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New advances in the management and treatment of cystic fibrosis

Florin Mihălţan
Institutul de Pneumoftiziologie „Marius Nasta“, București


Cystic fibrosis represented and continue to represent either for the system and for the practitioner a serious challenge through the severe manifestations of disease, progressive mainly in the lung, through the progres in the management registrated in the last time for fighting lung infections such as Pseudomonas aeruginosa, in understanding of genetic condition, new ways of administration of antibiotics and the problems posed by today transition of these patients from pediatrician to the pulmonologist, infectious disease specialist, rehabilitation specialist etc. There have been noted extensions of survival and improvement of diagnostic rate. Today in France in the Caucasian population, there were 6,000 cases with this common disease, of which half were adults (>18 years). I’ll review a number of novelties reported last year connected to this disease adding recent signals received after the congress organized by the North American Cystic Fibrosis Foundation in October 2013 in North Lake City that maybe in the future will extend the duration of survival of these patients.

Keywords: cystic fibrosis, complications, respiratory infections

Pag. 21-25 (1/2014)

The Montgomery tracheal prosthesis: actual solution for tracheal stenosis

Cornel Adrian Petreanu, Cornel Savu, Codin Saon, Emilia Crişan, Ruxandru Ulmeanu, Mihai Alexe
Institutul de Pneumoftiziologie „Marius Nasta“ București, România


Tracheal stenosis is a disorder which is very difficult to diagnose in its early stages. Most cases are reffered to the hospital with an obstruction of at least 50% of the tracheal lumen, when dyspnea is already symptomatic. The cases with obstructive phenomena of over 70% represent immediately endoscopic emergencies, due to the risk of decompensation by adding the obstruction secondary to tracheo-bronchial secretions and bleeding. Initial management of a compromised central airway by endoscopic technique allows to obtain optimal conditions for the curative treatment. The main cause is malignancy and the for treatment are used endoscopic techniques with palliative visa. After restoring the permeability of the affected airways, stenting is mandatory to keep them open. Among the first stents invented, there was Montgomery type in 1965. Besides the silicon stent, there are the newest type, metallic or hybrid, which try to compensate disadvantages of silicone type, but with significant financial costs. Though Montgomery stent appeared more than 50 years ago, they are still used with good results, with clear advantages, especially in low incomes public health systems. The paper presents technical data, indications, advantages, disadvantages and techniques for effective placement. It also presents a welldocumented clinical case of effective placement of a tracheal stent, with video-documentatio of the whole procedure performed by a mix team: endoscopist and surgeon.

Keywords: tracheal stenosis, interventional bronhology, stenting, Montgomery stent