Julio Ancochea

Hospital Universitario de La Princesa, Madrid, Madrid, Spain

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Publications (116)376.35 Total impact

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    ABSTRACT: Cystic fibrosis (CF) is a fatal inherited disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene whose mortality is conditioned by a progressive decline in lung function. Bacterial infections play a key role in this decline. Chronic bacterial infection in CF patients varies over time and the presence of Pseudomonas aeruginosa in sputum is a marker of poor prognosis. P. aeruginosa is eradicated from the airways using inhaled antibiotics administered in various formulations and devices. Antipseudomonal antibiotics have extended the survival of CF patients to 40 years. Tobramycin is a bactericidal aminoglycoside antibiotic with demonstrated activity against gram-negative microorganisms. Initially, the drug was administered as an inhaled parenteral solution. Subsequently, a specific tobramycin inhalation solution was developed. PulmoSphere™ technology enables dry tobramycin powder to be formulated for inhalation (tobramycin inhalation powder) using a small and portable capsule-based breath-activated device (T-326). Chronic colonization by P. aeruginosa is the main indication for aerosol antibiotic therapy. The American Cystic Fibrosis Foundation, European guidelines, and Spanish consensus guidelines provide different recommendations for eradication.
    Therapeutics and Clinical Risk Management 01/2015; 11:407-15. DOI:10.2147/TCRM.S75208 · 1.34 Impact Factor
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    ABSTRACT: Late prognosis of Community-Acquired Pneumonia (CAP) patients is related to cardiovascular events. Persistence of inflammation-related markers, defined by high circulatory levels of interleukin 6 and 10 (IL-6/IL-10), is associated with a higher post-event mortality rate for CAP patients. However, association between these markers and other components of the immune response, and the risk of cardiovascular events, has not been adequately explored. The main objectives of this study are: 1) to quantify the incidence of cardiovascular disease, in the year post-dating their hospital admittance due to CAP and, 2) to describe the distribution patterns of a wide spectrum of inflammatory markers upon admittance to and release from hospital, and to determine their relationship with the incidence of cardiovascular disease.Methods/design: A cohort prospective study. All patients diagnosed and hospitalized with CAP will be candidates for inclusion. The study will take place in the Universitary Hospital "La Princesa", Spain, during two years. Two samples of blood will be taken from each patient: the first upon admittance and the second one prior to release, in order to analyse various immune agents. The main determinants are: pro-adrenomedullin, copeptin, IL-1, IL-6, TNF-alpha, IL-17, IFN-gamma, IL-10 and TGF-beta, E-Selectin, ICAM-1, VCAM-1 and subpopulations of peripheral T lymphocytes (T regulator, Th1 and Th17), together with other clinical and analytical variables. Follow up will start at admittance and finish a year after discharge, registering incidence of death and cardiovascular events. The main objective is to establish the predictive power of different inflammatory markers in the prognosis of CAP, in the short and long term, and their relationship with cardiovascular disease. The level of some inflammatory markers (IL-6/IL-10) has been proposed as a means to differentiate the degree of severity of CAP, but their association with cardiovascular risk is not well established. In this study we aim to define new inflammatory markers associated with cardiovascular disease that could be helpful for the prognosis of CAP patients, by describing the distribution of a wide spectrum of inflammatory mediators and analyzing their association with the incidence of cardiovascular disease and mortality one year after release from hospital.
