Varón de 85 años con esputo hemoptoico / No disponible

La hemoptisis es un motivo de consulta frecuente en Atención Primaria y su causa más común es la infecciosa. Habitualmente las bronquitis dan lugar a hemoptisis leve y las bronquiectasias a hemoptisis moderada o grave. En el mundo occidental, las neoplasias son también causa frecuente de hemoptisis moderadas, leves o de repetición. Ante todo episodio de hemoptisis es fundamental tranquilizar al paciente y los familiares, mantener la vía aérea permeable y valorar la situación clínica y la cuantía de la pérdida, ya que de ello dependerá su inmediata derivación o manejo en Atención Primaria. En general, las hemoptisis leves podrán ser controladas y estudiadas ambulatoriamente para conocer su origen

Hemoptysis is a frequent reason for a visit to Primary Health Care. Its most common cause is an infectious one. Usually, bronchitis gives rise to mild hemoptysis and bronchiectasis to moderate or severe hemoptysis. In the Western world, neoplasms are also a frequent cause of moderate, mild or repetition of hemoptysis. When there is an episode of hemoptysis, it is essential to reassure the patient and family members, maintain the airway patent and evaluate the clinical condition and amount of loss since this will indicate the patient’s immediate referral or management in Primary Care. In general, mild hemoptysis can be controlled and studied in an out-patient setting to know its origin

[Comorbidity, hospitalization, and drug use for non-exacerbated chronic disease in the elderly population]. / Comorbilidad, ingreso hospitalario y consumo de fármacos por enfermedad crónica no reagudizada en población anciana.

OBJECTIVES: To evaluate the prevalence of comorbidity among elderly hospitalized patients and its influence on discharge diagnosis and medication due to non-exacerbated chronic disease (NECD). To evaluate the impact of hospital admission on the use of drugs due to NECD since admission to the month of discharge. METHODS: A study was made of 85 patients aged 65 years or older collected during two consecutive months. The study protocol consisted of a questionnaire on comorbidity, study of drug consume, discharge diagnosis and follow-up for one month post discharge. RESULTS: Patients had a mean of 6.4 chronic diseases; significant differences were observed regarding discharge report (mean: 2.1). The number of drugs due to NECD prior to admission (mean: 2.9), at discharge (1.5) and one month after discharge (1.9) showed significant differences between those prior to admission, at discharge, and one month after discharge (p < 0.0001). Hospital admission involved a decrease (p < 0.0001) in the number of patients with polypharmacy criteria (more than four drugs), which persisted one month after discharge (p < 0.01), and in the prescription of polyvitaminic compounds, nonsteroid antiinflammatory drugs, antiaggregants, peripheral vasodilators and antacids (p < 0.03). CONCLUSIONS: A relevant under-reporting of chronic diseases in the discharge report, particularly of those without exacerbations, as well as quantitative (decrease) and qualitative changes in the prescription due to NECD, maintained by the general practitioner one month after discharge. A higher awareness regarding chronic disease is necessary, as well as chronic disease is necessary, as well as establishing communication channels between Primary and Specialized Care.