REVUE DES MALADIES RESPIRATOIRES

[When tuberculosis makes you deaf]
Cauhape V, Risso K, Demonchy E, Flory V, Guevara N and Vandenbos F
Tuberculous otomastoiditis is a rare and serious infection that most often occurs in association with pulmonary involvement. It is easy to diagnose when the two pathologies are associated and isolated. We herein report the case of a patient initially hospitalized for Pseudomonas aeruginosa necrotising otitis externa (NOE), which delayed the diagnosis of tuberculous otomastoiditis.
[Pneumomediastinum as a rare complication in connective tissue disease]
Aydi Z, Rachdi I, Soli A, Somai M, Arbaoui I, Ben Dhaou B, Daoud F and Boussema F
Otherwise known as mediastinal emphysema, pneumomediastinum (PNM) in connective tissue diseases is a rare clinical entity. Few cases have been described in the literature. In fact, it only exceptionally complicates the evolution of connective tissue diseases. In this paper report, two cases of spontaneous PNM secondary to scleroderma and Sjogren's syndrome. Based on the data in the literature, we discuss the etiology, frequency of occurrence, and the pathophysiological mechanisms of this unusual complication.
[Psychosocial traits associated with maintenance of physical activity 12months after a pulmonary rehabilitation program - An exploratory study]
Teulier M, Fouquereau E, Bremond M, Courtois R, Reveillère C and Plantier L
After a pulmonary rehabilitation (PR) program, 30 to 70% of patients fail to pursue maintenance of physical activity. This study aimed to identify psychosocial markers associated with MPA subsequent to an initial outpatient PR course (≥10 sessions).
[Evaluation of local anesthesia with buffered Xylocaine in pleural procedures: The DOULAPLUX study]
Guiraud-Chaumeil V, Goussault H, Boudjemaa A, Viñas F, Bonnefoy V, Gibiot Q, Rousseau-Bussac G, Maitre B and Mangiapan G
Pleural procedures are painful interventions. While there exist recommendations aimed at preventing pain induced by local anesthesia, they have never been evaluated with regard to the thoracic wall. The objective of this study was to evaluate the effectiveness of buffered lidocaine local anesthesia in pleural procedures.
[Elexacaftor, Tezacaftor and Ivacaftor: immediate efficacy evaluation using home spirometry]
Thimmesch M, Boulay M, Defgnée E, Bauwens N and Palem A
Following two weeks of application of the triple combination therapy of Elexacaftor (E), Tezacaftor (T), and Ivacaftor (I) known as ETI, substantial pulmonary improvement in patients with cystic fibrosis is well-documented. However, few detailed data are available on the action of this treatment over the course of these first 14 days.
[Factors associated with venous thromboembolism in tuberculosis patients in Burkina Faso: A case control study]
Dembélé O, Maïga S, Ouédraogo AR, Sourabié A, Soubeiga D, Ngo Ngue TC, Ouédraogo A, Zongo M, Essaga Eloundou C, Bonsa E, Ali Moussa ML, Coulibaly A, Birba E, Boncoungou K and Ouédraogo M
The mortality caused by tuberculosis is partially explained by co-morbidities such as venous thromboembolic disease. Our study was aimed at identifying the factors associated with venous thromboembolism in tuberculosis patients.
[Cardiopulmonary exercise testing: Key practical aspects]
Soumagne T, Degano B and Günther S
Functional exercise testing (FET) assesses an individual's capacity to adapt to effort and identifies limiting factors, particularly dyspnea. It orients therapeutic choices, predicts the progression of chronic pathologies, and estimates preoperative risks, at times contraindicating surgery. The aim of this article is to provide a summary of the specific indications for functional exercise testing, test protocol selection, test equipment, appropriate personnel, and patient and test safety. This article is intended for healthcare professionals conducting or considering functional exercise testing.
[Safety of use of electronic cigarettes: A systematic review of bronchopulmonary, cardiovascular and cancer risks]
Dupont P and Verdier C
As the effects of electronic cigarettes (ECs) have rapidly become widely known, we propose to take stock of recent findings on the bronchopulmonary and cardiovascular adverse effects (AEs) and the risks of cancer occurrence entailed by EC use. METHOD: We carried out a search from 2018 to October 19, 2023 on PubMed, adopting the PRISMA guidelines (2020) with the following keywords in "Titles and abstracts": electronic cigarette, or e-cigarette, or ENDS, AND safety or toxicology or effect or health effect, using "Systematic Review" as a filter. The inclusion criteria were: systematic review of in vitro or in vivo studies in English or French dealing with the risks of ECs for the bronchopulmonary system, the cardiovascular system, or cancer occurrence. CONCLUSION: Twenty-eight systematic reviews on the adverse effects (AE) of electronic cigarettes (EC) in selected humans show that the toxic substances they generate can cause cancers and increase the risk of cardiac and pulmonary disorders. New studies on the potential dangerousness of EC use are essential and urgent.
