214 results on '"Germán Peces-Barba"'
Search Results
2. A Pilot Study on Proteomic Predictors of Mortality in Stable COPD
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Cesar Jessé Enríquez-Rodríguez, Carme Casadevall, Rosa Faner, Sergi Pascual-Guardia, Ady Castro-Acosta, José Luis López-Campos, Germán Peces-Barba, Luis Seijo, Oswaldo Antonio Caguana-Vélez, Eduard Monsó, Diego Rodríguez-Chiaradia, Esther Barreiro, Borja G. Cosío, Alvar Agustí, Joaquim Gea, and on behalf of the BIOMEPOC Group
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COPD ,mortality ,prognosis ,proteomic fingerprint ,immunity ,hemostasis ,Cytology ,QH573-671 - Abstract
Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of global mortality. Despite clinical predictors (age, severity, comorbidities, etc.) being established, proteomics offers comprehensive biological profiling to obtain deeper insights into COPD pathophysiology and survival prognoses. This pilot study aimed to identify proteomic footprints that could be potentially useful in predicting mortality in stable COPD patients. Plasma samples from 40 patients were subjected to both blind (liquid chromatography–mass spectrometry) and hypothesis-driven (multiplex immunoassays) proteomic analyses supported by artificial intelligence (AI) before a 4-year clinical follow-up. Among the 34 patients whose survival status was confirmed (mean age 69 ± 9 years, 29.5% women, FEV1 42 ± 15.3% ref.), 32% were dead in the fourth year. The analysis identified 363 proteins/peptides, with 31 showing significant differences between the survivors and non-survivors. These proteins predominantly belonged to different aspects of the immune response (12 proteins), hemostasis (9), and proinflammatory cytokines (5). The predictive modeling achieved excellent accuracy for mortality (90%) but a weaker performance for days of survival (Q2 0.18), improving mildly with AI-mediated blind selection of proteins (accuracy of 95%, Q2 of 0.52). Further stratification by protein groups highlighted the predictive value for mortality of either hemostasis or pro-inflammatory markers alone (accuracies of 95 and 89%, respectively). Therefore, stable COPD patients’ proteomic footprints can effectively forecast 4-year mortality, emphasizing the role of inflammatory, immune, and cardiovascular events. Future applications may enhance the prognostic precision and guide preventive interventions.
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- 2024
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3. Relationship between Respiratory Microbiome and Systemic Inflammatory Markers in COPD: A Pilot Study
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Carme Casadevall, Sara Quero, Laura Millares, Rosa Faner, Borja G. Cosío, Germán Peces-Barba, Ady Castro-Acosta, Concepción Montón, Alexandre Palou, Sergi Pascual-Guardia, Alvar Agustí, Joaquim Gea, Eduard Monsó, and on behalf of the BIOMEPOC group
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COPD ,respiratory microbiome ,systemic inflammation ,frequent exacerbators ,eosinophils ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
The respiratory microbiome may influence the development and progression of COPD by modulating local immune and inflammatory events. We aimed to investigate whether relative changes in respiratory bacterial abundance are also associated with systemic inflammation, and explore their relationship with the main clinical COPD phenotypes. Multiplex analysis of inflammatory markers and transcript eosinophil-related markers were analyzed on peripheral blood in a cohort of stable COPD patients (n = 72). Respiratory microbiome composition was analyzed by 16S rRNA microbial sequencing on spontaneous sputum. Spearman correlations were applied to test the relationship between the microbiome composition and systemic inflammation. The concentration of the plasma IL-8 showed an inverted correlation with the relative abundance of 17 bacterial genera in the whole COPD cohort. COPD patients categorized as eosinophilic showed positive relationships with blood eosinophil markers and inversely correlated with the degree of airway obstruction and the number of exacerbations during the previous year. COPD patients categorized as frequent exacerbators were enriched with the bacterial genera Pseudomonas which, in turn, was positively associated with the severity of airflow limitation and the prior year’s exacerbation history. The associative relationships of the sputum microbiome with the severity of the disease emphasize the relevance of the interaction between the respiratory microbiota and systemic inflammation.
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- 2024
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4. Sleep apnoea increases biomarkers of immune evasion, lymphangiogenesis and tumour cell aggressiveness in high-risk patients and those with established lung cancer
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Carolina Cubillos-Zapata, Fernanda Troncoso-Acevedo, Elena Díaz-García, Enrique Alfaro, Carolina Gotera-Rivera, Teresa Pérez-Warnisher, Germán Peces-Barba, Luis M. Seijo, and Francisco García-Río
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Medicine - Abstract
Background Intermittent hypoxaemia and obstructive sleep apnoea (OSA) have been linked to lung cancer through as yet unidentified pathophysiological mechanisms. This study evaluates the effect of OSA on serum levels of biomarkers of immunosurveillance, lymphangiogenesis and intrinsic tumour cell aggressiveness in high-risk individuals screened for lung cancer and patients with established lung cancer. Methods Serum samples from individuals participating in a lung cancer screening cohort (SAILS study) or with newly diagnosed lung cancer (SAIL study) were analysed. All patients underwent home sleep apnoea testing. Soluble levels of programmed cell death-1 (PD-1), programmed cell death ligand-1 (PD-L1), cytotoxic T-lymphocyte antigen-4, midkine (MDK), paraspeckle component-1 (PSPC1), transforming growth factor-β1 (TGF-β1), SMAD3, matrix metalloproteinase-2 and co-stimulus receptor of the tumour necrosis factor family of receptors (CD137) were determined by ELISA. Results The presence of moderate-to-severe OSA was associated with increased levels of PSPC1, MDK, PD-L1 and PD-1 in screened individuals, and with higher values of PSPC1, TGF-β1, PD-L1 and PD-1 in patients with established lung cancer. The findings correlated with nocturnal intermittent hypoxaemia indices. Conclusion Moderate-to-severe OSA is associated with increased expression of serum biomarkers of immune evasion, lymphangiogenesis and tumour cell aggressiveness in high-risk individuals screened for lung cancer and those with established disease.
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- 2024
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5. Differential lung gene expression identified Zscan2 and Bag6 as novel tissue repair players in an experimental COPD model.
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Laura Sánchez Carretero, Àdele Chole Cardeñosa Pérez, Germán Peces-Barba, and Sandra Pérez-Rial
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Medicine ,Science - Abstract
Chronic obstructive pulmonary disease is a common chronic lung disease with an ever-increasing incidence. Despite years of drug research and approvals, we are still not able to halt progress or restore normal lung function. Our previous studies have demonstrated that liver growth factor-LGF has an effect on the repair of the affected tissue in a mouse model of cigarette smoke exposure, but by what pathways it achieves this is unknown. The present study aimed to identify differentially expressed genes between emphysematous mice treated with LGF to identify potential therapeutic targets for the treatment of pulmonary emphysema. The emphysema mouse model was induced by prolonged exposure to cigarette smoke. To determine the gene expression profile of the lung in smokers treated or not with LGF, lung messenger RNA gene expression was assessed with the Agilent Array platform. We carried out differentially expressed gene analysis, functional enrichment and validated in treated mouse lung samples. The treated group significantly improved lung function (~35%) and emphysema level (~20%), consistent with our previous published studies. Microarray analysis demonstrated 290 differentially expressed genes in total (2.0-fold over or lower expressed). Injury repair-associated genes and pathways were further enhanced in the lung of LGF treated mice. The expression trends of two genes (Zscan2 and Bag6) were different in emphysematous lungs treated with LGF compared to untreated lungs. Therefore, Zscan2 and Bag6 genes could play a role in regulating inflammation and the immune response in the lung that undergoes partial lung regeneration. However, further studies are necessary to demonstrate this causal relationship.
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- 2024
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6. Effects of usual yoga practice on the diaphragmatic contractility: A cross-sectional controlled study
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Teresa E. Fernández-Pardo, Mercedes Furió-Valverde, María García-Arrabé, David Valcárcel-Linares, Ignacio Mahillo-Fernández, and Germán Peces-Barba Romero
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Yoga ,Ultrasonography ,Diaphragm ,Breathing exercise ,Science (General) ,Q1-390 ,Social sciences (General) ,H1-99 - Abstract
Objectives: The aim of this study is to observe and compare the effects of regular yoga practice on the main inspiratory muscle, the diaphragm, by analyzing its thickness, excursion, velocity and contraction time, using ultrasound. Design: A Cross-Sectional Controlled Study. Participants: 80 healthy subjects (40 habitual yoga practitioners and 40 non-practitioners), without previous respiratory pathology participated in this study. During maximum diaphragmatic breathing, the diaphragmatic thickness (at rest and after maximum inspiration), excursion, velocity and contraction time were measured by ultrasound. Results: in the experimental group, practicing yoga, statistically significant differences (p
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- 2023
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7. N-acetylcysteine for prevention and treatment of COVID-19: Current state of evidence and future directions
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José Luis Izquierdo-Alonso, Sandra Pérez-Rial, Carolina Gotera Rivera, and Germán Peces-Barba
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COVID-19 ,N-acetylcysteine ,SARS-CoV-2 ,Antioxidant ,Immunomodulation ,Therapeutic role ,Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes coronavirus disease 2019 (COVID-19) and can be associated with serious complications, including acute respiratory distress syndrome. This condition is accompanied by a massive release of cytokines, also denominated cytokine storm, development of systemic oxidative stress and a prothrombotic state. In this context, it has been proposed a role for acetylcysteine (NAC) in the management of patients with COVID-19. NAC is a molecule classically known for its mucolytic effect, but it also has direct and indirect antioxidant activity as a precursor of reduced glutathione. Other effects of NAC have also been described, such as modulating the immune and inflammatory response, counteracting the thrombotic state, and having an antiviral effect. The pharmacological activities of NAC and its effects on the mechanisms of disease progression make it a potential therapeutic agent for COVID-19. NAC is safe, tolerable, affordable, and easily available. Moreover, the antioxidant effects of the molecule may even prevent infection and play an important role as a complement to vaccination. Although the clinical efficacy and dosing regimens of NAC have been evaluated in the clinical setting with small series of patients, the results are promising. In this article, we review the pathogenesis of SARS-CoV-2 infection and the current knowledge of the mechanisms of action of NAC across disease stages. We also propose NAC posology strategies to manage COVID-19 patients in different clinical scenarios.
