Geographical differences in chronic obstructive pulmonary disease mortality trends by sex, Spain, 1980-2021.

BACKGROUND: To analyse changes in trends in mortality due to chronic obstructive pulmonary disease (COPD) in Spain by Autonomous Community (AC) and sex during the period 1980-2021.METHODS: Data on population and COPD death records (International Classification of Diseases, 10th edition, codes J40â-"J44 and J47) were retrieved from the National Institute of Statistics for the study period. Age-standardised mortality rates by AC and sex were assessed using joinpoint regression models.RESULTS: There were 562,668 deaths due to COPD (423,855 in men and 138,813 in women), with an average annual increase of 1.6%. COPD deaths in men increased in most ACs, except for Asturias (â-"0.5% per year). The Canary Islands (14% per year) and Madrid (6.5% per year) had the highest increases. In women, the figures show a wide range of values at the AC level (from a â-"1.4% decrease to 7.9% increase). Nationally, the sex ratio increased from 1980 to 2021. In men, six ACs showed a significant decrease, while in women only two ACs showed a significant decrease.CONCLUSION: A steady decrease in COPD mortality was observed in most ACs for men, while a different trend was observed in women in several ACs. Despite past and ongoing tobacco control initiatives, this condition remains a leading cause of death.

Differential biomarker profiles between unprovoked venous thromboembolism and cancer.

BACKGROUND: The relationship between cancer and venous thromboembolic disease (VTD) are complex because the activated coagulation factors are not only involved in thrombosis but also in malignant processes, such as angiogenesis and metastasis. OBJECTIVE: To compare phenotypes of extracellular vesicles (EVs), and levels of D-dimer, soluble P-selectin (sP-selectin) and antigenic tissue factor (TF) between unprovoked VTD patients, who did not develop cancer during one-year follow-up, and those with advanced stage of cancer but not associated with VTD. METHODS: A prospective study in which we included 138 unprovoked VTD patients and 67 advanced cancer patients, who did not develop thrombosis. Levels of EVs of different cellular origin (platelet, endothelium and leukocyte), EVs positive for tissue factor (TF) and P-selectin glycoprotein ligand 1 were quantified by flow cytometry. D-dimer, soluble P-selectin (sP-selectin) and antigenic TF were determined by ELISA. RESULTS: TF-positive EVs, D-dimer, and sP-selectin were markedly elevated in unprovoked VTD patients compared to cancer patients without association with thrombosis. CONCLUSIONS: Levels of TF-positive EVs, D-dimer and sP-selectin are able to discriminate between unprovoked VTD patients not related to cancer and cancer patients not associated with VTD. These results could lead to the application of EVs as biomarkers of both diseases. Key messages: Circulating EVs, specifically TF-positive EVs, in combination with plasmatic markers of hypercoagulable states, such as D-dimer, sP-selectin and antigen TF, are able to discriminate between cancer patients without thrombosis and patients with unprovoked VTD. Research fields could be opened. Future studies will assess if these biomarkers together serve as predicting thrombotic events in cancer populations.

Diesel exhausts particles: Their role in increasing the incidence of asthma. Reviewing the evidence of a causal link.

Exposure to air pollutants has been correlated with an increase in the severity of asthma and in the exacerbation of pre-existing asthma. However, whether or not environmental pollution can cause asthma remains a controversial issue. The present review analyzes the current scientific evidence of the possible causal link between diesel exhaust particles (DEP), the solid fraction of the complex mixture of diesel exhaust, and asthma. The mechanisms that influence the expression and development of asthma are complex. In children prolonged exposure to pollutants such as DEPs may increase asthma prevalence. In adults, this causal relation is less clear, probably because of the heterogeneity of the studies carried out. There is also evidence of physiological mechanisms by which DEPs can cause asthma. The most frequently described interactions between cellular responses and DEP are the induction of pulmonary oxidative stress and inflammation and the activation of receptors of the bronchial epithelium such as toll-like receptors or increases in Th2 and Th17 cytokines, which generally orchestrate the asthmatic response. Others support indirect mechanisms through epigenetic changes, pulmonary microbiome modifications, or the interaction of DEP with environmental antigens to enhance their activity. However, in spite of this evidence, more studies are needed to assess the harmful effects of pollution - not only in the short term in the form of increases in the rate of exacerbations, but in the medium and long term as well, as a possible trigger of the disease.

The role of air pollution in COPD and implications for therapy.

