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Publications
Publications (128)
Only a few therapies have been shown to prolong survival in specific patients with COPD. In recent years, the IMPACT and the ETHOS trials suggested that triple therapy (a combination of inhaled corticosteroid (ICS), long-acting muscarinic antagonist (LAMA) and long-acting β 2 -agonist (LABA) given in a single inhaler) may reduce mortality compared...
Transbronchial cryobiopsies (TBCB) for the diagnosis of interstitial lung disease (ILD) have shown promising results but prospective studies with matched surgical lung biopsy (SLB) yielded conflicting results. We aimed to assess within- and between-center diagnostic agreement between TBCB and SLB at both the histopathologic and multidisciplinary di...
Small airway remodeling (SAR) is a key phenomenon of airflow obstruction in smokers, leading to chronic obstructive pulmonary disease (COPD). SAR results in an increased thickness of small airway walls, with a combination of peribronchiolar fibrosis with increased fibrous tissue and accumulation of mesenchymal and epithelial cells. SAR pathogenesis...
Background:
Delaying time to prone positioning (PP) may be associated with higher mortality in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). We evaluated the use and the impact of early PP on clinical outcomes in intubated patients hospitalized in intensive care units (ICUs) for COVID-19.
Methods:
All int...
Introduction:
Several studies in COPD have shown a significant and early increase in the risk of cardiovascular mortality attributable to inhaled bronchodilators including long acting β2 agonists (LABAs) and muscarinic antagonists (LAMAs). Cardiac autonomic system impairment may be a potential mechanism involved.
Methods:
We performed a phase 4,...
Hemophagocytic lymphohistiocytosis (HLH) may be secondary to cancer or other conditions in adults. We aimed to compare characteristics and outcomes of secondary HLH depending on cancer status among adults. Weight loss over 10 %, headache and enlarged lymph nodes were more frequent in malignant- HLH (M-HLH). Higher phosphatase alkaline level and CRP...
Rationale:
Short-term oxygen therapy (STOT) is often prescribed to allow patients with chronic obstructive pulmonary disease (COPD) to be discharged safely from hospital following an acute illness. This practice is widely accepted without being based on evidence.
Purpose:
Our objective was to describe the characteristics and outcomes of patients...
Background:
Bronchoscopy is a safe procedure which is frequently performed for the investigation of respiratory diseases. Current guidelines recommend to delay bronchoscopy for 4-6 weeks after acute coronary syndrome (ACS), as this period is theoretically considered at risk for new onset of ACS. We therefore aimed to evaluate the safety and the to...
Introduction
Subglottic stenosis (SGS) is a rare condition that results from progressive narrowing of the upper airways. Outcomes and treatment options depend on the benign or complex nature of the stenosis. Treatment options for SGS include surgery and endoscopic techniques. The main endoscopic techniques used are dilation and laser resection. Obs...
The French Society of Respiratory Diseases (SPLF) decided to update its position on pharmacological treatment optimization in stable COPD in 2021. A working group expert in COPD, representative of pulmonologists, pharmacists, physiologists and general practitioners, reviewed the literature published between 2016 and 2021. The basis for this positio...
Background
The aim of this study is to determine whether severe COVID-19 patients harbour a higher risk of ICU-acquired pneumonia.
Methods
This retrospective multicentre cohort study comprised all consecutive patients admitted to seven ICUs for severe COVID-19 pneumonia during the first COVID-19 surge in France. Inclusion criteria were laboratory-...
Background
Controversies exist on the nature of COVID-19 related acute respiratory distress syndrome (ARDS) in particular on the static compliance of the respiratory system (Crs). We aimed to analyze the association of Crs with outcome in COVID-19-associated ARDS, to ascertain its determinants and to describe its evolution at day-14.
Methods
In th...
Rational
To evaluate the respective impact of standard oxygen, high-flow nasal cannula (HFNC) and noninvasive ventilation (NIV) on oxygenation failure rate and mortality in COVID-19 patients admitted to intensive care units (ICUs).
Methods
Multicenter, prospective cohort study (COVID-ICU) in 137 hospitals in France, Belgium, and Switzerland. Demog...
Background
Predicting outcomes of critically ill intensive care unit (ICU) patients with coronavirus-19 disease (COVID-19) is a major challenge to avoid futile, and prolonged ICU stays.
Methods
The objective was to develop predictive survival models for patients with COVID-19 after 1-to-2 weeks in ICU. Based on the COVID–ICU cohort, which prospect...
