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Background Reunion Island is a French overseas department located in a tropical area, where cystic fibrosis incidence is high. Cystic fibrosis (CF) patients are at risk of developing nontuberculous mycobacteria (NTM) infection. Epidemiologic studies are lacking in Reunion Island. Methods From 2002 to 2015, a retrospective review was performed in university hospitals on Reunion Island. All CF patients having at least 1 positive NTM isolate were included. Clinical, radiologic, and microbiologic data were collected from patient records. Results Fifty-one CF patients were included. The overall estimated prevalence of NTM was 26.4% in total CF population and 36.9% in patients over 12 years of age. Mycobacterium abscessus and Mycobacterium avium were the most frequently identified species found in 31 patients (60.8%) and 14 patients (27.4%), respectively. A rare NTM species: Mycobacterium simiae was found in 4 patients (7.8%). Twenty-nine patients (56.9%) met the American Thoracic Society (ATS) criteria for infection. They were more likely younger with a low body mass index and more frequently infected by Mycobacterium abscessus (22/29). Conclusion The overall prevalence of NTM in tropical Reunion Island is 3 times higher than in metropolitan France. A different environmental exposure in a tropical climate or risk factors related to cystic fibrosis or its treatment in Reunion patients could explain it.

The surgical lung biopsy (SLB) is the recommended sampling technique when the pathological analysis of the lung is required in the work-up of an interstitial lung disease (ILD) but trans-bronchial lung cryobiopsy (TBLC) is increasingly recognized as an alternative approach. As TBLCs have lower mortality and morbidity risks than SLB, this study aimed to investigate the safety of TBLCs in patients at higher risk of complications and for whom SLB was not considered as an alternative., info:eu-repo/semantics/published

Objectif Le syndrome d’apnees du sommeil (SAS) est une pathologie frequente mais sous-estimee. Les malades renaux chroniques (MRC) ne sont actuellement pas cites dans les recommandations francaises, comme un groupe a risque de SAS. Nous estimons, dans notre etude, la prevalence du SAS et sa severite dans une cohorte de MRC du CHU de La Reunion. Methodes Il s’agit d’une etude observationnelle retrospective portant sur une population de malades renaux chroniques de stades 1 a 4, definis par une mesure du debit de filtration glomerulaire (DFG) a l’EDTA, ayant accepte un enregistrement du sommeil par polygraphie ventilatoire. Le SAS etait defini par un IAH > 5/H. Resultats Cent trente-trois patients malades renaux chroniques ont ete inclus. Un SAS de tout stade confondu a ete retrouve chez 51 % des patients (n = 68), majoritairement obstructif (n = 60) dont 47 patients (35 %) presentant un SAS modere a severe (IAH > 15/H). Le sexe masculin et l’âge etaient significativement associes au diagnostic de SAS. Le DFG etait plus bas dans le groupe SAS que dans le groupe non SAS (47,8 ± 19,6 vs 59 ± 21,16 mL/min/1,73 m2, p Conclusion Nous avons retrouve une forte prevalence du SAS dans notre population. Une etude prospective permettrait de mieux caracteriser les facteurs de risque qui y sont associes chez les malades renaux chroniques, et ses consequences sur le DFG et son declin.

Mycobacterium simiae is a rare species of slow-growing nontuberculous mycobacteria (NTM). From 2002 to 2017, we conducted a retrospective study that included all patients with NTM-positive respiratory samples detected in two university hospitals of the French overseas department of Reunion Island. We recorded the prevalence of M. simiae in this cohort, as well as the clinical, radiological, and microbiological features of patients with at least 1 sample positive for M. simiae . In our cohort, 97 patients (15.1%) were positive for M. simiae . Twenty-one patients (21.6%) met the American Thoracic Society (ATS) criteria for infection. M. simiae infection was associated with bronchiectasis, micronodular lesions, and weight loss. Antibiotic susceptibility testing was performed for 60 patients, and the isolates were found to have low susceptibility to antibiotics, except for amikacin, fluoroquinolones, and clarithromycin. Treatment failed for 4 of the 8 patients treated for M. simiae infection. Here, we describe a specific cluster corresponding to a large cohort of patients with M. simiae , a rare nontuberculous mycobacterium associated with low pathogenicity and poor susceptibility to antibiotics.

