1
|
Pallarés-Sanmartín A, Mosteiro-Añón MDM, Macía M, Blanco N, Barros-Casas D, Corbacho Abelaira MD, Fernández-Sánchez T, Fiorentino F. Predictors of success/failure in the control of asthmatic smoking patients under conditions of clinical practice. J Asthma 2023:1-8. [PMID: 36847640 DOI: 10.1080/02770903.2023.2185153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Tobacco smoking directly affects the airway, where it triggers a very strong local inflammatory response. OBJECTIVE To determine the predictors of improvement or worsening of asthma control in asthmatic smokers. METHODS Observational, prospective, multicenter, single cohort study, carried out in the outpatient pulmonology departments with a follow-up period of 6 months. The treatment was adjusted according to the indications of standard clinical practice. RESULTS 196 patients were included, with a mean age of 54.64 years.39% of the patients were active smokers. Interpreting an Asthma Control Questionnaire (ACQ) score of ≤ 0.75 as asthma control, this was achieved in 30.2% of the cases. Patients with greater adherence were more likely to improve their asthma symptoms (p < 0.05), defined as a decrease in ACQ of 0.5 points or more at the final visit, while taking concomitant medication was a negative risk factor for improvement (p < 0.001). An eosinophil value >300 was a predictor for achieving control (p < 0.01). Patients treated with fluticasone propionate/formoterol versus those receiving budesonide/formoterol or beclomethasone/formoterol had a lower ACQ score (p < 0.01 and p < 0.01, respectively). CONCLUSION Asthmatic patients with active tobacco exposure and a higher number of anti-asthma medications are more likely to have poorer control. Correct adherence to treatment is the main intervention to be performed to achieve the control. An eosinophil count greater than 300 was the main predictor for achieving control. Fluticasone propionate/formoterol FP/FORM was associated with a greater likelihood of improving ACQ score.
Collapse
Affiliation(s)
| | | | - María Macía
- Pulmonology Service, Son Llatzer, Universitary Hospital, Palma de Mallorca, Spain
| | - Nagore Blanco
- Pulmonology Service, Lucus Augusti Universitary Hospital, Lugo, Spain
| | | | | | | | - Federico Fiorentino
- Pulmonology Service, Son Espasses, Universitary Hospital, Palma de Mallorca, Spain
| |
Collapse
|
2
|
Blanco-Pérez JJ, Arnalich-Montiel V, Salgado-Barreira Á, Alvarez-Moure MA, Caldera-Díaz AC, Melero-Gonzalez R, Pallarés-Sanmartín A, Fernandez-Villar A, González-Barcala FJ. Prevalence and clinical impact of systemic autoimmune rheumatic disease in patients with silicosis. Arch Bronconeumol 2021; 57:571-576. [PMID: 35702913 DOI: 10.1016/j.arbr.2021.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/16/2020] [Indexed: 06/15/2023]
Abstract
BACKGROUND Silicosis is associated with an increased risk of developing systemic autoimmune rheumatic disease (SARD). The prognostic implications of this association are poorly characterized. The aim of this study was to determine the prevalence of SARD and autoimmune markers in a cohort of patients with exposure to silica and assess their impact on prognosis. METHOD We performed a prospective observational study of all patients attending the dedicated silicosis clinic of our pulmonology unit between 2009 and December 2017. Diagnosis was confirmed by a rheumatologist according to Spanish Rheumatology Society criteria. Autoimmune markers, pulmonary function tests, radiological progression, visits to the emergency department and primary care center, and hospital admissions for respiratory causes, and mortality were analyzed. RESULTS Overall, 489 cases of silicosis and 95 cases of exposure were studied. In total, 54 (11.0%) patients with silicosis had SARD: 12 (2.4%) rheumatoid arthritis, 10 (2.0%) systemic lupus erythematosus, 10 (2.0%) systemic sclerosis, 3 (0.6%) Sjögren syndrome, 2 (0.4%) vasculitis associated with anti-neutrophil cytoplasmic antibodies (ANCA +), 6 (1.2%) psoriatic arthritis, 3 (0.6%) ankylosing spondylitis, and 8 (1.6%) other autoimmune diseases with no special features. The patients with SARD visited the emergency room more often (63.0% vs. 42.5%; p = 0.004), and progressed more rapidly (22.2 vs. 11.7%; p = 0.030). CONCLUSIONS The presence of systemic rheumatic autoimmune diseases involves radiological progression and a higher clinical impact.
