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NEW DEVELOPMENTS IN THE DIAGNOSIS AND MANAGEMENT OF ADULT ASTHMA Asthma management must be comprehensive, focusing on control¬ling symptoms with inhaled corticosteroids adapted to the stage of severity, but also on limiting the occurrence of exacerbations by correcting poor control factors and educating the patient. The diagnosis of asthma is not only clinical, but it must also include a measurement of respiratory function. Research is active in the field of asthma, with the development of new strategies for prescribing inhaled corticosteroids, which are simpler for patients, but which prescribers must take on board in order to control them. Biotherapies have revolutionized the management of severe asthma. It is important to identify severe patients so that they can benefit from these treat¬ments. It can be considered that any patient who has had two exa¬cerbations in the year should be referred to pulmonology., Competing Interests: M. Le Brun déclare n’avoir aucun lien d’intérêts. - C. Taillé déclare des interventions ponctuelles pour les laboratoires AstraZeneca, GSK, Novartis, Sanofi, Chiesi, ALK.

Exacerbations of asthma are still responsible for 900 deaths per year in France, most of which are considered preventable. They have a major impact on the quality of life of patients and are responsible for a large part of the socio-economic cost of asthma in France. Exacerbations of asthma can be partly prevented by inhaled corticosteroid treatment as controller therapy, at a dose adapted to the level of control of symptoms and the management of aggravating factors. Every patient should benefit from a written action plan that allows them to start oral corticosteroid therapy as soon as possible during an exacerbation. The treatment combines short-acting bronchodilators with systemic corticosteroids. Systemic antibiotic therapy has no place in the treatment of exacerbations. The patient must be seen early in the course of an exacerbation of asthma to review all of his follow-up., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Cystic echinococcosis, or hydatidosis, also known as hydatid cyst, is a cosmopolitan parasitosis mainly present in breeding areas. This anthropozoonosis is related to the tissue development of an hydatid of an echinococcus tænia, Echinococcus granulosus, found in the digestive tract of canids, at the adult state. In France, this larval cestosis is essentially an import disease developed by patients from endemic areas such as East and North Africa, South America or Asia. However, autochtonous forms, although rare, still persist. Here we describe the case of a 39-year-old non-smoking patient from Paris, admitted in the emergency department for chest pain associated with sweating and chills. The clinical examination found the notion of a right lower lobar pulmonary nodule discovered 20 years ago, on a chest X-ray, but never explored. Thoracic computed tomography shows two large cystic opacities with endocystic flaky images, including one ruptured in the pleura with right pleural effusion. This radiological suspicion of fissured cystic echinococcosis was confirmed by positive hydatidosis serology. The multidisciplinary meeting retained the indication of right basal segmentectomy enlarged to a diaphragmatic patch, associated with treatment by albendazole. The diagnosis was confirmed by parasitological and pathological data. In this article, we will deal with the macroscopic and microscopic features of this rare parasitosis in metropolitan France and we will discuss the elements of management of a fresh resected specimen during macroscopic examination to prevent parasite swarming., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Competing Interests: C. Dupin déclare des liens ponctuels avec GSK, Chiesi et Novartis - actions de formation -, avec AstraZeneca - activité de conseil/ board -, Sanofi - board - et avoir été prise en charge lors de congrès par Roche, Boehringer Ingelheim, Novartis, AstraZeneca et ALK. C. Taillé déclare des liens ponctuels - interventions ponctuelles et/ou prise en charge lors de congrès - avec les laboratoires Roche, Teva et Chiesi et être consultante pour les laboratoires AstraZeneca, GSK, Novartis et Sanofi.

Competing Interests: L’auteur déclare avoir perçu des honoraires ou des financements pour participer à des congrès, actions de formation, groupes d’experts, de la part des laboratoires AstraZeneca, Boehringer, GSK, Novartis, Roche et Teva.

Identifying new biomarkers in asthma is attractive but requires assessing their relevance and their reliability to clinical practice. Beyond fashion, the improvement in identification of new candidate biomarkers benefited of scientific and biologic progresses, biobanks and platforms robustly backed on longitudinal cohorts and registries. Paradoxically, the main issue is now to stress up the good question, in other words to correctly characterize the unmet needs in asthma that might benefit of a biomarker. Chronicity, variability, weakness of diagnostic tools and the heterogeneity of the disease are features of asthma claiming for identifying new biomarkers. Unmet needs in asthma encompass areas such as diagnosis, prognosis, management and follow-up, therapeutic guidance and phenotypic/endotypic identification. FEV1 is an available biomarker largely tested in asthma worth in most of these areas. Albeit, mandatory features required for a new biomarker to emerge, pro/con debates on those already existing and currently used methods for identifying new ones are worth explorations. We reviewed and summarized the current literature focusing biomarkers in asthma., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Organizing pneumonia is first of all a pathologic entity observed in different situations of pulmonary repair after aggression. It is characterized by the presence in the distal airways (alveoli, alveolar ducts, and respiratory bronchioli) of fibroblastic buds in a loose extracellular matrix. The same terminology also describes a clinical entity characterized by the appearance of patches of multiple alveolar opacities, especially suggestive when they are migratory. This entity is characterized by strong sensitivity to corticosteroids and the high frequency of disease relapses, which generally occur when the corticosteroid dose is reduced or in the weeks after treatment stops. Diagnostic certainty requires histologic proof, which is rarely obtained when the radiographic and clinical picture is typical. When it occurs without an identified cause, this entity is now known as cryptogenic organizing pneumonia (it was previously called bronchiolitis obliterans with organizing pneumonia, or BOOP). The same entity can be observed in other defined contexts (connective tissue disease, for example), or with identified causes (e.g., radiation therapy for breast cancer, drugs, or infections)., (Copyright 2009 Elsevier Masson SAS. All rights reserved.)