The UPLIFT study (Understanding Potential Long-term Impacts on Function with Tiotropium)

peer reviewedThe UPLIFT study (Understanding Potential Long-term Impacts on Function with Tiotropium) was a double-blind, randomised, international, multicentric, placebo-controlled clinical trial, investigating with tiotropium (Spiriva) the change in the annual rate of decline in FEV1 in chronic obstructive pulmonary disease (COPD). Secondary end points included COPD exacerbation rate with or without hospitalisation, lung function, quality of life and mortality. 5.993 patients were randomized. In this article, we briefly describe the most important results of the study. While tiotropium did not alter the annual rate of decline in FEV1 (pre and postbronchodilatation), it improved lung function and quality of life, and reduced exacerbations and hospitalisations by comparison with control for up to 4 years. Tiotropium also reduced respiratory and cardiac morbidity

Idiopathic pulmonary fibrosis

peer reviewedIdiopathic pulmonary fibrosis (IPF) is one of the multiple pathologies included in the large family of diffuse interstitial parenchymal lung diseases (IPD). The latter represent a large group of about 200 different diseases, most of which are orphan diseases. Recently, some new therapeutic options have appeared that require an early and accurate diagnosis of pulmonary fibrosis

Blood eosinophil count to predict bronchial eosinophilic inflammation in COPD.

No abstract available

IMPACT study in COPD

peer reviewedThe role of the anti-inflammatory and bronchodilator triple therapy, including a long acting ß2-agonist (LABA), a long-acting muscarinic antagonist (LAMA) and an inhaled corticosteroid (ICS), in the prevention of the exacerbations of chronic obstructive pulmonary disease (COPD) is still not clearly established, and requires comparison with dual therapy (LABA-CSI or LABA-LAMA). IMPACT is a phase 3, double-blind randomized study comparing the tritherapy (LABA-LAMA-ICS) in a single inhaler (vilanterol 25 µg/umeclidinium 62.5 µg/fluticasone furoate 100 µg) with the LABA-ICS association (vilanterol 25 µg-fluticasone furoate 100 µg) and the combination LABA-LAMA (vilanterol 25 µg/umeclidinium 62.5 µg) on the reduction of the rate of exacerbation as the primary outcome, but also on the pulmonary function, the quality of life, the dyspnea and the mortality.Triple therapy by comparison with dual therapy (LABA-ICS or LABA-LAMA) improves numerous parameters such as the rate of moderate to severe exacerbations, the symptoms, the respiratory function, the quality of life, while being well tolerated. Finally, the IMPACT study gives an “evidence base” for the GOLD guidelines proposing triple therapy in symptomatic COPD patients presenting exacerbations despite dual therapy. © Revue Medicale de Liege. All rights reserved

Pleurisy of unexpected etiology: a foreign body within the pleural cavity

peer reviewedFollowing three brief clinical reports, we review the literature concerning a rare cause of exudative pleural effusion: the presence of a foreign body in the pleural cavity. Frequently iatrogenical, this rare etiology of pleural effusion must be envisaged when this complication develops after any invasive peri-thoracic surgery and must be included in the differential diagnosis of recurrent pleural effusions. These effusions have a favorable prognosis after withdrawal of the foreign body

Lung transplantation benefits for terminal lung diseases

peer reviewedLung transplantation is an established treatment of pulmonary diseases at an advanced stage. The purpose of our study is to present the benefits, indications and complications of this surgical procedure in the CHU of Liege. The cohort includes 14 patients transplanted between 2005 and 2009, and who were inserted in a pulmonary rehabilitation programme at the university hospital of Liege. The criteria of assessment are the values of respiratory function tests at rest and exercise, and quality of life. Inherent complications related to this type of surgical operation have been collected. We found a dramatic improvement in pulmonary function tests performed at rest both immediately after the transplantation and after 6 months. Likewise exercise capacity was already increased shortly after the transplantation and further improved 6 months later. As for health related quality of life, parameters that improved the most were dyspnoea and global quality of life, and the improvement was already maximal immediately after the transplantation. Our retrospective study confirms the data of the literature, namely an improvement of respiratory function, effort capacity and quality of life after lung transplantation

Prognostic factors in non small cell lung cancer

peer reviewedRésumé : Le cancer pulmonaire non à petites cellules est le plus fréquent des cancers du poumon et son pronostic reste très réservé. Les rechutes sont fréquentes et peuvent même s’observer dans des stades précoces de la maladie, en dépit d’une prise en charge chirurgicale à visée curative. Cette revue de la littérature donne un aperçu des facteurs pronostiques principaux dont les deux plus importants, conditionnant la stratégie thérapeutique, demeurent la stadification («staging») et l’histologie de la tumeur. D’autres facteurs péjoratifs pourraient également s’avérer utiles pour les cliniciens, notamment en orientant le patient vers des thérapies adjuvantes.Summary : Non small cell lung cancer is the most frequent type of lung cancer and its prognosis is still very poor. Relapse is frequent and can be observed even in early stages of the disease, in spite of a surgical management with curative intent. This paper gives an overview of the main prognostic factors, the two most important of which remain the staging and tumor histology. These also determine the therapeutic strategy. Other factors of poor prognosis might also be useful for clinicians, particularly in their decision to refer patients for adjuvant therapies. Keywords : Non-small cell lung cancer – Prognostic factors – Pulmonary oncology – Surger

Y a-t-il une place pour les β-bloquants dans les maladies pulmonaires obstructives ?

peer reviewe

Clinical benefit to programmed death-1 inhibition for non-small-cell lung cancer is associated with higher blood eosinophil levels

peer reviewed[No abstract available