Antonio León-Jiménez

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• PhD
• Head of Department at Hospital Universitario Puerta del Mar, Cádiz

Despite the impressive performance of current deep learning models in the field of medical imaging, transferring the lung segmentation task in X-ray images to clinical practice is still a pending task. In this study, the performance of a fully automatic framework for lung field segmentation in chest X-ray images was evaluated. The framework is root...

Engineered stone silicosis (ESS), primarily caused by inhaling respirable crystalline silica, poses a significant occupational health risk globally. ESS has no effective treatment and presents a rapid progression from simple silicosis (SS) to progressive massive fibrosis (PMF), with respiratory failure and death. Despite the use of diagnostic metho...

This editorial addresses the recent decision by the Work Health and Safety Ministers to ban the use and importation of engineered stone (or "artificial stone") in Australia from July 1 2024. We analyse the rationale for the Australian decision and explore its implications for public health policy, particularly in the European Union.

Cough is a frequent symptom in many common respiratory diseases and is considered a predictor of early exacerbation or even disease progression. Continuous cough monitoring offers valuable insights into treatment effectiveness, aiding healthcare providers in timely intervention to prevent exacerbations and hospitalizations. Objective cough monitori...

Despite the impressive performance of current deep learning models in the field of medical imaging, the transfer of the lung segmentation task in X-ray images to clinical practice is still a pending task. In this study, we explored the performance of a fully automatic framework for lung fields segmentation in chest X-ray images, based on the combin...

Silicosis caused by engineered stone (ES-silicosis) is an emerging worldwide issue characterized by inflammation and fibrosis in the lungs. To our knowledge, only a few reports have investigated leukocyte/lymphocyte subsets in ES-silicosis patients. The present study was designed to explore the proportions of the main lymphocyte subsets in ES-silic...

Artificial stone (AS) silicosis has emerged as a specially aggressive form of silicosis that can lead to pulmonary fibrosis and respiratory failure. The utility of positron emission tomography combined with computed tomography (PET/CT), an essential tool in oncological diseases that shows increased metabolic activity in neoplastic cells, is being e...

Despite the impressive performance of current deep learning models in the field of medical imaging, the transfer of the lung segmentation task in X-ray images to clinical practice is still a pending task. In this study, we explored the performance of a fully automatic framework for lung fields segmentation in chest X-ray images, based on the combin...

Engineered stone silicosis has become an occupational epidemic disease that progresses rapidly to progressive massive fibrosis with respiratory failure and death, and there is no effective treatment. Silica deposition in the lung triggers a series of inflammatory reactions with the participation of multiple cytokines and cellular mediators whose ro...

Patients with silicosis caused by occupational exposure to engineered stone (ES) present a rapid progression from simple silicosis (SS) to progressive massive fibrosis (PMF). Patient classification follows international rules based on radiology and high-resolution computed tomography (HRCT), but limited studies, if any, have explored biomarkers fro...

Objectives To investigate differences in workplace exposure, demographic and clinical findings in engineered stone (ES) workers from a multinational consortium using the Engineered Stone Silicosis Investigators (ESSI) Global Silicosis Registry. Methods With ethics board approval in Israel, Spain, Australia and the USA, ES workers ages 18+ with a p...

Background Engineered stone silicosis is an emerging disease in many countries worldwide produced by the inhalation of respirable dust of engineered stone. This silicosis has a high incidence among young workers, with a short latency period and greater aggressiveness than silicosis caused by natural materials. Although the silica content is very hi...

BACKGROUND: Exposure to artificial stone machining, under the conditions in which marble workers work with this new product, can cause silicosis. OBJECTIVE: To examine the experiences of marble workers affected, both in workshop and during home installation of countertops, before diagnosis of silicosis. METHODS: Qualitative study in which 10 open-e...

The appropriate titration for the personalized oxygen needs of patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia is a determining factor in the success of long-term oxygen therapy. There are no standardized procedures to assist in determining the patient's needs during the physical activities of daily life. Despite tha...

Los sonidos pulmonares han recibido en los últimos años una creciente atención por su potencial para la evaluación de ciertos trastornos respiratorios. Más concretamente, de entre los sonidos adventicios que se manifiestan en el curso de la enfermedad, la tos se ha mostrado como el síntoma más común en algunas enfermedades respiratorias. Sin embarg...

