La Revue du praticien
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The pleura is characterized by its great capacity to drain liquids and particles from the pleural space and a strong inflammatory potential. Mesothelial cells react to various endogenous or exogenous agents, which are absent from the pleural space in normal conditions: air, blood, organic and inorganic particles. The pleura is a target organ, for specific lesions (pleural plaques, mesothelioma) induced by mineral fibers and for non-specific inflammatory lesions from multiple causes (drugs, systemic diseases, infections). The risk for diseases of the pleura appears disproportionate compared with its physiological role.
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La Revue du praticien · Jun 1997
[Radiotherapy and symptomatic treatments of advanced colorectal cancers].
Treatments of colorectal cancers can still be curative up to fairly advanced stage. Clinical situations vary greatly depending on the primary: local recurrence is a major event in rectal cancer whereas metastases are the main problem in colon cancer. Therefore, rectal cancer benefit from locoregional combined treatments, chemotherapy, radiotherapy and surgery, to control the pelvic disease. ⋯ Radiotherapy for bone or brain metastasis is well known and frequently used; irradiation of painful liver metastasis is less regularly discussed despite its efficacy. Symptomatic treatments like analgesics narcotic or not, non steroidal anti-inflammatory, anxiolytics, etc. are useful. All these treatments must be evaluated, not only in term of anti-tumoural but also from the quality of life point of view.
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Thoracoscopy, an endoscopic examination for pleurisy, can be performed using general anesthesia, usually without intubation, or using a neuroleptic, after induction of artificial pneumothorax if required. At the end of surgery, a thoracic drain is inserted to expand the lung. Complications are rare and mortality is below 0.017%. ⋯ In diffuse pulmonary diseases, thoracoscopy also allows lung biopsy. Some therapeutic measures are mainly feasible by this route. Pleurodesis is performed in case of recurrent pleural effusion of for pneumothorax.