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1. Alterations in the immune system persist after one year of convalescence in severe COVID-19 patients

Author: Judith Abarca-Zabalía, Adela González-Jiménez, Myriam Calle-Rubio, Andrea R. López-Pastor, Tomás Fariña, Carlos Ramos-Acosta, Eduardo Anguita, Elena Urcelay, and Laura Espino-Paisán
Subjects: COVID-19, SARS-CoV-2, NK cells, immune system, activation, convalescence, Immunologic diseases. Allergy, RC581-607
Abstract: IntroductionSevere COVID-19 originates a myriad of alterations in the immune system during active disease, especially in the T and NK cell compartments, but several studies in the last year have unveiled some alterations that persist in convalescence. Although most of the studies follow the participants for a short recovery time, studies following patients up to three or six months still find alterations. We aimed at evaluating changes in the NK, T and B cell compartments after severe COVID-19 in participants with a median recovery time of eleven months.MethodsEighteen convalescent of severe COVID-19 (CSC), 14 convalescent of mild COVID-19 (CMC) and nine controls were recruited. NKG2A, NKG2C, NKG2D and the activating receptor NKp44 were evaluated in NKbright, NKdim and NKT subpopulations. In addition, CD3 and CD19 were measured and a basic biochemistry with IL-6 levels was obtained.ResultsCSC participants showed lower NKbright/NKdim ratio, higher NKp44 expression in NKbright subpopulations, higher levels of serum IL-6, lower levels of NKG2A+ T lymphocytes and a trend to a lower expression of CD19 in B lymphocytes compared to controls. CMC participants showed no significant alterations in the immune system compared to controls.ConclusionsThese results are concordant with previous studies, which find alterations in CSC weeks or months after resolution of the symptoms, and point to the possibility of these alterations lasting one year or more after COVID-19 resolution.
Published: 2023
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2. Association of anti-SARS-COV-2 vaccine with increased incidence of myositis-related anti-RNA-synthetases auto-antibodies

Author: Laura García-Bravo, Myriam Calle-Rubio, Miguel Fernández-Arquero, Kauzar Mohamed Mohamed, Teresa Guerra-Galán, María Guzmán-Fulgencio, Antonia Rodríguez de la Peña, Cristina Cañizares, Bárbara López, Cristina Vadillo, Jorge Matías-Guiu, Asunción Nieto Barbero, José Luis Álvarez-Sala Walther, Silvia Sánchez-Ramón, and Juliana Ochoa-Grullón
Subjects: Myositis, Interstitial lung disease, Myositis specific antibodies, COVID19, SARS-CoV-2 vaccines, Immunologic diseases. Allergy, RC581-607
Abstract: Introduction: SARS-CoV-2 is a RNA virus that associates with heterogeneous clinical manifestations and complications. Auto-antibodies are identified in approximately 50% of hospitalized COVID-19 patients. Objectives: To determine the global incidence of myositis-related auto-antibodies (non Jo1-RNA synthetases: anti-PL7, anti-PL12, anti-EJ, anti-OJ and RNA-sensor: anti-MDA5) in our laboratory during COVID-19 pandemics, and to describe the clinical and laboratory features of these patients. Study design: A retrospective study was performed from 2015 to 2021 in a cohort of 444 patients with suspected inflammatory myopathy. The incidence of positive results for the MSA was expressed as absolute value per year for the reference population. Immunoblot analysis, indirect immunofluorescence and HLA typing of 36 patients with positivity for MSAs were collected and analyzed. Results: We observed MSA positive in 28 patients in 2020 and 36 patients in 2021, representing a mean increase of 6-fold respect to previous years since 2015 (range, 0 to 19). In 2020, the most common antibody detected was anti-MDA5 (68%). In contrast, in 2021 the most common antibodies were anti-PL7 and/or anti-PL12 (69%). All patients in 2021 with positive anti-synthetases were fully vaccinated, 4 had previous documented infection, with median time from vaccine to MSA positivity of 5 months. Eight out of 36 patients (22%) reported clinical onset after SARS-CoV-2 vaccination and 6 out of 36 (17%) presented clinical and/or radiological worsening after SARS-CoV-2 vaccination. All patients presented with a known human leukocyte antigen (HLA)-DRB1* allele associated with ASS. The most prevalent alleles identified were DRB1*03:01, DRB1*04, DRB1*11:01, corresponding to 70% (16/23) of our cohort. Conclusions: Our preliminary data show an increased incidence of anti-synthetase antibodies during COVID-19 pandemic and SARS-CoV-2 vaccination associated to HLA DRB1* risk allele. Differential profiles of MSA specificities were observed: mainly against RNA-sensors in 2020 and against RNA-synthetases in 2021. Further studies are needed to support the association between SARS-CoV-2 infection and/or vaccination and the occurrence of this autoimmune syndrome.
Published: 2022
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3. Clinical control in COPD and therapeutic implications: The EPOCONSUL audit.

Author: Myriam Calle Rubio, Marc Miravitlles, Juan José Soler Cataluña, José Luis López-Campos, Bernardino Alcázar Navarrete, Manuel E Fuentes Ferrer, and Juan Luis Rodríguez Hermosa
Subjects: Medicine, Science
Abstract: ObjectiveThis study aimed to evaluate clinical control in chronic obstructive pulmonary disease (COPD), the consequences in terms of treatment decisions, and their potentially associated factors during follow-up of patients in real-life clinical practice.MethodsEPOCONSUL 2021 is a cross-sectional audit that evaluated the outpatient care provided to patients with a diagnosis of COPD in respiratory clinics in Spain and multivariable logistic regression models to assess the relationships between clinical control and clinical inertia.Results4225 patients from 45 hospitals in Spain were audited. Clinical control was analyzed in 1804 (42.7%) patients who met all the Spanish COPD Guidelines (GesEPOC) criteria. 49.1% of patients were classified as uncontrolled, and 42.2% of patients disagreed with the level of control determined by their doctor, which was reported as good during the visit. There was therapeutic inertia (TI), in other words not making any change or taking any action in the treatment of COPD, in 68.4% of uncontrolled patients and no action was taken during the visit for 9.1% of uncontrolled patients. Factors associated with TI in uncontrolled patients were disagreement with the degree of control reported by the doctor who performed the examination ☯physician classifies and reports disease as controlled versus uncontrolled, OR: 3.37 (2.33-4.88), pConclusionsTherapeutic inertia exists in more than half of uncontrolled patients and is more likely when there is disagreement with the assessment of the physician responsible for the visit, who reported there being good disease control, a situation that was more likely in patients with less history of exacerbations.
Published: 2025
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4. Severe COVID-19 Illness and α1-Antitrypsin Deficiency: COVID-AATD Study

Author: Juan Luis Rodríguez Hermosa, Gianna Vargas Centanaro, María Estela González Castro, Marc Miravitlles, Lourdes Lázaro-Asegurado, Beatriz María Jiménez-Rodríguez, Rosanel Amaro Rodríguez, Rosaly Moreno Méndez, María Torres-Duran, José María Hernández-Pérez, Ana María Humanes-Navarro, and Myriam Calle Rubio
Subjects: SARS-CoV-2 infection, severe COVID-19, alpha-1 antitrypsin deficiency, genetic mutations, Biology (General), QH301-705.5
Abstract: Background: Epidemiologic studies have reported that the geographical distribution of the prevalence of allelic variants of serine protein inhibitor-A1 (SERPINA1) and severe cases of COVID-19 were similar. Methods: A multicenter, cross-sectional, observational study to evaluate the frequency of alpha-1 antitrypsin deficiency (AATD) in patients with COVID-19 and whether it was associated with having suffered severe COVID-19. Results: 2022 patients who had laboratory-confirmed SARS-CoV-2 infection. Mutations associated with AATD were more frequent in severe COVID versus non-severe (23% vs. 18.8%, p = 0.022). The frequency of Pi*Z was 37.8/1000 in severe COVID versus 17.5/1000 in non-severe, p = 0.001. Having an A1AT level below 116 was more frequent in severe COVID versus non-severe (29.5% vs. 23.1, p = 0.003). Factors associated with a higher likelihood of severe COVID-19 were being male, older, smoking, age-associated comorbidities, and having an A1AT level below 116 mg/dL [OR 1.398, p = 0.003], and a variant of the SERPINA1 gene that could affect A1AT protein [OR 1.294, p = 0.022]. Conclusions: These observations suggest that patients with AATD should be considered at a higher risk of developing severe COVID-19. Further studies are needed on the role of A1AT in the prognosis of SARS-CoV-2 infection and its possible therapeutic role.
Published: 2023
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5. Variations in Chronic Obstructive Pulmonary Disease Outpatient Care in Respiratory Clinics: Results From the 2021 EPOCONSUL Audit

Author: Myriam Calle Rubio, José Luis López-Campos, Marc Miravitlles, Juan José Soler Cataluña, Bernardino Alcázar Navarrete, Manuel E. Fuentes Ferrer, and Juan Luis Rodríguez Hermosa
Subjects: Pulmonary and Respiratory Medicine
Published: 2023
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6. Assessing the clinical practice in specialized outpatient clinics for chronic obstructive pulmonary disease: Analysis of the EPOCONSUL clinical audit.

Author: Myriam Calle Rubio, Juan José Soler-Cataluña, José Luis López-Campos, Bernardino Alcázar Navarrete, José Miguel Rodríguez González-Moro, Joan B Soriano, Manuel E Fuentes Ferrer, and Juan Luis Rodriguez Hermosa
Subjects: Medicine, Science
Abstract: BACKGROUND:Chronic obstructive pulmonary disease (COPD) is one of the main reasons for healthcare appointments and use of healthcare resources. In recent years, clinics specializing in COPD have been developed to offer improved care and optimization of recourses for patients with high complexity and frequent decompensations. However, little is known about the clinical practice in this clinical model specializing in COPD. The objectives of this study were to assess the prevalence, characteristics of specialized COPD outpatient respiratory clinics and to evaluate clinical practice in this healthcare model. METHODS:EPOCONSUL is a Spanish nationwide, observational, cross-sectional, clinical audit with prospective case recruitment including the clinical records for 4508 COPD cases from outpatient respiratory clinics over a 12-month period (May 2014-May 2015). The study evaluated clinical practice in 2378 cases from 28 hospitals with both general and specialized COPD outpatient respiratory clinics. RESULTS:Only 28 (47.5%) centers had an outpatient clinic specializing in COPD, which was characterized by longer patient visits and a higher prevalence of written protocols compared to a general clinic. Patients treated in a specialized clinic had greater obstruction severity, a higher degree of dyspnea and also suffered from more comorbidities. The majority of patients at both types of clinic were classified as high risk (81.1% versus 83%, p = 0.384) according to GesEPOC criteria. Clinical control of COPD was more frequent at specialized clinics, with significant differences in non-severe patients (70.5% versus 56.1%, p < 0.001). Testing was done more frequently in specialized clinics, with better adherence to good clinical practice recommendations. CONCLUSION:A specialized COPD outpatient clinic is a healthcare model found in few pulmonology departments that treats more severe patients and those with increased comorbidities. The COPD patients treated in a specialized clinic had a better clinical control, as defined by impact and clinical stability. It is a healthcare model to offer improved care with a higher degree of adherence to guidelines.
Published: 2019
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7. Effectiveness and Safety of Inhaled Antibiotics in Patients With Chronic Obstructive Pulmonary Disease. A Multicentre Observational Study

Author: David De la Rosa Carrillo, Miguel Ángel Martínez-García, Esther Barreiro, Eva Tabernero Huguet, Roser Costa Sola, Marta María García-Clemente, Nuria Celorrio Jiménez, Laura Rodríguez Pons, Carmen Calero Acuña, Juan Luís Rodríguez Hermosa, Rafael Golpe, Raquel Dacal Quintas, Silvia Sánchez-Cuéllar, Irene Torres Arroyo, Marina Blanco Aparicio, Virginia Almadana Pacheco, Marc Miravitlles, Annie Navarro Rolon, Xuejie Wang, Alicia Marín Tapia, Myriam Calle Rubio, María Jesús Linares Asensio, Iria Pérez Orbis, Pilar Martínez Olondris, Ascensión Hernando Sanz, Alicia de Pablos Gafas, Margarita Marín Royo, Selene Cuenca Peris, Julia Amaranta García Fuertes, Casilda Olveira, Guillermo Bentabol Ramos, Lirios Sacristán Bou, Rosa María Girón Moreno, Sandra Marín Arguedas, Raúl Moreno Zabaleta, Sarai Quirós Fernández, Mikel Sarasate, María Victoria Leal Arranz, Gema Castaño de las Pozas, Nuria Bruguera Ávila, Carlos Antonio Amado Diago, Soledad Alonso Viteri, María Isabel Ramos Cancelo, Carolina Gotera Rivera, Javier de Miguel Díez, Gemma Sánchez Muñoz, Esperanza Martín Zapatero, Sandra Ros Celis, Silvia Merlos Navarro, and Rut Ayerbe García
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pulmonary disease, medicine.disease_cause, Inhaled antibiotics, Exacerbaciones, Antibióticos inhalados, Exacerbations, 03 medical and health sciences, 0302 clinical medicine, Bronquiectasia, Internal medicine, medicine, Enfermedad pulmonar obstructiva crónica, COPD, Bronchiectasis, Pseudomonas aeruginosa, business.industry, Chronic obstructive pulmonary disease, Chronic bronchial infection, medicine.disease, respiratory tract diseases, 030228 respiratory system, Sputum, Observational study, medicine.symptom, business, Infección bronquial crónica, Cohort study
Abstract: Background We aimed to describe the effectiveness and safety of inhaled antibiotics in chronic obstructive pulmonary disease (COPD) patients, as well as the patient profile in which they are usually prescribed and the patient groups that can most benefit from this treatment. Methods Multicentre retrospective observational cohort study in COPD patients who had received ≥1 dose of inhaled antibiotics in the last 5 years. Clinical data from the two years prior to and subsequent to the start of the treatment were compared. Primary outcome: COPD exacerbations. Secondary outcomes: side effects, symptomatology (sputum purulence, dyspnoea), microbiological profile and pathogen eradication. Results Of 693 COPD patients analyzed (aged 74.1; 86.3% men; mean FEV1 = 43.7%), 71.7% had bronchiectasis and 46.6% presented chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA). After 1 year of treatment with inhaled antibiotics, there was a significant decrease in the number of exacerbations (−33.3%; P Conclusions In COPD patients with multiple exacerbations and/or CBI by any PPM (especially PA), inhaled antibiotics appear to be an effective and safe treatment, regardless of the presence of bronchiectasis.
Published: 2022
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8. Knowledge of chronic obstructive pulmonary disease, presence of chronic respiratory symptoms and use of spirometry among the Spanish population: CONOCEPOC 2019 study

Author: Myriam, Calle Rubio, Juan Luis, Rodríguez Hermosa, Marc, Miravitlles, and José Luis, López-Campos
Subjects: Adult, Male, Smoking, General Medicine, Middle Aged, Interviews as Topic, Pulmonary Disease, Chronic Obstructive, Cross-Sectional Studies, Knowledge, Spain, Spirometry, Prevalence, Humans, Female
Abstract: The aim of this study was to analyze current data on the population's level of knowledge about COPD and to evaluate certain diagnostic interventions, such as the use of spirometry.An epidemiological, observational, cross-sectional study by telephone interview, with random dialing of landline telephone numbers, was conducted in November 2019, in a nationally representative sample of adults over 40 years of age.From a total of 51,079 telephone calls, a total of 1920 individuals responded. Mean age was 61.9 years and 31.6% were men. Overall, 19.4% were current smokers and 13.4% reported respiratory disease (5% reported COPD). In total, 27.9% had spontaneous knowledge of COPD, which is a relative increase from the 17% observed in 2011. The most frequent information channel was the media (35.5%), with a significant presence of social networks and the Internet (25.7%). Almost one fifth (18.1%) had chronic respiratory symptoms. Of these, 59.3% had requested medical care, and 66.2% had undergone spirometry. Spirometry was performed less frequently in subjects treated in primary care compared to respiratory medicine departments (51.9% versus 79.1%; P .001).Knowledge of COPD is still scarce, and strategies are needed to increase awareness and the importance of assessing respiratory symptoms and increased use of spirometry.
Published: 2021
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9. Conocimiento de la enfermedad pulmonar obstructiva crónica, presencia de síntomas respiratorios crónicos y uso de la espirometría en la población española: estudio CONOCEPOC 2019

Author: Juan Luis Rodríguez Hermosa, José Luis López-Campos, Marc Miravitlles, and Myriam Calle Rubio
Subjects: Pulmonary and Respiratory Medicine, Spirometry, Spanish population, Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, medicine.diagnostic_test, business.industry, Medicine, Pulmonary disease, business
Abstract: Resumen Objetivo El objetivo de este estudio es analizar los datos actuales del nivel de conocimiento de la poblacion sobre la EPOC y evaluar algunas actuaciones diagnosticas, como el uso de espirometria. Material y metodos Estudio epidemiologico, observacional y transversal mediante entrevista telefonica, con marcacion aleatoria de numeros de telefono fijos, realizado en noviembre del 2019, con una muestra representativa a nivel nacional en adultos mayores de 40 anos. Resultados De un total de 51.079 contactos telefonicos se obtuvo un total de 1.920 encuestados. La edad media era 61,9 anos, con 31,6% de hombres. El 19,4% de ellos eran fumadores actuales y un 13,4% referia tener alguna enfermedad respiratoria (5% referia una EPOC). El 27,9% tenia conocimiento espontaneo sobre la EPOC, lo que supone un aumento relativo respecto al 17% observado en el 2011. El canal de informacion mas frecuente eran los medios de comunicacion (35,5%), con importante presencia de redes sociales e Internet (25,7%). Un 18,1% tenia sintomas respiratorios cronicos. De ellos, un 59,3% solicito atencion medica y un 66,2% se realizo la espirometria. La espirometria era realizada con menor frecuencia en sujetos atendidos en Atencion Primaria respecto a Neumologia (51,9% vs. 79,1%; p Conclusiones El conocimiento de la EPOC es todavia escaso y son necesarias estrategias para aumentar la concienciacion y la importancia de evaluar los sintomas respiratorios y el mayor uso de la espirometria.
Published: 2021
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10. Consenso sobre el diagnóstico, tratamiento y seguimiento de la EPOC: Grupo de trabajo EPOC Forum

Author: 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
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, COPD, Text mining, Diagnosis treatment, business.industry, Internal medicine, MEDLINE, Medicine, business, medicine.disease
Published: 2021
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11. Testing for alpha-1 antitrypsin in COPD in outpatient respiratory clinics in Spain: A multilevel, cross-sectional analysis of the EPOCONSUL study.

