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Aalst, Belgium

Background: Acute dyspnea is a common cause for emergency calls. In addition to cardiac causes, it may be related to pulmonary diseases. Results: In case of acute dyspnea, bronchial asthma may be primarily considered. However, there are other reasons for severe dyspnea, e.g., paradoxical adduction of the vocal cords (vocal cord dysfunction, VCD). Conclusion: Knowledge of VCD will enable the emergency physician to correctly assess and prevent harmful escalation of the therapeutic regimen. © 2015, Springer-Verlag Berlin Heidelberg. Source

Lung cancer is even today the leading cause of cancer mortality worldwide. The majority of patients are still diagnosed with advanced cancer so that curative therapy is feasible only in a minority of patients. The prognosis is up to now poor and palliative therapy unfortunately common. The bronchoscopist is confronted with an increasing number of patients suffering from centrally located cancer with life-threatening symptoms and immediate action is required. In recent years the techniques have been improved. For tumor destruction mechanical removal and different coagulation methods are available. The laser is losing popularity. Electrocoagulation and argon plasma beamer lead to comparable results. Recently cryorecanalization as a form of cryotherapy has become widely used. After removal of the intraluminal component and/or dilatation a stent can be used for securing airway patency. The repertoire also includes brachytherapy, photodynamic therapy and different methods to achieve hemostasis. An overview of the different methods of bronchoscopic tumor palliation and the differential therapy is given. © 2012 Springer-Verlag. Source

Cadranel J.,Pneumologie
Revue des Maladies Respiratoires Actualites | Year: 2015

The lung is often the target of collagen vascular diseases (CVD), usually with interstitial pneumonia. The type of interstitial lung disease may be a clue to the diagnosis of CVD, and is sometimes very specific (UIP and rheumatoid arthritis, COP and dermatoymyositis, LIP and Sjogren's syndrome). The development of interstitial lung disease affects the prognosis of CVD (Pulmonary hypertension and systemic sclerosis, UIP and Rheumatoid arthritis). Interstitial lung disease associated with CVD usually has a better prognosis than idiopathic interstitial lung disease. Currently, there is no effective specific treatment for interstitial pneumonia associated with CVD except cyclophosphamide in systemic sclerosis. © 2015 Elsevier Inc.. Source

Ploin D.,Urgences et Reanimation Pediatrique | Chidiac C.,Maladies infectieuses et tropicales | Carrat F.,University Pierre and Marie Curie | Cohen B.,University Paris Diderot | And 4 more authors.
Journal of Clinical Virology | Year: 2013

Background: The emergence of novel A(H1N1)pdm2009 virus threatened to lead to frequent severe manifestations. Objectives: To describe the clinical, virological, and biological characteristics of the disease and identify the factors associated with severe presentations. Study design: This prospective multicenter study recruited consecutive hospitalized patients with confirmed A(H1N1)pdm2009 disease. Clinical, virological and biological assessments were carried out at inclusion and 30 days post-inclusion. Disease manifestations were assessed by an adjudication committee using pre-identified definitions of complications and severity scores. Results: The study analyzed from November 30th, 2009 to February 8th, 2010, 40 hospitalized patients, 21 children and 19 adults. Eighteen (45%) were considered to have severe presentations. Except age, main characteristics in children and adults did not differ. The majority (18/21) of children and all adults had a respiratory presentation; extra-respiratory manifestations tended to be more frequent in children (12 vs. 6, P= 0.10). Two children against 5 adults presented acute respiratory distress syndrome (ARDS, P= 0.23), but more children suffered respiratory failure (7 vs. 1, P= 0.046) without ARDS. At day 30, one death had occurred in each group. The main factor associated with non-severe presentation was an early (<48. h) implementation of oseltamivir treatment ( P= 0.038). Conclusions: Although the study failed to achieve its main objective, due mainly to the difficulty of carrying a study of this nature in the midst of a pandemic, it allowed the description of a panel of unusual and complicated forms and confirmed the added value of early oseltamivir treatment in limiting severity in hospitalized children and adults. © 2013 Elsevier B.V. Source

Ferguson G.T.,Pulmonary Research Institute of Southeast Michigan | Feldman G.J.,S Carolina Pharmaceutical Research | Hofbauer P.,Pneumologie | Hamilto A.,Boehringer Ingelheim | And 3 more authors.
International Journal of COPD | Year: 2014

Background: Olodaterol is a long-acting β2-agonist with a 24-hour bronchodilator profile. Two replicate, randomized, double-blind, placebo-controlled, parallel-group, Phase III trials were performed as part of a comprehensive clinical program to investigate the long-term safety and efficacy of olodaterol in patients with moderate to very severe chronic obstructive pulmonary disease (COPD) receiving usual-care background therapy. Methods: Patients received olodaterol 5 μg or 10 μg or placebo once daily for 48 weeks. Coprimary end points were forced expiratory volume in 1 second (FEV1) area under the curve from 0 to 3 hours (AUC0-3) response (change from baseline), and trough FEV1 response at 12 weeks. Secondary end points included additional lung function assessments, use of rescue medications, FEV1 AUC response from 0 to 12 hours, and Patient Global Rating over 48 weeks. Results: Overall, 624 and 642 patients were evaluated in studies 1222.11 and 1222.12, respectively. In both studies, olodaterol 5 μg and 10 μg significantly improved the FEV1 AUC0-3 response (P<0.0001) and trough FEV1 (study 1222.11, P<0.0001; study 1222.12, P<0.05, post hoc) at week 12, with an incidence of adverse events comparable with that of placebo. Secondary end points supported the efficacy of olodaterol. Conclusion: These studies demonstrate the long-term efficacy and safety of once-daily olodaterol 5 μg and 10 μg in patients with moderate to very severe COPD continuing with usual-care maintenance therapy. © 2014 Ferguson et al. Source

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