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mortality and a worse quality of life in Portuguese patients&#46;&#8221;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In fact&#44; the huge impact of chronic non-communicable diseases is now recognized&#46; These include respiratory disorders&#44; cardiovascular diseases&#44; diabetes mellitus and oncological disorders and account for 86&#37; of mortality in developed countries&#46; Respiratory disorders are the second highest cause of death by disease&#59; this is not unconnected with the fact that there is an aging population and smoking is still common in these countries&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In Portugal the figures for various indicators in this area suggest that respiratory disease is responsible for about 20&#37; of hospital admissions and an even higher percentage is associated with the use of Emergency Department admissions &#40;over 30&#37; in &#8220;critical periods&#8221;&#41; and above all it accounts for the more than 20&#37; of directly related deaths&#44; despite significant progress in identifying and controlling these diseases&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">With the suppression of the post of High Commissioner of Health&#44; the Directorate General of Health took on the responsibility of the &#8220;national coordination of the design and implementation of health programs&#8221; and formed three new areas&#44; one of which related to Respiratory Diseases in according to the Dispatch No&#46; 404&#47;2012&#44; 2nd series&#44; No&#46; 10&#44; January 13&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">This was a source of considerable personal and institutional satisfaction&#44; and it also increased the status and responsibility of Portuguese Pulmonology today&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">It is&#44; as a matter of fact&#44; a moment in which among other commitments&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#40;a&#41;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Clinical recommendations are defined and structured based on the most up to date scientific evidence &#40;although there is much debate and dispute over the format for &#8220;Norms for Clinical Orientation&#8221; a designation that gives them a legal slant which is hardly in line with the variability and elasticity determined by clinical practice and with the personalized approach of modern medicine&#41;&#44;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;b&#41;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Efforts to introduce legislation for the protection of citizens in relation to passive smoking&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#40;c&#41;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Discussion of what new skills are required in the area of respiratory diseases&#44; like sleep studies&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;d&#41;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Creating the right institutional environment for the sharing of interdisciplinary scientific knowledge through the various different protocols for cooperation which have recently been set up</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#40;e&#41;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Where necessary being passionate and not always following a line of reason and common sense&#44; in relation to the rules and regulations of medical prescriptions&#46;</p></li></ul></p><p id="par0065" class="elsevierStylePara elsevierViewall">Pulmonology must calmly and consciously take on board the National Programme for Respiratory Diseases&#44; leaving aside inferiority or superiority complexes&#44; with the single vital objective&#44; that of improving the respiratory condition of the Portuguese population&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Building on the four cornerstones representing well defined areas of influence&#44; Bronchial Asthma&#44; COPD&#44; Sleep Apnea Syndrome and a raft of less common but clearly differentiated pathologies which include&#44; Pulmonary Hypertension&#44; Interstitial Lung Disease and Cystic Fibrosis&#44; this programme provides an opportunity to systematically take forward respiratory diseases as a priority health issue in Portugal&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">And so we proceed in a spirit of goodwill&#44; without exhibitionism or seeking centre stage&#44; but basically&#44; confident that there will be a better future for the respiratory health of our citizens&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">All the best to our patients&#33;</p></span>"
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Editorial
What can we make of this national programme?
O que fazer com este programa nacional?
Carlos Robalo Cordeiro
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years&#44; there has been a lot of effort by a great many of us&#44; to work together to make the health authorities aware of the need to deal with respiratory diseases in a more consistent and cohesive way&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">As part of this campaign I had the opportunity of making the point in a press release on the eve of the XXVI Pulmonology Conference &#40;the first one by this Board&#47;these Directors&#41;&#44; in December 2010 that &#8220;included in the National Health Plan which runs until the end of this year&#44; there are national coordinators for cancer&#44; for cardiovascular disease&#44; mental illness&#44; and for HIV&#44; AIDS and that respiratory diseases are not included as a key point in the strategic planning in the area of health in Portugal&#44; which seems absurd&#44; given that within the respiratory pathology there are so many different clinical areas which cause a very high rate of morbidity&#44; mortality and a worse quality of life in Portuguese patients&#46;&#8221;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In fact&#44; the huge impact of chronic non-communicable diseases is now recognized&#46; These include respiratory disorders&#44; cardiovascular diseases&#44; diabetes mellitus and oncological disorders and account for 86&#37; of mortality in developed countries&#46; Respiratory disorders are the second highest cause of death by disease&#59; this is not unconnected with the fact that there is an aging population and smoking is still common in these countries&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In Portugal the figures for various indicators in this area suggest that respiratory disease is responsible for about 20&#37; of hospital admissions and an even higher percentage is associated with the use of Emergency Department admissions &#40;over 30&#37; in &#8220;critical periods&#8221;&#41; and above all it accounts for the more than 20&#37; of directly related deaths&#44; despite significant progress in identifying and controlling these diseases&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">With the suppression of the post of High Commissioner of Health&#44; the Directorate General of Health took on the responsibility of the &#8220;national coordination of the design and implementation of health programs&#8221; and formed three new areas&#44; one of which related to Respiratory Diseases in according to the Dispatch No&#46; 404&#47;2012&#44; 2nd series&#44; No&#46; 10&#44; January 13&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">This was a source of considerable personal and institutional satisfaction&#44; and it also increased the status and responsibility of Portuguese Pulmonology today&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">It is&#44; as a matter of fact&#44; a moment in which among other commitments&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#40;a&#41;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Clinical recommendations are defined and structured based on the most up to date scientific evidence &#40;although there is much debate and dispute over the format for &#8220;Norms for Clinical Orientation&#8221; a designation that gives them a legal slant which is hardly in line with the variability and elasticity determined by clinical practice and with the personalized approach of modern medicine&#41;&#44;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;b&#41;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Efforts to introduce legislation for the protection of citizens in relation to passive smoking&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#40;c&#41;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Discussion of what new skills are required in the area of respiratory diseases&#44; like sleep studies&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;d&#41;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Creating the right institutional environment for the sharing of interdisciplinary scientific knowledge through the various different protocols for cooperation which have recently been set up</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#40;e&#41;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Where necessary being passionate and not always following a line of reason and common sense&#44; in relation to the rules and regulations of medical prescriptions&#46;</p></li></ul></p><p id="par0065" class="elsevierStylePara elsevierViewall">Pulmonology must calmly and consciously take on board the National Programme for Respiratory Diseases&#44; leaving aside inferiority or superiority complexes&#44; with the single vital objective&#44; that of improving the respiratory condition of the Portuguese population&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Building on the four cornerstones representing well defined areas of influence&#44; Bronchial Asthma&#44; COPD&#44; Sleep Apnea Syndrome and a raft of less common but clearly differentiated pathologies which include&#44; Pulmonary Hypertension&#44; Interstitial Lung Disease and Cystic Fibrosis&#44; this programme provides an opportunity to systematically take forward respiratory diseases as a priority health issue in Portugal&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">And so we proceed in a spirit of goodwill&#44; without exhibitionism or seeking centre stage&#44; but basically&#44; confident that there will be a better future for the respiratory health of our citizens&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">All the best to our patients&#33;</p></span>"
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ISSN: 21735115
Original language: English
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