J.I. Jaén Díaz’s scientific contributions

To estimate the prevalence of chronic obstructive pulmonary disease (COPD) in smokers and ex-smokers over 40 years of age and describe the associated risk factors. A cross-sectional descriptive study at primary care level in which 444 current or ex-smokers 40 years of age or older were enrolled. Spirometry was performed with all subjects. If the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) was less than 70%, a bronchodilator test was performed and spirometry was repeated after 2 inhalations of terbutaline (500 g/dose). If the FEV1/FVC ratio continued to be less than 70% and FEV1 less than 80% of predicted, COPD was diagnosed. Age, sex, smoking, age smoking began, index of smoking history (packs per day x year) and attempts to quit smoking were also recorded. The patients' mean age was 53.5 years and 65.8% were men. At the time of the study, 248 subjects (55.9%) were current smokers. The median age smoking began was 16.5 years and the median pack-years index was 26.7. At least 1 attempt to quit had been made by 72.1% of the patients. COPD was diagnosed in 70 subjects (24 with the diagnosis previously established), representing a prevalence of 16.4% (95% confidence interval, 12.9-19.9). COPD was serious in 10%. A multifactorial analysis indicated that age and smoking history in pack-years were significantly associated with COPD. The prevalence of COPD in our study is slightly higher than in other studies, although selection bias may have affected our results given that we were unable to contact 11.9% of the population sample. Almost two thirds of cases had not been previously diagnosed. Two major risk factors are age and cumulative tobacco consumption.

Objetivos Conocer la distribución de la presión intraocular (PIO) en nuestra población mayor de 40 años, así como la prevalencia de glaucoma (G) e hipertensión intraocular (HIO). Diseño Descriptivo. Emplazamiento Atención primaria. Sujetos Novecientas noventa personas ≥ 40 años. Mediciones Edad, sexo, índice de masa corporal (IMC), antecedentes oftálmicos, factores de riesgo, agudeza visual (optotipo), oftalmoscopia y PIO (tonometría de aplanación). Los pacientes con alteraciones en fondo de ojo y/o PIO ≥ 21 mmHg fueron remitidos al oftalmólogo para su valoración (campimetría). Resultados Ochocientas setenta personas; edad media, 54,66 años; 45,4%, varones. La PIO media fue de 12,96 en ojo derecho y 13,27 en izquierdo, existiendo diferencias significativas entre ambos, pero no entre sexos ni grupos de edad. Se derivaron 70 pacientes (11 por PIO ≥ 21; 54 por oftalmoscopia alterada y 5 por ambos motivos), catalogando el oftalmólogo a 9 como G, 12 como HIO y 15 como sospechosos de G. Estimamos una prevalencia de G en ≥ 40 años del 1,81% (IC del 95%, 0,98–2,63%), incluyendo 9 casos ya conocidos. La prevalencia de HIO es del 1,61% (IC del 95%, 0,82–2,39%). Mediante regresión logística, encontramos mayor riesgo de G en miopes (OR ajustada [ORa] por edad y sexo, 3,01) e hipertrigliceridemia (ORa, 6,34). El riesgo de HIO es significativamente superior en pacientes con IMC ≥ 30 (ORa, 4,20). Conclusiones La prevalencia de G coincide con lo publicado para poblaciones similares, mientras la PIO y la prevalencia de HIO son sensiblemente inferiores. Dado que la mitad de los G están sin diagnosticar, creemos que debería valorarse su detección precoz en atención primaria, al menos en colectivos de riesgo. Objective To find the distribution of intra-ocular pressure (IOP) in our population over 40 and the prevalence of glaucoma (G) and ocular hypertension (OH). Design Descriptive. Setting Primary care. Subjects 990 people ≥ 40 years old. Measurements Age, sex, body mass index (BMI), ophthalmic history, risk factors, visual sharpness (optotype), ophthalmoscopy and IOP (applanation tonometry). Patients with back-of-eye disorders and/or IOP ≥ 21 mmHg were referred to the ophthalmologist for assessment (campimeter). Results 870 people, average age 54.66 and 45.4% of them men. Mean IOP was 12.96 in the right eye and 13.27 in the left, with significant differences between them, but not between sexes or age-groups. 70 patients were referred (11 for IOP ≥ 21, 54 for disturbance perceived by ophthalmoscope and 5 for both reasons). The ophthalmologist classified 9 as G, 12 as OH and 15 as suspected G. We calculated 1.81% (95% CI, 0.98–2.63) prevalence of G in the ≥ 40s, including 9 cases already known. OH prevalence was 1.61% (95% CI, 0.82–2.39). Through logistical regression, we found greater risk of G in people with myopia (OR adjusted for age and sex = 3.01) and Hypertriglyceridaemia (ORa, 6.34). OH risk was significantly greater in patients with BMI ≥ 30 (ORa, ≥ 4.20). Conclusions Glaucoma prevalence confirms published findings from other similar populations, while IOP and OH prevalence were much less here. Given that half G cases are undiagnosed, we believe its early detection in primary care should be highlighted, at least in at-risk groups.