المؤلفون: Ughetto, Aurore, Aouinti, Safa, Molinari, Nicolas, Roubille, François, Delmas, Clément

المصدر: European Journal of Heart Failure; Mar2024, Vol. 26 Issue 3, p701-703, 3p

مصطلحات موضوعية: CARDIOGENIC shock, EXTRACORPOREAL membrane oxygenation, LEFT heart atrium, LOADING & unloading, ARTIFICIAL blood circulation, INTRA-aortic balloon counterpulsation, HEART assist devices

مستخلص: A meta-analysis published in the European Journal of Heart Failure examined the use of left ventricular (LV) unloading via active transseptal left atrial (LA) venting in patients with cardiogenic shock (CS) supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The study found that early active LA venting did not offer any prognostic advantages compared to the conventional approach using LA venting in case of pulmonary edema. The authors noted that the efficacy of LA venting for effective LV unloading remains debatable, and the optimal timing and device choice for LV unloading need further research. The study concluded that current evidence does not support the routine use of LA venting in patients on VA-ECMO. [Extracted from the article]

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المؤلفون: Bourdin, Arnaud, Bommart, Sébastien, Marin, Gregory, Vachier, Isabelle, Gamez, Anne Sophie, Ahmed, Engi, Suehs, Carey M., Molinari, Nicolas

المصدر: Allergy; Mar2023, Vol. 78 Issue 3, p780-790, 11p

مصطلحات موضوعية: OBESITY in women, ASTHMATICS, VITAL capacity (Respiration), FORCED expiratory volume, LUNG volume

مستخلص: Background: Obesity is known to diminish lung volumes and worsen asthma. However, mechanistic understanding is lacking, especially as concerns small‐airway responsiveness. The objective of this study was therefore to compare small‐airway responsiveness, as represented by the change in expiratory:inspiratory mean lung density ratios (MLDe/i, as determined by computed tomography [CT]) throughout methacholine testing in obese versus non‐obese women with asthma. Methods: Thoracic CT was performed during methacholine bronchoconstriction challenges to produce standardized response curves (SRC: response parameter versus ln[1 + % PD20], where PD20 is the cumulative methacholine dose) for 31 asthma patients (n = 18 non‐obese and n = 13 obese patients). Mixed models evaluated obesity effects and interactions on SRCs while adjusting for age and bronchial morphology. Small airway responsiveness as represented by SRC slope was calculated for each third of the MLDe/i response and compared between groups. Results: Obesity‐associated effects observed during experimental bronchoconstriction included: (i) a significant baseline effect for forced expiratory volume in 1 second with lower values for the obese (73.11 ± 13.44) versus non‐obese (82.19 ± 8.78; p = 0.002) groups prior to methacholine testing and (ii) significantly higher responsiveness in small airways as estimated via differences in MLDe/i slopes (group×ln(1 + % PD20 interaction; p = 0.023). The latter were pinpointed to higher slopes in the obese group at the beginning 2/3 of SRCs (p = 0.004 and p = 0.021). Significant obesity effects (p = 0.035 and p = 0.008) indicating lower forced vital capacity and greater % change in MLDe/I (respectively) throughout methacholine testing, were also observed. Conclusion: In addition to baseline differences, small‐airway responsiveness (as represented by the change in MLDe/i) during methacholine challenge is greater in obese women with asthma as compared to the non‐obese. [ABSTRACT FROM AUTHOR]

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المؤلفون: Roubille, François, Matzner‐Lober, Eric, Aguilhon, Sylvain, Rene, Max, Lecourt, Laurent, Galinier, Michel, Ricci, Jean‐Etienne, Molinari, Nicolas

المصدر: ESC Heart Failure; Feb2023, Vol. 10 Issue 1, p727-731, 5p

مصطلحات موضوعية: HEART failure patients, HEAT waves (Meteorology), GLOBAL warming, CHRONICALLY ill

