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1. Association between Initial Treatment Strategy and Long-Term Survival in Pulmonary Arterial Hypertension

Author: Vincent Cottin, David Montani, Jérémie Pichon, Martine Reynaud-Gaubert, Xavier Jaïs, Pascal Magro, Gérald Simonneau, Florence Parent, Fabrice Bauer, Marianne Riou, Laurent Bertoletti, Pamela Moceri, Ari Chaouat, Andrei Seferian, Antoine Beurnier, Sébastien Renard, Pierre Mauran, Delphine Horeau-Langlard, Pascal de Groote, Laurent Savale, Mitja Jevnikar, Sophie Bulifon, Pascal Roblot, Hélène Bouvaist, Yuanchao Feng, Patrice Poubeau, Sylvain Palat, Zhiying Liang, Emmanuel Bergot, François Picard, Etienne-Marie Jutant, C. Chabanne, Olivier Sitbon, Athénaïs Boucly, Grégoire Prévot, Jean-François Mornex, Cécile Tromeur, Marc Humbert, Bruno Degano, Claire Dauphin, Arnaud Bourdin, Olivier Sanchez, Nicolas Favrolt, Jason Weatherald, Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre chirurgical Marie Lannelongue-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Saclay, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Rouen, Normandie Université (NU), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Université de Caen Normandie (UNICAEN), Biologie intégrative du tissu osseux, Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire [Grenoble] (CHU), Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), CHU Pontchaillou [Rennes], Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167 (RID-AGE), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), University of Calgary, Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Nord Laennec [CHU Nantes], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Universitaire de Reims (CHU Reims), American Memorial Hospital (Hôpital des enfants) [Reims], Centre Hospitalier Universitaire de Nice (CHU Nice), Université Côte d'Azur (UCA), Hôpital Dupuytren [CHU Limoges], Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Université de Bordeaux (UB), Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Hôpital de la Timone [CHU - APHM] (TIMONE), Assistance Publique - Hôpitaux de Marseille (APHM), Aix Marseille Université (AMU), Nouvel Hôpital Civil de Strasbourg, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biologie Intégrative du Tissu Osseux (LBTO), Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), École Pratique des Hautes Études (EPHE), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre chirurgical Marie Lannelongue, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), and MORNET, Dominique
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, [SDV]Life Sciences [q-bio], Critical Care and Intensive Care Medicine, medicine.disease, survival, Pulmonary hypertension, 3. Good health, [SDV] Life Sciences [q-bio], pulmonary arterial hypertension, Internal medicine, pulmonary hypertension, Long term survival, therapeutics, Cardiology, Medicine, Initial treatment, business
Abstract: International audience; Rationale: The relationship between the initial treatment strategy and survival in pulmonary arterial hypertension (PAH) remains uncertain. Objectives: To evaluate the long-term survival of patients with PAH categorized according to the initial treatment strategy. Methods: A retrospective analysis of incident patients with idiopathic, heritable, or anorexigen-induced PAH enrolled in the French Pulmonary Hypertension Registry (January 2006 to December 2018) was conducted. Survival was assessed according to the initial strategy: monotherapy, dual therapy, or triple-combination therapy (two oral medications and a parenteral prostacyclin). Measurements and Main Results: Among 1,611 enrolled patients, 984 were initiated on monotherapy, 551 were initiated on dual therapy, and 76 were initiated on triple therapy. The triple-combination group was younger and had fewer comorbidities but had a higher mortality risk. The survival rate was higher with the use of triple therapy (91% at 5 yr) as compared with dual therapy or monotherapy (both 61% at 5 yr) (P < 0.001). Propensity score matching of age, sex, and pulmonary vascular resistance also showed significant differences between triple therapy and dual therapy (10-yr survival, 85% vs. 65%). In high-risk patients (n = 243), the survival rate was higher with triple therapy than with monotherapy or dual therapy, whereas there was no difference between monotherapy and double therapy. In intermediate-risk patients (n = 1,134), survival improved with an increasing number of therapies. In multivariable Cox regression, triple therapy was independently associated with a lower risk of death (hazard ratio, 0.29; 95% confidence interval, 0.11-0.80; P = 0.017). Among the 148 patients initiated on a parenteral prostacyclin, those on triple therapy had a higher survival rate than those on monotherapy or dual therapy. Conclusions: Initial triple-combination therapy that includes parenteral prostacyclin seems to be associated with a higher survival rate in PAH, particularly in the youngest high-risk patients.
Published: 2021

2. Position paper of the French Society of Respiratory Diseases regarding pharmacological treatment optimization for stable COPD in 2021

Author: Maeva Zysman, Bruno Ribeiro Baptista, Thibaud Soumagne, Vanessa Marques da Silva, Clémence Martin, Charlotte Thibault de Menonville, Laurent Boyer, Bruno Degano, Pierre-Régis Burgel, Thierry Perez, Arnaud Bourdin, Chantal Raherison, Hervé Pégliasco, Daniel Piperno, Christophe Zanetti, Hughes Morel, Bertrand Delclaux, Christian Delafosse, Alain Lorenzo, Bruno Housset, Capucine Morélot-Panzini, François Chabot, Philippe Devillier, Gaëtan Deslée, Nicolas Roche, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Hôpital Henri Mondor, Centre Hospitalier Universitaire [Grenoble] (CHU), Université Grenoble Alpes (UGA), CHU Lille, Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cancer environnement (EPICENE ), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen [Fondation Ambroise Paré - Marseille], CM PAROT, Lyon, Centre Hospitalier Régional d'Orléans (CHRO), Centre hospitalier Troyes (CH Troyes), Centre Hospitalier Simone Veil (CH Simone Veil), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Centre Hospitalier Intercommunal de Créteil (CHIC), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), UPRES EA 220, Pôle des maladies respiratoires, Hôpital Foch, Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Reims (CHU Reims)
Subjects: Pulmonary and Respiratory Medicine, [SDV]Life Sciences [q-bio], ComputingMilieux_MISCELLANEOUS
Abstract: International audience; No abstract available
Published: 2022

3. Sevrage tabagique et dépistage du cancer du poumon

Author: A.-M. Ruppert, A. Tiotiu, Gérard Peiffer, Jean Perriot, Michel Underner, Service de Pneumologie [CHR Metz-Thionville], Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Centre Hospitalier Henri Laborit (CHL), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Dispensaire Émile Roux, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Pneumologie [CHRU Nancy], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, education.field_of_study, business.industry, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Population, Smoking cessation intervention, Context (language use), Specific mortality, Disease, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, medicine, Smoking cessation, 030212 general & internal medicine, Intensive care medicine, education, business, Lung cancer, Lung cancer screening
Abstract: Several studies have shown that lung cancer screening, using annual low-dose computed tomography (CT) scan in a targeted population of smokers and ex-smokers reduces overall and lung cancer specific mortality rates. This form of screening strategy is not currently established for use in France by the French High Authority for Health. Quitting smoking is the most important measure in reducing mortality from lung cancer. The maximum benefit in reducing mortality from lung cancer should be seen through an effective combination of smoking cessation intervention and chest CT screening to identify early, curable disease. However, current data to guide clinicians in the choice of smoking cessation interventions in this specific context are limited due to the small number of randomized studies that have been carried out. The optimal approach to smoking cessation during lung cancer screening needs to be clarified by new studies comparing different motivation strategies, establishing the ideal moment to propose stopping smoking and the most effective therapies to use.
Published: 2020

4. French clinical practice guidelines for the diagnosis and management of lung disease with alpha 1-antitrypsin deficiency

Author: Mornex, J.-F., Balduyck, M., Bouchecareilh, M., Cuvelier, A., Epaud, R., Kerjouan, M., Le Rouzic, O., Pison, C., Plantier, L., Pujazon, M.-C., Reynaud-Gaubert, M., Toutain, A., Trumbic, B., Willemin, M.-C., Zysman, M., Brun, O., Campana, M., Chabot, F., Chamouard, V., Dechomet, M., Fauve, J., Girerd, B., Gnakamene, C., Lefrançois, S., Lombard, J.-N., Maitre, B., Maynié-François, C., Moerman, A., Payancé, A., Reix, P., Revel, D., Revel, M.-P., Schuers, M., Terrioux, P., Theron, D., Willersinn, F., Cottin, V., Mal, H., Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Maladies RAres du DEveloppement embryonnaire et du MEtabolisme : du Phénotype au Génotype et à la Fonction - ULR 7364 (RADEME), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Lille, Université de Lille, Bordeaux Research In Translational Oncology [Bordeaux] (BaRITOn), Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de Recherche sur le Handicap Ventilatoire et Neurologique (GRHVN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de pneumologie, oncologie thoracique et soins intensifs respiratoires [Rouen], Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Intercommunal de Créteil (CHIC), Hôpital Pontchaillou, Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Service de Pneumologie et Immuno-Allergologie [CHU LIlle], Pole Cardio-vasculaire et pulmonaire [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Grenoble Alpes (UGA), Service de pneumologie [Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Centre d’Etude des Pathologies Respiratoires (CEPR), UMR 1100 (CEPR), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Nord [CHU - APHM], Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Aix Marseille Université (AMU), Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Service de génétique [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de pneumologie et d'allergologie respiratoire [Perpignan], Centre Hospitalier Régional d'Orléans (CHRO), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre de Référence de l’Hypertension Pulmonaire Sévère [CHU Le Kremlin Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Faculté de Médecine Paris-Saclay, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)-Université Paris-Saclay, Centre Hospitalier Montélimar, CH Montélimar, Physiopathologie des Maladies du Système Nerveux Central, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Université de Lyon, Hôpital Jeanne de Flandre [Lille], Centre de référence des Maladies Vasculaires du Foie [Paris] (FILFOIE), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d’Hépatologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Sorbonne Paris Nord, Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), and AP-HP - Hôpital Bichat - Claude Bernard [Paris]
Subjects: Déficit en alpha 1-antitrypsine, Cirrhose du foie, Emphysème pulmonaire, Bronchopneumopathie chronique obstructive, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Abstract: International audience; Contexte: Le déficit en alpha 1-antitrypsine (DAAT) est une maladie génétique autosomique récessive associée à l’état homozygote du variant Z du gène SERPINA1. Les manifestations cliniques sont un déficit sévère en alpha 1-antitrypsine, un emphysème pulmonaire et une fibrose hépatique.Méthodes: Des recommandations de prise en charge du DAAT ont été élaborées à l’initiative du centre coordonnateur de référence des maladies pulmonaires rares, sous l’égide de la Société de pneumologie de langue française, par des groupes de coordination, rédaction, et lecture, impliquant des pneumologues de divers modes d’exercice, biologistes, hépatologue, pharmacien hospitalier, conseiller en génétique, radiologues, médecins généralistes, cadre de santé, et associations de patients. La méthode d’élaboration des « Recommandations pour la pratique clinique » de la Haute autorité de santé a été suivie, incluant un vote en ligne selonune échelle Likert.Résultats: Après une analyse bibliographique, 20 recommandations ont été proposées par les groupes de travail, portant sur tous les aspects de la maladie : diagnostic biologique, bilan initial, conseils d’hygiène de vie, information, indications et modalités du traitement substitutif, dépistage.Conclusion: Ces recommandations fondées sur les preuves sont destinées à guider le diagnostic et la prise en charge pratique du DAAT.
Published: 2022

5. AVANCEES DANS LA COMPREHENSION DE L’ASTHME: DE LA CLINIQUE A LA PHYSIOPATHOLOGIE ET LA BIOLOGIE MOLECULAIRE

Author: Tiotiu, Angelica, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Lorraine, Philippe Perrin, and TIOTIU, Angelica
Subjects: severe asthma, mechanisms, phenotypes, asthme sévère, mécanismes, comorbidities, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, respiratory tract diseases, toux, cough, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, comorbidités
Abstract: Asthma is one of the most frequent obstructive airway diseases with a prevalence of 6-12% in the adult population across the world. It is a heterogeneous disease characterized by chronic airway inflammation associated with bronchial hyperresponsiveness and symptoms such as wheezing, dyspnoea, cough, and chest tightness. Despite a controller treatment according to the current guidelines (e.g. inhaled/systemic corticosteroids, leukotriene receptor antagonists), 17% of adult asthmatics have difficult-to-treat asthma with a negative impact on their quality of life and high costs for the healthcare system. These patients should be addressed in expert centers in order to optimize their management. However, despite the optimization, 4% of asthmatic patients finally have the diagnosis of severe asthma. Most of the recent research was focused on the identification of different phenotypes of severe asthma and the mechanisms driving the inflammatory reaction for each phenotype in order to find biomarkers and to better adapt the therapeutic strategy to every patient. Several phenotypes were described but not all of the mechanisms involved are identified. The present work summarises my contribution to the understanding of mechanisms driving different phenotypes of severe asthma and my future projects in order to improve the management of asthmatic patients (particularly those with severe asthma) and the applying of personalized medicine in this domain.
Published: 2021

6. Pulmonary Function Testing in Work-Related Asthma: An Overview from Spirometry to Specific Inhalation Challenge

Author: Isabelle Thaon, Emmanuelle Penven, Mathias Poussel, Angelica Tiotiu, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre de consultations de pathologies professionnelles [CHRU Nancy] (CCPP), and Service de Pneumologie [CHRU Nancy]
Subjects: Spirometry, medicine.medical_specialty, medicine.drug_class, Health, Toxicology and Mutagenesis, spirometry, lcsh:Medicine, Work related asthma, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Article, Bronchial Provocation Tests, Pulmonary function testing, 03 medical and health sciences, Specific inhalation challenge, 0302 clinical medicine, Occupational Exposure, Bronchodilator, Administration, Inhalation, medicine, Humans, 030212 general & internal medicine, Asthma, Occupational, Intensive care medicine, Asthma, pulmonary function testing, medicine.diagnostic_test, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, medicine.disease, 3. Good health, respiratory tract diseases, Occupational Diseases, 030228 respiratory system, bronchial challenge, Objective evaluation, specific inhalation challenge, business, occupational asthma, Occupational asthma
Abstract: International audience; Work-related asthma (WRA) is a very frequent condition in the occupational setting, and refers either to asthma induced (occupational asthma, OA) or worsened (work-exacerbated asthma, WEA) by exposure to allergens (or other sensitizing agents) or to irritant agents at work. Diagnosis of WRA is frequently missed and should take into account clinical features and objective evaluation of lung function. The aim of this overview on pulmonary function testing in the field of WRA is to summarize the different available tests that should be considered in order to accurately diagnose WRA. When WRA is suspected, initial assessment should be carried out with spirometry and bronchodilator responsiveness testing coupled with first-step bronchial provocation testing to assess non-specific bronchial hyper-responsiveness (NSBHR). Further investigations should then refer to specialists with specific functional respiratory tests aiming to consolidate WRA diagnosis and helping to differentiate OA from WEA. Serial peak expiratory flow (PEF) with calculation of the occupation asthma system (OASYS) score as well as serial NSBHR challenge during the working period compared to the off work period are highly informative in the management of WRA. Finally, specific inhalation challenge (SIC) is considered as the reference standard and represents the best way to confirm the specific cause of WRA. Overall, clinicians should be aware that all pulmonary function tests should be standardized in accordance with current guidelines.
Published: 2021
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7. Serum and Pulmonary Uric Acid in Pulmonary Arterial Hypertension

