Revue des maladies respiratoires
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Bronchial thermoplasty is a recent endoscopic technique for the treatment of severe asthma. It is an innovative treatment whose clinical efficacy and safety are beginning to be better understood. ⋯ This technique is in harmony with the development of personalised medicine in the 21st century. It should be developed further in response to the numerous challenges and needs not yet met in the management of severe asthma.
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One out of two smokers who smoke throughout their lifetime will die from a disease related to smoking. Tobacco smoking therefore represents a major global public health issue. Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). ⋯ The combination of high intensity behavioral interventions and medication treatments (nicotine replacement therapy, varenicline, bupropion) is the most effective strategy for smokers with COPD. In contrast, behavioral interventions without medication are not more effective than simple advice to stop. Two factors seem to predict the success of the attempt to quit in smokers with COPD: a strong motivation to quit and the use of smoking cessation medications.
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Review Case Reports
[Cardiopulmonary exercise testing and dyspnea in patients with chronic respiratory diseases].
Cardiopulmonary exercise testing (CPET) is the most comprehensive investigation for understanding the mechanisms responsible for dyspnea in patients with chronic respiratory disease. The two observations presented here illustrate how CPET can contribute to the management of patients with interstitial lung diseases. A 60-year-old woman had been followed for 20 years for non-progressive pulmonary sarcoidosis, untreated for many years. ⋯ A 76-year-old man was treated for idiopathic pulmonary fibrosis. Before pulmonary rehabilitation, CPET was performed which revealed significant aortic valve stenosis, which had been to that point asymptomatic. In these two observations, CPET determined the presence of an associated disease, distinct from the interstitial lung disease.
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Breaking bad news is a complex and frequent clinical task for physicians working in oncology. It can have a negative impact on patients and their relatives who are often present during breaking bad news consultations. Many factors influence how the delivery of bad news will be experienced especially the communication skills used by physicians. ⋯ Communication skills and specific breaking bad news training programs are both necessary and effective. A recent study conducted in Belgium has shown their impact on the time allocated to each of the three phases of this process, on the communication skills used, on the inclusion of the relative in the consultation and on physicians' physiological arousal. These results underscore the importance of promoting intensive communication skills and breaking bad news training programs for health care professionals.