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Vauthier J, Touze C, Mauvieux B, Hingrand C, Delaunay P, Besnard S, Jouffroy R, Noirez P, Maboudou P, Parent C, Heyman E, Poussel M. Increased risk of acute kidney injury in the first part of an ultra-trail-Implications for abandonment. Physiol Rep 2024; 12:e15935. [PMID: 38684379 PMCID: PMC11058001 DOI: 10.14814/phy2.15935] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 05/02/2024] Open
Abstract
Acute kidneys injuries (AKIs) have been described in marathon and trail running. The currently available data allows assessment of before/after comparisons but does not allow an analysis of what happens during the race. A multidisciplinary assessment protocol was performed during the first trail of Clécy (Normandy France) in November 2021. This allowed an initial assay to be carried out, then at the end of each of the 6 loops of 26 km, and finally after 24 h of recovery. The race extends over 156 km in hilly terrain and 6000 m of elevation gain (D+). The level of impairment according to the RIFLE classification was defined for each runner at each assay. Fifty-five runners were at the start, and the per protocol analysis involved 36 runners (27 men and 9 women, 26 finishers). Fifteen (41.7%) of the riders presented at least one result corresponding to a "RIFLE risk" level. After 24 h of rest, only one runner still had a "RIFLE Risk". The distance around the marathon seems to be the moment of greatest risk. For the first time, we find an association between this renal risk and the probability of abandonment. Many runners are vulnerable to kidney damage during long-duration exercise, which is why it's important to limit risk situations, such as the use of potentially toxic drugs or hydration disorders. The consumption of NSAIDs (nonsteroidal anti-inflammatory drugs) before or during an ultra-distance race should therefore be prohibited. Attention should be paid to hydration disorders.
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Affiliation(s)
- Jean‐Charles Vauthier
- Département de Médecine GénéraleFaculté de MédecineNancyFrance
- Département of General PracticeMaison de Santé des Trois MontsDommartin‐lès‐RemiremontFrance
- INTERPSY 5UR4432Université de LorraineNnacyFrance
| | - Charlie Touze
- Département of General PracticeMaison de Santé des Trois MontsDommartin‐lès‐RemiremontFrance
| | | | | | | | - Stéphane Besnard
- UR 7480 VERTEXUniversité de CaenCaenFrance
- Service d'ORLCentre Hospitalier Universitaire de CaenCaenFrance
| | - Romain Jouffroy
- Intensive Care UnitAmbroise Paré University Hospital, Assistance Publique – Hôpitaux de Paris, and Paris Saclay UniversityBoulogneFrance
- IRMES – Institute for Research in Medicine and Epidemiology of SportInstitut National du Sport, de l'Expertise et de la PerformanceParisFrance
- INSERM U‐1018, Centre de recherche en Epidémiologie et Santé des PopulationsCentre de recherche en Epidémiologie et Santé des Populations, Paris Saclay UniversityParisFrance
| | - Philippe Noirez
- Performance Santé Métrologie Société (EA7507)Université Reims Champagne ArdenneReimsFrance
| | - Patrice Maboudou
- Univ. Lille, CHU Lille, Biologic et Pathologic CenterLilleFrance
| | - Cassandra Parent
- ULR 7369 – URePSSS – Unité de Recherche pluridisciplinaire Sport Santé SociétéUniv. Lille, Univ. LittoralLilleFrance
- Institut de Recherches Cliniques de MontréalMontréalQuébecCanada
| | - Elsa Heyman
- ULR 7369 – URePSSS – Unité de Recherche pluridisciplinaire Sport Santé SociétéUniv. Lille, Univ. LittoralLilleFrance
- Institut Universitaire de FranceParisFrance
| | - Mathias Poussel
- Department of Pulmonary Function Testing and Exercise PhysiologyUniversity Hospital of Nancy, University Centre of Sports Medicine and Adapted Physical Activity, University of LorraineNancyFrance
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Hasnaoui S, Van Hoye A, Soudant M, Rotonda C, Carvalho de Freitas A, Peiffert D, Delattre C, Raft J, Temperelli M, Allado E, Hily O, Chenuel B, Hornus-Dragne D, Omorou AY, Poussel M. Evaluating the feasibility and acceptability of an adapted fencing intervention in breast cancer surgery post-operative care: the RIPOSTE pilot randomized trial. Front Oncol 2024; 14:1335442. [PMID: 38665959 PMCID: PMC11043494 DOI: 10.3389/fonc.2024.1335442] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
Background Adapted physical activity programs have shown promising results in reducing the physical, social and psychological side effects associated with breast cancer, but the extent to which they can be effectively adopted, implemented and maintained is unclear. The aim of this study is to use the framework to guide the planning and evaluation of programs according to the 5 following keys: Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate a fencing program under the French acronym RIPOSTE (Reconstruction, Image de soi, Posture, Oncologie, Santé, Thérapie, Escrime) literally in English (Reconstruction, Self-Image, Posture, Oncology, Health, Therapy, Fencing). This program is an innovative intervention focused on improving the quality of life (QoL) of breast cancer surgery patients through fencing. Methods A convergent mixed methods pilot study was conducted to preliminary evaluate the different RE-AIM dimension of the pilot program. Twenty-four participants who have just undergone surgery for invasive breast cancer were randomly allocated in two groups: one group started immediately after their inclusion (Early RIPOSTE group) and the other started 3 months following their inclusion (Delayed RIPOSTE group). Participants answered a questionnaire at inclusion and at the end of the program on QoL, shoulder functional capacity, fatigue, anxiety-depression and physical activity. Results RIPOSTE program was able to reach mainly young and dynamic participants, attracted by the originality of fencing and keen to improve their physical condition. Regarding effectiveness, our results suggest a trend to the improvement of QoL, shoulder functional capacity, fatigue and anxiety-depression state, even without any significant differences between the Early RIPOSTE group and the Delayed RIPOSTE group. Discussions The cooperation, exchanges and cohesion within the group greatly facilitated the adoption of the program, whereas interruptions during school vacations were the main barriers. The intervention was moderately well implemented and adherence to the protocol was suitable. Conclusion RIPOSTE is an acceptable and effective program for involving breast cancer survivors in physical activity, that needs to be tested at a larger scale to investigate its effectiveness, but has the potential to be transferred and scaled up worldwide.
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Affiliation(s)
- Sabrine Hasnaoui
- Université de Lorraine, INSERM, UMR 1319, INSPIIRE, Nancy, France
| | - Aurélie Van Hoye
- Université de Lorraine, INSERM, UMR 1319, INSPIIRE, Nancy, France
- University of Limerick, Physical Activity for Health Research Center, Limerick, Ireland
| | - Marc Soudant
- Université de Lorraine, CHRU-Nancy, Inserm CIC-1433 Clinical Epidemiology, Nancy, France
| | - Christine Rotonda
- Université de Lorraine, INSERM, UMR 1319, INSPIIRE, Metz, France
- Université de Lorraine, Centre Pierre Janet, Metz, France
| | | | - Didier Peiffert
- Université de Lorraine, INSERM, UMR 1319, INSPIIRE, Nancy, France
- Lorraine Institute of Oncology, Department of Radiation Oncology, Vandoeuvre-Lès-Nancy, France
| | - Cécile Delattre
- Lorraine Institute of Oncology, Supportive Care Unit, Vandoeuvre-Lès-Nancy, France
| | - Julien Raft
- Lorraine Institute of Oncology, Department of Anesthesiology, Vandoeuvre-Lès-Nancy, France
- Université de Lorraine, INSERM UMR-S 1116 Equipe 2, Nancy, France
| | - Margaux Temperelli
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Edem Allado
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
| | - Oriane Hily
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Bruno Chenuel
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
| | | | - Abdou Y. Omorou
- Université de Lorraine, INSERM, UMR 1319, INSPIIRE, Nancy, France
- Université de Lorraine, CHRU-Nancy, Inserm CIC-1433 Clinical Epidemiology, Nancy, France
- The French National Platform Quality of Life and Cancer, Nancy, France
| | - Mathias Poussel
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
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Allado E, Chenuel B, Vauthier JC, Hily O, Richard S, Poussel M. Transient Central Facial Palsy at High Altitude: A Case Report. High Alt Med Biol 2024; 25:100-102. [PMID: 34191597 DOI: 10.1089/ham.2020.0184] [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] [Indexed: 11/12/2022] Open
Abstract
Allado, Edem, Bruno Chenuel, Jean-Charles Vauthier, Oriane Hily, Sébastien Richard, and Mathias Poussel. Transient central facial palsy at high altitude: a case report. High Alt Med Biol. 25:100-102, 2024.-High altitude cerebral edema (HACE) is a severe form of acute mountain sickness (AMS). Besides this life-threatening condition, other neurological disorders may develop at high altitude, even if the precise pathophysiological mechanisms generally remain undetermined and are often debated. We report the case of a 34-year-old woman presenting with moderate AMS during an ascent of Mount Kilimanjaro. While descending from the summit, she suddenly experienced focal neurological symptoms of visual blurring, tinnitus, lightheadedness, and the findings of left-sided central facial palsy (flattened nasolabial fold, fall of labial commissure, dysarthria, difficulty in whistling, and facial dysesthesia). These symptoms and signs were confirmed in the field by a physician. Her symptoms regressed spontaneously and completely while continuing to descend. The etiology of this neurological episode at high altitude is discussed. The most probable diagnosis is a transient ischemic attack based on personal and familial vascular history, confirmed unilateral transient central facial palsy and normal results on standard blood work and cerebral magnetic resonance imaging. In this case, migraine should also be considered based on association of headache and transient focal neurological impairment. Overall, special attention should be given to mountaineers presenting with neurological conditions at altitude. Not only HACE should be considered but also the wide spectrum of other neurological conditions that fall outside the usual definition of altitude sickness.
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Affiliation(s)
- Edem Allado
- CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | - Bruno Chenuel
- CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | - Jean-Charles Vauthier
- Department of General Practice, Maison de Santé des Trois Monts, Dommartin-lès-Remiremont, France
| | - Oriane Hily
- CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Sébastien Richard
- CHRU-Nancy, Department of Neurology, Stroke Unit, CIC-P 1433, INSERM U1116, Nancy, France
| | - Mathias Poussel
- CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
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Louis A, Pröpper C, Savina Y, Tanne C, Duperrex G, Robach P, Zellner P, Doutreleau S, Boulet JM, Frey A, Pillard F, Pistea C, Poussel M, Thuet T, Richalet JP, Lecoq-Jammes F. The Impact of COVID-19 on the Response to Hypoxia. High Alt Med Biol 2023; 24:321-328. [PMID: 37843910 DOI: 10.1089/ham.2022.0156] [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] [Indexed: 10/17/2023] Open
Abstract
Louis, Alexandre, Charlotte Pröpper, Yann Savina, Corentin Tanne, Guy Duperrex, Paul Robach, Pascal Zellner, Stéphane Doutreleau, Jean-Michel Boulet, Alain Frey, Fabien Pillard, Cristina Pistea, Mathias Poussel, Thomas Thuet, Jean-Paul Richalet, and François Lecoq-Jammes. The impact of COVID-19 on the response to hypoxia. High Alt Med Biol. 24:321-328, 2023. Background: Severe high-altitude illness (SHAI) and coronavirus disease 2019 (COVID-19), while differing in most aspects of pathophysiology, both involve respiratory capacity. We examined the long-term impact of COVID-19 on response to hypoxia in individuals free of symptoms but having tested positive during the pandemic. The need for recommendations for such individuals planning a stay at high altitude are discussed. Methods: This multicenter study recruited participants from the multiSHAI cohort, all of whom had previously undergone a hypoxic exercise test. These participants were classified into two groups depending on whether they had since suffered mild-to-moderate COVID-19 (COVID+) or not (Control) and then asked to retake the test. Primary outcomes were: desaturation induced by hypoxia at exercise (ΔSpE), hypoxic cardiac response at exercise, hypoxic ventilatory response at exercise, and SHAI risk score. Results: A total of 68 participants retook the test, 36 classified in the COVID+ group. Analyses of primary outcomes showed no significant differences between groups. However, the COVID+ group showed significantly increased ventilation (VE) parameters during both hypoxic (p = 0.003) and normoxic exercise (p = 0.007). However, only the VE/oxygen consumption relationship during hypoxic exercise was significantly different. Conclusion: This study demonstrates no negative impact of COVID-19 on response to hypoxia as evaluated by the Richalet test. Clinical Trial Registration: NTC number: NCT05167357.
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Affiliation(s)
- Alexandre Louis
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
| | | | - Yann Savina
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
- UPR-4278 Laboratoire de Physiologie Expérimentale Cardiovasculaire (LaPEC)-Avignon Université, Avignon, France
| | - Corentin Tanne
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
- Pediatric Service, Metropole Savoie Hospital Center, Chambéry, France
| | - Guy Duperrex
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
| | - Paul Robach
- National School for Mountain Sports, Site of the National School for Skiing and Mountaineering (ENSA), Chamonix, France
| | - Pascal Zellner
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
| | | | | | - Alain Frey
- Sports Medicine Department, CHI Poissy/St Germain, Poissy, France
| | - Fabien Pillard
- Sports Medicine Department, University Sports Clinic, Pierre Paul Riquet University Hospital, Toulouse, France
| | - Cristina Pistea
- Mitochondria, Oxidative Stress, and Muscle Protection, University of Strasbourg, Strasbourg, France
- Physiology and Functional Exploration Service, University Hospital of Strasbourg, CHU, Strasbourg, France
| | - Mathias Poussel
- Department of Pulmonary Function Testing and Exercise Physiology, Nancy University Hospital, Nancy, France
| | - Thomas Thuet
- Sports Medicine Department, CHI Poissy/St Germain, Poissy, France
| | - Jean-Paul Richalet
- INSERM U1272, University Sorbonne Paris Nord, Bobigny, France
- Medical Pole, INSEP, Paris, France
| | - François Lecoq-Jammes
- IFREMMONT (Training and Research Institute of Mountain Medicine), Chamonix-Mont-Blanc, France
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5
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Guilleminault L, Demoulin-Alexikova S, de Gabory L, Varannes SBD, Brouquières D, Balaguer M, Chapron A, Grassin-Delyle S, Poussel M, Guibert N, Reychler G, Trzepizur W, Woisard V, Crestani S. Guidelines for the management of chronic cough in adults. Endorsed by the French speaking society of respiratory diseases (Société de Pneumologie de Langue Française, SPLF), the Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou (SFORL), the Société Française de Phoniatrie et de Laryngologie (SFPL), the Société Nationale Française de Gastro-entérologie (SNFGE). Respir Med Res 2023; 83:101011. [PMID: 37087905 DOI: 10.1016/j.resmer.2023.101011] [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: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
Patients with chronic cough experience a high alteration of quality of life. Moreover, chronic cough is a complex entity with numerous etiologies and treatments. In order to help clinicians involved in the management of patients with chronic cough, guidelines on chronic cough have been established by a group of French experts. These guidelines address the definitions of chronic cough and the initial management of patients with chronic cough. We present herein second-line tests that might be considered in patients with cough persistence despite initial management. Experts also propose a definition of unexplained or refractory chronic cough (URCC) in order to better identify patients whose cough persists despite optimal management. Finally, these guidelines address the pharmacological and non-pharmacological interventions useful in URCC. Thus, amitryptilline, pregabalin, gabapentin or morphine combined with speech and/or physical therapy are a mainstay of treatment strategies in URCC. Other treatment options, such as P2 × 3 antagonists, are being developed.
