B Housset

Centre Hospitalier Intercommunal Creteil, Créteil, Île-de-France, France

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Publications (166)497.01 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to identify, from an hospital point of view, the care pathways of patients with chronic obstructive pulmonary disease (COPD) between the ambulatory and in-hospital settings in two regions to the East of Paris (Val-de-Marne and Seine-et-Marne). A qualitative multisite case study was conducted from January to October 2012 with hospital doctors managing patients with COPD. Semi-structured individual interviews were carried out with 46 hospital practitioners from the 25 main hospitals of this area. A marked variability in care pathways was observed between the 25sites studied, but no typology could be established. The care pathways depended on the configuration of the available local medical facilities. The main finding of this study was the global lack of coordination between ambulatory care and in-hospital care of patients before and after hospitalization. The care pathways identified concerned the probably most severely ill patients who frequently attend hospital emergency rooms. The lack of pre-hospital coordination for the management of acute exacerbations resulted in a very high hospitalization rate. However, international studies have showed that a better management in an ambulatory care setting reduced significantly the hospitalization rates. The problem ofcoordination between ambulatory and in-hospital carefor optimizing of the care pathways remains unsolved in the territories studied here. This example of COPD care shows that a better management of patients with chronic diseases requires a restructuring of the local health care systems in France.
    Santé Publique 07/2015; 27(1 Suppl):S177-87. · 0.28 Impact Factor
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is often associated with age-related systemic abnormalities that adversely affect the prognosis. Whether these manifestations are linked to the lung alterations or are independent complications of smoking remains unclear. To look for aging-related systemic manifestations and telomere shortening in COPD patients and smokers with minor lung destruction responsible for a decline in the diffusing capacity for carbon monoxide (DLCO) corrected for alveolar volume (KCO). Cross-sectional study in 301 individuals (100 with COPD, 100 smokers without COPD, and 101 nonsmokers without COPD). Compared to control smokers, patients with COPD had higher aortic pulse-wave velocity (PWV), lower bone mineral density (BMD) and appendicular skeletal muscle mass index (ASMMI), and shorter telomere length (TL). Insulin resistance (HOMA-IR) and glomerular filtration rate (GFR) were similar between control smokers and COPD patients. Smokers did not differ from nonsmokers for any of these parameters. However, smokers with normal spirometry but low KCO had lower ASMMI values compared to those with normal KCO. Moreover, female smokers with low KCO, had lower BMD and shorter TL compared to those with normal KCO. Aging-related abnormalities in patients with COPD are also found in smokers with minor lung dysfunction manifesting as a KCO decrease. Decreased KCO might be useful, particularly among women, for identifying smokers at high risk for aging-related systemic manifestations and telomere shortening.
    PLoS ONE 03/2015; 10(3):e0121539. DOI:10.1371/journal.pone.0121539 · 3.23 Impact Factor
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    ABSTRACT: The aim of this study was to determine whether nocturia is an independent predictor for prevalent hypertension in obstructive sleep apnea (OSA). We analyzed data from a national prospective clinical cohort of OSA patients participating in the French national prospective registry. Anthropometric data, comorbidities, OSA severity, and number of voids/night were included in multivariate analyses to determine the independent variables associated with prevalent hypertension. A total of 22,674 OSA patients were included, of which 11,332 were hypertensive. The prevalence of hypertension among OSA patients was about 1.3 times higher in patients suffering from nocturia at 61.45% versus 46.52% in hypertensive and non-hypertensive OSA patients (p <0.001). There was a significant positive relationship between hypertension and the severity of nocturia beyond two voids/night: two voids/night versus none: odds ratio (OR) = 1.270 (95% confidence interval (CI) = 1.175; 1.372), three voids/night versus none: OR = 1.422 (95% CI = 1.293; 1.565), and four voids/night versus none: OR = 1.575 (95% CI = 1.394; 1.781). The strength of the association was enhanced in patients over 64 years of age. Nocturia is a strong independent predictor of prevalent hypertension in OSA. This association exhibited a "dose-response" relationship beyond two voids/night. The resolution of nocturia after continuous positive airway pressure (CPAP) treatment might be an important outcome to consider for the response of hypertension to CPAP. Copyright © 2014 Elsevier B.V. All rights reserved.
    Sleep Medicine 01/2015; 16(5). DOI:10.1016/j.sleep.2014.10.019 · 3.15 Impact Factor
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    D Darmon · N Roche · C Ghasarossian · B Stach · J Cittée · B Housset
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    Revue des Maladies Respiratoires 11/2014; 32(2). DOI:10.1016/j.rmr.2014.11.001 · 0.62 Impact Factor
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    ABSTRACT: Catheter-related infection by non-tuberculous mycobacteria is rare but difficult to diagnose and the treatment is not standardized. A 64-year-old woman treated for lung cancer with intravenous chemotherapy developed an infection of her totally implanted perfusion device with Mycobacterium chelonae. The infection was cured after surgical removal of the device and treatment with oral clarithromycin. Mycobacteria may infect vascular access devices. Rapid diagnosis of such infections allows early treatment. Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.
