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Ferrand H, Crockett F, Naccache JM, Rioux C, Mayaud C, Yazdanpanah Y, Cadranel J. [Pulmonary manifestations in HIV-infected patients: a diagnostic approach]. Rev Mal Respir 2014; 31:903-15. [PMID: 25496788 DOI: 10.1016/j.rmr.2014.04.106] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 04/25/2014] [Indexed: 01/12/2023]
Abstract
The spectrum of pulmonary diseases that can affect human immunodeficiency virus (HIV)-infected patients is wide and includes both HIV and non-HIV-related conditions. Opportunistic infections and neoplasms remain a major concern even in the current era of combination antiretroviral therapy. Although these diseases have characteristic clinical and radiological features, there can be considerable variation in these depending on the patient's CD4 lymphocyte count. The patient's history, physical examination, CD4 count and chest radiograph features must be considered in establishing an appropriate diagnostic algorithm. In this article, we propose different diagnostic approaches HIV infected to patients with respiratory symptoms depending on their clinico-radiological pattern.
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Affiliation(s)
- H Ferrand
- Service de pneumologie, hôpital Tenon, université P&M Curie, AP-HP, 4, rue de la Chine, 75970 Paris, France; Service de maladies infectieuses et tropicales, hôpital Bichat-Claude-Bernard, université Denis-Diderot, AP-HP, Paris, France
| | - F Crockett
- Service de pneumologie, hôpital Tenon, université P&M Curie, AP-HP, 4, rue de la Chine, 75970 Paris, France
| | - J-M Naccache
- Service de pneumologie, hôpital Tenon, université P&M Curie, AP-HP, 4, rue de la Chine, 75970 Paris, France
| | - C Rioux
- Service de maladies infectieuses et tropicales, hôpital Bichat-Claude-Bernard, université Denis-Diderot, AP-HP, Paris, France
| | - C Mayaud
- Service de pneumologie, hôpital Tenon, université P&M Curie, AP-HP, 4, rue de la Chine, 75970 Paris, France
| | - Y Yazdanpanah
- Service de maladies infectieuses et tropicales, hôpital Bichat-Claude-Bernard, université Denis-Diderot, AP-HP, Paris, France
| | - J Cadranel
- Service de pneumologie, hôpital Tenon, université P&M Curie, AP-HP, 4, rue de la Chine, 75970 Paris, France.
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Tubiana S, Claessens YE, Rammaert B, Mayaud C, Brun AL, Casalino E, Duval X. COL02-03: Impacts diagnostique et thérapeutique du scanner thoracique chez les patients suspects de pneumopathie aiguë communautaire (PACSCAN) aux urgences. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70046-0] [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: 10/25/2022]
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Mayaud C, Wagner T, Benischke R, Birk S. Single event time series analysis in a binary karst catchment evaluated using a groundwater model (Lurbach system, Austria). J Hydrol (Amst) 2014; 511:628-639. [PMID: 24748687 PMCID: PMC3990444 DOI: 10.1016/j.jhydrol.2014.02.024] [Citation(s) in RCA: 5] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 01/14/2014] [Accepted: 02/06/2014] [Indexed: 06/03/2023]
Abstract
The Lurbach karst system (Styria, Austria) is drained by two major springs and replenished by both autogenic recharge from the karst massif itself and a sinking stream that originates in low permeable schists (allogenic recharge). Detailed data from two events recorded during a tracer experiment in 2008 demonstrate that an overflow from one of the sub-catchments to the other is activated if the discharge of the main spring exceeds a certain threshold. Time series analysis (autocorrelation and cross-correlation) was applied to examine to what extent the various available methods support the identification of the transient inter-catchment flow observed in this binary karst system. As inter-catchment flow is found to be intermittent, the evaluation was focused on single events. In order to support the interpretation of the results from the time series analysis a simplified groundwater flow model was built using MODFLOW. The groundwater model is based on the current conceptual understanding of the karst system and represents a synthetic karst aquifer for which the same methods were applied. Using the wetting capability package of MODFLOW, the model simulated an overflow similar to what has been observed during the tracer experiment. Various intensities of allogenic recharge were employed to generate synthetic discharge data for the time series analysis. In addition, geometric and hydraulic properties of the karst system were varied in several model scenarios. This approach helps to identify effects of allogenic recharge and aquifer properties in the results from the time series analysis. Comparing the results from the time series analysis of the observed data with those of the synthetic data a good agreement was found. For instance, the cross-correlograms show similar patterns with respect to time lags and maximum cross-correlation coefficients if appropriate hydraulic parameters are assigned to the groundwater model. The comparable behaviors of the real and the synthetic system allow to deduce that similar aquifer properties are relevant in both systems. In particular, the heterogeneity of aquifer parameters appears to be a controlling factor. Moreover, the location of the overflow connecting the sub-catchments of the two springs is found to be of primary importance, regarding the occurrence of inter-catchment flow. This further supports our current understanding of an overflow zone located in the upper part of the Lurbach karst aquifer. Thus, time series analysis of single events can potentially be used to characterize transient inter-catchment flow behavior of karst systems.