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- 2022
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8. Metallomic Signatures of Lung Cancer and Chronic Obstructive Pulmonary Disease
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Belén Callejón-Leblic, Saida Sánchez Espirilla, Carolina Gotera-Rivera, Rafael Santana, Isabel Díaz-Olivares, José M. Marín, Ciro Casanova Macario, Borja García Cosio, Antonia Fuster, Ingrid Solanes García, Juan P. de-Torres, Nuria Feu Collado, Carlos Cabrera Lopez, Carlos Amado Diago, Amparo Romero Plaza, Luis Alejandro Padrón Fraysse, Eduardo Márquez Martín, Margarita Marín Royo, Eva Balcells Vilarnau, Antonia Llunell Casanovas, Cristina Martínez González, Juan Bautista Galdíz Iturri, Celia Lacárcel Bautista, José Luis Gómez-Ariza, Antonio Pereira-Vega, Luis Seijo, José Luis López-Campos, Germán Peces-Barba, and Tamara García-Barrera
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lung cancer ,chronic obstructive pulmonary disease ,metals ,inductively coupled plasma ,metallomics ,mass spectrometry ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Lung cancer (LC) is the leading cause of cancer deaths, and chronic obstructive pulmonary disease (COPD) can increase LC risk. Metallomics may provide insights into both of these tobacco-related diseases and their shared etiology. We conducted an observational study of 191 human serum samples, including those of healthy controls, LC patients, COPD patients, and patients with both COPD and LC. We found 18 elements (V, Al, As, Mn, Co, Cu, Zn, Cd, Se, W, Mo, Sb, Pb, Tl, Cr, Mg, Ni, and U) in these samples. In addition, we evaluated the elemental profiles of COPD cases of varying severity. The ratios and associations between the elements were also studied as possible signatures of the diseases. COPD severity and LC have a significant impact on the elemental composition of human serum. The severity of COPD was found to reduce the serum concentrations of As, Cd, and Tl and increased the serum concentrations of Mn and Sb compared with healthy control samples, while LC was found to increase Al, As, Mn, and Pb concentrations. This study provides new insights into the effects of LC and COPD on the human serum elemental profile that will pave the way for the potential use of elements as biomarkers for diagnosis and prognosis. It also sheds light on the potential link between the two diseases, i.e., the evolution of COPD to LC.
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- 2023
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9. Elevated levels of arginase activity are related to inflammation in patients with COPD exacerbation
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Marcel Jose Rodríguez-Guzmán, Germán Peces-Barba Romero, Sandra Pérez Rial, Cristina Serrano del Castillo, Miguel Ángel Palomero Rodríguez, Ignacio Mahillo-Fernandez, and Felipe Villar-Álvarez
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COPD ,COPD exacerbation ,Arginase activity ,Inflammation ,Remodelling ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Introduction Within the pathogenesis of the chronic obstructive pulmonary disease (COPD) there are interactions between different inflammatory mediators that are enhanced during an exacerbation. Arginase is present in bronchial epithelial cells, endothelial, fibroblasts and alveolar macrophages, which make it a probable key enzyme in the regulation of inflammation and remodelling. We aimed to find a potential relationship between arginase activity, inflammatory mediators in COPD patients in stable phase and during exacerbations. Methods We performed a prospective, observational study of cases and controls, with 4 study groups (healthy controls, stable COPD, COPD during an exacerbation and COPD 3 months after exacerbation). We measured arginase, inflammation markers (IL-6, IL-8, TNF-∝, IFN-γ and C reactive protein), and mediators of immunity: neutrophils, monocytes, total TCD3 + lymphocytes (CD3ζ), CD4 + T cells, CD8 + T cells, NK cells. Results A total of 49 subjects were recruited, average age of 69.73 years (59.18% male). Arginase activity is elevated during an exacerbation of COPD, and this rise is related to an increase in IL-6 production. The levels of IL-6 and IL-8 remained elevated in patients with COPD at 3 months after hospital exacerbation. We did not find a clear relationship between arginase activity, immunity or with the degree of obstruction in COPD patients. Conclusions Arginase activity is elevated during an exacerbation of COPD, and it could be related to an increase in the production of IL-6. Levels of IL-6, IL-8, and arginase activity remain elevated in patients with COPD at 3 months after hospital exacerbation. Arginase activity could contribute to the development of COPD.
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- 2021
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10. Decrease in Readmissions after Hospitalisation for COPD Exacerbation through a Home Care Model
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Diana Sánchez-Mellado, Felipe Villar-Álvarez, Itziar Fernández Ormaechea, Alba Naya Prieto, Rebeca Armenta Fernández, Teresa Gómez del Pulgar Murcia, Ignacio Mahillo-Fernández, and Germán Peces-Barba Romero
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EPOC ,Exacerbación ,Reingreso ,Atención domiciliaria ,Supervivencia ,Diseases of the respiratory system ,RC705-779 - Abstract
Objective: To decrease readmissions at 30 and 90 days post-discharge from a hospital admission for chronic obstructive pulmonary disease exacerbation (COPDE) through the home care model of the Ambulatory Chronic Respiratory Care Unit (ACRCU), increase patient survival at one year, and validate our readmission risk scale (RRS). Materials and methods: This was an observational study, with a prospective data collection and a retrospective data analysis. A total of 491 patients with a spirometry diagnosis of chronic obstructive pulmonary disease (COPD) requiring hospitalisation for an exacerbation were included in the study. Subjects recruited within the first year (204 cases) received conventional care (CC). In the following year a home care (HC) programme was implemented and of those recruited that year (287) 104 were included in the ACRCU, administered by a specialised nurse. Results: In the group of patients included in the home care model of the Ambulatory Chronic Respiratory Care Unit (ACRCU) a lower number of readmissions was observed at 30 and 90 days after discharge (30.5% vs. 50%, p = 0.012 and 47.7% vs. 65.2%, p = 0.031, respectively) and a greater one-year survival (85.3% vs. 59.1%, p
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- 2022
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11. COPD Clinical Control: predictors and long-term follow-up of the CHAIN cohort
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Myriam Calle Rubio, Juan Luis Rodriguez Hermosa, Juan P. de Torres, José María Marín, Cristina Martínez-González, Antonia Fuster, Borja G. Cosío, Germán Peces-Barba, Ingrid Solanes, Nuria Feu-Collado, Jose Luis Lopez-Campos, Ciro Casanova, and the CHAIN Study Investigators
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Chronic obstructive pulmonary disease ,Control ,Management ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background Control in COPD is a dynamic concept that can reflect changes in patients’ clinical status that may have prognostic implications, but there is no information about changes in control status and its long-term consequences. Methods We classified 798 patients with COPD from the CHAIN cohort as controlled/uncontrolled at baseline and over 5 years. We describe the changes in control status in patients over long-term follow-up and analyze the factors that were associated with longitudinal control patterns and related survival using the Cox hazard analysis. Results 134 patients (16.8%) were considered persistently controlled, 248 (31.1%) persistently uncontrolled and 416 (52.1%) changed control status during follow-up. The variables significantly associated with persistent control were not requiring triple therapy at baseline and having a better quality of life. Annual changes in outcomes (health status, psychological status, airflow limitation) did not differ in patients, regardless of clinical control status. All-cause mortality was lower in persistently controlled patients (5.5% versus 19.1%, p = 0.001). The hazard ratio for all-cause mortality was 2.274 (95% CI 1.394–3.708; p = 0.001). Regarding pharmacological treatment, triple inhaled therapy was the most common option in persistently uncontrolled patients (72.2%). Patients with persistent disease control more frequently used bronchodilators for monotherapy (53%) at recruitment, although by the end of the follow-up period, 20% had scaled up their treatment, with triple therapy being the most frequent therapeutic pattern. Conclusions The evaluation of COPD control status provides relevant prognostic information on survival. There is important variability in clinical control status and only a small proportion of the patients had persistently good control. Changes in the treatment pattern may be relevant in the longitudinal pattern of COPD clinical control. Further studies in other populations should validate our results. Trial registration: Clinical Trials.gov: identifier NCT01122758.
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- 2021
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12. Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
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Miguel Górgolas Hernández-Mora, Alfonso Cabello Úbeda, Laura Prieto-Pérez, Felipe Villar Álvarez, Beatriz Álvarez Álvarez, María Jesús Rodríguez Nieto, Irene Carrillo Acosta, Itziar Fernández Ormaechea, Aws Waleed Mohammed Al-Hayani, Pilar Carballosa, Silvia Calpena Martínez, Farah Ezzine, Marina Castellanos González, Alba Naya, Marta López De Las Heras, Marcel José Rodríguez Guzmán, Ana Cordero Guijarro, Antonio Broncano Lavado, Alicia Macías Valcayo, Marta Martín García, Javier Bécares Martínez, Ricardo Fernández Roblas, Miguel Ángel Piris Pinilla, José Fortes Alen, Olga Sánchez Pernaute, Fredeswinda Romero Bueno, Sarah Heili-Frades, and Germán Peces-Barba Romero
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SARS-CoV-2 ,Covid-19 ,Tocilizumab ,Pneumonia ,Treatment ,Infectious and parasitic diseases ,RC109-216 - Abstract
Introduction: Tocilizumab (TCZ) is an interleukin-6 receptor antagonist, which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), which aims to ameliorate the cytokine release syndrome (CRS) induced acute respiratory distress syndrome (ARDS). However, there are no consistent data about who might benefit most from it. Methods: We administered TCZ on a compassionate-use basis to patients with SSP who were hospitalized (excluding intensive care and intubated cases) and who required oxygen support to have a saturation >93%. The primary endpoint was intubation or death after 24 h of its administration. Patients received at least one dose of 400 mg intravenous TCZ from March 8, 2020 to April 20, 2020. Results: A total of 207 patients were studied and 186 analyzed. The mean age was 65 years and 68% were male patients. A coexisting condition was present in 68% of cases. Prognostic factors of death were older age, higher IL-6, d-dimer and high-sensitivity C-reactive protein (HSCRP), lower total lymphocytes, and severe disease that requires additional oxygen support. The primary endpoint (intubation or death) was significantly worst (37% vs 13%, p < 0·001) in those receiving the drug when the oxygen support was high (FiO2 >0.5%). Conclusions: TCZ is well tolerated in patients with SSP, but it has a limited effect on the evolution of cases with high oxygen support needs.
