Etiología y factores pronósticos de la neumonía adquirida en la comunidad en el adulto hospitalizado, Puerto Montt, Chile (Rev Méd Chile 2006; 134: 597-605

(Rev Méd Chile 2004; 132: 588-94).

Community-acquired pneumonia in the elderly. Clinical and nutritional aspects Background: Community acquired pneumonia (CAP) in the elderly has unique features and there is little information about the effects of nutrition status on its outcome. Aim: To assess the clinical manifestations and prognostic factors of CAP in immunocompetent elderly patients requiring hospitalization. Patients and methods: Prospective study of all patients with CAP, admitted to Puerto Montt Hospital, Chile over one year. Epidemiological and clinical information and laboratory results were recorded. A nutritional assessment was also performed. Outcomes of elderly (>65 years) and young patients were compared. Results: Two hundred patients aged 63±19 years were studied. Of these, 109 were older than 65 years (78.4±8 years) and 91 were younger than 65 years (45.5±11 years). Multiple associated diseases, altered mental status, absence of fever, malnutrition and mortality were more common in the older group. Suspected aspiration pneumonia was more common in younger patients, probably related to alcoholism. Malnutrition was associated with longer hospital stay and mortality at any age. An univariate analysis showed that a low serum albumin (<3.4 g/dl) and a mid arm muscle circumference below the 25 th percentile were associated with higher mortality. Conclusions: CAP in the elderly has specific features and malnutrition is associated with a worse prognosis in young and elderly patients (Rev Méd Chile 2008; 136: 587-93).

No abstract

Report of a bronchial asthma control program in Puerto Montt, Chile Asthma is a disease with a variable clinical behaviour and usually insufficiently treated and managed. Methods: An Asthma Control Program was implemented in Puerto Montt, Chile, with the out patient participation of the primary medical care system. This Program classifies the asthmatic patients by using preestablished criteria of severity. We analyzed the evolution of 135 patients through six quarterly medical controls covering 18 months of follow up. Results: Patients diminished progressively and significantly their severity levels and their daily and nocturnal symptoms. Besides a significant increase of physical capacity (p = 0.001) and peak expiratory flow (PEF) (p = 0.0001) was observed. A series of severe asthmatic patients (12.5%) was identified. This group concentrated most of the emergency consultations and hospitalizations. Conclusions: An organized management of asthmatic patients has allowed us to show objectively clinical improvements in these patients after entering to this program.