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Perotin JM, Muggeo A, Lecomte-Thenot Q, Brisebarre A, Dury S, Launois C, Ancel J, Dormoy V, Guillard T, Deslee G. High Blood Eosinophil Count at Stable State is Not Associated with Airway Microbiota Distinct Profile in COPD. Int J Chron Obstruct Pulmon Dis 2024; 19:765-771. [PMID: 38524398 PMCID: PMC10959750 DOI: 10.2147/copd.s453526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose The heterogeneity of clinical features in COPD at stable state has been associated with airway microbiota. Blood eosinophil count (BEC) represents a biomarker for a pejorative evolution of COPD, including exacerbations and accelerated FEV1 decline. We aimed to analyse the associations between BEC and airway microbiota in COPD at stable state. Patients and Methods Adult COPD patients at stable state (RINNOPARI cohort) were included and characterised for clinical, functional, biological and morphological features. BEC at inclusion defined 2 groups of patients with low BEC <300/mm3 and high BEC ≥300/mm3. Sputa were collected and an extended microbiological culture was performed for the identification of viable airway microbiota. Results Fifty-nine subjects were included. When compared with the low BEC (n=40, 67.8%), the high BEC group (n=19, 32.2%) had more frequent exacerbations (p<0.001) and more pronounced cough and sputum (p<0.05). The global composition, the number of bacteria per sample and the α-diversity of the microbiota did not differ between groups, as well as the predominant phyla (Firmicutes), or the gender repartition. Conclusion In our study, high BEC in COPD at stable state was associated with a clinical phenotype including frequent exacerbation, but no distinct profile of viable airway microbiota compared with low BEC.
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Affiliation(s)
- Jeanne-Marie Perotin
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, Reims, France
- CHU de Reims, Service des Maladies Respiratoires, Reims, France
| | - Anaëlle Muggeo
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, CHU de Reims, Laboratoire de bactériologie-Virologie-Hygiène hospitalière-Parasitologie-Mycologie, Reims, France
| | - Quentin Lecomte-Thenot
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, CHU de Reims, Laboratoire de bactériologie-Virologie-Hygiène hospitalière-Parasitologie-Mycologie, Reims, France
| | - Audrey Brisebarre
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, Reims, France
| | - Sandra Dury
- CHU de Reims, Service des Maladies Respiratoires, Reims, France
| | - Claire Launois
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, Reims, France
- CHU de Reims, Service des Maladies Respiratoires, Reims, France
| | - Julien Ancel
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, Reims, France
- CHU de Reims, Service des Maladies Respiratoires, Reims, France
| | - Valérian Dormoy
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, Reims, France
| | - Thomas Guillard
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, CHU de Reims, Laboratoire de bactériologie-Virologie-Hygiène hospitalière-Parasitologie-Mycologie, Reims, France
| | - Gaëtan Deslee
- Université de Reims Champagne-Ardenne, INSERM UMR-S 1250, P3Cell, Reims, France
- CHU de Reims, Service des Maladies Respiratoires, Reims, France
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Mulette P, Perotin JM, Muggeo A, Guillard T, Brisebarre A, Meyer H, Hagenburg J, Ancel J, Dormoy V, Vuiblet V, Launois C, Lebargy F, Deslee G, Dury S. Bronchiectasis in renal transplant patients: a cross-sectional study. Eur J Med Res 2024; 29:120. [PMID: 38350996 PMCID: PMC10863148 DOI: 10.1186/s40001-024-01701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Bronchiectasis is a chronic airway disease characterized by permanent and irreversible abnormal dilatation of bronchi. Several studies have reported the development of bronchiectasis after renal transplantation (RT), but no prospective study specifically assessed bronchiectasis in this population. This study aimed to compare features of patients with bronchiectasis associated with RT to those with idiopathic bronchiectasis. METHODS Nineteen patients with bronchiectasis associated with RT (RT-B group) and 23 patients with idiopathic bronchiectasis (IB group) were prospectively included in this monocentric cross-sectional study. All patients underwent clinical, functional, laboratory, and CT scan assessments. Sputum was collected from 25 patients (n = 11 with RT-B and n = 14 with IB) and airway microbiota was analyzed using an extended microbiological culture. RESULTS Dyspnea (≥ 2 on mMRC scale), number of exacerbations, pulmonary function tests, total bronchiectasis score, severity and prognosis scores (FACED and E-FACED), and quality of life scores (SGRQ and MOS SF-36) were similar in the RT-B and IB groups. By contrast, chronic cough was less frequent in the RT-B group than in the IB group (68% vs. 96%, p = 0.03). The prevalence and diversity of the airway microbiota in sputum were similar in the two groups. CONCLUSION Clinical, functional, thoracic CT scan, and microbiological characteristics of bronchiectasis are overall similar in patients with IB and RT-B. These results highlight that in RT patients, chronic respiratory symptoms and/or airway infections should lead to consider the diagnosis of bronchiectasis. Further studies are required to better characterize the pathophysiology of RT-B including airway microbiota, its incidence, and impact on therapeutic management.
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Affiliation(s)
- Pauline Mulette
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France.
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Anaëlle Muggeo
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
- Laboratory of Bacteriology, Virology and Hygiene, Reims University Hospital, Reims, France
| | - Thomas Guillard
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
- Laboratory of Bacteriology, Virology and Hygiene, Reims University Hospital, Reims, France
| | - Audrey Brisebarre
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Hélène Meyer
- Department of Respiratory Diseases, Valenciennes Hospital Center, Valenciennes, France
| | - Jean Hagenburg
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
| | - Julien Ancel
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
| | - Valérian Dormoy
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Vincent Vuiblet
- Department of Nephrology and Renal Transplantation, Reims University Hospital, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
| | - Gaëtan Deslee
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
- EA7509 IRMAIC, University of Reims Champagne-Ardenne, Reims, France
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Charon L, Launois C, Perotin JM, Ravoninjatovo B, Mulette P, Ancel J, Guillard T, Muggeo A, Dormoy V, Griffon M, Carré S, Lebargy F, Deslée G, Dury S. Current cough and sputum assessed by the cough and sputum assessment-questionnaire (CASA-Q) is associated with quality of life impairment in cystic fibrosis. BMC Pulm Med 2023; 23:457. [PMID: 37990322 PMCID: PMC10664648 DOI: 10.1186/s12890-023-02701-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/09/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Cough and sputum are major symptoms in cystic fibrosis (CF) that contribute to the impairment of quality of life. METHODS This prospective single centre cross-sectional pilot study aimed to evaluate the results of a self-administered questionnaire assessing cough and sputum symptoms (2 domains), and their impact (2 domains) on daily activities in the previous week, named the Cough and Sputum Assessment Questionnaire (CASA-Q) in CF adult patients at stable state, and to analyse associations with clinical, functional, microbiological, radiological data, and two quality of life scales: the Cystic Fibrosis Questionnaire Revised (CFQ-R) and the Saint George Respiratory Questionnaire (SGRQ). RESULTS Forty-eight patients were included in this analysis (69% men; median age of 27.8 ± 8.1 years; median body mass index of 21.8 + 3.3 kg/m²; mean FEV1 of 64 ± 30% of the predicted value). The mean values of the CASA-Q domains were 58 ± 23 for cough symptoms, 77 ± 24 for cough impact, 62 ± 25 for sputum symptoms and 84 ± 21 for sputum impact. Impairment in CASA-Q cough and sputum domains was associated with dyspnea mMRC scale (p < 0.005 for all 4 domains of CASA-Q) and exacerbations in the previous year (p < 0.05 for CASA-Q symptoms domains). We also found correlations between all domains of the CASA-Q and quality of life questionnaires including SGRQ (p < 0.001) and to a lesser extend CFQ-R. We identified a clinical phenotype (female gender, ΔF508 heterozygous mutation, dyspnea mMRC scale) associated with an impairment of CASA-Q score and quality of life using a 2-step cluster analysis. CONCLUSIONS CASA-Q allows the assessment of cough and sputum in CF adult patients and is associated with quality of life impairment. This simple easy-to-use tool could be used in routine clinical practice and in clinical studies to assess cough and sputum in CF patients. TRIAL REGISTRATION The study was registered on ClinicalTrials.gov (NCT02924818, first posted on 5th October 2016).
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Affiliation(s)
- Lucie Charon
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Claire Launois
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Jeanne-Marie Perotin
- Service des Maladies Respiratoires et Allergiques, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, U 1250, Reims, France
| | - Bruno Ravoninjatovo
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Pauline Mulette
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Julien Ancel
- Service des Maladies Respiratoires et Allergiques, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, U 1250, Reims, France
| | - Thomas Guillard
- Laboratoire de Bactériologie-Virologie-Hygiène hospitalière- Parasitologie-Mycologie, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, Reims, U 1250, France
| | - Anaëlle Muggeo
- Laboratoire de Bactériologie-Virologie-Hygiène hospitalière- Parasitologie-Mycologie, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, Reims, U 1250, France
| | - Valérian Dormoy
- INSERM UMRS 1250, Université de Reims Champagne-Ardenne, Reims, France
| | - Muriel Griffon
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Sophie Carré
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - François Lebargy
- Service des Maladies Respiratoires et Allergiques, Université de Reims Champagne-Ardenne, EA7509 IRMAIC, CHU de Reims, Reims, France
| | - Gaëtan Deslée
- Service des Maladies Respiratoires et Allergiques, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, U 1250, Reims, France
| | - Sandra Dury
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France.
- EA7509 IRMAIC, Université de Reims Champagne-Ardenne, Reims, France.
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Bironneau V, Ingrand P, Pontier S, Iamandi C, Portel L, Martin F, Mallart A, Lerousseau L, Alfandary D, Levrat V, Portier F, Tamisier R, Goutorbe F, Rabec C, Codron F, Auregan G, Mercy M, Attali V, Soyez F, Launois C, Recart D, Vecchierini MF, Gagnadoux F, Meurice JC. Auto-adjusted versus fixed positive airway pressure in patients with severe OSA: A large randomized controlled trial. Respirology 2023; 28:1069-1077. [PMID: 37587548 DOI: 10.1111/resp.14569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/24/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Continuous positive airway pressure (CPAP) in the treatment of severe obstructive sleep apnoea (OSA) can be used in fixed CPAP or auto-adjusted (APAP) mode. The aim of this prospective randomized controlled clinical study was to evaluate the 3 month-efficacy of CPAP used either in fixed CPAP or APAP mode. METHODS Eight hundred one patients with severe OSA were included in twenty-two French centres. After 7 days during which all patients were treated with APAP to determine the effective pressure level and its variability, 353 and 351 patients were respectively randomized in the fixed CPAP group and APAP group. After 3 months of treatment, 308 patients in each group were analysed. RESULTS There was no difference between the two groups in terms of efficacy whatever the level of efficient pressure and pressure variability (p = 0.41). Exactly, 219 of 308 patients (71.1%) in the fixed CPAP group and 212 of 308 (68.8%) in the APAP group (p = 0.49) demonstrated residual apnoea hypopnoea index (AHI) <10/h and Epworth Score <11. Tolerance and adherence were also identical with a similar effect on quality of life and blood pressure evaluation. CONCLUSION The two CPAP modes, fixed CPAP and APAP, were equally effective and tolerated in severe OSA patients.
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Affiliation(s)
- Vanessa Bironneau
- INSERM CIC 1402, IS-ALIVE Research Group, University of Poitiers, Poitiers, France
- Pneumologie, CHU de Poitiers, Poitiers, France
| | | | | | | | | | | | | | | | | | | | | | - Renaud Tamisier
- Université Grenoble Alpes, Inserm U1300, CHU Grenoble Alpes, Grenoble, France
| | | | | | | | - Guy Auregan
- Pneumologie, Polyclinique de Poitiers, Poitiers, France
| | | | - Valérie Attali
- Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- Département R3S, Service des Pathologies du Sommeil, AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | | | | | - Didier Recart
- Pneumologie, Cabinet Médical Arnasa, Biarritz, France
| | | | - Frédéric Gagnadoux
- Département de Pneumologie et Médecine du sommeil, CHU d'Angers, Angers, France
| | - Jean-Claude Meurice
- INSERM CIC 1402, IS-ALIVE Research Group, University of Poitiers, Poitiers, France
- Pneumologie, CHU de Poitiers, Poitiers, France
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Launois C, Lebargy A, L'Huillier JP, Lalliard S, Lebargy F. [Medicolegal litigation in cases of occupational lung disease: Some practical tips]. Rev Mal Respir 2023:S0761-8425(23)00167-5. [PMID: 37208290 DOI: 10.1016/j.rmr.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/11/2023] [Indexed: 05/21/2023]
Abstract
Recognition and compensation for occupational diseases (OD) is based on the principle of presumption of occupational origin, provided that the disease meets the medical and administrative condition detailed in an OD table appended to the French social security code. A complementary system calling upon a regional committee for recognition of respiratory diseases (CRRMP, in French) attends to cases in which the medical or administrative conditions pertaining to the disease are not fulfilled. Decisions of health insurance funds may be appealed, by employer and employee alike, within the statutory timelines. That said, recent reform of social security litigation and the law of modernization of the justice system have thoroughgoingly modified appeal and redress procedures. Challenge of a decision of non-recognition of the occupational nature of a disease is now addressed to the social pole of the judicial tribunal (JT), which can request the assistance of a CRRMP other than the one that issued the first opinion. As for technical challenges having to do with the date of consolidation (date of the injury) or the degree of partial permanent incapacity (PI), they are put forward in a mandatory preliminary settlement proposal addressed to an amicable settlement board (CRA, in French), whose decisions can be contested face to the social pole of the JT. All judgments regarding medical litigations of social security may be appealed. Information for patients on compensation procedures and available means of remedying decisions by social security is essential to the establishment of the initial medical certificate and to the sequencing of the different phases of expert appraisals, the objectives being to avoid administrative incoherence and inappropriate legal recourse.
