37 results on '"Casanova, Ciro"'
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2. Actualización 2021 de la Guía Española de la EPOC (GesEPOC). Tratamiento no farmacológico
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Cosío, Borja G., Hernández, Carme, Chiner, Eusebi, Gimeno-Santos, Elena, Pleguezuelos, Eulogio, Seijas, Nuria, Rigau, David, López-Campos, José Luis, Soler-Cataluña, Juan José, Calle, Myriam, Miravitlles, Marc, and Casanova, Ciro
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- 2022
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3. Actualización 2021 de la guía española de la EPOC (GesEPOC). Diagnóstico y tratamiento del síndrome de agudización de la EPOC
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Soler-Cataluña, Juan José, Piñera, Pascual, Trigueros, Juan Antonio, Calle, Myriam, Casanova, Ciro, Cosío, Borja G., López-Campos, José Luis, Molina, Jesús, Almagro, Pere, Gómez, José-Tomás, Riesco, Juan Antonio, Simonet, Pere, Rigau, David, Soriano, Joan B., Ancochea, Julio, and Miravitlles, Marc
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- 2022
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4. Actualización 2021 de la Guía Española de la EPOC (GesEPOC). Tratamiento farmacológico de la EPOC estable
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Miravitlles, Marc, Calle, Myriam, Molina, Jesús, Almagro, Pere, Gómez, José-Tomás, Trigueros, Juan Antonio, Cosío, Borja G., Casanova, Ciro, López-Campos, José Luis, Riesco, Juan Antonio, Simonet, Pere, Rigau, David, Soriano, Joan B., Ancochea, Julio, and Soler-Cataluña, Juan José
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- 2022
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5. Nuevo estudio sobre la prevalencia de la EPOC en España: resumen del protocolo EPISCAN II, 10 años después de EPISCAN
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Alfageme, Inmaculada, de Lucas, Pilar, Ancochea, Julio, Miravitlles, Marc, Soler-Cataluña, Juan José, García-Río, Francisco, Casanova, Ciro, Rodríguez González-Moro, José Miguel, Cosío, Borja G., Sánchez, Guadalupe, and Soriano, Joan B.
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- 2019
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6. Características de los pacientes con EPOC tratados en neumología en España según grupos GOLD y fenotipos clínicos GesEPOC
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Izquierdo, José Luis, Miravitlles, Marc, Esquinas, Cristina, Pérez, Maite, Calle, Myriam, López Campos, José Luis, Rodríguez González-Moro, José Miguel, Casanova, Ciro, Esteban, Cristóbal, and de Lucas, Pilar
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- 2018
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7. Documento de expertos del uso de broncodilatadores inhalados en monoterapia en el tratamiento de la EPOC estable leve-moderada
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Riesco Miranda, Juan Antonio, Alcázar, Bernardino, Alfageme, Inmaculada, Casanova, Ciro, Celli, Bartolomé, de-Torres, Juan P., and Jiménez Ruiz, Carlos A.
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- 2017
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8. Consenso sobre el solapamiento de asma y EPOC (ACO) entre la Guía española de la EPOC (GesEPOC) y la Guía Española para el Manejo del Asma (GEMA)
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Plaza, Vicente, Álvarez, Francisco, Calle, Myriam, Casanova, Ciro, Cosío, Borja G., López-Viña, Antolín, Pérez de Llano, Luís, Quirce, Santiago, Román-Rodríguez, Miguel, Soler-Cataluña, Juan José, and Miravitlles, Marc
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- 2017
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9. Guía española de la enfermedad pulmonar obstructiva crónica (GesEPOC) 2017. Tratamiento farmacológico en fase estable
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Miravitlles, Marc, Soler-Cataluña, Juan José, Calle, Myriam, Molina, Jesús, Almagro, Pere, Quintano, José Antonio, Trigueros, Juan Antonio, Cosío, Borja G., Casanova, Ciro, Antonio Riesco, Juan, Simonet, Pere, Rigau, David, Soriano, Joan B., and Ancochea, Julio
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- 2017
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10. Documento de consenso «Uso adecuado de los corticoides inhalados en la enfermedad pulmonar obstructiva crónica»
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Alcázar Navarrete, Bernardino, Casanova, Ciro, Miravitlles, Marc, de Lucas, Pilar, Riesco, Juan Antonio, and Rodríguez González-Moro, José Miguel
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- 2015
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11. Chronic obstructive pulmonary disease History Assessment in Spain: una valoración multidimensional de la enfermedad pulmonar obstructiva crónica. Método y organización del trabajo
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López-Campos, José Luis, Peces-Barba, Germán, Soler-Cataluña, Juan José, Soriano, Joan B., de Lucas Ramos, Pilar, de-Torres, Juan P., Marín, José M., and Casanova, Ciro
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- 2012
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12. ANTES: Un año después en la EPOC
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Agustí, Alvar, Alcázar, Bernardino, Ancochea, Julio, Casanova, Ciro, Celli, Bartolome, Cosio, Borja, Echave-Sustaeta, José María, Fernandez Villar, Alberto, Garcia Rivero, Juan Luis, González, Cruz, Izquierdo, José Luis, Lopez-Campos, José Luis, Marín Trigo, José María, Martín Sánchez, Javier, Miravitlles, Marc, Molina, Jesús, Peces-Barba, Germán, Roman, Miguel, Soler Cataluña, Juan José, and Villar-Alvarez, Felipe
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- 2022
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13. Enfermedad pulmonar obstructiva crónica de origen no tabáquico
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Toledo-Pons, Nuria, Cosío, Borja G., Velasco, M. del Valle, and Casanova, Ciro
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- 2017
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14. Simplificando las guías: los 10 mandamientos de la EPOC
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Marin, José María, Cote, Claudia, Casanova, Ciro, Pinto-Plata, Victor, Montes de Oca, María, Divo, Miguel J, de Torres, Juan P, Zulueta, Javier, Cabrera, Carlos, Carrizo, Santiago, Polverino, Francesca, and Celli, Bartolomé R
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- 2016
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15. Guía clínica SEPAR-ALAT de diagnóstico y tratamiento de la EPOC
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Peces-Barba, Germán, Albert Barberà, Joan, Agustí, Àlvar, Casanova, Ciro, Casas, Alejandro, Luis Izquierdo, José, Jardim, José, Varela, Victorina López, Monsó, Eduard, Montemayor, Teodoro, and Luis Viejo, José
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- 2008
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16. Lung Function and Symptoms of Exposure to the Volcanic Eruption in the Canary Islands: First Follow-Up of the ASHES Study.
