Rev Pneumol Clin
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Interstitial lung diseases (ILD) associated with connective tissue disorders differ from idiopathic ILD in several aspects, although most of them are comparable. In most patients, ILD occurs during the course, or at the time of diagnosis of connective tissue disease. Opportunistic pulmonary infections, together with adverse effects of treatment should always be discussed. ⋯ ILD must be detected early in the course of collagen disorders by performing computed tomodensitometry and pulmonary function tests. The prognosis of connective tissue associated ILD is better than that of idiopathic ILD. The treatment requires corticosteroids and/or immunosuppressants, depending on the nature of the associated connective tissue disease and ILD progression.
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Review
[What are the questions concerning small cell lung cancer? How should research be orientated?].
Spectacular therapeutic progress for small cell lung cancer was obtained some thirty years ago with the introduction of polychemotherapy. Since when, except that which concerns radio-chemotherapy in the limited forms, the development of treatments has been relatively poor. Based on the analysis of published literature, the aim of this review is to discuss the research routes. The problems can be summarised in eleven principle axes: identification of new active drugs, development of new combinations with new chemotherapeutic agents, the place of analogs, the role of thoracic surgery, optimal radio-chemotherapeutic regimens, intensity of chemotherapy, the place of haematological growth factors, the duration of chemotherapy and maintenance treatments, biological treatments, prevention and treatment of cerebral metastases and salvage chemotherapy.
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Chyle is lymph fluid of intestinal origin containing fat digestion products. Chylothorax is produced by leaks from the thoracic duct or from one of its collaterals subsequent to valve incompetence. These leaks may be due to trauma (post-surgical chylothorax, the most frequent) or to spontaneous rupture of a lymph vessel distended by chyle reflux, the thoracic duct itself being pathological. ⋯ Recently, treatment with octreotide has been found to be beneficial. Surgery consists in thoracic duct ligation or suture of leaking collaterals. In difficult cases, when the chyle leakage cannot be identified, pleurodesis is the only option.