Juan Ruiz-Manzano

• MD, PhD
• Professor at Autonomous University of Barcelona

Interferon (IFN)-γ release assays (IGRAs) are used to diagnose latent tuberculosis (TB) infection (LTBI). To improve the accuracy of these tests, different approaches, such as alternative cytokine detection and using different antigens, are considered. Following this purpose, this study aims to evaluate the addition of EspC, EspF and Rv2348-B to th...

The aim of this study was to test the use of IP-10 detection in dried plasma from contact studies individuals (contacts of smear positive patients), by comparing it with IP-10 and IFN-γ detection in direct plasma, to establish IP-10 detection in DPS as a useful assay for LTBI diagnosis. Whole blood samples were collected from 80 subjects: 12 with a...

We developed a novel method, PyroTyping, for discrimination of Mycobacterium tuberculosis isolates combining pyrosequencing and IS6110 polymorphism. A total of 100 isolates were analysed with IS6110-restriction fragment length polymorphism (RFLP), spoligotyping, mycobacterial interspersed repetitive units – variable number tandem repeats (MIRU-VNTR...

AIM: Endobronchial valve placement is a safe alternative to surgery in patients with persistent pulmonary air leak. The aim of our study is to describe our experience in a series of patients with persistence air leak who underwent endobronchial valve placement. MATERIAL AND METHODS: We conducted a retrospective study that included patients with per...

Peripheral lung lesions are a common finding, however diagnosis is considered difficult because they cannot be visualized using conventional bronchoscopy and tissue obtained with the usual techniques may be insufficient. OBJ: To evaluate the diagnostic yield and usefulness of the combination of transbronchial cryobiopsy (TBCB) with a commercialized...

Objective: To determine the case-fatality rate (CFR) at the end of the intensive phase of tuberculosis (TB) treatment, and factors associated with fatality. Methods: TB patients diagnosed between 2006 and 2013 were followed-up during treatment. We computed the CFR at the end of the intensive phase of TB treatment, and the incidence of death per...

Study objectives: We investigated the diagnostic accuracy for the identification of obstructive sleep apnea syndrome (OSAS) and its severity of a noninvasive technology based on image processing (SleepWise®). Methods: This is an observational, prospective study to evaluate the degree of agreement between polysomnography (PSG) and SleepWise®. We...

The aim was to evaluate the array GenoFlow DR-MTB (DiagCor Bioscience, Hong Kong) on 70 cultured isolates and 50 sputum specimens. GenoFlow showed good sensitivity and specificity when compared to phenotypic BACTEC 460TB. This array accurately detected mutations in rpoB , katG , and inhA associated with resistance to rifampin and isoniazid.

Background: Severe sepsis, may be present on hospital arrival in approximately one-third of patients with community-acquired pneumonia (CAP). Objective: To determine the host characteristics and micro-organisms associated with severe sepsis in patients hospitalized with CAP. Results: We performed a prospective multicenter cohort study in 13 Sp...

. The relationship between air pollution and exacerbation of respiratory diseases is well established. Nevertheless, its association with hemoptysis has been poorly investigated. This paper describes the relationship of air pollutants with severe hemoptysis. Methods . All consecutive subjects with severe hemoptysis during a 5-year period were inclu...

Pleuroparenchymal fibroelastosis (PPFE) is a rare entity that has been recently included in the official American Thoracic Society/European Respiratory Society (ATS/ERS) statement in 2013 as a group of rare idiopathic interstitial pneumonias (IIPs). PPFE is characterized by pleural and subpleural parenchymal thickening due to elastic fiber prolifer...

Objective: To compare the required doses of sedatives, sedation level achieved and complications in patients who underwent transesophageal ultrasound using a convex probe bronchoscope (EUS-B) or endobronchial ultrasound (EBUS). Material and Methods: We included 38 patients sedated with propofol and remifentanil infusion. Two groups were established...

Introduction: Bronchoscopy is useful in patients (p) with difficult-to-control asthma to rule out other related conditions. The aim of the study was to describe bronchoscopic findings in p with severe asthma (SA). Material and Methods: It was a retrospective study. 39 p with persistent SA according to GINA 2014 were included. In 15 p (38.5%) sedati...

