D Dusser

Université René Descartes - Paris 5, Lutetia Parisorum, Île-de-France, France

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Publications (118)205.88 Total impact

  • D Dusser
    Revue des Maladies Respiratoires 12/2012; 29(10):1185. · 0.50 Impact Factor
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    ABSTRACT: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a cause of suffering for patients and a burden for healthcare systems and society. Their prevention represents individual and collective challenge. The present article is based on the work of a group of experts who met on 5th and 6th May 2011 and seeks to highlight the importance of AECOPD. In the absence of easily quantifiable criteria, the definition of AECOPD varies in the literature, making identification difficult and affecting interpretation of study results. Exacerbations increase mortality and risk of cardiovascular disease. They also increase the risk of developing further exacerbations, accelerate the decline in lung function and contribute to reduction in muscle mass. By limiting physical activity and affecting mental state (anxiety, depression), AECOPD are disabling and impair quality of life. They increase work absenteeism and are responsible for about 60% of the global cost of COPD. Earlier identification with simple criteria, possibly associated to patient phenotyping, could be helpful in preventing hospitalization. Given their immediate and delayed impact, AECOPD should not be trivialized or neglected. Their prevention is a fundamental issue.
    Revue des Maladies Respiratoires 06/2012; 29(6):756-74. · 0.50 Impact Factor
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    ABSTRACT: Introduction Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a cause of suffering for patients and a burden for healthcare systems and society. Their prevention represents individual and collective challenge. The present article is based on the work of a group of experts who met on 5th and 6th May 2011 and seeks to highlight the importance of AECOPD. State of the art In the absence of easily quantifiable criteria, the definition of AECOPD varies in the literature, making identification difficult and affecting interpretation of study results. Exacerbations increase mortality and risk of cardiovascular disease. They also increase the risk of developing further exacerbations, accelerate the decline in lung function and contribute to reduction in muscle mass. By limiting physical activity and affecting mental state (anxiety, depression), AECOPD are disabling and impair quality of life. They increase work absenteeism and are responsible for about 60% of the global cost of COPD. Perspectives Earlier identification with simple criteria, possibly associated to patient phenotyping, could be helpful in preventing hospitalization. Conclusions Given their immediate and delayed impact, AECOPD should not be trivialized or neglected. Their prevention is a fundamental issue.
    Revue des Maladies Respiratoires. 06/2012; 29(6):756–774.
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    ABSTRACT: The improvement of respiratory symptoms for emphysematous patients by surgery is a concept that has evolved over time. Initially used for giant bullae, this surgery was then applied to patients with diffuse microbullous emphysema. The physiological and pathological concepts underlying these surgical procedures are the same in both cases: improve respiratory performance by reducing the high intrapleural pressure. The functional benefit of lung volume reduction surgery (LVRS) in the severe diffuse emphysema has been validated by the National Emphysema Treatment Trial (NETT) and the later studies which allowed to identify prognostic factors. The quality of the clinical, morphological and functional data made it possible to develop recommendations now widely used in current practice. Surgery for giant bullae occurring on little or moderately emphysematous lung is often a simpler approach but also requires specialised support to optimize its results.
    Revue de Pneumologie Clinique 04/2012; 68(2):131–145. · 0.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The improvement of respiratory symptoms for emphysematous patients by surgery is a concept that has evolved over time. Initially used for giant bullae, this surgery was then applied to patients with diffuse microbullous emphysema. The physiological and pathological concepts underlying these surgical procedures are the same in both cases: improve respiratory performance by reducing the high intrapleural pressure. The functional benefit of lung volume reduction surgery (LVRS) in the severe diffuse emphysema has been validated by the National Emphysema Treatment Trial (NETT) and the later studies which allowed to identify prognostic factors. The quality of the clinical, morphological and functional data made it possible to develop recommendations now widely used in current practice. Surgery for giant bullae occurring on little or moderately emphysematous lung is often a simpler approach but also requires specialised support to optimize its results.
    Revue de Pneumologie Clinique 02/2012; 68(2):131-45. · 0.20 Impact Factor
  • Revue des Maladies Respiratoires 01/2012; 29:A10. · 0.50 Impact Factor
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    ABSTRACT: Eosinophilic pleural effusions have multiple aetiologies. We report on the case of a 40-year-old man who experienced an eosinophilic pleural effusion with blood hypereosinophilia that occurred nine weeks after a treatment with valproic acid was introduced. Usual aetiologies of eosinophilic pleural effusion were excluded. Once valproic acid was discontinued, both pleural effusion and blood eosinophilia decreased rapidly. The persistence of a residual pleural effusion required the introduction of oral corticosteroids, which resulted in the effusion disappearing completely and rapidly. Valproic acid is a rare cause of eosinophilic pleural effusion. The effusion usually regresses when treatment is discontinued but short-term oral corticotherapy may be necessary in order to heal the patient.