INTRODUCTION: Exposure to many environmental conditions, apart from tobacco, as a risk factor for developing chronic obstructive pulmonary disease (COPD) has been comprehensively studied. AREAS COVERED: Global estimates of air pollution depict a scenario of a considerable burden on respiratory health. Exposure to biomass smoke and occupational inhaled agents have been described as potentially related to causing or aggravating COPD. A number of emerging natural or accidental disasters have been suggested as a new source of exposure. Management of COPD patients exposed to different substances should include avoidance, especially in the more susceptible populations and proper pharmacological treatment considering potential association with particular clinical presentations. Expert commentary: Altogether, the available information indicates that appraisal of different environmental pollution exposures is clinically relevant, and should be systematically evaluated in COPD.

Determinants of between-hospital variations in outcomes for patients admitted with COPD exacerbations: findings from a nationwide clinical audit (AUDIPOC) in Spain.

BACKGROUND: Previous studies have demonstrated significant variability in the processes of care and outcomes of chronic obstructive pulmonary disease (COPD) exacerbations. The AUDIPOC is a Spanish nationwide clinical audit that identified large between-hospital variations in care and clinical outcomes. Here, we test the hypothesis that these variations can be attributed to either patient characteristics, hospital characteristics and/or the so-called hospital-clustering effect, which indicates that patients with similar characteristics may experience different processes of care and outcomes depending on the hospital to which they are admitted. METHODS: A clinical audit of 5178 COPD patients consecutively admitted to 129 Spanish public hospitals was performed, with a 90-day follow-up. Multilevel regression analysis was conducted to model the probability of patients experiencing adverse outcomes. For each outcome, an empty model (with no independent variables) was fitted to assess the clustering effect, followed by a model adjusted for the patient- and hospital-level covariables. The hospital-clustering effect was estimated using the intracluster correlation coefficient (ICC); the cluster heterogeneity was estimated with the median odds ratio (MOR), and the coefficients of predictors were estimated with the odds ratio (OR). RESULTS: In the empty models, the ICC (MOR) for inpatient mortality and the follow-up mortality and readmission were 0.10 (1.80), 0.08 (1.65) and 0.01 (1.24), respectively. In the adjusted models, the variables that most represented the patients' clinical conditions and interventions were identified as outcome predictors and further reduced the hospital variations. By contrast, the resource factors were primarily unrelated with outcomes. CONCLUSIONS: This study demonstrates a noteworthy reduction in the observed crude between-hospital variation in outcomes after accounting for the hospital-cluster effect and the variables representing patient's clinical conditions. This emphasises the predictor importance of the patients' clinical conditions and interventions, and understates the impacts of hospital resources and organisational factors.

Work-related asthma: diagnosis and prognosis of immunological occupational asthma and work-exacerbated asthma

The incidence and prevalence of asthma are increasing. One reason for this trend is the rise in adult-onset asthma, especially occupational asthma, which is 1 of the 2 forms of work-related asthma. Occupational asthma is defined as asthma caused by agents that are present exclusively in the workplace. The presence of pre-existing asthma does not rule out the possibility of developing occupational asthma. A distinction has traditionally been made between immunological occupational asthma (whether IgE-mediated or not) and nonimmunological occupational asthma caused by irritants, the most characteristic example of which is reactive airway dysfunction syndrome. The other form of work-related asthma is known as work-exacerbated asthma, which affects persons with pre-existing or concurrent asthma that is worsened by work-related factors. It is important to differentiate between the 2 entities because their treatment, prognosis, and medical and social repercussions can differ widely. In this review, we discuss diagnostic methods, treatment, and avoidance/nonavoidance of the antigen in immunological occupational asthma and work-exacerbated asthma (AU)

La incidencia y prevalencia del asma van en aumento. El asma de inicio en la edad adulta y especialmente el asma ocupacional (AO) podrían ser una de las causas que influyeran en este incremento. El AO, una de las dos formas de asma relacionada con el trabajo (ART), se define como el asma causada por agentes que están presentes exclusivamente en el lugar de trabajo. Clásicamente, se ha realizado una distinción entre AO inmunológica (mediada o no por un mecanismo IgE) y AO no inmunológica causada por irritantes, cuyo ejemplo más característico es el síndrome reactivo de disfunción de la vía aérea. La presencia de asma previa no descarta la posibilidad de desarrollar AO. El asma exacerbada por el trabajo (AET) es la otra forma de ART y se define como aquel asma pre-existente o concurrente que empeora por factores relacionados con el trabajo. Diferenciar estas dos entidades es importante ya que su tratamiento, pronóstico y repercusiones médica y social, pueden diferir ampliamente. En esta revisión se discuten los diversos métodos diagnósticos, tratamientos y las diferentes estrategias de evitación / no evitación del antígeno tanto en el AO inmunológica como en el AET (AU)

Work-related asthma: diagnosis and prognosis of immunological occupational asthma and work-exacerbated asthma.