Collapse
Affiliation(s)
- José Jesús Blanco-Pérez
- Servicio de Neumoloxía, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Spain; IRIDIS Group (Investigation in Rheumatology and Immuno-Mediated Diseases) del Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.
| | - Victoria Arnalich-Montiel
- Servicio de Neumoloxía, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Spain
| | - Ángel Salgado-Barreira
- Unidad de Metodología y Estadística, Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain
| | - María Angel Alvarez-Moure
- Servicio de Radiología, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Spain
| | | | - Rafael Melero-Gonzalez
- Servicio de Reumatología, Hospital Álvaro Cunqueiro de Vigo, Complexo Hospitalario Universitario de Vigo, Spain
| | - Abel Pallarés-Sanmartín
- Servicio de Neumoloxía, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Spain
| | - Alberto Fernandez-Villar
- Servicio de Neumoloxía, Hospital Álvaro Cunqueiro, Complexo Hospitalario Universitario de Vigo, Spain
| | - Francisco Javier González-Barcala
- Servicio de Neumoloxía, Complexo Hospitalario Universitario de Santiago de Compostela, Spanish Biomedical Research Networking Centre-CIBERES, A Coruña, Spain
| |
Collapse
|
3
|
Blanco-Pérez JJ, Blanco-Dorado S, Rodríguez-García J, Gonzalez-Bello ME, Salgado-Barreira Á, Caldera-Díaz AC, Pallarés-Sanmartín A, Fernandez-Villar A, González-Barcala FJ. Serum levels of inflammatory mediators as prognostic biomarker in silica exposed workers. Sci Rep 2021; 11:13348. [PMID: 34172787 PMCID: PMC8233419 DOI: 10.1038/s41598-021-92587-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/07/2021] [Indexed: 11/10/2022] Open
Abstract
Silicosis is a diffuse interstitial lung disease caused by sustained inhalation of silica and silicates. Several cytokines are activated by their inhalation and can mediate the process of pulmonary fibrosis. The identification of biomarkers could allow an early diagnosis before the development of radiological alterations and help monitor the evolution of patients. The objetive of this study was to determine the clinical significance of specific biomarkers, to estimate their association with the development, severity and/or progression of silicosis, and identify determinants of this evolution. We conducted a prospective observational study in patients attending the pulmonology clinic from 2009 to 2018. Serum levels of the following inflammatory mediators were assessed: interleukin-6 (IL-6), interleukin 2 receptor subunit alpha (IL2R) interleukin 1 beta (IL1B), interleukin-8 (IL-8), tumour necrosis factor-alpha (TNF-α), transforming growth factor-beta1 (TGF-β1), alpha-1 antitrypsin (AAT), C-reactive protein (CRP), lactate dehydrogenase (LDH) and ferritin in subjects exposed to silica, with and without silicosis. Association between those inflammatory mediators with lung function measurements and radiological severity of disease and their impact on prognosis were analysed. 337 exposed to silica (278 with silicosis) and 30 subjects in the control group were included. IL-8, α1AT, ferritin, CRP and LDH levels were higher in silicosis than in those exposed to silica without silicosis. IL-8, LDH and AAT levels were associated with progression of silicosis and IL-6, IL-8, LDH, AAT, ferritin, and CRP with vital status. The results of the ROC analysis indicated the potential of IL-8 as a biomarker in the presence of silicosis and for the prediction of mortality.
