C Villasante

Hospital Universitario La Paz, Madrid, Madrid, Spain

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Publications (119)426.33 Total impact

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    ABSTRACT: Background: There are a variable number of obese subjects with self-reported diagnosis of asthma but without current or previous evidence of airflow limitation, bronchial reversibility, or airway hyperresponsiveness (misdiagnosed asthma). However, the mechanisms of asthma-like symptoms in obesity remain unclear. Objectives: We sought to evaluate the perception of dyspnea during bronchial challenge and exercise testing in obese patients with asthma and misdiagnosed asthma compared with obese control subjects to identify the mechanisms of asthma-like symptoms in obesity. Methods: In a cross-sectional study we included obese subjects with asthma (n = 25), misdiagnosed asthma (n = 23), and no asthma or respiratory symptoms (n = 27). Spirometry, lung volumes, exhaled nitric oxide levels, and systemic biomarker levels were measured. Dyspnea scores during adenosine bronchial challenge and incremental exercise testing were obtained. Results: During bronchial challenge, patients with asthma or misdiagnosed asthma reached a higher Borg-FEV1 slope than control subjects. Moreover, maximum dyspnea and the Borg-oxygen uptake (V'O2) slope were significantly greater during exercise in subjects with asthma or misdiagnosed asthma than in control subjects. The maximum dyspnea achieved during bronchial challenge correlated with IL-1β levels, whereas peak respiratory frequency, ventilatory equivalent for CO2, and IL-6 and IL-1β levels were independent predictors of the Borg-V'O2 slope during exercise (r(2) = 0.853, P < .001). Conclusions: A false diagnosis of asthma (misdiagnosed asthma) in obese subjects is attributable to an increased perception of dyspnea, which, during exercise, is mainly associated with systemic inflammation and excessive ventilation for metabolic demands.
    No preview · Article · Jan 2016 · The Journal of allergy and clinical immunology

  • No preview · Article · Sep 2015 · European Respiratory Journal
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    ABSTRACT: Background Identifying inflammatory phenotypes is relevant in severe uncontrolled asthma. The aim of the present study was to identify the different clinical, inflammatory, functional and molecular phenotypes in patients with severe asthma and to investigate the potential role of sputum periostin as a biomarker of severe asthma phenotypes.Patients and methodsSputum induction was performed in 62 patients diagnosed with severe asthma. Skin prick testing, lung function tests, exhaled nitric oxide, hematimetry, and total serum IgE were performed. Periostin was measured in sputum supernatants.ResultsAsthma patients were phenotyped and 80% were late-onset asthma, 50% had fixed airflow obstruction, and 66% showed a Th2-high phenotype. With respect to inflammatory phenotypes, 71% were eosinophilic and 25% mixed granulocytic. Periostin levels were higher in patients with fixed as compared to variable airflow limitation (69.76 vs. 43.84 pg/ml, p<0.05), and in patients with eosinophilic as compared to mixed granulocytic phenotype (61.58 vs. 37.31 pg/ml, p<0.05). There was an inverse correlation between post-bronchodilator FEV1/FVC and periostin levels (-0.276, p<0.05).Conclusion This study demonstrates the utility of periostin in phenotyping severe asthma. Periostin levels in sputum are associated with persistent airflow limitation in asthma patients with airway eosinophilia despite treatment with high-dose inhaled corticosteroids.This article is protected by copyright. All rights reserved.
