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Combret Y, Prieur G, Medrinal C. Validity and reliability of the one-minute sit-to-stand test for the measurement of cardio-respiratory responses in children with cystic fibrosis. Authors' reply. Pulmonology 2023; 29:174-175. [PMID: 36274048 DOI: 10.1016/j.pulmoe.2022.08.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 08/18/2022] [Accepted: 08/20/2022] [Indexed: 03/04/2023] Open
Affiliation(s)
- Y Combret
- Physiotherapy Department, Le Havre Hospital, Le Havre 76600, France; Paris-Saclay University, UVSQ, Erphan, Versailles 78000, France.
| | - G Prieur
- Physiotherapy Department, Le Havre Hospital, Le Havre 76600, France; Research and Clinical Experimentation Institute (IREC), Pulmonology, ORL and Dermatology, Louvain Catholic University, Brussels 1200, Belgium; Institute for Research and Innovation in Biomedicine (IRIB), Normandie University, UNIROUEN, UPRES EA3830 - GRHV, Rouen 76000, France
| | - C Medrinal
- Physiotherapy Department, Le Havre Hospital, Le Havre 76600, France; Paris-Saclay University, UVSQ, Erphan, Versailles 78000, France; Saint Michel School of Physiotherapy, Paris 75015, France
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Beaumont M, Latiers AC, Prieur G. [The role of the physiotherapist in the assessment and management of dyspnea]. Rev Mal Respir 2023; 40:169-187. [PMID: 36682956 DOI: 10.1016/j.rmr.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/20/2022] [Indexed: 01/21/2023]
Abstract
The role of the physiotherapist in the assessment and management of dyspnea. Dyspnea is the most common symptom in cardio-respiratory diseases. Recently improved comprehension of dyspnea mechanisms have underlined the need for three-faceted assessment. The three key aspects correspond to the "breathing, thinking, functioning" clinical model, which proposes a multidimensional - respiratory, emotional and functional - approach. Before initiating treatment, it is essential for several reasons to assess each specific case, determining the type of dyspnea affecting the patient, appraising the impact of shortness of breath, and estimating the effectiveness of the treatment applied. The physiotherapist has a major role to assume in the care of dyspneic patients, not only in assessment followed by treatment but also as a major collaborator in a multidisciplinary team, especially with regard to pulmonary rehabilitation. The aim of this review is to inventory the existing assessment tools and the possible physiotherapies for dyspnea, using a holistic approach designed to facilitate the choice of techniques and to improve quality of care by fully addressing the patient's needs.
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Affiliation(s)
- M Beaumont
- Service de réadaptation respiratoire, Centre Hospitalier des Pays de Morlaix, Morlaix, France; Inserm, Univ Brest, CHRU Brest, UMR 1304, GETBO, Brest, France.
| | - A C Latiers
- Service ORL, Stomatologie et Soins Continus, Cliniques universitaires Saint-Luc, 1200 Brussels, Belgique
| | - G Prieur
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Groupe de Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, 1200 Brussels, Belgique; Université de Normandie, UNIROUEN, EA3830-GRHV, 76000 Rouen, France; Groupe Hospitalier du Havre, Service de pneumologie et de réadaptation respiratoire, avenue Pierre Mendes France, 76290 Montivilliers, France; Institut de Recherche et Innovation en Biomédecine (IRIB), 76000 Rouen, France
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Smondack P, Gravier FÉ, Prieur G, Repel A, Muir JF, Cuvelier A, Combret Y, Medrinal C, Bonnevie T. [Physiotherapy and COVID-19. From intensive care unit to home care-An overview of international guidelines]. Rev Mal Respir 2020; 37:811-822. [PMID: 33067078 PMCID: PMC7552976 DOI: 10.1016/j.rmr.2020.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/17/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The new coronavirus disease 2019 (COVID-19) is responsible for a global pandemic and many deaths. This context requires an adaptation of health systems as well as the role of each healthcare professional, including physiotherapists. STATE OF THE ART In order to optimize the management of people with COVID-19, many savant societies published guidelines about physiotherapy interventions within the crisis but none offered a global overview from the intensive care unit to home care. Therefore, the aim of this review is to offer an overview of recommended physiotherapy interventions in order to facilitate the management of these patients, whatever the stage of the disease. PERSPECTIVES Owing to the emergent character of the COVID-19, actual guidelines will have to be adjusted according to the evolution of the pandemic and the resources of the hospital and liberal sectors, in particular for the long-term follow-up of these patients. Current and future research will aim to assess the effectiveness of physiotherapy interventions for people with COVID-19. CONCLUSION The emergence of COVID-19 required a very rapid adaptation of the health system. The role of physiotherapists is justified at every stage of patients care in order to limit the functional consequences of the disease.