Background Silicosis is rapidly emerging in high-income countries in relation to the replacement of natural stone with artificial stone, especially in the manufacturing and installation of kitchen and bathroom countertops. Progression of this form of silicosis following the cessation of exposure is unknown. Research Question The objective of this...

Long-term oxygen therapy (LTOT) has become standard care for the treatment of patients with chronic obstructive pulmonary disease (COPD) and other severe hypoxemic lung diseases. The use of new portable O2 concentrators (POC) in LTOT is being expanded. However, the issue of oxygen titration is not always properly addressed, since POCs rely on prope...

Traditional long-term oxygen therapy devices used in daily-life activities need to be manually adjusted depending on the level of intensity of the activity done. In this study, a system to automatically control a commercial POC devices is proposed with the aim of improving the used and efficacy of the therapy in patients with chronic obstructive pu...

Acute exacerbations are one of the main causes that reduce health-related quality of life and lead to hospitalisations of patients of chronic obstructive pulmonary disease (COPD). Prediction of exacerbations could diminish those negative effects and reduce the high costs associated with COPD patients. In this study, 16 patients were telemonitored a...

Background and Objective Oxygen therapy has become a standard care for the treatment of patients with chronic obstructive pulmonary disease and other hypoxemic chronic lung diseases. In current systems, manually continuous adjustment of O2 flow rate is a time-consuming task, often unsuccessful, that requires experienced staff. The primary aim of th...

In recent years, new autonomous physiological close-loop controlled (PCLC) medical devices for oxygen delivery are being researched. Most of this PCLC devices are based on the feedback of arterial oxygen saturation, measured using a pulse oximeter. However, pulse oximeters may provide spuriously low or high SpO2 values. In this work, a different ap...

Major reported factors associated with the limited effectiveness of home telemonitoring interventions in chronic respiratory conditions include the lack of useful early predictors, poor patient compliance and the poor performance of conventional algorithms for detecting deteriorations. This article provides a systematic review of existing algorithm...

Collaboration between patients and their medical and technical experts enabled the development of an automated questionnaire for the early detection of COPD exacerbations (AQCE). The questionnaire consisted of fourteen questions and was implemented on a computer system for use by patients at home in an un-supervised environment. Psychometric evalua...

Chronic obstructive pulmonary disease (COPD) is one of the commonest causes of death in the world and poses a substantial burden on healthcare systems and patients' quality of life. The largest component of the related healthcare costs is attributable to admissions due to acute exacerbation (AECOPD). The evidence that might support the effectivenes...

Chronic Obstructive Pulmonary Disease (COPD) places an enormous burden on the health care systems and causes diminished health related quality of life. The highest proportion of human and economic cost is associated to admissions for acute exacerbation of respiratory symptoms. The remote monitoring of COPD patients with the view of early detection...

La Enfermedad Pulmonar Obstructiva Crónica (EPOC) es una de las principales causas de muerte en el mundo, siendo predecible en las próximas décadas un aumento de su prevalencia y mortalidad. Ello supone un serio problema para el sistema de salud público ya que las hospitalizaciones debidas a las exacerbaciones de EPOC (eEPOC) tienen una alto coste...

COPD places an enormous burden on the healthcare systems and causes diminished health-related quality of life. The highest proportion of human and economic cost is associated with admissions for acute exacerbation of respiratory symptoms (AECOPD). Since prompt detection and treatment of exacerbations may improve outcomes, early detection of AECOPD...

Resumen La Enfermedad Pulmonar Obstructiva Crónica (EPOC) es una enfermedad pulmonar progresiva con uno gran impacto social y económico. La mayor proporción del coste humano y económico asociado a la enfermedad es debida al ingreso hospitalario por exacerbaciones agudas (eEPOC). En este estudió se evaluó la potencialidad del análisis automático de...

Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease of the lung with a great prevalence and a remarkable socio-economic impact on patients and health systems. Early detection of exacerbations could diminish the adverse effects on patients' health and cut down costs burdened on patients with COPD. A group of 16 patients were telemo...

Introduction: Among factors that underlie high rates of non-participation reported in telehealth interventions are the low older users' acceptance of information technologies and the low levels of non-compliance with therapy of chronic patients. Therefore, inclusion of potential users into design stages of assistive technologies is challenging. In...

