ABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Pneumothorax/complications , Pneumothorax/diagnostic imaging , Arthritis, Rheumatoid/therapy , Oxygen Inhalation Therapy/methods , Subcutaneous Emphysema/etiology , Mediastinal Emphysema/etiology , Suction , Risk Factors , Pleura/diagnostic imaging , Pleura/pathology , Tomography, X-Ray ComputedABSTRACT
No disponible
Subject(s)
Humans , Tobacco Industry/ethics , Tobacco Use Disorder/prevention & control , Electronic Nicotine Delivery Systems/adverse effects , Legislation as Topic , Smoking/prevention & control , Tobacco Use Cessation/methods , Smoking PreventionABSTRACT
No disponible
Subject(s)
Humans , Education, Medical, Graduate/trends , Internship and Residency/trends , Specialization/trends , Professional Competence , Professional Review Organizations/trendsABSTRACT
Los grupos de control y tratamiento del tabaquismo de ALAT y SEPAR han colaborado para la realización de este documento en el que se da respuesta, siguiendo metodología PICO, a diferentes interrogantes relacionados con la asistencia sanitaria para ayudar a dejar de fumar a los pacientes con EPOC. Sus principales recomendaciones son: a)evidencia moderada y recomendación fuerte para realizar espirometría en pacientes con diagnóstico o en fumadores con alto riesgo de padecer EPOC, como instrumento de motivación, en particular evidenciando la edad pulmonar, y con fines diagnósticos y de búsqueda activa de casos; b)evidencia alta y recomendación fuerte para utilizar asesoramiento conductual intenso y específico y tratamiento farmacológico para ayudar a dejar de fumar a fumadores con EPOC; c)evidencia alta y recomendación fuerte para iniciar intervenciones para ayudar a dejar de fumar a fumadores con EPOC mientras se encuentran hospitalizados mejorando al mantener la intervención tras el alta, y d)evidencia alta y recomendación fuerte para la financiación del tratamiento del tabaquismo en fumadores con EPOC por su impacto sobre la salud y la economía de la salud (AU)
The ALAT and SEPAR Treatment and Control of Smoking Groups have collaborated in the preparation of this document which attempts to answer, by way of PICO methodology, different questions on health interventions for helping COPD patients to stop smoking. The main recommendations are: (I) moderate-quality evidence and strong recommendation for performing spirometry in COPD patients and in smokers with a high risk of developing the disease, as a motivational tool (particularly for showing evidence of lung age), a diagnostic tool, and for active case-finding; (II) high-quality evidence and strong recommendation for using intensive dedicated behavioral counselling and drug treatment for helping COPD patients to stop smoking; (III)high-quality evidence and strong recommendation for initiating interventions for helping COPD patients to stop smoking during hospitalization with improvement when the intervention is prolonged after discharge, and (IV) high-quality evidence and strong recommendation for funding treatment of smoking in COPD patients, in view of the impact on health and health economics (AU)
Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/complications , Tobacco Use Disorder/epidemiology , Smoking Cessation/methods , Spirometry , Respiratory Function Tests , Guidelines as Topic , OximetryABSTRACT
No disponible
Subject(s)
Humans , Pulmonary Medicine/trends , Environmental Pollution , Smoking/epidemiology , Anniversaries and Special Events , Disease PreventionSubject(s)
Education, Medical, Graduate/legislation & jurisprudence , Pulmonary Medicine/education , Specialization/legislation & jurisprudence , Curriculum , Education, Medical, Graduate/methods , Education, Medical, Graduate/organization & administration , Humans , Pulmonary Medicine/legislation & jurisprudence , SpainABSTRACT
The ALAT and SEPAR Treatment and Control of Smoking Groups have collaborated in the preparation of this document which attempts to answer, by way of PICO methodology, different questions on health interventions for helping COPD patients to stop smoking. The main recommendations are: (i)moderate-quality evidence and strong recommendation for performing spirometry in COPD patients and in smokers with a high risk of developing the disease, as a motivational tool (particularly for showing evidence of lung age), a diagnostic tool, and for active case-finding; (ii)high-quality evidence and strong recommendation for using intensive dedicated behavioral counselling and drug treatment for helping COPD patients to stop smoking; (iii)high-quality evidence and strong recommendation for initiating interventions for helping COPD patients to stop smoking during hospitalization with improvement when the intervention is prolonged after discharge, and (iv)high-quality evidence and strong recommendation for funding treatment of smoking in COPD patients, in view of the impact on health and health economics.
