José Antonio Gullón Blanco

Hospital Universitario de Canarias, San Cristóbal de La Laguna, Canary Islands, Spain

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Publications (10)17.55 Total impact

  • Age and Ageing 12/2008; 37(6):715-8. DOI:10.1093/ageing/afn226 · 3.11 Impact Factor
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    ABSTRACT: To analyze if cigarette smoking delays the sputum smear conversion in pulmonary tuberculosis. Ninety eight patients were diagnosed with pulmonary tuberculosis. Patients were all not immunosuppressed, infected by human immunodeficiecy virus (HIV) or drug resistant. Sixty four of them were smokers with a pack-year index (standard deviation) of 33.69 (23.12). Delayed sputum smear conversion (DC) was considered when 2 positive sputum culture results were obtained in the second month of anti-tuberculous treatment and was associated with the following variables in 2 groups: a) total group (in which all the patients were included): age, sex, smoking habits, risk factors (alcohol consumption, diabetes mellitus, immunosuppression, drug addicion, malnutrition), time with symptoms, radiologic presentation and bacterial load, and b) smokers: age, sex, risk factors, time with symptoms, radiologic presentation, bacterial load and pack-year index. For the statistical analysis, chi2 test, Student t test and logistic regression model were used, considering the dependant variable DC. In the total group, 17 patients (17.3%) had DC, 16 of them had a history of smoking and in the univariate analysis it was associated with: alcohol consumption, time with symptoms, radiologic presentation as bilateral cavitary infiltrates and smoking habits. The logistic regression analysis showed an association with smoking habits (odds ratio = 9.8; p = 0.03) and bilateral cavitary infiltrates (odds ratio = 3.61; p = 0.02). In the group of smokers, DC was associated in the univariate analysis with the female sex. Smoking habits delay sputum conversion in patients with pulmonary tuberculosis not associated with HIV and non-resistant bacilli. According to these results it is necessary to assist smoking cessation in patients who are receiving antituberculous treatment.
    Medicina Clínica 05/2007; 128(15):565-8. · 1.25 Impact Factor
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    ABSTRACT: Background and objective To analyze if cigarette smoking delays the sputum smear conversion in pulmonary tuberculosis. Patients and method Ninety eight patients were diagnosed with pulmonary tuberculosis. Patients were all not immunosuppressed, infected by human immunodeficiecy virus (HIV) or drug resistant. Sixty four of them were smokers with a pack-year index (standard deviation) of 33.69 (23.12). Delayed sputum smear conversion (DC) was considered when 2 positive sputum culture results were obtained in the second month of anti-tuberculous treatment and was associated with the following variables in 2 groups: a) total group (in which all the patients were included): age, sex, smoking habits, risk factors (alcohol consumption, diabetes mellitus, immuno-suppression, drug addicion, malnutrition), time with symptoms, radiologic presentation and bacterial load, and b) smokers: age, sex, risk factors, time with symptoms, radiologic presentation, bacterial load and pack-year index. For the statistical analysis, χ2 test, Student t test and logistic regression model were used, considering the dependant variable DC. Results In the total group, 17 patients (17.3%) had DC, 16 of them had a history of smoking and in the univariate analysis it was associated with: alcohol consumption, time with symptoms, radiologic presentation as bilateral cavitary infiltrates and smoking habits. The logistic regression analysis showed an association with smoking habits (odds ratio = 9.8; p = 0.03) and bilateral cavitary infiltrates (odds ratio = 3.61; p = 0.02). In the group of smokers, DC was associated in the univariate analysis with the female sex. Conclusions Smoking habits delay sputum conversion in patients with pulmonary tuberculosis not associated with HIV and non-resistant bacilli. According to these results it is necessary to assist smoking cessation in patients who are receiving antituberculous treatment.
    Medicina Clínica 04/2007; 128(15):565-568. DOI:10.1157/13101612 · 1.25 Impact Factor
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    ABSTRACT: To study the course of disease and outcomes in a group of patients with community-acquired pneumonia caused by atypical pathogens (Mycoplasma pneumoniae, Legionella species ,Coxiella burnetii, and Chlamydophila pneumoniae) according to the empiric treatment received. Of a total of 390 patients admitted to our hospital with pneumonia between January 1996 and February 2001, the causative microorganism was an atypical pathogen in 89 cases. Patients were divided retrospectively into 2 groups according to the empiric treatment they received: group A, who had received an antibiotic regime (quinolones or macrolides) that provided coverage for atypical pathogens; and group B, who had received treatment that did not provide such coverage. Clinical course was assessed in terms of the differences between the 2 groups in length of hospital stay, radiographic resolution, readmission at 30 days after discharge, and mortality. A total of 89 patients with pneumonia caused by atypical pathogens (39 in group A and 50 in group B) were studied. No significant between-group differences in the variables were found. In this group of patients hospitalized for community-acquired pneumonia, antibiotic regimens providing coverage for atypical pathogens did not improve either clinical or radiographic evolution.