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Affiliation(s)
- Laurent Guilleminault
- Pôle des voies respiratoires, service de pneumo-allergologie, Centre Hospitalo-Universitaire de Toulouse, 24 chemin de pouvourville, 31059, Toulouse, France; Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Inserm U1291, University of Toulouse, CNRS U5282, 31000, Toulouse, France.
| | - Silvia Demoulin-Alexikova
- CHU de Lille, Lille, France Univ. Lille, CNRS, Inserm, CHU Lille - Service des Explorations Fonctionnelles Respiratoires, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, 59000, Lille, France
| | - Ludovic de Gabory
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, Univ. Bordeaux, 33000, France
| | - Stanislas Bruley Des Varannes
- Gastroenterology Department, CHU de Nantes, Institut des Maladies de l'Appareil Digestif, IMAD CIC 1413, Université de Nantes, 44000, Nantes, France
| | - Danielle Brouquières
- Pôle des voies respiratoires, service de pneumo-allergologie, Centre Hospitalo-Universitaire de Toulouse, 24 chemin de pouvourville, 31059, Toulouse, France
| | - Mathieu Balaguer
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Anthony Chapron
- Université de Rennes 1, CHU Rennes, Département de Médecine Générale, 35000, Rennes, France
| | - Stanislas Grassin-Delyle
- Respiratory Diseases Department, Foch Hospital, 92150, Suresnes, France; Infection and Inflammation, Health Biotechnology Department, Paris-Saclay University, UVSQ, INSERM, 78180, Montigny le Bretonneux, France
| | - Mathias Poussel
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire-Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000, Nancy, France; DevAH, Université de Lorraine, F54000, Nancy, France
| | - Nicolas Guibert
- Pôle des voies respiratoires, service de pneumo-allergologie, Centre Hospitalo-Universitaire de Toulouse, 24 chemin de pouvourville, 31059, Toulouse, France
| | | | - Wojciech Trzepizur
- Department of Respiratory and Sleep Medicine, Angers University Hospital, INSERM 1083, UMR CNRS 6015, MITOVASC, Equipe CarME, SFR ICAT, University of Angers, 49000, Angers, France
| | - Virginie Woisard
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Sabine Crestani
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
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6
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Guilleminault L, Demoulin-Alexikova S, de Gabory L, Bruley des Varannes S, Brouquières D, Balaguer M, Chapron A, Grassin Delyle S, Poussel M, Guibert N, Reychler G, Trzepizur W, Woisard V, Crestani S. [Guidelines for the management of chronic cough in adults]. Rev Mal Respir 2023; 40:432-452. [PMID: 37080877 DOI: 10.1016/j.rmr.2023.03.001] [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: 02/01/2023] [Accepted: 03/03/2023] [Indexed: 04/22/2023]
Abstract
Patients with chronic cough experience major alteration in their quality of life. Given its numerous etiologies and treatments, this disease is a complex entity. To help clinicians involved in patient management of patients, guidelines have been issued by a group of French experts. They address definitions of chronic cough and initial management of patients with this pathology. We present herein the second-line tests that might be considered in patients whose coughing has persisted, notwithstanding initial management. The experts have also put forward a definition of unexplained or refractory chronic cough (URCC), the objective being to more precisely identify those patients whose cough persists despite optimal management. Lastly, these guidelines indicate the pharmacological and non-pharmacological interventions of use in URCC. Amitriptyline, pregabalin, gabapentin or morphine combined with speech and/or physical therapy are mainstays in treatment strategies. Other treatment options, such as P2X3 antagonists, are being developed and have generated high hopes among physicians and patients alike.
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Affiliation(s)
- L Guilleminault
- Pôle des voies respiratoires, service de pneumo-allergologie, centre hospitalo-universitaire de Toulouse, Toulouse, France; Institut toulousain des maladies infectieuses et inflammatoires (Infinity) INSERM UMR1291, CNRS UMR5051, université de Toulouse III, Toulouse, France.
| | - S Demoulin-Alexikova
- CHU de Lille, Lille, France; Inserm, CNRS, U1019-UMR9017, service des explorations fonctionnelles respiratoires, centre d'infection et d'immunité de Lille (CIIL), Institut Pasteur de Lille, university Lille, CHU Lille, Lille, France
| | - L de Gabory
- Department of otorhinolaryngology - head and neck surgery, university hospital of Bordeaux, Bordeaux, France; University of Bordeaux, 33000 Bordeaux, France
| | - S Bruley des Varannes
- IMAD CIC 1413, gastroenterology department, Institut des maladies de l'appareil digestif, université de Nantes, CHU de Nantes, Nantes, France
| | - D Brouquières
- Pôle des voies respiratoires, service de pneumo-allergologie, centre hospitalo-universitaire de Toulouse, Toulouse, France
| | - M Balaguer
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - A Chapron
- Département de médecine générale, université de Rennes 1, CHU Rennes, Rennes, France
| | - S Grassin Delyle
- Respiratory diseases department, Foch hospital, Suresnes, France; Inserm, UVSQ, infection and inflammation, health biotechnology department, Paris-Saclay university, Montigny-le-Bretonneux, France
| | - M Poussel
- Exploration fonctionnelle respiratoire, centre universitaire de médecine du sport et activités physiques adaptées, CHRU de Nancy, 54000 Nancy, France; DevAH, université de Lorraine, 54000 Nancy, France
| | - N Guibert
- Pôle des voies respiratoires, service de pneumo-allergologie, centre hospitalo-universitaire de Toulouse, Toulouse, France
| | - G Reychler
- Université catholique de Louvain, Louvain, Belgique
| | - W Trzepizur
- Department of respiratory and sleep medicine, Angers university hospital, Angers, France; Inserm 1083, UMR CNRS 6015, MITOVASC, équipe CarME, SFR ICAT, university of Angers, 49000 Angers, France
| | - V Woisard
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - S Crestani
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
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7
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Valentin S, Renel B, Manneville F, Caron B, Choukour M, Guillaumot A, Chaouat A, Poussel M, Chateau T, Peyrin-Biroulet C, Achit H, Peyrin-Biroulet L, Chabot F. Prevalence of and Factors Associated with Respiratory Symptoms Among Patients with Inflammatory Bowel Disease: A Prospective Study. Inflamm Bowel Dis 2023; 29:207-216. [PMID: 35394504 DOI: 10.1093/ibd/izac062] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND No large, prospective study has investigated respiratory symptoms in patients with inflammatory bowel diseases. We aimed to describe the prevalence of and factors associated with respiratory symptoms in patients with inflammatory bowel disease. METHODS In an observational, prospective, cross-sectional study, we evaluated the frequency of respiratory symptoms using a validated self-reporting questionnaire from February 2019 to February 2021 during routine follow-up outpatient visits of patients with inflammatory bowel disease followed in the Gastroenterology Department of the Nancy University Hospital. In case of a positive questionnaire, patients were systematically offered a consultation with a pulmonologist in order to investigate a potential underlying respiratory disease. RESULTS There were 325 patients included, and 180 patients had a positive questionnaire (144 with Crohn's disease). Of the included patients, 165 (50.8%) presented with respiratory symptoms, with dyspnea being the most frequent symptom (102 patients). There were 102 patients (56.7%) who benefited from a consultation in the pulmonology department: 43 (42.2%) were diagnosed with a respiratory disease, mainly asthma (n = 13) or chronic obstructive pulmonary disease (n = 10). Fourteen patients (13.7%) had obstructive sleep apnea. A body mass index increase, being a smoker or ex-smoker, and having articular extra-intestinal manifestations were independently associated with a higher prevalence of respiratory symptoms. CONCLUSIONS Half of patients with inflammatory bowel disease reported respiratory symptoms in our study. Patients with inflammatory bowel disease should be systematically screened, as pulmonary disease is frequently present in this population, with specific attention being given to smokers or ex-smokers and patients with extra-articular intestinal manifestations.
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Affiliation(s)
- Simon Valentin
- Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Médicale de Recherche (UMR)_S1116, Vandœuvre-Lès-Nancy, France
| | - Brian Renel
- Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Nancy, France
| | - Florian Manneville
- Centre Hospitalier Régional Universitaire (CHRU)-Nancy, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lorraine, Centre d'Investigation Cinique (CIC) Épidémiologie Clinique, Nancy, France
| | - Bénédicte Caron
- Nancy University Hospital, Department of Gastroenterology, Nancy, France.,Centre Hospitalier Régional Universitaire (CHRU) Nancy, Délégation à la Recherche Clinique et à l'Innovation, Plateforme Maladies Inflammatoires Chroniques de l'Intestin (MICI), Vandoeuvre-Lès-Nancy, France
| | - Myriam Choukour
- Centre Hospitalier Régional Universitaire (CHRU) Nancy, Délégation à la Recherche Clinique et à l'Innovation, Plateforme Maladies Inflammatoires Chroniques de l'Intestin (MICI), Vandoeuvre-Lès-Nancy, France
| | - Anne Guillaumot
- Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Nancy, France
| | - Ari Chaouat
- Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Médicale de Recherche (UMR)_S1116, Vandœuvre-Lès-Nancy, France
| | - Mathias Poussel
- Centre Hospitalier Régional Universitaire (CHRU)-Nancy, Department of Pulmonary Function Testing, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France.,Université de Lorraine, Développement, Adaptation et Handicap (DevAH), Nancy, France
| | - Thomas Chateau
- Nancy University Hospital, Department of Gastroenterology, Nancy, France
| | - Carina Peyrin-Biroulet
- Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Nancy, France
| | - Hamza Achit
- Centre Hospitalier Régional Universitaire (CHRU)-Nancy, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lorraine, Centre d'Investigation Cinique (CIC) Épidémiologie Clinique, Nancy, France
| | - Laurent Peyrin-Biroulet
- Nancy University Hospital, Department of Gastroenterology, Nancy, France.,Université de Lorraine, Inserm, Nutrition-Genetics and Environmental Risk Exposure (NGERE), Nancy, France
| | - François Chabot
- Université de Lorraine, Centre Hospitalier Régional Universitaire (CHRU) Nancy, Pôle des Spécialités Médicales/Département de Pneumologie, Nancy, France.,Université de Lorraine, Faculté de Médecine de Nancy, Institut National de la Santé et de la Recherche Médicale (INSERM) Unité Médicale de Recherche (UMR)_S1116, Vandœuvre-Lès-Nancy, France
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Allado E, Poussel M, Albuisson E, Paysant J, Temperelli M, Hily O, Moussu A, Benhajji N, Gauchard G, Chenuel B. Real intensity of physical activity capacity of patients with chronic disease: a cross-sectional study. Sci Rep 2022; 12:12593. [PMID: 35869273 PMCID: PMC9307794 DOI: 10.1038/s41598-022-17047-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 07/20/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractThe aim of this study was to evaluate the real intensity level of exercise in a sample of patients with chronic disease from obesity, rheumatology, hematology and other departments involved in a hospital-based program of adapted physical activity (APA). For this cross-sectional study, we studied seventy-five patients with chronic disease and no beta-blocker treatment. They systematically performed a cardiopulmonary exercise test before participating in a supervised APA practice using a telemetry wireless system to monitor heart rate (HR) during the first session. Based upon the results of the functional evaluation of exercise performance, we studied two groups of patients: (1) No limitation in exercise performance (maximal oxygen uptake greater than or equal to 80% of the theoretical reference) and (2) limited exercise performance (maximal oxygen uptake less than 80% of the theoretical value). Fifty-two patients (69.3%) were women, mean age was 42.6 (± 13.8), and mean BMI was 36.7 (± 10.6). Most patients had been referred for obesity (57.3%). We found 39 patients with normal exercise capacities and 36 patients with limited exercise performance. There were no significant differences in demographic and clinical characteristics between the two groups. For all populations, the mean and median real intensity levels of exercise in a sample of patients were moderate (55–70% HR max) and were the same for both groups. During the most intensive 15-min bout of the APA session, the HR for patients in both groups was greater than 70% of the actual maximum HR. This study observed a moderate level of APA exercise intensity in patients suffering from various chronic diseases. We found no significant difference in intensity level of exercise between patients’ capacities, i.e., with and without limitation of their maximal performance.
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9
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Allado E, Poussel M, Hamroun A, Moussu A, Kneizeh G, Hily O, Temperelli M, Corradi C, Koch A, Albuisson E, Chenuel B. Is There a Relationship between Hyperventilation Syndrome and History of Acute SARS-CoV-2 Infection? A Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10112154. [PMID: 36360494 PMCID: PMC9690850 DOI: 10.3390/healthcare10112154] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/20/2022] [Accepted: 10/22/2022] [Indexed: 01/08/2023] Open
Abstract
Following COVID-19 infection, many patients suffer from long-lasting symptoms that may greatly impair their quality of life. Persisting dyspnea and other functional respiratory complaints can evoke hyperventilation syndrome (HVS) as a putative contributor to long-COVID presentation in COVID-19 survivors. We aimed to assess the possible relationship between HVS and previous acute COVID-19 infection. We designed a cross-sectional, single-center study, including all patients consecutively referred to our Lung Function and Exercise Testing Department between January and June 2021. Participants completed a systematic Nijmegen Questionnaire, a modified Medical Research Council dyspnea scale assessment, a post-COVID screening questionnaire, and performed a standardized lung function test. The population was divided according to HVS diagnosis, defined as a Nijmegen score of > 23/64. The occurrence of previous COVID-19 infection was compared according to the Nijmegen score after adjustment for potential confounders by multivariate logistic regression. In total, 2846 patients were included: 1472 men (51.7%) with a mean age of 56 (±16.6) years. A total of 455 patients (16%) declared a previous SARS-CoV-2 infection, and 590 patients presented a positive score (>23/64) in the Nijmegen Questionnaire (20.7%). Compared with COVID-19-free patients, there was an increased occurrence of HVS+ in cases of COVID-19 infection that did not require hospitalization (aOR = 1.93 [1.17−3.18]). The results of this large-scale, cross-sectional study suggest an association between HVS diagnosis and a history of COVID-19 disease in patients who were not hospitalized.
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Affiliation(s)
- Edem Allado
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
- DevAH, Université de Lorraine, F54000 Nancy, France
| | - Mathias Poussel
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
- DevAH, Université de Lorraine, F54000 Nancy, France
| | - Aghiles Hamroun
- Department of Public Health, Epidemiology, Health Economics and Prevention, Regional and University Hospital Center of Lille, Lille University, F59000 Lille, France
| | - Anthony Moussu
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
| | - Ghias Kneizeh
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
| | - Oriane Hily
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
| | - Margaux Temperelli
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
| | - Christophe Corradi
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
| | - Alexandre Koch
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
| | - Eliane Albuisson
- CHRU-Nancy, Direction de la Recherche Clinique et de l’Innovation, F54000 Nancy, France
- CNRS, IECL, Université de Lorraine, F54000 Nancy, France
- Département du Grand Est de Recherche en Soins Primaires (DEGERESP), Université de Lorraine, F54000 Nancy, France
| | - Bruno Chenuel
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000 Nancy, France
- DevAH, Université de Lorraine, F54000 Nancy, France
- Correspondence:
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Dupont A, Hossu G, Cherifi A, Beaumont M, Mandry D, Poussel M. From training to overtraining: The necessity of an integrated approach. Sci Sports 2022. [DOI: 10.1016/j.scispo.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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11
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Allado E, Poussel M, Renno J, Moussu A, Hily O, Temperelli M, Albuisson E, Chenuel B. Remote Photoplethysmography Is an Accurate Method to Remotely Measure Respiratory Rate: A Hospital-Based Trial. J Clin Med 2022; 11:3647. [PMID: 35806932 PMCID: PMC9267568 DOI: 10.3390/jcm11133647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 02/04/2023] Open
Abstract
Remote photoplethysmography imaging (rPPG) is a new solution proposed to measure vital signs, such as respiratory rate (RR) in teleconsultation, by using a webcam. The results, presented here, aim at evaluating the accuracy of such remote measurement methods, compared with existing measurement methods, in a real-life clinical setting. For each patient, measurement of RR, using the standard system (control), has been carried out concomitantly with the experimental system. A 60-s time frame was used for the measurements made by our rPPG system. Age, gender, BMI, and skin phototype were collected. We performed the intraclass correlation coefficient and Bland-Altman plot to analyze the accuracy and precision of the rPPG algorithm readings. Measurements of RR, using the two methods, have been realized on 963 patients. Comparison of the two techniques showed excellent agreement (96.0%), with most of the patients (n = 924-standard patients) being in the confidence interval of 95% in Bland-Altman plotting. There were no significant differences between standard patients and outlier patients for demographic and clinical characteristics. This study indicates a good agreement between the rPPG system and the control, thus allowing clinical use of this remote assessment of the respiratory rate.