Author: Myriam Calle Rubio, Joan B Soriano, José Luis López-Campos, Juan J Soler-Cataluña, Bernardino Alcázar Navarrete, José Miguel Rodríguez González-Moro, Marc Miravitlles, Miriam Barrecheguren, Manuel E Fuentes Ferrer, Juan Luis Rodriguez Hermosa, and EPOCONSUL Study
Subjects: Medicine, Science
Abstract: BACKGROUND:Alpha-1 antitrypsin deficiency (AATD) is the most common hereditary disorder in adults, but is under-recognized. In Spain, the number of patients diagnosed with AATD is much lower than expected according to epidemiologic studies. The objectives of this study were to assess the frequency and determinants of testing serum α1-antitrypsin (AAT) levels in COPD patients, and to describe factors associated with testing. METHODS:EPOCONSUL is a cross-sectional clinical audit, recruiting consecutive COPD cases over one year. The study evaluated serum AAT level determination in COPD patients and associations between individual, disease-related, and hospital characteristics. RESULTS:A total of 4,405 clinical records for COPD patients from 57 Spanish hospitals were evaluated. Only 995 (22.5%) patients had serum AAT tested on some occasion. A number of patient characteristics (being male [OR 0.5, p < 0.001], ≤55 years old [OR 2.38, p
Published: 2018
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12. Consensus on the Management of the COPD Patient in the COVID-19 Setting: COPD Forum Working Group

Author: 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
Subjects: Pulmonary and Respiratory Medicine, COVID-19 (Malaltia), Pulmons--Malalties obstructives
Abstract: This study was funded by Chiesi.
Published: 2022

13. Assessing the Usefulness of the Prevexair Smartphone Application in the Follow-Up High-Risk Patients with COPD

Author: Myriam Calle Rubio, Juan Luis Rodríguez Hermosa, Manuel Fuentes Ferrer, Carlos Antonio Amado Diago, José Luis Álvarez-Sala, Rosa Malo De Molina Ruiz, Antonia Fuster Gomila, Francisco Javier Callejas González, and Luis Puente Maestu
Subjects: medicine.medical_specialty, clinical prediction, Copd patients, International Journal of Chronic Obstructive Pulmonary Disease, Smartphone application, chronic obstructive pulmonary disease, Cohort Studies, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, exacerbations, Adrenal Cortex Hormones, Health care, Humans, Medicine, 030212 general & internal medicine, mobile health, Original Research, Medical attention, COPD, electronic patient record, High risk patients, business.industry, telemonitoring, General Medicine, medicine.disease, 030228 respiratory system, Emergency medicine, Cohort, Disease Progression, Smartphone, business, management, Follow-Up Studies, Cohort study
Abstract: Introduction: This manuscript analyzes the exacerbations recorded by the Prevexair application through the daily analysis of symptoms in high-risk patients with COPD and explores its usefulness in assessing clinical stability with respect to that reported in visits. Patients and Methods: This study is a multi-centre cohort of COPD patients with the exacerbator phenotype who were monitored over 6 months. The Prevexair application was installed on the patients' smartphones. Patients used the app to record symptom changes, use of medication and use of healthcare resources. It is not established a recommended action plan when worsening of symptoms. At their clinical visit during the follow-up period, patients were asked about exacerbations suffered during these 6 months of monitoring. The investigators who conducted the visit were blinded about the Prevexair app records. Results: The patients experienced a total of 185 exacerbations according to daily records in the app whereas only 64 exacerbations were recalled during medical visits. Perception became more accurate for severe exacerbations (kappa 0.6577), although we found no factors that predicted poor recall. The proportion of 72.5% patients were classified as unstable if the exacerbations captured by Prevexair were used to define stability, versus 47.8% if the exacerbations recall in visit was used. Two-thirds of the exacerbations recorded in the Prevexair application were not reported to doctors during their clinical visits. Almost half were treated with oral corticosteroids and/or antibiotics and more than one-quarter of the exacerbations treated did not seek medical attention. Conclusion: The findings of this cohort study confirm that patients do not always remember the exacerbations suffered during their medical visit. The prevexair application is useful in monitoring COPD patients at high risk, in order to a better assessment of exacerbations of COPD during medical visits. Further research must be carried out to evaluate this strategy in clinical practice., This study has been promoted and sponsored by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). We thank AstraZeneca for its financial support with a donation to carry out the study. The financers had no role in study design, data collection, analysis, decision to publish or in the preparation of this manuscript. This does not alter our adherence to the Journal of Medical Internet Research policies on sharing data and materials.
Published: 2021
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14. Documento de consenso sobre el diagnóstico y tratamiento de la infección bronquial crónica en la enfermedad pulmonar obstructiva crónica

Author: 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
Subjects: 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
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15. Consensus document on the diagnosis and treatment of chronic bronchial infection in chronic obstructive pulmonary disease

Author: Bernardino Alcázar Navarrete, Casilda Olveira Fuster, Miguel Ángel Martínez-García, Juan Luis García-Rivero, David de la Rosa Carrillo, Rafael Cantón Moreno, Comité Asesor del Documento, José Luis López-Campos, Myriam Calle Rubio, and Luis Máiz Carro
Subjects: medicine.medical_specialty, COPD, Bronchiectasis, business.industry, General Medicine, Scientific literature, Guideline, medicine.disease, Scientific evidence, 03 medical and health sciences, 0302 clinical medicine, Pulmonology, 030228 respiratory system, Cardiothoracic surgery, Internal medicine, medicine, Disease management (health), business, Intensive care medicine
Abstract: Although the chronic presence of microorganisms in the airways of patients with stable chronic obstructive pulmonary disease (COPD) confers a poor outcome, no recommendations have been established in disease management guidelines on how to diagnose and treat these cases. In order to guide professionals, the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has prepared a document which aims to answer questions on the clinical management of COPD patients in whom microorganisms are occasionally or habitually isolated. Since the available scientific evidence is too heterogeneous to use in the creation of a clinical practice guideline, we have drawn up a document based on existing scientific literature and clinical experience, addressing the definition of different clinical situations and their diagnosis and management. The text was drawn up by consensus and approved by a large group of respiratory medicine experts with extensive clinical and scientific experience in the field, and has been endorsed by the SEPAR Scientific Committee.
Published: 2020
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16. A Proposed Approach to Chronic Airway Disease (CAD) Using Therapeutic Goals and Treatable Traits: A Look to the Future

Author: Carolina Cisneros, Ciro Casanova, Juan José Soler-Cataluña, Myriam Calle Rubio, Vicente Plaza, Carlos Almonacid, Marc Miravitlles, Juan P. de-Torres, Juan Luis García Rivero, Rafael Golpe, Francisco-Javier González-Barcala, Juan Luis Rodríguez Hermosa, Francisco Javier Álvarez-Gutiérrez, Eva Martínez-Moragón, José Luis López-Campos, Luis Pérez de Llano, David Ramos-Barbón, and Borja G. Cosío
Subjects: COPD, medicine.medical_specialty, Bronchiectasis, business.industry, General Medicine, medicine.disease, Clinical trial, 03 medical and health sciences, Therapeutic approach, 0302 clinical medicine, 030228 respiratory system, Medicine, Biomarker (medicine), Identification (biology), 030212 general & internal medicine, Airway, business, Intensive care medicine, Asthma
Abstract: Chronic airflow obstruction affects a wide range of airway diseases, the most frequent of which are asthma, COPD, and bronchiectasis; they are clearly identifiable in their extremes, but quite frequently overlap in some of their pathophysiological and clinical characteristics. This has generated the description of new mixed or overlapping disease phenotypes with no clear biological grounds. In this special article, a group of experts provides their perspective and proposes approaching the treatment of chronic airway disease (CAD) through the identification of a series of therapeutic goals (TG) linked to treatable traits (TT) - understood as clinical, physiological, or biological characteristics that are quantifiable using biomarkers. This therapeutic approach needs validating in a clinical trial with the strategy of identification of TG and treatment according to TT for each patient independently of their prior diagnosis.
Published: 2020
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17. Determinants in the Underdiagnosis of COPD in Spain—CONOCEPOC Study

Author: Myriam Calle Rubio, Juan Luis Rodríguez Hermosa, Marc Miravitlles, José Luis López-Campos, Institut Català de la Salut, [Calle Rubio M, Rodríguez Hermosa JL] Pulmonology Department, Research Institute of Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain. Department of Medicine, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain. [Miravitlles M] Servei de Pneumologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain. [López-Campos JL] CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain. Respiratory Disease Medical-Surgical Unit, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, 41013 Sevilla, Spain, Vall d'Hebron Barcelona Hospital Campus, Sociedad Española de Neumología y Cirugía Torácica, GlaxoSmithKline, and Universidad de Sevilla. Departamento de Medicina
Subjects: chronic obstructive pulmonary disease (COPD), respiratory symptoms, spirometry, underdiagnosis, autonomous community, Spain, Autonomous community, Pulmons - Malalties obstructives - Diagnòstic, Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive [DISEASES], Otros calificadores::/diagnóstico [Otros calificadores], Chronic obstructive pulmonary disease (COPD), General Medicine, Underdiagnosis, diagnóstico::técnicas y procedimientos diagnósticos::técnicas diagnósticas respiratorias::pruebas de función respiratoria::espirometría [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], enfermedades respiratorias::enfermedades pulmonares::enfermedades pulmonares obstructivas::enfermedad pulmonar obstructiva crónica [ENFERMEDADES], Spirometry, Other subheadings::/diagnosis [Other subheadings], Espirometria, Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Respiratory System::Respiratory Function Tests::Spirometry [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Respiratory symptoms, Neumología
Abstract: Factors such as seeking medical attention for respiratory symptoms and health professionals ordering spirometry come into play in the underdiagnosis of chronic obstructive pulmonary disease (COPD). The objective of this study was to analyze seeking medical attention and the use of spirometry in individuals with chronic respiratory symptoms and to compare these results with those obtained in the 2005 and 2011 surveys. Material and Methods: A cross-sectional, observational, epidemiological study was conducted via phone interview in December 2020 in Spain, with a representative sample from 17 autonomous communities. The study design was identical to that of the studies carried out in 2005 and 2011 to evaluate the changes that have occurred in seeking medical attention and performing spirometry in Spain, as well as the variability between autonomous communities. Results: From 89,601 phone contacts, a total of 6534 respondents were obtained. A total of 24.8% reported having some chronic respiratory symptom, and 17.9% reported a respiratory disease. Only 51.6% of those who had some chronic respiratory symptom had seen their doctor, which was less likely among current smokers (OR: 0.599, 95% CI: 0.467–0.769, p < 0.001) and those living in a rural setting (OR: 0.797, 95% CI: 0.651–0.975, p = 0.027). A total of 68.7% of the individuals who saw a doctor reported having undergone spirometry, most frequently males (OR: 1.535, 95% CI: 2.074–1.136, p < 0.005), former smokers (OR: 1.696, 95% CI: 2.407–1.195, p < 0.003), and those seen by a pulmonologist (OR: 6.151, 95% CI: 8.869–4.265, p < 0.001). With respect to the 2005 survey, more frequent use of spirometry has been observed (42.6 vs. 68.7%), without any change in seeking medical attention for respiratory symptoms. There is a clear variability according to the autonomous community (p < 0.05). Conclusions: Many individuals with chronic respiratory symptoms do not seek medical attention and although the use of spirometry has increased in the past 15 years, it is still an important area that needs improving in the primary care setting, especially among women. Both of these factors can be determinants in the underdiagnosis of COPD and its variability between autonomous communities., This study has been promoted and sponsored by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). We thank GlaxoSmithKline Spain for its financial support in carrying out the study; grant number 214465.
Published: 2022
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18. Testing for Vitamin D in High-Risk COPD in Outpatient Clinics in Spain: A Cross-Sectional Analysis of the VITADEPOC Study

Author: Myriam Calle Rubio, José Luis Álvarez-Sala, Gianna Vargas Centanaro, Ana María Humanes Navarro, and Juan Luis Rodríguez Hermosa
Subjects: Medicina, General Medicine, Neumología, vitamin D deficiency, testing for vitamin D, chronic obstructive pulmonary disease (COPD), high risk, adherence to recommendation
Abstract: Background: Vitamin D deficiency has been associated with an accelerated deterioration in lung function and increased exacerbations in chronic obstructive pulmonary disease (COPD). 25(OH) vitamin D levels have been indicated as a potentially useful marker for adverse results related to COPD. Methods: VITADEPOC is a cross-sectional clinical study recruiting consecutive patients with high-risk COPD. The objective of our study was to investigate vitamin D determination frequency in patients with high-risk COPD in clinical practice at outpatient clinics in Spain and to describe the factors associated with vitamin D testing. We also aimed to determine the frequency of vitamin D deficiency in these patients. Results: Only 51 (44%) patients underwent vitamin D determination and 33 (28.4%) had received vitamin D supplements in clinical practice. The patients who underwent testing for vitamin D in clinical practice were more often women (58.8% vs. 26.2%, p < 0.001) with comorbidities such as osteoporosis (19.6% vs. 6.2%, p < 0.001) or chronic renal failure (7.8% vs. 0%, p < 0.001) and with exacerbator phenotype (55% vs. 32.3%, p = 0.015). A total of 63 (54.3%) patients had serum vitamin D levels
Published: 2022
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19. Long-term Outcomes and Recovery of Patients who Survived COVID-19: LUNG INJURY COVID-19 Study

Author: Gianna Vargas Centanaro, Myriam Calle Rubio, José Luis Álvarez-Sala Walther, Fernando Martinez-Sagasti, Andrea Albuja Hidalgo, Rafael Herranz Hernández, and Juan Luis Rodríguez Hermosa
Subjects: Infectious Diseases, Oncology
Abstract: Background LUNG INJURY COVID-19 (clinicaltrials.gov NCT 21/399-E) is a registry-based prospective observational cohort study to evaluate long-term outcomes and recovery 12 months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection according to severity. Methods Three hundred five coronavirus disease 2019 (COVID-19) survivors were included (moderate, 162; severe, 143). Twelve months after SARS-CoV-2 infection, there was resolution of respiratory symptoms (37.9% in severe vs 27.3% in moderate pneumonia; P = .089). Results Exertional dyspnea was present (20% in severe vs 18.4% in moderate; P = .810). Abnormalities on chest radiology imaging were detected more often in severe COVID-19 infection vs moderate infection (29% vs 8.8%; P Conclusions At 12 months from infection onset, most patients refer to symptoms, particularly muscle weakness and dyspnea, and almost one-third of patients with severe COVID-19 pneumonia had impaired pulmonary diffusion and abnormalities on chest radiology imaging. These results emphasize the importance of systematic follow-up after severe COVID-19, with appropriate management of pulmonary sequelae.
Published: 2022
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20. Effect of a Pulmonary Embolism Diagnostic Strategy on Clinical Outcomes in Patients Hospitalized for COPD Exacerbation: A Randomized Clinical Trial

Author: Carmen Rodriguez, Ramón Agüero, Deisy Barrios, Laurent Bertoletti, Francis Couturaud, Alvar Agusti, Pedro Marcos-Rodríguez, Gregorio Pérez-Peñate, Myriam Calle-Rubio, Alfonso Muriel, Roger D. Yusen, José Luis Lobo, Behnood Bikdeli, María Jesús Rodríguez-Nieto, Agustina Rivas-Guerrero, Raquel López-Reyes, Remedios Otero, Eva Tabernero, Manuel Monreal, Luis Jara-Palomares, Menno V. Huisman, Aitor Ballaz, Ascensión Hernando, Sònia Jiménez, David Jiménez, and Pedro Ruiz-Artacho
Subjects: Male, medicine.medical_specialty, Randomization, Exacerbation, Computed Tomography Angiography, Hemorrhage, Patient Readmission, law.invention, Fibrin Fibrinogen Degradation Products, Pulmonary Disease, Chronic Obstructive, Randomized controlled trial, law, Recurrence, Internal medicine, Cause of Death, medicine, Confidence Intervals, Humans, Cause of death, Aged, COPD, business.industry, Absolute risk reduction, General Medicine, Venous Thromboembolism, medicine.disease, Pulmonary embolism, Hospitalization, Treatment Outcome, Spain, Relative risk, Disease Progression, Female, business, Pulmonary Embolism
Abstract: SLICE Trial Group., [Importance] Active search for pulmonary embolism (PE) may improve outcomes in patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD)., [Objective] To compare usual care plus an active strategy for diagnosing PE with usual care alone in patients hospitalized for COPD exacerbation., [Design, Setting, and Participants] Randomized clinical trial conducted across 18 hospitals in Spain. A total of 746 patients were randomized from September 2014 to July 2020 (final follow-up was November 2020)., [Interventions] Usual care plus an active strategy for diagnosing PE (D-dimer testing and, if positive, computed tomography pulmonary angiogram) (n = 370) vs usual care (n = 367)., [Main Outcomes and Measures] The primary outcome was a composite of nonfatal symptomatic venous thromboembolism (VTE), readmission for COPD, or death within 90 days after randomization. There were 4 secondary outcomes, including nonfatal new or recurrent VTE, readmission for COPD, and death from any cause within 90 days. Adverse events were also collected., [Results] Among the 746 patients who were randomized, 737 (98.8%) completed the trial (mean age, 70 years; 195 [26%] women). The primary outcome occurred in 110 patients (29.7%) in the intervention group and 107 patients (29.2%) in the control group (absolute risk difference, 0.5% [95% CI, −6.2% to 7.3%]; relative risk, 1.02 [95% CI, 0.82-1.28]; P = .86). Nonfatal new or recurrent VTE was not significantly different in the 2 groups (0.5% vs 2.5%; risk difference, −2.0% [95% CI, −4.3% to 0.1%]). By day 90, a total of 94 patients (25.4%) in the intervention group and 84 (22.9%) in the control group had been readmitted for exacerbation of COPD (risk difference, 2.5% [95% CI, −3.9% to 8.9%]). Death from any cause occurred in 23 patients (6.2%) in the intervention group and 29 (7.9%) in the control group (risk difference, −1.7% [95% CI, −5.7% to 2.3%]). Major bleeding occurred in 3 patients (0.8%) in the intervention group and 3 patients (0.8%) in the control group (risk difference, 0% [95% CI, −1.9% to 1.8%]; P = .99)., [Conclusions and Relevance] Among patients hospitalized for an exacerbation of COPD, the addition of an active strategy for the diagnosis of PE to usual care, compared with usual care alone, did not significantly improve a composite health outcome. The study may not have had adequate power to assess individual components of the composite outcome., [Trial Registration] ClinicalTrials.gov Identifier: NCT02238639.
Published: 2021

21. RCT Abstract - Randomized, double-blind, placebo-controlled, phase III clinical trial with MV130, a sublingual bacterial immunotherapy to prevent COPD exacerbations

Author: Ana Doyle, Raquel Caballero, Paola Benedetti, Julio Hernández Vázquez, María Jesús Buendía García, Carlos Alvarez Martinez, Luis Puente Maestu, Javier de Miguel Díez, Joan Serra Batlles, Carmen Rodríguez Sainz, Eduardo Fernández-Cruz, José Luis Subiza, Francisco García Río, Cristina Fernández Pérez, Julia García de Pedro, Soledad Alonso Viteri, Laura Conejero Hall, Myriam Calle Rubio, Walter Girón, José Luis Álvarez-Sala Walther, Juan Luis Rodríguez Hermosa, and Miguel Casanovas
Subjects: medicine.medical_specialty, COPD, business.industry, medicine.medical_treatment, Immunotherapy, Placebo, medicine.disease, law.invention, Double blind, Clinical trial, Randomized controlled trial, law, Internal medicine, medicine, business
Published: 2021
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22. COPD Clinical Control: predictors and long-term follow-up of the CHAIN cohort

