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Chevereau-Choquet M, Thoreau B, Taillé C, Marchand-Adam S, Morel H, Plantier L, Portel L. Smoking, Urban Housing and Work-Aggravated Asthma are Associated with Asthma Severity in a Cross-Sectional Observational Study. J Asthma Allergy 2024; 17:69-79. [PMID: 38318088 PMCID: PMC10840413 DOI: 10.2147/jaa.s424546] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/02/2023] [Indexed: 02/07/2024] Open
Abstract
Purpose Severe asthma affects 5 to 10% of asthmatics and accounts for a large part of asthma-related morbidity and costs. The determinants of asthma severity are poorly understood. We tested the hypothesis that asthma severity was associated with 1) atopy and allergy and 2) markers associated with environmental exposure. Patients and Methods Data from the FASE-CPHG study, a cross-sectional, observational, multicenter investigation, were analyzed to identify markers associated with asthma severity. Asthma severity was gauged using the ASSESS score, encompassing symptom control, exacerbations, FEV1 and therapeutic load. Bivariate and multivariate analyses were used to identify patient characteristics associated with the ASSESS score. Results The analysis involved 948 patients, with 592 women, of which 447 patients (47%) had severe asthma. Among these, 491 patients (52%) had at least one positive aeroallergen skin prick test and 525 (55%) had at least one allergic disease among atopic dermatitis, chronic rhinitis and food allergy. The mean±SD ASSESS score was 11.2±3.4. Characteristics associated with a higher ASSESS score were female sex, secondary or lower education, unemployed occupational status, smoking, work-aggravated asthma and urban housing. There was no association between the ASSESS score and allergic diseases, aeroallergen-specific skin prick tests and IgEs, or blood eosinophil counts. Conclusion While atopy and allergy were frequent among asthmatics, neither was associated with asthma severity. Modifiable environmental factors such as smoking, urban housing and work-aggravated asthma were independently associated with asthma severity.
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Affiliation(s)
- Marie Chevereau-Choquet
- Service de Pneumologie et Explorations Fonctionnelles Respiratoires, CHRU de Tours, Tours, France
| | - Benjamin Thoreau
- Service de Médecine Interne, National Referral Center for Rare Systemic Autoimmune Diseases, AP-HP, Hôpital Cochin, Paris, France
- Inserm U1016, CNRS UMR8104, Université Paris Cité, Institut Cochin, Paris, France
| | - Camille Taillé
- Service de Pneumologie A, AP-HP Nord, Hôpital Bichat Claude Bernard, Paris, France
- Inserm U1152, Université Paris Cité, Paris, France
| | - Sylvain Marchand-Adam
- Service de Pneumologie et Explorations Fonctionnelles Respiratoires, CHRU de Tours, Tours, France
- CEPR, Inserm UMR1100, Université de Tours, Tours, France
| | - Hugues Morel
- Service de Pneumologie, CHR d’Orléans, Orléans, France
| | - Laurent Plantier
- Service de Pneumologie et Explorations Fonctionnelles Respiratoires, CHRU de Tours, Tours, France
- CEPR, Inserm UMR1100, Université de Tours, Tours, France
| | - Laurent Portel
- Service de Pneumologie, Centre Hospitalier Robert Boulin, Libourne, France
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2
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Dhamelincourt E, Descourt R, Rousseau-Bussac G, Doubre H, Decroisette C, Demontrond P, Le Garff G, Falchero L, Huchot E, Vieillot S, Corre R, Kazulinski L, Bizieux A, Bigay-Gamé L, Morel H, Molinier O, Chouaïd C, Guisier F. Clinical Characteristics of Patients with Advanced ALK-Translocated Non-small Cell Lung Cancers and Long-Term Responses to Crizotinib (CRIZOLONG GFPC 05-19 Study). Target Oncol 2023; 18:905-914. [PMID: 37966566 DOI: 10.1007/s11523-023-01014-z] [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] [Accepted: 10/21/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Although ALK-translocated (ALK+) advanced non-small cell lung cancers (aNSCLCs) are currently treated with second- or third-generation ALK inhibitors (ALK-TKIs), some patients respond durably to the first-generation ALK-TKI crizotinib. OBJECTIVE This study aimed to describe the clinical characteristics of these long-term responders. PATIENTS AND METHODS This national, multicenter, retrospective, non-interventional study included patients with ALK+ aNSCLCs and long-term responses to first (L1)- or subsequent (≥ L2)-line crizotinib, defined, respectively, as treatments lasting > 18 and > 10 months. Median treatment duration (mDOT) was the primary endpoint. RESULTS A total of 85 patients (32 L1 and 53 ≥ L2 responders) from 23 centers were included (receiving crizotinib between 10/24/2011-10/02/2018): median age of 59 years, 83.6% non-smokers or ex-smokers, 85.9% performance status (PS) 0/1, 94.1% with adenocarcinomas, median of one metastatic site, and 22.4% with brain metastases (BMs). After median follow-up of 73.4 [95% confidence interval, 67.5-79.9] months, respective L1 and ≥ L2 mDOTs were 43.3 [26.7-56.8] and 29.6 [22.6-35.8] months, with overall survival (OS) not reached (NR) and 116.2 [83.4-NR] months. BM presence or absence did not affect mDOT (31.4 versus 32.9 months) but significantly impacted median OS (70.6 versus 158.6 months; p = 0.0008). Progression on crizotinib was paucisymptomatic (74.1%) and oligometastatic (34.8%), especially BMs (42.4%). After crizotinib discontinuation, 65 (76.5%) patients received subsequent systemic therapy: 57 (67.1%) with second-generation ALK-TKIs. Respective mDOTs of first- and second-line post-crizotinib ALK-TKIs lasted 19.4 [14.9-25.6] and 11.1 [4.8-17.9] months, respectively. CONCLUSIONS Most ALK+ aNSCLC patients with prolonged crizotinib efficacy had paucisymptomatic and oligometastatic disease without BMs. They subsequently benefited from a sequential strategy with other ALK-TKIs.
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Affiliation(s)
| | - Renaud Descourt
- Institut de Cancérologie, Hôpital Morvan, CHU de Brest, Brest, France
| | | | - Hélène Doubre
- Service d'Oncologie Thoracique, Hôpital Foch, Suresnes, France
| | | | | | | | - Lionel Falchero
- Service de Pneumologie, Hôpital Nord-Ouest de Villefranche-sur-Saône, Gleizé, France
| | - Eric Huchot
- Service de Pneumologie, CHU Saint-Pierre, La Réunion, France
| | - Sabine Vieillot
- Service d'Oncologie, Clinique Saint Pierre, Perpignan, France
| | - Romain Corre
- Service de Pneumologie, CH Quimper, Quimper, France
| | - Laure Kazulinski
- Service de Pneumologie, CH du Cotentin Cherbourg, Cherbourg, France
| | - Acya Bizieux
- Service de Pneumologie, CH La Roche-sur-Yon, La Roche-sur-Yon, France
| | | | - Hugues Morel
- Service de Pneumologie, CH Orléans, Orléans, France
| | | | - Christos Chouaïd
- Service de Pneumologie, Centre Hospitalier Intercommunal, Créteil, France
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3
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Calcaianu G, Degoul S, Michau B, Payen T, Gschwend A, Fore M, Iamandi C, Morel H, Oster JP, Bizieux A, Nocent-Ejnaini C, Carvallo C, Romanet S, Goupil F, Leurs A, Legrand MG, Portel L, Claustre J, Calcaianu M, Bresson D, Debieuvre D. Mid-term pulmonary sequelae after hospitalisation for COVID-19: The French SISCOVID cohort. Respir Med Res 2022; 82:100933. [PMID: 35905553 PMCID: PMC9192129 DOI: 10.1016/j.resmer.2022.100933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/28/2022] [Accepted: 06/04/2022] [Indexed: 01/08/2023]
Abstract
Background Methods Results Conclusion
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4
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Debieuvre D, Molinier O, Falchero L, Locher C, Templement-Grangerat D, Meyer N, Morel H, Duval Y, Asselain B, Letierce A, Trédaniel J, Auliac JB, Bylicki O, Moreau L, Fore M, Corre R, Couraud S, Cortot A. Lung cancer trends and tumor characteristic changes over 20 years (2000–2020): Results of three French consecutive nationwide prospective cohorts’ studies. Lancet Reg Health Eur 2022; 22:100492. [PMID: 36108315 PMCID: PMC9445429 DOI: 10.1016/j.lanepe.2022.100492] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Long-term changes in lung cancer (LC) patients are difficult to evaluate. We report results from the French KBP-2020 real-life cohort. Methods KBP-2020 was a prospective cohort that included all patients diagnosed with LC in 2020, in nonacademic public hospital in France. Patient and tumour characteristics were described and compared with similarly designed cohorts in 2000 and 2010. Findings In 2020, 82 centers included 8,999 patients diagnosed with LC. The proportion of women increased: 34·6% (3114/8999) compared to, 24·3% (1711/7051) and 16·0% (904/5667) in 2010 and 2000 (p<0·0001). The proportion of non-smokers was higher in 2020 (12·6%, 1129/8983) than in previous cohorts (10·9% (762/7008) in 2010; 7·2% (402/5586) in 2000, p<0·0001). In 2020, at diagnosis, 57·6% (4405/7648) of patients had a metastatic/disseminated stage non-small-cell lung cancer (NSCLC) (58·3% (3522/6046) in 2010; 42·6% (1879/4411) in 2000, p<0·0001). Compared with 2000 and 2010 data, early survival improved slightly. In 2020, 3-month mortality of NSCLC varied from 3·0% [2·2 – 3·8] for localized to 9·6% [8·1 – 11·0] for locally advanced to 29·2% [27·8 – 30·6] for metastatic and was 24·8% [22·3 – 27·3] for SCLC. Interpretation To our knowledge KBP cohorts have been the largest, prospective, real-world cohort studies involving LC patients conducted in worldwide. The trend found in our study shows an increase in LC in women and still a large proportion of patients diagnosed at metastatic or disseminated stage. Funding The study was promoted by the French College of General Hospital Pulmonologists with financial support of industrials laboratories.