Chronic Obstructive Pulmonary Disease (COPD) is a very serious progressive lung disease with a high socioeconomic impact and prevalence levels worldwide. Admissions for acute exacerbation of respiratory symptoms (AECOPD) have the highest proportion of economic and human cost. During a 6-months field trial in a group of 16 patients, a novel electron...

During the last few years, different COPD phenotypes are being defined. Despite being one of the basic characteristics of exacerbations, studies on changes and peculiarities of respiratory sounds during an exacerbation episode have been barely studied. A computerized analysis of respiratory sounds recorded in patients hospitalized because of acute...

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major event in the natural course of the disease, and is associated with significant mortality and socioeconomic impact. Abnormal respiratory sounds are commonly present in patients with AECOPD. Computerized analysis of these sounds can assist in diagnosis and in evaluation d...

Background Early diagnosis of pneumonia and discrimination between this disease and chronic obstructive pulmonary disease (COPD) exacerbations in patients with COPD are crucial for optimal clinical management and treatment. Objectives To examine the use of computerized analysis of respiratory sounds, a hybrid system based on principal component ana...

The Autonomy Motivation & Individual Self-Management for COPD patients (AMICA) is aimed at the disease management and medical care of chronic obstructive pulmonary disease (COPD) patients. AMICA is a Research and Development project funded by the states associated to the AAL Joint Programme and by the EC financial contribution (http://www.aal-europ...

Currently, Sleep Apnea-Hypopnea Syndrome (SAHS) is accurately diagnosed in Sleep Units. In the last decade, in order to reduce the burden for health systems and the consequent impact in patients, several home-located methods based on the binary classification of SAHS using overnight pulse oximetry (SpO2) have been proposed. Binary classifiers give...

Sleep apnea-hypopnea syndrome (SAHS) is significantly underdiagnosed and new screening systems are needed. The analysis of oxygen desaturation has been proposed as a screening method. However, when oxygen saturation (SpO(2)) is used as a standalone single channel device, algorithms working in time domain achieve either a high sensitivity or a high...

This work's goal is developing a COPD exacerbation symptoms and prodromes-based questionnaire for the early detection of exacerbations at home by a device for telemonitoring.

About 3% of people suffer from sleep apnea-hypopnea syndrome SAHS. SAHS is a sleep associated respiratory disorder that negatively affects life quality and life expectancy. It is assumed that more than 80% of SAHS concerned are neither diagnosed nor therapied. Reliable and easy-handling SAHS screening systems are needed. Within this study, the reli...

Aplicación del análisis de la variabilidad de la saturación de oxígeno en sangre a la detección del SAOS El análisis de las desaturaciones de oxígeno es una variable básica en los estudios polisomnográficos para la diagnosis del síndrome de apnea hipopnea del sueño (SAHS). Existen diversos algoritmos que operan en el dominio del tiempo para la dete...

This paper presents a body-fixed-sensor-based approach to assess potential sleep apnea patients. A trial involving 15 patients at a sleep unit was undertaken. Vibration sounds were acquired from an accelerometer sensor fixed with a noninvasive mounting on the suprasternal notch of subjects resting in supine position. Respiratory, cardiac, and snori...

This work presents the dialogue interface that is being developed for the AMICA project, aimed at self-management and follow-up of patients with Chronic Obstructive Pulmonary Disease (COPD). This platform tries to overcome possible problems of interaction of patients by extending the traditional mouse and keyboard with new information-communication...

The occurrence of a bronchopleural fistula (BPF) continues to represent a challenging management problem, and is associated with high morbidity and mortality. A novel and successful technique that uses submucosal injection of a tissue expander for bronchoscopic occlusion of BPFs has been designed. This method may be used either alone or in combinat...

To determine if inspiratory capacity (IC) assessment could be useful for chronic obstructive pulmonary disease (COPD) patient management in the primary care setting. A descriptive cross-sectional study was conducted in 93 patients diagnosed with COPD according to Spanish Thoracic Society (SEPAR) criteria. Patients were recruited in eight primary ca...