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Affiliation(s)
- C Launois
- Service des maladies respiratoires, CHU Reims, CHU Maison Blanche, 45, rue Cognacq-Jay, 51092 Reims, France
| | - A Lebargy
- 7, Place Général-Brosset, 69006 Lyon, France
| | - J-P L'Huillier
- Cabinet médical de pneumologie, 2, promenade des anglais, 94210 La Varenne Saint-Hilaire, France; Service de pathologie professionnelle, CHI de Créteil, Créteil, France
| | - S Lalliard
- Médecin coordonnateur, fonds d'indemnisation des victimes de l'Amiante, 1, Place Aimé-Césaire, 93102 Montreuil cedex, France
| | - F Lebargy
- Service des maladies respiratoires, CHU Reims, CHU Maison Blanche, 45, rue Cognacq-Jay, 51092 Reims, France; EA7509 IRMAIC, université de Reims Champagne-Ardenne, Reims, France.
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Delbarre B, Rapin A, Boyer FC, Thierry A, Perotin JM, Dury S, Dumazet A, Hagenburg J, Perdu D, Deslée G, Launois C. Dyspnea assessment in myotonic dystrophy type 1. Neuromuscul Disord 2023; 33:187-195. [PMID: 36669462 DOI: 10.1016/j.nmd.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/29/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
In myotonic mystrophy type 1 (DM1), combining respiratory symptom screening and respiratory function testing, is crucial to identify the appropriate time for ventilatory support initiation. Dyspnea has been little investigated in DM1. To provide a multidimensional description of dyspnea, questionnaires assessing dyspnea were administered to 34 consecutive adult patients with DM1 (median (25th-75th centile) age of 36 (28-49), Vital Capacity (VC) of 74 (64-87)% of predicted value). Dyspnea scores were low whatever the questionnaire used: Multidimensional Dyspnea Profile score of 2(0-4.7)/50 for dyspnea sensory descriptor and of 0 (0-4.7)/60 for the emotional descriptor, Visual Analogue Scale score of 0 (0-0)/10 in sitting and supine position and Borg score after six-minute walk test (6MWT) of 2.2 (1.8-4.2)/10. Eleven patients (32%) reported disabling dyspnea in daily living (modified Medical Research Council (mMRC) score ≥ 2). In comparison with patients with mMRC score < 2, patients with mMRC score ≥ 2 had a more severe motor handicap (Muscular Impairment Rating score of 4.0 (4.0-4.0) vs 3.0 (2.0-3.5), p<0.01), a lower 6MWT distance (373 (260-424) vs 436 (346-499)m, p = 0.03) and a lower VC (64 (48-74)% vs 75 (69-89)%, p = 0.02). These data suggest that the mMRC scale might be an easy-to-use and useful tool to assess dyspnea in daily living in DM1 patients. However, the interest of integrating the mMRC dyspnea scale in clinical practice to guide therapeutic management of DM1 patients remains to be assessed in further studies.
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Affiliation(s)
- B Delbarre
- Service des Maladies Respiratoires, CHU Reims, France
| | - A Rapin
- Service de Médecine Physique et Réadaptation, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - F C Boyer
- Service de Médecine Physique et Réadaptation, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - A Thierry
- Département de Méthodologie, CHU Reims, France; UR3797, VieFra, Université de Reims Champagne Ardenne, Reims, France
| | - J M Perotin
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France
| | - S Dury
- Service des Maladies Respiratoires, CHU Reims, France
| | - A Dumazet
- Service des Maladies Respiratoires, CHU Reims, France
| | - J Hagenburg
- Service des Maladies Respiratoires, CHU Reims, France
| | - D Perdu
- Service des Maladies Respiratoires, CHU Reims, France
| | - G Deslée
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France
| | - C Launois
- Service des Maladies Respiratoires, CHU Reims, France; INSERM UMRS-1250, Université Reims Champagne Ardenne, Reims, France.
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Vivien A, Ancel J, Godet S, Dury S, Perotin JM, Deslee G, Launois C. Pomalidomide-induced lung injury: A case report. Medicine (Baltimore) 2023; 102:e32473. [PMID: 36637962 PMCID: PMC9839242 DOI: 10.1097/md.0000000000032473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
RATIONALE Pomalidomide is an immunomodulatory imide drug used in multiple myeloma and in Kaposi sarcoma. PATIENT CONCERNS A 72-years-old male, treated for multiple myeloma with dexamethasone, pomalidomide and daratumumab, presented dyspnea, hypoxemia, biological inflammatory syndrome, ground glass opacities on computed tomography scan (CT-scan) and lymphocytic and eosinophilic alveolitis, with no specific cytologic or microbiological findings, 2 months after pomalidomide initiation. INTERVENTION AND OUTCOME Antibiotics were started after bronchoscopy. No improvement was noted in dyspnea and biological inflammatory syndrome after 5 days of treatment. Pomalidomide was then discontinued, with continuation of Daratumumab-Dexamethasone, resulting in a rapid recovery of symptoms and CT-scan anomalies. No recurrence of dyspnea was observed during the 15 months of follow-up. DIAGNOSES Pomalidomide-induced lung injury. LESSONS Pomalidomide-induced lung injury is a rare and serious adverse event that can occur early after Pomalidomide introduction. As pomalidomide use is increasing, the identification of drug toxicity as a possible cause of lung injury appears important. We report a rapid recovery of symptoms and CT-scan anomalies after pomalidomide discontinuation.
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Affiliation(s)
- Alexandre Vivien
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- * Correspondence: Alexandre Vivien, Department of Respiratory Diseases, Reims University Hospital, Reims, France (e-mail: )
| | - Julien Ancel
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- INSERM UMR-S 1250 “Pathologies Pulmonaires Et Plasticité Cellulaire,” University of Reims Champagne-Ardenne, Reims, France
| | - Sophie Godet
- Department of Hematology, Reims University Hospital, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- INSERM UMR-S 1250 “Pathologies Pulmonaires Et Plasticité Cellulaire,” University of Reims Champagne-Ardenne, Reims, France
| | - Gaetan Deslee
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- INSERM UMR-S 1250 “Pathologies Pulmonaires Et Plasticité Cellulaire,” University of Reims Champagne-Ardenne, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- INSERM UMR-S 1250 “Pathologies Pulmonaires Et Plasticité Cellulaire,” University of Reims Champagne-Ardenne, Reims, France
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Dury S, Ancel J, Ravoninjatovo B, Lambrecht I, Perotin JM, Mulette P, Lebargy F, Salmon JH, Deslée G, Launois C. Clinical relevance of low bone density in cystic fibrosis adult patients: A pilot study. Medicine (Baltimore) 2023; 102:e32227. [PMID: 36607849 PMCID: PMC9829254 DOI: 10.1097/md.0000000000032227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Survival improvement in cystic fibrosis (CF) is associated with more frequent long-term complications, including CF related bone disease (CFBD). Impact of CFBD on global health outcome remains poorly described. We aimed to assess the relationship between low bone mineral density (BMD) and spinal pain, disability, and quality of life in CF adult patients. This monocentric cross-sectional study with prospective data collection was conducted from November 2016 to December 2019 in the Department of Respiratory Diseases at the University Hospital of Reims (NCT02924818). BMD was assessed by X-ray absorptiometry (DXA). Disability was assessed by the Health Assessment Questionnaire (HAQ). Quality of life was assessed by both the St George's Respiratory Questionnaire and the Cystic Fibrosis Questionnaire for teenagers and adults (CFQ 14+). Forty patients were analyzed, 68% of men, with a median age of 25 years, a median body mass index of 21 kg/m² and a median FEV1% of 54%. Nine patients (23%) had spinal pain. Ten patients (25%) had a low BMD. Compared with patients with normal BMD, patients with low BMD had a significantly lower BMI (22 vs 19 kg/m²; P = .006) and less vitamin D supplementation (33% vs 0%; P = .035). Low BMD was not associated with spinal pain, disability and quality of life. Low BMD is frequent in CF, affecting 1-quarter of adult patients. No significant association was found between low BMD and spinal pain, disability or quality of life.
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Affiliation(s)
- Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital
- EA7509 IRMAIC, University of Reims Champagne-Ardenne
- * Correspondence: Sandra Dury, Department of Respiratory Diseases, Maison Blanche University Hospital, 45, rue DE Cognacq-Jay, 51 092 Reims cedex, France (e-mail: )
| | - Julien Ancel
- Department of Respiratory Diseases, Reims University Hospital
| | | | | | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital
- INSERM UMRS 1250, Reims University Hospital, Reims
| | - Pauline Mulette
- Department of Respiratory Diseases, Reims University Hospital
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital
- EA7509 IRMAIC, University of Reims Champagne-Ardenne
| | | | - Gaëtan Deslée
- Department of Respiratory Diseases, Reims University Hospital
- INSERM UMRS 1250, Reims University Hospital, Reims
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital
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9
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Dumazet A, Launois C, Lebargy F, Kessler R, Vallerand H, Schmitt P, Hermant C, Dury S, Dewolf M, Dutilh J, Abouda M, Ferreira M, Atallah I, Lachkar S, Charriot J, Jouneau S, Uzunhan Y, Chouabe S, Coiffard B, Dutau H, Hagenburg J, Briault A, Dormoy V, Lirsac M, Vergnon JM, Deslee G, Perotin JM. Tracheobronchopathia osteochondroplastica: clinical, bronchoscopic, and comorbid features in a case series. BMC Pulm Med 2022; 22:423. [PMID: 36397041 PMCID: PMC9670617 DOI: 10.1186/s12890-022-02225-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Background Tracheobronchopathia osteochondroplastica (TO) is a rare condition of unknown etiology. TO is characterized by submucosal nodules, with or without calcifications, protruding in the anterolateral walls of the trachea and proximal bronchi. The objective of this study was to describe TO features and associated comorbidities in a series of patients. Methods Patients suffering from TO were retrospectively included by investigators from the Groupe d’Endoscopie Thoracique et Interventionnelle Francophone (GETIF). Demographic, clinical, comorbidities, bronchoscopic, functional, and radiological characteristics, and outcomes were recorded and analyzed. Results Thirty-six patients were included (69% male with a mean of 65 ± 12 years). Chronic symptoms were described by 81% of patients including cough (74%) and dyspnea on exertion (74%). TO was associated with COPD in 19% of the cases and gastroesophageal reflux disease in 6%. A mild to severe airflow obstruction was present in 55% of the cases. CT scan showed tracheal submucosal nodules in 93% of patients and tracheal stenosis in 17%. Bronchoscopy identified TO lesions in the trachea in 65% of the cases, and 66% of them were scattered. A bronchoscopic reevaluation was performed in 7 cases, 9 ± 14 months [1–56] after initial diagnosis, and showed the stability of lesions in all cases. Three patients underwent interventional bronchoscopic treatment. Conclusion The diagnosis of TO relies on typical bronchoscopic findings and can be evoked on a CT scan. Histologic diagnosis can be useful in atypical cases for differential diagnosis. Given its low consequences in terms of symptoms, lung functions, and evolution, no treatment is usually required.
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10
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Rapin A, Boyer FC, Mourvillier B, Giordano Orsini G, Launois C, Taiar R, Deslee G, Goury A, Carazo-Mendez S. Post-Intensive Care Syndrome Prevalence Six Months After Critical Covid-19: Comparison Between First and Second Waves. J Rehabil Med 2022; 54:jrm00339. [PMID: 36193697 PMCID: PMC9627539 DOI: 10.2340/jrm.v54.4363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To explore the impact of improved intensive care for COVID-19 patients on the prevalence of post-intensive care syndrome (PICS). Design Ambispective cohort study. Patients Post-intensive care unit COVID-19 patients from the first and second waves of COVID-19. Methods Patients were evaluated at 6 months after infection. PICS was defined as the presence of a 1-min sit-to-stand test (1STS) score < 2.5th percentile or a Symbol Digit Modalities Test (SDMT) below the 2 standard deviation cut-off, or a Hospital Anxiety and Depression Scale score ≥ 11. Results A total of 60 patients were included (34 from wave 1 and 26 from wave 2). Intensive care unit management improved between waves, with shorter duration of orotracheal intubation (7 vs 23.5 days, p = 0.015) and intensive care unit stay (6 vs 9.5 days, p = 0.006) in wave 2. PICS was present in 51.5% of patients after wave 1 and 52% after wave 2 (p = 0.971). Female sex and diabetes were significantly associated with PICS by multivariate analysis. Conclusion Approximately half of post-intensive care unit COVID-19 patients have 1 or more impairments consistent with PICS at 6 months, with an impact on quality of life and participation. Improved intensive care unit management was not associated with a decrease in the prevalence of PICS. Identification of patients at risk, particularly women and diabetic patients, is essential. Further studies of underlying mechanisms and the need for rehabilitation are essential to reduce the risk of PICS.