    Revue des Maladies Respiratoires 10/2014; 32(7). DOI:10.1016/j.rmr.2014.09.007 · 0.62 Impact Factor
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    ABSTRACT: In Europe, administration of an inhaled corticosteroid (ICS) combined with a long-acting beta2 agonist is approved in chronic obstructive pulmonary disease (COPD) patients with a pre-bronchodilator FEV1 < 60% predicted normal, a history of repeated exacerbations, and who have significant symptoms despite regular bronchodilator therapy. Minimal data are available on the use of the fluticasone propionate / salmeterol xinafoate combination (FSC) in the real-life COPD setting and prescription compliance with the licensed specifications. A French observational study was performed to describe the COPD population prescribed with FSC, prescription modalities, and the coherence of prescription practices with the market authorized population. Data were collected for patients initiating FSC treatment (500 mug fluticasone propionate, 50 mug salmeterol, dry powder inhaler) prescribed by a general practitioner (GP) or a pulmonologist, using physician and patient questionnaires. A total of 710 patients were included, 352 by GPs and 358 by pulmonologists. Mean age was over 60 years, and 70% of patients were male. More than half were retired, and overweight or obese. Approximately half were current smokers and one-third had cardiovascular comorbidities. According to both physician evaluation and GOLD 2006 classification, the majority of patients (>75%) had moderate to very severe COPD. Strict compliance by prescribing physicians with the market-approved population for dry powder inhaler SFC in COPD was low, notably in ICS-naive patients; all three conditions were fulfilled in less than a quarter of patients with prior ICS and less than 7% of ICS-naive patients. Prescription of dry powder inhaler SFC by GPs and pulmonologists has very low conformity with the three conditions defining the licensed COPD population. Prescription practices need to be improved and systematic FEV1 evaluation for COPD diagnosis and treatment management should be emphasized.
    BMC Pulmonary Medicine 04/2014; 14(1):56. DOI:10.1186/1471-2466-14-56 · 2.40 Impact Factor
  • F. Chabot · A. Didier · B. Housset
    Revue des Maladies Respiratoires 01/2014; 31(1):6–7. DOI:10.1016/j.rmr.2014.01.003 · 0.62 Impact Factor
  • F Chabot · A Didier · B Housset
    Revue des Maladies Respiratoires 01/2014; 31(1):6-7. · 0.62 Impact Factor
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    ABSTRACT: Given the interest in defining biomarkers of asbestos exposure and to provide insights into asbestos-related and cell-specific mechanisms of neoplasia, the identification of gene alterations in asbestos-related cancers can help to a better understanding of exposure risk. To understand the aetiology of asbestos-induced malignancies and to increase our knowledge of mesothelial carcinogenesis, we compared genetic alterations in relevant cancer genes between lung cancer, induced by asbestos and tobacco smoke, and malignant pleural mesothelioma (MPM), a cancer related to asbestos, but not to tobacco smoke. TP53, KRAS, EGFR and NF2 gene alteration analyses were performed in 100 non-small cell lung cancer (NSCLC) patients, 50 asbestos-exposed and 50 unexposed patients, matched for age, gender, histology and smoking habits. Detailed assessment of asbestos exposure was based on both specific questionnaires and asbestos body quantification in lung tissue. Genetic analyses were also performed in 34 MPM patients. TP53, EGFR and KRAS mutations were found in NSCLC with no link with asbestos exposure. NF2 was only altered in MPM. Significant enhancement of TP53 G:C to T:A transversions was found in NSCLC from asbestos-exposed patients when compared with unexposed patients (P = 0.037). Interestingly, TP53 polymorphisms in intron 7 (rs12947788 and rs12951053) were more frequently identified in asbestos-exposed NSCLC (P = 0.046) and MPM patients than in unexposed patients (P < 0.001 and P = 0.012, respectively). These results emphasise distinct genetic alterations between asbestos-related thoracic tumours, but identify common potential susceptibility factors, i.e. single nucleotide polymorphisms in intron 7 of TP53. While genetic changes in NSCLC are dominated by the effects of tobacco smoke, the increase of transversions in TP53 gene is consistent with a synergistic effect of asbestos. These results may help to define cell-dependent mechanisms of action of asbestos and identify susceptibility factors to asbestos.