    No preview · Article · Jan 2015 · Allergy
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    ABSTRACT: Portable oxygen devices simplify and facilitate patient therapy. This study was designed to compare SpO2 and patient satisfaction with a portable oxygen concentrator or a combined system consisting of a fixed device with continuous-flow oxygen dispensation and a portable device with pulse dispensation for ambulation. This crossover trial assessed 25 subjects with COPD (92% men, mean age of 72.2 ± 7.4 y, mean FEV1 of 34.14 ± 12.51% of predicted) at 4 hospitals in Madrid. All subjects had previously used the combined system, consisting of a fixed oxygenation system and a portable system for ambulation, with 16 (64%) using stationary and portable concentrators and 9 (36%) using a stationary reservoir and portable liquid oxygen bag. Oxygenation settings at rest and while walking were determined at baseline. Subjects were maintained on the previous combined system for 1 week and then switched to the portable oxygen concentrator for 1 week. Mean SpO2 over 24 h was calculated using the software in the oximeter, and compliance was monitored (Visionox). Low SpO2 (< 90%) was significantly more frequent during use of the portable concentrator alone than with the combined system (37.1% vs 18.4%, P < .05). The portable system alone was preferred by 43% of subjects, and the combined system was preferred by 36%, whereas 21% were not sure. Subjects preferred using a single portable oxygenation system both at home and during ambulation. Portable systems alone, however, did not supply the same levels of oxygenation as the combination of fixed and portable systems. Before the widespread adoption of portable systems as a single device, additional studies are needed to determine best-practice protocols for adjustment of daytime and nighttime oxygenation settings. Copyright © 2015 by Daedalus Enterprises Inc.
    No preview · Article · Nov 2014 · Respiratory care
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    ABSTRACT: Asthma PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: to compare the perception of dyspnea (POD) during cycle exercise testing and airway challenge to adenosine in non-asmathic (group 1) fictitious asthmatic (group 2), and asthmatic (group 3) obese subjects. fictitious asthma was considered when patients have used bronchodilator or corticoid inhaler medication during the last year despite not having a positive bronchial responsiveness testing or elevation of exhaled nitric oxide (NO). Anxiety and depression questionnaires (State-Trait Anxiety Inventory for Adults [STAI] and Beck Depression Inventory [Beck], respectively), body impedance assessment, exhaled NO, spirometry and body plethysmography measurements were performed in all patients. POD was measured in both, adenosine challenge and cycle ergometer testing, using the modified 10-point Borg scale. Finally, incremental exercise testing was conducted on an electronically cycle ergometer (Oxycon Alpha, Viasys). we included 73 patients (group 1=27, group 2=22, group 3=24). Groups were not different by demographic (age, sex, smoking habit) and anthropometric variables. Group 2 had higher Trait anxiety scoring than group 1 (30.9±13.8 vs.19.1±13.4, p<0.05). Pulmonary function testing were similar between groups 1 and 2. During adenosine challenge, POD assessed by the rate of change in Borg score was greater in group 2 than in group 1 (1.95±1.66 vs. 0.57±1.12, p<0.05). Also, relationship between adenosine concentration and changes of the Borg score was greater in group 2 than in group 1 (p=0,051). Likewise, in the exercise testing, the intercept (but not the slope) for work intensity-Borg ratings was significantly lower in group 2 and 3 than in group 1 (13.7±11.6; 12.5±6.7; 30.6±10.8, p<0.001, respectively). Finally, fictitious asthmatic patients had lower intercept and higher slope for oxygen uptake-Borg rating than non-asthmatic patients (p<0.001). in obese patients, POD during exercise testing is greater in fictitious asthmatic than in non-asthmatic subjects but similar to asthmatic patients. Also, perceptual response to bronchoconstriction is higher in fictitious asthma than in non-asthma patients. overdiagnosis of asthma in obese subjects could be due to a greater PODDISCLOSURE: The following authors have nothing to disclose: Carlos Carpio, Francisco García-Río, David Romero, Isabel Fernández, Raul Galera, Carlos Villasante, Rodolfo Álvarez-SalaNo Product/Research Disclosure Information.