Author: Laurent Savale, Olivier Sitbon, Xavier Jaïs, Marc Humbert, Athénaïs Boucly, Raphaël Thuillet, Amélie Cumont, Christophe Guignabert, Satoshi Akagi, Nihel Berrebeh, Alice Huertas, Yuichi Tamura, Ari Chaouat, Cécile Tromeur, Etienne Marie Jutant, Carole Phan, Elie Fadel, Olaf Mercier, David Montani, Vincent Cottin, Benjamin Le Vely, Ly Tu, Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre de Référence de l’Hypertension Pulmonaire Sévère [CHU Le Kremlin Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris-Saclay, Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Infections Virales et Pathologie Comparée - UMR 754 (IVPC), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), European Brittany University [Brest, France] (EBU), Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Centre Chirurgical Marie Lannelongue (CCML), Centre chirurgical Marie Lannelongue, International University of Health and Welfare Hospital (IUHW Hospital), Guignabert, Christophe, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Hypertension, Pulmonary, [SDV]Life Sciences [q-bio], Proliferation, Hemodynamics, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Pulmonary Artery, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Pulmonary hypertension, Benzbromarone, chemistry.chemical_compound, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine.artery, Animals, Humans, Medicine, Xanthine oxidase, Lung, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, Urate, Pulmonary Arterial Hypertension, Monocrotaline, business.industry, Hypoxia (medical), medicine.disease, Rats, Uric Acid, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, [SDV] Life Sciences [q-bio], URATv1/SLC2A9, Disease Models, Animal, medicine.anatomical_structure, Smooth muscle cell, chemistry, Pulmonary artery, Cardiology, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Uric acid, medicine.symptom, business
Abstract: Previous studies have suggested an association between uric acid (UA) and the severity of pulmonary arterial hypertension (PAH), but it is unknown whether UA contributes to disease pathogenesis.The aim of this study was to determine the prognostic value of circulating UA in the era of current management of PAH and to investigate the role of UA in pulmonary vascular remodelling.Serum UA levels were determined in idiopathic, heritable or anorexigen PAH at baseline and first re-evaluation in the French Pulmonary Hypertension Network. We studied protein levels of xanthine oxidase (XO) and the voltage-driven urate transporter 1 (URATv1) in lungs of control and PAH patients and of monocrotaline (MCT) and Sugen/hypoxia (SuHx) rats. Functional studies were performed using human pulmonary artery smooth muscle cells (PA-SMCs) and two animal models of pulmonary hypertension (PH).High serum UA levels at first follow-up, but not at baseline, were associated with a poor prognosis. Both the generating enzyme XO and URATv1 were upregulated in the wall of remodelled pulmonary arteries in idiopathic PAH patients and MCT and SuHx rats. High UA concentrations promoted a mild increase in cell growth in idiopathic PAH PA-SMCs, but not in control PA-SMCs. Consistent with these observations, oxonic acid-induced hyperuricaemia did not aggravate MCT-induced PH in rats. Finally, chronic treatment of MCT and SuHx rats with benzbromarone mildly attenuated pulmonary vascular remodelling.UA levels in idiopathic PAH patients were associated with an impaired clinical and haemodynamic profile and might be used as a non-invasive indicator of clinical prognosis during follow-up. Our findings also indicate that UA metabolism is disturbed in remodelled pulmonary vascular walls in both experimental and human PAH.
Published: 2021

8. Detection of ALK fusion transcripts in plasma of non-small cell lung cancer patients using a novel RT-PCR based assay

Author: Michel Poudenx, Radj Gervais, Juliette Thariat, Jonathan Benzaquen, Michael Lee, Charles-Hugo Marquette, Jacques Boutros, Fabrice Barlesi, Marius Ilie, Angelica Tiotiu, Véronique Hofman, Denis Moro-Sibilot, Ellen Ordinario, Julien Mazieres, Jacques Cadranel, Simon Heeke, Paul Hofman, Marc G. Denis, Virginie Tanga, Julien Fayada, Audrey Vallee, Jaya Rajamani, Maryline Allegra, Laboratoire de Pathologie Clinique et Expérimentale. Hôpital Pasteur [Nice], Hôpital Pasteur [Nice] (CHU), Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Toulouse [Toulouse], Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Gustave Roussy (IGR), Aix Marseille Université (AMU), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Université Nice Sophia Antipolis (1965 - 2019) (UNS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Pneumologie = Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), HAL-SU, Gestionnaire, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: circulating free RNA (cfRNA), reverse transcription PCR (RT-PCR), non-small cell lung cancer (NSCLC), Non-small cell lung cancer (NSCLC), [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, hemic and lymphatic diseases, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], medicine, Anaplastic lymphoma kinase, Multiplex, Liquid biopsy, Lung cancer, 030304 developmental biology, 0303 health sciences, liquid biopsy, business.industry, General Medicine, medicine.disease, 3. Good health, Reverse transcription polymerase chain reaction, Real-time polymerase chain reaction, anaplastic lymphoma kinase (ALK), 030220 oncology & carcinogenesis, Cancer research, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Immunohistochemistry, Original Article, business
Abstract: International audience; Background: Detection of genomic rearrangements, like anaplastic lymphoma kinase (ALK) fusions, is a pivotal requirement in non-small cell lung cancer (NSCLC) for the initiation of a targeted treatment. While tissue testing remains the gold standard, detection of these alterations using liquid biopsies is an unmet need. To enable the detection of ALK rearrangements from circulating-free RNA (cfRNA) from NSCLC patients, we have evaluated a novel reverse transcription PCR (RT-PCR) based assay.Methods: Sixty-six patients with advanced stage NSCLC were included in the study. ALK status was determined by immunohistochemistry (IHC) and/or FISH on tissue sections. For the detection of ALK rearrangements from 2ml plasma collected in EDTA or Streck BCT DNA tubes, cfRNA was extracted using a prototype cfRNA sample preparation method and tested by a novel multiplex ALK/RET RT-PCR assay (Roche).Results: Of the forty-two patients with an ALK rearrangement, 30 (71%) were included at baseline. In 10 of the baseline patients, an ALK rearrangement was detected by RT-PCR [baseline sensitivity 33.33% (95% CI: 17.29–52.81%)]. All 24 negative ALK IHC/FISH-negative patients were negative using the RT-PCR based assay (specificity =100%).Conclusions: The prototype Roche ALK/RET RT-PCR assay was able to detect ALK fusion transcripts in the plasma of NSCLC patients at baseline as well as at disease progression with limited sensitivity but high specificity. Consequently, this assay could potentially be considered to select patients for an ALK-targeting therapy when tissue samples are lacking.
Published: 2021

9. Une maladie veino-occlusive pulmonaire familiale avec mutation biallélique hétérozygote composite d’EIF2AK4

Author: Mélanie Eyries, Anne Guillaumot, J.-F. Chabot, Emmanuel Gomez, A. Chaouat, I. Petit, G. Treffel, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Service de Radiologie [CHRU Nancy]
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Disease, medicine.disease, Pulmonary hypertension, 3. Good health, Hypoxemia, 03 medical and health sciences, 0302 clinical medicine, Clinical research, 030228 respiratory system, Internal medicine, medicine, Palpitations, Cardiology, Lung transplantation, 030212 general & internal medicine, Pulmonary Veno-Occlusive Disease, Stage (cooking), medicine.symptom, business
Abstract: Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary hypertension. Heritable and sporadic forms have been distinguished. Hypoxemia, profound reduction in the diffusion of carbon monoxide and haemodynamic confirmation of pre-capillary pulmonary hypertension are the major diagnostic criteria. Thoracic CT scanning and a response to pharmaceutical therapy provide additional information to confirm the diagnosis. A 52-year-old patient, three of whose siblings had pulmonary hypertension, was admitted with dyspnoea, malaise and palpitations. Right heart catheterisation confirmed pre-capillary pulmonary hypertension. A search for an EIF2AK4 mutation was carried out, and this showed a composite biallelic heterozygous mutation compatible with the diagnosis of familial PVOD, identical to that showed in one of his brothers. Given the signs of severity of the disease and the diagnosis of PVOD, whose response to pharmaceutical therapy is often poor, the patient was placed on a waiting list for lung transplantation. Despite a similar diagnosis in 3 brothers and follow-up proposed 11 years before the diagnosis, pulmonary hypertension appeared within a few weeks and led immediately to a severe clinical situation. Annual clinical and echocardiographic monitoring had been strongly advised to the patient, but had not allowed diagnosis at a mild or moderate stage of the disease. This clinical case shows that the identification of factors predicting the development of heritable PVOD at a pre-symptomatic stage is an important issue for clinical research.
Published: 2020

10. Will COVID-19 Infection be Less Severe in Ulcerative Colitis Than in Crohn’s Patients, Due to a Lower Rate of Smokers?

Author: Carina Peyrin-Biroulet, Laurent Peyrin-Biroulet, Ferdinando D'Amico, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Humanitas University [Milan] (Hunimed), Service d'Hépato-gastro-entérologie [CHRU Nancy], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Bodescot, Myriam, and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, MEDLINE, Global Health, Severity of Illness Index, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, Betacoronavirus, 0302 clinical medicine, Crohn Disease, Internal medicine, 0502 economics and business, Pandemic, Severity of illness, Global health, Medicine, Humans, Pandemics, Letter to the Editor, ComputingMilieux_MISCELLANEOUS, AcademicSubjects/MED00260, [SDV.MP.VIR] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, biology, business.industry, SARS-CoV-2, 05 social sciences, Smoking, Gastroenterology, COVID-19, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, General Medicine, biology.organism_classification, medicine.disease, Prognosis, Ulcerative colitis, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 050211 marketing, 030211 gastroenterology & hepatology, Colitis, Ulcerative, business, Coronavirus Infections
Abstract: International audience
Published: 2020

11. Pneumopathie à éosinophiles : une complication rare du divalproate de sodium

Author: N. Petitpain, M. Faure, Emmanuel Gomez, J. Ruuth-Praz, I. Petit, A. Chaouat, François Chabot, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Radiologie [CHRU Nancy], and Service de Pharmacologie Clinique et Toxicologie [CHRU Nancy]
Subjects: Pulmonary and Respiratory Medicine, Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, business.industry, [SDV]Life Sciences [q-bio], Medicine, 030212 general & internal medicine, business, Drug toxicity, 3. Good health
Abstract: Resume Introduction Les pneumopathies a eosinophiles sont caracterisees par une alveolite a polynucleaires eosinophiles. Elles peuvent etre idiopathiques ou relever de differentes causes. L’origine medicamenteuse doit etre toujours evoquee. Observation Nous rapportons le cas d’une femme de 57 ans, fumeuse, atteinte d’un trouble bipolaire, traitee par divalproate de sodium depuis plus de 2 ans, qui presentait une dyspnee non febrile depuis 5 mois. Les explorations realisees montraient une hypoxemie severe, un trouble ventilatoire obstructif severe, de multiples images en verre depoli avec un aspect de crazy paving au scanner thoracique, une hypereosinophilie sanguine et une alveolite a eosinophiles au lavage broncho-alveolaire. Le diagnostic de pneumopathie a eosinophiles au divalproate de sodium etait retenu apres un bilan etiologique exhaustif, et l’amelioration radio-clinique etait rapide apres l’arret du medicament, sans recours a la corticotherapie systemique. Conclusion Le divalproate de sodium peut induire une pneumopathie a eosinophiles plusieurs annees apres son introduction. Un diagnostic rapide et un arret du traitement ont permis une guerison complete dans le cas rapporte.
Published: 2020

12. Phenotype and outcome of pulmonary arterial hypertension patients carrying a TBX4 mutation

Author: Caroline Ovaert, Damien Bonnet, Gérald Simonneau, Céline Chabanne, Pierre Thoré, Olivier Sitbon, Marc Humbert, Marilyne Lévy, Claire Dauphin, Florent Soubrier, Laurent Savale, E. Boiffard, Xavier Jaïs, Martine Remy-Jardin, Amélie Servettaz, Barbara Girerd, Anne Guillaumot, Ari Chaouat, Frédéric Perros, Maria-Rosa Ghigna, David Montani, Vincent Cottin, Mélanie Eyries, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Université Paris-Saclay, Centre Chirurgical Marie Lannelongue (CCML), Centre chirurgical Marie Lannelongue, Service d'Oncogénétique et Angiogénétique Moléculaire [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Service de génétique [CHU Pitié-Salpêtrière], Service de cardiologie pédiatrique [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Clermont-Ferrand, CHU Pontchaillou [Rennes], Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon, Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Immuno-Régulation dans les Maladies Auto-Immunes Inflammatoires et le Cancer - EA 7509 (IRMAIC), Université de Reims Champagne-Ardenne (URCA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Hemodynamics, medicine.disease_cause, Gastroenterology, Vascular remodelling in the embryo, 03 medical and health sciences, 0302 clinical medicine, Diffusing capacity, Internal medicine, Parenchyma, medicine, Lung transplantation, Mutation, business.industry, Phenotype, 3. Good health, 030104 developmental biology, medicine.anatomical_structure, 030228 respiratory system, Vascular resistance, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: IntroductionTBX4 mutation causes small patella syndrome (SPS) and/or pulmonary arterial hypertension (PAH). The characteristics and outcomes of PAH associated with TBX4 mutations are largely unknown.MethodsWe report the clinical, functional, radiologic, histologic and haemodynamic characteristics and outcomes of heritable PAH patients carrying a TBX4 mutation from the French pulmonary hypertension (PH) network.Results20 patients were identified in 17 families. They were characterised by a median age at diagnosis of 29 years (0–76 years) and a female to male ratio of three. Most of the patients (70%) were in New York Heart Association (NYHA) functional class III or IV with a severe haemodynamic impairment (median pulmonary vascular resistance (PVR) of 13.6 (6.2–41.8) Wood units). Skeletal signs of SPS were present in 80% of cases. Half of the patients had mild restrictive or obstructive limitation and diffusing capacity of the lung for carbon monoxide (DLCO) was decreased in all patients. High-resolution computed tomography (HRCT) showed bronchial abnormalities, peri-bronchial cysts, mosaic distribution and mediastinal lymphadenopathies. PAH therapy was associated with significant clinical improvement. At follow-up (median 76 months), two patients had died and two had undergone lung transplantation. One-year, three-year and five-year event-free survival rates were 100%, 94% and 83%, respectively. Histologic examination of explanted lungs revealed alveolar growth abnormalities, major pulmonary vascular remodelling similar to that observed in idiopathic pulmonary arterial hypertension (IPAH) and accumulation of cholesterol crystals within the lung parenchyma.ConclusionPAH due to TBX4 mutations may occur with or without skeletal abnormalities across a broad age range from birth to late adulthood. PAH is usually severe and associated with bronchial and parenchymal abnormalities.
Published: 2020

13. Desensitization of the Cough Reflex Induced by Corticosteroids in Ovalbumin-Sensitized Rabbits During Artificial Limb Exercise

Author: Valentin, Simon, Chenuel, Bruno, Demoulin-Alexikova, Silvia, Demoulin, Bruno, Gérard, Delphine, Foucaud, Laurent, Poussel, Mathias, Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Service d'Hématologie [CHRU Nancy]
Subjects: Broncho-alveolar Lavage, exercise, Physiology, exercise-induced bronchoconstriction, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], ovalbumin, cough reflex, respiratory system, asthma, airway inflammation, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Original Research, corticosteroids
Abstract: International audience; Introduction: Cough is a major symptom frequently experienced during exercise, mainly in asthmatic patients. Inhaled glucocorticoids represent the keystone treatment in the management of asthma, but little is known about interactions between cough and exercise, especially in controlled patients. During exercise, cough reflex (CR) appears downregulated in healthy animal models whereas a lack of desensitization of CR has been shown in ovalbumin-sensitized animal models, mimicking asthmatic disease. Aims and Objectives: The goal of our study was to clarify the potential modulation of the CR induced by inhaled corticosteroids (CS) in ovalbumin (OVA) sensitized rabbits during artificial limb exercise. Materials and Methods: Seventeen OVA sensitized rabbits were studied. Among them, 9 were treated with CS delivered intravenously (OVA-Corticoids). The ventilatory response to direct tracheal stimulation, performed at rest and during exercise, was determined to assess the incidence and the sensitivity of the CR. Broncho-alveolar lavage (BAL) and cell counts were performed to determine the level of airway inflammation. Exercise was mimicked by electrically induced hindlimb muscular contractions (EMC). Results: Compared to rest values, EMC increased minute ventilation by 28% without any decrease in respiratory resistance (Rsr). Among 322 tracheal stimulations, 172 (53%) were performed at rest and 150 (47%) during exercise. The sensitivity of CR decreased during artificial limb exercise compared to baseline in OVA-Corticoids rabbits (p = 0.0313) while it remained unchanged in OVA rabbits (p = NS). Conclusion: Corticosteroids appear to restore the desensitization of the CR in OVA sensitized rabbits during artificial limb exercise, suggesting the potential role of airway inflammation in the pathophysiology of cough during exercise in asthmatics.
Published: 2020