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- 2021
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13. Actualidad y planes de acción en el desarrollo de la neumología y cirugía torácica española
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Carlos A. Jiménez-Ruiz, Germán Peces-Barba, Carmen Diego Roza, Agustin Valido Morales, Joaquin Gea, Gerardo Perez Chica, Segismundo Solano Reina, Ramon Moreno Balsalobre, Ernest Salas Llinas, Marta María Garcia Clemente, Nuria Mañes Bonet, María Jesús Rodriguez Nieto, Aurelio Arnedillo Muñoz, Teresa Martin de Carpi, Julio Sánchez de Cos Escuin, Graciliano Estrada Trigueros, Raúl Godoy Mayoral, Enric Barbeta Sánchez, Pedro Jorge Marcos Rodriguez, Jose Antonio Ros Lucas, Eva Martinez Moragón, and Laura Tomás López
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Pulmonology ,Thoracic surgery ,Management ,Activities ,Diseases of the respiratory system ,RC705-779 - Abstract
Resumen: Se ha comprobado que los temas de actualidad y los puntos claves para el desarrollo de la neumología y cirugía torácica son comunes independientemente de la comunidad autónoma valorada, aunque con realidades bien distintas a la hora de afrontarlos. Esto hace que este tipo de foros, además de enriquecedores al poner de manifiesto las diferencias territoriales existentes, sean necesarios para diseñar estrategias de futuro comunes que puedan ser lideradas desde SEPAR a nivel nacional. Abstract: Current issues and key points in the development of pulmonology and thoracic surgery are the same among the different autonomous communities of Spain, although each community takes a very different approach in addressing these issues. As a result, forums that shed light on territorial differences are not only informative, but are also essential for designing common SEPAR-led strategies for the future at a countrywide level.
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- 2020
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14. Aspectos claves de la Neumología y la Cirugía Torácica sometidos a debate en la era COVID-19
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Carlos A. Jiménez-Ruiz, Agustin Valido Morales, Gerardo Perez Chica, Isabel Urrutia Landa, Jose Antonio Rodriguez Portal, Aurelio Arnedillo Muñoz, Fernando Cózar Bernal, Germán Peces-Barba, Carmen Diego Roza, Segismundo Solano Reina, Pedro Rodriguez Suarez, Francisco Garcia Rio, Ernest Salas Llinas, Marta María Garcia Clemente, Jose Manuel Valencia Gallardo, María Jesús Rodriguez Nieto, Teresa Martin de Carpi, Julio Sánchez de Cos Escuin, Graciliano Estrada Trigueros, Raúl Godoy Mayoral, Enric Barbeta Sánchez, Alberto Fernández Villar, Jose Antonio Ros Lucas, Eva Martinez Moragón, and Laura Tomás López
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Diseases of the respiratory system ,RC705-779 - Published
- 2021
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15. Phenotypic characterisation of early COPD: a prospective case–control study
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Borja G. Cosío, Sergi Pascual-Guardia, Alicia Borras-Santos, Germán Peces-Barba, Salud Santos, Laura Vigil, Juan José Soler-Cataluña, Cristina Martínez-González, Ciro Casanova, Pedro J. Marcos, Carlos J. Alvarez, José Luis López-Campos, Joaquim Gea, Judith Garcia-Aymerich, Jesús Molina, Miguel Román, Jorge Moises, Viktoria Szabo, Elizabeth A. Reagan, Raúl San José Estépar, George Washko, Alvar Agustí, Rosa Faner, Full list of field participating investigators in the study:, Borja G. Cosio, Rocío Cordova Diaz, María Magdalena Pan Naranjo, Joan Palmer Sancho, Miguel Román Rodríguez, Rosa Faner Canet, Joan Albert Barberà, Josep Roca Torrent, Yolanda Torralba Garcia, Jorge Moises Lafuente, Anna Maria Pedro Pijoan, Amparo Hervas Docón, Carmen Herranz, Núria Sanchez Ruano, Diego A ChiaradíaRodríguez, Anna Rodó-Pin, Clara Martín-Ontiyuelo, Mireia Admetlló, Concepción Ballano Castro, Laura Gutiérrez Martín, JoséIgnacio Aoiz Linares, Marta Mourelo Cereijo, Germán Peces-Barba Romero, José Fernández Arias, Carolina Gotera Rivera, Manuel Martin Bernal, Guillermo Gallardo Madueño, Andrés Alcázar Peral, Carmelo Palacios Miras, Maria Teresa Pinedo Moraleda, Maria Belén Torres Labandeira, Mercedes Colomo Rodríguez, María Concepción Rodríguez Gallego, Carmen Lobon Agundez, Mónica Nácher Conches, María José Mansilla, Rosario Serrano Martín, Carlos J. Álvarez Martínez, Marta Padilla Bernáldez, Jesús Molina París, Laura Vigil Giménez, Eduard Monsó Molas, Laia Seto Gort, Mañas Montserrat Baré, Anna Maria Fabra Noguera, JoséLuís López Campos, Carmen Calero Acuña, Laura Carrasco Hernández, Salud Santos Perez, Montserrat Navarro, Elisabeth Serra, Ferran Ferrer Keysers, Damaris Batallé, M Dolores Peleato Catalan, Albert Dorca, Javier Burgos, Juan José, Soler-Cataluña Noelia González García, Lourdes Sánchez Sánchez, Cristina Martínez González, Amador Prieto Fernández, Susana Martínez González, Ciro Casanova Macario, Delia Mayato, Pedro J Marcos Rodriguez, Luis Domínguez Juncal, Rosario Timiraos Carrasco, and Rosa Garcia Palenzuela
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Medicine - Abstract
The phenotypic characteristics of chronic obstructive pulmonary disease (COPD) in individuals younger than 50 years of age (early COPD) are not well defined. This prospective, multicentre, case–control study sought to describe these characteristics and compare them with those of smokers (≥10 pack-years) of similar age with normal spirometry (controls). We studied 92 cases (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)
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- 2020
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16. Relationship between the respiratory microbiome and the severity of airflow limitation, history of exacerbations and circulating eosinophils in COPD patients
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Laura Millares, Sergi Pascual, Concepción Montón, Marian García-Núñez, Cristina Lalmolda, Rosa Faner, Carme Casadevall, Laia Setó, Silvia Capilla, Amàlia Moreno, Ady Angélica Castro-Acosta, Carlos José Alvarez-Martinez, Oriol Sibila, Germán Peces-Barba, Borja G. Cosio, Alvar Agustí, Joaquim Gea, and Eduard Monsó
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Bacterial community ,Diversity ,Eosinophils ,Exacerbations ,Sputum ,Stable COPD ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background The respiratory microbiome is altered in COPD patients but its relationship with core components of the disease, such as the severity of airflow limitation, the frequency of exacerbations or the circulating levels of eosinophils, is unclear. Methods Cross-sectional study comprising 72 clinically stable COPD patients (mean age 68 [SD 7.9] years; FEV1 48.7 [SD 20.1]% of reference) who provided spontaneous sputum samples for 16S rRNA gene amplification and sequencing. The microbiome composition was analysed with QIIME. Results We observed that: (1) more severe airflow limitation was associated with reduced relative abundance (RA) of Treponema and an increase in Pseudomonas; (2) patients with ≥2 exacerbations the previous year showed a significantly different bacterial community with respect to non-exacerbators (p = 0.014), with changes in 13 genera, including an increase of Pseudomonas, and finally, (3) peripheral eosinophils levels ≥2% were associated with more diverse microbiome [Chao1 224.51 (74.88) vs 277.39 (78.92) p = 0.006; Shannon 3.94 (1.05) vs 4.54 (1.06) p = 0.020], and a significant increase in the RAs of 20 genera. Conclusion The respiratory microbiome in clinically stable COPD patients varies significantly according to the severity of airflow limitation, previous history of exacerbations and circulating eosinophils levels.