Background
Patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-COV 2) and requiring intensive care unit (ICU) have a high incidence of hospital-acquired infections; however, data regarding hospital acquired bloodstream infections (BSI) are scarce. We aimed to investigate risk factors and outcome of BSI in critically ill...
Erdheim–Chester disease is a rare histiocytosis characterized by iconic features associated with compatible histology. Most patients have somatic mutations in the MAP-kinase pathway gene, and the mutations occur in CD14+ monocytes. Differentiation of the myeloid lineage plays a central role in the pathogenesis of histiocytosis. Monocytes are myeloi...
Introduction:
Stenotrophomonas maltophilia is an emerging Gram-negative MDR bacteria. In patients with chronic obstructive pulmonary disease (COPD), it is mostly found in those with severe exacerbation of COPD requiring mechanical ventilation. The significance of S. maltophilia when detected in the sputum of ambulatory patients with COPD is uncert...
Inflammatory response in patients with COPD secondary to organic dust exposure (OD-COPD) is poorly understood. We therefore aimed to characterize inflammatory and immune profile from peripheral blood mononuclear cells (PBMC) in a group of patients with mild-to-moderate COPD secondary to organic dust exposure (OD-COPD), tobacco smoking (T-COPD), or...
Although being a potential major source of infection in extracorporeal membrane oxygenation (ECMO) patients, data regarding cannula-related infections (CRI) remain scarce. We therefore aimed at describing the epidemiology of CRI among critically ill patients supported by ECMO. Between October 2017 and November 2019, adult patients supported by eith...
Introduction
La lymphohistiocytose hémophagocytaire secondaire est une pathologie rare, de diagnostic difficile, dont le mécanisme physiopathologique est complexe. Le délai diagnostique et donc thérapeutique peut menacer le pronostic vital [1] en l’absence d’éléments diagnostiques pathognomoniques. Les étiologies sont malignes dans 40 à 70 % des ca...
Background
Previous studies reporting the causes of death in patients with severe COVID-19 have provided conflicting results. The objective of this study was to describe the causes and timing of death in patients with severe COVID-19 admitted to the intensive care unit (ICU).
Methods
We performed a retrospective study in eight ICUs across seven Fr...
Introduction
Eccentric (ECC) cycling is viewed as an alternative to concentric (CON) cycling for exercise training in patients with severe COPD as it induces a much lower ventilatory demand for a given mechanical load than CON cycling. However, a more hyperpneic breathing pattern (i.e., higher fB and lower tidal volume (VT)) during ECC than during...
Background:
In idiopathic pulmonary fibrosis (IPF), some physiological parameters measured during a 6-min walk test (6-MWT) impart reliable prognostic information. Sit-to-stand tests (STSTs) are field exercise tests that are easier to implement than the 6-MWT in daily practice.
Objectives:
The aims of the study were to test the reproducibility a...
Objectives: Different phenotypes have been identified in acute respiratory distress syndrome (ARDS). Existence of several phenotypes in coronavirus disease (COVID-19) related acute respiratory distress syndrome is unknown. We sought to identify different phenotypes of patients with moderate to severe ARDS related to COVID-19.
Methods: We conducted...
Résumé
Introduction
Plusieurs travaux ont analysé la récupération fonctionnelle après ostéosynthèse par plaque d’une fracture déplacée du tiers moyen de la clavicule après la 6e semaine. Le but de cette étude était d’évaluer la récupération fonctionnelle précoce dans les 6 premières semaines qui n’a encore pas fait l’objet de travaux.
Hypothèse
L...
Résumé
Introduction
Le bilan d’adénopathies médiastinales est un motif de consultation fréquent auprès du pneumologue. Outre les causes fréquentes (pathologie tumorale, sarcoïdose, tuberculose, hémopathies), certaines causes plus rares doivent être évoquées dans un contexte particulier.
Observations
Nous rapportons les cas de trois jeunes patient...
Introduction: Although early identified as a deadly infectious disease, the precise mortality rate of the most severe forms of COVID-19 is a matter of debate. To the best of our knowledge, no study investigated so far, the causes that ultimately led to death as well as the relation between timing and causes of death.
Material & Methods: We performe...
Introduction: Several studies have analyzed the functional recovery after plate fixation of a displaced fracture of the middle third of the clavicle beyond the 6th week. The aim of this study was to assess the early functional recovery in the first 6 weeks, which has not yet been investigated.
Hypothesis: Functional recovery in the first 6 weeks af...