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Affiliation(s)
- Amandine Rapin
- Centre Hospitalo-Universitaire de Reims, CHU Reims, Hôpital Sébastopol, Département de Médecine Physique et de Réadaptation, 51092, Reims, France .
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11
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Perotin JM, Gierski F, Bolko L, Dury S, Barrière S, Launois C, Dewolf M, Chouabe S, Bongrain E, Picard D, Tran E, N'Guyen Y, Mourvillier B, Servettaz A, Rapin A, Marcus C, Lebargy F, Kaladjian A, Salmon JH, Deslee G. Cluster analysis unveils a severe persistent respiratory impairment phenotype 3-months after severe COVID-19. Respir Res 2022; 23:199. [PMID: 35918719 PMCID: PMC9344257 DOI: 10.1186/s12931-022-02111-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/09/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The mid-term respiratory sequelae in survivors of severe COVID-19 appear highly heterogeneous. In addition, factors associated with respiratory sequelae are not known. In this monocentric prospective study, we performed a multidisciplinary assessment for respiratory and muscular impairment and psychological distress 3 months after severe COVID-19. We analysed factors associated with severe persistent respiratory impairment, amongst demographic, COVID-19 severity, and 3-month assessment. METHODS Patients with severe SARS-CoV-2 pneumonia requiring ≥ 4L/min were included for a systematic 3-month visit, including respiratory assessment (symptoms, lung function, CT scan), muscular evaluation (body composition, physical function and activity, disability), psychopathological evaluation (anxiety, depression, post-traumatic stress disorder-PTSD) and quality of life. A cluster analysis was performed to identify subgroups of patients based on objective functional measurements: DLCO, total lung capacity and 6-min walking distance (6MWD). RESULTS Sixty-two patients were analysed, 39% had dyspnea on exercise (mMRC ≥ 2), 72% had DLCO < 80%, 90% had CT-scan abnormalities; 40% had sarcopenia/pre-sarcopenia and 31% had symptoms of PTSD. Cluster analysis identified a group of patients (n = 18, 30.5%) with a severe persistent (SP) respiratory impairment (DLCO 48 ± 12%, 6MWD 299 ± 141 m). This SP cluster was characterized by older age, severe respiratory symptoms, but also sarcopenia/pre-sarcopenia, symptoms of PTSD and markedly impaired quality of life. It was not associated with initial COVID-19 severity or management. CONCLUSIONS AND CLINICAL IMPLICATION We identified a phenotype of patients with severe persistent respiratory and muscular impairment and psychological distress 3 months after severe COVID-19. Our results highlight the need for multidisciplinary assessment and management after severe SARS-CoV-2 pneumonia. Trial registration The study was registered on ClinicalTrials.gov (May 6, 2020): NCT04376840.
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Affiliation(s)
- Jeanne-Marie Perotin
- Department of Pulmonary Medicine, University Hospital of Reims, Reims, France. .,INSERM P3Cell UMR-S1250, SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France.
| | - Fabien Gierski
- Department of Psychiatry, Marne Public Mental Health Institution & Reims University Hospital, Reims, France.,Cognition Health Society Laboratory (C2S - EA 6291), SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France
| | - Lois Bolko
- Faculty of Medicine, Rheumatology Department, University of Reims Champagne-Ardenne, Maison Blanche Hospital, Reims University Hospitals, 3797, Reims, EA, France
| | - Sandra Dury
- Department of Pulmonary Medicine, University Hospital of Reims, Reims, France.,EA7509 IRMAIC, University of Reims Champagne-Ardenne, Reims, France
| | - Sarah Barrière
- Department of Psychiatry, Marne Public Mental Health Institution & Reims University Hospital, Reims, France
| | - Claire Launois
- Department of Pulmonary Medicine, University Hospital of Reims, Reims, France.,INSERM P3Cell UMR-S1250, SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France
| | - Maxime Dewolf
- Department of Pulmonary Medicine, University Hospital of Reims, Reims, France
| | - Stéphane Chouabe
- Department of Pulmonary Medicine, Charleville Mézière Hospital, Charleville Mézière, France
| | - Eric Bongrain
- Department of Pulmonary Medicine, Epernay Hospital, Epernay, France
| | - Davy Picard
- Department of Pulmonary Medicine, University Hospital of Reims, Reims, France.,Department of Pulmonary Medicine, Chalons en Champagne Hospital, Chalons en Champagne, France
| | - Eric Tran
- Department of Psychiatry, Marne Public Mental Health Institution & Reims University Hospital, Reims, France
| | - Yoann N'Guyen
- Department of Infectious and Tropical Diseases, Reims University Hospital, Reims, France
| | - Bruno Mourvillier
- Medical Intensive Care Unit, University Hospital of Reims, Reims, France
| | - Amélie Servettaz
- Internal Medicine, Clinical Immunology and Infectious Diseases Department, University Hospital Centre, Reims, France
| | - Amandine Rapin
- Physical and Rehabilitation Medicine Department, Sebastopol Hospital, University Hospital of Reims, Reims, France.,Faculty of Medicine, University of Reims Champagne Ardennes, 3797, VieFra, Reims, UR, France
| | - Claude Marcus
- Department of Radiology, University Hospital of Reims, Reims, France
| | - François Lebargy
- Department of Pulmonary Medicine, University Hospital of Reims, Reims, France.,EA7509 IRMAIC, University of Reims Champagne-Ardenne, Reims, France
| | - Arthur Kaladjian
- Department of Psychiatry, Marne Public Mental Health Institution & Reims University Hospital, Reims, France.,Cognition Health Society Laboratory (C2S - EA 6291), SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France
| | - Jean-Hugues Salmon
- Faculty of Medicine, Rheumatology Department, University of Reims Champagne-Ardenne, Maison Blanche Hospital, Reims University Hospitals, 3797, Reims, EA, France
| | - Gaetan Deslee
- Department of Pulmonary Medicine, University Hospital of Reims, Reims, France.,INSERM P3Cell UMR-S1250, SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France
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12
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Prévost C, Doé de Maindreville A, Moulin M, Dubard T, Launois C, Honnorat J, Moulin S. Troubles du sommeil, mouvements anormaux, cognition, verticalité : anti-IgLON5 ? Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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13
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Hagenburg J, Bertin E, Salmon JH, Thierry A, Perotin JM, Dormoy V, Dury S, Gaubil I, Bolko L, Lebargy F, Deslee G, Launois C. Association between obesity-related dyspnea in daily living, lung function and body composition analyzed by DXA: a prospective study of 130 patients. BMC Pulm Med 2022; 22:103. [PMID: 35337302 PMCID: PMC8957162 DOI: 10.1186/s12890-022-01884-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/09/2022] [Indexed: 01/01/2023] Open
Abstract
Background Obesity is a risk factor for dyspnea. However, investigations of daily living obesity-related dyspnea are limited and its mechanisms remain unclear. We conducted a cross-sectional study to analyze the relationships between dyspnea in daily living, lung function, and body composition in patients with obesity. Methods One-hundred and thirty patients (103 women/27 men), candidate for bariatric surgery, with a mean ± SD Body Mass Index (BMI) of 44.8 ± 6.8 kg/m2 were included. Dyspnea was assessed by the modified Medical Research Council (mMRC) scale. Comorbidities, laboratory parameters, pulmonary function tests, arterial blood gases, six-minute walk test (6MWT), handgrip strength, and DXA body composition were analyzed. Results Thirty-one percent of patients exhibited disabling dyspnea in daily living (mMRC ≥ 2). Compared with patients without disabling dyspnea (mMRC < 2), significant dyspnea (mMRC ≥ 2) was associated with a lower 6MWT distance (395 ± 103 m vs 457 ± 73 m, p < 0.001), lower lung volumes including Expiratory Reserve Volume (42 ± 28% vs 54 ± 27%, p = 0.024), Vital Capacity (95 ± 14 vs 106 ± 15%, p < 0.001) and Forced expiratory volume in one second (95 ± 13 vs 105 ± 15%, p = 0.002), a higher BMI (48.2 ± 7.7 vs 43.2 ± 5.7 kg/m2, p = 0.001) and a higher percentage of fat mass in the trunk (46 ± 5 vs 44 ± 5 p = 0.012) and android region (52 ± 4 vs 51 ± 4%, p = 0.024). There was no difference regarding comorbidities (except hypertension), laboratory parameters, and sarcopenia markers between patients with (mMRC ≥ 2) and without (mMRC < 2) disabling dyspnea. Conclusion Dyspnea in patients with obesity is associated with a reduction in lung volumes and a higher percentage of fat mass in central body regions. How dyspnea and body composition may change with interventions like physical activity or bariatric surgery remains to be investigated. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01884-5.
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Affiliation(s)
- Jean Hagenburg
- Service Des Maladies Respiratoires, CHU Reims, Reims, France
| | - Eric Bertin
- Service d'Endocrinologie Diabète Nutrition, Centre Spécialisé Obésité, CHU Reims, Reims, France
| | | | | | - Jeanne-Marie Perotin
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.,INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Valérian Dormoy
- INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Sandra Dury
- Service Des Maladies Respiratoires, CHU Reims, Reims, France
| | - Isabelle Gaubil
- Service d'Endocrinologie Diabète Nutrition, Centre Spécialisé Obésité, CHU Reims, Reims, France
| | - Lois Bolko
- Service de Rhumatologie, CHU Reims, Reims, France
| | | | - Gaëtan Deslee
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.,INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Claire Launois
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.
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14
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Schmoll A, Launois C, Perotin JM, Ravoninjatovo B, Griffon M, Carré S, Mulette P, Ancel J, Hagenburg J, Lebargy F, Deslée G, Salmon JH, Dury S. Prevalence and Impact of Rheumatologic Pain in Cystic Fibrosis Adult Patients. Front Med (Lausanne) 2022; 8:804892. [PMID: 35211488 PMCID: PMC8861186 DOI: 10.3389/fmed.2021.804892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/21/2021] [Indexed: 12/04/2022] Open
Abstract
Background With the improvement of cystic fibrosis (CF) patient survival, the prevalence of long-term complications increased, among them rheumatologic disorders. Methods The aim of this prospective study was to evaluate the prevalence of spinal and joint pain, and their impact on disability, anxiety, depression, and quality of life in CF adult patients. Results Forty-seven patients were analyzed, 72% of men, mean aged 28 years, with a mean body mass index of 22 kg/m2 and a mean FEV1% of 63%. Twenty-two patients (47%) described rheumatologic pain either spinal (n = 15, 32%) and/or joint pain (n = 14, 30%). Patients with spinal and/or joint pain were shorter (p = 0.023), more frequently colonized with Staphylococcus aureus (p < 0.008), had more frequent ΔF508 homozygous mutations (p = 0.014), and a trend for more impairment of the 6-min walking distance (p = 0.050). The presence of rheumatologic pain tended to be associated with disability according to the Health Assessment Questionnaire (HAQ) and anxiety. Compared with patients with no pain patients with both spinal and joint pain exhibited a more pronounced impact on the St George's Respiratory Questionnaire (SGRQ). Conclusion Rheumatologic pain is frequent in CF adult patients, and may affect daily living, anxiety and quality of life. Systematic assessment of rheumatologic pain should be included in the management of CF patients.