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Affiliation(s)
- Edem Allado
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France
- OMEOS, F-54000 Nancy, France;
| | - Mathias Poussel
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France
| | | | - Anthony Moussu
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
- OMEOS, F-54000 Nancy, France;
| | - Oriane Hily
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
| | - Margaux Temperelli
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
| | - Eliane Albuisson
- CHRU-Nancy, Direction de la Recherche Clinique et de l’Innovation, F-54000 Nancy, France;
- CNRS, IECL, Université de Lorraine, F-54000 Nancy, France
- Département du Grand Est de Recherche en Soins Primaires (DEGERESP), Université de Lorraine, F-54000 Nancy, France
| | - Bruno Chenuel
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire—Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F-54000 Nancy, France; (M.P.); (A.M.); (O.H.); (M.T.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France
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Proença Lopes C, Allado E, Essadek A, Poussel M, Henry A, Albuisson E, Hamroun A, Chenuel B. Occurrence of Alexithymia and Its Association with Sports Practice from a Sample of University Students: Results from a French Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10050788. [PMID: 35627924 PMCID: PMC9141175 DOI: 10.3390/healthcare10050788] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background: This study aimed to assess the prevalence of alexithymia in a sample of university students and to determine its association with specific sports practice characteristics (competition and training). Methods: In this cross-sectional study, anthropometric data and characteristics of sport practice were collected, as well as level of alexithymia (Toronto Alexithymia Scale, (TAS-20)). Results: The study included 253 French university students who completed a questionnaire specifying their regular sports practice and level of alexithymia (TAS-20). We found 76 subjects (30%) who had proven alexithymia and 92 (36.4%) who were borderline alexithymic. A significant positive relationship between alexithymia and the weekly amount of training practice was observed. It should be noted that students who engage in more than 5 h of physical activity are more prone to be borderline or alexithymic (respectively, 19.6 and 19.7% versus 7.1% for non-alexithymics; p = 0.03). Conclusion: With a 30% frequency, alexithymia is more prevalent in this context than in the general population. Furthermore, alexithymia and borderline alexithymia are most favorably associated with higher physical activity (over 5 h per week).
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Affiliation(s)
- Catarina Proença Lopes
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Correspondence: ; Tel.: +33-6-12-21-87-42
| | - Edem Allado
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Aziz Essadek
- INTERPSY (EA 4432), University of Lorraine, 54000 Nancy, France;
| | - Mathias Poussel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Audrey Henry
- Cognition, Health and Society Laboratory, University of Reims Champagne-Ardenne, 51571 Reims, France;
| | - Eliane Albuisson
- Institut Elie-Cartan de Lorraine, CNRS, Université de Lorraine, 54000 Nancy, France;
| | - Aghilès Hamroun
- Department of Public Health, Epidemiology, Health Economics and Prevention, Regional and University Hospital Center of Lille, Lille University, 59000 Lille, France;
| | - Bruno Chenuel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
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Allado E, Poussel M, Albuisson E, Paysant J, Temperelli M, Hily O, Moussu A, Benhajji N, Gauchard GC, Chenuel B. Physical Activity Capacity Assessment of Patients with Chronic Disease and the Six-Minute Walk Test: A Cross-Sectional Study. Healthcare (Basel) 2022; 10:758. [PMID: 35627895 PMCID: PMC9141940 DOI: 10.3390/healthcare10050758] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to evaluate the efficacy of the Six-Minute Walk Test (6MWT) to determine the physical activity capacities of patients with chronic disease. Methods: For this cross-sectional study, we investigated 156 patients with chronic disease and no beta-blocker treatment. They systematically performed a maximal cardiopulmonary exercise test to determine their heart rate peak (HRPeak) and maximal oxygen uptake (V’O2max). We considered two groups of patients based upon the results of the functional evaluation of exercise performance: (1) No limitation in exercise performance (V’O2max greater or equal to 80% of the theoretical reference) and (2) limited exercise performance (V’O2max less than 80% of the theoretical value). All patients also received a 6MWT on the same day as the exercise test. Results: We found 68 (43.6%) patients with normal exercise capacities and 88 (56.4%) patients with limited exercise performance. In this sample, 6MWT mean distances were 510 (87) and 506 (86) m, respectively. There were no significant differences between the two groups for distance and end-test heart rate. The correlation between matrix V’O2max measured during the maximal incremental exercise test and the 6MWT distance displayed a positive slope (r = 0.549 CI95 [0.431−0.656]—p < 0.001). Conclusion: Our results showed a moderate relationship between 6MWT and physical activity capacity for patients with chronic disease.
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Affiliation(s)
- Edem Allado
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France; (J.P.); (G.C.G.)
- OMEOS, F-54000 Nancy, France;
| | - Mathias Poussel
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France; (J.P.); (G.C.G.)
| | - Eliane Albuisson
- Direction de la Recherche Clinique et de l’Innovation, CHRU-Nancy, F-54000 Nancy, France;
- IECL, CNRS, Université de Lorraine, F-54000 Nancy, France
- Département du Grand Est de Recherche en Soins Primaires (DEGERESP), Faculté de Médecine, Université de Lorraine, F-54000 Nancy, France
| | - Jean Paysant
- DevAH, Université de Lorraine, F-54000 Nancy, France; (J.P.); (G.C.G.)
- IECL, CNRS, Université de Lorraine, F-54000 Nancy, France
- Rehabilitation Medicine Department, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France
| | - Margaux Temperelli
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
| | - Oriane Hily
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
| | - Anthony Moussu
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
- OMEOS, F-54000 Nancy, France;
| | - Noura Benhajji
- OMEOS, F-54000 Nancy, France;
- IECL, CNRS, Université de Lorraine, F-54000 Nancy, France
| | | | - Bruno Chenuel
- University Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, Université de Lorraine, F-54000 Nancy, France; (M.P.); (M.T.); (O.H.); (A.M.); (B.C.)
- DevAH, Université de Lorraine, F-54000 Nancy, France; (J.P.); (G.C.G.)
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Omorou AY, Peiffert D, Rotonda C, Van Hoye A, Allado E, Hily O, Temperelli M, Chenuel B, Hornus-Dragne D, Poussel M. Adapted Fencing for Patients With Invasive Breast Cancer: The RIPOSTE Pilot Randomized Controlled Trial. Front Sports Act Living 2022; 4:786852. [PMID: 35425895 PMCID: PMC9002110 DOI: 10.3389/fspor.2022.786852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionEven if indications for mastectomy have been progressively reduced in loco-regional breast cancer (BC) treatment, the harmful effects of surgery are still numerous and can impact physical and psychological wellbeing of women. The RIPOSTE (Reconstruction, self-Image, Posture, Oncology, “Santé”-Health, Therapy, “Escrime”-Fencing) program aimed to propose adapted fencing to patients with BC. This study aims to investigate the effect and conditions of effectiveness of the RIPOSTE program.Methods and analysisThis is a prospective randomized controlled trial including 24 patients with invasive BC who have just undergone surgery. The study will be proposed to the patient and if interested, the patient will be referred to a sports physician for a medico-sportive evaluation. At the end the evaluation, if the patient meets the inclusion criteria, she will be randomly assigned to one of the 2 groups based on a 1:1 principle: Early RIPOSTE group (receive one fencing session per week for 3 months immediately after their inclusion), Delayed RIPOSTE group (receive one fencing session per week for 3 months but within the 3 months following their inclusion). Patients will be included for 6 months with 3 follow-up times (0, 3, and 6 months) by a sport physician. The primary outcome is the evolution of quality of life score. Secondary outcomes are disability score, fatigue, anxiety-depression, cost-effectiveness and process evaluation.Ethics and disseminationThe study protocol has been approved by a French ethics committee (CPP Sud Méditerranée IV, N°ID-RCB: 2020-A01916-33). Results will be submitted for publication, at scientific conferences and through press releases.Trial RegistrationNCT04627714.
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Affiliation(s)
- Abdou Y. Omorou
- Université de Lorraine, CHRU-Nancy, Inserm CIC-1433 Clinical Epidemiology, Nancy, France
- Université de Lorraine, Apemac, Nancy, France
- The French National Platform Quality of Life and Cancer, Nancy, France
| | - Didier Peiffert
- Université de Lorraine, Apemac, Nancy, France
- Lorraine Institute of Oncology, Department of Radiation Oncology, Vandoeuvre-Lès-Nancy, France
| | - Christine Rotonda
- Université de Lorraine, Apemac, Nancy, France
- Université de Lorraine, Centre Pierre Janet, Metz, France
| | | | - Edem Allado
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
| | - Oriane Hily
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Margaux Temperelli
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Bruno Chenuel
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
| | | | - Mathias Poussel
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Department of Physiology, Nancy, France
- *Correspondence: Mathias Poussel
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Allado E, Poussel M, Albuisson E, Paysant J, Temperelli M, Hily O, Moussu A, Benhajji N, Gauchard G, Chenuel B. Physical Activity Capacity Assessment of Patients With Chronic Disease and the 1-Minute Sit to Stand Test: Is There an Interest? Front Sports Act Living 2022; 4:839509. [PMID: 35368419 PMCID: PMC8970334 DOI: 10.3389/fspor.2022.839509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Received: 12/20/2021] [Accepted: 02/11/2022] [Indexed: 11/26/2022] Open
Abstract
Objective This study aimed to evaluate the efficacy of the 1-minute Sit to Stand test (1MSTS) to determine physical activity capacities for patients with chronic disease. Methods For this cross-sectional study, we studied fifty patients with chronic disease and no beta-blocker treatment. They systematically performed a cardiopulmonary exercise test to determine maximal oxygen uptake (V'O2max). We considered two groups of patients based on the results of the functional evaluation of exercise performance: (1) No limitation in exercise performance (V'O2max greater or equal to 80% of the theoretical reference) and (2) limited exercise performance (V'O2max <80% of the theoretical value). All patients also received an 1MSTS on the same day. Results We found 22 (44.0%) patients with normal exercise capacity and 28 (56.0%) patients with limited exercise performance. In this sample, mean 1MSTS repetitions were 27.1 (7.1) and 25.2 (8.7), respectively. There were no significant differences between the two groups for repetition and Borg Scale end test. The correlation between V'O2max measured during the exercise test and 1MSTS repetitions displayed a positive slope [r = 0.401 (95% CI 0.114–625)]. Conclusion This study demonstrated a moderate relationship between 1MSTS and V'O2max for patients with chronic disease. 1MSTS did not permit the precise determination of physical activity capacities in this sample.
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Affiliation(s)
- Edem Allado
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Nancy, France
- OMEOS, Nancy, France
- *Correspondence: Edem Allado
| | - Mathias Poussel
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Nancy, France
| | - Eliane Albuisson
- CHRU-Nancy, Direction de la Recherche Clinique et de l'Innovation, Nancy, France
- Université de Lorraine, CNRS, IECL, Nancy, France
- Université de Lorraine, Faculté de Médecine, Département du Grand Est de Recherche en Soins Primaires: DEGERESP, Nancy, France
| | - Jean Paysant
- Université de Lorraine, DevAH, Nancy, France
- Université de Lorraine, CHRU-Nancy, Rehabilitation Medicine Department, Nancy, France
| | - Margaux Temperelli
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Oriane Hily
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
| | - Anthony Moussu
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
- OMEOS, Nancy, France
| | - Noura Benhajji
- OMEOS, Nancy, France
- Université de Lorraine, CNRS, IECL, Nancy, France
| | | | - Bruno Chenuel
- Université de Lorraine, CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France
- Université de Lorraine, DevAH, Nancy, France
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16
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Proença Lopes C, Allado E, Poussel M, Essadek A, Hamroun A, Chenuel B. Alexithymia and Athletic Performance: Beneficial or Deleterious, Both Sides of the Medal? A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10030511. [PMID: 35326989 PMCID: PMC8955528 DOI: 10.3390/healthcare10030511] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 01/28/2022] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Numerous studies have been published on alexithymia among athletes in the last decades. The objective, here, is to provide a critical review on alexithymia in sport and identify elements demonstrating that alexithymic athletes can attain a competitive advantage. Methods: The Center for Reviews and Dissemination guidelines were used. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines served as the template for reporting the present systematic review. We searched PubMed, Embase, Science Direct, and PsycINFO, without language or date restrictions. Results: Within 72 eligible studies, 23 articles fulfilling the selection criteria were included in the review. Alexithymia is associated with various pathologies and considered to be counter-performing. However, despite considerable suspicion of an advantageous performance effect of alexithymia, there is a lack of data to quantify this effect. Studies identified are heterogeneous (different scales of measurement of alexithymia used or outcomes, different sports), that do not allow us to conclude on an observed causal relationship, because the studies are mostly observational. Conclusion: This systematic review opens a new search field on alexithymia, as possibly promoting performance.
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Affiliation(s)
- Catarina Proença Lopes
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Correspondence: ; Tel.: +33-6-12-21-87-42
| | - Edem Allado
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Mathias Poussel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Aziz Essadek
- INTERPSY (EA 4432), University of Lorraine, 54000 Nancy, France;
| | - Aghilès Hamroun
- Department of Public Health, Epidemiology, Health Economics and Prevention, Regional and University Hospital Center of Lille, Lille University, 59000 Lille, France;
| | - Bruno Chenuel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
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Proença Lopes C, Allado E, Poussel M, Hamroun A, Essadek A, Albuisson E, Chenuel B. An Association between Alexithymia and the Characteristics of Sport Practice: A Multicenter, Cross-Sectional Study. Healthcare (Basel) 2022; 10:healthcare10030432. [PMID: 35326910 PMCID: PMC8950812 DOI: 10.3390/healthcare10030432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 02/08/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 02/05/2023] Open
Abstract
Background: This was a multicenter, cross-sectional study which aimed to investigate the relationship between the characteristics of sport practice (weekly training duration, level of practice) and alexithymia in adults who were officially licensed at a sports club. Methods: From a sample of sports club licensed adults, 188 participants were included. The participants completed computerized questionnaires on anthropometric data and characteristics of sport practice (level and weekly time spent on sport practice) as well as alexithymia (TAS 20), depression (BDI-13) and anxiety traits (STAI-Y form B). Results: In this sample, 91 (48.4%) and 97 (51.6%) athletes engaged in recreational and competitive sport practice, respectively. We observed a prevalence of 31.9% for alexithymia. Moreover, alexithymics were more involved in competitive than recreational practice (40.2% versus 23.1%, respectively; p = 0.019) and they were less anxious (63.9% versus 80.2%, respectively; p = 0.010). Finally, alexithymia was significantly more pronounced than non-alexithymia among sports competition practitioners (OR: 3.57 (95 CI [1.26–10.08]; p = 0.016) and we observed less alexithymia in team sports practice than confrontation sports (OR: 0.20 (95 CI [0.05–0.78]; p = 0.020). Conclusions: Alexithymic athletes were more involved in competition than recreational sports compared to non-alexithymic subjects, whilst there were more alexithymic athletes in confrontation sports than in team sports.