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Candal-Pedreira C, Díaz-Pérez D, Velasco V, Casanova C, Acosta O, Peces-Barba G, Barreiro E, Cañas A, Castaño A, Cruz Carmona MJ, Diego C, Garcia-Aymerich J, Martínez C, Molina-Molina M, Muñoz X, Sánchez-Íñigo FJ, and Ruano-Ravina A
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- Humans, Spain epidemiology, Male, Female, Adult, Middle Aged, Follow-Up Studies, Spirometry, Aged, Forced Expiratory Volume, Particulate Matter adverse effects, Particulate Matter analysis, Lung physiopathology, Respiratory Function Tests, Volcanic Eruptions adverse effects, Environmental Exposure adverse effects
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Introduction: Exposure to gases and particulate matter released during volcanic eruptions can prove harmful to population health. This paper reports the preliminary results of the ASHES study, aimed at ascertaining the respiratory health effects of the 2021 volcanic eruption in La Palma Island (Spain) on the adult population without previous respiratory disease., Methods: Ambispective cohort study on the healthy adult population. Three exposure groups were considered: Group 1, high exposure; Group 2, moderate exposure; and Group 3, minor or no exposure. We carried out a descriptive analysis of symptoms during and after the eruption, as well as measure lung function after the eruption (through forced spirometry and diffusing capacity of carbon monoxide)., Results: The analysis included 474 subjects: 54 in Group 1, 335 in Group 2, and 85 in Group 3. A significant increase in most symptoms was observed for subjects in the groups exposed during the eruption. After the eruption, this increase remained for some symptoms. There seems to be a dose-response relationship, such that the higher the exposure, the higher the odds ratio. A prebronchodilator FEV
1 /FVC ratio<70% was observed in 13.0% of subjects in Group 1, 8.6% of subjects in Group 2, and 7.1% of subjects in Group 3., Conclusions: This study is the first to report a dose-response relationship between exposure to volcanic eruptions and the presence of symptoms in adults. Furthermore, there is a tendency toward obstructive impairment in individuals with higher exposure., (Copyright © 2024 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.)- Published
- 2024
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17. Triple Therapy and Clinical Control in B+ COPD Patients: A Pragmatic, Prospective, Randomized Trial.
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Agusti A, Lopez-Campos JL, Miravitlles M, Soler-Cataluña JJ, Marin JM, Cosio BG, Alcázar-Navarrete B, Echave-Sustaeta JM, Casanova C, Peces-Barba G, de-Torres JP, Fernandez-Villar A, Ancochea J, Villar-Alvarez F, Roman-Rodriguez M, Molina J, Garcia-Rivero JL, Gonzalez C, Sobradillo P, Faner R, Peña C, Sharma R, Izquierdo JL, and Celli BR
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- Female, Humans, Male, Middle Aged, Administration, Inhalation, Adrenal Cortex Hormones therapeutic use, Adrenergic beta-2 Receptor Agonists therapeutic use, Adrenergic beta-2 Receptor Agonists administration & dosage, Androstadienes therapeutic use, Androstadienes administration & dosage, Bronchodilator Agents therapeutic use, Bronchodilator Agents administration & dosage, Chlorobenzenes therapeutic use, Chlorobenzenes administration & dosage, Drug Therapy, Combination, Eosinophils, Muscarinic Antagonists therapeutic use, Muscarinic Antagonists administration & dosage, Prospective Studies, Quinuclidines therapeutic use, Quinuclidines administration & dosage, Treatment Outcome, Benzyl Alcohols therapeutic use, Benzyl Alcohols administration & dosage, Drug Combinations, Pulmonary Disease, Chronic Obstructive drug therapy
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Introduction: Treatment with LABA/LAMA is recommended in GOLD B patients. We hypothesized that triple therapy (LABA/LAMA/ICS) will be superior to LABA/LAMA in achieving and maintaining clinical control (CC), a composite outcome that considers both impact and disease stability in a subgroup of GOLD B patients (here termed GOLD B+ patients) characterized by: (1) remaining symptomatic (CAT≥10) despite regular LABA/LAMA therapy; (2) having suffered one moderate exacerbation in the previous year; and (3) having blood eosinophil counts (BEC) ≥150cells/μL., Methods: The ANTES B+ study is a prospective, multicenter, open label, randomized, pragmatic, controlled trial designed to test this hypothesis. It will randomize 1028 B+ patients to continue with their usual LABA/LAMA combination prescribed by their attending physician or to begin fluticasone furoate (FF) 92μg/umeclidinium (UMEC) 55μg/vilanterol (VI) 22μg in a single inhaler q.d. for 12 months. The primary efficacy outcome will be the level of CC achieved. Secondary outcomes include the clinical important deterioration index (CID), annual rate of exacerbations, and FEV1. Exploratory objectives include the interaction of BEC and smoking status, all-cause mortality and proportion of patients on LABA/LAMA arm that switch therapy arms. Safety analysis include adverse events and incidence of pneumonia., Results: The first patient was recruited on February 29, 2024; results are expected in the first quarter of 2026., Conclusions: The ANTES B+ study is the first to: (1) explore the efficacy and safety of triple therapy in a population of B+ COPD patients and (2) use a composite index (CC) as the primary result of a COPD trial., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)
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- 2024
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18. Impact of Applying the Global Lung Initiative Criteria for Airway Obstruction in GOLD Defined COPD Cohorts: The BODE and CHAIN Experience.
