No abstract

Although most CLAD patients develop an obstructive pulmonary function, 28% develop a restrictive pulmonary function, compatible with the recently defined restrictive allograft syndrome phenotype. Early-onset CLAD, previous development of NRAD, and the development of restrictive allograft syndrome are associated with worse survival after CLAD has been diagnosed.

Background and Purpose— Epidemiological studies suggest an association between stroke incidence and stroke mortality and long-term exposure to particulate matter (PM) air pollution. However, the magnitude of the association is still unclear. Methods— We searched the Pubmed citation database for epidemiological studies and reviews on stroke and PM exposure. Then, we carried out a meta-analysis to quantify the pooled association between stroke incidence and mortality and long-term exposure to PM. Meta-analyses were performed for stroke events and stroke mortality and for PM 10 and PM 2.5 separately and jointly. Results— We identified 20 studies, including a total of >10 million people, on long-term PM exposure and stroke event or stroke mortality. For exposure to PM 10 (including estimated exposure to PM 10 from studies using PM 2.5 ), the pooled hazard ratio for each 10-μg/m 3 increment in PM 10 was 1.061 (95% confidence interval, 1.018–1.105) and 1.080 (0.992–1.177) for overall stroke events and stroke mortality, respectively. A stratified analysis by continent revealed that the association between stroke and long-term PM 10 exposure was positive in North America (1.062 [1.015–1.110]) and Europe (1.057 [0.973–1.148]), but studies in Asia (1.010 [0.885–1.153]) showed a high degree of heterogeneity. Considering exposure to PM 2.5 (Europe and North America combined), the hazard ratios for a 5-μg/m 3 increment were 1.064 (1.021–1.109) and 1.125 (1.007–1.256) for stroke events and mortality, respectively. Conclusions— The scientific evidence of the past decade identifies long-term exposure to PM, and PM 2.5 in particular, as a risk factor for stroke. However, we found some currently unexplained geographical variability in this association.

IntroductionThere is a relative lack of information about the death rate and morbidity of non-cystic fibrosis bronchiectasis and most studies are limited due to referral bias. We wanted to assess death rate and morbidity in those patients at our hospital.MethodsAdult patients seen at our department between June 2006 and November 2009 were recruited if the key string "bronchiect-" was mentioned in electronic clinical records and if chest CT imaging was available. Clinical records of all patients with confirmed radiologic diagnosis of bronchiectasis were reviewed and clinical characteristics were analyzed.Results539 patients with a radiographic diagnosis of non-cystic fibrosis bronchiectasis were identified in a retrospective cross-sectional analysis giving a prevalence of 2.6% in our hospital population. A wide range of etiologies was found with idiopathic bronchiectasis in 26%. In the 41 months interval, 57 patients (10.6%) died. We found a median exacerbation rate of 1.94 per year. Bacterial colonization status was associated with more deaths, exacerbation rate, symptoms and reduced pulmonary function. Pulmonary hypertension was found in 48% of our patients.ConclusionsWe evaluated a large non-cystic fibrosis bronchiectasis population, and provided new epidemiological data on associations between clinical characteristics and deaths and morbidity in these patients.