Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 300
Filtrar
2.
Artigo em Inglês | MEDLINE | ID: mdl-39210531

RESUMO

BACKGROUND: Thoracic ultrasound (TUS) has garnered increased recognition, both in aiding pleural procedures and as a complement to physical examination. Operator ability is essential to obtain reliable findings. This study aimed to inquire pulmonology specialists and residents about their confidence with the technique and to determine future needs. METHODS: A self-administered online survey, including a total of 24 questions, was sent to pulmonology specialists and residents registered as members of the Portuguese Pulmonology Society. Participation was pseudoanonymized and voluntary. RESULTS: One hundred fourteen valid answers were obtained. Most responders had prior TUS training. The primary method for knowledge consolidation was unsupervised practice. The majority had an ultrasound machine available in their daily practice; only 17% performed TUS more than 3 times per week. Overall confidence in TUS usage for diagnostic purposes (median: 7/10), disease monitoring (median: 7/10), and invasive procedures (median: 8/10) were high. There was a significant relation between higher levels of confidence and regularly attending TUS courses and performing TUS more than 3 times per week. The main reasons cited as preventing regular use of TUS were the availability/cost of courses and the availability/cost of equipment. CONCLUSION: Regular TUS training and utilization are essential to boost user's confidence degree. Its use is already a regular feature in the daily practice of pulmonologists in Portugal, but further and better structured training is required to meet the needs of clinicians. The inclusion of mandatory TUS training in residency programs should be considered in the future.


Assuntos
Pneumologia , Pneumologistas , Ultrassonografia , Humanos , Portugal , Pneumologistas/educação , Pneumologia/educação , Ultrassonografia/estatística & dados numéricos , Ultrassonografia/métodos , Inquéritos e Questionários , Masculino , Competência Clínica/estatística & dados numéricos , Feminino , Padrões de Prática Médica/estatística & dados numéricos , Internato e Residência , Adulto , Pessoa de Meia-Idade
4.
Chron Respir Dis ; 21: 14799731241267305, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39075037

RESUMO

Considering a huge burden of chronic respiratory diseases (CRDs) in India, there is a need for locally relevant Pulmonary rehabilitation (PR) services. This cross-sectional survey was aimed to explore the interest, needs and challenges among various stakeholders for PR in Pune city, India. At the outpatient respiratory medicine department of a multi-speciality hospital in Pune, India, 403 eligible people with CRDs were invited to participate in the survey, of which 370 (92%) responded and agreed to participate. (220 males, mean ± SD age 56 ± 15 years). Out of the 370, 323 (87%) people with CRDs were keen to attend PR. In a multiple selection question, there was inclination towards paper-based manuals home-based (70%) and web-based (84%) programs. 207 healthcare providers (HCPs), including physicians, pulmonologists and physiotherapists involved in the care of people living with CRDs across Pune city were invited to participate in the survey. Out of the 207, (80%) of the HCPs believed that PR was an effective management strategy and highlighted the lack of information on PR and need for better understanding of PR (48%) and its referral process. The surveyed stakeholders are ready to take up PR, identifying specific needs around further knowledge of PR, modes of delivery, and referral processes, that could potentially feed the development of relevant PR programs in the Indian healthcare settings.


Assuntos
Participação dos Interessados , Humanos , Índia/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Adulto , Idoso , Inquéritos e Questionários , Avaliação das Necessidades , Doença Pulmonar Obstrutiva Crônica/reabilitação , Pneumologistas/estatística & dados numéricos , Atitude do Pessoal de Saúde , Fisioterapeutas/estatística & dados numéricos , Doença Crônica/reabilitação
5.
Clin Chest Med ; 45(3): 771-783, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39069337

RESUMO

Pediatric pulmonologists have the expertise to be advocates in many areas that affect the respiratory health of children. This article provides an overview of selected advocacy topics related to health equity and provides key examples that can improve child respiratory health in the clinical encounter and beyond.


