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152. Recommandations pratiques pour le diagnostic et la prise en charge de la fibrose pulmonaire idiopathique – Actualisation 2017. Version longue

Author

Cottin, Vincent, Crestani, B., Cadranel, J., Cordier, J.F., Marchand Adam, S., Prevot, Ghislaine, Wallaert, B., Bergot, E., Camus, P., Dalphin, J-C, Dromer, C., Gomez, E., Israel-Biet, D., Jouneau, Stéphane, Kessler, R., Marquette, C.-H., Reynaud-Gaubert, M., Aguilaniu, B., Bonnett, D., Carré, P., Danel, C., Faivre, J.-B., Ferretti, G., Just, N., Lebargy, F., Philippe, B., Terrioux, P., Thivolet-Bejui, F., Trumbic, B., Valeyre, D., Service de Pneumologie, Centre de Référence National des Maladies Pulmonaires Rares, Hospices Civils de Lyon (HCL), Centre de compétences pour les maladies pulmonaires rares, Laboratoire Chrono-environnement (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Abstract

National audience; La fibrose pulmonaire idiopathique (FPI) est la forme la plus fréquente de pneumopathie interstitielle diffuse (PID) idiopathique chronique chez l’adulte. Il s’agit d’une maladie fibroproliférative, irréversible, de cause inconnue, dont l’évolution est habituellement progressive, survenant principalement à partir de 60 ans et limitée aux poumons. Qualifiée de maladie orpheline notamment en raison de l’absence de traitement ayant fait la preuve formelle de son efficacité jusqu’à une période très récente, la FPI est une maladie rare dont la prévalence a été évaluée aux États-Unis entre 14 et 28/100 000 personnes [1], ce qui correspondrait à un minimum de 9000 patients en France et une incidence entre 6,8 et 9/100 000 par an [1,2], soit un minimum de 4400 nouveaux patients par an en France.

Published
2017

153. Facteurs déclenchant des exacerbations de BPCO

Author

Jouneau, Stéphane, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), L’actualisation des recommandations sur la BPCO est financée par la SPLF, promoteur de l’opération, sur ses fonds propres., Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
bactérie, inconnue, pollution, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, virus, infection
Abstract

National audience; Il existe différents facteurs déclenchant des exacerbations aiguës de BPCO (EA BPCO), principalement les infections, virales et bactériennes, mais sont également incriminés la pollution, l’arrêt des traitements de fond ou un terrain génétique spécifique...

Published
2017

154. Use of the COPD Assessment Test (CAT) to screen for COPD in dairy farmers: AIRBAg study.

Author

Jan, Simon, Metten, Marie‐Astrid, Chapron, Anthony, Marette, Solenne, Robert, Ange‐Marie, Guillot, Stéphanie, Mailloux, Carole, Jouneau, Stéphane, and Viel, Jean‐François

Subjects
OBSTRUCTIVE lung diseases, DAIRY farmers, SOCIODEMOGRAPHIC factors, CATS, SYMPTOMS
Abstract

Objectives: People at risk of chronic obstructive pulmonary disease (COPD) can benefit from appropriate medical management before severe symptoms appear. This study assesses the value of the COPD Assessment Test (CAT) questionnaire for screening dairy farmers, who tend to be slow or reluctant to seek health care. Methods: During the time period 2012‐2017, 2089 randomly selected dairy farmers in Brittany (France) were invited to complete self‐administered questionnaires (including the CAT) and to undergo an occupational health check‐up using an electronic mini‐spirometer and conventional spirometry. Those showing symptoms suggestive of COPD and/or a ratio FEV1/FEV6 < 80% were sent to a pulmonologist for a further check‐up, including spirometry with a reversibility test. Multivariate logistic models based on CAT scores and socio‐demographic or work‐related factors were developed to predict COPD. Results: The 1231 farmers who underwent the occupational health check‐up included 1203 who met the inclusion/exclusion criteria. Pulmonologist identified 16 (1.3%) cases of COPD. A multivariate logistic regression model (covariates: CAT sum score, on‐farm time, BMI, smoking status, free‐stall mulching) provided an area under the receiver‐operating characteristic curve (AUC) of 0.87 (95% CI: 0.75‐0.98). Using a cut‐off of 0.007 gave a sensitivity of 93.8% and a specificity of 62.4%. Another model that included CAT breathlessness and the same covariates performed marginally better (AUC = 0.88, 95% CI: 0.77‐0.98). Conclusion: Our predictive models can both benefit dairy farmers by providing early diagnosis and management of their COPD and avoid unnecessary, costly spirometry during the screening process. [ABSTRACT FROM AUTHOR]

Published
2020
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155. Non-influenza respiratory viruses in adult patients admitted with influenza-like illness: a 3-year prospective multicenter study.

Author

Bénézit, François, Loubet, Paul, Galtier, Florence, Pronier, Charlotte, Lenzi, Nezha, Lesieur, Zineb, Jouneau, Stéphane, Lagathu, Gisèle, L'Honneur, Anne-Sophie, Foulongne, Vincent, Vallejo, Christine, Alain, Sophie, Duval, Xavier, Houhou, Nawal, Costa, Yolande, Vanhems, Philippe, Amour, Sélilah, Carrat, Fabrice, Lina, Bruno, and Launay, Odile

Subjects
AGE distribution, CONFIDENCE intervals, DIABETES, INFLUENZA, LONGITUDINAL method, MEDICAL cooperation, SCIENTIFIC observation, POLYMERASE chain reaction, RESEARCH, RESPIRATORY infections, VIRUSES, DESCRIPTIVE statistics, HOSPITAL mortality, ODDS ratio
Abstract

Purpose: To describe the burden, and characteristics, of influenza-like illness (ILI) associated with non-influenza respiratory viruses (NIRV). Methods: We performed a prospective, multicenter, observational study of adults admitted with ILI during three influenza seasons (2012–2015). Patients were screened for picornavirus, respiratory syncytial virus (RSV), coronavirus, human metapneumovirus, adenovirus, bocavirus, parainfluenza virus, and influenza, by PCR on nasopharyngeal samples. We excluded patients coinfected with NIRV and influenza. Results: Among 1421 patients enrolled, influenza virus was detected in 535 (38%), and NIRV in 215 (15%), mostly picornavirus (n = 61), RSV (n = 53), coronavirus 229E (n = 48), and human metapneumovirus (n = 40). In-hospital mortality was 5% (NIRV), 4% (influenza), and 5% (no respiratory virus). As compared to influenza, NIRV were associated with age (median, 73 years vs. 68, P = 0.026), chronic respiratory diseases (53% vs. 45%, P = 0.034), cancer (14% vs. 9%, P = 0.029), and immunosuppressive drugs (21% vs. 14%, P = 0.028), and inversely associated with diabetes (18% vs. 25%, P = 0.038). On multivariable analysis, only chronic respiratory diseases (OR 1.5 [1.1–2.0], P = 0.008), and diabetes (OR 0.5 [0.4–0.8], P = 0.01) were associated with NIRV detection. Conclusions: NIRV are common in adults admitted with ILI during influenza seasons. Outcomes are similar in patients with NIRV, influenza, or no respiratory virus. [ABSTRACT FROM AUTHOR]

Published
2020
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156. Effect of Early Initiation of Varenicline on Smoking Cessation in COPD Patients Admitted for Exacerbation: The Save Randomized Clinical Trial.