    No preview · Article · Mar 2014 · Chest
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    ABSTRACT: COPD Safety of Treatment PostersSESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PMPURPOSE: Assess the associated comorbidity of patients with chronic obstructive pulmonary disease (COPD) and analyze the prescribed treatments, polypharmacy criteria and their correlation with other variables.METHODS: Cross-sectional observational study of 123 patients with stable COPD. We recorded demographic, anthropometric and lung function variables and the most relevant comorbidities. We also analyzed and quantified the prescribed treatments.RESULTS: A total of 123 patients were included. Mean age of 73 ± 9 years, 87% men and 13% women, mean BMI of 28 ± 4 kg/m2 and mean FEV1% of 57.29 ± 18% (GOLD I, 13%; II, 51%; III, 31%; IV, 5%). The most common comorbidities were high blood pressure (37%), dyslipidemia (24%), smoking (22%), heart disease (17%), diabetes (12,5%), neurological (11%), prostatic syndrome (13%), vascular disease (10%), neoplasms (9%), hyperuricemia (8.1%), gastrointestinal disease (7.3%), anxiety-depression syndrome (7%), renal failure (3%). The mean Charlson index (CI) was 1.5% ± 1.1, and the CI adjusted for age was 4.4 ±1.6. When comparing male and female patients, we found significant differences in terms of age and BMI. With regard to the treatments, 81% of the patients were polymedicated (more than 5 drugs). The average number of drugs prescribed was 8.8 ± 3.6 (2.2 ± 0.9 respiratory drugs). The most frequently prescribed drugs were anticholinergic inhalers (81%), inhaled corticosteroids and/or bronchodilators (73%), cardiovascular drugs (45%), antiplatelet-anticoagulant agents (34%), hypolipidemic agents (32%), oxygen therapy (27%), gastroprotective agents (25%), psychotropic agents (16%), prostatic hyperplasia agents (15%), antidiabetic agents (13%) and nervous system agents (11%). We found a significant correlation between the total number of drugs on one hand and age (r=0.22, p<0.02) and FEV1% (r=-0.24, p< 0.06) on the other. We compared the patient groups with and without polypharmacy and found significant differences for the FEV1% variables: 64.30 ± 17.15% vs. 55.68 ± 17.95% (p<0.01) and the Charlson index: 0.96 ± 0.64 vs. 1.65 ± 1.15 (p<0.006).CONCLUSIONS: 1. The most common comorbidities were HBP, dyslipidemia, smoking and heart diseases. 2. The majority of the patients were polymedicated with an average of 8.8 drugs. We found a correlation between the number of prescribed drugs on one hand and age and lung function on the other.CLINICAL IMPLICATIONS: The majority of the patients with COPD were polymedicatedDISCLOSURE: The following authors have nothing to disclose: Juan Fernandez-Lahera, Antonio Martínez Verdasco, Jaime Fernández Bujarrabal, Antonia Mendieta, Ana Santiago, Carlos VillasanteNo Product/Research Disclosure Information.
    No preview · Article · Oct 2013 · Chest
  • Dr. Carlos Villasante

    No preview · Article · Jul 2013 · Pharmacoeconomics - Spanish Research Articles
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    ABSTRACT: Subjective measurement of physical activity using questionnaires has prognostic value in COPD. However, their lack of accuracy and large individual variability limit their use for evaluation on an individual basis. We evaluated the capacity of the objective measurement of daily physical activity in patients with COPD using accelerometers to estimate their prognostic value. In 173 consecutive subjects with moderate to very severe COPD, daily physical activity was measured using a triaxial accelerometer providing a mean of 1-min movement epochs as vector magnitude units (VMUs). Patients were evaluated by lung function testing and 6-min walk, incremental exercise, and constant work rate tests. Patients were followed for 5 to 8 years, and the end points were all-cause mortality, hospitalization for COPD exacerbation, and annual declining FEV(1). After adjusting for relevant confounders, a high VMU decreased the mortality risk (adjusted hazard ratio [HR], 0.986; 95% CI, 0.981-0.992), and in a multivariate model, comorbidity, endurance time, and VMU were retained as independent predictors of mortality. The time until first admission due to COPD exacerbation was shorter for the patients with lower levels of VMU (adjusted HR, 0.989; 95% CI, 0.983-0.995). Moreover, patients with higher VMU had a lower hospitalization risk than those with a low VMU (adjusted incidence rate ratio, 0.099; 95% CI, 0.033-0.293). In contrast, VMU was not identified as an independent predictor of the annual FEV(1) decline. The objective measurement of the daily physical activity in patients with COPD using an accelerometer constitutes an independent prognostic factor for mortality and hospitalization due to severe exacerbation.