Assuntos
Equidade em Saúde , Papel do Médico , Humanos , Criança , Pneumologistas , Defesa do Paciente , Pediatria/organização & administração , Pneumologia , Defesa da Criança e do Adolescente
6.
Reumatol Clin (Engl Ed) ; 20(6): 334-340, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38991827

RESUMO

INTRODUCTION: Interstitial lung disease is a leading cause of mortality in patients with systemic sclerosis. Currently, there is a lack of consensus regarding screening, rescreening, diagnosis, and follow-up practices in interstitial lung disease associated with systemic sclerosis (SSc-ILD) in Colombia. METHODS: A structured survey focused on clinical practices in patients with SSc-ILD was conducted. Members of the Asociación Colombiana de Neumología y Cirugía de Tórax (Asoneumocito) and the Asociación Colombiana de Reumatología (Asoreuma) were invited to participate from March 2023 to May 2023. RESULTS: We surveyed 51 pulmonologists and 44 rheumatologists. Overall, 51.6% reported having access to multidisciplinary team discussion in ILD. Among the 95 participants, 78.9% would routinely perform a high-resolution computed tomography scan of the chest once a diagnosis of systemic sclerosis was established. This practice is more frequent among rheumatologists (84.1%) than among pulmonologists (74.5%). Approximately half of the participants would rescreen patients annually with computed tomography scan (56.8%) if baseline images were negative. Spirometry (81.1%), diffusing capacity of the lung for carbon monoxide (80.0%), and 6-min walk test (55.8%) were the most frequently performed tests upon diagnosis of systemic sclerosis. During follow-up, participants would consider repeating pulmonary function tests mostly every 6 months. CONCLUSIONS: Screening of SSc-ILD is high among pulmonologists and rheumatologists. Decision-making on diagnosis and follow-up is similar between specialties, but there are variations in their frequency and indications. Further research is needed to evaluate how to adapt recommendations for assessing SSc-ILD in different settings.


Assuntos
Doenças Pulmonares Intersticiais , Padrões de Prática Médica , Pneumologistas , Reumatologistas , Escleroderma Sistêmico , Escleroderma Sistêmico/complicações , Humanos , Doenças Pulmonares Intersticiais/etiologia , Doenças Pulmonares Intersticiais/complicações , Colômbia , Padrões de Prática Médica/estatística & dados numéricos , Masculino , Pesquisas sobre Atenção à Saúde , Tomografia Computadorizada por Raios X , Feminino , Pessoa de Meia-Idade , Adulto
7.
Int J Chron Obstruct Pulmon Dis ; 19: 1207-1223, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38831892

RESUMO

Purpose: Chronic obstructive pulmonary disease (COPD) poses a significant global health burden despite being largely preventable and treatable. Despite the availability of guidelines, COPD care remains suboptimal in many settings, including high-income countries (HICs) and upper-middle-income countries (UMICs), with varied approaches to diagnosis and management. This study aimed to identify common and unique barriers to COPD care across six countries (Australia, Spain, Taiwan, Argentina, Mexico, and Russia) to inform global policy initiatives for improved care. Methods: COPD care pathways were mapped for each country and supplemented with epidemiological, health-economic, and clinical data from a targeted literature review. Semi-structured interviews with 17 respiratory care clinicians were used to further validate the pathways and identify key barriers. Thematic content analysis was used to generate the themes. Results: Six themes were common in most HICs and UMICs: "Challenges in COPD diagnosis", "Strengthening the role of primary care", "Fragmented healthcare systems and coordination challenges", "Inadequate management of COPD exacerbations", "Limited access to specialized care" and, "Impact of underfinanced and overloaded healthcare systems". One theme, "Insurance coverage and reimbursement challenges", was more relevant for UMICs. HICs and UMICs differ in patient and healthcare provider awareness, primary care involvement, spirometry access, and availability of specialized care. Both face issues with healthcare fragmentation, guideline adherence, and COPD exacerbation management. In addition, UMICs also grapple with resource limitations and healthcare infrastructure challenges. Conclusion: Many challenges to COPD care are the same in both HICs and UMICs, underscoring the pervasive nature of these issues. While country-specific issues require customized solutions, there are untapped possibilities for implementing global respiratory strategies that support countries to manage COPD effectively. In addition to healthcare system-level initiatives, there is a crucial need for political prioritization of COPD to allocate the essential resources it requires.