Detection of the C-polysaccharide of Streptococcus pneumoniae in urine by an immune-chromatographic test is increasingly used to evaluate patients with community-acquired pneumonia. We assessed the sensitivity and specificity of this test in the largest series of cases to date and used logistic regression models to determine predictors of positivit...

Setting: The infection with Mycobacterium tuberculosis gives a delayed immune response, measured by the tuberculine skin test. We present a new technique for evaluation based on automatic detection and measurement of skin temperature due to infrared emission. Design: 34 subjects (46.8±16.9 years) (12/22, M/F) with suspected tuberculosis disease...

The aim of this work was to study the diagnostic accuracy of pyrosequencing to detect resistance to fluoroquinolones, kanamycin, amikacin, capreomycin, and ethambutol (EMB) in Mycobacterium tuberculosis clinical strains. One hundred four clinical isolates previously characterized by BACTEC 460TB/MGIT 960 were included. Specific mutations were targe...

Pleuroparenchymal fibroelastosis (PPFE) is a rare disease that has been recently included in the updated consensus on idiopathic interstitial pneumonias. It shares some clinical features with other chronic interstitial pneumonias (dyspnea, dry cough), and is radiologically characterized by pleural and subpleural parenchymal fibrosis and elastosis,...

To study the diagnostic accuracy of a multiplex real-time PCR (Anyplex II MTB/MDR/XDR, Seegene, Corea) that detects Mycobacterium tuberculosis resistant to isoniazid (INH), rifampicin (RIF), fluoroquinolones (FLQ) and injectable drugs (kanamycin [KAN], amikacin [AMK] and capreomycin [CAP]) in isolates and specimens. One hundred fourteen cultured is...

Rationale: The identification of patients with latent tuberculosis infection, who are at higher risk to develop active disease, is an important component of disease control. Objectives: We aim to compare the usefulness of the QuantiFERON-TB Gold in-tube assay and the tuberculin skin test to predict the development of active tuberculosis during f...

Extract One essential aspect for controlling the spread of tuberculosis (TB) is to diagnose it in an early stage. However, the commonly used test systems are still insufficient. Moreover, current assays perform poorly in discriminating between active TB and latent tuberculosis infection (LTBI). Due to limited knowledge of promising TB biomarkers, g...

Chronic hypoxemia has deleterious effects on psychomotor function that can affect daily life. There are no clear results regarding short term therapy with low concentrations of O2 in hypoxemic patients. We seek to demonstrate, by measuring the characteristics of drawing, these effects on psychomotor function of hypoxemic patients treated with O2. E...

This Pulmonary Perspective summarizes the content and main conclusions of an international workshop on personalized respiratory medicine co-organized by the Barcelona Respiratory Network (www.brn.cat) and the AJRCCM in June 2014. It discusses: (1) its definition, historical, social, legal and ethical aspects; (2) the view from different disciplines...

La elastografía en tiempo real realizada durante la ultrasonografía endoscópica digestiva es una técnica relativamente nueva que permite caracterizar la dureza de los tejidos, y ha sido utilizada con éxito como predictor de malignidad en ganglios mediastínicos.En la presente nota clínica se describe nuestra experiencia práctica en la técnica de la...

Real-time elastography performed during endoscopic ultrasonography is a relatively new method for characterizing tissue stiffness, and has been used successfully as a predictor of malignancy in mediastinal lymph nodes. This case report describes our practical experience with this technique using an ultrasound bronchoscope to examine mediastinal lym...

Objectives: To determine the sensitivity and specificity of AID TB Resistance line probe assay (AID Diagnostika, Germany) to detect Mycobacterium tuberculosis and its resistance to first- and second-line drugs in clinical samples using BACTEC 460TB as the reference standard. Methods: The test consists on three strips to detect resistance to ison...

