[Is stairclimbing a maximal exercise test for COPD patients?].

Introduction: Variable tests evaluate the cardio-respiratory working capacity of COPD patients. Stairclimbing testing has been less studied. Our hypothesis is that this functional exercise test represents a submaximal effort for these patients.

[Determining factors of walking distance during 6-minutes walk test in COPD patients].

Introduction: In stable COPD, we studied the factors determining six-minute walking distance and dyspnea at the end of the test.

Methods: Patients were evaluated by tests of lung function, St Georges' respiratory questionnaire (SGRQ) and 6MWT with inspiratory capacity measurements (IC) and continuous oxymetry.

Results: Eighty-two patients (mean FEV(1): 56+19% predicted) were studied.

Clinical use of the meropenem-clavulanate combination for extensively drug-resistant tuberculosis.

Mycobacterium tuberculosis strains resistant to almost all available anti-tuberculosis drugs are an increasing threat to public health worldwide. Among existing drugs with potential antimycobacterial effects, the combination of meropenem with clavulanate has been shown to have potent in vitro bactericidal activity against extensively drug-resistant tuberculosis (XDR-TB). To explore its potential clinical efficacy, a meropenem-clavulanate-containing salvage regimen was started in six patients with severe pulmonary XDR-TB, in association with the only one or two remaining active second-line drugs.

Hoover's sign is a predictor of airflow obstruction severity and is not related to hyperinflation in chronic obstructive pulmonary disease.

Background: Several phenotypes are described in COPD.

Objectives: To assess if COPD patients with Hoover's sign (HS) belong to a particular phenotype.

Methods: All consecutive COPD patients with varying degree of airflow obstruction that came for lung function testing in one university hospital were prospectively assessed, using clinical and magnetometer detection of HS, body mass index (BMI), St.

Meropenem/clavulanate and linezolid treatment for extensively drug-resistant tuberculosis.

The combination of meropenem with clavulanate has high antimycobacterial activity in vitro against extensively drug-resistant Mycobacterium tuberculosis strains. We report the successful use of this combination in association with linezolid in the management of an advanced extensively drug-resistant tuberculosis disease with complex second-line drug resistance in a 14-year-old teenager.

Sleep efficiency during sleep studies: results of a prospective study comparing home-based and in-hospital polysomnography.

To date, the clinical use of unattended home-based polysomnography (PSG) is not recommended. To assess whether sleep efficiency is better at home, we have performed a prospective, crossover, single-blind study comparing unattended home- versus attended in-hospital PSG in a population referred for high clinical suspicion of obstructive sleep apnoea syndrome (OSA). Within 2 weeks, all the patients underwent both PSG performed by the same sleep technician, which were analysed by another blinded technician.

[Chest physiotherapy techniques - can they reduce hyperinflation].

The authors review the literature concerning the possibilities of modifying the mechanical characteristics of the respiratory system with breathing retraining and other chest physiotherapy intervention. Breathing retraining techniques with prolonged and active expiration induce increased work of breathing and do not help diaphragmatic function. Only pursed lips breathing seems to produce some mechanical advantages.

Multidrug-resistant tuberculosis: a review of the 23 cases treated by the Saint-Pierre University Hospital (Brussels).

For about fifteen years, Belgium, as other developed countries, has been confronted with multidrug-resistant tuberculosis (MDR-TB). The treatment of MDR-TB is complex, associating several antibiotics and causing multiple adverse effects. The aim of this study is to report our experience with MDR-TB at the Saint-Pierre University Hospital in Brussels.

[Manual abdominal compression for the detection of expiratory flow limitation].

Introduction: Expiratory flow limitation (EFL) is a characteristic feature of chronic obstructive pulmonary disease (COPD) and leads to dynamic hyperinflation (DH) which is a major source of dyspnoea, particularly during exercise.

State Of The Art: A new technique for the detection of EFL, based on manual compression of the abdomen (MCA), was assessed both in normal subjects and patients with COPD. MCA was always associated with a moderate increase in pleural pressure and allowed the detection of EFL in a reproducible manner, in both the seated and supine postures.

P0.1 during exercise in normal subjects breathing mixtures of gas with varying densities.

Background And Aim: The aim of the study was to re-examine the occlusion pressure measured simultaneously in the mouth (P0.1) and the oesophagus (Poes.1) during exercise in normal subjects submitted to different gas mixtures.

[Respiratory physiotherapy in lung diseases].

Functionally COPD is characterized by a reduction in airflow and an increase in dead space. Physical therapy and breathing training is designed to increase tidal volume, decrease respiratory rate and sense of dysponea. The respiratory exercises include controlled breathing, diaphragmatic and pursed-lip breathing.

Expiratory flow limitation during exercise in COPD: detection by manual compression of the abdominal wall.

Manual compression of the abdomen (MCA) during spontaneous expiration is a simple method for the detection of flow limitation in the chronic obstructive pulmonary disease (COPD) patients during resting breathing, based on comparison of flow/volume curves obtained during MCA with that of the preceding control breath. It was assessed whether this nonstandardized technique is also feasible during exercise. MCA was performed during resting breathing and constant-exercise work at one- and two-thirds maximal mechanical power output (W'max) in six normal subjects and 12 COPD patients.

Detection of expiratory flow limitation by manual compression of the abdominal wall.

We have assessed a new method, manual compression of the abdominal wall (MCA) during expiration, in the detection of expiratory flow limitation. Twelve stable patients with chronic obstructive pulmonary disease (COPD) and five normal subjects were studied during spontaneous breathing in the supine and seated posture. MCA was performed during expiration with one hand at the umbilical level and we measured flow, volume, pleural (Ppl) and gastric (Pga) pressures and abdominal anteroposterior (AP) diameter at the umbilical level with magnetometers.

Effect of anti-asthmatic drugs on the response to inhaled endotoxin.

Background: Endotoxin is a pro-inflammatory agent contaminating the dust that has been associated with the risk to develop pulmonary diseases. There is no data on the protective efficacy of anti-asthmatic drugs on the response induced by inhaled endotoxin in human.

Methods: Twelve mildly asthmatic subjects were submitted weekly to bronchial challenge tests with 20 microg endotoxin.

Prognostic factors for patients with small cell lung carcinoma: analysis of a series of 763 patients included in 4 consecutive prospective trials with a minimum follow-up of 5 years.

Background: The purposes of this study were to identify prognostic factors for response to chemotherapy, overall survival, and long term survival of patients with small cell lung carcinoma and to construct a classification of patients on the basis of their expected overall survival.

Methods: In the 763 patients registered in 4 consecutive clinical trials conducted by the European Lung Cancer Working Party from 1982 to 1993, the impact of 21 pretreatment variables assessable in a routine practice was analyzed for the various outcomes with a minimum follow-up of 5 years.

Results: The key prognostic role of disease extent was confirmed for all the outcomes.

[Treatment of chronic obstructive bronchopneumopathies].

Guidelines and statements from ERS, ATS, BTS and SPLF are now available for adequate treatment of COPD. The recommendations are summarised but the author emphasizes what has changed, what remains unchanged or was adapted and what is new and promising. The therapeutic approach tends also to improve symptoms, especially dyspnea, and quality of life.