Author: Antonia Fuster, Germán Peces-Barba, Juan P. de Torres, Myriam Calle Rubio, Borja G. Cosío, Cristina Martínez-González, Juan Luis Rodríguez Hermosa, Ciro Casanova, Nuria Feu-Collado, José Luis López-Campos, Ingrid Solanes, Jose M. Marin, AstraZeneca, and Universidad de Sevilla. Departamento de Medicina
Subjects: Male, medicine.medical_specialty, Long term follow up, Pharmacological treatment, Cohort Studies, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Quality of life, Predictive Value of Tests, Internal medicine, Control, medicine, Humans, In patient, 030212 general & internal medicine, Longitudinal Studies, Prospective Studies, Aged, lcsh:RC705-779, COPD, business.industry, Research, Chronic obstructive pulmonary disease, Hazard ratio, lcsh:Diseases of the respiratory system, Middle Aged, medicine.disease, Management, Bronchodilator Agents, Persistent Disease, 030228 respiratory system, Spain, Cohort, Control, Management, Female, business, Follow-Up Studies
Abstract: CHAIN Study Investigators., [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., This study has been funded by AstraZeneca.
Published: 2021

23. Clinical Control Criteria to Determine Disease Control in Patients with Severe COPD: The CLAVE Study

Author: Pere Almagro, Diego González-Segura Alsina, Myriam Calle Rubio, Juan José Soler-Cataluña, Arturo Huerta, and Borja G Cosio
Subjects: medicine.medical_specialty, Concordance, Severe copd, International Journal of Chronic Obstructive Pulmonary Disease, clinical, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, exacerbations, Internal medicine, Medicine, Humans, COPD, In patient, 030212 general & internal medicine, Lung, Original Research, criteria, business.industry, CAT, General Medicine, medicine.disease, Disease control, Rescue treatment, respiratory tract diseases, Cross-Sectional Studies, Dyspnea, 030228 respiratory system, Spain, Copd assessment test, Disease Progression, Observational study, business, control
Abstract: Background: Clinical control in chronic obstructive pulmonary disease (COPD) has not been completely characterized. A proposal of clinical control criteria (CCC) has been recently defined and validated as a tool for determining control, but there is scarce information on patients with severe COPD. Objective: To evaluate clinical control in severe COPD using the CCC. Patients and Methods: The study design was observational, multicenter, cross-sectional study involving 4801 patients with severe COPD in Spain. Clinical control was defined according to clinical impact (dyspnea grade, use of rescue treatment in last week, sputum color, and daily physical activity) and stability (exacerbations in last 3 months and patient's perception about health status). Clinical control of COPD was alternatively evaluated with the COPD assessment test (CAT) and the presence of exacerbations in the last 3 months. Results: According to CCC, 61.0% of patients had low clinical impact, and 41.4% showed clinical stability. Overall, 29.9% of patients had both low clinical impact and stability (controlled), whereas 70.1% showed high clinical impact and/or no clinical stability (non-controlled). COPD control was also assessed by using only the definition of CAT, The study described within the paper was sponsored by Chiesi Espana SAU.
Published: 2021
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24. Consenso sobre el diagnóstico, tratamiento y seguimiento de la EPOC: Grupo de trabajo EPOC Forum

Author: José Luis López-Campos, Myriam Calle Rubio, José Luis Izquierdo Alonso, Alberto Fernández-Villar, Beatriz Abascal-Bolado, Bernardino Alcázar, Francisco García-Río, Germán Peces-Barba, Joan Serra Batlles, José Javier Martínez Garcerán, Juan Antonio Riesco Miranda, Juan Marco Figueira-Gonçalves, Juan José Soler-Cataluña, Mikel Temprano, Francisco Ortega Ruiz, Salud Santos Pérez, and Carlos José Álvarez Martínez
Subjects: General Medicine
Published: 2021

25. Benefits of Measured Isotiming in Constant Cardiopulmonary Exercise Testing in a Structured Physical Activity Program

Author: Juan Luis Rodríguez Hermosa, Gianna Vargas Centanaro, Walther Ivan Giron Matute, Myriam Calle Rubio, Marta Godin Vivancos, Luis Puente Maestu, Irene Milagros Dominguez Zabaleta, and Javier de Miguel Díez
Subjects: medicine.medical_specialty, COPD, business.industry, Physical activity, VO2 max, Cardiopulmonary exercise testing, medicine.disease, respiratory tract diseases, Internal medicine, Cardiology, Medicine, Constant load, business, Constant (mathematics), Exercise duration, Respiratory minute volume
Abstract: Introduction: There is no doubt about the benefits of physical activity in chronic obstructive pulmonary disease (COPD); however, evaluating its use with constant cardiopulmonary exercise testing (CPET) is less widespread. 1 This study aim is measuring maximum oxygen consumption (VO2max) and minute ventilation (VE) of a structured physical activity program (PAP) in COPD patients with dyspnea through constant cycloergometry. Material and Methods: Observational, prospective, multicenter study of COPD patients with dyspnea that limits their daily physical activity. With constant CPET, isotiming evaluation of VO2max and VE before and after a PAP was measured. Results: The sample was 40 patients, 45% men, with a median age 69 years, with moderate COPD (median FEV1% 56%), and grade 2 dyspnea of the mMRC in 63.8%. At a constant load with equivalent isotiming, average VO2 max lowers (13.75 to 12.46 ml / kg / min) alongside VE (41.55 to 38.07 L/min). Paired t-student shows 0.815 and 0.814 respectively, with p Conclusions: A physical activity program objectively benefits COPD patients whose dyspnea limits their daily basic activities, significantly decreasing at a constant load and at the same time, the maximum oxygen consumption and their minute ventilation. 1 Puente-Maestu L., et. al. Clinical relevance of constant power exercise duration in COPD. Eur Respir J 2009; 34: 340–345
Published: 2020
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26. KaLinix® in the treatment of Obstructive Sleep Apnea-Hypopnea syndrome (OSAHS)

Author: Nada Raissouni, José Luis Álvarez-Sala, Myriam Calle Rubio, Soha Esmaili, Gianna Vargas Centanaro, and Juan Luis Rodríguez Hermosa
Subjects: medicine.diagnostic_test, business.industry, Visual analogue scale, Apnea, Polysomnography, medicine.disease, respiratory tract diseases, Obstructive sleep apnea, Anesthesia, medicine, Observational study, medicine.symptom, Respiratory system, Airway, business, Hypopnea
Abstract: Introduction: Nasal CPAP is the treatment of choice in OSAHS, although it is not exempt from adaptation problemswhich occasionally compels to consider other therapeutic options. KαLinix® is an intelligent, portable, non-invasive medical device, that based on the detection of multisensory signals from the patient, detects respiratory events and corrects them in real time through the external application of electrical stimuli. These stimuli open the upper respiratory tract with imperceptible effects on patients. Materials and Methods: An observational study was carried out using KαLinix® in 20 patients with OSAHS. Simultaneously, polysomnography was performed while using KalinoT overnight in the hospital. The variables evaluated were AHI, ODI and the area of the upper airways determined by 4D ultrasound. Other variables were predicted, resolved and unresolved events along with the duration of events. Results: A total of 20 patients (mean age of 53.1 years, 84.2% males, average AHI of 45) were evaluated. The KαLinix® device improved AHI in 52.6% of patients while ODI improved in 62.5%. In 6 cases with class IV Mallampati classification, 83.3% improved both AHI and ODI. Regarding the events, 75.0% improved in duration, 45.95% of the events were prevented, and 37.40% were resolved. The opening of the upper airway occurred in all cases. The perception of pain resolved to be less than 3/10 using a visual analogue scale. Conclusions: KαLinix® offers a non-invasive solution as an alternative to CPAP and achieves the opening of the upper airway without causing discomfort reducing the average time of the events (apnea/hypopnea). Moreover, it has been proven effective in the most severe cases.
Published: 2020
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27. Development and Preliminary Evaluation of the Effects of an mHealth Web-Based Platform (HappyAir) on Adherence to a Maintenance Program After Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial

Author: Jordi Vilaró, Marta Sánchez Cortés, Eva Maroto López, María Teresa Hernández Criado, Santiago Angulo-Díaz-Parreño, Myriam Calle Rubio, Aitor Martín-Pintado-Zugasti, Marta López, Juan Luis Rodríguez Hermosa, Lourdes Juarros, Shane Fitch, and Begoña Jiménez-Reguera
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Psychological intervention, Health Informatics, Information technology, Disease, law.invention, chronic obstructive pulmonary disease, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Randomized controlled trial, Quality of life, law, Surveys and Questionnaires, Medicine, COPD, Humans, Pulmonary rehabilitation, 030212 general & internal medicine, adherence, mHealth, Aged, Original Paper, Internet, business.industry, T58.5-58.64, medicine.disease, pulmonary rehabilitation, Telemedicine, Integrated care, 030228 respiratory system, Physical therapy, Quality of Life, Female, Public aspects of medicine, RA1-1270, business
Abstract: Background Pulmonary rehabilitation is one of the main interventions to reduce the use of health resources, and it promotes a reduction in chronic obstructive pulmonary disease (COPD) costs. mHealth systems in COPD aim to improve adherence to maintenance programs after pulmonary rehabilitation by promoting the change in attitude and behavior necessary for patient involvement in the management of the disease. Objective This study aimed to assess the effects of an integrated care plan based on an mHealth web-based platform (HappyAir) on adherence to a 1-year maintenance program applied after pulmonary rehabilitation in COPD patients. Methods COPD patients from three hospitals were randomized to a control group or an intervention group (HappyAir group). Patients from both groups received an 8-week program of pulmonary rehabilitation and educational sessions about their illness. After completion of the process, only the HappyAir group completed an integrated care plan for 10 months, supervised by an mHealth system and therapeutic educator. The control group only underwent the scheduled check-ups. Adherence to the program was rated using a respiratory physiotherapy adherence self-report (CAP FISIO) questionnaire. Other variables analyzed were adherence to physical activity (Morisky-Green Test), quality of life (Chronic Obstructive Pulmonary Disease Assessment Test, St. George’s Respiratory Questionnaire, and EuroQOL-5D), exercise capacity (6-Minute Walk Test), and lung function. Results In total, 44 patients were recruited and randomized in the control group (n=24) and HappyAir group (n=20). Eight patients dropped out for various reasons. The CAP FISIO questionnaire results showed an improvement in adherence during follow-up period for the HappyAir group, which was statistically different compared with the control group at 12 months (56.1 [SD 4.0] vs 44.0 [SD 13.6]; P=.004) after pulmonary rehabilitation. Conclusions mHealth systems designed for COPD patients improve adherence to maintenance programs as long as they are accompanied by disease awareness and patient involvement in management. Trial Registration ClinicalTrials.gov NCT04479930; https://clinicaltrials.gov/ct2/show/NCT04479930
Published: 2020

28. Compliance and Utility of a Smartphone App for the Detection of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease: Cohort Study

Author: Juan Luis Rodríguez Hermosa, Carlos Antonio Amado Diago, Luis Puente Maestu, Francisco Javier Callejas González, Rosa Malo De Molina Ruiz, Myriam Calle Rubio, Manuel Fuentes Ferrer, Antonia Fuster Gomila, and Jose Luis Álvarez Sala-Walther
Subjects: Male, medicine.medical_specialty, Chronic condition, cumplimiento del paciente, Exacerbation, humanos, Health Informatics, Disease, Information technology, compliance, chronic obstructive pulmonary disease, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, estudios prospectivos, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, mHealth, Depression (differential diagnoses), COPD, Original Paper, mobile phone, business.industry, medicine.disease, T58.5-58.64, Comorbidity, Mobile Applications, 030228 respiratory system, Emergency medicine, Patient Compliance, Female, aplicaciones en aparatos electrónicos portátiles, Smartphone, Public aspects of medicine, RA1-1270, business, Cohort study
Abstract: Background: In recent years, mobile health (mHealth)-related apps have been developed to help manage chronic diseases. Apps may allow patients with a chronic disease characterized by exacerbations, such as chronic obstructive pulmonary disease (COPD), to track and even suspect disease exacerbations, thereby facilitating self-management and prompt intervention. Nevertheless, there is insufficient evidence regarding patient compliance in the daily use of mHealth apps for chronic disease monitoring. Objective: This study aimed to provide further evidence in support of prospectively recording daily symptoms as a useful strategy to detect COPD exacerbations through the smartphone app, Prevexair. It also aimed to analyze daily compliance and the frequency and characteristics of acute exacerbations of COPD recorded using Prevexair. Methods: This is a multicenter cohort study with prospective case recruitment including 116 patients with COPD who had a documented history of frequent exacerbations and were monitored over the course of 6 months. At recruitment, the Prevexair app was installed on their smartphones, and patients were instructed on how to use the app. The information recorded in the app included symptom changes, use of medication, and use of health care resources. The patients received messages on healthy lifestyle behaviors and a record of their cumulative symptoms in the app. There was no regular contact with the research team and no mentoring process. An exacerbation was considered reported if medical attention was sought and considered unreported if it was not reported to a health care professional. Results: Overall, compliance with daily records in the app was 66.6% (120/180), with a duration compliance of 78.8%, which was similar across disease severity, age, and comorbidity variables. However, patients who were active smokers, with greater dyspnea and a diagnosis of depression and obesity had lower compliance (P, The authors thank the investigators, Francisco Javier Agustin Martinez, Pulmonology Department, Complejo Hospitalario U de Albacete, and Walther Ivan Giron Matute, Pulmonology Department, Hospital U Gregorio Maranon Madrid, Spain, who participated in the Prevexair study. The authors also thank Astra Zeneca for its financial support to carry out the study. This study has been promoted and sponsored by the Spanish Society of Pneumology and Thoracic Surgery. The financers had no role in study design, data collection, analysis, and decision to publish or in the preparation of this manuscript. This does not alter our adherence to the policies of the Journal of Medical Internet Research on sharing data and materials.
Published: 2020

29. Atención médica según el nivel de riesgo y su adecuación a las recomendaciones de la guía española de la enfermedad pulmonar obstructiva crónica (EPOC) (GesEPOC): Estudio EPOCONSUL

Author: José Miguel Rodríguez González-Moro, Juan José Soler-Cataluña, Manuel Fuentes Ferrer, José Luis López-Campos, Bernardino Alcázar Navarrete, Juan Luis Rodríguez Hermosa, Joan B. Soriano, Marc Miravitlles, and Myriam Calle Rubio
Subjects: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, business.industry, Medicine, 030212 general & internal medicine, business, Humanities
Abstract: Resumen Introduccion EPOCONSUL es la primera auditoria nacional que analiza la atencion sanitaria de la EPOC en consultas de neumologia en Espana. El objetivo principal fue determinar, en un analisis retrospectivo, la distribucion de los niveles de riesgo de la EPOC segun GesEPOC 2017 y evaluar las actuaciones clinicas segun las nuevas recomendaciones. Material y metodos Es una auditoria clinica de diseno trasversal, con reclutamiento de casos consecutivos de EPOC durante un ano. Se evaluo el nivel de riesgo y el fenotipo clinico segun GesEPOC 2017 y su relacion con las intervenciones clinicas realizadas. Resultados El nivel de alto riesgo fue mas frecuente (79,8 versus 20,2%; p Conclusiones La mayoria de los pacientes atendidos en las consultas de neumologia fueron de alto riesgo y con fenotipo clinico no agudizador. La practica clinica realizada fue diferente segun el nivel de riesgo y mayoritariamente acorde con las recomendaciones de GesEPOC, aunque con importantes areas de mejora.
Published: 2018
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30. Benralizumab for the Prevention of COPD Exacerbations

