Rev Mal Respir
· 2025 Mar · PMID 40023714
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Post-infectious bronchiolitis obliterans (PIBO) is a rare but severe pulmonary disease in children, often associated with adenovirus infection. Risk factors include male sex, hypoxemia, and mechanical ventilation. Diagno...Post-infectious bronchiolitis obliterans (PIBO) is a rare but severe pulmonary disease in children, often associated with adenovirus infection. Risk factors include male sex, hypoxemia, and mechanical ventilation. Diagnosis is based on clinical history, bronchial obstruction, and radiological abnormalities. PIBO is characterized by chronic inflammation leading to tissue remodeling and bronchiolar fibrosis. Airway epithelial lesions, potentially linked to viral infection, are considered key mechanisms of PIBO. In the absence of specific treatments, research efforts aim to better understand mechanisms of PIBO, identify biomarkers, and improve management strategies.
Morichon L, Assou S, Bourdin A
… +2 more, Muriaux D, De Vos J
Rev Mal Respir
· 2025 Mar · PMID 40023713
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Highlighted by the COVID-19 pandemic, the study of respiratory infections is a global health priority. To this end, many preclinical in vitro study models have been developed to reproduce nasal, bronchial or alveolar res...Highlighted by the COVID-19 pandemic, the study of respiratory infections is a global health priority. To this end, many preclinical in vitro study models have been developed to reproduce nasal, bronchial or alveolar respiratory epithelium. These models can be established from immortalised cell lines, primary culture or induced pluripotent stem cells (iPSC). They can also be constructed in various three-dimensional structures that are more or less physiological and easy to use. This synthetic review puts into perspective the advantages and limitations of these models, while highlighting their relevance for the study of the mechanisms of SARS-CoV-2 infection.
Kemoun G, Jimenez D, Nierat MC
… +8 more, Wattiez N, Bachasson D, Mayaux J, Lecronier M, Similowski T, Demoule A, Dres M, Decavèle M
Rev Mal Respir
· 2025 Mar · PMID 40021391
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In intubated patients in intensive care, respiratory-related brain suffering is frequent and harmful. Its detection and quantification rely on the patient's self-reporting abilities. However, half of the patients in inte...In intubated patients in intensive care, respiratory-related brain suffering is frequent and harmful. Its detection and quantification rely on the patient's self-reporting abilities. However, half of the patients in intensive care are unable to report their sensations. Observational scales are promising alternative tools to suspect respiratory suffering in these patients. However, they still partially depend on subjective evaluation. The aim of the study is to assess brain activity measured by functional near-infrared spectroscopy in intubated patients, whether dyspneic or not, during a spontaneous breathing trial.
Bergereau H, Hassoun D, Marquant Q
… +4 more, Rousselle M, Magnan A, Loirand G, Sauzeau V
Rev Mal Respir
· 2025 Mar · PMID 40016060
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Asthma is a chronic airway disease characterized by exacerbated inflammation, hyperresponsiveness, and associated bronchial remodeling. Despite innovative biotherapies, severe asthma remains largely uncontrolled, highlig...Asthma is a chronic airway disease characterized by exacerbated inflammation, hyperresponsiveness, and associated bronchial remodeling. Despite innovative biotherapies, severe asthma remains largely uncontrolled, highlighting the need for new therapeutic approaches. Rac1 GTPase has recently been identified as a major contributor to bronchial hyperresponsiveness and remodeling. In this study, we demonstrate Rac1 overactivation in pulmonary eosinophils of asthmatic patients. Identifying the role of Rac1 GTPase in the molecular mechanisms of polymorphonuclear cells during allergic asthma could validate Rac1 as an innovative therapeutic target for severe asthma.