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Affiliation(s)
- C. Mayaud
- Institute for Earth Sciences, University of Graz, Heinrichstraße 26, A-8010 Graz, Austria
| | - T. Wagner
- Institute for Earth Sciences, University of Graz, Heinrichstraße 26, A-8010 Graz, Austria
| | - R. Benischke
- Department of Water Resources and Environmental Analytics, Institute for Water, Energy and Sustainability, Joanneum Research Forschungsgesellschaft mbH., Elisabethstraße 18/II, A-8010 Graz, Austria
| | - S. Birk
- Institute for Earth Sciences, University of Graz, Heinrichstraße 26, A-8010 Graz, Austria
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Ferrand H, Foulon S, Mangiapan G, Naccache JM, Taillé C, Bouaud J, Mayaud C, Cadranel J, Séroussi B, Lioté H. Validation des performances du logiciel Pneumodoc®pour l’aide au diagnostic d’imputabilité médicamenteuse des pneumopathies infiltrantes diffuses. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.018] [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: 10/14/2022]
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Bommenel T, Launay O, Meynard JL, Gilquin J, Katlama C, Lascaux AS, Mahamat A, Martinez V, Pradier C, Rouveix E, Simon A, Costagliola D, Abgrall S, Abgrall S, Barin F, Bentata M, Billaud E, Boue F, Burty C, Cabie A, Costagliola D, Cotte L, de Truchis P, Duval X, Duvivier C, Enel P, Gasnault J, Gaud C, Gilquin J, Grabar S, Katlama C, Khuong MA, Lang JM, Lascaux AS, Launay O, Mahamat A, Mary-Krause M, Matheron S, Meynard JL, Pavie J, Pialoux G, Pilorge F, Poizot-Martin I, Pradier C, Reynes J, Rouveix E, Simon A, Tattevin P, Tissot-Dupont H, Viard JP, Viget N, Brosseau M, Salomon V, Jacquemet N, Guiguet M, Lanoy E, Lievre L, Selinger-Leneman H, Lacombe JM, Potard V, Bricaire F, Herson S, Desplanque N, Girard PM, Meyohas MC, Picard O, Cadranel J, Mayaud C, Clauvel JP, Decazes JM, Gerard L, Molina JM, Diemer M, Sellier P, Honore P, Jeantils V, Tassi S, Mechali D, Taverne B, Bouvet E, Crickx B, Ecobichon JL, Picard-Dahan C, Yeni P, Berthe H, Dupont C, Chandemerle C, Mortier E, Tisne-Dessus D, Weiss L, Salmon D, Auperin I, Roudiere L, Fior R, Delfraissy JF, Goujard C, Jung C, Lesprit P, Vittecoq D, Fraisse P, Rey D, Beck-Wirth G, Stahl JP, Lecercq P, Gourdon F, Laurichesse H, Fresard A, Lucht F, Bazin C, Verdon R, Chavanet P, Arvieux C, Michelet C, Choutet P, Goudeau A, Maitre MF, Hoen B, Elinger P, Faller JP, Borsa-Lebas F, Caron F, Daures JP, May T, Rabaud C, Berger JL, Remy G, Arlet-Suau E, Cuzin L, Massip P, Thiercelin Legrand MF, Pontonnier G, Yasdanpanah Y, Dellamonica P, Pugliese P, Aleksandrowicz K, Quinsat D, Ravaux I, Delmont JP, Moreau J, Gastaut JA, Retornaz F, Soubeyrand J, Galinier A, Ruiz JM, Allegre T, Blanc PA, Bonnet-Montchardon D, Lepeu G, Granet-Brunello P, Esterni JP, Pelissier L, Cohen-Valensi R, Nezri M, Chapadaud S, Laffeuillade A, Raffi F, Boibieux A, Peyramond D, Livrozet JM, Touraine JL, Trepo C, Strobel M, Bissuel F, Pradinaud R, Sobesky M, Contant M. Comparative effectiveness of continuing a virologically effective first-line boosted protease inhibitor combination or of switching to a three-drug regimen containing either efavirenz, nevirapine or abacavir. J Antimicrob Chemother 2011; 66:1869-77. [DOI: 10.1093/jac/dkr208] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sire JM, Sow PS, Chartier L, Ndiaye B, Ndaye M, Sarr FD, Vray M, Boye CS, M'boup S, L'her P, Debonne JM, Mayaud C, Diop B. [Aetiology of AFB negative pneumonias in hospitalized HIV patients in Dakar]. Rev Mal Respir 2010; 27:1015-21. [PMID: 21111271 DOI: 10.1016/j.rmr.2010.09.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Accepted: 09/27/2009] [Indexed: 11/28/2022]
Abstract
A prospective study was carried out in two tertiary hospitals in Dakar to determine the main causes of sputum acid-fast bacillus (AFB) smear-negative pneumonia in HIV-infected patients. All clinical and microbiological records were reviewed by experts. Seventy patients were finally enrolled. Most of them were hospitalized at an advanced stage of AIDS. The median CD4 cell count was 62/mm(3) and the median body mass index (BMC) was 18 kg/m(2). Thirty-one patients (44 %) were known as seropositive for HIV infection prior to admission. Radiological opacities were localized in 70 % of patients and diffuse in 21 %. Fiberoptic bronchoscopy was performed in 50 patients (71 %). A definite or probable diagnosis was obtained in 55 patients (79 %). Bacterial pneumonia (usually due to Enterobacteriaceae and Pseudomonas aeruginosa), tuberculosis, Pneumocystis pneumoniae and other causes (Kaposi's sarcoma, atypical mycobacteria) were diagnosed in 67 %, 24 %, 5 %, and 13 % of these patients respectively. In conclusion, pneumonia of bacterial origin and tuberculosis can be incriminated in the majority of cases of AFB negative pneumonia observed in HIV patients in Dakar.
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Affiliation(s)
- J M Sire
- Laboratoire de biologie médicale, Institut Pasteur, Dakar, Sénégal
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Kousignian I, Launay O, Mayaud C, Rabaud C, Costagliola D, Abgrall S. Does enfuvirtide increase the risk of bacterial pneumonia in patients receiving combination antiretroviral therapy? J Antimicrob Chemother 2009; 65:138-44. [DOI: 10.1093/jac/dkp402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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de Prost N, Parrot A, Picard C, Ancel PY, Mayaud C, Fartoukh M, Cadranel J. Diffuse alveolar haemorrhage: factors associated with in-hospital and long-term mortality. Eur Respir J 2009; 35:1303-11. [DOI: 10.1183/09031936.00075309] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Blin P, Lignot S, Lassalle R, Lamarque S, Bernard MA, Demeaux JL, Housset B, Mayaud C, Peyramond D, Pouchain D, Moore N, Molimard M. Efficacité en situation réelle de la stratégie thérapeutique initiale dans l’exacerbation aiguë de la bronchite chronique (EABC) en France. Rev Epidemiol Sante Publique 2009. [DOI: 10.1016/j.respe.2009.07.041] [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] Open
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Abstract
The anti-CD20 antibody rituximab has been reported to induce a heterogeneous spectrum of lung disorders. The aim of the present study was to critically review data on the clinical presentations, causality assessments and management strategies of lung diseases possibly related to rituximab. A systematic literature review was performed on English-language reports in PubMed until September 2008. Cases of lung diseases ascribed to rituximab (n = 45) were identified, with three time-to-onset patterns. The most common presentation was acute/subacute hypoxaemic organising pneumonia (n = 37), starting 2 weeks after the last infusion (often around the fourth cycle) and resolving, in most cases, provided glucocorticoid therapy was given early. Acute respiratory distress syndrome occurred in five patients, within a few hours and usually after the first infusion. In the remaining three patients, macronodular organising pneumonia developed insidiously long after rituximab therapy and responded to steroids. Eight patients died. Based on time to onset, symptoms, and responses to discontinuation and rechallenge with rituximab and other drugs, 13 cases were highly compatible and 32 compatible with rituximab-induced lung disease. Knowledge of these presentations of rituximab-induced lung disease should prove helpful for diagnosis and causality assessment purposes. Time-to-onset data, suggesting different pathogenic mechanisms, support closer clinical and perhaps radiological monitoring between infusions, particularly in patients with a history of reversible respiratory symptoms.
