Revue des maladies respiratoires
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Mucormycosis is a rare opportunistic fungal infection due to filamentous fungi of the order Mucorales in the class Zygomycetes. Rhino-cerebral and pulmonary manifestations predominate on account of the airborn spread of the spores. Gastro-intestinal, cutaneous and disseminated disease is less common. The principal risk factors are immuno-suppression and diabetic keto-acidosis. ⋯ Currently there is hope of new therapeutic approaches with posaconozole but the ineffectiveness of voriconozole and the echinocandines, used more and more against aspergillus, raises the possibility of an increase in mucormycosis by selection.
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The association between idiopathic pulmonary fibrosis and patent foramen ovale has rarely been described. ⋯ These two cases underline the importance of diagnosing right-to-left shunts in patients who have pulmonary fibrosis with severe hypoxemia, in order to reduce their oxygen needs.
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A 21 year old man was admitted to hospital as an emergency complaining of left sided chest pain. Chest radiograph revealed a complete non compressive left-sided pneumothorax which resolved following thoracic drainage. A more detailed history revealed repeated and regular use of nitrous oxide by inhalation, for its consciousness-altering effect during rave parties. ⋯ Inhaled nitrous oxide can reveal asymptomatic pneumothorax by worsening it. The consequences can be dramatic in case of illicit use because of ignorance of side effects.
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As the quality of asthma care influences hospital admission rates, we described hospitalizations for asthma and studied trends in admission rates in France from 1998 to 2002. ⋯ Admission rates for asthma decreased between 1998 and 2002 in people aged 10 years and older. However, changes in coding practices or admission policies cannot be excluded and the extent to which the observed trends reflect changes in preventive care among patients with asthma remains to be assessed.
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Exercise-induced desaturation is a well-described phenomenon in COPD patients during exercise assessments such as the six minute walk test (6MWT). Some of the pathophysiological mechanisms involved in this O2 desaturation could be modified by individualized exercise training as part of a pulmonary rehabilitation programme. The aim of this study was to determine the effect of pulmonary rehabilitation on O2 desaturation exhibited by COPD patients during a 6MWT. ⋯ It seems that responses to a pulmonary rehabilitation programme including individualized exercise training could act on O2 desaturation. Indeed 7 of 20 (35%) COPD patients exhibiting O2 desaturation during a 6MWT showed no O2 desaturation after rehabilitation programme while 13 on 20 (65%) do it.