Dinh A, Barbier F, Bedos JP
… +17 more, Blot M, Cattoir V, Claessens YE, Duval X, Fillâtre P, Gautier M, Guegan Y, Jarraud S, Le Monnier A, Lebeaux D, Loubet P, de Margerie C, Serayet P, Tandjaoui-Lambotte Y, Varon E, Welker Y, Basille D
Rev Mal Respir
· 2025 Mar · PMID 40011168
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Lung dynamic hyperinflation (DH) is one of the main determinants of dyspnea in chronic respiratory disease patients. Producing evidence of DH is critical during dyspnea assessment, the objectives being to explain the cau...Lung dynamic hyperinflation (DH) is one of the main determinants of dyspnea in chronic respiratory disease patients. Producing evidence of DH is critical during dyspnea assessment, the objectives being to explain the cause, to target treatments, and to monitor their efficacy. The gold standard method consists in repeated measurement of inspiratory capacity (IC) during cardiopulmonary exercise testing (CPET). Unfortunately, access to CPET is limited and assessment of IC during CPET can be challenging in some patients. An alternative method consists in assessment of IC during the testing known as metronome-paced tachypnea (MPT) challenge. This method is feasible, repeatable, valid (i.e. corelated with dyspnea patients' activities of daily living), and responsive to treatments. However, while its diagnostic performance is acceptable, it is lacking in specificity. Methodological standardization is detailed in the present review, as are the differences between IC changes in CPET and in MPT. As a means of assessing DH, MPT challenge is not only applicable to patients outside a pulmonary function test laboratory, but also easily affordable to any chest physician equipped with a simple spirometry device. A diagnosis threshold of 11% for IC decrease during MPT challenge can be used, albeit while bearing in mind the possibility of a false positive result. Moreover, assessment of IC variations during MPT can help to monitor a patient's overall evolution and response to treatments.
Rev Mal Respir
· 2025 Feb · PMID 39893062
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Acute community-acquired pneumonia (CAP) during pregnancy is a frequently encountered and potentially severe condition. CAP incidence and ecology are unchanged during pregnancy as compared with the overall young adult po...Acute community-acquired pneumonia (CAP) during pregnancy is a frequently encountered and potentially severe condition. CAP incidence and ecology are unchanged during pregnancy as compared with the overall young adult population. Risk factors specifically identified in pregnant women include advanced gestational age, asthma, anemia and repeated courses of corticosteroid therapy for fetal lung maturation. The clinical presentation of CAP is not altered during pregnancy. Key points in the pregnant host encompass: (i) reduced maternal tolerance to hypoxia, due to physiological adaptations during pregnancy; (ii) heightened severity of some infections, notably viral pneumonias such as influenza, varicella or SARS-CoV-2 pneumonia; (iii) potentially deleterious fetal repercussions of infection and maternal hypoxia, with an increased risk of premature delivery and prematurity; (iv) the need for specific attention to the risk of fetal irradiation in the performance of possibly repeated radiological examinations and (v) therapeutic specificities arising from the possible embryo-fetal toxicity of certain anti-infectious agents. CAP prevention is premised on compliance with universal hygiene measures and on vaccination, which guarantees protection against severe forms of pneumonia not only in the mother (Streptococcus pneumoniae, seasonal flu, chickenpox, COVID-19), but also in the child during the first few months of life (whooping cough, RSV).