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Affiliation(s)
- Axelle Schmoll
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital, Reims, France.,INSERM UMRS 1250, University of Reims Champagne-Ardenne, Reims, France
| | - Bruno Ravoninjatovo
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Muriel Griffon
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Sophie Carré
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Pauline Mulette
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Julien Ancel
- Department of Respiratory Diseases, Reims University Hospital, Reims, France.,INSERM UMRS 1250, University of Reims Champagne-Ardenne, Reims, France
| | - Jean Hagenburg
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital, Reims, France.,EA7509 IRMAIC, University of Reims Champagne-Ardenne, Reims, France
| | - Gaëtan Deslée
- Department of Respiratory Diseases, Reims University Hospital, Reims, France.,INSERM UMRS 1250, University of Reims Champagne-Ardenne, Reims, France
| | - Jean-Hugues Salmon
- Department of Rheumatology, Reims University Hospital, Reims, France.,EA3797, University of Reims Champagne-Ardenne, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, Reims, France.,EA7509 IRMAIC, University of Reims Champagne-Ardenne, Reims, France
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15
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Muggeo A, Perotin JM, Brisebarre A, Dury S, Dormoy V, Launois C, Ancel J, Mulette P, de Champs C, Deslée G, Guillard T. Extended Bacteria Culture-Based Clustering Identifies a Phenotype Associating Increased Cough and Enterobacterales in Stable Chronic Obstructive Pulmonary Disease. Front Microbiol 2022; 12:781797. [PMID: 34970242 PMCID: PMC8712763 DOI: 10.3389/fmicb.2021.781797] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by airflow limitation. This chronic respiratory disease represents the third leading cause of death worldwide. Alteration of the airway microbiota has been reported to be associated with exacerbation frequency in COPD, but its role on the symptoms in patients at stable state is still incompletely described. This study aimed to determine whether bacteria isolated in sputum can be associated with the clinical features of COPD patients within stable state. Our study highlights, for the first time, that altered microbiota with Enterobacterales is associated with pejorative clinical symptoms in stable COPD patients. The airway microbiota of 38 patients was analyzed using an extended culture approach and mass spectrometry identification. Cluster analysis by principal coordinate analysis of the bacterial communities showed that the patients could be classified into three distinct clusters in our cohort. The clusters showed no differences in proportions of the phylum, but one of them was associated with a high prevalence of Enterobacterales (71.4% in cluster 1 vs. 0% in cluster 3), loss of microbiota diversity, and higher bacterial load (107 vs. 105 CFU/ml, respectively) and characterized by predominant cough and impact on mental health. These novel findings, supported by further studies, could lead to modifying the processing of COPD sputum in the everyday practice of clinical microbiology laboratories.
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Affiliation(s)
- Anaëlle Muggeo
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France.,Laboratory of Bacteriology-Virology-Hospital Hygiene-Parasitology-Mycology, Reims University Hospital, Reims, France
| | - Jeanne-Marie Perotin
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France.,Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Audrey Brisebarre
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Valérian Dormoy
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Julien Ancel
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France.,Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Pauline Mulette
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France.,Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Christophe de Champs
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France.,Laboratory of Bacteriology-Virology-Hospital Hygiene-Parasitology-Mycology, Reims University Hospital, Reims, France
| | - Gaëtan Deslée
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France.,Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Thomas Guillard
- Inserm UMR-S 1250 Pulmonary pathologies and cellular plasticity (P3Cell), Reims-Champagne-Ardenne University, SFR CAP Santé, Reims, France.,Laboratory of Bacteriology-Virology-Hospital Hygiene-Parasitology-Mycology, Reims University Hospital, Reims, France
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16
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Mulette P, Jacquet A, Durlach A, Papathanassiou D, Lalire P, Graesslin O, Delepine G, Dury S, Dormoy V, Perotin JM, Lebargy F, Deslée G, Launois C. Pulmonary cavitations with increased 18F-FDG uptake revealing a thoracic endometriosis: A case report. Medicine (Baltimore) 2021; 100:e27550. [PMID: 34678890 PMCID: PMC8542117 DOI: 10.1097/md.0000000000027550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/13/2021] [Accepted: 10/01/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Thoracic endometriosis is a rare disorder that can involve airways, pleura and lung parenchyma. It is the most frequent form of extra-abdominopelvic endometriosis. Multiple lung cavitations are a rare feature of thoracic endometriosis. PATIENT CONCERNS A 46-year-old woman was referred to our hospital after incidental finding of multiple pulmonary cavitations with surrounding areas of ground glass opacity on a thoraco-abdominal computed tomography-scan performed for abdominal pain. Retrospectively, the patient also reported mild hemoptysis occurring 4 months ago. DIAGNOSES Positron emission tomography-computed tomography scan revealed moderate and homogeneous [18F] fluoro-2-deoxy-D-glucose (18F-FDG) uptake in pulmonary cavitations (maximum standardized uptake value 5.7). The diagnosis of thoracic endometriosis was confirmed by histological examination of surgical resection of a left lower lobe cavitation. INTERVENTIONS AND OUTCOME Gonadotropin-releasing hormone analogues associated with add-back therapy was started. Four months after initiating pharmacological treatment, the chest computed tomography-scan showed a dramatic decrease in lung cavitations size. LESSONS Thoracic endometriosis is a rare disorder requiring a multidisciplinary management including gynaecologist, pulmonologist, radiologist, nuclear physician, pathologist and thoracic surgeon for early diagnosis and treatment. Our case report highlights that an increased 18F-FDG uptake can be found in thoracic endometriosis syndrome presenting as multiple lung cavitations.
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Affiliation(s)
- Pauline Mulette
- Department of Respiratory Diseases, Reims University Hospital, France
| | - Amaury Jacquet
- Department of Pathology, Reims University Hospital, France
| | - Anne Durlach
- Department of Pathology, Reims University Hospital, France
- Pulmonary Pathologies and Cellular Plasticity, Inserm UMR-S 1250, Reims, France
| | - Dimitri Papathanassiou
- Department of Nuclear Medicine, Jean Godinot Institute, Reims, France
- Laboratory of Biophysics, Research Unit of Medicine, University of Reims Champagne-Ardenne, Reims, France
- Science and Information Technology Research Center (CReSTIC) EA 3804, University of Reims Champagne-Ardenne, Reims, France
| | - Paul Lalire
- Department of Nuclear Medicine, Jean Godinot Institute, Reims, France
| | - Olivier Graesslin
- Department of Obstetrics and Gynecology, Reims University Hospital, France
| | - Gonzague Delepine
- Department of Cardiothoracic Surgery, Reims University Hospital, France
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, France
| | - Valérian Dormoy
- Pulmonary Pathologies and Cellular Plasticity, Inserm UMR-S 1250, Reims, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital, France
- Pulmonary Pathologies and Cellular Plasticity, Inserm UMR-S 1250, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital, France
| | - Gaëtan Deslée
- Department of Respiratory Diseases, Reims University Hospital, France
- Pulmonary Pathologies and Cellular Plasticity, Inserm UMR-S 1250, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, France
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17
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Ancel J, Belgacemi R, Diabasana Z, Perotin JM, Bonnomet A, Dewolf M, Launois C, Mulette P, Deslée G, Polette M, Dormoy V. Impaired Ciliary Beat Frequency and Ciliogenesis Alteration during Airway Epithelial Cell Differentiation in COPD. Diagnostics (Basel) 2021; 11:diagnostics11091579. [PMID: 34573921 PMCID: PMC8469815 DOI: 10.3390/diagnostics11091579] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 12/19/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a frequent respiratory disease. However, its pathophysiology remains partially elucidated. Epithelial remodeling including alteration of the cilium is a major hallmark of COPD, but specific assessments of the cilium have been rarely investigated as a diagnostic tool in COPD. Here we explore the dysregulation of the ciliary function (ciliary beat frequency (CBF)) and differentiation (multiciliated cells formation in air-liquid interface cultures) of bronchial epithelial cells from COPD (n = 17) and non-COPD patients (n = 15). CBF was decreased by 30% in COPD (11.15 +/- 3.37 Hz vs. 7.89 +/- 3.39 Hz, p = 0.037). Ciliary differentiation was altered during airway epithelial cell differentiation from COPD patients. While the number of multiciliated cells decreased (p < 0.005), the number of primary ciliated cells increased (p < 0.05) and primary cilia were shorter (p < 0.05). Altogether, we demonstrate that COPD can be considered as a ciliopathy through both primary non-motile cilia modifications (related to airway epithelial cell repair and remodeling) and motile cilia function impairment (associated with decrease sputum clearance and clinical respiratory symptoms). These observations encourage considering cilia-associated features in the complex COPD physiopathology and highlight the potential of cilia-derived biomarkers for diagnosis.
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Affiliation(s)
- Julien Ancel
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
- Department of Respiratory Diseases, Centre Hospitalier Universitaire de Reims, Hôpital Maison Blanche, 51092 Reims, France; (M.D.); (C.L.)
| | - Randa Belgacemi
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
| | - Zania Diabasana
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
| | - Jeanne-Marie Perotin
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
- Department of Respiratory Diseases, Centre Hospitalier Universitaire de Reims, Hôpital Maison Blanche, 51092 Reims, France; (M.D.); (C.L.)
| | - Arnaud Bonnomet
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
- Platform of Cellular and Tissular Imaging (PICT), Université de Reims Champagne Ardenne, 51097 Reims, France
| | - Maxime Dewolf
- Department of Respiratory Diseases, Centre Hospitalier Universitaire de Reims, Hôpital Maison Blanche, 51092 Reims, France; (M.D.); (C.L.)
| | - Claire Launois
- Department of Respiratory Diseases, Centre Hospitalier Universitaire de Reims, Hôpital Maison Blanche, 51092 Reims, France; (M.D.); (C.L.)
| | - Pauline Mulette
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
- Department of Respiratory Diseases, Centre Hospitalier Universitaire de Reims, Hôpital Maison Blanche, 51092 Reims, France; (M.D.); (C.L.)
| | - Gaëtan Deslée
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
- Department of Respiratory Diseases, Centre Hospitalier Universitaire de Reims, Hôpital Maison Blanche, 51092 Reims, France; (M.D.); (C.L.)
| | - Myriam Polette
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
- Department of Biopathology, Centre Hospitalier Universitaire de Reims, Hôpital Maison Blanche, 51092 Reims, France
| | - Valérian Dormoy
- Inserm UMR-S1250, P3Cell, Université de Reims Champagne Ardenne, SFR CAP-SANTE, 51092 Reims, France; (J.A.); (R.B.); (Z.D.); (J.-M.P.); (A.B.); (P.M.); (G.D.); (M.P.)
- Correspondence:
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18
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Dury S, Perotin JM, Ravoninjatovo B, Llerena C, Ancel J, Mulette P, Griffon M, Carré S, Perrin A, Lebargy F, Deslée G, Launois C. Identifying specific needs in adult cystic fibrosis patients: a pilot study using a custom questionnaire. BMC Pulm Med 2021; 21:270. [PMID: 34404378 PMCID: PMC8371823 DOI: 10.1186/s12890-021-01613-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background Adult patients with cystic fibrosis (CF) experience daily physical symptoms and disabilities that can be challenging to address for health care teams. Methods We sought to identify the most frequent topics that CF adults need to discuss with health care teams using a custom questionnaire including 62 items. Results Fifty patients were included, 70% men, mean age 27.6 years, with a mean body mass index of 21.8 kg/m2. Mean FEV1% was 64% of predicted value. Forty-two percent of patients selected at least one topic. The most frequently selected topics were fatigue (20%), professional or scholar worries (18%), procreation (16%), physical activities (16%) and evolution of CF disease (16%). Women were more frequently concerned about fatigue, procreation and profession/school. Conclusions Using a custom questionnaire, we identified that CF adults express various unmet needs that extend beyond usual respiratory and nutritional concerns or treatment adherence. The interest of this questionnaire by health care team for improving therapeutic management of CF patients remains to be validated. Trial registration: The study was registered on ClinicalTrials.gov (NCT02924818) on 5th October 2016.
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Affiliation(s)
- Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France. .,EA 4683 Medical and Pharmacological, University of Reims, Reims, France.
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France.,INSERM UMRS 1250, Reims University Hospital, Reims, France
| | - Bruno Ravoninjatovo
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Catherine Llerena
- Department of Pediatrics, Grenoble University Hospital, Grenoble, France
| | - Julien Ancel
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Pauline Mulette
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Muriel Griffon
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Sophie Carré
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
| | - Amélie Perrin
- Department of Pediatrics, Nantes University Hospital, Nantes, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France.,EA 4683 Medical and Pharmacological, University of Reims, Reims, France
| | - Gaëtan Deslée
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France.,INSERM UMRS 1250, Reims University Hospital, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51 092, Reims cedex, France
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19
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Seret R, Launois C, Barbe C, Larre S, Léon P. [Evolution of the USP and IPSS score after continuous positive airway pressure sleep apnea therapy at night]. Prog Urol 2021; 32:130-138. [PMID: 34158219 DOI: 10.1016/j.purol.2020.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/29/2020] [Accepted: 12/20/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION To assess the impact of nocturnal continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) on lower urinary tract (LUTS) symptoms. MATERIALS AND METHODS A prospective, monocentric study was conducted between June 2018 and August 2019. Patients with moderate to severe OSA with an indication for treatment with nocturnal CPAP in combination with SBAU were included. SBAUs and their impact were evaluated by completing two self-administered questionnaires (Urinary Symptom Profile (USP) and International Prostate Score Symptom (IPSS)) filled out during the night-time ventilatory polygraph or diagnostic polysomnography for OSA and after 4 months of CPAP treatment. RESULTS In 79 patients, after four months of CPAP treatment, USP scores for stress urinary incontinence and overactive bladder were significantly improved, respectively 0.65±1.38 vs 1.13±2.10 ; p<0.0001 and 3.24±2.58 vs 5.43±3.66 ; p<0.0001, IPSS and IPSS-Qdv were significantly improved, respectively 5.20±3.78 vs. 7.44±5.05 ; p<0.0001 and 1.93±1.26 vs. 2.27±1.56 ; p=0.002 as well as IPSS score items on pollakiuria, urgency and nocturia. CONCLUSION Treatment with CPAP significantly improved SBAU in four months. Testing urology patients for symptoms of OSA in urology patients seeking SBAU would allow referral of patients suspected of OSA to a specialist for diagnosis and management if necessary.
