Impact of obesity on the clinical profile of a population-based sample with chronic obstructive pulmonary disease.

Aims: To characterize the distribution of BMI in a population-based sample of COPD patients and to evaluate the impact of obesity on their health status, exercise tolerance, systemic inflammation and comorbidity.

Methods: A population-based sample of 3,797 subjects aged 40-80 years from the EPI-SCAN study was selected. Subjects were categorized according their body mass index (BMI) as underweight (<18.

Characterisation of the overlap COPD-asthma phenotype. Focus on physical activity and health status.

Background: Patients with COPD may share some clinical characteristics with asthma sufferers. This phenotypic overlap between COPD and asthma is not yet well characterised.

Method: We have analysed data from the EPI-SCAN study, an epidemiological, population-based study in Spain that included 3885 (40 to 80-year-old) subjects in order to investigate the clinical and systemic inflammatory characteristics of COPD patients previously diagnosed with asthma.

Frequency of multi-dimensional COPD indices and relation with disease activity markers.

Our aim was to describe the population-based distribution of several COPD multi-dimensional indices and to evaluate their relationship with daily physical activity, co-morbidity, health status and systemic inflammatory biomarkers. From a population-based sample of 3,802 subjects aged 40-80 from the EPI-SCAN study, 382 subjects (10.2%) with a post-bronchodilator FEV1/FVC<0.

Underdiagnosis of chronic obstructive pulmonary disease in women: quantification of the problem, determinants and proposed actions.

Introduction: The distribution of chronic obstructive pulmonary disease (COPD) in women, and its underdiagnosis and determinants in the general population, have not been well described. The EPI-SCAN study is an epidemiologic, observational study conducted at 11 Spanish centers on the general population aged 40 to 80.

Patients And Method: This paper describes the rates and extrapolates the population burden from the 3,802 participants of the EPI-SCAN study.

Spirometrically-defined restrictive ventilatory defect: population variability and individual determinants.

Background: A spirometrically-defined restrictive ventilatory defect is a common finding when performing spirometry.

Aims: We aimed to determine the frequency, geographical variation, individual consequences, and 'severity' of the restrictive ventilatory defect.

Methods: A population-based study was conducted in Spain.

Overdiagnosing subjects with COPD using the 0.7 fixed ratio: correlation with a poor health-related quality of life.

Background: The current debate about the lower limit of normal (LLN) vs the 0.7 fixed ratio to diagnose COPD is not completely resolved, and little information about the clinical impact of these different criteria is available. We compared differences in health-related quality of life, exacerbations, exercise tolerance, physical activity, comorbidity, and systemic biomarkers of subjects with FEV(1)/FVC < 0.

Systemic inflammation in chronic obstructive pulmonary disease: a population-based study.

Background: Elevated circulating levels of several inflammatory biomarkers have been described in selected patient populations with COPD, although less is known about their population-based distribution. The aims of this study were to compare the levels of several systemic biomarkers between stable COPD patients and healthy subjects from a population-based sample, and to assess their distribution according to clinical variables.

Methods: This is a cross-sectional study design of participants in the EPI-SCAN study (40-80 years of age).

Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities.

Aims: This study aimed to determine the prevalence of chronic obstructive pulmonary disease (COPD) in Spain and identify the level of undiagnosed disease and its impact on health-related quality of life (HRQL) and activities of daily living (ADL).

Methods: A population-based sample of 4274 adults aged 40-80 years was surveyed. They were invited to answer a questionnaire and undergo prebrochodilator and postbronchodilator spirometry.

[The EPI-SCAN survey to assess the prevalence of chronic obstructive pulmonary disease in Spanish 40-to-80-year-olds: protocol summary].

Background And Objectives: Chronic obstructive pulmonary disease (COPD) causes considerable morbidity and mortality in Spain. The 1997 IBERPOC study, applying the old criteria of the European Respiratory Society, reported a COPD prevalence of 9.1% in the adult population of Spain.

[Assessment of patient satisfaction and preferences with inhalers in asthma with the FSI-10 Questionnaire].

Background And Objective: Lack of adherence to inhaled corticosteroid therapy is common in patients with asthma, and it has been suggested that allowing patients to choose their own inhalers would resolve this problem. The FSI-10 (Feeling of Satisfaction with Inhaler) is a self-completed questionnaire to assess patient opinions regarding ease or difficulty of use, portability, and usability of devices for delivery of inhaled corticosteroids. The aim of this study was to define the measurement properties of the FSI-10 questionnaire and to use this inventory to compare satisfaction and preferences of patients with asthma regarding 3 different devices for delivery of inhaled corticosteroids: Turbuhaler, Accuhaler, and Novolizer.

Characteristics of a population of COPD patients identified from a population-based study. Focus on previous diagnosis and never smokers.