Thimmesch M, Boulay M, Defgnée E
… +2 more, Bauwens N, Palem A
Rev Mal Respir
· 2025 Feb · PMID 39837691
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INTRODUCTION: Following two weeks of application of the triple combination therapy of Elexacaftor (E), Tezacaftor (T), and Ivacaftor (I) known as ETI, substantial pulmonary improvement in patients with cystic fibrosis is...INTRODUCTION: Following two weeks of application of the triple combination therapy of Elexacaftor (E), Tezacaftor (T), and Ivacaftor (I) known as ETI, substantial pulmonary improvement in patients with cystic fibrosis is well-documented. However, few detailed data are available on the action of this treatment over the course of these first 14 days. METHODS: In this prospective study (NCT05599230), 20 patients aged≥12 years, all of them eligible for ETI, were recruited at the initiation of treatment. Home spirometry (MIR Spirobank®) was performed during the three days preceding the start of treatment and then daily for 14 days, while a respiratory symptom score (RSS) was calculated and a log maintained concerning the events experienced by each patient. RESULTS: Mean age (± SD) of the 20 patients was 29.4 (± 11.1) years, mean FEV1 was 84.2% (± 17.7), and the mean BMI z-score was 0.18 (± 0.82). Thirteen of them were already on modulators. When compared to the average scores recorded for the three days preceding the start of treatment, FEV1 improvement became significant from the 6th day (D6). After having significantly worsened on D1 (P<0.05), the RSS improved from D6 onwards. The quality of home FEV1 measurements was high (grade A: 81.2%). CONCLUSIONS: Under ETI treatment, respiratory benefits were significant from D6. The side effects most commonly perceived by the patients occurred during the first four days of treatment. While daily monitoring of home spirometry could indeed be a valuable tool in follow-up of patients with cystic fibrosis, its administration requires suitable and sustained training.
Dembélé O, Maïga S, Ouédraogo AR
… +12 more, Sourabié A, Soubeiga D, Ngo Ngue TC, Ouédraogo A, Zongo M, Essaga Eloundou C, Bonsa E, Ali Moussa ML, Coulibaly A, Birba E, Boncoungou K, Ouédraogo M
Rev Mal Respir
· 2025 Feb · PMID 39837690
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INTRODUCTION: The mortality caused by tuberculosis is partially explained by co-morbidities such as venous thromboembolic disease. Our study was aimed at identifying the factors associated with venous thromboembolism in...INTRODUCTION: The mortality caused by tuberculosis is partially explained by co-morbidities such as venous thromboembolic disease. Our study was aimed at identifying the factors associated with venous thromboembolism in tuberculosis patients. METHODS: This was a case-control study of patients with pulmonary tuberculosis with or without venous thromboembolic disease. The study was conducted in the pneumology department of Yalgado Ouédraogo University Hospital from 1st January 2021 to 31st March 2024. RESULTS: All in all, 80 patients were included in the study. In univariate analysis, the factors significantly associated with venous thromboembolic disease were: prolonged bed rest (P=0.000), hyperleukocytosis (P=0.044), hemoglobin level less than 10g/dL (P=0.024), C-reactive protein level greater than or equal to 150mg/L (P=0.036), bronchial dilatation lesions (P=0.041), and extensive lung lesions (P=0.016). After adjustment, prolonged bed rest (OR=7.68; [1.52-38.74]), hemoptysis (OR=24.65; [1.84-328.77]), leukocytosis (OR=2.13; [1.33-26.51]), were significantly associated with venous thromboembolism. CONCLUSION: Venous thromboembolism remains a dreaded complication that should be investigated in any tuberculosis patient with thromboembolic risk factors.
Teulier M, Fouquereau E, Bremond M
… +3 more, Courtois R, Reveillère C, Plantier L
Rev Mal Respir
· 2025 Jan · PMID 39794246
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INTRODUCTION: After a pulmonary rehabilitation (PR) program, 30 to 70% of patients fail to pursue maintenance of physical activity. This study aimed to identify psychosocial markers associated with MPA subsequent to an i...INTRODUCTION: After a pulmonary rehabilitation (PR) program, 30 to 70% of patients fail to pursue maintenance of physical activity. This study aimed to identify psychosocial markers associated with MPA subsequent to an initial outpatient PR course (≥10 sessions). MATERIAL AND METHODS: Patients were enrolled in an exploratory quantitative monocentric retrospective study. Clinical data were extracted from the PR center database. Psychosocial data were collected by a postal questionnaire. A telephone interview assessed maintenance of physical activity at 12months, which was defined as self-reported physical activity≥30min,≥2 times per week. RESULTS: Among 134 patients (age 67years [31-88], 88% COPD, FEV1 55% [25-103]), 95 (71%) reported maintenance of physical activity at 12months. Multivariate logistic regression analysis showed that compared with subjects without maintenance of physical activity, those with the latter: (1) reported greater self-efficacy and internal locus of control, (2) considered their health status as less severe and (3) resided closer to the PR center. CONCLUSION: Patient-declared self-efficacy and locus of control internalization were independently associated with maintenance of physical activity 12months after an initial PR program.