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Affiliation(s)
- H Lioté
- Centre de compétence maladies pulmonaires rares, Hôpital -Tenon, Paris, France.
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Lamarque S, Lassalle R, Bernard M, Gullemot D, Demeaux J, Housset B, Mayaud C, Peyramond D, Pouchain D, Blin P, Moore N, Molimard M. Prise en charge de l’exacerbation aiguë de la bronchite chronique (EABC) en pratique courante. Rev Epidemiol Sante Publique 2009. [DOI: 10.1016/j.respe.2009.02.128] [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] Open
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Lioté H, Séroussi B, Bouaud J, Voiriot G, Mayaud C. [PneumoDoc: a computer-based decision-making system for drug-related pulmonary disease]. Rev Pneumol Clin 2007; 63:193-201. [PMID: 17675943 DOI: 10.1016/s0761-8417(07)90124-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Establishing the diagnosis of drug-related pulmonary disease (DRPD) remains a difficult task because of the large number of drug-related toxic situations and the variety of clinical presentations. PneumoDoc is a computer-based support system designed to facilitate the diagnosis of lung disease using chronological, clinical, imaging, and cytological (alveolar lavage) input. These intrinsic items are crosschecked against extrinsic items reported in the literature (Pneumotox). Data input is in the form of yes-no questions. The final output displays the characteristic features of the observed clinical situation and calculates the probability of DRPD defined in five categories: incompatible, doubtful, compatible, suggestive, and highly suggestive. Use of multiple drugs, interaction with cardiopulmonary disease, and the absence of reported cases are limitations of the system.
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Affiliation(s)
- H Lioté
- UFR de Médecine, Université Paris 6, Paris.
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Ngo AT, Duc NH, Lan NH, Maynart M, Mayaud C, Quy TH. [Mechanisms and causes of death in 143 Vietnamese HIV-infected patients hospitalized for tuberculosis]. Rev Pneumol Clin 2007; 63:139-46. [PMID: 17675937 DOI: 10.1016/s0761-8417(07)90118-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE OF THE STUDY To know the mechanisms and causes of death in Vietnamese VIH-infected patients hospitalized for tuberculosis. METHODS Retrospective analysis of a monocentric cohort of 143 consecutive co infected patients admitted to Pham Ngoc Thach Hospital, in Ho Chi Minh City, between January 2004 and November 2004. MAIN RESULTS All the patients were HIV-infected and AFB smear positive. The CD4 T lymphocyte count was 55/mm3 and the body mass index was 15.8 +/- 2 kg/m2. During the first three months after hospital admission and tuberculosis diagnosis, the percentage of deaths was 28.7% (41/143). The mechanisms of deaths were: progressive cachexia, acute respiratory failure, cardiogenic or bacteremic shock, coma and unexpected cardio respiratory arrest. The causes of death were tuberculosis (particularly mechanical complications such as compressive pneumothorax, pericarditis or pleuritis), metabolic disorders (mainly hyponatrémie and dyskaliema) and associated infection. In multivariate analysis, two parameters (available at admission) were predictive of short-term death: anemia (p=0.024) and hyponatrémie (p=0.026). CONCLUSION The short term mortality of co infected patients with AIDS and tuberculosis remains high in developing countries. However, some causes of death such as compressive pneumothorax-pleuritis-pericarditis, metabolic disorder or even associated opportunistic infection i. e. pneumocystosis may be prevented or cured. Consequently, such patients must be carefully monitored and more particularly those with severe anemia and/or hyponatrémie at admission. Similarly appropriate diagnostic algorithms must be used in case of unfavorable evolution particularly to diagnose curable complication.
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Affiliation(s)
- A T Ngo
- Pham Ngoc Thach Hospital, 120 Hung Vuong St, District 5, Ho Chi Minh City, Vietnam
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Parrot A, Khalil A, Roques S, Andréjak C, Savale L, Carette MF, Mayaud C, Bazelly B, Fartoukh M. [Management of severe hemoptysis: experience in a specialized center]. Rev Pneumol Clin 2007; 63:202-10. [PMID: 17675944 DOI: 10.1016/s0761-8417(07)90125-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Bronchiectasis, cancer and tuberculosis account for the majority of haemoptysis requiring intensive care unit admission. Bedside evaluation (volume and bronchoscopic active bleeding) is safe to screen patients for arteriography and bronchial artery embolisation (BAE). First-line interventional arteriography should be favour over surgery in patients with non traumatic life-threatening hemoptysis. Surgery must be reserved in cases of failure or recurrence of bleeding after BAE.
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Affiliation(s)
- A Parrot
- Service de Pneumologie et Unité de Réanimation, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75970 Paris Cedex 20
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Mayaud C. [What may be the future of the Thoracic Department in Tenon Hospital (Paris)?]. Rev Pneumol Clin 2007; 63:235-6. [PMID: 17675948 DOI: 10.1016/s0761-8417(07)90129-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- C Mayaud
- Hôpital Tenon, AP-HP, 4, rue de la Chine, 75970 Paris Cedex 20.
