[ diagnosis of COPD is recommendation dependent]

Different spirometric criteria are recommended to diagnosis chronic obstructive pulmonary disease [COPD]: -American Thoracic Society/European Respiratory Society [ATS/ERS], Global initiative for chronic Obstructive Lung Disease [GOLD]: a post bronchodilator [PBD] ratio between the 1st second Forced Expiratory Volume and Forced Vital Capacity [FEV1/FVC] < 0.70; -Thoracic Society of Australia and New Zealand [ANZTS]: a PBD FEV1/FVC < 0.70 and a PBD FEV1 < 80%; -British Thoracic Society [BTS]: a before BD [BBD] FEV1/FVC < 0.70 and a BBD FEV1 < 80%; -Old criterion retained, till 2010, by the French Society of Pneumology [SPLF]: a PBD ratio between FEV1 and slow vital capacity < 0.70. To determine, according to the different recommendations, the percentage of smokers having COPD among a population of smokers of more than 40 Packets/Year [PY] addressed for plethysmography. The plethysmographic data of 531 consecutive stable male smokers that underwent reversibility testing [400 micro g of Salbutamol[registered sign]] were analyzed. The mean + - SD of age, cigarettes consumption, PBD FEV1 [%], were, respectively, 61 + - 11 Yr, 64 + - 20 PY and 52 + - 21%. The percentages of subjects having COPD according to the above criteria were 75.5% [SPLF old criterion]; 71.2% [ATS/ERS, GOLD]; 70.8% [BTS] and 69.7% [ANZTS]. The diagnosis of COPD depends on which guidelines are used for defining the disease. This forms a barrier to early diagnosis, affects public health decisions and wrong planning strategies

[Chemotherapy in advanced non small cell lung cancer]

Lung cancer is the worlds first cause of death by cancer. Locally advanced and metastatic non small cell cancers represent 2/3rd of cases at diagnosis and are of worst prognosis. We conducted a retrospective study of 202 patients to investigate the effect of chemotherapy on survival and quality of life. 95 patients received chemotherapy with VP16- CDDP [88%] or Gemcitabin-CDDP Improvement survival was observed in the chemotherapy group: 8 month IC 95% [6.6-9.3]4 month IC 95% [3.1-4.9] in the control group. Chemotherapy also had a good perfect on the quality of life with improvement of performance status symptoms and need of analgesic. However, although significant the role of chemotherapy in NSCLC remains modest and new therapeutic approaches are needed including prevention and early detection which are probably more effective and cheaper

Evolution de la fonction ventilatoire chez les BPCO. Etude analytique de 160 cas

The incidence of chronic obstructive pulmonary disease [COPD] is increasing particularly in developing countries. Their prognosis depend on several factors in particular the one second forced expiratory volume [FEV1] decline. To study FEV1 decline speed and factors affecting it, we carried out a retrospective study of 160 cases of COPD in stable state and heaving at least two FEV1 measures at 6 months of interval in the minimum and. The middle age was 63 +/- 12 yr, 52% was former smokers and 46% current smokers, with middle of 50 +/- 27pack-yr.The FEV1 decline was calculated by linear regression models. The decline average in FEV1 with time was 72 +/- 55 ml/yr. Absolute value was higher than 30 ml/yr therefore more accelerated than general population in 79% of cases. We confirmed by multivariate analysis that age and smoking habit and increased the FEV1 decline. However this last correlated with FEV1% predicted. We concluded that the decline of FEV1 is higher in COPD that in the general population and I slowing it needs smoking stop