Cauhape V, Risso K, Demonchy E
… +3 more, Flory V, Guevara N, Vandenbos F
Rev Mal Respir
· 2025 Feb · PMID 39794245
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INTRODUCTION: Tuberculous otomastoiditis is a rare and serious infection that most often occurs in association with pulmonary involvement. It is easy to diagnose when the two pathologies are associated and isolated. We h...INTRODUCTION: Tuberculous otomastoiditis is a rare and serious infection that most often occurs in association with pulmonary involvement. It is easy to diagnose when the two pathologies are associated and isolated. We herein report the case of a patient initially hospitalized for Pseudomonas aeruginosa necrotising otitis externa (NOE), which delayed the diagnosis of tuberculous otomastoiditis. OBSERVATION: The 50-year-old patient was hospitalized for NOE and concurrently presented with pulmonary tuberculosis. NOE was associated with temporal bone lysis with carotid canal involvement. Despite appropriate treatment, NOE evolution was unfavourable. Two months later, the patient underwent a mastoidectomy to evacuate a mastoid abscess. In a deep tissue sample, tuberculosis complex was detected by PCR assay. For 12 months, the patient underwent for pulmonary and osseous tuberculosis. While the clinical course was favourable but deafness occurred subsequently. CONCLUSION: An association of P. aeruginosa NOE and tuberculous otomastoiditis is a highly exceptional event.
Aydi Z, Rachdi I, Soli A
… +5 more, Somai M, Arbaoui I, Ben Dhaou B, Daoud F, Boussema F
Rev Mal Respir
· 2025 Jan · PMID 39755531
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Otherwise known as mediastinal emphysema, pneumomediastinum (PNM) in connective tissue diseases is a rare clinical entity. Few cases have been described in the literature. In fact, it only exceptionally complicates the e...Otherwise known as mediastinal emphysema, pneumomediastinum (PNM) in connective tissue diseases is a rare clinical entity. Few cases have been described in the literature. In fact, it only exceptionally complicates the evolution of connective tissue diseases. In this paper report, two cases of spontaneous PNM secondary to scleroderma and Sjogren's syndrome. Based on the data in the literature, we discuss the etiology, frequency of occurrence, and the pathophysiological mechanisms of this unusual complication.
Rev Mal Respir
· 2025 Feb · PMID 39743434
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INTRODUCTION: Pulmonary airway dystrophy (PAD) is a rare disease that may be either innate or acquired. Very few publications have been dedicated to the repercussions of the air pressure variations that may be encountere...INTRODUCTION: Pulmonary airway dystrophy (PAD) is a rare disease that may be either innate or acquired. Very few publications have been dedicated to the repercussions of the air pressure variations that may be encountered during an airplane journey in a pressurized cabin, an aerial tramway ascent or a stay in a high-altitude setting. Variations may also occur during deep-sea diving with modification of absolute air pressure. STATE OF KNOWLEDGE: The published observations show that all PAD cases have been associated with accidents during exposure or with variations in ambient air pressure. The different published reports should be considered with maximum caution and circumspection. It is of the utmost importance to painstakingly study each case in view of proposing a line of conduct in accordance with the etiology and severity of the disease. It also matters to take into full account the activity under consideration (climbing into altitude or deep-sea diving); the risks incurred are by no means identical. PERSPECTIVES: It would be of interest to hold a register of barotrauma cases or other accidents resulting from air pressure variations affecting persons with cystic lung disease or with pulmonary bullae in cases of PAD. CONCLUSION: While expert opinions and recommendations differ from one another, and notwithstanding the assistance provided by thoracic tomodensitometry, a premium should be placed on caution. In contentious cases, it makes sense to obtain the informed opinion of a pneumologist or certified hyperbaric physician familiar with PAD and its possible complications.
