[Treatment specifics for spontaneous pneumothorax in flight personnel]. / Spécificités de la prise en charge du pneumothorax spontané chez le personnel navigant.

Spontaneous pneumothorax is one cause of aeronautical unfitness in flight personnel, because of the risk of recurrence in flight, making it an issue of flight safety. Specific treatment is required for fighter pilots, pilots flying single-pilot and pilots in professional training: surgical synthesis via video-thoracoscopy is obligatory from the first episode. Considering the exposure to an accumulation of aeronautical factors that are likely to encourage pneumothorax recurrence in flight, it is apical pleurectomy together with abrasion of the remaining pleura and resection of bullae/blebs that is required for fighter pilots to allow them to recover aeronautical fitness unrestrictedly. For all other categories of flight personnel, treatment is no different from that of the common patient. Knowledge of these treatment specifics is essential, to avoid unnecessary systematic surgical indication for all flight personnel, or jeopardise professional fitness in some of them due to inappropriate treatment.

[Risk factors for transmissible cardiovascular diseases]. / Les facteurs de risque cardiovasculaire transmissibles.

Atherosclerosis is a multi-factor disease representing a real plague for developed countries, and spreading at an increasing rate in third world nations. In industrialized countries, coronary pathology occupied the first place in terms of morbidity and cardiovascular mortality, affecting more and more frequently younger people, thus constituting a serious problem of public health. Therefore, it seems absolutely necessary to carry out systematic screening for atherosclerosis amongst all high cardiovascular risk families groups, from infancy onwards. Lacking knowledge about the exact cause of atheroma, we had to determine what are commonly called the factors of cardiovascular risk. Among these, some are transmissible. Transmission may be direct: genetic and hereditary factors (sex, race, antecedents, dyslipemia, high blood pressure, diabetes) but it may also concern the transmission of a way of life. To prevent ischaemic heart disease, it is necessary to bring out change in behaviour from infancy onwards to detect high risk subjects and to correct every factor of cardiovascular risk upon which an action is possible.