    BMC Pulmonary Medicine 12/2014; 14(1):197. DOI:10.1186/1471-2466-14-197 · 2.49 Impact Factor
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    ABSTRACT: BackgroundPulmonary exacerbation is one of the main risk factors for death in patients with cystic fibrosis. Several biomarkers have proven useful in the diagnosis and treatment of pulmonary exacerbations, although none has been associated with severity. The objective of the present study was to investigate whether C-reactive protein (CRP) level was associated with the severity of pulmonary exacerbation requiring admission to hospital in patients with cystic fibrosis.MethodsWe designed a severity index for exacerbations based on 4 clinical parameters and determined whether there was an association between CRP levels and severity of the exacerbation. We also investigated the association between CRP and baseline functional and clinical variables.ResultsTwenty-seven patients with cystic fibrosis required 62 admissions to hospital. CRP levels were not significantly associated with the severity index, although they were associated with specific patient characteristics: colonization by Pseudomonas aeruginosa, allergic bronchopulmonary aspergillosis, treatment with oral corticosteroids, and number of severe exacerbations treated with intravenous antibiotics during the previous year.ConclusionsCRP level is not associated with the severity of pulmonary exacerbations, but it is associated with specific clinical characteristics. This simple scoring system (severity index) could prove very useful for evaluating the severity of exacerbations.
    BMC Pulmonary Medicine 09/2014; 14(1):150. DOI:10.1186/1471-2466-14-150 · 2.49 Impact Factor
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    ABSTRACT: Aims: To characterize the distribution of BMI in a population-based sample of COPD patients and to evaluate the impact of obesity on their health status, exercise tolerance, systemic inflammation and comorbidity. Methods: A population-based sample of 3,797 subjects aged 40-80 years from the EPI-SCAN study was selected. Subjects were categorized according their body mass index (BMI) as underweight (<18.5 kg/m(2)), normal weight (18.5-24.9 kg/m(2)), overweight (25.0-29.9 kg/m(2)) or obese (BMI >= 30.0 kg/m(2)). Subjects were evaluated with post-bronchodilator spirometry and 6-minute walk tests. Smoking habits, respiratory symptoms, generic and specific quality of life, daily physical activities, comorbidities and systemic inflammatory biomarkers were recorded. Results: The prevalence of obesity or being overweight was higher in the 382 COPD patients than in the subjects without airflow limitation (29.4%, 95% CI 24.8-33.9% vs. 24.3, 95% CI 22.9-25.8; and 44.7%, 95% CI 39.7-49.6% vs. 43.0%, 95% CI 41.3-44.6, respectively; p = 0.020). In the COPD subgroup, obese subjects presented more dyspnea and less chronic cough, chronic bronchitis or chronic phlegm than normal-weight patients, as well as a worse health status. Moreover, reduced exercise tolerance and higher plasmatic C-reactive protein levels were found in the obese patients, who also presented a greater prevalence of cardiovascular disease (adjusted odds ratio 4.796, 95% CI 1.806-12.736, p = 0.002). Conclusions: In a population-based sample, obesity is more prevalent in COPD patients than in subjects without airflow limitation. Furthermore, obesity affects the clinical manifestations, quality of life and exercise tolerance of COPD patients, and it may contribute to a phenotype characterized by increased systemic inflammation and greater frequency of cardiovascular comorbidity.
    PLoS ONE 08/2014; 9(8):e105220. DOI:10.1371/journal.pone.0105220 · 3.53 Impact Factor