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Affiliation(s)
- R Seret
- Service d'urologie, centre hospitalier universitaire Reims, rue du Général-Koenig, 51100 Reims, France.
| | - C Launois
- Service des maladies respiratoires, unité de sommeil et ventilation, centre hospitalier universitaire Reims, 51100 Reims, France
| | - C Barbe
- Service de santé publique et d'aide méthologique, centre hospitalier universitaire Reims, 51100 Reims, France
| | - S Larre
- Service d'urologie, centre hospitalier universitaire Reims, rue du Général-Koenig, 51100 Reims, France
| | - P Léon
- Service d'urologie, clinique Pasteur, 17200 Royan, France
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20
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Launois C, Mulette P, Ancel J, Dury S, Hagenburg J, Lebargy F, Dormoy V, Deslee G, Perotin JM. [Treatment of GERD in asthma]. Rev Mal Respir 2021; 38:733-742. [PMID: 34016495 DOI: 10.1016/j.rmr.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/25/2021] [Indexed: 11/28/2022]
Abstract
Gastro-oesophageal reflux disease (GORD) is one of the most frequent conditions associated with asthma. GORD has an impact on asthma control and quality of life of asthmatic patients. Its treatment relies on lifestyle modifications, anti-acidic treatment with proton pump inhibitors (PPI) and/or surgical management by fundoplication in some situations. The impact of lifestyle modifications has not been analysed on asthma outcomes alone. Several randomised controlled trials assessed the efficacy of PPI on asthma control, peak expiratory flow and/or quality of life. The impact of fundoplication in asthma has mainly been analysed in retrospective or prospective observational studies. This review highlights the limited impact of GORD treatment on asthma control. Current guidelines are to restrict GORD treatment in asthma to asthmatic patients with actual symptomatic GORD. Given the lack of controlled studies, the place of surgical management of GORD in asthma is currently not defined.
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Affiliation(s)
- C Launois
- Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - P Mulette
- Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - J Ancel
- Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - S Dury
- Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France; EA 4683, université de Reims Champagne-Ardenne, 51092 Reims, France
| | - J Hagenburg
- Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France
| | - F Lebargy
- Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France; EA 4683, université de Reims Champagne-Ardenne, 51092 Reims, France
| | - V Dormoy
- Inserm UMR-S 1250, P3Cell, université de Reims Champagne-Ardenne, 51092 Reims, France
| | - G Deslee
- Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France; Inserm UMR-S 1250, P3Cell, université de Reims Champagne-Ardenne, 51092 Reims, France
| | - J-M Perotin
- Service des maladies respiratoires, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France; Inserm UMR-S 1250, P3Cell, université de Reims Champagne-Ardenne, 51092 Reims, France.
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21
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Mulette P, Ravoninjatovo B, Guguen C, Barbe C, Ancel J, Dury S, Dumazet A, Perdu D, Perotin JM, Guillard T, Lebargy F, Deslee G, Launois C. Insomnia in adults with cystic fibrosis: strong association with anxiety/depression and impaired quality of life. BMC Pulm Med 2021; 21:108. [PMID: 33794842 PMCID: PMC8017792 DOI: 10.1186/s12890-021-01473-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/22/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND While sleep disruption is a common complaint among children with cystic fibrosis (CF), only a few studies have investigated insomnia in adults. The aim of this study was to identify factors associated with insomnia in clinically stable adult CF patients. METHODS Twenty-eight CF patients (18M/10F), with a median age of 27 (22-34) (median (interquartile range) years and a median of forced expiratory volume in one second of 72 (39-93) % predicted completed questionnaires on insomnia (Insomnia Severity Index, ISI), sleep quality (PSQI), daytime sleepiness (Epworth), restless legs syndrome (IRLS), pain (NRS), anxiety/depression (HAD) and quality of life (CFQ-R 14+). Respiratory assessment data, including symptoms, sputum analysis, arterial blood gases, 6-min walking test, pulmonary function tests and polysomnographic variables, were also analyzed. RESULTS Forty-three percent of patients were insomniac (ISI > 7). Compared with non-insomniac patients (ISI ≤ 7), insomniac patients had more severely impaired quality of life and a higher HAD score: median anxiety score of 9 (8-11) vs 4 (3-6) (p < 0.0001), median depression score of 7 (5-10) vs 1 (1-4) (p < 0.001), with a positive correlation between ISI and HAD anxiety/depression scores (r = 0.702/r = 0.701, respectively, p < 0.0001). Insomnia was also associated with mMRC dyspnea scale ≥ 2, restless legs syndrome, pain and lower SpO2 during sleep. CONCLUSIONS The strong association between insomnia, impaired quality of life and increased HAD score should prompt physicians to be particularly attentive to the management of anxiety and depression in adult CF patients with insomnia. TRIAL REGISTRATION On clinicaltrials.gov (NCT02924818, date of registration: October 5, 2016).
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Affiliation(s)
- Pauline Mulette
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France.,Inserm UMR-S 1250 "Pathologies Pulmonaires et Plasticité Cellulaire", Reims, France
| | - Bruno Ravoninjatovo
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France
| | - Camille Guguen
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France
| | - Coralie Barbe
- Département de Méthodologie, CHU Reims, Reims, France
| | - Julien Ancel
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France.,Inserm UMR-S 1250 "Pathologies Pulmonaires et Plasticité Cellulaire", Reims, France
| | - Sandra Dury
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France.,EA 4683 Université de Médecine et de Pharmacie, Reims, France
| | - Antoine Dumazet
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France
| | - Dominique Perdu
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France
| | - Jeanne-Marie Perotin
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France.,Inserm UMR-S 1250 "Pathologies Pulmonaires et Plasticité Cellulaire", Reims, France
| | - Thomas Guillard
- Inserm UMR-S 1250 "Pathologies Pulmonaires et Plasticité Cellulaire", Reims, France.,Laboratoire de Bactériologie-Virologie-Hygiène-Parasitologie-Mycologie, CHU Reims, Reims, France
| | - François Lebargy
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France.,EA 4683 Université de Médecine et de Pharmacie, Reims, France
| | - Gaëtan Deslee
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France.,Inserm UMR-S 1250 "Pathologies Pulmonaires et Plasticité Cellulaire", Reims, France
| | - Claire Launois
- Service Des Maladies Respiratoires, CHU Reims, 45, Rue Cognacq Jay Reims Cedex, 51092, Reims, France.
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22
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Perotin JM, Dewolf M, Launois C, Dormoy V, Deslee G. Bronchoscopic management of asthma, COPD and emphysema. Eur Respir Rev 2021; 30:30/159/200029. [PMID: 33650526 DOI: 10.1183/16000617.0029-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/15/2020] [Indexed: 11/05/2022] Open
Abstract
In recent years, many bronchoscopic techniques have been developed in chronic obstructive airway inflammatory diseases, including asthma, COPD and emphysema. The main techniques with available data from randomised controlled trials are: 1) bronchial thermoplasty in asthma; 2) valves, coils and thermal vapor ablation in emphysema; and 3) targeted lung denervation in COPD. The objectives of this article are to describe the levels of evidence for efficacy and safety, long-term follow-up results beyond 1 year, and current recommendations for clinical practice from international guidelines for each technique.
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Affiliation(s)
- Jeanne Marie Perotin
- Dept of Pulmonary Medicine, University Hospital of Reims, Reims, France.,INSERM P3Cell UMR-S1250, SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France
| | - Maxime Dewolf
- Dept of Pulmonary Medicine, University Hospital of Reims, Reims, France
| | - Claire Launois
- Dept of Pulmonary Medicine, University Hospital of Reims, Reims, France
| | - Valérian Dormoy
- INSERM P3Cell UMR-S1250, SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France
| | - Gaëtan Deslee
- Dept of Pulmonary Medicine, University Hospital of Reims, Reims, France .,INSERM P3Cell UMR-S1250, SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France
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23
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Lamkouan Y, Dury S, Perotin JM, Picot R, Durlach A, Passouant O, Sandu S, Dewolf M, Dumazet A, Lebargy F, Deslee G, Launois C. Acute severe idiopathic lymphoid interstitial pneumonia: A case report. Medicine (Baltimore) 2020; 99:e21473. [PMID: 32791765 PMCID: PMC7387017 DOI: 10.1097/md.0000000000021473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Lymphoid interstitial pneumonia is a rare benign pulmonary lymphoproliferative disorder usually presenting with a sub-acute or chronic condition and frequently associated with autoimmune disorders, dysgammaglobulinemia, or infections. PATIENT CONCERNS A 74-year-old woman with no past medical history presented with acute dyspnea, nonproductive cough, hypoxemia (room air PaO2: 48 mmHg) and bilateral alveolar infiltrates with pleural effusion. Antibiotics and diuretics treatments did not induce any improvement. No underlying condition including cardiac insufficiency, autoimmune diseases, immunodeficiency, or infections was found after an extensive evaluation. Bronchoalveolar lavage revealed a lymphocytosis (60%) with negative microbiological findings. High-dose intravenous corticosteroids induced a mild clinical improvement only, which led to perform a surgical lung biopsy revealing a lymphoid interstitial pneumonia with no sign of lymphoma or malignancies. DIAGNOSES Acute severe idiopathic lymphoid interstitial pneumonia. INTERVENTIONS Ten days after the surgical lung biopsy, the patient experienced a dramatic worsening leading to invasive mechanical ventilation. Antibiotics and a new course of high-dose intravenous corticosteroids did not induce any improvement, leading to the use of rituximab which was associated with a dramatic clinical and radiological improvement allowing weaning from mechanical ventilation after 10 days. OUTCOMES Despite the initial response to rituximab, the patient exhibited poor general state and subsequent progressive worsening of respiratory symptoms leading to consider symptomatic palliative treatments. The patient died 4 months after the diagnosis of lymphoid interstitial pneumonia. LESSONS Idiopathic lymphoid interstitial pneumonia may present as an acute severe respiratory insufficiency with a potential transient response to rituximab.
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Affiliation(s)
| | - Sandra Dury
- Department of Pulmonary Medicine
- Equipe d’Accueil 4683
| | - Jeanne Marie Perotin
- Department of Pulmonary Medicine
- Institut National de la Santé Et de la Recherche Médicale Unité Mixte de Recherche en Santé 1250, University of Reims Champagne-Ardenne
| | | | - Anne Durlach
- Institut National de la Santé Et de la Recherche Médicale Unité Mixte de Recherche en Santé 1250, University of Reims Champagne-Ardenne
- Department of Biopathology
| | | | - Sebastian Sandu
- Department of Thopracic Surgery, University Hospital of Reims, Reims, France
| | | | | | | | - Gaëtan Deslee
- Department of Pulmonary Medicine
- Institut National de la Santé Et de la Recherche Médicale Unité Mixte de Recherche en Santé 1250, University of Reims Champagne-Ardenne
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24
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Ancel J, Perotin JM, Dewolf M, Launois C, Hagenburg J, Chouabe S, Lebargy F. [A case of multifocal cavernous haemangiomas of the lung, spleen and bone]. Rev Mal Respir 2020; 37:275-279. [PMID: 32171443 DOI: 10.1016/j.rmr.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 12/11/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Haemangiomas are vascular malformations, frequently cutaneous, hepatic and splenic. Respiratory involvement and multiple localisations are uncommon. CASE REPORT We present a rare case of multiple cavernous haemangiomas in a 35 year old woman presenting with repeated haemoptysis. Thoracic CT scanning showed a mass in the left lower lobe associated with lymph node enlargement above and below the diaphragm, heterogeneous splenomegaly and a single spinal lesion without hypermetabolism on PET scanning. Enbronchial ultrasound-guided trans-bronchial needle aspiration was not contributory. Histopathological diagnostic was made firstly by splenectomy with lumbar-aortic curettage and then by lobectomy for haemostasis. A final diagnosis of multiple cavernous haemangiomas involving lung, lymph nodes, spleen and bone was made. CONCLUSIONS Bronchopulmonary cavernous haemangiomas associated with extra-thoracic lesions are exceptionally rare and their presentation, suggesting, a malignant cause, often leads to surgical resection for diagnostic and, eventually, therapeutic management. We report an original case of cavernous haemangiomas involving lung, lymph nodes, spleen and bone.