14. Facteurs prédictifs de survenue d’évènements osseux dans le cancer bronchique

Author: O. Menard, A. Tiotiu, A. Villemain, Y. Martinet, N. Paillot, M. Soudant, B. Ribeiro Baptista, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Faculté de Médecine [Nancy], and Université de Lorraine (UL)
Subjects: Pulmonary and Respiratory Medicine, Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, business.industry, [SDV]Life Sciences [q-bio], medicine, Skeletal related events, 030212 general & internal medicine, business, 3. Good health
Abstract: Resume Introduction Les evenements osseux (EO) sont frequents chez les patients atteints de cancer bronchique (CB) metastatique au niveau osseux et ont un impact negatif sur la qualite de vie et la survie. L’objectif de cette etude est d’identifier les facteurs predictifs de survenue d’EO dans cette population. Methodes Une analyse retrospective sur 3 ans a ete realisee incluant 100 patients avec un CB metastatique au niveau osseux. Resultats Quatre-vingt-deux patients presentaient au moins un EO (69,5 % au diagnostic). La mediane de survenue d’un EO etait de 4,5 mois et les douleurs osseuses severes etaient l’EO le plus frequent (56 %). Les facteurs predictifs identifies pour la survenue d’EO etaient un taux serique de phosphatases alcalines (PAL) > 120 UI/L (risque relatif [RRs] = 2,8 ; intervalle de confiance (IC) 95 % [1,5–5,4] ; p = 0,002) et une calcemie > 2,6 mmol/L ([RRs] = 9,7 ; IC 95 % [5,1–18,4] ; p Conclusion Le taux eleve de PAL seriques et l’hypercalcemie sont des facteurs predictifs d’EO chez les patients ayant un CB metastatique au niveau osseux et devraient etre utilises dans la pratique courante comme biomarqueurs pour adapter la prise en charge de ces patients.
Published: 2020

15. Phenotype and outcome of PAH patients carrying a TBX4 mutation

Author: Pierre Thoré, Barbara Girerd, Xavier Jaïs, Laurent Savale, Maria Rosa Ghigna, Mélanie Eyries, Marilyne Levy, Caroline Ovaert, Amélie Servettaz, Anne Guillaumot, Claire Dauphin, Céline Chabanne, Emmanuel Boiffard, Vincent Cottin, Frédéric Perros, Gérald Simonneau, Sitbon Olivier, Florent Soubrier, Damien Bonnet, Martine Remy Jardin, Ari Chaouat, Marc Humbert, David Montani, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Hypertension artérielle pulmonaire : physiopathologie et innovation thérapeutique [Le Kremlin-Bicêtre], Institut National de la Santé et de la Recherche Médicale (INSERM), Faculté de Médecine Paris-Saclay, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)-Université Paris-Saclay, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, France, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Médecine Interne, Immunologie clinique et maladies infectieuses [CHU Reims], Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de Cardiologie [La Roche-sur-Yon], Centre Hospitalier Départemental site de la Roche-sur-Yon (CHD de la Roche-sur-Yon), Department of Pneumology [Lyon], Hospices Civils de Lyon (HCL), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service de pneumologie [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Centre Chirurgical Marie Lannelongue (CCML), Centre chirurgical Marie Lannelongue, Service de cardiologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Albert Calmette, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Perros, Frédéric, Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Marie-Lannelongue, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), CHU Gabriel Montpied (CHU), Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], and AP-HP - Hôpital Antoine Béclère [Clamart]
Subjects: [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, 3. Good health, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Abstract: International audience; INTRODUCTION:TBX4 mutation cause small patella syndrome (SPS) and/or pulmonary arterial hypertension (PAH). The characteristics and outcomes of PAH associated with TBX4 mutations are largely unknown.METHODS:We report the clinical, functional, radiologic, histologic and haemodynamic characteristics and outcomes of heritable PAH patients carrying a TBX4 mutation from the French PH Network.RESULTS:Twenty patients were identified in 17 families. They were characterised by a median age at diagnosis of 29 (0-76) year-old and a female to male ratio of 3. Most of the patients were in NYHA functional class III or IV (70%) with a severe hemodynamic impairment (median pulmonary vascular resistance of 13.6 [6.2-41.8] Wood Units). Skeletal signs of SPS were present in 80% of cases. Half of the patients had mild restrictive or obstructive limitation and diffusing capacity for carbon monoxide was decreased in all patients. High-resolution computed tomography showed bronchial abnormalities, peri-bronchial cysts, mosaic distribution and mediastinal lymphadenopathies. PAH therapy was associated with significant clinical improvement. At follow-up (median 76 months), two patients died and two underwent lung transplantation. One-, three- and five-year event-free survival rates were 100%, 94% and 83%, respectively. Histologic examination of explanted lungs revealed alveolar growth abnormalities, major pulmonary vascular remodelling similar to that observed in idiopathic PAH, and accumulation of cholesterol crystals within the lung parenchyma.CONCLUSION:PAH due to TBX4 mutations may occur with or without skeletal abnormalities across a broad age range from birth to late adulthood. PAH is usually severe and associated with bronchial and parenchymal abnormalities.
Published: 2020

16. Relationship between calcifications and structural lesions on hand radiography and axial calcifications on CT-scan

Author: Bauer, Elodie, Fauny, Marine, Tanguy, Maurice, Albuisson, Eliane, Mandry, Damien, Huttin, Olivier, Chabot, Francois, Deibener, Joelle, Chary-Valckenaere, Isabelle, Loeuille, Damien, Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), InSciDens [Nancy], Université de Lorraine (UL), Institut Élie Cartan de Lorraine (IECL), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Cardiologie [CHRU Nancy], Service de Pneumologie [CHRU Nancy], Service de Médecine Interne et Médecine Générale [CHRU Nancy], Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), and BIRKER, Juliette
Subjects: [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, calcifications, systemic sclerosis, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine
Abstract: International audience; The objectives of this study were to describe the prevalence and characteristics of radiographic lesions of the hands, and calcifications of the spine on computer tomography scans (CT-scans), and to investigate the relationships between radiographic and CT-scan abnormalities and clinical features in a population of patients with systemic sclerosis (SSc).Subjects underwent X-ray examination of the hands, and thoracic or thoraco-abdominal and pelvic CT scan or lumbar CT scan in the year. Structural lesions on hand X ray was scored and spinal calcifications were evaluated in the anterior, intracanal and posterior segments. Intra and inter-reliability was tested for radiography and CT- scan. Prognostic factors considered were interstitial pulmonary lesions on the CT scan, pulmonary arterial hypertension (PAH) and death.This study involved 77 SSc patients, 58 (75%) with limited cutaneous SSc (lcSSc) and 19 (25%) with diffuse SSc (dSSc). The prevalences of radiographic lesions of the hand were 28.6% for periarticular calcifications and 26% for calcinosis. On CT scan, 64 (83%) patients exhibited at least 1 calcification. Spine calcifications were depicted in 80.5%, 27.3%, and 35.1% at the anterior, intracanal and posterior segments respectively. Calcifications were mainly localized on thoracic spine. Inter reader reliabilities were good for hands and moderate for spine respectively. Spine calcifications and periarticular calcifications in the hands were associated (P = .012). Calcinosis in the hands was related to PAH (P = .02). Posterior calcification segment and foraminal calcifications were associated with interstitial lung disease (ILD) (P = .029) and death (P = .001).More than 80% of systemic sclerosis patients presented spine calcifications. A significant association between hands and spinal calcifications were confirmed and some localization in the posterior segment considered as a bad prognostic factor.
Published: 2020

17. Three-Dimensional Echocardiography for the Assessment of Right Ventriculo-Arterial Coupling

Author: Damien Mandry, Laura Filippetti, Pierre-Yves Marie, François Chabot, Clément Venner, Olivier Huttin, Ari Chaouat, Anne Guillaumot, Raphaël Aubert, Christine Selton-Suty, Yves Juillière, Djalila Haine, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Pneumologie [CHRU Nancy], Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Service de Médecine Nucléaire [Nancy]
Subjects: Male, Cardiac Catheterization, medicine.medical_specialty, Hypertension, Pulmonary, Ventricular Dysfunction, Right, Echocardiography, Three-Dimensional, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Pulmonary Artery, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Afterload, medicine.artery, Internal medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, medicine, Humans, Radiology, Nuclear Medicine and imaging, Ventricular arterial coupling, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, business.industry, Stroke Volume, Three dimensional echocardiography, Stroke volume, Middle Aged, medicine.disease, Pulmonary hypertension, 3. Good health, medicine.anatomical_structure, Ventricle, Pulmonary artery, Cardiology, Female, Vascular Resistance, France, Cardiology and Cardiovascular Medicine, business, Cardiac magnetic resonance, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: The analysis of right ventriculo-arterial coupling (RVAC) from pressure-volume loops is not routinely performed. RVAC may be approached by the combination of right heart catheterization (RHC) pressure data and cardiac magnetic resonance (CMR)-derived right ventricular (RV) volumetric data. RV pressure and volume measurements by Doppler and three-dimensional echocardiography (3DE) allows another way to approach RVAC.Ninety patients suspected of having pulmonary hypertension underwent RHC, 3DE, and CMR (RHC mean pulmonary artery pressure [mPAP] 37.9 ± 11.3 mm Hg; range, 15-66 mm Hg). Three-dimensional (3D) echocardiography was performed in 30 normal patients (echocardiographic mPAP 18.4 ± 3.1 mm Hg). Pulmonary artery (PA) effective elastance (Ea), RV maximal end-systolic elastance (Emax), and RVAC (PA Ea/RV Emax) were calculated from RHC combined with CMR and from 3DE using simplified formulas including mPAP, stroke volume, and end-systolic volume.Three-dimensional echocardiographic and RHC-CMR measures for PA Ea (3DE, 1.27 ± 0.94; RHC-CMR, 0.71 ± 0.52; r = 0.806, P .001), RV Emax (3DE, 0.72 ± 0.37; RHC-CMR, 0.38 ± 0.19; r = 0.798, P .001), and RVAC (3DE, 2.01 ± 1.28; RHC-CMR, 2.32 ± 1.77; r = 0.826, P .001) were well correlated despite a systematic overestimation of 3DE elastance parameters. Among the whole population, 3D echocardiographic PA Ea and 3D echocardiographic RVAC but not 3D echocardiographic RV Emax were significantly lower in patients with mPAP25 mm Hg (n = 41) than in others (n = 79). Among the 90 patients who underwent RHC, 3D echocardiographic PA Ea and 3D echocardiographic RVAC but not 3D echocardiographic RV Emax increased significantly with increasing levels of pulmonary vascular resistance.Three-dimensional echocardiography-derived PA Ea, RV Emax, and RVAC correlated well with the reference RHC-CMR measurements. Ea and RVAC but not Emax were significantly different between patients with different levels of afterload, suggesting failure of the right ventricle to maintain coupling in severe pulmonary hypertension.
Published: 2018

18. Paraneoplastic hypoglycemia: The hopes of pathophysiological documentation

Author: O. Menard, Y. Martinet, J.-M. Vignaud, A. Villemain, D. Mandry, Angelica Tiotiu, J. Siat, Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), and Service d’Anatomie Pathologique [CHRU Nancy]
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, Gynecology, medicine.medical_specialty, business.industry, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 3. Good health, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Medicine, 030212 general & internal medicine, business, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Resume Le syndrome de Doege-Potter associe une hypoglycemie paraneoplasique a une tumeur fibreuse solitaire. Les tumeurs fibreuses solitaires sont rares et le plus souvent asymptomatiques. L’apparition de signes cliniques ou de syndromes paraneoplasiques est le fait de tumeurs volumineuses avec un index mitotique eleve. Le diagnostic est evoque par l’imagerie mais la confirmation diagnostique est apportee par la chirurgie qui reste le traitement de choix. L’hypoglycemie resulte de la secretion par la tumeur de formes incompletes d’un facteur de croissance apparente a l’insuline appele « big »-IGF-2 ( insulin-like growth factor ). Plusieurs tests biologiques permettent de demontrer l’augmentation du taux plasmatique du « big »-IGF-2 confirmant le diagnostic de « non islet cell tumour induced hypoglyceamia ». L’exerese tumorale conduit a la resolution de l’hypoglycemie. Ces tumeurs ont un potentiel de malignite intermediaire. Malgre l’analyse histologique et immunohistochimique, leur pronostic et leur agressivite restent difficiles a etablir. Des recidives et des transformations malignes sont possibles tardivement, ce qui impose un suivi radiologique au long terme. Nous rapportons un cas de syndrome de Doege-Potter concernant une tumeur fibreuse solitaire pleurale a recidive maligne tardive dont l’interet est de documenter la physiopathologie de l’hypoglycemie paraneoplasique.
Published: 2017

19. Efficacy of Whole-Lung Lavage in Pulmonary Alveolar Proteinosis: A Multicenter International Study of GELF

Author: Gay, Pierre, Wallaert, Benoit, Nowak, Stefan, Yserbyt, Jonas, Anevlavis, Stavros, Hermant, Christophe, Lovis, Alban, Menard, Olivier, Maitre, Bernard, Vandemoortele, Thomas, Dutau, Hervé, Briault, Amandine, Bourdin, Arnaud, Vergnon, Jean-Michel, Froudarakis, Marios, Service de Pneumologie [Saint-Etienne], CHU Saint-Etienne, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Service de pneumologie [Toulouse], CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Pneumologie [CHI Créteil], CHI Créteil, Assistance Publique - Hôpitaux de Marseille (APHM), CHU Grenoble, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Herrada, Anthony, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Pulmonary Alveolar Proteinosis, 030204 cardiovascular system & hematology, Bronchoalveolar Lavage, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Pulmonary function testing, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Bronchoscopy, Humans, Medicine, In patient, Respiratory system, Flexible bronchoscopy, Aged, medicine.diagnostic_test, business.industry, Whole lung lavage, Middle Aged, medicine.disease, Respiratory Function Tests, 3. Good health, Endoscopy, Surgery, Treatment Outcome, 030228 respiratory system, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Female, Respiratory Insufficiency, business, Pulmonary alveolar proteinosis, Rare disease
Abstract: Background: New therapies have emerged in the treatment of pulmonary alveolar proteinosis (PAP) and, therefore, there is a real need to evaluate the efficacy of whole-lung lavage (WLL) in this rare disease. Objectives: The aim of this study was to assess the efficacy of WLL in patients with PAP. Methods: We included 33 patients from 12 centers, which are members of the French-Speaking Thoracic Endoscopy Group, for analysis. Data collection concerned patients and disease characteristics, pulmonary function tests (PFTs) and technical information on the procedure. Results: The median age of the patients was 44 years (range 13-77). There were 23 (71.9%) patients with respiratory insufficiency at presentation. All patients underwent WLL by general anesthesia and selective lung ventilation, except 1 who underwent awake flexible bronchoscopy. We noted differences in the technique, as 12 (36.36%) patients had percussion during the procedure and only 4 (12.1%) patients underwent 2-lung lavage during 1 anesthesia. A median of 12 L was used to perform WLL (1.0-40 L). Complications occurred in 11 (33.3%) patients, and 18 (56.25%) of them relapsed in a median period of 16.9 months. No significant changes were found in any PFT parameters studied, except for PaO2, which was significantly improved by 6.375 mm Hg (p = 0.0213) after the procedure compared to before. Conclusions: Although the application of the WLL technique was variable, overall, it significantly improved patients' short-term respiratory condition by improving PaO2. However, a long-term effect needs to be confirmed, as many of our patients relapsed.
Published: 2017

20. Uncontrolled occupational asthma: Talking about comorbidities

Author: P, Thoré, A, Tiotiu, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), and Université de Lorraine (UL)
Subjects: Hypersensitivity, Immediate, Male, Sleep Apnea, Obstructive, Risk Factors, Occupational Exposure, [SDV]Life Sciences [q-bio], Gastroesophageal Reflux, Humans, Asthma, Occupational, Middle Aged, Severity of Illness Index, Isocyanates
Abstract: International audience; IntroductionOccupational asthma is a disease where the pathophysiological characteristics of asthma are linked to repeated exposure to a sensitizing agent present in the workspace. Assessment of patients with severe asthma to identify and manage comorbidities improves asthma control and is recommended in international guidelines on the management of severe asthma.Case reportWe report the case of a 49-year-old patient, nonsmoker, without atopy, who had severe work-related asthma due to exposure to isocyanates, which was uncontrolled despite the avoidance of the occupational exposure and maximal medical treatment. A systematic assessment for possible comorbidities revealed gastroesophageal reflux and obstructive sleep apnea syndrome. The specific management of these two comorbidities led to an improvement of asthma control with a reduction in the number of exacerbations, a reduced burden of treatment and a resumption of employment.ConclusionsAs with all cases of severe asthma, the assessment of comorbidities must be systematic in the presence of an occupational asthma which persists after the cessation of the occupational exposure. The management of these comorbidities can lead to an improvement in asthma control and severity.; IntroductionL’asthme professionnel associe les caractéristiques habituelles de la maladie asthmatique et la sensibilisation à un agent présent dans le milieu professionnel, responsable de cette symptomatologie. Si la prise en charge de comorbidités dans l’asthme sévère est rentrée dans la pratique habituelle, peu de données existent concernant leur lien avec l’asthme professionnel.ObservationsNous présentons le cas d’un patient non-fumeur de 49 ans, diagnostiqué d’un asthme professionnel aux isocyanates, avec des critères de sévérité, qui malgré l’éviction de l’exposition professionnelle et un traitement médical maximal, restait non contrôlé. Après plusieurs changements thérapeutiques sans effet sur le contrôle de l’asthme et le nombre d’exacerbations, la recherche de comorbidités a permis d’abord la mise en évidence d’un reflux gastro-œsophagien, puis d’un syndrome d’apnées-hypopnées obstructives du sommeil. La prise en charge de ces comorbidités a permis une amélioration du contrôle de l’asthme et du nombre d’exacerbations, conduisant à une diminution de la pression thérapeutique et la reprise d’une activité après reclassement professionnel.ConclusionsComme dans tous les cas d’asthme sévère, la recherche de comorbidités doit être entreprise en cas d’asthme professionnel non contrôlé malgré l’arrêt de l’exposition professionnelle et un traitement médical optimal. Leur prise en charge permettra un meilleur contrôle de la maladie asthmatique.
Published: 2019