The incidence and prevalence of asthma are increasing. One reason for this trend is the rise in adult-onset asthma, especially occupational asthma, which is 1 of the 2 forms of work-related asthma. Occupational asthma is defined as asthma caused by agents that are present exclusively in the workplace. The presence of pre-existing asthma does not rule out the possibility of developing occupational asthma. A distinction has traditionally been made between immunological occupational asthma (whether IgE-mediated or not) and nonimmunological occupational asthma caused by irritants, the most characteristic example of which is reactive airway dysfunction syndrome. The other form of work-related asthma is known as work-exacerbated asthma, which affects persons with pre-existing or concurrent asthma that is worsened by work-related factors. It is important to differentiate between the 2 entities because their treatment, prognosis, and medical and social repercussions can differ widely. In this review, we discuss diagnostic methods, treatment, and avoidance/nonavoidance of the antigen in immunological occupational asthma and work-exacerbated asthma. Key words: Specific inhalation challenge. Peak expiratory flow. Workplace. Irritants.

Expresión de aquaporinas en tejido pulmonar de pacientes con enfermedad pulmonar obstructiva crónica / Aquaporin expression in the lung tissue of copd patients

INTRODUCCIÓN: Estudio de la expresión de aquaporinas (AQP1 y AQP5) en el tejido bronquial y parénquima pulmo-nar de pacientes con enfermedad pulmonar obstructiva cróni-ca (EPOC) y fumadores sin la enfermedad. MÉTODO: Utilizando un diseño caso-control, se seleccionó un grupo de 15 pacientes con EPOC (93,3% varones, con una edad media de 68 años, una media de FEV1 del 72% y 26,7% con corticosteroides inhalados) y 15 fumadores sin la enfermedad, a los cuales se les sometió a cirugía de resección pulmonar por neoplasia pulmonar. Se estudió la expresión de AQP1 y AQP5 en el tejido bronquial y en parénquima pulmo-nar mediante reacción en cadena de la polimerasa en tiempo real.RESULTADOS: No encontramos diferencias en la expresión génica de estas AQPs en ambos territorios pulmonares entre los pacientes con EPOC y los fumadores sin la enfermedad. Sin embargo, en los pacientes EPOC, la expresión de AQP1 era 2,41 veces mayor en el parénquima comparado con los controles, mientras que la AQP5 mostraba un patrón inverso, con 7,75 veces mayor expresión en el tejido bronquial de los sujetos control.CONCLUSIÓN: Los resultados del presente trabajo proporcio-nan evidencia inicial respecto a la expresión de AQP1 y AQP5 en pacientes con EPOC

INTRODUCTION: Study of aquaporin expression (AQP1 and AQP5) in the bronchial tissue and lung parenchyma of pa-tients with chronic obstructive pulmonary disease (COPD) and smokers without the disease. METHOD: Using a case-control design, a group of 15 patients with COPD was selected (93.3% males, with an average age of 68 years, an average FEV1 of 72% and 26.7% with inha-led corticosteroids) and 15 smokers without the disease, who underwent lung resection surgery due to lung neoplasm. The expression of AQP1 and AQP5 in the bronchial tissue and in lung parenchyma was studied using real-time polymerase chain reaction (PCR). RESULTS: No differences were found in the gene expression of these AQPs in either lung territories between the patients with COPD and the smokers without the disease. Nevertheless, in the COPD patients, the expression of AQP1 was 2.41 times greater in the parenchyma compared with the controls, while the AQP5 showed an inverse pattern, with 7.75 times greater expression in the bronchial tissue of the control subject. CONCLUSION: The results of this study provide initial evidence regarding the expression of AQP1 and AQP5 in patient with COPD

Prevalencia de comorbilidades en pacientes con EPOC / Prevalence of comorbidity in patients with COPD