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Affiliation(s)
- Didier Debieuvre
- Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Emile Muller, Mulhouse, France
- Corresponding author at: Service de Pneumologie, GHRMSA, Hôpital Emile Muller, 20 rue du Dr Laënnec, BP 1370, 68070 Mulhouse CEDEX, France.
| | - Olivier Molinier
- Respiratory Medicine Department, Centre Hospitalier Le Mans, Le Mans, France
| | - Lionel Falchero
- Respiratory Medicine Department, L'Hôpital Nord-Ouest, Villefranche-Sur-Saône, France
| | - Chrystèle Locher
- Respiratory Medicine Department, Grand Hôpital de l'Est Francilien (GHEF), Meaux, France
| | | | - Nicolas Meyer
- Biostatistician, Public Health Department, CHU de Strasbourg, GMRC, Strasbourg, France
| | - Hugues Morel
- Respiratory Medicine Department, Centre Hospitalier Régional D'Orléans Hôpital de La Source, Orléans, France
| | - Yannick Duval
- Respiratory Medicine Department, Hôpital de Cannes Simone Veil, Cannes, France
| | - Bernard Asselain
- Methodologist, Groupe Statistique, ARCAGY - GINECO, Paris, France
| | | | - Jean Trédaniel
- Department of Thoracic Oncology, Groupe hospitalier Paris-Saint Joseph, Paris, France
| | - Jean-Bernard Auliac
- Respiratory Medicine Department, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Olivier Bylicki
- Respiratory Medicine Department, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France
| | - Lionel Moreau
- Respiratory Medicine Department, Centre Hospitalier de Colmar, Colmar, France
| | - Mathieu Fore
- Respiratory Medicine Department, Groupe Hospitalier de la Région Mulhouse Sud-Alsace, Hôpital Emile Muller, Mulhouse, France
| | - Romain Corre
- Respiratory Medicine Department, Centre Hospitalier de Cornouaille, Quimper, France
| | - Sébastien Couraud
- Respiratory Medicine Department, Centre Hospitalier de Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Alexis Cortot
- Department of Thoracic Oncology, CHU de Lille, CNRS, Inserm, Institut Pasteur de Lille, UMR9020-U1277-CANTHER, Lille, France
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5
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Barlesi F, Tomasini P, Karimi M, Michiels S, Raimbourg J, Daniel C, Janicot H, Madroszyk A, Audigier-Valette C, Quoix E, Mazieres J, Moro-Sibilot D, Dansin E, Molinier O, Morel H, Pichon E, Cortot A, Otto J, Chomy FO, Souquet PJ, Cloarec N, Giroux Leprieur E, Bieche I, Lacroix L, Boyault S, Attignon V, Soubeyran I, Morel A, Tran-Dien A, Jacquet A, Dall'Olio FG, Jimenez M, Soria JC, Besse B. Comprehensive genome profiling in patients with metastatic non-small cell lung cancer: the precision medicine phase 2 randomized SAFIR02-Lung trial. Clin Cancer Res 2022; 28:4018-4026. [PMID: 35802649 DOI: 10.1158/1078-0432.ccr-22-0371] [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] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 04/20/2022] [Accepted: 07/06/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE Targeted therapies (TT) and immune checkpoint blockers (ICB) have revolutionized the approach to non-small cell lung cancer (NSCLC) treatment in the era of precision medicine. Their impact as switch maintenance therapy based on molecular characterization is unknown. EXPERIMENTAL DESIGN SAFIR02-Lung was an open-label, randomized, phase 2 trial, involving 33 centers in France. We investigated eight TT (substudy-1) and one ICB (substudy-2), compared to standard-of-care as a maintenance strategy in advanced EGFR, ALK wild-type (wt) NSCLC patients without progression after first line chemotherapy, based on high-throughput genome analysis. The primary outcome was progression-free survival (PFS). RESULTS Among the 175 patients randomized in substudy-1, 116 received TT (selumetinib, vistusertib, capivasertib, AZD4547, AZD8931, vandetanib, olaparib, savolitinib) and 59 standard-of-care. Median PFS was 2.7 months (95% CI 1.6-2.9) with TT vs. 2.7 months (1.6-4.1) with standard-of-care (HR 0.97, 0.7-1.36; p=0.87). There were no significant differences in PFS within any molecular subgroup. In substudy-2, 183 patients were randomized, 121 received durvalumab and 62 standard-of-care. Median PFS was 3.0 months (2.3-4.4) with durvalumab versus 3.0 months (2.0-5.1) with standard-of-care (HR=0.86; 0.62-1.20; p=0.38). Preplanned subgroup analysis showed an enhanced benefit with durvalumab in patients with PD-L1 Tumor Proportion Score (TPS) ≥ 1%, (n=29, HR=0.29; 0.11-0.75) as compared to PD-L1 <1% (n=31, HR=0.71, 0.31-1.60, interaction p= 0.036). CONCLUSIONS Molecular profiling can feasibly be implemented to guide treatment choice for the maintenance strategy in EGFR/ALK wt NSCLC; in the current study it did not lead to substantial treatment benefits beyond durvalumab for PD-L1 ≥ 1 patients.
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Affiliation(s)
- Fabrice Barlesi
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | - Pascale Tomasini
- Aix Marseille University, CNRS, INSERM, CRCM, APHM, Marseille, France
| | | | | | | | | | - Henri Janicot
- CHU - Hopital Gabriel Montpied, Clermont-Ferrand, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alain Morel
- Institut de Cancérologie de l'Ouest, Angers, France
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6
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Cortot AB, Madroszyk A, Giroux-Leprieur E, Molinier O, Quoix E, Bérard H, Otto J, Rault I, Moro-Sibilot D, Raimbourg J, Amour E, Morin F, Hureaux J, Moreau L, Debieuvre D, Morel H, Renault A, Pichon E, Huret B, Charpentier S, Denis MG, Cadranel J. First-Line Afatinib plus Cetuximab for EGFR-Mutant Non-Small Cell Lung Cancer: Results from the Randomized Phase II IFCT-1503 ACE-Lung Study. Clin Cancer Res 2021; 27:4168-4176. [PMID: 34031056 DOI: 10.1158/1078-0432.ccr-20-4604] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/12/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Double inhibition of epidermal growth factor receptor (EGFR) using a tyrosine kinase inhibitor plus a monoclonal antibody may be a novel treatment strategy for non-small cell lung cancer (NSCLC). We assessed the efficacy and toxicity of afatinib + cetuximab versus afatinib alone in the first-line treatment of advanced EGFR-mutant NSCLC. PATIENTS AND METHODS In this phase II, randomized, open-label study, patients with stage III/IV EGFR-positive NSCLC were randomly assigned (1:1) to receive afatinib (group A) or afatinib + cetuximab (group A + C). Oral afatinib 40 mg was given once daily; cetuximab 250 mg/m² was administered intravenously on day 15 of cycle 1, then every 2 weeks at 500 mg/m² for 6 months. The primary endpoint was time to treatment failure (TTF) rate at 9 months. Exploratory analysis of EGFR circulating tumor DNA in plasma was performed. RESULTS Between June 2016 and November 2018, 59 patients were included in group A and 58 in group A + C. The study was ended early after a futility analysis was performed. The percentage of patients without treatment failure at 9 months was similar for both groups (59.3% for group A vs. 64.9% for group A + C), and median TTF was 11.1 (95% CI, 8.5-14.1) and 12.9 (9.2-14.5) months, respectively. Other endpoints, including progression-free survival and overall survival, also showed no improvement with the combination versus afatinib alone. There was a slight numerical increase in grade ≥3 adverse events in group A + C. Allele frequency of the EGFR gene mutation in circulating tumor DNA at baseline was associated with shorter PFS, regardless of the treatment received. CONCLUSIONS These results suggest that addition of cetuximab to afatinib does not warrant further investigation in treatment-naïve advanced EGFR-mutant NSCLC.