Author

Le Mao, Raphael, Tromeur, Cécile, Paleiron, Nicolas, Sanchez, Olivier, Gagnadoux, Frédéric, Jouneau, Stéphane, Magnan, Antoine, Hayem-Vannimenus, Corinne, Dansou, Anne, Proust, Alain, Dion, Angelina, Larhantec, Gaelle, Brestec, Anne Le, Dewitte, Jean-Dominique, Roche, Nicolas, Leroyer, Christophe, and Couturaud, Francis

Subjects
NICOTINE replacement therapy, SMOKING cessation, VARENICLINE, CLINICAL trial registries, OBSTRUCTIVE lung diseases, CLINICAL trials
Abstract

Our main objective was to demonstrate that, in smoker patients hospitalised for Chronic Obstructive Pulmonary Disease (COPD) exacerbation, early initiation of varenicline during 12 weeks, combined with an intensive counselling, is associated with a higher continuous abstainers rate (CAR) at one year as compared to intensive counselling alone. In this multicenter, prospective, double-blind, randomised study, 81 smoking COPD patients hospitalised for an acute exacerbation for at least 24 h were allocated to receive either varenicline (n = 42) or placebo (n = 39) for 12 weeks, in association with an intensive counselling in the 2 groups, and followed up for 40 weeks. The primary outcome was CAR at week 52. Secondary outcomes included CAR at week 12 and 26, partial abstinence rate (PAR) at week 12, 26 and 52, nicotinic substitute consumption and adverse events. At week 52, CAR was not different in placebo and varenicline groups (25.6%). At week 12, CAR was significantly higher in the varenicline group (50%) as compared to placebo group (27%) (p = 0.041). Nicotine consumption was significantly higher at week 52 in the placebo group (55.3%) as compared to the varenicline group (24.4%) (p = 0.005). There was no significant difference in PAR at week 12, 26 and 52; the frequency of adverse events was similar between the two groups. Among active smoker COPD patients with exacerbation, 12-week varenicline associated with intensive counselling for smoking cessation increased the rate of continuous abstainers as compared to placebo. However, benefit was not maintained after varenicline discontinuation. Clinical Trials Registration: URL: . Unique identifier: NCT01694732 [ABSTRACT FROM AUTHOR]

Published
2020
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162. Impaired efferocytosis and neutrophil extracellular trap clearance by macrophages in ARDS

Author

Grégoire, Murielle, primary, Uhel, Fabrice, additional, Lesouhaitier, Mathieu, additional, Gacouin, Arnaud, additional, Guirriec, Marion, additional, Mourcin, Frederic, additional, Dumontet, Erwan, additional, Chalin, Arnaud, additional, Samson, Michel, additional, Berthelot, Laure-Line, additional, Tissot, Adrien, additional, Kerjouan, Mallorie, additional, Jouneau, Stéphane, additional, Le Tulzo, Yves, additional, Tarte, Karin, additional, Zmijewski, Jaroslaw W., additional, and Tadié, Jean-Marc, additional

Published
2018
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166. Distinct Properties of Human M-CSF and GM-CSF Monocyte-Derived Macrophages to Simulate Pathological Lung Conditions In Vitro: Application to Systemic and Inflammatory Disorders with Pulmonary Involvement

Author

Lescoat, Alain, primary, Ballerie, Alice, additional, Augagneur, Yu, additional, Morzadec, Claudie, additional, Vernhet, Laurent, additional, Fardel, Olivier, additional, Jégo, Patrick, additional, Jouneau, Stéphane, additional, and Lecureur, Valérie, additional

Published
2018
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167. Case-Finding for Persistent Airway Obstruction in Farmers: A Questionnaire With Optimal Diagnosis Criteria

Author

Guillien, Alicia, primary, Soumagne, Thibaud E., additional, Puyraveau, Marc, additional, Berger, Patrick, additional, Guillot, Stéphanie L., additional, Rannou, Fabrice, additional, Jouneau, Stéphane, additional, Mauny, Frédéric J., additional, Laplante, Jean-Jacques, additional, Dalphin, Jean-Charles, additional, and Degano, Bruno, additional

Published
2017
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168. Management of acute exacerbations of chronic obstructive pulmonary disease (COPD). Guidelines from the Société de pneumologie de langue française (summary).

Author

UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de pneumologie, Jouneau, Stéphane, Dres, Martin, Guerder, Antoine, Bélé, Nicolas, Bellocq, Agnès, Bernady, Alain, Berne, Gabriel, Bourdin, Arnaud, Brinchault, Graziella, Burgel, Pierre Régis, Carlier, N, Chabot, François, Chavaillon, Jean-Michel, Cittee, Jacques, Claessens, Yann Erick, Delclaux, Bertrand, Deslée, Gaëtan, Ferré, Alexis, Gacouin, Arnaud, Girault, Christophe, Ghasarossian, Christian, Gouilly, Pascal, Gut-Gobert, Christophe, Gonzalez-Bermejo, Jésus, Jebrak, Gilles, Le Guillou, Frédéric, Léveiller, G, Lorenzo, Alain, Mal, Hervé, Molinari, Nicolas, Morel, Hugues, Morel, Vincent, Noel, Frédérique, Pégliasco, Hervé, Perotin, Jeanne-Marie, Piquet, Jacques, Pontier, Sandrine, Rabbat, Antoine, Revest, Matthieu, Reychler, Gregory, Stelianides, Sandrine, Surpas, Pascale, Tattevin, Pierre, Roche, Nicolas, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de pneumologie, Jouneau, Stéphane, Dres, Martin, Guerder, Antoine, Bélé, Nicolas, Bellocq, Agnès, Bernady, Alain, Berne, Gabriel, Bourdin, Arnaud, Brinchault, Graziella, Burgel, Pierre Régis, Carlier, N, Chabot, François, Chavaillon, Jean-Michel, Cittee, Jacques, Claessens, Yann Erick, Delclaux, Bertrand, Deslée, Gaëtan, Ferré, Alexis, Gacouin, Arnaud, Girault, Christophe, Ghasarossian, Christian, Gouilly, Pascal, Gut-Gobert, Christophe, Gonzalez-Bermejo, Jésus, Jebrak, Gilles, Le Guillou, Frédéric, Léveiller, G, Lorenzo, Alain, Mal, Hervé, Molinari, Nicolas, Morel, Hugues, Morel, Vincent, Noel, Frédérique, Pégliasco, Hervé, Perotin, Jeanne-Marie, Piquet, Jacques, Pontier, Sandrine, Rabbat, Antoine, Revest, Matthieu, Reychler, Gregory, Stelianides, Sandrine, Surpas, Pascale, Tattevin, Pierre, and Roche, Nicolas

