A. Moreno

Defining the Asthma-COPD Overlap Syndrome in a COPD Cohort.

BACKGROUNDnAsthma-COPD overlap syndrome (ACOS) has been recently described by international guidelines. A stepwise approach to diagnosis using usual features of both diseases is recommended although its clinical application is difficult.nnnMETHODSnTo identify patients with ACOS, a cohort of well-characterized patients with COPD and up to 1 year of follow-up was analyzed. We evaluated the presence of specific characteristics associated with asthma in this COPD cohort, divided into major criteria (bronchodilator test >xa0400xa0mL and 15%xa0and past medical history of asthma) and minor criteria (blood eosinophils >xa05%, IgE > 100 IU/mL, or two separate bronchodilator tests >xa0200xa0mL and 12%). We defined ACOS by the presence of one major criterion or two minor criteria. Baseline characteristics, health status (COPD Assessment Test [CAT]), BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index, rate of exacerbations, and mortality up to 1xa0year of follow-up were compared between patients with and without criteria for ACOS.nnnRESULTSnOf 831 patients with COPD included,125 (15%) fulfilled the criteria for ACOS, and 98.4%xa0of them sustained these criteria after 1 year. Patients with ACOS were predominantly male (81.6%), with symptomatic mild to moderate disease (67%), who were receiving inhaled corticosteroids (63.2%). There were no significant differences in baseline characteristics, and only survival was worse in patients with non-ACOS COPD after 1 year of follow-up (Pxa0< .05).nnnCONCLUSIONSnThe proposed ACOS criteria are present in 15%xa0of a cohort of patients with COPD and these patients show better 1-year prognosis than clinically similar patients with COPD with no ACOS criteria.nnnTRIAL REGISTRYnClinicalTrials.gov; No.: NCT01122758; URL: www.clinicaltrials.gov.

Prevalence of persistent blood eosinophilia: relation to outcomes in patients with COPD

The impact of blood eosinophilia in chronic obstructive pulmonary disease (COPD) remains controversial. To evaluate the prevalence and stability of a high level of blood eosinophils (≥300u2005cells·μL–1) and its relationship to outcomes, we determined blood eosinophils at baseline and over 2u2005years in 424 COPD patients (forced expiratory volume in 1u2005s (FEV1) 60% predicted) and 67 smokers without COPD from the CHAIN cohort, and in 308 COPD patients (FEV1 60% predicted) in the BODE cohort. We related eosinophil levels to exacerbations and survival using Cox hazard analysis. In COPD patients, 15.8% in the CHAIN cohort and 12.3% in the BODE cohort had persistently elevated blood eosinophils at all three visits. A significant proportion (43.8%) of patients had counts that oscillated above and below the cut-off points, while the rest had persistent eosinophil levels <300u2005cells·μL–1. A similar eosinophil blood pattern was observed in controls. Exacerbation rates did not differ in patients with and without eosinophilia. All-cause mortality was lower in patients with high eosinophils compared with those with values <300u2005cells·μL–1 (15.8% versus 33.7%; p=0.026). In patients with COPD, blood eosinophils ≥300u2005cells·μL–1 persisting over 2u2005years was not a risk factor for COPD exacerbations. High eosinophil count was associated with better survival. The stability of blood eosinophils ≥300u2005cells per μL is low in COPD patients and it does not confer a poor prognosis http://ow.ly/TwGX30etVIy

20 Inconclusive diagnosis following newborn screening for cystic fibrosis (CF): clinical outcomes in 56 infants from three Spanish CF centres

20 Inconclusive diagnosis following newborn screening for cystic fibrosis (CF): clinical outcomes in 56 infants from three Spanish CF centres S. Gartner1, T. Casals2, J.L. Marin3, S. Rovira1, A. Moreno1, O. Asensio4, J. Costa5, I. de Mir1, A. Torrent1, G. Sacoto1, M. Cols5, M. Bosque4. 1Hospital Universitari Vall d’Hebron, Pediatric Pulmonology and Cystic Fibrosis Center, Barcelona, Spain; 2Medical and Molecular Genetics Center − IDIBELL, Barcelona, Spain; 3Institut de Bioquimica de Cataluna, Barcelona, Spain; 4Hospital Sabadell, Corporacio Parc Tauli, Pediatric Pulmonology and Cystic Fibrosis Center, Barcelona, Spain; 5Hospital Sant Joan de Deu, Pediatric Pulmonology and Cystic Fibrosis Center, Barcelona, Spain