Assessment of the degree of asthma control in a primary care center Achieve a good clinical control by reducing symptoms and management of modifiable risk factors for exacerbations is the main goal of asthma treatment. Our objective was to assess the degree of clini-tRAbAjo oRiginAl introducción el objetivo actual del tratamiento del asma consiste en alcanzar y mantener el control clínico de la enfermedad 1 , el que se compone de dos dominios: a) el control de síntomas y limitaciones del paciente y b) el manejo de los riesgos de mala evolución futura, que incluye las exacerbaciones, el desarrollo de obstrucción fija al flujo de aire y las reacciones adversas a los medicamentos 2 . el nivel de control se refiere al estado actual de la enfermedad, el que puede variar marcadamente en períodos cortos de tiempo y refleja más directamente la efectividad de las intervenciones terapéuticas 3 . Como tanto los pacientes como los médicos tratantes generalmente sobrestiman el grado de control de la enfermedad 4 , se han desarrollado una serie de herramientas simples de aplicar en la práctica diaria para identificar a los pacientes con asma mal controlada. las más utilizadas son los cuestionarios de GINA, el aCQ (Asthma Control Questionnaire) y el aCT (Asthma Control Test) 5 . en cuanto a la reducción de los riesgos futuros, el riesgo de desarrollar exacerbaciones es el más importante debido su asociación con mayor
Clinical profile of patients admitted to a CoPd program in a primary care setting during 10 years Our objective was to determine the clinical profile of patients admitted to the COPD program of CESFAM Silva Henríquez of Puente Alto, Chile, between 2004 and 2014. We analyzed the clinical and spirometric data of medical and controls records as being admitted to the program. The predicted FEV 1 percentage average of the 65 patients analyzed was 76.6%. 47.7% had mild, 40% moderate and 12.3% severe COPD. The patients were 62 years-old in average, 55.4% were women, 78.5% had smoking history, 73.6% had been exposed to wood and/or coal combustion (50.1% to both), 61.5% had some comorbidity (90% cardiovascular). 40% were under monotherapy with short-acting bronchodilator (BDc) and 50.7% received dual therapy with BDc and inhaled corticosteroid. Our COPD patients were predominantly women over 60 years old, exposed to tobacco and biomass and most of them had cardiovascular comorbidities.
Marijuana use has increased in Chile in recent years, particularly in teenagers and young people. It seems to be a general perception that its use does not involve great risks. The current discussion on the legalization of marijuana should make the necessary distinction between medical and recreational use of it. There are few indications approved by international health agencies for medicinal use, all of them with synthetic derivatives and oral administration, and countless other indications based mostly on studies with serious methodological flaws. The recreational use of marijuana, in addition to the widely known psychosocial deleterious effects, induce on the respiratory system the onset of chronic respiratory symptoms, airway inflammation and immunomodulatory effects. Depending on the exposure time and amount, use of marijuana has been associated with adverse effects on pulmonary function, development of COPD and lung cancer. Therefore, the recreational use without restriction of this drug could have adverse impact on personal and public health, so then the free use of marijuana should not be recommended. ResumenEl consumo de marihuana ha aumentado en Chile en los últimos años, especialmente en jóvenes y adolescentes y pareciera existir una percepción general de que su uso no conlleva mayores riesgos. La discusión actual sobre la legalización de la marihuana debe hacer la distinción necesaria entre uso medicinal y uso recreacional de ella. Existen escasas indicaciones aprobadas por los organismos de salud internacionales para su uso medicinal, todas ellas con derivados sintéticos de administración oral, y un sinnúmero de otras indicaciones basadas en su gran mayoría en estudios que adolecen de serias deficiencias metodológicas. El uso recreacional de marihuana, además de los efectos psicosociales deletéreos ampliamente conocidos, induce sobre el sistema respiratorio la aparición de síntomas crónicos de la vía aérea, inflamación local y efectos inmunomoduladores y, dependiendo del tiempo y cantidad de exposición, se ha asociado con efectos negativos sobre la función pulmonar, desarrollo de EPOC y de cáncer pulmonar. Por tanto, el uso recreacional sin restricción de esta droga podría tener a futuro gran impacto desfavorable sobre la salud personal y la salud pública, por lo que no debería recomendarse el consumo libre de la marihuana.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.