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The epidemiology of chronic beryllium disease (CBD) in France is poorly understood. The aim of this study was to determine the number of prevalent cases of CBD in France between 2010 and 2014.We conducted a national survey using a specific questionnaire distributed by the professional pathology services.In total, 33 CBD cases were reported in France, with a diagnosis established between 1982 and 2014. 85% (28/33) of CBD cases resulted from professional exposure and mostly concerned foundry workers (39%). A definite diagnosis defined by the association of an abnormal beryllium lymphocyte proliferation test and of a granulomatous inflammatory response in the lung, was obtained in 29/33 cases (88%). The other cases were probable CBD, defined by a granulomatous lung disease with a beryllium exposure, but without evidence of beryllium sensitisation. The diagnosis of granulomatous disease was confirmed a mean of 4 years after the end of exposure. The median delay between diagnosis of a granulomatous disease and diagnosis of CBD was 2 years (range 0-38 years). A genetic predisposition was found in 14 of 17 tested patients (82%).In this study, we report 33 cases of CBD followed in France between 2010 and 2014. The poor understanding of CBD and the exposure leading to it, the late development after the end of exposure, the complexity of the diagnosis and the similarities with sarcoidosis may explain the small number of cases reported.

Laser Doppler flowmetry (LDF) is a noninvasive method to monitor skin perfusion and is very useful in studying reactive hyperemia signals. For this latter case, the determination of peak flow (pLDF) and time to peak flow (tpLDF) is of great interest in discriminating between subjects with peripheral arterial obliterative diseases and those who are healthy. However, the myogenic mechanism provokes marked oscillations on all LDF signals. Therefore, an accurate detection of the parameters is very difficult. The present study shows that wavelets are a powerful tool to overcome this drawback. Six different processes using several wavelets are tested on 44 signals recorded on 11 healthy volunteers. The results prove that thresholding coefficients of a multilevel wavelet decomposition does not allow a valuable computation of the parameters but that the reconstruction of the approximation branch is an efficient method to accurately determine pLDF and tpLDF. Using this latter method, mean results for a 3-min occlusion give pLDF = 46.80 a.u. and tpLDF = 17. 08 s. For a 2-min occlusion, pLDF and tpLDF are 39.19 a.u. and 11.63 s, respectively. For a 1-min occlusion, the results give pLDF = 36. 01 a.u., tpLDF = 8.48 s. Eventually, for a 30-s occlusion they give pLDF = 33.86 a.u. and tpLDF = 5.60 s. These results can now be compared with those obtained on pathological subjects.

Although the neurological and cardiovascular effects of Freons have been extensively described, the respiratory effects have been less well documented. We report four cases of occupational asthma following accidental exposure to bromochlorodifluoromethane (Halon 1211) due to release of the contents of a fire extinguisher. All subjects developed an irritative reaction of the upper airways and lower respiratory symptoms immediately after exposure. Non-specific bronchial hyperreactivity was present for at least two months in all subjects and was still present more than two years after exposure in one case. The diagnosis of reactive airways dysfunction syndrome can be adopted in at least three of these four cases.

Several etiologies are involved in the pathogenesis of cavitating pulmonary disease including neoplastic, infectious or inflammatory processes. Another is pulmonary infarction associated with venous thromboembolism. The lung cavities tend to be located peripherally and are the result of pulmonary embolism. We report the case of a woman with chronic thromboembolic pulmonary hypertension (CTEPH), associated with familial thrombophilia, revealed by cavitating pulmonary infarcts. CTEPH is sometimes diagnosed during an episode of recurrent pulmonary embolism following previously unnoticed lesions. Thrombophilias such as isolated elevated factor VIII are risk factors for CTEPH.