Author: Criner, G. J., Celli, B. R., Brightling, C. E., Agusti, A., Papi, A., Singh, D., Sin, D. D., Vogelmeier, C. F., Sciurba, F. C., Bafadhel, M., Backer, V., Kato, M., Ramirez-Venegas, A., Wei, Y. -F., Bjermer, L., Shih, V. H., Jison, M., O'Quinn, S., Makulova, N., Newbold, P., Goldman, M., Martin, U. J., GALATHEA Study Investigators, TERRANOVA Study Investigators, Otto, Burghuber, Bernhard, Forstner, Gerhard, Köberl, Bernd, Lamprecht, Judith, Löffler-Ragg, Horst, Olschewski, Michael, Studnicka, Francois, Beaucage, Guy, Chouinard, Anthony, Dechant, Anthony, Dowell, Jacques, Hebert, Sohail, Khattak, Kieran, Killian, William, Killorn, Andy, Lam, Francois, Maltais, Darcy, Marciniuk, Lyle, Melenka, Bonavuth, Pek, Jeremy, Road, Donald, Sin, Alain, Vaugeois, Brandie, Walker, Tomas, Dvorak, Stanislav, Holub, Otakar, Hokynar, Vitezslav, Kolek, Daniela, Kopecka, Jan, Krepelka, Jaroslav, Mares, Josef, Veverka, Vladimir, Zindr, Sabine, Ballenberger, Rolf, Dichmann, Christian, Geßner, Margret, Jandl, Claus, Keller, Joachim, Kirschner, Marc, Kornmann, Petra, Mikloweit, Ingomar, Naudts, Axel, Overlack, Isabelle, Schenkenberger, Volker, Schlegel, Lutz Von Versen, Claus Franz Vogelmeier, Stefan, Zielen, István, Albert, Beatrix, Bálint, Mária Csilla Hangonyi, Teréz, Kecskés, Anikó, Kurucz, Balázs, Medgyasszay, Lajos, Molnár, János, Mucsi, Márta, Papp, Magdolna, Póczi, Éva, Radeczky, Zsolt Pápai Székely, Csilla, Szabó, Gyöngyi, Szabó, Melinda, Szabó, Alfredo Antonio Chetta, Giuseppe Di Maria, Giulio, Donazzan, Federica, Meloni, Elisabetta, Pace, Pierluigi, Paggiaro, Alberto, Papi, Ricciardolo, Fabio Luigi Massimo, Antonio, Spanevello, Fumiaki, Aoki, Ryosuke, Eda, Takeo, Endo, Yasushi, Fukushima, Kenichi, Gemba, Naoki, Hagimoto, Hiromasa, Harada, Yasuko, Harada, Norihiko, Hata, Osamu, Hataji, Nobuo, Hatakeyama, Takahiko, Horiguchi, Gen, Ideura, Motoyasu, Iikura, Azusa, Ikegami, Shirou, Imokawa, Yoshikazu, Inoue, Takeshi, Isobe, Ryoji, Ito, Susumu, Iwata, Tadashi, Kamei, Motokazu, Kato, Hideki, Katsura, Yuji, Kawarada, Norio, Kihara, Masaharu, Kinoshita, Takashi, Kinoshita, Tomoo, Kishaba, Hideo, Kita, Arihiro, Kiyosue, Shigeru, Komatsu, Kazuki, Konishi, Sekiya, Koyama, Makoto, Kudo, Kazuhiko, Machida, Hironi, Makita, Hiroto, Matsuse, Naoki, Miyazawa, Hiroyuki, Nakamura, Yuji, Nakatani, Kazuyuki, Nishimura, Takashi, Nishimura, Junichi, Ogawa, Hiroyuki, Ohbayashi, Tetsuro, Ohdaira, Tsukasa, Ohnishi, Kazuhiko, Oki, Masahiko, Saito, Kenji, Sakamoto, Osamu, Sakamoto, Hisakuni, Sekino, Noriharu, Shijubo, Masaharu, Shinkai, Hideo, Soto, Yoshitaka, Sugawara, Noriaki, Suko, Hisaho, Takahashi, Masamitsu, Takahashi, Tsuneyuki, Takahashi, Hiroshi, Tanaka, Hiroyuki, Taniguchi, Tadayuki, Terada, Takao, Tochigi, Kazuyo, Tohyama, Hirokazu, Tokuyasu, Keisuke, Tomii, Tomomasa, Tsuboi, Mitsuyoshi, Utsugi, Katsumaru, Yamamoto, Michiko, Yamamoto, Shuichi, Yano, Makoto, Yoshida, Frank, Custers, Richard, Dekhuijzen, Remco, Djamin, Jan Willem Van Dan Berg, Lowie, Vanfleteren, Pascal, Wielders, Bogusława, Cimoszko, Anna, Doboszyńska, Andrzej, Dyczek, Andrzej, Fal, Krystyna, Folcik, Łukasz, Goliński, Marek, Jutel, Andrzej, Kolczyński, Piotr, Kuna, Ewa, Łączyńska, Wojciech, Machowiak, Maciej, Marczak, Joanna, Markiewicz, Janusz, Milanowski, Grzegorz, Mincewicz, Maria, Nittner-Marszalska, Wojciech, Papiewski, Małgorzata, Pawlukiewicz, Witold, Pomiećko, Barbara, Rewerska, Cezary, Rybacki, Wojciech, Skucha, Ewa, Trębas-Pietraś, Ewa, Uhryn, Małgorzata, Żurowska-Gębala, Laurentia, Andrei, Traian, Mihaescu, Stefan, Mihaicuta, Eniko Vera Pall, Ioan, Petrui, Angelica, Savu, Claudia, Toma, Ana, Trailescu, Vladimir, Abrosimov, Nataliya, Astafyeva, Evgenyi, Bazdyrev, Nadezhda, Berdnikova, Laura, Bolieva, Ekaterina, Bukreeva, Valery, Chistyakov, Anna, Galustyan, Halida, Gantseva, Svetlana, Goncharova, Sergey, Grigoriev, Galina, Ignatova, Inna, Ilyashevich, Nadezhda, Izmozherova, Magomed, Kamalov, Yaroslava, Khovaeva, Natalia, Kuzubova, Lyudmila, Kvitkova, Liudmila, Lenskaya, Igor, Leshchenko, Olga, Magnitskaya, Boris, Molotilov, Artem, Molotkov, Svetlana, Myasoedova, Sergey, Nedogoda, Vladimir, Nosov, Marina, Osipenko, Andrey, Peskov, Veronika, Popova, Oksana, Ratushnay, Irina, Ryzhova, Olga, Shangina, Natalia, Shaporova, Evgeny, Shmelev, Lybov, Shpagina, Alexander, Shutkin, Yuri, Shvarts, Mikhail, Smirnov, Irina, Stitsenko, Maksim, Vasilev, Arkadiy, Vertkin, Elena, Vishneva, Alexander, Vizel, Anna, Zateyschikova, Mohamed, Abdool-Gaffar, Ismail, Abdullah, Axel, Bruning, Nyda, Fourie, Michael, Greenblatt, Mohammed, Tayob, Venter, K, An Soo Jang, Kwan Ho Lee, Sang Haak Lee, Sook Young Lee, Suk Joong Yong, Kwang Ha Yoo, Soo Taek Uh, Ramón Agüero Balbín, David Ramos Barbón, Álvar Agustí García-Navarro, José Luis Velasco Garrido, Sergi Pascual Guardia, Eduard Monso Molas, Luis De Teresa Parreño, Borja García-Cosio Piqueras, German Peces-Barba Romero, Myriam Calle Rubio, Fernando Sánchez-Toril López, Alicia Marín Tapia, Heidi Martin Braschler, Martin, Brutsche, Michael, Grob, Jörg, Leuppi, Daiana, Stolz, Alexander, Turk, Nawar, Bakerley, Mona, Bafadhel, Christopher, Brightling, Rekha, Chaudhuri, Gourab, Choudhury, Graham, Devereux, Imran, Hussain, Kai, Lee, William, Macnee, Ravindran, Mahadeva, Matthew, Masoli, Monica, Nordstrom, Manish, Patel, Allan, Reid, Dinesh, Saralaya, Tariq, Sethi, Sukh Dave Singh, Anthony, G de Soyza, Tom, Wilkinson, Alice, Turner, Helen, Ward, Chandar, Abboy, Ivan, Ackerman, Idalia, Acosta, Arun, Adlakha, Bassil, Aish, Mohamed, Ali, Charles, Andrews, Robby, Ayoub, Anil, Badhwar, Dennis, Bassetti, Sherif El Bayadi, Richard, Beasley, Shashi, Bellam, Jonathan, Bernstein, Maria, Blahey, Scott, Bloom, Eugene, Bleecker, Wesley, Bray, Johnathan, Brewer, Robert, Buynak, William, Calhoun, Edward, Campbell, Anthony, Captain, Birjis, Chinoy, Kenneth, Chinsky, Geoffrey, Chupp, Arsenio, Columbie, Clinton, Corder, Gerard, Criner, Humberto, Cruz, Edward, Cullen, Kevin, Deboer, Michael, Denenberg, Mark, Dransfield, Leonard, Dunn, Miles, Elmore, David, Erb, Faisal, Fakih, Gary, Ferguson, Charles, Fogarty, Mark, Freed, Stephen, Fritz, David, Fuentes, Shariar, Cohen-Gadol, Robert, Garver, John, Given, Luis Ramos Gonez, Raul Ebran Gonzalez, Robert, Gordon, Gregory, Gottschlich, Donald, Graham, David, Grant, Gary, Greenwald, James, Greenwald, Kenneth, Haft, Gregory, Hammond, Nadia, Hansel, Jeffrey, Harris, Humberto, Hernandez, Marvin, Heuer, Albrecht, Heyder, David, Hill, Willis, Holloway, Octavian, Ioachimescu, Richard, Jackson, Ajay, Jain, Nan, Jiang, Thomas, Kaelin, Adolfo, Kaplan, Mitchell, Kaye, Akram, Khan, Yekaterina, Khronusova, Ryan, Klein, Joel, Kline, Firas, Koura, Ritsu, Kuno, Ware, Kuschner, Jean Claude Labissiere, David Laman Jr, John, Lee, Mitchell, Lee, Lawrence, Levinson, Njira, Lugogo, Mador, M, Nathaniel, Marchetti, Rafael, Martinez, Richard, Martinez, Peter, Mattar, David, Maybee, Dennis, Mcgraw, Michael, Mcguire, Curtis, Mello, Aaron, Milstone, John, Mitchell, Wendy, Moore, Timothy, Moriarty, Cheta, Nand, Brooke, Nevins, Ikeadi, Ndukwu, Rachel, Nisbet, David, Nyanjom, Maria, Nualart, Thomas, O'Brien, Mikhail, Palatnik, Gnyandev, Patel, Amit, Patel, Guido, Perez, Christopher, Perry, Michael, Pfeffer, Krishna, Pudi, Marina, Raikhel, Murali, Ramaswamy, Joe, Ramsdell, Donato, Ricci, Gary, Richmond, Eugene, Ryan, Fadi, Saba, Boris, Sagalovich, C Andrew Schroeder, Timothy, Scialla, Frank, Sciurba, Amit, Shah, Nirav, Shah, Zeeshan, Shaikh, Akhtar, Siddiqui, Barry, Sigal, Thomas, Siler, Howard, Silverboard, William, Sims, Clyde, Southwell, Selwyn, Spangenthal, Peruvemba, Sriram, James, Stocks, Tony, Su, John, Suen, Robert, Sussman, Horia, Tatu, Antonio, Terrelonge, Alan, Thomas, Mario, Torres, Rodolfo, Trejo, Miguel, Trevino, Banks, Turner, Manuel, Villareal, Janine, Vintch, Neal, Warshoff, Jan, Westerman, Philip, Wexler, Thomas, Yunger, Amir, Zeki, Mariano Fernandez Acquier, Norma, Aramayo, German, Arce, Juan, Belloni, Víctor, Cambursano, Carlos De La Vega, Fernando Rodriguez Chariarse, Pedro, Elias, Marcelo, Fernández, Ana, Lopez, Andrea, Medina, María, Otaola, Maria Salazan Saez, Maria De Salvo, Fernando, Scherbovsky, Ana, Stok, Jorge, Taborda, Alberto, Tolcachier, Fernando, Verra, Carlos, Victorio, Rita Gisela Delgado Vizcarra, Philip, Bardin, Peter, Bremner, Martin, Phillips, John, Upham, Peter, Wark, Antoine, Bolly, Alain, Delobbe, Peter, Driesen, Eduard, Janssens, Wim, Janssens, Olivier, Michel, Bernard, Vandooren, Martti, Antila, Jussara, Fiterman, Carlos, Fritscher, Jorge, Hetzel, Jose, Jardim, Waldo De Mattos, Rafael, Martins, Maria Eunice De Oliveira, Andreia, Pez, Maria, Sales, Rafael, Stelmach, Priscila, Wolff, Svetla, Andreeva, Reneta, Antonova, Ana, Dancheva, Yuliya, Ivanova, Slavcho, Ivanov, Hristo, Metev, Iveta, Naydenova, Tatyana, Petkova, Galina, Petrova, Kostadinka, Sotirova, Mariyana, Stoyanova, Rumen, Tiholov, Iliyana, Valkanova, Oleg, Yakov, Rosa, Feijoo, Juana, Pavie, Patricia, Schönffeldt, Absalon, Silva, Victor, Martinez, David, Espinosa, Alejandro, Londono, Dora, Molina, Gonzalo, Prada, Andrés, Rico, Gregorio Sanchez Vallejo, Alvaro, Urbina, Ana, Vanegas, Maria, Villegas, Josip, Aralica, Gordana, Stjepanovic, Vibeke, Backer, Uffe, Bødtger, Christian, Meyer, Læge Sven Nielsen, Anders Loekke Ottesen, Ingrid, Titlestad, Nathalie, Bautin, Arnaud, Bourdin, Pascal, Chanez, Francis, Couturaud, Antoine, Cuvelier, Gilles, Devouassoux, Pierre-Olivier, Girodet, Jean-François, Muir, Jean-Louis, Pépin, Alain, Proust, Azzedine, Yaici, Yochai, Adir, Gershon, Fink, Zvi, Fridlender, Gabriel, Izbicki, Mordechai, Kramer, Yehuda, Schwartz, Juan Moreno Hoyos Abril, Ricardo Campos Cerda, Efraín Montaño Gonzalez, Ricardo Ramirez Terrones, Rodolfo Posadas Valay, Alejandra, Ramirez-Venegas, Paul, Dawkins, Syed, Hussain, Benedict, Brockway, John, Richmond, Colin, Helm, Catherina, Chang, Jørn, Ahlqvist, Terje, Tollåli, Tadeusz, Tomala, Socorro, Castro, William, Chavez, Octavio, Cubas, Rolando, Estrella, Efrain, Felix, Ronal, Gamarra, Alfredo, Guerreros, Alberto, Matsuno, Danilo, Salazar, Miguel, Tsukayama, Albert Albay Jr, Teresita, Aquino, Tito, Atienza, Joven Roque Gonong, Ronnie, Samoro, Joel, Santiaguel, Beata, Asankowicz-Bargiel, Ewa, Pisarczyk-Bogacka, Renata, Bijata-Bronisz, Marta, Chełmińska, Małgorzata, Dobryniewska, Anna, Olech-Cudzik, Tomasz, Fijołek, Krzysztof, Filipek, Agata, Kot, Bożena, Kucińska, Krzysztof, Lis, Elżbieta, Rybicka-Liszewska, Marzenna, Tarnowska-Matusiak, Robert, Mróz, Piotr, Napora, Wojciech, Naumnik, Artur, Niemiec, Władysław, Pierzchała, Grzegorz, Przybylski, Katarzyna, Styka, Danuta, Wrońska, Branislava, Milenkovic, Dobrivoje, Novkovic, Matijaz, Flezar, Niksa, Segota, Snezana Ulcar Kostic, Albert, Klobucar, Leif, Bjermer, Dan, Curiac, Christer, Janson, Pekka, Koskinen, Lundback, Bo, Åke, Olsson, Shih-Lung, Cheng, Ming-Lin, Ho, Jeng-Yuan, Hsu, Wu-Huei, Hsu, Ping-Hung, Kuo, Chin-Chou, Wang, Yu-Feng, Wei, Kuang-Yao, Yang, Watchara, Boonsawat, Somchai, Chantarothorn, Warangkana, Keeratichananont, Kittipong, Maneechotesuwan, Kanok, Pipatvech, Piamlarp, Sangsayunh, Sibel, Arinc, Sermin, Borekci, Arzu Kaner Erturk, Filiz, Kosar, Hakan, Gunen, Ismail, Hanta, Pinar Akin Kabalak, Tunc Alp Demir, Sibel, Nayci, Serir Aktogu Ozkan, Abdullah, Sayiner, Esra, Uzaslan, Viktor, Blazhko, Volodymyr, Gavrysyuk, Olena, Golub, Liudmyla, Iashyna, Tetiana, Ilashchuk, Volodymyr, Koshlia, Olena, Krakhmalova, Vitali, Kryvenko, Lesia, Kuryk, Olena, Levchenko, Yuriy, Mostovoy, Mykola, Ostrovskyy, Tetyana, Pertseva, Olena, Piura, Nadiya, Rudnytska, Ganna, Stupnytska, Nataliia, Velychko, Oleh, Yakovenko, Lilia Rodriguez Ables, Roger, Abrahams, Jose, Alvarez, Fernando, Arencibia, Chander, Arora, Samir, Arora, Francis, Averill, Kwabena, Ayesu, Stephen, Basheda, Steven, Bauer, Jose, Bautista, Matthew, Beacom, Hernando, Bernal, Subodh, Bhuchar, J'Cinda, Bitters, John, Burk, Elizabeth, Burkett, James, Cain, Robert, Call, Christopher, Chappel, Bartolome, Celli, Tom, Christensen, Jeremy, Cole, Jerome, Daniel, Nguyen, Dang, Enrique, Davis, Samuel, Deleon, Robert, Deluca, Ernesto, Diaz, Anthony, Dimarco, Calvin, Dixon, Ankur, Doshi, Hugh, Durrence, Alain, Eid, John, Elsen, Herbon, Fleming, May, Flores, Scott, Franczek, Gregory, Funk, Stuart, Garay, Bernard, Garcia, Joseph, Graif, Carl, Griffin, Yamirka Duardo Guerra, David, Headley, Mitzie, Hewitt, Susan, Hole, Robert, Holladay, Ira, Horowitz, Yu-Luen, Hsu, Jonathan, Ilowite, Stephen, Jones, Ravindra, Kashyap, Edward, Kerwin, Ahtaram, Khan, Nicole, Kimzey, James, Krainson, Flory, Kreutter, Kannappan, Krishnaswamy, Shahrukh, Kureishy, Albert, Lai, Alex, Lechin, Daria, Lee, Marcus, Lee, Williams, Leeds, Joseph, Lillo, Edward, Lisberg, Lawrence, Madoff, Narendra, Maheskwari, Mujibur, Majumder, Sashi, Makam, Douglas, Mapel, Matthew, Mardiney, Jennifer, Martin, Isaac, Melamed, Elvin, Mendez, Stuart, Millstone, Joseph, Montes, Lee, Morrow, Frank, Murphy, Dany, Obeid, France, Occy, Godson, Oguchi, Juan, Ortiz, Francisco, Padron, Ward, Paine, James, Pearle, Enrique, Pelayo, Vandely, Perez, David, Pham, Carlos, Piniella, Kevin, Pritchett, Padmashri, Rastogi, Stephen, Ryan, Syed, Rehman, Jackson, Rhudy, Eustace, Riley, James, Riser, Clifford, Risk, Emory, Robinette, Christopher, Roney, Gary, Ruoff, David, Russian, Mercedes, Samson, Jay, Sandberg, Jose, Santiago, William, Sargeant, Alan, Schecter, Jeffrey, Scott, Ilia, Segal, Sudhir, Sehgal, Frederic, Seifer, Sudhir, Sekhsaria, Richard, Sellman, Paul, Shapero, Jeffrey, Shea, Lawrence, Sher, John, Sibille, Jawed, Siddiqui, Toniya, Singh, Deren, Sinkowitz, Denise, Smyth, Daniel, Soteres, Daniel, Sousa, Ralph, Steele, Thomas, Stern, Jose, Suarez, Sever, Surdulescu, Ricardo, Tan, Tonny, Tanus, Raymond, Tidman, Aurelio, Torres-Consuegra, Barry, Troyan, John, Updegrove, Sanjay, Vadgama, Armando, Pineda-Velez, Eduardo, Viera, Andrew, Wachtel, Ralph, Wade, Jimin, Wang, Dave, Webster, Paul, Weinberg, Terry, Wells, Jeffrey, White, Bram, Wieskopf, Hugh, Windom, Patrick, Wright, David, Wyatt, Bassam, Yousef, Zahid, Zafar, Chau, Ngo, Huong, Le, Lan, Nguyen, Thanh, Nguyen, Nhung, Nguyen, SALAS, Danielle, Temple University [Philadelphia], Pennsylvania Commonwealth System of Higher Education (PCSHE), Harvard Medical School [Boston] (HMS), University of Leicester, University of Barcelona, Università degli Studi di Ferrara = University of Ferrara (UniFE), University of Manchester [Manchester], St. Paul’s Hospital - University of British Columbia [Vancouver, BC, Canada] (SPH-UBC), Philipps Universität Marburg = Philipps University of Marburg, University of Pittsburgh School of Medicine, University of Oxford, Bispebjerg University Hospital [Copenhagen, Denmark] (BUH), Kishiwada City Hospital [Osaka, Japan] (KCH), Instituto Nacional de Enfermedades Respiratorias [México, Mexico], I-Shou University [Kaohsiung, Taiwan] (ISU), Lund University [Lund], AstraZeneca [Gaithersburg, MD, USA] (AZ), Hypoxie et PhysioPathologie (HP2), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), and Otto Burghuber, Bernhard Forstner, Gerhard Köberl, Bernd Lamprecht, Judith Löffler-Ragg, Horst Olschewski, Michael Studnicka, Francois Beaucage, Guy Chouinard, Anthony Dechant, Anthony Dowell, Jacques Hebert, Sohail Khattak, Kieran Killian, William Killorn, Andy Lam, Francois Maltais, Darcy Marciniuk, Lyle Melenka, Bonavuth Pek, Jeremy Road, Donald Sin, Alain Vaugeois, Brandie Walker, Tomas Dvorak, Stanislav Holub, Otakar Hokynar, Vitezslav Kolek, Daniela Kopecka, Jan Krepelka, Jaroslav Mares, Josef Veverka, Vladimir Zindr, Sabine Ballenberger, Rolf Dichmann, Christian Geßner, Margret Jandl, Claus Keller, Joachim Kirschner, Marc Kornmann, Petra Mikloweit, Ingomar Naudts, Axel Overlack, Isabelle Schenkenberger, Volker Schlegel, Lutz Von Versen, Claus Franz Vogelmeier, Stefan Zielen, István Albert, Beatrix Bálint, Mária Csilla Hangonyi, Teréz Kecskés, Anikó Kurucz, Balázs Medgyasszay, Lajos Molnár, János Mucsi, Márta Papp, Magdolna Póczi, Éva Radeczky, Zsolt Pápai Székely, Csilla Szabó, Gyöngyi Szabó, Melinda Szabó, Alfredo Antonio Chetta, Giuseppe Di Maria, Giulio Donazzan, Federica Meloni, Elisabetta Pace, Pierluigi Paggiaro, Alberto Papi, Fabio Luigi, Massimo Ricciardolo, Antonio Spanevello, Fumiaki Aoki, Ryosuke Eda, Takeo Endo, Yasushi Fukushima, Kenichi Gemba, Naoki Hagimoto, Hiromasa Harada, Yasuko Harada, Norihiko Hata, Osamu Hataji, Nobuo Hatakeyama, Takahiko Horiguchi, Gen Ideura, Motoyasu Iikura, Azusa Ikegami, Shirou Imokawa, Yoshikazu Inoue, Takeshi Isobe, Ryoji Ito, Susumu Iwata, Tadashi Kamei, Motokazu Kato, Hideki Katsura, Yuji Kawarada, Norio Kihara, Masaharu Kinoshita, Takashi Kinoshita, Tomoo Kishaba, Hideo Kita, Arihiro Kiyosue, Shigeru Komatsu, Kazuki Konishi, Sekiya Koyama, Makoto Kudo, Kazuhiko Machida, Hironi Makita, Hiroto Matsuse, Naoki Miyazawa, Hiroyuki Nakamura, Yuji Nakatani, Kazuyuki Nishimura, Takashi Nishimura, Junichi Ogawa, Hiroyuki Ohbayashi, Tetsuro Ohdaira, Tsukasa Ohnishi, Kazuhiko Oki, Masahiko Saito, Kenji Sakamoto, Osamu Sakamoto, Hisakuni Sekino, Noriharu Shijubo, Masaharu Shinkai, Hideo Soto, Yoshitaka Sugawara, Noriaki Suko, Hisaho Takahashi, Masamitsu Takahashi, Tsuneyuki Takahashi, Hiroshi Tanaka, Hiroyuki Taniguchi, Tadayuki Terada, Takao Tochigi, Kazuyo Tohyama, Hirokazu Tokuyasu, Keisuke Tomii, Tomomasa Tsuboi, Mitsuyoshi Utsugi, Katsumaru Yamamoto, Michiko Yamamoto, Shuichi Yano, Makoto Yoshida, Frank Custers, Richard Dekhuijzen, Remco Djamin, Jan Willem Van Dan Berg, Lowie Vanfleteren, Pascal Wielders, Bogusława Cimoszko, Anna Doboszyńska, Andrzej Dyczek, Andrzej Fal, Krystyna Folcik, Łukasz Goliński, Marek Jutel, Andrzej Kolczyński, Piotr Kuna, Ewa Łączyńska, Wojciech Machowiak, Maciej Marczak, Joanna Markiewicz, Janusz Milanowski, Grzegorz Mincewicz, Maria Nittner-Marszalska, Wojciech Papiewski, Małgorzata Pawlukiewicz, Witold Pomiećko, Barbara Rewerska, Cezary Rybacki, Wojciech Skucha, Ewa Trębas-Pietraś, Ewa Uhryn, Małgorzata Żurowska-Gębala, Laurentia Andrei, Traian Mihaescu, Stefan Mihaicuta, Eniko Vera Pall, Ioan Petrui, Angelica Savu, Claudia Toma, Ana Trailescu, Vladimir Abrosimov, Nataliya Astafyeva, Evgenyi Bazdyrev, Nadezhda Berdnikova, Laura Bolieva, Ekaterina Bukreeva, Valery Chistyakov, Anna Galustyan, Halida Gantseva, Svetlana Goncharova, Sergey Grigoriev, Galina Ignatova, Inna Ilyashevich, Nadezhda Izmozherova, Magomed Kamalov, Yaroslava Khovaeva, Natalia Kuzubova, Lyudmila Kvitkova, Liudmila Lenskaya, Igor Leshchenko, Olga Magnitskaya, Boris Molotilov, Artem Molotkov, Svetlana Myasoedova, Sergey Nedogoda, Vladimir Nosov, Marina Osipenko, Andrey Peskov, Veronika Popova, Oksana Ratushnay, Irina Ryzhova, Olga Shangina, Natalia Shaporova, Evgeny Shmelev, Lybov Shpagina, Alexander Shutkin, Yuri Shvarts, Mikhail Smirnov, Irina Stitsenko, Maksim Vasilev, Arkadiy Vertkin, Elena Vishneva, Alexander Vizel, Anna Zateyschikova, Mohamed Abdool-Gaffar, Ismail Abdullah, Axel Bruning, Nyda Fourie, Michael Greenblatt, Mohammed Tayob, K Venter, An Soo Jang, Kwan Ho Lee, Sang Haak Lee, Sook Young Lee, Suk Joong Yong, Kwang Ha Yoo, Soo Taek Uh, Ramón Agüero Balbín, David Ramos Barbón, Álvar Agustí García-Navarro, José Luis Velasco Garrido, Sergi Pascual Guardia, Eduard Monso Molas, Luis De Teresa Parreño, Borja García-Cosio Piqueras, German Peces-Barba Romero, Myriam Calle Rubio, Fernando Sánchez-Toril López, Alicia Marín Tapia, Heidi Martin Braschler, Martin Brutsche, Michael Grob, Jörg Leuppi, Daiana Stolz, Alexander Turk, Nawar Bakerley, Mona Bafadhel, Christopher Brightling, Rekha Chaudhuri, Gourab Choudhury, Graham Devereux, Imran Hussain, Kai Lee, William MacNee, Ravindran Mahadeva, Matthew Masoli, Monica Nordstrom, Manish Patel, Allan Reid, Dinesh Saralaya, Tariq Sethi, Sukh Dave Singh, Anthony G de Soyza, Tom Wilkinson, Alice Turner, Helen Ward, Chandar Abboy, Ivan Ackerman, Idalia Acosta, Arun Adlakha, Bassil Aish, Mohamed Ali, Charles Andrews, Robby Ayoub, Anil Badhwar, Dennis Bassetti, Sherif El Bayadi, Richard Beasley, Shashi Bellam, Jonathan Bernstein, Maria Blahey, Scott Bloom, Eugene Bleecker, Wesley Bray, Johnathan Brewer, Robert Buynak, William Calhoun, Edward Campbell, Anthony Captain, Birjis Chinoy, Kenneth Chinsky, Geoffrey Chupp, Arsenio Columbie, Clinton Corder, Gerard Criner, Humberto Cruz, Edward Cullen, Kevin Deboer, Michael Denenberg, Mark Dransfield, Leonard Dunn, Miles Elmore, David Erb, Faisal Fakih, Gary Ferguson, Charles Fogarty, Mark Freed, Stephen Fritz, David Fuentes, Shariar Cohen-Gadol, Robert Garver, John Given, Luis Ramos Gonez, Raul Ebran Gonzalez, Robert Gordon, Gregory Gottschlich, Donald Graham, David Grant, Gary Greenwald, James Greenwald, Kenneth Haft, Gregory Hammond, Nadia Hansel, Jeffrey Harris, Humberto Hernandez, Marvin Heuer, Albrecht Heyder, David Hill, Willis Holloway, Octavian Ioachimescu, Richard Jackson, Ajay Jain, Nan Jiang, Thomas Kaelin, Adolfo Kaplan, Mitchell Kaye, Akram Khan, Yekaterina Khronusova, Ryan Klein, Joel Kline, Firas Koura, Ritsu Kuno, Ware Kuschner, Jean Claude Labissiere, David Laman Jr, John Lee, Mitchell Lee, Lawrence Levinson, Njira Lugogo, M Mador, Nathaniel Marchetti, Rafael Martinez, Richard Martinez, Peter Mattar, David Maybee, Dennis McGraw, Michael McGuire, Curtis Mello, Aaron Milstone, John Mitchell, Wendy Moore, Timothy Moriarty, Cheta Nand, Brooke Nevins, Ikeadi Ndukwu, Rachel Nisbet, David Nyanjom, Maria Nualart, Thomas O'Brien, Mikhail Palatnik, Gnyandev Patel, Amit Patel, Guido Perez, Christopher Perry, Michael Pfeffer, Krishna Pudi, Marina Raikhel, Murali Ramaswamy, Joe Ramsdell, Donato Ricci, Gary Richmond, Eugene Ryan, Fadi Saba, Boris Sagalovich, C Andrew Schroeder, Timothy Scialla, Frank Sciurba, Amit Shah, Nirav Shah, Zeeshan Shaikh, Akhtar Siddiqui, Barry Sigal, Thomas Siler, Howard Silverboard, William Sims, Clyde Southwell, Selwyn Spangenthal, Peruvemba Sriram, James Stocks, Tony Su, John Suen, Robert Sussman, Horia Tatu, Antonio Terrelonge, Alan Thomas, Mario Torres, Rodolfo Trejo, Miguel Trevino, Banks Turner, Manuel Villareal, Janine Vintch, Neal Warshoff, Jan Westerman, Philip Wexler, Thomas Yunger, Amir Zeki, Mariano Fernandez Acquier, Norma Aramayo, German Arce, Juan Belloni, Víctor Cambursano, Carlos De La Vega, Fernando Rodriguez Chariarse, Pedro Elias, Marcelo Fernández, Ana Lopez, Andrea Medina, María Otaola, Maria Salazan Saez, Maria De Salvo, Fernando Scherbovsky, Ana Stok, Jorge Taborda, Alberto Tolcachier, Fernando Verra, Carlos Victorio, Rita Gisela Delgado Vizcarra, Philip Bardin, Peter Bremner, Martin Phillips, John Upham, Peter Wark, Antoine Bolly, Alain Delobbe, Peter Driesen, Eduard Janssens, Wim Janssens, Olivier Michel, Bernard Vandooren, Martti Antila, Jussara Fiterman, Carlos Fritscher, Jorge Hetzel, Jose Jardim, Waldo De Mattos, Rafael Martins, Maria Eunice De Oliveira, Andreia Pez, Maria Sales, Rafael Stelmach, Priscila Wolff, Svetla Andreeva, Reneta Antonova, Ana Dancheva, Yuliya Ivanova, Slavcho Ivanov, Hristo Metev, Iveta Naydenova, Tatyana Petkova, Galina Petrova, Kostadinka Sotirova, Mariyana Stoyanova, Rumen Tiholov, Iliyana Valkanova, Oleg Yakov, Rosa Feijoo, Juana Pavie, Patricia Schönffeldt, Absalon Silva, Victor Martinez, David Espinosa, Alejandro Londono, Dora Molina, Gonzalo Prada, Andrés Rico, Gregorio Sanchez Vallejo, Alvaro Urbina, Ana Vanegas, Maria Villegas, Josip Aralica, Gordana Stjepanovic, Vibeke Backer, Uffe Bødtger, Christian Meyer, Læge Sven Nielsen, Anders Loekke Ottesen, Ingrid Titlestad, Nathalie Bautin, Arnaud Bourdin, Pascal Chanez, Francis Couturaud, Antoine Cuvelier, Gilles Devouassoux, Pierre-Olivier Girodet, Jean-François Muir, Jean-Louis Pépin, Alain Proust, Azzedine Yaici, Yochai Adir, Gershon Fink, Zvi Fridlender, Gabriel Izbicki, Mordechai Kramer, Yehuda Schwartz, Juan Moreno Hoyos Abril, Ricardo Campos Cerda, Efraín Montaño Gonzalez, Ricardo Ramirez Terrones, Rodolfo Posadas Valay, Alejandra Ramirez-Venegas, Paul Dawkins, Syed Hussain, Benedict Brockway, John Richmond, Colin Helm, Catherina Chang, Jørn Ahlqvist, Terje Tollåli, Tadeusz Tomala, Socorro Castro, William Chavez, Octavio Cubas, Rolando Estrella, Efrain Felix, Ronal Gamarra, Alfredo Guerreros, Alberto Matsuno, Danilo Salazar, Miguel Tsukayama, Albert Albay Jr, Teresita Aquino, Tito Atienza, Joven Roque Gonong, Ronnie Samoro, Joel Santiaguel, Beata Asankowicz-Bargiel, Ewa Pisarczyk-Bogacka, Renata Bijata-Bronisz, Marta Chełmińska, Małgorzata Dobryniewska, Anna Olech-Cudzik, Tomasz Fijołek, Krzysztof Filipek, Agata Kot, Bożena Kucińska, Krzysztof Lis, Elżbieta Rybicka-Liszewska, Marzenna Tarnowska-Matusiak, Robert Mróz, Piotr Napora, Wojciech Naumnik, Artur Niemiec, Władysław Pierzchała, Grzegorz Przybylski, Katarzyna Styka, Danuta Wrońska, Branislava Milenkovic, Dobrivoje Novkovic, Matijaz Flezar, Niksa Segota, Snezana Ulcar Kostic, Albert Klobucar, Leif Bjermer, Dan Curiac, Christer Janson, Pekka Koskinen, Bo Lundback, Åke Olsson, Shih-Lung Cheng, Ming-Lin Ho, Jeng-Yuan Hsu, Wu-Huei Hsu, Ping-Hung Kuo, Chin-Chou Wang, Yu-Feng Wei, Kuang-Yao Yang, Watchara Boonsawat, Somchai Chantarothorn, Warangkana Keeratichananont, Kittipong Maneechotesuwan, Kanok Pipatvech, Piamlarp Sangsayunh, Sibel Arinc, Sermin Borekci, Arzu Kaner Erturk, Filiz Kosar, Hakan Gunen, Ismail Hanta, Pinar Akin Kabalak, Tunc Alp Demir, Sibel Nayci, Serir Aktogu Ozkan, Abdullah Sayiner, Esra Uzaslan, Viktor Blazhko, Volodymyr Gavrysyuk, Olena Golub, Liudmyla Iashyna, Tetiana Ilashchuk, Volodymyr Koshlia, Olena Krakhmalova, Vitali Kryvenko, Lesia Kuryk, Olena Levchenko, Yuriy Mostovoy, Mykola Ostrovskyy, Tetyana Pertseva, Olena Piura, Nadiya Rudnytska, Ganna Stupnytska, Nataliia Velychko, Oleh Yakovenko, Lilia Rodriguez Ables, Roger Abrahams, Bassil Aish, Jose Alvarez, Fernando Arencibia, Chander Arora, Samir Arora, Francis Averill, Kwabena Ayesu, Stephen Basheda, Steven Bauer, Jose Bautista, Matthew Beacom, Richard Beasley, Hernando Bernal, Subodh Bhuchar, J'Cinda Bitters, John Burk, Elizabeth Burkett, James Cain, Robert Call, Christopher Chappel, Bartolome Celli, Tom Christensen, Jeremy Cole, Jerome Daniel, Nguyen Dang, Enrique Davis, Samuel Deleon, Robert DeLuca, Ernesto Diaz, Anthony DiMarco, Calvin Dixon, Ankur Doshi, Hugh Durrence, Alain Eid, John Elsen, Herbon Fleming, May Flores, Charles Fogarty, Scott Franczek, Stephen Fritz, Gregory Funk, Stuart Garay, Bernard Garcia, Luis Ramos Gonez, Gregory Gottschlich, Joseph Graif, Carl Griffin, Yamirka Duardo Guerra, David Headley, Mitzie Hewitt, Susan Hole, Robert Holladay, Ira Horowitz, Yu-Luen Hsu, Jonathan Ilowite, Stephen Jones, Ravindra Kashyap, Edward Kerwin, Ahtaram Khan, Nicole Kimzey, James Krainson, Flory Kreutter, Kannappan Krishnaswamy, Shahrukh Kureishy, Albert Lai, Alex Lechin, Daria Lee, Marcus Lee, Williams Leeds, Joseph Lillo, Edward Lisberg, Lawrence Madoff, Narendra Maheskwari, Mujibur Majumder, Sashi Makam, Douglas Mapel, Matthew Mardiney, Jennifer Martin, David Maybee, Isaac Melamed, Elvin Mendez, Stuart Millstone, Joseph Montes, Lee Morrow, Frank Murphy, Dany Obeid, France Occy, Godson Oguchi, Juan Ortiz, Francisco Padron, Ward Paine, James Pearle, Enrique Pelayo, Vandely Perez, David Pham, Carlos Piniella, Kevin Pritchett, Padmashri Rastogi, Stephen Ryan, Syed Rehman, Jackson Rhudy, Eustace Riley, James Riser, Clifford Risk, Emory Robinette, Christopher Roney, Gary Ruoff, David Russian, Mercedes Samson, Jay Sandberg, Jose Santiago, William Sargeant, Alan Schecter, Frank Sciurba, Jeffrey Scott, Ilia Segal, Sudhir Sehgal, Frederic Seifer, Sudhir Sekhsaria, Richard Sellman, Paul Shapero, Jeffrey Shea, Lawrence Sher, John Sibille, Jawed Siddiqui, William Sims, Toniya Singh, Deren Sinkowitz, Denise Smyth, Daniel Soteres, Daniel Sousa, Ralph Steele, Thomas Stern, Jose Suarez, Sever Surdulescu, Ricardo Tan, Tonny Tanus, Raymond Tidman, Aurelio Torres-Consuegra, Barry Troyan, John Updegrove, Sanjay Vadgama, Armando Pineda-Velez, Eduardo Viera, Andrew Wachtel, Ralph Wade, Jimin Wang, Dave Webster, Paul Weinberg, Terry Wells, Jeffrey White, Bram Wieskopf, Hugh Windom, Patrick Wright, David Wyatt, Bassam Yousef, Zahid Zafar, Chau Ngo, Huong Le, Lan Nguyen, Thanh Nguyen, Nhung Nguyen
Subjects: Male, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Anti-asthmatic Agent, law.invention, Pulmonary Disease, Chronic Obstructive, Leukocyte Count, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, law, Monoclonal, Receptors, Medicine, Anti-Asthmatic Agents, 030212 general & internal medicine, Humanized, COPD Exacerbations, benralizumab, clinical trials, COPD, Subcutaneous, General Medicine, Middle Aged, anti–IL-5Rα, Benralizumab, Pulmonary Disease, Chronic Obstructive/drug therapy, [SDV] Life Sciences [q-bio], Female, Antibodies, Monoclonal, Humanized/administration & dosage, Chronic Obstructive, Benralizumab COPD exacerbations, Injections, Subcutaneous, Socio-culturale, Aged, Antibodies, Monoclonal, Humanized, Double-Blind Method, Eosinophils, Humans, Patient Acuity, Receptors, Interleukin-5, Antibodies, chronic obstructive pulmonary disease, Injections, Pulmonary Disease, 03 medical and health sciences, Phase III, Anti-Asthmatic Agents/administration & dosage, In patient, business.industry, Eosinophils/metabolism, medicine.disease, Clinical trial, Receptors, Interleukin-5/antagonists & inhibitors, chemistry, Multicenter study, randomized controlled trial, Immunology, Interleukin-5, business
Abstract: BACKGROUND: The efficacy and safety of benralizumab, an interleukin-5 receptor alpha-directed cytolytic monoclonal antibody, for the prevention of exacerbations in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) are not known.METHODS: In the GALATHEA and TERRANOVA trials, we enrolled patients with COPD (at a ratio of approximately 2:1 on the basis of eosinophil count [≥220 per cubic millimeter vs. RESULTS: In GALATHEA, the estimates of the annualized exacerbation rate were 1.19 per year (95% confidence interval [CI], 1.04 to 1.36) in the 30-mg benralizumab group, 1.03 per year (95% CI, 0.90 to 1.19) in the 100-mg benralizumab group, and 1.24 per year (95% CI, 1.08 to 1.42) in the placebo group; the rate ratio as compared with placebo was 0.96 for 30 mg of benralizumab (P = 0.65) and 0.83 for 100 mg of benralizumab (P = 0.05). In TERRANOVA, the estimates of the annualized exacerbation rate for 10 mg, 30 mg, and 100 mg of benralizumab and for placebo were 0.99 per year (95% CI, 0.87 to 1.13), 1.21 per year (95% CI, 1.08 to 1.37), 1.09 per year (95% CI, 0.96 to 1.23), and 1.17 per year (95% CI, 1.04 to 1.32), respectively; the corresponding rate ratios were 0.85 (P = 0.06), 1.04 (P = 0.66), and 0.93 (P = 0.40). At 56 weeks, none of the annualized COPD exacerbation rate ratios for any dose of benralizumab as compared with placebo reached significance in either trial. Types and frequencies of adverse events were similar with benralizumab and placebo.CONCLUSIONS: Add-on benralizumab was not associated with a lower annualized rate of COPD exacerbations than placebo among patients with moderate to very severe COPD, a history of frequent moderate or severe exacerbations, and blood eosinophil counts of 220 per cubic millimeter or greater (Funded by AstraZeneca [GALATHEA and TERRANOVA] and Kyowa Hakko Kirin [GALATHEA]; GALATHEA and TERRANOVA ClinicalTrials.gov numbers, NCT02138916 and NCT02155660.).
Published: 2019
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31. Identification and distribution of COPD phenotypes in clinical practice according to Spanish COPD Guidelines: the FENEPOC study

