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Georgopoulou A, Papadopoulou E, Moyseos M, Zagalioti SC, Hatzis C, Karanasios D, Tryfon S. Diffuse Alveolar Hemorrhage after Receiving Oral Levonorgerstrel for Emergency Contraception: A Case Report. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2021; 14:11795476211005821. [PMID: 34211306 PMCID: PMC8218619 DOI: 10.1177/11795476211005821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/09/2021] [Indexed: 01/22/2023]
Abstract
Introduction: Drug-induced diffuse alveolar hemorrhage (DAH) has been associated with the
administration of various medications, among which levonorgestrel (LN) has
not been reported until now. Case Presentation: This case study describes a 42-year-old woman who presented with hemoptysis,
hypoxemia, and radiological depiction of ground glass opacities, 3 days
after she had received emergency contraceptive medication containing
levonorgestrel. Emergent bronchoscopy was performed, and BAL was diagnostic
of diffuse alveolar hemorrhage (DAH). A thorough diagnostic approach was
followed, in order to detect the underlying pathological condition that
induced DAH. The absence of other identifiable pathological conditions in
this patient raised suspicion of LN’s potential causative role. Conclusion: DAH has not been reported as an adverse effect of LN until now. However, LN
has been found to exert immunomodulatory effects and to present potential
for manifestations of vasculitis as well as severe hypersensitivity
reactions. These mechanisms may have been implicated in the development of
DAH in our patient, who presented no other pathological conditions.
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Affiliation(s)
- Athina Georgopoulou
- Pulmonary Department of NHS, General Hospital "George Papanikolaou," Thessaloniki, Greece
| | - Efthymia Papadopoulou
- Pulmonary Department of NHS, General Hospital "George Papanikolaou," Thessaloniki, Greece
| | - Marianna Moyseos
- Pulmonary Department of NHS, General Hospital "George Papanikolaou," Thessaloniki, Greece
| | | | | | | | - Stavros Tryfon
- Pulmonary Department of NHS, General Hospital "George Papanikolaou," Thessaloniki, Greece
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2
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[Role of non pharmacological Interventions for asthma]. Presse Med 2019; 48:282-292. [PMID: 30871852 DOI: 10.1016/j.lpm.2019.02.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/27/2018] [Accepted: 02/13/2019] [Indexed: 12/14/2022] Open
Abstract
Smoking cessation remains a major issue for asthmatic smokers. Respiratory rehabilitation and respiratory physiotherapy have shown a benefit in controlling symptoms, preventing exacerbations and improving the quality of life. The control of the environment is crucial and must be approached in a global way. Management of obesity and psychological disorders should be systematically proposed. Allergen immunotherapy may be discussed in allergic persistent asthma to house dust mites. Certain dietary interventions or alternative medicines have not proved their worth.
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Sánchez-Ramos JL, Pereira-Vega AR, Alvarado-Gómez F, Maldonado-Pérez JA, Svanes C, Gómez-Real F. Risk factors for premenstrual asthma: a systematic review and meta-analysis. Expert Rev Respir Med 2016; 11:57-72. [DOI: 10.1080/17476348.2017.1270762] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | | | - Francisco Alvarado-Gómez
- Library, Juan Ramón Jiménez Hospital, Huelva, Spain
- Andalusian Health Service e-Library, Seville, Spain
| | | | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Francisco Gómez-Real
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Barnig C, Veaudor M, Gautier C, Margelidon-Cozzolino V, Pigearias B, Devouassoux G, Raherison C, De Blay F, Chanez P. [How to consider triggers and comorbid conditions in severe asthma in adults]. Presse Med 2016; 45:1030-1042. [PMID: 27544706 DOI: 10.1016/j.lpm.2016.07.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/05/2016] [Accepted: 07/12/2016] [Indexed: 12/16/2022] Open
Abstract
Triggers and precipitating factors as well as comorbid conditions are associated with asthma and severe asthma. They interfere with the potential to control the disease and represent an additional burden for the patients. Allergen exposure is well known to induce loss of control and exacerbations. Comorbid conditions belong to various fields of medicines including cardiovascular diseases, osteoporosis, obesity and sleep apneas and GERD. They should be diagnosed and treated for themselves according to the best state of the art. Their precise role et their contribution to severe asthma pathophysiology is largely unknown and longitudinal cohort studies are needed to better understand and treat the patients with severe asthma.
