Introduction Le traitement de référence du syndrome d’apnées hypopnées obstructives du sommeil (SAHOS) est la pression positive continue (PPC). Ses effets bénéfiques sont certains si les indications sont respectées et l’observance thérapeutique est bonne.
Introduction La bronchopneumopathie chronique obstructive (BPCO) est une pathologie fréquente qui, bien que pouvant sembler banale, est susceptible de dissimuler d’autres diagnostics à même d’accélérer son histoire naturelle ou à même de la simuler.
Nous présentons le cas de quatre patients, suivis pour BPCO emphysémateuse, mais dont certaines caractéristiques cliniques et radiologiques ont conduit à reconsidérer le diagnostic.
Introduction Le mésothéliome pleural malin (MPM) est un cancer rare mais d’incidence croissante, associé à l’amiante. Son pronostic est mauvais, favorisé par l’absence de traitement curatif validé. La chirurgie et le traitement multimodal sont d’indication discutée et limitée par quelques équipes expertes. La chimiothérapie standard de première ligne, cisplatine/pémétrexed est d’efficacité faible même si l’association du bévacizumab a amélioré ses performances. Aucun traitement n’est recommandé en deuxième ligne ou plus.
Purpose of review: Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disorder characterized by progressive, poorly reversible airflow limitation. In addition to its pulmonary manifestations, COPD is also associated with several systemic expressions including anemia, osteoporosis, coronary artery disease, and malnutrition. In COPD, malnutrition is a consequence of reduced nutritional intake and muscle loss, further compounded by systemic inflammation. In the developing world, malnutrition is a significant problem by itself, even without any systemic illness. It is likely that the occurrence and consequence of malnutrition in COPD may be even more profound in developing countries. In this review, we discuss the relationship between malnutrition and COPD and their overall impact in the developing world.
Recent findings: COPD is highly prevalent in developing countries with an estimated 15–43 million patients suffering from COPD. The pooled prevalence of malnutrition in COPD was found to be 47.6% [95% confidence interval (CI), 23.5–71.5%] with the prevalence being higher in acute exacerbations of COPD compared to stable COPD.
Summary: There is a need for generating good quality evidence from the developing world regarding the prevalence of malnutrition in COPD, the role of nutritional supplementation and its impact on exercise capacity, and overall health-related quality of life in patients with COPD.
Purpose of review: The interplay between genetic susceptibilities and environmental exposures in the pathogenesis of a variety of diseases is an area of increased scientific, epidemiologic, and social interest. Given the variation in methodologies used in the field, this review aims to create a framework to help understand occupational exposures as they currently exist and provide a foundation for future inquiries into the biological mechanisms of the gene–environment interactions. Understanding of this complex interplay will be important in the context of occupational health, given the public health concerns surrounding a variety of occupational exposures.
Recent findings: Studies found evidence that suggest genetics influence the progression of disease postberyllium exposure through genetically encoded major histocompatibility complex, class II, DP alpha 2 (HLA–DP2)–peptide complexes as it relates to T-helper cells. This was characterized at the molecular level by the accumulation of Be-responsive CD4+ T cells in the lung, which resulted in posttranslational change in the HLA–DPB1 complex.
Summary: These studies provide important evidence of gene–environment association, and many provide insights into specific pathogenic mechanisms. The following includes a review of the literature regarding gene–environment associations with a focus on pulmonary diseases as they relate to the workplace.