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J Bellido-Casado

Publications and source records attributed to J Bellido-Casado.

6 recordsLinked to original sources

[Usefulness of the Guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) in identifying the causes of chronic cough].

OBJECTIVE: The usefulness of the recently published guidelines of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on the diagnosis and treatment of chronic cough has not yet been demonstrated. The objectives of the present study were a) to evaluate the usefulness of the SEPAR guidelines for identifying the possible causes of chronic cough, and b) to determine the most frequent causes of chronic cough treated by primary care physicians. METHODS: We carried out a prospective descriptive study that included 57 consecutive patients (mean age, 62 years) seeking medical attention for chronic cough in a primary health care area. The patients were evaluated using the algorithm proposed in the SEPAR guidelines, whereby the diagnostic procedure is divided into 3 phases in function of complexity. Phase I was carried out at the primary care level, and phases II and III at a hospital pneumology department. RESULTS: For 56 patients (98%), the potential cause of cough was identified: for 52 (91%) in phase I; for 3 (5%), in phase II; and for 1 (2%), in phase III. In 30 patients (53%), a single cause was identified; in 20 (36%), 2 causes; and in 6 (11%), more than 2 causes. Considered individually, the most common causes were postnasal drip in 26 cases (46%), the use of cough-inducing drugs (10 of them attributable to angiotensin-converting enzyme inhibitors) in 16 (28%), asthma in 15 (27%), infection in 13 (23%), gastroesophageal reflux in 12 (21%), and others in 9 (16%). CONCLUSIONS: The application of the SEPAR guidelines on chronic cough is useful for the identification of its causes. The use of angiotensin-converting enzyme inhibitors is a frequent cause of coughs diagnosed at the level of primary outpatient health care.

Adolescent↗

[Markers of airway remodeling in induced sputum from healthy smokers].

OBJECTIVE: Airway remodeling in chronic obstructive pulmonary disease (COPD) has been linked to the equilibrium between matrix metalloproteinase (MMP) 9 and its inhibitor, tissue inhibitor of metalloproteinase (TIMP) 1. However, that equilibrium has not been analyzed in healthy smokers. The aim of this study was to assess the equilibrium between MMP-9 and TIMP-1 in induced sputum from healthy smokers, healthy nonsmokers (controls), and patients with COPD. PATIENTS AND METHODS: Samples of induced sputum were obtained from 35 individuals: 12 healthy smokers, 12 controls, and 11 patients with COPD. In each sample, a differential cell count was performed and enzyme-linked immunosorbent assays were used to analyze the concentrations of MMP-9 (total and active fraction) and TIMP-1. RESULTS: Compared with controls, healthy smokers were found to have a higher mean (SD) concentration of total MMP-9 (273 [277] ng/mL vs 128 [146] ng/mL) and a higher ratio of total MMP-9 to TIMP-1 (0.16 [0.14] vs 0.08 [0.06]). However, the ratio of active MMP-9 to TIMP-1 was similar in the 2 groups. Samples from patients with COPD had the highest concentrations of total MMP-9 (477 [262] ng/mL) and active MMP-9 (178 [126] ng/mL) and the lowest concentrations of TIMP-1 (1.044 [1.036] microg/mL). When all groups were considered together, there was an inverse relationship between the MMP-9/TIMP-1 ratio and the forced expiratory volume in the first second (FEV1). The relationship between the active MMP-9/TIMP-1 ratio and FEV1 was even stronger, and the relation of both ratios with FEV1 became stronger still when smoking was considered. CONCLUSIONS: Healthy smokers had a higher concentration of total MMP-9 and that concentration was correlated with their exposure to tobacco smoke. Maintenance of the active MMP-9/TIMP-1 ratio in healthy smokers may explain the absence of progressive airway obstruction. Measurement of active MMP-9 concentration could be useful for assessment of airway remodeling.

Adult↗

The SF-36 Questionnaire as a measurement of health-related quality of life: assessing short- and medium-term effects of exposure to tobacco versus the known long-term effects.

