José Antonio Díaz Peromingo, María Gómez Antúnez and Jesús Díez Manglano.
The consensus on the comorbidities of Chronic Obstructive Pulmonary Disease (COPD) is another topic of the meeting Internal in Valencia. In fact, the specialists emphasize a series of agreements and fix the use of cardioselective beta-blockers in COPD to address the pathology, receiving the approval of all internists.
And it is that the use of these cardioselective beta-blockers in COPD is “necessary” in the face of comorbidities in exacerbation of the pathology. In this sense, Jose Antonio Diaz Peromingofrom the Internal Medicine Service of the Santiago de Compostela University Clinical Hospital, assures that it must “maintain beta-blocker therapy in COPDespecially with comorbidities such as heart failure or related ischemic heart disease.”
A consensus on the use of beta-blockers that the internist defends in the XV Meeting of the COPD Group of the Spanish Society of Internal Medicine (SEMI). In this sense, and despite the fact that there is unanimous agreement for its use, Díaz Peromingo points out the “lack of inclusion of this use in the guides on aspects such as management of comorbiditiesthe prevention of disability and care at the end of life”. And this is essential to “make a correct diagnosis and the most appropriate treatment”, according to the specialist.
José Antonio Díaz Peromingo: To manage comorbidities in stable COPD “a nutritional, anxiety, depression and osteoporosis assessment should be carried out” |
A request that he makes together with that of the management of comorbidities in stable COPD. In this case, Díaz Peromingo states that “to manage them in a better way, according to consensus, a nutritional, anxiety, depression and osteoporosis assessment should be carried out, but it is not necessary to do it routinely.” This would have to be carried out, above all, “in patients with ischemic heart disease and smokers and, furthermore, these people should have a spirometry to assess COPD“.
Simple intervention in exacerbation of COPD
Another consensus of internists on the approach to this respiratory pathology is “the Simple intervention in COPD exacerbationsince this can be very useful”, as pointed out by Jesus Diez Manglano, president of the SEMI and specialist of the Internal Medicine Service of the Royo Villanova Hospital in Zaragoza. He also adds that “carrying out this intervention is necessary since most internists carry a false diagnosis in these patients.”
And it is that this simple intervention “can improve the attention of the COPD exacerbation patientsespecially in the treatment of lung disease, with small changes in comorbidities”. An entire approach that requires, according to Díez Manglano, “specialist care, because we cannot forget that we are internists”.
Jesús Díez Manglano: “We must take advantage of the admission of COPD patients to analyze in greater depth the behavior of this respiratory pathology” |
a whole series of consensus and recommendations that the president of the SEMI shares with the attendees since, in addition, he is one of the coordinators of the ‘Diagnostic and therapeutic management protocol for comorbidities in COPD‘. This has “a great impact, not only for pulmonologists, but also for all Internal Medicine Services in Spain.”
In short, the two specialists emphasize that “the COPD is a heterogeneous, underdiagnosed disease whose prevalence increases with age and smokingrepresenting the third cause of death in the world“. For all these reasons, “the main objective of Internal Medicine is analyze the diagnostic and therapeutic management of cardiovascular comorbidities in COPD such as ischemic heart disease, heart failure and atrial fibrillation, so it is necessary to take advantage of the admission of these patients to analyze in greater depth the behavior of this respiratory pathology”, they conclude.
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