Bone location is uncommon in both sarcoidosis and in neck cancer (HNC). Diagnosis of a bone lesion is therefore challenging to distinguish its nature in a patient suffering from both diseases. We report the case of a 69-years-old woman referred for P16 positive HPV-HNC. Magnetic Resonance Imaging (MRI) showed T2 hypo-signal on iliac crest and spine...
Case Presentation
A 35-year-old man was admitted for recurrent episodes of pneumonia. He complained of a 2-month history of exertional dyspnea and productive cough with whitish and viscous sputum which was poorly responsive to antibiotic therapy. He also reported a weight loss of 5 kg since the first symptoms appeared. There was no dysphagia, fever...
Background:
There is now substantial evidence to support venovenous extracorporeal membrane oxygenation efficacy and safety for patients with severe acute respiratory distress syndrome. However, recent guidelines recommend against the initiation of extracorporeal membrane oxygenation in patients with mechanical ventilation for coronavirus disease...
Background: Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covid-19-related acute respiratory distress syndrome (ARDS). Methods: Comparison of antiviral strategies (none, hydroxychloroquine (OHQ), lopinavir/ritonavir (L/R), others (combination or remdesivir) in an observation...
Background:
COPD in never-smokers exposed to organic dusts is still poorly characterized. Therapeutic strategies in COPD are only evaluated in smoking-related COPD. To understand how never-smokers with COPD behave during exercise is an important prerequisite for optimal management.
Objectives:
To compare physiological parameters measured at exer...
Background:
COVID-19 may predispose to venous thromboembolism. We determined factors independently associated with computed tomography pulmonary angiography (CTPA)-confirmed pulmonary embolism (PE) in hospitalised severe COVID-19 patients.
Methods:
Among all (N=349) patients hospitalised for COVID-19 in a university hospital in a French region w...
Résumé
Introduction
La pneumopathie d’hypersensibilité (PHS) est une pneumopathie interstitielle diffuse liée à une réaction immunitaire d’hypersensibilité dont le mécanisme physiopathologique reste mal connu. Son diagnostic peut être difficile, notamment si la présentation est atypique ou si l’antigène causal n’est pas identifié et demande un int...
Background
Limited data are available for antiviral therapy efficacy especially for the most severe patients under mechanical ventilation suffering from Covid-19 related Acute Respiratory Distress Syndrome (ARDS).
Methods
Observational multicenter cohort of patients with moderate to severe Covid-19 ARDS, comparing antiviral strategies (none, hydrox...
Background:
Comorbidities including cardiovascular diseases are very common in chronic obstructive pulmonary disease (COPD) secondary to tobacco smoking and contribute to the overall severity of the disease. In non-smoking COPD, which accounts for about 25% of COPD cases worldwide, current knowledge on the frequency and determinants of comorbiditi...
Résumé
Introduction
Les malformations artério-veineuses pulmonaires (MAVP) sont des communications directes anormales entre des artères et des veines pulmonaires sans interposition d’un secteur capillaire. L’artério-embolisation est considérée comme le traitement de choix avec un bénéfice en termes d’hématose et de prévention des complications. El...
Risk factors associated with pulmonary embolism in coronavirus disease 2019 acute respiratory distress syndrome patients deserve to be better known. We therefore performed a post hoc analysis from the COronaVirus-Associated DIsease Study (COVADIS) project, a multicenter observational study gathering 21 ICUs from France (n = 12) and Belgium (n = 9)....
Coronavirus disease 19 (Covid-19) is a new emerging virus responsible for pandemic and death. High blood pressure, diabetes, obesity have been described as poor prognosis factors. Few data have been reported in patient with solid tumor, hematological malignancy, rheumatoid conditions or organ transplant. In a cohort of 80 patients with immunodepres...
Background
Although farming is often considered a risk factor for COPD, data regarding the burden and characteristics of COPD in dairy farmers are sparse and conflicting.
Objectives
To characterize COPD in dairy farmers.
Methods
4788 subjects entered two parallel COPD screening programs, one in agricultural workers and one in general practice fro...
Rationale:
Pulmonary hypertension associated with neurofibromatosis type 1 (PH-NF1) is a rare and largely unknown complication of NF1.
Objectives:
To describe characteristics and outcomes of PH-NF1.
Methods:
We reported the clinical, functional, radiologic, histologic and hemodynamic characteristics, response to pulmonary arterial hypertension...
Pulmonary venoocclusive disease (PVOD) is a rare form of pulmonary vascular disease with pulmonary hypertension characterized by preferential involvement of the pulmonary venous system. Hepatic venoocclusive disease (HVOD), also known as sinusoidal obstruction syndrome, is a condition that occurs in 13% to 15% of patients after hematopoietic stem c...