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Affiliation(s)
- Catarina Proença Lopes
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Correspondence: ; Tel.: +33-6-12-21-87-42
| | - Edem Allado
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Mathias Poussel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
| | - Aghilès Hamroun
- Nephrology Department, Regional and University Hospital Center of Lille, Lille University, 59000 Lille, France;
| | - Aziz Essadek
- INTERPSY, University of Lorraine, 54000 Nancy, France;
| | - Eliane Albuisson
- InstitutElie-Cartan de Lorraine, CNRS, Université de Lorraine, 54000 Nancy, France;
| | - Bruno Chenuel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54000 Nancy, France; (E.A.); (M.P.); (B.C.)
- Center of Sports Medicine and Adapted Physical Activity, CHRU-Nancy, University of Lorraine, 54000 Nancy, France
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Basin S, Valentin S, Demoulin-Alexikova S, Demoulin B, Foucaud L, Gérard D, Pouget C, Chenuel B, Poussel M. Impact of inhaled corticosteroids on the modulation of respiratory defensive reflexes during exercise in ovalbumin-sensitized rabbits. Rev Mal Respir 2022. [DOI: 10.1016/j.rmr.2022.02.053] [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: 11/28/2022]
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Basin S, Valentin S, Demoulin-Alexikova S, Demoulin B, Foucaud L, Gérard D, Pouget C, Allado E, Chenuel B, Poussel M. Impact of Inhaled Corticosteroids on the Modulation of Respiratory Defensive Reflexes During Artificial Limb Exercise in Ovalbumin-Sensitized Rabbits. Front Physiol 2022; 12:804577. [PMID: 35145425 PMCID: PMC8821955 DOI: 10.3389/fphys.2021.804577] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/09/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Cough is a major lower airway defense mechanism that can be triggered by exercise in asthma patients. Studies on cough reflex in experimental animal models revealed a decrease of cough reflex sensitivity during exercise in healthy animals, but a lack of desensitization in ovalbumin-sensitized rabbits. The aim of our study is to evaluate the impact of inhaled corticosteroids on cough reflex during artificial limb exercise in an animal model of eosinophilic airway inflammation. Materials and Methods Sixteen adult ovalbumin-sensitized rabbits were randomly divided into two groups. The “OVA-Corticoid” group (n = 8) received inhaled corticosteroids (budesonide; 1 mg/day during 2 consecutive days) while the “OVA-Control” (n = 8) group was exposed to saline nebulization. The sensitivity of defensive reflexes induced by direct mechanical stimulation of the trachea was studied in anesthetized animals, at rest and during artificial limb exercise. Cell count was performed on bronchoalveolar lavage fluid and middle lobe tissue sections to assess the level of eosinophilic inflammation. Results All rabbits were significantly sensitized but there was no difference in eosinophilic inflammation on bronchoalveolar lavage or tissue sections between the two groups. Artificial limb exercise resulted in a significant (p = 0.002) increase in minute ventilation by 30% (+ 209 mL.min–1, ± 102 mL/min–1), with no difference between the two groups. 322 mechanical tracheal stimulations were performed, 131 during exercise (40.7%) and 191 at rest (59.3%). Cough reflex was the main response encountered (46.9%), with a significant increase in cough reflex threshold during artificial limb exercise in the “OVA-Corticoid” group (p = 0.039). Cough reflex threshold remained unchanged in the “OVA-Control” group (p = 0.109). Conclusion Inhaled corticosteroids are able to restore desensitization of the cough reflex during artificial limb exercise in an animal model of airway eosinophilic inflammation. Airway inflammation thus appears to be involved in the physiopathology of exercise-induced cough in this ovalbumin sensitized rabbit model. Inhaled anti-inflammatory treatments could have potential benefit for the management of exercise-induced cough in asthma patients.
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Affiliation(s)
- Sarah Basin
- Department of Pneumology, CHRU Nancy, Nancy, France
- EA 3450 DevAH—Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
- *Correspondence: Sarah Basin,
| | - Simon Valentin
- Department of Pneumology, CHRU Nancy, Nancy, France
- EA 3450 DevAH—Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | - Silvia Demoulin-Alexikova
- EA 3450 DevAH—Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
- Department of Pediatric Respiratory Function Testing, CHRU Nancy, Nancy, France
| | - Bruno Demoulin
- EA 3450 DevAH—Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | - Laurent Foucaud
- EA 3450 DevAH—Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | | | - Celso Pouget
- Department of Pathology CHRU Nancy, Nancy, France
| | - Edem Allado
- EA 3450 DevAH—Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
- Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France
| | - Bruno Chenuel
- EA 3450 DevAH—Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
- Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France
| | - Mathias Poussel
- EA 3450 DevAH—Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
- Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France
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Basin S, Valentin S, Maurac A, Pequignot B, Brindel A, Robert C, Baumann C, Luc A, Poussel M, Chabot F, Chaouat A. Évaluation de la prévalence des formes critiques de la COVID-19 parmi les patients hospitalisés porteurs d’une maladie respiratoire chronique. Revue des Maladies Respiratoires Actualités 2022. [PMCID: PMC8709704 DOI: 10.1016/j.rmra.2021.11.136] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Les infections virales respiratoires, dont l’infection à SARS-CoV-2, peuvent déclencher des symptômes respiratoires chez les patients souffrant de maladies respiratoires chroniques, entraînant des exacerbations et parfois des hospitalisations. Malgré le tropisme préférentiellement respiratoire du SARS-CoV-2, les études évaluant les maladies respiratoires chroniques comme facteurs de risque de forme critique de la COVID-19 sont controversées. L’objectif de cette étude était d’évaluer la prévalence de formes critiques de la COVID-19 chez les patients hospitalisés porteurs d’une maladie respiratoire chronique. Méthodes Cette étude rétrospective française bicentrique a inclus tous les patients hospitalisés du 15 mars au 30 juin 2020 pour motif respiratoire liée à la COVID-19, hors unités de soins intensifs et réanimation. Résultats Au total, 617 patients ont été inclus dont 125 présentant une maladie respiratoire chronique, principalement une bronchopneumopathie chronique obstructive (45 %) et un asthme (30 %) (Tableau 1). Le pourcentage de patients ayant obtenu un score de 6 ou plus sur l’échelle de progression clinique de l’Organisation mondiale de la santé 1 pendant leur hospitalisation était plus faible chez les patients atteints d’une maladie respiratoire chronique que dans la population générale (21,6 % contre 31,3 %, p = 0,03 %). Parmi les patients porteurs d’une maladie respiratoire chronique, une température supérieure à 38 °C à l’admission (OR 16,88 [IC 95 % 4,01–71,00]), une lymphopénie (OR 5,08 [1,25–20,72]), un traitement par pression positive continue (OR 4,46 [1,04–19,17]) et un âge élevé (OR 1,09 [1,02–1,16]) étaient associés à un risque accru d’atteindre un score de 6 ou plus. Conclusion Selon cette étude, les patients porteurs d’une maladie respiratoire chronique hospitalisés pour forme grave de la COVID-19 ont un risque plus faible de développer une forme critique de la maladie, en particulier les patients souffrant d’une broncho-pneumopathie chronique obstructive et d’un asthme. Des études prospectives pourraient permettre de confirmer nos résultats et d’éclaircir l’impact des traitements inhalés et notamment de la corticothérapie sur la sévérité des infections à SARS-CoV-2.
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Basin S, Valentin S, Maurac A, Poussel M, Pequignot B, Brindel A, Poupet G, Robert C, Baumann C, Luc A, Soler J, Chabot F, Chaouat A. Progression to a severe form of COVID-19 among patients with chronic respiratory diseases. Respir Med Res 2021; 81:100880. [PMID: 34974204 PMCID: PMC8718099 DOI: 10.1016/j.resmer.2021.100880] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/18/2021] [Accepted: 12/09/2021] [Indexed: 01/08/2023]
Abstract
RATIONALE Viral respiratory infections, including SARS-CoV-2 infection, can trigger respiratory symptoms among patients suffering from chronic respiratory diseases, leading to exacerbations and hospitalizations. Despite the tropism of SARS-CoV-2 into the respiratory tract, chronic respiratory diseases do not seem to be risk factors for severe forms of COVID-19. OBJECTIVES To assess whether hospitalized patients for COVID-19 with chronic respiratory diseases were at lower risk of developing a severe form than other patients. METHODS This French study included patients admitted to hospital in COVID-19 ward, suffering from a SARS-CoV-2 infection, diagnosed on RT-PCR or chest computed tomography associated with clinical symptoms, from March 15 to June 30, 2020. Ambulatory patients who were tested in the emergency department and patients with severe hypoxaemia requiring intensive care were not included. All data were collected from electronic medical records up to discharge of the patient. MAIN RESULTS 617 patients were included: 125 with a chronic respiratory disease, mainly chronic obstructive pulmonary disease (45%) and asthma (30%). The percentage of patients scoring 6 or higher on the WHO Clinical Progression Scale during hospital stay was lower in patients with chronic respiratory disease compared to those without chronic respiratory disease (21.6% versus 31.3%, respectively, p = 0.03). Among patients with chronic respiratory disease, temperature above 38 °C on admission (OR 16.88 (95% CI 4.01-71.00)), lymphopenia (OR 5.08 (1.25-20.72)), CPAP therapy (OR 4.46 (1.04-19.17)) and age (OR 1.09 (1.02-1.16)) were associated with an increased risk to reach a score of 6 or above. CONCLUSIONS Hospital admissions in COVID-19 ward of patients suffering from chronic respiratory diseases are at lower risk of developing a severe form of COVID- 19, especially in patients with chronic obstructive pulmonary disease or asthma. Prospective studies would confirm our results and allow to better organize the follow-up of these patients in a pandemic period.
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Affiliation(s)
- Sarah Basin
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France
| | - Simon Valentin
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France; Université de Lorraine, Faculté de Médecine de Nancy, Inserm UMR_S1116, Vandœuvre-Lès- Nancy, France.
| | - Arnaud Maurac
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France
| | - Mathias Poussel
- Université de Lorraine, CHRU-Nancy, Department of Pulmonary Function Testing and Exercise Physiology, University Centre of Sports Medicine and Adapted Physical Activity, F-54000 Nancy, France; Université de Lorraine, EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations cardio-respiratoires et de la motricité, Nancy, France
| | - Benjamin Pequignot
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France
| | - Aurélien Brindel
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France
| | - Guillaume Poupet
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France
| | - Céline Robert
- Service de Maladies Infectieuses, Metz Thionville Regional Hospital, Ars-Laquenexy, France
| | - Cédric Baumann
- DRCI, Département MPI, Unité de Méthodologie, Data Management et Statistiques, Plateforme d'aide à la recherche clinique, hôpitaux de Brabois, CHRU de Nancy, rue du Morvan, 54511 Vandoeuvre-lès-Nancy, France
| | - Amandine Luc
- DRCI, Département MPI, Unité de Méthodologie, Data Management et Statistiques, Plateforme d'aide à la recherche clinique, hôpitaux de Brabois, CHRU de Nancy, rue du Morvan, 54511 Vandoeuvre-lès-Nancy, France
| | - Julien Soler
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France
| | - François Chabot
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France; Université de Lorraine, Faculté de Médecine de Nancy, Inserm UMR_S1116, Vandœuvre-Lès- Nancy, France
| | - Ari Chaouat
- Université de Lorraine, CHRU-Nancy, Pôle des spécialités médicales/département de pneumologie, F-54000 Nancy, France; Université de Lorraine, Faculté de Médecine de Nancy, Inserm UMR_S1116, Vandœuvre-Lès- Nancy, France
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Manferdelli G, Narang BJ, Poussel M, Osredkar D, Millet GP, Debevec T. Long-Term Effects of Prematurity on Resting Ventilatory Response to Hypercapnia. High Alt Med Biol 2021; 22:420-425. [PMID: 34905392 DOI: 10.1089/ham.2021.0054] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Manferdelli, Giorgio, Benjamin J. Narang, Mathias Poussel, Damjan Osredkar, Grégoire P. Millet, and Tadej Debevec. Long-term effects of prematurity on resting ventilatory response to hypercapnia. High Alt Med Biol. 22:420-425, 2021. Background: This study investigated the resting ventilatory response to hypercapnia in prematurely born adults. Materials and Methods: Seventeen preterm and fourteen full-term adults were exposed to normoxic hypercapnia (two 5-minute periods at 3% and 6% carbon dioxide [CO2] interspersed by 5-minute in normoxia). Pulmonary ventilation ([Formula: see text]) and end-tidal partial pressure of CO2 (Petco2) were measured continuously. Results: No difference in lung function was observed between preterm and full-term adults. Petco2 was lower in preterm than in full-term adults (p < 0.05) during normoxia. During exposure to 3% CO2, both [Formula: see text] and Petco2 increased in a similar way in preterm and full-term adults. However, at the end of the 6% CO2 period, there was a significantly higher [Formula: see text] in preterm compared with full-term adults (30.2 ± 7.5 vs. 23.7 ± 4.5 L/min, p < 0.0001), whereas no difference was observed for Petco2 (46.9 ± 2.1 vs. 50.6 ± 2.1 L/min, p = 0.99). Breath frequency was higher in preterm than in full-term adults (17.9 ± 4.0 vs. 12.8 ± 3.5 b/min, p < 0.01) during 6% CO2 exposure. Conclusions: Although data suggest that prematurity results in resting hypocapnia, the exact underlying mechanisms remain to be elucidated. Moreover, preterm adults seem to have increased chemosensitivity to hypercapnia.
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Affiliation(s)
| | - Benjamin J Narang
- Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia.,Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Mathias Poussel
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Department of Pulmonary Function Testing and Exercise Physiology, CHRU de Nancy, Nancy, France
| | - Damjan Osredkar
- Department of Pediatric Neurology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Tadej Debevec
- Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia.,Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Debevec T, Poussel M, Osredkar D, Willis SJ, Sartori C, Millet GP. Post-exercise accumulation of interstitial lung water is greater in hypobaric than normobaric hypoxia in adults born prematurely. Respir Physiol Neurobiol 2021; 297:103828. [PMID: 34890833 DOI: 10.1016/j.resp.2021.103828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/03/2021] [Revised: 11/24/2021] [Accepted: 12/05/2021] [Indexed: 10/19/2022]
Abstract
We aimed to gauge the interstitial lung water accumulation following moderate-intensity exercise under normobaric and hypobaric hypoxic conditions in a group of preterm born but otherwise healthy young adults. Sixteen pre-term-born individuals (age = 21±2yrs.; gestational age = 29±3wk.; birth weight = 1160±273 g) underwent two 8 -h hypoxic/altitude exposures in a cross-over manner: 1) Normobaric hypoxic exposure (NH; FIO2 = 0.142±0.001; PIO2 = 90.6±0.9 mmHg) 2) Hypobaric hypoxic exposure (HH; terrestrial high-altitude 3840 m; PIO2 = 90.2±0.5 mmHg). Interstitial lung water was assessed via quantification of B-Lines (using lung ultrasound) before (normoxia) and after 4-h and 8-h of respective exposures. At each time point, B-Lines were quantified before (Pre) and immediately after (Post) a 6-min moderate-intensity exercise. The baseline B-lines count were comparable between both conditions (P = 0.191). A higher B-lines count was noted at Pre-H4 in HH versus NH (P = 0.0420). At Post-H8 B-lines score was significantly higher in HH (4.6 ± 1.6) than in NH (3.1 ± 1.4; P = 0.0073). Furthermore, at this time point, a significantly higher number of individuals with B-line scores ≥5 was observed in HH (n = 7) than in NH (n = 3; P = 0.0420). These findings suggest that short moderate-intensity exercise provokes a significant increase in the interstitial lung water accumulation after 8 h of exposure to terrestrial but not simulated altitude (≈3840 m) in prematurely born adults. Further work is needed to elucidate the exact mechanisms of (moderate-intensity) exercise-induced interstitial lung water accumulation in this population and directly compare the obtained data to full-term born adults.
