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

Analysis and modeling of green wood milling: Chip production by slabber

During the primary transformation of wood, logs are faced with slabber heads. Chips produced are raw materials for pulp paper and particleboard industries. Efficiency of these industries is partly due to particle size distribution. Command of this distribution is no easy matter because of great dependence on cutting conditions and variability in material. This study aimed a better understanding and predictionof chip fragmentation. It starts with a detailed description of cutting kinematic and interaction between knife and log. This leads to the numerical development of a generic slabber head. Chip fragmentation phenomena were studied through experiments in dynamic conditions. These experiments were carried out thanks to a pendulum (Vc = 400 m/min). It was instrumented with piezoelectric force sensors and high speed camera. Obtained results agreed very well with previous quasi-static experiments

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

Targeted asthma therapies: confirmations, hopes, and disappointments

peer reviewedAsthma is a chronic inflammatory disease of the airways. The inflammatory process is driven by different pathways involving cytokines and other protein mediators. Patients with severe asthma are at high risk of severe exacerbations and death and have few therapeutic options available. Therefore, biological agents have been developed to help patients with refractory asthma by interfering with several compounds of the asthma inflammatory cascade. In addition to decreasing exacerbations, some of those treatments have a steroid sparing role and many beneficial effects in asthmatics

Pulmonary Arterial Hypertension Due to Copd

peer reviewedIn this paper we review the current knowledge on pulmonary hypertension (PH) occurring in COPD. PH is defined as a mean pulmonary arterial pressure at rest greater than 20 mmHg measured by right heart catheterisation. PH is usually present during exercise before appearing at rest. PH in COPD increases the risk of hospitalisation and darkens the disease prognosis. Chronic hypoxemia is the major contributor to PH, but remodelling of arterial wall and mechanical factors such as hyperinflation also play a role. Transthoracic echocardiography is the most useful non invasive investigation, but right heart catheterisation is necessary to ascertain the diagnosis. Long term 02 supplementation is the basis of the treatment while vasodilatators may worsen hypoxemia

The Effect of Three Months of Aerobic Training on Response Preparation in Older Adults

This study assessed the effects of an aerobic training program on reaction time tasks that manipulated preparatory intervals (PI) to produce temporal preparation effects using short (1, 3, 5 s) and long (5, 7, 9 s) PI. Older adults were assigned to either a 3-month aerobic training group or to a control group. Individuals in the training group participated in an aerobic training program of three 60-min sessions per week. The control group did not receive any training. Results indicated that 12 weeks of aerobic training induced a significant improvement in cardiorespiratory capacity (VO2max estimate). All participants who completed the aerobic program showed improvement after training in the choice RT task, along with enhanced preparation, such that they maintained preparation over time more efficiently after the training program. Moreover, enhanced ability to use the short PI was observed but only in lower fit individuals. Results of the present study suggest that improving aerobic fitness may enhance attentional control mechanisms in older adults

Corticosteroids: still at the frontline in asthma treatment?

Inhaled corticosteroids (ICS) have led to improved asthma control and reduced asthma mortality in the Western world. ICS are effective in combating T-helper type 2-driven inflammation featuring mast cell and eosinophilic airway infiltration. Their effect on innate immunity-driven neutrophilic inflammation is poor and their ability to prevent airway remodeling and accelerated lung decline is controversial. Although ICS remain pivotal drugs in asthma management, research is needed to find drugs complementary to the combination ICS/long-acting beta2-agonist in refractory asthma and perhaps a new class of drugs as a first-line treatment in mild to moderate noneosinophilic asthma.Peer reviewe

Vaccination with Mycobacterium: Can It Cure Allergies?

peer reviewedIn developed countries, the prevalence of tuberculosis has evolved in an opposite direction as to the one of allergy over the last century. The immunological response is mainly Th1 in tuberculosis while it features a Th2 pattern in allergy. Vaccination with BCG in early life is associated with a reduction in the prevalence of allergy later in childhood. In an experimental mouse model of asthma, administration of BCG or killed Mycobacterium vaccae inhibits the sensitisation process as well as the bronchial inflammation and hyperresponsiveness that follows allergen exposure. In children and adolescents suffering from atopic dermatitis, subcutaneous injection of killed Mycobacterium vaccae attenuates the severity of skin lesions

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