Abstract

Chronic obstructive pulmonary disease (COPD) is the chronic respiratory disease with the most important burden on public health in terms of morbidity, mortality and health costs. For patients, COPD is a major source of disability because of dyspnea, restriction in daily activities, exacerbation, risk of chronic respiratory failure and extra-respiratory systemic organ disorders. The previous French Language Respiratory Society (SPLF) guidelines on COPD exacerbations were published in 2003. Using the GRADE methodology, the present document reviews the current knowledge on COPD exacerbation through 4 specific outlines: (1) epidemiology, (2) clinical evaluation, (3) therapeutic management and (4) prevention. Specific aspects of outpatients and inpatients care are discussed, especially regarding assessment of exacerbation severity and pharmacological approach., [Prise en charge des exacerbations de la bronchopneumopathie chronique obstructive (BPCO). Recommandations de la Société de pneumologie de langue française (texte court)] La bronchopneumopathie chronique obstructive (BPCO) est la maladie respiratoire chronique dont le poids sur la santé publique est le plus grand par sa morbidité, sa mortalité et les dépenses de santé qu’elle induit. Pour les individus atteints, la BPCO est une source majeure de handicap du fait de la dyspnée, de la limitation d’activité, des exacerbations, du risque d’insuffisance respiratoire chronique et des manifestations extra-respiratoires qu’elle entraîne. Les précédentes recommandations de la Société de pneumologie de langue française (SPLF) sur la prise en charge des exacerbations BPCO date de 2003. Se fondant sur une méthodologie adaptée de GRADE, le présent document propose une actualisation de la question des exacerbations de BPCO en développant un argumentaire couvrant quatre champs d’investigation : (1) épidémiologie, (2) évaluation clinique, (3) prise en charge thérapeutique et (4) prévention. Les modalités spécifiques de la prise en charge hospitalière et ambulatoire y sont discutées, particulièrement les aspects relevant de l’évaluation de la sévérité de l’exacerbation et de la prise en charge pharmacologique.

Published
2017

169. Prevalence and risk factors for COPD in farmers: a cross-sectional controlled study

Author

Guillien , Alicia, Puyraveau , Marc, Soumagne , Thibaud, Guillot , Stéphanie, Rannou , Fabrice, Marquette , David, Berger , Patrick, Jouneau , Stéphane, Monnet , Elisabeth, Mauny , Frédéric, Laplante , Jean-Jacques, Dalphin , Jean-Charles, Degano , Bruno, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Physiopathologie de la réactivite bronchique et vasculaire, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Mutualité sociale agricole de Franche-Comté, Mutualité sociale agricole, Université de Franche-Comté ( UFC ), Physiopathologie cardiovasculaire et prévention, and Département de physiologie

Subjects
[ SDV ] Life Sciences [q-bio], food and beverages, respiratory tract diseases
Abstract

International audience; There are conflicting data regarding the magnitude and determinants of chronic obstructive pulmonary disease (COPD) risk in farmers.In a cross-sectional study of 917 nonfarming working controls and 3787 farmers aged 40-75 years, we assessed respiratory symptoms, tobacco exposure, job history (without direct exposure measurement) and lung function. COPD was defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criterion (post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)\textless0.70) and by the Quanjer reference equation (post-bronchodilator FEV1/FVC\textlesslower limit of normal (LLN)).The prevalence (95% CI) of COPD according to the GOLD criterion was 5.1% (4.4-5.8%) and 2.9% (1.8-4.0%) in farmers and controls, respectively (p=0.005), and 3.1% (2.5-3.6%) and 1.5% (0.7-2.3%), respectively, for the LLN criterion (p\textless0.01). For both COPD criteria after adjustment for age, sex and smoking status, COPD prevalence was similar in controls and crop farmers. Compared to controls, four job categories had a higher prevalence of COPD according to the GOLD criterion, namely, cattle breeders, swine breeders, poultry breeders and breeders of two or more livestock types. Among cattle breeders, only those from Franche-Comté had higher prevalence of COPD according to both GOLD and LLN criteria.The prevalence of COPD in farmers is higher than in nonfarming working controls, and depends on the farming activity, the region and the criterion used to define COPD

Published
2016

172. Soluble CD14 acts as a DAMP in human macrophages: origin and involvement in inflammatory cytokine/chemokine production

Author

Lévêque, Manuella, primary, Jeune, Karin Simonin-Le, additional, Jouneau, Stéphane, additional, Moulis, Solenn, additional, Desrues, Benoit, additional, Belleguic, Chantal, additional, Brinchault, Graziella, additional, Le Trionnaire, Sophie, additional, Gangneux, Jean-Pierre, additional, Dimanche-Boitrel, Marie-Thérèse, additional, and Martin-Chouly, Corinne, additional

Published
2017
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173. Prise en charge des exacerbations : de la ville à l’hôpital [Management of COPD exacerbations: from primary care to hospitalization]

Author

Jouneau , Stéphane, Brinchault , Graziella, Desrues , Benoît, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Service de pneumologie, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -CHU Pontchaillou [Rennes], Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), and Lecoupe-Grainville, Marie

Subjects
[SDV] Life Sciences [q-bio], [ SDV ] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS, respiratory tract diseases
Abstract