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Affiliation(s)
- Tadej Debevec
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia; Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia.
| | - Mathias Poussel
- Department of Pulmonary Function Testing and Exercise Physiology, CHRU de Nancy, Nancy, France; Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Damjan Osredkar
- Department of Pediatric Neurology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
| | - Sarah J Willis
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Claudio Sartori
- Department of Internal Medicine and the Botnar Center for Extreme Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Basin S, Valentin S, Maurac A, Poussel M, Pequignot B, Brindel A, Robert C, Baumann C, Luc A, Soler J, Chabot F, Chaouat A. Progression to a severe form of COVID-19 among patients with chronic respiratory diseases: a French multicentric study. Epidemiology 2021. [DOI: 10.1183/13993003.congress-2021.pa1734] [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: 11/05/2022]
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Allado E, Poussel M, Chary-Valckenaere I, Potier C, Loeuille D, Albuisson E, Chenuel B. Are Three-Dimensional-Printed Foot Orthoses Able to Cover the Podiatric Physician's Needs? J Am Podiatr Med Assoc 2021; 111. [PMID: 34861694 DOI: 10.7547/20-062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Current management of foot pain requires foot orthoses (FOs) with various design features (eg, wedging, height) and specific mechanical properties (eg, hardness, volume). Development of additive manufacturing (three-dimensional [3-D] printing) raises the question of applying its technology to FO manufacturing. Recent studies have demonstrated the physical benefits of FO parts with specific mechanical properties, but none have investigated the relationship between honeycomb architecture (HcA) infilling density and Shore A hardness of thermoplastic polyurethane (TPU) used to make FOs, which is the aim of this study. METHODS Sixteen different FO samples were made with a 3-D printer using TPU (97 Shore A), with HcA infilling density ranging from 10 to 40. The mean of two Shore A hardness measurements was used in regression analysis. RESULTS Interdurometer reproducibility was excellent (intraclass correlation coefficient, 0.91; 95% confidence interval [CI], 0.64-0.98; P < .001) and interprinter reproducibility was excellent/good (intraclass correlation coefficient, 0.84; 95% CI, 0.43-0.96; P < .001). Linear regression showed a positive significant relationship between Shore A hardness and HcA infilling density (R2 = 0.955; P < .001). Concordance between evaluator and durometer was 86.7%. CONCLUSIONS This study revealed a strong relationship between Shore A hardness and HcA infilling density of TPU parts produced by 3-D printing and highlighted excellent concordance. These results are clinically relevant because 3-D printing can cover Shore A hardness values ranging from 40 to 70, representing most FO production needs. These results could provide important data for 3-D manufacturing of FOs to match the population needs.
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Allado E, Poussel M, Moussu A, Saunier V, Bernard Y, Albuisson E, Chenuel B. Innovative measurement of routine physiological variables (heart rate, respiratory rate and oxygen saturation) using a remote photoplethysmography imaging system: a prospective comparative trial protocol. BMJ Open 2021; 11:e047896. [PMID: 34389569 PMCID: PMC8365801 DOI: 10.1136/bmjopen-2020-047896] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Physiological signals are essential for assessing human health. The absence of a medical device to carry out these measurements remotely is one of the main limitations of telemedicine. Remote photoplethysmography imaging (rPPG) makes it possible to use a camera video to measure some of the most valuable physiological variables: heart rate (HR), respiratory rate (RR) and oxygen saturation (SpO2). Our objective was to evaluate the value of such remote measurements compared with existing contact point measurements techniques in real-life clinical settings. METHODS AND ANALYSIS Prospective hospital-based study that will recruit 1045 patients who require a pulmonary function test. For each patient, measurements of HR, RR and SpO2, using a standard acquisition system, will be carried out concomitantly with the measurements made by the rPPG system. 30, 60 and 120 s time frames will be used to take measurements. Age, gender and skin phototype will also be collected. The intraclass coefficient correlation will be performed to determine the accuracy and precision of the rPPG algorithm readings. ETHICS AND DISSEMINATION The study protocol has been approved by the French Agency for the Safety of Health Products (ANSM registration no. ID RCB 2020-A02428-31) and by a French ethics committee (CPP OUEST I-TOURS-2020T1-30 DM at 30 October 2020). Results will be published in peer-reviewed journals, at scientific conferences and through press releases. TRIAL REGISTRATION NUMBER NCT04660318.
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Affiliation(s)
- Edem Allado
- CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Centre hospitalier régional universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, DevAH, Université de Lorraine, Nancy, Lorraine, France
- OMEOS, Nancy, Lorraine, France
| | - Mathias Poussel
- CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Centre hospitalier régional universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, DevAH, Université de Lorraine, Nancy, Lorraine, France
| | - Anthony Moussu
- CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Centre hospitalier régional universitaire de Nancy, Nancy, Lorraine, France
- OMEOS, Nancy, Lorraine, France
| | - Véronique Saunier
- CHRU-Nancy, Direction de la Recherche Clinique et de l'Innovation, Centre hospitalier régional universitaire de Nancy, Nancy, Lorraine, France
| | - Yohann Bernard
- CHRU-Nancy, Direction de la Recherche Clinique et de l'Innovation, Centre hospitalier régional universitaire de Nancy, Nancy, Lorraine, France
| | - Eliane Albuisson
- OMEOS, Nancy, Lorraine, France
- CHRU-Nancy, Direction de la Recherche Clinique et de l'Innovation, Centre hospitalier régional universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, CNRS, IECL, Université de Lorraine, Nancy, Lorraine, France
| | - Bruno Chenuel
- CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Centre hospitalier régional universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, DevAH, Université de Lorraine, Nancy, Lorraine, France
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Allado E, Poussel M, Gambier N, Saunier V, Starck M, Buisson C, Cinquetti G, Albuisson E, Chenuel B. SporTRIA study-a multicentre trial protocol for excretion kinetics of triamcinolone acetonide following sport-related intra-articular injections in knees: definitions of the washout periods. BMJ Open 2021; 11:e047548. [PMID: 34108168 PMCID: PMC8191621 DOI: 10.1136/bmjopen-2020-047548] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/25/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Intra-articular (IA) and peri-articular glucocorticoid (GC) injections are common in sports medicine. However, from 1 January 2022, all injectable GC routes (including IA administration) will be prohibited in-competition by World Anti-Doping Agency (WADA). Owing to these rules, an IA GC treatment out-of-competition could result in an adverse analytical finding in-competition if the washout period is not clearly defined. The aim of this study is to determine the urinary excretion profile of triamcinolone acetonide following IA injection to strengthen the definition of the washout periods. METHODS AND ANALYSIS This is a prospective multicentre trial to include 20 subjects who practice sports for at least 4 hours/week and present a knee disorder requiring IA injection of triamcinolone acetonide for therapeutic purposes. To determine the excretion profile of triamcinolone acetonide in both urine and blood following IA injection of the drug, We will perform 20 urinary tests and 20 dried blood spot tests, two prior to GC injection (baseline) and the last one at 35 days. Analyses will be performed by the French antidoping agency laboratory in accordance with WADA standards and regulations. ETHICS AND DISSEMINATION The study protocol was approved by the French ethics committee (CPP Sud Est III-Lyon-2020-070B on 06 October 2020). All subjects will provide written informed consent. The results of this study will be accessible in peer-reviewed publication and be presented at academic conference. TRIAL REGISTRATION NUMBER NCT04574232.
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Affiliation(s)
- Edem Allado
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Centre Hospitalier Régional Universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, DevAH, Université de Lorraine, Nancy, Lorraine, France
| | - Mathias Poussel
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Centre Hospitalier Régional Universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, DevAH, Université de Lorraine, Nancy, Lorraine, France
| | - Nicolas Gambier
- Université de Lorraine, CHRU-Nancy Department of Clinical Pharmacology and Toxicology, Centre Hospitalier Régional Universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, CNRS, IMoPA, Université de Lorraine, Nancy, Lorraine, France
| | - Véronique Saunier
- CHRU-Nancy, Direction de la Recherche Clinique et de l'Innovation, Centre Hospitalier Régional Universitaire de Nancy, Nancy, Lorraine, France
| | - Marjorie Starck
- CHRU-Nancy, Direction de la Recherche Clinique et de l'Innovation, Centre Hospitalier Régional Universitaire de Nancy, Nancy, Lorraine, France
| | - Corinne Buisson
- Département des Analyses, AFLD, AFLD, Chatenay-Malabry, Île-de-France, France
| | - Gael Cinquetti
- Service des Maladies Infectieuses et Systémiques, Hôpital d'Instruction des Armées Legouest, Metz, Lorraine, France
| | - Eliane Albuisson
- CHRU-Nancy, Direction de la Recherche Clinique et de l'Innovation, Centre Hospitalier Régional Universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, CNRS, IECL, Université de Lorraine, Nancy, Lorraine, France
| | - Bruno Chenuel
- Université de Lorraine, CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, Centre Hospitalier Régional Universitaire de Nancy, Nancy, Lorraine, France
- Université de Lorraine, DevAH, Université de Lorraine, Nancy, Lorraine, France
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Richalet JP, Pillard F, LE Moal D, Rivière D, Oriol P, Poussel M, Chenuel B, Doutreleau S, Vergès S, Demanez S, Vergnion M, Boulet JM, Douard H, Dupré M, Mesland O, Remetter R, Lonsdorfer-Wolf E, Frey A, Vilcoq L, Nedelec Jaffuel A, Debeaumont D, Duperrex G, Lecoq F, Hédon C, Hayot M, Giardini G, Lhuissier FJ. Validation of a Score for the Detection of Subjects with High Risk for Severe High-Altitude Illness. Med Sci Sports Exerc 2021; 53:1294-1302. [PMID: 33433150 DOI: 10.1249/mss.0000000000002586] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE A decision tree based on a clinicophysiological score (severe high-altitude illness (SHAI) score) has been developed to detect subjects susceptible to SHAI. We aimed to validate this decision tree, to rationalize the prescription of acetazolamide (ACZ), and to specify the rule for a progressive acclimatization. METHODS Data were obtained from 641 subjects in 15 European medical centers before and during a sojourn at high altitude. Depending on the value of the SHAI score, advice was given and ACZ was eventually prescribed. The outcome was the occurrence of SHAI at high altitude as a function of the SHAI score, ACZ prescription, and use and fulfillment of the acclimatization rule. RESULTS The occurrence of SHAI was 22.6%, similar to what was observed 18 yr before (23.7%), whereas life-threatening forms of SHAI (high-altitude pulmonary and cerebral edema) were less frequent (2.6%-0.8%, P = 0.007). The negative predictive value of the decision tree based was 81%, suggesting that the procedure is efficient to detect subjects who will not suffer from SHAI, therefore limiting the use of ACZ. The maximal daily altitude gain that limits the occurrence of SHAI was established at 400 m. The occurrence of SHAI was reduced from 27% to 12% when the recommendations for ACZ use and 400-m daily altitude gain were respected (P < 0.001). CONCLUSIONS This multicenter study confirmed the interest of the SHAI score in predicting the individual risk for SHAI. The conditions for an optimized acclimatization (400-m rule) were also specified, and we proposed a rational decision tree for the prescription of ACZ, adapted to each individual tolerance to hypoxia.
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Affiliation(s)
| | - Fabien Pillard
- Université Paul Sabatier III, Faculté de Médecine Purpan, UMR INSERM U1048 Institut des maladies métaboliques et cardiovasculaires, Hôpital Pierre Paul Riquet, Unité de Médecine du Sport, Toulouse, FRANCE
| | - David LE Moal
- Université Sorbonne Paris Nord, UMR INSERM 1272 Hypoxie et poumon, Bobigny, FRANCE
| | - Daniel Rivière
- Université Paul Sabatier III, Faculté de Médecine Purpan, UMR INSERM U1048 Institut des maladies métaboliques et cardiovasculaires, Hôpital Pierre Paul Riquet, Unité de Médecine du Sport, Toulouse, FRANCE
| | - Philippe Oriol
- Institut Régional de Médecine et d'Ingénierie de Sport, Médecine du sport et Myologie, CHU Saint-Etienne, Saint-Etienne, FRANCE
| | - Mathias Poussel
- Centre Hospitalier Régional Universitaire de Nancy, Centre Universitaire de Médecine du Sport et Activité Physique Adaptée, Service des Explorations de la Fonction Respiratoire, Université de Lorraine, EA 3450 Développement, Adaptation et Handicap, Nancy, FRANCE
| | - Bruno Chenuel
- Centre Hospitalier Régional Universitaire de Nancy, Centre Universitaire de Médecine du Sport et Activité Physique Adaptée, Service des Explorations de la Fonction Respiratoire, Université de Lorraine, EA 3450 Développement, Adaptation et Handicap, Nancy, FRANCE
| | | | | | - Sophie Demanez
- Centre de physiologie de l'effort-CB Move Herve-Julémont, BELGIUM
| | - Michel Vergnion
- Centre de physiologie de l'effort-CB Move Herve-Julémont, BELGIUM
| | - Jean-Michel Boulet
- Hôpital cardiologique, Service maladies coronaires, tests d'effort et readaptation, Pessac, FRANCE
| | - Hervé Douard
- Hôpital cardiologique, Service maladies coronaires, tests d'effort et readaptation, Pessac, FRANCE
| | - Maryse Dupré
- Institut Régional de Médecine du Sport, CHU Nantes, PHU 10, Hôpital Saint Jacques, Nantes, FRANCE
| | - Olivier Mesland
- Institut Régional de Médecine du Sport, CHU Nantes, PHU 10, Hôpital Saint Jacques, Nantes, FRANCE
| | - Romain Remetter
- Centre Hospitalier Universitaire de Strasbourg, Service de Physiologie et EFR, Nouvel Hôpital Civil, Strasbourg, FRANCE
| | - Evelyne Lonsdorfer-Wolf
- Centre Hospitalier Universitaire de Strasbourg, Service de Physiologie et EFR, Nouvel Hôpital Civil, Strasbourg, FRANCE
| | - Alain Frey
- Centre Hospitalier Intercommunal Poissy/Saint-Germain, Service Médecine du Sport, Site Saint Germain, Saint-Germain en Laye, FRANCE
| | - Louis Vilcoq
- Centre Hospitalier Intercommunal Poissy/Saint-Germain, Service Médecine du Sport, Site Saint Germain, Saint-Germain en Laye, FRANCE
| | - Anne Nedelec Jaffuel
- Centre Hospitalier Intercommunal Poissy/Saint-Germain, Service Médecine du Sport, Site Saint Germain, Saint-Germain en Laye, FRANCE
| | - David Debeaumont
- Centre Hospitalo-Universitaire de Rouen, Hôpital Charles Nicolle, CIC-CRB 1404, Unité de physiologie respiratoire et de l'exercice, Rouen, FRANCE
| | - Guy Duperrex
- Hôpitaux du Pays du Mont Blanc, Consultation de Médecine et Traumatologie du Sport, Montagne, Sallanches, FRANCE
| | - François Lecoq
- Hôpitaux du Pays du Mont Blanc, Consultation de Médecine et Traumatologie du Sport, Montagne, Sallanches, FRANCE
| | - Christophe Hédon
- UMR INSERM U1046-CNRS 9214-PhyMedExp, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier, FRANCE
| | - Maurice Hayot
- UMR INSERM U1046-CNRS 9214-PhyMedExp, Université de Montpellier, CHU Arnaud de Villeneuve, Montpellier, FRANCE
| | - Guido Giardini
- Ospedale U. Parini-Azienda USL della Valle d'Aosta, Centro di Medicina e Neurologia di Montagna, Aosta, ITALY
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Allado E, Ankri M, Khiami F, Tamgho T, Hamroun A, Proenca Lopes C, Poussel M, Chenuel B. Case Report: Stress Fracture in an International Triple Jumper: Importance of an Integrated Care Approach Which Also Incorporates Biomechanics. Front Sports Act Living 2021; 3:683691. [PMID: 34124662 PMCID: PMC8193055 DOI: 10.3389/fspor.2021.683691] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Athletes fear stress fracture (SF) injuries as they can put a premature end to their athletic careers. Understanding any mechanical constraints can suggest preventive management approach. Specifically, for the triple jump, the mechanical stresses that occur during the event appear to be the main factors for risk of injury. This clinical case describes three successive episodes of anterior tibial fracture in an international triple jumper between 2011 and 2013. The first fracture received surgical treatment involving intramedullary nailing. The second fracture occurred in the same location and was considered a recurrence requiring medical treatment, whilst the third was a complete fracture of the surgical material and required surgical revision. These recurrent fractures can be explained by the fatigue of materials (bone and nail) induced by triple jump practice and emphasize the importance of integrating biomechanics into an assessment of the case. The use of biomechanical modelization to identify these weaknesses could be an approach for clinical management of such patients. Observation of the intrinsic mechanical stresses during high-level triple jump may lead to identification of modifiable risk factors for bone fragility.
