Interpretando la función pulmonar. Una perspectiva para el siglo XXI desde la Neumología pediátrica / No disponible

Las pruebas de función pulmonar son básicas para el diagnóstico y seguimiento del paciente respiratorio. Su correcta interpretación es fundamental para distinguir lo normal de lo patológico. La aparición de las primeras ecuaciones globales para todas las edades (Global Lung Initiative [GLI]-2012) supone un reto para cualquier médico encargado de interpretar una espirometría, no solo por los cambios "numéricos" esperables al utilizar otros patrones de referencia, sino por la necesidad de expresar los resultados como desviaciones de la media (z-scores) y abandonar el clásico porcentaje sobre el valor predicho. La visión de los pediatras neumólogos, acostumbrados a trabajar con pacientes en constante cambio, puede ayudar a entender la necesidad de este tipo de ecuaciones. Este artículo pretende revisar el concepto de normalidad, los parámetros necesarios para interpretar una espirometría, las características ideales de una ecuación de referencia y las bondades y defectos de las nuevas ecuaciones GLI-2012

Pulmonary function tests are basic in the diagnosis and monitoring of respiratory patients. The proper interpretation of these tests is essential to distinguish normal from pathological. The first global equations for all ages (Global Lung Initiative [GLI]-2012) poses a challenge for any physician responsible for interpreting spirometry, not only due to the "numerical" changes expected when using a new reference equation, but also because of the need to express the results as deviations from the mean (z-scores) and leave the classical percentage of the predicted value. The view of the paediatric pulmonologists, who are used to working with patients in constant evolution, can help to understand the need for this type of equations. This article reviews the concept of normality, the parameters required to interpret a spirometry, the ideal characteristics of a reference equation and the virtues and defects of the new GLI-2012 equations

Personalized respiratory medicine: exploring the horizon, addressing the issues. Summary of a BRN-AJRCCM workshop held in Barcelona on June 12, 2014.

This Pulmonary Perspective summarizes the content and main conclusions of an international workshop on personalized respiratory medicine coorganized by the Barcelona Respiratory Network ( www.brn.cat ) and the AJRCCM in June 2014. It discusses (1) its definition and historical, social, legal, and ethical aspects; (2) the view from different disciplines, including basic science, epidemiology, bioinformatics, and network/systems medicine; (3) the bottlenecks and opportunities identified by some currently ongoing projects; and (4) the implications for the individual, the healthcare system and the pharmaceutical industry. The authors hope that, although it is not a systematic review on the subject, this document can be a useful reference for researchers, clinicians, healthcare managers, policy-makers, and industry parties interested in personalized respiratory medicine.

Ethical concerns of congresses and joint winter meetings of the Spanish Society of Pneumology and Thoracic Surgery.

The pharmaceutical industry contributes to the development of new drugs, provides funding for research and collaborates in continuing medical education. Although this relationship with medical practice is beneficial and desirable, commercial interests could potentially eclipse patient benefits and compromise professional integrity. Congresses and meetings of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) agglutinate different spheres of knowledge, including aspects such as bioethics, management and communication, always centered on patient and their well-being. SEPAR congresses and meetings should provide sufficient economic benefits to be reinvested in research and other purposes which are reflected in SEPAR statutes in order to ensure the solvency, sustainability and economic independence of the Society. SEPAR has developed strict regulations governing the sponsorship and accreditation of training activities while striving for a balance between the interests of the industry and its own necessary independence, which results from the constant concern for maintaining good medical practice and complying with ethical aspects. This regulation is useful from an organizational and logistical standpoint, and it is necessary to prevent or resolve any possible conflicts of interest. Scientific societies should regulate common practices that could potentially result in conflicts of interest.

[Chronic obstructive pulmonary disease in Archivos de Bronconeumología in 2010]. / Enfermedad pulmonar obstructiva crónica en Archivos de Bronconeumología en el año 2010.

Chronic obstructive pulmonary disease (COPD) continues to cause concern among health professionals treating respiratory diseases worldwide. The reasons for the increasing tendency in prevalence, morbidity and mortality rates are under constant investigation. Areas of research include identification of new phenotypes, predisposing factors, and physiopathological and epidemiological features that are still not completely known, as well as the systemic behavior of this disease and its relationship with other, associated pathological states. New and encouraging alternative treatments are also being investigated. This unceasing search for scientific knowledge is reflected in the number of studies published in each of the sections of Archivos de Bronconeumología throughout 2010, which deal with most of the pressing issues concerning this disease and which will be summarized in the present article. More than 60% of the contents of the journal's supplements were related to COPD. A monographic issue, produced for training purposes, was published and consisted of three units: the first was entitled "The thousand and one faces of COPD", the second "COPD: from etiopathogenesis to treatment" and the third "COPD: how can patient care be improved?". The authors of these units provide an in-depth and up-to-date analysis of topics relating COPD to various pathological states and include an analysis of the disease in two population groups that have aroused recent interest, namely, women and non-smokers. The third unit of the monograph deals exclusively with the patient.