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Camuset J, Lavolé A, Wislez M, Khalil A, Bellocq A, Bazelly B, Mayaud C, Cadranel J. [Bronchopulmonary aspergillosis infections in the non-immunocompromised patient]. Rev Pneumol Clin 2007; 63:155-66. [PMID: 17675939 DOI: 10.1016/s0761-8417(07)90120-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The definition of broncho-pulmonary aspergillosis infections in non-immunocompromised patients remains vague and a wide range of clinical, radiological and pathological entities have been described with a variety of names, i.e. simple aspergilloma, complex aspergilloma, semi-invasive aspergillosis, chronic necrotizing pulmonary aspergillosis, chronic cavitary and fibrosing pulmonary and pleural aspergillosis, pseudomembranous tracheobronchitis caused by Aspergillus, and invasive aspergillosis. However, these disease entities share common characteristics suggesting that they belong to the same group of pulmonary aspergillosis infectious disorders: 1- a specific diathesis responsible for the deterioration in local or systemic defenses against infection (alcohol, tobacco abuse, or diabetes); 2- an underlying bronchopulmonary disease responsible or not for the presence of a residual pleural or bronchopulmonary cavity (active tuberculosis or tuberculosis sequelae, bronchial dilatation, sarcoidosis, COPD); 3- generally, the prolonged use of low-dose oral or inhaled corticosteroids and 4- little or no vascular invasion, a granulomatous reaction and a low tendency for metastasis. There are no established treatment guidelines for broncho-pulmonary aspergillosis infection in non-immunocompromised patients, except for invasive aspergillosis. Bronchial artery embolization may stop hemoptysis in certain cases. Surgery is generally impossible because of impaired respiratory function or the severity of the comorbidity and when it is possible morbidity and mortality are very high. Numerous clinical cases and short retrospective series have reported the effect over time of the various antifungal agents available. Oral triazoles, i.e. itraconazole, and in particular voriconazole, appear to provide suitable treatment for broncho-pulmonary aspergillosis infections in non-immunocompromised patients.
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Affiliation(s)
- J Camuset
- Service de Pneumologie, Hôpital Victor-Dupouy, Argenteuil
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Abstract
The risk of Pseudomonas aeruginosa (Pa) acquisition, colonization, and infection during chronic bronchial disease varies according to the disease (cystic fibrosis, bronchial dilatation, post-tobacco abuse chronic obstructive bronchopneumonia), its evolutive stage, and a number of known or suspected factors. The involvement of Pa marks an important evolution of the disease, well demonstrated in cystic fibrosis. P. aeruginosa can adhere to epithelial cells (initial colonization) then organizes itself in complex structures evolving from simples microcolonies to macrocolonies in a structured biofilm supporting chronic colonization. P. aeruginosa can produce several factors of virulence, leading to the permanent destruction of host cells, thus inducing the regular liberation of pro-inflammatory mediators implementing a vicious circle worsening these chronic respiratory diseases and favoring their exacerbation. Chronic Pa suppuration has a systemic impact and justifies a global multidisciplinary management. In cystic fibrosis, the presence of P. aeruginosa is a major prognostic element. The current consensus is to detect the primary colonization as early as possible eradication is still possible and to treat it before it evolves to chronicity. But right now, this type of management has not been justified for other chronic bronchial diseases.
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Affiliation(s)
- C Mayaud
- Service de pneumologie et de réanimation respiratoire, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
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Picard C, Parrot A, Prigent H, Fartoukh M, Mayaud C, Cadranel J. 518 Construction d’un score diagnostic de l’origine immune des hémorragies intra-alvéolaires (HIA) chez l’immunocompétent. Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72895-4] [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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Lioté H, Séroussi B, Bouaud J, Mayaud C. 116 Pneumodoc : Système d’aide au diagnostic des pneumopathies médicamenteuses (PM). Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72492-0] [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: 11/24/2022]
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Messika J, Stoclin A, Parrot A, Prigent H, Mayaud C, Fartoukh M. 49 Épidémiologie microbienne des pneumonies liées aux soins (Bourse SPLF 2006). Rev Mal Respir 2007. [DOI: 10.1016/s0761-8425(07)72424-5] [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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Abstract
AIDS related mortality has fallen sharply in industrialised countries since 1996 following the introduction of highly active antiretroviral therapy. This has been accompanied by an increase in the proportion of deaths attributable to non-AIDS defining solid tumours, especially lung cancer. The risk of developing lung cancer seems to be higher in HIV infected subjects than in the general population of the same age, partly because the former tend more frequently to be smokers and, especially, intravenous drug users. The carcinogenic role of the antiretroviral nucleoside drugs and their interaction with smoking needs to be examined. Interestingly, there is no clear relationship between the degree of immunosuppression and the risk of lung cancer, so the reason for the increased risk is unknown. The mean age of HIV infected patients at the time of lung cancer diagnosis is 45 years and most are symptomatic. Lung cancer is diagnosed when locally advanced or metastatic (stage III-IV) in 75-90% of cases, similar to patients with unknown HIV status. Adenocarcinoma is the most frequent histological type. The prognosis is worse in HIV infected patients than in the general lung cancer population. Efficacy and toxicity data for chemotherapy and radiation therapy are few and imprecise. Surgery remains the treatment of choice for localised disease in patients with adequate pulmonary function and general good health, regardless of immune status. Prospective clinical trials are needed to define the optimal detection and treatment strategies for lung cancer in HIV infected patients.
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Affiliation(s)
- J Cadranel
- Service de Pneumologie et Réanimation Respiratoire, Hôpital Tenon, 4 rue de la Chine 75970, Paris cedex 20, France.
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Mayaud C, Fartoukh M, Prigent H, Parrot A, Cadranel J. [Critical evaluation and predictive value of clinical presentation in out-patients with acute community-acquired pneumonia]. Med Mal Infect 2006; 36:625-35. [PMID: 17084571 DOI: 10.1016/j.medmal.2006.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Accepted: 07/21/2006] [Indexed: 10/23/2022]
Abstract
Diagnostic probability of community-acquired pneumonia (CAP) depends on data related to age and clinical and radiological findings. The critical evaluation of data in the literature leads to the following conclusions: 1) the prevalence of CAP in a given population with acute respiratory disease is 5% in outpatients and 10% in an emergency care unit. This could be as low as 2% in young people and even higher than 40% in hospitalized elderly patients; 2) the collection of clinical data is linked to the way the patient is examined and to the expertise of the clinician. The absolute lack of "vital signs" has a good negative predictive value in CAP; presence of unilateral crackles has a good positive predictive value; 3) there is a wide range of X-ray abnormalities: localized alveolar opacities; interstitial opacities, limited of diffused. The greatest radiological difficulties are encountered in old people with disorders including chronic respiratory or cardiac opacities and as a consequence of the high prevalence of bronchopneumonia episodes at this age; 4) among patients with lower respiratory tract (LRT) infections, the blood levels of leukocytes, CRP and procalcitonine are higher in CAP patients, mainly when their disease has a bacterial origin. Since you have not a threshold value reliably demonstrated in large populations with LRT infections or acute respiratory disease, presence or absence of these parameters could only be taken as a slight hint for a CAP diagnosis.
