The aim of this study was to determine the prevalence and risk factors for lower airway bacterial colonization (LABC) in stable chronic bronchitis (CB).Forty-one outpatients with CB were enrolled in the study (age 63.89.1 yrs (mean SD); forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) 62.811.2; current/former smokers 24/17). All patients had normal chest radiographs and an indication for performing fibreoptic bronchoscopy (pulmonary nodule, remote haemoptysis). The protected specimen brush (PSB) was used for bacterial sampling, and concentrations $1,000 colony-forming units (cfu) . mL -1 were considered positive for LABC. The repeatability of the procedure in CB was assessed in a random subsample of 18 subjects.A 72.2% quantitative agreement was found in the repeatability assessment of the PSB technique. Positive PSB cultures, obtained in 9 out of 41 (22%) patients, mainly yielded Haemophilus influenzae. The logistic regression model, used to determine which variables were related to colonization, showed that LABC was associated with current smoking (odds ratio (OR) 9.83, confidence interval (CI) 1.16±83.20) and low FVC (OR 0.73, CI 0.65±0.81). Age and FEV1 were not related to LABC.It was concluded that the prevalence of LABC in stable CB is high (22%), and current smoking is an important risk factor. Eur Respir J 1999; 13: 338±342. A cross-sectional study of 41 outpatients with stable CB was conducted using the protected specimen brush (PSB) technique [6,7], in order to determine the prevalence of LABC and the risk factors associated with such colonization in this population. Materials and methods PopulationA series of 41 stable CB outpatients were defined as having chronic phlegm (>3 months . yr -1 for $2 yrs) and normal or near-normal (pulmonary nodule <3 cm diameter) chest radiographs, with no acute lung disease [8]. Only patients with no changes in the volume or appearance of sputum or level of dyspnoea in the previous 15 days were considered to have stable CB. Patients who had been admitted to hospital within the last 6 months, who had been treated with antibiotics during the month prior to microbiological sampling, with clinical or radiological signs suggestive of bronchiectasis or who had alveolar or interstitial opacities on a chest radiograph were not included. Patients with a history of diagnosed bronchial asthma or positive reversibility tests were also excluded. All patients meeting the inclusion criteria who had been examined with fibreoptic bronchoscopy (indication: pulmonary nodule <3 cm diameter or remote haemoptysis) over a 1-yr period were included in a cohort study on the effect of bronchial colonization on lung health (age 63.89.1 yrs (meanSD), height 164.36.5 cm, all males, current/former smokers 24/17). This paper describes the findings of the initial cross-sectional phase of this cohort study.Forced spirometry was performed in all patients using a dry spirometer (Micro Medical, Rochester, UK) 1 h before premedication and fibreoptic bronchoscopy. The high...

A new system for automatic monitoring and analysis of snores during the night is presented. Sound intensity and several snore frequency parameters allow differentiation of snorers according to obstructive sleep apnea syndrome severity (OSAS). Automatic snore intensity and frequency monitoring and analysis could be a promising tool for screening OSAS patients, significantly improving the managing of this pathology.

BackgroundThe detection of early neuropsychological abnormalities as precursors of cognitive decline of vascular origin in patients with lacunar stroke is a subject of increasing interest. The objective of this study was to assess whether there were differences in the performance of a battery of neuropsychological tests in first-ever lacunar stroke patients with and without associated silent multiple lacunar infarctions found incidentally on the brain magnetic resonance imaging (MRI) scan.MethodsA total of 72 consecutive patients with first-ever lacunar infarction were studied 1 month after stroke. All patients underwent a comprehensive neuropsychological evaluation, which included the California Verbal Learning Test (CVLT), Phonetic Verbal Fluency Test (PMR), Semantic Verbal Fluency Test (category “animals”), Digit Span Forward and Backward from the Wechsler Adult Intelligence Scale (WAIS-III), and Mini-Mental State Examination (MMSE).ResultsA total of 38 patients (52.7%) had silent multiple lacunar infarcts, with corona radiata as the most frequent topography (P < 0.023). White matter hyperintensities (leukoaraiosis) were observed in 81.1% of patients with silent multiple lacunar infarcts and in 50% with a single lacunar infarction (P < 0.007). Patients in both groups showed similar scores in the MMSE, but those with associated silent lacunar infarctions showed a poorer performance in the semantic fluency test (P < 0.008) and in short delayed verbal memory (P < 0.001). In both cases, however, leukoaraiosis was not statistically significant in multivariate linear regression models adjusted by confounding covariates. In these models, multiple silent lacunar infarctions and education were independent predictors of poor performance in the semantic fluency test and in short delayed verbal memory.ConclusionsThe presence of silent multiple lacunar infarctions documented on brain MRI scans in patients with first-ever lacunar stroke was associated with mild neuropsychological abnormalities, particularly in the performance of executive functions (semantic fluency) and short delayed verbal memory. According to these findings, in the initial stages of small vessel disease, mild neuropsychological abnormalities appear to be related to lacunes rather than to leukoaraiosis or perivascular hyperintensities of vascular cause.

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