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L'essentiel de la littérature réçente en Pneumologie

Dans cette rubrique on vous propose une revue de la littérature à travers une sélection d'abstracts d'articles originaux.
On essaiera de vous tenir informé des dernières nouveautés de recherche en matière de Pneumologie. On ne vous fournit que le résumé de l'article et le lien correspondant, pour accéder à l'article en full text vous devez être inscrits à la revue correspondante.
Cliquez ici pour consulter la liste des revues de Pneumologie disponibles en libre accès.



Risk of thromboembolism in cisplatin versus carboplatin-treated patients with lung cancer. Imprimer Envoyer
Lundi, 08 Janvier 2018 06:57
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Risk of thromboembolism in cisplatin versus carboplatin-treated patients with lung cancer.

PLoS One. 2017;12(12):e0189410

Authors: Kim ES, Baran AM, Mondo EL, Rodgers TD, Nielsen GC, Dougherty DW, Pandya KJ, Rich DQ, Wijngaarden EV

Abstract
INTRODUCTION: Carboplatin is widely used to treat lung cancer in the United States as an alternative to cisplatin. Several studies have demonstrated that cisplatin-based regimen is associated with a high frequency of thromboembolic complications. However, there has been limited investigation directly comparing the risk of thromboembolic events (TEEs) between cisplatin- and carboplatin-treated patients with lung cancer.
METHODS: All lung cancer patients treated with cisplatin or carboplatin at Wilmot Cancer Center, University of Rochester between 2011 and 2014 were included. Patient characteristics including exposure (cisplatin vs. carboplatin) and outcome (TEEs between the time of the first dose of cisplatin or carboplatin and 4 weeks after the last dose) were collected by reviewing electronic medical records. A Fisher's exact test was used to compare the proportion of incident TEEs between cisplatin and carboplatin groups. The risk of TEE associated with carboplatin compared to cisplatin was assessed using multiple logistic regression.
RESULTS: Among 415 subjects, 317 patients (76.4%) received carboplatin and 98 (23.6%) patients received cisplatin. In the carboplatin group, 10.9% (33/302) of evaluable patients developed treatment-related TEEs vs. 14.7% (14/95) in the cisplatin group. There was no significant difference in the risk of developing TEEs between the two groups (P = 0.32). However, 15.2% of carboplatin-related TEEs were arterial thromboses compared to none in the cisplatin group.
CONCLUSIONS: The incidence of carboplatin-related TEEs was high in lung cancer patients without significant difference in the risk of developing TEEs between cisplatin and carboplatin groups. Potential use of prophylactic anticoagulation in all platinum-treated patients should be further investigated.

PMID: 29228042 [PubMed - indexed for MEDLINE]

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Bronchial Artery Embolization for the Treatment of Acute Hemoptysis. Imprimer Envoyer
Lundi, 08 Janvier 2018 06:57
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Bronchial Artery Embolization for the Treatment of Acute Hemoptysis.

Tech Vasc Interv Radiol. 2017 Dec;20(4):263-265

Authors: Cody O'Dell M, Gill AE, Hawkins CM

Abstract
Massive hemoptysis is a life-threatening condition often defined as coughing up 300-600mL of blood in 24 hours in an adult, or >8mL/kg in 24 hours in a child. Although the definition is controversial, one should view massive hemoptysis as any volume of expectorated blood that can cause respiratory failure. This is because mortality in the setting of hemoptysis is usually associated with asphyxiation, rather than exsanguination. Massive hemoptysis accounts for only about 5% of cases of hemoptysis, but when treated conservatively, has a reported mortality rate between 50% and 85%. Etiologies vary widely based on demographics. In children, infectious causes predominate in developing countries, and cystic fibrosis predominates among children of European descent. In adults, malignancy, bronchiectasis, and chronic infection are the most common causes. Treatment begins with resuscitation and airway protection, followed by minimally invasive bronchoscopic and endovascular techniques. Surgical interventions are considered last line therapy due to mortality rates of 37%-43% in the setting of massive hemoptysis. Bronchial artery embolization is now considered the treatment of choice for massive hemoptysis.

PMID: 29224659 [PubMed - indexed for MEDLINE]

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Bedside lung ultrasound in the care of the critically ill. Imprimer Envoyer
Lundi, 08 Janvier 2018 06:57
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Bedside lung ultrasound in the care of the critically ill.

Crit Care Resusc. 2017 Dec;19(4):327-336

Authors: Rudas M, Orde S, Nalos M

Abstract
OBJECTIVE: To describe the technique and review the utility of bedside lung ultrasound in acute care.
SUMMARY: Lung ultrasound is a useful point-of-care investigation in acute care, especially in patients with dyspnoea or haemodynamic instability. Although normal lung parenchyma is not accessible to ultrasound, distinctive artefacts arising from parietal and visceral pleura indirectly imply the presence of normal lung. As aeration of lung tissue reduces with disease process, visual assessment of several pathologic entities by ultrasound becomes possible. Ultrasound can be used for qualitative and quantitative assessment as well as to guide intervention. Compared with supine anteroposterior chest x-rays, lung ultrasound is faster and superior at ruling out pneumothorax and diagnosing lung consolidation, pleural effusions or pulmonary oedema. It is a logical and highly valuable extension of echocardiography and can be incorporated into diagnostic algorithms for assessment of dyspnoea, hypotension, chest pain or trauma. It provides rapid information about potentially reversible pathology in cardiac arrest scenarios. Other advantages include bedside availability, repeatability, provision of dynamic diagnostic information, ease of use and the absence of radiation exposure.

PMID: 29202259 [PubMed - indexed for MEDLINE]

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