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Affiliation(s)
- Edem Allado
- CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France.,Université de Lorraine, DevAH, Nancy, France
| | - Marine Ankri
- Department of Orthopedic Surgery and Trauma, Hospital Group (GH) Saint-Louis, Lariboisière, Fernand-Widal, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Frédéric Khiami
- Department of Orthopedic Surgery and Trauma, Hospital Group (GH) Pitié-Salpêtrière, Charles Foix, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Teddy Tamgho
- Institut National du Sport, de l'Expertise et de la Performance (INSEP), Paris, France
| | - Aghiles Hamroun
- Centre for Research in Epidemiology and Population Health, Paris-Saclay University, UMRS 1018, Villejuif, France
| | - Catarina Proenca Lopes
- Medicine Department, American Memorial Hospital, Reims, France.,University Hospital of Reims, Reims, France
| | - Mathias Poussel
- CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France.,Université de Lorraine, DevAH, Nancy, France
| | - Bruno Chenuel
- CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, Nancy, France.,Université de Lorraine, DevAH, Nancy, France
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Allado E, Poussel M, Valentin S, Kimmoun A, Levy B, Nguyen DT, Rumeau C, Chenuel B. The Fundamentals of Respiratory Physiology to Manage the COVID-19 Pandemic: An Overview. Front Physiol 2021; 11:615690. [PMID: 33679424 PMCID: PMC7930571 DOI: 10.3389/fphys.2020.615690] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 10/09/2020] [Accepted: 12/29/2020] [Indexed: 01/08/2023] Open
Abstract
The growing coronavirus disease (COVID-19) crisis has stressed worldwide healthcare systems probably as never before, requiring a tremendous increase of the capacity of intensive care units to handle the sharp rise of patients in critical situation. Since the dominant respiratory feature of COVID-19 is worsening arterial hypoxemia, eventually leading to acute respiratory distress syndrome (ARDS) promptly needing mechanical ventilation, a systematic recourse to intubation of every hypoxemic patient may be difficult to sustain in such peculiar context and may not be deemed appropriate for all patients. Then, it is essential that caregivers have a solid knowledge of physiological principles to properly interpret arterial oxygenation, to intubate at the satisfactory moment, to adequately manage mechanical ventilation, and, finally, to initiate ventilator weaning, as safely and as expeditiously as possible, in order to make it available for the next patient. Through the expected mechanisms of COVID-19-induced hypoxemia, as well as the notion of silent hypoxemia often evoked in COVID-19 lung injury and its potential parallelism with high altitude pulmonary edema, from the description of hemoglobin oxygen affinity in patients with severe COVID-19 to the interest of the prone positioning in order to treat severe ARDS patients, this review aims to help caregivers from any specialty to handle respiratory support following recent knowledge in the pathophysiology of respiratory SARS-CoV-2 infection.
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Affiliation(s)
- Edem Allado
- EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations cardio-respiratoires et de la motricité, Université de Lorraine, Nancy, France.,Explorations Fonctionnelles Respiratoires et de l'Aptitude à l'Exercice, Centre Universitaire de Médecine du Sport et Activité Physique Adaptée, CHRU-Nancy, Nancy, France
| | - Mathias Poussel
- EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations cardio-respiratoires et de la motricité, Université de Lorraine, Nancy, France.,Explorations Fonctionnelles Respiratoires et de l'Aptitude à l'Exercice, Centre Universitaire de Médecine du Sport et Activité Physique Adaptée, CHRU-Nancy, Nancy, France
| | - Simon Valentin
- EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations cardio-respiratoires et de la motricité, Université de Lorraine, Nancy, France.,Département de Pneumologie, CHRU-Nancy, Nancy, France
| | - Antoine Kimmoun
- Médecine Intensive et Réanimation Brabois, CHRU-Nancy, Nancy, France.,INSERM U1116, Université de Lorraine, Nancy, France
| | - Bruno Levy
- Médecine Intensive et Réanimation Brabois, CHRU-Nancy, Nancy, France.,INSERM U1116, Université de Lorraine, Nancy, France
| | - Duc Trung Nguyen
- ORL et Chirurgie Cervico-Faciale, CHRU-Nancy, Nancy, France.,INSERM U1254-IADI, Université de Lorraine, Nancy, France
| | - Cécile Rumeau
- EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations cardio-respiratoires et de la motricité, Université de Lorraine, Nancy, France.,ORL et Chirurgie Cervico-Faciale, CHRU-Nancy, Nancy, France
| | - Bruno Chenuel
- EA 3450 DevAH-Développement, Adaptation et Handicap, Régulations cardio-respiratoires et de la motricité, Université de Lorraine, Nancy, France.,Explorations Fonctionnelles Respiratoires et de l'Aptitude à l'Exercice, Centre Universitaire de Médecine du Sport et Activité Physique Adaptée, CHRU-Nancy, Nancy, France
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Tiotiu A, Ioan I, Poussel M, Schweitzer C, Kafi SA. Comparative analysis between available challenge tests in the hyperventilation syndrome. Respir Med 2021; 179:106329. [PMID: 33610050 DOI: 10.1016/j.rmed.2021.106329] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/24/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The hyperventilation syndrome (HVS) is characterized by somatic/ psychological symptoms due to sustained hypocapnia and respiratory alkalosis without any organic disease. OBJECTIVE The purpose of this study was to compare ventilatory parameters and symptoms reproducibility during the hyperventilation provocation test (HVPT) and cardiopulmonary exercise test (CPET) as diagnostic tools in patients with HVS, and to identify the most frequent etiologies of the HVS by a systematic assessment. METHODS After exclusion of organic causes, 59 patients with HVS according to Nijmegen's questionnaire (NQ) score ≥23 with associated hypocapnia (PaCO2/PETCO2<35 mm Hg) were studied. RESULTS The most frequent comorbidities of HVS were anxiety and asthma (respectively 95% and 73% of patients). All patients described ≥3 symptoms of NQ during the HVPT vs 14% of patients during the CPET (p<0.01). For similar maximal ventilation (61 L/min during HVPT vs 60 L/min during CPET), the median level of PETCO2 decreased from 30 mmHg at baseline to 15 mmHg during hyperventilation and increased from 31 mmHg at baseline to 34 mmHg at peak exercise (all p<0.01). No significant difference for the ventilatory parameters was found between patients with HVS (n = 16) and patients with HVS + asthma (n = 43). CONCLUSIONS In term of symptoms reproducibility, HVPT is a better diagnostic tool than CPET for HVS. An important proportion of patients with HVS has an atypical asthma previously misdiagnosed. The exercise-induced hyperventilation did not induce abnormal reduction in PETCO2, suggesting that the exercise could be a therapeutic tool in HVS.
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Affiliation(s)
- Angelica Tiotiu
- Department of Pulmonology, University Hospital of Nancy, 9 Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France; Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH) Research Unit, University of Lorraine, 9 Avenue de la Forêt de Haye, 54505, Vandoeuvre-lès-Nancy, France.
| | - Iulia Ioan
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH) Research Unit, University of Lorraine, 9 Avenue de la Forêt de Haye, 54505, Vandoeuvre-lès-Nancy, France; Lung Function Testing Lab, Children's University Hospital, 8 Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France
| | - Mathias Poussel
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH) Research Unit, University of Lorraine, 9 Avenue de la Forêt de Haye, 54505, Vandoeuvre-lès-Nancy, France; University Centre of Sports Medicine and Adapted Physical Activity, Department of Pulmonary Function Testing and Exercise Physiology, 9 Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France
| | - Cyril Schweitzer
- Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH) Research Unit, University of Lorraine, 9 Avenue de la Forêt de Haye, 54505, Vandoeuvre-lès-Nancy, France; Lung Function Testing Lab, Children's University Hospital, 8 Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France
| | - Sophia Abdel Kafi
- Department of Pulmonology, Jolimont Hospital, 159 Rue Ferrer, 7100, La Louvière, Belgium
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Poussel M, Touzé C, Allado E, Frimat L, Hily O, Thilly N, Rousseau H, Vauthier JC, Chenuel B. Ultramarathon and Renal Function: Does Exercise-Induced Acute Kidney Injury Really Exist in Common Conditions? Front Sports Act Living 2020; 1:71. [PMID: 33344994 PMCID: PMC7739841 DOI: 10.3389/fspor.2019.00071] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 10/11/2019] [Accepted: 12/19/2019] [Indexed: 12/29/2022] Open
Abstract
Background: Increasing ultramarathons participation, investigation into strenuous exercise and kidney function has to be clarified. Study Design: Prospective observational study. Methods and Protocol: The study used data collected among ultra-marathon runners completing the 2017 edition of the 120 km “Infernal trail” race. Samples were collected within 2 h pre-race (start) and immediately post-race (finish). Measurements of serum creatinine (sCr), cystatin C (Cys), creatine kinase, and urine albumin were completed. Acute Kidney Injury (AKI) as defined by the RIFLE criteria. “Risk” of injury was defined as increased serum Creatinine (sCr) × 1.5 or Glomerular Filtration Rate (GFR) decrease >25%. Injury was defined as 2 × sCr or GFR decrease >50%. These two categories of AKI were combined to calculate total incidence at the finish line. GFR was estimated by two methods, using measure of sCr and using measure of cystatin C. Urinary biomarkers [neutrophil gelatinase-associated lipocalin (NGAL)] were also used to define AKI. Outcome results before and after the race were compared by using McNemar test for qualitative data and Wilcoxon signed-rank test for quantitative data, in modified intent-to-treat and per-protocol analyses. Results: A sample of 24 included finishers, with no use of non-steroidal anti-inflammatory drugs (NSAIDs) was studied. Depending the methodology used to calculate GFR, the prevalence of AKI was observed from 0 to 12.5%. Urinary biomarkers of kidney damage were increased following the race but with no significant decrease in GFR. Discussion/Conclusion: Our study showed a very low prevalence of AKI and no evidence that ultra-endurance running can cause important kidney damage in properly hydrated subjects with no use of NSAIDs. Whether the increase in urinary biomarkers of kidney damage following the race reflects structural kidney injury or a simple metabolic adaptation to strenuous exercise needs to be clarified.
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Affiliation(s)
- Mathias Poussel
- Center of Sports Medicine and Adapted Physical Activity, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | - Charlie Touzé
- Department of General Practice, Maison de Santé des Trois Monts, Dommartin-les-Remiremont, France
| | - Edem Allado
- Center of Sports Medicine and Adapted Physical Activity, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | - Luc Frimat
- Nephrology Department, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Oriane Hily
- Center of Sports Medicine and Adapted Physical Activity, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Nathalie Thilly
- Department of Methodology, Promotion and Investigation in Clinical Research, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Hélène Rousseau
- Department of Methodology, Promotion and Investigation in Clinical Research, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
| | - Jean-Charles Vauthier
- Department of General Practice, Maison de Santé des Trois Monts, Dommartin-les-Remiremont, France
| | - Bruno Chenuel
- Center of Sports Medicine and Adapted Physical Activity, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
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Allado E, Poussel M, Hily O, Chenuel B. The interest of rehabilitation of respiratory disorders in athletes: Myth or reality? Ann Phys Rehabil Med 2020; 65:101461. [PMID: 33271343 DOI: 10.1016/j.rehab.2020.101461] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 10/19/2022]
Abstract
BACKGROUND Healthy trained athletes generally have an "overbuilt" respiratory system in order to face the huge ventilation and gas-exchange demand imposed by strenuous exercise. Athletes frequently complain of respiratory symptoms regardless of whether they have a diagnosed respiratory disease, therefore evoking a kind of respiratory limitation during exercise. Some respiratory pathologies athletes present are closely linked to exercise and include asthma, exercise-induced bronchoconstriction (EIB) or exercise-induced laryngeal obstruction. Management of asthma and EIB are mainly based on pharmacological treatments. However, many athletes still complain of respiratory symptoms despite optimal pharmacological treatments, which highlights the need for non-pharmacological approaches including breathing retraining, inspiratory muscle training and/or laryngeal exercise performed under the guidance of a physiotherapist in this specific population. OBJECTIVES With this literature overview, we aimed to report evidence supporting the interest of rehabilitation for athletes with respiratory disorders and discuss whether inspiratory muscle training programs can improve performance in healthy athletes. METHODS We searched MEDLINE and Cochrane databases for trials, reviews and meta-analyses assessing respiratory rehabilitation and muscle training programs in athletes by using the MesH terms "athletes", "asthma", "dyspnea", "rehabilitation" and "education" published from January 2010 to March 2020. The selection of articles was based on the author's expertise to elaborate this review of the literature. RESULTS Major findings suggest that breathing retraining may help asthmatic athletes better control their respiratory symptoms and that inspiratory muscle training may improve respiratory symptoms of exercise-induced laryngeal obstruction in athletes. Improvement of performance by respiratory muscle training still remains controversial. CONCLUSIONS Respiratory rehabilitation could be of interest in the specific population of athletes but should be further evaluated to improve the level of evidence of such strategies.