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Affiliation(s)
- J Ancel
- Service de pneumologie, hôpital Maison Blanche, CHU de Reims, 45, rue Cognacq Jay, 51092 Reims cedex.
| | - J M Perotin
- Service de pneumologie, hôpital Maison Blanche, CHU de Reims, 45, rue Cognacq Jay, 51092 Reims cedex
| | - M Dewolf
- Service de pneumologie, hôpital Maison Blanche, CHU de Reims, 45, rue Cognacq Jay, 51092 Reims cedex
| | - C Launois
- Service de pneumologie, hôpital Maison Blanche, CHU de Reims, 45, rue Cognacq Jay, 51092 Reims cedex
| | - J Hagenburg
- Service de pneumologie, hôpital Maison Blanche, CHU de Reims, 45, rue Cognacq Jay, 51092 Reims cedex
| | - S Chouabe
- Service de pneumologie, hôpital Manchester, Charleville-Mézières
| | - F Lebargy
- Service de pneumologie, hôpital Maison Blanche, CHU de Reims, 45, rue Cognacq Jay, 51092 Reims cedex
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Dury S, Malihy A, Mahfoud M, Launois C, Perotin JM, Deslée G, Lebargy F. An unusual cause of calcified pulmonary opacity: A metastasis of a benign giant cell tumour of bone. Respir Med Res 2020; 77:55-57. [PMID: 32416584 DOI: 10.1016/j.resmer.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/17/2020] [Accepted: 01/24/2020] [Indexed: 10/25/2022]
Affiliation(s)
- S Dury
- Department of Respiratory Diseases, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51092 Reims cedex, France; EA 4683 Medical and Pharmacological University of Reims, Reims, France.
| | - A Malihy
- Department of Pathology, Children's Hospital, Ibn Sina University Hospital of Rabat, Rabat, Morocco
| | - M Mahfoud
- Department of Orthopaedic Surgery, Ibn Sina University Hospital of Rabat, Rabat, Morocco
| | - C Launois
- Department of Respiratory Diseases, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51092 Reims cedex, France
| | - J M Perotin
- Department of Respiratory Diseases, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51092 Reims cedex, France; Inserm UMRS 903, Reims University Hospital, Reims, France
| | - G Deslée
- Department of Respiratory Diseases, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51092 Reims cedex, France; Inserm UMRS 903, Reims University Hospital, Reims, France
| | - F Lebargy
- Department of Respiratory Diseases, Maison Blanche University Hospital, 45, rue de Cognacq-Jay, 51092 Reims cedex, France; EA 4683 Medical and Pharmacological University of Reims, Reims, France
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Guguen C, Launois C, Dormoy V, Dewolf M, Dumazet A, Dury S, Lebargy F, Deslee G, Perotin JM. [Obesity and asthma: Mechanisms and therapeutic options]. Rev Mal Respir 2019; 37:134-143. [PMID: 31864881 DOI: 10.1016/j.rmr.2019.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 03/06/2019] [Indexed: 12/22/2022]
Abstract
Asthma and obesity are both common conditions, which lead to a substantial public health burden. The obese-asthma phenotype is characterized by poor asthma control, impaired lung function and decreased efficacy of inhaled treatment. However, this phenotype is highly heterogeneous and involves numerous mechanisms, including systemic inflammation and adipokines. A role for microbiota modifications and genetics has been suggested. Obese-asthma patient management currently consists in weight loss and usual anti-asthmatic treatment. New therapeutic options are being evaluated.
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Affiliation(s)
- C Guguen
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France
| | - C Launois
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France
| | - V Dormoy
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France
| | - M Dewolf
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France
| | - A Dumazet
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France
| | - S Dury
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France
| | - F Lebargy
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France
| | - G Deslee
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France
| | - J-M Perotin
- Service des maladies respiratoires, Inserm UMR-S 1250, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France.
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Launois C, Nierat M, Attali V, Raux M, Arnulf I, Similowski T, Redolfi S. Postural preinspiratory cortical activity, genioglossus activity and fluid shift in awake obstructive sleep apnoea patients. Exp Physiol 2019; 105:370-378. [DOI: 10.1113/ep087804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 11/12/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Claire Launois
- Sorbonne UniversitéINSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
| | - Marie‐Cécile Nierat
- Sorbonne UniversitéINSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
| | - Valérie Attali
- Sorbonne UniversitéINSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de Pathologies du Sommeil Département R3S Paris France
| | - Mathieu Raux
- Sorbonne UniversitéINSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixDépartement d'Anesthésie Réanimation Paris France
| | - Isabelle Arnulf
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de Pathologies du Sommeil Département R3S Paris France
| | - Thomas Similowski
- Sorbonne UniversitéINSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de PneumologieMédecine Intensive et Réanimation Département R3S Paris France
| | - Stefania Redolfi
- Sorbonne UniversitéINSERM, UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de Pathologies du Sommeil Département R3S Paris France
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Abstract
Relapsing polychondritis (RP) is a rare immune-mediated disease affecting cartilaginous structures. Respiratory tract manifestations are frequent and constitute a major cause of morbidity and mortality. The present review of the literature was designed to assess the efficacy of tumor necrosis factor alpha (TNF-α) inhibitors in respiratory tract involvement of RP.A MEDLINE literature search was performed from January 2000 to December 2016 to identify all studies and case reports of anti-TNF-α therapy in RP. Articles published in English or French concerning patients with respiratory tract involvement were eligible. Two authors (JB, FL) independently reviewed and extracted data concerning each patient and 2 personal cases were added. Treatment efficacy was assessed according to systemic and/or respiratory criteria.A total of 28 patients (mean age: 41.6 years; 16 females/12 males) were included in the final analysis. Anti-TNF-α therapy was associated with improved health status and respiratory symptoms in 67.8% and 60.1% of cases, respectively.These results suggest that TNF-α inhibitors could be considered for the treatment of respiratory tract involvement of RP.
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Affiliation(s)
- Josette Biya
- Department of Respiratory Diseases, Reims University Hospital
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital
- EA 4683 Medical and Pharmacological Sciences
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital
- UMRS 903, Reims University Hospital, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital
| | - Maxime Dewolf
- Department of Respiratory Diseases, Reims University Hospital
| | - Gaëtan Deslée
- Department of Respiratory Diseases, Reims University Hospital
- UMRS 903, Reims University Hospital, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital
- EA 4683 Medical and Pharmacological Sciences
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Launois C, Perger E, Attali V, Nierat M, Raux M, Arnulf I, Similowski T, Redolfi S. Postural respiratory‐related cortical activation and rostral fluid shift in awake healthy humans. Exp Physiol 2019; 104:887-895. [DOI: 10.1113/ep087468] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 02/27/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Claire Launois
- Sorbonne UniversitéINSERM UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
| | - Elisa Perger
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de Pathologies du SommeilDépartement R3S Paris France
| | - Valérie Attali
- Sorbonne UniversitéINSERM UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de Pathologies du SommeilDépartement R3S Paris France
| | - Marie‐Cécile Nierat
- Sorbonne UniversitéINSERM UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
| | - Mathieu Raux
- Sorbonne UniversitéINSERM UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixDépartement d'Anesthésie Réanimation Paris France
| | - Isabelle Arnulf
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de Pathologies du SommeilDépartement R3S Paris France
| | - Thomas Similowski
- Sorbonne UniversitéINSERM UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de PneumologieMédecine Intensive et RéanimationDépartement R3S Paris France
| | - Stefania Redolfi
- Sorbonne UniversitéINSERM UMRS 1158 Neurophysiologie Respiratoire Expérimentale et Clinique Paris France
- AP‐HPGroupe Hospitalier Pitié‐Salpêtrière Charles FoixService de Pathologies du SommeilDépartement R3S Paris France
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Dumazet A, Launois C, Dury S, Sailhan F, Alifano M, Dewolf M, Lebargy F, Deslee G, Perotin JM. Hereditary multiple exostoses of the ribs as an uncommon cause of pneumothorax: A case report. Medicine (Baltimore) 2018; 97:e11894. [PMID: 30170381 PMCID: PMC6393102 DOI: 10.1097/md.0000000000011894] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
RATIONALE Hereditary multiple exostoses (HME) is a genetic musculoskeletal condition causing multiple exostoses. Rib location of exostosis can be complicated by thoracic injuries. PATIENT CONCERNS AND DIAGNOSES We report a case of pneumothorax in a 32-year-old man with a partial left-sided pneumothorax caused by an exostosis of the fourth and fifth ribs. INTERVENTIONS AND OUTCOMES Clinical and radiological presentations allowed a conservative management. A video-assisted thoracoscopic surgery was performed a few weeks later to avoid any recurrence. LESSONS Rib exostosis represents an unusual cause of pneumothorax. Any local modification of symptoms or size of the exostosis should lead to investigations in regard to chondrosarcoma transformation.
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Affiliation(s)
- Antoine Dumazet
- Department of Respiratory Diseases, University Hospital, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, University Hospital, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, University Hospital, Reims, France
- EA 4683, Laboratoire D’immunologie et de Biotechnologies, UFR de Pharmacie, Reims
| | - Frédéric Sailhan
- Department of Orthopedic Surgery, Cochin Hospital, APHP, Paris Descartes University
| | - Marco Alifano
- Department of Thoracic Surgery, Cochin hospital, APHP, Paris Descartes University, Paris
| | - Maxime Dewolf
- Department of Respiratory Diseases, University Hospital, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, University Hospital, Reims, France
- EA 4683, Laboratoire D’immunologie et de Biotechnologies, UFR de Pharmacie, Reims
| | - Gaëtan Deslee
- Department of Respiratory Diseases, University Hospital, Reims, France
- INSERM UMRS 1250, University Hospital, Reims, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, University Hospital, Reims, France
- INSERM UMRS 1250, University Hospital, Reims, France
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Perotin JM, Launois C, Dewolf M, Dumazet A, Dury S, Lebargy F, Dormoy V, Deslee G. Managing patients with chronic cough: challenges and solutions. Ther Clin Risk Manag 2018; 14:1041-1051. [PMID: 29922064 PMCID: PMC5995432 DOI: 10.2147/tcrm.s136036] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Chronic cough is a common complaint and a frequent cause of medical consultation. Its management can be difficult. We present here an overview of the current guidelines for the management of chronic cough. Different steps are detailed, including the initial research of an obvious etiology and alert signs that should lead to further investigation of underlying condition. The diagnosis of the most frequent causes: asthma, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease and upper airway cough syndrome should be considered, assessed and treated accordingly. Recent advances have been made in the comprehension of refractory chronic cough pathophysiology as well as its pharmacologic and non-pharmacologic treatment, especially speech pathology therapy.
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Affiliation(s)
- Jeanne-Marie Perotin
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France.,INSERM UMRS 1250, University Hospital of Reims, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Maxime Dewolf
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Antoine Dumazet
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Valérian Dormoy
- INSERM UMRS 1250, University Hospital of Reims, Reims, France
| | - Gaëtan Deslee
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France.,INSERM UMRS 1250, University Hospital of Reims, Reims, France
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Boissière L, Perotin-Collard JM, Bertin E, Gaubil I, Diaz Cives A, Barbe C, Dury S, Nardi J, Lebargy F, Deslée G, Launois C. Improvement of dyspnea after bariatric surgery is associated with increased Expiratory Reserve Volume: A prospective follow-up study of 45 patients. PLoS One 2017; 12:e0185058. [PMID: 28931052 PMCID: PMC5607210 DOI: 10.1371/journal.pone.0185058] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 09/06/2017] [Indexed: 12/28/2022] Open
Abstract
Objectives To assess the effects of bariatric surgery in patients with obesity on dyspnea and to analyze the relationships between improvement of dyspnea after bariatric surgery and changes in pulmonary function, especially Expiratory Reserve Volume (ERV) which is the lung volume abnormality most frequently associated with obesity. Methods Forty-five patients (5 males/40 females, mean Body Mass Index = 46.2 ± 6.8 kg/m2) were evaluated before and 6 to 12 months after bariatric surgery. Dyspnea was assessed by the modified Medical Research Council (mMRC) scale. Pulmonary function tests, arterial blood gases and six-minute walk test were performed. Laboratory parameters including C-Reactive Protein (CRP) were analyzed. Results Ninety percent of patients were dyspneic before surgery (mMRC scale ≥ 1) versus 59% after surgery (p<0.001). Mean mMRC score improved after bariatric surgery (1.5 ± 0.9 vs 0.7 ± 0.7, p<0.0001). Among patients with dyspnea before surgery (n = 38), a more marked increase in ERV after surgery was observed in patients with improvement of dyspnea compared to patients with no improvement of dyspnea (+0.17 ± 0.32 L vs +0.49 ± 0.35 L, p = 0.01). Multivariate analysis including age, variation of BMI, variation of CRP, variation of Total Lung Capacity and variation of ERV demonstraded that ERV was the only variable associated with improvement of the mMRc score after bariatric surgery (p = 0.04). Conclusion Weight loss associated with bariatric surgery improves dyspnea in daily living. This improvement could be partly related to increased ERV.
