Papers by Bernabe Jurado-Gamez
International Journal of Molecular Sciences
The high mortality, the presence of an initial asymptomatic stage and the fact that diagnosis in ... more The high mortality, the presence of an initial asymptomatic stage and the fact that diagnosis in early stages reduces mortality justify the implementation of screening programs in the populations at risk of lung cancer. It is imperative to develop less aggressive methods that can complement existing diagnosis technologies. In this study, we aimed to identify lung cancer protein biomarkers and pathways affected in sputum samples, using the recently developed diaPASEF mass spectrometry (MS) acquisition mode. The sputum proteome of lung cancer cases and controls was analyzed through nano-HPLC–MS using the diaPASEF mode. For functional analysis, the results from differential expression analysis were further analyzed in the STRING platform, and feature selection was performed using sparse partial least squares discriminant analysis (sPLS-DA). Our results showed an activation of inflammation, with an alteration of pathways and processes related to acute-phase, complement, and immune respo...
Aging, 2022
Background: COVID-19 survivors report residual lung abnormalities after discharge from the hospit... more Background: COVID-19 survivors report residual lung abnormalities after discharge from the hospital. The aim of this study was to identify biomarkers in serum and induced sputum samples from patients after hospitalization for COVID-19. Methods: Patients admitted to hospitals in Spain with laboratory-confirmed COVID-19 were recruited for this study. SARS-CoV-2-infected patients were divided into groups with mild/moderate and severe disease according to the severity of their symptoms during hospitalization. Levels of 92 biomarkers were measured in serum and induced sputum samples.
Clinical Microbiology and Infection, 2021
Objectives COVID-19 survivors are reporting residual abnormalities after discharge from the hospi... more Objectives COVID-19 survivors are reporting residual abnormalities after discharge from the hospital. Limited information is available about this stage of recovery or the lingering effects of the virus on pulmonary function and inflammation. The aim of this study was to describe lung function and to identify biomarkers in serum and induced sputum samples from patients recovering from COVID-19 hospitalisation. Methods Patients admitted to Spanish hospitals with laboratory-confirmed COVID-19 infection by a real-time PCR (RT-PCR) assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recruited for this study. Each hospital screened their lists of discharged patients at least 45 days after symptom onset. SARS-CoV-2-infected patients were divided into mild/moderate and severe disease groups according to the severity of their symptoms during hospitalisation. Patients’ epidemiological and medical histories, comorbidities, chronic treatments, and laboratory parameters were evaluated. Pulmonary function tests, the standardised 6-minute walk test (6 MWT) and chest computed tomography (CT) were also performed. The levels of proteases, their inhibitors, and shed receptors were measured in serum and induced sputum samples. Results A total of 100 patients with respiratory function tests were included in this study. The median number of days after the onset of symptoms was 104 (IQR 89.25, 126.75). COVID-19 was severe in 47% (47/100) of patients. CT was normal in 48% (48/100) of patients. Lung function was normal (FEV1 ≥80%, FVC ≥80%, FEV1/FVC ≥0.7, and diffusing capacity for carbon monoxide [DLCO] ≥80%) in 92% (92/100), 94% (94/100), 100% (100/100) and 48% (48/100) of patients, respectively. Multivariate analysis showed that a DLCO <80% (OR 5.92; 95%CI 2.28-15.37; p <0.0001) and a lower serum LDH level (OR 0.98; 95%CI 0.97-0.99) were associated with the severe disease group of SARS-CoV-2 during hospital stay. Conclusions A diffusion deficit (DLCO <80%) was still present after hospital discharge and was associated with the most severe SARS-CoV-2 cases.
Canadian Respiratory Journal, 2020
Background and Objective. To determine the diagnostic yield of nocturnal oximetry versus polygrap... more Background and Objective. To determine the diagnostic yield of nocturnal oximetry versus polygraphy for the diagnosis and classification of sleep apnea hypopnea syndrome (SAHS). Methods. Prospective study conducted in a university hospital. Subjects with a clinical suspicion of SAHS were included. All of them underwent home polygraphy and oximetry on the same night. A correlation was made between the apnea-hypopnea index (AHI) and the oximetry variables. The variable with the highest diagnostic value was calculated using the area under the curve (AUC), and the best cut-off point for discriminating between patients with SAHS and severe SAHS was identified. Results. One hundred and four subjects were included; 73 were men (70%); mean age was 52 ± 10.1 years; body mass index was 30 ± 4.1, and AHI = 29 ± 23.2/h. A correlation was observed between the AHI and oximetry variables, particularly ODI3 (r = 0.850; P < 0.001 ) and ODI4 (r = 0.912; P < 0.001 ). For an AHI ≥ 10/h, the ODI3 ...