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Affiliation(s)
- Cindy Barnig
- Hôpitaux universitaires de Strasbourg, département de pneumologie, 67000 Strasbourg, France
| | - Martin Veaudor
- Université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, service de pneumologie, HCL, CIRI Inserm U1111, 69001 Lyon, France
| | - Clarisse Gautier
- AP-HM, Aix-Marseille université, département des maladies respiratoires, UMR 7333 CNRS, Inserm U1067, 13015 Marseille, France
| | - Victor Margelidon-Cozzolino
- Université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, service de pneumologie, HCL, CIRI Inserm U1111, 69001 Lyon, France
| | | | - Gilles Devouassoux
- Université Claude-Bernard Lyon 1, hôpital de la Croix-Rousse, service de pneumologie, HCL, CIRI Inserm U1111, 69001 Lyon, France
| | - Chantal Raherison
- CHU de Bordeaux, université de Bordeaux, service des maladies respiratoires, ISPED, U897, 33000 Bordeaux, France
| | - Frederic De Blay
- Hôpitaux universitaires de Strasbourg, département de pneumologie, 67000 Strasbourg, France
| | - Pascal Chanez
- AP-HM, Aix-Marseille université, département des maladies respiratoires, UMR 7333 CNRS, Inserm U1067, 13015 Marseille, France.
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Santos BAHD, Gbary AR, Kpozehouen A, Kassa F. [Factors associated with a severe asthma in asthmatic patients followed at Pneumo-phthisiology National Hospital of Cotonou (Benin) in 2014]. Pan Afr Med J 2015; 22:11. [PMID: 26600910 PMCID: PMC4646438 DOI: 10.11604/pamj.2015.22.11.5625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 08/16/2015] [Indexed: 11/11/2022] Open
Abstract
Introduction la présente étude vise à déterminer la fréquence de l'asthme sévère chez les patients asthmatiques suivis au Centre National Hospitalier de Pneumo-Phtisiologie (CNHPP) de Cotonou et identifier les facteurs de risque qui lui sont associés Méthodes l’étude transversale, descriptive et analytique a porté sur 213 patients asthmatiques de la file active 2013 du CNHPP. Les données ont été collectées par l'exploitation des dossiers et l'entretien individuel avec les patients. Elles ont été traitées et analysées à l'aide des logiciels EPIINFO7 et STATA11. Le test Chi2 de Pearson, la régression logistique uni variée et multi variée ont été utilisés au seuil de signification de 0,05 Résultats au total, 154 patients asthmatiques soit 72,7% ont répondu au questionnaire. Parmi eux 20,8% (IC95%:(14,67; 28,05)) souffraient d'asthme sévère. L’âge des patients s’étendait de 10 à 76 ans avec une médiane de 41 ans; 51,3% étaient de sexe féminin, 79,9% avaient des antécédents d'allergie, 61,7% ont commencé leur asthme après l’âge de 12 ans et seuls 11% ont consommé ou consommaient du tabac. Les facteurs associés à la survenue de l'asthme sévère étaient: l’âge de 46 à 55 ans (p = 0,04); les troisième et quatrième quintiles du bien-être économique (p = 0,01) et le début de l'asthme après l’âge de 12 ans (p < 0,001) Conclusion l’étude a montré une fréquence élevée de l'asthme sévère au Bénin et permettra d'améliorer sa prise en charge au CNHPP.