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- 2019
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17. Self-reported walking and associated factors in the Spanish population with chronic obstructive pulmonary disease
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Pedro Barbolla Benito and Germán Peces-Barba Romero
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Chronic obstructive pulmonary disease ,Physical activity ,Epidemiology ,Spain ,Diseases of the respiratory system ,RC705-779 - Abstract
Abstract Background The level of physical activity among individuals with chronic obstructive pulmonary disease (COPD) is associated with the disease severity and prognosis. The aim of this study was to describe the prevalence of self-reported walking at least 150 min per week and the associated factors among the Spanish population with COPD. Methods Analyses were based on data drawn from the 2009 European Health Interview Survey in Spain (2009 EHIS). Twenty-two thousand one hundred eighty-eight subjects participated in the survey (response rate of 96.5%). Participants were classified according to international physical activity recommendations. The prevalence of walking among participants with and without COPD (≥40 years old) was described. Univariate and multivariate logistic regression models were used to study the association of walking with socio-demographic and health outcome variables. Results Of the participants with COPD, 55.0% reached the minimum walking recommendations compared to 59.9% of the general population. The level of walking physical activity of the participants with COPD differed according to sex, age, educational level, area of residence, living as a couple, self-rated health status, mental health, body mass index and hospital admissions. In the multivariate analysis, being male,
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- 2018
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18. First and Second Waves of Coronavirus Disease 2019 in Madrid, Spain: Clinical Characteristics and Hematological Risk Factors Associated With Critical/Fatal Illness
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Irene Mollinedo-Gajate, PhD, Felipe Villar-Álvarez, MD, PhD, María de los Ángeles Zambrano-Chacón, MD, Laura Núñez-García, MD, Laura de la Dueña-Muñoz, MD, Carlos López-Chang, MD, Miguel Górgolas, MD, PhD, Alfonso Cabello, MD, PhD, Olga Sánchez-Pernaute, MD, PhD, Fredeswinda Romero-Bueno, MD, PhD, Álvaro Aceña, MD, PhD, Nicolás González-Mangado, MD, PhD, Germán Peces-Barba, MD, PhD, and Faustino Mollinedo, PhD
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Objectives:. This study aims to determine similarities and differences in clinical characteristics between the patients from two waves of severe acute respiratory syndrome coronavirus-2 infection at the time of hospital admission, as well as to identify risk biomarkers of coronavirus disease 2019 severity. Design:. Retrospective observational study. Setting:. A single tertiary-care center in Madrid. Patients:. Coronavirus disease 2019 adult patients admitted to hospital from March 4, 2020, to March 25, 2020 (first infection wave), and during July 18, 2020, and August 20, 2020 (second infection wave). Interventions:. Treatment with a hospital-approved drug cocktail during hospitalization. Measurements and Main Results:. Demographic, clinical, and laboratory data were compared between the patients with moderate and critical/fatal illness across both infection waves. The median age of patients with critical/fatal coronavirus disease 2019 was 67.5 years (interquartile range, 56.75–78.25 yr; 64.5% male) in the first wave and 59.0 years (interquartile range, 48.25–80.50 yr; 70.8% male) in the second wave. Hypertension and dyslipidemia were major comorbidities in both waves. Body mass index over 25 and presence of bilateral pneumonia were common findings. Univariate logistic regression analyses revealed an association of a number of blood parameters with the subsequent illness progression and severity in both waves. However, some remarkable differences were detected between both waves that prevented an accurate extrapolation of prediction models from the first wave into the second wave. Interleukin-6 and d-dimer concentrations at the time of hospital admission were remarkably higher in patients who developed a critical/fatal condition only during the first wave (p < 0.001), although both parameters significantly increased with disease worsening in follow-up studies from both waves. Multivariate analyses from wave 1 rendered a predictive signature for critical/fatal illness upon hospital admission that comprised six blood biomarkers: neutrophil-to-lymphocyte ratio (≥ 5; odds ratio, 2.684 [95% CI, 1.143–6.308]), C-reactive protein (≥ 15.2 mg/dL; odds ratio, 2.412 [95% CI, 1.006–5.786]), lactate dehydrogenase (≥ 411.96 U/L; odds ratio, 2.875 [95% CI, 1.229–6.726]), interleukin-6 (≥ 78.8 pg/mL; odds ratio, 5.737 [95% CI, 2.432–13.535]), urea (≥ 40 mg/dL; odds ratio, 1.701 [95% CI, 0.737–3.928]), and d-dimer (≥ 713 ng/mL; odds ratio, 1.903 [95% CI, 0.832–4.356]). The predictive accuracy of the signature was 84% and the area under the receiver operating characteristic curve was 0.886. When the signature was validated with data from wave 2, the accuracy was 81% and the area under the receiver operating characteristic curve value was 0.874, albeit most biomarkers lost their independent significance. Follow-up studies reassured the importance of monitoring the biomarkers included in the signature, since dramatic increases in the levels of such biomarkers occurred in critical/fatal patients over disease progression. Conclusions:. Most parameters analyzed behaved similarly in the two waves of coronavirus disease 2019. However, univariate logistic regression conducted in both waves revealed differences in some parameters associated with poor prognosis in wave 1 that were not found in wave 2, which may reflect a different disease stage of patients on arrival to hospital. The six-biomarker predictive signature reported here constitutes a helpful tool to classify patient’s prognosis on arrival to hospital.
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- 2021
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19. Expression of Macrophage Scavenger Receptor (MSR1) in Peripheral Blood Cells from Patients with Different Respiratory Diseases: Beyond Monocytes
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Selene Baos, Lucía Cremades-Jimeno, María López-Ramos, María Ángeles de Pedro, Silvia A. Uriarte, Joaquín Sastre, Nicolás González-Mangado, María Jesús Rodríguez-Nieto, Germán Peces-Barba, and Blanca Cárdaba
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asthma ,biomarker ,COPD ,cytometry ,gene expression ,macrophage scavenger receptor ,Medicine - Abstract
Background: Macrophage scavenger receptor 1 (MSR1) has mostly been described in macrophages, but we previously found a significant gene expression increase in peripheral blood mononuclear cells (PBMCs) of asthmatic patients. Objective: To confirm those results and to define its cellular origin in PBMCs. Methods: Four groups of subjects were studied: healthy controls (C), nonallergic asthmatic (NA), allergic asthmatic (AA), and chronic obstructive pulmonary disease (COPD) patients. RNA was extracted from PBMCs. MSR1 gene expression was analyzed by RT-qPCR. The presence of MSR1 on the cellular surface of PBMC cellular subtypes was analyzed by confocal microscopy and flow cytometry. Results: MSR1 gene expression was significantly increased in the three clinical conditions compared to the healthy control group, with substantial variations according to disease type and severity. MSR1 expression on T cells (CD4+ and CD8+), B cells, and monocytes was confirmed by confocal microscopy and flow cytometry. In all clinical groups, the four immune cell subtypes studied expressed MSR1, with a greater expression on B lymphocytes and monocytes, exhibiting differences according to disease and severity. Conclusions: This is the first description of MSR1’s presence on lymphocytes’ surfaces and reinforces the potential role of MSR1 as a player in asthma and COPD.
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- 2022
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20. Guía SEPAR de las terapias respiratorias domiciliarias, 2020
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Germán Peces-Barba Romero, José Luis López-Campos, Olga Mediano, Paz Vaquero, and Antonio Tomás Ríos Cortés
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Diseases of the respiratory system ,RC705-779 - Published
- 2020
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21. Early detection of skeletal muscle bioenergetic deficit by magnetic resonance spectroscopy in cigarette smoke-exposed mice.
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Sandra Pérez-Rial, Esther Barreiro, María Jesús Fernández-Aceñero, María Encarnación Fernández-Valle, Nicolás González-Mangado, and Germán Peces-Barba
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Medicine ,Science - Abstract
Skeletal muscle dysfunction is a common complication and an important prognostic factor in patients with chronic obstructive pulmonary disease (COPD). It is associated with intrinsic muscular abnormalities of the lower extremities, but it is not known whether there is an easy way to predict its presence. Using a mouse model of chronic cigarette smoke exposure, we tested the hypothesis that magnetic resonance spectroscopy allows us to detect muscle bioenergetic deficit in early stages of lung disease. We employed this technique to evaluate the synthesis rate of adenosine triphosphate (ATP) and characterize concomitant mitochondrial dynamics patterns in the gastrocnemius muscle of emphysematous mice. The fibers type composition and citrate synthase (CtS) and cytochrome c oxidase subunit IV (COX4) enzymatic activities were evaluated. We found that the rate of ATP synthesis was reduced in the distal skeletal muscle of mice exposed to cigarette smoke. Emphysematous mice showed a significant reduction in body weight gain, in the cross-sectional area of the total fiber and in the COX4 to CtS activity ratio, due to a significant increase in CtS activity of the gastrocnemius muscle. Taken together, these data support the hypothesis that in the early stage of lung disease, we can detect a decrease in ATP synthesis in skeletal muscle, partly caused by high oxidative mitochondrial enzyme activity. These findings may be relevant to predict the presence of skeletal bioenergetic deficit in the early stage of lung disease besides placing the mitochondria as a potential therapeutic target for the treatment of COPD comorbidities.
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- 2020
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22. Distribution and Outcomes of a Phenotype-Based Approach to Guide COPD Management: Results from the CHAIN Cohort.
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Borja G Cosio, Joan B Soriano, Jose Luis López-Campos, Myriam Calle, Juan José Soler, Juan Pablo de-Torres, Jose Maria Marín, Cristina Martínez, Pilar de Lucas, Isabel Mir, Germán Peces-Barba, Nuria Feu-Collado, Ingrid Solanes, Inmaculada Alfageme, and CHAIN study
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Medicine ,Science - Abstract
The Spanish guideline for COPD (GesEPOC) recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE), asthma-COPD overlap syndrome (ACOS), frequent exacerbator phenotype with emphysema (FEE) or frequent exacerbator phenotype with chronic bronchitis (FECB). However, little is known on the distribution and outcomes of the four suggested phenotypes.We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes.We followed a cohort of well-characterized patients with COPD up to one-year. Baseline characteristics, health status (CAT), BODE index, rate of exacerbations and mortality up to one year of follow-up were compared between the four phenotypes.Overall, 831 stable COPD patients were evaluated. They were distributed as NE, 550 (66.2%); ACOS, 125 (15.0%); FEE, 38 (4.6%); and FECB, 99 (11.9%); additionally 19 (2.3%) COPD patients with frequent exacerbations did not fulfill the criteria for neither FEE nor FECB. At baseline, there were significant differences in symptoms, FEV1 and BODE index (all p
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- 2016
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23. Proliferative activity of liver growth factor is associated with an improvement of cigarette smoke-induced emphysema in mice.
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Álvaro Girón-Martínez, Sandra Pérez-Rial, Raúl Terrón-Expósito, Juan José Díaz-Gil, Nicolás González-Mangado, and Germán Peces-Barba
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Medicine ,Science - Abstract
Cigarette smoke (CS)-induced emphysema is a major component of chronic obstructive pulmonary disease (COPD). COPD treatment is based on the administration of bronchodilators and corticosteroids to control symptoms and exacerbations, however, to date, there are no effective therapies to reverse disease progression. Liver growth factor (LGF) is an albumin-bilirubin complex with mitogenic properties, whose therapeutic effects have previously been reported in a model of emphysema and several rodent models of human disease. To approach the therapeutic effect of LGF in a model of previously established emphysema, morphometric and lung function parameters, matrix metalloproteinase (MMP) activity and the expression of several markers, such as VEGF, PCNA, 3NT and Nrf2, were assessed in air-exposed and CS-exposed C57BL/6J male mice with and without intraperitoneal (i.p.) injection of LGF. CS-exposed mice presented a significant enlargement of alveolar spaces, higher alveolar internal area and loss of lung function that correlated with higher MMP activity, higher expression of 3NT and lower expression of VEGF. CS-exposed mice injected with LGF, showed an amelioration of emphysema and improved lung function, which correlated with lower MMP activity and 3NT expression and higher levels of VEGF, PCNA and Nrf2. Taken together, this study suggests that LGF administration ameliorates CS-induced emphysema, highlights the ability of LGF to promote alveolar cell proliferation and may be a promising strategy to revert COPD progression.
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- 2014
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24. Identifying COPD patients with poor health status and low exercise tolerance through the five-repetition sit-to-stand test and modified Medical Research Council Dyspnea Score
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Ortega, Francisco, Mendoza, Leovigildo Ginel, Navarrete, Bernardino Alcázar, Rodriguez, Miguel Román, Medina, Ana Martín, Gea, Quim, Pleguezuelos, Eulogio, Miranda, Juan Antonio Riesco, Villar, Alberto Fernández, Río, Francisco García, Puente, Luis, Ancochea, Julio, Romero, Germán Peces-Barba, campos, Sergio, Esteban, Cristobal, Soler, Juan José, Bernabéu-Mora, Roberto, Oliveira-Sousa, Silvana Loana, Medina-Mirapeix, Francesc, and Gacto-Sánchez, Mariano
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- 2024
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25. Role of recently migrated monocytes in cigarette smoke-induced lung inflammation in different strain of mice.