Assuntos
Atitude do Pessoal de Saúde , Acessibilidade aos Serviços de Saúde , Doença Pulmonar Obstrutiva Crônica , Pesquisa Qualitativa , Doença Pulmonar Obstrutiva Crônica/terapia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Humanos , Países em Desenvolvimento/economia , Atenção Primária à Saúde/normas , Países Desenvolvidos , Conhecimentos, Atitudes e Prática em Saúde , México/epidemiologia , Disparidades em Assistência à Saúde , Entrevistas como Assunto , Prestação Integrada de Cuidados de Saúde , Padrões de Prática Médica/normas , Pneumologistas , Argentina/epidemiologia , Fidelidade a Diretrizes , Taiwan/epidemiologia
8.
PeerJ ; 12: e17368, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38803582

RESUMO

Objective: During the COVID-19 pandemic, universal mask-wearing became one of the main public health interventions. Because of this, most physical examinations, including lung auscultation, were done while patients were wearing surgical face masks. The aim of this study was to investigate whether mask wearing has an impact on pulmonologist assessment during auscultation of the lungs. Methods: This was a repeated measures crossover design study. Three pulmonologists were instructed to auscultate patients with previously verified prolonged expiration, wheezing, or crackles while patients were wearing or not wearing masks (physician and patients were separated by an opaque barrier). As a measure of pulmonologists' agreement in the assessment of lung sounds, we used Fleiss kappa (K). Results: There was no significant difference in agreement on physician assessment of lung sounds in all three categories (normal lung sound, duration of expiration, and adventitious lung sound) whether the patient was wearing a mask or not, but there were significant differences among pulmonologists when it came to agreement of lung sound assessment. Conclusion: Clinicians and health professionals are safer from respiratory infections when they are wearing masks, and patients should be encouraged to wear masks because our research proved no significant difference in agreement on pulmonologists' assessment of auscultated lung sounds whether or not patients wore masks.


Assuntos
Auscultação , COVID-19 , Estudos Cross-Over , Máscaras , Sons Respiratórios , SARS-CoV-2 , Humanos , Máscaras/efeitos adversos , COVID-19/prevenção & controle , COVID-19/diagnóstico , Auscultação/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Pandemias/prevenção & controle , Pneumologistas , Idoso
9.
Clin Chest Med ; 45(2): 237-248, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38816085

RESUMO

The pericardium comprises a double-walled fibrous-serosal sac that encloses the heart. Reflections of the serosal layer form sinuses and recesses. With advances in multidetector computed tomography (CT) technology, pericardial recesses are frequently detected with thin-section CT. Knowledge of pericardial anatomy on imaging is crucial to avoid misinterpretation of fluid-filled pericardial sinuses and recesses as adenopathy/pericardial metastasis or aortic dissection, which can impact patient management and treatment decisions. The authors offer a comprehensive review of pericardial anatomy and its variations observed on CT, potential pitfalls in image interpretation, and implications for the pulmonologist with respect to unnecessary diagnostic procedures or interventions.


Assuntos
Pericárdio , Humanos , Pericárdio/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Pneumologistas , Tomografia Computadorizada Multidetectores/métodos
10.
Pediatr Pulmonol ; 59(6): 1708-1715, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38558404

RESUMO

INTRODUCTION: Advanced diagnostic bronchoscopy includes endobronchial ultrasound (EBUS) guided transbronchial lung and lymph node biopsies, CT navigation and robotic bronchoscopy. Interventional bronchoscopy refers to procedures performed for therapeutic purposes such as balloon dilation of the airway, tissue debulking, cryotherapy, removal of foreign bodies and insertion of endobronchial valves [1]. For adult patients, these procedures are standard of care [2, 3]. Despite a lack of formalized training, there are numerous case reports and case series describing the use of advanced diagnostic and interventional bronchoscopy techniques in children. The safety and feasibility of EBUS-TBNA, cryotherapy techniques, endobronchial valves among other techniques have been demonstrated in these publications [1, 4-9]. METHODS: We sought to better understand the current practices and perspectives on interventional and advanced bronchoscopy among pediatric pulmonologists through surveys sent to pediatric teaching hospitals across the United States. RESULTS: We received 43 responses representing 28 programs from 25 states. The highest bronchoscopy procedure volume occurred in the 0-5 years age group. Among our respondents, 31% self-identified as a pediatric interventional/advanced bronchoscopist. 79% believe that advanced and interventional training is feasible in pediatric pulmonology and 77% believe it should be offered to pediatric pulmonary fellows. DISCUSSION: This is the first study to characterize current practices and perspectives regarding advanced diagnostic and interventional bronchoscopy procedures among pediatric pulmonologists in the United States. Pediatric interventional pulmonology (IP) is in its infancy and its beginnings echo those of the adult IP where only certain centers were performing these procedures.