Collapse
Affiliation(s)
- José Jesús Blanco-Pérez
- Department of Pneumonology, University Hospital Complex of Vigo, Pontevedra, Spain. .,IRIDIS Group (Investigation in Rheumatology and Immuno-Mediated Diseases) Galicia Sur Health Research Institute (IIS Galicia Sur), Vigo, Spain.
| | - Sara Blanco-Dorado
- Department of Pharmacy, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Javier Rodríguez-García
- Department of Clinical Analysis, University Hospital Complex of Santiago de Compostela (CHUS)-SERGAS, Santiago de Compostela, Spain.,Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | | | - Ángel Salgado-Barreira
- Methodology and Statistics Unit, Galicia Sur Health Research Institute (IIS Galicia Sur), Vigo, Spain
| | | | | | | | - Francisco Javier González-Barcala
- Department of Pneumonology, University Hospital Complex of Santiago de Compostela, Spanish Biomedical Research Networking Centre-CIBERES, Santiago de Compostela, Spain
| |
Collapse
|
4
|
Crespo-Lessmann A, Bernal S, del Río E, Rojas E, Martínez-Rivera C, Marina N, Pallarés-Sanmartín A, Pascual S, García-Rivero JL, Padilla-Galo A, Curto E, Cisneros C, Serrano J, Baiget M, Plaza V. Association of the CFTR gene with asthma and airway mucus hypersecretion. PLoS One 2021; 16:e0251881. [PMID: 34086689 PMCID: PMC8177500 DOI: 10.1371/journal.pone.0251881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/05/2021] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Asthma with airway mucus hypersecretion is an inadequately characterized variant of asthma. While several studies have reported that hypersecreting patients may carry genetic variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, many of those studies have been questioned for their numerous limitations and contradictory results. OBJECTIVES (1) To determine the presence of genetic variants of the CFTR gene in patients with asthma with and without airway mucus hypersecretion. (2) To identify the clinical, inflammatory and functional characteristics of the asthma phenotype with airway mucus hypersecretion. METHOD Comparative multicentre cross-sectional descriptive study that included 100 patients with asthma (39 hypersecretors and 61 non-hypersecretors). Asthmatic hypersecretion was defined as the presence of cough productive of sputum on most days for at least 3 months in 2 successive years. The patients were tested for fractional exhaled nitric oxide, spirometry, induced sputum cell count, total immunoglobulin E (IgE), peripheral blood eosinophil count, C-reactive protein, blood fibrinogen and blood albumin and underwent a skin prick test. Asthma control and quality of life were assessed by the Asthma Control Test and Mini Asthma Quality of Life questionnaires, respectively. Blood DNA samples were collected from the patients and next-generation sequencing using a MiSeq sequencer and the Illumina platform was used for the CFTR gene analysis. RESULTS Genetic differences were observed in the c.1680-870T>A polymorphism of the CFTR gene, significantly more evident in hypersecretors than in non-hypersecretors: 78.94% vs. 59.32% in the majority allele and 21.05% vs. 40.67% in the minority allele (p = 0.036). Clinically, asthma hypersecretors compared to non-hypersecretors were older (57.4 years vs. 49.4 years; p = 0.004); had greater asthma severity (58.9% vs. 23.7%; p = 0.005); experienced greater airway obstruction (FEV1/FVC% 64.3 vs. 69.5; p = 0.041); had poorer asthma control (60% vs. 29%; p = 0.021); had lower IgE levels (126.4 IU/mL vs. 407.6 IU/mL; p = 0.003); and were less likely to have a positive prick test (37.5% vs. 68.85%; p = 0.011). CONCLUSION The results suggest that patients with asthma and with mucus hypersecretion (1) may have a different phenotype and disease mechanism produced by an intronic polymorphism in the CFTR gene (NM_000492.3:c.1680-870T>A), and (2) may have a poorer clinical outcome characterized by severe disease and poorer asthma control with a non-allergic inflammatory phenotype.