Objetivo: Estudiar la prevalencia de comorbilidades en pacientes con EPOC estables, en Andalucía y Extremadura, y analizar su relación con el consumo de recursos sanitarios, grado de obstrucción al flujo aéreo y calidad de vida. Material y métodos: Estudio con dos fases, una primera prospectiva transversal multicéntrica concurrente de pacientes con EPOC estables, reclutados en seis hospitales de Andalucía y Extremadura. Se recogieron datos demográficos, funcionales respiratorios, índice de comorbilidad de Charlson, índice BODE, escala hospitalaria de ansiedad y depresión y cuestionario específico de calidad de vida (SGRQ). Se recogió la existencia de comorbilidad a través de la historia clínica del paciente y entrevista detallada. Una segunda fase prospectiva longitudinal de un año para estudiar el consumo de recursos sanitarios. Resultados: Se incluyeron 164 pacientes, el 83,5% varones, con edad media de 65,7 años, y FEV1 medio de 48,1%. Las prevalencias de comorbilidades mas frecuentes en nuestros pacientes fueron de cardiopatía isquémica 9,8%, insuficiencia cardiaca 6,1%, enfermedad vascular periférica 6,1%, enfermedad cerebrovascular 4,9%, diabetes mellitus 12,8%, neoplasias 10,9%, hepatopatía 10,4%, ansiedad 15,2% y depresión 14%. No se observó asociación significativa entre la prevalencia de comorbilidades o el índice de comorbilidad de Charlson y la necesidad de asistencia sanitaria, calidad de vida o función pulmonar. Conclusiones: la prevalencia de comorbilidades en pacientes con EPOC estable en Andalucía y Extremadura es elevada. La existencia de comorbilidad fue independiente del deterioro de la función pulmonar, de la necesidad de asistencia a urgencias o ingresos hospitalarios y del deterioro de la calidad de vida (AU)

Objective: To Study the prevalence of comorbidity in patients with stable COPD, in Andalusia and Extremadura and to analyze its relationship with the consumption of healthcare resources, degree of airway obstruction and quality of life. Material and methods: Two phase study: the first was a transversal, multi-center, prospective study, concurrent with stable COPD patients, recruited from six hospitals in the regions of Andalusia and Extremadura (Spain). Demographic data was collected, as well as respiratory function, Charlson comorbidity index, BODE index, hospital scale for anxiety and depression and specific quality of life questionnaire). The existence of comorbidity was assessed through patient clinical history and detailed interview. The second phase was a longitudinal, one year prospective study to review the use of healthcare resources. Results: 164 patients were included, of which 83.5% were males with an average age of 65.7 years, and an average FEV1 of 48.1%. The most frequent prevalence of comorbidity in our patients was ischemic heart disease 9.8%, cardiac insufficiency 6.1%, peripheral vascular disease 6.1%, cerebrovascular disease 4.9%, diabetes mellitus 12.8%, neoplasm 10.9%, hepatopathy 10.4%, anxiety 15.2% and depression 14%. No significant association was observed between the prevalence of comorbidities or Charlson comorbidity Index and the need for healthcare, the quality of living or pulmonary function. Conclusions: the prevalence of comorbidities in patients with stable COPD in the regions of Andalusia and Extremadura is high. The existence of comorbidity was independent on the deterioration of pulmonary function, the need for emergency healthcare or admittance to hospital and deterioration of living quality (AU)

Determinantes de la capacidad de esfuerzo en pacientes adultos diagnosticados de fibrosis quística / Determining exertion capacity of adult cystic fibrosis patients

Introducción: La fibrosis quística (FQ) es una enfermedad hereditaria que se relaciona con un deterioro de la función pulmonar, malnutrición e intolerancia progresiva al ejercicio. La finalidad de nuestro estudio fue examinar la capacidad de esfuerzo de pacientes adultos diagnosticados de FQ y su relación con la función pulmonar, el estado nutricional y la actividad física. Método: Incluimos a 50 pacientes adultos diagnosticados de FQ, edad 24,4 (5,9) años con FEV1 60,4 (28)%. Las medidas incluyeron el índice de masa corporal (IMC), masa magra de extremidades (MMe), función pulmonar, evaluación de la capacidad de ejercicio (VO2max) y test de los 6 minutos (6MM). La actividad física fue medida mediante un acelerómetro portátil. Se calculó un modelo de regresión lineal múltiple para VO2max.Resultados: Los pacientes tenían un reducido IMC (20,6 (2,7) kg/m2) y MMe (17,2 (2,6) g/cm2). La distancia media andada en el 6MM fue 633,3 (74,5) m y el VO2max alcanzado fue 70,9 (17,7)%. La media de los pasos medios medidos fue 8.173,8 (3.776,2). La VO2max se relacionaba de forma significativa con la edad (–0,3 (–0,561 / –0,061), FEV1 (0,117; 0,059-0,175), media de pasos diarios (0,001 [0-0,001]), 6MM (0,022[0-0,045]) e IMC (–0,658[–1,2 / –0,067]). Conclusiones: En nuestro grupo de pacientes con FQ, había limitación en la realización de ejercicio, estando ésta influenciada por la función respiratoria, la actividad física y el estado nutriciona (AU)

