The impact of alpha-1 antitrypsin deficiency alleles on lung cancer survival.

Different studies have shown that carrying an alpha-1 antitrypsin (AAT) deficiency allele is an independent risk factor for developing lung cancer (LC). However, to date, little is known regarding whether carrying a deficiency allele may be a prognostic factor in the evolution of LC. A prospective observational study was carried out which consecutively included patients diagnosed with LC in University Hospital "Nuestra Señora de Candelaria" between December 2017 and August 2020. A blood sample was taken from each of the patients in order to determine both AAT serum concentration and genotype. Based on AAT genotype, patients were divided into the deficiency (Pi*≠MM) or non-deficiency (Pi*=MM) group. One hundred and sixty-four patients were included. The average length of follow-up was 13±10 months. Patients were classified as stage I (4.2%), stage II (8.3%), stage III (31.2%) and stage IV (56.3%), according to tumour, node and metastasis (TNM) staging. Twenty-eight patients (17%) were carriers of a deficiency allele (6 Pi*MS, 1 Pi*MZ, 1 Pi*MMheerlen). No significant differences were found with respect to baseline characteristics between Pi*≠MM and Pi*=MM. Patients in the Pi*≠MM group had a higher risk of death in the first 6 months after the LC diagnosis compared to Pi*=MM subjects (HR =2.04; 95% CI: 1.04-4.0; P=0.038). The presence of an AAT deficiency genotype could be a potential prognostic marker in LC. However, larger studies that justify these findings are needed.

Technology Seduction and Smoking / Seducción tecnológica y consumo de tabaco

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The Genomics and Metagenomics of Asthma Severity (GEMAS) Study: Rationale and Design.

Asthma exacerbations are a major contributor to the global disease burden, but no significant predictive biomarkers are known. The Genomics and Metagenomics of Asthma Severity (GEMAS) study aims to assess the role of genomics and the microbiome in severe asthma exacerbations. Here, we present the design of GEMAS and the characteristics of patients recruited from March 2018 to March 2020. Different biological samples and demographic and clinical variables were collected from asthma patients recruited by allergy and pulmonary medicine units in several hospitals from Spain. Cases and controls were defined by the presence/absence of severe asthma exacerbations in the past year (oral corticosteroid use, emergency room visits, and/or asthma-related hospitalizations). A total of 137 cases and 120 controls were recruited. After stratifying by recruitment location (i.e., Canary Islands and Basque Country), cases and controls did not differ for most demographic and clinical variables (p > 0.05). However, cases showed a higher proportion of characteristics inherent to asthma exacerbations (impaired lung function, severe disease, uncontrolled asthma, gastroesophageal reflux, and use of asthma medications) compared to controls (p < 0.05). Similar results were found after stratification by recruitment unit. Thereby, asthma patients enrolled in GEMAS are balanced for potential confounders and have clinical characteristics that support the phenotype definition. GEMAS will improve the knowledge of potential biomarkers of asthma exacerbations.

Granulomatosis broncocéntrica como expresión de toxicidad pulmonar por lamotrigina / Bronchocentric granulomatosis as expression of pulmonary toxicity by lamotrigine

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Hemangiopericitoma pulmonar primario / Primary Pulmonary Hemangiopericytoma

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Vareniclina: pasado, presente y futuro / Varenicline: past, present and future

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Comorbilidad cardiovascular en pacientes con enfermedad pulmonar obstructiva crónica en Canarias (estudio CCECAN) / Cardiovascular comorbidity in patients with chronic obstructive pulmonary disease in the Canary Islands (CCECAN study)

Introducción: Múltiples estudios han revelado una alta prevalencia de patología cardiovascular en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). El objetivo de este estudio ha sido analizar la prevalencia de factores de riesgo y comorbilidad cardiovascular en una muestra de pacientes canarios diagnosticados de EPOC y compararla con datos procedentes de la población general de Canarias. Pacientes y métodos: Estudio trasversal en 300 pacientes con EPOC y en 524 sujetos del grupo control sin patología respiratoria. Los pacientes fueron seleccionados según criterios de inclusión de las consultas ambulatorias de Neumología, mientras que los grupos control procedían de la población general adulta. Se registró información referente a: edad, sexo, hábito tabáquico, pruebas de función pulmonar y comorbilidad cardiovascular. Se compararon mediante análisis bivariado las dos muestras en cuanto al riesgo cardiovascular y, mediante modelos de regresión logística, se estimaron los riesgos en relación con la morbilidad cardiovascular de los pacientes con EPOC sobre la del grupo control. Resultados: Los pacientes con EPOC presentaron una elevada prevalencia de hipertensión arterial (72%), dislipidemia (73%), obesidad (41%), diabetes tipo 2 (39%) y síndrome apnea-hipopnea del sueño (30%) desde estadios leves de la enfermedad (GOLD 2009). La prevalencia de arritmia cardíaca fue del 22%, la de cardiopatía isquémica del 16%, la de insuficiencia cardíaca del 16%, la de enfermedad vascular periférica del 12% y la de enfermedad cerebrovascular del 8%. Respecto al grupo control, los pacientes con EPOC presentaban un mayor riesgo de tener dislipidemia (OR 3,24; IC del 95%: 2,21-4,75), diabetes tipo 2 (OR 1,52; IC del 95%: 1,01-2,28) y cardiopatía isquémica (OR 2,34; IC del 95%: 1,22-4,49). En el caso de la dislipidemia, se obtuvo un incremento del riesgo cuando se ajustó por edad, sexo y consumo de tabaco acumulado (OR 5,04; IC del 95%:2,36-10,74). Conclusiones: Los pacientes con EPOC residentes en Canarias tienen una alta prevalencia de hipertensión arterial, dislipidemia, cardiopatía isquémica y arritmia cardíaca. Frente a población general, los pacientes con EPOC presentan un importante incremento en el riesgo de presentar dislipidemia (AU)

