David Díaz Pérez

Introduction: Hospital readmission after an exacerbation of COPD (AECOPD) reflects clinical and organizational complexity and is associated with worse outcomes and increased healthcare burden. Social conditions and treatment complexity may influence this process. This study aimed to evaluate readmission rates after AECOPD and identify associated factors, focusing on social risk and pharmacological burden. Materials and Methods Prospective observational longitudinal study conducted in a pulmonology department in Tenerife. Forty-two patients admitted for AECOPD between November 2022 and November 2023 were followed for 12 months after discharge. Clinical and social variables were recorded, including the Gijón Scale and number of medications at discharge. Binary logistic regression identified independent predictors of readmission. Results: The 12-month readmission rate was 36.6%. Median time to readmission was 49 days; 25% were readmitted within 22 days. Multivariate analysis was significant (p=0.034). Higher social risk independently predicted readmission (OR=1.55; 95% CI: 1.03–2.27; p=0.024). A greater number of discharge medications was also associated with readmission (OR=1.27; 95% CI: 1.05–2.35; p=0.028). Conclusions: Readmission after AECOPD is frequent, especially in the first weeks post-discharge. Social vulnerability and treatment burden show strong predictive value. Discharge planning should integrate social assessment, medication optimization, coordinated follow-up, and nurse-led transitional care.

Rationale: The Tajogaite volcano (La Palma, Spain) erupted in September 2021 for 85 days, releasing gases, ash, and lava over populated areas. Data on the respiratory effects of volcanic emissions in children remain limited. Objectives: To describe the prevalence of respiratory symptoms and lung function patterns in a paediatric population exposed to emissions from the Tajogaite volcano. Methods: A cross-sectional study with a follow-up component was conducted in a high-exposure area. A total of 188 children aged 6 to 18 years were interviewed 10–17 months after the eruption. Sociodemographic data, medical history, and symptom records during and after the eruption were collected. Post-eruption lung function was assessed using spirometry, diffusing capacity for carbon monoxide (DLCO) and fractional exhaled nitric oxide (FeNO). Results: During the eruption, 25–50% of participants reported respiratory symptoms, mainly upper airway (itching and nasal congestion). Post-eruption, ocular symptoms decreased (p<0.05), while cough, headache, nasal congestion, sore throat, and skin problems persisted. Symptom frequency and persistence were higher in children with a history of asthma or environmental tobacco smoke exposure (p<0.05). Post-eruption, 6.4% of participants had reduced FEV₁ and/or FVC, 15.2% showed decreased DLCO (< GLI 5th percentile), and 44% had FeNO≥20 ppb. Conclusions: Children and adolescents exposed to Tajogaite volcano presented a high prevalence and persistence of respiratory symptoms, particularly in those with environmental tobacco smoke exposure or underlying respiratory conditions. Including DLCO and FeNO in spirometric evaluation may help detect respiratory abnormalities and support further longitudinal monitoring.

In January 2020, the WHO classified SARS-CoV-2 infection as a public health emergency and it was declared a pandemic on 11 March 2020. The media warned about the danger of infection, fuelling the population’s fear of the new situation and increasing the perception of risk. This fear can cause behaviour that will determine the course of the pandemic and, therefore, the purpose of this study was to analyse the fear of infection from COVID-19 among the Spanish population during the state of emergency. A cross-sectional, descriptive observational study was conducted with 16,372 participants. Data on sociodemographic factors, health factors, risk perception and fear were collected through an online survey. Level of fear is associated with older age, a lower level of education, having a person infected with SARS-CoV-2 in the immediate surroundings and living with and belonging to the most socioeconomically vulnerable group of people. Risk perception is associated with increased preventive behaviour. This paper provides relevant information for the public health sector since it contributes first-hand knowledge of population data that is highly useful in terms of prevention. Understanding the experiences of people in this pandemic helps to create more effective future intervention strategies in terms of planning and management for crisis situations.

Background: Adherence to pharmacological treatment is a fundamental factor in the control of chronic respiratory disease such as asthma and chronic obstructive disease (COPD). Poor disease control is associated with increased morbidity and mortality and higher health cost. Methods: A multicenter, observational cross-sectional study was performed. Four hundred patientes with diagnosis of asthma or COPD were recruited from 18 Spanish hospitals. A total of 15 different inhalation devices used in yhe treatment of these diseases and grouped depending on inhaler adherence, satisfaction, and disease control. Results: Satisfaction was lower when adherence was intermediate or poor than when it was good (good vs. intermediate p=0.035;poor vs. good p=0.009). Multivariate analyses of feeling of satisfaction with inhaler respiratory diseases and for the Asthma Control Test in the case of asthma, but not for COPD. Conclusions: High degree of satisfaction with the inhalers was observed in asthma and COPD patientes, with no difference among device types. A positive association was found between satisfaction and both adherence and the degree of disease control in asthma, but not in COPD. Nevertheless, further investigations are needed to better clarify these associations