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Background The concept of clinical control has been proposed as an instrument for evaluating patients with COPD. However, the possible association between clinical control, reduced symptom severity and HRQoL has yet to be confirmed. Methods This multicentre, prospective and observational study was carried out in 15 pulmonology clinics in Spain. The patients were followed up for six months, with a baseline visit (V0), followed by visits at three months (V1) and six months (V2). Clinical control was determined at V1, with the application of both clinical criteria and the COPD assessment test (CAT). All patients reported their symptoms by a validated symptom diary (E-RS) using a portable device, and their HRQoL was assessed using the EQ5D questionnaire. The relationship between clinical control and E-RS and HRQoL during follow-up was assessed with t-test. Results A total of 126 patients were screened. After application of the inclusion/exclusion criteria, 93 were finally included (mean age 66 ± 8 years, 84.9% male), with a mean FEV1 predicted of 49.8% ± 16.5%. Of these patients, 44 (47.3%) achieved clinical control at V1, according to CAT criteria, and 50 (53.8%), according to clinical criteria. The E-RS scores differed between controlled and uncontrolled patients at all time points, both according to CAT (mean differences of -4.6, -5.6 and -6.2 units at V0, V1 and V2, respectively, p

Juan-Antonio Riesco-Miranda,1,2 Segismundo Solano-Reina,3 Carlos Rábade-Castedo,4 José-Ignacio de Granda-Orive,5 Esther Pastor-Esplá,6 Marcos García-Rueda,7 Francisco-Javier Callejas-Gonzalez,8 Ángel Azpeitia-Anadón,9 Silvia Mas,10 Carlos-Andrés Jiménez-Ruiz11 1Servicio de Neumología, Hospital Universitario de Cáceres, Cáceres, Spain; 2CIBERES, Madrid, Spain; 3Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain; 4Servicio de Neumología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; 5Servicio de Neumología, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, Madrid, Spain; 6Servicio de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain; 7Servicio de Neumología, Hospital Universitario Carlos Haya, Málaga, Spain; 8Servicio de Neumología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain; 9Departamento Médico Labs, Esteve S.A, Barcelona, Spain; 10Universidad Pompeu Fabra, Barcelona, Spain; 11Unidad Especializada de Tabaquismo, Hospital Clínico Universitario, Madrid, SpainCorrespondence: Silvia MasUniversitat Pompeu Fabra, Campus Poble Nou, Roc Boronat 138, Barcelona, 08018, SpainEmail silviamas.md@gmail.comPurpose: Smokers attending smoking cessation units (SCUs) may offer a unique opportunity for early recognition of undiagnosed chronic obstructive pulmonary disease (COPD). We aimed at assessing the impact of SCUs on the early diagnosis of COPD and describing the clinical and smoking profile of newly-diagnosed COPD cases at SCUs certified by the Spanish Society of Respiratory Diseases and Thoracic Surgery (SEPAR).Patients and Methods: A multicenter cross-sectional observational cohort study (DIPREPOQ study) was performed in eight SEPAR-certified SCUs in Spain. Adult current smokers with no previously diagnosed respiratory disease and having one o more respiratory symptoms were included. Lung functional tests were performed and previously undiagnosed COPD cases were identified and characterized based on national guidelines.Results: Out of 401 individuals newly attending the SCUs, 252 participants were included and 73 (28.9%) met the definition of previously undiagnosed COPD. A characterization of patients with COPD being newly recognized in SCUs showed: age (mean±SD) 61± 9 years; men 59%; active work status 53.1%; functional class I/II dyspnea 82.8%, GOLD state mild/moderate/severe 57%/31%/12%; non-exacerbators 90%, CAT 14± 4; emphysema in X-rays 40%. Most common co-morbidities were cardiovascular and psychiatric (anxiety and depression) ones. Usual smoking history included a lengthy smoking history (41± 9 years) and a current consumption of 24± 9 cigarettes/day.Conclusions and Implications: Consistently certified SCUs can have a substantial contribution to early diagnosis of COPD. A typical profile of newly detected cases is reported, with most patients being men at their early sixties, with mild symptoms and with high and lengthy smoking history. Our study reports a high usefulness of lung functional tests to detect undiagnosed COPD in appropriately selected participants attending SCUs at a large national scale, using a standardized methodology. This is likely to be facilitated by the certification of SCUs using well-defined requirements by national scientific societies.Keywords: health consequences, smoking, chronic obstructive pulmonary disease, smoking cessation unit

