Revue des maladies respiratoires
-
Multicenter Study Clinical Trial
[The quality of oxygen therapy delivery systems using oxygen-saving valves. A multicenter study. The ANTADIR Medico-Technical Commission].
The saturation of oxygen (SaO2) using oxygen therapy with an oxygen saving system, Optimox (CFPO) or COS 5 (Puritan, Bennett) has been compared to the SaO2 using continuous oxygen therapy. The oxygen output using the oxygen saving system was regulated in such a way as to be equivalent to the oxygen flow without the economiser. Three situations were studied: the day, the night and during effort. ⋯ T greater than 90 AVECO was below T greater than 90 SSECO in 52% of patients and was greater in 23% of subjects. The nasal, auditory and respiratory comfort was good whatever the period of examination for more than half of the subjects. In conclusion for an equivalent oxygen flow the addition of an oxygen saving device significantly alters the quality of diurnal and nocturnal oxygen therapy in one patient out of two.
-
Bronchiolitis obliterans organizing pneumonia (BOOP) is defined by endoluminal obstruction of distal airspaces by a fibrous granulation tissue consisting of inflammatory cells, fibroblasts, and connective tissue. The morphogenesis of the process is the following: diffuse alveolar injury leading to basement membrane denudation and intra-alveolar exudate of fibrinogen, immunoglobulins, coagulation factors, fibronectin; intra-alveolar migration of interstitial fibroblasts through gaps of the epithelial basement membrane; intra-alveolar secretion of loose connective tissue (codistribution of collagens I, III, V, and fibronectin) by the fibroblasts-myofibroblasts. The main characteristic of this peculiar fibrosis is its possible reversibility. ⋯ But in some cases BOOP remains idiopathic and has to be individualized. Three clinical and imaging profiles are distinguished: the most characteristic consists of an inflammatory context with imaging patchy alveolar opacities, migrating and relapsing, and most steroid sensitive; the other two presentations are less remarkable: pseudo-neoplastic localized chronic pneumonia, and diffuse infiltrative lung disease. BOOP is a clinico-pathologic entity that the clinician must know because of the efficacy of corticosteroid treatment in most cases, and it further represents an unique model to understand the pathogenesis of fibrosing pulmonary diseases.
-
Review Case Reports
[Episodic laryngeal dyskinesia: a functional cause of stridor].
We present five cases of episodic laryngeal dyskinesia. This term describes an entity associating acute dyspnea with inspiratory and/or expiratory stridor, sometimes ending in acute respiratory distress. ⋯ The definitive diagnosis is made by excluding organic pathology, by visualising laryngeal spasm and by the inspection of flow volume curve. A comparison of all the published papers since 1974 reveals the benign nature of this "noisy" disorder and to bring out the diagnostic criteria thus avoiding too aggressive an approach in these patients.
-
We have studied post-operative pain in 116 patients who underwent a thoracotomy. The pains were assessed using a visual analogue scale and were significant and identical whatever type of operation was used and irrespective of sex or diagnostic disease category. On the operative day only the surgeon seemed to have any influence. ⋯ The insertion of drains had no influence on the pain. Massage and physiotherapy decreased the pain in a significant fashion. The importance of taking account of post-operative pain is underlined.