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Affiliation(s)
- Alexis B Cortot
- Univ. Lille, CHU Lille, Thoracic Oncology Department, CNRS, Inserm, Institut Pasteur de Lille, UMR9020, UMR-S 1277, Canther, Lille, France. .,Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - Anne Madroszyk
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Institut Paoli-Calmettes, Marseille, France
| | - Etienne Giroux-Leprieur
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Respiratory Diseases and Thoracic Oncology, APHP-AmbroiseParé Hospital and EA 4340 University Versailles-Saint Quentin en Yvelines, Boulogne, France
| | - Olivier Molinier
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service des Maladies Respiratoires, Centre Hospitalier, Le Mans, France
| | - Elisabeth Quoix
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, University Hospital, Strasbourg, France
| | - Henri Bérard
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie, hôpital d'instruction des armées Sainte-Anne, Toulon, France
| | - Josiane Otto
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Medicine, Centre Antoine Lacassagne, Nice, France
| | - Isabelle Rault
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie et réanimation respiratoire, CHU Amiens-Picardie, Amiens, France
| | - Denis Moro-Sibilot
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Thoracic Oncology Unit Teaching Hospital A Michallon, INSERM U823, Grenoble, France
| | - Judith Raimbourg
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,ICO René Gauducheau, Saint-Herblain, France
| | - Elodie Amour
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
| | - José Hureaux
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de pneumologie, pôle Hippocrate, CHU, Angers, France; MINT, UNIV Angers, Inserm 1066, CNRS 6021, université Bretagne Loire, Angers, France
| | - Lionel Moreau
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie, Hôpital Louis Pasteur, Hôpitaux Civils de Colmar, Colmar, France
| | - Didier Debieuvre
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,GHRMSA, Mulhouse, France
| | - Hugues Morel
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, CHR Orléans, Orléans, France
| | - Aldo Renault
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, Hospital, Pau, France
| | - Eric Pichon
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie, CHRU Bretonneau, Tours, France
| | - Benjamin Huret
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Pneumology, Private Hospital, Ramsay Generale de Sante, Villeneuve d'Ascq, France
| | - Sandrine Charpentier
- Department of Biochemistry, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Marc G Denis
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Department of Biochemistry, Centre Hospitalier Universitaire Nantes, Nantes, France
| | - Jacques Cadranel
- Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France.,Service de Pneumologie et d'Oncologie Thoracique, hôpital Tenon, Assistance Publique Hôpitaux de Paris and GRC 04 Theranoscan Sorbonne Université, Paris, France
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7
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Zysman M, Ribeiro Baptista B, Soumagne T, Marques da Silva V, Martin C, Thibault de Menonville C, Boyer L, Degano B, Morelot Panzini C, Burgel PR, Perez T, Bourdin A, Raherison C, Pégliasco H, Piperno D, Zanetti C, Morel H, Delclaux B, Delafosse C, Lorenzo A, Housset B, Chabot F, Devillier P, Deslée G, Roche N. [Pharmacological treatment optimisation in patients with stale COPD. Position of the French-language Respiratory Society. 2021 Update]. Rev Mal Respir 2021; 38:539-561. [PMID: 33985869 DOI: 10.1016/j.rmr.2021.02.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 02/21/2021] [Indexed: 01/19/2023]
Affiliation(s)
- M Zysman
- Université Bordeaux, centre de recherche cardiothoracique de Bordeaux, U1045, CIC 1401, 33604 Pessac, France; Service des maladies respiratoires, CHU Bordeaux, Bordeaux, France.
| | - B Ribeiro Baptista
- Université Paris-Est, UMR S955, UPEC, 94000 Créteil, France; Département de pneumologie, CHRU Nancy, université de Lorraine, Inserm, U1116, université de Lorraine, Nancy/Vandœuvre-lès-Nancy, France
| | - T Soumagne
- Service de pneumologie, oncologie thoracique et allergologie respiratoire, CHU de Besançon, Besançon, France
| | | | - C Martin
- Department of Respir Med, Cochin Hospital, Assistance publique-Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U1016, Institut Cochin, Paris, France
| | | | - L Boyer
- Université Paris-Est, UMR S955, UPEC, 94000 Créteil, France; Département de physiologie-explorations fonctionnelles, AP-HP, hôpital Henri-Mondor, Paris, France
| | - B Degano
- Service hospitalier universitaire pneumologie physiologie, pôle thorax et vaisseaux, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, Grenoble, France
| | - C Morelot Panzini
- Sorbonne Université, AP-HP, Service de Pneumologie, Médecine Intensive et Réanimation, Pitié-Salpêtrière Hospital, Paris, France
| | - P R Burgel
- Department of Respir Med, Cochin Hospital, Assistance publique-Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U1016, Institut Cochin, Paris, France
| | - T Perez
- Service de pneumologie, CHU Lille, institut Pasteur de Lille, U1019, UMR9017, centre d'infection et d'immunité de Lille (CIIL), Lille, France
| | - A Bourdin
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, Montpellier, France; Department of Respiratory Diseases, University of Montpellier, CHU Montpellier, Montpellier, France
| | - C Raherison
- Service des maladies respiratoires, CHU Bordeaux, Bordeaux, France; Bordeaux Population Health Research Center, université Bordeaux, INSERM, Team EPICENE, UMR 1219, Bordeaux, France
| | - H Pégliasco
- Service de pneumologie, hôpital européen, Marseille, France
| | | | - C Zanetti
- Cabinet de pneumologie, 62300 Lens, France
| | - H Morel
- Service de pneumologie d'allergologie et d'oncologie thoracique, CHR d'Orléans, 45067 Orléans, France
| | - B Delclaux
- Service de pneumologie, centre hospitalier de Troyes, 10003 Troyes, France
| | - C Delafosse
- Centre hospitaliser Simone-Veil, 95602 Eaubonne, France
| | - A Lorenzo
- Médecine Sorbonne université, département de médecine générale, Paris, France
| | - B Housset
- Département de pneumologie, CHI de Créteil, University Paris Est Créteil, Créteil, France
| | - F Chabot
- Département de pneumologie, CHRU Nancy, université de Lorraine, Inserm, U1116, université de Lorraine, Nancy/Vandœuvre-lès-Nancy, France
| | - P Devillier
- Department of Airway Diseases, VIM-Suresnes, UMR0892, Foch Hospital, Paris-Saclay University, Suresnes, France
| | - G Deslée
- Service de pneumologie, Inserm U1250, CHU Reims, université Reims Champagne Ardenne, Reims, France
| | - N Roche
- Department of Respir Med, Cochin Hospital, Assistance publique-Hôpitaux de Paris, Paris, France; Université de Paris, Paris, France; INSERM U1016, Institut Cochin, Paris, France
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Graff A, Donadille B, Morel H, Villy MC, Bourcigaux N, Vatier C, Borgel A, Khodawardi A, Siffroi JP, Christin-Maitre S. Added value of buccal cell FISH analysis in the diagnosis and management of Turner syndrome. Hum Reprod 2021; 35:2391-2398. [PMID: 32810206 DOI: 10.1093/humrep/deaa197] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 05/02/2020] [Revised: 07/05/2020] [Indexed: 12/17/2022] Open
Abstract
STUDY QUESTION Is there an added diagnosis value of buccal cell FISH analysis compared with blood lymphocyte chromosomal investigations in patients with Turner syndrome (TS)? SUMMARY ANSWER Buccal cell FISH analysis, a non-invasive technique, modified the chromosomal results obtained with the blood karyotype in 17 patients (12%) of our cohort. WHAT IS KNOWN ALREADY Few studies have evaluated buccal cell FISH analysis and compared them with blood karyotype in patients with TS. STUDY DESIGN, SIZE, DURATION A prospective, monocentric cohort study was conducted in a rare diseases centre (CMERC) between July 2017 and August 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS In total, 142 adult patients with TS, and at least 5% 45,X cells in a previous blood karyotype, were recruited. All the patients' files were included in the CEMARA database. This national database has been declared to the French data protection agency (CNIL approval number 1187326). In compliance with French law, consent regarding non-opposition to collect and use the data was obtained from each patient. A FISH analysis on a buccal smear was performed. MAIN RESULTS AND THE ROLE OF CHANCE The percentage of 45,X cells was identical between the two tissues in only 32.4% of cases. The discrepancy was higher than 41% for 12% of the cohort. The percentage of 45,X cells was higher in blood in 53 (37.3%) patients, and higher in buccal cells in 43 (30.3%) of cases. In 17 (12%) cases, the blood karyotype had to be reconsidered in regard to the buccal cell analysis. LIMITATIONS, REASONS FOR CAUTION It would have been interesting to evaluate karyotypes in cells from other tissues such as cells from skin biopsy or from the urinary tract and even from blood vessels or gonads in case of surgery and to compare them with each patient's phenotype. However, most of the time, these tissues are not available. WIDER IMPLICATIONS OF THE FINDINGS Although blood lymphocyte karyotype remains the gold standard for the diagnosis of TS, buccal cell FISH analysis is an efficient tool to evaluate the global chromosomal constitution in these patients, thus allowing them to have better care and follow-up. For instance, identifying a Y chromosome can prevent the occurrence of a gonadoblastoma, as gonadectomy should be discussed. On the other hand, finding normal XX cells in a patient with a previous diagnosis of homogenous 45,X TS, may be psychologically helpful and relevant for gynaecological care. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was sought for the study. The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- A Graff
- Sorbonne Université, Service d'Endocrinologie, diabétologie et médecine de la reproduction, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - B Donadille
- Sorbonne Université, Service d'Endocrinologie, diabétologie et médecine de la reproduction, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - H Morel
- Département de Génétique Médicale, Sorbonne Université, AP-HP, Hôpital d'Enfants Armand Trousseau, Paris, France
| | - M C Villy
- Département de Génétique Médicale, Sorbonne Université, AP-HP, Hôpital d'Enfants Armand Trousseau, Paris, France
| | - N Bourcigaux
- Sorbonne Université, Service d'Endocrinologie, diabétologie et médecine de la reproduction, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - C Vatier
- Sorbonne Université, Service d'Endocrinologie, diabétologie et médecine de la reproduction, Hôpital Saint-Antoine, AP-HP, Paris, France
| | - A Borgel
- Département de Génétique Médicale, Sorbonne Université, AP-HP, Hôpital d'Enfants Armand Trousseau, Paris, France
| | - A Khodawardi
- Département de Génétique Médicale, Sorbonne Université, AP-HP, Hôpital d'Enfants Armand Trousseau, Paris, France
| | - J P Siffroi
- Département de Génétique Médicale, Sorbonne Université, AP-HP, Hôpital d'Enfants Armand Trousseau, Paris, France.,INSERM, Maladies génétiques d'expression pédiatrique UMR 933, Hôpital d'Enfants Armand Trousseau, Paris, France
| | - S Christin-Maitre
- Sorbonne Université, Service d'Endocrinologie, diabétologie et médecine de la reproduction, Hôpital Saint-Antoine, AP-HP, Paris, France.,INSERM, Maladies génétiques d'expression pédiatrique UMR 933, Hôpital d'Enfants Armand Trousseau, Paris, France
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Legué S, Marchand-Adam S, Plantier L, Bayeh BA, Morel H, Mangiapan G, Flament T. ThOracic Ultrasound in Idiopathic Pulmonary Fibrosis Evolution (TOUPIE): research protocol of a multicentric prospective study. BMJ Open 2021; 11:e039078. [PMID: 33766834 PMCID: PMC7996371 DOI: 10.1136/bmjopen-2020-039078] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Idiopathic pulmonary fibrosis (IPF) is the most common and severe interstitial lung disease (ILD). It is a progressive disease that requires a regular follow-up: clinical examination, pulmonary function testing (PFT) and CT scan, which is performed yearly in France. These exams have two major disadvantages: patients with severe dyspnoea have difficulties to perform PFT and repeated CT scans expose to high dose of radiations. Considering these limits, it would be relevant to develop new tools to monitor the progression of IPF lesions. Three main signs have been described in ILD with lung ultrasound (LUS): the number of B lines, the irregularity and the thickening of the pleural line. Cross-sectional studies already correlated the intensity of these signs with the severity of fibrosis lesions on CT scan in patients with IPF, but no prospective study described the evolution of the three main LUS signs, nor the correlation between clinical evaluation, PFT and CT scan. Our hypothesis is that LUS is a relevant tool to highlight the evolution of pulmonary lesions in IPF. The main objective of our study is to show an increase in one or more of the three main LUS signs (total number of B lines, pleural line irregularity score and pleural line thickness) during the follow-up. METHODS ThOracic Ultrasound in Idiopathic Pulmonary Fibrosis Evolution is a French prospective, multicentric and non-interventional study. Every 3 months, patients with IPF will have a clinical examination, PFT and LUS. CT data will be collected if the CT scan is performed within 3 months before the inclusion; the second CT scan will be performed from 9 to 12 months after the inclusion. The presence, location and severity of LUS signs will be recorded for each patient, and their correlation with clinical, functional and CT scan evolution will be evaluated. 30 patients will be enrolled. ETHICS AND DISSEMINATION The protocol was approved by the French Research Ethics Committee (Comité de Protection des Personnes SUD OUEST ET OUTRE MER II, reference RIPH3-RNI19-TOUPIE) on 11 April 2019. Results will be disseminated via peer-reviewed publication and presentation at international conferences. TRIAL REGISTRATION NUMBER NCT03944928;Pre-results.