The analysis of oxygen desaturations is a basic variable in polysomnographic studies for the diagnosis of sleep apnea. Several algorithms operating in the time domain already exist for sleep apnea detection via pulse oximetry, but in a disadvantageous way--they achieve either a high sensitivity or a high specificity. The aim of this study was to as...

Malignant pleural mesothelioma (MPM) results from malignant transformation of mesothelial cells. Past asbestos exposure represents a major risk factor for MPM and other benign pleural disease. Soluble mesothelin-related peptides (SMRP) have been regarded as a promising serum biomarker for MPM. The aim of this study was to investigate serum levels o...

Target: After the appearance of 5 cases with respiratory symptoms in an aeronautical company and their exposal to different chemical substances, we proposed to investigate their possible link with the working environment. Material and methods: Aluminium environmental dust measurements, trichloroethylene and glycol, alergic study with these substanc...

The objective of this study was to evaluate factors associated with health-related quality of life (HRQOL) among patients receiving home mechanical ventilation (HMV). Observational, cross-sectional study. Patients receiving HMV were recruited from hospital outpatients facilities at five participating centers; a single follow-up visit was scheduled....

Retrospectively to analyse the influence of clinical and histo-pathological characteristics in the local recurrence after non-small cell lung cancer surgery. 146 patients were included and studied during a minimum of two years. The free survival of disease function (FSD) was constructed according to the Kaplan-Meier method. The univariant compariso...

To validate the Spanish Severe Respiratory Insufficiency (SRI) questionnaire, the first health-related quality-of-life questionnaire specific for patients receiving home mechanical ventilation (HMV). This multicenter prospective study enrolled 115 patients (53 males, age 62+/-13 years) receiving HMV, recruited from five hospitals. Patients were sch...

Objetives: Retrospectively to analyse the influence of clinical and histo-pathological characteristics in the local recurrence after non-small cell lung cancer surgery. Method: 146 patients were included and studied during a minimum of two years. The free survival of disease function (FSD) was constructed according to the Kaplan-Meier method. The u...

Clopidogrel is a new antiplatelet prescribed for the secondary prevention of atherosclerotic events. The literature shows that the clinical manifestations of clopidogrel hypersensitivity include urticaria1, skin rash2-4, and angioedema5. The precise immunological mechanism underlying clopidogrel hypersensitivity has not been established. We describ...

Continuous positive airway pressure (CPAP) is the main treatment for obstructive sleep apnea-hypopnea syndrome (OSAHS). Polysomnography (PSG) is the gold standard for CPAP titration. However, alternative methods have been sought to titrate CPAP at less expense in terms of time and resources. The aim of this study was to analyze CPAP success in cont...

La fibrobroncoscopia (FB) representa una gran ayuda para la realización de intubaciones difíciles o fallidas por los métodos convencionales. Nuestro objetivo fue conocer el número de intubaciones realizadas mediante FB, así como características de las mismas y analizar los problemas detectados en base a la experiencia acumulada. Metodología: Se rec...

OBJECTIVES: To study health-related quality of life (HRQL) of patients receiving home mechanical ventilation (HMV) for different causes using a new specific questionnaire (SRI). METHODS: Observational transversal multicentre trial in which 5 hospitals participated. Patients enrolled were scheduled for one only visit, where sociodemographic and clin...

Home mechanical ventilation is used with patients with severe, chronic respiratory failure, a condition that has a serious impact on quality of life. The aim of this study was to produce a translation and cultural adaptation of the Severe Respiratory Insufficiency. Questionnaire for the Spanish population, the first health-related quality of life q...

Objective Home mechanical ventilation is used with patients with severe, chronic respiratory failure, a condition that has a serious impact on quality of life. The aim of this study was to produce a translation and cultural adaptation of the Severe Respiratory Insufficiency. Questionnaire for the Spanish population, the first health-related quality...

Although non-invasive ventilation (NIV) efficacy in the treatment of acute hypercapnic respiratory failure (AHRF) have been previously demonstrated, not all the studies reveal this fact in the same degree, with some variability in the results. This study aimed to analyse variables related to NIV outcome for AHRF. A group of consecutive patients req...

The aim of this study was to analyze changes in pulmonary function after radiation therapy (RT) for breast cancer. A total of 39 consecutive eligible women, who underwent postoperative irradiation for breast cancer, were entered in the study. Spirometry consisting of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), carbon mon...