The aim of our work here was to evaluate the immunogenicity of 60 mycobacterial antigens, some of which have not been previously assessed, notably a novel series of in vivo-expressed Mycobacterium tuberculosis (IVE-TB) antigens. We enrolled 505 subjects and separated them in individuals with and without latent tuberculosis infection (LTBI) vs. pati...

Background: Although some authors have suggested that there is some seasonal periodicity of hemoptysis, or relation to respiratory tract infections, the association of influenza or climatic parameters with hemoptysis has been poorly investigated. Our aim was to describe the relationship between influenza and climatic parameters with severe hemopty...

Introduction: The magnitude of current resistance to antituberculosis drugs in Spain is unknown. The objective of this study is to describe resistance to first-line antituberculosis drugs and determine the associated factors. Methods: Prospective multicenter study of adult tuberculosis patients with positive Mycobacterium tuberculosis culture an...

Background Endobronchial ultrasonography (EBUS) has been applied as a routine procedure for the diagnostic of hiliar and mediastinal nodes. The authors assessed the relationship between the echographic appearance of mediastinal nodes, based on endobronchial ultrasound images, and the likelihood of malignancy. Methods The images of twelve malignant...

Background The aim of the study was to assess the correlation between the tuberculin skin test (TST) and in vitro interferon-gamma released assays (IGRAs) with risk factors for the spread of infection in smear positive pulmonary tuberculosis (TB) contacts. Methods We recruited prospective contacts with smear positive pulmonary TB cases. We looked...

Active smoking increases the risk of developing community-acquired pneumonia (CAP) and invasive pneumococcal disease (IPD), although its impact on mortality in pneumococcal CAP outcomes remains unclear. The aim of the study was to investigate the influence of current smoking status in pneumococcal CAP mortality. We performed a multicentre, prospect...

Several studies have shown that the interaction between chronic obstructive pulmonary disease (COPD) and cardiovascular comorbidity is complex and bidirectional, since each of these diseases complicates the prognosis of the other. Recent advances in imaging technology have led to better characterization of cardiac chambers and allowed the relations...

Several studies have shown that the interaction between chronic obstructive pulmonary disease (COPD) and cardiovascular comorbidity is complex and bidirectional, since each of these diseases complicates the prognosis of the other. Recent advances in imaging technology have led to better characterization of cardiac chambers and allowed the relations...

The consequences of phrenic nerve paralysis vary from a considerable reduction in respiratory function to an apparently normal state. Acoustic analysis of lung sound intensity (LSI) could be an indirect non-invasive measurement of respiratory muscle function, comparing activity on the two sides of the thoracic cage. Lung sounds and airflow were rec...

Background: In 2005, the Spanish government approved Law 28/2005 on health measures against smoking; this was amended in 2010 by Law 42/2010. Objective: The purpose of this study was to assess the impact of these laws on passive smoking. Methods: Three epidemiological studies were conducted on a representative sample of the population via tele...

Introduction The magnitude of current resistance to antituberculosis drugs in Spain is unknown. The objective of this study is to describe resistance to first-line antituberculosis drugs and determine the associated factors. Methods Prospective multicenter study of adult tuberculosis patients with positive Mycobacterium tuberculosis culture and an...

To describe experience with bronchial artery embolization (BAE) in a cohort of patients with cancer. All consecutive patients with cancer and at least one episode of hemoptysis that required BAE during a 14-year period were included in this observational retrospective review. The endpoints of the study were immediate success, recurrence of hemoptys...

To determine predictive factors for changes in standard anti-tuberculosis chemotherapy at the time of diagnosis. A prospective study was performed among tuberculosis (TB) patients treated at specialised centres during 2008-2009. Treatment outcome was monitored per standard guidelines. Treatment was considered successful if the patient was cured or...

Artery embolization (AE) is a safe and useful procedure in the management of massive hemoptysis. The objective of our study was to describe the experience of AE in a tertiary referral center, to characterize angiographic findings at the time of recurrence, and to analyze factors associated with these findings. Observational retrospective study of p...

Chronic obstructive pulmonary disease (COPD) is one of the most prevalent chronic diseases, with an increasing rate in morbidity and mortality. In recent years, there has been a greater awareness about the clinical importance of systemic effects and other chronic conditions associated with COPD, as these significantly impact on the course of diseas...