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Affiliation(s)
- Sylvie Legué
- Pulmonology Unit, CHRU Tours, Tours, Centre, France
- Chest Ultrasound Working Group (G-ECHO), Societe de Pneumologie de Langue Francaise, Paris, Île-de-France, France
| | | | - Laurent Plantier
- Pulmonology Unit, CHRU Tours, Tours, Centre, France
- U1100, INSERM, Tours, France
| | | | - Hugues Morel
- Chest Ultrasound Working Group (G-ECHO), Societe de Pneumologie de Langue Francaise, Paris, Île-de-France, France
- Pulmonology Unit, CHR Orleans, Orleans, Centre, France
| | - Gilles Mangiapan
- Chest Ultrasound Working Group (G-ECHO), Societe de Pneumologie de Langue Francaise, Paris, Île-de-France, France
- Pulmonology Unit, Centre Hospitalier Intercommunal de Créteil, Creteil, Île-de-France, France
| | - Thomas Flament
- Pulmonology Unit, CHRU Tours, Tours, Centre, France
- Chest Ultrasound Working Group (G-ECHO), Societe de Pneumologie de Langue Francaise, Paris, Île-de-France, France
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Barlesi F, Karimi M, Tomasini P, Daniel C, Raimbourg J, Quoix AE, Flandin ACM, Mazieres J, Molinier O, Audigier-Valette C, Moro-Sibilot D, Morel H, Souquet PJ, Bieche I, Tran-Dien A, Jacquet A, Adam J, Soria JC, Besse B. 1273P Durvalumab (D) compared to maintenance chemotherapy (SoC) in patients (pts) with metastatic non-small cell lung cancer (NSCLC): Results from the randomized SAFIR02 LUNG-IMMUNO trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1587] [Citation(s) in RCA: 1] [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: 11/26/2022] Open
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11
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Mizrahi A, Delerue T, Morel H, Le Monnier A, Carbonnelle E, Pilmis B, Zahar J. Infections caused by naturally AmpC-producing Enterobacteriaceae: Can we use third-generation cephalosporins? A narrative review. Int J Antimicrob Agents 2020; 55:105834. [DOI: 10.1016/j.ijantimicag.2019.10.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 10/07/2019] [Accepted: 10/20/2019] [Indexed: 12/21/2022]
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Gangneux JP, Bouvrais M, Frain S, Morel H, Deguen S, Chevrier S, Le Cann P. Asthma and Indoor Environment: Usefulness of a Global Allergen Avoidance Method on Asthma Control and Exposure to Molds. Mycopathologia 2020; 185:367-371. [PMID: 31897973 DOI: 10.1007/s11046-019-00417-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/10/2019] [Indexed: 02/02/2023]
Abstract
The usefulness and feasibility of a global allergens avoidance method with counselors visiting patients' home for allergens measures and adapted advices were prospectively evaluated through asthma control and environment evaluation. Twenty seven patients were prospectively included and compared to a cohort of 30 control patients. The level of control of asthma at inclusion and after 1 year was evaluated by the clinical signs, the evolution of the FEV1, and the healthcare use. Environmental measurements included the fungal load of 5 surfaces of the dwellings and the evaluation of moisture. A significant clinical improvement in the population that benefited from the home counselors visit was observed compared to the baseline (p < 0.0001), as well as a decreased number of hospitalizations for asthma and of the consumption of anti-asthma drugs (p < 0.01). Dampness markers slightly improved with an improvement of the fungal loads in two-third of the dwellings.
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Affiliation(s)
- Jean-Pierre Gangneux
- Irset (Institut de Recherche en santé, environnement et travail) - UMR_S 1085, Univ Rennes, CHU Rennes, Inserm, EHESP, 35000, Rennes, France. .,Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Rennes, 2 rue Henri le Guilloux, 35033, Rennes Cedex 09, France.
| | - Matthieu Bouvrais
- Département de Médecine Générale, Université de Rennes 1, Rennes, France
| | | | - Hugues Morel
- Service de Pneumologie, Centre Hospitalier d'Orléans, Orléans, France
| | - Séverine Deguen
- EHESP, Inserm, Irset (Institut de Recherche en santé, environnement et travail) - UMR_S 1085, 35000, Rennes, France
| | - Sylviane Chevrier
- Irset (Institut de Recherche en santé, environnement et travail) - UMR_S 1085, Univ Rennes, CHU Rennes, Inserm, EHESP, 35000, Rennes, France
| | - Pierre Le Cann
- EHESP, Inserm, Irset (Institut de Recherche en santé, environnement et travail) - UMR_S 1085, 35000, Rennes, France
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Vergnenegre A, Geier M, Guisier F, Lamy R, Comet B, Le Garff G, Do P, Janicot H, Morel H, Decroisette C, Andre M, Falchero L, Paleiron N, Monnet I. Management and outcomes of non-small cell lung cancer patients with rapid progression under second-or-more-line immune checkpoint inhibitors: ERORECI study (GFPC 2016-04). Cancer Med 2019; 9:432-439. [PMID: 31747137 PMCID: PMC6970062 DOI: 10.1002/cam4.2716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/02/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have been approved as second-line therapy for advanced non-small cell lung cancers (NSCLCs) progressing after platinum-based chemotherapy. However, some patients' disease progressed rapidly and sometimes exhibited explosive tumor progression. This descriptive, prospective study aimed to assess the characteristics of nonresponders with rapid progression (RP), defined as progression-free survival (PFS) ≤2 or 2-4 months under ICIs. METHODS This analysis included all consecutive ICI-treated (second-or-more line) patients with RP ≤4 months from 1 September 2016 to 31 August 2017 and compared the clinical characteristics, treatments, and outcomes (overall survival [OS]; responses; PFS, according to treatment line) of NSCLCs that progressed after ≤2 vs 2-4 months on ICIs. RESULTS Comparisons of the 224 (70.2%) patients with ≤2-month and 95 (29.8%) with 2- to 4-month RP revealed the former had less frequent nonsmokers and ECOG PS = 0, more frequent stage IV disease and higher neutrophil/lymphocyte ratio. Their respective ICI PFS rates were: 1.6 [95% CI: 0.1-2] and 2.7 [2.0-4.2] months, with 16.5% and 11.6% having partial responses to first- and second-line therapies post-ICI chemotherapy. Their respective median OS rates were 6.0 and 9.0 months (P ≤ .009). Multivariate analysis retained only PFS of the first-line therapy pre-ICI and neutrophil/lymphocyte ratio at ICI onset as being significantly associated with ≤2-month RP. CONCLUSION In the real-life setting, NSCLC RP on ICI remains a challenge. New descriptive and analytic studies are needed to identify factors predictive of RP.