[Understanding teenagers' experiences of asthma. A qualitative approach to adolescents' perceptions of the disease and management of the symptoms]
Merienne A, Claude Roux P and Chassagne A
In a qualitative investigation carried out in different environments (hospital, school, home) among 12-to-21-year-old asthmatics, we describe their perceptions of a pathology that is at once chronic and intermittent. More specifically, we show how an asthma attack constitutes a traumatic experience occurring in a temporality characterized by bodily upheaval. We describe the emotional labor provided by young asthmatics in their interpretation of their bodily signs, which are often read differently than in the medical sphere. The intermittency of the disease and the occurrence of crises in specific situations lead adolescents to achieve improved knowledge of their bodies. In this study, we analyze the roles of supports (inhalers…) and adaptative techniques in the development of know-how enabling them to autonomously treat their symptoms and monitor the signs of an upcoming attack.
[Obstructive apnea hypopnea syndrome in pregnancy]
Bironneau V
Obstructive sleep apnea hypopnea syndrome (OSA) in pregnant women is an under-diagnosed but common condition, due to the numerous physiological changes favoring upper airway collapse. Risk factors such as significant weight gain during the 1st trimester, maternal age and parity should be systematically investigated. Diagnosis is made by sleep recording. OSA can lead to maternal and fetal complications (gestational diabetes, eclampsia, intrauterine growth restriction, prematurity…) during pregnancy, delivery and the post-partum period. It is therefore essential to treat apneic patients as early as possible in pregnancy. Treatment includes hygienic and dietary measures, as well as continuous positive airway pressure (CPAP). Systematic post-partum follow-up with polygraphic monitoring should be proposed.
[CT imaging of chronic obstructive pulmonary disease: What aspects and what role?]
Dournes G, Zysman M, Benlala I and Berger P
Chronic obstructive pulmonary disease (COPD), commonly defined as irreversible airflow limitation, is associated with specific morphological changes involving all three parts of the lung, namely the bronchi, parenchyma and pulmonary vessels. In vivo imaging, with its ability to describe the different types of lung alterations and their regional distribution, helps to elucidate the relationship between lung structure and respiratory function. High-resolution computed tomography (CT) of the lung is the imaging modality best suited to assessing the pathological changes associated with airflow obstruction occurring in COPD. Over the last few decades, numerous studies have demonstrated the role of CT as a morphological and functional method conducive to the phenotyping of COPD patients. This review proposes to examine the data on CT imaging of COPD with a critical approach to recent data, and to determine the extent to which CT could be integrated into care or clinical research on patients with this/these disease(s).
[Real-life utilization of fixed triple therapy in COPD: The Trilife study. Beclomethasone/formoterol/glycopyrronium triple fixed-dose therapy in extra-fine particles]
Roche N, Bernady A, Piperno D, Bachiri A, Fiocca J, Lardy-Cléaud A, Lafargue S, Guillemin S and Devillier P
The Trilife study describes the real-life use, in France, of the beclomethasone/formoterol/glycopyrronium triple fixed-dose combination in solution for inhalation, which is indicated as continuous treatment for moderate-to-severe chronic obstructive pulmonary disease.
[Non-small cell lung cancer in adults under 40 years of age]
Lemaire M, Durieux V, Meert AP and Berghmans T
Non-small cell lung cancers (NSCLC) are the most common lung cancers, withpeak incidence at 65years of age. These cancers rarely occur before the age of 40.
[Indications of home oxygen therapy for patients with COPD or ILD]
Sandot A, Bunel V and Mal H
Long-term oxygen therapy (defined by oxygen administration exceeding 15hours/day) for patients with severe resting chronic hypoxemia is the most validated modality of home oxygen therapy, its survival benefit having been demonstrated several decades ago. In addition to this well-accepted indication for home oxygen therapy, other modalities of home oxygen administration have been proposed, such as long-term oxygen therapy for patients with moderate hypoxemia, ambulatory oxygen therapy for patients with severe exertional room air hypoxemia, and nocturnal oxygen therapy for patients with nocturnal hypoxemia. The aim of the present manuscript is to review the evidence supporting the indications for the different modalities of home oxygen therapy for patients with chronic obstructive pulmonary disease or interstitial lung disease, two lung pathologies for which most data are available. We also wished to synthetize the recommendations of different thoracic societies/groups of experts on the indications for long-term oxygen therapy.