Collapse
Affiliation(s)
- Astrid Crespo-Lessmann
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sara Bernal
- Department of Genetics, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705), Barcelona, Spain
| | - Elisabeth del Río
- Department of Genetics, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705), Barcelona, Spain
| | - Ester Rojas
- Department of Genetics, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705), Barcelona, Spain
| | | | - Nuria Marina
- Department of Respiratory Medicine, H. de Cruces, Barakaldo, Vizcaya, Spain
| | | | - Silvia Pascual
- Department of Respiratory Medicine, H. de Galdakao, Vizcaya, Spain
| | | | - Alicia Padilla-Galo
- Department of Respiratory Medicine, H. Costa del Sol de Marbella, Málaga, Spain
| | - Elena Curto
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carolina Cisneros
- Department of Respiratory Medicine, H. U. de La Princesa, Madrid, Spain
| | - José Serrano
- Department of Respiratory Medicine, Hospital Comarcal de Inca, Baleares, Spain
| | - Montserrat Baiget
- Department of Genetics, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, U705), Barcelona, Spain
| | - Vicente Plaza
- Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Institute of Sant Pau Biomedical Research (IBB Sant Pau), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | |
Collapse
|
5
|
Alcazar-Navarrete B, Fuster A, García Sidro P, García Rivero JL, Abascal-Bolado B, Pallarés-Sanmartín A, Márquez E, Valido-Morales A, Boldova Loscertales A, Callejas-Gonzalez FJ, Palop M, Riesco JA, Golpe R, Soler-Cataluña JJ, Miravitlles M. Relationship Between Clinical Control, Respiratory Symptoms and Quality of Life for Patients with COPD. Int J Chron Obstruct Pulmon Dis 2020; 15:2683-2693. [PMID: 33149566 PMCID: PMC7604255 DOI: 10.2147/copd.s265470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/28/2020] [Indexed: 11/23/2022] Open
Abstract
Background The concept of clinical control has been proposed as an instrument for evaluating patients with COPD. However, the possible association between clinical control, reduced symptom severity and HRQoL has yet to be confirmed. Methods This multicentre, prospective and observational study was carried out in 15 pulmonology clinics in Spain. The patients were followed up for six months, with a baseline visit (V0), followed by visits at three months (V1) and six months (V2). Clinical control was determined at V1, with the application of both clinical criteria and the COPD assessment test (CAT). All patients reported their symptoms by a validated symptom diary (E-RS) using a portable device, and their HRQoL was assessed using the EQ5D questionnaire. The relationship between clinical control and E-RS and HRQoL during follow-up was assessed with t-test. Results A total of 126 patients were screened. After application of the inclusion/exclusion criteria, 93 were finally included (mean age 66 ± 8 years, 84.9% male), with a mean FEV1 predicted of 49.8% ± 16.5%. Of these patients, 44 (47.3%) achieved clinical control at V1, according to CAT criteria, and 50 (53.8%), according to clinical criteria. The E-RS scores differed between controlled and uncontrolled patients at all time points, both according to CAT (mean differences of −4.6, −5.6 and −6.2 units at V0, V1 and V2, respectively, p<0.005 for all comparisons) and to clinical criteria (mean differences of −3.3, −5-6 and −4.99 units, respectively, p<0.005 for all comparisons). The controlled patients also presented a significantly better HRQoL, measured by the EQ5D questionnaire (mean difference 0.13 and 0.10 at V2 by CAT or clinical criteria, respectively, p<0.05). Conclusion Clinical control in patients with COPD, whether measured by CAT or by clinical criteria, is associated with a lower symptom load and a better HRQoL.