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Affiliation(s)
| | | | - Florian Guisier
- Department of Pneumology, Thoracic Oncology and Respiratory Intensive Care - CHU de Rouen, Hôpital Charles Nicolle, Rouen, France
| | - Regine Lamy
- Department of Oncology, Centre Hospitalier Bretagne Sud-Lorient, Lorient, France
| | - Bénédicte Comet
- Department of Oncology, Centre Catalan d'Oncologie, Perpignan, France
| | | | - Pascal Do
- Centre François Baclesse, Caen, France
| | - Henri Janicot
- Department of Pneumology, CHU Hôpital Montpied, Clermont Ferrand, France
| | - Hugues Morel
- Department of Pneumology, CHR Orléans, Orléans, France
| | - Chantal Decroisette
- Department of Pneumology, Centre Hospitalier Annecy-Genevoise, Pringy, France
| | - Michel Andre
- Department of Pneumology, CHU La Réunion, Saint-Denis, France
| | - Lionel Falchero
- Department of Pneumology, L'Hôpital Nord-Ouest, Villefranche Sur Saône, France
| | - Nicolas Paleiron
- Department of Pneumology, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France
| | - Isabelle Monnet
- Department of Pneumology, Centre Hospitalier Intercommunal Créteil, Créteil, France
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Antoun S, Morel H, Souquet PJ, Surmont V, Planchard D, Bonnetain F, Foucher P, Egenod T, Krakowski I, Gaudin H, Debieuvre D. Staging of nutrition disorders in non-small-cell lung cancer patients: utility of skeletal muscle mass assessment. J Cachexia Sarcopenia Muscle 2019; 10:782-793. [PMID: 30932365 PMCID: PMC6711412 DOI: 10.1002/jcsm.12418] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 02/04/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND An international consensus proposed in 2011 a definition and classification system for cachexia (CAX), mainly based on weight loss, sarcopenia [skeletal muscle mass (SMM) loss], inflammation, and anorexia. The aim of this study was to stage CAX in non-small-cell lung cancer (NSCLC) patients by using a classification based on the Fearon criteria and supported by quantifiable parameters. METHODS This was a cross-sectional and non-interventional multicentre study. SMM was assessed by analysing L3 computed tomography-scan images. Patients completed the anorexia/CAX subscale of the Functional Assessment of Anorexia/Cachexia Therapy, EORTC QLQ-C30 quality of life (QoL) and International Physical Activity Questionnaire (IPAQ). RESULTS Patients were recruited in 56 sites. The analysis population comprised 531 patients, and SMM was assessed in 312 patients. Male patients were 66.5%, with a mean (SD) age of 65.2 (10.0) years, 79.9% were PS 0-1, and the tumour stage was mainly IIIB-IV (87.3%). Overall, 38.7% of patients had CAX, 33.8% pre-CAX, and 0.9% refractory CAX. Molecular tumour profiles were significantly associated with the presence of CAX: 23.9% in EGFR, ALK, ROS1, BRAF, or HER2+ patients, 41.4% in K-RAS+, and 43.2% in patients with no molecular abnormality (P = 0.003). The more advanced the CAX stage, the poorer the scores of functional items of the QoL (P < 0.001) and International Physical Activity Questionnaire (P < 0.001). Sarcopenia was present in 66.7% of CAX and 68.5% of pre-CAX patients. Overall, 43.8% of pre-CAX patients had only sarcopenia with limited weight loss (≤2%) and no anorexia. CONCLUSIONS This is the first study to show the distribution of CAX in a population of NSCLC patients and an association between molecular abnormality in NSCLC and CAX. The original Fearon classification for CAX stages was supported by the associated functional QoL scores and physical activity levels, resulting in a clinically relevant system for detection of early stages of CAX.
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Affiliation(s)
- Sami Antoun
- Emergency Unit, Gustave Roussy, Paris Saclay University, Villejuif, France
| | - Hugues Morel
- Pneumology Department, Centre Hospitalier Régional d'Orleans, Orleans, France
| | | | - Veerle Surmont
- Thoracic Oncology Unit, Universitair Ziekenhuis Gent, Ghent, Belgium
| | - David Planchard
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit (EA 3181), Centre Hospitalier Régional Universitaire de Besançon, Besançon, France
| | - Pascal Foucher
- Department of Thoracic Oncology, Centre Hospitalier Universitaire Dijon Bourgogne, Dijon Cedex, France
| | - Thomas Egenod
- Thoracic and Skin Oncology Unit, Centre Hospitalier Universitaire De Limoges Dupuytren, Limoges, France
| | - Ivan Krakowski
- Interdisciplinary Department of Supportive care in Oncology (DISSPO-CARE), French-Speaking Association of Supportive Care in Cancer (AFSOS), Institut Bergonié, Bordeaux, France
| | - Hélène Gaudin
- Chugai Pharma France, Tour Franklin - Arche Sud, Paris, France
| | - Didier Debieuvre
- GHRMSA, Pneumology Department, French College of General Hospital Respiratory Physicians (CPHG), Hôpital Emile Muller, Mulhouse, France
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Ganga Debieuvre D, Duval Y, Morel H, Baranzelli A, Falchero L, Romand P, Ganga E, Bizieux A, Locher C, Molinier O. ALK-2016-CPHG : caractéristiques des patients présentant un CBNPC ALK+/ROS1+ traités par crizotinib en vie réelle indépendamment de la ligne de traitement. Rev Epidemiol Sante Publique 2019. [DOI: 10.1016/j.respe.2019.04.028] [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: 10/26/2022] Open
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Cortot AB, Madroszyk A, Giroux Leprieur E, Molinier O, Quoix EA, Berard H, Otto J, Rault I, Raimbourg J, Hureaux J, Moreau L, Debieuvre D, Morel H, Denis MG, Amour E, Morin F, Moro-Sibilot D, Cadranel J. Phase II randomized trial of afatinib with or without cetuximab as first-line treatment for EGFR mutated non-small cell lung cancer (NSCLC) patients (IFCT-1503 ACE-Lung). J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.9079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9079 Background: First-line treatment of metastatic EGFR-mutated NSCLC relies on EGFR-TKIs. However, all patients (pts) eventually develop progression. Dual inhibition of EGFR with afatinib (A), an irreversible pan-erbB TKI, and cetuximab (C), an EGFR monoclonal antibody, has shown activity in EGFR-mutated pts with acquired resistance to TKIs, regardless of the T790M status. Methods: We conducted a phase II randomized trial in advanced NSCLC pts harboring an activating EGFR mutation, who had not received prior therapy. Pts were treated with A (40 mg/d) until progression alone or with C 500 mg/m² every 2 weeks during 6 months (mos) (beginning at D15 at 250 mg/m²). Primary endpoint was time-to-treatment failure (TTF) at 9 mos for pts with del19 and L858R mutations. Secondary endpoints include safety, progression-free survival (PFS), overall survival (OS). Prospective monitoring of the T790M mutation was performed on circulating tumoral DNA (ctDNA) by digital PCR. Results: Trial was stopped early due to futility analysis after 118 pts were enrolled (59 in each arm). Baseline characteristics were balanced between the 2 arms, and especially for the types of EGFR mutation (del19, 55.9 vs 50.8%; L858R, 39 vs 40.7%; others, 5.1 vs 8.5% in AC and A arms, respectively). Treatment-related AEs of any grades were similar, although there was an excess of grade 3 AEs in the AC arm (50 vs 37.3%), but no of grade 5. The excess in grade 3-5 AEs was essentially due to cutaneous (96.6 vs 81.4%), eyes (32.8 vs 27.1%), hematological (22.4 vs 15.3%) but not to digestive toxicities (89.7 vs 98.3%). Among the 117 pts included in the efficacy analysis, 9-months TTF was 63.3% (47.5-75.6) in arm A and 65.8% (50.1-77.66) in arm AC. Median TTF was 11.1 mos (8.3-not reached [NR]) and 10.8 mos (9.2-13.7) in arms A and AC, respectively. Median PFS was 11.1 mos (8.3-NR) and 12.8 mos (9.2-13.7), respectively. Median OS was 20.8 mos (17.5-NR) and NR (17-NR), respectively. Conclusions: Efficacy of AC was similar to that of A alone. These results don’t support further evaluation of this combination in this setting. Results of ctDNA monitoring will be reported during the meeting. Clinical trial information: NCT02716311.