Assuntos
Broncoscopia , Pediatria , Pneumologistas , Broncoscopia/métodos , Broncoscopia/estatística & dados numéricos , Humanos , Estados Unidos , Pneumologistas/estatística & dados numéricos , Criança , Pediatria/educação , Inquéritos e Questionários , Pneumologia/educação , Padrões de Prática Médica/estatística & dados numéricos , Lactente , Pré-Escolar , Recém-Nascido
11.
Respir Care ; 69(8): 975-981, 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-38688545

RESUMO

BACKGROUND: Inhaler education for patients with asthma and patients with COPD is typically provided by non-pulmonologists. We studied inhaler education by pulmonologists to determine changes in clinical outcomes and inhaler use. METHODS: This was a retrospective study of 296 subjects diagnosed with asthma, COPD, or both that evaluated use of inhaler technique education and its impact on (1) inhaler/dosage change consisting of dosage change in the same class of inhaler and/or change in number of inhalers, (2) forced expiratory volume in one second/forced vital capacity (FEV1/FVC%), (3) disease symptom control, (4) out-patient visits, (5) urgent care visits (6) emergency department visits, and (7) hospital admissions. One group received inhaler technique education by a pulmonologist while the other group did not. RESULTS: The pulmonologist inhaler technique-educated group had significantly decreased relative risk for inhaler/dosage increase (relative risk 0.57 [95% CI 0.34-0.96], P = .03) and significantly increased odds for symptom control (odds ratio 2.15 [95% CI 1.24-3.74], P = .01) at 1-y follow-up as compared to the no education group. No differences occurred for FEV1/FVC%, out-patient visits, urgent care visits, emergency department visits, and hospital admissions. CONCLUSIONS: Pulmonologist education of inhaler technique for patients with asthma and patients with COPD was associated with decreased relative risk for inhaler/dosage increase and increased odds for symptom control. We recommend pulmonologists provide education of inhaler technique to patients with asthma and patients with COPD and not rely on non-pulmonologist education alone. Prospective research is needed to confirm the importance of proper inhaler techniques.


Assuntos
Asma , Nebulizadores e Vaporizadores , Educação de Pacientes como Assunto , Doença Pulmonar Obstrutiva Crônica , Pneumologistas , Humanos , Asma/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Feminino , Estudos Retrospectivos , Masculino , Educação de Pacientes como Assunto/métodos , Pessoa de Meia-Idade , Pneumologistas/educação , Administração por Inalação , Idoso , Volume Expiratório Forçado , Adulto , Broncodilatadores/administração & dosagem , Capacidade Vital , Hospitalização/estatística & dados numéricos , Assistência Ambulatorial/métodos
13.
14.
Rev Mal Respir ; 41(2): 102-109, 2024 Feb.
Artigo em Francês | MEDLINE | ID: mdl-38228440

RESUMO

INTRODUCTION: Despite evidence of the benefits of the written asthma action plans (WAP) in asthma control, they remain poorly applied. The aim of our study was to assess the practices of French-speaking pulmonologists and paediatricians in their use of WAP for asthma control and to analyse the contents of several WAPs routinely consulted in treatment of asthma patients. METHODS: Members of three French medical societies (SPLF, G2A, SP2A) were requested to share their WAPs for asthma patients and to participate in an online survey about the possible influence of these documents on their practices. RESULTS: Most (95%) of the 41 WAPs taken into consideration were symptom-based and 34% included peak expiratory flow measurement. All of these action plans were in full compliance with current guidelines. Among the 110 survey respondents, while 65% systematically provided a WAP to their asthma patients, only 30% often or always supplemented the written document with therapeutic education sessions. In almost every case, it was the doctor who presented the WAP to the patient, generally devoting to less than 10minutes to explanation of what they were handing out. CONCLUSIONS: In France, WAPs are generally presented to the patient by the physician, which probably limits the time devoted to explanation of their contents. Furthermore, WAPs are rarely reinforced with therapeutic education. The current study suggests ways of improving the utilization of WAPs in asthma care and treatment.