Quantitative reverse transcription PCR (RT-PCR) has become an important tool for studying functional gene expression. However, the most often used cycle threshold (CT)-based method, primarily related to the required amplification efficiency determination via serial dilution, can call into question the level of quantitative reliability and accuracy that can be achieved, in addition to the impracticalities inherent to CT-based methodologies. In this study, an alternative method, named the sigmoidal curve-fitting (SCF) method, was compared with the classic CT method for two target genes (XRCC4 and HIF-1α) and a reference gene (HPRT). The PCR conditions were optimized for each gene on a LightCycler® apparatus. Fluorescence data were fitted to a four-parametric sigmoidal function, and the initial messenger RNA (mRNA) copy number was determined by a theoretical fluorescence (F0) value calculated from each fitting curve. The relative expression of the target gene versus that of the reference gene was calculated using an equation based upon these F0 values. The results show that the F0 value had a good linearity with the initial number of target genes between 107 and 101 copies. The reproducibility tests showed that the variations of initial target quantity were well reflected by F0 values. Relative expression of target gene calculated by the SCF method and by the CT method showed similar results. In our hands, the SCF method gave reliable results and a more precise error description of quantitative RT-PCR.

Introduction: COPD is actually underdiagnosed. The development of office spirometry in general practice could allow diagnosis and early management of COPD in patient-at-risk. Objectives : to assess COPD prevalence in a population of at-risk patients and to identify the effect of COPD diagnosis on the management, in the general practitioner’s (GP) office. Methods: a prospective study was performed in GP’s office during one year. We did spirometry in patient aged over 40years with a history of smoking (smoker or ex-smoker) or exposed to wood smoke, with or without chronic respiratory symptoms. The diagnosis of COPD was established for the presence of irreversible airflow obstruction (FEV1/FVC < 70%). Result : of the 31 patients included, 7 were diagnosed COPD. The prevalence of COPD in Reun-ion island in patients at risk was 22,58%. The management of patients diagnosed with COPD was improved : inhaled medications were introduced in 6 patients (85,71% of COPD patients), smoking cessation advice was given to all patients diagnosed with COPD and pulmonary consultation was requested for the most severe patients (66,66% for COPD GOLD II). Conclusion: targeted screening for COPD in patients with risk factors can be performed by spi-rometry in general practice, and allows early management of COPD. However, it should be noted that spirometry remains underused in general practice., Introduction : la BPCO est actuellement sous-diagnostiquée. Le développement des spiromètres portables dans les cabinets de médecine générale pourrait permettre de diagnostiquer et de prendre en charge précocement la BPCO chez des patients à risques. Objectifs : mesurer la prévalence de la BPCO chez des patients à risques et déterminer l’impact du diagnostic de la BPCO sur la prise en charge de ses patients, au cabinet du médecin généraliste. Méthode : étude prospective réalisée en cabinet de médecine générale sur 1 an. Nous avons fait des mesures de spirométrie chez des patients de plus de 40ans avec une histoire tabagique (fumeur ou ex-fumeur) ou exposé à la cuisine au feu de bois présentant ou non des symptômes respiratoires chroniques. Le diagnostic de BPCO a été posé pour les troubles ventilatoires obstructives non réversibles (VEMS/CVF < 70%). Résultats : sur les 31 patients inclus, 7 étaient diagnostiqués BPCO. La prévalence de la BPCO à la Réunion chez des patients à risque s’élevait à 22,58%. La prise en charge des patients diagnostiqués BPCO était améliorée : des traitements inhalés étaient introduit chez 6 patients soit 85,71% des patients BPCO, l’aide au sevrage tabagique était proposé à l’ensemble des patients diagnostiqués BPCO et une consultation pneumologique était demandée pour les patients les plus sévère (66,66% pour les BPCO stade 2). Conclusion : un dépistage ciblé de la BPCO chez des patients à risque peut être réalisé en médecine générale par spirométrie et permet une prise en charge précoce de la BPCO. Cependant, il est à noter que la spirométrie reste sous-utilisée en médecine générale.