Subject(s)
Evidence-Based Medicine/methods , Pulmonary Disease, Chronic Obstructive/psychology , Smoking Cessation/psychology , Smoking/psychology , Spirometry/psychology , Biomarkers , Bupropion/economics , Bupropion/therapeutic use , Clinical Trials as Topic , Cost-Benefit Analysis , Counseling/economics , Counseling/methods , Humans , Motivation , Nicotine/economics , Nicotine/therapeutic use , Nicotinic Agonists/economics , Nicotinic Agonists/therapeutic use , Pulmonary Disease, Chronic Obstructive/physiopathology , Randomized Controlled Trials as Topic , Smoking/drug therapy , Smoking/economics , Smoking/therapy , Smoking Cessation/economics , Smoking Cessation/methods , Surveys and Questionnaires , Varenicline/economics , Varenicline/therapeutic useABSTRACT
No disponible
Subject(s)
Humans , Community-Acquired Infections/epidemiology , Pneumonia/epidemiology , Severity of Illness Index , Risk AdjustmentSubject(s)
Community-Acquired Infections/epidemiology , Pneumonia, Bacterial/epidemiology , Pneumonia, Viral/epidemiology , Community-Acquired Infections/therapy , Comorbidity , Disease Outbreaks , Hospital Mortality/trends , Hospitalization/statistics & numerical data , Humans , Morbidity/trends , Pneumonia, Bacterial/therapy , Pneumonia, Viral/therapy , Risk Assessment , Severity of Illness IndexABSTRACT
Los objetivos del estudio son estimar la prevalencia del hábito tabáquico entre los socios y las actitudes e intervenciones sobre tabaquismo que realizan los miembros SEPAR ante sus pacientes. Se realizó una encuesta on line, a la que respondieron 640 socios (496 neumólogos, 45 enfermeras, 34 cirujanos torácicos, 37 fisioterapeutas y 28 profesionales de otras especialidades). El 5% de los socios encuestados confiesan ser fumadores: neumólogos 3,4%; enfermería 8,9%; cirujanos torácicos 8,8%; fisioterapeutas 13,5%. El 96% de los socios dan mucha o bastante importancia a la función modélica. El 98% de los socios preguntan siempre o a menudo a sus pacientes sobre el consumo de tabaco. La intervención más eficaz para tratar el tabaquismo para un 77% de los socios es el uso de fármacos, combinado con soporte psicológico. Estos resultados son un exponente de la firme sensibilización e implicación que los miembros SEPAR tienen frente al tabaquismo
The aims of this study were to estimate the prevalence of smoking among SEPAR members, and their approach to smoking cessation in their patients. An online survey was completed by 640 members (496 pulmonologists, 45 nurses, 34 thoracic surgeons, 37 physiotherapists, and 28 other specialists). Of the members interviewed, 5% confessed that they were smokers: 3.5% pulmonologists; 8.9% nurses; 8.8% thoracic surgeons, and 13.5% physiotherapists. A total of 96% of members assign a lot or quite a lot of importance to setting an example; 98% of members always or often ask their patients about their smoking habit. The most effective anti-smoking intervention, according to 77% of members, is a combination of drugs and psychological support. These results are an indicator of the awareness and commitment of SEPAR members to smoking and its cessation
Subject(s)
Humans , Male , Female , Health Knowledge, Attitudes, Practice , Tobacco Smoke Pollution/prevention & control , Tobacco Smoke Pollution/statistics & numerical data , Smoking/epidemiology , Health Personnel/statistics & numerical data , Societies, Medical/organization & administration , Societies, Medical/statistics & numerical data , Social Support , Analysis of Variance , Surveys and Questionnaires , Public Health/methodsABSTRACT
No disponible
Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/etiology , Pulmonary Disease, Chronic Obstructive/prevention & control , Smoking/adverse effects , Smoking/prevention & control , Nicotiana/adverse effects , Nicotiana/toxicity , Tobacco Use Disorder/complications , Tobacco Use Disorder/prevention & control , Smoking Cessation/methodsABSTRACT
The aims of this study were to estimate the prevalence of smoking among SEPAR members, and their approach to smoking cessation in their patients. An online survey was completed by 640 members (496 pulmonologists, 45 nurses, 34 thoracic surgeons, 37 physiotherapists, and 28 other specialists). Of the members interviewed, 5% confessed that they were smokers: 3.5% pulmonologists; 8.9% nurses; 8.8% thoracic surgeons, and 13.5% physiotherapists. A total of 96% of members assign a lot or quite a lot of importance to setting an example; 98% of members always or often ask their patients about their smoking habit. The most effective anti-smoking intervention, according to 77% of members, is a combination of drugs and psychological support. These results are an indicator of the awareness and commitment of SEPAR members to smoking and its cessation.