    Mutagenesis 02/2013; 28(3). DOI:10.1093/mutage/get008 · 2.79 Impact Factor
  • Revue des Maladies Respiratoires 01/2013; 30:A38. DOI:10.1016/j.rmr.2012.10.121 · 0.62 Impact Factor
  • Revue des Maladies Respiratoires 01/2013; 30:A10. DOI:10.1016/j.rmr.2012.10.037 · 0.62 Impact Factor
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    ABSTRACT: The hypothesis that asbestos exposure may have more specific associations with particular histological types of lung cancer remains controversial. The aim of this study was to analyze the relationships between asbestos exposure and pulmonary carcinoid tumors. A retrospective case-control study was conducted in 28 cases undergoing surgery for pulmonary carcinoid tumors and aged >40 years and in 56 controls with lung cancer of a different histological type, matched for gender and age, from 1994 to 1999, recruited in two hospitals in the region of Paris. Asbestos exposure was assessed via expertise of a standardized occupational questionnaire and mineralogical analysis of lung tissue, with quantification of asbestos bodies (AB). Definite asbestos exposure was identified in 25% of cases and 14% of controls (ns). Cumulative asbestos exposure was significantly higher in cases than in controls (P < 0.05), and results of the quantification of AB tended to be higher in cases than in controls (24 and 9% had >1000 AB per gram dry lung tissue, respectively, P = 0.09). Mean cumulative smoking was lower in cases than in controls (P < 0.05). This study argues in favor of a relationship between asbestos exposure and certain pulmonary carcinoid tumors.
    Annals of Occupational Hygiene 05/2012; 56(7):789-95. DOI:10.1093/annhyg/mes017 · 2.10 Impact Factor
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    ABSTRACT: Several etiologies are involved in the pathogenesis of cavitating pulmonary disease including neoplastic, infectious or inflammatory processes. Another is pulmonary infarction associated with venous thromboembolism. The lung cavities tend to be located peripherally and are the result of pulmonary embolism. We report the case of a woman with chronic thromboembolic pulmonary hypertension (CTEPH), associated with familial thrombophilia, revealed by cavitating pulmonary infarcts. CTEPH is sometimes diagnosed during an episode of recurrent pulmonary embolism following previously unnoticed lesions. Thrombophilias such as isolated elevated factor VIII are risk factors for CTEPH.
    Revue des Maladies Respiratoires 05/2012; 29(5):723–726. DOI:10.1016/j.rmr.2011.12.018 · 0.62 Impact Factor
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    ABSTRACT: Several etiologies are involved in the pathogenesis of cavitating pulmonary disease including neoplastic, infectious or inflammatory processes. Another is pulmonary infarction associated with venous thromboembolism. The lung cavities tend to be located peripherally and are the result of pulmonary embolism. We report the case of a woman with chronic thromboembolic pulmonary hypertension (CTEPH), associated with familial thrombophilia, revealed by cavitating pulmonary infarcts. CTEPH is sometimes diagnosed during an episode of recurrent pulmonary embolism following previously unnoticed lesions. Thrombophilias such as isolated elevated factor VIII are risk factors for CTEPH.
    Revue des Maladies Respiratoires 05/2012; 29(5):723-6. · 0.62 Impact Factor
  • American Thoracic Society 2012 International Conference, May 18-23, 2012 • San Francisco, California; 05/2012
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    ABSTRACT: Swallowing disorders (or dysphagia) are common in the elderly and their prevalence is often underestimated. They may result in serious complications including dehydration, malnutrition, airway obstruction, aspiration pneumonia (infectious process) or pneumonitis (chemical injury caused by the inhalation of sterile gastric contents). Moreover the repercussions of dysphagia are not only physical but also emotional and social, leading to depression, altered quality of life, and social isolation. While some changes in swallowing may be a natural result of aging, dysphagia in the elderly is mainly due to central nervous system diseases such as stroke, parkinsonism, dementia, medications, local oral and oesophageal factors. To be effective, management requires a multidisciplinary team approach and a careful assessment of the patient's oropharyngeal anatomy and physiology, medical and nutritional status, cognition, language and behaviour. Clinical evaluation can be completed by a videofluoroscopic study which enables observation of bolus movement and movements of the oral cavity, pharynx and larynx throughout the swallow. The treatment depends on the underlying cause, extent of dysphagia and prognosis. Various categories of treatment are available, including compensatory strategies (postural changes and dietary modification), direct or indirect therapy techniques (swallow manoeuvres, medication and surgical procedures).