Introduction: Numerous studies have shown a high prevalence of cardiovascular disease in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to analyse the prevalence of cardiovascular risk factors and comorbidity in a Canary Islands population diagnosed with COPD, and compared it with data from the general population. Patients and methods: A cross-sectional study was carried out in 300 patients with COPD and 524 subjects without respiratory disease (control group). The two groups were compared using standard bivariate methods. Logistic regression models were used to estimate the cardiovascular risks in COPD patients compared to control group. Results: Patients with COPD showed a high prevalence of hypertension (72%), dyslipidaemia (73%), obesity (41%), diabetes type 2 (39%), and sleep apnoea syndrome (30%) from mild stages of the disease (GOLD 2009). There was a 22% prevalence of cardiac arrhythmia, 16% of ischaemic heart disease, 16% heart failure, 12% peripheral vascular disease, and 8% cerebrovascular disease. Compared to the control group, patients with COPD had a higher risk of dyslipidaemia (OR 3.24, 95% CI; 2.21-4.75), diabetes type 2 (OR 1.52, 95% CI; 1.01-2,28), and ischaemic heart disease (OR 2.34, 95% CI; 1.22-4.49). In the case of dyslipidaemia, an increased risk was obtained when adjusted for age, gender, and consumption of tobacco (OR 5.04, 95% CI; 2.36-10.74). Conclusions: Patients with COPD resident in the Canary Islands have a high prevalence of hypertension, dyslipidaemia, ischaemic heart disease, and cardiac arrhythmia. Compared to general population, patients with COPD have a significant increase in the risk of dyslipidaemia (AU)

Cardiovascular comorbidity in patients with chronic obstructive pulmonary disease in the Canary Islands (CCECAN study). / Comorbilidad cardiovascular en pacientes con enfermedad pulmonar obstructiva crónica en Canarias (estudio CCECAN).

INTRODUCTION: Numerous studies have shown a high prevalence of cardiovascular disease in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to analyse the prevalence of cardiovascular risk factors and comorbidity in a Canary Islands population diagnosed with COPD, and compared it with data from the general population. PATIENTS AND METHODS: A cross-sectional study was carried out in 300 patients with COPD and 524 subjects without respiratory disease (control group). The two groups were compared using standard bivariate methods. Logistic regression models were used to estimate the cardiovascular risks in COPD patients compared to control group. RESULTS: Patients with COPD showed a high prevalence of hypertension (72%), dyslipidaemia (73%), obesity (41%), diabetes type 2 (39%), and sleep apnoea syndrome (30%) from mild stages of the disease (GOLD 2009). There was a 22% prevalence of cardiac arrhythmia, 16% of ischaemic heart disease, 16% heart failure, 12% peripheral vascular disease, and 8% cerebrovascular disease. Compared to the control group, patients with COPD had a higher risk of dyslipidaemia (OR 3.24, 95% CI; 2.21-4.75), diabetes type 2 (OR 1.52, 95% CI; 1.01-2,28), and ischaemic heart disease (OR 2.34, 95% CI; 1.22-4.49). In the case of dyslipidaemia, an increased risk was obtained when adjusted for age, gender, and consumption of tobacco (OR 5.04, 95% CI; 2.36-10.74). CONCLUSIONS: Patients with COPD resident in the Canary Islands have a high prevalence of hypertension, dyslipidaemia, ischaemic heart disease, and cardiac arrhythmia. Compared to general population, patients with COPD have a significant increase in the risk of dyslipidaemia.

Un invitado inesperado en la ecobroncoscopia / An unexpected guest in ultrasound-guided bronchoscopy

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Un inesperado e indeseado efecto de la ley 42/2010 / No disponible

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[Journal of the year 2009 in interventionist pneumology, interstitial diseases and transplant]. / Revista del año 2009 en neumología intervencionista, enfermedades intersticiales y trasplante.

