Revue des maladies respiratoires
-
There is no clear consensus about what constitutes reversibility of airway obstruction. European Respiratory Society (ERS): Increase in FEV1 and/or FVC>12% of their theoretical value and>0.2l. British Thoracic Society: FEV1>15% of initial value and FEV1>0.2l. Global Initiative for Chronic Obstructive Lung Disease: Increase in FEV1>12% and>0.2l. Australia and New Zealand Thoracic Society: Increase in FEV1 >15%. American Thoracic Society/ERS: Increase in FEV1>12% and>0.2l or increase in FVC>12% and 0.2l. Our principal objective was to determine the percentage of patients with COPD (n=62) who were significant responders to the reversibility test according to the 5 recommendations. ⋯ Reversibility of airway obstruction is recommendation dependent.
-
Second line treatments of non-small cell lung cancer are currently largely used because of their effectiveness in terms of survival and quality of life. Three drugs are currently licensed for this indication (docetaxel, pemetrexed and erlotinib), and possibly others will follow in the years to come. A true therapeutic strategy can thus be applied in advanced non-small cell lung cancer. The questions which need to be resolved are the optimum choice of treatments (mono-chemotherapy? Poly-chemotherapy? Therapeutic biological?) related to the still poorly understood "characteristics" of patients and tumours, as well as the specific question as to whether patients who have received adjuvant chemotherapy and then relapse should receive "first line" or "second line" therapy?
-
Interstitial lung diseases (ILD) in systemic sclerosis (SSc) are mainly encountered in patients with diffuse disease although they may occur less frequently in patients with limited cutaneous disease. ⋯ A subgroup of patients with rapidly progressive ILD might benefit from pulsed intravenous cyclophosphamide combined with prednisone 15 mg daily, but this remains to be confirmed.
-
Pulmonary lymphangioleiomyomatosis (LAM) is a rare disease affecting young women and presenting with recurrent pneumothorax. ⋯ Analysis of the molecular mechanisms induced by mutations of the TSC2 suppressor gene and the demonstration of the migratory properties of smooth muscle cells, whose origin may be extra-thoracic, reveal new specific antiproliferative therapeutic options.