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Affiliation(s)
- Edem Allado
- CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, F-54000 Nancy, France; Université de Lorraine, DevAH, Department of Physiology, F-54000 Nancy, France
| | - Mathias Poussel
- CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, F-54000 Nancy, France; Université de Lorraine, DevAH, Department of Physiology, F-54000 Nancy, France.
| | - Oriane Hily
- CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, F-54000 Nancy, France; Université de Lorraine, DevAH, Department of Physiology, F-54000 Nancy, France
| | - Bruno Chenuel
- CHRU-Nancy, University Centre of Sports Medicine and Adapted Physical Activity, F-54000 Nancy, France; Université de Lorraine, DevAH, Department of Physiology, F-54000 Nancy, France
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Valentin S, Chenuel B, Demoulin-Alexikova S, Demoulin B, Gérard D, Foucaud L, Poussel M. Desensitization of the Cough Reflex Induced by Corticosteroids in Ovalbumin-Sensitized Rabbits During Artificial Limb Exercise. Front Physiol 2020; 11:466. [PMID: 32528305 PMCID: PMC7247830 DOI: 10.3389/fphys.2020.00466] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/16/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction Cough is a major symptom frequently experienced during exercise, mainly in asthmatic patients. Inhaled glucocorticoids represent the keystone treatment in the management of asthma, but little is known about interactions between cough and exercise, especially in controlled patients. During exercise, cough reflex (CR) appears downregulated in healthy animal models whereas a lack of desensitization of CR has been shown in ovalbumin-sensitized animal models, mimicking asthmatic disease. Aims and Objectives The goal of our study was to clarify the potential modulation of the CR induced by inhaled corticosteroids (CS) in ovalbumin (OVA) sensitized rabbits during artificial limb exercise. Materials and Methods Seventeen OVA sensitized rabbits were studied. Among them, 9 were treated with CS delivered intravenously (OVA-Corticoids). The ventilatory response to direct tracheal stimulation, performed at rest and during exercise, was determined to assess the incidence and the sensitivity of the CR. Broncho-alveolar lavage (BAL) and cell counts were performed to determine the level of airway inflammation. Exercise was mimicked by electrically induced hindlimb muscular contractions (EMC). Results Compared to rest values, EMC increased minute ventilation by 28% without any decrease in respiratory resistance (Rsr). Among 322 tracheal stimulations, 172 (53%) were performed at rest and 150 (47%) during exercise. The sensitivity of CR decreased during artificial limb exercise compared to baseline in OVA-Corticoids rabbits (p = 0.0313) while it remained unchanged in OVA rabbits (p = NS). Conclusion Corticosteroids appear to restore the desensitization of the CR in OVA sensitized rabbits during artificial limb exercise, suggesting the potential role of airway inflammation in the pathophysiology of cough during exercise in asthmatics.
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Affiliation(s)
- Simon Valentin
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France.,Department of Pneumology, CHRU Nancy, Nancy, France
| | - Bruno Chenuel
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France.,Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France
| | - Silvia Demoulin-Alexikova
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | - Bruno Demoulin
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | | | - Laurent Foucaud
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France
| | - Mathias Poussel
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Nancy, France.,Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France
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Lancaster G, Debevec T, Millet GP, Poussel M, Willis SJ, Mramor M, Goričar K, Osredkar D, Dolžan V, Stefanovska A. Relationship between cardiorespiratory phase coherence during hypoxia and genetic polymorphism in humans. J Physiol 2020; 598:2001-2019. [PMID: 31957891 PMCID: PMC7317918 DOI: 10.1113/jp278829] [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: 08/16/2019] [Accepted: 01/15/2020] [Indexed: 12/15/2022] Open
Abstract
Key points High altitude‐induced hypoxia in humans evokes a pattern of breathing known as periodic breathing (PB), in which the regular oscillations corresponding to rhythmic expiration and inspiration are modulated by slow periodic oscillations. The phase coherence between instantaneous heart rate and respiration is shown to increase significantly at the frequency of periodic breathing during acute and sustained normobaric and hypobaric hypoxia. It is also shown that polymorphism in specific genes, NOTCH4 and CAT, is significantly correlated with this coherence, and thus with the incidence of PB. Differences in phase shifts between blood flow signals and respiratory and PB oscillations clearly demonstrate contrasting origins of the mechanisms underlying normal respiration and PB. These novel findings provide a better understanding of both the genetic and the physiological mechanisms responsible for respiratory control during hypoxia at altitude, by linking genetic factors with cardiovascular dynamics, as evaluated by phase coherence.
Abstract Periodic breathing (PB) occurs in most humans at high altitudes and is characterised by low‐frequency periodic alternation between hyperventilation and apnoea. In hypoxia‐induced PB the dynamics and coherence between heart rate and respiration and their relationship to underlying genetic factors is still poorly understood. The aim of this study was to investigate, through novel usage of time–frequency analysis methods, the dynamics of hypoxia‐induced PB in healthy individuals genotyped for a selection of antioxidative and neurodevelopmental genes. Breathing, ECG and microvascular blood flow were simultaneously monitored for 30 min in 22 healthy males. The same measurements were repeated under normoxic and hypoxic (normobaric (NH) and hypobaric (HH)) conditions, at real and simulated altitudes of up to 3800 m. Wavelet phase coherence and phase difference around the frequency of breathing (approximately 0.3 Hz) and around the frequency of PB (approximately 0.06 Hz) were evaluated. Subjects were genotyped for common functional polymorphisms in antioxidative and neurodevelopmental genes. During hypoxia, PB resulted in increased cardiorespiratory coherence at the PB frequency. This coherence was significantly higher in subjects with NOTCH4 polymorphism, and significantly lower in those with CAT polymorphism (HH only). Study of the phase shifts clearly indicates that the physiological mechanism of PB is different from that of the normal respiratory cycle. The results illustrate the power of time‐evolving oscillatory analysis content in obtaining important insight into high altitude physiology. In particular, it provides further evidence for a genetic predisposition to PB and may partly explain the heterogeneity in the hypoxic response. High altitude‐induced hypoxia in humans evokes a pattern of breathing known as periodic breathing (PB), in which the regular oscillations corresponding to rhythmic expiration and inspiration are modulated by slow periodic oscillations. The phase coherence between instantaneous heart rate and respiration is shown to increase significantly at the frequency of periodic breathing during acute and sustained normobaric and hypobaric hypoxia. It is also shown that polymorphism in specific genes, NOTCH4 and CAT, is significantly correlated with this coherence, and thus with the incidence of PB. Differences in phase shifts between blood flow signals and respiratory and PB oscillations clearly demonstrate contrasting origins of the mechanisms underlying normal respiration and PB. These novel findings provide a better understanding of both the genetic and the physiological mechanisms responsible for respiratory control during hypoxia at altitude, by linking genetic factors with cardiovascular dynamics, as evaluated by phase coherence.
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Affiliation(s)
| | - Tadej Debevec
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.,Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Gregoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Mathias Poussel
- Department of Pulmonary Function Testing and Exercise Physiology, CHRU de Nancy, Nancy, France
| | - Sarah J Willis
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Minca Mramor
- University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Katja Goričar
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Damjan Osredkar
- University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Vita Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Tiotiu A, Thaon I, Poussel M, Penven E. Occupational Asthma Caused by Powder Paint in the Automotive Industry. J Investig Allergol Clin Immunol 2019; 29:316-318. [PMID: 30957758 DOI: 10.18176/jiaci.0394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A Tiotiu
- Department of Pulmonology, University Hospital of Nancy, Nancy, France.,Development, Adaptation and Disadvantage. Cardiorespiratory regulations and motor control (EA 3450 DevAH), University of Lorraine, Nancy, France.,National Heart and Lung Institute, Airway Disease Section, Imperial College London, London, UK
| | - I Thaon
- Occupational Diseases Department, University Hospital of Nancy, Nancy, France
| | - M Poussel
- Development, Adaptation and Disadvantage. Cardiorespiratory regulations and motor control (EA 3450 DevAH), University of Lorraine, Nancy, France.,Department of Pulmonary Function Testing and Exercise Physiology, University Hospital of Nancy, Nancy, France
| | - E Penven
- Occupational Diseases Department, University Hospital of Nancy, Nancy, France
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Plantier L, Beydon N, Chambellan A, Degano B, Delclaux C, Dewitte JD, Dinh-Xuan AT, Garcia G, Kauffmann C, Paris C, Perez T, Poussel M, Wuyam B, Zerah-Lancner F, Chenuel B. [Guidelines for methacholine provocation testing]. Rev Mal Respir 2018; 35:759-775. [PMID: 30097294 DOI: 10.1016/j.rmr.2018.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 02/15/2018] [Indexed: 12/01/2022]
Abstract
Bronchial challenge with the direct bronchoconstrictor agent methacholine is commonly used for the diagnosis of asthma. The "Lung Function" thematic group of the French Pulmonology Society (SPLF) elaborated a series of guidelines for the performance and the interpretation of methacholine challenge testing, based on French clinical guideline methodology. Specifically, guidelines are provided with regard to the choice of judgment criteria, the management of deep inspirations, and the role of methacholine bronchial challenge in the care of asthma, exercise-induced asthma, and professional asthma.
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Affiliation(s)
- L Plantier
- CEPR/Inserm UMR1100, CHRU de Tours, service de pneumologie et explorations fonctionnelles respiratoires, université François-Rabelais, 37044 Tours cedex 9, France.
| | - N Beydon
- Unité fonctionnelle d'exploration fonctionnelle respiratoire et du sommeil, AP-HP, hôpital Armand-Trousseau, 75012 Paris, France
| | - A Chambellan
- Inserm UMR1087, explorations fonctionnelles et réhabilitation respiratoire, l'institut du thorax, CHU, 44093 Nantes cedex 1, France
| | - B Degano
- Service d'explorations fonctionnelles, hôpital Jean-Minjoz, 25000 Besançon, France
| | - C Delclaux
- Inserm U1141, DHU PROTECT, service de physiologie explorations fonctionnelles pédiatriques-CPPS, AP-HP, hôpital Robert-Debré, université Paris Diderot, 75019 Paris, France
| | - J-D Dewitte
- Santé au travail-laboratoire d'étude et de recherche en sociologie, UFR médecine et sciences de la santé, université de Bretagne occidentale, 29238 Brest cedex 3, France
| | - A T Dinh-Xuan
- Service de physiologie-explorations fonctionnelles, université Paris Descartes, AP-HP, hôpital Cochin, 75014 Paris, France
| | - G Garcia
- Service de physiologie, Inserm UMR999, AP-HP, hôpital de Bicêtre, 94270 Le Kremlin-Bicêtre cedex, France
| | - C Kauffmann
- Service d'explorations fonctionnelles respiratoires, CHU, 63000 Clermont-Ferrand, France
| | - C Paris
- EA7892, service de pathologie professionnelle, université de Lorraine, CHU de Nancy, 54500 Vandœuvre-Les-Nancy, France
| | - T Perez
- Clinique de pneumologie, centre de compétences maladies pulmonaires rares, CHRU de Lille, hôpital Albert-Calmette, 59037 Lille, France
| | - M Poussel
- Antenne médicale de prévention du dopage, EA 3450, service des examens de la fonction respiratoire et de l'aptitude à l'exercice médecine du sport, CHRU de Nancy Brabois, 54500 Vandœuvre-lès-Nancy, France
| | - B Wuyam
- Laboratoire HP2, Inserm 1042, service sport et pathologies, CHU de Grenoble, hôpital Sud, 38130 Echirolles, France
| | - F Zerah-Lancner
- Service de physiologie-explorations fonctionnelles, AP-HP, hôpital Henri-Mondor, 94000 Créteil, France
| | - B Chenuel
- Antenne médicale de prévention du dopage, EA 3450, service des examens de la fonction respiratoire et de l'aptitude à l'exercice médecine du sport, CHRU de Nancy Brabois, 54500 Vandœuvre-lès-Nancy, France
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Poussel M, Penven E, Essari LA, Chabot F, Barbaud A, Paris C. Occupational Asthma to Detergent Protease Associated With a Late-Phase Neutrophilic Cutaneous Response. J Investig Allergol Clin Immunol 2017; 27:60-62. [PMID: 28211347 DOI: 10.18176/jiaci.0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M Poussel
- Department of Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France.,EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - E Penven
- Occupational Diseases Department, Bâtiment Philippe Canton, CHRU Nancy, Vandoeuvre-lès-Nancy, France.,EA-7298 INGRES, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - L A Essari
- Department of Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France.,Pulmonology Department, CHRU Nancy, Nancy, France
| | - F Chabot
- EA-7298 INGRES, Université de Lorraine, Vandoeuvre-lès-Nancy, France.,Pulmonology Department, CHRU Nancy, Nancy, France
| | - A Barbaud
- EA-7298 INGRES, Université de Lorraine, Vandoeuvre-lès-Nancy, France.,Department of Dermatology and Allergy, CHRU Nancy, Vandoeuvre-lès-Nancy, France
| | - C Paris
- Occupational Diseases Department, Bâtiment Philippe Canton, CHRU Nancy, Vandoeuvre-lès-Nancy, France.,EA-7298 INGRES, Université de Lorraine, Vandoeuvre-lès-Nancy, France
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Thil C, Agrinier N, Chenuel B, Poussel M. Longitudinal course of lung function in myotonic dystrophy type 1. Muscle Nerve 2017; 56:816-818. [DOI: 10.1002/mus.25604] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Catherine Thil
- Department of Pulmonary Function Testing and Exercise PhysiologyCHRU NancyNancyF‐54000 France
| | | | - Bruno Chenuel
- Department of Pulmonary Function Testing and Exercise PhysiologyCHRU NancyNancyF‐54000 France
| | - Mathias Poussel
- Department of Pulmonary Function Testing and Exercise PhysiologyCHRU NancyNancyF‐54000 France
- EA 3450Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de LorraineNancy France
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Tiotiu A, Chenuel B, Foucaud L, Demoulin B, Demoulin-Alexikova S, Christov C, Poussel M. Lack of desensitization of the cough reflex in ovalbumin-sensitized rabbits during exercise. PLoS One 2017; 12:e0171862. [PMID: 28182749 PMCID: PMC5300204 DOI: 10.1371/journal.pone.0171862] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 01/26/2017] [Indexed: 12/04/2022] Open
Abstract
Introduction Cough is a major symptom of asthma frequently experienced during exercise but little is known about interactions between cough and exercise. The goal of our study was to clarify the potential modulation of the cough reflex (CR) by exercise in a spontaneously breathing anaesthetized animal model of airway eosinophilic inflammation. Materials & methods Ten ovalbumin (OVA) sensitized adult rabbits and 8 controls were studied. The ventilatory response to direct tracheal stimulation, performed both at rest and during exercise was determined to quantify the incidence and the sensitivity of the CR. Broncho-alveolar lavages (BAL) and cell counts were performed to assess the level of the airway inflammation following OVA-induced sensitization. Exercise was mimicked by Electrically induced hindlimb Muscular Contractions (EMC). Results Among 494 tracheal stimulations, 261 were performed at rest and 233 at exercise. OVA challenges in sensitized rabbits caused a significant increase in the percentage of eosinophils (p = 0.008) in BAL. EMC increased minute ventilation by 36% and 35% in OVA and control rabbits respectively, compared to rest values. The sensitivity of the CR decreased during exercise compared to baseline in control rabbits (p = 0.0313) while it remained unchanged in OVA rabbits. Conclusion The desensitization of the CR during exercise in control rabbits was abolished in OVA rabbits. The precise role of airway inflammation in this lack of CR desensitization needs to be further investigated but it might contribute to the exercise-induced cough in asthmatics.
