Revue des maladies respiratoires
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Review Comparative Study
[Acute circulatory failure caused by primary pulmonary hypertension or pulmonary embolism].
Patients with acute massive pulmonary embolism or primary pulmonary hypertension may develop acute circulatory failure and are therefore admitted in the intensive care. The mortality rate of patients with pulmonary embolism and shock varies between 25 and 35% whereas the corresponding figure in patients with submassive embolism is less than 10%. Spiral computed tomography may be the most convenient test for diagnosing pulmonary embolism in the setting of acute circulatory failure. ⋯ Symptomatic treatment combines oxygen, inotropic drugs, as well as the optimisation of right ventricular filling pressure. Specific treatment includes inhaled nitric oxide or intravenous epoprostenol followed by anticoagulants with either calcium channel blockers in patients responding acutely to vasodilators or a continuous infusion of epoprostenol in those who do not respond to acute challenge or who are not improving with calcium channel blockers. Although the long term survival has markedly improved as a result of epoprostenol treatment, some patients with refractory primary pulmonary hypertension remain candidates for lung transplantation.
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Eosinophils are the most characteristic inflammatory cells in the airway mucosa in asthma. Eosinophils release highly toxic products and cytokines which may influence the immune system, amplify the inflammatory response and participate in damaging and remodeling processes that occur in the airway mucosa. Eosinophilic inflammation in asthma is related to the blunted perception of bronchoconstriction. ⋯ The number and activation of eosinophils in the airway mucosa are related to the magnitude of airway hyperresponsiveness to bradykinin but not to an agonist acting directly on smooth muscle such as methacholine. Inhaled corticosteroids reduce eosinophil inflammation in asthma whereas beta 2-agonists appear to increase the magnitude of eosinophilic inflammation induced by allergen exposure. The eosinophilic inflammation can be assessed by non-invasive methods using sputum analysis and, indirecly, by measuring the airway reactivity to bradykinin.
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Comparative Study Clinical Trial
[Efficacy of docetaxel in non-small cell lung cancer patients previously treated with platinum-containing chemotherapy. French Group of Pneumo-Cancerology].
Determine the response to, and toxicity of docetaxel (Taxotere) in patients (pts) with inoperable non-small-cell lung cancer (NSCLC) previously treated with platinum-containing chemotherapy. ⋯ Docetaxel (Taxotere) administered at 100 mg/m2/3 weeks has relevant clinical activity against platinum treated NSCLC pts. Neutropenia is the main toxicity.