Journal of Thoracic Disease, 2020
Respiratory Care, 2020
BACKGROUND: The objective of the current study was to determine whether overnight pulse oximetry ... more BACKGROUND: The objective of the current study was to determine whether overnight pulse oximetry in patients with amyotrophic lateral sclerosis is prognostic of the onset of awake respiratory failure and hospital admissions. METHODS: This was an observational study in a cohort of subjects with amyotrophic lateral sclerosis. The study included subjects with a baseline S pO 2 6 94% on home overnight pulse oximetry testing. Patients age 6 80 y and those with comorbidities and with poor short-term prognosis or sleep apnea were excluded. The subjects were classified as nocturnal desaturators according to percentage of sleep time with S pO 2 < 90% (T90) > 10%. RESULTS: A total of 76 subjects were included: 40 men (53%), mean 6 SD age 60 6 14.4 y, mean 6 SD body mass index 25.7 6 4.60 kg/m 2 , and spinal presentation in 63.2%. After overnight pulse oximetry, 20 subjects (26%) were classified as desaturators and 56 (74%) as non-desaturators. In the first year, the subjects with nocturnal desaturation had respiratory failure more often compared with the subjects without desaturation (35% vs 10.91%; P 5 .02) and had a higher risk of developing respiratory failure during the course of the study (hazard ratio 2.48; P 5 .030). The desaturator group also had a higher rate of 6 1 admission (40% vs 7.3%; P 5 .01) and a higher likelihood of respiratory-related hospitalization (hazard ratio 2.41; P 5 .02). Median survival was almost 1 year less if T90 > 10% was observed in the overnight pulse oximetry: 21 months versus 32 months survival if T90 was^10%. CONCLUSIONS: In subjects with amyotrophic lateral sclerosis, nocturnal desaturation conferred a higher risk of respiratory failure and poorer prognosis. Even in the absence of other clinical criteria, early pulse oximetry should be performed and the need for nocturnal ventilatory support assessed.
Noninvasive Ventilatory Support, 2018
Introduction: There are scarce studies published that evaluate the survival of tracheotomy perfor... more Introduction: There are scarce studies published that evaluate the survival of tracheotomy performance in ALS as well as early decision making existing very disparate tracheotomy realization rates between countries and centers. Objective: To evaluate the survival, anticiped decision making and clinical characteristics of patients with ALS and tracheotomy. Methods: Observational and retrospective study from January 2005 to October 2017 of patients with ALS and tracheotomy under pneumologic follow up. It was recorded:age, sex, onset of symptoms, type of ALS, urgent or planned tracheotomy, early decision, captivity syndrome, gastrostomy, hospitalitations. They were analyzed by Chi-square and U-Mann-Whitney. Survival after tracheotomy and overall survival was analyzed by Kaplan-Meier. Results: We included 152 patients. Only 9 (5.9%) accepted tracheotomy. In 5 (55.6%) of them there was early information. One patient accepted elective tracheotomy (11.1%). Five patients showed captivity syndrome. Patients with tracheotomy were younger, more frequently males and bulbar onset, without statistical significance. Gastrostomy[OR= 1.16 (IC 95% 1.05-1.26)(p=0,000)], admissions[3.89 ± 3.48 (p=0,000)] and stay [99.67± 127.35 days (p=0,000)] were statistical significant in tracheotomy. Mean survival after tracheotomy was 44.72±17.82 months. The mean overall survival was 74.44±30.70 months without significant difference respect to non traqueotomy. Conclusion: In our study the rate of tracheotomy is small, although similar to others such as France with rates between 2% - 5%. Survival of tracheotomy was higher than published but with more captivity syndrome and worse quality of life because a longer hospital admissions and increased need for gastrostomy.