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Affiliation(s)
- C Mayaud
- Service de pneumologie et de réanimation respiratoire, hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
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Mayaud C. [Pneumology, chronic cough and the "Recommendations"]. Rev Pneumol Clin 2006; 62:269. [PMID: 17124459 DOI: 10.1016/s0761-8417(06)75454-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Jankowski R, Périé S, Abitbol P, Bouccara D, Demoly P, Ducrotté P, Marie JP, Masse G, Mayaud C, Vallot T, Van Amerongen AP, Wallaert B, Wierre P. [Definition, prevalence and measurement methods of chronic cough]. Rev Pneumol Clin 2006; 62:291-2. [PMID: 17124465 DOI: 10.1016/s0761-8417(06)75460-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Mayaud C, Wallaert B, Demoly P. [Current understanding of chronic cough appearing in the broncho-pulmonary context]. Rev Pneumol Clin 2006; 62:299-308. [PMID: 17124467 PMCID: PMC7135446 DOI: 10.1016/s0761-8417(06)75462-1] [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] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
La toux est très fréquente au cours de l’asthme. Elle est constante eu cours de la bronchite chronique qu’elle contribue à définir ; habituellement cette bronchite chronique est d’origine tabagique mais l’inhalation de canabis, des expositions professionnelles, la pollution domestique ou atmosphérique, peuvent également être en cause. Au cours de l’asthme et de la bronchite chronique, la toux résulte de l’inflammation et de l’hypersécrétion de la muqueuse bronchique. Chez le fumeur, la toux peut également révéler un cancer bronchique. Parmi les nombreuses autres causes de toux chronique, la dilatation des bronches est habituellement reconnue contrairement à la bronchite à éosinophiles.
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Affiliation(s)
- C Mayaud
- Service de Pneumologie, Hôpital Tenon, 4, rue de la Chine, 75020 Paris.
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Périé S, Abitbol P, Masse G, Mayaud C, Vallot T, Van Amerongen AP. [Diagnostic approach and initial management of cough by general practitioners]. Rev Pneumol Clin 2006; 62:320-9. [PMID: 17124470 DOI: 10.1016/s0761-8417(06)75465-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- S Périé
- Hôpital Tenon, 4, rue de la Chine, 75020 Paris.
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Van Amerongen AP, Masse G, Demoly P, Mayaud C. [Current understanding of chronic cough appearing in another context: allergic, cardiac, medicamentous, neuropsychiatric, and systemic diseases]. Rev Pneumol Clin 2006; 62:315-9. [PMID: 17124469 DOI: 10.1016/s0761-8417(06)75464-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Abstract
We report a case of pheochromocytoma revealed by alveolar hemorrhage in a 51-year-old woman. Pheochromocytomas are rare tumors deriving from the chromaffin tissue, and which clinical manifestations are highly variable, mostly unspecific, and very rarely concern the lung. Therefore, the diagnosis is often missed or delayed. However, without correct diagnosis and subsequently adapted treatment, the disease may be fatal. Thus, clinicians should be aware of the possible diagnosis of pheochromocytoma in patients presenting hemoptysis of an unknown origin.
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Affiliation(s)
- N Bourvis
- Service de Pneumologie, Hôpital Tenon, 4, rue de la Chine, 75970 Paris Cedex 20
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Picard C, Parrot A, Mayaud C, Cadranel J. [Immune mediated intra-alveolar haemorrhage in the adult]. Rev Mal Respir 2006; 23:3S61-73. [PMID: 16604015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
INTRODUCTION The diagnosis of diffuse intra-alveolar haemorrhage (DAH) is suggested by the combination of haemoptysis, anaemia and pulmonary infiltrates. Broncho-alveolar lavage produces macroscopically haemorrhagic fluid and/or haemosiderin laden macrophages. The diagnostic approach should allow distinction between immune mediated and other causes on account of the therapeutic implications. BACKGROUND The main immunological causes are small and medium vessel vasculitis (Wegener's granulomatosis, microscopic polyangeitis), lupus and Goodpasture's syndrome. Other immune disorders are only rarely involved. The association of DAH with an acute glomerulonephritis, indicating the pulmonary-renal syndrome, extra-thoracic involvement and immunological abnormalities suggest an immune aetiology. Immunosuppressant treatment should be started as soon as possible with corticosteroids often combined with intravenous cyclophosphamide. Plasmapharesis is indicated for Goodpasture's syndrome and poorly responding lupus. Aggravating factors such as hypervolaemia and disorders of haemostasis should be searched for and treated. Hospital mortality is close to 20%. VIEWPOINT AND CONCLUSION Immune mediated DAH is a disorder whose rarity justifies the establishment of a national registry with the aim of developing standardised diagnostic and therapeutic strategies.
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Affiliation(s)
- C Picard
- Service de Pneumologie et de Réanimation Respiratoire, Hôpital Tenon, Paris, France
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Savale L, Khalil A, Parrot A, Carette M, Mayaud C, Fartoukh M. Hémoptysies cryptogéniques : épidémiologie descriptive, prise en charge et devenir. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72323-3] [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: 11/26/2022]
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Planquette B, Dujon C, Mayaud C, Faisy C, Petitpretz P. Pleurésies purulentes : existe-t-il des critères prédictifs de l’échec du drainage pleural ? Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72297-5] [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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Messika J, Berkane N, Parrot A, Prigent H, Mayaud C, Fartoukh M. Œdème pulmonaire au cours de la tocolyse par les inhibiteurs calciques. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72311-7] [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: 11/27/2022]
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Mayaud C. [Update on the human form of bird flu]. Rev Pneumol Clin 2005; 61:347-51. [PMID: 16449922 DOI: 10.1016/s0761-8417(05)84862-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
- C Mayaud
- Service de Pneumologie et Réanimation Respiratoire, Hôpital Tenon, 4, rue de la Chine, 75020 Paris.