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Affiliation(s)
| | | | | | | | | | - Henri Berard
- Hopital D'instruction Des Armes Sainte-Anne, Toulon, France
| | | | | | | | | | - Lionel Moreau
- Centre Hospitalier Pneumologie Colmar, Colmar, France
| | | | | | | | | | - Franck Morin
- Intergroupe Francophone de Cancérologie Thoracique, Paris, France
| | | | - Jacques Cadranel
- Hôpital Tenon, AP-HP and Faculté de Médecine Pierre et Marie Curie, Université Paris VI, Paris, France
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Corbaux P, Fontaine-Delaruelle C, Souquet PJ, Couraud S, Morel H, Tronc F, Eker E, Peron J, Raynard B. Is Nutritional Screening of Patients with Lung Cancer Optimal? An Expert Opinion Survey of French Physicians and Surgeons. Nutr Cancer 2019; 71:971-980. [DOI: 10.1080/01635581.2019.1595051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Pauline Corbaux
- Department of Medical Oncology, Centre Hospitalier Lyon-Sud, Institut de Cancérologie des Hospices Civils de Lyon-IC-HCL, University of Lyon 1, Pierre-Bénite, France
| | - Clara Fontaine-Delaruelle
- Department of Respiratory Medicine, Centre Hospitalier Lyon-Sud, University of Lyon 1, Pierre-Bénite, France
| | - Pierre-Jean Souquet
- Department of Respiratory Medicine, Centre Hospitalier Lyon-Sud, University of Lyon 1, Pierre-Bénite, France
| | - Sébastien Couraud
- Department of Respiratory Medicine, Centre Hospitalier Lyon-Sud, University of Lyon 1, Pierre-Bénite, France
| | - Hugues Morel
- Department of Respiratory Medicine, Centre Hospitalier Régional d’Orléans, Orléans, France
| | - François Tronc
- Department of Thoracic Surgery, Hôpital Louis Pradel, University of Lyon 1, Bron, France
| | - Elife Eker
- Department of Radiotherapy, Centre Hospitalier Lyon Sud, University of Lyon 1, Pierre-Bénite, France
| | - Julien Peron
- Department of Medical Oncology, Centre Hospitalier Lyon-Sud, Institut de Cancérologie des Hospices Civils de Lyon-IC-HCL, University of Lyon 1, Pierre-Bénite, France
- Centre National de la Recherche Scientifique, Unités Mixtes de Recherche 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Department of Biostatistics, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Bruno Raynard
- Transversal Unit of Dietetics and Nutrition, Institut Gustave Roussy, University of Paris Sud, Villejuif, France
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Gut-Gobert C, Cavaillès A, Dixmier A, Guillot S, Jouneau S, Leroyer C, Marchand-Adam S, Marquette D, Meurice JC, Desvigne N, Morel H, Person-Tacnet C, Raherison C. Women and COPD: do we need more evidence? Eur Respir Rev 2019; 28:28/151/180055. [PMID: 30814138 PMCID: PMC9488562 DOI: 10.1183/16000617.0055-2018] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/21/2018] [Indexed: 01/20/2023] Open
Abstract
The increasingly female face of chronic obstructive pulmonary disease (COPD) prevalence among women has equalled that of men since 2008, due in part to increased tobacco use among women worldwide and exposure to biomass fuels. This finding is supported by a number of characteristics. There is evidence of susceptibility to smoking and other airborne contaminants, along with epidemiological and phenotypic manifestations. COPD has thus become the leading cause of death in women in the USA. The clinical presentation is characterised by increasingly pronounced dyspnoea with a marked tendency towards anxiety and depression, undernutrition, nonsmall cell lung cancer (especially adenocarcinoma) and osteoporosis. Quality of life is also more significantly impacted. The theories advanced to explain these differences involve the role played by oestrogens, impaired gas exchange in the lungs and smoking habits. While these differences require appropriate therapeutic responses (smoking cessation, pulmonary rehabilitation, long-term oxygen therapy), barriers to the treatment of women with COPD include greater under-diagnosis than in men, fewer spirometry tests and medical consultations. Faced with this serious public health problem, we need to update and adapt our knowledge to the epidemiological changes. The face of COPD is increasingly female. We need more evidence and a change in how the disease is managed. http://ow.ly/zueL30mWqlS
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Affiliation(s)
- Christophe Gut-Gobert
- G.E.T.B.O. (Groupe d'Etude de la Thrombose de Bretagne Occidentale), Université Européenne de Bretagne, Université de Brest, EA3878, IFR148, Hôpital La Cavale Blanche, Département de Médecine Interne et Pneumologie, Brest, France
| | - Arnaud Cavaillès
- Institut du Thorax, CHU de Nantes, Dept of Pulmonology, Nantes, France
| | - Adrien Dixmier
- Dept of Pulmonology, Orléans Regional Hospital, Orléans, France
| | - Stéphanie Guillot
- Unité d'Explorations Fonctionnelles Respiratoires, CHRU Rennes, Rennes, France
| | - Stéphane Jouneau
- Service de Pneumologie, Hôpital Pontchaillou, Rennes, France.,IRSET UMR 1085, Université de Rennes 1, Rennes, France
| | - Christophe Leroyer
- G.E.T.B.O. (Groupe d'Etude de la Thrombose de Bretagne Occidentale), Université Européenne de Bretagne, Université de Brest, EA3878, IFR148, Hôpital La Cavale Blanche, Département de Médecine Interne et Pneumologie, Brest, France
| | - Sylvain Marchand-Adam
- Université François Rabelais Faculté de Médecine de Tours, Inserm 1100, CHRU de Tours Service de Pneumologie, Tours, France
| | - David Marquette
- Dept of Pulmonary Medicine, Centre Hospitalier Bretagne Atlantique, Vannes, France
| | - Jean-Claude Meurice
- Dept of Pulmonology Centre Hospitalier de l'Université de Poitiers, Poitiers, France
| | | | - Hugues Morel
- Dept of Pulmonology, Orléans Regional Hospital, Orléans, France
| | | | - Chantal Raherison
- Service des Maladies Respiratoires, CHU Bordeaux, Epicene U1219 Université de Bordeaux, Bordeaux, France
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Krakowski I, Morel H, Debieuvre D, Souquet PJ, Surmont V, Bonnetain F, Planchard D, Gaudin H, Antoun S. La mesure de la masse musculaire permet de préciser les différents stades de cachexie cancéreuse chez les patients (pts) suivis pour un cancer du poumon non à petites cellules (CPNPC). NUTR CLIN METAB 2018. [DOI: 10.1016/j.nupar.2018.09.119] [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: 11/16/2022]
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Ferreira M, Morel H, Dixmier A, Arbion F, Marchand-Adam S. [Osteochondroplastic tracheobronchopathy: About three cases]. Rev Mal Respir 2018; 35:738-744. [PMID: 29945809 DOI: 10.1016/j.rmr.2017.10.668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/27/2017] [Accepted: 10/25/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Osteochondroplastic tracheobronchopathy (OCTB) is a rare disorder of unknown cause that affects the tracheobronchial tree. It is characterized by multiple cartilaginous formations or bone nodules projecting into the tracheal or proximal bronchial lumen. It is usually asymptomatic because of the slow progression of the nodules. However, chronic cough, recurrent hemoptysis or recurrent respiratory infections have been reported. OBSERVATIONS We describe the cases of three patients with symptomatic OCTB: two men and one woman consulting for bronchial infections or pneumonia with sputum difficulties (2 cases) or simply for chronic cough (1 case). In all three cases, the diagnosis was suspected because of irregularities of the tracheal or bronchial wall with calcification seen on imaging and confirmed at bronchoscopy with biopsy specimens. No specific therapy was initiated in these patients except for the treatment of associated complications or comorbidities. CONCLUSION OCTB is a benign pathology which can lead to bronchial symptoms ranging from mild cough to severe airway obstruction due to tracheobronchial stenosis. A key to diagnosis, limiting non-essential examinations and biopsies, is to consider OCTB based on CT scan or bronchoscopy based on irregularities of the tracheal or bronchial wall with calcification.
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Affiliation(s)
- M Ferreira
- Service de pneumologie et d'explorations fonctionnels respiratoires, centre hospitalier universitaire de Tours, 37000 Tours, France.
| | - H Morel
- Service de pneumologie et d'oncologie thoracique, centre hospitalier Régional d'Orléans, 45067 Orléans, France
| | - A Dixmier
- Service de pneumologie et d'oncologie thoracique, centre hospitalier Régional d'Orléans, 45067 Orléans, France
| | - F Arbion
- Service d'anatomie et cytologie pathologiques, centre hospitalier universitaire de Tours, 37000 Tours, France
| | - S Marchand-Adam
- Service de pneumologie et d'explorations fonctionnels respiratoires, centre hospitalier universitaire de Tours, 37000 Tours, France; Inserm U1100, faculté de médecine de Tours, université François Rabelais, 37000 Tours, France
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Pernot E, Antoun S, Debieuvre D, Morel H, Souquet PJ, Planchard D, Surmont V, Bonnetain F, Krakowski I, Gaudin H, Bazin F. Mesure de la masse musculaire pour l’évaluation des différents stades de la cachexie cancéreuse : une étude observationnelle chez 531 patients suivis pour un cancer du poumon non à petites cellules. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.038] [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: 11/16/2022] Open
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Souquet P, Debieuvre D, Morel H, Surmont V, Bonnetain F, Krakowski I, Antoun S, Gaudin H, Planchard D. La masse musculaire (MM) est un paramètre intéressant à mesurer chez les patients pris en charge pour un cancer du poumon non à petites cellules (CPNPC). Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.039] [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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Ferreira M, Morel H, Marchand-Adam S, Dixmier A. Trachéobronchopathie ostéochrondroplastique : à propos de 3 cas. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2017.07.013] [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: 10/18/2022]
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Debieuvre D, Morel H, Souquet PJ, Surmont V, Planchard D, Bonnetain F, Krakowski I, Gaudin H, Antoun S. Cancer cachexia (CAX), anorexia and muscle wasting (sarcopenia) assessment in non-small cell lung cancer (NSCLC): an observational study in 531 patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Bourgeois H, Grudé F, Solal-Céligny P, Dupuis O, Voog E, Ganem G, Denis F, Zinger M, Juhel-Voog L, Lafond C, Maillart P, Capitain O, Delva R, Soulié P, Abadie-Lacourtoisie S, Guérin-Meyer V, Morin-Meschin M, Commer J, Gangler A, d’Aillières B, Zannetti A, Bourbouloux E, Berton-Rigault D, Lebouvier-Sadot S, Kaassis M, Baudon J, Lam Y, Bizieux A, Marcq M, Edeline J, Le Du F, Lefeuvre C, Deguiral P, Delecroix V, Blot E, Egreteau J, Goudier M, Lamy R, Ferec M, Artignan X, Corbinais S, Morel H, Hardy-Bessard A, Alleaume C, Naudeix E, Cojocarasu O, Metges J, Riché C, Gamelin E, Déniel-Lagadec D, Marhuenda F, Ingrand P, Douillard J. Clinical validation of a prognostic tool in a population of outpatients treated for incurable cancer undergoing anticancer therapy: PRONOPALL study. Ann Oncol 2017; 28:1612-1617. [DOI: 10.1093/annonc/mdx172] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Indexed: 12/25/2022] Open
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Morel H. [What is the role of non-inhaled drug management in acute COPD exacerbation?]. Rev Mal Respir 2017; 34:423-426. [PMID: 28502368 DOI: 10.1016/j.rmr.2017.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- H Morel
- Service de pneumologie et oncologie thoracique, CHR d'Orléans, 14, avenue de l'Hôpital, CS 86709, 45067 Orléans cedex 2, France.