Objective: To identify factors associated with diagnosis and health-related quality of life (HRQL) impairment in chronic obstructive pulmonary disease (COPD) patients from a population-based epidemiological study.

Design And Participants: This was an epidemiologic, multicenter, population-based study. Three hundred and sixty-three individuals diagnosed with COPD from a randomly general population sample of 4035 individuals aged 40-69 were included in the analyses.

[Smoking habits among sixth-year medical students in Spain].

Objective: To describe and analyze the smoking habits of sixth-year Spanish medical students.

Material And Methods: The target population of this descriptive cross-sectional study was students completing their sixth year in Spanish medical schools. An anonymous, self-administered questionnaire was sent to the students' homes by ordinary mail.

Can cumulative tobacco consumption, FTND score, and carbon monoxide concentration in expired air be predictors of chronic obstructive pulmonary disease?

Between 15% and 20% of smokers develop chronic obstructive pulmonary disease (COPD). The aim of the present study was to determine which characteristics of smoking, particularly the Fagerström Test for Nicotine Dependence (FTND) score, were associated with the risk of developing COPD. Data from the IBERPOC epidemiological study were analyzed.

[Costs of chronic obstructive pulmonary disease in Spain. Estimation from a population-based study].

Objective: In the studies carried out to date, the cost of chronic obstructive pulmonary disease (COPD) may have been overestimated due to the inclusion of previously diagnosed patients seeking medical attention for their symptoms. As a result, the severity of the cases included in these studies may have been greater than in an unselected sample of the general population. The aim of the present study was to estimate the direct cost of COPD on the basis of a representative sample of the overall Spanish population between 40 and 69 years of age (from the IBERPOC study).

[Second consensus report on the use of antimicrobial agents in exacerbations of chronic obstructive pulmonary disease].

Aware of the importance of chronic obstructive pulmonary disease (COPD), a panel of experts belonging to the Spanish Society of Respiratory Medicine and Thoracic Surgery (SEPAR), the Spanish Society of Chemotherapy (SEQ) and the Spanish Society of Family and Community Medicine (SEMFyC) issued a statement of consensus in 2000 to serve as the basis for adequate antibiotic control of the disease. Three years later, in accordance with significant scientific progress made in this area, the statement has been thoroughly revised. The new paper in fact constitutes a second consensus statement on the use of antibiotics in COPD exacerbations.

Effect of montelukast added to inhaled budesonide on control of mild to moderate asthma.

Background: Proinflammatory leukotrienes, which are not completely inhibited by inhaled corticosteroids, may contribute to asthmatic problems [corrected]. A 16 week multicentre, randomised, double blind, controlled study was undertaken to study the efficacy of adding oral montelukast, a leukotriene receptor antagonist, to a constant dose of inhaled budesonide.

Methods: A total of 639 patients aged 18-70 years with forced expiratory volume in 1 second (FEV(1)) > or =55% predicted and a minimum predefined level of asthma symptoms during a 2 week placebo run in period were randomised to receive montelukast 10 mg (n=326) or placebo (n=313) once daily for 16 weeks.

[Respiratory symptoms and diagnosis of COPD in smokers of various types to tobacco. Results from the IBERPOC study].

Background: The aim of this study was to investigate the sociodemographic characteristics, smoking habits, the prevalence of respiratory symptoms and chronic obstructive pulmonary disease (COPD) in four groups of smokers: of cigarettes (SCt), of cigars (SCigar), of both (SB), of cigars currently but of cigarettes in the past (SCigarExCt) and of cigarettes currently but of cigars in the past (SCtExCigar).

Method: A multicenter epidemiological study enrolling 4,035 subjects aged between 40 and 69 years. One thousand nine hundred sixty-three were non-smokers and 1,146 were current smokers.

[Spirometry: quality in the respiratory medicine clinics of a public health care area].

Background: Spirometry can be considered a routine way to evaluate patients with respiratory complaints, both inside and outside the hospital setting.

Objective: To assess the quality of spirometry in a public health care area with respect to two factors: the technicians' performance and the calibration of spirometers.

Material And Method: Four health care clinics were studied.

Interpretation of quality of life scores from the St George's Respiratory Questionnaire.

The aim of the study was to obtain the general population norms for the St. George's Respiratory Questionnaire (SGRQ), a specific questionnaire for respiratory diseases. The IBERPOC project was a cross-sectional study of representative samples of the general population aged between 40-69 yrs.

[Early discharge and home health care program for patients with exacerbated COPD and asthma].

Objective: To shorten hospital stays of patients with exacerbated chronic obstructive pulmonary disease (COPD) or asthma by way of a home care program and to assess whether the program increased the number of readmissions.

Methods: Patients admitted due to COPD exacerbation or asthma who did not need critical care and were discharged before the fourth day. A registered nurse experienced with respiratory disease patients and in regular contact with the pneumologist who supervised the program made follow-up home care visits to give instructions and check compliance with treatment.