18 de febrero de 2015

Impacto de un paquete de recomendaciones al alta tras reingreso por una exacerbación de la EPOC

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0116187#sec009

Contenidos del paquete de recomendaciones:
The care bundle recommendations are that all patients admitted with an AECOPD receive the following interventions from staff who have the appropriate competencies, most often delivered by one or more clinicians who are members of a respiratory team; 

  • (1) Evidence-based smoking cessation interventions (support and pharmacotherapy) and offer of referral to smoking cessation service if a current smoker; 
  • (2) Assessment for, explanation of, and referral to, a pulmonary rehabilitation programme; 
  • (3) Appropriate education, written personalised information including information about patient support groups (British Lung Foundation (BLF) Breathe Easy Groups), self-management plans (for example, BLF self-management booklet), and, if appropriate, rescue packs for future exacerbations and an oxygen alert card or equivalent; 
  • (4) Assessment of patient understanding and use of medications with focus on enabling effective inhaler technique; 
  • (5) Leave hospital with booked review once discharged from hospital. 

Care bundles aim both to improve quality of care, and to standardise delivery, so that all of the included elements are delivered routinely.

Conclusions


The COPD discharge care bundle appeared to be associated with a reduction in readmission rate among hospitals using it. The significance of this is unclear because of changes to background trends in London and nationally.

Uso de la vacuna antineumocócica en adultos

http://jama.jamanetwork.com/article.aspx?articleid=2110955

Major recommendations
  • Pneumococcal vaccine–naive adults aged 65 years or older (or adults ≥65 years whose pneumococcal vaccine history is unknown) should receive 1 dose of 13-valent pneumococcal conjugate vaccine (PCV13) followed by a dose of 23-valent pneumococcal polysaccharide vaccine (PPSV23) 6 to 12 months later (minimum duration between PCV13 and PPSV23, 8 weeks).
  • Adults aged 65 years or older who have previously received 1 or more doses of PPSV23 should receive 1 dose of PCV13 1 year or longer after the most recent PPSV23 dose.
  • In adults who received PPSV23 before age 65 years, PCV13 should be given after age 65 years (and ≥1 year after the PPSV23 was given). PPSV23 should then be repeated 6 to 12 months later (and ≥5 years since the initial PPSV23 injection).

¿Qué papel juega el tiotropio en el asma? : Una revisión sistemática con metaanálisis

http://journal.publications.chestnet.org/article.aspx?articleid=1918417

15 de febrero de 2015

Efecto de la vacuna antineumocócica 13-valente sobre la enfermedad neumocócica invasiva en niños y adultos de USA

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(14)71081-3/abstract

PCV13 reduced invasive pneumococcal disease across all age groups when used routinely in children in the USA. These findings provide reassurance that, similar to PCV7, PCVs with additional serotypes can also prevent transmission to unvaccinated populations.

Documento de consenso SEPAR-ALAT sobre vacunación antineumocócica en fumadores

https://www.alatorax.org/tabaquismo/biblioteca-tabaquismo/guias-tabaquismo/documento-de-consenso-separ-alat-sobre-vacunacion-antineumococica-en-fumadores

Streptococcus pneumoniae es causante de diversos cuadros clínicos: neumonía adquirida en la comunidad, sinusitis, otitis media, etc. Sin duda, la forma clínica más grave ocasionada por este germen es la enfermedad neumocócica invasiva. Se sabe que determinados factores, entre los que destaca el consumo de tabaco, y el padecimiento de enfermedades subyacentes concomitantes aumentan el riesgo de padecer estos procesos. Este artículo muestra un documento de consenso sobre vacunación antineumocócica en fumadores que ha sido realizado por un grupo de expertos en tabaquismo de la Sociedad Española de Neumología y Cirugía Torácica y de la Asociación Latinoamericana del Tórax.

Mejora de la adherencia al tratamiento con corticoides inhalados en niños con asma mediante un recordatorio electrónico

http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(15)00008-9/abstract

The use of an electronic monitoring device with an audiovisual reminder led to significant improvements in adherence to inhaled corticosteroids in school-aged children with asthma. This intervention could be beneficial for the improvement of asthma control in patients for whom poor asthma control is related to poor adherence.