Collapse
Affiliation(s)
- Bernardino Alcazar-Navarrete
- AIG De Medicina. Hospital De Alta Resolución De Loja. Agencia Sanitaria Hospital De Poniente, Loja, Granada, Spain.,CIBERES. Instituto De Salud Carlos III, Madrid, Spain
| | - Antonia Fuster
- Servicio De Neumología. Hospital Universitario De Son Llatzer, Palma De Mallorca, Spain
| | | | | | | | | | - Eduardo Márquez
- CIBERES. Instituto De Salud Carlos III, Madrid, Spain.,Unidad Médico-Quirúrgica De Enfermedades Respiratorias. Hospital Virgen Del Rocío, Sevilla, Spain
| | | | | | | | - Marta Palop
- Servicio De Neumología. Hospital De Sagunto, Sagunto, Spain
| | - Juan Antonio Riesco
- CIBERES. Instituto De Salud Carlos III, Madrid, Spain.,Servicio De Neumología. Hospital San Pedro De Alcántara, Cáceres, Spain
| | - Rafael Golpe
- Servicio De Neumología. Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Juan Jose Soler-Cataluña
- CIBERES. Instituto De Salud Carlos III, Madrid, Spain.,Servicio De Neumología. Hospital Arnau De Villanova- Lliria, Valencia, Spain
| | - Marc Miravitlles
- CIBERES. Instituto De Salud Carlos III, Madrid, Spain.,Servicio De Neumología. Hospital Universitari Vall De Hebron/Vall d'Hebron Institut De Recerca, Barcelona, Spain
| |
Collapse
|
6
|
Pallarés-Sanmartín A, Callejas Gonzalez FJ, Fiorentino F, GENOVÉS CRESPO M. VALIDATION OF THE SLEEP JENKINS QUESTIONNAIRE (SJQ) INTO SPANISH: ASSESSMENT OF QUALITY OF SLEEP IN PATIENTS WITH ASTHMA. Chest 2019. [DOI: 10.1016/j.chest.2019.08.1501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
7
|
Martínez-Rivera C, Crespo A, Pinedo-Sierra C, García-Rivero JL, Pallarés-Sanmartín A, Marina-Malanda N, Pascual-Erquicia S, Padilla A, Mayoralas-Alises S, Plaza V, López-Viña A, Picado C. Mucus hypersecretion in asthma is associated with rhinosinusitis, polyps and exacerbations. Respir Med 2018; 135:22-28. [PMID: 29414449 DOI: 10.1016/j.rmed.2017.12.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 12/23/2017] [Accepted: 12/30/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Bronchial hypersecretion is a poorly studied symptom in asthma. The aim of the study was to determine the specific characteristics of asthmatics with bronchial hypersecretion. METHODS A total of 142 asthmatics (21.8% men; mean age 49.8 years) were prospectively followed for one year. Mucus hypersecretion was clinically classified into two severity categories: daily sputum production and frequent expectoration but not every day. Clinical and pulmonary function variables associated with mucus hypersecretion were assessed by multiple logistic regression analysis. RESULTS Daily cough was recorded in 28.9% of patients and sputum production daily or most of the days in 52.1%. Patients with mucus hypersecretion had more dyspnoea, poorer asthma control and quality of life, had suffered from more exacerbations and showed anosmia associated with chronic rhinosinusitis and nasal polyposis more frequently. Factors associated to mucus hypersecretion were anosmia, one exacerbation or more in the previous year and FEV1/FVC <70% (AUC 0.75, 95% CI 0.66-0.85) for the first definition of hypersecretion, and anosmia, poor asthma control and age (AUC 0.75, 95% CI 0.67-0.83) for the second definition. CONCLUSIONS Mucus hypersecretion is frequent in patients with asthma, and is associated with chronic upper airways disease, airway obstruction, poor asthma control and more exacerbations.
Collapse
Affiliation(s)
- Carlos Martínez-Rivera
- Department of Respiratory Medicine, Hospital Universitari Germans TriasiPujol, Badalona, Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en Red Enfermedades Respirtorias (CIBERES), Barcelona, Spain.
| | - Astrid Crespo
- Department of Pneumology, Hospital de la Santa CreuiSant Pau, Institute Sant Pau Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en red Enfermedades Respirtorias (CIBERES), Barcelona, Spain.
| | | | | | | | - Núria Marina-Malanda
- Department of Pneumology, Hospital Universitario Cruces, BioCruces, Barakaldo, Bizkaia, Spain.
| | | | - Alicia Padilla
- Unit of Pneumology, Agencia Sanitaria Costa del Sol, Marbella, Málaga, Spain.
| | | | - Vicente Plaza
- Department of Pneumology, Hospital de la Santa CreuiSant Pau, Institute Sant Pau Biomedical Research (IBB Sant Pau), Universitat Autònoma de Barcelona, Centro de Investigación Biomédica en red Enfermedades Respirtorias (CIBERES), Barcelona, Spain.
| | - Antolín López-Viña
- Service of Pneumology, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
| | - César Picado
- Service of Pneumology, Hospital Clinic de Barcelona, Institut d'InvestigacionsBiomèdiques August Pi iSunyer (IDIBAPS), Centro de Investigación Biomédica en red Enfermedades Respirtorias (CIBERES), Barcelona, Spain.