Revista de Neurología, 2011
Introduccion. El sindrome de apnea/hipopnea del sueno (SAHS) es una enfermedad cronica caracteriz... more Introduccion. El sindrome de apnea/hipopnea del sueno (SAHS) es una enfermedad cronica caracterizada por episodios repetidos de obstruccion de las vias aereas durante el sueno. Los trastornos emocionales se han asociado frecuentemente al SAHS, aunque no hay consenso entre los resultados de las diferentes investigaciones. Objetivos. Evaluar la depresion y la ansiedad en pacientes con SAHS y determinar cuales son las variables polisomnograficas que mejor predicen el estado de animo en esta muestra. Pacientes y metodos. La muestra estuvo compuesta de 100 personas: 50 pacientes con SAHS, diagnosticados mediante polisomnografia convencional, y 50 sujetos sin sintomas de SAHS. Ambos grupos respondieron al inventario de ansiedad estado-rasgo y al inventario de depresion estado-rasgo. Resultados. Los resultados muestran que los pacientes con SAHS presentan niveles mas elevados de depresion y ansiedad, estado y rasgo, respecto al grupo de personas sin sintomas. Las variables que mejor predijeron el estado de animo fueron el indice de masa corporal y el tiempo total de sueno. Conclusiones. En este estudio se muestra la repercusion que el SAHS tiene sobre el estado de animo de los pacientes y se confirma la compleja relacion existente entre obesidad, calidad de sueno y trastornos emocionales en pacientes con SAHS.
Archivos de Bronconeumología, 2018
Objectives: Although an association between uric acid (UA) levels and obstructive sleep apnea (OS... more Objectives: Although an association between uric acid (UA) levels and obstructive sleep apnea (OSA) has been reported, the effect of continuous positive airway pressure (CPAP) on this measure is yet unclear. We aimed to investigate the effect of CPAP therapy on serum UA levels in patients with OSA. Methods: We conducted a multicenter, open-label, randomized controlled trial in 307 women diagnosed with moderate-to-severe OSA (apnea-hypopnea index [AHI] ≥ 15) in 19 Spanish Sleep Units. Women were randomized to CPAP (n = 151) or conservative treatment (n = 156) for 12 weeks. Changes in serum UA measures were assessed on an intention-to-treat basis. Additional analyses were conducted in the subgroup of women with CPAP adherence ≥4 h/night and those with UA levels ≥6 mg/dl. Results: Women had a mean (SD) age of 57.1 (10.1) years, median (first-third quartile) body mass index of 33.7 (29.0-38.5) mg/kg 2 and AHI of 32.0 (22.6-48.5). The average serum UA measure was 5.11 (1.26) mg/dl, and 80 (26.1%) participants had UA ≥ 6 mg/dl. Compared with the control group, the CPAP group did
Treatments and CPAP, 2017
OBJECTIVE Evaluate the diagnostic reliability of overnight pulse oximetry versus respiratory poly... more OBJECTIVE Evaluate the diagnostic reliability of overnight pulse oximetry versus respiratory polygraphy in sleep apnea diagnosis. METHODS Prospective study. Outpatient, aged 18-70 years who were tested with a home polygraphy. Patients with low level of collaboration or potential risk of nocturnal oxygen desaturation diseases, like morbid obesity (BMI›40), diagnosis of heart failure or respiratory failure were excluded. The variables related to SapO 2 at night were recorded, ODI 3, ODI 4 and T90 and it was calculated the highest diagnostic value by the area under the curve ROC for them, and the best cut-off point in order to discriminate between patients with or without OSAS and patients with severe OSAS. RESULTS 104 patients were included, 73 males (70%), mean age of 52.7±10.1 years, BMI =30.4±4.1 and AHI= 28.9±23.2 /hour. Pulse oximetry analysis presented ODI 4 = 25.3±26.2/hour, ODI 3 = 40.3±26.2/hour and T90= 5±9.7. Pearson9s correlation showed a significant relation between AHI and ODI 4 (r=0.91, p 3 with area under the curve=0.94 and ODI 4 = 0.98 and its best point of diagnostic discrimination was 5.4/hour. For AHI ≥30, ODI 4 is the most predictor variable with an area under the curve of 0.92, its better cut- off point was 10.5/hour. CONCLUSIONS In OSAS patients, there is a correlation between the SapO 2 variables from the pulse oximetry and AHI from the home polygraphy. The variable with higher discrimination capacity between patients with or without OSAS and severe OSAS was ODI 4 .