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de-Torres JP, Casanova C, Marín JM, Cabrera C, Marín M, Ezponda A, Cosio BG, Martínez C, Solanes I, Fuster A, Calle M, Peces-Barba G, Gotera C, Feu-Collado N, Marin A, Alcaide AB, Sangro M, Bastarrika G, and Celli BR
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- Humans, Lung diagnostic imaging, Dyspnea etiology, Comorbidity, Severity of Illness Index, Exercise Tolerance, Body Mass Index, Forced Expiratory Volume, Pulmonary Disease, Chronic Obstructive diagnosis, Airway Obstruction epidemiology
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Introduction: The Global Lung Function Initiative (GLI) has proposed new criteria for airflow limitation (AL) and recommends using these to interpret spirometry. The objective of this study was to explore the impact of the application of the AL GLI criteria in two well characterized GOLD-defined COPD cohorts., Methods: COPD patients from the BODE (n=360) and the COPD History Assessment In SpaiN (CHAIN) cohorts (n=722) were enrolled and followed. Age, gender, pack-years history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, history of exacerbations and survival were recorded. CT-detected comorbidities were registered in the BODE cohort. The proportion of subjects without AL by GLI criteria was determined in each cohort. The clinical, CT-detected comorbidity, and overall survival of these patients were evaluated., Results: In total, 18% of the BODE and 15% of the CHAIN cohort did not meet GLI AL criteria. In the BODE and CHAIN cohorts respectively, these patients had a high clinical burden (BODE≥3: 9% and 20%; mMRC≥2: 16% and 45%; exacerbations in the previous year: 31% and 9%; 6MWD<350m: 15% and 19%, respectively), and a similar prevalence of CT-diagnosed comorbidities compared with those with GLI AL. They also had a higher rate of long-term mortality - 33% and 22% respectively., Conclusions: An important proportion of patients from 2 GOLD-defined COPD cohorts did not meet GLI AL criteria at enrolment, although they had a significant burden of disease. Caution must be taken when applying the GLI AL criteria in clinical practice., (Copyright © 2023 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)
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- 2024
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19. Association between occupational exposure and chronic obstructive pulmonary disease and respiratory symptoms in the Spanish population.
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Loeb E, Zock JP, Miravitlles M, Rodríguez E, Soler-Cataluña JJ, Soriano JB, García-Río F, de Lucas P, Alfageme I, Casanova C, Rodríguez González-Moro JM, Ancochea J, Cosío BG, and Ferrer Sancho J
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- Humans, Female, Middle Aged, Aged, Male, Cross-Sectional Studies, Gases, Spirometry, Dust, Risk Factors, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Disease, Chronic Obstructive etiology, Pulmonary Disease, Chronic Obstructive diagnosis, Occupational Exposure adverse effects, Occupational Diseases epidemiology, Occupational Diseases etiology
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Introduction: The aim of this study was to analyze the impact of occupational exposure on chronic obstructive pulmonary disease (COPD) and respiratory symptoms in the general Spanish population., Methods: This was a study nested in the Spanish EPISCAN II cross-sectional epidemiological study that included participants who had completed a structured questionnaire on their occupational history, a questionnaire on respiratory symptoms, and forced spirometry. The data were analyzed using Chi-square and Student's t tests and adjusted models of multiple linear regression and logistic regression., Results: We studied 7502 subjects, 51.1% women, with a mean age of 60±11 years. Overall, 53.2% reported some respiratory symptoms, 7.9% had respiratory symptoms during their work activity, 54.2% were or had been smokers, and 11.3% (851 subjects) met COPD criteria on spirometry. A total of 3056 subjects (40.7%) reported exposure to vapors, gases, dust or fumes (VGDF); occupational exposure to VGDF was independently associated with the presence of COPD (OR 1.22, 95% CI: 1.03-1.44), respiratory symptoms (OR 1.45, 95%: CI 1.30-1.61), and respiratory symptoms at work (OR 4.69, 95% CI: 3.82-5.77), with a population attributable fraction for COPD of 8.2%., Conclusions: Occupational exposure is associated with a higher risk of COPD and respiratory symptoms in the Spanish population. These results highlight the need to follow strict prevention measures to protect the respiratory health of workers., (Copyright © 2023 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)
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- 2024
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20. Tobacco Patterns and Risk of Chronic Obstructive Pulmonary Disease: Results From a Cross-Sectional Study.