Author: Marc Miravitlles, Myriam Calle Rubio, and Ricard Casamor
Subjects: Male, Vital capacity, Chronic bronchitis, diagnosis, Vital Capacity, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Forced Expiratory Volume, Surveys and Questionnaires, Epidemiology, Prevalence, Pulmonary Medicine, 030212 general & internal medicine, Lung, Original Research, COPD, Overlap syndrome, General Medicine, Syndrome, Middle Aged, Clinical Practice, Bronchitis, Chronic, Pulmonology, emphysema, Pulmonary Emphysema, Practice Guidelines as Topic, Disease Progression, chronic bronchitis, Female, Guideline Adherence, medicine.medical_specialty, phenotype, International Journal of Chronic Obstructive Pulmonary Disease, chronic obstructive pulmonary disease, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Humans, Aged, ACO, business.industry, medicine.disease, Asthma, respiratory tract diseases, Cross-Sectional Studies, 030228 respiratory system, Spain, Physical therapy, business, Body mass index
Abstract: Myriam Calle Rubio,1,2 Ricard Casamor,3 Marc Miravitlles4 On behalf of the FENEPOC study group1Pulmonary Department, Hospital Clínico San Carlos, 2Department of Medicine, Faculty of Medicine, University Complutense of Madrid, Research Institute of Hospital Clínico San Carlos (IdISSC), Madrid, 3Medical Department, Novartis Farmaceutica, Barcelona, 4Pneumology Department, University Hospital Vall d’Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, SpainBackground: The Spanish Guidelines for COPD (GesEPOC) describe four clinical phenotypes: non-exacerbator (NE), asthma-COPD overlap syndrome (ACO), frequent exacerbator with emphysema (EE), and exacerbator with chronic bronchitis (ECB). The objective of this study was to determine the frequency of COPD phenotypes, their clinical characteristics, and the availability of diagnostic tools to classify COPD phenotypes in clinical practice.Materials and methods: This study was an epidemiological, cross-sectional, and multicentered study. Patients ≥40 years old with a post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity ratio of 80% of the diagnostic tools needed to classify COPD phenotypes were available, with the exception of computed tomography (26.9%) and carbon monoxide transfer test (13.5%) in PC, and sputum eosinophilia count in PC and pulmonology centers (40.4% and 49.4%, respectively).Conclusion: In Spanish clinical practice, almost half of the patients with COPD presented with NE phenotype. The prevalence of ACO according to the Spanish consensus definition was very low. In general, physicians indicated that they had the necessary tools for diagnosing COPD phenotypes.Keywords: chronic obstructive pulmonary disease, phenotype, diagnosis, emphysema, chronic bronchitis, ACO
Published: 2017