To investigate the smoking cessation period during pregnancy.Questionnaire-based, descriptive study of 979 pregnant women in four regions of France. The variables analysed included the characteristics of the mother and neonate at delivery, the smoking habits of the mother before and during pregnancy, the perception of risk linked to smoking, and the reasons for giving up smoking.Eighteen percent of women smoked until delivery. Forty-five percent of women gave up smoking during pregnancy, usually in the first trimester. More precisely, about one woman who smoked out of 50 gives up in order to prepare pregnancy. The proportion of women who stop smoking in each of the three trimesters of pregnancy is 84,1, 8,8 and 7,1% respectively.Most women appear to stop smoking before any intervention therapy is possible. The first contact with a midwife or an obstetrician takes place whereas smoking cessation is already successful.

A 30-year-old woman consulted for recent repeated episodes of hemoptysis occurring at the onset of the menses a few months after interruption of estrogen-progesterone treatment. This patient's only surgical history involved uterine curetage. She was a smoker and had cumulated 10 pack-years. Physical examination and chest x-rays were normal. Bronchial endoscopy and cytological examination of the bronchial aspiration were normal. Thoracic CT demonstrated an alveolar image in the right lower lobe. A second CT performed later after resolution of the episode of hemoptysis was normal. Laparoscopy was performed and visualized an endometrial nodule in the pelvis which was removed. The patient's clinical signs disappeared after treatment with triptoreline. Bronchopulmonary endometriosis is an uncommon condition. The main manifestations are catamenial hemoptysis during the first days of the menses. Chest pain is exceptional. Diagnosis may result from an incidental discovery. A traumatic intervention on the uterus is often found in the patient's history. The most commonly proposed pathogenic mechanism involves hematogenic migration following a uterine procedure. Imaging does not disclose specific signs and bronchial endoscopy is often normal but may demonstrate a tracheal or bronchial plaque of endometriosis, or exceptionally endometrial tissue in the endoscopy biopsies. LH-RH agonists remain the current treatment.

In its pulmonary form, sarcoidosis generally resolves spontaneously, but it may lead to fibrosis of the lung. The clinical, radiological and functional tests, as well as activity markers such as the serum angiotensin converting enzyme, intrathoracic uptake of 67Gallium and the cytological data provided by bronchoalveolar lavage are only the expressions at any given time of a disease which is constantly progressing and only partly express its evolutive potential. The authors studied the distribution of T-lymphocyte subsets in the peripheral blood and from bronchoalveolar lavage. 32 patients were included in the study. They were suffering from acute or chronic sarcoidosis of the mediastinum and lungs and were divided into 2 groups according to clinical, radiological and pulmonary function criteria; Group A (n = 19) included regressive forms (minimum follow up 2 years) and group B (n = 13) the progressive untreated forms. Lymphopenia with a decrease in the percentage of CD3 cells was found in both groups. The percentage of CD4 cells is significantly lower in group B (28 +/- 11%) than in group A (45 +/- 8%) (p0.01) or in the control population (46 +/- 8%) (p0.01). The percentage of CD8 cells is higher in group B (30 +/- 8%) than in group A (18 +/- 6%). This results in a CD4/CD8 ratio which is significantly reduced in group B (1 +/- 0.5) when compared with group A (2.72 +/- 0.8) (p0.01) and the control group (2.17 +/- 0.8) (p0.01), the difference between group A and the controls being minimal.(ABSTRACT TRUNCATED AT 250 WORDS)

A 27 year old white woman with a history of chronic eczema and episodes of serious infection of the chest, skin, and bone presented with acute respiratory failure. She was found to have a spontaneous right pneumothorax and a pneumatocele in the left upper lobe. Despite a left upper lobectomy she was left with chronic respiratory failure, bullous lung disease, and bilateral bronchiectasis. The hyperimmunoglobulinaemia E and recurrent infections syndrome was diagnosed only in adult life.

A 38-year-old woman was known to have had a histologically proven "idiopathic" pulmonary hemosiderosis for 7 years; the authors report the onset in this patient of polyarthralgias with articular swelling and positivity of rheumatoid factor, all features consistent with the diagnosis of rheumatoid arthritis, whose beginning was certainly hidden by steroid therapy. This case, as some others previously published, outlines the possibility of the association of pulmonary hemosiderosis and rheumatoid arthritis: is this a casual association, or may pulmonary hemosiderosis be a rare manifestation of rheumatoid arthritis?