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Sandra Pérez-Rial, Laura del Puerto-Nevado, Raúl Terrón-Expósito, Álvaro Girón-Martínez, Nicolás González-Mangado, and Germán Peces-Barba
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Medicine ,Science - Abstract
This study investigates the role of proinflammatory monocytes recruited from blood circulation and recovered in bronchoalveolar lavage (BAL) fluid in mediating the lung damage in a model of acute cigarette smoke (CS)-induced lung inflammation in two strains of mice with different susceptibility to develop emphysema (susceptible -C57BL/6J and non susceptible -129S2/SvHsd). Exposure to whole-body CS for 3 consecutive research cigarettes in one single day induced acute inflammation in the lung of mice. Analysis of BAL fluid showed more influx of recently migrated monocytes at 72 h after CS-exposition in susceptible compared to non susceptible mice. It correlated with an increase in MMP-12 and TNF-α protein levels in the lung tissue, and with an increment of NF-κB translocation to the nucleus measured by electrophoretic mobility shift assay in C57BL/6J mice. To determine the functional role of these proinflammatory monocytes in mediating CS-induced airway inflammation, alveolar macrophages and blood monocytes were transiently removed by pretreatment with intratracheal and intravenous liposome-encapsulated CL2MDP, given 2 and 4 days prior to CS exposure and their repopulation was studied. Monocytes/macrophages were maximally depleted 48 h after last liposome application and subsequently recently migrated monocytes reappeared in BAL fluid of susceptible mice at 72 h after CS exposure. Recently migrated monocytes influx to the lung correlated with an increase in the MMP-12 protein level in the lung tissue, indicating that the increase in proinflammatory monocytes is associated with a major tissue damaging. Therefore our data confirm that the recruitment of proinflammatory recently migrated monocytes from the blood are responsible for the increase in MMP-12 and has an important role in the pathogenesis of lung disease induced by acute lung inflammation. These results could contribute to understanding the different susceptibility to CS of these strains of mice.
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- 2013
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26. Early Detection of Susceptibility to Acute Lung Inflammation by Molecular Imaging in Mice Exposed to Cigarette Smoke
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Sandra Pérez-Rial, Laura del Puerto-Nevado, Nicolás González-Mangado, and Germán Peces-Barba
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Biology (General) ,QH301-705.5 ,Medical technology ,R855-855.5 - Abstract
Matrix metalloproteinases (MMPs) are extracellular proteolytic enzymes involved in acute lung inflammation in response to cigarette smoke exposure (CSE). We present the in vivo detection of MMP activity using a specific MMP-activatable, near-infrared, polymer-based proteolytic probe in strains of mice with different susceptibility to developing smoking-induced emphysema (susceptible mice, C57BL/6j, and resistant mice, 129S2/SvHsd) to characterize the distinctive profile of CSE-induced acute inflammation. In vivo imaging of pulmonary inflammation expressing MMPs revealed a significantly different median ratio twofold higher in smoker than in nonsmoker susceptible mice (C57BL/6j) and no significant differences between the smoker and the nonsmoker group in resistant mice (129S2/SvHsd). Ex vivo imaging of the lungs of each group of mice confirmed the same in vivo experiment results obtained for both strains of mice. In the biochemical study of lung tissue, the proteolytic signal colocalized with the endogenously expressed MMP protein levels, with MMP-9 levels that are 2.2 times higher than in the nonsmoke-exposed group in C57BL/6j mice and no significant differences in the 129S2/SvHsd mice. The MMP-activatable probe provides a useful reagent for the in vivo and ex vivo detection of MMP-selective proteolytic activity. We are able to distinguish between susceptible and resistant strains of mice in terms of the profile of MMP activity in the early stages of pulmonary disease.
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- 2011
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27. Identifying COPD patients with poor health status and low exercise tolerance through the five-repetition sit-to-stand test and modified Medical Research Council Dyspnea Score
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Bernabéu-Mora, Roberto, primary, Oliveira-Sousa, Silvana Loana, additional, Medina-Mirapeix, Francesc, additional, Gacto-Sánchez, Mariano, additional, Ortega, Francisco, additional, Mendoza, Leovigildo Ginel, additional, Navarrete, Bernardino Alcázar, additional, Rodriguez, Miguel Román, additional, Medina, Ana Martín, additional, Gea, Quim, additional, Pleguezuelos, Eulogio, additional, Miranda, Juan Antonio Riesco, additional, Villar, Alberto Fernández, additional, Río, Francisco García, additional, Puente, Luis, additional, Ancochea, Julio, additional, Romero, Germán Peces-Barba, additional, campos, Sergio, additional, Esteban, Cristobal, additional, and Soler, Juan José, additional
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- 2024
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28. Analysis of Exposure and Respiratory Health Effects of Volcanic Eruption in the Canary Islands (ASHES). A SEPAR Study
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Alberto Ruano-Ravina, Orlando Acosta, David Díaz Pérez, Ciro Casanova, Valle Velasco, Ana Belén Llanos, Germán Peces-Barba, Esther Barreiro, Ana Cañas, Argelia Castaño, María Jesús Cruz Carmona, Carmen Diego, Judith Garcia-Aymerich, Cristina Martínez, María Molina-Molina, Xavier Muñoz, Francisco Javier Sánchez-Íñigo, and Cristina Candal-Pedreira
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Pulmonary and Respiratory Medicine - Published
- 2022
29. IGF1R acts as a cancer-promoting factor in the tumor microenvironment facilitating lung metastasis implantation and progression
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Elvira Alfaro-Arnedo, Icíar P. López, Sergio Piñeiro-Hermida, Marta Canalejo, Carolina Gotera, Jesús Javier Sola, Alejandra Roncero, Germán Peces-Barba, Carlos Ruíz-Martínez, and José G. Pichel
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Inflammation ,Cancer Research ,Lung Neoplasms ,Receptor, IGF Type 1 ,Mice ,Carcinoma, Non-Small-Cell Lung ,Cell Line, Tumor ,Biomarkers, Tumor ,Tumor Microenvironment ,Genetics ,Animals ,Humans ,Molecular Biology ,Cell Proliferation - Abstract
Given the long-term ineffectiveness of current therapies and late-stage diagnoses, lung cancer is a leading cause of malignant diseases. Tumor progression is influenced by cancer cell interactions with the tumor microenvironment (TME). Insulin-like growth factor 1 receptor (IGF1R) was reported to affect the TME; however, the role of IGF1R in lung TME has not been investigated. First, we assessed IGF1R genomic alterations and expression in NSCLC patient tissue samples, as well as IGF1R serum levels. Next, we performed tumor heterotopic transplantation and pulmonary metastases in IGF1R-deficient mice using melanoma and Lewis lung carcinoma (LLC) cells. Herein we report increased amplification and mRNA expression, as well as increased protein expression (IGF1R/p-IGF1R) and IGF1R levels in tumor samples and serum from NSCLC patients, respectively. Moreover, IGF1R deficiency in mice reduced tumor growth, proliferation, inflammation and vascularization, and increased apoptosis after tumor heterotopic transplantation. Following induction of lung metastasis, IGF1R-deficient lungs also demonstrated a reduced tumor burden, and decreased expression of tumor progression markers, p-IGF1R and p-ERK1/2. Additionally, IGF1R-deficient lungs showed increased apoptosis and diminished proliferation, vascularization, EMT and fibrosis, along with attenuated inflammation and immunosuppression. Accordingly, IGF1R deficiency decreased expression of p-IGF1R in blood vessels, fibroblasts, tumor-associated macrophages and FOXP3+ tumor-infiltrating lymphocytes. Our results demonstrate that IGF1R promotes metastatic tumor initiation and progression in lung TME. Furthermore, our research indicates that IGF1R could be a potential biomarker for early prediction of drug response and clinical evolution in NSCLC patients.
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- 2022
30. [Translated article] ANTES Program: One Year on
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Alvar Agustí, Bernardino Alcázar, Julio Ancochea, Ciro Casanova, Bartolome Celli, Borja Cosio, José María Echave-Sustaeta, Alberto Fernandez Villar, Juan Luis Garcia Rivero, Cruz González, José Luis Izquierdo, José Luis Lopez-Campos, José María Marín Trigo, Javier Martín Sánchez, Marc Miravitlles, Jesús Molina, Germán Peces-Barba, Miguel Roman, Juan José Soler Cataluña, and Felipe Villar-Alvarez
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Pulmonary and Respiratory Medicine - Published
- 2022
31. ANTES: Un año después en la EPOC
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Julio Ancochea, Juan Luis García Rivero, Ciro Casanova, Cruz González, Jose Echave-Sustaeta, Juan José Soler Cataluña, Borja G. Cosío, Bernardino Alcázar, J Alberto Fernandez Villar, Alvar Agusti, Felipe Villar-Álvarez, Germán Peces-Barba, Miguel Roman, Bartolome R. Celli, Jesús Molina, José Luis López-Campos, José Luis Izquierdo, Javier Martín Sánchez, Marc Miravitlles, and José María Marín Trigo
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Pulmonary and Respiratory Medicine ,business.industry ,Medicine ,business ,Humanities - Published
- 2022
32. Untargeted metabolomic study of lung cancer patients after surgery with curative intent: possible metabolites of good prognosis, intervention failure and recurrence
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Saida Sánchez-Espirilla, Antonio Pereira Vega, Belén Callejón-Leblic, Isabel Díaz-Olivares, Rafael Santana-Martín, Carolina Gotera Rivera, José Luis Gómez-Ariza, José Luis López-Campos, Ana Isabel Blanco-Orozco, Luis Seijo, María Rodríguez, Luis Padrón Fraysse, Ángela Herrera-Chilla, Germán Peces-Barba, and Tamara García-Barrera
- Abstract
Background Lung cancer (LC) is a leading cause of mortality claiming more than 1.8 million deaths per year worldwide. Surgery is one of the most effective treatments when the disease is in early stages. The study of metabolic alterations after surgical intervention with curative intent could be used to assess the response to treatment or the detection of cancer recurrence. Methods In this study, we have evaluated the changes in the metabolomic profile in serum samples (n = 110) from preoperative (PRE) and postoperative (POST) LC patients collected at two different timepoints (1 month - A; 3–6 months - B) with respect to a group of healthy people. An untargeted metabolomic platform based on reversed phase (RP) and hydrophilic interaction chromatography (HILIC), both mounted into an ultra-high performance liquid chromatography (UHPLC) coupled to mass spectrometry (MS) was applied. Results A total of 33 altered metabolites belonging to carboxylic acids, organooxygen compounds, prenol lipids, fatty acyls, glycerolipids and glycerophospholipids classes were annotated comparing all the different studied groups. We found a group of metabolites altered in PRE (gabaculine, DG(14:0/22:1), stearamide, proline and E,e-carotene-3,3'-dione) whose levels returned to those of a baseline control group 3–6 months after surgery. Furthermore, humulinic acid A and 3-galactosyllactose levels may predict an unsuccessful surgery because they remained altered after the intervention in some patients. In addition, tranexamic acid could be studied more exhaustively to be proposed for monitoring the postoperative recurrence of the LC because its levels seem to be close to controls after one month of the intervention, but may differ significantly after 3–6 months. Conclusions This study provides unique insights into the metabolic profiles of LC patients after surgery at two different time points with a wide metabolic coverage combining complementary analytical methods.