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Trémolières F, Mayaud C, Mouton Y, Weber P, Dellatolas F, Caulin E. [Efficacy and safety of pristinamycin vs amoxicillin in community acquired pneumonia in adults]. ACTA ACUST UNITED AC 2005; 53:503-10. [PMID: 16181747 DOI: 10.1016/j.patbio.2005.07.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2005] [Accepted: 07/08/2005] [Indexed: 11/27/2022]
Abstract
STUDY OBJECTIVE Evaluation of efficacy and safety of pristinamycin (PRI), compared with amoxicillin (AMX), both at 3 g daily for 7 to 10 days in adults with community-acquired pneumonia (CAP). PATIENTS AND METHODS Multinational, randomized, double blind, double dummy clinical trial of non-inferiority was conducted in 399 patients with a CAP. RESULTS At inclusion, the mean age was 47.8+/-18.3 years, 24.3% patients were 65 or older. The Fine score was < or =III in 85.4% patients. The bacterial etiology was documented in 34.8% of patients: Streptococcus pneumoniae (48.1%), Mycoplasma pneumoniae (18.6%), Haemophilus influenzae (14.7%), Chlamydia pneumoniae (13.2%), Legionella pneumophila (9.3%). In the clinical per-protocol population, the clinical success rate was 87.6% in each group: 149/170 patients (PRI) and 148/169 (AMX); The 95% confidence interval was [-6.61%; 7.23%]. In modified intend to treat population, the clinical success rate was 79.9% (151/189) in the PRI group and 83.0% (151/182) in the AMX group [CI 95% (-10.87%; 4.69%)]. A satisfactory bacteriological response was observed in 82.3% (51/62) of PRI patients and 88.1% (59/67) of AMX patients. Treatment related adverse events occurred similarly in both groups according to the expected tolerance profile of the two drugs. No serious adverse events in both groups were related to the study drugs. CONCLUSIONS In this study, PRI 3 g daily was clinically as effective and well tolerated as AMX 3 g daily, for 7 to 10 days, in PPc, in the treatment of bacterial community-acquired pneumonia.
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Affiliation(s)
- F Trémolières
- Médecine interne-maladies infectieuses, hôpital François-Quesnay, CHG Mantes-La-Jolie, 2 boulevard Sully, 78201 Mantes-La-Jolie cedex, France.
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Costagliola D, Potard V, Duvivier C, Pradier C, Dupont C, Salmon D, Duval X, Billaud E, Boué F, Costagliola D, Duval X, Duvivier C, Enel P, Fournier S, Gasnault J, Gaud C, Gilquin J, Grabar S, Khuong MA, Lang JM, Mary-Krause M, Matheron S, Meyohas MC, Pialoux G, Poizot-Martin I, Pradier C, Rouveix E, Salmon-Ceron D, Sobel A, Tattevin P, Tissot-Dupont H, Yasdanpanah Y, Aronica E, Tirard-Fleury V, Tortay I, Abgrall S, Costagliola D, Grabar S, Guiguet M, Lanoy E, Leneman H, Lièvre L, Mary-Krause M, Potard V, Saidi S, Matheron S, Vildé JL, Leport C, Yeni P, Bouvet E, Gaudebout C, Crickx B, Picard-Dahan C, Weiss L, Tisne-Dessus D, Tarnier-Cochin GH, Sicard D, Salmon D, Gilquin J, Auperin I, Viard JP, Roudière L, Boué F, Fior R, Delfraissy JF, Goujard C, Lesprit P, Jung C, Meyohas MC, Meynard JL, Picard O, Desplanque N, Cadranel J, Mayaud C, Pialoux JF, Rozenbaum W, Bricaire F, Katlama C, Herson S, Simon A, Decazes JM, Molina JM, Clauvel JF, Gerard L, Widal GHLF, Sellier P, Diemer M, Dupont C, Berthé H, Saïag P, Mortier E, Chandemerle C, de Truchis P, Bentata M, Honoré P, Tassi S, Jeantils V, Mechali D, Taverne B, Laurichesse H, Gourdon F, Lucht JF, Fresard A, de Dijon C, de Belfort CH, Faller JP, Eglinger P, Bazin C, Verdon R, de Grenoble C, de Lyon C, Peyramond D, Boibieux A, Touraine JL, Livrozet JM, Trepo C, Cotte L, Ravaux I, Tissot-Dupont H, Delmont JP, Moreau J, Gastaut JA, Poizot-Martin I, Soubeyrand J, Retornaz F, Blanc PA, Allegre T, Galinier A, Ruiz JM, d'Arles CH, d'Avignon CH, Lepeu G, Granet-Brunello P, Pelissier L, Esterni JP, de Martigues CH, Nezri M, Cohen-Valensi R, Laffeuillade A, Chadapaud S, de Nîmes JRCHG, May T, Rabaud C, Raffi F, Billaud E, Pradier C, Pugliese P, Michelet C, Arvieux C, Caron F, Borsa-Lebas F, Lang JM, Rey D, de Mulhouse PFCH, Massip P, Cuzin L, Arlet-Suau E, Legrand MFT, Rangueil CHU, de Tourcoing CH, Yasdanpanah Y, Sobesky M, Pradinaud R, Gaud C, Contant M. Impact of Newly Available Drugs on Clinical Progression in Patients with Virological Failure after Exposure to Three Classes of Antiretrovirals. Antivir Ther 2005. [DOI: 10.1177/135965350501000406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective To study the prognosis of HIV-infected patients with virological failure after exposure to three classes of antiretroviral drugs (ARVs). Design Cohort study. Setting: French Hospital Database on HIV. Patients Patients previously exposed to at least two nucleoside reverse transcriptase inhibitors (NRTIs), two protease inhibitors and one non-NRTI, with viral load (VL) values of >5000 copies/ml after the exposure criteria were met and a new treatment initiated between 1998 and 2001 with VL >5000 copies/ml. Main outcome measures Risk of new AIDS-defining-events (ADEs) or death from first introduction of a drug never used before occurring between 1998 and 2001 defined as baseline. Results The main baseline characteristics of the 1092 patients were: previous ADE in 49% of cases, median CD4 cell count 181 μl, median VL 4.9 log10 copies/ml, median duration of ARV therapy 5.0 years and previous exposure to a median of nine ARVs. The crude progression rates were 20.1/100 patient-years among patients included in 1998, 15.1 in 1999, 11.1 in 2000 and 8.6 in 2001. After adjustment for baseline characteristics, the calendar year of inclusion was associated with the risk of clinical progression ( P<0.001). When the types of newly available drugs used at baseline or during follow-up were introduced into the model, year of inclusion was no longer associated with the risk of clinical progression ( P=0.42), while exposure to amprenavir/r, lopinavir/r, abacavir or tenofovir was associated with a lower risk. Conclusions The clinical prognosis of heavily pretreated patients experiencing virological failure improved between 1998 and 2001, mainly thanks to the use of newly available drugs with more favourable resistance profiles.