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Affiliation(s)
- P Smondack
- ADIR Association, 147, avenue du Maréchal-Juin, 76230 Bois-Guillaume, France.
| | - F-É Gravier
- ADIR Association, 147, avenue du Maréchal-Juin, 76230 Bois-Guillaume, France; UPRES EA 3830 (GRHV), institut de recherche et d'innovation biomédicale de Haute-Normandie, Normandie université UNIROUEN, Rouen, France
| | - G Prieur
- UPRES EA 3830 (GRHV), institut de recherche et d'innovation biomédicale de Haute-Normandie, Normandie université UNIROUEN, Rouen, France; Unité de soins intensifs, groupe hospitalier du Havre, Montivilliers, France
| | | | - J-F Muir
- UPRES EA 3830 (GRHV), institut de recherche et d'innovation biomédicale de Haute-Normandie, Normandie université UNIROUEN, Rouen, France; Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, centre hospitalier universitaire de Rouen, Rouen, France
| | - A Cuvelier
- UPRES EA 3830 (GRHV), institut de recherche et d'innovation biomédicale de Haute-Normandie, Normandie université UNIROUEN, Rouen, France; Service de pneumologie, oncologie thoracique et soins intensifs respiratoires, centre hospitalier universitaire de Rouen, Rouen, France
| | - Y Combret
- Unité de soins intensifs, groupe hospitalier du Havre, Montivilliers, France; Institut de recherche expérimentale et clinique, université Catholique de Louvain, Bruxelles, Belgique
| | - C Medrinal
- UPRES EA 3830 (GRHV), institut de recherche et d'innovation biomédicale de Haute-Normandie, Normandie université UNIROUEN, Rouen, France; Unité de soins intensifs, groupe hospitalier du Havre, Montivilliers, France
| | - T Bonnevie
- ADIR Association, 147, avenue du Maréchal-Juin, 76230 Bois-Guillaume, France; UPRES EA 3830 (GRHV), institut de recherche et d'innovation biomédicale de Haute-Normandie, Normandie université UNIROUEN, Rouen, France
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Medrinal C, Combret Y, Prieur G, Robledo Quesada A, Bonnevie T, Gravier F, Frenoy E, Contal O, Lamia B. Comparaison des techniques de réhabilitation précoce pour patients alités en réanimation : effets cardio-respiratoires, hémodynamiques et musculaires. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.094] [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: 11/29/2022]
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Medrinal C, Prieur G, Combret Y, Robledo-Quesada A, Debeaumont D, Quieffin J, Contal O, Lamia B. Comparaison de la consommation en métabolique en oxygène des patients BPCO sur cycloergomètre synchronisé ou non à une stimulation électrique fonctionnelle. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Medrinal C, Prieur G, Contal O, Villiot-Danger E, Doyle C, Reychler G, Quieffin J. Non-invasive ventilation: evaluation of CO2 washout by intentional leaking in three recent oronasal masks. A pilot study. Minerva Anestesiol 2015; 81:526-532. [PMID: 25317575] [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: 06/04/2023]
Abstract
BACKGROUND Many types of interfaces with intentional leaks exist for Non Invasive Ventilation. The purpose of intentional leaks is to remove CO2 from the interface, however the calibration does not allow a sufficiently large flow and rebreathing of CO2 can occur. The aim of this study was to compare the CO2 rinsing capacities of three new generation oronasal masks with intentional leaks (A: Quattro®, [Resmed]; B: Amara® [Respironics]; C: Forma® [Fisher&Paykel]) in healthy subjects. METHODS Seventeen healthy volunteers were included in this prospective cross-sectional, randomized, double-blinded trial. Each subject underwent ventilation with a home ventilator (IPAP: 14 cmH2O; EPAP: 4 cmH2O) with each mask consecutively. Transcutaneous capnography (PtcCO2) recordings were carried out throughout the trial and ventilator data (tidal volume, respiratory rate, minute ventilation and unintentional leaks) were also analyzed. Mask comfort was assessed using a visual analog scale (0 to 10). RESULTS The results showed no differences in PtcCO2 between masks (P=0.82). There were no significant differences in respiratory parameters (tidal volume, P=0.79; respiratory rate, P=0.65; minute ventilation, P=0.12) between masks. The rate of unintentional leaks were significantly lower for Mask A (P=0.016). Subjects rated Mask A and Mask C as more comfortable than Mask B (P=0.041). CONCLUSION There was no effect of mask on PtcCO2 in healthy subjects. The mask with the highest comfort rating had not the lowest rate of unintentional leaks.