Objective: To determine the incidence of latent tuberculosis infection (LTBI), and risk factors for tuberculosis skin test (TST) conversion among Healthcare workers (HCWs) during a 20-year follow-up period. Design: Prospective cohort analysis. Surveillance was conducted from January 1, 1988, to December 31, 2007. Setting: 600-bed tertiary refe...

Introduction Artery embolization (AE) is a safe and useful procedure in the management of massive hemoptysis. The objective of our study was to describe the experience of AE in a tertiary referral center, to characterize angiographic findings at the time of recurrence, and to analyze factors associated with these findings. Material and methods Obs...

Background Although some authors have suggested that there is some seasonal periodicity in hemoptysis, temporal patterns of hemoptysis have been poorly investigated. The aim of this study is to describe the temporal pattern of severe hemoptysis which required bronchial artery embolization (BAE). Methods All consecutive patients with at least one e...

Intrathoracic lymph node enlargement is a common finding in patients with extrathoracic malignancies. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a technique that is commonly used for lung cancer diagnosis and staging but that has not been widely investigated for the diagnosis of enlarged mediastinal and lobar ly...

Background Adherence to tuberculosis (TB) treatment is troublesome, due to long therapy duration, quick therapeutic response which allows the patient to disregard about the rest of their treatment and the lack of motivation on behalf of the patient for improved. The objective of this study was to develop and validate a scoring system to predict the...

Background The objective of this study was to determine the level of knowledge about chronic obstructive pulmonary disease (COPD) and its determinants in the general population of Spain, and to compare it with a similar survey conducted in 2002.Methods We conducted a cross-sectional, observational, epidemiological study in September 2011 by means o...

Since the development of endobronchial ultrasound-guided real-time needle aspiration (EBUS-rt-TBNA) no false positive (FP) cases have been described. We present the first FP case for EBUS-rt-TBNA secondary to a carcinoma in situ (CIS) in the bronchial point of puncture. A 66-years-old male was referred to our Institution because of a mass in left l...

The evaluation of the disabilities of patients with respiratory disease is regulated by the Spanish Ministry of Labor and Social Security, as are disabilities of any other type. We believe, however, that in respiratory pathologies this evaluation is especially complicated because, as they are chronic processes, they inter-relate with other systems....

The objective of this study was to determine the level of knowledge about chronic obstructive pulmonary disease (COPD) and its determinants in the general population of Spain, and to compare it with a similar survey conducted in 2002. We conducted a cross-sectional, observational, epidemiological study in September 2011 by means of a telephone inte...

Initial care has been associated with improved survival of community-acquired pneumonia (CAP). We aimed to investigate patient comorbidities and health status measured by the Charlson index and clinical signs at diagnosis associated with adherence to recommended processes of care in CAP. We studied 3844 patients hospitalized with CAP. The evaluated...

Several sonographic features observed by endobronchial ultrasonography have been suggested to be useful to predict malignancy in mediastinal lymph nodes. To evaluate agreement to describe sonographic features, 28 video images were evaluated twice by eight expert bronchoscopists. The observers reviewed each case for the presence of coagulation necro...

Central early lung cancers (CELC) are tumors arising from the central airways, roentgenographically occult, which are usually diagnosed by bronchoscopy after a positive sputum cytology. Most CELCs are undetectable for conventional white light bronchoscopy (WLB) but can be identified under autofluorescence bronchoscopy (AFB). Although AFB increases...

The evaluation of the disabilities of patients with respiratory disease is regulated by the Spanish Ministry of Labor and Social Security, as are disabilities of any other type. We believe, however, that in respiratory pathologies this evaluation is especially complicated because, as they are chronic processes, they inter-relate with other systems....

The purpose of this study was to evaluate the GenoType MTBDRsl assay (Hain Lifescience GmbH, Nehren, Germany) for its ability to detect resistance to fluoroquinolones (FLQ), injectable second-line antibiotics [kanamycin (KM) and capreomycin (CM)], and ethambutol (EMB) in Mycobacterium tuberculosis clinical strains and directly in clinical samples....

