[Physical activity and exercise training for patients with cystic fibrosis]. / Activité physique et réentraînement à l'effort du patient atteint de mucoviscidose.

In France patients with cystic fibrosis benefit from a multidisciplinary follow-up in Cystic Fibrosis Centres. In this follow-up, despite the numerous therapeutic benefits of exercise in this disease, little emphasis is placed on the promotion of physical activity. The aim of this article is to improve this aspect of management, giving advice from a working group of experts, based on the medical literature and clinical experience. These proposals include quantification of physical activity, evaluation of exercise, training and rehabilitation programs and finally, modification of behaviour to include physical activity in the overall cystic fibrosis treatment strategy. It is intended to set up multicentre studies to evaluate the impact of these proposals.

[What is the place of conventional radiology in the exploration of esophageal dyskinesia and hiatal hernia?]. / Que reste-t-il de la radiologie conventionnelle dans l'exploration des dyskinésies oesophagiennes et des hernies hiatales?

Esophageal dyskinesias are due to various aetiologies and sometimes present with marked clinical symptoms. The barium swallow remains the preferred first-line examination. Upper GI endoscopy and manometry are useful to confirm the functional nature and eliminate any concomitant or secondary mucosal lesions of these motor disorders. The clinical signs of hiatus hernia are essentially due to complications related to gastro-esophageal reflux. They can be asymptomatic or may present in the form of atypical, sometimes extra-gastrointestinal, symptoms. Although conventional radiology allows the diagnosis of hiatus hernia by specifying the type, the morphology and the anatomical relations, it may fail to detect the consequences of gastro-esophageal reflux, especially ulcerated lesions. Upper gastrointestinal endoscopy appears to be the first-line examination of choice for the diagnosis of hiatus hernia. Barium swallow is useful in cases of failure of endoscopy and in the context of preoperative assessment, as these two investigations are often complementary.

[Megaesophagus]. / Mégaoesophage.

Although it was first described a long time ago, the pathophysiology of megaesophagus, a primary esophageal motor disorder due to an abnormality of the esophageal sphincter reflex ("achalasia"), remains poorly understood. Our paper shows that it may also be missed clinically for a long time, sometimes for psychological reasons.