32. Clinical control of COPD according to outpatient respiratory clinics: general versus specialized COPD

Author: Andrea Albuja, Guillermo Rubio De La Garza, Elena Forcen Vicente De Vera, Gianna Vargas Centanaro, Ana Palomar Santamaria, Fernando Pelaez Castro, Juan Luis Rodríguez Hermosa, Soha Smaili, and Myriam Calle Rubio
Subjects: medicine.medical_specialty, COPD, business.industry, Disease, Audit, medicine.disease, Medical care, Pharmacological treatment, Pulmonology, Internal medicine, Emergency medicine, medicine, In patient, National audit, business
Abstract: Introduction: COPD is a heterogeneous disease characterized by a variable clinical evolution. The concept of clinical control of COPD is proposed as an assistant tool for therapeutic decision making in the adjustment of pharmacological treatment. M&M: The EPOCONSUL study is the first national audit to analyze medical care for COPD in pulmonology departments in Spain. The present work uses the EPOCONSUL database with the aim of analyzing the level of control and treatments dispensed according to the consultation model (specialized in COPD versus general) . 2378 audited patients from 28 hospital centers were evaluated, where both models of consultations were available. Results: Patients attended in a specialized consultation had a higher level of clinical control of COPD, with significant differences in patients with a level of mild or moderate severity (70.5% versus 56.1%, p Conclusions: the patients attended in the specialized consultation had a higher level of clinical control of COPD and greater treatment modifications. which may reflect a more proactive attention in these specialized consultations Thanks to EPOCONSUL and Boehringer Ingelheim
Published: 2019
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33. The use of Prevexair application in patients with COPD

Author: Rosa Malo De Molina Ruiz, Luis Puente Maestu, Soha Esmaili, Antonia Fuster Gomila, Alfonso Montero Pacios, Carlos Antonio Amado Diago, Francisco Javier Callejas González, Myriam Calle Rubio, and Juan Luis Rodríguez Hermosa
Subjects: medicine.medical_specialty, COPD, business.industry, Internal medicine, medicine, In patient, medicine.disease, business
Published: 2019
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34. Clinical characteristics of COPD and resources in general and specialized COPD outpatient respiratory clinics

Author: Soha Smaili, Gianna Vargas Centanaro, Elena Forcen Vicente De Vera, Myriam Calle Rubio, Domingo Sesma Gonzalez, Juan Luis Rodríguez Hermosa, and M. Jose Bernabe Barrios
Subjects: medicine.medical_specialty, COPD, business.industry, medicine, Respiratory system, Intensive care medicine, business, medicine.disease
Published: 2019
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35. Assessing the clinical practice in specialized outpatient clinics for chronic obstructive pulmonary disease: Analysis of the EPOCONSUL clinical audit

Author: Manuel Fuentes Ferrer, José Miguel Rodríguez González-Moro, Bernardino Alcázar Navarrete, Juan José Soler-Cataluña, José Luis López-Campos, Juan Luis Rodríguez Hermosa, Myriam Calle Rubio, Joan B. Soriano, and Sociedad Española de Neumología y Cirugía Torácica
Subjects: Clinical audit, Male, Pulmonology, Cross-sectional study, Ambulatory Care Facilities, Geographical locations, Diagnostic Radiology, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Health care, Outpatients, Medicine and Health Sciences, Medicine, Outpatient clinic, 030212 general & internal medicine, Practice Patterns, Physicians', Tomography, COPD, Multidisciplinary, Radiology and Imaging, Middle Aged, Europe, Female, Guideline Adherence, Research Article, medicine.medical_specialty, Patients, Imaging Techniques, Chronic Obstructive Pulmonary Disease, Science, Neuroimaging, Research and Analysis Methods, 03 medical and health sciences, Diagnostic Medicine, Internal medicine, Humans, European Union, Outpatient Clinics, Aged, Quality of Health Care, Treatment Guidelines, Health Care Policy, Clinical Audit, business.industry, Biology and Life Sciences, medicine.disease, Computed Axial Tomography, respiratory tract diseases, Health Care, Dyspnea, Cross-Sectional Studies, 030228 respiratory system, Health Care Facilities, Spain, Emergency medicine, Good clinical practice, Observational study, People and places, business, Neuroscience
Abstract: [Background] Chronic obstructive pulmonary disease (COPD) is one of the main reasons for healthcare appointments and use of healthcare resources. In recent years, clinics specializing in COPD have been developed to offer improved care and optimization of recourses for patients with high complexity and frequent decompensations. However, little is known about the clinical practice in this clinical model specializing in COPD. The objectives of this study were to assess the prevalence, characteristics of specialized COPD outpatient respiratory clinics and to evaluate clinical practice in this healthcare model., [Methods] EPOCONSUL is a Spanish nationwide, observational, cross-sectional, clinical audit with prospective case recruitment including the clinical records for 4508 COPD cases from outpatient respiratory clinics over a 12-month period (May 2014–May 2015). The study evaluated clinical practice in 2378 cases from 28 hospitals with both general and specialized COPD outpatient respiratory clinics., [Results] Only 28 (47.5%) centers had an outpatient clinic specializing in COPD, which was characterized by longer patient visits and a higher prevalence of written protocols compared to a general clinic. Patients treated in a specialized clinic had greater obstruction severity, a higher degree of dyspnea and also suffered from more comorbidities. The majority of patients at both types of clinic were classified as high risk (81.1% versus 83%, p = 0.384) according to GesEPOC criteria. Clinical control of COPD was more frequent at specialized clinics, with significant differences in non-severe patients (70.5% versus 56.1%, p < 0.001). Testing was done more frequently in specialized clinics, with better adherence to good clinical practice recommendations., [Conclusion] A specialized COPD outpatient clinic is a healthcare model found in few pulmonology departments that treats more severe patients and those with increased comorbidities. The COPD patients treated in a specialized clinic had a better clinical control, as defined by impact and clinical stability. It is a healthcare model to offer improved care with a higher degree of adherence to guidelines., This study has been promoted and sponsored by the SEPAR.
Published: 2019

36. Long-term safety and efficacy of benralizumab in patients with severe, uncontrolled asthma: 1-year results from the BORA phase 3 extension trial

