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Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Anaesthesia / Journal Canadien d'Anesthésie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: the use of invasive mechanical ventilation (IMV) in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) constitutes a negative turning point in the progression of the disease. The purpose of this study is to determine factors predicting the need for IMV in AECOPD. Methods: we conducted a retrospective study by reviewing the medical records of patients with AECOPD hospitalized in our Department over a 18-year period (20002017). We compared 2 groups: G1: patients with AECOPD undergoing at least one IMV and G2: patients who had never undergone IMV following AECOPD. Results: the study included 1152 patients with COPD: 133 in the G1 group (11.5%), and 1019 in the G2 group (88.5%). G1 patients were more symptomatic (p < 0.001), with more severe bronchial obstruction (p < 0.001). G1 patients had more exacerbations (p < 0.001), more hospitalizations and a higher need for non-invasive ventilation (NIV) (p < 0.001). Similarly, G1 patients more often developed chronic respiratory failure (p < 0.001) and had significantly lower survival rates. Independent risk factors associated with IMV were hypercapnia and decreased pH (in patients with severe AECOPD), a history of NIV, and chronic respiratory failure (CRF). Conclusion: respiratory function impairment, the severity of exacerbation and the need for NIV in a previous episode are factors predicting the need for IMV and poor outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Population & Sociétés is the property of Institut National d'Etudes Demographiques and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context and objective: Acute generalized peritonitis has high morbidity and mortality in Sub-Saharan Africa. Although spinal anesthesia has accepted in mesocolic surgery, it remains nevertheless contraindicated in peritonitis, due to hemodynamics disorders that it causes. The objective of this study was to present the results of spinal anesthesia in patients operated on for generalized acute peritonitis. Patients and Methods: This was a prospective study that involved 115 patients classified ASA III and IV, operated under spinal anesthesia (RA) combining a local anesthetic and morphine, for generalized acute peritonitis of various etiologies at Saint Luc Hospital in Kisantu, between March 1, 2008 and Feb 28, 2011. Hemodynamic parameters, level of analgesia and adverse effects of opioids were studied. Results: Blood pressure remained stable per and postoperatively. Preoperative tachicardia (134 beats/min on average) was normalized per and postoperatively. Respiratory rate decreased from an average of 26 cycles per minute preoperatively to 14 postoperatively. Analgesia was sufficient. Adverse effects were pruritus (10%) and nausea or vomiting (14%). No respiratory depression was recorded. Conclusion: Due to its satisfactory results, spinal anesthesia deserves to be used in generalized acute peritonitis, provided preoperative hemodynamic stability. [ABSTRACT FROM AUTHOR]

Context and objective: Acute generalized peritonitis has high morbidity and mortality in Sub-Saharan Africa. Although spinal anesthesia has accepted in mesocolic surgery, it remains nevertheless contraindicated in peritonitis, due to hemodynamics disorders that it causes. The objective of this study was to present the results of spinal anesthesia in patients operated on for generalized acute peritonitis. Patients and Methods: This was a prospective study that involved 115 patients classified ASA III and IV, operated under spinal anesthesia (RA) combining a local anesthetic and morphine, for generalized acute peritonitis of various etiologies at Saint Luc Hospital in Kisantu, between March 1, 2008 and Feb 28, 2011. Hemodynamic parameters, level of analgesia and adverse effects of opioids were studied. Results: Blood pressure remained stable per and postoperatively. Preoperative tachicardia (134 beats/min on average) was normalized per and postoperatively. Respiratory rate decreased from an average of 26 cycles per minute preoperatively to 14 postoperatively. Analgesia was sufficient. Adverse effects were pruritus (10%) and nausea or vomiting (14%). No respiratory depression was recorded. Conclusion: Due to its satisfactory results, spinal anesthesia deserves to be used in generalized acute peritonitis, provided preoperative hemodynamic stability. [ABSTRACT FROM AUTHOR]