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Jouneau S, Dres M, Guerder A, Bele N, Bellocq A, Bernady A, Berne G, Bourdin A, Brinchault G, Burgel P, Carlier N, Chabot F, Chavaillon J, Cittee J, Claessens Y, Delclaux B, Deslée G, Ferré A, Gacouin A, Girault C, Ghasarossian C, Gouilly P, Gut-Gobert C, Gonzalez-Bermejo J, Jebrak G, Le Guillou F, Léveiller G, Lorenzo A, Mal H, Molinari N, Morel H, Morel V, Noel F, Pégliasco H, Perotin J, Piquet J, Pontier S, Rabbat A, Revest M, Reychler G, Stelianides S, Surpas P, Tattevin P, Roche N. Management of acute exacerbations of chronic obstructive pulmonary disease (COPD). Guidelines from the Société de pneumologie de langue française (summary). Rev Mal Respir 2017; 34:282-322. [DOI: 10.1016/j.rmr.2017.03.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 08/31/2016] [Indexed: 11/25/2022]
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Debieuvre D, Morel H, Raynard B, Oster JP, Bizieux A, Lévy A, Mathieu JP, Dumont P, Leroy-Terquem É, Asselain B, Blanchon F, Grivaux M. P1.01-038 Prognosis Value of Body Mass Index (BMI) and Weight Loss at Diagnosis in Primary Lung Cancer: Results of KBP-2010-CPHG Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.562] [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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Skandikova C, Richard M, Morel H, Lemaire B, Longo M, Gallais-Stenz M. Comparaison d’un suivi nutritionnel précoce formalisé à une prise en charge ponctuelle dans le cancer du poumon. NUTR CLIN METAB 2016. [DOI: 10.1016/j.nupar.2016.09.052] [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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Bakkar S, Benouali W, Morel H, Yaici A, Amiot N, Lemaire B. Syndrome thoracique aigu… pas si aigu ! Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2016.04.013] [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: 11/16/2022]
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Morel H, Raynard B, Dixmier A, Asselain B, Debieuvre D, Badour K, Perrus G, Gay M, Dion P, Lierman Y, Rangasamy R, De Groote E, Grivaux M. Étude KBP-2010-CPHG : valeur pronostique de l’indice de masse corporelle (IMC) au diagnostic dans le cancer bronchique primitif (CBP). Rev Mal Respir 2016. [DOI: 10.1016/j.rmr.2015.10.654] [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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Brinchault G, Diot P, Dixmier A, Goupil F, Guillais P, Gut-Gobert C, Leroyer C, Marchand-Adam S, Meurice JC, Morel H, Person C, Cavaillès A. [Comorbidities of COPD]. Rev Pneumol Clin 2015; 71:342-349. [PMID: 26585876 DOI: 10.1016/j.pneumo.2015.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 09/08/2015] [Indexed: 06/05/2023]
Abstract
COPD is a slowly progressive chronic respiratory disease causing an irreversible decrease in air flow. The main cause is smoking, which provokes inflammatory phenomena in the respiratory tract. COPD is a serious public health issue, causing high morbidity, mortality and disability. Related comorbidities are linked to ageing, common risk factors and genetic predispositions. A combination of comorbidities increases healthcare costs. For instance, patients with more than two comorbidities represent a quarter of all COPD sufferers but account for half the related health costs. Our review describes different comorbidities and their impact on the COPD prognosis. The comorbidities include: cardiovascular diseases, osteoporosis, denutrition, obesity, ageing, anemia, sleeping disorders, diabetes, metabolic syndrome, anxiety-depression and lung cancer. The prognosis worsens with one or more comorbidities. Clinicians are faced with the challenge of finding practical and appropriate ways of treating these comorbidities, and there is increasing interest in developing a global, multidisciplinary approach to management. Managing this chronic disease should be based on a holistic, patient-centred approach and smoking cessation remains the key factor in the care of COPD patients.
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Affiliation(s)
- G Brinchault
- Service de pneumologie, CHU Pontchaillou, 2, rue Henri-le-Guilloux, 35033 Rennes cedex, France
| | - P Diot
- Service de pneumologie, hôpital Bretonneau, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - A Dixmier
- Service de pneumologie et oncologie thoracique, centre hospitalier régional d'Orléans, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
| | - F Goupil
- Service de pneumologie, CH Le Mans, 194, avenue Rubillard, 72037 Le Mans cedex, France
| | - P Guillais
- CHP Saint-Martin, 18, rue des Roquemonts, 14000 Caen, France
| | - C Gut-Gobert
- Département de pneumologie et médecine interne, CHRU la Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest cedex 2, France
| | - C Leroyer
- UBO, EA3878 (GETBO) IFR 148, département de médecine interne et de pneumologie, CHU de la Cavale-Blanche, université européenne de Bretagne, 29609 Brest, France
| | - S Marchand-Adam
- UMR 1100, service de pneumologie et explorations fonctionnelles respiratoires, université François-Rabelais, CHRU de Tours, 37032 Tours, France; UMR 1100/EA6305, Inserm, centre d'étude des pathologies respiratoires, 37032 Tours, France
| | - J-C Meurice
- Service de pneumologie du CHU de Poitiers, faculté de médecine et pharmacie de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - H Morel
- Service de pneumologie et oncologie thoracique, centre hospitalier régional d'Orléans, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
| | - C Person
- Département de pneumologie, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France
| | - A Cavaillès
- Service de pneumologie, l'institut du thorax, CHU de Nantes, boulevard Jacques-Monod, 44093 Nantes cedex 1, France.
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Milhade N, Berthelot A, Yaïci A, Morel H, Lemaire B. Le tabac ce n’est pas……toux ! Au sujet de 2 cas de maladie veino-occlusive pulmonaire. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2015.04.015] [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: 10/23/2022]
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Cavaillès A, Brinchault-Rabin G, Dixmier A, Goupil F, Gut-Gobert C, Marchand-Adam S, Meurice JC, Morel H, Person-Tacnet C, Leroyer C, Diot P. Comorbidities of COPD. Eur Respir Rev 2014; 22:454-75. [PMID: 24293462 PMCID: PMC9639181 DOI: 10.1183/09059180.00008612] [Citation(s) in RCA: 293] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
By 2020, chronic obstructive pulmonary disease (COPD) will be the third cause of mortality. Extrapulmonary comorbidities influence the prognosis of patients with COPD. Tobacco smoking is a common risk factor for many comorbidities, including coronary heart disease, heart failure and lung cancer. Comorbidities such as pulmonary artery disease and malnutrition are directly caused by COPD, whereas others, such as systemic venous thromboembolism, anxiety, depression, osteoporosis, obesity, metabolic syndrome, diabetes, sleep disturbance and anaemia, have no evident physiopathological relationship with COPD. The common ground between most of these extrapulmonary manifestations is chronic systemic inflammation. All of these diseases potentiate the morbidity of COPD, leading to increased hospitalisations and healthcare costs. They can frequently cause death, independently of respiratory failure. Comorbidities make the management of COPD difficult and need to be evaluated and treated adequately.
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Affiliation(s)
- Arnaud Cavaillès
- Dept of Pulmonology, Institut du Thorax, CHU de Nantes, Nantes, 2 Dept of Pulmonology, Hôpital Pontchaillou, Rennes, 11 Université Européenne de Bretagne, UBO, EA3878 (GETBO) IFR 148, Rennes, 3 Dept of Pulmonology, CHR d'Orléans, Orléans, 4 Dept of Pulmonology, Centre Hospitalier Le Mans, Le Mans, 5 Dept of Internal Medicine and Pulmonology, University Hospital La Cavale Blanche, Brest, 6 Universite François Rabelais de Tours, INSERM U1100, Tours, 12 Universite François Rabelais de Tours, EA6305, Tours, 7 Dept of Pulmonology, CHU de Tours, Tours, 8 Dept of Pulmonology, Centre hospitalier de l'Université de Poitiers, Poitiers, 9 Dept of Pulmonology, Hôpital Broussais Hospital, Saint-Malo, and 10 Dept of Pulmonology, CHU Angers, Angers, France
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Héry G, Corre R, Leveiller G, Dansin E, Migaud I, Sohier L, Morel H, Jouneau S, Briens E. Intérêt du drain pleural tunnélisé (DPT) dans les pleurésies néoplasiques récidivantes : étude rétrospective sur 129 cas. Rev Mal Respir 2013. [DOI: 10.1016/j.rmr.2013.04.006] [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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Héry G, Jouneau S, Corre R, Briens E, Leveiller G, Migaud I, Morel H, Dansin E. Drain pleural tunnélisé dans les pleurésies métastatiques : étude rétrospective sur 129 cas. Rev Mal Respir 2013. [DOI: 10.1016/j.rmr.2012.10.142] [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: 10/27/2022]
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Devillier P, Jebrak G, Morel H, Chinet T, Didier A, Roche N. [Treatment of distal airways involvement in COPD]. Rev Mal Respir 2011; 28:1340-56. [PMID: 22152941 DOI: 10.1016/j.rmr.2011.08.005] [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] [Received: 01/16/2011] [Accepted: 08/06/2011] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The current pharmacological treatment of COPD provides only partial beneficial effects on symptoms, exercise tolerance, frequency of exacerbations and quality of life. This could be related to poor targeting of the distal airways by current treatments, yet these airways are particularly involved in airflow obstruction and its consequences such as hyperinflation. BACKGROUND Many treatments used in COPD could have effects on distal airways, including bronchodilators, corticosteroids, mucolytics and antibiotics. However, these possible effects remain poorly understood. VIEWPOINTS New treatments targeting more specifically the mechanisms of inflammation, oxidative stress and tissue remodeling that characterize COPD, could prove useful in its management, but most are still only in the early stages of their development. Advances could also come from improvements in inhalation devices, delivering more of the medication to the distal airways. CONCLUSIONS Improvement in the management of COPD could come from progress in terms of both molecules and their mode of administration.