Author: William W Busse, Eugene R Bleecker, J Mark FitzGerald, Gary T Ferguson, Peter Barker, Stephanie Sproule, Richard F Olsson, Ubaldo J Martin, Mitchell Goldman, Anahí Yañez, Marcelo Fernández, Alberto Tolcachier, Juan Belloni, Jorge Taborda, Maria De Salvo, Jorge Maspero, Carlos Victorio, Miguel Chirino Navarta, Monica Grilli, Pablo Rodríguez, María Otaola, Víctor Cambursano, Patricia Malamud, Ana Stok, German Arce, Osiris Roza, Fernando Scherbovsky, Pedro Elias, Maria Salazan Saez, Matthew Peters, Martin Phillips, John Upham, Peter Gibson, Francis Thien, Jo Douglass, Paul Thomas, Philip Bardin, Dimitar Sajkov, Mark Hew, David Langton, Andreia Pez, Carlos Fritscher, Jorge Hetzel, Waldo Mattos, Rafael Stelmach, Martti Antila, Ana Luisa Fernandes, Hristo Metev, Yavor Ivanov, Aneliya Bogdanova, Ana Dancheva Markova, Marinka Peneva, Rumyana Veselinova, Tatyana Petkova, Vanushka Petrova, Elena Shopova, Yuliya Ivanova, Rumyana Yotsova, Ginka Kirkova, Galina Petrova, Svetoslav Dachev, Kostadinka Sotirova, Mariyana Stoyanova, Oleg Yakov, Vanya Ilieva-Fartunova, Catherine Lemiere, Michel Laviolette, William Yang, Bonavuth Pek, William Patrick Killorn, Claude Poirier, Guy Chouinard, Lyle Melenka, Richard Leigh, Parameswaran Nair, Delbert Dorscheid, James Martin, Juana Pavie, Andres Rosenblut, Claudia Cartagena, Carlos Quilodran, Silvia Muñoz, Ivana Malkusova, Josef Veverka, Stanislav Holub, Jaroslav Mares, Radovan Kozel, Daniela Kopecka, Vladimir Zindr, Pavel Cerva, Pascal Chanez, Arnaud Bourdin, Gilles Devouassoux, Camille Taille, Frédéric De Blay, Francois Goupil, Christophe Leroyer, Delphine Gourcerol, Toufik Didi, Alain Didier, Gilles Garcia, Philippe Bonniaud, Riazate Rossanaly Vasram, Marek Lommatzsch, Ulf Harnest, Anneliese Linnhoff, Claus Keller, Gerhard Hoheisel, Karin Förster, Thomas Schultz, Isabelle Schenkenberger, Joachim Kirschner, Tibor Schmoller, Stefan Zielen, Marc Kornmann, Ekkehard Beck, Lutz Volgmann, Rolf Dichmann, Axel Overlack, Jörg Winkler, Petra Mikloweit, Sabine Ballenberger, Mathias Rolke, Stephanie Korn, Helmut Pabel, Martin Hoffmann, Jan Feimer, Klaus Rabe, Regina Deckelmann, Tobias Welte, Hiroyuki Ohbayashi, Soichiro Hozawa, Terufumi Shimoda, Makoto Yoshida, Toshikazu Nagakura, Tadashi Kamei, Yasuyuki Sano, Shinichiro Kagami, Hisaho Takahashi, Michiko Haida, Goro Kimura, Hiroyuki Nakamura, Yasuo To, Masaharu Shinkai, Tadasuke Shimokawaji, Makoto Kudo, Noriharu Shijyubo, Takao Tochigi, Motokazu Kato, Akihiko Tanaka, Yasuhiro Gon, Norihisa Sasaki, Tetsuro Ohdaira, Chiharu Omori, Toshiki Takahashi, Satomi Takeuchi, Kiyotaka Nakajima, Hironi Makita, Masahiro Kaneko, Kenjiro Furuta, Masami Taniguchi, Yoshito Inobe, Hiroshi Miki, Yoichi Nakamura, Naoki Miyazawa, Shuichi Yano, Masayuki Iijima, Tsuyoshi Yamato, Javier Diaz, Alberto Matsuno, Efrain Felix, Alfredo Guerreros, Alejandro Daly, Fernando Rodriguez Chariarse, Danilo Salazar, Socorro Castro, William Chavez, Rolando Estrella, Teresita Aquino, Tito Atienza, Ronnie Samoro, Marie Grace Dawn Isidro, Piotr Kuna, Adam Antczak, Michał Bednarek, Danuta Mądra-Rogacka, Teresa Hofman, Marek Jutel, Ewa Pisarczyk-Bogacka, Agata Kot, Robert Mróz, Małgorzata Czupryńska-Borkowska, Małgorzata Żurowska-Gębala, Andrzej Dyczek, Grażyna Jasieniak-Pinis, Piotr Wojnowski, Ewa Trębas-Pietraś, Małgorzata Dobryniewska, Marcin Stobiecki, Marzenna Tarnowska-Matusiak, Alina Magner, Andrzej Kolczyński, Tomasz Kachel, Zbigniew Bartuzi, Bernadetta Majorek-Olechowska, Paweł Śliwiński, Violetta Balicka, Elżbieta Hajoł, Jacek Stachera, Marta Rachel, Marek Michnar, Jarosław Tałałaj, Ewa Springer, Piotr Napora, Tomasz Grzelewski, Renata Bijata-Bronisz, Anna Świderska, Grzegorz Mincewicz, Zbigniew Sankowski, Tomasz Fijołek, Artur Kwaśniewski, Joanna Jerzyńska, Jerzy Cygler, Ryszard Olesiejuk, Iwona Von Steiner, Wojciech Machowiak, Krzysztof Filipek, Piotr Piskorz, Ewa Uhryn, Marita Nittner-Marszalska, Elżbieta Rybicka-Liszewska, Anna Bodzenta-Łukaszyk, Marta Chełmińska, Izabella Krupa-Borek, Wojciech Skucha, Anna Płoszczuk, Traian Mihaescu, Ioan Dorin Petrui, Angelica Savu, Ghiulten Apti, Claudia Toma, Ana Trailescu, Sergei Sokurenko, Vasiliy Trofimov, Igor Leshchenko, Natalia Shaporova, Inna Ilyashevich, Irina Stitsenko, Alexander Vizel, Yulia Ilkovich, Dmitrii Tikhanov, Svetlana Goncharova, Andrey Ezhov, Galina Ignatova, Nadezhda Izmozherova, Nadezhda Berdnikova, Ludmila Goryachkina, Veronika Popova, Laura Bolieva, Andrey Rebrov, Vladimir Nosov, Olga Magnitskaya, Sergey Nedogoda, Vladimir Abrosimov, Artem Molotkov, Galina Reshedko, Mikhail Smirnov, Marina Osipenko, Elena Pavlysh, Svetlana Myasoedova, Liudmila Lenskaya, Valery Chistyakov, Elena Vishneva, Liliya Uon, Anna Zateyschikova, Svetlana Laleko, Tatiana Pak, Axel Bruning, Visvakuren Naidoo, Jeevren Reddy, Richard Van Zyl Smit, Hae-Sim Park, Young Joo Cho, Sang-Heon Cho, Sang Haak Lee, Byung Jae Lee, Ju Sang Kim, You Sook Cho, Choon-Sik Park, Mi-Kyeong Kim, Young-Il Koh, Joo-Hee Kim, Sook Young Lee, Sang Pyo Lee, Jung Won Park, Kwang Ha Yoo, Hyoungkyu Yoon, Jaechun Lee, Gyu-Young Hur, Soo Keol Lee, HeeKyoo Kim, David Ramos Barbón, Elena Laffond Yges, Eva Martínez Moragón, Miguel Arias Guillen, Alberto Saura Vinuesa, Fernando Sánchez-Toril López, José Luis Velasco Garrido, Borja García-Cosio Piqueras, Luis Pérez de Llano, Antonio Luis Valero Santiago, Myriam Calle Rubio, Leif Bjermer, Bo Lundbäck, Bilun Gemicioglu, Sevim Bavbek, Dane Ediger, Munevver Erdinc, Ismail Hanta, Sibel Nayci, Sibel Arinc, Liudmyla Iashyna, Yuriy Mostovoy, Mykola Ostrovskyy, Lesia Kuryk, Ivan Lemko, Tetyana Ospanova, Liubov Moskalenko, Oleksii Korzh, Viktor Blazhko, Olena Krakhmalova, Liliia Romaniuk, Yevgeniya Dytyatkovs'ka, Oleh Yakovenko, Volodymyr Gavrysyuk, Hassan Burhan, Dinesh Saralaya, Stephen Scott, Alyn Morice, Ewart Jackson-Voyzey, Thida Win, Shuab Nasser, Richard Harrison, Rekha Chaudhuri, Monica Nordstrom, Pradip De, Matthew Masoli, Adel Mansur, Anthony Gunstone, Robert Niven, Timothy Harrison, Suresh Babu, Subodh Bhuchar, Shahrukh Kureishy, John Zwetchkenbaum, Lawrence Kaplan, Eugene Bleecker, Santiago Reyes, Faisal Fakih, Marvin Heuer, Ryan Klein, Michael Marcus, Iftikhar Hussain, Tonny Tanus, Hengameh Raissy, Sady Alpizar, Hector Rodriguez, Gerald Gleich, Tracy Bridges, Joe Pouzar, Gary Steven, Jonathan Matz, Shana Krstevska, Dama Ziworitin, Adolfo Kaplan, James Sublett, James DeAngelo, Amy Darter, John Agaiby, John Hagan, Enrique Davis, Dareen Siri, Charlene Mcevoy, Chrisette Dharma, Najmuddin Karimjee, Steven Kelsen, Manuel Frade, Amy Silverthorn, Joel Kline, Francis Averill, Jose Ruiz, Emory Robinette, Zeeshan Shaikh, Carlos Aguilar, William Nish, German Alvarez, Younus Ismail, Purvi Parikh, Mila Leong, Dennis Murphy, Francisco Garcia, Alan Goldsobel, Antonio Blanco, Edward Campbell, Guido Perez, Geoffrey Chupp, Toby Bates, Vandely Perez, Sally Wenzel, Kartik Shenoy, Rohit Katial, David Bernstein, Neil Parikh, William Sims, Gary Ferguson, David Pham, Anu George, Richard Beasley, Gilberto Perez, Robert Garver, Miriam Garcia-Portela, Stephen Wong, Weily Soong, Richard Guillot, Golda Hudes, Ahmed Arif, Josefa Binker, Manuel Villareal, Ulrike Ziegner, Joseph Ojile, Sanjeev Goswami, Carlos Piniella, Ilia Segal, Heidi Zafra, Mitchell Lee, Martha Tarpay, John Panuto, Rajan Merchant, Peter Springsteen, Timothy Scialla, Paul Shapero, Karen Allen, Mark Moss, Humberto Cruz, Jeffrey Rumbyrt, Amy Boyd, Robert Nathan, Jonathan Bernstein, Joshua Jacobs, Elliot Ginchansky, Janice Johnston, Barbara Baxter, Thomas Johnson II, Stephen Apaliski, Clinton Corder, David Fuentes, Joseph Diaz, Chau Ngo, Lan Le, Department of Medicine, University of Wisconsin-Madison-School of Medicine and Public Health, Fundación Cidea Allergy and Respiratory Research Unit, University of Oxford [Oxford], University of Newcastle, Newcastle, NSW Australia., Defence Science and Technology Laboratory (Dstl), Ministry of Defence (UK) (MOD), Organização Multinacional de Formação, Agence Universitaire de la Francophonie (AUF), University of Calgary, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), laboratoire du sommeil, CHU Grenoble, Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, Centre Hospitalier du Mans, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Service de pneumologie, Centre hospitalier de la région d'Annecy, Cytokines, chimiokines et immunopathologie, Université Paris-Sud - Paris 11 (UP11)-IFR13-Institut National de la Santé et de la Recherche Médicale (INSERM), J.W. Goethe Universität, Institut für Geowissenschaften, Altenhöferallee 1, D-60438 Frankfurt am Main, Germany, Department of Pulmonary Medicine, Leiden University Medical Center (LUMC), Hannover Medical School [Hannover] (MHH), Japan Energy Corporation, Medical University of Łódź (MUL), Wroclaw Medical University, Saint-Petersburg State University, Physical Department, Petrodvoretz, 194508 St.-Petersburg, Russia, Physical Department (PD), St Petersburg State University (SPbU)-St Petersburg State University (SPbU), Ankara University, Oak Ridge National Laboratory [Oak Ridge] (ORNL), UT-Battelle, LLC, Department of Earth Sciences, University of Cambridge, University of Cambridge [UK] (CAM), Center for Genomics and Personalized Medicine, Wake Forest University, Mayo Clinic [Rochester], Department of Wildlife Management, Pir Mehr Ali Shah Arid Agriculture University, Lab Biotecnol Bacteriana, Inst Ciencia & Tecnol Alimentos & Nutr ICTAN, Universidade da Coruña, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Centre recherche en CardioVasculaire et Nutrition (C2VN), Université de Brest (UBO), University of Oxford, University of Newcastle [Callaghan, Australia] (UoN), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Universiteit Leiden-Universiteit Leiden, Wrocław Medical University, Department of Earth Sciences [University of Cambridge], and Pir Mehr Ali Shah Arid Agriculture University = PMAS-Arid Agriculture University Rawalpindi (AAUR)
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], Antibodies, Monoclonal, Humanized, Placebo, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Time, law.invention, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Double-Blind Method, Randomized controlled trial, law, Internal medicine, Clinical endpoint, Humans, Medicine, Anti-Asthmatic Agents, 030212 general & internal medicine, Child, Adverse effect, ComputingMilieux_MISCELLANEOUS, Aged, Asthma, business.industry, Middle Aged, medicine.disease, Benralizumab, 3. Good health, Clinical trial, Treatment Outcome, 030228 respiratory system, Tolerability, chemistry, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: Benralizumab is an interleukin-5 receptor α-directed cytolytic monoclonal antibody that has been shown to safely reduce exacerbations and improve lung function for patients with asthma. We assessed the long-term safety and efficacy of benralizumab for patients with severe, uncontrolled eosinophilic asthma.We conducted a randomised, double-blind, parallel-group, phase 3 extension study at 447 sites in 24 countries. Eligible patients had to have completed the SIROCCO or CALIMA trials and remained on subcutaneous benralizumab 30 mg every 4 weeks (Q4W) or every 8 weeks (Q8W). Patients who had received placebo in those trials were re-randomised in a 1:1 ratio, using an interactive web-based system, to benralizumab 30 mg either Q4W or Q8W (first three doses 4 weeks apart). Treatment lasted for 56 weeks for adult patients (age ≥18 years) and 108 weeks for adolescent patients (age 12-17 years). The primary endpoint was the safety and tolerability of the two dosing regimens of benralizumab up to 68 weeks for adult patients (including the follow-up visit post-treatment) and up to 56 weeks for adolescent patients. This endpoint was assessed in the full analysis set, which included all patients from the SIROCCO and CALIMA predecessor studies who received at least one dose of study treatment in BORA and did not continue into another trial. This study is registered with ClinicalTrials.gov (NCT02258542).Between Nov 19, 2014, and July 6, 2016, we enrolled 1926 patients, of whom 633 had received benralizumab Q4W and 639 had received benralizumab Q8W in SIROCCO or CALIMA. The remaining 654 patients had received placebo in those trials and were randomly re-assigned in this trial to receive benralizumab Q4W (n=320) or Q8W (n=334). 1576 patients, including 783 who received benralizumab Q4W (265 newly assigned) and 793 who received benralizumab Q8W (281 newly assigned), were included in the full analysis set. The most common adverse events in all groups were viral upper respiratory tract infection (14-16%) and worsening asthma (7-10%). The most common serious adverse events were worsening asthma (3-4%), pneumonia (1% to 1%), and pneumonia caused by bacterial infection (0-1%). The percentages of patients who had any on-treatment adverse event, any serious adverse event, or any adverse event leading to treatment discontinuation during BORA were similar between patients originally assigned benralizumab and those originally assigned placebo and between benralizumab treatment regimens. The percentage of patients who had any adverse event was similar between SIROCCO or CALIMA (71-75%; benralizumab group only) and BORA (65-71%), as was the percentage of patients who had an adverse event that led to treatment discontinuation (2% in SIROCCO and CALIMA vs 2-3% in BORA).The 2 years of safety results validate that observations observed in the first year of benralizumab continued through a second year of treatment. No new consequences of long-term eosinophil depletion occurred, and the incidence of other adverse events, including opportunistic infections, were similar during the second year.AstraZeneca and Kyowa Hakko Kirin.
Published: 2019
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37. Correction: Testing for alpha-1 antitrypsin in COPD in outpatient respiratory clinics in Spain: A multilevel, cross-sectional analysis of the EPOCONSUL study

Author: Myriam Calle Rubio, Joan B Soriano, José Luis López-Campos, Juan J Soler-Cataluña, Bernardino Alcázar Navarrete, José Miguel Rodríguez González-Moro, Marc Miravitlles, Miriam Barrecheguren, Manuel E Fuentes Ferrer, Juan Luis Rodriguez Hermosa, and EPOCONSUL Study
Subjects: Multidisciplinary, lcsh:R, lcsh:Medicine, lcsh:Q, lcsh:Science
Abstract: [This corrects the article DOI: 10.1371/journal.pone.0198777.].
Published: 2019

38. For the Patient

Author: Myriam Calle Rubio, Müge Olgaç, and ZEYNEP FERHAN OZSEKER
Subjects: Pulmonary and Respiratory Medicine, Immunology and Allergy, General Medicine
Published: 2018

39. Factors associated with testing of COPD patients for serum AAT levels to detect cases of AATD. The EPOCONSUL study

Author: José Miguel Rodríguez Gonzalez Moro, Juan Luis Rodríguez Hermosa, Myriam Calle Rubio, Joan B. Soriano, Gianna Vargas Centanaro, José Luis López Campos, Juan José Soler Cataluña, and Bernardino Alcázar Navarrete
Subjects: medicine.medical_specialty, business.industry, Copd patients, Internal medicine, Medicine, business
Published: 2018
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40. Variability in adherence to clinical practice guidelines and recommendations in COPD outpatients: a multi-level, cross-sectional analysis of the EPOCONSUL study

Author: José Luis López-Campos Bodineau, Juan Luis Rodriguez Hermosa, Eduardo Márquez-Martín, Cristina Represas-Represas, Joan B Soriano, Jose Miguel Rodriguez Gonzalez-Moro, Bernardino Alcázar-Navarrete, Myriam Aburto, Manuel Enrique Fuentes Ferrer, Miriam Barrecheguren, Myriam Calle Rubio, Luis Puente-Maestu, Pablo Catalan Serra, ALBERTO FERNANDEZ-VILLAR, Cristina Martinez-Gonzalez, David De la Rosa Carrillo, Juan José Soler-Cataluña, Rubén Andújar-Espinosa, [Calle Rubio, Myriam] Univ Complutense Madrid, Fac Med, Res Inst Hosp Clin San Carlos IdISSC, Pulm Dept, C Martin Lagos S-N, E-28040 Madrid, Spain, [Rodriguez Hermosa, Juan Luis] Univ Complutense Madrid, Fac Med, Res Inst Hosp Clin San Carlos IdISSC, Pulm Dept, C Martin Lagos S-N, E-28040 Madrid, Spain, [Luis Lopez-Campos, Jose] Univ Seville, Unidad Med Quirurg Enfermedades Resp, Inst Biomed Sevilla IBiS, Hosp Univ Virgen del Rocio, Seville, Spain, [Luis Lopez-Campos, Jose] Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain, [Soler-Cataluna, Juan J.] Hosp Arnau Villanova, Pulm Dept, Valencia, Spain, [Alcazar Navarrete, Bernardino] Hosp Alta Resoluc Loja, Pulm Dept, Granada, Spain, [Soriano, Joan B.] Univ Autonoma Madrid, Res Inst Hosp Univ La Princesa IISP, Madrid, Spain, [Rodriguez Gonzalez-Moro, Jose Miguel] Hosp Univ Principe Asturias, Pulm Dept, Madrid, Spain, [Fuentes Ferrer, Manuel E.] Univ Complutense Madrid, UGC Med Prevent, Res Inst Hosp Clin San Carlos IdISSC, Hosp Clin San Carlos,Fac Med, Madrid, Spain, SEPAR, and Boehringer Ingelheim
Subjects: Male, Clinical audit, medicine.medical_specialty, Outpatient Clinics, Hospital, Exacerbation, Cross-sectional study, Audit, Outcomes, Exacerbations, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Ambulatory care, Diagnosis, Ambulatory Care, medicine, Humans, Outpatient clinic, 030212 general & internal medicine, Mortality, Admissions, Adherence to recommendations, Obstructive pulmonary-disease, Aged, lcsh:RC705-779, Sweden, Medical Audit, COPD, Medical care, business.industry, Research, Chronic obstructive pulmonary disease, lcsh:Diseases of the respiratory system, Guideline, Middle Aged, medicine.disease, Quality, respiratory tract diseases, Management, Cross-Sectional Studies, 030228 respiratory system, Practice Guidelines as Topic, Emergency medicine, Female, Guideline Adherence, business, Clinical practice guidelines
Abstract: Background Clinical audits have reported considerable variability in COPD medical care and frequent inconsistencies with recommendations. The objectives of this study were to identify factors associated with a better adherence to clinical practice guidelines and to explore determinants of this variability at the the hospital level. Methods EPOCONSUL is a Spanish nationwide clinical audit that evaluates the outpatient management of COPD. Multilevel logistic regression with two levels was performed to assess the relationships between individual and disease-related factors, as well as hospital characteristics. Results A total of 4508 clinical records of COPD patients from 59 Spanish hospitals were evaluated. High variability was observed among hospitals in terms of medical care. Some of the patient’s characteristics (airflow obstruction, degree of dyspnea, exacerbation risk, presence of comorbidities), the hospital factors (size and respiratory nurses available) and treatment at a specialized COPD outpatient clinic were identified as factors associated with a better adherence to recommendations, although this only explains a small proportion of the total variance. Conclusion To be treated at a specialized COPD outpatient clinic and some intrinsic patient characteristics were factors associated with a better adherence to guideline recommendations, although these variables were only explaining part of the high variability observed among hospitals in terms of COPD medical care.
Published: 2017

41. Prevalence of persistent blood eosinophilia: relation to outcomes in patients with COPD

Author: Ramón Agüero, Eva Balcells, Pilar de Lucas-Ramos, Celia Lacarcel, Inmaculada Alfageme, Jose M. Marin, Carlos Javier Gutiérrez Cabrera, Victor Pinto-Plata, Miguel Divo, Juan P. de-Torres, Alfredo de Diego, Rafael Golpe, Myriam Calle-Rubio, Amalia Moreno, Ingrid Solanes, Juan B. Galdiz, José Luis López-Campos, Joan B. Soriano, Nuria Feu-Collado, Bartolome R. Celli, Juan José Soler-Cataluña, Antonia Fuster, Amparo Romero, Antonia Llunell, Borja G. Cosío, Cristina Martínez-González, Ciro Casanova, Margarita Marín, Germán Peces-Barba, [Casanova, Ciro] Hosp Univ Ntra Sra La Candelaria, Pulmonol Dept, Tenerife, Spain, [Celli, Bartolome R.] Brigham & Womens Hosp, Pulm & Crit Care Dept, 75 Francis St, Boston, MA 02115 USA, [Divo, Miguel] Brigham & Womens Hosp, Pulm & Crit Care Dept, 75 Francis St, Boston, MA 02115 USA, [de-Torres, Juan P.] Clin Univ Navarra, Pulm Dept, Pamplona, Spain, [Martinez-Gonzalez, Cristina] Hosp Cent Asturias, Pulm Dept, Oviedo, Spain, [Cosio, Borja G.] Hosp Son Espases IdISPa, Pulm Dept, Palma de Mallorca, Spain, [Cosio, Borja G.] Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain, [Peces-Barba, German] Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain, [Luis Lopez-Campos, Jose] Inst Salud Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain, [Pinto-Plata, Victor] Baystate Med Ctr, Springfield, MA USA, [de Lucas-Ramos, Pilar] Hosp Gregorio Maranon, Pulm Dept 1, Madrid, Spain, [Fuster, Antonia] Hosp Son Llatzer, Pulm Dept, Mallorca, Spain, [Peces-Barba, German] Fdn Jimenez Diaz, Pulm Dept, Madrid, Spain, [Calle-Rubio, Myriam] Univ Complutense Madrid, Fac Med, Med Dept, Hosp Clin San Carlos,Pulm Dept, Madrid, Spain, [Solanes, Ingrid] Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Pulm Dept, Barcelona, Spain, [Aguero, Ramon] Hosp Marques Valdecilla, Pulm Dept, Santander, Spain, [Feu-Collado, Nuria] Hosp Univ Reina Sofia, IMIBIC, UCO, Pulm Dept, Cordoba, Spain, [Alfageme, Inmaculada] Hosp Univ Valme, Pulm Dept, Seville, Spain, [De Diego, Alfredo] Hosp Univ La Fe, Pulm Dept, Valencia, Spain, [Romero, Amparo] Hosp Manacor, Pulm Dept, Mallorca, Spain, [Balcells, Eva] Hosp Mar, Pulm Dept, Barcelona, Spain, [Llunell, Antonia] Hosp Tarrasa, Pulm Dept, Tarrasa, Spain, [Galdiz, Juan B.] Hosp Cruces, Pulm Dept, Bilbao, Spain, [Marin, Margarita] Hosp Gen Castellon, Pulm Dept, Castellon de La Plana, Spain, [Moreno, Amalia] Hosp Parc Tauli, Pulm Dept, Barcelona, Spain, [Cabrera, Carlos] Hosp Dr Negrin, Pulm Dept, Las Palmas Gran Canaria, Spain, [Golpe, Rafael] Hosp Univ Lucus Augusti, Pulm Dept, Lugo, Spain, [Lacarcel, Celia] Hosp Ciudad Jaen, Pulm Dept, Jaen, Spain, [Soriano, Joan B.] Hosp Univ La Princesa IISP, Inst Invest, Madrid, Spain, [Luis Lopez-Campos, Jose] Hosp Univ Virgen Rocio, Inst Biomed Sevilla IBiS, Unidad Med Quirrurg Enfermedades Resp, Seville, Spain, [Soler-Cataluna, Juan J.] Hosp Arnau Vilanova, Pulm Dept, Valencia, Spain, [Marin, Jose M.] Hosp Univ Miguel Servet, IISAragon, CIBERES, Pulm Dept, Zaragoza, Spain, and AstraZeneca (Madrid, Spain)
Subjects: Male, Cohort Studies, Leukocyte Count, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Risk Factors, Forced Expiratory Volume, Prevalence, Medicine, Eosinophilia, 030212 general & internal medicine, Obstructive pulmonary-disease, COPD, Inhaled corticosteroids, respiratory system, Middle Aged, medicine.anatomical_structure, Cohort, Disease Progression, Female, medicine.symptom, Cohort study, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Efficacy, Guidelines, Exacerbations, 03 medical and health sciences, Internal medicine, Humans, In patient, Risk factor, Survival analysis, Aged, Clinical characteristics, business.industry, Biomarker, Eosinophil, medicine.disease, Survival Analysis, Asthma, respiratory tract diseases, Eosinophils, Dyspnea, 030228 respiratory system, Spain, Immunology, Fluticasone, business
Abstract: The impact of blood eosinophilia in chronic obstructive pulmonary disease (COPD) remains controversial.To evaluate the prevalence and stability of a high level of blood eosinophils (>= 300 cells.mu L-1) and its relationship to outcomes, we determined blood eosinophils at baseline and over 2 years in 424 COPD patients (forced expiratory volume in 1 s (FEV1) 60% predicted) and 67 smokers without COPD from the CHAIN cohort, and in 308 COPD patients (FEV1 60% predicted) in the BODE cohort. We related eosinophil levels to exacerbations and survival using Cox hazard analysis.In COPD patients, 15.8% in the CHAIN cohort and 12.3% in the BODE cohort had persistently elevated blood eosinophils at all three visits. A significant proportion (43.8%) of patients had counts that oscillated above and below the cut-off points, while the rest had persistent eosinophil levels = 300 cells.mu L-1) and its relationship to outcomes, we determined blood eosinophils at baseline and over 2 years in 424 COPD patients (forced expiratory volume in 1 s (FEV1) 60% predicted) and 67 smokers without COPD from the CHAIN cohort, and in 308 COPD patients (FEV1 60% predicted) in the BODE cohort. We related eosinophil levels to exacerbations and survival using Cox hazard analysis.In COPD patients, 15.8% in the CHAIN cohort and 12.3% in the BODE cohort had persistently elevated blood eosinophils at all three visits. A significant proportion (43.8%) of patients had counts that oscillated above and below the cut-off points, while the rest had persistent eosinophil levels = 300 cells.mu L-1 persisting over 2 years was not a risk factor for COPD exacerbations. High eosinophil count was associated with better survival.
Published: 2017

