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Biomedical subjects

A Lachman

Publications and source records attributed to A Lachman.

6 recordsLinked to original sources
PubMed1992

[Transthoracic lung punctures].

Transcutaneous needle aspiration (PTT) is a diagnostic technique which consists of biopsying pathological lung tissue using a needle (which in general is specifically designed for the purpose) which is introduced into the thorax transcutaneously. The target is lined up, either radioscopically or using a CT scanner and this enables the needle to be positioned in the centre of the lesion radiologically where one or more biopsies can be taken. According to the type and diameter of the needle these biopsies will enable a histological examination to be performed in addition to a cytological and bacteriological examination. This performance is particularly indicated in the final assessment of a periphery pulmonary nodule which is suspected of being neoplastic where bronchofibroscopy has been non contributory and where an immediate thoracotomy (diagnostic or therapeutic) is not recommended for one or other reason. When performed for this indication the technique often achieves a sensitivity of 90% with an average specificity of 98%. The diagnostic yield for benign tumours is less. It is always necessary to maintain a degree of vigilance in view of the risk of false negative or "benign" results. The complications exist above all of pneumothoraces which occur in 20-30% of cases and which will require a drain in 5-10% of cases. Haemorrhage and haemoptysis are less frequent but potentially fatal even in the absence of any coagulation disturbance.

Biopsy, Needle↗
PubMed1992

[Hyperventilation syndrome: current advances].

The hyperventilation syndrome has been described for half a century but clearly remains underdiagnosed. Its acute manifestation is easily diagnosed ("the tip of the iceberg") but its recognition in numerous subtle forms requires a particular degree of alertness on the part of the clinician ("the hidden part of the iceberg"). The incidence of this syndrome in the general population varies according to different authors as between 6-11% and may mimic diverse organic disorders. The physiological consequences of hyperventilation are reviewed as well as their contribution in the clinical picture. The aetiology of the syndrome and its links with organic pathology or psychiatric disturbances continues to be debated. Is hyperventilation the expression of abnormal respiratory function or a preferred manifestation of anxiety? This article discusses and reviews the variety of tests which enable the presumptive diagnosis to be confirmed. The response to the proposed treatments is generally excellent when one takes account of the numerous possible options. These include comportmental therapies such as respiratory re-education, the utilisation of betablockers and psychotrophic drugs or psychotherapy.

Bronchial Provocation Tests↗
PubMed1992

[Exercise tests in pneumology. C.R.E.D.O].

Exercise tests have proved very useful in numerous areas such as sports medicine, research, clinical medicine and rehabilitation to exercise and therapeutic trials. It is not always easy for a pneumologist to decide what sort of effort and which protocol to use. There is also the question of which parameter to use and the relationship between parameters and which are the most pertinent as a function of the aim of the research. Above all the exercise test should be adaptable in view of the diversity of the objectives. In routine pneumology the exercise test using a bicycle ergometer and a triangular type of protocol are recommended for numerous reasons. The usual parameters (ventilation, oxygen consumption, production of carbonic dioxide, cardiac rate and blood gases) and their derivatives all have a value in the domain of cardiorespiratory physiology. It is important in clinical practice not to give too great an emphasis to the exact relationship expressed as a function of the workload, because the cycloergometer is practically never calibrated or even checked by the user. Dyspnoea was the major symptom leading the patient to seek a consultation and it is of primary importance that all effort tests include an estimation of the sensation of breathlessness.

Blood Gas Analysis↗
PubMed1991

[Contribution of polysomnography in the assessment of patients with chronic obstructive bronchopneumopathy].

15 COPD patients underwent a polysomnographic study demonstrating poor quality of sleep, a mean of SAO2 of 88.8 +/- 3.9% and a apneic-hypopnea index (AHI) of 5.7 +/- 11.8. AHI was higher in sleep stages I and II than in REM sleep. SAO2 showed a progressive drop when going from an awake stage to REM sleep. Respiratory events responsible for the most important desaturation where mostly observed in REM sleep and corresponded in 8 patients to obstructive events (overlap syndrome). The lower mean SAO2 in REM probably explains the best the importance in desaturation related to the respiratory events (Hb dissociation curve). Ear oximetry recordings however interesting are not able to quantify and recognise correctly the respiratory events. Therefore a polysomnographic study remains necessary in order to diagnose adequately the overlap syndrome.

Electrophysiology↗