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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.



Recommendations for the early diagnosis of COPD: the AIMAR view. Imprimer Envoyer
Mercredi, 04 Mars 2015 06:25

Chronic obstructive pulmonary disease (COPD) has the dubious distinction of being one of the few major causes of death that continues to rise in the United States and the world. In that sense, its prevention, early diagnosis when clinically present, and finally its appropriate treatment should constitute a priority item in today’s health care agenda. In this sense, the recently published AIMAR’s recommendation for the early diagnosis of COPD constitutes a valuable contribution to this concerted effort . Professor Nardini and colleagues are to be commended for the comprehensive effort that has made this publication possible.

Perhaps the title is a little misguided as it only describes the document as a “recommendation for diagnosis”, when in reality the content is extremely comprehensive covering not just diagnostic issues of relevance, but it also develops, in rich detail, primary and secondary prevention as well as treatment. Furthermore, it extends its recommendations to the often forgotten area of end-of-life and palliative care so important in our ageing population. Perhaps the title should have included the fact that it recommends prevention and treatment as well as diagnosis. In their modesty, the authors do not pretend this to be an evidence based document, primarily due to the fact that no evidence methodology was used, but its recommendations are very much in line with those existing in the international guidelines.

The document begins with a layout of the landscape. It attempts to relate what is known about prevalence and the burden of COPD around the world to the situation in Italy itself. Overall, it would appear that there is room to improve and in a more precise manner determine the Italian situation. It follows with a section on prevention and then with an excellent discussion on the issue of secondary screening ...
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Antibiotic de-escalation in the ICU: how is it best done? Imprimer Envoyer
Mercredi, 04 Mars 2015 06:25
Purpose of review: An antimicrobial policy consisting of the initial use of wide-spectrum antimicrobials followed by a reassessment of treatment when culture results are available is termed de-escalation therapy. Our aim is to examine the safety and feasibility of antibiotic de-escalation in critically ill patients providing practical tips about how to accomplish this strategy in the critical care setting. Recent findings: Numerous studies have assessed the rates of de-escalation therapy (range from 10 to 60%) in patients with severe sepsis or ventilator-associated pneumonia as well as the factors associated with de-escalation. De-escalation generally refers to a reduction in the spectrum of administered antibiotics through the discontinuation of antibiotics or switching to an agent with a...
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Rapid diagnostic tests for defining the cause of community-acquired pneumonia Imprimer Envoyer
Mercredi, 04 Mars 2015 06:25
Purpose of review: We review the potential new diagnostic tools for determining the cause of pneumonia in the setting of community-acquired infection after outlining the limitation of currently available tests. Recent findings: A number of new tools are on the horizon with the potential to overcome the problems of existing tests. These tools include new nucleic acid amplification platforms, real-time computer-assisted microscopy, next-generation sequencing and high-throughput mass spectrometry. All of these tests still face significant barriers before they can enter general clinical practice including cost, reliability and physician acceptance. Summary: Although new platforms are exciting and do offer the promise of finally moving beyond our current very limited scope of microbiological te...
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