Argoulon N, Morel H, Lanotte P
… +3 more, Ferreira M, Prazuck T, Marchand-Adam S
Rev Mal Respir
· 2025 Feb · PMID 39668052
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INTRODUCTION: BCG therapy is the standard treatment for bladder tumors that do not infiltrate smooth muscle. Fluoroquinolones for antibiotic prophylaxis are recommended to lessen the risk of BCG infection (BCGitis) with...INTRODUCTION: BCG therapy is the standard treatment for bladder tumors that do not infiltrate smooth muscle. Fluoroquinolones for antibiotic prophylaxis are recommended to lessen the risk of BCG infection (BCGitis) with respiratory involvement. CASE REPORT: This study describes five cases of BCGitis in males, with a median age of 71years [range: 66-77years] having undergone ofloxacin prophylaxis during their BCG therapy for a non-invasive bladder tumor (grade pT1a). Among these patients, four experienced fever within eight hours of the last instillation, as well as respiratory symptoms such as dyspnea and cough. Three of them exhibited substantial weight loss over the course of one month. Chest scans consistently revealed miliary patterns. While only in one patient was BCG identification confirmed, typical clinical and CT presentations prompted the initiation of treatment, predominantly employing a combination of isoniazid, rifampicin, and ethambutol in four patients, and isoniazid and rifampicin in the fifth. Treatment duration ranged from six to nine months. One-year follow-up indicated a favourable outcome for all patients. CONCLUSIONS: This study shows that ofloxacin prophylaxis may in some cases fail to prevent iatrogenic BCGitis.
Rev Mal Respir
· 2025 Jan · PMID 39665952
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In a qualitative investigation carried out in different environments (hospital, school, home) among 12-to-21-year-old asthmatics, we describe their perceptions of a pathology that is at once chronic and intermittent. Mor...In a qualitative investigation carried out in different environments (hospital, school, home) among 12-to-21-year-old asthmatics, we describe their perceptions of a pathology that is at once chronic and intermittent. More specifically, we show how an asthma attack constitutes a traumatic experience occurring in a temporality characterized by bodily upheaval. We describe the emotional labor provided by young asthmatics in their interpretation of their bodily signs, which are often read differently than in the medical sphere. The intermittency of the disease and the occurrence of crises in specific situations lead adolescents to achieve improved knowledge of their bodies. In this study, we analyze the roles of supports (inhalers…) and adaptative techniques in the development of know-how enabling them to autonomously treat their symptoms and monitor the signs of an upcoming attack.
Rev Mal Respir
· 2025 Jan · PMID 39665951
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As the effects of electronic cigarettes (ECs) have rapidly become widely known, we propose to take stock of recent findings on the bronchopulmonary and cardiovascular adverse effects (AEs) and the risks of cancer occurre...As the effects of electronic cigarettes (ECs) have rapidly become widely known, we propose to take stock of recent findings on the bronchopulmonary and cardiovascular adverse effects (AEs) and the risks of cancer occurrence entailed by EC use. METHOD: We carried out a search from 2018 to October 19, 2023 on PubMed, adopting the PRISMA guidelines (2020) with the following keywords in "Titles and abstracts": electronic cigarette, or e-cigarette, or ENDS, AND safety or toxicology or effect or health effect, using "Systematic Review" as a filter. The inclusion criteria were: systematic review of in vitro or in vivo studies in English or French dealing with the risks of ECs for the bronchopulmonary system, the cardiovascular system, or cancer occurrence. CONCLUSION: Twenty-eight systematic reviews on the adverse effects (AE) of electronic cigarettes (EC) in selected humans show that the toxic substances they generate can cause cancers and increase the risk of cardiac and pulmonary disorders. New studies on the potential dangerousness of EC use are essential and urgent.