European Respiratory Journal, 2016
Obstructive sleep apnoea (OSA) is a chronic pathology characterised by the presence of repetitive... more Obstructive sleep apnoea (OSA) is a chronic pathology characterised by the presence of repetitive upper airway obstruction during the sleep, the prevalence of which increases with the age [1], and for which continuous positive airway pressure (CPAP) is the treatment of choice [2-4]. However, there have been few studies on diagnosis and management of OSA in elderly people. A qualitative systematic review of randomised clinical trials (RCTs) was conducted to evaluate the impact of CPAP therapy on health-related quality of life (HRQL) in OSA patients (aged >65 years), diagnosed by polysomnography or polygraphy and treated with CPAP for at least 3 months (>4 h•day −1). Studies whose primary outcome did not assess HRQL were excluded. Interventions were categorised according to whether or not they included CPAP treatment. The primary outcome was HRQL based on validated generic or specific questionnaires. Following quality guidelines for conducting systematic literature reviews [5], research was carried out in November and December 2015; trials were identified in the records of Trip, Scopus, the Cochrane Controlled Trials Register and Medline. Studies published since November 2000 were identified using Medical Subject Headings: "CPAP", "SAHS", "quality of life", "therapeutic effect" and "elderly". The search formula was: "CPAP [AND] OSA [AND] quality life; CPAP [AND] quality life; OSA [AND] quality life". Subsequently, two authors classified the studies independently, taking into account the summary, key words and title of the study. At a second level, two researchers independently determined the eligibility and quality of the studies, and the performed intervention. Disagreements were analysed and resolved by discussion. We found up to 896 potentially relevant articles; in the first evaluation, 868 of them were rejected, as they did not comply with some of the requirements. In the second evaluation, from these 28 studies, one was ruled out because it was not finished and nine because they were not RCTs with control groups. In the third evaluation, from 18 studies, 16 were ruled out because the average age was <65 years. Finally, only two RCTs were included in the review; the main results are shown in table 1.
European Respiratory Journal, 2016
Objective: To assess the effect of continuous positive airway pressure (CPAP) on blood pressure (... more Objective: To assess the effect of continuous positive airway pressure (CPAP) on blood pressure (BP), glucose and lipid profile, in women with moderate-to-severe obstructive sleep apnoea (OSA). Methods: We conducted a multicentre, open-label, randomized controlled trial in 307 consecutive women diagnosed with moderate-to-severe OSA (apnoea-hypopnoea index ≥15) in 19 Spanish Sleep Units. Women were randomized to receive effective CPAP (n=151) or conservative treatment (n=156) for 3 months. Systolic (SBP) and diastolic office BP (DBP), fasting glucose, glycated haemoglobin (HbA1c), insulin resistance measured by the homeostasis model assessment (HOMA) and total, LDL and HDL cholesterol were assessed at baseline and at the end of the follow-up. Data were analysed on an intention-to-treat basis, with adjustment for baseline values, body mass index, age, and specific medical treatment. The results are expressed as adjusted intergroup changes (95%CI). Results: Women had a mean (SD) age 57.1 (10.1) years, body mass index 34.3 (7.0) Kg/m2, ESS 9.8 (4.4) and apnoea-hypopnoea index 38.6 (20.8). Compared to the control group, the CPAP group achieved a significantly greater improvement in DBP (mean difference -2.04 mmHg; 95%CI -4.02 to -0.05; p=0.045), and a non-significant improvement in SBP (mean difference -1.54 mmHg, 95%CI -4.58 to 1.51; p=0.32). No differences were shown in fasting glucose, HbA1c, HOMA, and cholesterol measures between groups. Conclusion: In women with moderate-to-severe OSA, 3 months of CPAP therapy improves BP, but not the glucose and lipid profile, compared to conservative treatment.
Revista Neumosur, 2010
Respecto a un grupo control, en el SAHS se observa aumento de las moleculas de adhesion celular (... more Respecto a un grupo control, en el SAHS se observa aumento de las moleculas de adhesion celular (ICAM-1 y VCAM-1) relacionado con los episodios de hipoxemia nocturna (ID3) y gravedad de la SapO2 nocturna (T90). El presente estudio aumenta el grado de evidencia del SAHS como factor de riesgo vascular.