Purpose: Respiratory hazards of farming have been identified for centuries, with little focus on gender differences. We used data from the AGRICOH consortium, a collective of prospective cohorts of agricultural workers, to assess respiratory disease prevalence among adults in 18 cohorts representing over 200,000 farmers, farm workers, and their spo...
Introduction
L’hypertension pulmonaire associée à la neurofibromatose de type 1 (HTP-NF1) est une complication rare mais sévère de la NF1. Les données disponibles dans la littérature sont limitées à des cas isolés ou de petites séries (< 10 patients). L’objectif principal est de décrire les caractéristiques et le pronostic des patients HTP-NF1.
Mé...
L’objectif de notre étude était d’évaluer la fiabilité de l’examen clinique couplé à l’IRM pour déterminer si une ou deux des racines supérieures C5 et C6 sont greffables, dans les paralysies complètes du plexus brachial.
Nous avons mené une étude rétrospective avec un recueil de données de 2013 à 2018. Vingt-sept patients ont été inclus. Les critè...
Hypersensitivity pneumonitis and allergic bronchopulmonary aspergillosis are two forms of lung disease with presumed distinct immunoallergic mechanisms. We report the observation of a 38-year-old French farmer who, for one month, had fever and dyspnoea resistant to antibiotic therapy. A diagnosis of farmer's lung, and allergic bronchopulmonary aspe...
Background:
The observation that chronic obstructive pulmonary disease (COPD) is an independent risk factor for cardiovascular disease (CVD) comes from comparisons between smokers with COPD and smokers without COPD. The mechanisms that explain increased risk of CVD in patients with COPD are still unclear.
Objectives:
To assess systemic arterial...
La broncho-pneumopathie chronique obstructive (BPCO) est caractérisée par l’existence de symptômes respiratoires et d’une obstruction permanente des voies aériennes. Le tabagisme reste le principal facteur de risque bien que des causes environnementales et professionnelles comme l’exposition aux poussières organiques aient été identifiées.La préval...
The objective of our study was to evaluate the reliability of clinical examination paired with MRI to determine whether one or both of the superior C5 and C6 roots are graftable in cases of complete brachial plexus palsy. We conducted a retrospective study from 2013 to 2018. Twenty-seven patients who had total brachial plexus palsy and were more th...
Exposure to organic dusts is an independent causative factor of chronic obstructive pulmonary disease (COPD). Unhealthy dietary patterns have been associated with poor lung function in smokers. This study investigated whether dietary patterns were associated with post-bronchodilator airway obstruction, a hallmark of COPD, in dairy farmers exposed t...
Introduction:
Proper diagnosis of COPD remains a challenge. Spirometry testing in primary care may help to reduce misdiagnosis, but its reliability as a diagnostic instrument needs to be assessed.
Objectives:
To investigate (1) the validity of spirometry testing performed in primary care and (2) the accuracy of the diagnostic of airflow limitati...
Allergic mechanisms related to environmental and occupational exposure have been suggested to contribute to the development of chronic obstructive pulmonary disease (COPD).
Objectives:
To investigate the relationships between atopy markers, persistent airflow limitation (PAL) and occupational exposure in dairy farmers.
Methods:
Clinical and bio...
Hypersensitivity pneumonitis (HP) is an interstitial lung disease caused by an immune response to a variety of antigens to which patients have been previously sensitised. It can occur at any age. In children, it is a rare disease, probably under-diagnosed, with an estimated prevalence of 4 per million. The paediatric forms are not really different...
La dispnea acuta è un sintomo complesso e un motivo frequente di visita. Un attento interrogatorio, un esame clinico completo e semplici esami complementari consentono al medico, nella maggior parte dei casi, di identificare la causa della dispnea o di orientare l’approccio terapeutico. L’esistenza di segni di gravità correlati alla dispnea acuta r...
La disnea aguda es un síntoma complejo y un frecuente motivo de consulta. Una minuciosa anamnesis, una exploración física completa y pruebas complementarias sencillas permiten al médico, en la mayoría de los casos, identificar la causa de la disnea u orientar el enfoque terapéutico. La existencia de signos de alarma ligados a la disnea aguda requie...
Introduction
L’association entre le tabagisme et le risque cardio-vasculaire (RCV) chez les patients atteints de bronchopneumopathie obstructive chronique (BPCO) n’est pas clairement établie. En effet, la plupart des études évaluant le RCV chez ces patients se basent sur des comparaisons entre des patients présentant une BPCO tabagique et des témoi...