[Impact of gender and influence of tobacco on the etiology of patients with hemoptysis]. / Importancia del sexo e influencia del tabaco en la etiología de los pacientes con hemoptisis.

OBJECTIVE: To evaluate the importance of the sex and the influence of tobacco on the etiology of patients with hemoptysis. METHODS: We analyzed and compared the etiology of 394 consecutive patients with hemoptysis, divided in two groups: I (males) and II (females), and stratified in relation to tobacco. RESULTS: 305 males (77.4%) and 89 females (p < 0.0001). Lung cancer was more frequent in both groups (26.9%), especially squamous cell carcinoma, but nonmalignant etiologies were more common when we considered all globally (73.1%), including chronic obstructive lung disease (COPD) (14.9%) or bronchiectasis (20.4%) as the more frequent diseases, and 14.2% of unknown etiology (5.2% if we excluded bronchitis or lung infections). Lung tuberculosis was decreased (1.5%) in relation to a increased frequency of its sequelaes or residual lesions (10%). The initial increased frequency of lung cancers or COPD in males and bronchiectasis or heart diseases in females disappeared after the stratification and elimination of the tobacco effect. CONCLUSIONS: Hemoptysis was more frequent in males and nonmalignant etiologies were more common in both groups, with similar rates as in previous literature and a low number of cases with a unknown etiology associated to a protocolized study and the increased use of diagnostic procedures. In our study, the etiology of patients with hemoptysis was sex independent, to show that the susceptibility to tobacco illness was similar in both sexes.

Importancia del sexo e influencia del tabaco en la etiologíade los pacientes con hemoptisis / Impact of the sex and influence of tobacco on the etiology of patients with hemoptysis

Objetivo: Analizar la importancia del sexo en la etiología de los pacientes con hemoptisis y la influencia del tabaco sobre la misma. Métodos: Estudiar y comparar la etiología de 394 pacientes consecutivos con hemoptisis, divididos en dos grupos: I (varones) y II (mujeres), posteriormente estratificados en relación al tabaquismo. Resultados: 305 varones (77,4%) y 89 mujeres (p<0,0001). La etiología más frecuente fue la neoplasia pulmonar (26,9%), la mayoría por carcinoma epidermoide, aunque globalmente predominaban las etiologías no malignas (73,1%), y de entre ellas la bronquitis crónica (14,9%) y las bronquiectasias (20,4%), con un 14,2 porciento de causa desconocida (5,2%de las benignas si excluimos las bronquitis o infecciones respiratorias), destacando una disminución de la etiología tuberculosa (1,5%) a diferencia de sus secuelas o lesiones residuales (10%). Se observó un predominio inicial de bronquitis crónica y neoplasias en hombres, y de bronquiectasias y cardiopatía en mujeres que desapareció tras la estratificación y eliminación del efecto del tabaco. Conclusiones: La hemoptisis fue más frecuente en varones y su etiología no neoplásica fue la que predominó de forma global y en ambos sexos, con unas frecuencias similares a las descritas en la literatura y con un bajo porcentaje de etiología desconocida al realizar un estudio protocolizado y un amplio número de exploraciones complementarias. La etiología de la hemoptisis fue independiente del sexo demostrando una susceptibilidad similar para las enfermedades relacionadas o no con el tabaco en nuestros pacientes (AU)

Occupational asthma in the community: risk factors in a western Mediterranean population.

Risk factors and prevalence of occupational asthma in the general population were examined in a cross-sectional community study conducted in north Barcelona. A self-administered questionnaire that contained questions about bronchial asthma and occupation was mailed to a random sample of 4000 adults who lived in north Barcelona; the response rate was 31.0%. Investigators made phone calls to nonresponders to determine response bias. Risk factors for occupational asthma were assessed with logistic regression. Investigators, who sought a definite diagnosis of occupational asthma, offered a chest examination to all subjects who reported asthma in life and who experienced clinically relevant occupational exposures. The examination included skin tests to common allergens, forced spirometry with reversibility test, and peak expiratory flow rate at and away from work. Cumulative prevalences obtained from responders were good estimates for the general population: asthma in life, 9.0%; clinically relevant occupational exposure, 28.9%; and respiratory symptoms at work, 18.3%. Adjustments were made for age, sex, and smoking habits, and relevant exposure caused an increase in asthma risk (odds ratio [OR] = 1.9; 95% confidence interval [95% CI] = 1.1, 3.2); however, when investigators introduced specific occupations in the model as independent variables, only occupational exposure to leather (OR = 12.8 [95% CI = 4.4, 37.4]), animals (OR = 10.3 [95% CI = 1.6, 65.2]), dyes (OR = 5.6 [95% CI = 2.1, 15.3]), and flour (OR = 4.6 [CI = 1.3, 15.7]) persisted as significant risk factors. A 1.7/1000 minimum prevalence of occupational asthma for the north Barcelona population was estimated from chest examination results. Occupational risk for asthma appeared to be associated with exposure to leather, animals, dyes, or flour in the north Barcelona area.

[Tuberculous pseudochylothorax. Presentation of a case with positive Mycobacterium tuberculosis culture and review of the literature]. / Seudoquilotórax tuberculoso. Presentación de un caso con cultivo positivo para Mycobacterium tuberculosis y revisión de la literatura.

Pseudo chylothorax is a rare form of pleural effusion. It appears in long-term effusions, generally those lasting more than 5 years. The most frequent causes are tuberculous pleuritis and pleurel effusion secondary to rheumatoid arthritis. We describe a patient with pleural effusion lasting over 20 years who developed pseudo chylothorax and Mycobacterium tuberculosis in fluid culture.