Résumé: Introduction: Pour de nombreux patients, antécédent de tuberculose rime avec séquelles handicapantes, altération de la qualité de vie et grande morbi-mortalité. Méthodologie: Cette étude rétrospective a été réalisée, sur 12 mois, sur des patients hospitalisés pour séquelles de tuberculose thoracique, dans le but d'apprécier les différentes manifestations et leur impact sur la qualité de vie. Résultats: Sur 176 patients colligés, ¾ étaient âgés de 35 à 65 ans, le sex-ratio était de 3,76. Le niveau socio-économique était majoritairement bas (70 %). Un seul épisode de tuberculose avait suffi pour entraîner des séquelles dans 89,8 % des cas. Un tabagisme était souvent noté (52,3 %). Les signes fonctionnels étaient dominés par la toux (90,3 %) et la dyspnée (72,7 %). Les séquelles pulmonaires à type de cicatrisation fibreuse étaient prédominantes (52.2 %). La surinfection bactérienne et/ou virale, était la principale cause d'hospitalisation (50 %). Le taux de décès en cours d'hospitalisation était de 19 %. Une amélioration suivie d'exéat était notée dans 81 % des cas ; avec chez 14,2 % d'entre eux une insuffisance respiratoire chronique et 13,28 % de décès 6 mois post-exéat. Conclusion: Les séquelles de tuberculose thoraciques doivent être considérées comme des affections de longue durée et méritent la même prise en charge. Background: For many patients, a history of tuberculosis is synonymous with disabling sequelae, impaired quality of life, and high morbidity and mortality. Methodology: This retrospective study reviewed the files of patients hospitalized for sequelae of thoracic tuberculosis during 2017, to assess its various manifestations and their impact on quality of life. Results: Of the 176 patients included, 75 % were aged from 35 to 65 years. They were predominantly male, with a sex ratio of 3.76. The socioeconomic level was mostly low (70 %). Only one episode of tuberculosis sufficed to cause sequelae in 89.8 % of cases. Smoking was often noted (52.3 %). Functional signs were dominated by coughs (90.3 %) and dyspnea (72.7 %). Pulmonary sequelae with fibrous scarring were observed in 52.2 % of the patients. Bacterial and/or viral superinfection was the leading cause of hospitalization (50 %). The death rate during hospitalization was 19 %. An improvement followed by discharge was observed for 81 %, 14.2 % of them with chronic respiratory insufficiency. In all, 13.28 % of the discharged patients died within the 6 months that followed. Conclusion: The sequelae of thoracic tuberculosis should be considered as long-term chronic conditions and deserve the same treatment. [ABSTRACT FROM AUTHOR]

The accumulation of senescent cells in tissues is a key process of aging and age-related diseases, including lung diseases such as chronic obstructive pulmonary disease, lung fibrosis, or cancer. In recent years, the spectrum of respiratory diseases associated with cellular senescence has been broadened, in particular acute viral pulmonary infections, foremost among which is coronavirus disease 2019 (COVID19), which is particularly severe in the elderly or in subjects with comorbidities. Influenza virus infection, which strikes more severely at the extreme ages of life, is also associated with severe pulmonary senescence. Cellular senescence potentially represents an original target for attacking these diseases, although its specific mechanisms remain largely misunderstood. New anti-senescent therapeutic approaches are thus proposed during severe viral pulmonary infections, with the aim of preventing acute effects and/or, in the longer term, pulmonary sequelae., (© 2022 l'Académie nationale de médecine. Published by Elsevier Masson SAS. All rights reserved.)

Fentanyl (N-phenyl-N-(1-2-phenylethyl-4-piperidyl)propanamide) is a potent synthetic narcotic analgesic. He has an analgesic effect 100 times greater than that of morphine. The use of transdermal fentanyl delivrery systems has increased over recent years especially in patients with chronic pain who are already treated with high doses of morphine or it is derivate. However, many cases of fentanyl intoxication through a variety of transderrmal systems have been reported. This paper reports a fatality due to excessive administered Fentanyl Sandoz Matrix 50g/h transdermal therapeutic systems.

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ACUTE RESPIRATORY FAILURE IN THE ELDERLY PATIENTS Acute respiratory failure (ARF) requiring an admission in intensive care unit in the old patients presents specific characteristics that must be considered for diagnosis, treatment and prognosis. Old patients are at increased risk of ARF after any assault. It is imperative to assess the prognosis of an old patient requiring invasive treatment in the ICU f or an ARF. Age is only one of the factor accounting for high mortality together with comorbidities, previous functional status, severity of the ARF and frailty. Simple and reliable tools are available to determine the degree of frailty. Thus, chronological age should not only be considered to determine the intensity of care; the concept of physiological age may better assist the clinician in his decision making. Management should be comprehensive and multi-professional; rehabilitation should be as early as possible, which emphasizes the absolute necessity of having a physiotherapist attached to the service., Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts.

