Pollution atmosphérique acide, effets sur la santé

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Air pollution and acute respiratory infections

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Le dépistage du cancer du poumon: Importance de la sélection de la population à dépister

SCOPUS: ed.jSCOPUS: ed.jinfo:eu-repo/semantics/publishe

Traitements endoscopiques dans le cancer bronchique

Except its essential role in the diagnosis, bronchial endoscopy also takes an important part in the treatment of lung cancer. First, bronchial endoscopy has a key-role in the treatment of cancer with bronchial obstruction. Endoscopic techniques can lead to quick bronchial desobstruction and therefore they allow symptoms improvement and decrease of respiratory and infectious complications. This improvement of the patient health situation also will permit a more complete and efficient approach using curative therapies (radiotherapy and chemotherapy). Endoscopic local treatment must be integrated in a multimodal therapeutic approach in association with curative treatments. Modern endoscopy also contributes into the treatment of early roentgen occult lung cancer. Phototherapy, and as an alternative, techniques of electrocautery, cryotherapy and brachytherapy, can be used to treat these early lung cancer in patients who are not surgical candidates.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Réponse des muscles respiratoires aux vibrations mécaniques du gril costal

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

Dépistage du cancer du poumon et approche endoscopique du nodule pulmonaire

Lung cancer screening corresponds to any investigation carried out to detect the presence of this type of cancer before the appearance of any symptomatology. According to the results of a large multicenter study in the US (NLST), American scientific societies are currently recommending the use of the CT Thoracic Scanner with a low dose of irradiation once a year for lung cancer screening in high-risk populations. European expert groups, for the most part, reserve their recommendations after publication of the results of a major European study (NELSON). As a corollary of screening campaigns, the management of lung nodules is likely to be more and more frequent in the targeted populations. This can be performed in different ways ranging from the less invasive, the CT Scanner follow-up, to the more invasive, the surgical resection. The endoscopic approach of the pulmonary nodule, whose results were so far limited, is actually regaining interest due to the contribution of new technologies in bronchial endoscopy.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Insuffisance respiratoire aiguë et asthme

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Toxic gases and vapors exposure

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Mechanism of increased inspiratory rib elevation in ascites

The detrimental effect of ascites on the lung-expanding action of the diaphragm is partly compensated for by an increase in the inspiratory elevation of the ribs, but the mechanism of this increase is uncertain. To identify this mechanism, the effect of ascites on the response of rib 4 to isolated phrenic nerve stimulation was first assessed in four dogs with bilateral pneumothoraces. Stimulation did not produce any axial displacement of the rib (Xr) in the control condition and caused a cranial rib displacement in the presence of ascites. This displacement, however, was small. In a second experiment, the effects of ascites on the pleural pressure swing (ΔPpl), intercostal activity, and Xr during spontaneous inspiration were measured in eight animals. As the volume of ascites increased from 0 to 200 ml/kg body wt, Xr increased from 3.5 ± 0.5 to 7.5 ± 0.9 mm (P < 0.001), ΔPpl decreased from −6.4 ± 0.4 to −3.6 ± 0.3 cmH20 (P < 0.001), and parasternal intercostal activity increased 61 ± 19% (P < 0.001). The role of the decrease in ΔPpl in causing the increase in Xr was then separated from that of the increase in intercostal muscle force using the relation between Xr and ΔPpl during passive lung inflation. The loss in ΔPpl accounted for two-thirds of the increase in Xr. These observations indicate that 1) the increased inspiratory elevation of the ribs in ascites is not the result of the increase in the rib cage-expanding action of the diaphragm and 2) it is due mostly to the decrease in ΔPpl and partly to the increase in the force exerted by the parasternal intercostals on the ribs. These observations also suggest, however, that the rib cage expansion caused by ascites makes the parasternal intercostals less effective in pulling the ribs cranially

Dysfunction of the canine respiratory muscle pump in ascites

Ascites, a complicating feature of many diseases of the liver and peritoneum, commonly causes dyspnea. The mechanism of this symptom, however, is uncertain. In the present study, progressively increasing ascites was induced in anesthetized dogs, and the hypothesis was initially tested that ascites increases the impedance on the diaphragm and, so, adversely affects the lung-expanding action of the muscle. Ascites produced a gradual increase in abdominal elastance and an expansion of the lower rib cage. Concomitantly, the caudal displacement of the diaphragm and the fall in airway opening pressure during isolated stimulation of the phrenic nerves decreased markedly; transdiaphragmatic pressure during phrenic stimulation also decreased. To assess the adaptation to ascites of the respiratory system overall, we subsequently measured the changes in lung volume, the arterial blood gases, and the electromyogram of the parasternal intercostal muscles during spontaneous breathing. Tidal volume and minute ventilation decreased progressively as ascites increased, leading to an increase in arterial PCO2 and parasternal intercostal inspiratory activity. It is concluded that 1) ascites, acting through an increase in abdominal elastance and an expansion of the lower rib cage, impairs the lung-expanding action of the diaphragm; 2) this impairment elicits a compensatory increase in neural drive to the inspiratory muscles, but the compensation is not sufficient to maintain ventilation; and 3) dyspnea in this setting results in part from the dissociation between increased neural drive and decreased ventilation.SCOPUS: ar.jinfo:eu-repo/semantics/publishe