Introduction: Cystic fibrosis (CF) is a hereditary disease linked to the deterioration of lung function, malnutrition and progressive exercise intolerance. The objective of this study was to examine the exertion capacity of CF patients and the relationship with lung function, nutritional status and physical activity. Method: Included in the study were fifty (50) patients who had been diagnosed with CF, age 24.4 (±5.9 years with FEV160.4 (28%). Measurements included body mass index (BMI), limb lean mass (LLM), lung function, assessment of exercise capacity (VO2 max) and 6-minute walk test. Physical activity was measured using a portable accelerometer. A multiple lineal regression model was calculated for VO2 max. Results: Patients had a reduced BMI (20.6 (±2.7) kg/m2) and LLM (17.2 (±2.6) g/cm2). The mean distance walked for the 6-minute walk was 633.3 (±74.5) m and the VO2 max reached was 70.9% (±17.7) The mean of the average steps measured was 8,173.8 (3,776.2). The VO2 max related significantly with the age (–0.3 (–0.561 / –0.061), FEV1 (0.117; 0.059-0.175), average of daily steps (0.001 [0-0.001]), 6-minute walk (0.022[0-0.045]) and BMI (–0.658[–1.2 / –0.067]). Conclusions: In our group of patients with CF, there were limits when exercising, with exercise being influenced by respiratory function, physical activity and nutritional status (AU)

COPD mortality rates in Andalusia, Spain, 1975-2010: a joinpoint regression analysis.

OBJECTIVES: To describe chronic obstructive pulmonary disease (COPD) mortality rates in Andalusia, Spain, between 1975 and 2010 using a joinpoint regression analysis. DESIGN: Mortality figures for Andalusian residents aged >40 years from 1975 to 2010 were obtained from the National Institute of Statistics. Causes of death were classified based on the 8th, 9th and 10th revisions of the International Classification of Diseases. Crude, standardised (SMR) and 40- to 70-year truncated mortality rates were calculated. Trends were analysed using joinpoint regression analysis to identify significant trend changes, and an annual percentage of change (APC) was computed from each trend. RESULTS: Mortality rates showed a downward trend for both sexes. The SMR ranged from 109.9 to 98.0 deaths/100 000 males, and between 35.8 and 12.0 deaths/100 000 females. An increase in the average age at death for men and women with COPD was also observed. Both sexes experienced an increase in SMR in the early 1980s, although female mortality rates began to decline in 1985 (APC -5.8% thereafter), whereas those for males remained high until 1998 (APC -4% thereafter). CONCLUSIONS: COPD mortality remains higher in male than female inhabitants of Andalusia. These rates have decreased following different sex- and age-dependent patterns.

Estudio de la asociación de los polimorfismos de laglutation -S-transferasa y la enfermedad pulmonar obstructiva crónica en la raza caucásica / Study of the association of polymorphisms of glutathione-s-transferase and chronic obstructive pulmonary disease in caucasians

Introducción: Diversos estudios previos han encontrado una asociación no consistente entre los polimorfismos de la Glutation-S-transferasa (GST) y la enfermedad pulmonar obstructiva crónica (EPOC), con una asociación diferente según el área geográfica estudiada a nivel mundial. El objetivo del presente trabajo fue estudiar esa relación en una muestra caucásica española. Método: Estudio observacional analítico de casos-control en el que se incluyeron pacientes con EPOC y sujetos fumadores sin la enfermedad. A cada sujeto incluido se le recogieron sus datos sociodemográficos y clínicos mediantes un cuestionario estandarizado y se les extrajo una muestra de sangre para el estudio de los polimorfismos GSTP1 Ile105Val (A131G) Exon5, GSTP1 Ala114Val exón 6, GSTM1 de elección y GGSTT1delección.Resultados: La muestra estaba compuesta por 143 casos (64años, FEV1 69%) y 55 controles. El polimorfismo más asociado fue el GSTT que en el análisis bivariante se acercó a la significación estadística, alcanzándola en el análisis de regresión ajustado por sexo, paquetes-año e IMC (p = 0,031). El análisis (..) (AU)