Résumé: L’obésité devient une préoccupation chez le sujet âgé, car la progression épidémique de la surcharge pondérale touche particulièrement cette tranche d’âge. La corpulence associée au plus faible taux de mortalité semble plus élevée chez le sujet âgé (indice de masse corporelle [IMC] entre 25 et 32). Néanmoins, le vieillissement augmente le risque de complications chez le sujet obèse, notamment le diabète de type 2, les maladies cardiovasculaires, l’insuffisance respiratoire, l’apnée du sommeil, le cancer, l’incontinence urinaire et la démence. Ces complications semblent réduites par une perte de poids modérée (5–10kg). Ces bénéfices ont été évalués notamment chez les sujets à risque cardiovasculaire et chez les sujets diabétiques ou prédiabétiques, montrant des effets favorables sur la morbidité et probablement sur la mortalité. Le renforcement de l’activité physique est indispensable pour préserver la masse musculaire. La sarcopénie aggrave considérablement les conséquences fonctionnelles de l’obésité chez les personnes âgées ; compte tenu de sa fréquence, son dépistage est souhaitable. Dans ce cas et en raison des risques de rebond pondéral, les régimes à très basses calories ne sont pas recommandés et l’accent doit être mis sur l’activité physique. De même, dans plusieurs situations cliniques, telles que l’insuffisance rénale ou cardiaque, l’obésité semble protectrice. Bien que l’obésité ait pu favoriser ces pathologies, en l’absence d’étude spécifique, la perte de poids ne peut être recommandée. En revanche, l’augmentation de l’activité physique semble bénéfique. La restriction calorique modérée et l’exercice physique pourraient donc avoir un effet favorable chez les sujets obèses âgés et présentant des complications. Dans tous les cas, les apports en protéines doivent être maintenus. Chez les personnes de plus de 65ans, la chirurgie bariatrique ne comporte pas plus de risque si l’intervention est effectuée par laparoscopie, mais les bénéfices sur la mortalité n’ont pas été évalués à long terme. Des études randomisées contrôlées sont nécessaires pour valider des stratégies d’intervention. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Oxygen hood is largely used to deliver O2 to newborn infants with respiratory failure in the northern region of France. The oxygen flow is set to obtain the target arterial blood oxygen saturation. Thus, O2 flow delivers into the hood may be below the recommended gas flow of 6L/min. However, gas flow below 6L/min exposes to CO2 rebreathing. The aim of this study was to evaluate the effect of various rates of gas flows on the values of partial pressure of CO2 into the hood. Material and methods: We measured CO2 and O2 partial pressure into hoods of two different volumes (4 and 10L) under two experimental bench test conditions. Protocol 1: gas flow was constant at 6L/min, while oxygen fraction varied from 0.21 to 1. Partial pressure of CO2 and O2 were recorded. Protocol 2: while O2 fraction was kept constant, oxygen flow varied from 0.5 to 7L/min (by step of 0.5L/min). Partial pressure of CO2 and O2 were recorded. Results: Partial pressure of CO2 increases proportionally to the decrease in the gas flow delivered into the hood, and reached 14mmHg at gas flow of 0.5L/min. Conclusion: Risk of CO2 rebreathing exists as soon as the gas is delivered into the hood at minimal flow rates below 6L/min. [Copyright &y& Elsevier]