    Revue des Maladies Respiratoires 10/2011; 28(8):e76-93. DOI:10.1016/j.rmr.2011.09.007 · 0.62 Impact Factor
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    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is a major risk factor for cardiovascular disease. Polycythemia, a common complication of hypoxic COPD, may affect systemic vascular function by altering blood viscosity, vessel wall shear stress (WSS), and endothelium-derived nitric oxide (NO) release. Here, we evaluated the effects of hypoxia-related polycythemia on systemic endothelial function in patients with COPD. We investigated blood viscosity, WSS, and endothelial function in 15 polycythemic and 13 normocythemic patients with COPD of equal severity, by recording brachial artery diameter variations in response to hyperemia and by using venous occlusion plethysmography (VOP) to measure forearm blood flow (FBF) responses to a brachial artery infusion of acetylcholine (ACh), bradykinin (BK), sodium nitroprusside (SNP), substance P (SP), isoptin, and N-monomethyl-L-arginine (L-NMMA). At baseline, polycythemic patients had higher blood viscosity and larger brachial artery diameter than normocythemic patients but similar calculated WSS. Flow-mediated brachial artery vasodilation was increased in the polycythemic patients, in proportion to the hemoglobin levels. ACh-induced vasodilation was markedly impaired in the polycythemic patients and negatively correlated with hemoglobin levels. FBF responses to endothelium- (BK, SP) and non-endothelium-dependent (SNP, isoptin) vasodilators were not significantly different between the two groups. L-NMMA infusion induced a similar vasoconstrictor response in both groups, in accordance with their similar baseline WSS. In conclusion, systemic arteries in polycythemic patients adjust appropriately to chronic or acute WSS elevations by appropriate basal and stimulated NO release. Overall, our results suggest that moderate polycythemia has no adverse effect on vascular function in COPD.
    Journal of Applied Physiology 05/2011; 110(5):1196-203. DOI:10.1152/japplphysiol.01204.2010 · 3.06 Impact Factor
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    ABSTRACT: Mycobacterium chelonae (M. chelonae) is rarely responsible for respiratory infection. This report concerns the case of an 81-year-old man with previously asymptomatic bronchiectasis, colonised by M. chelonae for 3 years. He was hospitalised for acute dyspnoea and fever due to a right hydro-pneumothorax with cavitated alveolar opacities of the right lung. Pleural fluid and bronchial aspiration were positive for M. chelonae and no other microorganisms were detected. The effusion was drained and the patient treated with clarythromycin and amikacin. The radiological abnormalities improved but the patient's general condition remained poor. Treatment was continued for 11 months. Because of the absence of any other bacteria, clinical deterioration following broad-spectrum antibiotics and stabilisation of the lesions after anti-mycobacterial treatment, our diagnosis was severe M. chelonae pleuro-pneumonia in an immunocompetent patient.
    Revue des Maladies Respiratoires 03/2011; 28(3):348-51. DOI:10.1016/j.rmr.2010.07.008 · 0.62 Impact Factor
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    ABSTRACT: To evaluate the possible involvement of obstructive sleep apnea (OSA) in retinal vein occlusion (RVO). From the medical records of 63 consecutive patients with RVO, 30 patients with 2 of the 3 following risk factors for OSA were selected for further screening from February 1, 2008, through March 31, 2009: associated cardiovascular disease, snoring, or daytime sleepiness. Of the 30 selected patients, 23 (77%) had OSA. If all 33 of the unscreened patients did not have OSA, the OSA prevalence would have been 37%. Among the patients with OSA, the mean apnea-hypopnea index (AHI) was 21; OSA was mild (AHI <15) in 13 patients, moderate in 5 patients (AHI 15-30), and severe (AHI >30) in 5 patients. The AHI was correlated with body mass index (P = .02). We found a higher than expected prevalence of OSA in a series of patients with RVO. Our findings suggest that OSA could be an additional risk factor that plays an important role in the pathogenesis of RVO or at least that it is a frequently associated condition that could be a triggering factor. This association may explain why most patients discover visual loss on awakening. It is too early to assess whether OSA treatment could improve visual outcome of RVO, but it seems vital to recognize OSA in RVO for the general health of the patient.
    Archives of ophthalmology 12/2010; 128(12):1533-8. DOI:10.1001/archophthalmol.2010.272 · 4.40 Impact Factor

Publication Stats

2k Citations
497.01 Total Impact Points


  • 1995–2015
    • Centre Hospitalier Intercommunal Creteil
      Créteil, Île-de-France, France
  • 2009–2013
    • Université Paris-Est Créteil Val de Marne - Université Paris 12
      • Faculty of medicine
      Créteil, Île-de-France, France
  • 2006
    • Société Française de Cardiologie
      Lutetia Parisorum, Île-de-France, France
    • Université René Descartes - Paris 5
      • Faculté de Médecine
      Lutetia Parisorum, Île-de-France, France
    • Computational Hydraulics Int.
      XIA, Ontario, Canada
  • 2000–2005
    • Institut Pasteur
      Lutetia Parisorum, Île-de-France, France
  • 2001
    • Unité Inserm U1077
      Caen, Lower Normandy, France
  • 1990
    • Hôpital La Pitié Salpêtrière (Groupe Hospitalier "La Pitié Salpêtrière - Charles Foix")
      • Service de Pneumologie
      Lutetia Parisorum, Île-de-France, France