Introduction: Various previous studies have found a non consistent association between polymorphisms of Glutathione-S-transferase (GST) and chronic obstructive pulmonary disease (COPD), with a different association according to the geographic area studied at global level. The objective of the present work was to study that relationship in a Spanish Caucasian sample. Method: Analytical observational case-control study including patients with COPD and smokers without the disease. Socio-demographic and clinical data were recorded by means of a standardized questionnaire, and a blood sample extracted from each participant for the study of the polymorphisms (..) (AU)

Oclusión bronquial endoscópica con prótesis de silicona de wata-nabe y pegamento biológico para el tratamiento de fístulas bronco-pleurales / Endoscopic bronchial occlusion with a Watabane silicone prosthesis and biological glue for the treatment of bronchopleural fistulas

Introducción: La fístula broncopleural (FBP) es la comunicación del árbol bronquial con el espacio pleural y su existencia supone un serio problema por su morbimortalidad asociada. El objetivo es evaluar una técnica de oclusión bronquial endoscópica con prótesis de silicona (..) (AU)

Introduction: Bronchopleural fistula (BPF) is the communication of the bronchial tree and pleural space, and its existence supposes a serious problem for its associated morbid-mortality. The objective is to evaluate a technique of endoscopic (..) (AU)

Tecnología de simulación tridimensional para la planificación de la implantación de endoprótesis traqueales / Three-dimensional simulation technology for planning tracheal stenting

Objetivo: Se ha realizado un estudio observacional sobre pacientes con estenosis de la vía aérea principal con el objetivo de demostrar la mejorar en los resultados del tratamiento mediante broncoscopia rígida al realizar una planificación preoperatoria (..) (AU)

Objective: An observational study was made of patients with stenosis of the main airway in order to demonstrate the improved results of treatment by rigid bronchoscopy to perform preoperative planning with computer simulation (..) (AU)

Modificación del índice BODE tras un programa de entrenamiento al ejercicio frente a ventilación mecánica no invasiva en EPOC estable e insuficiencia respiratoria hipercápnica / BODE index modification after an exercise training programme versus non-invasive mechanical ventilation in stable COPD and hypercapnic respiratory insufficiency

Objetivos: El objetivo de nuestro trabajo fue analizar los beneficios de un programa de entrenamiento al ejercicio y la instauración de ventilación mecánica no invasiva (VMNI) en pacientes EPOC severos en situación de insuficiencia respiratoria hipercápnica. Materiales y Métodos (..) (AU)

Objectives: The aim of our study was to analyse the benefits of an exercise training programme and the introduction of non-invasive mechanical ventilation (NIMV) in patients with severe COPD (..) (AU)

Lung cancer mortality in Spain: estimating the future burden to the year 2028.

OBJECTIVE: To use lung cancer mortality rates from 1979 to 2008 in Andalusia, southern Spain (population >8,000,000), to provide an estimate of the future number of deaths for the period 2009-2028. DESIGN: The numbers of lung cancer deaths from 1979 to 2008 were obtained from the Andalusian Institute for Statistics (AIS). Data were arranged in 5-year age groups using an age-period-cohort model. Age-standardised rates (ASR) per 100, 000 were calculated for males and females. Population projections for Andalusia 2009-2028 were downloaded from the AIS database. RESULTS: In males, the ASR varied from 46.1 in 2004-2008 to 34.6 in 2024-2028, with a projected 33% decrease. In females, the ASR varied from 4.9 in 2004-2008 to 8.9 per 100,000 in 2024-2028, with a projected 45% increase. This reflects an annual change of -1.3% for males and of +2.7% for females for the period 2009-2028. The sex ratio is projected to drop from a male:female ratio of 11 (1979-1983) to 3.8 (2024-2028). CONCLUSIONS: Our projections emphasise the significance of a continuously increasing trend in female lung cancer mortality, with a drop in the projected sex ratio.

Expresión local de reactantes de fase aguda en la enfermedad pulmonar obstructiva crónica / Local expression of acute-phase reactants in chronic obstructive pulmonary disease

Objetivo: Determinar la expresión de ARN, de proteína-C-reactiva (PCR) y amiloide-A-sérico (AAS) en parénquima pulmonar y tejido bronquial de pacientes EPOC en fase estable. Comparar dicha expresión de ARNm con la de sujetos fumadores sin la enfermedad. (..) (AU)

Objective: To determine the mRNA expression of C-reactive protein (CPR) and serum amyloid-A (SAA) in pulmonary parenchyma and (..) (AU)