[Hyperbaric oxygen therapy and eye disease: Review of the literature]. / Oxygénothérapie hyperbare et maladies oculaires : une revue de la littérature.

Hyperbaric oxygen therapy consists of breathing 100% oxygen continuously or intermittently in a chamber at a pressure equal to or greater than 1.4 absolute atmospheres. Indicated for the emergency treatment of carbon monoxide poisoning and other medical-surgical pathologies such as gas embolism or necrotizing soft-tissue infections, various studies have shown a beneficial effect of hyperbaric oxygen therapy in certain ocular pathologies, notably of microcirculatory origin, such as central retinal artery occlusion or macular edema linked to retinal vein occlusions. In addition, hyperbaric oxygen might represent an alternative treatment for ocular quinine toxicity and might also be useful as an adjuvant to surgery and antibiotics in cases of periorbital necrotizing fasciitis. On the other hand, oxygen in high concentrations has toxic ocular effects due to the production of reactive oxygen derivatives.

[Biomechanics of the lamina cribrosa: A determining factor in glaucomatous neuropathy. A review of the literature]. / Biomécanique de la lame criblée : un facteur déterminant de la neuropathie glaucomateuse. Une revue de la littérature.

Glaucoma is a chronic optic neuropathy characterized by progressive sclero-laminar remodeling. The main factor at the origin of these deformations is the intraocular pressure (IOP), the effect of which varies according to the biomechanical properties of the individual lamina cribrosa (LC). In this environment, the LC represents a malleable zone of weakness within a rigid corneoscleral shell. It is a dynamic structure whose movements play a key role in the pathogenesis of glaucoma: displacing it posteriorly, in addition to contributing to the characteristic appearance of glaucomatous cupping, would increase constriction on the nerve fibers and the laminar capillaries. Often incorrectly considered permanent in adults, these deformations have a certain degree of reversibility, which is currently better characterized thanks to progress in imaging techniques. The occurrence of anterior displacement and laminar thickening following a reduction in IOP could thus constitute a good prognostic factor by reducing mechanical stress on this region. These changes would tend to reduce laminar pore tortuosity and shear forces, which are probably key mechanisms of axonal loss in glaucoma.

[Treatment of respiratory and ORL diseases with mineral waters in children]. / Crénothérapie des affections respiratoires et ORL de l'enfant.

Many questions arise when a paediatrician prescribes thermal treatment. Answers to these questions have come to light in recent literature. For paediatric indications, thermal treatment is dominated by asthma and its allergic equivalents. In such cases, sodium chloride and bicarbonated spas are used. Such indications are based on the research of the Pasteur Institute for Le Mont-Dore spa and on different modifications of intracelllular enzymes and increase of resistance to hypoxy incited by the La Bourboule spa. The waters in the spas of the Pyrenees contain sulphur, and are mainly used for the treatment of chronic or repeated ENT infections. Fundamental studies in favour of thermal treatment have only aroused indirect views. Following the enquiry made by the French National Health Service on 3,000 patients over a period of 3 years from 1983, it was found that this treatment reduces medical consumption, doctor's visits and hospital care in many cases. However no double-blind research could be performed despite the desire of several spas. These spas improve either the quality of the final product or the strict hygiene level in the thermal installations, and also the sanitary educational measures associated with thermal treatment.

Flexible bronchoscopy in infants and children.

The authors describe the use of flexible bronchoscope in infants and children ranging in age from 20 hours to 17 years and in weight from 1.5 kg upwards. Bronchoscopy was carried out under local (17 cases) and general anesthesia (95 cases). Seventeen-six of the 95 examinations under general anesthesia were conducted using the jet-ventilation technique. The advantages and drawbacks of this technique are discussed. The authors list the indications which they regard as favoring the flexible tube rather than the rigid one, and emphasize the complementary nature of these 2 techniques in pediatrics.