International audience; The Société de pneumologie de langue française defines acute exacerbation of chronic obstructive pulmonary disease (AE COPD) as an increase in daily respiratory symptoms, basically duration ≥ 48h or need for treatment adjustment. Etiology of EA COPD are mainly infectious, viral (rhinovirus, influenzae or parainfluenzae virus, coronavirus, adenovirus and respiratory syncytial virus) or bacterial (Haemophilus influenzae, Streptococcus pneumoniae, or Moraxella catarrhalis). Pollutant exposure can also lead to AE COPD, such as NO2, SO2, ozone or particulates (PM10 and PM2.5). In 30% the etiology remains unknown. Differential diagnoses of AE COPD include infectious pneumonia, pneumothorax, acute heart failure and pulmonary embolism. Presences of signs of severity impose hospitalization: signs of respiratory distress, shock, acute confusion but also fragile patients, insufficient home support or absence of response to initial treatment. AE COPD treatments consist on increase in bronchodilators, chest physiotherapy, and antibiotics if sputum is frankly purulent. Systemic corticosteroids should not be systematic.Recommended dose is 0.5 mg/kg on short course (7 days). During hospitalization, oxygen supplementation and thromboprophylaxis could be prescribed. The main interest in noninvasive ventilation is persistent hypercapnia despite optimal medical management. During ambulatory management or hospitalization, clinical assessment at 48-72h is mandatory. L’exacerbation aiguë de bronchopneumopathie chronique obstructive (EA BPCO) représente un événement important dans l’histoire naturelle de la BPCO, notamment en cas d’hospitalisation. Les EA BPCO interviennent dans la gravité et l’évolution de la BPCO ; et leur prévention est un des objectifs principal des traitements de fond.; La Société de pneumologie de langue française définie l’exacerbation aiguë de bronchopneumopathie chronique obstructive (EA BPCO) comme une majoration des symptômes respiratoires au-delà des variations quotidiennes, en pratique, d’une durée ≥ 48h ou justifiant une modification thérapeutique. L’étiologie de ces EA BPCO est principalement infectieuse, virale (rhinovirus, virus influenzae et parainfluenzae, coronavirus, adénovirus et virus respiratoire syncytial) ou bactérienne (principalement Haemophilus influenzae, Streptococcus pneumoniae et Moraxella catarrhalis). Elles peuvent également résulter de l’exposition à certains polluants comme le NO2, le SO2, l’ozone et la pollution particulaire (PM10 et PM2,5). L’étiologie reste indéterminée dans près de 30 % des cas. Les diagnostics différentiels des EA BPCO incluent les pneumopathies infectieuses, les pneumothorax, les poussées d’insuffisance cardiaque et les embolies pulmonaires. La présence de signes de gravité conditionnent l’hospitalisation : signes d’insuffisance respiratoire aiguë, de choc ou de défaillance neurologique, mais aussi en cas de patient fragile, d’absence de soutien familial à domicile ou d’absence de réponse au traitement initial. Le traitement d’une EA BPCO consiste en une majoration des bronchodilatateurs, une kinésithérapie respiratoire, une antibiothérapie en cas d’expectoration franchement purulente.La prescription de corticoïdes systémiques ne doit pas être systématique. La dose recommandée est de 0,5 mg/kg sur une courte période (7 jours). Lors d’une hospitalisation, une oxygénothérapie et une thromboprophylaxie peuvent être prescrite. La ventilation noninvasiveest principalement indiquée en cas de persistance d’une hypercapnie malgré un traitement médical optimal. Que le patient soit pris en charge en ambulatoire ou en hospitalisation, une réévaluation clinique à 48-72h est indispensable.

Published
2015

174. Les manifestations pulmonaires du syndrome des antisynthétases

Author

Jouneau, Stéphane, Hervier, Baptiste, Jutant, Etienne-Marie, Decaux, Olivier, Kambouchner, Marianne, Humbert, Marc, Delaval, Philippe, Montani, David, Cadieu, Muriel, Service de pneumologie, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de Département de médecine interne et immunologie clinique [CHU Pitié-Salpêtrière] (DMIIC), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie, Hôpital Bicêtre, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d’anatomie pathologique, Hôpital Avicenne [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)

Subjects
Anti-Jo1, Myositis, Pneumopathie infiltrante diffuse, Pneumopathie interstitielle, Hypertension pulmonaire, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Infiltrative lung disease, Inflammatory myopathy, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, ComputingMilieux_MISCELLANEOUS, Myopathie inflammatoire, Pulmonary hypertension, Myosite
Abstract

National audience

Published
2015

175. Efferocytosis capacities of blood monocyte‐derived macrophages in systemic sclerosis.

Author

Ballerie, Alice, Lescoat, Alain, Augagneur, Yu, Lelong, Marie, Morzadec, Claudie, Cazalets, Claire, Jouneau, Stéphane, Fardel, Olivier, Vernhet, Laurent, Jégo, Patrick, and Lecureur, Valérie

Subjects
MONOCYTES, MACROPHAGES, SYSTEMIC scleroderma, SCAVENGER receptors (Biochemistry), INTEGRINS
Abstract

A defect in the apoptotic cell clearance (efferocytosis) by phagocytic cells may participate in autoimmunity and chronic inflammation. The mechanisms leading to the emergence of autoimmunity in systemic sclerosis (SSc) are still to be determined. In this study, the efferocytosis capacities of blood monocyte‐derived macrophages (MDM) from patients with SSc were evaluated. Blood monocytes obtained from patients with SSc and healthy donors (HD) were differentiated in vitro into macrophages. The capacities of MDM to engulf CFSE+ apoptotic Jurkat human T lymphocytes were compared between SSc MDM and HD using flow cytometry. The expression of classical engulfing receptors in SSc MDM and HD MDM was also evaluated and their involvement in the modulation of efferocytosis was confirmed using a siRNA approach. The mean phagocytic index (PI) reflecting efferocytosis capacities of SSc MDM (PI = 19.3 ± 3.0; n = 21) was significantly decreased in comparison with the PI of HD MDM (PI = 35.9 ± 3.0; n = 31; P < 0.001). In comparison with HD, SSc MDM exhibited a downregulated expression of scavenger receptor (SR)‐B1, SR‐A1 and integrin β5 (ITGβ5). In HD MDM, the extinction of these receptors was followed by a reduction of efferocytosis only for the repression of ITGβ5, suggesting a possible selective role of this integrin in the impaired efferocytosis observed in SSc. As efferocytosis may be at the crossroads of inflammation, autoimmunity and fibrosis, in showing impaired efferocytosis capacities of blood MDM in SSc, our study offers new pathogenesis considerations for the involvement of macrophages in the autoimmune processes driving this disorder. Efferocytosis capacities are strongly decreased in monocyte‐derived macrophages from systemic sclerosis (SSc) patients. A downexpression of integrin β5 in proinflammatory and in SSc macrophages may explain a deficient efferocytosis. Impaired efferocytosis of macrophages may play a key role in autoimmune processes in SSc. [ABSTRACT FROM AUTHOR]

Published
2019
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176. Macrolides au long cours et pathologie bronchique chronique de l'adulte: intérêts et limites [Long-term macrolide treatment in adult chronic bronchial diseases: benefits and limits]

Author

Jouneau, Stéphane, Desrues, Benoît, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
MESH: Bronchiectasis, MESH: Humans, MESH: Asthma, MESH: Chronic Disease, MESH: Time Factors, AZITHROMYCIN, PSEUDOMONAS-AERUGINOSA, CYSTIC FIBROSIS BRONCHIECTASIS, MESH: Adult, MESH: Pulmonary Disease, Chronic Obstructive, MYCOPLASMA-PNEUMONIAE, RANDOMIZED CONTROLLED-TRIAL, PLACEBO-CONTROLLED TRIAL, PREVENTION, CHLAMYDIA-PNEUMONIAE, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, DOUBLE-BLIND, COPD EXACERBATIONS, MESH: Macrolides
Abstract

