Rev Pneumol Clin
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Historical Article
[Auscultation of pulmonary rales, from Laënnec to phonopneumography].
The invention in 1819 of the stethoscope by Laënnec was followed by the first classification of pulmonary adventitial sounds. A number of new nomenclatures based upon acoustic principles have subsequently been suggested. Phonopneumography consists of the recording of respiratory sounds and their breakdown into different harmonics by frequential analysis. Broadly speaking, a distinction is drawn between continuous sounds, including sibilants and rhonchi, and discontinuous sounds, covering crepitations and coarse rales.
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Comparative Study
[Effect of positive end expiratory pressure on the intrapulmonary shunt and the oxygen alveolo-arterial difference in adult acute respiratory distress].
The aim of this study was to analyse two groups of 10 patients with hypoxaemia. One group of patients had acute respiratory distress (A. R. ⋯ R. D. A. group of patients, the shunt does not vary with the PEEP and the difference remains negative.
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Since 1974 a few cases of pneumothorax after acupuncture have been reported. We report a new case of complete pneumothorax after insertion of needles in the chest wall.
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The treatment of status asthmaticus remains poorly defined. Even the definition of the condition is controversial. We have therefore attempted to define a therapeutic protocol consisting of a combination of terbutaline, aminophylline and hydrocortisone administered parenterally. ⋯ The effectiveness of this combination is reflected by the rapid improvement in the clinical and blood gas parameters, the relatively rare use of mechanical ventilation (of brief duration) and the low mortality. The tolerance proved to be excellent, as the terbutaline only had to be stopped in 1 case (permanently) and the aminophylline in one other case (temporarily). These initial results encourage us to a more aggressive approach in the early treatment of status asthmaticus with particular attention to the associated metabolic acidosis.