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Rey-Brandariz J, Pérez-Ríos M, Ahluwalia JS, Beheshtian K, Fernández-Villar A, Represas-Represas C, Piñeiro M, Alfageme I, Ancochea J, Soriano JB, Casanova C, Cosío BG, García-Río F, Miravitlles M, de Lucas P, Rodríguez González-Moro JM, Soler-Cataluña JJ, and Ruano-Ravina A
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- Humans, Cross-Sectional Studies, Bronchodilator Agents therapeutic use, Risk Factors, Spirometry, Forced Expiratory Volume, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Disease, Chronic Obstructive etiology, Pulmonary Disease, Chronic Obstructive drug therapy
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Introduction: There is still uncertainty about which aspects of cigarette smoking influence the risk of Chronic Obstructive Pulmonary Disease (COPD). The aim of this study was to estimate the COPD risk as related to duration of use, intensity of use, lifetime tobacco consumption, age of smoking initiation and years of abstinence., Methods: We conducted an analytical cross-sectional study based on data from the EPISCAN-II study (n=9092). All participants underwent a face-to-face interview and post-bronchodilator spirometry was performed. COPD was defined as post-bronchodilator FEV1/FVC<70%. Parametric and nonparametric logistic regression models with generalized additive models were used., Results: 8819 persons were included; 858 with COPD and 7961 without COPD. The COPD risk increased with smoking duration up to ≥50 years [OR 3.5 (95% CI: 2.3-5.4)], with smoking intensity up to ≥39cig/day [OR 10.1 (95% CI: 5.3-18.4)] and with lifetime tobacco consumption up to >29 pack-years [OR 3.8 (95% CI: 3.1-4.8)]. The COPD risk for those who started smoking at 22 or later was 0.9 (95% CI: 0.6-1.4). The risk of COPD decreased with increasing years of cessation. In comparison with both never smokers and current smokers, the lowest risk of COPD was found after 15-25 years of abstinence., Conclusion: COPD risk increases with duration, intensity, and lifetime tobacco consumption and decreases importantly with years of abstinence. Age at smoking initiation shows no effect. After 15-25 years of cessation, COPD risk could be equal to that of a never smoker. This work suggests that the time it takes to develop COPD in a smoker is about 30 years., (Copyright © 2023 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2023
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21. Trends of COPD in Spain: Changes Between Cross Sectional Surveys 1997, 2007 and 2017.
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García Castillo E, Alonso Pérez T, Peláez A, Pérez González P, Miravitlles M, Alfageme I, Casanova C, Cosío BG, de Lucas P, García-Río F, Rodríguez González-Moro JM, Soler-Cataluña JJ, Sánchez G, Soriano JB, and Ancochea J
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- Male, Humans, Female, Cross-Sectional Studies, Spain, Vital Capacity, Forced Expiratory Volume, Risk Factors, Spirometry, Prevalence, Pulmonary Disease, Chronic Obstructive diagnosis
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Introduction: We aim to describe the changes in prevalence and risk factors associated to chronic obstructive pulmonary disease (COPD) in Spain, comparing three population-based studies conducted in three timepoints., Methods: We compared participants from IBERPOC conducted in 1997, EPISCAN conducted in 2007 and EPISCAN II in 2017. COPD was defined as a postbronchodilator FEV
1 /FVC (forced expiratory volume in 1s/forced vital capacity) ratio <0.70, according to GOLD criteria; subsequently, also as the FEV1 /FVC below the lower limit of normal (LLN)., Results: COPD prevalence in the population between 40 and 69 years decreased from 21.6% (95% CI 20.7%-23.2%) in 1997 to 8.8% (95% CI 8.2%-9.5%) in 2017, a 59.2% decline (p<0.001). In 2007, the prevalence was 7.7% (95% CI 6.8%-8.7%) with an upward trend of 1.1 percentage points in 2017 (p=0.073). Overall COPD prevalence decreased in men and women, although a significant increase was observed in the last decade in females (p<0.05). Current smokers significantly increased in the last decades (25.4% in 1997, 29.1% in 2007 and 23.4% in 2017; p<0.001). Regrettably, COPD underdiagnosis was constantly high, 77.6% in 1997, 78.4% in 2007, and to 78.2% in 2017 (p=0.95), higher in younger ages (40-49 yrs and 50-59 yrs) and also higher in women than in men in all three studies (p<0.05)., Conclusions: We report a significant reduction of 59.2% in the prevalence of COPD in Spain from 1997 to 2017 in subjects aged 40-69 years. Our study highlights the significant underdiagnosis of COPD, particularly sustained in women and younger populations., (Copyright © 2022 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)- Published
- 2023
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22. Analysis of Exposure and Respiratory Health Effects of Volcanic Eruption in the Canary Islands (ASHES). A SEPAR Study.
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Ruano-Ravina A, Acosta O, Díaz Pérez D, Casanova C, Velasco V, Llanos AB, Peces-Barba G, Barreiro E, Cañas A, Castaño A, Cruz Carmona MJ, Diego C, Garcia-Aymerich J, Martínez C, Molina-Molina M, Muñoz X, Sánchez-Íñigo FJ, and Candal-Pedreira C
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- Humans, Spain epidemiology, Respiratory System, Volcanic Eruptions adverse effects, Environmental Monitoring
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- 2022
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23. The 7 Cardinal Sins of COPD in Spain.
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Luis Izquierdo J, Casanova C, Celli B, Santos S, Sibila O, Sobradillo P, and Agusti A
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- Adult, Humans, Incidence, Prevalence, Spain epidemiology, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Disease, Chronic Obstructive therapy
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Chronic obstructive pulmonary disease (COPD) is a public health problem due to its high prevalence (11% in the adult population in Spain), increasing incidence, and great social and economic impact. Despite this, it is underdiagnosed (and, therefore, undertreated) at a rate of around 80%. In this paper, a group of respiratory physicians specializing in COPD discuss 7 fundamental problems ("cardinal sins") that contribute to this situation, with the explicit aim of proposing specific solutions that may help to improve this unfavorable state of affairs., (Copyright © 2022 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)
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- 2022
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24. Spanish COPD Guideline (GesEPOC) Update: Comorbidities, Self-Management and Palliative Care.