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Affiliation(s)
| | | | - Valérie Potard
- INSERM U720, Université Pierre et Marie Curie, Paris, France
| | - Claudine Duvivier
- INSERM U720, Université Pierre et Marie Curie, Paris, France
- CHU Pitié-Salpétrière, AP-HP, Paris, France
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- Hôpital Bichat-Claude Bernard
| | | | | | | | | | - L Weiss
- Hôpital Européen Georges Pompidou
| | | | | | - D Sicard
- Hôpital Européen Georges Pompidou
| | - D Salmon
- Hôpital Européen Georges Pompidou
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Mayaud C, Fartoukh M, Prigent H, Lavolé A, Gounand V, Parrot A. [Acute forms of diffuse interstitial hypoxemic pneumonia in immunocompetent patients]. Rev Pneumol Clin 2005; 61:70-7. [PMID: 16012360 DOI: 10.1016/s0761-8417(05)84792-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The large majority of patients with acute respiratory failure present diffuse pulmonary opacities resulting from pulmonary embolism, intra-alveolar hemorrhage, or a classical cause of ARDS. In a small number of patients however, these opacities correspond to diffuse interstitial pneumonia. This should be suspected in light of the context, the time of formation, and the unusual respiratory and/or extrarespiratory signs. If there is a clinical doubt, thoracic scan and bronchoalveolar lavage should be performed together with infectious and immunology tests. Treatment depends on the cause and/or the type of lesion.
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Affiliation(s)
- C Mayaud
- Service de Pneumologie et de Réanimation Respiratoire, Hôpital Tenon, 4 rue de la Chine, 75970 Paris.
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Mayaud C, Souidi A, Fartoukh M, Parrot A. [How far should we go in reducing the length of antibiotic therapy for community-acquired pneumonia?]. Rev Pneumol Clin 2005; 61:61-6. [PMID: 16012359 DOI: 10.1016/s0761-8417(05)84791-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- C Mayaud
- Service de Pneumologie et de Réanimation Respiratoire, Hôpital Tenon, 4 rue de la Chine, 75970 Paris.
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Milleron B, Gounant V, Lavole A, Mayaud C. [Current diagnostic approach for pulmonary nodules]. Rev Pneumol Clin 2005; 61:3-5. [PMID: 15772573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- B Milleron
- Service de Pneumologie, CancerEst, Hôpital Tenon, 4, rue de la Chine, 75970 Paris Cedex 20.
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Freymuth F, Vabret A, Gouarin S, Petitjean J, Charbonneau P, Lehoux P, Galateau-Salle F, Tremolières F, Carette MF, Mayaud C, Mosnier A, Burnouf L. [Epidemiology and diagnosis of respiratory syncitial virus in adults]. Rev Mal Respir 2004; 21:35-42. [PMID: 15260036 PMCID: PMC7135519 DOI: 10.1016/s0761-8425(04)71233-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction Le virus respiratoire syncytial (VRS) est rarement recherché dans les infections respiratoires de l’adulte. Ce travail en étudie la fréquence et le diagnostic. Méthodes Trois enquêtes distinctes ont été menées chez des adultes atteints soit d’un syndrome pseudo-grippal, d’une infection respiratoire basse communautaire ou hospitalisés pour une pneumopathie infectieuse grave. La recherche du VRS a été faite par PCR dans tous les cas et comparée à la détection antigénique et la culture dans deux enquêtes. Résultats Le VRS est identifié chez 20 (11,7 %) des 170 adultes vaccinés contre la grippe atteints d’un syndrome pseudo-grippal. Dans 270 infections respiratoires basses communautaires sans signes de gravité on trouve un virus dans 86 (31,8 %) cas, dont 13 VRS (4,8 %) ; un virus est détecté dans 64 (36,7 %) des 164 bronchites aiguës : 11 VRS (6,3 %), 37 rhinovirus (21,3 %), 5 virus influenza A et B, et 12 autres virus ; dans les 60 bronchites chroniques surinfectées, il y a 9 rhinovirus (15 %), 2 virus parainfluenza 3 et aucun VRS ; dans les 21 pneumopathies infectieuses aiguës, on trouve 1 VRS, 1 virus influenza A et 2 rhinovirus, et dans les 11 cas d’infections respiratoires basses sur poumon pathologique, 1 VRS, 1 virus parainfluenza 3 et 4 rhinovirus ; il y a au total 19 infections bactériennes et virales associées. Enfin, dans les 51 pneumopathies infectieuses avec détresse respiratoire hospitalisées en réanimation, un virus est isolé dans 17 (33,3 %) cas : 3 VRS (5,8 %), 6 virus influenza A, 3 rhinovirus, 2 adénovirus, 2 herpes simplex et un CMV ; il y a 6 infections bactériennes associées dont 4 d’origine nosocomiale. Tous les patients infectés par le VRS sont âgés et présentent un facteur de risque respiratoire ou cardiaque. Conclusions Chez l’adulte le VRS est responsable de fréquents syndromes pseudo-grippaux et parfois d’infections respiratoires basses, qui peuvent être graves et qu’il faut penser à rechercher. La technique PCR est particulièrement efficace mais non disponible en routine.
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Affiliation(s)
- F Freymuth
- Laboratoire de Virologie Humaine et Moléculaire, Service de Réanimation Médicale, CHU Caen, France.
