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1.
Rev Mal Respir ; 39(6): 566-570, 2022 Jun.
Article in French | MEDLINE | ID: mdl-35710470

ABSTRACT

INTRODUCTION: Systemic nocardiosis is an infectious disease that is rarely associated with mediastinal lymph nodes. CASE REPORT: We report the case of a 72-year-old male patient treated with a high dose of oral corticosteroids for rheumatoid polyarthritis. This patient presented with rapid overall deterioration associated with mediastinal lymph nodes. Endobronchial ultrasound enabled us to establish a diagnosis of systemic nocardiosis. The patient recovered after having received suitable antibiotic treatment for four months. CONCLUSION: This work reports on a rare clinical presentation of systemic nocardiosis associated with mediastinal lymphadenopathies and highlights the key role of endobronchial ultrasound in diagnosing mediastinal lymph nodes, especially in differential diagnosis for lung cancer.


Subject(s)
Lung Neoplasms , Nocardia Infections , Aged , Bronchoscopy , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Endosonography , Humans , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Lung Neoplasms/pathology , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Male , Mediastinum/diagnostic imaging , Mediastinum/pathology , Nocardia Infections/diagnosis , Nocardia Infections/drug therapy
2.
Lung Cancer ; 35(1): 1-7, 2002 Jan.
Article in English | MEDLINE | ID: mdl-11750705

ABSTRACT

BACKGROUND: No standard treatment is defined for elderly patients with small cell lung cancer (SCLC). Carboplatin and etoposide are highly active agents against SCLC. In this study, we evaluated the activity and toxicity of a combination of these two agents. PATIENTS AND METHODS: Thirty-four untreated patients with limited or extensive SCLC and median age of 73.9 years entered the study. Chemotherapy consisted of carboplatin i.v. on day 1 (AUC 5 using Calvert's formula) and etoposide 100 mg/m(2) given orally on days 1-5, every 4 weeks, and thoracic irradiation was given to limited disease patients after chemotherapy. RESULTS: The overall response rates was 59% (95% CI: 43-76). The median survival for all patients was 37 weeks (range 3-76 weeks). The toxicity was mainly haematological with grade 3-4 neutropenia in 59% of courses, febrile neutropenia in 15% of courses, and toxic death in 9% of patients. CONCLUSION: The results of this regimen are disappointing with worse response and survival, and more haematological toxicity than expected and previously reported, despite the use of Calvert's formula. Possible explanations are the use of etoposide per os rather than i.v., the frequent comorbidities of older patients and the inclusion of patients with poor prognosis factors.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Small Cell/drug therapy , Lung Neoplasms/drug therapy , Administration, Oral , Age Factors , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carboplatin/administration & dosage , Carboplatin/adverse effects , Etoposide/administration & dosage , Etoposide/adverse effects , Female , Humans , Male , Neoplasm Staging , Neutropenia/chemically induced , Survival Rate , Treatment Outcome
3.
Rev Pneumol Clin ; 55(6): 353-63, 1999 Dec.
Article in French | MEDLINE | ID: mdl-10685470

ABSTRACT

Knowledge of asthma and its treatment were evaluated in a survey of 1,000 asthmatics using a self-questionnaire with closed questions. As far as the disease was concerned, 87.4% of patients knew that the bronchi were the pathological organ and 70.6% that the disease persisted between attacks. Overall knowledge of the disease (pathological organ, persistence of the disease between attacks, chronic inflammation associated with acute bronchoconstriction) was adequate in only 25.6% of patients. It was associated with the educational level [higher > primary; p = 0.001], the grade of asthma [severe > mild; p = 0.007] and the number of medicines inhaled [(n > 3) > (N < 2); p = 0.001)]. As far as medicines were concerned, knowledge of their mechanisms of action varied according to therapeutic groups: antiallergics [78.6%], antibiotics [77.7%], antihistamines [74.5%], LA beta2-mimetics [45.9%], theophylline [31.9%], corticosteroids [31.7%], beta2-mimetics [24.8%]. No factor was statistically correlated with greater familiarity. However, only 7.2% of patients treated with metered-dose aerosols expressed handling problems and 78.8% of asthmatics questioned felt that they were sufficiently informed about their disease and its treatment. Information and education thus remain a priority in the management of asthma.


Subject(s)
Asthma , Health Knowledge, Attitudes, Practice , Adolescent , Adult , Asthma/therapy , Data Interpretation, Statistical , Female , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Surveys and Questionnaires
5.
Arch Intern Med ; 154(14): 1633-40, 1994 Jul 25.
Article in English | MEDLINE | ID: mdl-8031212

ABSTRACT

We identified eight patients (six women and two men) who had pulmonary infiltrates during treatment with minocycline hydrochloride between 1989 and 1992 in French referral centers for drug-induced pulmonary diseases. Clinical files, chest roentgenograms, computed tomographic scans, pulmonary function, and bronchoalveolar lavage data were reviewed. Minocycline treatment was given for acne (n = 4), genital infection (n = 3), and Lyme disease (n = 1). The duration of treatment averaged 13 +/- 5 days (mean +/- SE); the total dose, 2060 +/- 540 mg. Patients presented with dyspnea (n = 8), fever (n = 7), dry cough (n = 5), hemoptysis (n = 1), chest pain (n = 2), fatigue (n = 3), and rash (n = 3). Chest roentgenograms showed bilateral infiltrates in all cases. Pulmonary function was measured in five patients; four had airflow obstruction and two had mild restriction. Blood gas tests demonstrated hypoxemia in seven patients (58 +/- 3 mmHg). Seven patients had blood eosinophilia (1.76 +/- 0.2 x 10(9)/L). Bronchoalveolar lavage (performed in seven patients) showed an increased proportion of eosinophils (0.30 +/- 0.07). The Cd4+/CD8+ ratio was determined in four cases and was low in three. Transbronchial lung biopsy, performed in two patients, showed interstitial pneumonitis in both patients, with marked infiltration by eosinophils in one patient. The outcome was favorable in all patients. Because of severe symptoms, steroid therapy was required in three patients. Rechallenge was not attempted. We conclude that minocycline can induce the syndrome of pulmonary infiltrates and eosinophilia, that presenting symptoms may be severe and may culminate in transient respiratory failure, and that the disease has a favorable prognosis.


Subject(s)
Eosinophilia/chemically induced , Lung Diseases, Interstitial/chemically induced , Minocycline/adverse effects , Adolescent , Adult , Eosinophilia/pathology , Eosinophilia/physiopathology , Female , Humans , Lung Diseases, Interstitial/pathology , Lung Diseases, Interstitial/physiopathology , Male , Middle Aged , Prognosis
6.
Rev Mal Respir ; 11(1): 67-70, 1994.
Article in French | MEDLINE | ID: mdl-8128099

ABSTRACT

Acute pulmonary eosinophilia was observed in the patient after taking minocycline. The clinical picture recurred when the drug was re-introduced. However, this is a rare complication after taking a derivative of tetracycline. An eosinophilia was seen in the peripheral blood and also in the bronchoalveolar lavage. Cessation of the drug therapy without the addition of corticosteroids allowed a cure.


Subject(s)
Minocycline/adverse effects , Pulmonary Eosinophilia/chemically induced , Acne Vulgaris/drug therapy , Adult , Bronchoalveolar Lavage Fluid/cytology , Drug Hypersensitivity/etiology , Eosinophilia/blood , Eosinophilia/chemically induced , Humans , Male , Pulmonary Eosinophilia/pathology
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