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Affiliation(s)
- Angelica Tiotiu
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, Vandoeuvre-les-Nancy, France
- Pulmonology Department, CHRU Nancy, Nancy, France
- * E-mail:
| | - Bruno Chenuel
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, Vandoeuvre-les-Nancy, France
- Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France
| | - Laurent Foucaud
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Bruno Demoulin
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Silvia Demoulin-Alexikova
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Christo Christov
- Department of Histology, Université de Lorraine, Vandoeuvre-les-Nancy, France
| | - Mathias Poussel
- EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control, Université de Lorraine, Vandoeuvre-les-Nancy, France
- Pulmonary Function Testing and Exercise Physiology, CHRU Nancy, Nancy, France
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Didier S, Vauthier JC, Gambier N, Renaud P, Chenuel B, Poussel M. Substance use and misuse in a mountain ultramarathon: new insight into ultrarunners population? Res Sports Med 2017; 25:244-251. [PMID: 28114830 DOI: 10.1080/15438627.2017.1282356] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Endurance and ultra-endurance events have become increasingly popular. The aim of our study was to explore the use of medication among endurance runners participating in the 2014 Infernal Trail des Vosges. Among the 389 runners engaged, 297 (76.3%) completed a specific questionnaire dealing with substance use/misuse. Our results show a 27% (before the race) and 18% (during the race) prevalence of substance use. The two major classes of substances used were non-steroidal anti-inflammatory drugs (NSAIDs; 9.8%) and painkillers (6.7%), principally because of osteo-articular pain (29.6%) or to prevent pain (28.2%). A positive correlation was found between substance consumption before (past month) and during the race (overall medication: p < 0.0001; NSAIDs: p = 0.008). Our results could be explained by the specific characteristics of ultrarunners predominantly motivated by personal achievement and general health (recreational approach). However, education interventions should further be delivered regarding the risks of substance use in ultra-endurance events.
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Affiliation(s)
- Sandra Didier
- a Department of General Practice , Maison de Santé des Trois Monts , Dommartin-les-Remiremont , France
| | - Jean-Charles Vauthier
- a Department of General Practice , Maison de Santé des Trois Monts , Dommartin-les-Remiremont , France
| | - Nicolas Gambier
- b Department of Clinical Pharmacology and Toxicology , CHRU Nancy , Nancy , France
| | - Pierre Renaud
- c Department of Pulmonary Function Testing and Exercise Physiology , CHRU Nancy , Nancy , France
| | - Bruno Chenuel
- c Department of Pulmonary Function Testing and Exercise Physiology , CHRU Nancy , Nancy , France.,d EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control , Université de Lorraine , Nancy , France
| | - Mathias Poussel
- c Department of Pulmonary Function Testing and Exercise Physiology , CHRU Nancy , Nancy , France.,d EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control , Université de Lorraine , Nancy , France
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Dupont AC, Poussel M, Hossu G, Marie PY, Chenuel B, Felblinger J, Mandry D. Aortic compliance variation in long male distance triathletes: A new insight into the athlete's artery? J Sci Med Sport 2016; 20:539-542. [PMID: 27838232 DOI: 10.1016/j.jsams.2016.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 02/21/2016] [Revised: 09/21/2016] [Accepted: 10/21/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To assess cardiac and vascular adaptations in long-distance male triathletes and the influence of an increased training volume on these parameters. DESIGN Case-control study using long-distance male triathletes (Tri) (n=12) and an age-matched cohort of sedentary volunteers (Ctrl). METHODS All participants gave an informed consent and underwent a Cardiovascular Magnetic Resonance imaging (CMR) exam to measure left and right ventricle functional parameters, and aortic parameters (surface, strain, compliance, pulse wave velocity). This exam was repeated in the triathletes' group after an increased training volume of at least 2h/week for six weeks. RESULTS Compared to control volunteers, triathletes presented at baseline a typical pattern of athlete's heart (higher end-diastolic, end-systolic and stroke volumes index, p≤0.009, and lower cardiac rate, p=0.015) but similar vascular characteristics except a trend towards an enlarged ascending aorta (surface 942±106 vs 812±127mm2, p=0.058). Between the two visits, the triathletes increased their weekly training time from 9.67±2.43 (Tri1) to 12.15±3.01h (Tri2): no modifications were found regarding cardiac parameters, but compliance and distensibility of the ascending aorta increased, from 2.60 to 3.34mm2/mmHg (p=0.028) and from 3.36 to 4.40×10-3mmHg-1 (p=0.048) respectively. CONCLUSIONS Using CMR, we showed that vascular characteristics of the ascending aorta may vary along the sport season in endurance athletes. This remodelling could be considered as a physiological adaptation, but could eventually lead to an adverse vascular remodelling.
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Affiliation(s)
| | - Mathias Poussel
- CHRU Nancy, Department of Pulmonary Function Testing and Exercise Physiology, France; Universite de Lorraine, EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, France
| | | | - Pierre-Yves Marie
- CHRU Nancy, Department of Medical Imaging, France; INSERM UMR-1116, France; Universite de Lorraine, France
| | - Bruno Chenuel
- CHRU Nancy, Department of Pulmonary Function Testing and Exercise Physiology, France; Universite de Lorraine, EA 3450 DevAH-Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, France
| | - Jacques Felblinger
- INSERM, IADI U 947, France; INSERM, CIC-IT 1433, France; CHRU Nancy, Department of Medical Imaging, France
| | - Damien Mandry
- INSERM, IADI U 947, France; CHRU Nancy, Department of Medical Imaging, France; Universite de Lorraine, France.
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Abstract
This paper presents a brief history of the successive anatomical, physiological and pathophysiological concepts about the paranasal sinuses. Sinusology, the science of the paranasal sinuses, is founded on scientific work on the production of nitric oxide (NO) by the sinuses and on the evo-devo theory of their formation. The paranasal sinuses seem to develop after regression of the erythropoietic marrow in the maxillary, frontal and sphenoid bones and its replacement by cavities filled with gas, which escapes into the nasal fossae through the ostium. The sinus epithelium synthesizes NO continuously. The paranasal sinus cavities form a compartmentalized reservoir of NO, which is released discontinuously in boli after an opening of the ostium. Ostium opening can be induced by sound vibration, either internal (humming) or external (an acoustic vibration added to the in-breath). NO plays the role of an "aerocrine" messenger between the upper and lower respiratory tracts, reducing pulmonary vascular resistance and facilitating alveolar oxygen transfer into the bloodstream. Its physiological role in arterial blood oxygenation could be involved in speech and singing or be activated by physiological snoring during sleep. Rhinology, the science of the nose, in which the evo-devo concept distinguishes the respiratory and the olfactory nose, is now backed up by sinusology.
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Affiliation(s)
- R Jankowski
- Service ORL et chirurgie cervico-faciale, hôpital de Brabois, centre hospitalier régional universitaire de Nancy, université de Lorraine, bâtiment Louis-Mathieu, 54500 Vandœuvre-lès-Nancy, France.
| | - D T Nguyen
- Service ORL et chirurgie cervico-faciale, hôpital de Brabois, centre hospitalier régional universitaire de Nancy, université de Lorraine, bâtiment Louis-Mathieu, 54500 Vandœuvre-lès-Nancy, France
| | - M Poussel
- Service des examens de la fonction respiratoire et de l'aptitude à l'exercice-médecine du sport, CHRU de Nancy, 54000 Nancy, France; EA 3450 DevAH, développement, adaptation et handicap, régulations cardiorespiratoires et de la motricité, université de Lorraine, 54505 Lorraine, France
| | - B Chenuel
- Service des examens de la fonction respiratoire et de l'aptitude à l'exercice-médecine du sport, CHRU de Nancy, 54000 Nancy, France; EA 3450 DevAH, développement, adaptation et handicap, régulations cardiorespiratoires et de la motricité, université de Lorraine, 54505 Lorraine, France
| | - P Gallet
- Service ORL et chirurgie cervico-faciale, hôpital de Brabois, centre hospitalier régional universitaire de Nancy, université de Lorraine, bâtiment Louis-Mathieu, 54500 Vandœuvre-lès-Nancy, France
| | - C Rumeau
- Service ORL et chirurgie cervico-faciale, hôpital de Brabois, centre hospitalier régional universitaire de Nancy, université de Lorraine, bâtiment Louis-Mathieu, 54500 Vandœuvre-lès-Nancy, France
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Penven E, Poussel M, Herin F, Richard C, Jacquenet S, Thaon I, Barbaud A, Paris C. Asthme professionnel à la poudre d’argan : première description. ARCH MAL PROF ENVIRO 2016. [DOI: 10.1016/j.admp.2016.03.215] [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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Paris C, Herin F, Penven E, Thaon I, Richard C, Jacquenet S, Barbaud A, Poussel M. First evidence of occupational asthma to argan powder in a cosmetic factory. Allergy 2016; 71:550-5. [PMID: 26606505 DOI: 10.1111/all.12811] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Argan is used worldwide in numerous cosmetic products, as this fruit is supposed to have many beneficial properties on health. New cases of allergy can be expected with the growing use of argan. We investigated all workers (9) employed by a cosmetic factory and exposed to argan powder to identify possible allergies related to exposure to argan powder. METHODS Patients were investigated in the occupational disease department and, according to their symptoms, underwent pulmonary function testing, methacholine challenge, specific inhalation challenge to argan powder, skin prick tests, and immunoblotting analysis. RESULTS We report three cases of occupational asthma to argan powder and a probable case of rhinitis. Fifteen argan proteins were recognized by the patients' IgE. Identification of proteins, cross-reactions to nuts, and ELISA inhibition tests suggested that some argan allergens can cross-react in vitro with hazelnut allergens, including 11S globulin and vicilin. CONCLUSION High-level exposure to argan powder should be considered to be a potential cause of IgE-mediated allergy, and workers handling argan powder should be carefully investigated.
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Affiliation(s)
- C. Paris
- Occupational Diseases Department; Bâtiment Philippe Canton; CHU Nancy; Vandoeuvre-lès-Nancy France
- EA-7298 INGRES; Université de Lorraine; Nancy France
| | - F. Herin
- INSERM UMR1027 (The French National Institute of Health and Medical Research); Toulouse France
- University of Toulouse III Paul Sabatier; Toulouse France
- Occupational diseases department; Toulouse University Hospital; Toulouse France
| | - E. Penven
- Occupational Diseases Department; Bâtiment Philippe Canton; CHU Nancy; Vandoeuvre-lès-Nancy France
- EA-7298 INGRES; Université de Lorraine; Nancy France
| | - I. Thaon
- Occupational Diseases Department; Bâtiment Philippe Canton; CHU Nancy; Vandoeuvre-lès-Nancy France
- EA-7298 INGRES; Université de Lorraine; Nancy France
| | | | | | - A. Barbaud
- EA-7298 INGRES; Université de Lorraine; Nancy France
- Dermatology and Allergy Department; Bâtiment Philippe Canton; CHU Nancy; Vandoeuvre-lès-Nancy France
| | - M. Poussel
- Department of Pulmonary Function Testing and Exercise Physiology; CHU Nancy; Vandoeuvre-lès-Nancy France
- EA 3450 DevAH - Development, Adaptation and Disadvantage. Cardiorespiratory regulations and motor control; Université de Lorraine; Nancy France
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Poussel M, Guerci P, Kaminsky P, Heymonet M, Roux-Buisson N, Faure J, Fronzaroli E, Chenuel B. Exertional Heat Stroke and Susceptibility to Malignant Hyperthermia in an Athlete: Evidence for a Link? J Athl Train 2015; 50:1212-4. [PMID: 26565425 DOI: 10.4085/1062-6050-50.12.01] [Citation(s) in RCA: 23] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe the possible association (pathophysiologic and clinical features) between exertional heat stroke (EHS) and malignant hyperthermia (MH). BACKGROUND Both EHS and MH are acute and life-threatening disorders. It has repeatedly been shown that EHS can occur in well-trained patients with known MH-associated mutation in the RYR1 gene in the absence of any extreme environmental conditions or extreme physical activity, thereby supporting a possible link between EHS and MH. In this case, a highly trained 30-year-old male athlete suddenly collapsed while running. He had initial hyperthermia (40.2°C) and progressive multiple organ failure requiring medical management in an intensive care unit. After he recovered completely, a maximal exercise test was performed and showed an obvious abnormality of oxidative metabolism in muscle; genetic analysis of the RYR1 gene identified a heterozygous missense variation p.K1393R. Consequently, the athlete was given appropriate information and allowed to progressively return to sport competition. DIFFERENTIAL DIAGNOSIS Doping, use of drugs and toxic agents, exercise-associated hyponatremia, exertional heat illness. TREATMENT Initial management started with the basic resuscitative guidelines of airway, breathing, and circulation (intubation). Cooling, administration of fresh frozen plasma, and intensive rehydration resulted in improvement. UNIQUENESS To our knowledge, ours is the first description of this MH mutation (p.K1393R) in the RYR1 gene that was associated with exertional rhabdomyolysis involving a dramatic impairment of oxidative metabolism in muscle. CONCLUSIONS Common features are shared by EHS and MH. Careful attention must therefore be paid to athletes who experience EHS, especially in temperate climates or when there are no other predisposing factors.
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Affiliation(s)
| | | | | | - Marie Heymonet
- Centre Hospitalier Regional Universitaire de Nancy, France
| | | | - Julien Faure
- Centre Hospitalier Universitaire de Grenoble, France
| | | | - Bruno Chenuel
- Centre Hospitalier Regional Universitaire de Nancy, France
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Poussel M, Penven E, Richard C, Jacquenet S, Chabot F, Paris C. Occupational asthma to "the miracle tree" (Moringa oleifera): first description. J Allergy Clin Immunol Pract 2015; 3:813-4. [PMID: 26116950 DOI: 10.1016/j.jaip.2015.05.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 04/02/2015] [Accepted: 05/05/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Mathias Poussel
- Department of Pulmonary Function Testing and Exercise Physiology, Centre Hospitalier Universitaire Nancy, Nancy, France; Development, Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control, Université de Lorraine, France
| | - Emmanuelle Penven
- Occupational Diseases Department, Bâtiment Philippe Canton, Centre Hospitalier Universitaire Nancy, Vandoeuvre-lès-Nancy, France; Interactions Gènes-Risques Environnementaux et Effets sur la Santé, Université de Lorraine, France
| | | | | | - François Chabot
- Interactions Gènes-Risques Environnementaux et Effets sur la Santé, Université de Lorraine, France; Pulmonology Department, Centre Hospitalier Universitaire Nancy, Nancy, France
| | - Christophe Paris
- Occupational Diseases Department, Bâtiment Philippe Canton, Centre Hospitalier Universitaire Nancy, Vandoeuvre-lès-Nancy, France; Interactions Gènes-Risques Environnementaux et Effets sur la Santé, Université de Lorraine, France.
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Boltz P, Pape E, Scarfone S, Scala-Bertola J, Berthelon L, Poussel M, Gambier N, Puskarczyk E. Naturel pour maigrir ? La preuve…. Toxicologie Analytique et Clinique 2015. [DOI: 10.1016/j.toxac.2015.03.039] [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: 10/23/2022]
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Poussel M, Laroppe J, Hurdiel R, Girard J, Poletti L, Thil C, Didelot A, Chenuel B. Sleep Management Strategy and Performance in an Extreme Mountain Ultra-marathon. Res Sports Med 2015; 23:330-6. [PMID: 26020095 DOI: 10.1080/15438627.2015.1040916] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We intended to assess the relationship between sleep strategies and performance during the North-Face Ultra-Trail du Mont-Blanc 2013, to test the hypothesis that sleep management can influence athletic performance. Almost all runners specifically adopted sleep management strategies before the race. Among the finishers 72% didn't sleep at all during the race and 28% took a least one break for sleep. Non-sleepers completed the race faster than the sleepers (P = 0.0008). Race time was positively correlated with drowsiness (P < 0.0001) and negatively correlated with the number participations in this race (P = 0.0039). Runners who adopted a sleep management strategy based on increased sleep time before the race completed the race faster (P = 0.0258). Most finishers seemed to be aware of the importance of developing sleep management strategies and increasing sleep time some nights before the race appeared to be the most relevant strategy to improve performance.
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Affiliation(s)
- Mathias Poussel
- a Department of Pulmonary Function Testing and Exercise Testing, CHU Nancy, Nancy, F-54000, France and EA 3450 DevAH - Development, Adaptation and Disadvantage, Cardiorespiratory regulations and motor control , Université de Lorraine , Nancy , F-54000 , France
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