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Wislez M, Philippe C, Antoine M, Rabbe N, Moreau J, Bellocq A, Mayaud C, Milleron B, Soler P, Cadranel J. Upregulation of bronchioloalveolar carcinoma-derived C-X-C chemokines by tumor infiltrating inflammatory cells. Inflamm Res 2004; 53:4-12. [PMID: 15021975 DOI: 10.1007/s00011-003-1215-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2003] [Accepted: 08/19/2003] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE AND DESIGN The presence of increased numbers of tumor-infiltrating neutrophils is associated with poorer outcome in patients with adenocarcinoma of the bronchioloalveolar (BAC) subtype. We evaluated the role of inflammatory environment on C-X-C chemokine tumor production. MATERIALS Bronchoalveolar lavage from 31 consecutive patients with adenocarcinoma of the BAC subtype as well as tumor and normal pulmonary tissue samples. A549 BAC cell line. Peripheral blood mononuclear cells (PBMC), polymorphonuclear neutrophils (PMN) and alveolar macrophages (AM). METHODS Elisa measurements and immunohistochemical studies of ENA-78, IL-8, IL-1beta and TNF-alpha. RNA isolation, reverse transcription, and PCR amplification of ENA-78 and IL-8. RESULTS C-X-C peptides were expressed by tumor cells of all the tumor specimens tested. ENA-78 and IL-8 were also expressed by AM. To better understand the regulation of the C-X-C production, BAC cell line was cultured alone or with inflammatory cells. PBMC upregulated both tumor ENA-78 and IL-8 mRNA expression and protein release whereas AM only upregulated ENA-78 mRNA expression and protein release; PMN had no effect. Anti-human IL-1beta antibodies (ab) inhibited the A549 ENA-78 and IL-8 production stimulated by PBMC-CM. Anti-human TNF-alpha ab inhibited A549 ENA-78 production stimulated by AM-CM. IL-1beta and TNF-alpha were expressed in vivo by inflammatory cells, although TNF-alpha was also expressed by tumor cells. CONCLUSIONS This work emphasizes the role of the host inflammatory response in promoting tumor growth in vivo.
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Affiliation(s)
- M Wislez
- Service de Pneumologie et de Réanimation Respiratoire, AP-HP, Hôpital Tenon, 4 rue de la chine, 75020 Paris, France
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Fartoukh M, Louis L, Parrot A, Khalil A, Cadranel J, Mayaud C. 14 Epidémiologie, prise en charge et devenir des hémoptysies en réanimation respiratoire. Rev Mal Respir 2004. [DOI: 10.1016/s0761-8425(04)71640-x] [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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Plantier L, Saidi F, Choukroun G, Boussaud V, Parrot A, Bazelly B, Mayaud C. [Moderately abundant hemoptysis revealing endobronchial hamartochondroma]. Rev Pneumol Clin 2003; 59:49-51. [PMID: 12717327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Hemoptysis is rarely the inaugural sign of endobronchial hamartoma. Abundance may range from moderate to massive, and may be life-threatening. We report the case of a 44-year-old woman who was referred to our center with moderate and persistent hemoptysis. A left upper lobe lobectomy was performed. We discuss the therapeutic options in such cases.
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Affiliation(s)
- L Plantier
- Service de Pneumologie et de Réanimation Respiratoire, Hôpital Tenon, 4, rue de la Chine, 75020 Paris Cedex 20
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Latouche S, Lacube P, Maury E, Bolognini J, Develoux M, Girard PM, Godet C, Lebrette MG, Mayaud C, Guillot J, Roux P. Pneumocystisjiroveciidihydropteroate synthase genotypes in French patients with pneumocystosis: a 1998–2001 prospective study. Med Mycol 2003; 41:533-7. [PMID: 14725329 DOI: 10.1080/13693780310001615394] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Dihydropteroate synthase gene (DHPS) mutations at codons 55 and 57 have been associated with sulfa/sulfone resistance in Pneumocystis jirovecii strains from patients who previously received prophylaxis. To evaluate the prevalence of these mutations, a portion of P. jirovecii DHPS gene was analysed using PCR combined with restriction fragment length polymorphism (RFLP) analysis in 92 bronchoalveolar fluid samples collected between January 1998 and September 2001 from French patients with pulmonary pneumocystosis (PCP). Seventy-six samples contained the wild-type DHPS genotype (82.6%) and 16 contained a mutant genotype (17.4%). Twelve out of the 16 isolates with a mutant DHPS genotype corresponded to patients who had never received sulfa or sulfone prophylaxis, suggesting that DHPS mutants may be acquired de novo. There was no significant difference in favourable or adverse outcome in PCP caused by the wild or mutant DHPS genotypes (P = 0.34).
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Affiliation(s)
- S Latouche
- Service de Parasitologie-Mycologie, UFR Saint-Antoine, Paris, France
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Wislez M, Mayaud C, Cadranel J. [AIDS and the lung at the era of highly active antiretroviral therapies]. Rev Mal Respir 2002; 19:675-9. [PMID: 12524483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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Abstract
In human immunodeficiency virus (HIV)-infected patients, bacterial lower respiratory tract infections are the most frequent respiratory diseases. They are frequently the first clinical manifestation of HIV infection. The incidence and severity of bacterial lower respiratory tract infections increase with the degree of immunosuppression. At the acquired immune deficiency syndrome (AIDS) stage, the responsible bacteria and clinical presentation may be atypical. Bacterial pneumonia may be fatal, particularly in AIDS patients, and its occurrence is predictive of a reduced survival time. Pneumococcal vaccine is recommended in patients with a CD4 T-lymphocyte count of > 200 cells mm(-3) and cotrimoxazole (trimethoprim/sulfamethoxazole) in patients with a CD4 T-lymphocyte count of < 200 cells x mm(-3). Unfortunately, such prophylaxis remains insufficiently prescribed and its protective effect is limited. Highly active antiretroviral treatment has dramatically reduced the incidence of lower respiratory tract infection due to Pseudomonas aeruginosa and opportunistic bacteria. In contrast, successful highly active antiretroviral therapy slightly decreased the risk of bacterial pneumonia due to usual bacteria, even in patients on successful highly active antiretroviral therapy.
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Affiliation(s)
- C Mayaud
- Respiratory Division, Tenon Hospital, Paris, France.
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Mayaud C, Cadranel J, Parrot A, Milleron B. [When should surgical lung biopsy be proposed for patients with diffuse infiltrating lung disease?]. Rev Pneumol Clin 2002; 58:3-8. [PMID: 11981498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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