ABSTRACT
La sarcoidosis es una enfermedad multisistémica presente a nivel mundial que se caracteriza por el compromiso pulmonar y mediastinal en la mayoría de los pacientes. Para confirmar el diagnóstico, es importante contar con una biopsia que demuestre granulomas no caseificantes y la exclusión de otros diagnósticos diferenciales. Por lo tanto, la selección del método diagnostico para la confirmación histológica juega un rol fundamental en estos pacientes. Es así como, en los últimos años, el ultrasonido endoscópico bronquial (EBUS) ha mostrado ser un método seguro y con un alto rendimiento diagnóstico que debe considerarse en el abordaje de esta patología cuando existe compromiso mediastinal.
Sarcoidosis is a multisystemic disease present worldwide that is characterized by pulmonary and mediastinal involvement in most patients. To confirm the diagnosis, it is important to have a biopsy showing non-caseating granulomas and the exclusion of other differential diagnoses. Therefore, the selection of the diagnostic method for histological confirmation plays a fundamental role in these patients. Thus, in recent years, endoscopic bronchial ultrasound (EBUS) has shown to be a safe method with a high diagnostic yield that should be considered in the approach to this pathology when there is mediastinal involvement.
Subject(s)
Humans , Sarcoidosis , Ultrasonics , DiagnosisABSTRACT
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
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.
