RESUMEN
Bronchiectasis in adults is a chronic disorder associated with poor quality of life and frequent exacerbations in many patients. There have been no previous international guidelines.The European Respiratory Society guidelines for the management of adult bronchiectasis describe the appropriate investigation and treatment strategies determined by a systematic review of the literature.A multidisciplinary group representing respiratory medicine, microbiology, physiotherapy, thoracic surgery, primary care, methodology and patients considered the most relevant clinical questions (for both clinicians and patients) related to management of bronchiectasis. Nine key clinical questions were generated and a systematic review was conducted to identify published systematic reviews, randomised clinical trials and observational studies that answered these questions. We used the GRADE approach to define the quality of the evidence and the level of recommendations. The resulting guideline addresses the investigation of underlying causes of bronchiectasis, treatment of exacerbations, pathogen eradication, long term antibiotic treatment, anti-inflammatories, mucoactive drugs, bronchodilators, surgical treatment and respiratory physiotherapy.These recommendations can be used to benchmark quality of care for people with bronchiectasis across Europe and to improve outcomes.
Asunto(s)
Humanos , Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Bronquiectasia/tratamiento farmacológico , Bronquiectasia/cirugía , Broncodilatadores/uso terapéutico , Modalidades de FisioterapiaRESUMEN
This study describes the profile of noncognitive symptoms in Chilean AD patients and its effects on the caregiver's mental health. In a sample of 26 urban dwelling AD patients, 21 of them women, age range 63-90 years, diagnosed using NINCDS-ADRDA, the intensity and frequency of noncognitive symptoms and caregivers distress was assessed using NPI. Seventeen caregivers were first degree relatives. The most prevalent symptoms were apathy, irritability, and anxiety. The least were euphoria, hallucinations, and disinhibition. The most stressful conditions were disinhibition and agitation: the best well-tolerated were euphoria and anxiety. Caregivers responded most frequently with feelings of concern and depression. Few of them reported to be ashamed. These results may reflect cultural differences and represents the first description of this reality in Chile.