21. The impact of the patient's age on the delay of the lung cancer treatment

Author: Knoepfli, Arnaud, Vaillant, Pierre, Billon, Yves, ZYSMAN, Maeva, Menard, Olivier, Tiotiu, Angelica, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), and Université de Lorraine (UL)
Subjects: Male, Lung Neoplasms, Time Factors, [SDV]Life Sciences [q-bio], Age Factors, Humans, Female, Middle Aged, Aged, Retrospective Studies, Time-to-Treatment
Abstract: International audience; IntroductionThe results from the medical literature regarding the influence of patient's age on the delay of treatment in lung cancer are controversial in the absence of a consensual definition. The aim of this study was to determine the impact of the patient's age on the delay of the lung cancer treatment.MethodsA retrospective monocentric study was performed including patients treated for a lung cancer in our department between November 1, 2014 and October 31, 2015. The delay of treatment was defined by the delay between the first abnormal imaging and the first treatment. The patients were divided into three groups depending on their age: group 1 with ≤ 60 years old, group 2 between 60 and 70 years old, and group 3 with > 70 years old. The statistical analysis was realized with Pearson's chi-squared and the Anova tests.ResultsTwo-hundred and forty-six patients were included with a mean age at 65 ± 10 years. The mean delay of the treatment was 97 ± 41 days. The mean delay of the treatment in patients with > 70 years old was statically longer than the delay of treatment in patients with ≤ 60 years old (116 ± 98 days vs. 76 ± 65 days, P = 0.04), secondary to an extended time for the lung cancer surgery (129 ± 75 days vs. 88 ± 54 days, P = 0.03).ConclusionIn patients with > 70 years old, the delay of treatment is longer than in other groups, secondary to an extended time for the preoperative assessment. An improvement in therapeutic management is necessary in our care system to shorten this delay.; IntroductionLes données de la littérature concernant l’influence de l’âge sur le délai de prise en charge du cancer bronchique font l’objet de controverses et les études se révèlent très hétérogènes en absence d’une définition consensuelle. L’objectif principal de la présente étude est de déterminer la relation entre l’âge des patients et le délai de prise en charge du cancer bronchique au CHRU de Nancy.MéthodesUne étude rétrospective monocentrique a été réalisée sur les patients ayant reçu un premier traitement spécifique pour un cancer bronchique entre le 1er novembre 2014 et 31 octobre 2015. Le délai de prise en charge était défini par l’intervalle de temps compris entre la première imagerie anormale et le premier traitement réalisé (chirurgie, chimiothérapie, radiothérapie, thérapie ciblée). Les patients étaient répartis en trois groupes : groupe 1 (âge ≤ 60 ans), groupe 2 (âge entre 60 et 70 ans) et groupe 3 (âge > 70 ans).RésultatsAu total, 246 patients étaient inclus avec une moyenne d’âge de 65 ± 10 ans. Le délai moyen de prise en charge du cancer bronchique est de 97 ± 41 jours. Le délai moyen de prise en charge des patients âgés de > 70 ans est statistiquement plus long que celui des patients âgés de ≤ 60 ans (116 ± 98 jours vs 76 ± 65 jours, p = 0,04) du fait, notamment, d’un allongement du délai de prise en charge chirurgicale (129 ± 75 jours vs 88 ± 54 jours, p = 0,03).ConclusionLe délai de prise en charge, plus long pour les patients âgés de > 70 ans que pour les autres groupes, est notamment le reflet d’une attente prolongée pour réaliser le bilan préopératoire avant une prise en charge chirurgicale. Des efforts sont nécessaires pour optimiser notre parcours de soins et raccourcir ce délai.
Published: 2019

22. Histoire naturelle d’une forme bronchectasiante de la maladie à dépôts de chaînes légères

Author: Anne Guillaumot, Emmanuel Gomez, Magali Colombat, F. Millet, Sandrine Hirschi, A. Chaouat, M.-P. Chenard, B. Mouget, I. Petit, François Chabot, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département de radiologie, Institut Gustave Roussy (IGR), Service d'Anatomo-Pathologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Beaujon [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP)
Subjects: Pulmonary and Respiratory Medicine, Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, 030228 respiratory system, business.industry, [SDV]Life Sciences [q-bio], Medicine, 030212 general & internal medicine, business
Abstract: Resume Introduction L’histoire naturelle des maladies pulmonaires orphelines est rarement connue. Nous presentons l’evolution a long terme d’une forme bronchectasiante de la maladie a depots de chaines legeres (MDCL) d’immunoglobulines non amyloides. Observation Il s’agit d’une femme fumeuse chez qui le diagnostic de dilatation des bronches d’etiologie indeterminee est porte a l’âge de 50 ans. Dix ans apres, l’hypothese d’une MDCL pulmonaire est evoquee devant l’aspect caracteristique des bronchectasies, l’apparition de kyste pulmonaires, l’augmentation du taux serique des chaines legeres Kappa. La confirmation diagnostique est obtenue par biopsie pulmonaire chirurgicale. Aucune hemopathie maligne n’est retrouvee. Durant les 12 ans de suivi, l’aggravation de la dyspnee d’effort est lente et concomitante a l’extension des bronchectasies et des kystes realisant un aspect de pneumopathie multikystique. Les EFR montrent une preservation des volumes pulmonaires et une diminution moderee de la capacite de diffusion du monoxyde de carbone (DLCO). Conclusion Nous decrivons l’evolution d’une presentation rare de la MDCL pulmonaire isolee sous la forme de bronchectasies kystiques diffuses, a parois fines, non secretantes, s’associant a une destruction kystique du parenchyme pulmonaire. L’hypothese d’une MDCL pulmonaire doit etre evoquee devant des bronchectasies atypiques d’etiologie indeterminee.
Published: 2019

23. Occupational Asthma Caused by Powder Paint in the Automotive Industry

Author: Emmanuelle Penven, Mathias Poussel, Angelica Tiotiu, Isabelle Thaon, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Imperial College London, and Centre de consultations de pathologies professionnelles [CHRU Nancy] (CCPP)
Subjects: Adult, Immunology, MEDLINE, Automotive industry, Air Pollutants, Occupational, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, Air pollutants, Occupational Exposure, Environmental health, Paint, medicine, Humans, Industry, Immunology and Allergy, 030212 general & internal medicine, Asthma, Occupational, ComputingMilieux_MISCELLANEOUS, Asthma, business.industry, Allergens, medicine.disease, Respiratory Function Tests, 030228 respiratory system, Female, business, Occupational asthma
Abstract: International audience
Published: 2019

24. Validation of respiratory rate measurements from remote monitoring device in COPD patients

Author: X.L. Le, Jésus Gonzalez-Bermejo, D.P.Q. Nguyen, R. Antoine, J. Alves Pegoraro, Leo Grassion, Antoine Guerder, J. Soler, Service de Pneumologie et Réanimation Médicale [CHU Pitié-Salpêtrière] (Département ' R3S '), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Pneumologie [CHRU Nancy], Mathématiques Appliquées Paris 5 (MAP5 - UMR 8145), Université Paris Descartes - Paris 5 (UPD5)-Institut National des Sciences Mathématiques et de leurs Interactions (INSMI)-Centre National de la Recherche Scientifique (CNRS), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Neurophysiologie Respiratoire Expérimentale et Clinique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Telemonitoring, Respiratory rate, Exacerbation, LTOT, Copd patients, medicine.medical_treatment, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Home care, 03 medical and health sciences, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Respiratory Rate, Oxygen therapy, Forced Expiratory Volume, medicine, Confidence Intervals, COPD, Humans, Telemetry, Respiratory system, 030304 developmental biology, Mechanical ventilation, 0303 health sciences, business.industry, Oxygen Inhalation Therapy, medicine.disease, 3. Good health, 030228 respiratory system, Emergency medicine, Breathing, Disease Progression, Regression Analysis, business
Abstract: International audience; With healthcare objectives and budget constraint, remote monitoring of chronic obstructive pulmonary disease (COPD) patients is an important challenge in most European countries. Recent works have shown that it is possible to predict COPD exacerbation based on monitoring of simple parameters, such as the respiratory rate (RR) of the patient in spontaneous ventilation or under non-invasive ventilation. Until now, these devices do not allow a daily automatic data remote transmission,[4] or it is restricted to patients under mechanical ventilation. TeleOx® (SRETT, Boulogne-Billancourt, France), the first oxygen flow rate remote monitoring device, also allows a RR measurement by associating a pressure sensor and a fluidic oscillator flow sensor. A median RR is output every 5 minutes based on time interval between two consecutive respiratory cycles.In this study, we compared the corresponding RR measurements between TeleOx® and the reference polygraph (Nox-T3®, Nox Medical Inc. Reykjavik, Iceland) from COPD patients under nasal oxygen therapy with flow rates between 0.5 and 5.0 litres per minute. Patients without mechanical ventilation and without any other respiratory pathology were eligible to the study if they would undergo a ventilatory polygraph record for other reasons
Published: 2019

25. Comorbidities in inflammatory bowel disease: a call for action

Author: Laurent Peyrin-Biroulet, Marjorie Argollo, Silvio Danese, Carina Peyrin-Biroulet, Daniela Gilardi, Jean-Francois Chabot, Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed), Universidade Federal de São Paulo, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Arthritis, Disease, Comorbidity, Inflammatory bowel disease, digestive system, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Psoriasis, medicine, Prevalence, Humans, Life Style, Fatigue, Metabolic Syndrome, Hepatology, business.industry, Gastroenterology, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, Inflammatory Bowel Diseases, digestive system diseases, 3. Good health, Reproductive Health, Treatment Outcome, Cardiovascular Diseases, 030220 oncology & carcinogenesis, Rheumatoid arthritis, Osteoporosis, 030211 gastroenterology & hepatology, Metabolic syndrome, Nervous System Diseases, Sexual Health, business, Uveitis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Inflammatory bowel disease (IBD) is a chronic systemic inflammatory condition. Previously, the focus has been on extraintestinal manifestations of IBD, including arthritis, psoriasis, and uveitis. Although comorbidities have long been the subject of intensive research in other chronic inflammatory diseases such as rheumatoid arthritis, the concept of comorbidities is only beginning to emerge in IBD. Several comorbid conditions have been proposed to be related to IBD, including cardiovascular disease, neuropsychological disorders, and metabolic syndrome. Recognition of these conditions and their treatment could lead to better management of IBD. This Review aims to explore current knowledge regarding classic and emerging comorbidities related to IBD.Copyright © 2019 Elsevier Ltd. All rights reserved.
Published: 2019

26. Worsening and newly diagnosed paraneoplastic syndromes following anti-PD-1 or anti-PD-L1 immunotherapies, a descriptive study

Author: Julie Perrin, Florence Poizeau, Johan Pluvy, Alexandra Forestier, Franck Grados, Capucine Baldini, Maud Pallix-Guyot, Dimitri Psimaras, Solenn Brosseau, Laurianne Grignou, Jean-Marie Michot, Alexandre Thibault Jacques Maria, Guillaume Manson, Aurélien Marabelle, Olivier Lambotte, Benoit Godbert, Jérôme Honnorat, Fanny Duval, Maxime Roger, Pauline Du Rusquec, Frederic Bourdain, G. Maigné, Léa Dousset, Marie Kostine, Christophe Massard, Anne-Laure Voisin, Gilles Quere, Sandrine Aspeslagh, François-Xavier Danlos, Marc Ruivard, Beatris Irina Taifas, Patricia Martin-Romano, Salvy-Córdoba, Nathalie, CHU Pontchaillou [Rennes], Institut Gustave Roussy (IGR), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de rhumatologie, CHU Bordeaux [Bordeaux], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d’Innovation Thérapeutique et essais précoces [Gustave Roussy] (DITEP), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, Centre d'Energétique et de Thermique de Lyon (CETHIL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de biochimie générale [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Régional d'Orléans (CHRO), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Université de Bordeaux (UB), Université de Brest (UBO), Service de Neuroradiologie [CHU Pitié-Salpêtrière], 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), Service d'Oncologie Thoracique (BREST - ICH), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), CHU Amiens-Picardie, Laboratoire de Génie des Procédés et Matériaux - EA 4038 (LGPM), CentraleSupélec, Service de Neurologie, Hôpital Foch [Suresnes], Hôpital de Bayonne, CH de la Côte Basque, Service de médecine interne [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Robert Schuman, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital d'instruction des Armées Percy, Service de Santé des Armées, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Universitaire de Technologie - Clermont-Ferrand (IUT Clermont-Ferrand), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut NeuroMyoGène (INMG), Université de Lyon, Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier de la Côte Basque (CHCB), Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Normandie Université (NU)-Centre hospitalier universitaire de Rouen, Université Lille Nord de France (COMUE)-UNICANCER, Laboratoire d'Imagerie Biomédicale (LIB), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Medical Oncology, and Laboratory for Medical and Molecular Oncology
Subjects: Male, Cancer Research, Paraneoplastic Syndromes, medicine.medical_treatment, Programmed Cell Death 1 Receptor, Severity of Illness Index, B7-H1 Antigen, Antineoplastic Agents, Immunological, 0302 clinical medicine, Neoplasms, Immunology and Allergy, Aged, 80 and over, Melanoma, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Cohort, Molecular Medicine, Female, France, Symptom Assessment, Encephalitis, Research Article, medicine.medical_specialty, animal structures, Immunology, [SDV.CAN]Life Sciences [q-bio]/Cancer, lcsh:RC254-282, Autoimmune Diseases, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Pharmacovigilance, Severity of illness, medicine, Humans, Lung cancer, Aged, Pharmacology, business.industry, anti-PD-L1 immunotherapy, Cancer, Immunotherapy, Paraneoplastic syndromes (PNS), medicine.disease, nervous system, business, 030217 neurology & neurosurgery
Abstract: International audience; BACKGROUND:Paraneoplastic syndromes (PNS) are autoimmune disorders specifically associated with cancer. There are few data on anti-PD-1 or anti-PD-L1 immunotherapy in patients with a PNS. Our objective was to describe the outcome for patients with a pre-existing or newly diagnosed PNS following the initiation of anti-PD-1 or anti-PD-L1 immunotherapy.METHODS:We included all adult patients (aged ≥18) treated with anti-PD-1 or anti-PD-L1 immunotherapy for a solid tumor, diagnosed with a PNS, and registered in French pharmacovigilance databases. Patients were allocated to cohorts 1 and 2 if the PNS had been diagnosed before vs. after the initiation of immunotherapy, respectively.FINDINGS:Of the 1304 adult patients screened between June 27th, 2014, and January 2nd, 2019, 32 (2.45%) had a PNS and were allocated to either cohort 1 (n = 16) or cohort 2 (n = 16). The median (range) age was 64 (45-88). The tumor types were non-small-cell lung cancer (n = 15, 47%), melanoma (n = 6, 19%), renal carcinoma (n = 3, 9%), and other malignancies (n = 8, 25%). Eleven (34%) patients presented with a neurologic PNS, nine (28%) had a rheumatologic PNS, eight (25%) had a connective tissue PNS, and four (13%) had other types of PNS. The highest severity grade for the PNS was 1-2 in 10 patients (31%) and ≥ 3 in 22 patients (69%). Four patients (13%) died as a result of the progression of a neurologic PNS (encephalitis in three cases, and Lambert-Eaton syndrome in one case). Following the initiation of immunotherapy, the PNS symptoms worsened in eight (50%) of the 16 patients in cohort 1.INTERPRETATION:Our results show that PNSs tend to be worsened or revealed by anti-PD-1 or anti-PD-L1 immunotherapy. Cases of paraneoplastic encephalitis are of notable concern, in view of their severity. When initiating immunotherapy, physicians should carefully monitor patients with a pre-existing PNS.
Published: 2019