National audience; Decreased frequency of pulmonary exacerbations, mainly related to immunomodulatory effects of macrolide antibiotics, has been demonstrated in bronchiectasis and chronic obstructive pulmonary diseases (COPD). Due to its tolerance, azithromycin is the antibiotic of choice for maintenance therapy at the dose of 250 mg per day or 500 mg × 3 per week (for body weight >55 kg). Maintenance therapy with macrolide could be proposed in selected patients with bronchiectasis or COPD with more than 3 acute exacerbations in the previous year or decreased lung function despite compliance with optimum treatment. The risk of sudden cardiac death with azithromycin is rare and controversial. It should be avoided in patients with a high baseline risk of cardiovascular disease, QT>450 msec, pulse rate>100 bpm and potential drug interactions, particularly those known to cause QT prolongation. It is recommended to search for hearing deficit (audiometry) and sputum culture positive for mycobacteria. Patients must also be aware that it can rapidly lead to macrolide resistance in commensal or pathogenic flora. Follow-up evaluation every 3 month can be proposed with medical history (hearing deficit) and electrocardiography. After one year, the treatment should be stopped in the absence of reduction in the frequency of exacerbations.; Points essentielsLes macrolides administrés au long cours permettent, grâce en partie à leurs propriétés anti-inflammatoires, de diminuer la fréquence des exacerbations dans la DDB et la BPCO.Du fait de sa tolérance, l’azithromycine est le macrolide de choix, pouvant être utilisé à la dose de 250 mg/j ou 500 mg 3 fois par semaine chez les patients de plus de 55 kg.Un traitement par macrolides au long cours pourrait être proposé à des patients atteints de DDB ou de BPCO ayant eu plus de 3 exacerbations l’année précédente ou ayant une dégradation de leur fonction respiratoire malgré un traitement de fond bien conduit.Du fait d’un risque rare et controversé de mort subite d’origine cardiaque, il ne doit pas être proposé en cas de pathologie cardiovasculaire évoluée, d’intervalle QT > 450 ms, de traitement pouvant allonger l’intervalle QT, de tachycardie > 100/min.Il est recommandé de s’assurer de l’absence de troubles auditifs (audiogramme) et de mycobactérie atypique dans les cultures des expectorations. Les patients doivent aussi être informés du risque d’apparition de résistance aux macrolides de la flore commensale et pathogène.Une surveillance clinique, avec en particulier la recherche de troubles auditifs et électrocardiographique, peut être proposée tous les 3 mois. L’absence de diminution de la fréquence des exacerbations, lors du bilan annuel, justifie l’arrêt du traitement.

Published
2014

177. The aryl hydrocarbon receptor is functionally upregulated early in the course of human T-cell activation

Author

Prigent, Laurie, Robineau, Marc, Jouneau, Stéphane, Morzadec, Claudie, Louarn, Laetitia, Vernhet, Laurent, Fardel, Olivier, Sparfel, Lydie, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Contaminants Chimiques, immunité et Inflammation, Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes 1 (UR1), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Cell Nucleus, Interleukins, T-Lymphocytes, [SDV]Life Sciences [q-bio], Messenger, Active Transport, Cell Nucleus, respiratory system, Lymphocyte Activation, Active Transport, respiratory tract diseases, Up-Regulation, Receptors, Aryl Hydrocarbon, Aryl Hydrocarbon, Protein Biosynthesis, Gene Knockdown Techniques, Cytochrome P-450 CYP1B1, Receptors, Cytochrome P-450 CYP1A1, Humans, RNA, RNA, Messenger, Aryl Hydrocarbon Hydroxylases
Abstract

International audience; The aryl hydrocarbon receptor (AhR) is a ligand-dependent transcription factor that mediates immunosuppression caused by a variety of environmental contaminants, such as polycyclic aromatic hydrocarbons or dioxins. Recent evidence suggests that AhR plays an important role in T-cell-mediated immune responses by affecting the polarization and differentiation of activated T cells. However, the regulation of AhR expression in activated T cells remains poorly characterized. In the present study, we used purified human T cells stimulated with anti-CD3 and anti-CD28 Abs to investigate the effect of T-cell activation on AhR mRNA and protein expression. The expression of AhR mRNA increased significantly and rapidly after T-cell activation, identifying AhR as an immediate-early activation gene. AhR upregulation occurred in all of the T-cell subtypes, and is associated with its nuclear translocation and induction of the cytochromes P-450 1A1 and 1B1 mRNA expression in the absence of exogenous signals. In addition, the use of an AhR antagonist or siRNA-mediated AhR knockdown significantly inhibited IL-22 expression, suggesting that expression and functional activation of AhR is necessary for the secretion of IL-22 by activated T cells. In conclusion, our data support the idea that AhR is a major player in T-cell physiology.

Published
2014

178. La protéinose alvéolaire pulmonaire

Author

Jouneau, Stéphane, Kerjouan, Mallorie, Briens, Eric, Lenormand, Jean-Paul, Meunier, Catherine, Letheulle, Julien, Chiforeanu, Dan, Lainé-Caroff, Catherine, Desrues, Benoît, Delaval, Philippe, Cadieu, Muriel, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Service de pneumologie, Hôpital Yves-Le-Foll, Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Service d’imagerie thoracique, Hôpital Pontchaillou, Service de réanimation médicale, Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], and Service d’immunologie, de thérapie cellulaire et d’hématopoïèse

Subjects
Granulocyte-macrophage colony-stimulating factor, Protéinose alvéolaire pulmonaire, Grand lavage pulmonaire, Surfactant, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Whole lung lavage, Pulmonary alveolar proteinosis, Rituximab, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, ComputingMilieux_MISCELLANEOUS
Abstract

National audience

Published
2014

180. Factors associated with poor outcomes among adults hospitalized for influenza in France: A three-year prospective multicenter study

Author

Loubet, Paul, primary, Samih-Lenzi, Nezha, additional, Galtier, Florence, additional, Vanhems, Philippe, additional, Loulergue, Pierre, additional, Duval, Xavier, additional, Jouneau, Stéphane, additional, Postil, Déborah, additional, Rogez, Sylvie, additional, Valette, Martine, additional, Merle, Corinne, additional, Régis, Corinne, additional, Costa, Yolande, additional, Lesieur, Zineb, additional, Tattevin, Pierre, additional, Lina, Bruno, additional, Carrat, Fabrice, additional, and Launay, Odile, additional

Published
2016
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185. Extrathoracic investigation in adult patients with isolated pulmonary langerhans cell histiocytosis