Assuntos
Asma , Pneumologistas , Humanos , Asma/terapia , Asma/tratamento farmacológico , Cooperação do Paciente , Autocuidado , França/epidemiologia
15.
Rev Mal Respir ; 41(1): 1-17, 2024 Jan.
Artigo em Francês | MEDLINE | ID: mdl-37980184

RESUMO

INTRODUCTION: Ultrasonography is an emerging tool that helps to assess diaphragmatic function. It is now widely used in ICUs to predict weaning from mechanical ventilation. Ultrasonography is readily available, harmless (no radiation), and repeatable with good interoperator reproducibility. Over the past few years, ultrasonography has seen increasing use in patients with chronic pulmonary pathologies. STATE OF THE ART: The aim of this review is (1) to describe the ultrasound techniques used to assess diaphragmatic excursion and thickening, (2) to indicate the expected, normal values in healthy patients, and (3) to summarize the main findings and clinical applications in treatment of chronic respiratory disorders. CONCLUSIONS: Chronic pulmonary diseases are associated with diaphragmatic dysfunction that can be assessed with ultrasound. Diaphragmatic dysfunction is primary in neuromuscular disorders and secondary to respiratory disease in other chronic pulmonary conditions (COPD, ILD). Ultrasound is correlated with the severity of the underlying disease (functional and clinical parameters). PERSPECTIVES: The prognostic interest of diaphragm ultrasonography remains to be established, after which its utilization should become routine.


Assuntos
Diafragma , Pneumologistas , Humanos , Diafragma/diagnóstico por imagem , Reprodutibilidade dos Testes , Pulmão , Ultrassonografia/métodos
16.
Thorax ; 79(5): 476-485, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38123347

RESUMO

Significant inconsistencies in respiratory care provision for Duchenne muscular dystrophy (DMD) are reported across different specialist neuromuscular centres in the UK. The absence of robust clinical evidence and expert consensus is a barrier to the implementation of care recommendations in public healthcare systems as is the need to increase awareness of key aspects of care for those living with DMD. Here, we provide evidenced-based and/or consensus-based best practice for the respiratory care of children and adults living with DMD in the UK, both as part of routine care and in an emergency. METHODOLOGY: Initiated by an expert working group of UK-based respiratory physicians (including British Thoracic Society (BTS) representatives), neuromuscular clinicians, physiotherapist and patient representatives, draft guidelines were created based on published evidence, current practice and expert opinion. After wider consultation with UK respiratory teams and neuromuscular services, consensus was achieved on these best practice recommendations for respiratory care in DMD. RESULT: The resulting recommendations are presented in the form of a flow chart for assessment and monitoring, with additional guidance and a separate chart setting out key considerations for emergency management. The recommendations have been endorsed by the BTS. CONCLUSIONS: These guidelines provide practical, reasoned recommendations for all those managing day-to-day and acute respiratory care in children and adults with DMD. The hope is that this will support patients and healthcare professionals in accessing high standards of care across the UK.


Assuntos
Distrofia Muscular de Duchenne , Criança , Adulto , Humanos , Distrofia Muscular de Duchenne/terapia , Pessoal de Saúde , Pneumologistas , Reino Unido
17.
Med J Malaysia ; 78(6): 751-755, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38031216

RESUMO

INTRODUCTION: Ultrasound guided lung biopsy (USLB) is a minimally invasive diagnostic tool with short examination time and real-time monitoring conducted bedside for accurate diagnosis in order to provide the best treatment. However, it is not widely performed by pulmonologists. We aim to explicate the efficacy and safety of USLB led by pulmonologists. The objective of this study is to assess safety and efficacy of USLB performed by pulmonologists in an outpatient setting. MATERIALS AND METHODS: We retrospectively enrolled patients who underwent the procedure from January 2018 to April 2022. Under real time ultrasound (Hitachi Medical ProSound F37), thoracic lesions adjacent to the chest wall were sampled with a full-core biopsy needle (CT Core Single Action Biopsy Device, 18G × 15 cm, Vigeo, Italy). Chest x-ray was performed 30 minutes post procedure ruling out pneumothorax. Patients were discharged home 1-2 hours post biopsy. Data was analysed using Microsoft Excel 2010 and Statistical Package for Social Science (SPSS) Version 26. RESULTS: A total of 18 patients (14 males, 4 females) underwent USLB for lung tumours. Biopsies were histologically deemed adequate with an overall diagnostic yield of 77.8% (14/18). A total of 57% were positive for thoracic malignancy (21% squamous cell carcinoma, 21% adenocarcinoma, 15% small cell carcinoma) and another 43% were positive for extra thoracic malignancy (1 hepatocellular carcinoma, 2 DLBCL, 1 Hodgkin's lymphoma, 1 seminoma, 1 thymoma). Four patients had inconclusive results but managed to get positive results from surgical or lymph node biopsy (thymoma and adenocarcinoma). Statistical analysis showed more than two passes are needed to achieve a positive HPE yield (p value<0.05). There were nil complications to all the cases done. CONCLUSIONS: USLB can safely and effectively be performed by trained pulmonologists with excellent accuracy and low complication rate in outpatients.