27. Vertebral fracture prevalence and measurement of the scanographic bone attenuation coefficient on CT-scan in patients with systemic sclerosis

Author: J. Perrier-cornet, Damien Mandry, Damien Loeuille, François Chabot, Isabelle Chary-Valckenaere, Eliane Albuisson, Elodie Bauer, Olivier Huttin, Joëlle Deibener, Marine Fauny, Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Élie Cartan de Lorraine (IECL), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), InSciDens [Nancy], Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Service de Médecine Interne et Médecine Générale [CHRU Nancy], Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Service de Cardiologie [CHRU Nancy], and Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA)
Subjects: Adult, Male, medicine.medical_specialty, Multivariate analysis, Immunology, Osteoporosis, Computed tomography, 03 medical and health sciences, 0302 clinical medicine, Absorptiometry, Photon, Rheumatology, Calcinosis, Bone Density, Internal medicine, Hounsfield scale, medicine, Prevalence, Immunology and Allergy, Humans, In patient, 030212 general & internal medicine, Aged, Retrospective Studies, 030203 arthritis & rheumatology, Lumbar Vertebrae, Scleroderma, Systemic, medicine.diagnostic_test, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, 3. Good health, Spinal Fractures, Female, Radiology, business, Tomography, X-Ray Computed, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; To study vertebral fracture (VF) prevalence and the scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1) on computed tomography scans (CT-scans) in systemic sclerosis patients. This monocentric retrospective study included patients followed from 2000 to 2014 and fulfilling ACR/EULAR 2013 criteria for systemic sclerosis and who underwent a thoracic or thoraco-abdomino-pelvic CT-scan during their follow-up. Clinical characteristics for sclerosis and osteoporosis risk factors were collected. For CT-scan, the VFs were determined according to Genant’s classification, the SBAC-L1 was measured in Hounsfield Units (HU), and a SBAC-L1 ≤ 145 HU (fracture threshold) defined patients at VF risk. Predictive factors for SBAC-L1 ≤ 145 HU were studied. A total of 70 patients were included [mean age, 62.3 (± 15.6) years, women 88.5%, diffuse sclerosis 22.9% (n = 16)]. On CT-scans, three VFs were detected in three patients (4.3%). The mean SBAC-L1 was 157.26 HU (± 52.1), and 35 patients (50%) presented a SBAC-L1 ≤ 145 HU. In multivariate analysis, only age (especially patients older than 63 years, OR = 1.08, CI 95% 1.04–1.13, p = 0.001) and calcinosis (OR = 6.04, CI 95% 1.27–28.70, p = 0.02) were independently associated with a SBAC-L1 ≤ 145 HU. On a large sample of patients with systemic sclerosis, the VF prevalence on CT-scan was low (4.3%) while 50% of the patients presented a SBAC-L1 ≤ 145 HU. Interestingly, the presence of calcinosis, periarticular calcifications or acro-osteolysis was linked with low SBAC-L1 and should lead to an osteoporosis screening, especially for patients under 63 years old.
Published: 2018

28. Evaluation of cardiac MRI in the follow up assessment of patients with pulmonary arterial hypertension

Author: Anne Guillaumot, François Chabot, Magalie Mercy, Olivier Sitbon, Renaud Fay, A. Chaouat, M. Faure, Pierre-Yves Marie, Aboubaker Cherifi, Maeva Zysman, Damien Mandry, Nicolas Girerd, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hypertension pulmonaire : physiopathologie et innovation thérapeutique (HPPIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Service de Médecine Nucléaire [Nancy], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, medicine.medical_treatment, Population, Cardiac index, Hemodynamics, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Cardiac magnetic resonance imaging, Internal medicine, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, education, ComputingMilieux_MISCELLANEOUS, Cardiac catheterization, education.field_of_study, Ejection fraction, medicine.diagnostic_test, business.industry, medicine.disease, Pulmonary hypertension, 3. Good health, 030228 respiratory system, Predictive value of tests, Cardiology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Haemodynamic follow up in pulmonary arterial hypertension (PAH) is currently based on right heart catheterisation (RHC). The primary objective of the EVITA study is to compare the use of cardiac magnetic resonance imaging (cMRI) with RHC in the identification of an unfavourable hemodynamic status. The secondary objectives are to determine the role of cMRI in the follow up process. Patients will undergo at diagnosis and at follow up visits both RHC and cMRI. Patients will be followed and treated according to the current guidelines. The primary endpoint will be an unfavourable haemodynamic status defined by cardiac index
Published: 2018

29. Effectiveness of bacteriophages in the sputum of cystic fibrosis patients

Author: Raphaël Chiron, Laurent Debarbieux, Frédérique Carrié, Nicolas Molinari, Isabelle Sermet, Isabelle Vachier, Jean-Paul Pirnay, Emilie Saussereau, Nicolas Dufour, Benoit Godbert, Daniel De Vos, Debarbieux, Laurent, Cellule Pasteur UPMC, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut Pasteur [Paris] (IP), Biologie Moléculaire du Gène chez les Extrêmophiles (BMGE), Institut Pasteur [Paris] (IP), Département des Maladies Respiratoires [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre de recherche Croissance et signalisation (UMR_S 845), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Cellule Pasteur, Université Paris Diderot - Paris 7 (UPD7)-PRES Sorbonne Paris Cité, Laboratory for Molecular and Cellular Technology, Queen Astrid Military Hospital [Brussels], PHAGESPOIRS, Mathématiques, Informatique et STatistique pour l'Environnement et l'Agronomie (MISTEA), Institut National de la Recherche Agronomique (INRA)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), This work was supported by Vaincre la Mucoviscidose, the French Cystic Fibrosis Foundation [RC20120600714/1/1/141], and Programme Transversal de Recherches [417] from Institut Pasteur and Assistance Publique Hôpitaux de Paris., Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut Pasteur [Paris], Institut Pasteur [Paris], Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de la Recherche Agronomique (INRA), PRES Sorbonne Paris Cité-Université Paris Diderot - Paris 7 (UPD7), Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro)-Institut National de la Recherche Agronomique (INRA), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut Pasteur [Paris], Biologie Moléculaire du Gène chez les Extrêmophiles ( BMGE ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Centre de recherche Croissance et signalisation ( UMR_S 845 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Diderot - Paris 7 ( UPD7 ) -PRES Sorbonne Paris Cité, Mathématiques, Informatique et STatistique pour l'Environnement et l'Agronomie ( MISTEA ), and Institut National de la Recherche Agronomique ( INRA ) -Institut national d’études supérieures agronomiques de Montpellier ( Montpellier SupAgro )
Subjects: Male, Time Factors, Cystic Fibrosis, medicine.medical_treatment, Antibiotics, pulmonary infection, [ SDV.MP.BAC ] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, medicine.disease_cause, MESH: Bacterial Load, Cystic fibrosis, MESH : Cross-Sectional Studies, MESH: Sputum, MESH : Female, MESH: Microbial Viability, MESH: Middle Aged, biology, MESH: Pseudomonas Infections, General Medicine, MESH : Adult, MESH : Pseudomonas aeruginosa, Middle Aged, MESH : Pseudomonas Infections, 3. Good health, Biological Therapy, Chronic infection, medicine.anatomical_structure, Infectious Diseases, MESH: Young Adult, Pseudomonas aeruginosa, MESH: Pseudomonas aeruginosa, Female, MESH : Bacterial Load, medicine.symptom, Pseudomonas Phages, MESH : Time Factors, Adult, Microbiology (medical), phage therapy, Phage therapy, Adolescent, MESH: Cystic Fibrosis, medicine.drug_class, MESH : Male, MESH : Young Adult, MESH: Pseudomonas Phages, Microbiology, Young Adult, MESH: Cross-Sectional Studies, MESH : Adolescent, MESH : Cystic Fibrosis, medicine, Humans, MESH : Middle Aged, Pseudomonas Infections, MESH: Adolescent, Microbial Viability, MESH: Humans, MESH : Humans, MESH: Time Factors, MESH : Microbial Viability, Sputum, MESH: Adult, medicine.disease, biology.organism_classification, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Bacterial Load, MESH: Male, Cross-Sectional Studies, MESH : Pseudomonas Phages, MESH : Sputum, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, MESH: Biological Therapy, MESH: Female, MESH : Biological Therapy, Bacteria, Respiratory tract
Abstract: International audience; Bacteriophages have been shown to be effective for treating acute infections of the respiratory tract caused by antibiotic-resistant bacteria in animal models, but no evidence has yet been presented of their activity against pathogens in complex biological samples from chronically infected patients. We assessed the efficacy of a cocktail of ten bacteriophages infecting Pseudomonas aeruginosa following its addition to 58 sputum samples from cystic fibrosis (CF) patients collected at three different hospitals. Ten samples that did not contain P. aeruginosa were not analysed further. In the remaining 48 samples, the addition of bacteriophages led to a significant decrease in the levels of P. aeruginosa strains, as shown by comparison with controls, taking two variables (time and bacteriophages) into account (p = 0.024). In 45.8% of these samples, this decrease was accompanied by an increase in the number of bacteriophages. We also tested each of the ten bacteriophages individually against 20 colonies from each of these 48 samples and detected bacteriophage-susceptible bacteria in 64.6% of the samples. An analysis of the clinical data revealed no correlation between patient age, sex, duration of P. aeruginosa colonization, antibiotic treatment, FEV1 (forced expiratory volume in the first second) and the efficacy of bacteriophages. The demonstration that bacteriophages infect their bacterial hosts in the sputum environment, regardless of the clinical characteristics of the patients, represents a major step towards the development of bacteriophage therapy to treat chronic lung infections.
Published: 2014
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30. Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension

Author: Florence Parent, Xavier Jaïs, Athénaïs Boucly, Jason Weatherald, Emmanuel Bergot, Gérald Simonneau, Laurent Savale, C. Chabanne, François Picard, Arnaud Bourdin, David Montani, Vincent Cottin, Pascal de Groote, Ari Chaouat, Mitja Jevnikar, Grégoire Prévot, Olivier Sitbon, Marc Humbert, Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), Hôpital Bicêtre, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre chirurgical Marie Lannelongue, Centre de Référence des Maladies Pulmonaires Rares [Hôpital Louis Pradel - HCL], Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de pneumologie [Toulouse], CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Hôpital cardiologique, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique - Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, Universiteacute, Paris-Sud, Agence Nationale de la Recherche, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), and Centre chirurgical Marie Lannelongue-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Hypertension, Pulmonary, Atrial Pressure, Walk Test, Risk management tools, 030204 cardiovascular system & hematology, World Health Organization, Risk Assessment, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Natriuretic Peptide, Brain, medicine, Lung transplantation, Humans, Pulmonary Vascular Diseases, Familial Primary Pulmonary Hypertension, Registries, Survival analysis, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, business.industry, Central venous pressure, Retrospective cohort study, Original Articles, Middle Aged, Prognosis, Survival Analysis, 3. Good health, 030228 respiratory system, Multivariate Analysis, Practice Guidelines as Topic, Physical therapy, Female, France, business, Risk assessment, Biomarkers, Lung Transplantation
Abstract: Current European guidelines recommend periodic risk assessment for patients with pulmonary arterial hypertension (PAH). The aim of our study was to determine the association between the number of low-risk criteria achieved within 1 year of diagnosis and long-term prognosis. Incident patients with idiopathic, heritable and drug-induced PAH between 2006 and 2016 were analysed. The number of low-risk criteria present at diagnosis and at first re-evaluation were assessed: World Health Organization (WHO)/New York Heart Association (NYHA) functional class I or II, 6-min walking distance (6MWD) >440 m, right atrial pressure, Simplified risk assessment using the number of low-risk criteria predicts prognosis at baseline and follow-up in PAH http://ow.ly/KMsj30cPNbm
Published: 2017

31. Lack of desensitization of the cough reflex in ovalbumin-sensitized rabbits during exercise

Author: Silvia Demoulin-Alexikova, Bruno Demoulin, Bruno Chenuel, Laurent Foucaud, Mathias Poussel, Christo Christov, Angelica Tiotiu, Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Department of Pulmonary Function Testing and Exercise Physiology [Nancy]
Subjects: Pulmonology, Physiology, medicine.medical_treatment, lcsh:Medicine, Stimulation, Pathology and Laboratory Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, White Blood Cells, 0302 clinical medicine, Animal Cells, Reflexes, Coughing, Medicine and Health Sciences, Medicine, lcsh:Science, Immune Response, Sensitization, Desensitization (medicine), Mammals, Multidisciplinary, biology, Respiration, Animal Models, respiratory system, 3. Good health, medicine.anatomical_structure, Experimental Organism Systems, Breathing, Anesthesia, Vertebrates, Rabbits, Cellular Types, Muscle Contraction, Research Article, Ovalbumin, Immune Cells, Cough reflex, Physical Exertion, Immunology, Surgical and Invasive Medical Procedures, Research and Analysis Methods, 03 medical and health sciences, Signs and Symptoms, Diagnostic Medicine, Reflex, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Animals, Asthma, Inflammation, Blood Cells, Functional Electrical Stimulation, business.industry, lcsh:R, Organisms, Biology and Life Sciences, Cell Biology, medicine.disease, respiratory tract diseases, Eosinophils, Cough, 030228 respiratory system, Desensitization, Immunologic, Amniotes, biology.protein, lcsh:Q, Physiological Processes, business, Airway, 030217 neurology & neurosurgery, Respiratory minute volume, Neuroscience
Abstract: International audience; IntroductionCough is a major symptom of asthma frequently experienced during exercise but little is known about interactions between cough and exercise. The goal of our study was to clarify the potential modulation of the cough reflex (CR) by exercise in a spontaneously breathing anaesthetized animal model of airway eosinophilic inflammation.Materials & methodsTen ovalbumin (OVA) sensitized adult rabbits and 8 controls were studied. The ventilatory response to direct tracheal stimulation, performed both at rest and during exercise was determined to quantify the incidence and the sensitivity of the CR.Broncho-alveolar lavages (BAL) and cell counts were performed to assess the level of the airway inflammation following OVA-induced sensitization. Exercise was mimicked by Electrically induced hindlimb Muscular Contractions (EMC).ResultsAmong 494 tracheal stimulations, 261 were performed at rest and 233 at exercise. OVA challenges in sensitized rabbits caused a significant increase in the percentage of eosinophils (p = 0.008) in BAL. EMC increased minute ventilation by 36% and 35% in OVA and control rabbits respectively, compared to rest values. The sensitivity of the CR decreased during exercise compared to baseline in control rabbits (p = 0.0313) while it remained unchanged in OVA rabbits.ConclusionThe desensitization of the CR during exercise in control rabbits was abolished in OVA rabbits. The precise role of airway inflammation in this lack of CR desensitization needs to be further investigated but it might contribute to the exercise-induced cough in asthmatics.
Published: 2017