Objective: this study analyses long-term results of sublobar resection in daily clinical activity versus the standard procedure (lobectomy). Method: From a prospective database, patients treated with sublobar resection for NSCLC were identified (2007-2017). None of them had malignant disease in the 5 previous years nor induction treatment. Log-rank test was used to compare overall survival and disease free survival. One-to-one propensity score matching was performed for age, sex, stage, and comorbities to reduce bias selection. Results: 1214 patients were surgically treated for lung cancer in that period of time. Finally, 52 patients were included in sublobar group with following resections: pulmonary wedge 37(71.2%) cases; anatomic segmentectomy 15(28.8%) cases. Women 4(7.7%); Men 48(92.3%). Mean age: 68.6 y.o. (range 42-86). Pulmonary function test (FEV1 64.9% vs 77.3% p=0.004) and tumoral size (1.9cm vs 3.0cm p

Resumen: Introducción: El síndrome de apneas-hipopneas del sueño (SAHS) es altamente prevalente en la edad pediátrica y un problema importante de salud pública. Se pretende conocer la presentación clínica y polisomnográfica del SAHS infantil en nuestro medio. Pacientes y métodos: Estudio descriptivo retrospectivo de los estudios del sueño realizados a menores de 14 años desde 1999 hasta 2012 en la Unidad del Sueño del Complejo Hospitalario Universitario de Albacete. Se recogen edad, sexo, datos antropométricos, clínicos, indicación y variables del estudio del sueño, tratamiento y evolución. Resultados: Doscientos treinta y cuatro niños. SAHS el 71,8%: moderado 42,3% y grave 44,6%. 60,7% varones y mediana de edad 5 años; el 78% en edad preescolar o escolar. Presentaban sobrepeso/obesidad 44%, ronquidos 93,4%, apneas 84,5% y somnolencia diurna 5,4%; 23 polisomnografías y 145 poligrafías: mediana de índice de apneas-hipopneas (IAH) 10, de SatO2 mínima 84% y de índice de desaturaciones 8, y media de sueño en supino 53,65% y de eventos en supino 57,61%. El tratamiento fue medidas higiénico-dietéticas en el 29,2%, CPAP el 6% y cirugía el 42,9%. Mejoraron los ronquidos y/o apneas el 69,4% y el peso el 32,4% de los niños con sobrepeso/obesidad. Conclusiones: La mayoría de los niños estudiados tenían un IAH patológico. Casi la mitad presentaban sobrepeso/obesidad y un alto porcentaje tenía SAHS moderado-grave. El tratamiento más indicado fue la cirugía. La evolución clínica fue favorable en casi el 70%. Menos de un tercio con SAHS y sobrepeso/obesidad mejoraron el peso. Abstract: Introduction: Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Patients and methods: Retrospective descriptive study of sleep tests conducted on children up to 14 years-old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. Results: The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age 5 was years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, Sat.O2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Conclusions: Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight.