Assuntos
Adenocarcinoma , Neoplasias Pulmonares , Neoplasias Torácicas , Timoma , Neoplasias do Timo , Masculino , Feminino , Humanos , Estudos Retrospectivos , Pneumologistas , Timoma/patologia , Malásia , Tomografia Computadorizada por Raios X , Pulmão/diagnóstico por imagem , Pulmão/patologia , Biópsia Guiada por Imagem/efeitos adversos , Biópsia Guiada por Imagem/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Adenocarcinoma/patologia , Neoplasias do Timo/patologia , Ultrassonografia de Intervenção
19.
Medicina (Kaunas) ; 59(10)2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37893587

RESUMO

Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare chronic disease of the small pulmonary arteries that causes right heart failure and death. Accurate management of PAH is necessary to decrease morbidity and mortality. Understanding current practices and perspectives on PAH is important. For this purpose, we intended to determine physicians' knowledge, attitudes, and practice patterns in adult pulmonary arterial hypertension (PAH) in Turkey. Materials and Methods: Between January and February 2022, an online questionnaire was sent via e-mail to all cardiologists and pulmonologists who were members of the Turkish Society of Cardiology (TSC) and the Turkish Thoracic Society (TTS). Results: A total of 200 physicians (122 pulmonologists and 78 cardiologists) responded to the questionnaire. Cardiologists were more frequently involved in the primary diagnosis and treatment of PAH than pulmonologists (37.2% vs. 23.8%, p = 0.042). More than half of the physicians had access to right heart catheterization. In mild/moderate PAH patients with a negative vasoreactivity test, the monotherapy option was most preferred (82.8%) and endothelin receptor antagonists (ERAs) were the most preferred group in these patients (73%). ERAs plus phosphodiesterase-5 inhibitors (PDE-5 INH) were the most preferred (69%) combination therapy, and prostacyclin analogues plus PDE-5 INH was preferred by only pulmonologists. Conclusions: Overall, clinical management of patients with PAH complied with guideline recommendations. Effective clinical management of PAH in specialized centers that having right heart catheterization achieve better outcomes.


Assuntos
Cardiologistas , Hipertensão Pulmonar , Hipertensão Arterial Pulmonar , Adulto , Humanos , Hipertensão Arterial Pulmonar/complicações , Hipertensão Arterial Pulmonar/tratamento farmacológico , Hipertensão Pulmonar/etiologia , Pneumologistas , Conhecimentos, Atitudes e Prática em Saúde , Turquia , Inibidores da Fosfodiesterase 5/uso terapêutico
20.
Rev Med Suisse ; 19(847): 1974-1977, 2023 Oct 25.
Artigo em Francês | MEDLINE | ID: mdl-37878096

RESUMO

Asthma, a chronic inflammatory lung disease affecting about 10 % of the population, involves both the general internist and the pulmonologist. The risk of over and underdiagnosis generates significant health costs and evitable clinical consequences. Improved screening through dedicated anamneses and questionnaires, as well as use of fractional exhaled nitric oxide (FeNO) may improve the diagnosis of asthma in general internal medicine.


L'asthme, maladie pulmonaire inflammatoire chronique affectant environ 10 % de la population, implique autant la médecine interne générale (MIG) que la pneumologie. Les risques de sous- et surdiagnostic engendrent d'importants coûts et conséquences cliniques évitables. Améliorer le dépistage lors de l'anamnèse avec l'utilisation de questionnaires dédiés et lors des examens fonctionnels par l'utilisation de la mesure de la fraction exhalée de l'oxyde nitrique pourrait être la clé d'un meilleur diagnostic de l'asthme en MIG.


Assuntos
Asma , Médicos , Humanos , Asma/diagnóstico , Medicina Interna , Custos de Cuidados de Saúde , Pneumologistas
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA