Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 10 de 10
Filter
Add more filters










Publication year range
1.
Rev Mal Respir ; 38(4): 418-422, 2021 Apr.
Article in French | MEDLINE | ID: mdl-33832809

ABSTRACT

INTRODUCTION: Vocal Cord Dysfunction (VCD) is a syndrome characterized by paradoxical adduction of the vocal folds during breathing. Its non-specific clinical manifestations frequently lead to misdiagnosis and delay in its treatment. The treatment of VCD is not pharmacological but rehabilitative and remains poorly appreciated. OBSERVATION: In this clinical case we describe a 16-year-old female judoka who presented with effort intolerance associated with occasional dyspnea, which had suddenly worsened over the preceding few months so that in now produced sudden respiratory difficulty, mainly during intense and sudden efforts. After a period where her symptoms were confused with asthma, she was diagnosed with exercise-induced VCD. Her treatment was aimed to: (a) rehabilitate respiratory mechanics in order to eliminate abdominal-thoracic asynchrony, (b) rehabilitate naso-nasal breathing, (c) train her to control abdominal-diaphragmatic breathing at rest and then during effort, (d) train her to use ventilatory control as soon as prodromal symptoms appear in order to prevent the development of stridor or complete closure of the vocal folds (at rest and then progressively during exercise). CONCLUSION: Following the implementation of these rehabilitation strategies to correct her ventilatory and dyskinetic issues, the patient no longer develops respiratory discomfort during exercise, including during judo competitions.


Subject(s)
Vocal Cord Dysfunction , Adolescent , Athletes , Diagnosis, Differential , Dyspnea/diagnosis , Dyspnea/etiology , Female , Humans , Respiratory Sounds , Vocal Cord Dysfunction/diagnosis , Vocal Cords
2.
Rev Mal Respir ; 36(3): 364-368, 2019 Mar.
Article in French | MEDLINE | ID: mdl-30902442

ABSTRACT

INTRODUCTION: Cardio-pulmonary exercise testing (CPET) is frequently used to assess aerobic capacity, to evaluate respiratory tolerance and to provide prognostic information. Therefore, CPET is often incorporated in the preoperative assessment of cancer patients. This clinical case report presents the preoperative assessment of a patient before thoracic surgery, in whom an important decrease of aerobic capacity was noted, possibly because of muscular toxicity linked to chemotherapy. CASE REPORT: This clinical case concerns a fit, 66-year-old man with a large cell carcinoma of the bronchus. He had received 2 cycles of adjuvant chemotherapy. Subsequently, a left pneumonectomy had been proposed and preoperative assessment performed. CPET showed no further increase in oxygen uptake after the first ventilatory threshold, in spite of increases in carbon dioxide output, minute ventilation and heart rate. Moreover, maximal oxygen uptake was low and there was a decrease of oxygen pulse at maximal effort. CONCLUSION: We suggest that the limitation of effort was due to a limitation of muscular oxygen extraction, which could be explained by possible muscular toxicity due to chemotherapy.


Subject(s)
Antineoplastic Agents/adverse effects , Carcinoma, Non-Small-Cell Lung/drug therapy , Cardiorespiratory Fitness/physiology , Exercise Tolerance/drug effects , Lung Neoplasms/drug therapy , Muscular Diseases/chemically induced , Aged , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/surgery , Chemotherapy, Adjuvant/adverse effects , Exercise Test/adverse effects , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/surgery , Male , Muscular Diseases/complications , Oxygen Consumption/drug effects , Oxygen Consumption/physiology , Pneumonectomy/adverse effects
3.
Rev Mal Respir ; 33(6): 422-30, 2016 Jun.
Article in French | MEDLINE | ID: mdl-26520778

ABSTRACT

INTRODUCTION: Pulmonary rehabilitation is currently the gold standard treatment for patients with chronic obstructive pulmonary disease (COPD). However, the workload achieved may be insufficient to obtain physiological benefits because of the restricted respiratory capacity. BACKGROUND: In patients with COPD, changes in flow as well as biomechanical factors (distension) compromise respiratory adaptation to exertion. Some studies have shown that noninvasive ventilation (NIV) during exercise has a positive effect on respiratory muscle workload, physiological parameters and perceived exertion. However the evidence remains insufficient regarding the effects of the NIV during comprehensive pulmonary rehabilitation programs. OBJECTIVES: The identification of criteria which determine responsive patients is necessary in order to reduce human and time costs and to optimize the use of NIV during exercise. CONCLUSIONS: NIV is used during training to overcome dyspnoea and to increase muscle workload. Further studies are needed to verify the effectiveness of NIV in pulmonary rehabilitation.


Subject(s)
Noninvasive Ventilation , Pulmonary Disease, Chronic Obstructive/rehabilitation , Exercise/physiology , Exercise Tolerance/physiology , Humans , Noninvasive Ventilation/methods , Respiratory Mechanics/physiology , Respiratory Muscles/physiopathology
4.
J Endocrinol Invest ; 39(6): 635-42, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26694707

ABSTRACT

PURPOSE: The aims were to: (1) compare peak oxygen uptake ([Formula: see text]peak) predicted from four standard equations to actual [Formula: see text]peak measured from a cardiopulmonary exercise test (CPET) in obese patients with metabolic syndrome (MetS), and (2) develop a new equation to accurately estimate [Formula: see text]peak in obese women with MetS. METHODS: Seventy-five obese patients with MetS performed a CPET. Anthropometric data were also collected for each participant. [Formula: see text]peak was predicted from four prediction equations (from Riddle et al., Hansen et al., Wasserman et al. or Gläser et al.) and then compared with the actual [Formula: see text]peak measured during the CPET. The accuracy of the predictions was determined with the Bland-Altman method. When accuracy was low, a new prediction equation including anthropometric variables was proposed. RESULTS: [Formula: see text]peak predicted from the equation of Wasserman et al. was not significantly different from actual [Formula: see text]peak in women. Moreover, a significant correlation was found between the predicted and actual values (p < 0.001, r = 0.69). In men, no significant difference was noted between actual [Formula: see text]peak and [Formula: see text]peak predicted from the prediction equation of Gläser et al., and these two values were also correlated (p = 0.03, r = 0.44). However, the LoA95% was wide, whatever the prediction equation or gender. Regression analysis suggested a new prediction equation derived from age and height for obese women with MetS. CONCLUSIONS: The methods of Wasserman et al. and Gläser et al. are valid to predict [Formula: see text]peak in obese women and men with MetS, respectively. However, the accuracy of the predictions was low for both methods. Consequently, a new prediction equation including age and height was developed for obese women with MetS. However, new prediction equation remains to develop in obese men with MetS.


Subject(s)
Biomarkers/analysis , Metabolic Syndrome/etiology , Metabolic Syndrome/physiopathology , Obesity/complications , Oxygen Consumption , Oxygen/metabolism , Adolescent , Adult , Anthropometry , Exercise Test , Female , Humans , Male , Middle Aged , Models, Theoretical , Regression Analysis , Young Adult
5.
Rev Mal Respir ; 32(9): 913-20, 2015 Nov.
Article in French | MEDLINE | ID: mdl-25511813

ABSTRACT

AIM: There are few data showing how pulmonary rehabilitation (PR) for COPD patients carried out at home impacts on health-related quality of life (HRQL). The aim of this study was to determine if PR conducted at home improves quality of life. METHODS: We compared the results of home-based PR versus PR performed in an outpatient center. The outcomes were the HRQL measured by the Saint-George's Hospital questionnaire and the 6-minute walk test distance (6MWT). Fifty-six COPD patients were included for PR either at home (n=27) or in the outpatient center (n=29) depending on distance from the center and patients preference. The two groups were similar for sex, age, BMI, lung function, and initial peak oxygen uptake. RESULTS: 6MWT showed a similar non-significant improvement in both groups after PR (+12±46m in home-based PR,+13±34m in outpatient center). HRQL was significantly improved in the home-based group in 2 domains : "Activity" (-8.6±6.4 vs -0.7±17.7, P<0.05), "Impact" (-8.4±6.5 vs 1.6±11.7, P<0.001) and total score (-8.2±4.0 vs 0.0±8.8, P<0.001). CONCLUSION: Pulmonary rehabilitation at home is associated with improvements in health-related quality of life, and thus can be considered where availability of treatment in specialized centers is limited.