Introduction: Obstructive sleep apnoea (OSA) is highly prevalent in children and a major public health problem. An attempt is made to determine the clinical and polysomnographic presentation of paediatric OSA in our area. Patients and methods: Retrospective descriptive study of sleep tests conducted on children up to 14 years old from 1999 to 2012 in the Sleep Unit of the University Hospital of Albacete. Age, gender, anthropometric, clinical data, indication and variables of sleep study, treatment, and outcomes were collected. Results: The study included 234 children. OSA was found in 71.8%, with 42.3% moderate and 44.6% severe. The majority were male (60.7%) and the mean age was 5 years, of whom 78% were pre-school or school age. There was overweight/obesity in 44%, with 93.4% snoring, apnoea 84.5%, and 5.4% daytime sleepiness. There were 23 polysomnographies and 145 polygraphies, with a median apnoea/hypopnoea index (AHI) of 10, SatO2 minimum 84%, desaturation index 8, and mean sleep supine 53.65% and supine events 57.61%. Treatment was lifestyle modifications 29.2%, CPAP 6%, and surgery 42.9%. Improved snoring and/or apnoea 69.4%, and weight 32.4% of overweight/obesity children. Conclusions: Most of the studied children had a pathological AHI. Almost half were overweight/obese, and a high percentage had moderate-severe OSA. Most frequent treatment was surgery. The clinical outcome was favourable in almost 70%. Less than a third with OSA and overweight/obesity improved weight. Resumen: Introducción: El síndrome de apneas-hipopneas del sueño (SAHS) es altamente prevalente en la edad pediátrica y un problema importante de salud pública. Se pretende conocer la presentación clínica y polisomnográfica del SAHS infantil en nuestro medio. Pacientes y métodos: Estudio descriptivo retrospectivo de los estudios del sueño realizados a menores de 14 años desde 1999 hasta 2012 en la Unidad del Sueño del Complejo Hospitalario Universitario de Albacete. Se recogen edad, sexo, datos antropométricos, clínicos, indicación y variables del estudio del sueño, tratamiento y evolución. Resultados: Doscientos treinta y cuatro niños. SAHS el 71,8%: moderado 42,3% y grave 44,6%. 60,7% varones y mediana de edad 5 años; el 78% en edad preescolar o escolar. Presentaban sobrepeso/obesidad 44%, ronquidos 93,4%, apneas 84,5% y somnolencia diurna 5,4%; 23 polisomnografías y 145 poligrafías: mediana de índice de apneas-hipopneas (IAH) 10, de SatO2 mínima 84% y de índice de desaturaciones 8, y media de sueño en supino 53,65% y de eventos en supino 57,61%. El tratamiento fue medidas higiénico-dietéticas en el 29,2%, CPAP el 6% y cirugía el 42,9%. Mejoraron los ronquidos y/o apneas el 69,4% y el peso el 32,4% de los niños con sobrepeso/obesidad. Conclusiones: La mayoría de los niños estudiados tenían un IAH patológico. Casi la mitad presentaban sobrepeso/obesidad y un alto porcentaje tenía SAHS moderado-grave. El tratamiento más indicado fue la cirugía. La evolución clínica fue favorable en casi el 70%. Menos de un tercio con SAHS y sobrepeso/obesidad mejoraron el peso.

Introduction Smoking is the cause of multiple diseases. Effective treatment is critical, and when there is, and fails, to detect posible contributing factors. Objectives Analyze the characteristics of people who fail in anti-smoking treatment. Material and methods Retrospective study of the patients evaluated in smoking unit between 2009-2011. Patients who had treatment failure were detected and were compared with those who had any time of abstinence. Chi square, Fisher statistic and student t was used. We defined failure as that one who has not been able to leave smoking even 24 hours. Results N=901 patients. 83 failed. Conclusions 1. Male gender influences in therapeutic failure. 2. Age, number of cigarettes, ECM and SBP are also associated. 3. Among respiratory diseases, suffering COPD and SAHS is more likely to fail. 4. Arrythmias, dyslipidemia, IBD and neoplasias also have a higher frecuency of treatment failure. 5. Neither psychiatric illness nor the use of other drugs or alcohol were associated with a higher frecuency of failure.

Introduction Smoking is a systemic disease. It is the the most important isolated cause of premature morbidity and mortality preventable and avoidable in developed countries. Multiple diseases and pathological conditions are directly caused or have been related to snuff exposure. Objectives We decided to see if with the experience the success rate, defined as a year of continuous abstinence, of our patients had improved. Material and methods Retrospective study using the database of our unit over years 2008 and 2012. Chi-square test was used to compare the success and relapse in one year and another, and student t test and chi-square were used to compare if the main characteristic of the samples were comparable.The study was made with all the patients who attended to the consultation. Results Conclusions: 1- More patients in 2012 than in 2008, but there were no differences in success. 2- Patients in 2008 smoked more and had more dependence. 3- There were fewer relapses in 2012. 4- We got more abstinence days in 2008.