Abstract: Background: The aim of the study was to determine the activity and the available human resources working in 66 intensive care unit (ICU). Methods: One-day audit performed between January 2009 and May 2009 by trained residents. Results: Among 710 beds, 695 (98%) beds were available for 626 patients (occupation rate=90%). The two most frequent causes of admission were shock and pneumonia. On admission, the median SAPS II was 46. More than 75% of patients had at least two organ dysfunctions within their ICU stay (respiratory failure=80%, circulatory failure=67%). At the moment of the audit, the median SOFA score was 3, and 549 (88%) patients had required a billing procedure with an admission SAPS II greater or equal to 15. Twenty seven percent of ICUs had a ratio patients/nurses or patients/aid nurse greater than 2.5 and 4, respectively whereas 58% ICUs had a ratio open beds/nurse greater than 2.5 or open beds/aid nurse greater than 4. Conclusion: In this study, more than 75% patients had at least two organ dysfunctions within their ICU stay and 88% required a billing procedure and had an admission SAPS II greater or equal to 15. Nevertheless, the staff resource remained below the 2002 decree in 27% ICUs. [ABSTRACT FROM AUTHOR]

Abstract: Some pulmonary embolism may present electrocardiogram changes, which suggest the diagnosis of myocardial infarction. We report the case of a patient with such a confounding presentation. In this patient, the wrong diagnosis of myocardial infarction led to a primary coronarography which was normal and finally, echocardiogram gave us the key leading to a fibrinolitic treatment which improved the patient. [Copyright &y& Elsevier]

Abstract: Background: In the last years Non-Invasive Ventilation (NIV) has been playing an important role in the treatment of Acute Respiratory Failure (ARF). Prospective randomised controlled trials have shown improvements in clinical features (respiratory rate, neurological score), pH and arterial blood gases and in particular clinical conditions (Acute Cardiogenic Pulmonary Edema, ACPE, and acute exacerbation of Chronic Obstructive Pulmonary Disease, COPD) systematic reviews and metha-analysis confirm a reduction in the need for intubation and in-hospital mortality compared to standard medical treatment. Methods: The most important techniques of ventilation in spontaneous breathing are: Continuous Positive Airway Pression (CPAP), usually performed with Venturi-like flow generators, and bi-level positive pressure ventilation (an high inspiratory pressure and a low expiratory pressure), performed with ventilators. Facial mask rather than nasal mask is used in ARF: the helmet is useful for prolonged treatments. Results: NIV''s success seems to be determined by early application, correct selection of patients and staff training. Controindications to NIV are: cardiac or respiratory arrest, a respiratory rate < 12 per minute, upper airway obstruction, hemodynamic instability or unstable cardiac arrhythmia, encephalopathy (Kelly score > 3), facial surgery trauma or deformity, inability to cooperate or protect the airway, high risk of aspiration and an inability to clear respiratory secretions. Conclusions: Bi-level ventilation for ARF due to COPD and CPAP or bi-level bentilation for ARF due to ACPE are feasible, safe and effective also in a General Medical ward if the selection of patients, the staff''s training and the monitoring are appropriate: they improve clinical parameters, arterial blood gases, prevent ETI, decrease mortality and hospitalisation. This should encourage the diffusion of NIV in this specific setting. [Copyright &y& Elsevier]

Summary: Background: Acute eosinophilic pneumonia (AEP) is one of the heterogeneous group of disorders termed eosinophilic lung diseases showing an abnormal accumulation of eosinophils in distal airways, air spaces, and the interstitial compartment of the lung. AEP is characterized by acute febrile respiratory failure, a typical radiographic pattern similar to that of acute pulmonary edema, eosinophilia in bronchoalveolar lavage (BAL), a dramatic response to corticosteroid therapy with no relapse when tapering or withdrawing treatment in the absence of infection. It can be idiopathic o secondary to known causes such as drugs, or fungal and parasitic infections. Clinical case: We report a case of a 76-year-old woman who developed symptoms, respiratory signs, and radiological and histological findings compatible with secondary AEP, we assessed as being associated with sertraline assumption (second case in literature). Discussion: The AEP we detected could be related to a secondary hypersensitivity syndrome to drug exposure (DRESS syndrome: Drug Rush with Eosinophilia and Systemic Symptoms) characterized by 1) skin rush, 2) increased eosinophilia, and 3) systemic involvement. The presence of all three criteria confirmed our diagnosis. [Copyright &y& Elsevier]

Summary: We report 2 cases of severe apnea in newborns presenting with Prader-Willi syndrome. They required transient mechanical ventilation and finally returned to spontaneous breathing. Clinical progression was then usual for the syndrome. Respiratory failure appearing after a few days of life could be a new neonatal clinical feature for the diagnosis of Prader-Willi syndrome. It is not related to poor outcome. [Copyright &y& Elsevier]