42. Medical Care According to Risk Level and Adaptation to Spanish COPD Guidelines (Gesepoc): The Epoconsul Study

Author: Myriam, Calle Rubio, Juan Luis, Rodríguez Hermosa, Juan José, Soler-Cataluña, José Luis, López-Campos, Bernardino, Alcazar Navarrete, Joan B, Soriano, José Miguel, Rodríguez Gónzalez-Moro, Manuel E, Fuentes Ferrer, and Marc, Miravitlles
Subjects: Male, Respiratory Therapy, Clinical Audit, National Health Programs, Hospitals, Public, Oxygen Inhalation Therapy, Disease Management, Middle Aged, Risk Assessment, Bronchodilator Agents, Respiratory Function Tests, Pulmonary Disease, Chronic Obstructive, Cross-Sectional Studies, Phenotype, Spain, Practice Guidelines as Topic, Humans, Female, Aged, Retrospective Studies
Abstract: EPOCONSUL is the first national audit to analyze medical care for COPD in pulmonology departments in Spain. The main objective was to perform a retrospective analysis to determine the distribution of GesEPOC 2017 COPD risk levels and to evaluate clinical activity according to the new recommendations.This is a cross-sectional clinical audit in which consecutive COPD cases were recruited over one year. The study evaluated risk and clinical phenotype according to GesEPOC 2017, and their correlation with the clinical interventions employed.The most common risk category was high risk (79.8% versus 20.2%; p 0.001), characterized by a higher level of severity on BODE and BODEx indexes, and a higher comorbidity burden. The most common phenotype was non-exacerbator. The most commonly used treatment in low-risk patients was bronchodilator monotherapy (34.8%) and triple therapy in high-risk patients (53.7%). High risk was most frequently characterized by phenotype (57.6% versus 52%; p = 0.014) and pulmonary function test results: lung volume (47.7% versus 35.8%; p 0.001), lung diffusion (51.4% versus 42.1%; p 0.001) and walk test (37.8% versus 15.8%; p 0.001).Most patients treated in pulmonology departments were high-risk and non-exacerbator phenotype. Clinical interventions differed according to risk level and mainly followed GesEPOC recommendations, although there is significant room for improvement.
Published: 2017

43. Clinical audit of COPD in outpatient respiratory clinics in Spain. Effect of specialized COPD clinics and general respiratory clinics: the EPOCONSUL study

Author: Juan José Soler-Cataluña, José Miguel Rodríguez González-Moro, Gianna Vargas Centanaro, José Luis López-Campos, Jose Luis Rodríguez Hermosa, Juan Rigual Bobillo, Joan B. Soriano, Bernandino Alcázar Navarrete, and Myriam Calle Rubio
Subjects: Clinical audit, COPD, medicine.medical_specialty, business.industry, Copd patients, medicine.disease, Medical care, respiratory tract diseases, Clinical Practice, Health care, Emergency medicine, medicine, Observational study, Respiratory system, business
Abstract: Background: EPOCONSUL is the first national audit on the medical care for COPD patients delivered in outpatient respiratory clinics conducted in Spain. Large variability between centers could be partly explained due to the organization among centers. We aimed to evaluate differences between outpatients clinics COPD-specific vs respiratory-general. Methodology: This is an observational study with prospective recruitment (2014–15) of patients COPD as seen in respiratory clinics. The information collected was historical of the last and previous consultations and the information hospital resources was concurrent. Results: A total of 59 centers participated (47,5% COPD-specific clinics available). Overall, 4,508 patients were assessed (3,470 patients seen in respiratory-general and 1,038 seen in COPD-specific). Significant differences were found in active smokers, exacerbations in the last year, GOLD-type, and therapy (all p Conclusion: These results highlight the disparity between clinical practice within health care professionals providing care for COPD patients from COPD-specific and respiratory-general clinics. Supported by SEPAR and Boehringer Ingelheim
Published: 2017
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44. Use of health care resources in admissions of COPD exacerbations

Author: Juan Rigual Bobillo, Juan Luis Rodríguez Hermosilla, Mariara Calderon, Fernando Pelaez Catro, Gianna Vargas Centanaro, Myriam Calle Rubio, and José Luis Álvarez-Sala
Subjects: medicine.medical_specialty, COPD, business.industry, Health care, medicine, business, Intensive care medicine, medicine.disease
Published: 2017
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45. Determinants of use of the bronchodilator test in primary and secondary care: results of a national survey in Spain

Author: José Luis López-Campos Bodineau, Joan B Soriano, Jose Miguel Rodriguez Gonzalez-Moro, Myriam Calle Rubio, Aurelio Arnedillo Munoz, Cristina Martinez-Gonzalez, and Borja G Cosio
Subjects: Pulmonary and Respiratory Medicine, Spirometry, Waiting time, medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.drug_class, Retraining, Test (assessment), Secondary care, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, Bronchodilator, Physical therapy, Immunology and Allergy, Medicine, 030212 general & internal medicine, Positive test, business, Genetics (clinical)
Abstract: Background and Aims A recent study evaluated the use of spirometry in primary (PC) and secondary care (SC) in Spain. In the present study, we aimed to analyze the determinants of use of the bronchodilator test (BDT) with a special emphasis in the type of drugs used, waiting times and positive test criteria followed. Methods Cross-sectional trial surveying 605 PC and 200 SC centers in Spain. Regarding the BDT, variables collected were: name of the drugs available for the BDT, name of the drug normally used, number of inhalations, waiting time for the second spirometry, staff involved and criteria used for a positive test. Adherence to actual guidelines according to five quality criteria was evaluated. Results Although a range of short-acting bronchodilators were used, only 25.9% of centers used a correct dose. The waiting time was correct in 63.7% and 72.8% of PC and SC, respectively (P = 0.023). A threshold higher than 12% and 200 mL to consider a positive test was fulfilled in 55.8% and 52.8% of PC and SC, respectively. Altogether, only 7.6% of PC and 6.0% of SC fulfilled all five quality criteria. Factors identified to be associated with this fulfillment were the number of spirometries per week, not being conducted by a nurse, periodical retraining, training for interpreting and daily calibration. Conclusion The present study identifies determinants of the performance of the BDT in Spain identifying strengths and weaknesses. Health managers should use this information to improve the quality of spirometries in chronic respiratory patients.
Published: 2014
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46. Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study

Author: José Luis López-Campos Bodineau, Juan Luis Rodriguez Hermosa, Joan B Soriano, Jose Miguel Rodriguez Gonzalez-Moro, Bernardino Alcázar-Navarrete, Myriam Aburto, Manuel Enrique Fuentes Ferrer, Myriam Calle Rubio, Luis Puente-Maestu, Juan José Soler-Cataluña, [Calle Rubio, Myriam] Hosp Clin San Carlos, Dept Pneumol, C Martin Lagos S-N, Madrid 28040, Spain, [Calle Rubio, Myriam] Univ Complutense Madrid, Dept Med, Fac Med, Madrid, Spain, [Fuentes Ferrer, Manuel E.] Univ Complutense Madrid, Dept Med, Fac Med, Madrid, Spain, [Calle Rubio, Myriam] Hosp Clin San Carlos IdISSC, Res Inst, Madrid, Spain, [Fuentes Ferrer, Manuel E.] Hosp Clin San Carlos IdISSC, Res Inst, Madrid, Spain, [Alcazar Navarrete, Bernardino] Hosp Alta Resoluc Noja, Dept Pulm, Granada, Spain, [Soriano, Joan B.] Univ Autonoma Madrid, Hosp Univ La Princesa IISP, Res Inst, E-28049 Madrid, Spain, [Soler-Cataluna, Juan J.] Hosp Arnau de Villanova, Dept Pulm, Valencia, Spain, [Rodriguez Gonzalez-Moro, Jose Miguel] Hosp Univ Principe Asturias, Dept Pulm, Madrid, Spain, [Fuentes Ferrer, Manuel E.] Hosp Clin San Carlos, UGC Prevent Med & Res Inst, Madrid, Spain, [Luis Lopez-Campos, Jose] Hosp Univ Virgen del Rocio, Dept Pulm, Inst Biomed Sevilla IBiS, Seville, Spain, SEPAR, and Boehringer Ingelheim
Subjects: Clinical audit, Male, Exacerbation, Care, Severity of Illness Index, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Diagnosis, Pulmonary Medicine, Outpatient clinic, 030212 general & internal medicine, adherence, Prospective Studies, Practice Patterns, Physicians', Lung, Referral and Consultation, Original Research, COPD, Medical Audit, Process Assessment (Health Care), Exercise Tolerance, medicine.diagnostic_test, Process Assessment, Health Care, General Medicine, Middle Aged, Quality, Obstructive lung disease, Management, Phenotypes, Pulmonologists, Treatment Outcome, medical care, Practice Guidelines as Topic, Female, Guideline Adherence, Spirometry, medicine.medical_specialty, Standards, Outpatient Clinics, Hospital, International Journal of Chronic Obstructive Pulmonary Disease, Guidelines, chronic obstructive pulmonary disease, 03 medical and health sciences, medicine, Humans, Aged, Sweden, business.industry, clinical audit, medicine.disease, respiratory tract diseases, Cross-Sectional Studies, 030228 respiratory system, clinical guidelines, Spain, Emergency medicine, Good clinical practice, Physical therapy, Observational study, business, Delivery of Health Care
Abstract: Myriam Calle Rubio,1–3 Bernardino Alcázar Navarrete,4 Joan B Soriano,5 Juan J Soler-Cataluña,6 José Miguel Rodríguez González-Moro,7 Manuel E Fuentes Ferrer,2,3,8 José Luis López-Campos9 On behalf of the EPOCONSUL Study 1Pulmonary Department, Hospital Clínico San Carlos, 2Department of Medicine, Faculty of Medicine, University Complutense of Madrid, 3Research Institute of Hospital Clínico San Carlos (IdISSC), Madrid, 4Pulmonary Department, Hospital de Alta Resolución de Noja, Granada, 5Research Institute of Hospital University La Princesa (IISP), University Autónoma of Madrid, 6Pulmonary Department, Hospital de Arnau de Villanova, Valencia, 7Pulmonary Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, 8UGC of Preventive Medicine and Research Institute of Hospital Clínico San Carlos, Madrid, 9Pulmonary Department, Hospital University Virgen del Rocio, Institute of Biomedicine of Sevilla (IBiS), Sevilla, Spain Background: Chronic obstructive pulmonary disease (COPD) outpatients account for a large burden of usual care by respirologists. EPOCONSUL is the first national clinical audit conducted in Spain on the medical care for COPD patients delivered in outpatient respiratory clinics. We aimed to evaluate the clinical interventions and the degree of adherence to recommendations in outpatients of current COPD clinical practice guidelines.Methodology: This is an observational study with prospective recruitment (May 2014–May 2015) of patients with a COPD diagnosis as seen in outpatient respiratory clinics. The information collected was historical in nature as for the clinical data of the last and previous consultations, and the information concerning hospital resources was concurrent.Results: A total of 17,893 clinical records of COPD patients in outpatient respiratory clinics from 59 Spanish hospitals were evaluated. Of the 5,726 patients selected, 4,508 (78.7%) were eligible. Overall, 12.1% of COPD patients did not fulfill a diagnostic spirometry criteria. Considerable variability existed in the available resources and work organization of the hospitals, although the majority were university hospitals with respiratory inpatient units. There was insufficient implementation of clinical guidelines in preventive and educational matters. In contrast, quantitative evaluation of dyspnea grade (81.9%) and exacerbation history (70.9%) were more frequently performed. Only 12.4% had COPD severity calculated according to the Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) index. Phenotype characteristics according to Spanish National Guideline for COPD were determined in 46.3% of the audited patients, and the risk evaluation according to Global initiative for chronic Obstructive Lung Disease was estimated only in 21.9%.Conclusion: The EPOCONSUL study reports the current situation of medical care for COPD patients in outpatient clinics in Spain, revealing its variability, strengths, and weaknesses. This information has to be accounted for by health managers to define corrective strategies and maximize good clinical practice. Keywords: chronic obstructive pulmonary disease, clinical audit, medical care, adherence, clinical guidelines
Published: 2017

47. Home pulmonary rehabilitation program in COPD : Conditioning factors

Author: Maria Estévez, Beatriz Morales Chacón, Juan Luis Rodriguez, Myriam Calle Rubio, Juan Ringual, Alfonso Montero Pacios, Ina Guerassimova, Manuel Fuentes Ferrer, Mariara Calderon Alcala, Mercedes Bernabeu Lledo, Eva Escobar García, and Elena Forcén
Subjects: COPD, medicine.medical_specialty, Disease factors, business.industry, Socio demographics, medicine.medical_treatment, medicine, Physical therapy, Pulmonary rehabilitation, medicine.disease, business
Abstract: To assess the constraints to participate in a program of home rehabilita-tion and analyze its relationship with socio demographic variables and disease factors.
Published: 2016
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48. Role of bronchodilators in new treatment guidelines

Author: Juan Luis Rodríguez Hermosa, Myriam Calle Rubio, and Ina Guerassimova
Subjects: Pulmonary and Respiratory Medicine
Published: 2012
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49. Enfermedad pulmonar obstructiva crónica en archivos de bronconeumología en el año 2010

Author: Yadira Dobarganes Sansón, Juan Luis Rodríguez Hermosa, and Myriam Calle Rubio
Subjects: Pulmonary and Respiratory Medicine, education.field_of_study, medicine.medical_specialty, COPD, business.industry, Mortality rate, Population, MEDLINE, Pulmonary disease, Disease, medicine.disease, Epidemiology, medicine, education, Intensive care medicine, business, Pathological
Abstract: Chronic obstructive pulmonary disease (COPD) continues to cause concern among health professionals treating respiratory diseases worldwide. The reasons for the increasing tendency in prevalence, morbidity and mortality rates are under constant investigation. Areas of research include identification of new phenotypes, predisposing factors, and physiopathological and epidemiological features that are still not completely known, as well as the systemic behavior of this disease and its relationship with other, associated pathological states. New and encouraging alternative treatments are also being investigated. This unceasing search for scientific knowledge is reflected in the number of studies published in each of the sections of Archivos de Bronconeumologia throughout 2010, which deal with most of the pressing issues concerning this disease and which will be summarized in the present article. More than 60% of the contents of the journal's supplements were related to COPD. A monographic issue, produced for training purposes, was published and consisted of three units: the first was entitled "The thousand and one faces of COPD", the second "COPD: from etiopathogenesis to treatment" and the third "COPD: how can patient care be improved?". The authors of these units provide an in-depth and up-to-date analysis of topics relating COPD to various pathological states and include an analysis of the disease in two population groups that have aroused recent interest, namely, women and non-smokers. The third unit of the monograph deals exclusively with the patient.
Published: 2011
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50. Tratamiento farmacológico de la EPOC. ¿Dónde nos encontramos?

Author: Myriam Calle Rubio, Celia Pinedo Sierra, and Juan Luis Rodríguez Hermosa
Subjects: Pulmonary and Respiratory Medicine, Spirometry, COPD, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Severe disease, Pulmonary disease, Disease, medicine.disease, Airflow obstruction, respiratory tract diseases, Pharmacological treatment, Surgery, medicine, In patient, Intensive care medicine, business
Abstract: Current clinical guidelines recommend a step-wise approach to the pharmacological treatment of chronic obstructive pulmonary disease (COPD), with drugs being added according to the severity of airflow obstruction, symptoms, and the number of acute exacerbations in patients with severe disease. However, greater knowledge of the physiopathogenesis of this disease has led to COPD being considered a heterogeneous process in which therapeutic decisions should not be based exclusively on the results of spirometry. Treatment is increasingly individualized according to the patient's characteristics. The present article reviews the scientific evidence on the aims of treatment in COPD and the benefits achieved by the various pharmacological options available.
Published: 2010
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