Summary

Once again, Prof. Jardim took the meeting stage to discuss some COPD risk factors peculiar to Latin America. Smoking tobacco hand-rolled in tobacco leaves and exposure to smoke from wood stoves are widespread in Brazilian rural areas, with dramatic COPD risks over a few decades. Conversely, Brazil’s high parasitic infestation rates seem trouble-free, with the eosinophil cut-off points (100 and 300 eosinophils/mm³) keeping their universally accepted value.

Prof. Cosío also intervened again to discuss the Spanish situation. About 55% of smokers and 40% of non-smokers showed respiratory symptoms in the EPISCAN II study, with 10-12% diagnosed with COPD (Young COPD 6%, Pre-COPD 22.3%). Still, underdiagnosis is rampant—74.7% in the EPISCAN II study. A risk calculator, derived from the Lovelace cohort and validated in subjects from the COPDGene study, showed helpful in estimating how many Pre-COPD situations will evolve into frank COPD. Over 6.3 years, the estimated incident CAL (Chronic Airways Limitation as defined by GOLD) in Lovelace smokers with normal baseline spirometry will be 26 per 1,000 person-years. Even more dramatically, in pre-COPD patients with all main predictors positive at baseline, the CAL risk will increase to 85%. An interesting discussion on the role of respiratory physiotherapy concluded the session.