Subject(s)
Attitude of Health Personnel , Health Knowledge, Attitudes, Practice , Pulmonary Medicine , Smoking/epidemiology , Societies, Medical , Thoracic Surgery , Adult , Counseling , Female , Health Behavior , Humans , Male , Middle Aged , Nurses/psychology , Physical Therapists/psychology , Physicians/psychology , Prevalence , Pulmonary Medicine/organization & administration , Smoking/legislation & jurisprudence , Smoking/psychology , Smoking Cessation/psychology , Smoking Prevention/legislation & jurisprudence , Spain , Surveys and Questionnaires , Thoracic Surgery/organization & administration , Tobacco Use Disorder/epidemiology , Tobacco Use Disorder/psychologyABSTRACT
La neumonía adquirida en la comunidad (NAC) es una enfermedadinfecciosa respiratoria aguda que tiene una incidenciade 3 - 8 casos/1.000 habitantes, y aumenta con la edad y lascomorbilidades. El neumococo es el microorganismo más frecuentementeimplicado en la NAC en los adultos (30 - 35%).El 40% de los pacientes con NAC requieren ingreso hospitalarioy alrededor del 10% necesitan ser admitidos en una unidadde cuidados intensivos (UCI). Las formas más graves de infecciónneumocócica se incluyen en la enfermedad neumocócicainvasiva (ENI), que agrupa a los casos de bacteriemia (asociadaso no a neumonía), meningitis, pleuritis, artritis, peritonitisprimaria y pericarditis.En la actualidad, el mayor problema con el neumococo es laaparición de resistencias a los agentes antimicrobianos y suelevada morbimortalidad, a pesar del uso de antibióticos apropiadosy de un tratamiento médico correcto. Ciertas condicionesmédicas subyacentes aumentan el riesgo de ENI y de suscomplicaciones, destacando, desde el punto de vista neumoló-gico, el tabaquismo y las enfermedades respiratorias crónicas La enfermedad neumocócica, según la OMS, es la primeracausa de muerte prevenible en el mundo en niños y adultos.Entre las estrategias para prevenir la ENI se encuentra la vacunación.La OMS considera esencial y prioritaria su introduccióne implementación considera esencial y prioritaria su intro-ducción e implementación frente al neumococo, de forma universal, en todos los países. Actualmente disponemos de 2 vacunas antineumocócicas para el adulto: la polisacárida de 23 serotipos (VNP23) y la conjugada de 13 serotipos (VNC13).Las sociedades científicas aquí representadas han trabajado para elaborar unas recomendaciones, basadas en la evidencia científica actual, respecto a la vacunación antineumocócica en el adulto inmunocompetente con enfermedad respiratoria crónica y en fumadores con riesgo de padecer ENI
Subject(s)
Humans , Pneumococcal Infections/prevention & control , Pneumonia, Pneumococcal/prevention & control , Pneumococcal Vaccines/administration & dosage , /prevention & control , Streptococcus pneumoniae/pathogenicity , Community-Acquired Infections/prevention & control , Respiratory Tract Diseases , Chronic Disease , Pulmonary Disease, Chronic Obstructive , Asthma , SmokingABSTRACT
No disponible
Subject(s)
Humans , Pneumonia/classification , Cross Infection , Risk Factors , Hospitalization/statistics & numerical dataABSTRACT
OBJECTIVE: The COPD Assessment Test (CAT) has been proposed for assessing health status in COPD, but little is known about its longitudinal changes. The objective of this study was to evaluate 1-year CAT variability in patients with stable COPD and to relate its variations to changes in other disease markers. METHODS: We evaluated the following variables in smokers with and without COPD at baseline and after 1 year: CAT score, age, sex, smoking status, pack-year history, BMI, modified Medical Research Council (mMRC) scale, 6-min walk distance (6MWD), lung function, BODE (BMI, obstruction, dyspnea, exercise capacity) index, hospital admissions, Hospital and Depression Scale, and the Charlson comorbidity index. In patients with COPD, we explored the association of CAT scores and 1-year changes in the