Rev Mal Respir
· 2025 Jan · PMID 39632241
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Functional exercise testing (FET) assesses an individual's capacity to adapt to effort and identifies limiting factors, particularly dyspnea. It orients therapeutic choices, predicts the progression of chronic pathologie...Functional exercise testing (FET) assesses an individual's capacity to adapt to effort and identifies limiting factors, particularly dyspnea. It orients therapeutic choices, predicts the progression of chronic pathologies, and estimates preoperative risks, at times contraindicating surgery. The aim of this article is to provide a summary of the specific indications for functional exercise testing, test protocol selection, test equipment, appropriate personnel, and patient and test safety. This article is intended for healthcare professionals conducting or considering functional exercise testing.
Guiraud-Chaumeil V, Goussault H, Boudjemaa A
… +6 more, Viñas F, Bonnefoy V, Gibiot Q, Rousseau-Bussac G, Maitre B, Mangiapan G
Rev Mal Respir
· 2025 Jan · PMID 39613553
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INTRODUCTION: Pleural procedures are painful interventions. While there exist recommendations aimed at preventing pain induced by local anesthesia, they have never been evaluated with regard to the thoracic wall. The obj...INTRODUCTION: Pleural procedures are painful interventions. While there exist recommendations aimed at preventing pain induced by local anesthesia, they have never been evaluated with regard to the thoracic wall. The objective of this study was to evaluate the effectiveness of buffered lidocaine local anesthesia in pleural procedures. METHODS: Descriptive, monocentric, prospective study, including all initial pleural procedures performed in our unit. Pain was assessed 20minutes after the procedure using the VAS (Visual Analog Scale) or the NRS (Numerical Rating Scale). RESULTS: Two hundred and fifty-one patients were included. The procedures included thoracocentesis (58%), pleural or pulmonary biopsy (28%), or drainage (14%). Average pain intensity was 0.6 on a scale of 10. Over two thirds (68%) of patients had a VAS or NRS score of 0, and 91%≤2. Infectious pleuritis, pneumothorax, and drainage were associated with more pain. The pain levels were acceptable (average VAS/NRS scores of 1.3, 1.8, 1.7 respectively). CONCLUSION: Buffered lidocaine local anesthesia provides excellent pain control for pleural procedures, regardless of their nature. Recommendations regarding local anesthesia apply to the thoracic wall, and their dissemination is essential to reduction of the pain induced by pleural procedures.
Caron F, Mathieu F, Talleux M
… +2 more, Basille D, Rames C
Rev Mal Respir
· 2024 Dec · PMID 39523143
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INTRODUCTION: Bronchoscopy is an invasive procedure that can be difficult for patients to tolerate, especially if the operator is inexperienced. Simulation enables trainees to perfect their skills, while adhering to an e...INTRODUCTION: Bronchoscopy is an invasive procedure that can be difficult for patients to tolerate, especially if the operator is inexperienced. Simulation enables trainees to perfect their skills, while adhering to an ethical approach: "never the first time on a patient". The main aim of our study is to demonstrate the benefits of simulation in learning how to perform bronchial endoscopy, in terms of dexterity, speed of execution and anatomical recognition by the operator. METHODS: Prospective, monocentric study conducted at SIMU SANTE in the Amiens university hospital. Our study population consisted of volunteer interns or young doctors who were new to bronchoscopy. After filling out a questionnaire and undergoing theoretical training, participants completed three training sessions at regular intervals. We compared three groups according to the interval between sessions (group A: 15 days, group B: 30 days, group C: 60 days). Regarding judgment criteria, we observed several parameters: dexterity, speed and anatomical recognition by the operator. RESULTS: In terms of speed, median procedure time was reduced by 40% after three sessions. Dexterity improved in the 15-day interval group, with a significant reduction in wall contact. Concerning the precision parameter, we observed a significant difference between the three groups, with greater improvement in the identification score in the 15-day interval group. CONCLUSION: Simulation has made it possible to acquire basic skills in bronchoscopy. Training sessions with a short time interval (one session every 15 days) most rapidly increase operators' speed, dexterity and precision.