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- 2023
33. Consensus on the Management of the COPD Patient in the COVID-19 Setting: COPD Forum Working Group
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Myriam Calle Rubio, José Luis López-Campos, José Luis Izquierdo Alonso, Dolores Martínez Pitarch, Milagros Iriberri Pascual, Bernardino Alcázar Navarrete, Manuel Valle Falcones, María Jesús Avilés Inglés, Carlos Cabrera López, Carlos José Álvarez Martínez, Francisco Ortega Ruiz, Rafael Golpe, Antònia Fuster Gomila, Sergi Pascual Guardia, Juan Antonio Riesco Miranda, Germán Peces-Barba, Francisco García-Río, Manuel Ángel Martínez Muñiz, Borja G. Cosío, and Chiesi Limited
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Pulmonary and Respiratory Medicine ,COVID-19 (Malaltia) ,Pulmons--Malalties obstructives - Abstract
This study was funded by Chiesi.
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- 2022
34. Consenso sobre el diagnóstico, tratamiento y seguimiento de la EPOC: Grupo de trabajo EPOC Forum
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Carlos J. Álvarez Martínez, Mikel Temprano, Myriam Calle Rubio, Francisco Ruiz, Beatriz Abascal-Bolado, Juan Antonio Riesco Miranda, Juan Marco Figueira-Gonçalves, Francisco García-Río, Joan Serra Batlles, José Luis Izquierdo Alonso, Alberto Fernández-Villar, José Javier Martínez Garcerán, Juan José Soler-Cataluña, José Luis López-Campos, Salud Santos Pérez, Germán Peces-Barba, and Bernardino Alcázar
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,COPD ,Text mining ,Diagnosis treatment ,business.industry ,Internal medicine ,MEDLINE ,Medicine ,business ,medicine.disease - Published
- 2021
35. Natural Course of the Diffusing Capacity of the Lungs for Carbon Monoxide in COPD
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Myriam Calle, Carlos Javier Gutiérrez Cabrera, Bartolome R. Celli, Carlos Antonio Amado, Elena Ojeda, Borja G. Cosío, Enrique González-Dávila, Marta Marin-Oto, Ingrid Solanes, Juan P. de Torres, Nuria Feu, Jose M. Marin, Victor Pinto-Plata, Cristina Martínez-González, José Luis López-Campos, Ciro Casanova, Germán Peces-Barba, Miguel Divo, Rafael Golpe, Eva Balcells, and Antonia Fuster
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Natural course ,COPD ,business.industry ,Critical Care and Intensive Care Medicine ,Control subjects ,medicine.disease ,respiratory tract diseases ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,DLCO ,Internal medicine ,Diffusing capacity ,medicine ,Cardiology ,In patient ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Lung function ,Differential impact - Abstract
Background The value of the single-breath diffusing capacity of the lungs for carbon monoxide (D lco ) relates to outcomes for patients with COPD. However, little is known about the natural course of D lco over time, intersubject variability, and factors that may influence D lco progression. Research Question What is the natural course of D lco in patients with COPD over time, and which other factors, including sex differences, could influence this progression? Study Design and Methods We phenotyped 602 smokers (women, 33%), of whom 506 (84%) had COPD and 96 (16%) had no airflow limitation. Lung function, including D lco, was monitored annually over 5 years. A random coefficients model was used to evaluate D lco changes over time. Results The mean (± SE) yearly decline in D lco % in patients with COPD was 1.34% ± 0.015%/y. This was steeper compared with non-COPD control subjects (0.04% ± 0.032%/y; P = .004). Sixteen percent of the patients with COPD, vs 4.3% of the control subjects, had a statistically significant D lco % slope annual decline (4.14%/y). At baseline, women with COPD had lower D lco values (11.37% ± 2.27%; P lco annual decline of 0.89% ± 0.42%/y (P = .039). Interpretation Patients with COPD have an accelerated decline in D lco compared with smokers without the disease. However, the decline is slow, and a testing interval of 3 to 4 years may be clinically informative. The lower and more rapid decline in D lco values in women, compared with men, suggests a differential impact of sex in gas exchange function. Trial Registry ClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov
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- 2021
36. Pulmonary Pressure-volume Curves of Elastase-treated and Control Rats.
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Angelos Kyriazis, Jesús Ruiz-Cabello, Ignacio Rodríguez, Sandra Pérez-Rial, Laura del Puerto Nevado, and Germán Peces-Barba
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- 2009
37. Cigarette Smoke Directly Promotes Pulmonary Arterial Remodeling and Kv7.4 Channel Dysfunction
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Laura Fernández-Blanco, Maria J. Calzada, Sandra Pérez-Rial, David Labrousse-Arias, Javier Sevilla-Montero, Icíar P. López, José G. Pichel, Gema Mondejar-Parreño, Germán Peces-Barba, Angel Cogolludo, Bianca Barreira, Elvira Alfaro-Arnedo, Victor I. Peinado, and Cintia Fernández-Pérez
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Pulmonary and Respiratory Medicine ,Senescence ,medicine.medical_specialty ,Pulmonary disease ,Pulmonary Arterial Remodeling ,Pulmonary Artery ,Vascular Remodeling ,Critical Care and Intensive Care Medicine ,Mice ,Pulmonary Disease, Chronic Obstructive ,03 medical and health sciences ,0302 clinical medicine ,Smoke ,Internal medicine ,Tobacco ,medicine ,Animals ,Humans ,Cigarette smoke ,030212 general & internal medicine ,COPD ,KCNQ Potassium Channels ,business.industry ,Smoking ,Editorials ,Voltage-gated potassium channel ,medicine.disease ,respiratory tract diseases ,Vasodilation ,Disease Models, Animal ,030228 respiratory system ,Vasoconstriction ,Cardiology ,business - Abstract
Rationale: Cigarette smoke is considered the chief leading cause of chronic obstructive pulmonary disease (COPD). Its impact on the progressive deterioration of airways has been extensively studied...
- Published
- 2021
38. A Social Return on Investment Analysis of Improving the Management of Chronic Obstructive Pulmonary Disease Within the Spanish National Healthcare System
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María Merino, Teresa Martín Lorenzo, Paulina Maravilla-Herrera, Julio Ancochea, José Tomás Gómez Sáenz, Nicole Hass, Jesús Molina, Germán Peces-Barba, Marta Trapero-Bertran, Juan Antonio Trigueros Carrero, and Álvaro Hidalgo-Vega
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Avaluació econòmica ,Evaluación económica ,Enfermedad crónica ,España ,616.2 ,Health Care Costs ,General Medicine ,International Journal of Chronic Obstructive Pulmonary Disease ,Chronic disease ,Economic evaluation ,Manejo de enfermedades ,Pulmonary Disease, Chronic Obstructive ,Enfermedad respiratoria ,Spain ,Disease management ,Social impact ,Quality of Life ,Malalties cròniques ,Impacto social ,Humans ,Gestió de malalties ,Espanya ,Impacte social ,Respiratory disease - Abstract
MarÃa Merino,1 Teresa MartÃn Lorenzo,1 Paulina Maravilla-Herrera,1 Julio Ancochea,2â 4 José Tomás Gómez Sáenz,5 Nicole Hass,6 Jesús Molina,7 Germán Peces-Barba,8 Marta Trapero-Bertran,9 Juan Antonio Trigueros Carrero,10 Ãlvaro Hidalgo-Vega11 1Health Outcomes Research, Weber, Madrid, Spain; 2Pulmonology Service, La Princesa University Hospital - IIS-Princesa, Madrid, Spain; 3Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain; 4Respiratory Diseases Networking Biomedical Research Centre - CIBERES, Carlos III Institute of Health - ISCIII, Madrid, Spain; 5Nájera Health Centre, Nájera, La Rioja, Spain; 6Chronic Obstructive Pulmonary Disease Patient and Family Association - APEPOC, Pontevedra, Spain; 7Francia Health Centre, Fuenlabrada, Madrid, Spain; 8Pulmonology Service, Fundación Jiménez DÃaz University Hospital, Madrid, Spain; 9Basic Sciences Department, University Institute for Patient Care, Universitat Internacional de Catalunya, Barcelona, Spain; 10Menasalbas Health Centre, Mensalbas, Toledo, Spain; 11Department of Economic Analysis and Finances, Universidad de Castilla-La Mancha, Toledo, SpainCorrespondence: MarÃa Merino, Health Outcomes Research, Weber, Calle Moreto 17, 5° Dcha, Madrid, 28014, Spain, Tel +34 91 639 38 24, Fax +34 91 634 6643, Email maria.merino@weber.org.esPurpose: To define a set of proposals that would improve the current management of chronic obstructive pulmonary disease (COPD) within the Spanish National Healthcare System (SNHS) from a comprehensive multidisciplinary perspective and to assess the impact of its implementation from clinical, healthcare, economic, and social perspectives.Patients and Methods: A group of 20 stakeholders related to COPD (healthcare professionals, patients, and informal caregivers, among others) participated in an online Delphi process to agree on a set of 15 proposals that would improve the current management of COPD within the SNHS in four areas: diagnosis, risk stratification, management of exacerbations, and management of stable COPD. A one-year forecast-type social return on investment (SROI) analysis was used to estimate the impact that implementing the set of proposals would have in relation to the investment required. A sensitivity analysis was used to test the strength of the model when varying assumption-based data-points.Results: The hypothetical implementation of the complete set of 15 proposals would require a ⬠668 million investment and would generate a ⬠2079 million social impact concerning savings for the SNHS and quality of life improvements for patients and their informal caregivers, among others. Accordingly, for every euro invested in the set of proposals, a social return of ⬠3.11 would be generated (⬠2.71 in the worst-case scenario and ⬠3.62 in the best-case scenario) of both tangible (32.56%) and intangible nature (67.44%).Conclusion: Altogether, implementing this set of 15 proposals would generate a positive social impact, threefold the required investment. The results may inform decisions relative to healthcare policy and practice regarding COPD management within the SNHS, further contributing to reduce the large burden of COPD.Keywords: disease management, chronic disease, respiratory disease, economic evaluation, social impact, Spain