Summary: Spinal muscular atrophy (SMA) is an autosomal recessive disorder with a highly variable clinical course and prognosis. We report on the cases of three siblings with SMA. The weakness muscular observes at three siblings but more earlier and severe to the index case with a fast evolution towards respiratory distress syndrome resulting in its death at 5 years. The homozygous deletions of exons 7 and 8 of the telomeric SMN gene were found in all three siblings. No child showed deletion of NAIP gene. Muscular weakness and respiratory distress severity however were different among the siblings. The index patient died at the age of 5 because of respiratory insufficiency. Several molecular mechanisms may be involved in such phenotypic variability. The PCR–RFLP method allows to confirm clinical diagnosis of SMA in children, while avoiding more invasive methods such as EMG and muscular biopsy. However, this diagnostic tool does not allow yet the distinction between different clinical forms of SMA. [Copyright &y& Elsevier]

Abstract: The psychological studies carried out to date in children with infantile spinal muscular atrophy have focused essentially on cognitive processes. All of them have demonstrated performances which are comparable or even superior to those found in the general population, notably in the acquisition of language. These results have shown that the limitation in motor skills does not prevent the constitution of an efficient cognitive system. However, few publications have addressed the question of living with this disease, which is still lethal in some forms, and in all cases, very disabling. The cases described in this article relate to the specific psychic re-arrangements patients use to deal with the disease processes, and its therapeutic constraints. Taking the somatopsychic aspects of the individual into account makes it possible for the psychologist to work in a pluridisciplinary consultation oriented towards orthopedic and respiratory management. [Copyright &y& Elsevier]

This article provides the author's reaction to the article in this issue by E. Bret, "Dépendance et insuffisance respiratoire chronique," particularly the idea of interdependence proposed in that article. The author defines the ideas of dependence and autonomy noting that autonomy cannot exist without a certain amount of dependence and dependence can be defined as the negative of autonomy. Ultimately, the question hinges on what the difference is between the two.

Abstract: Objectives: To assess the prognosis of newborn infants with refractory hypoxemia who required extracorporeal membrane oxygenation (ECMO). Methods: Eighty-nine newborn infants treated by ECMO during more than 24 hours over a 8-year period (1996–2003) were included in this observational cohort study with a 9-month and 24-month evaluation. Results: Respiratory failure mainly resulted from meconium aspiration syndrome (MAS, 43%), congenital diaphragmatic hernia (CDH, 15%) and sepsis (15%). Overall survival at hospital discharge was 67%. Infants with MAS had the best survival rate (82%) and those with CDH had the worst (46%). Of the remaining 60 survivors, 53% remained oxygen dependent at 28 days and 33% at 45 days. At the age of 2 years, only 1 infant remained oxygen dependent (but did not required oxygen at 3 years) and only 3 infants had significant neurodevelopmental problems. CDH group was associated with a prolonged duration in supplementary oxygen (P <0.001) and a prolonged duration for tube feeding (P =0.01) as compared with other diagnoses. Regarding neurologic outcome, CDH infants had the poorer neurological acquisition rate at 9 months but a very good evolution by the time of the 24-month evaluation. Conclusions: Morbidity in ECMO survivors is low considering the severity of illness in the newborn period, mainly related to pulmonary and feeding dysfunctions during the first months, in particular for the CDH group. Outcome at the age of 2 years of CDH infants is most often favourable regarding growth and neurodevelopmental evolution. [Copyright &y& Elsevier]

Abstract: The effect of oxygen in modulating metabolism has been largely investigated in vitro and in animal studies, but very little in humans. This paper focuses on recent literature regarding pathological and physiological situations characterized by chronic exposure to hypoxia, particularly in patients with chronic respiratory insufficiency and in healthy subjects staying at high altitude. The latest allow for very interesting comparison because they do not experience comorbidities observed in patients with chronic respiratory insufficiency and therefore provide a unique model to assess the specific effect of hypoxia on human body and metabolism. [Copyright &y& Elsevier]

