This study presents longitudinal data on RBBB in a highly selected cohort of North American men. Thus, caution should be exercised when extrapolating these data to the general population. However, the relatively young age at entry of the majority of this cohort permits more accurate estimation both of the age at onset of RBBB and freedom from preexisting disease than is possible in studies commencing with older age groups. It also provides longitudinal data on this conduction disturbance from a young age. Other cautions include the problem of measuring A QRS in the right bundle. The exact time during the QRS that activation of the right ventricle occurs is not always apparent or predictable for each individual case. Although much of the interest is centered on extremes of axis deviation, the small number of cases in some subgroups of A QRS is also a concern. Another precaution in the extrapolation of these results is the different lengths of follow-up within each age group. Those 30 years of age and younger at detection of RBBB have been under observation for almost 30 years, but the length of follow-up is decreased in older age groups.
The present study demonstrated that the ominous prognosis attributed to RBBB and marked right or left axis deviation in patients with heart disease should not be applied to persons without heart disease who have the same ECG finding recorded on a routine examination.
The natural history of right bundle branch block (RBBB) has been studied primarily from the perspective of its prognostic importance in patients with organic heart disease. The limited number of studies that included primarily persons without 
The present report extends earlier investigations on mechanisms of pulmonary injury associated with the presence of respirable particles in the bronchoalveolar milieu. In the animal model, this study documents that asbestos-associated alveolitis which progresses to peribronchiolar and endobronchiolar fibrosis (the fundamental lesion of asbestosis) is associated with significant early increase in the level of procollagen 3 in bronchoalveolar lavage fluid and a sustained increase in the fibronectin level, which do not occur in the nonfibrosing and regressive latex-associated alveolitis. In asbestos workers with clinical and lavage evidences of alveolitis, levels of procollagen 3 and fibronectin are similarly increased in bronchoalveolar lavage fluid, which should improve our understanding of disease activity in asbestos workers.
The present study confirms previous data on the effect of muscle mass on mortality in patients with COPD. In stable patients, MD is associated to an increased risk of death. In addition, as a remarkable finding, we show that the prognostic influence of muscle mass can be assessed by determining the MAMA, an inexpensive, simple, and rapidly obtained anthropometric measure. MAMA < p25 was found to be a poor prognosis marker, exerting an influence in our series superior to that of other anthropometric parameters such as BMI or FFMi. In underweight patients, the presence of muscle depletion did not contribute significant prognostic information. However, those subjects with normal body weight or overweight status who presented MAMA < p25 had a poorer prognosis.
Alow body mass index (BMI) has been shown to be an independent indicator of poor prognosis in patients with COPD. This observation has renewed interest in the study of the nutritional aspects of COPD. In this context, a new severity classification has recently been proposed: the BODE index—(BMI, airflow obstruction, dyspnea, and exercise capacity)—which in addition to BMI considers the degree of bronchial obstruction, dyspnea, and exercise tolerance. This classification, proposed by Celli et al, stresses the multicomponent nature of COPD and addresses not only its pulmonary consequences but also the systemic manifestations of the disease. Among the latter, the authors point to the need to conduct an adequate nutritional study. However, the assessment of nutritional status based on body weight (or BMI) has limitations, since it affords no qualitative information on body composition, which is also altered in these patients.