BACKGROUND: In order to determine the magnitude of the short- or medium-term effects of tobacco use on the health-related quality of life (HRQOL) of smokers and ex-smokers, and to compare them with the estimated long-term effects reported in other studies, a cross-sectional epidemiological study was designed. METHODS: A representative study of the general population over 14 years of age was conducted in the western health area of Valladolid, Spain. HRQOL was evaluated using the SF-36 Health Questionnaire. Differences in HRQOL among smokers, non-smokers, and former smokers were determined. Standardized scores from the general population and long-term effects of tobacco exposure were compared. RESULTS: Former smokers had a better HRQOL than smokers and non-smokers on the emotional dimensions, especially "vitality" and "role emotional", while differences between the groups on the physical and emotional dimensions did not reach statistical significance. Smokers displayed deterioration in "bodily pain", "general health", "vitality", "social function", and "role emotional", while deterioration in ex-smokers only occurred in "bodily pain" and "general health." The variable package/year was correlated with "general health." CONCLUSIONS: Short- and medium-range effects of tobacco consumption on HRQOL cannot be demonstrated with the SF-36 Health Questionnaire in the general Spanish population, whereas long-term effects can.

Journal Article↗

[Lung function in cardiac dysfunction].

OBJECTIVE: The alterations in lung function caused by heart failure were first described some decades ago. The advent of new tools for the diagnosis and investigation of heart disease, such as echocardiography, has subsequently made it possible to classify cardiac dysfunction with greater precision. The objective of this study was to analyze and compare a series of lung function and gas exchange variables in patients who had been classified into 4 groups according to type of heart disease as diagnosed by echocardiography. MATERIALS AND METHOD: Emergency room patients whose main symptom was acute dyspnea caused by cardiac or respiratory disease were included in the study. The final sample comprised 71 patients whose echocardiogram revealed cardiac dysfunction. Spirometry was carried out and resting arterial blood gases measured in this group. RESULTS: Of the 71 patients with cardiopathy, 31 had systolic dysfunction, 27 diastolic dysfunction, 7 cor pulmonale, and 6 primary valve disease. Spirometry revealed a generally obstructive pattern, more marked in the group with cor pulmonale. Analysis of arterial blood gases revealed slight hypoxemia with normocapnia in all groups, but this was more accentuated in the patients with cor pulmonale and diastolic dysfunction. An analysis of the correlations (Pearson's r) between cardiac and pulmonary variables revealed the statistically significant associations between cardiac mass and other variables to be as follows: forced vital capacity r=0.34 (P=.02), forced expiratory volume in one second r=0.526 (P=.0001), forced expiratory volume in one second as a percentage of predicted r=0.3 (P=.037), and forced midexpiratory flow rate r=0.31 (P=.03). The correlation between left ventricular ejection fraction and PaO2 was r=-0.312 (P=.01); the correlation between left ventricular end-diastolic diameter and PaO2 was r=0.369 (p=.006). CONCLUSIONS: In patients with cardiac dysfunction, spirometry reveals a generally obstructive pattern, which is more accentuated in patients with right ventricular dysfunction owing to the existence of prior lung disease. The associations found between the cardiac and lung function variables do not help the physician to determine the predominant diagnosis for a patient more precisely or to establish a prognosis.

Adult↗

Report on five cases of tularaemic pneumonia in a tularaemia outbreak in Spain.

A report is given on five cases of atypical tularaemic pneumonia selected from among 140 cases of tularaemic infection in a previously reported outbreak occurring in 1997. Prior to this outbreak no human cases of tularaemia had been reported in Spain. All cases were diagnosed serologically. All five patients reported on here had a mild form of the disease, which was treated successfully with streptomycin in four cases and ciprofloxacin in one case. Tularaemic pneumonia should be considered in the differential diagnosis of atypical pneumonia in Spain, especially in hunters and other persons who handle animal carcasses.

Aged↗