Morphologic diversity of chronic pigeon breeder's disease: clinical features and survival.

Morphology in chronic HP is characterized by bronchiolocentric mononuclear inflammation, poorly formed granulomas and variable degree of fibrosis. However, recent findings suggest that this disease may present different pathologic patterns. In this study we evaluated the clinical behavior and survival of patients with pigeon breeder's disease according to the pathologic pattern. One-hundred ten biopsies were classified as "typical" (n = 58), non-specific interstitial pneumonia (NSIP)-pattern (n = 22), usual interstitial pneumonia (UIP)-like (n = 10), mixed pattern (n = 9), organizing pneumonia (OP)-pattern (n = 3), airway-centered interstitial fibrosis (ACIF)-pattern (n = 3), and non-classified (n = 5). Clinical features and survival were compared between patients with "typical", NSIP, and UIP patterns. There were no statistical differences between the groups in age, gender, time of symptoms, smoking, clubbing, and PaO(2). By the one-way ANOVA test we found differences in the percent of lymphocytes in bronchoalveolar lavage (BAL; p < 0.002) and in the forced vital capacity (p < 0.05) between the 3 groups. After Bonferroni correction the difference in BAL lymphocytes remained significant among the UIP-like and the typical pattern (36.1 ± 22.9 versus 64.6 ± 20.9, p = 0.001). UIP-like patients exhibited the worst survival rate (HR: 4.19; 95% CI: 1.66-14.47; p < 0.004) while NSIP-like pattern showed the best survival (HR: 0.18; 95% CI: 0.04-0.82; p < 0.03). Multivariate Cox regression analysis revealed that patients with a UIP-like pattern retained a significantly worse survival (HR: 3.4 (IC 95%: 1.15-10.29; p < 0.03), and mortality for the NSIP group was best and approached statistical significance (p = 0.07). These findings demonstrate that a variety of histopathologic and imaging patterns are seen in PBD, and the presence of a UIP-like pattern confers the worst prognosis.

[Morbidity in postmenopausal women with poverty]. / Morbilidad en mujeres postmenopáusicas pobres.

BACKGROUND: Less favored social classes usually have more unhealthy life-styles and a more difficult access to Health Resources. AIM: To study the possible association between poverty and some common diseases, in a population of postmenopausal women. MATERIAL AND METHODS: Four hundred and forty nine poor women aged 56 +/- 12 years and 776 consecutive women aged 53 +/- 12 years, answered a personal interview about their lifestyles and medications used. Their medical records were reviewed and they were subjected to a complete physical examination, including weight and height measurement. A fasting blood sample was also obtained. Poverty was defined according to criteria of the Spanish National Institute of Statistics that is based on the income in Euros and the number of family members that share such income. RESULTS: A higher proportion of poor women live in rural areas. They were shorter, had a higher weight and thus a higher body mass index, smoked less and drank less alcohol than their non-poor counterparts drink. The consumption of caffeine, the actual calcium intake and the physical activity during leisure time was similar in both groups. Compared with their counterparts, poor women had a higher prevalence of diabetes mellitus (15.9 and 10.1% respectively, p = < 0.01), obesity (44.2 and 24.3% respectively, p < 0.01) hypertension (24.3 and 16.4%o respectively, p<0.01) and autoimmune rheumatic diseases (7.8 and 4.8% > respectively, p = 0.03). A multiple logistic regression model showed that obesity, hypertension, diabetes mellitus, smoking, alcohol consumption and living in rural areas, were independently associated to poverty. CONCLUSIONS: Poor postmenopausal women have a higher prevalence of diabetes mellitus, obesity, autoimmune rheumatic diseases and hypertension and lower frequency of smoking and alcohol consumption than their affluent counterparts do.