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Lopez-Campos JL, Almagro P, Gómez JT, Chiner E, Palacios L, Hernández C, Navarro MD, Molina J, Rigau D, Soler-Cataluña JJ, Calle M, Cosío BG, Casanova C, and Miravitlles M
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- Comorbidity, Dyspnea epidemiology, Dyspnea etiology, Dyspnea therapy, Humans, Palliative Care, Quality of Life, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive epidemiology, Pulmonary Disease, Chronic Obstructive therapy, Self-Management
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The current health care models described in GesEPOC indicate the best way to make a correct diagnosis, the categorization of patients, the appropriate selection of the therapeutic strategy and the management and prevention of exacerbations. In addition, COPD involves several aspects that are crucial in an integrated approach to the health care of these patients. The evaluation of comorbidities in COPD patients represents a healthcare challenge. As part of a comprehensive assessment, the presence of comorbidities related to the clinical presentation, to some diagnostic technique or to some COPD-related treatments should be studied. Likewise, interventions on healthy lifestyle habits, adherence to complex treatments, developing skills to recognize the signs and symptoms of exacerbation, knowing what to do to prevent them and treat them within the framework of a self-management plan are also necessary. Finally, palliative care is one of the pillars in the comprehensive treatment of the COPD patient, seeking to prevent or treat the symptoms of a disease, the side effects of treatment, and the physical, psychological and social problems of patients and their caregivers. Therefore, the main objective of this palliative care is not to prolong life expectancy, but to improve its quality. This chapter of GesEPOC 2021 presents an update on the most important comorbidities, self-management strategies, and palliative care in COPD, and includes a recommendation on the use of opioids for the treatment of refractory dyspnea in COPD., (Copyright © 2021 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2022
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25. The ANTES program in COPD: First year.
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Agustí A, Alcázar B, Ancochea J, Casanova C, Celli B, Cosio B, Echave-Sustaeta JM, Fernandez Villar A, Garcia Rivero JL, González C, Izquierdo JL, Lopez-Campos JL, Marín Trigo JM, Martín Sánchez J, Miravitlles M, Molina J, Peces-Barba G, Roman M, Soler Cataluña JJ, and Villar-Alvarez F
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- Humans, Pulmonary Disease, Chronic Obstructive therapy
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- 2022
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26. Spanish COPD Guidelines (GesEPOC 2021): Non-pharmacological Treatment Update.
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Cosío BG, Hernández C, Chiner E, Gimeno-Santos E, Pleguezuelos E, Seijas N, Rigau D, López-Campos JL, Soler-Cataluña JJ, Calle M, Miravitlles M, and Casanova C
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- Bronchodilator Agents therapeutic use, Humans, Oxygen, Oxygen Inhalation Therapy, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Emphysema therapy
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In addition to recommendations for pharmacological treatment stratified for risk and phenotype, the new 2021 edition of the Spanish COPD Guidelines (GesEPOC 2021) proposes a personalized approach to treatable traits, defined as a characteristic (clinical, physiological, or biological) that can be identified by diagnostic tests or biomarkers, for which a specific treatment is available. Some treatable traits, such as malnutrition, sedentarism, emphysema or respiratory failure, can be treated with non-pharmacological therapies, and this was not covered in detail in the guidelines. This section of GesEPOC 2021 includes a narrative update with recommendations on dietary treatment, physical activity, respiratory rehabilitation, oxygen therapy, non-invasive ventilation, volume reduction, and lung transplantation. A PICO question with recommendations on the use of supplemental oxygen during exercise in COPD patients without severe hypoxemia is also included., (Copyright © 2021 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2022
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27. Spanish COPD Guidelines (GesEPOC) 2021 Update Diagnosis and Treatment of COPD Exacerbation Syndrome.
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Soler-Cataluña JJ, Piñera P, Trigueros JA, Calle M, Casanova C, Cosío BG, López-Campos JL, Molina J, Almagro P, Gómez JT, Riesco JA, Simonet P, Rigau D, Soriano JB, Ancochea J, and Miravitlles M
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This article details the GesEPOC 2021 recommendations on the diagnosis and treatment of COPD exacerbation syndrome (CES). The guidelines propose a definition-based syndromic approach, a new classification of severity, and the recognition of different treatable traits (TT), representing a new step toward personalized medicine. The evidence is evaluated using GRADE methodology, with the incorporation of 6 new PICO questions. The diagnostic process comprises four stages: 1) establish a diagnosis of CES, 2) assess the severity of the episode, 3) identify the trigger, and 4) address TTs. This diagnostic process differentiates an outpatient approach, that recommends the inclusion of a basic battery of tests, from a more comprehensive hospital approach, that includes the study of different biomarkers and imaging tests. Bronchodilator treatment for immediate relief of symptoms is considered essential for all patients, while the use of antibiotics, systemic corticosteroids, oxygen therapy, and assisted ventilation and the treatment of comorbidities will vary depending on severity and possible TTs. The use of antibiotics will be indicated particularly if sputum color changes, when ventilatory assistance is required, in cases involving pneumonia, and in patients with elevated C-reactive protein (≥ 20 mg/L). Systemic corticosteroids are recommended in CES that requires admission and are suggested in moderate CES. These drugs are more effective in patients with blood eosinophil counts ≥ 300 cells/mm
3 . Acute-phase non-invasive mechanical ventilation is specified primarily for patients with CES who develop respiratory acidosis despite initial treatment., (Copyright © 2021 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)- Published
- 2022
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28. [Translated article] Spanish COPD Guidelines (GesEPOC) 2021 Update. Diagnosis and Treatment of COPD Exacerbation Syndrome.
