Revue des maladies respiratoires
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At a time when non-invasive ventilation (NIV) is commonly used in acute as well as chronic respiratory failure, it is important to consider the current place, if any, of long-term tracheostomy. ⋯ Even if the indications for LTVT have diminished considerably since the emergence of NIV, tracheostomy remains mandatory in some situations of respiratory distress and it should be considered as a potential resource, possibly temporary in some cases in the light of recent work on the possibility of decanulation after LTVT.
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How do residents, specialists or general practitioners advise patients who are smokers when they are admitted to hospital? Do they assess their smoking status? How much do they know about smoking cessation? Do they know the tests essential to allow an effective approach to smokers? ⋯ The approach to the smoking patient varied according to the resident's speciality. Smoking assessment was done systematically by most but did not always lead to an assessment of patients' motivation to stop smoking or to an offer of assistance with quitting. This observation led to the development of a tool to improve the approach to smokers, available within the CHRU intranet covering the principles of the management of the tobacco quitting process; informing, helping to stop feeling guilty, assessing the motivation to quit (Q.MAT), assessing the smoker's addiction (Fagerström test), offering assistance and a list of nicotine substitutes.
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Asthma exacerbations are characterized by a progressive aggravation of respiratory symptoms such as dyspnea, cough, wheezing or chest tightness. ⋯ Most studies provide evidence that allergen exposure contributes to the risk of asthma exacerbations, but other precipitating factors, such as viruses, can interact and increase the risk.
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Case Reports
[Non-small cell carcinoma presenting as limbic encephalitis. Place of endobronchial ultrasound in the diagnosis].
Limbic encephalitis is a rare neurological paraneoplastic syndrome, characterized by anterograde amnesia, epilepsy and confusion. Diagnosis of the underlying cancer is essential for treatment. ⋯ The neurological prognosis is poor. The search for bronchial cancer, when suspected, should include positron emission tomography, to be repeated if necessary, and sampling of the mediastinal lymph nodes using endobronchial ultrasound.