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[Genetic and environmental factors of asthma and allergy: Results of the EGEA study]. Rev Mal Respir 2015; 32:822-40. [PMID: 25794998 DOI: 10.1016/j.rmr.2014.12.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 12/12/2014] [Indexed: 12/26/2022]
Abstract
INTRODUCTION AND METHODS The EGEA study (epidemiological study on the genetics and environment of asthma, bronchial hyperresponsiveness and atopy), which combines a case-control and a family-based study of asthma case (n=2120 subjects) with three surveys over 20 years, aims to identify environmental and genetic factors associated with asthma and asthma-related phenotypes. We summarize the results of the phenotypic characterization and the investigation of environmental and genetic factors of asthma and asthma-related phenotypes obtained since 2007 in the EGEA study (42 articles). RESULTS Both epidemiological and genetic results confirm the heterogeneity of asthma. These results strengthen the role of the age of disease onset, the allergic status and the level of disease activity in the identification of the different phenotypes of asthma. The deleterious role of active smoking, exposure to air pollution, occupational asthmogenic agents and cleaning products on the prevalence and/or activity of asthma has been confirmed. Accounting for gene-environment interactions allowed the identification of new genetic factors underlying asthma and asthma-related traits and better understanding of their mode of action. CONCLUSION The EGEA study is contributing to the advances in respiratory research at the international level. The new phenotypic, environmental and biological data available in EGEA study will help characterizing the long-term evolution of asthma and the factors associated to this evolution.
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Estivals M, Dubus JC, Porcher S, Auquier P, Dieudonné-Loundou A, Missotte I, Besson-Leaud L, Laumond-Barny S. [Tobacco and marijuana use in adolescent students in Noumea]. Rev Mal Respir 2011; 28:636-46. [PMID: 21645834 DOI: 10.1016/j.rmr.2011.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Accepted: 10/11/2010] [Indexed: 11/24/2022]
Abstract
INTRODUCTION New Caledonia is situated in the western South Pacific 20000 km from France. In this Overseas Territory (pays d'outre-mer [POM]) the prevalence of tobacco smoking is very high and estimated at 30% among men and 34% among women. Experimenting with cannabis is also very widespread. The incidence of chronic respiratory illness and lung cancer remains high in the Territory. Modern laws protecting non-smokers still do not exist. This study aims at describing the behaviour of young people from 14 to 18 years old, at school in the public sector of Noumea, with respect to tobacco and marijuana consumption. This survey examines the way this behaviour varies according to age, sex, community, place of residence and socioeconomic conditions, in order to identify the most exposed groups. Finally, we study the effect of this consumption on the respiratory health of young school people. METHODS The enquiry was undertaken from May 4th to 15th 2009 in 16 classes drawn randomly from the colleges and secondary schools of Noumea (439 pupils). The survey consisted of an anonymous questionnaire containing 48 questions grouped into five subjects: a sociodemographic description of the subject and his/her family, the family lifestyle, tobacco consumption, marijuana consumption and a respiratory questionnaire. The completion of the questionnaires took, on average, 25 minutes and took place in class in the presence of the doctor undertaking the survey. The data were analysed with Ethnos-4 software. The analysis was made in two stages: a descriptive study after uni- and bivariate analysis and an analytical study to identify the risk factors of the addictive practices. The statistical tests used were Pearson's chi(2) test and the Hosmer-Lemeshow test for calculation of odds ratio. RESULTS The participation rate was 95.2% (n = 415). The sample was predominantly female (56.6%) and 31% of the pupils were less than 16 years old. The number of tobacco smokers was considerable at 41.1%, 27.3% were regular daily smokers including 38.5% who smoked more than six cigarettes a day. The results were dependent on sex (female predominence) but independent of ethnic origin and socioeconomic factors. The number of cannabis smokers was 48% among whom 32% were regular consumers. The daily smokers were uniquely boys and the custom was more frequent among the Melanesian population. Only 11% of the pupils were worried about their consumption and, among them, only the regular smokers were more at risk of bronchial infection. CONCLUSIONS In New Caledonia, tobacco consumption levels are higher than those in developed countries. We did not find a falling trend compared with previous data. The use of cannabis remains very widespread at an early age, with a male predominance for daily consumption. For both, these addictions the perception of the risk and the desire to stop are weak. The population studied is representative of teenagers in the public sector schools in Grand-Noumea but probably does not reflect the situation on the whole territory. The results obtained suggest the value of a study of the whole of New Caledonia, the eventual purpose being to guide the public health authorities towards policies that help the young people of the country.