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Affiliation(s)
- C Medrinal
- Groupe Hospitalier du Havre, Service de Pneumologie, Montivilliers, France -
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Bru P, Lauribe P, Rouane A, Nadi M, Prieur G, Ricard P, De CC, Aliot E, Lévy S. Catheter ablation using very high frequency current: effects on the atrioventricular junction and ventricular myocardium in sheep. Europace 2002; 4:69-75. [PMID: 11846319 DOI: 10.1053/eupc.2001.0205] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Radiofrequency ablation is currently used in the treatment of various cardiac arrhythmias. However, this technique is limited by impedance rise, leading to coagulum formation and desiccation of tissue. We developed a new generator, providing very high frequency (27 MHz) current, which is in the intermediate range between radiofrequency and microwave energy. The aim of this study was to evaluate the results for catheter ablation of the atrioventricular junction and characteristics of the lesions obtained at ventricular sites. METHODS AND RESULTS The generator was coupled to a specially designed 7-French coaxial catheter. The study included experiments performed on 10 sheep (Wt. 31- 42 kg). In seven sheep, the catheter was introduced into the femoral vein and advanced across the tricuspid annulus to record the largest possible His electrogram. VHF current was applied for 25 s, with increasing energies. The energy needed to obtain complete atrioventricular (AV) block ranged from 60 to 100 Watts. Six animals were observed for 6 to 21 days. Complete AV block was found to be persistent. In those seven sheep in whom AV junction was ablated and in three additional sheep, the ablation catheter was positioned toward the right ventricular apex using the same approach and into the left ventricle via the femoral artery, and 20 to 90 Watts energy was delivered in order to assess the size of the induced lesions. Side effects included ventricular tachycardia degenerating into ventricular fibrillation in six cases, but the same effect was observed in this animal model with radiofrequency energy. No cardiac perforation was noted. No thrombus was observed at the catheter tip. The size of the lesion ranged from 3 to 45 mm in width and 1 to 15 mm in depth. CONCLUSIONS Catheter ablation using VHF current is feasible and appears effective in producing stable AV block when applied at the AV junction and results in substantial myocardial lesions. Further studies are needed to define its clinical interest and side effects.
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Affiliation(s)
- P Bru
- Division of Cardiology, Hĵpital Nord, University of Marseille, School of Medicine, France
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Rouane A, Nadi M, Bru P, Staiquly A, Kourtiche D, Hedjiedj A, Prieur G. Intracardiac high-frequency catheter ablatherapy: technical aspects. Med Eng Phys 1995; 17:36-41. [PMID: 7704342 DOI: 10.1016/1350-4533(95)90375-l] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Arrhythmia and conduction disorders can be treated by intracardiac ablation. The paper presents an original intracardiac catheter ablation method using a high-frequency (HF) electromagnetic power source. A high-frequency signal is emitted through an electrophysiological catheter introduced into the femoral vein and passed along the course of that vein into the heart. To prevent impedance rise, a problem encountered with other techniques, HF signal wave trains are used for half-period impedance match control and, where necessary, automatic impedance adjustment. Fully automated impedance matching combined with frequency-specific catheter design prevents power reflection between load and source. Resulting lesions can be controlled as to location, area and depth. In addition, HF pulses can be released independently of cardiac rhythm. Additional comprehensive animal experimentation is currently going forward.