32. Occupational Asthma to Detergent Protease Associated With a Late-Phase Neutrophilic Cutaneous Response

Author: L Essari, Emmanuelle Penven, A. Barbaud, Mathias Poussel, Christophe Paris, François Chabot, Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Service de Pneumologie [CHRU Nancy], and Service de Dermatologie et Allergologie [CHRU Nancy]
Subjects: medicine.medical_specialty, Colorectal cancer, Neutrophils, Bronchoconstriction, Immunology, Detergents, Vital Capacity, Cumulative Exposure, medicine.disease_cause, Asbestos, Bronchial Provocation Tests, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Forced Expiratory Volume, Occupational Exposure, medicine, Immunology and Allergy, Humans, Specific inhalation challenge, Asthma, Occupational, Lung, Occupational Health, Skin, 030201 allergy, Occupational asthma, Proportional hazards model, business.industry, Incidence (epidemiology), Respuesta neutrofílica, Cancer, Neutrophilic response, Asma ocupacional, Immunoglobulin E, Intradermal Tests, Middle Aged, Proteasa, medicine.disease, 3. Good health, Protease, Relative risk, Cohort, Amylases, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Provocación específica por inhalación, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Peptide Hydrolases
Abstract: International audience; Background: The relationships between asbestos exposure and colorectal cancer remain controversial. Objectives: We examined the association between asbestos exposure and colorectal cancer incidence. Methods: Volunteer retired workers previously exposed to asbestos were invited to participate in the French ARDCo screening program between 2003 and 2005. Additional data on risk factors for colorectal cancer were collected from the ARDCo-Nut subsample of 3,769 participants in 2011. Cases of colon and rectal cancer were ascertained each year through 2014 based on eligibility for free medical care following a cancer diagnosis. Survival regression based on the Cox model was used to estimate the relative risk of colon and rectal cancer separately, in relation to the time since first exposure (TSFE) and cumulative exposure index (CEI) to asbestos, and with adjustment for smoking in the overall cohort and for smoking, and certain risk factors for these cancers in the ARDCo-Nut subsample. Results: Mean follow-up was 10.2 years among 14,515 men, including 181 colon cancer and 62 rectal cancer cases (41 and 17, respectively, in the ARDCo-Nut subsample). In the overall cohort, after adjusting for smoking, colon cancer was significantly associated with cumulative exposure (HR = 1.14; 95% CI: 1.04, 1.26 for a 1-unit increase in ln-CEI) and ≥ 20–40 years since first exposure (HR = 4.67; 95% CI: 1.92, 11.46 vs. 0–20 years TSFE), and inversely associated with 60 years TSFE (HR = 0.26; 95% CI: 0.10, 0.70). Although rectal cancer was also associated with TSFE 20–40 years (HR = 4.57; 95% CI: 1.14, 18.27), it was not associated with ln-CEI, but these findings must be interpreted cautiously due to the small number of cases. Conclusions: Our findings provide support for an association between occupational exposure to asbestos and colon cancer incidence in men. Citation: Paris C, Thaon I, Hérin F, Clin B, Lacourt A, Luc A, Coureau G, Brochard P, Chamming’s S, Gislard A, Galan P, Hercberg S, Wild P, Pairon JC, Andujar P. 2017. Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the Asbestos-Related Diseases Cohort (ARDCo-Nut). Environ Health Perspect 125:409–415; http://dx.doi.org/10.1289/EHP153
Published: 2017

33. A diffuse lung emphysema, severe pulmonary hypertension and lack of airflow limitation

Author: Ari Chaouat, Romain Kessler, François Chabot, M. Faure, Matthieu Canuet, Emmanuel Gomez, Peter Dorfmüller, Damien Mandry, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre chirurgical Marie Lannelongue, Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), BIRKER, Juliette, Centre Chirurgical Marie Lannelongue (CCML), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pathology, medicine.medical_treatment, Airflow, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, Case Report, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, 030204 cardiovascular system & hematology, [SDV.IB.MN] Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Pulmonary hypertension, Pulmonary function testing, 03 medical and health sciences, 0302 clinical medicine, Diffusing capacity, Internal medicine, Pulmonary veno-occlusive disease, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Lung transplantation, Lung emphysema, ComputingMilieux_MISCELLANEOUS, Emphysema, lcsh:RC705-779, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, lcsh:Diseases of the respiratory system, respiratory system, medicine.disease, Pathophysiology, respiratory tract diseases, 3. Good health, surgical procedures, operative, 030228 respiratory system, Cardiology, Pulmonary Veno-Occlusive Disease, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Pulmonary veno-occlusive disease is characterized by remodeling of pulmonary arteries, capillaries and venules. We report a case of diffuse lung emphysema and pulmonary veno-occlusive disease with the characteristic of having no airflow limitation. A very low diffusing capacity for carbon monoxide and results of high-resolution computed tomography of the chest suggested pulmonary veno-occlusive disease. The diagnosis was confirmed on histological analysis after lung transplantation. The combination of results of the computed tomography of the chest and the histological analysis suggested a relationship between diffuse lung emphysema and remodeling of pulmonary vessels. A distinctive pattern of mild-to-moderate airflow limitation in patients with chronic obstructive pulmonary disease and severe pulmonary hypertension has been described. This observation of the combination of diffuse emphysema, pulmonary veno-occlusive disease and no airflow limitation supports further pathophysiological studies on severe pulmonary hypertension in chronic obstructive pulmonary disease.
Published: 2017

34. Quality of Resection and Outcome in Stage III TETs: The French RYTHMIC Network Experience

Author: Bluthgen, Maria, Dansin, Eric, Ou, Dan, Lena, Herve, Mazieres, Julien, Pichon, Eric, Thillays, Francois, Massard, Gilbert, Quantin, Xavier, Oulkhouir, Youssef, Nguyen, Thierry, Thiberville, Luc, Clement-Duchene, Christelle, Lindsay, Colin, Missy, Pascale, thierry Molina, Girard, Nicolas, Besse, Benjamin, Thomas, Pascal Alexandre, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de la Radio-Oncologie [Saint-Herblain], Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER-UNICANCER, CHU Strasbourg, UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM), CRLCC Val d'Aurelle - Paul Lamarque, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Service de pneumologie, oncologie thoracique et soins intensifs respiratoires [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Epidémiologie et Biostatistique, Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infections Virales et Pathologie Comparée - UMR 754 (IVPC), Institut National de la Recherche Agronomique (INRA)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Oncologie thoracique, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Center Oscar Lambret, CRLCC Oscar Lambret, Service de pneumologie, Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Cancérologie de l'Ouest- ICO Gauducheau, UNICANCER - Institut régional du Cancer [Montpellier] (ICM), Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-CHU Rouen, Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Institut National de la Recherche Agronomique (INRA)-École pratique des hautes études (EPHE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lille-UNICANCER, Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Institut National de la Recherche Agronomique (INRA)-École Pratique des Hautes Études (EPHE), and Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Subjects: [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2017

35. Updated Incidence of Thymic Epithelial Tumors (TET) in France and Clinical Presentation at Diagnosis

Author: Bluthgen, Maria, Dansin, Eric, Kerjouan, Mallorie, Mazieres, Julien, Pichon, Eric, Thillays, Francois, Massard, Gilbert, Quantin, Xavier, Oulkhouir, Youssef, Westeel, Virginie, Thiberville, Luc, Clement-Duchene, Christelle, Thomas, Pascal Alexandre, Girard, Nicolas, Besse, Benjamin, Center Oscar Lambret, CRLCC Oscar Lambret, CHU Pontchaillou [Rennes], Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de la Radio-Oncologie [Saint-Herblain], Institut de Cancérologie de l'Ouest- ICO Gauducheau, CHU Strasbourg, UNICANCER - Institut régional du Cancer [Montpellier] (ICM), CRLCC Val d'Aurelle - Paul Lamarque, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Service de pneumologie, oncologie thoracique et soins intensifs respiratoires [Rouen], Normandie Université (NU)-Normandie Université (NU)-Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU), Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Université Le Havre Normandie (ULH), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Infections Virales et Pathologie Comparée - UMR 754 (IVPC), Institut National de la Recherche Agronomique (INRA)-École pratique des hautes études (EPHE)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Oncologie thoracique, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Institut Universitaire du Cancer de Toulouse - Oncopole ( IUCT Oncopole - UMR 1037 ), Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire de Tours, CHRU Tours, UNICANCER - Institut régional du Cancer [Montpellier] ( ICM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), UNIROUEN - UFR Santé, Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Normandie Université ( NU ) -Normandie Université ( NU ) -Hôpital Charles Nicolle [Rouen]-CHU Rouen, Equipe Quantification en Imagerie Fonctionnelle ( QuantIF-LITIS ), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes ( LITIS ), Université Le Havre Normandie ( ULH ), Normandie Université ( NU ) -Normandie Université ( NU ) -Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Institut national des sciences appliquées Rouen Normandie ( INSA Rouen Normandie ), Normandie Université ( NU ) -Université Le Havre Normandie ( ULH ), Normandie Université ( NU ), Interactions Gènes-Risques environnementaux et Effets sur la Santé ( INGRES ), Université de Lorraine ( UL ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes ( URMITE ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR48, INSB-INSB-Centre National de la Recherche Scientifique ( CNRS ), Infections virales et pathologie comparée - UMR 0754 ( IVPC ), Institut National de la Recherche Agronomique ( INRA ) -École pratique des hautes études ( EPHE ) -Université Claude Bernard Lyon 1 ( UCBL ), Institut Gustave Roussy ( IGR ) -Institut Gustave Roussy ( IGR ), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER-UNICANCER, UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut National de la Recherche Agronomique (INRA)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Claude Bernard Lyon 1 (UCBL), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Université de Lille-UNICANCER, Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), and Institut National de la Recherche Agronomique (INRA)-École Pratique des Hautes Études (EPHE)
Subjects: [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2017

36. Pulmonary infection with Mycobacterium malmoense. Difficulties in diagnosis and treatment

Author: Huet, D., Godbert, B., Hermann, J., Zordan, J. -M., Chabot, F., Andrejak, Claire, Centre hospitalier de Remiremont, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Service d’Anatomie Pathologique [CHRU Nancy], Laboratoire Lasers, Plasmas et Procédés photoniques (LP3), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Société de Pneumologie de Langue Française (SPLF), CHU Amiens-Picardie, Agents infectieux, résistance et chimiothérapie - UR UPJV 4294 (AGIR ), and Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie
Subjects: [SDV]Life Sciences [q-bio]
Abstract: International audience; Introduction. Pulmonary infection due to Mycobacterium malmoense can be difficult to diagnose. These difficulties can be responsible for a delay in the implementation of optimal treatment. Moreover, the treatment is not standardized. Observation. We report the case of a 56-year-old patient who developed a Mycobacterium malmoense pulmonary infection whose diagnosis was delayed due to initial suspicion of pulmonary Mycobacterium tuberculosis infection. Once the diagnosis was confirmed, the patient was treated empirically with rifampicin, ethambutol, and clarithromycin for 12 months after culture conversion, giving a total of 15 months. The clinical and radiological outcomes were favorable. Discussion. This clinical case highlights the difficulties of diagnosing pulmonary atypical mycobacterial infection according to the American Thoracic Society criteria, particularly Mycobacterium malmoense, a non-tuberculous mycobacterium (NTM) quite uncommon in France. Currently, there are new diagnostic techniques such as GenoType Mycobacteria Direct. The second issue is the poorly standardized treatment of this NTM and many others, that are based on the recommendations of the British Thoracic Society. A national register has been set up by the MycoMed network, based essentially on the work of microbiologists but this register is unfortunately not exhaustive. Conclusion. A more systematic reporting strategy could allow cohort studies and therefore provide us with data on the most efficient drugs in the treatment of the rarest NTM infections. (C) 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.
Published: 2017

37. Présentation multi-kystique d’un adénocarcinome lépidique mucineux

Author: A. Chaouat, A. Beurton, Damien Mandry, Emmanuel Gomez, François Chabot, J. Champigneulle, P. Perez, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d’Anatomie Pathologique [CHRU Nancy], and Service de Réanimation Médicale [CHRU Nancy]
Subjects: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 3. Good health, 030218 nuclear medicine & medical imaging
Abstract: Resume Introduction La forme « pneumonique » est tres caracteristique de l’adenocarcinome pulmonaire lepidique. Cependant, le diagnostic et le traitement peuvent etre retardes par les atypies radiologiques et la severite de l’hypoxemie. Observation Une patiente âgee de 48 ans, non fumeuse, asthmatique depuis l’âge de 20 ans, etait hospitalisee pour une pneumopathie infiltrante diffuse compliquee d’insuffisance respiratoire aigue. L’histoire comportait une toux chronique, une dyspnee d’effort croissante evoluant depuis 14 mois et l’apparition d’hemoptysies minimes associees a des arthralgies depuis un mois. La patiente ne presentait aucun facteur de risque. Le scanner thoracique revelait des condensations alveolaires bilaterales, des opacites en verre depoli avec epaississement des septas et aspect de crazy paving . De plus, il retrouvait de nombreux kystes de taille et distributions variables, a paroi fine souvent irreguliere. Le bilan microbiologique et immunologique etait negatif. En depit d’une ventilation invasive, d’une ECMO veino-veineuse et d’une antibiotherapie probabiliste large spectre, l’evolution etait fatale apres 39 jours de reanimation. L’autopsie revelait des lesions kystiques avec un aspect d’adenocarcinome lepidique mucineux, n’exprimant pas de mutation EGFR ni KRAS , associe a une suppuration pulmonaire. Conclusion L’adenocarcinome lepidique mucineux constitue un diagnostic alternatif des condensations pneumoniques associees a des kystes multiples.
Published: 2016

38. Rapid emergence of Mycobacterium tuberculosis bedaquiline resistance: lessons not to repeat past errors

Author: Alexandra Aubry, Yazdan Yazdanpanah, Florence Brossier, Nicolas Veziris, Nadine Lemaître, Jérôme Robert, Lorenzo Guglielmetti, Angelica Tiotiu, Christophe Rioux, Christine Bernard, Vincent Jarlier, Eric Caumes, Damien Le Dû, Isabelle Lerat, Marie Jaspard, Dhiba Marigot-Outtandy, Wladimir Sougakoff, Centre d'Immunologie et de Maladies Infectieuses (CIMI), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Centre National de Référence des Mycobactéries et de la Résistance aux Antituberculeux [CHU Pitié-Salpêtrière], 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), Centre Hospitalier de Bligny, Service de Médecine Aiguë Spécialisée, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), HAL-UPMC, Gestionnaire, Centre National de Référence des Mycobactéries et de la Résistance aux Antituberculeux [CHU Pitié-Salpêtrière] (CNR-MyRMA), and Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière]
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Tuberculosis, biology, business.industry, 030106 microbiology, Drug resistance, biology.organism_classification, medicine.disease, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 3. Good health, Mycobacterium tuberculosis, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, 030228 respiratory system, chemistry, medicine, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, In patient, Bedaquiline, business, After treatment
Abstract: On behalf of the CNR MyRMA and the Tuberculosis Consilium of the CNR MyRMA; International audience; Bedaquiline (BDQ) has demonstrated potent clinical activity against multidrug-resistant (MDR) and extensively drug-resistant (XDR) Mycobacterium tuberculosis complex strains [1–3]. It has now been used in >50 countries, and it is estimated that ∼2500 patients had been treated with BDQ by the end of 2015. In spite of its recent clinical use, there are few reports of BDQ-resistant strains [4, 5]. Mutations in the rv0678 gene encoding the MmpL5 efflux pump repressor generate low-level BDQ resistance and clofazimine (CFZ) cross-resistance [6]. To our knowledge, this is the sole mechanism of BDQ resistance described in clinical strains [4, 5]. Despite its introduction in France in 2011 for XDR- and MDR-tuberculosis (TB) treatment, we report herein four BDQ-resistant cases, and discuss strategies to avoid a surge of BDQ resistance.
Published: 2016

39. Can MRI detect pulmonary hypertension in a population pre-selected by echocardiography?

Author: Damien Voilliot, Laurent Bonnemains, Freddy Odille, Jacques Felblinger, Ari Chaouat, François Chabot, Clément Venner, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie [CHRU Nancy], Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Cardiaque [CHU Strasbourg], and CHU Strasbourg
Subjects: Male, Cardiac Catheterization, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, medicine.medical_treatment, 030204 cardiovascular system & hematology, Logistic regression, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Second line, pulmonary hypertension, 030212 general & internal medicine, Cardiac catheterization, education.field_of_study, Ejection fraction, Radiological and Ultrasound Technology, medicine.diagnostic_test, Limits of agreement, General Medicine, Stroke volume, Middle Aged, Magnetic Resonance Imaging, medicine.anatomical_structure, Echocardiography, Cardiology, Female, Radiology, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Hypertension, Pulmonary, Population, Pulmonary Artery, Pulmonary arterial pressure, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine.artery, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Arterial Pressure, Magnetic resonance imaging (MRI), education, business.industry, Magnetic resonance imaging, Stroke Volume, medicine.disease, Pulmonary hypertension, Blood pressure, Ventricle, Pulmonary artery, diagnostic power, business
Abstract: Background The place of magnetic resonance imaging (MRI) in the assessment of pulmonary hypertension (PH) remains controversial. Several studies proposed to use MRI to assess pulmonary pressure but the level of proof is low. Purpose To evaluate the diagnostic power of cardiac MRI within a non-selected population of patients suspected of PH after an echocardiography. Material and Methods Fifty-six consecutive patients, suspected of PH after an echocardiography, were assessed with right heart catheterization and cardiac MRI (including a high temporal resolution pulmonary flow curve). We extracted from the MRI data the main parameters proposed by all precedent studies available in the literature. We looked for multivariate linear relations between those parameters and the mean pulmonary arterial pressure (mPAP), and eventually assessed with a logit regression the ability of those parameters to diagnose PH in our population. Results The multivariate model retained only two parameters: the right ventricle ejection fraction and the pulmonary trunk minimum area. The prediction of mPAP (r2 = 0.5) yielded limits of agreement of 15 mmHg. However, the prediction of PH within the population was feasible and the method yielded a specificity of 80% for a sensitivity of 100%. Conclusion The performance of MRI to assess mPAP is too low to be used as a replacement for right heart catheterization but MRI could be used as second line examination after echocardiography to avoid right heart catheterization for normal patients.
Published: 2018