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Affiliation(s)
- P Devillier
- UPRES EA 220, pôle des maladies respiratoires, hôpital Foch, 11 rue Guillaume-Lenoir, Suresnes, France
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Burgel PR, Bourdin A, Chanez P, Chabot F, Chaouat A, Chinet T, de Blic J, Devillier P, Deschildre A, Didier A, Garcia G, Jebrak G, Laurent F, Morel H, Perez T, Pilette C, Roche N, Tillie-Leblond I, Verbanck S, Dusser D. Update on the roles of distal airways in COPD. Eur Respir Rev 2011; 20:7-22. [DOI: 10.1183/09059180.10010610] [Citation(s) in RCA: 59] [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] Open
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Millet A, Morel H, Heautot JF, Corre R, Curran Y. [False aneurysm of the pulmonary artery secondary to a cancer recurrence]. Presse Med 2008; 37:1817-9. [PMID: 18774678 DOI: 10.1016/j.lpm.2007.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2007] [Revised: 09/23/2007] [Accepted: 10/24/2007] [Indexed: 11/29/2022] Open
Affiliation(s)
- Arnaud Millet
- Service de pneumologie, centre hospitalier Broussais, F-35400 Saint-Malo, France.
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Morel H, Jaffrin MY. A bridge from bioimpedance spectroscopy to 50 kHz bioimpedance analysis: application to total body water measurements. Physiol Meas 2008; 29:S465-78. [PMID: 18544829 DOI: 10.1088/0967-3334/29/6/s39] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
This paper presents a method for extrapolating the total body water (TBW) resistance R(t50) from the resistance measured at 50 kHz (R(50)). A DXA examination and impedance measurements were carried out in a 1st group of 57 healthy volunteers with a Xitron 4200 multifrequency impedancemeter, in order to determine their values of R(t50) by comparison with resistances extrapolated at an infinite frequency by the Xitron (R(infinity)). TBW volumes were calculated using our modified BIS method (Jaffrin et al 2006 Med. Biol. Eng. Comput. 44 873-82) from R(infinity), R(t50) and from the fat-free mass measured by DXA, assuming a hydration rate of 73.2%. The same protocol and calculations were also carried out on a 2nd group of 21 subjects for independent validation. Data of the 1st group showed that values of R(t50), not significantly different from those of R(infinity), could be obtained by dividing R(50) by 1.231 in men and by 1.224 in women. Applying this method to the 2nd group yielded also values of R(t50) not significantly different from R(infinity). TBW volumes V(t50) obtained from R(t50) were not significantly different from those of our modified BIS method V(tn), or from TBW volumes obtained from DXA in both groups. A comparison with three BIA methods of TBW determination showed that our new method gave results in better agreement with TBW from DXA and from our modified BIS method.
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Affiliation(s)
- H Morel
- UMR CNRS 6600, Department of Biological Engineering, Technological University of Compiègne, Compiègne, France
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Millet A, Morel H, Sanchez O, Meyer G, Le Roy Ladurie F, Dartevelle P, Dulmet E, Goarant E, Curran Y. [Invasion of the pulmonary artery by an undifferentiated carcinoma]. Rev Mal Respir 2008; 25:63-7. [PMID: 18288053 DOI: 10.1016/s0761-8425(08)70468-6] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The diagnosis of chronic obstruction of the pulmonary artery is difficult. We present the case of a woman with an invasive, undifferentiated carcinoma of the pulmonary artery. CASE REPORT A 61 year old woman complained of increasing dyspnoea. This was evaluated by computed tomography which showed a defect in the main pulmonary artery. There was no clinical or radiological improvement following anticoagulant treatment for two months. A repeat CT scan showed a persisting intravascular defect and the diagnoses considered included post-embolic pulmonary arterial hypertension and angiosarcoma. A surgical biopsy was performed and pericardial and aortic tumour nodules were found during the operation. The pathological examination revealed undifferentiated carcinoma. Further investigations failed to reveal the primary site. CONCLUSION Invasion of the pulmonary artery by angiosarcoma or other tumour is part of the differential diagnosis of chronic thromboembolic disease. The diagnosis rests on histology obtained by an intravascular or surgical procedure. Complete surgical excision may be possible in angiosarcoma but it was impossible in our patient. The patient died despite two courses of chemotherapy and targeted therapy with erlotinib.
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Affiliation(s)
- A Millet
- Service de Pneumologie, Hôpital Broussais, Saint-Malo, France
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Morel H, Jaffrin M, Legallais C, Vienken J. In vitrobicarbonate and urea kinetics during hemodialysis and online hemodiafiltration. Comput Methods Biomech Biomed Engin 2008. [DOI: 10.1080/10255840802297218] [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: 10/21/2022]
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Morel H, Jaffrin M, Moréno MV. Measurement of skeletal muscle mass in lower limbs with a foot-to-foot impedance meter. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)85000-1] [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: 10/24/2022]
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Roche N, Morel H, Martel P, Godard P. Clinical practice guidelines: medical follow-up of patients with asthma--adults and adolescents. Respir Med 2005; 99:793-815. [PMID: 15893464 DOI: 10.1016/j.rmed.2005.03.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2005] [Accepted: 03/09/2005] [Indexed: 11/25/2022]
Abstract
The follow-up of patients with asthma should focus on asthma control (disease course over a number of weeks).
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Affiliation(s)
- Nicolas Roche
- ANAES (French National Agency for Accreditation and Evaluation in Health) 2, Avenue du Stade de France, 93218 Saint Denis la Plaine Cedex, France
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Roche N, Morel H, Martel P, Godard P. [Monitoring adult and adolescent asthmatics: the ANAES and AFSSAPS guidelines, September 2004]. Rev Mal Respir 2005; 22:4S32-6. [PMID: 15976650] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- N Roche
- Pneumologie et Réanimation, Hôtel-Dieu, Paris.
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Blouquit S, Morel H, Hinnrasky J, Naline E, Puchelle E, Chinet T. Characterization of ion and fluid transport in human bronchioles. Am J Respir Cell Mol Biol 2002; 27:503-10. [PMID: 12356585 DOI: 10.1165/rcmb.4869] [Citation(s) in RCA: 26] [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] [Indexed: 11/24/2022] Open
Abstract
The regulation of the volume and composition of airway surface liquid is achieved through epithelial ion transport processes. In humans, these processes have been characterized in proximal but not distal airways. Segments of human bronchioles were dissected from surgically removed lung pieces. The transmural potential difference of microperfused bronchioles was inhibited by luminal exposure to amiloride and increased when exposed to the Cl secretagogues forskolin and ATP in the presence of amiloride. Human bronchiolar epithelial cells were cultured on permeable supports and studied in Ussing chambers. They generated a short circuit current (Isc) that decreased in response to amiloride and increased in response to forskolin and to ATP in the presence of amiloride. In low-Cl Kreb's Ringer bicarbonate, the baseline Isc and amiloride-induced decrease in Isc were not different, whereas the forskolin- and ATP-induced increases in Isc were smaller. Fluid transport measurement in excised bronchioles revealed a basal absorptive flow that was reduced by amiloride, whereas forskolin and ATP combined induced a secretory flow in the presence of amiloride. We conclude that human bronchioles actively absorb Na and fluid in unstimulated conditions and are capable of active Cl and fluid secretion when exposed to forskolin and to ATP.
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Affiliation(s)
- Sabine Blouquit
- Laboratoire de Biologie et Pharmacologie des Epithéliums Respiratoires, Université Paris V, Boulogne, France
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Mignon F, Chevrière A, Mesurolle B, El Hajam M, Morel H, Lacombe P. [Miliary induced by intravesical BCG immunotherapy for carcinoma of the bladder: CT Findings]. J Radiol 2002; 83:368-71. [PMID: 11979232] [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: 02/24/2023]
Abstract
The authors describe the case of a patient presenting miliary involvement of the lung due to mycobacterium bovis after intravesical BCG administration. After initial transurethral resection, the patient was treated with immunotherapy by intravesical instillation of BCG and received 9 treatments without any problem. After the 10th treatment, the patient presented with cough and signs of urinary infection. At admission the chest radiograph showed a miliary pattern, better seen at high resolution CT, and using helical technique with the maximum intensity projection (MIP) reconstructions. MIP demonstrated to better advantage the well defined contours of the nodules, distributed evenly and randomly in the whole lung. After anti-TB treatment, the patient had regained full activity with persistence of the miliary pattern but a decreased number and size of nodules and calcification in some of them. This case illustrates a rare complication of intravesical immunotherapy, and points out the superiority of Sliding Thin Slab MIP (STS-MIP) compared with standard HRCT which allows a better detection of extent and follow-up of a military pattern, notably in moderate forms, by improvement of the anatomical resolution.
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Affiliation(s)
- F Mignon
- Service de radiologie, Hôpital de Versailles, 78157 Le Chesnay, France.
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Cabrol S, Morel H, Qanadli S, Delaisement-Pol C, Labrune S, Bisson A, Huchon G, Chinet T. [Massive hemoptysis during sarcoidosis]. Rev Mal Respir 2000; 17:1111-3. [PMID: 11217510] [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: 02/19/2023]
Abstract
Hemoptysis is a rare but often severe event in sarcoidosis. It usually occurs in patients with advanced, fibrotic lung disease. We herein report the case of a 36-year old female patient with type II pulmonary sarcoidosis who presented with abundant hemoptysis very early during the course of her disease. Two attempts to embolize bronchial arteries remained unsuccessful and surgery was eventually required to stop the bleeding. Clinical, microbiological, radiological and pathological data indicate that haemoptysis was caused by systemic hypervascularization around sarcoidosis granuloma.
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Affiliation(s)
- S Cabrol
- Service de Pneumologie, Hôpital Ambroise Paré, Université Paris V, UFR Paris Ouest, Boulogne-Billancourt
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Roche N, Morel H, Maissonneuve H, Thoral F, Charvet-Protat S. [Clinical and economical assessment of surgical treatment for obstructive sleep apnea. National Agency for Accreditation and Evaluation in Health]. Rev Pneumol Clin 2000; 56:49-51. [PMID: 10740116] [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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