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Affiliation(s)
- Louis Boissière
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - Jeanne-Marie Perotin-Collard
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- INSERM UMRS 903, Reims University Hospital, Reims, France
| | - Eric Bertin
- Department of Nutrition, Reims University Hospital, Reims, France
| | - Isabelle Gaubil
- Department of Nutrition, Reims University Hospital, Reims, France
| | - Ana Diaz Cives
- Department of Gastroenterological Surgery, Reims University Hospital, Reims, France
| | - Coralie Barbe
- Clinical Research Unit, Reims University Hospital, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- EA 4683, University of Reims, Reims, France
| | - Julie Nardi
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- EA 4683, University of Reims, Reims, France
| | - Gaëtan Deslée
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- INSERM UMRS 903, Reims University Hospital, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, Reims, France
- * E-mail:
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Boleto G, Perotin JM, Launois C, Uro-Coste E, Birembaut P, Dury S, Vallerand H, Lebargy F, Deslée G, Vella-Boucaud J. Nuclear protein in testis carcinoma of the mediastinum: a case report. J Med Case Rep 2017; 11:152. [PMID: 28595655 PMCID: PMC5465526 DOI: 10.1186/s13256-017-1328-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/22/2017] [Indexed: 11/24/2022] Open
Abstract
Background Nuclear protein in testis carcinoma is a rare and very aggressive undifferentiated cancer which characteristically arises in the midline of the head, neck, and mediastinum. Case presentation We describe the case of a 46-year-old white woman admitted for superior vena cava syndrome revealing a mediastinal tumor. Pathological examination of specimens obtained by mediastinoscopy revealed an undifferentiated tumor with solid growth and positive immunoreactivity for p40 and negative immunoreactivity for cytokeratin markers. Immunohistochemical staining was positive for nuclear protein in testis, allowing the diagnosis of nuclear protein in testis midline carcinoma of the mediastinum. Conclusions We present a rare case of mediastinal nuclear protein in testis carcinoma with diagnosis based on nuclear protein in testis protein positivity and atypical immunohistochemical features including p40 positivity and anti-cytokeratin negativity. Physicians must remain aware of the possibility of nuclear protein in testis carcinoma especially in young patients with thoracic symptoms and suspicion of neoplasm.
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Affiliation(s)
- Gonçalo Boleto
- Department of Respiratory Medicine, Reims University Hospitals, Reims, France. .,Service de Pneumologie, Hôpital Maison Blanche, CHU Reims, 45 rue Cogncaq-Jay, 51092, Reims cedex, France.
| | - Jeanne-Marie Perotin
- Department of Respiratory Medicine, Reims University Hospitals, Reims, France.,INSERM UMR-S 903, Reims, France
| | - Claire Launois
- Department of Respiratory Medicine, Reims University Hospitals, Reims, France
| | - Emmanuelle Uro-Coste
- Department of Anatomy and Cytopathology, Cancer-Oncopole Institute, University of Toulouse, Toulouse, France.,INSERM UMR 1037, Cancer Research Centre, Toulouse, France
| | - Philippe Birembaut
- INSERM UMR-S 903, Reims, France.,Department of Pathology, Maison Blanche Hospital, Reims University Hospitals, Reims, France
| | - Sandra Dury
- Department of Respiratory Medicine, Reims University Hospitals, Reims, France.,EA 4683 Medical and Pharmacological University of Reims, Reims, France
| | - Hervé Vallerand
- Department of Respiratory Medicine, Reims University Hospitals, Reims, France
| | - François Lebargy
- Department of Respiratory Medicine, Reims University Hospitals, Reims, France.,EA 4683 Medical and Pharmacological University of Reims, Reims, France
| | - Gaëtan Deslée
- Department of Respiratory Medicine, Reims University Hospitals, Reims, France.,INSERM UMR-S 903, Reims, France
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Ammar Y, Launois C, Perotin JM, Dury S, Servettaz A, Perdu D, Vallerand H, Nardi J, Boulagnon-Rombi C, Pluot M, Lebargy F, Deslee G. Hypoventilation alvéolaire sévère révélant un shrinking lung syndrome lupique. Rev Mal Respir 2017; 34:571-575. [DOI: 10.1016/j.rmr.2016.10.875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 10/17/2016] [Indexed: 12/01/2022]
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35
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Meurice J, Ingrand P, Sedkaoui K, Iamandi C, Portel L, Martin F, Lerousseau L, Alfandary D, Levrat V, Portier F, Tamisier R, Goutorbe F, Georges M, Codron F, Auregan G, Mercy M, Attali V, Soyez F, Launois C, Recart D, Vecchierini M, Gagnadoux F. Évaluation comparative de l’efficacité de la PPC constante et de l’auto-PPC dans le traitement du SAHOS en fonction du profil de variabilité de la pression et du niveau de pression efficace individuelle. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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36
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Boissière L, Bertin E, Gaubil-Kaladjian I, Diaz Cives A, Perotin Collard J, Dury S, Lebargy F, Nardi J, Deslee G, Launois C. La chirurgie bariatrique améliore la dyspnée des sujets obèses. Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bironneau V, Loustonneau E, Pontier S, Gagnadoux F, Iamandi C, Portel L, Martin F, Mallart A, Lerousseau L, Alfandary D, Levrat V, Portier F, Tamisier R, Goutorbe F, Rabec C, Codron F, Auregan G, Mercy M, Attali V, Soyez F, Launois C, Recart D, Vecchierini F, Meurice J. Et s’il était possible de prédire le type d’appareil de PPC (constant ou autopiloté) à utiliser dans le traitement du SAHOS ? Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Vella-Boucaud J, Papathanassiou D, Bouche O, Prevost A, Lestra T, Dury S, Vallerand H, Perotin JM, Launois C, Boissiere L, Brasseur M, Lebargy F, Deslee G. Incidental gastrointestinal 18F-Fluorodeoxyglucose uptake associated with lung cancer. BMC Pulm Med 2015; 15:152. [PMID: 26630933 PMCID: PMC4668630 DOI: 10.1186/s12890-015-0152-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 11/25/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND F-Fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is increasingly used for the initial staging and restaging of lung cancer. Incidental gastrointestinal findings are often observed on (18)F-FDG PET/CT. The objective of this study was to assess incidental 18F-FDG uptake by the gastrointestinal tract (GIT) in patients with lung cancer. METHODS Two hundred thirty consecutive 18F-FDG PET/CT examinations performed for lung cancer over a 3-year period were retrospectively reviewed for the presence of incidental FDG uptake in the GIT. The charts of patients with positive FDG uptake were then reviewed and analysed to determine the GIT uptake sites, the standardized uptake value (SUV) max and the final clinical diagnosis. RESULTS Fifty-two patients (52/230, 23%) demonstrated incidental FDG uptake in the GIT. Thirty-three patients (63.5%) had diffuse uptake (oesophagus, n = 2, colon, n = 31) and 19 patients (36.5%) had focal uptake (oesophagus, n = 1, small bowel, n = 1, ascending colon, n = 5, descending colon, n = 4, sigmoid, n = 4, rectum, n = 3, and anal margin, n = 1). Twelve of the 52 patients with GIT uptake were further investigated, revealing, a diagnosis of malignancy in 4 patients with focal FDG uptake. No significant differences in mean SUVmax were observed between patients with malignant and benign GIT diseases. CONCLUSION This study demonstrates a high incidence of FDG uptake in the GIT associated with lung cancer. Focal GIT uptake was frequently associated with malignant disease. These results suggest that further GIT investigations should be performed in patients with focal GIT uptake.
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Affiliation(s)
- Juliette Vella-Boucaud
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay, 51092, Reims, Cedex, France.
| | - Dimitri Papathanassiou
- Service de Médecine Nucléaire, Institut Jean Godinot, Centre de Lutte Contre le Cancer à Reims, Reims, France.
| | - Olivier Bouche
- Service d'Hépato-Gastro-Entérologie et Cancérologie Digestive, Hôpital Robert Debré, CHU de Reims, Reims, France. .,Unité de Médecine Ambulatoire Cancérologie Hématologie, Hôpital Robert Debré, CHU Reims, Reims, France.
| | - Alain Prevost
- Service d'Oncologie Médicale, Institut Jean Godinot, Centre de Lutte Contre le Cancer à Reims, Reims, France.
| | - Thibault Lestra
- Service de Médecine Nucléaire, Institut Jean Godinot, Centre de Lutte Contre le Cancer à Reims, Reims, France.
| | - Sandra Dury
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay, 51092, Reims, Cedex, France.
| | - Hervé Vallerand
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay, 51092, Reims, Cedex, France.
| | - Jeanne-Marie Perotin
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay, 51092, Reims, Cedex, France.
| | - Claire Launois
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay, 51092, Reims, Cedex, France.
| | - Louis Boissiere
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay, 51092, Reims, Cedex, France.
| | - Mathilde Brasseur
- Service d'Hépato-Gastro-Entérologie et Cancérologie Digestive, Hôpital Robert Debré, CHU de Reims, Reims, France.
| | - François Lebargy
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay, 51092, Reims, Cedex, France.
| | - Gaëtan Deslee
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU de Reims, 45 rue Cognacq Jay, 51092, Reims, Cedex, France.
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Dury S, Colosio C, Etienne I, Anglicheau D, Merieau E, Caillard S, Rivalan J, Thervet E, Essig M, Babinet F, Subra JF, Toubas O, Rieu P, Launois C, Perotin-Collard JM, Lebargy F, Deslée G. Bronchiectasis diagnosed after renal transplantation: a retrospective multicenter study. BMC Pulm Med 2015; 15:141. [PMID: 26545860 PMCID: PMC4636796 DOI: 10.1186/s12890-015-0133-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
Background Bronchiectasis is characterized by abnormal, permanent and irreversible dilatation of the bronchi, usually responsible for daily symptoms and frequent respiratory complications. Many causes have been identified, but only limited data are available concerning the association between bronchiectasis and renal transplantation. Methods We conducted a retrospective multicenter study of cases of bronchiectasis diagnosed after renal transplantation in 14 renal transplantation departments (French SPIESSER group). Demographic, clinical, laboratory and CT scan data were collected. Results Forty-six patients were included (mean age 58.2 years, 52.2 % men). Autosomal dominant polycystic kidney disease (32.6 %) was the main underlying renal disease. Chronic cough and sputum (50.0 %) were the major symptoms leading to chest CT scan. Mean duration of symptoms before diagnosis was 1.5 years [0–12.1 years]. Microorganisms were identified in 22 patients, predominantly Haemophilus influenzae. Hypogammaglobulinemia was observed in 46.9 % patients. Bronchiectasis was usually extensive (84.8 %). The total bronchiectasis score was 7.4 ± 5.5 with a significant gradient from apex to bases. Many patients remained symptomatic (43.5 %) and/or presented recurrent respiratory tract infections (37.0 %) during follow-up. Six deaths (13 %) occurred during follow-up, but none were attributable to bronchiectasis. Conclusions These results highlight that the diagnosis of bronchiectasis should be considered in patients with de novo respiratory symptoms after renal transplantation. Further studies are needed to more clearly understand the mechanisms underlying bronchiectasis in this setting.
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Affiliation(s)
- Sandra Dury
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. .,EA 4683 Université de Médecine et de Pharmacie, Reims, France.
| | | | - Isabelle Etienne
- Service de Néphrologie, Rouen University Hospital, Rouen, France.
| | - Dany Anglicheau
- Service de Néphrologie, Hôpital Necker, APHP, Paris, France.
| | | | - Sophie Caillard
- Service de Néphrologie, Hôpitaux Universitaires, Strasbourg, France.
| | | | - Eric Thervet
- Service de Néphrologie, Hôpital Européen Georges Pompidou, APHP, Paris, France.
| | - Marie Essig
- Service de Néphrologie, CHU, Limoges, France.
| | | | | | - Olivier Toubas
- Service de Radiologie, Hôpital Maison Blanche, CHU, Reims, France.
| | - Philippe Rieu
- Service de Néphrologie, Hôpital Maison Blanche, CHU, Reims, France.
| | - Claire Launois
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France.
| | - Jeanne-Marie Perotin-Collard
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. .,Unité 903 Inserm, Reims, France.
| | - François Lebargy
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. .,EA 4683 Université de Médecine et de Pharmacie, Reims, France.
| | - Gaëtan Deslée
- Service des Maladies Respiratoires, Hôpital Maison Blanche, CHU, 45, rue de Cognacq-Jay, 51092, Reims, Cedex, France. .,Unité 903 Inserm, Reims, France.