Subject(s)
Ambulatory Care Facilities , Home Care Services , Pulmonary Disease, Chronic Obstructive/rehabilitation , Aged , Ambulatory Care Facilities/statistics & numerical data , Exercise Test , Exercise Tolerance , Female , Home Care Services/statistics & numerical data , Home Care Services, Hospital-Based/statistics & numerical data , Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/psychology , Quality of Life , Retrospective Studies , Surveys and Questionnaires
6.
Arch Mal Coeur Vaiss ; 82 Spec No 4: 139-43, 1989 Nov.
Article in French | MEDLINE | ID: mdl-2514654

ABSTRACT

The effects of cicletanine hydrochloride on glucose tolerance parameters were studied in a two-phase trial in which patients received a placebo for 2 weeks, followed by cicletanine 50 mg/day for 3 months. Ten patients with mild to moderate hypertension, who were neither obese nor diabetic and had no disorder of glucose tolerance entered the study. None of the patients was withdrawn. Glucose tolerance was evaluated by two oral glucose tolerance tests performed at 90 days' interval, each with half hourly blood glucose and insulin assays. The clinical effectiveness of the drug was assessed by monthly blood pressure measurements. No significant change in glycaemia and insulinaemia was observed. There was a significant decrease of supine SBP from 170.7 +/- 9.1 mmHg to 150.3 +/- 6.7 mmHg (p less than 0.0001) and of supine DBP from 101.3 +/- 4.1 to 80.3 +/- 7.7 mmHg (p less than 0.0001). At the end of the study, 9 of the 10 patients had normal blood pressure values. No undesirable clinical or biochemical effect was noted. thus, cicletanine, an antihypertensive drug derived from furopyridine, proved to be devoid of adverse effects on glycoregulation and clinically effective on hypertension.


Subject(s)
Antihypertensive Agents/pharmacology , Blood Glucose/metabolism , Diuretics/pharmacology , Hypertension/metabolism , Pyridines , Adult , Aged , Antihypertensive Agents/therapeutic use , Diuretics/therapeutic use , Female , Glucose Tolerance Test , Humans , Hypertension/blood , Hypertension/drug therapy , Male , Middle Aged
7.
Clin Orthop Relat Res ; (167): 263-8, 1982 Jul.
Article in English | MEDLINE | ID: mdl-7094471

ABSTRACT

Plaster of Paris is an effective ancillary treatment in the surgery of infected cavities in bone. It is well tolerated and spontaneously absorbed over a period of weeks to months, being replaced by bone of normal architecture. It effectively obliterates much of the dead space, leaving little room for hematoma formation. It would appear logical to treat local infection, especially involving rigid walled cavities, by a locally diffused antibiotic. When incorporated into plaster of Paris pellets, two antibiotics, Fucidin and gentamicin, are capable of prolonged local release in bacteriocidal concentrations. On the basis of in vitro observations on bacterial cultures, it is proposed that antibiotic-plaster of Paris pellets might be a simple adjuvant technique to good surgical debridement in the treatment of bone infection. Plaster of Paris has the practical advantage over acrylic cement beads containing antibiotics in that it is resorbed and would not need a subsequent operation to be moved.


Subject(s)
Anti-Bacterial Agents/administration & dosage , Calcium Sulfate , Osteomyelitis/drug therapy , Cefazolin/administration & dosage , Fusidic Acid/administration & dosage , Gentamicins/administration & dosage , Humans , In Vitro Techniques , Lincomycin/administration & dosage , Methylmethacrylate , Methylmethacrylates , Staphylococcus aureus/drug effects
8.
Clin Chim Acta ; 71(1): 35-46, 1976 Aug 16.
Article in French | MEDLINE | ID: mdl-971522

ABSTRACT

Bisalbuminaemia in pancreatitis is a transient abnormality related to the presence, on electrophoresis of the serum, of a fast-moving albumin; this abnormal form is also found, in large amounts, in the ascitic or pleural effusions of the patients. Experiments reported here indicate clearly that the fast albumin can be produced by a degradation of normal serum albumin by the proteolytic enzymes of the pancreas (chymotrypsin or elastase in association with carboxypeptidases A and B). Stuctural analysis of the isolated fast albumin of the patients shows that the C-terminal end of the molecule is different from normal serum albumin, which can be understood by a limited enzymatic degradation by chymotrypsin or elastase followed by the action of carboxypeptidases. The discovery of bisalbuminaemia in a patient affected by pancreatitis is suspicious of the presence of an ascitic or pleural effusion and of a pancreatic pseudo-cyst with a fistula emerging in the effusion.


Subject(s)
Pancreas/enzymology , Pancreatitis/blood , Peptide Hydrolases/metabolism , Serum Albumin/metabolism , Carboxypeptidases/metabolism , Chymotrypsin/metabolism , Electrophoresis, Cellulose Acetate , Humans , Molecular Weight , Pancreatic Elastase/metabolism , Pancreatitis/enzymology , Trypsin/metabolism
SELECTION OF CITATIONS
SEARCH DETAIL
...