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Affiliation(s)
- A Rouane
- LIEN Université de Nancy, Vandoevure-les Nancy, France
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Brunotte F, Prieur G, Hueber A, Hennequin L, Walker PM, Aliot E, Robert J, Bernadac P, Gilgenkrantz JM. Improved subtraction technique in intravenous digital left ventriculography: comparison with radionuclide studies. Int J Cardiol 1990; 28:237-43. [PMID: 2394526 DOI: 10.1016/0167-5273(90)90066-e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Adequate processing of left ventricular angiograms depends on the visualisation of all segments of the ventricular wall. At the same time, subtraction of different images can enhance different heart segments but commercially available methods do not allow simultaneous viewing of several images masked by different processes. Using our software, for each studied frame, a four quadrant display permits the simultaneous visualisation of a mask mode image, a diastolic-systolic difference image, an image obtained by subtraction of a frame at the same cycle time and a composite mask subtracted image. The composite mask image is obtained by weighting three images according to videodensitometric measurements by reference to previously acquired data. This method facilitates contour delineation and computation of the ejection fraction by area-length method. Correlation with radionuclide estimates of left ventricular ejection fraction is higher (n = 60, r = 0.90, SEE = 8%) than using the classical mask mode display (n = 60, r = 0.82, SEE = 11%). In a subgroup of 30 patients the contrast medium was injected in an antecubital vein and the correlation coefficient remained satisfactory (n = 30, r = 0.89, SEE = 7%) when compared with the classical subtraction technique (n = 30, r = 0.70, SEE = 12%). We therefore conclude that the composite mask method gives comparatively similar values for left ventricular ejection fraction to those acquired by radionuclide angiography.
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Affiliation(s)
- F Brunotte
- Department of Cardiology, Hôpital Central, Nancy, France
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Abstract
A practical interstitial capacitive method of heating using thin flexible coated electrodes operating at 27.12 MHz is described. Advantages compared to classical interstitial methods are: uniform heating, control of the inserted length, compatibility with curie therapy, simplicity and low cost. The electrode geometry could be designed according to tumour site and volume. Restriction of longitudinal heating to a part of the wire is also possible. A simple matching circuit can be connected to the active wires to obtain a standing wave ratio (SWR) of less than 1.5. Individual power regulation of the electrode should be used and is feasible at this frequency. Numerical, experimental and clinical results demonstrate the practical value of this method.
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Affiliation(s)
- C Marchal
- Centre Alexis Vautrin, Radiotherapy Department, Vandoeuvre les Nancy, France
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Hueber A, Brunotte F, Hennequin L, Bernadac P, Prieur G, Tosser A, Robert J, Gilgenkrantz JM. [Value of digital subtraction of left ventriculographies by the venous route. Comparison with balanced scintigraphy of the heart cavities]. Ann Cardiol Angeiol (Paris) 1989; 38:293-6. [PMID: 2667441] [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: 01/02/2023]
Abstract
The development of numerisation material in radiology currently permits to perform usual cardiovascular tests. The authors report a series of 48 patients who benefited from the determination by numerised left ventriculography, of their stroke volume (SV). In 37 cases, the peripheral venous route is used while in 11 cases the central venous route is used, in the pulmonary artery trunk. The SV values obtained with both methods (one advocated by the manufacture and another one developed by the authors), are correlated with the SV values obtained with the isotopic method, used as reference. The correlations are satisfactory, approximately 0.79 for all patients of the study, and markedly improve when the injection of the contrast material is performed in the pulmonary artery (approximately 0.95). The authors conclude that determination of the left ventricle SV by numerisation is an interesting technique in centers where there is no department of nuclear medicine, and is absolutely necessary to complement right catheterisation.
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Affiliation(s)
- A Hueber
- Service de Radiologie, Hôpital Central, CHRU, Nancy
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Barritault L, Dubois F, Prieur G, Limoge A. [Electrical anesthesia. Mathematical approach to currents used (1)]. Inf Dent 1982; 64:3929-36. [PMID: 6963257] [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: 01/22/2023]
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