide humanized care and demonstrate greater willingness to help others, are those who in their life experience had the need to go through a similar situation as they were in the role of beneficiaries (when being treated or accompanying someone else in the recovery process) and they got to know this situation closely, in which it is expected to receive humanized attention that is not always found. CONCLUSIONS: the concept of humanized care is not only reduced to kindness, the human being must be considered in an integral way and as part of this integral treatment it is also implicitly understood to provide technical excellence to attend to the human being and not only to the disease. Sometimes from an excessively biomedical perspective, the psychosocial aspect is neglected, from which no one, healthy or ill, can discard.


Subject(s)
Humans , Attention , Pulmonary Medicine , Humanization of Assistance , Patients , Role , Thorax
14.
Med. UIS ; 33(1): 39-52, ene.-abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1124984

ABSTRACT

Resumen La neumonía en niños es causa frecuente de morbilidad y mortalidad, especialmente en países de bajos ingresos; es indispensable proporcionar una adecuada conducta terapéutica, idealmente orientada por etiología, pues la principal consecuencia de no establecer un diagnóstico etiológico preciso es el abuso de antibióticos. La evaluación clínica y radiológica son los pilares básicos para el diagnóstico de neumonía, y el conocimiento del comportamiento epidemiológico de los gérmenes y los biomarcadores ayudan a su aproximación etiológica. Se revisaron aspectos prácticos sobre el diagnóstico de la neumonía en niños, abordando criterios clínicos y epidemiológicos (edad y género), reactantes de fase aguda, hallazgos radiológicos y modelos de predicción etiológica utilizados como herramientas para la diferenciación de neumonía bacteriana de viral en menores de 18 años, en escenarios donde no se dispone rutinariamente de técnicas más precisas para diagnóstico rápido, como aquellas de tipo inmunológico o moleculares. MÉD.UIS.2020;33(1):39-52.


Abstract Pneumonia in children is a frequent cause of morbidity and mortality, especially in low-income countries. Due to this, it is indispensable to get a right therapeutic behavior, ideally focused by etiology, because the main consequence of not establishing an accurate etiological diagnosis is the abuse of antibiotics. The radiologic and clinic evaluations are basic pillars for pneumonia diagnosis and the knowledge in epidemiological behavior and biomarkers is very useful for an etiological approximation. Practical aspects were reviewed about pneumonia diagnosis in children, addressing clinic and epidemiological criteria (age and gender), acute phase reactants, radiological findings and etiological prediction models used as tools for differentiation between viral and bacterial pneumonia in children under 18 years old, in scenarios where it is not possible to find techniques for a right diagnostic, as those of immunologic and molecular types. MÉD.UIS.2020;33(1):39-52.


Subject(s)
Humans , Child , Pediatrics , Pneumonia , Pneumonia, Viral , Acute-Phase Proteins , Radiography, Thoracic , Pulmonary Medicine , Uses of Epidemiology , Pneumonia, Bacterial , Diagnosis , Diagnosis, Differential , Clinical Decision-Making
15.
Rev. am. med. respir ; 20(1): 64-71, mar. 2020. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1178760

ABSTRACT

La presión positiva continua en las vías aéreas (CPAP) es el tratamiento estándar más eficaz para el síndrome de apneas e hipopneas obstructivas del sueño (SAHOS). La falta de adherencia se debe con frecuencia a la incomodidad o el disconfort generados por efectos secundarios relacionados con las máscaras. La aceptación de la CPAP depende en gran medida de la selección de la interfaz adecuada y para ello se requiere de experiencia del personal, de la posibilidad de seleccionar el modelo que mejor se adapta a cada paciente, y de que las interfaces cumplan con requisitos mínimos para proporcionar confort y eficacia terapéutica. La evidencia actual sugiere que la máscara nasal es mejor tolerada, requiere menor presión para resolver la obstrucción y se asocia con una mejor calidad de sueño y adherencia al tratamiento. Por lo tanto, máscaras o almohadillas nasales deben ser la primera opción. Máscaras oronasales pueden ser apropiadas cuando no se tolere la máscara nasal o la fuga bucal documentada persista. Los especialistas en medicina respiratoria somos responsables de controlar el proceso de selección y suministro de la máscara y de orientar a nuestros pacientes acerca de las opciones disponibles.


Continuous positive airway pressure (CPAP) is the most effective standard treatment for the obstructive sleep apnea and hypopnea syndrome (OSAHS). The lack of adherence to the treatment is frequently due to inconvenience or discomfort generated by side effects related to the masks. CPAP acceptance depends greatly on the selection of the adequate interface. To make the right choice, it is necessary to have experienced personnel and the possibility to select the model that best suits every patient. Also, interfaces must meet minimum requirements to provide comfort and therapeutic efficacy. Current evidence suggests that the nasal mask is better tolerated, requires less pressure to solve obstructions and is associated with better quality of sleep and adherence to the treatment. So, nasal masks or pillows should be the first option. Oronasal masks may be suitable when the nasal mask is not tolerated or the documented oral leakage persists. Specialists in respiratory medicine are responsible for controlling the process of selection and administration of the mask and guiding our patients on the available options.


Subject(s)
Humans , Sleep Apnea, Obstructive , Sleep , Therapeutics , Pulmonary Medicine , Efficacy , Continuous Positive Airway Pressure , Treatment Adherence and Compliance , Masks
19.
J. bras. pneumol ; 46(3): e20190280, 2020. tab, graf
Article in English | LILACS | ID: biblio-1134867

ABSTRACT

ABSTRACT Palliative care was initially developed for patients with advanced cancer. The concept has evolved and now encompasses any life-threatening chronic disease. Studies carried out to compare end-of-life symptoms have shown that although symptoms such as pain and dyspnea are as prevalent in patients with lung disease as in patients with cancer, the former receive less palliative treatment than do the latter. There is a need to refute the idea that palliative care should be adopted only when curative treatment is no longer possible. Palliative care should be provided in conjunction with curative treatment at the time of diagnosis, by means of a joint decision-making process; that is, the patient and the physician should work together to plan the therapy, seeking to improve quality of life while reducing physical, psychological, and spiritual suffering.


RESUMO Inicialmente os cuidados paliativos foram desenvolvidos para pacientes com câncer avançado. Hoje este conceito evoluiu e engloba qualquer doença crônica que ameace a vida. Estudos realizados para comparar os sintomas de fim de vida mostraram que os pacientes pneumológicos apresentavam a mesma prevalência de sintomas, como dor e dispneia, porém recebiam menos tratamento paliativo que os pacientes oncológicos. É preciso desmitificar a ideia de que cuidados paliativos só devem ser adotados quando não há mais possibilidade de tratamento curativo. O cuidado paliativo deve ser associado ao tratamento curativo no momento do diagnóstico, por meio de decisão compartilhada, isto é, paciente e médico planejam as decisões sobre a terapêutica a ser tomada, buscam a melhora na qualidade de vida e a redução do sofrimento, tanto espiritual como físico e psicológico.


Subject(s)
Humans , Palliative Care , Pulmonary Medicine , Dyspnea/therapy , Lung Diseases/therapy , Pain , Quality of Life , Pain Management , Lung Diseases/complications
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