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    ABSTRACT: BACKGROUND: Nintedanib (formerly known as BIBF 1120) is an intracellular inhibitor that targets multiple tyrosine kinases. A phase 2 trial suggested that treatment with 150 mg of nintedanib twice daily reduced lung-function decline and acute exacerbations in patients with idiopathic pulmonary fibrosis. METHODS: We conducted two replicate 52-week, randomized, double-blind, phase 3 trials (INPULSIS-1 and INPULSIS-2) to evaluate the efficacy and safety of 150 mg of nintedanib twice daily as compared with placebo in patients with idiopathic pulmonary fibrosis. The primary end point was the annual rate of decline in forced vital capacity (FVC). Key secondary end points were the time to the first acute exacerbation and the change from baseline in the total score on the St. George's Respiratory Questionnaire, both assessed over a 52-week period. RESULTS: A total of 1066 patients were randomly assigned in a 3:2 ratio to receive nintedanib or placebo. The adjusted annual rate of change in FVC was -114.7 ml with nintedanib versus -239.9 ml with placebo (difference, 125.3 ml; 95% confidence interval [CI], 77.7 to 172.8; P<0.001) in INPULSIS-1 and -113.6 ml with nintedanib versus -207.3 ml with placebo (difference, 93.7 ml; 95% CI, 44.8 to 142.7; P<0.001) in INPULSIS-2. In INPULSIS-1, there was no significant difference between the nintedanib and placebo groups in the time to the first acute exacerbation (hazard ratio with nintedanib, 1.15; 95% CI, 0.54 to 2.42; P=0.67); in INPULSIS-2, there was a significant benefit with nintedanib versus placebo (hazard ratio, 0.38; 95% CI, 0.19 to 0.77; P=0.005). The most frequent adverse event in the nintedanib groups was diarrhea, with rates of 61.5% and 18.6% in the nintedanib and placebo groups, respectively, in INPULSIS-1 and 63.2% and 18.3% in the two groups, respectively, in INPULSIS-2. CONCLUSIONS: In patients with idiopathic pulmonary fibrosis, nintedanib reduced the decline in FVC, which is consistent with a slowing of disease progression; nintedanib was frequently associated with diarrhea, which led to discontinuation of the study medication in less than 5% of patients.
    New England Journal of Medicine 05/2014; 370(22):2071-82. · 54.42 Impact Factor
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    ABSTRACT: BACKGROUND: Nintedanib (formerly known as BIBF 1120) is an intracellular inhibitor that targets multiple tyrosine kinases. A phase 2 trial suggested that treatment with 150 mg of nintedanib twice daily reduced lung-function decline and acute exacerbations in patients with idiopathic pulmonary fibrosis. METHODS: We conducted two replicate 52-week, randomized, double-blind, phase 3 trials (INPULSIS-1 and INPULSIS-2) to evaluate the efficacy and safety of 150 mg of nintedanib twice daily as compared with placebo in patients with idiopathic pulmonary fibrosis. The primary end point was the annual rate of decline in forced vital capacity (FVC). Key secondary end points were the time to the first acute exacerbation and the change from baseline in the total score on the St. George's Respiratory Questionnaire, both assessed over a 52-week period. RESULTS: A total of 1066 patients were randomly assigned in a 3:2 ratio to receive nintedanib or placebo. The adjusted annual rate of change in FVC was -114.7 ml with nintedanib versus -239.9 ml with placebo (difference, 125.3 ml; 95% confidence interval [CI], 77.7 to 172.8; P<0.001) in INPULSIS-1 and -113.6 ml with nintedanib versus -207.3 ml with placebo (difference, 93.7 ml; 95% CI, 44.8 to 142.7; P<0.001) in INPULSIS-2. In INPULSIS-1, there was no significant difference between the nintedanib and placebo groups in the time to the first acute exacerbation (hazard ratio with nintedanib, 1.15; 95% CI, 0.54 to 2.42; P=0.67); in INPULSIS-2, there was a significant benefit with nintedanib versus placebo (hazard ratio, 0.38; 95% CI, 0.19 to 0.77; P=0.005). The most frequent adverse event in the nintedanib groups was diarrhea, with rates of 61.5% and 18.6% in the nintedanib and placebo groups, respectively, in INPULSIS-1 and 63.2% and 18.3% in the two groups, respectively, in INPULSIS-2. CONCLUSIONS: In patients with idiopathic pulmonary fibrosis, nintedanib reduced the decline in FVC, which is consistent with a slowing of disease progression; nintedanib was frequently associated with diarrhea, which led to discontinuation of the study medication in less than 5% of patients.
    New England Journal of Medicine 05/2014; 370(22):2071-82. DOI:10.1056/NEJMoa1402584 · 54.42 Impact Factor
  • J Ancochea, A Xaubet
    SEMERGEN - Medicina de Familia 04/2014; 40(3):119-20.
