[Take-home messages from the 2nd COPD 2023 Biennial of the French Society of Respiratory Diseases. Placing the patient at the center of the care pathway]. / Principaux messages de la deuxième Biennale BPCO 2023 de la SPLF. Le patient au cœur du parcours de soins.

INTRODUCTION: The second COPD Biennial organized by the COPD working group of the French Society of Respiratory Diseases took place in Paris (Cochin) on 13th December 2023. STATE OF THE ART: Major trends in 2023 were discussed; they encompassed concepts, definitions, biologics, care pathways, pulmonary rehabilitation and complex situations entailed by respiratory infections, cardiovascular comorbidities and pulmonary hypertension, and modalities of oxygen therapy and ventilation. PERSPECTIVES: The different talks underlined major changes in COPD including the concepts of pre-COPD, etiotypes, health trajectories and new definitions of exacerbation. Recent results in biologics for COPD open the door to new pharmacological options. Assessment of current care pathways in France highlighted some causes for concern. For example, pulmonary rehabilitation is a key but insufficiently practiced element. Respiratory infections require careful assessment and treatments. Diagnosis and treatment of cardiovascular comorbidities and pulmonary hypertension are of paramount importance. As of late, oxygen therapy and ventilation modalities have evolved, and are beginning to afford more personalized options. CONCLUSIONS: As regards COPD, a personalized approach is crucial, placing the patient at the center of the care pathway and facilitating coordination between healthcare providers.

Assessment of conduction from C8 nerve root exit to supraclavicular fossa--its value in the diagnosis of thoracic outlet syndrome.

Conduction across the thoracic outlet in the components of the lower trunk of the brachial plexus was studied. With the recording electrode over the abductor digiti quinti latencies of stimulation in the supraclavicular fossa and of the C8 nerve root were ascertained. The difference between these 2 values reflected conduction time between C8 and the supraclavicular fossa. Four normal volunteers, 150 patients without Thoracic Outlet Syndrome and 50 patients with clinical thoracic outlet syndrome were studied. Using this method, conduction time from C8 to supraclavicular fossa ranged from 0.4 to 1.2 msec (mean = 0.6570, S.D. = 0.2097) in patients without thoracic outlet syndrome, and from 1.0 to 2.6 msec (mean = 1.7836, S.D. = 0.1984) in patients with thoracic outlet syndrome. These values show a significant difference between the 2 groups at the 0.05 level of confidence (T-Test). In thoracic outlet syndrome, conduction time has a tendency to be prolonged and the value above 1.3 msec is strongly suggestive of thoracic outlet syndrome. The values are consistent and reproducible. This method is easy to carry out and is a useful addition to the diagnostic assessment of thoracic outlet syndrome.