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Launois C, Attali V, Georges M, Raux M, Morawiec E, Rivals I, Arnulf I, Similowski T. Cortical Drive to Breathe during Wakefulness in Patients with Obstructive Sleep Apnea Syndrome. Sleep 2015; 38:1743-9. [PMID: 26158887 DOI: 10.5665/sleep.5156] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 05/22/2015] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES The obstructive sleep apnea syndrome (OSAS) involves recurrent sleep-related upper airways (UA) collapse. UA mechanical properties and neural control are altered, imposing a mechanical load on inspiration. UA collapse does not occur during wakefulness, hence arousal-dependent compensation. Experimental inspiratory loading in normal subjects elicits respiratory-related cortical activity. The objective of this study was to test whether awake OSAS patients would exhibit a similar cortical activity. DESIGN Descriptive physiology study. SETTING Sleep laboratory in a large university affiliated tertiary hospital. PATIENTS 26 patients with moderate OSAS according to polysomnography (5 < apnea-hypopnea index [AHI] ≤ 30, n = 14) or severe OSAS (AHI > 30, n = 12); 13 non-OSAS patients for comparison. INTERVENTIONS None. MEASUREMENTS Respiratory time-locked electroencephalographic segments ensemble averaged and analyzed for slow premotor potentials preceding inspiration ("pre-inspiratory potentials" [PIPs]). RESULTS PIPs were present in 1/13 controls and 11/26 patients (P = 0.0336; 4/14 "moderate" and 7/12 "severe" patients). Awake OSAS patients therefore exhibit respiratory-related cortical activity during quiet breathing significantly more frequently than non-OSAS individuals. The corresponding PIPs resemble those observed during prepared voluntary inspirations and in response to experimental inspiratory loads in normal subjects, which involve a cortical network comprising the supplementary motor area. CONCLUSIONS A respiratory-related cortical activity could contribute to the increased neural drive to upper airway and to inspiratory muscles that has previously been described in obstructive sleep apnea, and could therefore contribute to the arousal-dependent compensation of upper airway abnormalities. Whether or not such cortical compensatory mechanisms have cognitive consequences remains to be determined.
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Affiliation(s)
- Claire Launois
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France
| | - Valérie Attali
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Pathologies du Sommeil (Département "R3S"), Paris, France
| | - Marjolaine Georges
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France
| | - Mathieu Raux
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Surveillance Post-Interventionnelle et d'Accueil des Polytraumatisés (Département d'Anesthésie Réanimation), Paris, France
| | - Elise Morawiec
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale (Département "R3S"), Paris, France
| | - Isabelle Rivals
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,Ecole Supérieure de Physique et de Chimie de la Ville de Paris, Paris, France
| | - Isabelle Arnulf
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Pathologies du Sommeil (Département "R3S"), Paris, France
| | - Thomas Similowski
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France.,AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale (Département "R3S"), Paris, France
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Zouak A, Bongrain É, Launois C, Nardi J, Vella-Boucaud J, Deslee G, Lebargy F, Perotin JM. Pleurésie à éosinophiles : une complication rare d’un traitement par inhibiteur de l’enzyme de conversion de l’angiotensine. Rev Mal Respir 2015; 32:737-41. [DOI: 10.1016/j.rmr.2014.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 06/14/2014] [Indexed: 10/24/2022]
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Perotin JM, Barbe C, Nguyen KL, Fontaine JF, Gabignon Y, Nardi J, Launois C, Lebargy F, Lavaud F, Deslee G. Work-related respiratory symptoms in Champagne vineyard workers. Eur Ann Allergy Clin Immunol 2015; 47:140-144. [PMID: 26356997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Vineyard workers (VW) are exposed to various respiratory allergens. The aims of the study were to determine the prevalence of work related respiratory symptoms (WRS) in Champagne VW in France and to analyze the relationships between symptoms, occupational exposure and sensitization profile. METHODS VW of Reims area were prospectively recruited between 2007 and 2010. Demographic and occupational characteristics were recorded. Respiratory symptoms were scored for each month of the past year. Results of respiratory functional tests and skin prick tests for common respiratory allergens, grape moulds and vine pollen were recorded. RESULTS 307 subjects were included. The prevalence of WRS was 11%. Compared to subjects with symptoms unrelated to work, subjects with WRS were more frequently sensitized to gramineae (34% vs 18%, p = 0.05), described ocular itching (74% vs 37%, p < 0.001) and seasonal symptoms (88% vs 69%, p = 0.03) mainly during lifting and trellising (57% vs 17%, p < 0.001). CONCLUSION WRS are frequent in Champagne WV and are associated with a sensitization to gramineae and with activities performed close to vine in late spring.
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Affiliation(s)
- J-M Perotin
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France. INSERM UMRS 903, University Hospital, 51100, 45 Rue Cognacq Jay, 51100 Reims, France. Phone: +33 32 67 87 614 Fax: +33 32 678 40 30 E-mail:
| | - C Barbe
- Clinical Research Unit, University Hospital, 51100 Reims, France
| | - K L Nguyen
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - J-F Fontaine
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - Y Gabignon
- Department of Occupational Medicine, Mutualité Sociale Agricole, 51100 Reims, France
| | - J Nardi
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - C Launois
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - F Lebargy
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - F Lavaud
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France
| | - G Deslee
- Department of Respiratory Medicine, University Hospital, 51100 Reims, France. INSERM UMRS 903, University Hospital, 51100 Reims, France
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Launois C, Vallerand H, Perotin JM, Nardi J, Dury S, Toubas O, Lebargy F, Deslée G. [The Proteus syndrome: a rare cause of pulmonary emphysema]. Rev Mal Respir 2013; 30:789-93. [PMID: 24267771 DOI: 10.1016/j.rmr.2013.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 04/04/2013] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The Proteus syndrome is a rare genetic disease which is characterized by the overgrowth of tissues, especially bone, connective and adipose tissue. This condition is related to a somatic mosaic activating mutation in the AKT1 oncogene. CASE REPORT We report the case of a 25-year-old man, diagnosed with the Proteus syndrome at the age of 6 months. He exhibited an asymmetric overgrowth of the extremities leading to bilateral amputation of the legs at the age of 10 years. He was hospitalized for acute respiratory failure due to a bronchopulmonary infection. Severe bullous pulmonary emphysema, predominantly on the left, with mediastinal deviation, was diagnosed. The patient recovered with antibiotics. An assessment 2 months later revealed mild hypoxaemia (PaO2=75 mmHg) and severe airflow limitation (FEV1=1260 mL [28% th.], FEV1/V C=69%) with hyperinflation (TLC=7840 mL [107% th.], RV=6010 mL [253% th.]). CONCLUSION The Proteus syndrome is a very rare cause of pulmonary emphysema. The pathophysiology of emphysema in this syndrome is unknown. It can be hypothesized that the development of pulmonary cysts leading to emphysema may share the same AKT1 activation pathway with lymphangioleiomyomatosis.
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Affiliation(s)
- C Launois
- Inserm UMRS 903, service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51092 Reims cedex, France.
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Launois C, Nardi J, Bertin E, Barbe C, Perotin J, Dury S, Lebargy F, Deslee G. The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: A pilot study. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Launois C, Leu-Semenescu S, Brion A, Arnulf I. Major depression after withdrawing dopamine agonists in two patients with restless legs syndrome and impulse control disorders. Sleep Med 2013; 14:696. [DOI: 10.1016/j.sleep.2013.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022]
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Launois C, Leu-Semenescu S, Brion A, Arnulf I. Dépression sévère au sevrage en agonistes dopaminergiques chez des patients souffrant de syndrome des jambes sans repos (SJSR). Neurophysiol Clin 2013. [DOI: 10.1016/j.neucli.2013.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Langlet K, Van Der Linden T, Launois C, Fourdin C, Cabaret P, Kerkeni N, Barbe C, Lebargy F, Deslée G. Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study. BMC Pulm Med 2012; 12:66. [PMID: 23078114 PMCID: PMC3517314 DOI: 10.1186/1471-2466-12-66] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 09/20/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mechanical ventilation (MV) is imperative in many forms of acute respiratory failure (ARF) in COPD patients. Previous studies have shown the difficulty to identify parameters predicting the outcome of COPD patients treated by invasive MV. Our hypothesis was that a non specialized score as the activities daily living (ADL) score may help to predict the outcome of these patients. METHODS We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n = 17, 68%) or failure (group B n = 8, 32%). We investigated the correlation between the ADL score and the outcome and mortality. RESULTS The ADL score was higher in group A (5.1 ±1.1 vs 3.7 ± 0.7 in group B, p < 0.01). Weaning was achieved in 76.5% of the cases with an ADL score ≥ 4 and in 23.5% of the cases with an ADL score < 4 (p < 0.05). Pulmonary function test, arterial blood gases collected during period of clinical stability and at admission and nutritional status were similar in both groups. The mortality, at six months, was 36%. The ADL score was a significant predictor of 6-month mortality (80 with an ADL score <4, 20 with an ADL score ≥4, p < 0.01). CONCLUSION Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6 months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.
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Affiliation(s)
- Ketty Langlet
- Service d’Urgences et de Réanimation médicale polyvalente, Hôpital Saint Philibert, Lomme, France
- Unité d’Aide Méthodologique, Pôle Recherche et Innovations, Hôpital Robert Debré, CHU de Reims, France
| | - Thierry Van Der Linden
- Service d’Urgences et de Réanimation médicale polyvalente, Hôpital Saint Philibert, Lomme, France
| | - Claire Launois
- Service de Pneumologie, INSERM UMRS 903, Hôpital Maison Blanche, CHU de Reims, France
| | - Caroline Fourdin
- Service d’Urgences et de Réanimation médicale polyvalente, Hôpital Saint Philibert, Lomme, France
| | - Philippe Cabaret
- Service d’Urgences et de Réanimation médicale polyvalente, Hôpital Saint Philibert, Lomme, France
| | - Nadia Kerkeni
- Service d’Urgences et de Réanimation médicale polyvalente, Hôpital Saint Philibert, Lomme, France
| | - Coralie Barbe
- Unité d’Aide Méthodologique, Pôle Recherche et Innovations, Hôpital Robert Debré, CHU de Reims, France
| | - François Lebargy
- Unité d’Aide Méthodologique, Pôle Recherche et Innovations, Hôpital Robert Debré, CHU de Reims, France
| | - Gaetan Deslée
- Service de Pneumologie, INSERM UMRS 903, Hôpital Maison Blanche, CHU de Reims, France
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Launois C, Barbe C, Bertin E, Nardi J, Perotin JM, Dury S, Lebargy F, Deslee G. The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study. BMC Pulm Med 2012; 12:61. [PMID: 23025326 PMCID: PMC3515513 DOI: 10.1186/1471-2466-12-61] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 09/22/2012] [Indexed: 11/19/2022] Open
Abstract
Background Dyspnea is very frequent in obese subjects. However, its assessment is complex in clinical practice. The modified Medical Research Council scale (mMRC scale) is largely used in the assessment of dyspnea in chronic respiratory diseases, but has not been validated in obesity. The objectives of this study were to evaluate the use of the mMRC scale in the assessment of dyspnea in obese subjects and to analyze its relationships with the 6-minute walk test (6MWT), lung function and biological parameters. Methods Forty-five obese subjects (17 M/28 F, BMI: 43 ± 9 kg/m2) were included in this pilot study. Dyspnea in daily living was evaluated by the mMRC scale and exertional dyspnea was evaluated by the Borg scale after 6MWT. Pulmonary function tests included spirometry, plethysmography, diffusing capacity of carbon monoxide and arterial blood gases. Fasting blood glucose, total cholesterol, triglyceride, N-terminal pro brain natriuretic peptide, C-reactive protein and hemoglobin levels were analyzed. Results Eighty-four percent of patients had a mMRC ≥ 1 and 40% a mMRC ≥ 2. Compared to subjects with no dyspnea (mMRC = 0), a mMRC ≥ 1 was associated with a higher BMI (44 ± 9 vs 36 ± 5 kg/m2, p = 0.01), and a lower expiratory reserve volume (ERV) (50 ± 31 vs 91 ± 32%, p = 0.004), forced expiratory volume in one second (FEV1) (86 ± 17 vs 101 ± 16%, p = 0.04) and distance covered in 6MWT (401 ± 107 vs 524 ± 72 m, p = 0.007). A mMRC ≥ 2 was associated with a higher Borg score after the 6MWT (4.7 ± 2.5 vs 6.5 ± 1.5, p < 0.05). Conclusion This study confirms that dyspnea is very frequent in obese subjects. The differences between the “dyspneic” and the “non dyspneic” groups assessed by the mMRC scale for BMI, ERV, FEV1 and distance covered in 6MWT suggests that the mMRC scale might be an useful and easy-to-use tool to assess dyspnea in daily living in obese subjects.
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Affiliation(s)
- Claire Launois
- Service des Maladies Respiratoires, INSERM UMRS 903, Hôpital Maison Blanche, CHU de Reims, Reims, Cedex, France.
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Langlet K, Van Der Linden T, Launois C, Fourdin C, Cabaret P, Kerkeni N, Barbe C, Lebargy F, Deslée G. Le score d’activité quotidienne (ADL) prédit le devenir des patients BPCO intubés pour exacerbations aiguës. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Launois C, Vallerand H, Lebargy F, Deslee G. Une cause exceptionnelle d’emphysème pulmonaire : le syndrome de Protée. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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