    Archivos de Bronconeumología 10/2006; 42(9):430-3. · 1.82 Impact Factor
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    ABSTRACT: Objective To study the course of disease and outcomes in a group of patients with community-acquired pneumonia caused by atypical pathogens (Mycoplasma pneumoniae, Legionella species, Coxiella burnetii, and Chlamydophila pneumoniae) according to the empiric treatment received. Patients and methods Of a total of 390 patients admitted to our hospital with pneumonia between January 1996 and February 2001, the causative microorganism was an atypical pathogen in 89 cases. Patients were divided retrospectively into 2 groups according to the empiric treatment they received: group A, who had received an antibiotic regime (quinolones or macrolides) that provided coverage for atypical pathogens; and group B, who had received treatment that did not provide such coverage. Clinical course was assessed in terms of the differences between the 2 groups in length of hospital stay, radiographic resolution, readmission at 30 days after discharge, and mortality. Results A total of 89 patients with pneumonia caused by atypical pathogens (39 in group A and 50 in group B) were studied. No significant between-group differences in the variables were found. Conclusions In this group of patients hospitalized for community-acquired pneumonia, antibiotic regimens providing coverage for atypical pathogens did not improve either clinical or radiographic evolution.
    Archivos de Bronconeumología 09/2006; 42(9). DOI:10.1157/13092412 · 1.82 Impact Factor
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    ABSTRACT: OBJECTIVE: To study the course of disease and outcomes in a group of patients with community-acquired pneumonia caused by atypical pathogens (Mycoplasma pneumoniae, Legionella species, Coxiella burnetti, and Chlamydophila pneumoniae) according to the empiric treatment received. PATIENTS AND METHODS: Of a total of 390 patients admitted to our hospital with pneumonia between January 1996 and February 2001, the causative microorganism was an atypical pathogen in 89 cases. Patients were divided retrospectively into 2 groups according to the empiric treatment they received: group A, who had received an antibiotic regime (quinolones or macrolides) that provided coverage for atypical pathogens; and group B, who had received treatment that did not provide such coverage. Clinical course was assessed in terms of the differences between the 2 groups in length of hospital stay, radiographic resolution, readmission at 30 days after discharge, and mortality. RESULTS: A total of 89 patients with pneumonia caused by atypical pathogens (39 in group A and 50 in group B) were studied. No significant between-group differences in the variables were found. CONCLUSIONS: In this group of patients hospitalized for community-acquired pneumonia, antibiotic regimens providing coverage for atypical pathogens did not improve either clinical or radiographic evolution.
    Archivos de Bronconeumología 09/2006; 42(9-42):430-433. DOI:10.1016/S1579-2129(06)60564-8 · 2.17 Impact Factor
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    ABSTRACT: Few studies have assessed whether the advantage chemotherapy has been shown to have in treating advanced non-small lung carcinoma in clinical trials is transferrable to normal health care activity. This could explain the skepticism of a large number of pneumologists towards this treatment. The objective of our study was to analyze prognostic factors related to survival and to see whether cytostatic treatment was an independent predictor. Patients enrolled in the study had been diagnosed with non-small cell carcinoma in stages IV or IIIB with pleural or N2-N3 involvement and with a performance status of 2 or below according to the Eastern Cooperative Oncology Group (ECOG). Survival was analyzed with regard to the following variables: age, sex, comorbidity, weight loss, laboratory test results, histological type, ECOG score, TNM staging, and treatment. The Student t test, the chi(2) test, the Kaplan-Meier method, the log-rank test, and Cox regression analysis were used in the statistical analysis. We enrolled 190 patients (157 men and 33 women) with a mean (SD) age of 61.75 (10.85) years (range, 33-85 years). Of these patients, 144 received cytostatic treatment and 46 palliative treatment. The median survival was 31 weeks and was related to absence of weight loss (hazard ratio [HR], 1.73; 95% confidence interval [CI], 1.26-2.39; P=.001), cytostatic treatment (HR, 1.85; 95% CI, 1.25-2.76; P=.002), and ECOG score of 0 to 1 (HR, 2.84; 95% CI, 1.62-5.00; P=.0001). In patients with ECOG scores of 0 to 1, weight loss and treatment were significant prognostic factors. Survival in the ECOG 2 group was 15 weeks for patients undergoing cytostatic treatment and 11 weeks for patients with symptomatic treatment. In normal clinical practice, chemotherapy significantly prolongs survival in patients with performance status of less than 2, more time being gained if there is no associated weight loss. We conclude that the reluctance shown by many pneumologists toward using this treatment is not entirely justified.