Abstract: The nutritional guidelines in patients suffering from acute respiratory insufficiency are close to these recommended in the critically ill patients. But in acute respiratory failure, the constancy of an oxygen debt and the frequent high carbon dioxide levels, are particular elements to consider at the time of the choice of the nutrition support. Lipid emulsions used in parenteral nutrition have been associated with different pulmonary function changes. In general, caloric intakes should not exceed the total energy expenditure because of the risk of hypercapnia, mainly in patients with reduced ventilatory capacities, carbohydrates ensuring 65 to 70% of the energy. Parenteral fat emulsions, in particular those containing soybean oil, may induce pulmonary gas exchange disturbances in patients with underlying abnormalities of the ventilation-perfusion ratio, but only with fast infusion rates or if the amounts of linoleic acid are too high. Some pharmaconutrients, in particular glutamine, n-3 serie long chains polyunsaturated fatty acids (DHA and EPA), gamma-linoleic acid and trace elements, represent important ways of progress in the population of ARDS patients. By modulating pulmonary inflammation, immunity, bronchial reactivity and by improving the nutritional status, they open new and promising prospects in the prevention and the treatment of ARDS, whose prognosis remains poor. [Copyright &y& Elsevier]

Abstract: Purpose: Using deformable registration methods from a phase two clinical study of air breath control during radiotherapy in patients suffering from severe respiratory insufficiency and non-small cell lung carcinoma. Patients and methods: Between April 2002 and November 2005, 22 patients with severe respiratory insufficiency were treated with curative intent by conformal therapy combined with active breathing control. Results: After a mean of follow-up of 22 months, the local control rate is 28% and the method is feasible despite the severe respiratory insufficiency. However the overall survival is still poor due to metastatic widespread. For the second part of the study, the clinical protocol was also used for two studies using deformable registration methods. In the first study, a deformable registration method has been developed in order to register several breath-hold 3D CT of the same patient acquired at several days of interval. It allowed quantifying the interfraction breath-hold reproducibility by analysing the resulting displacement field. For 6 patients, the breath-hold was effective, while for 2 patients, motion greater than 10 mm were detected. The second study aimed to simulate 4D images from 3D breath-hold images. Developing an ad-hoc methodology based on the interpolation of 3D dense deformation fields performed it. The approach has been validated with expert selected landmarks, with accuracy lower than 3 mm. Conclusion: ABC is feasible, even in case of severe insufficiency respiratory syndrome but metastatic widespread disease is still a major challenge even with an acceptable local control rate without serious side effects: regarding the deformable registration method. Such artificial 4D images could allow decreasing the dose need to acquire a full 4D image, to simulate irregular breathing pattern and to be used for 4D dosimetry planning. [Copyright &y& Elsevier]

Abstract: Objectives. – Patient scheduled for infrarenal abdominal aortic aneurysm surgery carries a high risk of cardiac or respiratory comorbidity. To outline the perioperative management for these patients. Methods. – Review of the literature using MesH Terms “abdominal aortic aneurysm”, “anesthesia”, “analgesia” “critical care” and/or “surgery” in Medline database. Results. – Cardiac preoperative evaluation and management have recently been reviewed. Intermediate and high-risk patients should undergo non-invasive cardiac testing to decide between a preoperative medical strategy (using betablocker±statin and aspirin) and an interventional strategy (coronary angioplasty or cardiac surgery). Perioperative myocardial ischaemia should also be investigated by clinical, electrocardiographic and biologic monitoring such as plasmatic troponin Ic dosage. Specific score could also assess the respiratory failure risk preoperatively. Epidural analgesia decreases this risk. There is no evidence that a pharmacological treatment decreases the incidence of acute renal failure after aortic surgery. Endovascular repair is actually recommended for older, higher-risk patients or patients with a hostile abdomen or other technical factors that may complicate standard open repair. [Copyright &y& Elsevier]

Copyright of EMC-Pneumologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: We report a case of intracranial dural arteriovenous (DAVF) draining into the spinal medullary veins. A 49-year-old woman presented a rapidly progressive ascending myelopathy resulting in a C3-C4 tetraplegia associated with acute respiratory failure at the twelfth hour. MRI revealed swelling of the cervical spinal cord, hyperintensity on T2 and enhancement of enlarged veins on MR angiography. A conventional angiography showed the DAVF with venous drainage into the spinal vein extending to the conus medullaris. After embolization, neurological recovery occurred during the first week, allowing tracheal extubation on day 2. Clinical, radiological and therapeutic aspects of this uncommon pathology are presented. [Copyright &y& Elsevier]