[The benefits of simulation in bronchial endoscopy]
Caron F, Mathieu F, Talleux M, Basille D and Rames C
Bronchoscopy is an invasive procedure that can be difficult for patients to tolerate, especially if the operator is inexperienced. Simulation enables trainees to perfect their skills, while adhering to an ethical approach: "never the first time on a patient". The main aim of our study is to demonstrate the benefits of simulation in learning how to perform bronchial endoscopy, in terms of dexterity, speed of execution and anatomical recognition by the operator.
[Antibioprophylaxis failure with BCG therapy for bladder neoplasia]
Argoulon N, Morel H, Lanotte P, Ferreira M, Prazuck T and Marchand-Adam S
BCG therapy is the standard treatment for bladder tumors that do not infiltrate smooth muscle. Fluoroquinolones for antibiotic prophylaxis are recommended to lessen the risk of BCG infection (BCGitis) with respiratory involvement.
[The repercussions of variations in ambient air pressure on pulmonary airway dystrophy. Applications to scuba diving with mask, commercial air travel and stays in high-altitude settings]
Coëtmeur D, Lemmens B and Storme S
Pulmonary airway dystrophy (PAD) is a rare disease that may be either innate or acquired. Very few publications have been dedicated to the repercussions of the air pressure variations that may be encountered during an airplane journey in a pressurized cabin, an aerial tramway ascent or a stay in a high-altitude setting. Variations may also occur during deep-sea diving with modification of absolute air pressure.
[Efficacy and toxicity of short-course corticosteroid therapy in chronic bronchial diseases]
Regard L, Lazureanu PC, Pascal B, Laurichesse G and Rolland-Debord C
Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) are characterized by airway inflammation. While corticosteroids (CS) are frequently prescribed during exacerbations of these conditions, their repeated use is associated with numerous side effects. The aim of this review is to synthesize the recent literature on the indications, benefits, and risks of short-term CS therapy for these two diseases. French guidelines recommend short-term CS as a first-line treatment during asthma exacerbation (0,5 to 1mg/kg/day, not exceeding 60mg/day, for at least 5 to 7 days) or as a second-line treatment for COPD exacerbation (5 days, 30 to 40mg/day). However, these recommendations are not without limitations; they are primarily based on studies conducted in hospital settings, raising questions about the generalizability of their results to primary care, and as they employ a "one size fits all" strategy, they do not take into account the phenotypic heterogeneity of different patients. Moreover, repeated short-term CS courses generate side effects that even at low doses can appear early in young asthma patients, and they can exacerbate pre-existing comorbidities in COPD patients. The concept of a threshold dose should be employed in routine practice in view of accurately assessing the risk of side effects. In the near future, it will be important to consider recently published data supporting the use of predictive biomarkers for responses to CS, particularly in COPD cases.
[Extended length of stay following robot-assisted minimally invasive pulmonary lobectomy: Is incomplete ERAS protocol to blame?]
Zayene B, Rivera C, Mallet M, Falchetti A and Mazeres F
Enhanced Recovery After Surgery (ERAS) is a series of measures designed to promote early recovery after surgery. Application of this approach has led to significantly decreased morbi-mortality and reduced length of hospital stay. The aim of our study was to determine whether non-completion of the ERAS protocol following robotic-assisted mini-invasive lobectomy could be the cause of prolonged hospital stay (exceeding 6 days). We conducted a longitudinal retrospective analysis of 34 patients (17 men and 17 women) having undergone robotic-assisted lobectomy for early-stage primary lung carcinoma from January 1, 2022 to December 31, 2022. The study population was divided into two groups based on length of hospital stay: group 1 with length of stay not exceeding 6 days and group 2 with a stay of 7 days or more. Comparative analysis showed no significant difference in ERAS completion score between the two groups, whatever the preoperative (P=0.15), perioperative (P=0.73) or postoperative (P=0.97) time. That said, prolonged air leak (P=0.01) was the main difference among the analyzed variables, followed by Charlson score (P=0.01), grade of complications (P=0.03) and smoking status (P=0.01). Incorporation of complementary measures in our ERAS protocol strategy would in all probability optimize air leak management and further reduce length of hospital stay.
[Mechanisms of prolonged symptoms following acute COVID-19: Some pathophysiological pathways]
Gaudry C, Dhersin R and Dubée V
Following the Omicron wave in early 2022, an estimated 60-70% of the French population was infected with the SARS-CoV-2 virus. One out of ten infected subjects could have persistent symptoms three months after infection, representing a public health challenge.
[Impact of smoking and respiratory diseases on pregnancy: A challenge for women's health]
Marin B