  • SEMERGEN - Medicina de Familia 04/2014; DOI:10.1016/j.semerg.2014.02.001
  • J. Ancochea, A. Xaubet
    SEMERGEN - Medicina de Familia 04/2014; 40(3):119–120. DOI:10.1016/j.semerg.2014.03.002
  • SEMERGEN - Medicina de Familia 03/2014;
  • Adolfo Villar, Julio Ancochea, Antonio Xaubet
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    ABSTRACT: Pulmonary Hypertension Posters IISESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: The prevalence of PAH in patients with IPF is not well known. There has been no prospective study to date. The purpose of our study was to know the prevalence of PAH in patients with IPF at any stage of severity IPF patients diagnosed by clinical-radiological or pathological criteria were included. All patients underwent echocardiography. If the systolic pulmonary arterial pressure was greater than 40 mmHg, right heart catheterization was performed. A mean pulmonary artery pressure greater than or equal to 25 mmHg with a wedge pressure less than 16 mmHg was considered diagnostic of PAH. 60 patients (18 women, age at diagnosis 64 years) were included and 56 completed the study protocol. Patient characteristics: FVC 64%, DLCO 41%, 6MWT 357 meters, systolic pulmonary arterial pressure 46 mmHg. 17 patients showed a systolic pulmonary artery pressure greater than 40 mmHg and in 14 of them PAH was confirmed by right heart catheterization with a mean pulmonary arterial pressure of 28.6 mmHg. When comparing various clinical and functional parameters between patients with and without PAH significant differences were seen in FVC, FEV1, DLCO, 6MWT and Functional Class. In a multivariate analysis DLCO was associated with the presence of PAHCONCLUSIONS: PAH is not infrequent in patients with IPF (around 26%).Patients with more severe disease are more likely to develop PAH. A marked decrease in DLCO is independently associated with the presence of PAHCLINICAL IMPLICATIONS: PAH is a devastating disease with prognostic and therapeutic implications in patients with IPF. To know the prevalence and associated factors in very important for a better management of this patients because we now have effective treatments in PAHDISCLOSURE: The following authors have nothing to disclose: Adolfo Villar, Julio Ancochea, Antonio XaubetNo Product/Research Disclosure Information.
    Chest 03/2014; 145(3 Suppl):512A. DOI:10.1378/chest.1816876 · 7.13 Impact Factor
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    ABSTRACT: COPD Epidemiology & Physiology PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: The aim of our study was to evaluated the capacity of NT-proBNP to identify high risk patients with COPD exacerbations. Pilot observational prospective study. We did the present study at the Hospital Universitario La Princesa (Madrid) in the period between 2012 may and 2013 may. We included 41 patients with COPD exacerbation and respiratory acidosis (pH<7,35 and PaCO2>45 mmHg) and needed of non-invasive mechanical ventilation. We did the following mesurements: 1.Clinical dates: spirometric values, previous COPD exacerbations, chronic oxygen therapy, comorbidities. 2.Laboratorie test. 3.NT-proBNP in the first 24th hours at the admission. 4.Complications during the income. 5.Death during the income. We classificated the patients into four groups according to the values of NT-proBNP: <500 pg/ml, 500-1.000 pg/ml, 1.000-5.000 pg/ml and >5.000 pg/ml. 56% were men with about 76 years old. 25 patients had almost 2 exacerbations in the previous year. Patients with NT-proBNP>500 pg/ml had more probability of clinical complications during the income (more frequency cardiovascular one), more time of hospitalizations (13,3 vs 8,1 days), more death (7 vs 2), lower pH levels (7,26 vs 7,29) and higer PaCO2 levels (83,4 vs 70,6 mmHg). NT-proBNP was a good biomarker in patients with COPD exacerbation and could difference a high risk group. 1. Pre-selected a patients with poor prognostic. 2. Evaluated the implications of right ventricular function in the pathogenesis of the COPD exacerbation. 3. Evaluated news biomarkers in the COPD exacerbations. The following authors have nothing to disclose: Elena Garcia Castillo, Tamara Alonso Pérez, Gonzalo Segrelles Calvo, Olga Rajas Naranjo, Enrique Zamora García, Julio AncocheaNo Product/Research Disclosure Information.