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Soler-Cataluña JJ, Piñera P, Trigueros JA, Calle M, Casanova C, Cosío BG, López-Campos JL, Molina J, Almagro P, Gómez JT, Riesco JA, Simonet P, Rigau D, Soriano JB, Ancochea J, and Miravitlles M
- Subjects
- Adrenal Cortex Hormones therapeutic use, Anti-Bacterial Agents therapeutic use, Bronchodilator Agents therapeutic use, Humans, Oxygen Inhalation Therapy, Pulmonary Disease, Chronic Obstructive drug therapy, Pulmonary Disease, Chronic Obstructive therapy
- Abstract
This article details the GesEPOC 2021 recommendations on the diagnosis and treatment of COPD exacerbation syndrome (CES). The guidelines propose a definition-based syndromic approach, a new classification of severity, and the recognition of different treatable traits (TT), representing a new step toward personalized medicine. The evidence is evaluated using GRADE methodology, with the incorporation of 6 new PICO questions. The diagnostic process comprises four stages: 1) establish a diagnosis of CES, 2) assess the severity of the episode, 3) identify the trigger, and 4) address TTs. This diagnostic process differentiates an outpatient approach, that recommends the inclusion of a basic battery of tests, from a more comprehensive hospital approach, that includes the study of different biomarkers and imaging tests. Bronchodilator treatment for immediate relief of symptoms is considered essential for all patients, while the use of antibiotics, systemic corticosteroids, oxygen therapy, and assisted ventilation and the treatment of comorbidities will vary depending on severity and possible TTs. The use of antibiotics will be indicated particularly if sputum color changes, when ventilatory assistance is required, in cases involving pneumonia, and in patients with elevated C-reactive protein (≥ 20 mg/L). Systemic corticosteroids are recommended in CES that requires admission and are suggested in moderate CES. These drugs are more effective in patients with blood eosinophil counts ≥ 300 cells/mm
3 . Acute-phase non-invasive mechanical ventilation is specified primarily for patients with CES who develop respiratory acidosis despite initial treatment., (Copyright © 2021 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)- Published
- 2022
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29. Spanish COPD Guidelines (GesEPOC) 2021: Updated Pharmacological treatment of stable COPD.
- Author
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Miravitlles M, Calle M, Molina J, Almagro P, Gómez JT, Trigueros JA, Cosío BG, Casanova C, López-Campos JL, Riesco JA, Simonet P, Rigau D, Soriano JB, Ancochea J, and Soler-Cataluña JJ
- Abstract
The Spanish COPD Guidelines (GesEPOC) were first published in 2012, and since then have undergone a series of updates incorporating new evidence on the diagnosis and treatment of COPD. GesEPOC was drawn up in partnership with scientific societies involved in the treatment of COPD and the Spanish Patients' Forum. Their recommendations are based on an evaluation of the evidence using GRADE methodology, and a narrative description of the evidence in areas in which GRADE cannot be applied. In this article, we summarize the recommendations on the pharmacological treatment of stable COPD based on 9 PICO questions. COPD treatment is a 4-step process: 1) diagnosis, 2) determination of the risk level, 3) initial and subsequent inhaled therapy, and 4) identification and management of treatable traits. For the selection of inhaled therapy, high-risk patients are divided into 3 phenotypes: non-exacerbator, eosinophilic exacerbator, and non-eosinophilic exacerbator. Some treatable traits are general and should be investigated in all patients, such as smoking or inhalation technique, while others affect severe patients in particular, such as chronic hypoxemia and chronic bronchial infection. COPD treatment is based on long-acting bronchodilators with single agents or in combination, depending on the patient's risk level. Eosinophilic exacerbators must receive inhaled corticosteroids, while non-eosinophilic exacerbators require a more detailed evaluation to choose the best therapeutic option. The new GesEPOC also includes recommendations on the withdrawal of inhaled corticosteroids and on indications for alpha-1 antitrypsin treatment. GesEPOC offers a more individualized approach to COPD treatment tailored according to the clinical characteristics of patients and their level of complexity., (Copyright © 2021 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2022
- Full Text
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30. Psoas Muscle Density Evaluated by Chest CT and Long-Term Mortality in COPD Patients.
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Ezponda A, Casanova C, Cabrera C, Martin-Palmero Á, Marin-Oto M, Marín JM, Pinto-Plata V, Divo M, Celli BR, Zulueta JJ, Bastarrika G, and de-Torres JP
- Abstract
Rationale: Poor muscle quality in COPD patients relates to exercise intolerance and mortality. Muscle quality can be estimated on computed tomography (CT) by estimating psoas density (PsD). We tested the hypothesis that PsD is lower in COPD patients than in controls and relates to all-cause mortality., Methods: At baseline, PsD was measured using axial low-dose chest CT images in 220 COPD patients, 80% men, who were 65±8 years old with mild to severe airflow limitation and in a control group of 58 subjects matched by age, sex, body mass index (BMI) and body surface area (BSA). COPD patients were prospectively followed for 76.5 (48-119) months. Anthropometrics, smoking history, BMI, dyspnoea, lung function, exercise capacity, BODE index and exacerbations history were recorded. Cox proportional risk analysis determined the factors more strongly associated with long-term mortality., Results: PsD was lower in COPD patients than in controls (40.5 vs 42.5, p=0.045). During the follow-up, 54 (24.5%) deaths occurred in the COPD group. PsD as well as age, sex, pack-year history, FEV
1 %, 6MWD, mMRC, BODE index, were independently associated with mortality. Multivariate analysis showed that age (HR 1.06; 95% CI 1.02-1.12, p=0.006) and CT-assessed PsD (HR 0.97; 95%CI 0.94-0.99, p=0.023) were the variables independently associated with all-cause mortality., Conclusions: In COPD patients with mild to severe airflow limitation, chest CT-assessed psoas muscle density was lower than in matched controls and independently associated with long-term mortality. Muscle quality using the easy to evaluate psoas muscle density from chest CT may provide clinicians with important prognostic information in COPD., (Copyright © 2021 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)- Published
- 2021
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31. Prevalence and Determinants of COPD in Spain: EPISCAN II.
