Revue des maladies respiratoires
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Editorial Comparative Study
[Non-invasive ventilation at home: preset volume or pressure?].
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Radon is a noble gas derived from the decay of radium, which itself is a decay product of uranium. The decay products of radon can collect electrostatically on dust particles in the air and, if these particles are inhaled and attach to bronchial epithelium, produce a high local radiation dose. Alpha particles can induce DNA double-strand breaks and the development of cancer. ⋯ The estimates obtained from case-control studies of indoor radon are very contradictory. Scientific knowledge of effects of low levels of exposure to radon and the role of cigarette smoking, as a combined factor, must be studied. Smoking and radon probably interact in a multiplicative fashion.
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Nocturnal polysomnography is the reference tool for the exploration of sleep disorders in children. Noninvasive methods are to be preferred for children. Recording respiratory signals identifies respiratory events (episodes of apnea, hyponea) and their effect on gas exchange. ⋯ Recordings of neurophysiolgical signals can be used to analyze sleep organization and to quantify cortical awaking reactions. The most frequent indication in pediatric patients with sleep disorders is to explore suspected obstructive sleep apnea syndrome. The prevalence of this syndrome in the general pediatric population would be 1.6%, increasing to 8.4% in members of a family with a child having obstructive sleep apnea syndrome.
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Lung transplantation (LT) became during the ten past years an important therapeutic option for cystic fibrosis adult patients with end-stage chronic lung disease. LT clearly improves both survival and long term quality of life. A rigorous selection of the candidates is of paramount importance to improve the results of LT because of the lack of shortage of organs. ⋯ The selection period is also an active process to prepare the patients to the postoperative follow-up and includes a nutritional and rehabilitation program with an educational and psychological preparation. The aim of the present work is to gather the worldwide principles of the selection of the CF patients for LT, commonly used by the LT centers. These recommendations should provide the CF center practitioners with the main elements to prepare their patients to an LT project before a relentless end-stage clinical condition.
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Non invasive mechanical ventilation represents all the techniques of mechanical ventilation not using endotracheal connection to the respirator. Non invasive mechanical ventilation is essentially represented nowadays by facial (generally used for acute respiratory failure) and nasal ventilation (widely used for long term mechanical ventilation at home). ⋯ In parallel, more recent studies have demonstrated the interest of that technique in immediate ventilatory link in the spectrum of weaning of endotracheal mechanical ventilation. In hypoxic acute respiratory failure, non invasive mechanical ventilation remains controversial and seems to be better indicated in moderate to severe respiratory status.