    No preview · Article · Jan 2012 · Chest
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    ABSTRACT: Although asthma is one of the most prevalent chronic respiratory diseases, the participation of Spanish pulmonology units in the management of asthma may have room for improvement. To determine the degree of involvement of the Spanish pulmonology services in the patient care, education and research related with asthma disease and especially in difficult-to-control asthma. A survey made up of 75 questions was sent to the heads of several pulmonology departments. The survey asked questions pertaining to respiratory disease care in general, and in asthma in particular, as well as the educational activities and research in asthma during the previous five years. Out of the 107 surveys sent, 69 (645%) centers filled them out and returned them. Forty-seven (681%) met the criteria for an important level of health-care activity in asthma. However, only 29 (42%) had a monographic consultation for difficult-to-control asthma and 37 (536%) used an education program. As for postgraduate education, only 31 (449%) provided their resident physicians with specific asthma training. And in the research field, 12 (174%) reported having projects funded by SEPAR and 25 (362%) had published studies in journals with an impact factor. Although the majority of the pulmonology centers interviewed report a notable activity in asthma patient care, their involvement in the specialized approach for difficult-to-control asthma is insufficient. Likewise, participation in educational activities and research related with the disease is inconsistent and limited to few centers.
    Full-text · Article · Jan 2012 · Archivos de Bronconeumología

  • No preview · Article · Sep 2011 · Sleep Medicine
  • M. González Viñolis · C. Villasante · J.M. Pino

    No preview · Article · Oct 2010 · Medicine - Programa de Formación Médica Continuada Acreditado
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    ABSTRACT: A very weak relationship has been reported between the health-related quality of life (HRQL) of patients with asthma and their degree of airway hyper-responsiveness (AHR), evaluated in terms of sensitivity. However, this relationship still has not been sufficiently explored for bronchial reactivity indices. To analyse the relationship between bronchial reactivity and sensitivity with the HRQL of patients with stable asthma, identifying the functional parameters that determine HRQL. In 103 consecutive patients with stable asthma, HRQL was evaluated using the Asthma Quality of Life Questionnaire (AQLQ). Patients underwent spirometry and non-specific bronchial provocation with methacoline. Sensitivity (PD(20)) and reactivity (dose-response slope (DRS), continuous index of responsiveness (CIR) and bronchial reactivity index (BRI)) of the dose-response curve were analysed. BRI presented significant differences with different degrees of asthma severity. Although patients with AHR showed poorer quality of life than patients without AHR, the AQLQ total score was not related to PD(20) but rather to DRS (r=-0.784), CIR (r=-0.712) and BRI (r=-0.776). The indices of bronchial reactivity reached a negative correlation with all the domains of the AQLQ. In a multiple linear regression model, BRI, DRS, FIV(1) (forced inspiratory volume in 1 s) and VCIN (inspiratory vital capacity) were identified as independent predictors of the AQLQ total score (r(2)=0.742, p<0.001). In patients with stable asthma, bronchial reactivity is associated with HRQL. This could justify incorporating bronchial reactivity indices in bronchial provocation analyses.