    Chest 03/2014; 145(3 Suppl):363A. DOI:10.1378/chest.1824409 · 7.13 Impact Factor
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    Archivos de Bronconeumología 01/2014; 50 Suppl 1:1-16. DOI:10.1016/S0300-2896(14)70070-5 · 2.17 Impact Factor
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    ABSTRACT: Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and lethal fibrosing interstitial pneumonia. The median survival from the onset of the symptoms is 2.8 - 4.2 years and the 5-year survival rate is 20%. Its poor prognosis, combined with the scarcity of treatment options, provides a strong rationale for the development of novel therapeutic strategies. During the past decade there has been a huge rise in clinical trials with anti-fibrotic drugs, although only pirfenidone (Esbriet) has shown a beneficial effect. Areas covered: This article reviews the medical literature on the effectiveness and safety of pirfenidone in IPF, by means of a PubMed search from 1995 to present, completed with some data on file from the manufacturer. Expert opinion: Pirfenidone is the only anti-fibrotic drug approved for the treatment of IPF. Pirfenidone provides a meaningful clinical effect on reductions in the decrease in forced vital capacity (FVC), six-minute walk test (6MWT) distance and mortality, and it improves the progression-free survival in IPF patients with mild-to-moderate disease. Pirfenidone is well tolerated, with the most common side-effects being gastrointestinal discomfort and photosensitivity. Pirfenidone has a favorable benefit-risk profile and represents a suitable treatment option for patients with mild-to-moderate IPF.
    Expert Opinion on Pharmacotherapy 12/2013; DOI:10.1517/14656566.2014.867328 · 3.09 Impact Factor
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    ABSTRACT: Introduction Patients with chronic bronchiectasis (BQ) may suffer from psychological disorders. The objective of this study was to assess the presence of anxiety and depression in patients from a specialised BQ Unit, using validated questionnaires. Patients and methods We included patients consecutively diagnosed with BQ (unrelated to cystic fibrosis) by high resolution computed tomography in the study. Patients were clinically stable in the previous three weeks and voluntarily completed the Beck Depression Inventory, State-Trait Anxiety Inventory and St. George's Respiratory Questionnaire, after signing the informed consent. They were classified according to their scores on the psychological screening questionnaires, and their results were compared with the clinical, radiological and functional parameters and Quality of Life. Results Seventy patients were included, 48 women and 22 men, with a mean age of 64.19 years. Thirty-four percent (34%) of patients showed symptoms of depression, and around 55% had scores above the 50th percentile in trait and state anxiety. The amount of sputum was associated with trait anxiety. Bacterial colonization was related to anxiety (trait and state), especially Pseudomonas aeruginosa colonization. Female patients showed a higher risk of depression. There was no relationship between the Quality of Life scores and the established classifications of anxiety and depression. Conclusions A high percentage of patients with BQ presented anxiety (trait and state) and depression. The daily sputum production and bacterial colonization (especially with P. aeruginosa) were the variables most related to anxiety; depression was more common in women. We believe that the presence of psychological disorders should be evaluated, especially in patients with this profile.
