Novedades en la enfermedad pulmonar obstructiva crónica
Advances in chronic obstructive pulmonary disease
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"titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Aunque la enfermedad pulmonar obstructiva crónica (EPOC) se define por la presencia de obstrucción crónica y poco reversible al flujo aéreo, desde un punto de vista clínico, debemos seguir avanzando en el diagnóstico y el tratamiento de estos pacientes, de modo que no queden relegados a un simple valor espirométrico. Entender que la EPOC es un proceso heterogéneo y que la complejidad del paciente suele aumentar por la asociación de otras enfermedades, permitirá diseñar estrategias más individualizadas, que pueden mejorar nuestros resultados en el control del proceso.</p><p class="elsevierStyleSimplePara elsevierViewall">Los estudios TORCH y UPLIFT nos han mostrado que con el tratamiento actual podemos mejorar aspectos muy importantes de la enfermedad, incluyendo la mortalidad. Sin embargo, la finalización de estos dos grandes estudios ha generado una corriente de opinión que favorece un abordaje más individualizado de los pacientes, abordaje que deberá tener en cuenta todos los factores, pulmonares y no pulmonares, que pueden modificar la forma de presentación del paciente en la clínica.</p><p class="elsevierStyleSimplePara elsevierViewall">Aunque ya estamos asistiendo a un cambio en el enfoque terapéutico de la EPOC, el futuro del tratamiento deberá basarse en estudios realizados en subgrupos específicos de pacientes, así como en clarificar la interrelación entre la EPOC y otras enfermedades que frecuentemente presentan estos pacientes. Aunque un mejor conocimiento de su patogenia puede desembocar en mejores tratamientos farmacológicos, no se prevén fármacos que por sí solos cambien, a corto y medio plazo, la situación de la EPOC; no obstante, un abordaje más dirigido al paciente puede ser la principal herramienta que actualmente tiene el médico para mejorar la calidad y, posiblemente, la cantidad de vida de estos pacientes.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Although chronic obstructive pulmonary disease (COPD) is characterized by poorly reversible, chronic airflow obstruction, from the clinical point of view we must continue to make progress in the diagnosis and management of these patients so that spirometry is not the only technique used. Understanding that COPD is a heterogeneous process and that patient complexity usually increases due to the presence of comorbidities will allow more individualized strategies to be designed, which may improve control of the process.</p><p class="elsevierStyleSimplePara elsevierViewall">The TORCH and UPLIFT trials have shown that current treatment can improve important aspects of the disease, including mortality. However, the finalizing of these two large trials has generated a current of opinion favoring a more individually-tailored approach that should include all the factors –both pulmonary and extrapulmonary– that can modify the patient's form of presentation.</p><p class="elsevierStyleSimplePara elsevierViewall">Although we are witnessing a change in the therapeutic approach to COPD, future treatment will probably be based on studies performed in specific patient subgroups and on clarifying the interrelation between COPD and other diseases that are common in these patients. Greater knowledge of the pathogenesis of the disease may improve pharmacological treatment but drugs that, by themselves, alter the short- and longterm course of COPD are not on the horizon. However, a more patient-focussed approach may be the main tool available to physicians to increase quality of life –and possibly survival– in these patients.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Report of the conclusions of CIBA guest symposium: terminology, defi nitions and classifi cation of chronic obstructive pulmonary emphysema and related conditions. Thorax. 1959;14:286-99." ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 3 | 8 |