Revista Neumosur, 2006
RESUMEN INTRODUCCIÓN: La rehabilitación respiratoria (RR) es una terapia beneficiosa para los enf... more RESUMEN INTRODUCCIÓN: La rehabilitación respiratoria (RR) es una terapia beneficiosa para los enfermos con enfermedad pulmonar obstructiva crónica (EPOC). Sin embargo, la aplicación de la mayoría de los programas diseñados exige un elevado consumo de recursos y pocos han demostrado su eficacia a largo plazo. OBJETIVO: Comparar en pacientes con Enfermedad Pulmonar Obstructiva Crónica (EPOC) la efectividad a largo plazo de un programa de RR domiciliaria mínimamente supervisado en relación a los cambios en la disnea y capacidad funcional. DISEÑO: Ensayo clínico prospectivo, aleatorizado, de 1 año de duración, con 2 grupos: rehabilitación y control. Se presentan los resultados de los pacientes que han completado un periodo de inclusión de 6 meses. Se midieron pre-entrenamiento y post-entrenamiento dos variables: la disnea mediante el índice de disnea basal de Mahler (IDBM) e índice transicional de disnea (ITD), y la capacidad de ejercicio mediante la prueba de 6 minutos marcha (P6MM). PACIENTES: Individuos con EPOC moderada y grave que acuden a una consulta de Neumología y que cumplen unos criterios establecidos de inclusión en un programa de RR. INTERVENCIÓN: Al grupo de RR se le instruyó en un programa de ejercicio domiciliario con entrenamiento de extremidades superiores e inferiores. RESULTADOS: Se evaluaron 19 sujetos (edad 65 ± 6 años y porcentaje de FEV1 medio de 39%), que se asignaron aleatoriamente a cada grupo de estudio: Grupo RR (n = 11) y grupo control (n = 8). El IDBM fue de 4,6 en el grupo RR y 4,75 en el grupo control. A los 6 meses el ITD fue 3,5 en el grupo RR y 0,63 en el control, con diferencias en todas las subescalas. La distancia recorrida en el 6MWT se incrementó en ambos grupos, aunque con una diferencia de 46 metros a favor del grupo de RR. CONCLUSIONES: Un programa de RR domiciliario y mínimamente supervisado consigue una mejoría significativa en la disnea y en la capacidad de esfuerzo en los pacientes con EPOC.
Revista Neumosur, 2010
Objetivos: determinar si el sindrome de apneas-hipopneas del sueno (SAHS) incrementa las cifras d... more Objetivos: determinar si el sindrome de apneas-hipopneas del sueno (SAHS) incrementa las cifras de catecolaminas y a traves de este mecanismo puede alterar el perfil lipidico. Pacientes y metodos: estudio prospectivo, grupo control y muestreo consecutivo de sujetos con sospecha de SAHS. Fueron excluidos aquellos con enfermedad grave de organo o ingesta de farmacos con efecto sobre la actividad simpatica y/o perfil lipidico. Segun el indice de apneas-hipopneas (IAH) obtenido en la polisomnografia, los sujetos se asignaron al grupo clinico (IAH >5) o al grupo control (IAH <5). En ambos se compararon las cifras de colesterol total, HDL-c, trigliceridos y noradrenalina urinaria. Resultados: Fueron incluidos 33 en el grupo clinico y 16 en el control sin existir diferencias en edad, genero e indice de masa corporal (IMC). En el grupo clinico, la noradrenalina en orina y colesterol total se elevaron significativamente mientras que disminuyeron las del HDL-colesterol. Se observo una correlacion significativa entre los valores de la saturacion periferica de O2 (SapO2) y la noradrenalina urinaria, aunque la variabilidad de esta solo se asocio independientemente con el indice de desaturacion y el IMC. Tambien se detecto correlacion significativa entre la noradrenalina urinaria y colesterol total, HDL-c y trigliceridos, sin embargo esta correlacion desaparecio al ajustar por edad, genero e IMC. Conclusiones: el SAHS aumenta la actividad simpatica nocturna y el indice de desaturacion es el factor de mayor influencia. En los pacientes con SAHS se incrementan significativamente las cifras sericas de colesterol total mientras descienden las del HDL-c, aunque estos resultados no fueron explicados de forma independiente por el aumento en la actividad simpatica.
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Papers by Bernabe Jurado-Gamez