    Archivos de Bronconeumología 10/2013; 49(10):415–420. DOI:10.1016/j.arbres.2013.01.012 · 1.82 Impact Factor
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    ABSTRACT: Patients with chronic bronchiectasis (BQ) may suffer from psychological disorders. The objective of this study was to assess the presence of anxiety and depression in patients from a specialised BQ Unit, using validated questionnaires. We included patients consecutively diagnosed with BQ (unrelated to cystic fibrosis) by high resolution computed tomography in the study. Patients were clinically stable in the previous three weeks and voluntarily completed the Beck Depression Inventory, State-Trait Anxiety Inventory and St. George's Respiratory Questionnaire, after signing the informed consent. They were classified according to their scores on the psychological screening questionnaires, and their results were compared with the clinical, radiological and functional parameters and Quality of Life. Seventy patients were included, 48 women and 22 men, with a mean age of 64.19years. Thirty-four percent (34%) of patients showed symptoms of depression, and around 55% had scores above the 50th percentile in trait and state anxiety. The amount of sputum was associated with trait anxiety. Bacterial colonization was related to anxiety (trait and state), especially Pseudomonas aeruginosa colonization. Female patients showed a higher risk of depression. There was no relationship between the Quality of Life scores and the established classifications of anxiety and depression. A high percentage of patients with BQ presented anxiety (trait and state) and depression. The daily sputum production and bacterial colonization (especially with P. aeruginosa) were the variables most related to anxiety; depression was more common in women. We believe that the presence of psychological disorders should be evaluated, especially in patients with this profile.
    Archivos de Bronconeumología 09/2013; · 2.17 Impact Factor
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    ABSTRACT: Objetivo: Estimar la relación de coste-efectividad de roflumilast frente al tratamiento farmacológico más prescrito en España en pacientes adultos con enfermedad pulmonar obstructiva crónica (EPOC) grave con historia de exacerbaciones frecuentes. Metodología: Se utilizó un modelo de Markov para estimar la relación de costeefectividad de roflumilast más un broncodilatador antagonista de los receptores muscarínicos de acción prolongada (roflumilast+LAMA) frente a un LAMA más un agonista beta-2 de acción prolongada asociado a un corticoide inhalado (LAMA+LABA/CI). Se utilizó la perspectiva del Sistema Nacional de Salud (SNS) español y un horizonte temporal de la esperanza de vida de los pacientes. Los resultados de salud evaluados fueron los siguientes: episodios de exacerbación evitados, años de vida ajustados por calidad (AVAC) y años de vida ganados (AVG). La incertidumbre en los parámetros del modelo se examinó en un análisis de sensibilidad. Resultados: Durante el periodo correspondiente a la esperanza de vida de los pacientes, roflumilast+LAMA supuso un coste 3.510 € menor que el de LAMA+LABA/CI. Se estimó que un paciente tratado con roflumilast+LAMA tendría 1,24 exacerbaciones menos, 0,142 AVAC más y 0,16 AVG más que un paciente en tratamiento con LAMA+LABA/CI. El análisis de sensibilidad confirmó la robustez de los resultados. Conclusiones: La combinación de roflumilast+LAMA es la opción dominante (menor coste y mayor efectividad) en España para el tratamiento de pacientes con EPOC grave asociada a bronquitis crónica con historia de exacerbaciones frecuentes, al compararla con LAMA+LABA/CI.
    Pharmacoeconomics - Spanish Research Articles 09/2013; 9(3). DOI:10.1007/BF03320879
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    ABSTRACT: Idiopathic pulmonary fibrosis is defined as a chronic fibrosing interstitial pneumonia limited to the lung, of unknown cause, with poor prognosis and few treatment options. In recent years there has been an increase in their prevalence, probably due to the optimization of diagnostic methods and increased life expectancy. The ATS/ERS Consensus (2000) established the diagnostic criteria and recommendations for the assessment of the disease course and treatment. Later studies have helped to redefine diagnostic criteria and treatment options. In 2011, an international consensus was published, establishing diagnostic criteria and new treatment strategies. These guidelines have been updated with the newest aspects of diagnosis and treatment of idiopathic pulmonary fibrosis. A level of evidence has been identified for the most relevant questions, particularly with regard to treatment options.