    Preview · Article · Sep 2010 · Thorax
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    ABSTRACT: We aimed to describe changes in the prevalence of chronic obstructive pulmonary disease (COPD) in Spain by means of a repeated cross-sectional design comparing two population-based studies conducted 10 yrs apart. We compared participants from IBERPOC (Estudio epidemiológico de EPOC en España) (n = 4,030), conducted in 1997, with those of EPI-SCAN (Epidemiologic Study of COPD in Spain) (n = 3,802), conducted in 2007. Poorly reversible airflow obstruction compatible with COPD was defined according to the old European Respiratory Society definitions. COPD prevalence in the population between 40 to 69 yrs of age dropped from 9.1% (95% CI 8.1-10.2%) in 1997 to 4.5% (95% CI 2.4-6.6%), a 50.4% decline. The distribution of COPD prevalence by severity also changed from 38.3% mild, 39.7% moderate and 22.0% severe in 1997, to 85.6% mild, 13.0% moderate and 1.4% severe in 2007, and in the 40-69 yr EPI-SCAN sub-sample to 84.3% mild, 15.0% moderate and 0.7% severe. Overall, underdiagnosis was reduced from 78% to 73% (not a significant difference) and undertreatment from 81% to 54% (p<0.05) within this 10-yr frame. The finding of a substantial reduction in the prevalence of COPD in Spain is unexpected, as were the observed changes in the severity distribution, and highlights the difficulties in comparisons between repeated cross-sectional surveys of spirometry in the population.
    Preview · Article · Dec 2009 · European Respiratory Journal
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    ABSTRACT: Study objectives: To examine the central inspiratory drive response to hypoxia in patients with obstructive sleep apnea (OSA), according to their circadian BP profile, and in healthy control subjects. Another objective was to evaluate the relationships among sleep architecture, hypoxic sensitivity, urinary catecholamine excretion, and BP in OSA patients, Patients and interventions: Polysomnography, 24-h ambulatory BP recording, and urinary excretion of catecholamines were simultaneously examined in 24 consecutive OSA patients and 11 healthy subjects. OSA patients were categorized as being normotensive (type 1), having BP elevation only during sleep (type 2), and as being hypertensive with elevated BP at an times (type 3), The response of mouth occlusion pressure at 0.1 s after onset (P-0.1) to progressive isocapnic hypoxic stimulation was measured, Results: There was a significant difference in the P-0.1 response to hypoxia among control subjects ([mean +/- SD] 0.353 +/- 0.129 cm H2O/%) and type 1 (0.228 +/- 0.062 cm H2O/%), type 2 (0.345 +/- 0.106 cm H2O/%), and type 3 (0.508 +/- 0.118 cm H2O/%) OSA patients. In OSA patients, chemosensitivity was related to the apnea-hypopnea index and to the nocturnal excretion of epinephrine, Significant relationships between the nocturnal excretion of epinephrine and BP were noted. On multiple linear regression analysis, the P-0.1 response to hypoxia was the only variable significantly related to diurnal (r(2) = 0.364; p = 0.005) and nocturnal mean BP (r(2) = 0.461; p = 0.002). Conclusion: The findings of the present study suggest a possible mediating role of the peripheral chemosensitivity in the association between sleep apnea and hypertension.
    No preview · Article · Nov 2009 · Chest
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    ABSTRACT: In elderly subjects, static lung volumes are interpreted using prediction equations derived from primarily younger adult populations. To provide reference equations for static lung volumes for European adults 65 to 85 years of age and to compare the predicted values of this sample with those from other studies including middle-aged adults. We compare the lung volumes by plethysmography and helium dilution in elderly subjects. Reference equations were derived from a randomly selected sample from the general population of 321 healthy never-smoker subjects 65 to 85 years of age. Spirometry and lung volume determinations by plethysmography and multibreath helium equilibration method were performed following the American Thoracic Society/European Respiratory Society recommendations. Reference values and lower and upper limits of normal were derived using a piecewise polynomial model. Plethysmography provided higher values than the dilutional method for all lung volumes, with wide limits of agreement. In addition to height, our reference equations confirm the age- and body size dependence of lung volumes in older subjects. Practically all the estimations performed by extrapolating reference equations of middle-aged adults overpredicted the true lung volumes of our healthy elderly volunteers. Middle-aged reference equations classify subjects as being below the total lung capacity lower limit of normal between 17.9 and 62.5% of the women and between 12.5 and 42.2% of the men of the current study. These results underscore the importance of using prediction equations appropriate to the origin, age, and height characteristics of the subjects being studied.