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Affiliation(s)
- M Estivals
- Service de Pneumologie, CHT G-Bourret, BP J5, 98849 Nouméa cedex, Nouvelle-Calédonie, France.
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Sex-specific effect of IL9 polymorphisms on lung function and polysensitization. Genes Immun 2009; 10:559-65. [PMID: 19536153 DOI: 10.1038/gene.2009.46] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sex differences in asthma-associated phenotypes are well known but the genetic factors that may account for these differences have received little attention. This study aimed to characterize sex-specific and pleiotropic genetic factors underlying four quantitative phenotypes involved in the main asthma physiopathological pathways: immunoglobulin E levels, a measure of polysensitization (SPTQ), eosinophil counts and a measure of lung function FEV(1)/H(2) (forced expiratory volume in one second divided by height square). Sex-stratified univariate and bivariate linkage analyses were conducted in 295 families from the Epidemiological study on the Genetics and Environment of Asthma study. We found genome-wide significant evidence for a male-specific pleiotropic QTL (quantitative trait loci) on 5q31 (P=7 x 10(-9)) influencing both FEV(1)/H(2) and SPTQ and for a female-specific pleiotropic QTL on 11q23 underlying SPTQ and immunoglobulin E (P=2 x 10(-5)). Three other sex-specific regions of linkage were detected for eosinophil: 4q24 and 22q13 in females, and 3p25 in males. Further, bivariate association analysis of FEV(1)/H(2) and SPTQ with 5q31 candidate genes in males showed a significant association with two single-nucleotide polymorphisms within IL9 gene, rs2069885 and rs2069882 (P=0.02 and P=0.002, respectively, after Bonferroni's correction). This study underlies the importance of taking into account complex mechanisms, such as heterogeneity according to sex and pleiotropy to unravel the genes involved in asthma phenotypes.
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Deschildre A, Pin I, Gueorguieva I, de Blic J. [Asthma and obesity in childhood: what is the link?]. Arch Pediatr 2009; 16:1166-74. [PMID: 19442499 DOI: 10.1016/j.arcped.2009.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Revised: 12/01/2008] [Accepted: 04/01/2009] [Indexed: 11/17/2022]
Abstract
According to the definition (body mass index>97 degrees percentile), overweight and obesity concern 15% of French children. The parallel trends in the increase in asthma and obesity may indicate a potential link between these two conditions. The purpose of this study was to review the epidemiological data indicating a relationship between asthma and obesity, to evaluate the consequences of obesity on asthma and to assess the mechanisms of this association. We conclude with the implications for treatment strategies.
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Affiliation(s)
- A Deschildre
- Unité de pneumologie pédiatrique, hôpital Jeanne-de-Flandre, CHRU de Lille, 59037 Lille cedex, France.
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11
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[Allergy and refractory asthma: new etiological and treatment pathways]. Presse Med 2007; 37:129-35. [PMID: 18042340 DOI: 10.1016/j.lpm.2007.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2007] [Accepted: 08/29/2007] [Indexed: 11/21/2022] Open
Abstract
Severe asthma is often refractory to standard treatments and presents real problems of management. It necessitates rigorous clinical procedures to identify the aggravating factors. Allergic factors probably play an important role but are often ignored; atopy is more often associated with mild or moderate asthma. The prevalence of severe refractory asthma is not known with any precision, in view of the lack of a consensus definition. Few studies have examined the role of allergic factors. From a pathophysiologic perspective, genetic factors are probably responsible for greater severity, and allergic response plays an important role in some severe asthma phenotypes. From an environmental perspective, some airborne allergens are associated with the refractory character of the disease. Molds such as Alternaria are, for example, implicated in the onset of asthma attacks, as are some occupational exposure. Better knowledge of the pathophysiology of refractory asthma and its allergic dimensions have made it possible to use new treatment agents, such as omalizumab. New treatment targets are being discovered and evaluated in this domain.
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Murris-Espin M. [A new series: pulmonary pathology in women]. Rev Mal Respir 2007; 24:937-8. [PMID: 18033181 DOI: 10.1016/s0761-8425(07)92758-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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