Zoran Stojanovic

Factores predictores de recanalización arterial en pacientes con hemoptisis amenazante que requieren embolización arterial

INTRODUCTIONnArtery embolization (AE) is a safe and useful procedure in the management of massive hemoptysis. The objective of our study was to describe the experience of AE in a tertiary referral center, to characterize angiographic findings at the time of recurrence, and to analyze factors associated with these findings.nnnMATERIAL AND METHODSnObservational retrospective study of patients presenting with life-threatening hemoptysis. All consecutive patients with at least one episode of hemoptysis that required AE during a 13-year period were included. The effects of i)time to recurrence; ii)use of coils, and iii)number of arteries embolized on the likelihood that the recurrence was secondary to recanalization were assessed.nnnRESULTSnOne hundred seventy-six patients were included in the study. Twenty-two patients (12.5%) died due to hemoptysis. Probability of recurrence-free survival at one month was 0.91 (95%CI: 0.87 to 0.95), at 12months was 0.85 (95%CI: 0.79 to 0.91), and after 3 years was 0.75 (95%CI: 0.66 to 0.83). A longer time to recurrence was associated with a higher probability that the hemorrhage affected the same artery (estimate=0.0157, z-value=2.41, p-value=0.016).nnnCONCLUSIONnAE is a safe and useful technique in the management of massive and recurrent hemoptysis. Nevertheless, recurrence after embolization is not uncommon. Recurring hemoptysis due to recanalization is related to time to recurrence, but not to the use of coils or number of arteries embolized.

Asociación entre factores ambientales e ingresos por bronquiectasias en Badalona, Barcelona (2007-2015)

INTRODUCTIONnThe relationship between environmental factors and the exacerbation of respiratory diseases has been widely studied. However, there are no studies examining the relationship between these factors and bronchiectasis exacerbations. Our objective was to analyse the association between various environmental factors and hospitalisation for bronchiectasis.nnnMATERIAL AND METHODSnThis was a retrospective observational study conducted at two hospitals in Badalona (Barcelona). The number of hospital admissions for exacerbation of bronchiectasis between 2007 and 2015 was obtained. Through multiple regression we analysed the relationship between the number of exacerbations and mean monthly values of temperature, SO2, NO, NO2, O3 and CO.nnnRESULTSnTemperature, SO2, NO, NO2, O3 and CO were significantly associated with an increase in admissions due to exacerbation of bronchiectasis. By controlling the effect of temperature on the pollution variables, only SO2 maintained statistical significance (P=.008).nnnCONCLUSIONnWe have detected an increase in hospital admissions for exacerbation of bronchiectasis with increases in the atmospheric concentration of SO2 and the decrease in temperature. Prospective studies with different geographical locations to confirm these results are needed.

Effect of Air Pollution on Exacerbations of Bronchiectasis in Badalona, Spain, 2008–2016

Introduction: Air pollution has been widely associated with respiratory diseases. Nevertheless, the association between air pollution and exacerbations of bronchiectasis has been less studied. Objective: To analyze the effect of air pollution on exacerbations of bronchiectasis. Methods: This was a retrospective observational study conducted in Badalona. The number of daily hospital admissions and emergency room visits related to exacerbation of bronchiectasis (ICD-9 code 494.1) between 2008 and 2016 was obtained. We used simple Poisson regressions to test the effects of daily mean temperature, SO2, NO2, CO, and PM10 levels on bronchiectasis-related emergencies and hospitalizations on the same day and 1–4 days after. All p values were corrected for multiple comparisons. Results: SO2 was significantly associated with an increase in the number of hospitalizations (lags 0, 1, 2, and 3). None of these associations remained significant after correcting for multiple comparisons. The number of emergency room visits was associated with higher levels of SO2 (lags 0–4). After correcting for multiple comparisons, the association between emergency room visits and SO2 levels was statistically significant for lag 0 (p = 0.043), lag 1 (p = 0.018), and lag 3 (p = 0.050). Conclusions: The number of emergency room visits for exacerbation of bronchiectasis is associated with higher levels of SO2.