    Preview · Article · Oct 2009 · American Journal of Respiratory and Critical Care Medicine
  • F García-Río · M Ramírez · O Mediano · V Lores · B Rojo · C Villasante · J Villamor
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    ABSTRACT: Data on the relationship between exercise-induced bronchoconstriction (EIB) and exhaled nitric oxide (NO) in adult patients with asthma are controversial. It is unclear whether endogenous NO may act as either a protective or stimulatory factor in the airway response to exercise or whether changes in exhaled NO simply reflect acute narrowing of the airway. The aim of this study was to assess the changes in the fraction of exhaled nitric oxide (FE(NO)) before and after exercise challenge in patients with asthma and to analyze the relationship between FE(NO) and airway obstruction. Twenty-five non-smoking, steroid-naïve, atopic, adult patients with mild persistent asthma and 12 non-smoking, nonatopic, healthy subjects (control group) performed an exercise challenge on a cycloergometer, with monitored ventilation. FEV1 and FE(NO) were measured at baseline and 1, 5, 10, 15 and 20 minutes after the exercise challenge. Eleven of the asthmatic patients had exercise-induced bronchoconstriction (EIB group) and the remaining 14 did not (non-EIB group). Baseline FE(NO) was higher in the EIB and non-EIB asthmatic groups than in the control group. In the EIB group, FE(NO) was significantly lower 5, 10 and 15 minutes after exercise, and the changes in FE(NO) correlated with variation in FEV1 10 and 15 min after exercise. A significant correlation between baseline FE(NO) and maximal post-exercise decrease in FEV1 was found in asthmatic patients (EIB group). In conclusion, exhaled nitric oxide levels transiently decrease during exercise-induced bronchoconstriction in adult patients with asthma. Baseline FE(NO) might predict the airway obstruction resulting after exercise.
    No preview · Article · Dec 2006 · International Journal of Sports Medicine
  • O Mediano · F García-Río · C Villasante
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    ABSTRACT: A comparison is made between the end-tidal fractional concentration of carbon dioxide (FETCO2) obtained during application of varying levels of continuous positive airway pressure (CPAP) with a prototype mask (from Carburos Metálicos) and FETCO2 obtained with 2 commonly used nasal masks (Profile Lite and ComfortClassic from Respironics). The nasal FETCO2 was measured on 3 consecutive days in 11 healthy volunteers, 12 patients with severe obstructive sleep apnea-hypopnea syndrome, and 12 hypercapnic patients. A different mask was randomly assigned on each day and the FETCO2 was measured after 3 minutes of CPAP at 4, 5, 6, 8, 10, 15, and 20 cm H2O. Although in all cases a progressive reduction in FETCO2 was observed with increasing CPAP, the effect was greatest with the prototype mask at all pressures. In the 3 different study groups the pressures obtained with the prototype mask were similar to those generated by the CPAP machine. In conclusion, the lower concentration of nasal CO2 obtained using the prototype mask suggests that it causes less rebreathing.