| |
Collapse
|
8
|
Botana-Rial M, Núñez-Delgado M, Pallarés-Sanmartín A, Leiro-Fernández V, Represas Represas C, González Silva AI, Fernández-Villar A. Intramural Hematoma of the Pulmonary Artery and Hemopneumomediastinum after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration. Respiration 2012; 83:353-6. [DOI: 10.1159/000332925] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 08/31/2011] [Indexed: 11/19/2022] Open
|
9
|
Lourido Cebreiro T, Pallarés-Sanmartín A, Cobas Paz A, Muñoz Martínez M, Bandrés Gimeno R. Criptococosis y adenocarcinoma de pulmón: una asociación poco frecuente. Rev Clin Esp 2011; 211:e13-5. [DOI: 10.1016/j.rce.2010.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Revised: 09/13/2010] [Accepted: 09/27/2010] [Indexed: 11/26/2022]
|
10
|
Botana-Rial M, Núñez-Delgado M, Pallarés-Sanmartín A, Leiro-Fernández V, Torres-Durán M, Represas-Represas C, Fernández-Villar A. Erratum to: Multivariate study of predictive factors for clearly defined lung lesions without visible endobronchial lesions in transbronchial biopsy. Surg Endosc 2010. [DOI: 10.1007/s00464-010-1249-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
11
|
Pallarés-Sanmartín A, Leiro-Fernández V, Cebreiro TL, Botana-Rial M, Fernández-Villar A. Validity and reliability of the Schamroth sign for the diagnosis of clubbing. JAMA 2010; 304:159-61. [PMID: 20628128 DOI: 10.1001/jama.2010.935] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
12
|
Botana-Rial M, Rial MB, Núñez-Delgado M, Delgado MN, Pallarés-Sanmartín A, Sanmartín AP, Leiro-Fernández V, Torres-Durán M, Durán MT, Represas-Represas C, Represas CR, Fernández-Villar A. Multivariate study of predictive factors for clearly defined lung lesions without visible endobronchial lesions in transbronchial biopsy. Surg Endosc 2010; 24:3031-6. [PMID: 20499106 DOI: 10.1007/s00464-010-1080-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 04/09/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although the diagnostic validity and predictive factors for the diagnostic yield of transbronchial biopsy (TBB) of clearly defined pulmonary lesions with no visible endobronchial lesion have been analyzed in numerous studies, very few have used multivariate analysis techniques to evaluate the validity of TBB as a diagnostic tool or to analyze the independent influence of clearly dependent variables, such as the bronchus sign and lesion size. METHODS We retrospectively analyzed all cases in which this type of lesion underwent TBB under fluoroscopic control between 2006 and 2008. The analyzed variables included lesion size, localization, the presence of the bronchus sign, and the final result obtained. We performed a descriptive analysis of the TBB results and a multivariate analysis of the predictive factors for the results using logistic regression techniques. RESULTS A total of 273 patients (206 males, 75.5%) were included in the study. The average lesion diameter was 34 (± 16) mm, with 24% 2 cm or smaller. Twenty-eight percent of the lesions were localized in the lower lobes and 32% in the peripheral third of the lung. The bronchus sign was present in 28% of the patients. Seventy-eight percent of the patients had primary or metastatic malignant lung lesions, the rest were benign lesions of diverse etiology. TBB was diagnostic in 45.4% of cases. In the multivariate analysis, the only independent predictors of outcome were malignant etiology (OR = 4.8; 95% CI = 2.210.4), diameter >20 mm (OR = 3.6; 95% CI = 1.8-7.3), and the presence of the bronchus sign (OR = 2.4; 95% CI = 1.3-4.3). CONCLUSIONS TBB of lesions clearly delimited without an endobronchial lesion can lead to diagnosis in almost half of the patients. The nature of the lesion, diameter >20 mm, and the presence of the bronchus sign are independent predictors of outcome.
Collapse
Affiliation(s)
- Maribel Botana-Rial
- Unit of Interventional Bronchopleural Pathology, Pneumology Department, University Hospital Complex of Vigo, Pizarro 22, 36204, Vigo, Pontevedra, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|