    Revue de Pneumologie Clinique 12/2011; 67(6):363-6. · 0.20 Impact Factor
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    ABSTRACT: Eosinophilic pleural effusions have multiple aetiologies. We report on the case of a 40-year-old man who experienced an eosinophilic pleural effusion with blood hypereosinophilia that occurred nine weeks after a treatment with valproic acid was introduced. Usual aetiologies of eosinophilic pleural effusion were excluded. Once valproic acid was discontinued, both pleural effusion and blood eosinophilia decreased rapidly. The persistence of a residual pleural effusion required the introduction of oral corticosteroids, which resulted in the effusion disappearing completely and rapidly. Valproic acid is a rare cause of eosinophilic pleural effusion. The effusion usually regresses when treatment is discontinued but short-term oral corticotherapy may be necessary in order to heal the patient.
    Revue De Pneumologie Clinique - REV PNEUMOL CLIN. 12/2011;
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    ABSTRACT: Chronic obstructive pulmonary disease is a major public health issue, with a 7.5 % prevalence in France. Even if the main symptom, dyspnea, remains difficult to evaluate, objective clinical assessment using various scales and questionnaires is fundamental to appreciate therapeutic effects. Identification of phenotypic subsets is permitted by efforts directed at improving our knowledge on pathophysiological processes. Future innovation could spread out the development of more specific treatments.
    Revue des Maladies Respiratoires Actualites 11/2011; 3(3):257–265.
  • A Chaouat, F Chabot, D Dusser
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    ABSTRACT: Symptoms and natural history of COPD: role of the distal airways. The natural history of chronic obstructive pulmonary disease (COPD) is characterized by a progressive worsening of airway obstruction and health-related quality of life, and an increased risk of death. Symptoms of COPD are dominated by cough, sputum production and dyspnoea whose intensity varies between individuals and during the progression of the disease. The symptoms and natural history of COPD result from damage to the airways, including remodelling and inflammation, which commence and are predominant in the distal airways (DA). This article examines the relationship between symptoms and the natural history of COPD in the light of large cohorts published in the literature. The role of the DA in the development and intensity of symptoms and in the natural history of COPD is difficult to define. We have attempted to examine this role using either published studies which have evaluated the relationship between lung structure and the clinical phenotypes of COPD or studies involving the earlier stages of the disease when damage to the DA are known to be predominant. These data suggest a potential role for early therapies targeting remodelling and inflammation in the distal airways of patients suffering from COPD.
    Revue des Maladies Respiratoires 10/2011; 28(8):1071-8. · 0.50 Impact Factor
  • A. Chaouat, F. Chabot, D. Dusser
    [Show abstract] [Hide abstract]
    ABSTRACT: Symptoms and natural history of COPD: role of the distal airways. The natural history of chronic obstructive pulmonary disease (COPD) is characterized by a progressive worsening of airway obstruction and health-related quality of life, and an increased risk of death. Symptoms of COPD are dominated by cough, sputum production and dyspnoea whose intensity varies between individuals and during the progression of the disease. The symptoms and natural history of COPD result from damage to the airways, including remodelling and inflammation, which commence and are predominant in the distal airways (DA). This article examines the relationship between symptoms and the natural history of COPD in the light of large cohorts published in the literature. The role of the DA in the development and intensity of symptoms and in the natural history of COPD is difficult to define. We have attempted to examine this role using either published studies which have evaluated the relationship between lung structure and the clinical phenotypes of COPD or studies involving the earlier stages of the disease when damage to the DA are known to be predominant. These data suggest a potential role for early therapies targeting remodelling and inflammation in the distal airways of patients suffering from COPD.
    Revue Des Maladies Respiratoires - REV MAL RESPIR. 10/2011;
  • Source
    Allergy 04/2011; 66(9):1254-6. · 5.88 Impact Factor
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    ABSTRACT: The natural history of cystic fibrosis (CF) may be associated both with acute respiratory complications (respiratory exacerbations, haemoptysis, pneumothorax) and with non-respiratory complications (distal intestinal obstruction syndrome, dehydration) that may result in hospitalizations. The aim of this article is to describe the main therapeutic approaches that are adopted in the management of acute complications occurring in CF adults, and to discuss indications for admission of these patients to intensive care units. Adult CF patients admitted to intensive care unit often benefit from antibiotic courses adapted to their chronic bronchial infection, especially when the hospitalization is related to respiratory disease (including haemoptysis and pneumothorax). Nutritional support, including hypercaloric diet, control of hyperglycemia and pancreatic enzyme supplementation is warranted. The recommended therapy for major haemoptysis is bronchial artery embolization. Patient with significant pneumothorax should have a chest tube inserted, while the treatment of distal intestinal obstruction syndrome will most often be medical. In case of respiratory failure, non-invasive ventilation is the preferred mode of ventilatory support because invasive ventilation is associated with poor outcomes. Therapeutic options should always have been discussed between the patient, family members and the CF medical team to allow for informed decision making.