40. Amylose AA secondaire à une tuberculose pulmonaire multi-résistante : implications thérapeutiques

Author: Baux, E., Henard, S., Alauzet, C., Goehringer, F., Laurain, C., Champigneulle, J., Vaillant, P., Hardy, A., Rabaud, C., May, T., Service des Maladies Infectieuses et Tropicales [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire de Bactériologie [CHU Nancy], Laboratoire d'Anatomie et de Cytologie Pathologiques, Université Paris 13 (UP13), Service de Pneumologie [CHRU Nancy], and Centre médical de Bligny
Subjects: Multidrug resistant, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Multi-résistance, Tuberculosis, Tuberculose, [SDV.IMM]Life Sciences [q-bio]/Immunology, Amyloidosis, Amylose
Abstract: International audience; Multidrug resistant pulmonary tuberculosis was diagnosed to a 32-year-old man. An AA-amyloidosis was subsequently diagnosed on the renal biopsy performed for nephrotic syndrome and macroscopic hematuria. A 6-drug antibiotic treatment was delivered quickly after first results of genotypic antibiogram given the renal failure, and was secondarily adapted to the phenotypic antibiogram. Multidrug therapy was fairly well tolerated. Clinical and biological improving were slow. Although tuberculosis is a classic cause of amyloidosis, this is the first case reporting an association between a multidrug resistant case and an amyloidosis in adults. This case also raises the question of MDR probabilistic treatments in situations whether a vital organ prognosis is engaged.; Une tuberculose pulmonaire, qui s’avèrera multi-résistante et associée à une amylose rénale secondaire, est diagnostiquée chez un homme de 32 ans d’origine arménienne. Une hexa-antibiothérapie probabiliste basée sur les résultats bactériologiques préliminaires de l’antibiogramme génotypique est débutée en urgence, sans attendre l’antibiogramme phénotypique définitif. L’évolution clinique et biologique sera lentement favorable et la tolérance du traitement sera acceptable. Cette observation illustre le premier cas d’association entre amylose secondaire et tuberculose multi-résistante, qui pose le problème de la nécessité de traiter en urgence un patient chez qui les risques de résistance et d’échec thérapeutique sont élevés.
Published: 2015

41. Occupational asthma to 'the miracle tree' ( Moringa oleifera ): First description

Author: Emmanuelle Penven, Mathias Poussel, Christelle Richard, Christophe Paris, Sandrine Jacquenet, François Chabot, Service des examens de la Fonction respiratoire et de l’aptitude à l’exercice [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Evaluations et prévention des risques professionnels et environnementaux, Cancéropôle du Grand Est-Université Henri Poincaré - Nancy 1 (UHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Genclis SAS, and Service de Pneumologie [CHRU Nancy]
Subjects: Adult, Male, Allergy, medicine.medical_specialty, media_common.quotation_subject, Rhinitis allergic, Moringa, 03 medical and health sciences, FEV1/FVC ratio, Specific inhalation challenge, 0302 clinical medicine, Administration, Inhalation, Immunology and Allergy, Humans, Medicine, 030212 general & internal medicine, Asthma, Occupational, Adrenergic beta-2 Receptor Agonists, media_common, Skin Tests, Moringa oleifera, Traditional medicine, Plant Extracts, business.industry, Allergens, Antigens, Plant, Immunoglobulin E, respiratory system, medicine.disease, Rhinitis, Allergic, 3. Good health, Surgery, respiratory tract diseases, Eosinophils, 030228 respiratory system, Bronchial hyperresponsiveness, Miracle, Seeds, Exhaled nitric oxide, Sputum, medicine.symptom, business, Plant immunology, Occupational asthma, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Introduction: Moringa oleifera is a small native tree of North West India. Many bioactive compounds of Moringa have recently been isolated, leading to industrial and medicinal uses worldwide. We report the first case of occupational asthma (OA) to Moringa. Patient, Methods and Results: A 32 year-old cosmetic factory technician (without allergy history) exposed into the workplace to a powder of Moringa seed progressively complained of rhinitis and respiratory symptoms. Initial investigations (patient still working) didn9t show baseline airway obstruction (FEV1=4.15L, 96% of predicted value; FEV1/FVC%=81%), exhaled nitric oxide fraction ( F eno) was increased to 91.21 ppb, methacholine challenge showed nonspecific bronchial hyperresponsiveness (22% decrease of FEV1), and the Oasys II score was 3.29. Specific inhalation challenge (SIC) to Moringa seed powder showed immediate positive reaction (21% decrease of FEV1). Sputum eosinophil counts and F eno evaluated at baseline and 24h after SIC showed an increase of eosinophils from 6% to 62%, and an increase of F eno from 32.37 to 94.34 ppb. The prick-tests to a 10% solution of Moringa seed powder was positive while we observed negative control prick tests in 4 volunteers never exposed. OA to Moringa seed was retained and the patient removed from further exposure to the implicated agent into the workplace. Conclusion: Moringa has shown numerous health benefits rapidly leading the cosmetic industry to incorporate Moringa as a compound of various products (moisturizers or skin ointment). New cases of allergy could therefore appear regarding to the increasing consumption of Moringa worldwide, as suggested by our description of the first case of OA to Moringa.
Published: 2015

42. Lack of correlation between the ventilatory response to CO2 and lung function impairment in myotonic dystrophy patients: evidence for a dysregulation at central level

Author: François Chabot, Mathias Poussel, Emmanuel Gomez, Bruno Chenuel, Pierre Kaminsky, Catherine Thil, A. Chaouat, Magalie Mercy, Service des examens de la Fonction respiratoire et de l’aptitude à l’exercice [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité (DevAH), Université de Lorraine (UL), Service de Pneumologie [CHRU Nancy], Service de Médecine Interne et Médecine Générale [CHRU Nancy], Centre de Référence des Maladies Neuromusculaires [CHRU Nancy], and Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES)
Subjects: Spirometry, Adult, Male, Weakness, Control of breathing, Hypercapnia, medicine, Respiratory muscle, Humans, Myotonic Dystrophy, Lung volumes, Respiratory system, Muscular dystrophy, Lung, Genetics (clinical), medicine.diagnostic_test, business.industry, Carbon Dioxide, Middle Aged, medicine.disease, Lung function, Respiratory Muscles, 3. Good health, Respiratory Function Tests, Neurology, Respiratory failure, Anesthesia, Pediatrics, Perinatology and Child Health, Muscle, Female, Neurology (clinical), medicine.symptom, business, Respiratory Insufficiency, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Myotonic dystrophy Type 1 (DM1) is the most common muscular dystrophy in adults. Respiratory failure is common but clinical findings support a dysregulation of the control of breathing at central level, furthermore contributing to alveolar hypoventilation independently of the severity of respiratory weakness. We therefore intended to study the relationship between the ventilatory response to CO2 and the impairment of lung function in DM1 patients. Sixty-nine DM1 patients were prospectively investigated (43.5 ± 12.7 years). Systematic pulmonary lung function evaluation including spirometry, plethysmography, measurements of respiratory muscle strength, arterial blood gas analysis and ventilatory response to CO2 were performed. Thirty-one DM1 patients (45%) presented a ventilatory restriction, 38 (55%) were hypoxaemic and 15 (22%) were hypercapnic. Total lung capacity decline was correlated to hypoxaemia (p = 0.0008) and hypercapnia (p = 0.0013), but not to a decrease in ventilatory response to CO2 (p = 0.194). Ventilatory response to CO2 was reduced to 0.85 ± 0.67 L/min/mmHg and not correlated to respiratory muscle weakness. Ventilatory response to CO2 was neither different among restricted/non-restricted patients (p = 0.2395) nor among normoxaemic/hypoxaemic subjects (p = 0.6380). The reduced ventilatory response to CO2 in DM1 patients appeared independent of lung function impairment and respiratory muscle weakness, suggesting a central cause of CO2 insensitivity.
Published: 2014

43. Perceptions of plain packaging among young adult roll-your-own smokers in France: a naturalistic approach

Author: Karine Gallopel-Morvan, Yves Martinet, Emmanuelle Béguinot, Figen Eker, Crawford Moodie, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institute for Social Marketing, Comité national contre le tabagisme, Service de Pneumologie [CHRU Nancy], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Subjects: Adult, Male, Pleasure, Health (social science), Adolescent, media_common.quotation_subject, medicine.medical_treatment, Emotions, Embarrassment, Product Labeling, Young Adult, Naturalistic observation, Surveys and Questionnaires, Credibility, Tobacco, medicine, Product Packaging, Humans, Young adult, Cities, Drug Packaging, media_common, [SHS.SOCIO]Humanities and Social Sciences/Sociology, business.industry, Smoking, Public Health, Environmental and Occupational Health, Tobacco Products, Awareness, Feeling, Attitude, Taste, Smoking cessation, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Perception, Smoking Cessation, France, Packaging and labeling, business, Social psychology, Demography
Abstract: International audience; Background We explored, for the first time, young adult roll-your-own smokers’ response to using plain packaging in real-world settings.Methods Naturalistic research was employed, where 133 French young adult smokers (18–25 years of age) used plain roll-your-own packs for 10 days; the plain packs they were provided with contained their usual brand of rolling tobacco and displayed the name of their usual brand. Participants were recruited in five cities in France (Paris, Marseille, Metz, Nantes, Toulouse) and completed two questionnaires to measure their response to their own branded packs and the plain packs. Both questionnaires assessed pack perceptions, brand attachment, product perceptions (eg, taste, quality, natural), feelings about smoking (satisfying, pleasurable), feelings when using the pack in front of others (embarrassment, image), warning response (credibility, awareness of risks) and smoking-related behaviour (eg, consumption, quitting).Results Compared to their own fully branded packs, plain packs were associated with less positive pack and product perceptions, lower brand attachment and less positive feelings about smoking and feelings when using the pack in front of others. Participants were also more likely to report feeling like reducing consumption and quitting when using the plain packs, and more likely to feel like missing out on rolling a cigarette. No significant differences between the two pack types (plain and branded) were found in terms of credibility of warnings and perceptions of level of tar.Conclusions The study suggests that the impacts of plain packaging for roll-your-own cigarette smokers are the same as for smokers of factory-made cigarettes.
Published: 2014

44. Quality of life after the initial treatments of non-small cell lung cancer: a persistent predictor for patients' survival

Author: Lemonnier, Irawati, Guillemin, Francis, Arveux, Patrick, Clément-Duchêne, Christelle, Velten, Michel, Woronoff-Lemsi, Marie-Christine, Jolly, Damien, Baumann, Cédric, CIC-Nancy, Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Département d'information médicale [Centre Georges-François Leclerc] (DIM), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'Epidémiologie et de Biostatistique, Centre Paul Strauss, Progression tumorale et microenvironnement. Approches translationnelles et épidémiologie, Université de Strasbourg (UNISTRA)-CHU Strasbourg-Les Hôpitaux Universitaires de Strasbourg (HUS)-Institut Régional du Cancer-Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC), Service de l'Innovation et Recherche Clinique, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (HOTE GREFFON), Université de Franche-Comté (UFC)-Etablissement français du sang [Bourgogne-France-Comté] (EFS [Bourgogne-France-Comté])-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de soutien méthodologique à la recherche clinique, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Santé publique, vieillissement, qualité de vie et réadaptation des sujets fragiles - EA 3797 (SPVQVRSF), Université de Reims Champagne-Ardenne (URCA)-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), This study was supported by the Ministry of Health, the Urban Community of Nancy, and the Region of Lorraine. Irawati Lemonnier received a doctoral scholarship from the Fondation de France., Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy]-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Département d'information médicale [Centre Georges-François Leclerc] ( DIM ), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Université de Strasbourg ( UNISTRA ) -CHU Strasbourg-Les Hôpitaux Universitaires de Strasbourg (HUS)-Institut Régional du Cancer-Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) ( HOTE GREFFON ), Université de Franche-Comté ( UFC ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims ( CHU Reims ), Santé publique, vieillissement, qualité de vie et réadaptation des sujets fragiles - EA 3797 ( SPVQVRSF ), Université de Reims Champagne-Ardenne ( URCA ) -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 ), BMC, Ed., Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)
Subjects: Male, Lung Neoplasms, Survival, Research, Public Health, Environmental and Occupational Health, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Kaplan-Meier Estimate, Middle Aged, Prognosis, humanities, Treatment Outcome, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, SF-36, Carcinoma, Non-Small-Cell Lung, Surveys and Questionnaires, Quality of Life, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Prospective Studies, Social Adjustment, Non-small-cell lung cancer, QLQ C-30, Proportional Hazards Models
Abstract: International audience; BACKGROUND: Health-related quality of life (HRQoL) before treatment may predict survival of patients with non-small-cell lung cancer (NSCLC). We investigated the predictive role of HRQoL after the initial treatments, on the survival of these patients. METHODS: A prospective multi-center study conducted in northeastern France. The SF-36 and European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (QLQ C-30) were mailed to patients 3 months after the end of the diagnostic process. High scores for functioning dimensions on both questionnaires indicated better QoL, and low scores for symptom dimensions on the QLQ C-30 indicated few symptoms. Cox regression modeling was used to identify predictive factors of survival. RESULTS: In total, 230 (63.5%) patients responded to the SF-36 and QLQ C-30. Before completing the questionnaires, almost 60% of patients had undergone some chemotherapy, about 10% underwent radio/chemotherapy or both and more than 30% underwent surgery or surgery plus chemo/radiotherapy.On SF-36, the highest mean score was for social functioning dimension (55.5 ± 28), and the lowest was for the physical role dimension (17.9 ± 32.2).On QLQ C-30, for the functioning dimensions, the highest mean score was for cognitive functioning (74.6 ± 25.9) and the lowest was for role functioning (47.2 ± 34.1). For symptom dimensions, the lowest score was for diarrhoea (11.5 ± 24.2) and the highest was for fatigue (59.7 ± 27.7).On multivariate analysis, high bodily pain, social functioning and general health scores (SF-36) were associated with a lower risk of death (hazard ratio 0.580; 95% confidence interval [0.400-0.840], p = 0.004; HR 0.652 [0.455-0.935], p
Published: 2013

45. Diffuse pulmonary ossification in a patient exposed to silica

Author: Yves Martinet, Marie-Pierre Wissler, Helene Jungmann, Jean-Michel Vignaud, Zola Bavelele, Denis Regent, Benoît Godbert, Centre hospitalier de Remiremont, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Service d’Anatomie Pathologique [CHRU Nancy], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Physical examination, Collapsed Lung, 03 medical and health sciences, 0302 clinical medicine, Silicosis, Medicine, Letters, ComputingMilieux_MISCELLANEOUS, lcsh:RC705-779, Lung, medicine.diagnostic_test, business.industry, Mediastinum, lcsh:Diseases of the respiratory system, respiratory system, medicine.disease, respiratory tract diseases, 3. Good health, Surgery, medicine.anatomical_structure, 030228 respiratory system, Pneumothorax, 030220 oncology & carcinogenesis, Heart failure, Radiology, business, Rare disease
Abstract: To the Editor: Pulmonary ossification is a rare disease characterised by the formation of diffuse small fragments of mature bone tissue in the lungs. It can be idiopathic or associated with underlying chronic lung, heart or systemic disorders. We present the case of an 83-year-old male, who had diffuse dendriform pulmonary ossification (DPO) and a spontaneous pneumothorax. An 83-year-old male nonsmoker with a history of hypertension and carotid and coronary angioplasties visited his medical practitioner for right chest pain after a flight from Spain to France. He had no history of lung disease or heart failure. He worked as a dentist with a dental prosthesis manufacturer. Our patient was frequently in the same workshop as the prostheses technician. The patient had no trauma, cough, sputum disorders or dyspnoea. A physical examination and the usual biological analyses were normal, particularly the phosphocalcic values. Chest radiography revealed a partial right pneumothorax with micronodular calcified opacities in both lungs. Computed tomography revealed the presence of bilateral disseminated micronodular opacities of calcified densities, predominantly located in the lower lung, which had lower densities than silicosis. There were no calcified lymph nodes in the mediastinum (figs 1 and 2). Figure 1. a) Computed tomography (CT) of the chest in a parenchymal window demonstrating a right pneumothorax and a nodular round shadow in the collapsed lung; b) CT of the chest in …
Published: 2013

