Revue des maladies respiratoires
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The prevalence of patent foramen ovale (PFO) is high. As identified at autopsy it is found in approximately 25% of the general population. Anatomically a PFO represents a channel through which unidirectional blood flow from the right to the left atrium may occur. ⋯ High pressure in the right heart chambers, even without pulmonary arterial hypertension, can potentially lead to the reopening of a foramen ovale. In other cases inferior vena cava flow deviation might lead to right to left shunting across a PFO. Right to left shunting without pressure increase inside the right heart chambers is usually transient and even positional and its diagnosis is more difficult.
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Multidrug resistant tuberculosis (MDR-TB) has spread to most regions of the world and represents a serious threat to the success of the struggle against tuberculosis. It can result from errors in management that favour the selection of drug resistant organisms and can in the worst case lead to the development of extremely resistant organisms (XDR-TB) which are practically untreatable. ⋯ This can have implications for the modification and development of national strategies. The future of the fight against tuberculosis depends in part on the success of strategies to combat the development and spread of MDR-TB.