Author

Tazi, Abdellatif, primary, de Margerie-Mellon, Constance, additional, Vercellino, Laetitia, additional, Naccache, Jean Marc, additional, Fry, Stéphanie, additional, Dominique, Stéphane, additional, Jouneau, Stéphane, additional, Lorillon, Gwenaël, additional, Bugnet, Emmanuelle, additional, Chiron, Raphael, additional, Wallaert, Benoit, additional, Valeyre, Dominique, additional, and Chevret, Sylvie, additional

Published
2016
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186. Opportunistic PulmonaryBordetella hinziiInfection after Avian Exposure

Author

Fabre, Aude, primary, Dupin, Clarisse, additional, Bénézit, François, additional, Goret, Julien, additional, Piau, Caroline, additional, Jouneau, Stéphane, additional, Guillot, Sophie, additional, Mégraud, Francis, additional, Kayal, Samer, additional, Desrues, Benoit, additional, Le Coustumier, Alain, additional, and Guiso, Nicole, additional

Published
2015
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187. Pneumopathie induite par l'hydroxyurée. [Hydroxyurea-induced pneumonia]

Author

Girard, Anne, Ricordel, Caroline, Poullot, Elsa, Claeyssen, Valérie, Decaux, Olivier, Desrues, Benoît, Delaval, Philippe, Jouneau, Stéphane, Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Service d'hématologie clinique, Université de Rennes (UR)-Hôpital Pontchaillou, Service des urgences [Rennes] = Emergency [Rennes], Service de Médecine interne et immunologie clinique [Rennes] = internal medicine and clinical immunology [Rennes], Contaminants Chimiques, immunité et Inflammation, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou, Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Fièvre, Pneumopathie médicamenteuse, hemic and lymphatic diseases, Pneumopathie interstitielle, Hydroxyurée, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Abstract

International audience; Introduction: Hydroxyurea is an antimetabolite widely used in the treatment of myeloproliferative diseases. Usual side effects are mainly hematological, gastrointestinal, neurological disorders and induced-fevers. More rarely, hydroxyurea-induced pneumonitis are reported. Case report: We report a case of a patient treated for polycythemia vera. She was admitted 20 days after introduction of hydroxyurea for a high fever, productive cough and clear sputum associated with nausea. Chest CT-scan found diffuse bilateral ground-glass opacities. The microbiological investigations were negative. Symptoms disappeared few days after discontinuation of treatment. Its reintroduction led to recurrence of symptoms. Conclusion: This additional case completes the 15 cases of hydroxyurea-induced pneumonitis described in the literature. Two forms of this disease seem to exist: an acute form with fever occurring in the month following introduction of hydroxyurea; and a chronic form without fever. Even if it is uncommon, pulmonologists should be aware of this complication.

Published
2013

188. Une cause rare de maladie kystique pulmonaire : maladie à dépôts de chaînes légères d'immunoglobuline. [An unusual cause of cystic lung disease: Light chain deposition disease]

Author

Luraine, Régis, Sohier, Laurent, Kerjouan, Mallorie, Desrues, Benoit, Delaval, Philippe, Jouneau, Stéphane, Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Service de pneumologie [Lorient], Groupe Hospitalier Bretagne Sud (GHBS), Contaminants Chimiques, immunité et Inflammation, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Le Corre, Morgane, and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Pneumopathie infiltrante diffuse, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Non amyloïde, Immunoglobulines Kappa, respiratory system, Maladie à dépôts de chaînes légères, Kystes pulmonaires, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, respiratory tract diseases
Abstract

International audience; INTRODUCTION: Light chain deposition disease is a rare clinical entity characterized by deposition of monoclonal immunoglobulin light chains in organs. The kidneys are almost always affected, while the lung manifestations that have been reported, including nodular or diffuse disease, especially cystic lesions, are unusual. CASE REPORT: We report the case of a 60-year-old man with a diffuse infiltrative lung disease characterized by numerous apical cysts. The diagnosis of light chain deposition cystic lung disease was obtained by surgical lung biopsy. Light chain deposits in the salivary glands were the only extrapulmonary manifestation. Despite 12 chemotherapy cycles, the patient's lung function and radiological appearances worsened. CONCLUSION: This is the fourth case describing a cystic lung disease due to light chain deposition in the literature. It highlights the need for comprehensive investigations so as not to miss this rare cause of cystic lung disease, which appears to be related to a primary pulmonary lymphoproliferative disorder. The only treatment that appears to be effective is lung transplantation.

Published
2013

189. Outcome of anti-PL12 positive patients with antisynthetase syndrome.[Profil évolutif du syndrome des antisynthétases avec anticorps anti-PL12]

Author

Marie, Isabelle, Josse, Séverine, Decaux, Olivier, Dominique, Stéphane, Landron, Cédric, Roblot, Pascal, Jouneau, Stéphane, Vittecoq, Olivier, Jouen, Fabienne, Service de Médecine Interne [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Physiopathologie et biothérapies des maladies inflammatoires et autoimmunes, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Service de Médecine interne et immunologie clinique [Rennes] = internal medicine and clinical immunology [Rennes], CHU Pontchaillou [Rennes], Service de pneumologie, oncologie thoracique et soins intensifs respiratoires [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Service de Médecine Interne, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de rhumatologie [CHU Rouen], Laboratoire d'immunologie et biothérapies [Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Le Corre, Morgane

Subjects
MESH: Myositis, MESH: Alanine-tRNA Ligase, MESH: Humans, MESH: Middle Aged, [SDV.CAN] Life Sciences [q-bio]/Cancer, MESH: Autoantibodies, MESH: Retrospective Studies, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Female, MESH: Male, MESH: Prognosis
Abstract

International audience; OBJECTIVES: The aim of the present study was to assess the outcome in anti-PL12 patients with antisynthetase syndrome (ASS). METHODS: The medical records of anti-PL12 (n=5) patients with ASS were retrospectively analyzed without prior selection. To exclude false-positive patients, we included patients who were successively tested positive for anti-PL12 antibody at least twice by immunodot and/or Western blot. RESULTS: Anti-PL12 patients experienced: myositis (n=2), Raynaud's phenomenon (n=2), mechanic's hands (n=1), joint impairment (n=4), digestive involvement (n=2), and interstitial lung disease (ILD) (n=4). The two patients with myositis exhibited deterioration of muscle manifestations despite therapy. As regards outcome of ILD, patients developed resolution (n=1), stabilization (n=1) or deterioration (n=2) of pulmonary status. One patient died of pyogenic pneumonia. CONCLUSION: Our series underscores that the presence of anti-PL12 antibody is associated with a particular phenotype of ASS characterized by: (1) less frequent although severe/steroid refractory myositis; (2) less common mechanic's hands and calcinosis cutis; (3) both frequent and severe ILD. Taken together, our findings suggest that PM/DM patients should routinely undergo the search for anti-PL12 antibody as this autoantibody appears to impact patients' prognosis. Furthermore, ILD patients with anti-PL12 antibody should routinely undergo clinical screening for underlying ASS.

