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© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license., Background: Small airways obstruction is a common feature of obstructive lung diseases. Research is scarce on small airways obstruction, its global prevalence, and risk factors. We aimed to estimate the prevalence of small airways obstruction, examine the associated risk factors, and compare the findings for two different spirometry parameters. Methods: The Burden of Obstructive Lung Disease study is a multinational cross-sectional study of 41 municipalities in 34 countries across all WHO regions. Adults aged 40 years or older who were not living in an institution were eligible to participate. To ensure a representative sample, participants were selected from a random sample of the population according to a predefined site-specific sampling strategy. We included participants' data in this study if they completed the core study questionnaire and had acceptable spirometry according to predefined quality criteria. We excluded participants with a contraindication for lung function testing. We defined small airways obstruction as either mean forced expiratory flow rate between 25% and 75% of the forced vital capacity (FEF25-75) less than the lower limit of normal or forced expiratory volume in 3 s to forced vital capacity ratio (FEV3/FVC ratio) less than the lower limit of normal. We estimated the prevalence of pre-bronchodilator (ie, before administration of 200 μg salbutamol) and post-bronchodilator (ie, after administration of 200 μg salbutamol) small airways obstruction for each site. To identify risk factors for small airways obstruction, we performed multivariable regression analyses within each site and pooled estimates using random-effects meta-analysis. Findings: 36 618 participants were recruited between Jan 2, 2003, and Dec 26, 2016. Data were collected from participants at recruitment. Of the recruited participants, 28 604 participants had acceptable spirometry and completed the core study questionnaire. Data were available for 26 443 participants for FEV3/FVC ratio and 25 961 participants for FEF25-75. Of the 26 443 participants included, 12 490 were men and 13 953 were women. Prevalence of pre-bronchodilator small airways obstruction ranged from 5% (34 of 624 participants) in Tartu, Estonia, to 34% (189 of 555 participants) in Mysore, India, for FEF25-75, and for FEV3/FVC ratio it ranged from 5% (31 of 684) in Riyadh, Saudi Arabia, to 31% (287 of 924) in Salzburg, Austria. Prevalence of post-bronchodilator small airways obstruction was universally lower. Risk factors significantly associated with FEV3/FVC ratio less than the lower limit of normal included increasing age, low BMI, active and passive smoking, low level of education, working in a dusty job for more than 10 years, previous tuberculosis, and family history of chronic obstructive pulmonary disease. Results were similar for FEF25-75, except for increasing age, which was associated with reduced odds of small airways obstruction. Interpretation: Despite the wide geographical variation, small airways obstruction is common and more prevalent than chronic airflow obstruction worldwide. Small airways obstruction shows the same risk factors as chronic airflow obstruction. However, further research is required to investigate whether small airways obstruction is also associated with respiratory symptoms and lung function decline., National Heart and Lung Institute and Wellcome Trust. Supported by Wellcome Trust grant 085790/Z/08/Z for the BOLD study

Eosinophilic pleural effusions (EPE) are rare with an estimated incidence of 7.2% of all pleural effusions. EPE due to echinococcosis is exceptionally described in the literature. Pleural echinococcosis is almost always secondary to a ruptured primary lung cyst.Intrathoracic rupture of hepatic hydatid cyst (HC) is a rare clinical entity the rupture into the pleural cavity is less common than in the bronchial tree. We report a case of a 72 year old patient, presented with dyspnea, the chest X-ray showed a right-sided pleural effusion. The initial diagnostic process included two thoracentesis which yield eosinophilic pleural effusions. A transthoracic ultrasound showed cystic formations in the pleura, in addition to an abdominal collection with classic ultrasound images of water-lily sign and serpent sign. CT features suggested ruptured hepatic hydatid cyst in the pleura. Surgical intervention was indicated with postoperative chemotherapy. &nbsp

Rationale: The Global Burden of Disease program identified smoking and ambient and household air pollution as the main drivers of death and disability from chronic obstructive pulmonary disease (COPD). Objective: To estimate the attributable risk of chronic airflow obstruction (CAO), a quantifiable characteristic of COPD, due to several risk factors. Methods: The Burden of Obstructive Lung Disease study is a cross-sectional study of adults, aged ≥40, in a globally distributed sample of 41 urban and rural sites. Based on data from 28,459 participants, we estimated the prevalence of CAO, defined as a postbronchodilator FEV1-to-FVC ratio less than the lower limit of normal, and the relative risks associated with different risk factors. Local relative risks were estimated using a Bayesian hierarchical model borrowing information from across sites. From these relative risks and the prevalence of risk factors, we estimated local population attributable risks. Measurements and Main Results: The mean prevalence of CAO was 11.2% in men and 8.6% in women. The mean population attributable risk for smoking was 5.1% in men and 2.2% in women. The next most influential risk factors were poor education levels, working in a dusty job for ≥10 years, low body mass index, and a history of tuberculosis. The risk of CAO attributable to the different risk factors varied across sites. Conclusions: Although smoking remains the most important risk factor for CAO, in some areas, poor education, low body mass index, and passive smoking are of greater importance. Dusty occupations and tuberculosis are important risk factors at some sites.

Objectif Le but est de depister la somnolence diurne excessive (SDE), d’en determiner la prevalence et d’en analyser les etiologies chez 380 patients consultants au centre de diagnostic du CHU Hassan 2 de Fes. Methodes Le materiel d’etude est la version arabe dialectale marocaine validee par notre unite de l’echelle d’Epworth (EE), un auto-questionnaire global des troubles du sommeil et des facteurs de risque de SDE, et le score de Berlin (SB). Resultats L’âge moyen est plus de 18 ans. Le taux de participation de 96,5 % : les hommes 46,3 % (170) et les femmes 53,7 % (197). La prevalence de la (SDE) selon (EE) est de 9,5 %. L’analyse multivariee montre que les principaux facteurs de risque sont : l’âge > 55 ans (OR = 5,62), IMC > 25 (OR = 4,07), une duree de sommeil inferieure a six heures (OR = 2,47), la forte probabilite du syndrome d’apnee obstructif de sommeil (SAOS) selon(SB)(OR = 3,57), les antecedents cardiovasculaires (OR = 10,11), et endocrinologiques (OR = 3,01). Notre etude a recense d’autres troubles de sommeil : insomnie d’endormissement 32,7 %, forte probabilite de SAOS selon (SB) 37,3 %, ronflement 33,5 %, syndrome de jambe sans repos 11,4 %, somniloquie 13 %, bruxisme 6 %, nycturie 33 %, agitation au sommeil 32 % et cauchemars 17,4 %. Cependant le recours a des somniferes n’est que de 6 %. Conclusion Nous insistons sur la prevalence assez elevee de la SDE chez nos consultants, et la necessite de la depister chez les patients particulierement suivis pour des problemes cardiaques ou endocrinologiques et d’en chercher l’etiologie particulierement le SAOS.