    Archivos de Bronconeumología 07/2006; 42(6):273-7. DOI:10.1016/S1579-2129(06)60142-0 · 1.82 Impact Factor
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    ABSTRACT: Objective Few studies have assessed whether the advantage chemotherapy has been shown to have in treating advanced non-small lung carcinoma in clinical trials is transferrable to normal health care activity. This could explain the skepticism of a large number of pneumologists towards this treatment. The objective of our study was to analyze prognostic factors related to survival and to see whether cytostatic treatment was an independent predictor. Patients and methods Patients enrolled in the study had been diagnosed with non-small cell carcinoma in stages IV or IIIB with pleural or N2-N3 involvement and with a performance status of 2 or below according to the Eastern Cooperative Oncology Group (ECOG). Survival was analyzed with regard to the following variables: age, sex, comorbidity, weight loss, laboratory test results, histological type, ECOG score, TNM staging, and treatment. The Student t test, the χ2 test, the Kaplan-Meier method, the logrank test, and Cox regression analysis were used in the statistical analysis. Results We enrolled 190 patients (157 men and 33 women) with a mean (SD) age of 61.75 (10.85) years (range, 33-85 years). Of these patients, 144 received cytostatic treatment and 46 palliative treatment. The median survival was 31 weeks and was related to absence of weight loss (hazard ratio [HR], 1.73; 95% confidence interval [CI], 1.26-2.39; P=001), cytostatic treatment (HR, 1.85; 95% CI, 1.25-2.76; P=002), and ECOG score of 0 to 1 (HR, 2.84; 95% CI, 1.62-5.00; P=.0001). In patients with ECOG scores of 0 to 1, weight loss and treatment were significant prognostic factors. Survival in the ECOG 2 group was 15 weeks for patients undergoing cytostatic treatment and 11 weeks for patients with symptomatic treatment. Conclusions In normal clinical practice, chemotherapy significantly prolongs survival in patients with performance status of less than 2, more time being gained if there is no associated weight loss. We conclude that the reluctance shown by many pneumologists toward using this treatment is not entirely justified.
    Archivos de Bronconeumología 06/2006; 42(6):273–277. DOI:10.1157/13089538 · 1.82 Impact Factor
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    ABSTRACT: Adenosine deaminase (ADA) is a cytoplasmic enzyme which activity is increased in disorders that stimulate cells involved in the immune system. In community-acquired pneumonia (CAP), increased levels of serum ADA have been associated with the presence of atypical microorganisms as the source of the former. Previous studies have shown ADA increases in non-infectious diseases. We evaluated the factors that may influence plasmatic ADA (ADAp) levels in CAP patients. A study with cases (245 episodes of CAP) and controls (49) was designed, and the differences in ADAp activity with regard to organisms, comorbidity factors and complications were analyzed. A logistic regression analysis was performed. CAP caused by atypical microorganisms were found to have increased ADAp values. Variables that independently increased ADAp levels were: atypical etiology (OR = 5.9), liver disease (OR = 5.8), diabetes mellitus (OR = 1.9), and prior antibiotic consumption (OR = 1.7). ADAp is an etiologic marker that could be useful in the empiric approach of the treatment of CAP.
    Medicina Clínica 11/2002; 119(13):481-4. · 1.25 Impact Factor
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    ABSTRACT: Background Adenosine deaminase (ADA) is a cytoplasmic enzyme which activity is increasedin disorders that stimulate cells involved in the immune system. In community-acquired pneumonia(CAP), increased levels of serum ADA have been associated with the presence of «atypical» microorganisms as the source of the former. Previous studies have shown ADA increases innon-infectious diseases. We evaluated the factors that may influence plasmatic ADA (ADAp) levelsin CAP patients. Patients and methods A study with cases (245 episodes of CAP) and controls (49) was designed,and the differences in ADAp activity with regard to organisms, comorbidity factors andcomplications were analyzed. A logistic regression analysis was performed. Results CAP caused by «atypical» microorganisms were found to have increased ADAp values.Variables that independently increased ADAp levels were: «atypical» etiology (OR = 5.9), liverdisease (OR = 5.8), diabetes mellitus (OR = 1.9), and prior antibiotic consumption (OR = 1.7). Conclusions ADAp is an etiologic marker that could be useful in the empiric approach of thetreatment of CAP.
    Medicina Clínica 01/2002; 119(13):481–484. DOI:10.1016/S0025-7753(02)73468-4 · 1.25 Impact Factor