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Introduction: In COPD, inhaler choice should be based on the likelihood that the patient will be able to use the device correctly in order to favour adherence and compliance, and therefore treatment efficacy. SATE OF THE ART: Performances of usual inhalers are limited by the necessity of a good coordination of patient inspiration and inhaler activation (pressurized metered dose inhalers), or a sufficient inspiratory flow (dry powder inhalers). Respimat®, the first "Soft Mist™ inhaler" (SMI), releases the drug solution as a low and sustained soft mist, so that lung deposition is both improved and reproducible., Perspectives: In clinical studies, Respimat® has been shown to allow equivalent bronchodilator response and tolerability to metered dose or dry powder inhalers, but with lower doses of active drugs. Furthermore, studies assessing inhaler preference in COPD showed that patients preferred Respimat® to usual inhalers., Conclusion: Respimat® SMI offers new perspectives for the management of chronic respiratory diseases, particularly in newly diagnosed or poorly compliant patients., (Copyright © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Methods: A questionnaire was sent to 50 000 general practicioners (GP) and specialists., Results: 4,898 physicians (9.4%) responded, including 59.1% GP, 16.9% pneumologists, 13% pediatricians and about 10% other specialists, ENT, allergologists, and intensivists. The main reason for pneumologists to prescribe nebulization was the efficiency on long term of approved drugs. GP prescribe nebulization for its local effects, using unapproved drugs, on short periods of time, especially in COPD, asthma, bronchitis and tracheitis/laryningitis. Although pneumologists have been trained during their fellowship and do not ask for further education, MG have learned by their own experience and are asking for further education., Conclusion: This study should help to develop teaching programs on nebulization with the aim to optimize its practice.

Lung cancer is the leading cause of cancer related deaths throughout the world, with a 5 year survival rate of 15%. However, significant improvements in median survival times and 1 and 2 year survival rates have been achieved in the last decade. This progress has been accomplished by the use of platinum based regimens with newer chemotherapeutic agents and, more recently, targeted therapy. For advanced stage non-small cell lung cancer chemotherapy prolongs survival and improves quality of life in patients with good performance status. Platinum based doublet chemotherapy regimes are now the standard care for patients with advanced stage NSCLC and non-platinum based combination therapies are reasonable alternatives for certain groups of patients. The combination of chemotherapy with vascular endothelial growth factor inhibitors has been proven to prolong survival.

Mediastinal germ cell tumours (teratomas, seminomas, and non-seminomatous malignant germ cell tumours) are a heterogeneous group of benign and malignant neoplasms. The standard treatment of mediastinal non-seminomatous malignant germ cell tumours is four cycles of chemotherapy followed by surgical resection of the residual mass. Small localized mediastinal seminomas may be treated with primary resection followed by radiotherapy. In patients with locally advanced disease, the preferred treatment is systemic chemotherapy followed by surgical resection of any residual disease. Thymomas can be locally invasive and associated with parathymic syndromes. Complete surgical excision is attempted in most cases of thymoma. Radiation therapy is usually recommended for invasive or incompletely excised tumours. Invasive thymoma is chemosensitive.