Published
2013

190. Le cancer bronchique de la femme enceinte : prise en charge diagnostique et thérapeutique en 2012. [Diagnosis and management of lung cancer during pregnancy]

Author

Kerjouan, Mallorie, Jouneau, Stéphane, Corre, Romain, Le Ho, H., Pracht, M., Léna, H., Desrues, Benoit, Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Département d'oncologie médicale [Rennes], and CRLCC Eugène Marquis (CRLCC)

Subjects
MESH: Contraception, MESH: Abnormalities, Drug-Induced, MESH: Smoking, MESH: Radiotherapy, MESH: Maternal-Fetal Exchange, MESH: Neoplastic Cells, Circulating, MESH: Disease Management, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Prognosis, MESH: Pregnancy, MESH: Risk Factors, Toxicité fœtale, MESH: Neoplasms, MESH: Incidence, MESH: Humans, MESH: Abortion, Therapeutic, MESH: Diagnostic Imaging, MESH: Infant, Newborn, MESH: Fetus, MESH: Adult, MESH: Abnormalities, Radiation-Induced, MESH: Pregnancy Outcome, Cancer bronchopulmonaire, MESH: Lung Neoplasms, Grossesse, Imagerie, MESH: Breast Feeding, MESH: Pregnancy Complications, Neoplastic, MESH: Antineoplastic Agents, MESH: Maternal Age, MESH: Female, Chimiothérapie
Abstract

International audience; The incidence of lung cancer during pregnancy is very low, but it is becoming more frequent in industrialized countries both because of the increase in smoking in young women and because women are becoming pregnant later in life. Usually, the cancer has a poor prognosis due to the presence of metastatic disease at the time of diagnosis. Diagnosis and management are delicate, and should deal with the gestational age, the maternal prognosis, the fetal toxicity of treatments, but also with the worsening of maternal prognosis and the risk of neoplastic cells being transmitted to the fetus in case of delayed treatment. Psychological and ethical considerations complicate the decision process. We present a review of the epidemiology, clinical characteristics, management, and prognosis concerning lung cancer during pregnancy. Finally, it is important to remember that young women with lung cancer should be advised to use a reliable form of contraception.

Published
2013

191. Syndrome de détresse respiratoire aiguë sur hémorragie intra-alvéolaire révélant une vascularite. [Acute respiratory distress syndrome related to intra-alveolar hemorrhage revealing a vasculitis]

Author

Kerjouan, Mallorie, Gacouin, Arnaud, Gros, A., Caulet Maugendre, S., Le Tulzo, Yves, Delaval, Philippe, Jouneau, Stéphane, Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes], Service d'anatomopathologie [Rennes], and Hôpital Pontchaillou

Subjects
MESH: Humans, MESH: Middle Aged, MESH: Pulmonary Alveoli, Syndrome de détresse respiratoire aiguë, MESH: Vasculitis, MESH: Radiography, Thoracic, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Vascularite, MESH: Bronchial Diseases, Hémorragie intra-alvéolaire, MESH: Diagnosis, Differential, Lavage broncho-alvéolaire, MESH: Respiratory Distress Syndrome, Adult, MESH: Female, MESH: Hemorrhage
Abstract

International audience; Intra-alveolar hemorrhage (IAH) could be revealed by acute respiratory failure. The classic association of hemoptysis - anemia - radiological infiltrates is suggestive and has to be confirmed by broncho-alveolar lavage with Golde score. Etiologies included immune and non-immune diseases, with specific treatment for each. We report a case of IAH revealed by acute respiratory distress syndrome and anemia (3 g/dL), related to pulmonary and cerebral vasculitis without renal involvement. The patient was efficiently treated with corticosteroids and cyclophosphamide. This case highlights the critical role of BAL cytological analysis with Golde score, and the need for a rapid and accurate diagnosis in order to guide specific treatment. If histology is needed, renal biopsy even without renal involvement, or surgical lung biopsy is possible.

Published
2012

192. Le syndrome des ongles jaunes : présentation de cinq cas. [The yellow nail syndrome: a series of five cases]

Author

Letheulle, Julien, Deslee, Gaëtan, Guy, T., Lebargy, F., Jego, Patrick, Delaval, Philippe, Desrues, Benoit, Jouneau, Stéphane, Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Plasticité de l'épithélium respiratoire dans les conditions normales et pathologiques - UMR-S 903 (PERPMP), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-Institut National de la Santé et de la Recherche Médicale (INSERM)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Service de Médecine interne et immunologie clinique [Rennes] = internal medicine and clinical immunology [Rennes], and Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA)

Subjects
Transsudat, MESH: Aged, MESH: Bronchiectasis, MESH: Humans, MESH: Middle Aged, integumentary system, MESH: Sinusitis, MESH: Chronic Disease, MESH: Retrospective Studies, Chylothorax, Lymphœdème, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Male, Syndrome des ongles jaunes, MESH: Chylothorax, MESH: Yellow Nail Syndrome, Bronchectasies, Épanchement pleural, MESH: Pleural Effusion
Abstract

International audience; INTRODUCTION: The yellow nail syndrome is a rare disorder described for the first time in 1964. The pathophysiology remains unclear. Its definition is based on a clinical triad of yellow nails, lymphoedema and chronic respiratory disorders including pleural effusions and bronchiectasis. CASES REPORTS: We describe a retrospective series of five patients diagnosed with the yellow nail syndrome. All the patients were male, aged from 52 to 71 years (median=56). Three patients were diagnosed with the classic triad, whereas the other two had only yellow nails and bronchiectasis. Yellow nails and chronic sinusitis were present in all five patients. We also report atypical manifestations such as a transudative pleural effusion and facial oedema. The yellow nail syndrome was associated with cancer in two cases. CONCLUSION: More common alternative diagnoses must be excluded. The association with cancer should be explored. The treatment is only symptomatic.