Endobronchial ultrasound bronchoscopy has been one of the most important contributions to the minimally invasive diagnosis and staging of mediastinal disease in the last few years. Two original works with linear and radial endobronchial ultrasound bronchoscopy published in the Archivos de Bronconeumología are analysed. In pleural pathology, we have selected a multicentre study one the usefulness of an outpatient tunnelised pleural drainage in 63 patients with malignant neoplastic effusions. This technique was indicated in 20% when pleurodesis failed or was not indicated, and an overall symptomatic improvement was achieved in 95% of cases. In interstitial diseases, we highlight the article on the usefulness of BAL in the initial diagnosis of these diseases in a series of 562 patients studied over 14 years. The authors highlight the minimal invasiveness of the technique and its value which, when added to the radiological and clinical findings, enables these diseases to be managed without surgical biopsy in around 90% of cases. Finally, we highlight the works on lung transplant which analysed the value of interleukin-8 by BAL in the donor lung to detect sub-clinical involvement that could lead to a primary dysfunction of the lung graft, the risk factors associated to mortality in 92 lung transplant receivers due to emphysema and, lastly, the experience of the transplant in 15 patients with pulmonary arterial hypertension in an advanced functional class, with a peri-operative survival at 5 years of 40%.

Revista del año 2009 en neumología intervencionista, enfermedades intersticiales y trasplante / Journal of the Year 2009 in Interventionist Pneumology, Interstitial Diseases and Transplant

En los últimos años, la ecobroncoscopia ha representado una de las aportaciones más importantes para eldiagnóstico y la estadifi cación mínimamente invasiva de la enfermedad mediastínica. En nuestra revisión,se analizan 2 trabajos originales con ecobroncoscopia lineal y radial publicados en ARCHIVOS DE BRONCONEUMOLOGÍA.En enfermedad pleural, hemos seleccionado el estudio multicéntrico sobre la utilidad del drenajepleural tunelizado ambulatorio en 63 pacientes con derrames neoplásicos malignos. En el 20% se indicóesta técnica cuando la pleurodesis había fallado o no estaba indicada y la mejoría sintomática se logró globalmenteen el 95% de los casos.En enfermedad intersticial destacamos el artículo sobre la utilidad del lavado broncoalveolar (LBA) en laorientación diagnóstica de estas enfermedades en una serie de 562 pacientes estudiados durante 14 años.Los autores destacan la baja invasividad de la técnica y el valor orientativo que, sumado a los hallazgos radiológicosy clínicos, permiten el tratamiento de estas enfermedades sin biopsia quirúrgica en cerca del90% de los casos.Finalmente, destacaremos los trabajos en trasplante pulmonar que analizaron el valor de la interleucina 8determinado por LBA en el pulmón donante para detectar una afectación subclínica que pudiera llevar adisfunción primaria del injerto pulmonar, los factores de riesgo asociados a la mortalidad en 92 receptoresde trasplante pulmonar por enfi sema y, por último, la experiencia del trasplante en 15 pacientes con hipertensiónarterial pulmonar en clase funcional avanzada, con una mortalidad perioperatoria del 26% y unasupervivencia a los 5 años del 40%(AU)

Endobronchial ultrasound bronchoscopy has been one of the most important contributions to the minimallyinvasive diagnosis and staging of mediastinal disease in the last few years. Two original works with linear andradial endobronchial ultrasound bronchoscopy published in the ARCHIVOS DE BRONCONEUMOLOGÍA are analysed. Inpleural pathology, we have selected a multicentre study one the usefulness of an outpatient tunnelised pleuraldrainage in 63 patients with malignant neoplastic effusions. This technique was indicated in 20% when pleurodesisfailed or was not indicated, and an overall symptomatic improvement was achieved in 95% of cases.In interstitial diseases, we highlight the article on the usefulness of BAL in the initial diagnosis of thesediseases in a series of 562 patients studied over 14 years. The authors highlight the minimal invasivenessof the technique and its value which, when added to the radiological and clinical fi ndings, enables thesediseases to be managed without surgical biopsy in around 90% of cases.Finally, we highlight the works on lung transplant which analysed the value of interleukin-8 by BAL in thedonor lung to detect sub-clinical involvement that could lead to a primary dysfunction of the lung graft,the risk factors associated to mortality in 92 lung transplant receivers due to emphysema and, lastly, theexperience of the transplant in 15 patients with pulmonary arterial hypertension in an advanced functionalclass, with a peri-operative survival at 5 years of 40%(AU)

Tumor fibroso pleural solitario. Presentación de 4 casos / Solitary pleural fibrous tumor: study of 4 cases

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