    Revue des Maladies Respiratoires 04/2011; 28(4):503-16. · 0.50 Impact Factor
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    ABSTRACT: The natural history of cystic fibrosis (CF) may be associated both with acute respiratory complications (respiratory exacerbations, haemoptysis, pneumothorax) and with non-respiratory complications (distal intestinal obstruction syndrome, dehydration) that may result in hospitalizations. The aim of this article is to describe the main therapeutic approaches that are adopted in the management of acute complications occurring in CF adults, and to discuss indications for admission of these patients to intensive care units. Adult CF patients admitted to intensive care unit often benefit from antibiotic courses adapted to their chronic bronchial infection, especially when the hospitalization is related to respiratory disease (including haemoptysis and pneumothorax). Nutritional support, including hypercaloric diet, control of hyperglycemia and pancreatic enzyme supplementation is warranted. The recommended therapy for major haemoptysis is bronchial artery embolization. Patient with significant pneumothorax should have a chest tube inserted, while the treatment of distal intestinal obstruction syndrome will most often be medical. In case of respiratory failure, non-invasive ventilation is the preferred mode of ventilatory support because invasive ventilation is associated with poor outcomes. Therapeutic options should always have been discussed between the patient, family members and the CF medical team to allow for informed decision making.
    Revue des Maladies Respiratoires. 04/2011; 28(4):503-516.
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    ABSTRACT: This review is the summary of a workshop on the role of distal airways in chronic obstructive pulmonary disease (COPD), which took place in 2009 in Vence, France. The evidence showing inflammation and remodelling in distal airways and the possible involvement of these in the pathobiology, physiology, clinical manifestations and natural history of COPD were examined. The usefulness and limitations of physiological tests and imaging techniques for assessing distal airways abnormalities were evaluated. Ex vivo studies in isolated lungs and invasive measurements of airway resistance in living individuals have revealed that distal airways represent the main site of airflow limitation in COPD. Structural changes in small conducting airways, including increased wall thickness and obstruction by muco-inflammatory exudates, and emphysema (resulting in premature airway closure), were important determinants of airflow limitation. Infiltration of small conducting airways by phagocytes (macrophages and neutrophils), dendritic cells and T and B lymphocytes increased with airflow limitation. Distal airways abnormalities were associated with patient-related outcomes (e.g. dyspnoea and reduced health-related quality of life) and with the natural history of the disease, as reflected by lung function decline and mortality. These data provide a clear rationale for targeting distal airways in COPD.
    European Respiratory Review 03/2011; 20(119):7-22.
  • D Dusser
    Revue des Maladies Respiratoires 02/2011; 28(2):127. · 0.50 Impact Factor
  • Journal of Cystic Fibrosis - J CYST FIBROS. 01/2011; 10.
  • D. Dusser
    Revue Des Maladies Respiratoires - REV MAL RESPIR. 01/2011; 28(2):127-127.
  • European Respiratory Review. 01/2011;
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    ABSTRACT: The 2nd French Clinical Vaccinology conference held on 20th April 2009 in Paris (France) was a unique opportunity to discuss basic and translational research in vaccinology and its implications for patients for respiratory diseases. This conference is organized by the Clinical Research Center Cochin-Pasteur, that has been involved for several years clinical research in vaccines. We report on here the key findings of the conference, especially the immunization of the chronic respiratory diseases, the clinical effectiveness of vaccines and the development of new vaccines in pulmonology.
    Vaccine 09/2010; 28(40):6551-5. · 3.77 Impact Factor

Publication Stats

745 Citations
205.88 Total Impact Points

Institutions

  • 1986–2012
    • Université René Descartes - Paris 5
      • Faculté de Médecine
      Lutetia Parisorum, Île-de-France, France
  • 2011
    • Université Paris Descartes
      • Faculté de Médecine
      Lutetia Parisorum, Île-de-France, France
  • 2009
    • Hôtel-Dieu de Paris – Hôpitaux universitaires Paris Centre
      Lutetia Parisorum, Île-de-France, France
  • 2007
    • Groupe Hospitalier Saint Vincent
      Strasburg, Alsace, France
  • 1994–2006
    • Hôpital Cochin (Hôpitaux Universitaires Paris Centre)
      • Service de Pneumologie
      Paris, Ile-de-France, France
  • 2002–2005
    • Hôpital Européen Georges-Pompidou (Hôpitaux Universitaires Paris-Ouest)
      • Service d’Anatomie-Pathologie
      Lutetia Parisorum, Île-de-France, France
  • 2004
    • Mapi Values
      Lyons, Rhône-Alpes, France
  • 2000
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France