Lives on the line? Ethics and practicalities of duty of care in pandemics and disasters.

Pandemics and acute emergencies raise pressing medical, ethical and organisational challenges. These include global governance, priority setting, triaging of patients, allocation of scarce resources and restricting individual liberty in the interests of public health. We will focus particularly on an issue of direct relevance to all respiratory team members, i.e. what is the duty of the healthcare worker to continue working in the face of personal risk, and draw lessons from guidelines, ethical considerations, past pandemics and evolving experience with H1N1 swine influenza.

Los neumólogos y el tabaco / No disponible

No disponible

2006: Año de la Apnea del Sueño. Análisis de las publicaciones en ARCHIVOS DE BRONCONEUMOLOGÍA / Sleep apnea year 2006: review of publications in Archivos de Bronconeumología

No disponible

No disponible

[Clinical research ethics in respiratory medicine]. / Aspectos éticos de la investigación clínica en neumología.

Clinical research plays an increasingly strong role in the development of respiratory medicine. Familiarity with issues that affect research on human subjects is therefore essential, particularly so with regard to the conduct of clinical trials of medical with medications. This paper begins with a brief introduction to the ethics of clinical research. We highlight the importance of directives on ethics and the need to understand and comply with them when any type of experiment is conducted on humans. Following is a brief description of historical codes of bioethics and an account of their underlying principles, origins, and consequences. Finally, we discuss Spanish Royal Decree 23/2004 of February 6, 2004 which came into force on May 1 that year; we outline its general principles and analyze 2 types of problem that have emerged: those that result from the article requiring a single central opinion and those of investigators who act independently of the pharmaceuticals industry. The situation of clinical research in respiratory medicine at our hospital is then described. Finally, the 7 requirements of ethical research listed by Emanuel and colleagues are proposed as a tool that pneumologists can use to analyze and assess whether or not a specific trial meets minimum ethical requirements.

Aspectos éticos de la investigación clínica en neumología / Clinical research ethics in respiratory medicine

La investigación clínica en neumología desempeña un papel cada vez más relevante en el desarrollo de la especialidad. Por ello se hace necesario el conocimiento de los aspectos éticos en investigación con seres humanos y, en concreto, en ensayos clínicos con medicamentos. Se comienza la revisión con una breve introducción a los aspectos éticos en investigación clínica resaltando su importancia y obligado conocimiento y cumplimiento a la hora de llevar a cabo cualquier tipo de experimentación en seres humanos. Posteriormente, se realiza una breve descripción de los códigos éticos históricos y de los principios de la bioética mencionando su origen, así como las consecuencias que de ellos se derivan. Nos detenemos en el reciente Real Decreto 223/2004, de 6 de febrero, que entró en vigor en España el pasado 1 de mayo de 2004, para destacar sus principios generales y analizar los principales problemas que de él se derivan, fundamentalmente 2: los que son consecuencia de la exigencia del "dictamen único", y los relativos a los investigadores cuando actúan como promotores independientes de la industria farmacéutica. Se describe el papel de la neumología dentro de la investigación clínica con medicamentos en nuestro hospital, para posteriormente proponer los 7 requisitos del grupo de Emanuel como guía práctica para ayudar a los investigadores en neumología a analizar y valorar si un determinado ensayo cumple las mínimas exigencias de la ética clínica

Clinical research plays an increasingly strong role in the development of respiratory medicine. Familiarity with issues that affect research on human subjects is therefore essential, particularly so with regard to the conduct of clinical trials of medical with medications. This paper begins with a brief introduction to the ethics of clinical research. We highlight the importance of directives on ethics and the need to understand and comply with them when any type of experiment is conducted on humans. Following is a brief description of historical codes of bioethics and an account of their underlying principles, origins, and consequences. Finally, we discuss Spanish Royal Decree 23/2004 of February 6, 2004 which came into force on May 1 that year; we outline its general principles and analyze 2 types of problem that have emerged: those that result from the article requiring a single central opinion and those of investigators who act independently of the pharmaceuticals industry. The situation of clinical research in respiratory medicine at our hospital is then described. Finally, the 7 requirements of ethical research listed by Emanuel and colleagues are proposed as a tool that pneumologists can use to analyze and assess whether or not a specific trial meets minimum ethical requirements