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- 2022
39. Deep-learning characterization and quantification of COVID-19 pneumonia lesions from chest CT images
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David Bermejo-Pelaez, Raúl San José Estépar, Maria Fernández-Velilla, Carmelo Palacios Miras, Guillermo Gallardo Madueño, Mariana Benegas, Miguel Luengo Oroz, Jacobo Sellares, Marcelo Sánchez, Gorka Bastarrika, Germán Peces-Barba, Luis M. Seijo, and Maria J. Ledesma Carbayo
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- 2022
40. Compassionate use of tocilizumab in severe SARS-CoV2 pneumonia
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María Jesús Rodríguez Nieto, Marta Lopez de las Heras, Silvia Calpena Martínez, Sarah Heili-Frades, Irene Carrillo Acosta, Aws Waleed Mohammed Al-Hayani, Laura Prieto-Pérez, Alba Naya, Javier Martinez, Miguel Ángel Piris Pinilla, Alicia Macias Valcayo, Marcel Jose Rodriguez Guzman, Ricardo Fernández Roblas, Miguel de Górgolas Hernández-Mora, Felipe Villar Álvarez, Alfonso Cabello Úbeda, José Fortes Alen, Pilar Carballosa, B. Alvarez, Fredeswinda Romero Bueno, Germán Peces-Barba Romero, Olga Sánchez Pernaute, Itziar Fernández Ormaechea, Marina Castellanos Gonzalez, Farah Ezzine, Antonio Broncano Lavado, Marta Martin Garcia, and Ana Cordero Guijarro
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Adult ,Compassionate Use Trials ,Male ,0301 basic medicine ,Microbiology (medical) ,ARDS ,medicine.medical_specialty ,Critical Care ,medicine.medical_treatment ,030106 microbiology ,Severe disease ,Antibodies, Monoclonal, Humanized ,Article ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tocilizumab ,Intensive care ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Immunologic Factors ,Intubation ,lcsh:RC109-216 ,030212 general & internal medicine ,ComputingMethodologies_COMPUTERGRAPHICS ,Aged ,Aged, 80 and over ,SARS-CoV-2 ,Interleukin-6 ,business.industry ,COVID-19 ,Pneumonia ,General Medicine ,Middle Aged ,medicine.disease ,COVID-19 Drug Treatment ,Treatment ,Cytokine release syndrome ,C-Reactive Protein ,Infectious Diseases ,chemistry ,Spain ,Female ,business - Abstract
Graphical abstract, Highlights • The survival rate is high (94% vs 72%) if tocilizumab is administered with a FiO2 ≤ 0.5%. • There are very limited side effects and secondary infections. • A significant decrease in the median serum ferritin and the median HSCRP was observed., Introduction Tocilizumab is an interleukin 6 receptor antagonist which has been used for the treatment of severe SARS-CoV-2 pneumonia (SSP), aiming to ameliorate the cytokine release syndrome (CRS) -induced acute respiratory distress syndrome (ARDS). However, there are no consistent data whom might benefit most from it. Methods We provided tocilizumab on a compassionate-use basis to patients with SSP hospitalized (excluding intensive care and intubated cases) who required oxygen support to have a saturation >93%. Primary endpoint was intubation or death after 24 hours of its administration. Patients received at least one dose of 400 mg intravenous tocilizumab during March 8-2020, through April 20-2020. Results A total of 207 patients were studied and 186 analysed. The mean age was 65 years and 68% were male. A co-existing condition was present in 68 % of cases. Death prognostic factors were older age, higher IL-6, D-dimer and high sensitivity C reactive protein (HSCRP), lower total lymphocytes and severe disease requiring higher oxygen support. The primary endpoint (intubation or death) was significantly worst (37% vs 13%, p 0.5%). Conclusions Tocilizumab is well tolerated in patients with severe SARS-CoV-2 pneumonia, but it has a limited effect on the evolution of cases with high oxygen support needs.
- Published
- 2021
41. Can a Telemedicine Program Reduce the Number of Admissions in the Second and Third Month After Hospital Discharge for an Exacerbation of COPD Compared to a Conventional Follow-up System?
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Alba Naya Prieto, Carlos López Chang, Rebeca Armenta Fernández, Teresa Gómez del Pulgar Murcia, Diana Sánchez Mellado, Miren Itziar Fernández Ormaechea, Germán Peces Barba, and Felipe Villar-Álvarez
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Pulmonary and Respiratory Medicine - Published
- 2023
42. A longitudinal and multidesign epidemiological study to analyze the effect of the volcanic eruption of Tajogaite volcano (La Palma, Canary Islands). The ASHES study protocol
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Alberto Ruano-Ravina, Orlando Acosta, David Díaz Pérez, Ciro Casanova, Valle Velasco, Germán Peces-Barba, Esther Barreiro, Ana Cañas, Argelia Castaño, María Jesús Cruz Carmona, Carmen Diego, Judith Garcia-Aymerich, Cristina Martínez, María Molina-Molina, Xavier Muñoz, Francisco Javier Sánchez-Íñigo, and Cristina Candal-Pedreira
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Cohort Studies ,Spain ,Air Pollution ,Humans ,Particulate Matter ,Volcanic Eruptions ,Child ,Biochemistry ,General Environmental Science - Abstract
Volcanic eruptions emit gases and particulate matter into the atmosphere which, if inhaled, can have an impact on health. The eruption of the volcano situated in the Cumbre Vieja Nature Reserve (La Palma, Canary Islands, Spain) affords a unique opportunity to study the effect of such a phenomenon on health. The aim of the proposed study is to assess the short-, medium- and long-term respiratory health effects of exposure to volcanic emissions from the eruption in three different population groups.We propose to undertake a multidesign study: an ambispective cohort study to analyze the effect of the eruption on the general population, the highly exposed population, and the childhood population; and a pre-post quasi-experimental study on subjects with previously diagnosed respiratory diseases. The information will be collected using a personal interview, biologic specimens, air pollution data, data from medical records, respiratory tests and imaging tests. The study has an envisaged follow-up of five years, to run from the date of initial recruitment, with annual data-collection. This study has been approved by the Santa Cruz de Tenerife Provincial Research Ethics Committee (Canary Island Health Service) on March 10, 2022.This study will make it possible to advance our knowledge of the effect a volcano eruption has on population health, both short- and long-term, and to assess the potential respiratory injury attributable to volcanic eruptions. It may serve as a model for future studies of new volcanic eruptions in the coming years.
- Published
- 2023
43. Histiocytic hyperplasia with hemophagocytosis and acute alveolar damage in COVID-19 infection
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Marcela Valverde-Monge, Soraya de la Fuente, Carlos Soto, Laura Astilleros Blanco de Cordova, Álvaro Trascasa, Miguel Górgolas, Alberto Lazaro-Garcia, Elizabet Petkova, Socorro María Rodríguez-Pinilla, Ánxela Vidal-González, Marina Alonso-Riaño, Itziar Fernández-Ormaechea, Miguel A. Piris, Diana Fresneda, Germán Peces-Barba, María José Cortti, Sheila Recuero, Ignacio Cornejo, Raul Cordoba, Anabel Antonio, Alfonso Cabello, Silvia Calpena, Rafael Rubio-Martín, Marina Castellanos, Andrés M. Silva, B. Alvarez, Laura Prieto-Pérez, María José Díez Medrano, Irene Carrillo, Miguel Lafarga, Oderay Cedeño, José Fortes, Marta Lopez de las Heras, and Ramón Pérez-Tanoira
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Male ,0301 basic medicine ,ARDS ,Pathology ,medicine.medical_specialty ,Pneumonia, Viral ,Article ,Lymphohistiocytosis, Hemophagocytic ,Pathology and Forensic Medicine ,Betacoronavirus ,03 medical and health sciences ,0302 clinical medicine ,Bone Marrow ,medicine ,Humans ,Diffuse alveolar damage ,Lung ,Pandemics ,Histiocyte ,Aged ,Aged, 80 and over ,Respiratory Distress Syndrome ,Hyperplasia ,SARS-CoV-2 ,business.industry ,COVID-19 ,Diagnostic markers ,Histiocytes ,Middle Aged ,medicine.disease ,Histiocytosis ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Macrophage activation syndrome ,Infectious diseases ,Female ,Bone marrow ,Hemophagocytosis ,Coronavirus Infections ,business - Abstract
The spectrum of COVID-19 infection includes acute respiratory distress syndrome (ARDS) and macrophage activation syndrome (MAS), although the histological basis for these disorders has not been thoroughly explored. Post-mortem pulmonary and bone marrow biopsies were performed in 33 patients. Samples were studied with a combination of morphological and immunohistochemical techniques. Bone marrow studies were also performed in three living patients. Bone marrow post-mortem studies showed striking lesions of histiocytic hyperplasia with hemophagocytosis (HHH) in most (16/17) cases. This was also observed in three alive patients, where it mimicked the changes observed in hemophagocytic histiocytosis. Pulmonary changes included a combination of diffuse alveolar damage with fibrinous microthrombi predominantly involving small vessels, in particular the alveolar capillary. These findings were associated with the analytical and clinical symptoms, which helps us understand the respiratory insufficiency and reveal the histological substrate for the macrophage activation syndrome-like exhibited by these patients. Our results confirm that COVID-19 infection triggers a systemic immune-inflammatory disease and allow specific therapies to be proposed.