Published
2012

193. Sarcoïdose pulmonaire apparue sous étanercept [Pulmonary sarcoidosis developing during treatment with etanercept]

Author

Kerjouan, Mallorie, Jouneau, Stéphane, Lena, Hervé, Luraine, R., Desrues, Benoit, Delaval, Philippe, Service de pneumologie [Rennes] = Pneumology [Rennes], and CHU Pontchaillou [Rennes]

Subjects
Pneumopathie médicamenteuse, MESH: Immunoglobulin G, Étanercept, MESH: Antirheumatic Agents, MESH: Humans, MESH: Middle Aged, MESH: Sarcoidosis, Pulmonary, Sarcoïdose, MESH: Receptors, Tumor Necrosis Factor, MESH: Spondylitis, Ankylosing, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, TNF⍺, MESH: Male, Granulomatose, MESH: Glucocorticoids, MESH: Treatment Outcome
Abstract

International audience; INTRODUCTION: TNF blockers are widely used to treat inflammatory rheumatic diseases and also in the treatment of extrapulmonary sarcoidosis. TNFα plays a major role in the development and persistence of sarcoid granulomata. However, recent studies have reported the involvement of anti-TNF therapies in the development of granulomatosis associated with the clinical and radiological features of sarcoidosis. CASE REPORT: A 54-years-old man with ankylosing spondylitis was treated with etanercept for two years. He was admitted with symptoms of bronchitis associated with radiological evidence of bilateral pulmonary nodules and a right upper lobe infiltrate. Anti-TNF therapy was stopped even though the patient had received 3 months of prophylactic treatment with rifampicin and isoniazid before starting etanercept. Bronchoalveolar lavage excluded infection, particularly tuberculosis. The chest CT-scan showed bilateral pulmonary nodules with peribronchovascular micronodules and enlarged mediastinal lymph nodes. Surgical lung biopsy was performed and revealed non-caseating granulomata. All the data were consistent with a diagnosis of pulmonary sarcoidosis. The patient remained symptomatic despite discontinuation of etanercept for ten months. Corticosteroids were then introduced, leading to a clinical, functional and radiological improvement. CONCLUSION: This case report underlines the importance of studying the pulmonary complications of TNF blockers. The first priority is to exclude tuberculosis but a diagnosis of sarcoid-like granulomatosis has to be considered. Twenty-three cases have been described in the literature to date.

Published
2011

194. Prevalence and risk factors for COPD in farmers: a cross-sectional controlled study

Author

Guillien, Alicia, primary, Puyraveau, Marc, additional, Soumagne, Thibaud, additional, Guillot, Stéphanie, additional, Rannou, Fabrice, additional, Marquette, David, additional, Berger, Patrick, additional, Jouneau, Stéphane, additional, Monnet, Elisabeth, additional, Mauny, Frédéric, additional, Laplante, Jean-Jacques, additional, Dalphin, Jean-Charles, additional, and Degano, Bruno, additional

Published
2015
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196. Granulomatosis with polyangiitis: endoscopic management of tracheobronchial stenosis: results from a multicentre experience

Author

Terrier, Benjamin, primary, Dechartres, Agnès, additional, Girard, Charlotte, additional, Jouneau, Stéphane, additional, Kahn, Jean-Emmanuel, additional, Dhote, Robin, additional, Lazaro, Estibaliz, additional, Cabane, Jean, additional, Papo, Thomas, additional, Schleinitz, Nicolas, additional, Cohen, Pascal, additional, Begon, Edouard, additional, Belenotti, Pauline, additional, Chauveau, Dominique, additional, Diot, Elisabeth, additional, Généreau, Thierry, additional, Hamidou, Mohamed, additional, Hayem, Gilles, additional, Le Guenno, Guillaume, additional, Le Guern, Véronique, additional, Michel, Marc, additional, Moulis, Guillaume, additional, Puéchal, Xavier, additional, Rivière, Sophie, additional, Samson, Maxime, additional, Gonin, François, additional, Le Jeunne, Claire, additional, Corlieu, Pascal, additional, and Mouthon, Luc, additional

Published
2015
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197. Severe hematologic complications after lung transplantation in patients with telomerase complex mutations

Author

Borie, Raphael, primary, Kannengiesser, Caroline, additional, Hirschi, Sandrine, additional, Le Pavec, Jérôme, additional, Mal, Hervé, additional, Bergot, Emmanuel, additional, Jouneau, Stéphane, additional, Naccache, Jean-Marc, additional, Revy, Patrick, additional, Boutboul, David, additional, Peffault de la Tour, Régis, additional, Wemeau-Stervinou, Lidwine, additional, Philit, Francois, additional, Cordier, Jean-François, additional, Thabut, Gabriel, additional, Crestani, Bruno, additional, and Cottin, Vincent, additional

Published
2015
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199. The natural history of adult pulmonary Langerhans cell histiocytosis: a prospective multicentre study

Author

Tazi, Abdellatif, primary, de Margerie, Constance, additional, Naccache, Jean Marc, additional, Fry, Stéphanie, additional, Dominique, Stéphane, additional, Jouneau, Stéphane, additional, Lorillon, Gwenaël, additional, Bugnet, Emmanuelle, additional, Chiron, Raphael, additional, Wallaert, Benoit, additional, Valeyre, Dominique, additional, and Chevret, Sylvie, additional

Published
2015
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200. Lung cancer in combined pulmonary fibrosis and emphysema: A series of 47 western patients

Author

UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, Girard, Nicolas, Marchand-Adam, Sylvain, Naccache, Jean-Marc, Borie, Raphaël, Urban, Thierry, Jouneau, Stéphane, Marchand, Eric, Ravel, Anne-Claire, Kiakouama, Lize, Etienne-Mastroianni, Bénédicte, Groupe d'Etudes et de Recherche sur les Maladies "Orphelines Pulmonaires (GERMOP), Cadranel, Jacques, Cottin, Vincent, Cordier, Jean-François, UCL - (MGD) Service de pneumologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, Girard, Nicolas, Marchand-Adam, Sylvain, Naccache, Jean-Marc, Borie, Raphaël, Urban, Thierry, Jouneau, Stéphane, Marchand, Eric, Ravel, Anne-Claire, Kiakouama, Lize, Etienne-Mastroianni, Bénédicte, Groupe d'Etudes et de Recherche sur les Maladies "Orphelines Pulmonaires (GERMOP), Cadranel, Jacques, Cottin, Vincent, and Cordier, Jean-François

Abstract

Introduction: The syndrome of combined pulmonary fibrosis and emphysema (CPFE) is characterized by imaging features consisting of the association of centrilobular and/or paraseptal emphysema and pulmonary fibrosis. Virtually all patients are smokers and thus at high risk of developing lung cancer. Methods: This retrospective multicentre study was conducted by the Groupe d'Etudes et de Recherche sur les Maladies "Orphelines" Pulmonaires (GERM"O"P). Results: A total of 47 patients presenting with lung cancer and CPFE syndrome were identified. All patients were smokers, with a mean of 47 pack-years. A pathological diagnosis of lung cancer was obtained for 38 (81%) patients. Histological type was squamous cell carcinoma in 17 (36%) patients, adenocarcinoma in 14 (30%), non- small-cell lung cancer not otherwise specified in three (6%), smallcell lung cancer in three (6%), and sarcomatoid carcinoma in one (2%). Overall, 20 of the 47 patients could not receive standard-ofcare treatment for lung cancer, as per international recommendations or guidelines; this limitation was considered to be directly related to the CPFE syndrome in eight (40%) cases. Conclusion: Lung cancer in patients with CPFE syndrome represents a specific entity with a poor prognosis, that further represents the most characteristic and severe model of tobacco-related disease. Copyright © 2014 by the International Association for the Study of Lung.

Published
2014

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