Marin-Marin, M. (Marta)
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- Clinical and prognostic impact of low diffusing capacity for carbon monoxide values in patients with global initiative for obstructive lung disease I COPD(2021) Cabrera, C. (Carlos); Cosio, B.G. (Borja G.); Martinez-Gonzalez, C. (Cristina); Celli, B.R. (Bartolomé R.); Casanova, C. (Ciro); Marin, J.M. (José M.); Gonzalez-Gutierrez, J. (Jessica); Torres, J.P. (Juan P.) de; Fuster, A. (Antonia); Ezponda, A. (Ana); Solanes-García, I. (Ingrid); Marin-Marin, M. (Marta); O'Donnell, D.E. (Denis E.); Neder, J.A. (J. Alberto)Background The Global Initiative for Obstructive Lung Disease (GOLD) does not promote diffusing capacity for carbon monoxide (Dlco) values in the evaluation of COPD. In GOLD spirometric stage I COPD patients, the clinical and prognostic impact of a low Dlco has not been explored. Research Question Could a Dlco threshold help define an increased risk of death and a different clinical presentation in these patients? Study Design and Methods GOLD stage I COPD patients (n = 360) were enrolled and followed over 109 ± 50 months. Age, sex, pack-years’ history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, and history of exacerbations were recorded. A cutoff value for Dlco was identified for all-cause mortality and the clinical and physiological characteristics of patients above and below the threshold compared. Cox regression analysis explored the predictive power of that cutoff value for all-cause mortality. Results A Dlco cutoff value of <60% predicted was associated with all-cause mortality (Dlco ≥ 60%: 9% vs Dlco < 60%: 23%, P = .01). At a same FEV1% predicted and Charlson score, patients with Dlco < 60% had lower BMI, more dyspnea, lower inspiratory capacity (IC)/total lung capacity (TLC) ratio, lower 6-min walk distance (6MWD), and higher BODE. Cox multiple regression analysis confirmed that after adjusting for age, sex, pack-years history, smoking status, and BMI, a Dlco < 60% is associated with all-cause mortality (hazard ratio [HR], 95% CI = 3.37, 1.35-8.39; P = .009) Interpretation In GOLD I COPD patients, a Dlco < 60% predicted is associated with increased risk of death and worse clinical presentation. What the cause(s) of this association are and whether they can be treated need to be determined.
- Impact of applying the global lung initiative criteria for airway obstruction in GOLD defined COPD cohorts: the BODE and CHAIN experience(2024) Cabrera, C. (Carlos); Cosio, B.G. (Borja G.); Bastarrika, G. (Gorka); Celli, B.R. (Bartolomé R.); Gotera-Rivera, C. (Carolina); Casanova, C. (Ciro); Sangro, M. (Matilde); Marin, J.M. (José M.); Torres, J.P. (Juan P.) de; Fuster, A. (Antonia); Alcaide, A.B. (Ana Belén); Ezponda, A. (Ana); Solanes-García, I. (Ingrid); Feu-Collado, N. (Nuria); Marin-Marin, M. (Marta); Martínez, C. (Cristina); Calle, M. (Myriam); Marin, A. (Alicia); Peces-Barba, G. (German)Introduction: The Global Lung Function Initiative (GLI) has proposed new criteria for airflow limitation (AL) and recommends using these to interpret spirometry. The objective of this study was to explore the impact of the application of the AL GLI criteria in two well characterized GOLD-defined COPD cohorts. Methods: COPD patients from the BODE (n=360) and the COPD History Assessment In SpaiN (CHAIN) cohorts (n=722) were enrolled and followed. Age, gender, pack-years history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, history of exacerbations and survival were recorded. CT-detected comorbidities were registered in the BODE cohort. The proportion of subjects without AL by GLI criteria was determined in each cohort. The clinical, CT-detected comorbidity, and overall survival of these patients were evaluated. Results: In total, 18% of the BODE and 15% of the CHAIN cohort did not meet GLI AL criteria. In the BODE and CHAIN cohorts respectively, these patients had a high clinical burden (BODE≥3: 9% and 20%; mMRC≥2: 16% and 45%; exacerbations in the previous year: 31% and 9%; 6MWD<350m: 15% and 19%, respectively), and a similar prevalence of CT-diagnosed comorbidities compared with those with GLI AL. They also had a higher rate of long-term mortality - 33% and 22% respectively. Conclusions: An important proportion of patients from 2 GOLD-defined COPD cohorts did not meet GLI AL criteria at enrolment, although they had a significant burden of disease. Caution must be taken when applying the GLI AL criteria in clinical practice.
- Análisis farmacocinético-farmacodinámico de Voriconazol en pacientes adultos con infección fúngica(2016-06-03) Marin-Marin, M. (Marta); Aldaz, A. (Azucena)El objetivo principal de este trabajo es estimar los parámetros farmacocinéticos poblacionales de voriconazol y estudiar la relación entre la farmacocinética de voriconazol y el resultado de su empleo en términos de eficacia y toxicidad. Para el estudio se ha considerado la administración oral y la población de pacientes adultos con infección fúngica activa. De dicho análisis se derivará la optimización de su empleo en la práctica asistencial.