46. Efficacy of a smoking cessation program in a population of adolescent smokers in vocational schools: a public health evaluative controlled study

Author: Minary, Laetitia, Cambon, Linda, Martini, Hervé, Wirth, Nathalie, Acouetey, Dovi, Thouvenot, Francine, Maire, Céline, Martinet, Yves, Bohadana, Abraham, Zmirou-Navier, Denis, Alla, François, Centre d'Epidémiologie Clinique ( CIC-EC ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Nutrition-Génétique et Exposition aux Risques Environnementaux ( NGERE ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), IREPS Lorraine, IREPS, Réseau Lorrain d'Alcoologie et des Dépendances Associées, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Hôpital Villemin, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Médecin généraliste, Médecine générale, École des Hautes Études en Santé Publique [EHESP] ( EHESP ), The study was supported by the following institutions: MILDT/INCa/Inserm (Grant 2006), Société de pneumologie de langue française (PhD fellowship 2007), Ligue nationale contre le cancer (Grant 2008) and the Conseil régional de Lorraine (PhD fellowship 2008 and 2009)., Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Hôpital Villemin, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), École des Hautes Études en Santé Publique [EHESP] (EHESP), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), and BMC, Ed.
Subjects: Male, Vocational Education, Adolescent, Public Health, Environmental and Occupational Health, Addiction, Smoking Prevention, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Smoking prevention & control, Young Adult, Tobacco cessation, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Humans, Female, Smoking Cessation, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Prospective Studies, Evaluation, Follow-Up Studies, Program Evaluation, School Health Services, Research Article
Abstract: International audience; ABSTRACT: BACKGROUND: To evaluate the public health efficacy of a community-based smoking cessation program (TABADO) among vocational school trainees (15 to 20 years old). METHODS: This prospective, controlled, quasi-experimental study was conducted in eight vocational training centres (VTC) in France. The intervention group underwent the TABADO program, which included a general information session for all students and small-group sessions plus individual counselling and nicotine therapy, if needed, for volunteers in an enhanced program. The control group received no specific intervention other than the educational services usually available. The primary outcome was 30-day point prevalence abstinence at 12 months. RESULTS: The mean age of the 1,814 students included was 16.9 years (SD = 1.0); 84.7% were males. At baseline, 52% were smokers and 5.7% ex-smokers. In the intervention group, 24.6% of smokers volunteered for the enhanced program and 18.1% could be included. By 12-month follow-up, with participants lost to follow-up considered non-abstinent, 10.6% of smokers in the intervention group had become abstinent versus 7.4% in the control group (adjusted p = 0.03; odds ratio [OR] = 1.8; 95% confidence interval [CI] = 1.05--3.0); considering lost to follow-up as missing data, 17% of intervention group participants were abstinent versus 11.9% in the control group (univariate p = 0.08; adjusted p = 0.008; OR = 2.1; 95% CI = 1.2--3.6). CONCLUSION: The TABADO program, targeting teenagers in vocational schools, was effective in producing a higher 12-month abstinence rate among all smokers in the intervention group.Trial registration: Clinical trial identification number is NTC00973570.
Published: 2013

47. Adherence to Anti-TNF Therapy in Inflammatory Bowel Diseases

Author: Lopez, Anthony, Billioud, Vincent, Peyrin-Biroulet, Carina, Peyrin-Biroulet, Laurent, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), and Service de Pneumologie [CHRU Nancy]
Subjects: [SDV]Life Sciences [q-bio]
Abstract: International audience; BACKGROUND:Nonadherence to medications may affect disease outcomes. The aim of this article was to review methods of assessment, prevalence, and predictors of nonadherence to anti-tumor necrosis factor therapy in inflammatory bowel diseases (IBD).METHODS:Studies were identified through the electronic database of MEDLINE (up to January 2012) and the annual meetings of Digestive Disease Week, the American College of Gastroenterology, the United European Gastroenterology Week, and the European Crohn's and Colitis Organization.RESULTS:Among 1783 citations identified, 13 studies evaluated adherence to biologics in IBD. Several methods were used to assess adherence to anti-tumor necrosis factor, including the medication possession ratio, the medication refill adherence, and the Morisky Medication Adherence Scale 8. Pooled adherence to anti-tumor necrosis factor therapy was 82.6%. Pooled adherence was 83.1% in adalimumab and 70.7% in infliximab-treated patients. Female gender, smoking, constraints related to treatment, anxiety, and moodiness were associated with nonadherence to both infliximab and adalimumab. Concomitant immunomodulator use and time since first infusion more than 18 weeks were predictors for nonadherence to infliximab . Regimen of 40 mg every other week, syringe use (versus pen), internal medicine center prescription (versus gastroenterology center prescription), retail pharmacy (versus speciality pharmacy) and new user (versus previous user) were predictors for adalimumab nonadherence.CONCLUSIONS:More than three-quarters of patients with IBD adhere to biologics. Predictors of nonadherence include female gender, smoking, constraints related to treatment, anxiety, and moodiness. These data could be used to develop intervention studies aimed at improving adherence to biologics in IBD.
Published: 2013

48. Caractéristiques du tabagisme chez les adolescents en Centre de formation des apprentis [Tobacco use characteristics among apprentices in Vocational Centers]

Author: Minary, Laetitia, Martini, Hervé, Wirth, Nathalie, Thouvenot, F., Acouetey, S., Maire, Céline, Martinet, Yves, Bohadana, Abraham, Zmirou-Navier, Denis, Alla, François, Centre d'Epidémiologie Clinique ( CIC-EC ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Nutrition-Génétique et Exposition aux Risques Environnementaux ( NGERE ), Université de Lorraine ( UL ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Ecole de Santé Publique [Nancy], Faculté de Médecine [Nancy], Université de Lorraine ( UL ) -Université de Lorraine ( UL ), Réseau Lorrain d'Alcoologie et des Dépendances Associées, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Hôpital Villemin, Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), IREPS Lorraine, IREPS, École des Hautes Études en Santé Publique [EHESP] ( EHESP ), Conseil régional de Lorraine (Bourse de thèse), la MILDT/INCa/Inserm (Appel à projet 2006), la Ligue nationale contre le cancer (appel à projets de recherche épidémiologique 2008), la Société de pneumologie de langue française (Bourse de recherche, session automne 2007)., Centre d'investigation clinique - Epidémiologie clinique [Nancy] (CIC-EC), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université de Lorraine (UL)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Hôpital Villemin, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre d'Epidémiologie Clinique (CIC-EC), and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: MESH: Smoking, MESH: Schools, Adolescent, MESH : Male, MESH : Young Adult, MESH: Vocational Education, Tabagisme, MESH: Cross-Sectional Studies, MESH : Cross-Sectional Studies, MESH : Students, MESH : Adolescent, MESH : Schools, MESH : Vocational Education, MESH : Female, MESH : France, MESH: Adolescent, MESH: Humans, MESH : Humans, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Male, Prévalence, MESH: France, MESH : Smoking, MESH: Young Adult, MESH: Students, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female
Abstract: International audience; BACKGROUND: Most smokers start smoking during adolescence and become dependent before 20 years old. In France, vocational trainees are a population not much explored. The objective of our study is to present tobacco use characteristics among apprentices in Vocational Centers (VC). METHODS: This cross-sectional exhaustive study covered 1814 students (among whose 943 smokers) entering in a 1st year of the eight participating Vocational Centers in the Lorraine region (Eastern France, 2.3 million inhabitants, 16,500 vocational trainees), during the school years 2007-2008 and 2008-2009. Data collection concerned the sociocultural environment, tobacco use habits, degree of dependency to tobacco and co-addictions. RESULTS: Among the study population, 52.0% declared they were smokers among whom 89.4% daily smokers, and 5.7% were ex-smokers. The average age of tobacco use initiation was 12.1 years (standard deviation [SD]=2.1) and the average age at inception of regular cigarette smoking was 13.8 years (SD=1.6). Current consumption of the smokers was 12.8 cigarettes per day (SD=7.8). The average score of smoking addiction was 6.1 (SD=2.8), according to the Hooked On Nicotine checklist test (score from 0 to 10=strongly dependent). Finally, 37.1% of students (58.9% among smokers) smoked or have smoked cannabis. CONCLUSION: The high prevalence of smoking in Vocational Centers, the early start of tobacco use and the high tobacco consumption among apprentices show that they are overexposed compared to the general population of adolescents. In addition, these young people are already dependant to tobacco use. This underlines the need of specific measures dedicated to this population that amounts to 361,500 individuals in France.
Published: 2011

49. Associations of airway inflammation and responsiveness markers in non asthmatic subjects at start of apprenticeship

Author: Valérie Demange, Pascal Wild, A. Barbaud, Denis Zmirou-Navier, Paul Tossa, Abraham Bohadana, Christophe Paris, Département épidémiologie en entreprise (EE), Institut national de recherche et de sécurité (Vandoeuvre lès Nancy) (INRS ( Vandoeuvre lès Nancy)), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), École des Hautes Études en Santé Publique [EHESP] (EHESP), Centre antipoison et de toxicovigilance (Nancy) (CAPTV Nancy), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Pneumologie [CHRU Nancy], Service de Dermatologie et Allergologie [CHRU Nancy], This study was financed through grants awarded by AFSSET [Agence Française de Sécurité Sanitaire de l'Environnement et du Travail contract RD-2003-04], the French Ministry of Labour (2002 Health and Occupation call for tenders), the regional health insurance fund (CRAM Nord-Est), the Lorraine Region, ANR [French National Research Agency, grant 05 9 75/ANR 05 SEST 021-01] and by INRS. The Soufflet group and L'Oréal also provided financial support. Dr Tossa was recipient of a doctorate grant awarded by the Lorraine Region., and BMC, Ed.
Subjects: Male, MESH: Asthma, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Atopy, MESH: Conjunctivitis, 0302 clinical medicine, Airway resistance, Risk Factors, MESH: Risk Factors, Surveys and Questionnaires, Epidemiology, Prevalence, Cooking, 030212 general & internal medicine, Rhinitis, education.field_of_study, MESH: Rhinitis, respiratory system, MESH: Predictive Value of Tests, Occupational Diseases, Bronchial hyperresponsiveness, Predictive value of tests, Female, Bronchial Hyperreactivity, Research Article, Pulmonary and Respiratory Medicine, MESH: Occupational Diseases, medicine.medical_specialty, Adolescent, Population, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Humans, Students, education, MESH: Prevalence, Asthma, lcsh:RC705-779, MESH: Adolescent, MESH: Humans, business.industry, MESH: Questionnaires, MESH: Biological Markers, MESH: Bronchial Hyperreactivity, MESH: Cooking, lcsh:Diseases of the respiratory system, Conjunctivitis, medicine.disease, MESH: Male, respiratory tract diseases, 030228 respiratory system, MESH: Students, Immunology, Exhaled nitric oxide, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, business, MESH: Female, Biomarkers
Abstract: Background Bronchial Hyperresponsiveness (BHR) is considered a hallmark of asthma. Other methods are helpful in epidemiological respiratory health studies including Fractional Exhaled Nitric Oxide (FENO) and Eosinophils Percentage (EP) in nasal lavage fluid measuring markers for airway inflammation along with the Forced Oscillatory Technique measuring Airway resistance (AR). Can their outcomes discriminate profiles of respiratory health in healthy subjects starting apprenticeship in occupations with a risk of asthma? Methods Rhinoconjunctivitis, asthma-like symptoms, FEV1 and AR post-Methacholine Bronchial Challenge (MBC) test results, FENO measurements and EP were all investigated in apprentice bakers, pastry-makers and hairdressers not suffering from asthma. Multiple Correspondence Analysis (MCA) was simultaneously conducted in relation to these groups and this generated a synthetic partition (EI). Associations between groups of subjects based on BHR and EI respectively, as well as risk factors, symptoms and investigations were also assessed. Results Among the 441 apprentice subjects, 45 (10%) declared rhinoconjunctivitis-like symptoms, 18 (4%) declared asthma-like symptoms and 26 (6%) suffered from BHR. The mean increase in AR post-MBC test was 21% (sd = 20.8%). The median of FENO values was 12.6 ppb (2.6-132 range). Twenty-six subjects (6.7%) had EP exceeding 14%. BHR was associated with atopy (p < 0.01) and highest FENO values (p = 0.09). EI identified 39 subjects with eosinophilic inflammation (highest values of FENO and eosinophils), which was associated with BHR and atopy. Conclusions Are any of the identified markers predictive of increased inflammatory responsiveness or of development of symptoms caused by occupational exposures? Analysis of population follow-up will attempt to answer this question.
Published: 2010

50. Exhaled nitric oxide and airway hyperresponsiveness in workers: a preliminary study in lifeguards

Author: Abraham Bohadana, Valérie Demange, N. Massin, Pascal Wild, Institut national de recherche et de sécurité (Vandoeuvre lès Nancy) (INRS ( Vandoeuvre lès Nancy)), Service de Pneumologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and BMC, Ed.
Subjects: Male, MESH: Swimming, MESH: Asthma, MESH: Occupational Health, Logistic regression, Gastroenterology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Linear Models, 0302 clinical medicine, Forced Expiratory Volume, Medicine, 030212 general & internal medicine, Methacholine Chloride, medicine.diagnostic_test, Confounding, respiratory system, MESH: Predictive Value of Tests, MESH: Respiratory Hypersensitivity, Predictive value of tests, Female, medicine.drug, Spirometry, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, MESH: Forced Expiratory Volume, Nitric Oxide, Sensitivity and Specificity, Bronchial Provocation Tests, MESH: Bronchial Provocation Tests, 03 medical and health sciences, MESH: Cross-Sectional Studies, Predictive Value of Tests, Internal medicine, Linear regression, Research article, MESH: Methacholine Chloride, Respiratory Hypersensitivity, Humans, Occupational Health, Swimming, Asthma, lcsh:RC705-779, MESH: Humans, business.industry, MESH: Adult, lcsh:Diseases of the respiratory system, medicine.disease, MESH: Sensitivity and Specificity, MESH: Male, respiratory tract diseases, Cross-Sectional Studies, 030228 respiratory system, MESH: Nitric Oxide, Immunology, Exhaled nitric oxide, Linear Models, Feasibility Studies, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Methacholine, MESH: Spirometry, business, MESH: Feasibility Studies, MESH: Female
Abstract: Background Airway inflammation and airway hyperresponsiveness (AHR) are two characteristic features of asthma. Fractional exhaled nitric oxide (FENO) has shown good correlation with AHR in asthmatics. Less information is available about FENO as a marker of inflammation from work exposures. We thus examined the relation between FENO and AHR in lifeguards undergoing exposure to chloramines in indoor pools. Methods 39 lifeguards at six indoor pools were given a respiratory health questionnaire, FENO measurements, spirometry, and a methacholine bronchial challenge (MBC) test. Subjects were labeled MBC+ if the forced expiratory volume (FEV1) fell by 20% or more. The normalized linear dose-response slope (NDRS) was calculated as the percentage fall in FEV1 at the last dose divided by the total dose given. The relation between MBC and FENO was assessed using logistic regression adjusting on confounding factors. The association between NDRS and log-transformed values of FENO was tested in a multiple linear regression model. Results The prevalence of lifeguards MBC+ was 37.5%. In reactors, the median FENO was 18.9 ppb (90% of the predicted value) vs. 12.5 ppb (73% predicted) in non-reactors. FENO values ≥ 60% of predicted values were 80% sensitive and 42% specific to identify subjects MBC+. In the logistic regression model no other factor had an effect on MBC after adjusting for FENO. In the linear regression model, NDRS was significantly predicted by log FENO. Conclusions In lifeguards working in indoor swimming pools, elevated FENO levels are associated with increased airway responsiveness.
Published: 2009

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