    No preview · Article · May 2006 · Archivos de Bronconeumología
  • O. Mediano · F. García-Río · C. Villasante
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    ABSTRACT: A comparison is made between the end-tidal fractional concentration of carbon dioxide (FETCO2) obtained during application of varying levels of continuous positive airway pressure (CPAP) with a prototype mask (from Carburos Metálicos) and FETCO2 obtained with 2 commonly used nasal masks (Profile Lite and ComfortClassic from Respironics). The nasal FETCO2 was measured on 3 consecutive days in 11 healthy volunteers, 12 patients with severe obstructive sleep apnea-hypopnea syndrome, and 12 hypercapnic patients. A different mask was randomly assigned on each day and the FETCO2 was measured after 3 minutes of CPAP at 4, 5, 6, 8, 10, 15, and 20 cm H2O. Although in all cases a progressive reduction in FETCO2 was observed with increasing CPAP, the effect was greatest with the prototype mask at all pressures. In the 3 different study groups the pressures obtained with the prototype mask were similar to those generated by the CPAP machine. In conclusion, the lower concentration of nasal CO2 obtained using the prototype mask suggests that it causes less rebreathing.
    No preview · Article · Apr 2006
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    ABSTRACT: To identify factors associated with diagnosis and health-related quality of life (HRQL) impairment in chronic obstructive pulmonary disease (COPD) patients from a population-based epidemiological study. This was an epidemiologic, multicenter, population-based study. Three hundred and sixty-three individuals diagnosed with COPD from a randomly general population sample of 4035 individuals aged 40-69 were included in the analyses. Forced spirometry was performed on eligible subjects, and the European Commission for Steel and Coal (ECSC) and the St. George's Respiratory Questionnaires (SGRQ) were completed. Logistic regression models were constructed to identify variables associated with the previous diagnosis of COPD and with COPD in never smokers. A multiple linear regression model attempted to identify variables influencing HRQL impairment. Only 79 (21.7%) COPD patients had been previously diagnosed. Disease severity based on FEV(1), worse SGRQ score, previous respiratory disease, as well as the presence of wheezing were significantly associated with previous diagnosis. Being a woman, older than 55, with previous respiratory disease and without expectoration or wheezing characterized COPD in never smokers. A worse HRQL was associated with chronic symptoms, especially dyspnea; and with older age, cardiac comorbidity and impairment in lung function. Diagnosis of COPD in the community is more likely in patients with worse lung function and HRQL, and wheezing is the symptom most strongly associated with a diagnosis of COPD. Women older than 55, with previous respiratory diseases, without respiratory symptoms and mild airflow obstruction constitute the majority of individuals with COPD who have never smoked. Chronic respiratory symptoms are strongly associated with impairment in HRQL.
    Full-text · Article · Sep 2005 · Respiratory Medicine
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    ABSTRACT: This study aimed to evaluate the cost-effectiveness of formoterol (Oxis) Turbuhaler 4.5 microg and salbutamol 200 microg as reliever medications in Sweden and Spain. The study used data on effectiveness (exacerbations and symptom-free days) and resource utilisation from an open, 6-month, parallel-group, multicentre randomised trial with 18,124 asthma patients in 24 countries. Country-specific unit costs for Sweden and for Spain were used to transform resource utilisation data into costs. Total healthcare costs were not significantly different between formoterol and salbutamol dry powder inhalers in Sweden, whereas in Spain, the healthcare costs were 20% higher for formoterol vs. salbutamol pressurised metered dose inhalers. Total healthcare costs increased with disease severity, defined according to the Global Initiative for Asthma guidelines. Compared with salbutamol, formoterol produced statistically significant improvements in effectiveness, less reliever and maintenance medication usage, reduced healthcare resource utilisation, with no increase or a limited increase in healthcare cost.
    No preview · Article · Feb 2005 · International Journal of Clinical Practice

Publication Stats

2k Citations
426.33 Total Impact Points

Institutions

  • 1992-2016
    • Hospital Universitario La Paz
      • Servicio de Neumología
      Madrid, Madrid, Spain
  • 2010
    • Universidad Autónoma de Madrid
      • Department of Medicine
      Madrid, Madrid, Spain
  • 2000
    • Hospital Universitario de La Princesa
      • Servicio de Neumología
      Madrid, Madrid, Spain
  • 1999
    • Hospital Universitari i Politècnic la Fe
      • Servicio de Neumología
      Valenza, Valencia, Spain