Abstract: Platypnea-orthodeoxia syndrome is a rare cause of hypoxaemia per or postsurgery. This one is characterized by right-to-left intracardiac shunting responsible of postural hypoxemia in orthostatic position, which is improved by supine position. We described the first case of a platypnea-orthodeoxia syndrome occurred during laparoscopic surgery. [Copyright &y& Elsevier]

Abstract: Non-invasive ventilation is a ventilatory technique applied to patients in respiratory distress, without the need for endotracheal intubation. In the intensive care unit, the most frequently used interface between the patient and the ventilator is the facial mask. Two ventilatory modes are preferentially used: continuous positive airway pressure (CPAP) and pressure support ventilation. Since the beginning of the years 1990, non-invasive ventilation became the first line ventilatory method during chronic obstructive pulmonary disease acute exacerbations and cardiogenic pulmonary edema. In these indications, the application of non-invasive ventilation showed its effectiveness in term of limitation of the intubation and nosocomial infection rates, as well as mortality. It is currently more and more frequently performed in other indications such as bilateral hypoxemic pneumonia and the postoperative course... In short, non-invasive ventilation has become within a few years an essential therapeutic tool in intensive care. [Copyright &y& Elsevier]

Introduction: Pulmonary actinomycosis due to Actinomyces Odontolyticus is a rare and seldom reported pathology in pediatrics. The unspecific radio-clinical symptomatology and the slow growth of the germ make the diagnosis difficult., Case Report: A 2-year-old boy is admitted to the emergency room for acute respiratory distress in a context of febrile bronchitis that had been evolving for 10days. Quickly, the patient's state deteriorate, invasive ventilation was required. Bronchial fibroscopy was performed immediately and enabled extraction of large mucous filaments, leading to significant improvement. Mechanical ventilation was stopped after 72hours. Five days later, blood culture tested positive for Actinomyces Odontolyticus. In the absence of any other cause and given a compatible clinical picture, the child was treated with long-term antibiotherapy for a total duration of 6months, which was stopped following reassuringly normal endoscopic and radiological control., Conclusions: This is the second pediatric case of pulmonary actinomycosis due to A. Odontolyticus reported in the literature. The clinical symptoms and imaging are not specific. The presence of sulphide granules on pathological examination or in germ culture at a sterile site confirms the diagnosis. Prolonged antibiotic therapy is still recommended to avoid pulmonary sequels., (Copyright © 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

The most frequent type of complication in patients undergoing aortic surgery is respiratory. Preoperative lung function (PFT) and arterial blood gas measurement (ABG) are often carried out to assess the risk more precisely. The aim of the present retrospective study was to determine which value of lung function test could identify patients who developed such complications. "Receiver Operating Characteristic" (ROC) curves and the area beneath the curve for the diagnosis of respiratory complications were calculated for each variable of PFT and ABG. The greatest Youden index for each variable was chosen as indicative pulmonary function criterion of increased risk of pulmonary complications. One hundred and ninety-five patients (age: 65 +/- 10 years) were included. Respiratory complications occurred in 15% of patients. Respiratory complications increased from 12% if the vital capacity (VC) was > or = 77% of the predicted value to 35% if the VC was < 77% (P = 0.002), and from 10% if the FEV1 was > 76% to 34% if the FEV1 was > or = 76% (P = 0.0005). A decreased PaO2 or increased PaCO2 was not correlated with an increased incidence of respiratory complications. Length of stay in ICU or in hospital were increased when VC or FEV1 were low. Frequency of pulmonary complications was 9% in patients without PFT abnormalities, 16% in patients with either diminished VC or FEV1 and 35% in patients with both lowered VC and FEV1. However, all the areas under the ROC curves were < 0.7 and the sensitivity of the different variables was low. It is concluded that routine preoperative PFT and ABG cannot predict respiratory complications after abdominal aortic surgery. [ABSTRACT FROM AUTHOR]