Objective To estimate the prevalence of tuberculous infection (TI) in the health-care workers of a hospital over the course of a 20-year period and analyze the associated risk factors.

To estimate the prevalence of tuberculous infection (TI) in the health-care workers of a hospital over the course of a 20-year period and analyze the associated risk factors. A cross-sectional, descriptive study of the workers of a general hospital from 1988 until 2007, using a tuberculin test (TT) and questionnaire. 2,179 workers were studied (mea...

The aim of this study was to investigate whether procalcitonin (PCT), neopterin, C-reactive protein (CRP), and mid regional pro-atrial natriuretic peptide (MR-proANP) levels at admission and during the clinical course can be useful for the management of patients with pneumonia. The study population consisted of 75 patients with clinical and radiolo...

Processes of care and adherence to guidelines have been associated with improved survival in community-acquired pneumonia (CAP). In sepsis, bundles of processes of care have also increased survival. We aimed to audit compliance with guideline-recommended processes of care and its impact on outcome in hospitalised CAP patients with sepsis. We prospe...

The aim of this study was to evaluate a pyrosequencing method for the detection of Mycobacterium tuberculosis isolates resistant to rifampin and isoniazid using both clinical strains and clinical samples, comparing the results with those of the Bactec 460TB and GenoType MTBDRplus assays. In comparison to Bactec 460TB as the gold standard, the sensi...

The aim of the present study was to compare the performance of the interferon (IFN)-γ tests (QuantiFERON®-TB Gold In-Tube (QFT-G-IT) and T-SPOT®. TB ) with the tuberculin skin test (TST) in diagnosing tuberculosis (TB) infection in children, and to analyse discordant results. This was a prospective study including 98 children from contact-tracing s...

The identification of biological markers in order to assess different aspects of COPD is an area of growing interest. The objective of this study was to investigate whether levels of procalcitonin (PCT), C-reactive protein (CRP), and neopterin in COPD patients could be useful in identifying the etiological origin of the exacerbation and assessing i...

A recent approach for the management of chronic obstructive pulmonary disease (COPD) is the measurement of systemic biomarkers. The aim of this study was to evaluate the usefulness of mid regional pro-atrial natriuretic peptide (MR-proANP) to predict short and long term prognosis. We included 318 COPD patients: 46 in a stable phase, 217 undergoing...

To identify the differential tuberculosis (TB) characteristics within the immigrant population with respect to natives in Spain. A prospective cohort study design was implemented to examine the TB cases diagnosed and starting standard antituberculous treatment in Spain, between January 1st 2006 and March 31st 2007. A logistic regression analysis wa...

The present study was designed to describe the clinical profile of acute exacerbations of chronic obstructive pulmonary disease (COPD) and the treatment prescribed by primary care physicians (PCPs) in Spain. An observational, multicenter and cross-sectional study was performed in patients diagnosed with acute exacerbation of COPD and treated by PCP...

Pulmonary TB should be suspected in patients with respiratory symptoms longer than 2–3 weeks. Immunosuppression may modify clinical and radiological presentation. Chest X-ray shows very suggestive, albeit sometimes atypical, signs of TB. Complex radiological tests (CT scan, MR) are more useful in extrapulmonary TB.At least 3 serial representative s...

Pulmonary TB should be suspected in patients with respiratory symptoms longer than 2-3 weeks. Immunosuppression may modify clinical and radiological presentation. Chest x-ray shows very suggestive, albeit sometimes atypical, signs of TB. Complex radiological tests (CT scan, MR) are more useful in extrapulmonary TB. At least 3 serial representative...

The aim of the present study was to determine the role of previous non-tuberculous mycobacteria sensitisation in children as a factor of discordant results between tuberculin skin test (TST) and an in vitro T-cell based assay (T-SPOT.TB; Oxford Immunotec, Oxford, UK). We enrolled 21 non-bacille Calmette-Guérin-vaccinated paediatric patients for sus...