Objective: To assess the impact of a telemedicine project that uses the Medtep platform in patients diagnosed with asthma. Method: An asthma consultation in the Integrated Care Management center of Albacete, in collaboration with the Pneumology department, which treat patients with possible asthma and/or acute asthma. In March of 2015 a group of 25 patients diagnosed with asthma, previously invited to participate in the study, were selected. Several training meetings were scheduled to assist them in using a web portal to control their asthma. They were also delivered a Peak-Flow and taught how it works. For 6 months clinical evolution and web portal entrances to follow. The data which was collected: smoking, how long they were diagnosed with asthma, asthma attacks, hospitalizations. Treatments- Evolution, According to patient level. Results: Out of the total 25 patients diagnosed, 17 (67%) were men and 8 (32%) women. The patient’s average age is of 34 years old. The total amount of smokers were 5 patients (20%), 3 of the remaining patients had never smoked. The average cigarette consumption of the smokers was of 2 packs a day. 42% had been diagnosed with asthma for less than 1 year; 20% between 1 and 5 years and the rest of patients had been diagnosed for over 5 years. Before entering the study, 50% had to attend emergency visits at least once (a year?), and some patients as much as 4 times in the last year. After entering the study, none of the patients had to attend ER visits. 80% of the total patients entered their health related data on a daily basis, as well as medication registers, which was above 95% in those who assiduously used the system. The total Peak flow of the patients saw an increase of 7% over baseline. More than 50% of patients increased their treatment before entering the study, and none and even 25% decreased their dose of treatment. 32% of patients have improved their level depending on the base treatment. Conclusions: Improvements in asthma control were achieved in patients who received Medtep Asthma support for 6 months, decreasing assistance in emergency services and, as a result, requiring less treatment.

Heterozygous familial hypercholesterolemia affects one every 400 individuals, is caused by mutations in the LDL receptor gene and is associated with premature coronary artery disease. Nowadays, LDL cholesterol can be efficiently reduced with the new therapies to reduce blood lipids. We report a female patient who consulted in 1975, when she was 46 years old, for severe hypercholesterolemia. In 2003, a sample of leukocyte DNA was obtained and the uncommon 1705 + 1G >A mutation of the LDL receptor gene was detected. No mutations in the apolipoprotein B gene were found. The patient was treated successfully with simvastatin 80 mg/day and ezetimibe 10 mg/day and LDL cholesterol levels were reduced below 200 mg/dl

The Cystic Fibrosis (CF) carrier rate in Chile was estimated to be1/40. CF is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator(CFTR) gene. Delta F508 mutation is the most common in CF patients in Chile and worldwide. DeltaF508 has linkage disequilibrium with two Single Nucleotide Polymorphisms (SNP), often used todefine the haplotypic frameworks of CF mutations.

La frutilla es una de las frutas de importante crecimiento economico tanto en Chile como a nivel Mundial. Desde hace varios anos su produccion ha experimentado perdidas economicas, principalmente a causa de las enfermedades producidas por Fusarium oxysporum f.sp. fragariae (Fof). Este patogeno, se ha propagado rapidamente por casi todo el mundo debido a su dificil diagnostico y actualmente la unica manera de detectarlo es mediante test de patogenicidad, tecnica laboriosa que requiere de bastante tiempo y material, lo que dificulta su deteccion oportuna. Debido a que el diagnostico genetico y las tecnicas moleculares son metodologias rapidas y altamente eficaces, el objetivo de este trabajo fue disenar un metodo para detectar a Fof, con el fin de controlar y certificar el ingreso o salida del pais de este patogeno. Para esto se amplifico el gen «Factor de Elongacion 1-α» (EF1-α), en 25 cepas de F. oxysporum aisladas desde diversas localidades de la VIII region y R. Metropolitana, 4 cepas otorgadas por el laboratorio Nacional del Servicio Agricola y Ganadero (SAG), y 4 cepas patogenicas controles importadas desde ATCC, EE.UU. Posteriormente por digestion con endonucleasas MseI y MspI se logro diferenciar las cepas de Fusarium oxysporum f.sp. fragariae de las respectivas cepas no patogenicas de este hongo. Estos resultados fueron confirmados mediante electroforesis en geles de poliacrilamida denaturante, RFLP con dos endonucleasas y parcialmente mediante secuenciacion del producto amplificado de Fof, revelandose de esta manera la eficacia de esta metodologia.