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Soriano JB, Alfageme I, Miravitlles M, de Lucas P, Soler-Cataluña JJ, García-Río F, Casanova C, Rodríguez González-Moro JM, Cosío BG, Sánchez G, and Ancochea J
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Prevalence, Spain epidemiology, Spirometry, Electronic Nicotine Delivery Systems, Pulmonary Disease, Chronic Obstructive epidemiology
- Abstract
Background: Two previous national epidemiological studies, IBERPOC in 1997 and EPISCAN in 2007, determined the COPD burden in Spain. Changes in demographics and exposure to risk factors demand the periodic update of COPD prevalence and its determinants., Methods: EPISCAN II aimed to estimate the prevalence of COPD in the general population aged 40 years or older in all 17 regions of Spain. A random population screening sample, requiring 600 participants per region performed a questionnaire plus post-bronchodilator (post-BD) spirometry., Results: A total of 12,825 subjects were initially contacted, and 9433 (73.6%) agreed to participate, of whom 9092 performed a valid spirometry. Baseline characteristics were: 52.6% women, mean±SD age 60±11 years, 19.8% current- and 34.2% former-smokers. The prevalence of COPD measured by post-BD fixed ratio FEV
1 /FVC<0.7 was 11.8% (95% C.I. 11.2-12.5) with a high variability by region (2.4-fold). Prevalence was 14.6% (95% C.I. 13.5-15.7) in males and 9.4% (95% C.I. 8.6-10.2) in females; according to the lower limit of normal (LLN) was 6.0% (95% C.I. 5.5-6.5) overall, by sex being 7.1% (95% C.I. 6.4-8.0) in males and 4.9% (95% C.I. 4.3-5.6) in females. Underdiagnosis of COPD was 74.7%. Cases with COPD were a mean of seven years older, more frequently male, of lower attained education, and with more smokers than the non-COPD population (p<0.001). However, the number of cigarettes and pack-years in non-COPD participants was substantial, as it was the reported use of e-cigarettes (7.0% vs. 5.5%) (p=0.045). There were also significant social and clinical differences including living alone, previous respiratory diagnoses, more comorbidities measured with the Charlson index, greater BODE and COTE scores, cognitive impairment, and depression (all p<0.001)., Conclusions: COPD remains prevalent in Spain and frequently underdiagnosed., (Copyright © 2020 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)- Published
- 2021
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32. 10 Years After EPISCAN: A New Study on the Prevalence of COPD in Spain -A Summary of the EPISCAN II Protocol.
- Author
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Alfageme I, de Lucas P, Ancochea J, Miravitlles M, Soler-Cataluña JJ, García-Río F, Casanova C, Rodríguez González-Moro JM, Cosío BG, Sánchez G, and Soriano JB
- Subjects
- Adult, Aged, Aged, 80 and over, Clinical Protocols, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Patient Selection, Prevalence, Sample Size, Spain epidemiology, Pulmonary Disease, Chronic Obstructive epidemiology
- Abstract
Introduction: The EPISCAN study, published in 2007, was an update of the results of the 1997 IBERPOC study. Changes in demographics and exposure to risk factors demand the periodic update of prevalence and determining factors in COPD. This article is a summary of the protocol and tools used in EPISCAN II., Materials and Methods: The primary objective of EPISCAN II is to estimate the prevalence of COPD among the general population aged 40 years or more in the 17 autonomous communities of Spain. The sample size requires 600 participants (300 men and 300 women) per center, selected by screening 10,200 participants in a short visit (questionnaire plus forced post-bronchodilator spirometry). Of these, 800 (400 with COPD and 400 without COPD) will also perform a long visit (including a walking test, blood tests, determination of diffusion, pulse oximetry and bioimpedance, and low radiation CT)., Results: The first participant was recruited on 28 February 2017. As of 22 November 2017, a total of 3,581 participants had been included, of whom 422 had already performed the long visit. It is estimated that the field work will be completed by December 2018. The new imaging data, biomarkers, and information on new exposures, such as electronic cigarettes and environmental pollution, will help us re-quantify the burden of COPD., Conclusions: EPISCAN II will provide updated information on prevalence and determinants of COPD in Spain, allowing for the comparison of spirometric results and other factors associated with COPD among the 17 autonomous communities., (Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2019
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33. Expert Statement on the Single-Agent Use of Inhaled Bronchodilator in the Treatment of Stable Mild-Moderate Chronic Obstructive Pulmonary Disease.
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Riesco Miranda JA, Alcázar B, Alfageme I, Casanova C, Celli B, de-Torres JP, and Jiménez Ruiz CA
- Subjects
- Administration, Inhalation, Adult, Aged, Aged, 80 and over, Bronchodilator Agents administration & dosage, Delphi Technique, Evidence-Based Medicine, Female, Humans, Male, Middle Aged, Bronchodilator Agents therapeutic use, Practice Guidelines as Topic, Pulmonary Disease, Chronic Obstructive drug therapy
- Abstract
Objective: To describe the evidence- and experience-based expert consensus on the use of single-agent bronchodilators in patients with stable mild-moderate chronic obstructive pulmonary disease (COPD)., Methods: Using Delphi methodology, a panel of 7 respiratory medicine experts was established, who, in the first nominal group meeting defined the scope, users, and document sections. The panel drew up 14 questions on the use of single-agent bronchodilators in patients with mild-moderate stable COPD to be answered with a systematic review of the literature. The results of the review were discussed in a second nominal group meeting and 17 statements were generated. Agreement/disagreement with the statements was tested among16 different experts including respiratory medicine experts and primary care physicians. Statements were scored from1 (total disagreement) to10 (total agreement). Agreement was considered if at least 70% voted ≥7. The level of evidence and grade of recommendation of the systematic literature review was assessed using the Oxford Centre for Evidence-based Medicine levels., Results: A total of 12 of the 17 statements were selected. Specific statements were generated on different profiles of patients with stable mild-moderate COPD in whom single-agent bronchodilators could be prescribed., Conclusions: These statements on the use of single-agent bronchodilators might improve the outcomes and prognosis of patients with stable mild-moderate COPD., (Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
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34. Spanish Guidelines for Management of Chronic Obstructive Pulmonary Disease (GesEPOC) 2017. Pharmacological Treatment of Stable Phase.
