Revue des maladies respiratoires
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[Sequential administration of a reduced dose of almitrine to patients with chronic obstructive bronchopneumopathies. A controlled multicenter study].
Recent multi-centre studies have shown that high doses of Almitrine (100-200 mg per day), lead to a significant improvement in the hypoxaemia of patients presenting with chronic airflow obstruction, but that a high blood level (greater than 500 ng/ml) is often seen after 1 year, sometimes associated with signs of peripheral neuropathy. In order to maintain Almitrine blood levels in the range 200-300 ng/ml we have used an intermittent regime (with a "window" of 1 month every 3 months) and a dose limited to 100 mg per day. 102 hypoxic patients with chronic airflow obstruction, who were in a stable state were included. 65 patients were in the Almitrine group (A) and 37 patients in the placebo group (P). The treatment lasted for 1 year. ⋯ The PaCO2 did not change in either group. On the other hand there was a significant fall in the subgroup of patients with hypercapnia in group A (p less than 0.001). The outcome of the neurological and electrophysiological assessments did not show any significant difference between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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A survey of high school pupils and their attitudes to tobacco was carried out by an anonymous auto questionnaire by 630 pupils at the Alienor Aquitaine Lycee in Poitiers in April 1991. The population study had the following characteristics: 30% were boys, 70% were girls. The mean age was 18 +/- 1.31 years. ⋯ The knowledge of the dangers of smoking were imperfectly understood, in particular, for chronic bronchitis, myocardial infarction, small birth weight of the newborn and cancer of the bladder. The changers of passive smoking were known by 91.6% of the pupils. Finally this study explored the opinion of the lycee pupils as regards to the six measures in the propaganda against smoking and on seven methods of information relating to the dangers of tobacco.
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Pleural diseases frequently pose problems to the pulmonary physician. The clinical and radiological approaches are often insufficient and it is necessary to resort to techniques which enable a precise morphological diagnosis of the pleural lesion. ⋯ Using this technique the diagnostic yield and the harmless nature of the technique are of the first importance. After recording traditional techniques of investigation of lung disease (puncture, needle biopsy) the equipment, the technique, the indications and the risks and the diagnostic results from thoracoscopy are discussed.
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Review Case Reports
[A rare and curable cause of acute respiratory insufficiency after a pneumonectomy. The platypnea-orthodeoxia syndrome by the reopening of the foramen ovale].
We describe a case of a 54 year old patient who had developed a right to left shunt due to a patent foramen ovale as a late consequence of a pneumonectomy; this was responsible for acute respiratory insufficiency and respiratory failure. This is a rare complication, but its clinical presentation as platypnea-orthodeoxia should lead to the correct diagnosis. ⋯ The treatment is surgical with excellent results. The pathophysiological mechanism is also discussed.