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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.

Palliative care and chronic obstructive pulmonary disease: where the lines meet Imprimer Envoyer
Jeudi, 16 Février 2017 05:35

Purpose of review: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and is expected to increase as the population ages. Patients have a high symptom burden, low healthcare quality of life, and unmet needs at the end of life.

his review highlights specific palliative care needs of patients with advanced COPD and opportunities to integrate palliative care into standard practice. Recent findings: There are many barriers to providing integrated palliative care in COPD, including difficulty with prognostication, communication barriers surrounding advance care planning, and lack of access to specialty palliative care. Because of the unique disease trajectory, emphases on early and primary palliative care are being studied in this patient population.

Summary: Palliative care is appropriate for patients with COPD and should be integrated with disease-specific therapies. The line between life prolonging and palliative care undoubtedly overlaps and maximizing quality of life throughout the continuum of care should be prioritized for patients with this progressive illness.

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Electronic cigarettes as smoking cessation tool: are we there? Imprimer Envoyer
Jeudi, 16 Février 2017 05:35

Purpose of review: Electronic cigarette (e-cigarette) use is rapidly increasing, with many users reporting trying e-cigarettes as a method to quit combustible cigarettes. This review highlights recently published studies assessing the use of e-cigarettes as a tool for cessation of combustible cigarettes.

Recent findings: When evaluating data from four randomized controlled trials and multiple cohort studies, differential association between e-cigarette use and cessation rates was seen. Cessation rates are highest in UK cohort studies and in studies using a multifaceted approach, such as with the addition of varenicline. The largest evidence base is derived from observational cohort studies. Overall, the current evidence remains too small for conclusive results regarding efficacy of e-cigarettes for combustible cessation. There does appear to be a consistent reduction in daily combustible cigarette use in regular e-cigarette users.

Summary: Currently, there are conflicting data which can be used to support or dismiss e-cigarettes as a tool for smoking cessation. As larger population-based studies become available, the potential harms and benefits of e-cigarettes will become clearer. In the short term, shared decision-making with combustible cigarette users will be imperative when considering e-cigarettes as a smoking cessation tool.

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Occupational asthma: diagnostic challenges and management dilemmas Imprimer Envoyer
Jeudi, 16 Février 2017 05:35

Purpose of review: Work-related asthma encompasses both sensitizer-induced and irritant-induced occupational asthma as well as work-exacerbated asthma. This review summarizes current diagnostic and management strategies for occupational asthma.

Recent findings: Occupational asthma is the most common occupational lung disease in the industrialized world. Over 400 agents have been described to cause occupational asthma. Specific inhalation challenge is often considered the reference method for diagnosis of occupational asthma but specific inhalation challenge as well as other diagnostic tests all generate false positive or false negative results. Definitive avoidance of the inciting agent is the preferred strategy for sensitizer-induced occupational asthma and reduction of exposure is the next best step. Immunotherapy is not currently well established and can cause systemic reactions.

Summary: An accurate diagnosis made in a timely fashion can positively impact the health and socioeconomic burden associated with occupational asthma. Newer diagnostic tools are promising, but much work needs to be done to standardize and validate these testing methods. Primary, secondary, and tertiary prevention strategies are crucial for effective management of sensitizer-induced occupational asthma.

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