    Archivos de Bronconeumología 06/2013; 49(8). DOI:10.1016/j.arbres.2013.03.011 · 2.17 Impact Factor
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    ABSTRACT: IntroductionThe distribution of chronic obstructive pulmonary disease (COPD) in women, and its underdiagnosis and determinants in the general population, have not been well described. The EPI-SCAN study is an epidemiologic, observational study conducted at 11 Spanish centers on the general population aged 40 to 80.Patients and methodThis paper describes the rates and extrapolates the population burden from the 3,802 participants of the EPI-SCAN study.ResultsWith 2,005 female and 1,797 male participants, there was a lower prevalence of COPD in women (5.7%; 95% CI, 4.7-6.7) than in men (15.1%; 95% CI, 13.5-16.8; P < .05). Among the 386 participants with COPD, 114 (29.5%) were women, who were younger, currently smoked less and had lower tobacco smoke exposure, while reporting a lower level of education (P < .05). As for the respiratory symptoms, there were no differences between sexes for cough, dyspnea or wheezing, but the women with COPD reported sputum less frequently (P < .05). There were no differences in the spirometric severity of COPD between women and men. Overall, 73% of the patients with a spirometric COPD criteria were underdiagnosed, and this percentage is unevenly distributed by sex, being 1.27 times more frequent in women (86.0%) than in men (67.6%) (P < .05). By extrapolating the rates of prevalence and underdiagnosis of COPD to the general population, we estimate that there are 628,102 Spanish women between the ages of 40 and 80 with COPD, 540,168 of whom still have not been diagnosed.Conclusions There is a greater underdiagnosis of COPD in women than in men in Spain.
    Archivos de Bronconeumología 06/2013; 49(6):223–229. DOI:10.1016/j.arbres.2012.11.010 · 1.82 Impact Factor
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    ABSTRACT: BACKGROUND: Single nucleotide polymorphisms (SNPs) in angiotensinogen (AGT) at positions -20 and -6 are associated with increased severity and progression of various fibrotic diseases. Our earlier work demonstrated that the progression of idiopathic pulmonary fibrosis (IPF) was associated with the A-6 allele. This study examined the hypothesis that the homozygous CC genotype at -20 and the AA genotype at -6 would confer worse measures of pulmonary function (measured by pulmonary function tests) in IPF. METHODS: Multiple logistic regression analysis was applied to a NIH Lung Tissue Research Consortium cohort and a Spanish cohort, while also adjusting for covariates to determine the effects of these SNPs on measures of pulmonary function. RESULTS: Analysis demonstrated that the CC genotype at -20 was strongly associated with reduced diffusing capacity in males in both cohorts (p = 0.0028 for LTRC and p = 0.017 for the Spanish cohort). In females, the AA genotype was significantly associated with lower FVC (p = 0.0082) and V alv (p = 0.022). In males, the haplotype CA at -20 and -6 in AGT was also strongly associated with reduced diffusing capacity in both cohorts. CONCLUSIONS: This study is the first to demonstrate an association of AGT polymorphisms (-20A > C and -6G > A) with lower measures of pulmonary function in IPF. It is also the first to relate the effect of gender in lung fibrosis with polymorphisms in AGT.
    Beiträge zur Klinik der Tuberkulose 05/2013; 191(4). DOI:10.1007/s00408-013-9476-2 · 2.17 Impact Factor

Publication Stats

2k Citations
376.35 Total Impact Points

Institutions

  • 1991–2015
    • Hospital Universitario de La Princesa
      • Servicio de Neumología
      Madrid, Madrid, Spain
  • 2013
    • Centro de Investigacion Biomédica en Red de Enfermedades Respiratorias
      Bunyola, Balearic Islands, Spain
  • 2011–2013
    • Instituto de Investigación Sanitaria
      Madrid, Madrid, Spain
  • 1993–2012
    • Universidad Autónoma de Madrid
      Madrid, Madrid, Spain
  • 2010
    • Fundación Caubet-Cimera Centro Internacional de Medicina Respiratoria Avanzada
      Bunyola, Balearic Islands, Spain
  • 2004
    • Hospital Universitario Ramón y Cajal
      Madrid, Madrid, Spain
  • 2003
    • Hospital de la Santa Creu i Sant Pau
      Barcino, Catalonia, Spain
  • 1997
    • Hospital Clínic de Barcelona
      Barcino, Catalonia, Spain