- Author
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Miravitlles M, Soler-Cataluña JJ, Calle M, Molina J, Almagro P, Quintano JA, Trigueros JA, Cosío BG, Casanova C, Antonio Riesco J, Simonet P, Rigau D, Soriano JB, and Ancochea J
- Subjects
- Adrenal Cortex Hormones therapeutic use, Anti-Bacterial Agents therapeutic use, Antioxidants therapeutic use, Bronchitis complications, Bronchodilator Agents therapeutic use, Diagnostic Techniques, Respiratory System standards, Disease Management, Expectorants therapeutic use, Oxygen Inhalation Therapy, Phenotype, Phosphodiesterase Inhibitors therapeutic use, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive therapy, Pulmonary Emphysema complications, Pulmonary Medicine organization & administration, Pulmonary Medicine standards, Risk Assessment, Societies, Medical, Spain, alpha 1-Antitrypsin therapeutic use, Pulmonary Disease, Chronic Obstructive drug therapy
- Abstract
The clinical presentation of chronic obstructive pulmonary disease (COPD) varies widely, so treatment must be tailored according to the level of risk and phenotype. In 2012, the Spanish COPD Guidelines (GesEPOC) first established pharmacological treatment regimens based on clinical phenotypes. These regimens were subsequently adopted by other national guidelines, and since then, have been backed up by new evidence. In this 2017 update, the original severity classification has been replaced by a much simpler risk classification (low or high risk), on the basis of lung function, dyspnea grade, and history of exacerbations, while determination of clinical phenotype is recommended only in high-risk patients. The same clinical phenotypes have been maintained: non-exacerbator, asthma-COPD overlap (ACO), exacerbator with emphysema, and exacerbator with bronchitis. Pharmacological treatment of COPD is based on bronchodilators, the only treatment recommended in low-risk patients. High-risk patients will receive different drugs in addition to bronchodilators, depending on their clinical phenotype. GesEPOC reflects a more individualized approach to COPD treatment, according to patient clinical characteristics and level of risk or complexity., (Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
35. Chronic Obstructive Pulmonary Disease in Non-Smokers.
- Author
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Toledo-Pons N, Cosío BG, Velasco MD, and Casanova C
- Subjects
- Adolescent, Airway Obstruction etiology, Asthma complications, Biomass, Child, Environmental Exposure, Female, Humans, Male, Pregnancy, Prenatal Exposure Delayed Effects, Pulmonary Disease, Chronic Obstructive epidemiology, Risk Factors, Smoke adverse effects, Smoke Inhalation Injury complications, Smoking, Tuberculosis, Pulmonary complications, Young Adult, Pulmonary Disease, Chronic Obstructive etiology
- Published
- 2017
- Full Text
- View/download PDF
36. "Correct use of inhaled corticosteroids in chronic obstructive pulmonary disease": a consensus document.
- Author
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Alcázar Navarrete B, Casanova C, Miravitlles M, de Lucas P, Riesco JA, and Rodríguez González-Moro JM
- Subjects
- Administration, Inhalation, Adrenal Cortex Hormones administration & dosage, Adrenal Cortex Hormones adverse effects, Adrenergic beta-Agonists administration & dosage, Adrenergic beta-Agonists therapeutic use, Anti-Inflammatory Agents administration & dosage, Anti-Inflammatory Agents adverse effects, Asthma complications, Asthma drug therapy, Bronchodilator Agents administration & dosage, Bronchodilator Agents therapeutic use, Disease Progression, Drug Administration Schedule, Drug Therapy, Combination, Humans, Muscarinic Antagonists administration & dosage, Muscarinic Antagonists therapeutic use, Phenotype, Pulmonary Disease, Chronic Obstructive complications, Pulmonary Disease, Chronic Obstructive physiopathology, Sputum cytology, Adrenal Cortex Hormones therapeutic use, Anti-Inflammatory Agents therapeutic use, Pulmonary Disease, Chronic Obstructive drug therapy
- Abstract
Introduction: Indications for inhaled corticosteroids (IC) in combination with long-acting bronchodilators (LABD) are well defined in clinical practice guidelines. However, there are some doubts about their efficacy and safety. The aim of this document is to establish an expert consensus to clarify these issues., Method: A coordinator group was formed, which systematically reviewed the scientific evidence with the aim of identifying areas of uncertainty about the efficacy of ICs, the adverse effects associated with their use and criteria for withdrawal. Their proposals were submitted to a panel of experts and the Delphi technique was used to test the level of consensus., Results: Twenty-five experts participated in the panel, and consensus was reached on the use of IC in the mixed chronic obstructive pulmonary disease (COPD)-asthma phenotype and in frequent exacerbators, and on not using IC in association with LABD for improving lung function in COPD. There was no general consensus on restricting the use of IC to prevent adverse effects. The panel did agree that IC withdrawal is feasible but should be undertaken gradually, and patients who have discontinued must be evaluated in the short term., Conclusions: Consensus was reached regarding the indication of IC in mixed COPD-asthma and frequent exacerbator phenotypes. The potential for adverse effects must be taken into consideration, but there is no consensus on whether limiting use is justified. The withdrawal of ICs was uniformly agreed to be feasible., (Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.)
- Published
- 2015
- Full Text
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37. [Diagnosis and management of chronic obstructive pulmonary disease: joint guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Latin American Thoracic Society (ALAT)].
- Author
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Peces-Barba G, Barberà JA, Agustí A, Casanova C, Casas A, Izquierdo JL, Jardim J, López Varela V, Monsó E, Montemayor T, and Viejo JL
- Subjects
- Anti-Inflammatory Agents therapeutic use, Bronchodilator Agents therapeutic use, Hospitalization, Humans, Latin America, Oxygen therapeutic use, Pulmonary Surgical Procedures methods, Respiration, Artificial methods, Spain, International Cooperation, Pulmonary Disease, Chronic Obstructive classification, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive therapy, Pulmonary Medicine methods, Thoracic Surgery methods
- Published
- 2008
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