Background: Knowing the cost of hospitalizations for exacerbation in bronchiectasis patients is essential to perform cost-effectiveness studies of treatments that aim to reduce exacerbations in these patients. Objectives: To find out the mean cost of hospitalizations due to exacerbations in bronchiectasis patients, and to identify factors associated with higher costs. Methods: Prospective, observational, multicenter study in adult bronchiectasis patients hospitalized due to exacerbation. All expenses from the patients’ arrival at hospital to their discharge were calculated: diagnostic tests, treatments, transferals, home hospitalization, admission to convalescence centers, and hospitals’ structural costs for each patient (each hospital’s tariff for emergencies and 70% of the price of a bed for each day in a hospital ward). Results: A total of 222 patients (52.7% men, mean age 71.8 years) admitted to 29 hospitals were included. Adding together all the expenses, the mean cost of the hospitalization was EUR 5,284.7, most of which correspond to the hospital ward (86.9%), and particularly to the hospitals’ structural costs. The adjusted multivariate analysis showed that chronic bronchial infection by Pseudomonas aeruginosa, days spent in the hospital, and completing the treatment with home hospitalization were factors independently associated with a higher overall cost of the hospitalization. Conclusions: The mean cost of a hospitalization due to bronchiectasis exacerbation obtained from the individual data of each episode is higher than the cost per process calculated by the health authorities. The most determining factor of a higher cost is chronic bronchial infection due to P. aeruginosa, which leads to a longer hospital stay and the use of home hospitalization.

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We studied the discriminative power of the transfer factor (TL_C0), K_co (TL_C0/V_a) and Z_co (a corrected TL_co according to alveolar volume measured (V_a), introduced by our group), in order to differentiate diffuse interstitial disease from other restrictive diseases. Measurements were taken in 46 subjects, divided into two groups: Pure restriction (group 1: normal subjects with voluntary restriction and diseased subjects) and (2) diffuse interstitial restriction (group 2). There were no statistical differences in V_a between groups 1 and 2. TL_C0 was statistically lower in groups 1 and 2 in comparison with the control group (normal values of our laboratory in test with V_a > 90% of predicted) and showed a significant difference when group 1 was compared with group 2. Similar results (but with higher values than those of the control group) were found for K_co. A similar difference exists in Z_co only when group 2 is compared with group 1 but not when group 1 is compared with the control group. The corrected diffusion capacity Z_co yields the highest discriminative power

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We report a case of spontaneous pneumomediastinum after cocaine inhalation. The possible mechanisms implicated in an inspiratory manoeuvre are discussed