| 2024 October | 33 | 14 | 47 |
| 2024 September | 45 | 14 | 59 |
| 2024 August | 71 | 39 | 110 |
| 2024 July | 32 | 26 | 58 |
| 2024 June | 54 | 26 | 80 |
| 2024 May | 70 | 30 | 100 |
| 2024 April | 37 | 22 | 59 |
| 2024 March | 39 | 28 | 67 |
| 2024 February | 36 | 42 | 78 |
| 2023 March | 2 | 5 | 7 |
| 2023 February | 26 | 17 | 43 |
| 2023 January | 24 | 23 | 47 |
| 2022 December | 34 | 26 | 60 |
| 2022 November | 35 | 14 | 49 |
| 2022 October | 30 | 34 | 64 |
| 2022 September | 35 | 27 | 62 |
| 2022 August | 44 | 36 | 80 |
| 2022 July | 28 | 42 | 70 |
| 2022 June | 41 | 29 | 70 |
| 2022 May | 36 | 19 | 55 |
| 2022 April | 35 | 28 | 63 |
| 2022 March | 36 | 38 | 74 |
| 2022 February | 67 | 25 | 92 |
| 2022 January | 36 | 38 | 74 |
| 2021 December | 26 | 41 | 67 |
| 2021 November | 38 | 48 | 86 |
| 2021 October | 41 | 47 | 88 |
| 2021 September | 35 | 60 | 95 |
| 2021 August | 33 | 42 | 75 |
| 2021 July | 30 | 44 | 74 |
| 2021 June | 33 | 32 | 65 |
| 2021 May | 37 | 27 | 64 |
| 2021 April | 77 | 52 | 129 |
| 2021 March | 43 | 14 | 57 |
| 2021 February | 38 | 19 | 57 |
| 2021 January | 31 | 26 | 57 |
| 2020 December | 23 | 15 | 38 |
| 2020 November | 28 | 11 | 39 |
| 2020 October | 22 | 8 | 30 |
| 2020 September | 24 | 19 | 43 |
| 2020 August | 28 | 19 | 47 |
| 2020 July | 27 | 22 | 49 |
| 2020 June | 28 | 7 | 35 |
| 2020 May | 30 | 19 | 49 |
| 2020 April | 20 | 12 | 32 |
| 2020 March | 30 | 28 | 58 |
| 2020 February | 36 | 11 | 47 |
| 2020 January | 39 | 21 | 60 |
| 2019 December | 23 | 17 | 40 |
| 2019 November | 14 | 8 | 22 |
| 2019 October | 36 | 16 | 52 |
| 2019 September | 24 | 15 | 39 |
| 2019 August | 21 | 18 | 39 |
| 2019 July | 28 | 27 | 55 |
| 2019 June | 15 | 16 | 31 |
| 2019 May | 24 | 21 | 45 |
| 2019 April | 19 | 28 | 47 |
| 2019 March | 77 | 19 | 96 |
| 2019 February | 13 | 23 | 36 |
| 2019 January | 20 | 9 | 29 |
| 2018 December | 14 | 12 | 26 |
| 2018 November | 31 | 44 | 75 |
| 2018 October | 46 | 32 | 78 |
| 2018 September | 23 | 39 | 62 |
| 2018 May | 15 | 1 | 16 |
| 2018 April | 21 | 10 | 31 |
| 2018 March | 16 | 5 | 21 |
| 2018 February | 12 | 11 | 23 |
| 2018 January | 11 | 8 | 19 |
| 2017 December | 13 | 25 | 38 |
| 2017 November | 22 | 41 | 63 |
| 2017 October | 16 | 43 | 59 |
| 2017 September | 20 | 47 | 67 |
| 2017 August | 43 | 56 | 99 |
| 2017 July | 27 | 63 | 90 |
| 2017 June | 38 | 65 | 103 |
| 2017 May | 22 | 59 | 81 |
| 2017 April | 19 | 47 | 66 |
| 2017 March | 11 | 64 | 75 |
| 2017 February | 19 | 62 | 81 |
| 2017 January | 20 | 15 | 35 |
| 2016 December | 12 | 33 | 45 |
| 2016 November | 28 | 39 | 67 |
| 2016 October | 27 | 35 | 62 |
| 2016 September | 32 | 38 | 70 |
| 2016 August | 41 | 17 | 58 |
| 2016 July | 39 | 21 | 60 |
| 2016 June | 44 | 29 | 73 |
| 2016 May | 61 | 40 | 101 |
| 2016 April | 14 | 2 | 16 |
| 2016 March | 21 | 3 | 24 |
| 2016 February | 26 | 9 | 35 |
| 2016 January | 48 | 35 | 83 |
| 2015 December | 57 | 32 | 89 |
| 2015 November | 102 | 72 | 174 |
| 2015 October | 70 | 10 | 80 |
| 2015 September | 52 | 0 | 52 |
| 2015 August | 45 | 0 | 45 |
| 2015 July | 36 | 0 | 36 |
| 2015 June | 25 | 0 | 25 |
| 2015 May | 35 | 0 | 35 |
| 2015 April | 20 | 0 | 20 |
| 2015 March | 28 | 0 | 28 |
| 2015 February | 22 | 0 | 22 |
| 2015 January | 26 | 0 | 26 |
| 2014 December | 23 | 0 | 23 |
| 2014 November | 35 | 0 | 35 |
| 2014 October | 41 | 0 | 41 |
| 2014 September | 28 | 0 | 28 |
| 2014 August | 36 | 0 | 36 |
| 2014 July | 31 | 0 | 31 |
| 2014 June | 46 | 0 | 46 |
| 2014 May | 42 | 0 | 42 |
| 2014 April | 46 | 0 | 46 |
| 2014 March | 35 | 0 | 35 |
| 2014 February | 34 | 0 | 34 |
| 2014 January | 36 | 0 | 36 |
| 2013 December | 28 | 0 | 28 |
| 2013 November | 32 | 0 | 32 |
| 2013 October | 42 | 0 | 42 |
| 2013 September | 38 | 0 | 38 |
| 2013 August | 72 | 0 | 72 |
| 2013 July | 53 | 0 | 53 |
| 2013 June | 32 | 0 | 32 |
| 2013 May | 30 | 0 | 30 |
| 2013 April | 16 | 0 | 16 |
| 2013 March | 8 | 0 | 8 |
| 2000 January | 688 | 0 | 688 |
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