Factores de riesgo en la EPOC

La enfermedad pulmonar obstructiva crónica es de origen multifactorial y se desarrolla gracias a la interacción de diferentes factores de riesgo. La mayor parte de la evidencia de la influencia de éstos factores en el desarrollo de la EPOC proviene de estudios epidemiológicos transversales que, en lugar de relación causa-efecto, sugieren asociaciones entre distintos factores de riesgo y esta enfermedad. Estos estudios indican la existencia de 2 tipos de factores de riesgo: un primer grupo, marcadores de riesgo, sobre los que no se puede intervenir, y que dependen del huésped o paciente, y un segundo grupo, o factores de riesgo propiamente dichos, sobre los que sí se puede actuar, que están ligados a la exposición medioambiental

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Factores de riesgo en la EPOC

La enfermedad pulmonar obstructiva crónica es de origen multifactorial y se desarrolla gracias a la interacción de diferentes factores de riesgo. La mayor parte de la evidencia de la influencia de éstos factores en el desarrollo de la EPOC proviene de estudios epidemiológicos transversales que, en lugar de relación causa-efecto, sugieren asociaciones entre distintos factores de riesgo y esta enfermedad. Estos estudios indican la existencia de 2 tipos de factores de riesgo: un primer grupo, marcadores de riesgo, sobre los que no se puede intervenir, y que dependen del huésped o paciente, y un segundo grupo, o factores de riesgo propiamente dichos, sobre los que sí se puede actuar, que están ligados a la exposición medioambiental