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- 2020
44. Documento de consenso sobre el diagnóstico y tratamiento de la infección bronquial crónica en la enfermedad pulmonar obstructiva crónica
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David de la Rosa Carrillo, José Luís López-Campos, Bernardino Alcázar Navarrete, Myriam Calle Rubio, Rafael Cantón Moreno, Juan Luis García-Rivero, Luís Máiz Carro, Casilda Olveira Fuster, Miguel Ángel Martínez-García, Francisco Javier Callejas, Ángela Cervera Juan, Marta Palop Cervera, Antonia Fuster Gomila, Alicia Marín Tapia, Xavier Pomares Amigo, Mirian Torres González, Jacinto Hernández Borge, Gerardo Pérez Chica, Rocío Jimeno Galván, Rafael Golpe Gómez, Pedro J. Marcos Rodríguez, Pilar Cebollero Rivas, Eva Tabernero Huguet, Carlos Álvarez Martínez, Concha Prados Sánchez, José Javier Martínez Garcerán, Carlos Peñalver Mellado, Marta García Clemente, Juan Rodríguez López, Juan Marco Figueira Gonçalves, Guillermo José Pérez Mendoza, Jesús Hernández Hernández, Carlos Amado Diago, Laura Pérez Giménez, Virginia Moya Álvarez, Alexandre Palou Rotger, Rosa Girón Moreno, Marina Blanco Aparicio, Annie Navarro Rolón, Oriol Sibila, Marc Miravitlles Fernández, Juan José Soler Cataluña, José Alberto Fernández Villar, and Germán Peces-Barba Romero
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Pulmonary and Respiratory Medicine ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,business.industry ,Medicine ,business ,Humanities - Abstract
Resumen A pesar de que es conocido que la presencia cronica de microorganismos en las vias aereas de pacientes con enfermedad pulmonar obstructiva cronica (EPOC) en fase de estabilidad conlleva una evolucion desfavorable, ninguna guia de manejo de la enfermedad establece pautas sobre como diagnosticar y tratar este tipo de casos. Con la intencion de orientar a los profesionales, desde la Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR) se ha elaborado un documento que pretende aportar respuestas clinicas sobre el manejo de pacientes con EPOC en los que se aislan microorganismos de forma puntual o persistente. Dado que la heterogeneidad de las evidencias cientificas disponibles no permite crear una Guia de Practica Clinica, se ha elaborado un documento basado en la literatura cientifica existente y/o en la propia experiencia clinica que aborda tanto la definicion de las diferentes situaciones clinicas como su diagnostico y manejo. El texto ha sido consensuado entre un amplio numero de neumologos con gran experiencia clinica y cientifica en este ambito. Este documento cuenta con el aval del Comite Cientifico de SEPAR.
- Published
- 2020
45. Insulin-like Growth Factor 1 Receptor facilitates NSCLC tumor growth acting in the tumor microenvironment
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José Manuel García Pichel, Icíar P. López, Sergio Piñeiro-Hermida, Marta Canalejo, Carolina Gotera, Jesús J. Sola, Alejandra Roncero, Germán Peces-Barba, Carlos Ruíz-Martínez, and Elvira Alfaro-Arnedo
- Published
- 2022
46. Patient Management Assisted by a Neural Network Reduces Mortality in an Intermediate Care Unit
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Nicolás González Mangado, Daniel Heili Frades, Sarah Heili-Frades, Arnoldo Santos, Alba Naya Prieto, Itziar Fernández Ormaechea, Luis Jiménez Hiscock, Germán Peces-Barba Romero, Ignacio Mahillo Fernández, María del Pilar Carballosa de Miguel, Pablo Minguez, and Laura Álvarez Suárez
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Multivariate statistics ,business.industry ,Vital signs ,General Medicine ,Guideline ,Logistic regression ,Tachypnea ,Leukocytopenia ,Intensive care ,Emergency medicine ,Medicine ,medicine.symptom ,business ,Risk assessment - Abstract
Introduction Mortality risk prediction for Intermediate Respiratory Care Unit's (IRCU) patients can facilitate optimal treatment in high-risk patients. While Intensive Care Units (ICUs) have a long term experience in using algorithms for this purpose, due to the special features of the IRCUs, the same strategics are not applicable. The aim of this study is to develop an IRCU specific mortality predictor tool using machine learning methods. Methods Vital signs of patients were recorded from 1966 patients admitted from 2007 to 2017 in the Jimenez Diaz Foundation University Hospital's IRCU. A neural network was used to select the variables that better predict mortality status. Multivariate logistic regression provided us cut-off points that best discriminated the mortality status for each of the parameters. A new guideline for risk assessment was applied and mortality was recorded during one year. Results Our algorithm shows that thrombocytopenia, metabolic acidosis, anemia, tachypnea, age, sodium levels, hypoxemia, leukocytopenia and hyperkalemia are the most relevant parameters associated with mortality. First year with this decision scene showed a decrease in failure rate of a 50%. Conclusions We have generated a neural network model capable of identifying and classifying mortality predictors in the IRCU of a general hospital. Combined with multivariate regression analysis, it has provided us with an useful tool for the real-time monitoring of patients to detect specific mortality risks. The overall algorithm can be scaled to any type of unit offering personalized results and will increase accuracy over time when more patients are included to the cohorts.
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- 2020
47. Actualidad y planes de acción en el desarrollo de la neumología y cirugía torácica española
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Graciliano Estrada Trigueros, Segismundo Solano Reina, Agustín Salvador Valido Morales, Raúl Godoy Mayoral, Carlos A. Jiménez-Ruiz, Julio Sánchez de Cos Escuín, Laura Tomás López, Carmen Diego Roza, Germán Peces-Barba, Joaquin Gea, Jose Antonio Ros Lucas, Nuria Mañes Bonet, Pedro Jorge Marcos Rodríguez, Ramon Moreno Balsalobre, Gerardo Perez Chica, Marta María Garcia Clemente, Eva Martinez Moragón, Ernest Salas Llinas, Aurelio Arnedillo Muñoz, María Jesús Rodriguez Nieto, Teresa Martin de Carpi, and Enric Barbeta Sánchez
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lcsh:RC705-779 ,Thoracic surgery ,Pulmonology ,lcsh:Diseases of the respiratory system ,Activities ,Management - Abstract
Resumen: Se ha comprobado que los temas de actualidad y los puntos claves para el desarrollo de la neumología y cirugía torácica son comunes independientemente de la comunidad autónoma valorada, aunque con realidades bien distintas a la hora de afrontarlos. Esto hace que este tipo de foros, además de enriquecedores al poner de manifiesto las diferencias territoriales existentes, sean necesarios para diseñar estrategias de futuro comunes que puedan ser lideradas desde SEPAR a nivel nacional. Abstract: Current issues and key points in the development of pulmonology and thoracic surgery are the same among the different autonomous communities of Spain, although each community takes a very different approach in addressing these issues. As a result, forums that shed light on territorial differences are not only informative, but are also essential for designing common SEPAR-led strategies for the future at a countrywide level.
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- 2020
48. Análisis de costes y mortalidad de una unidad de cuidados intermedios respiratorios. ¿Es realmente eficiente y segura?
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Alba Naya Prieto, Germán Peces Barba, Nicolás González Mangado, Marina Galdeano Lozano, María José Checa Venegas, Xavier Mate García, Sarah Heili-Frades, Laura Álvarez Suárez, Farah Ezzine de Blas, María del Pilar Carballosa de Miguel, Ignacio Mahillo Fernández, and Itziar Fernández Ormaechea
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Pulmonary and Respiratory Medicine ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,business.industry ,Medicine ,business ,Humanities - Abstract
Resumen Introduccion Historicamente se ha asumido que las unidades de cuidados intermedios respiratorios (UCIR) eran estructuras eficientes por los costes evitados atribuibles a la reduccion de los ingresos en las unidades de cuidados intensivos (UCI) y eficaces por la especializacion neumologica. Metodos Se evaluo el numero de ingresos y mortalidad en la unidad, historica y en el ano 2016. Ese ano ademas se describieron los grupos relacionados de diagnostico (GRD) agrupados y el coste evitado por estancia en UCI en relacion con todos los capitulos presupuestarios. Se realizo un analisis multivariante para asociar costes a pesos medios y complejidad y se realizo una regresion logistica multiple sobre la totalidad de enfermos ingresados de 2004 a 2017 para describir las variables asociadas a la mortalidad en nuestra unidad. Resultados La UCIR evita un coste al hospital de 500.000 €/ano al reducir dias de estancia en las UCI. El analisis sobre la cohorte de 2016 describe que los costes se asocian al peso medio y mortalidad, y por tanto, a la complejidad. El analisis de regresion logistica multivariante sobre la cohorte de 2004-2017 describe la frecuencia respiratoria, la leucopenia, la anemia, la hiperpotasemia y la acidosis como las variables que mejor se asocian con la mortalidad. El area bajo la curva para el modelo logistico fue de 0,75. Conclusion La UCIR analizada ha demostrado ser eficiente en terminos de «coste evitado» y ahorro ligado a la complejidad. Nuestros resultados sugieren que las UCIR son un entorno seguro para los pacientes al tener una mortalidad menor que otras unidades similares.
- Published
- 2019
49. The ANTES program in COPD: First year
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Alvar, Agustí, Bernardino, Alcázar, Julio, Ancochea, Ciro, Casanova, Bartolome, Celli, Borja, Cosio, José María, Echave-Sustaeta, Alberto, Fernandez Villar, Juan Luis, Garcia Rivero, Cruz, González, José Luis, Izquierdo, José Luis, Lopez-Campos, José María, Marín Trigo, Javier, Martín Sánchez, Marc, Miravitlles, Jesús, Molina, Germán, Peces-Barba, Miguel, Roman, Juan José, Soler Cataluña, and Felipe, Villar-Alvarez
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Pulmonary Disease, Chronic Obstructive ,Humans - Published
- 2021
50. La notoriedad de la salud respiratoria y de los profesionales sanitarios que la cuidan
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Carmen Diego Roza, Germán Peces-Barba, Segismundo Solano Reina, Pedro Rodríguez Suárez, Francisco García Río, Carlos A. Jiménez-Ruiz, and Luis Guinot
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Pulmonary and Respiratory Medicine ,business.industry ,Medicine ,business ,Humanities - Published
- 2022
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