studied parameters. RESULTS: A total of 824 smokers with COPD and 126 without COPD were evaluated at baseline and 441 smokers with COPD and 66 without COPD 1 year later. At 1 year, CAT scores for patients with COPD were similar (± 4 points) in 56%, higher in 27%, and lower in 17%. Of note, mMRC scale scores were similar (± 1 point) in 46% of patients, worse in 36%, and better in 18% at 1 year. One-year CAT changes were best predicted by changes in mMRC scale scores (ß-coefficient, 0.47; P < .001). Similar results were found for CAT and mMRC scale score in smokers without COPD. CONCLUSIONS: One-year longitudinal data show variability in CAT scores among patients with stable COPD similar to mMRC scale score, which is the best predictor of 1-year CAT changes. Further longitudinal studies should confirm long-term CAT variability and its clinical applicability. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.
Subject(s)
Exercise Tolerance/physiology , Health Status , Pulmonary Disease, Chronic Obstructive/diagnosis , Risk Assessment/methods , Exercise Test , Follow-Up Studies , Morbidity/trends , Prognosis , Prospective Studies , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/physiopathology , Severity of Illness Index , Spain/epidemiology , Time FactorsABSTRACT
Las enfermedades respiratorias crónicas con frecuencia provocan alteraciones en las funciones y/o en la estructura del aparato respiratorio que condicionan limitaciones en diferentes actividades de la vida de las personas que las padecen. En los pacientes más jóvenes y con una vida laboral activa estas limitaciones pueden suponer dificultades para el desempeño de su trabajo habitual. El artículo 41 de la Constitución Española establece que «los poderes públicos mantendrán un régimen público de Seguridad Social para todos los ciudadanos que garantice la asistencia y prestaciones sociales suficientes en casos de necesidad». En este marco se encuadra la evaluación de la incapacidad laboral como un proceso de naturaleza mixta (médico-legal) que tiene por objeto determinar si procede o no el reconocimiento del derecho a una prestación que sustituya las rentas que deja de percibir una persona al no poder desempeñar su trabajo, como consecuencia de una pérdida de la salud. El papel de neumólogo es imprescindible en la evaluación del diagnóstico, tratamiento, pronóstico y capacidad funcional de los enfermos respiratorios. Estas recomendaciones tratan de acercar el complejo ámbito de la valoración de la capacidad laboral a los neumólogos y cirujanos torácicos, ofreciendo unas pautas de actuación que les permitan asesorar a sus propios pacientes acerca de su incorporación a la vida laboral (AU)
Chronic respiratory diseases often cause impairment in the functions and/or structure of the respiratory system, and impose limitations on different activities in the lives of persons who suffer them. In younger patients with an active working life, these limitations can cause problems in carrying out their normal work. Article 41 of the Spanish Constitution states that the public authorities shall maintain a public Social Security system for all citizens guaranteeing adequate social assistance and benefits in situations of hardship. Within this framework is the assessment of fitness for work, as a dual-nature process (medico-legal) that aims to determine whether it is appropriate or not to recognize a person's right to receive benefits which replace the income that they no longer receive as they cannot carry out their work, due to loss of health. The role of the pulmonologist is essential in evaluating the diagnosis, treatment, prognosis, and functional capacity of respiratory patients. These recommendations seek to bring the complex setting of fitness for work evaluation to pulmonologists and thoracic surgeons, providing action guidelines that allow them to advise their own patients about their incorporation into working life (AU)