مصطلحات جغرافية: FRANCE

مستخلص: Heatwaves affect human health and should be more and more frequent because of global warming and could lead to increase mortality in general population, especially regarding cardiovascular mortality. During the summer 2019, Europe experienced a strong episode of heatwave. Telemonitoring of patients with heart failure (HF) provide an elegant tool to monitor closely the weights, and we assumed to be able to assess our hypothesis through a nationwide telemonitoring system. Here, we hypothesize that (i) there will be a change in patients' weight during the heatwave and (ii) that the telemonitoring would enable us to follow these changes. The change in weight would be a surrogate for clinical worsening (with or without decompensated HF). Briefly, 1420 patients with a median age of 73.0 years and mean weight of 78.1 kg have been included in this analysis. The relationship between temperature and weight is very strong (P < 10−7). The magnitude of the effect seems clinically relevant with a variation of 1.5 kg during a short period. This could expose patients to increased symptoms, HF decompensations, and poor outcomes. These results suggest a new way to implement weight telemonitoring in HF. This suggests also a direct impact of global warming on Human health, with acute episodes that are expected to occur more often, threatening patients with chronic diseases, especially patients with heart failure. In clinical practice, this urges to take into consideration the episodes of extreme heatwave and suggest that we have already useful tools including telemonitoring available in frail patients. [ABSTRACT FROM AUTHOR]

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المؤلفون: Bessis, Didier, Devoye, Céline, Molinari, Nicolas, Quéré, Isabelle, de La Villéon, Grégoire, Jeziorski, Éric

المصدر: Pediatric Dermatology; Mar2024, Vol. 41 Issue 2, p377-378, 2p

مصطلحات موضوعية: ORTHOSTATIC intolerance, DYSAUTONOMIA, POSTURAL orthostatic tachycardia syndrome, SYNDROMES

مستخلص: This article discusses the BASCULE syndrome, a condition characterized by Bier anemic spots, cyanosis, and urticaria-like eruption. The authors conducted a retrospective study of 33 adolescents and adults with BASCULE syndrome, finding a female predominance and a median age of symptom onset at 13 years. The syndrome was triggered by orthostatism and involved the lower limbs and upper limbs. The study also found associations with autonomic dysfunction, including postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension, as well as electrocardiographic abnormalities. However, no significant clinical improvement was observed with treatment. The authors suggest further research on the potential efficacy of propranolol for BASCULE syndrome. [Extracted from the article]

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المؤلفون: Tanno, Luciana Kase^1,2,3,4 (AUTHOR) luciana.tanno@gmail.com, Molinari, Nicolas^2,3 (AUTHOR), Annesi‐Maesano, Isabella³ (AUTHOR), Demoly, Pascal^2,3,4 (AUTHOR), Bierrenbach, Ana Luiza^1,5 (AUTHOR)

المصدر: Clinical & Experimental Allergy. Sep2022, Vol. 52 Issue 9, p1071-1078. 8p. 1 Color Photograph, 3 Charts, 3 Graphs.

مصطلحات موضوعية: *ANAPHYLAXIS, *HEALTH planning, *PRESCHOOL children, *MIDDLE-income countries, *NOSOLOGY, *INSECT bites & stings

مصطلحات جغرافية: BRAZIL

مستخلص: Background: There is a lack of population‐based studies of anaphylaxis from low‐ and middle‐income countries. This hampers public health planning and investments and may influence availability of adrenaline auto‐injectors. Objective: We conducted the first national population‐based study of anaphylaxis hospitalization in Brazil. Methods: Descriptive study using routinely reported data to the Brazilian Hospital Information System for the years 2011–2019. Information available is coded based on the International Classification of Diseases (ICD)‐10 and covers main cause of hospitalization (primary cause) and any conditions contributing to it (secondary cause). Results: Over 9 years, we identified 5716 admissions due to anaphylaxis for all causes. The average hospitalization rate related to anaphylaxis was 0.71/100,000 population per year, with a 2.4% (95% CI 1.9%, 2.9%) increase per annum over the study period. Admissions were more frequent among females (52.8%), except for cases due to insect sting. Most admissions occurred in adulthood, from 30 to 59 years (36.3%) but 13.8% in preschool children (0–4 years). There were more young children admitted for food‐related anaphylaxis, and more adults admitted for drug/iatrogenic‐related anaphylaxis. There were 334 cases (5.8% of admissions) of fatal anaphylaxis over the study period, with increased case fatality rate over time. Conclusions and Clinical Relevance: This is the first study of anaphylaxis hospital admissions using nation‐wide data from a low‐ or middle‐income country. Hospital admissions and fatalities from anaphylaxis in Brazil appear to be increasing. [ABSTRACT FROM AUTHOR]

المؤلفون: Abraham, Christophe, Molinari, Nicolas, Servien, Rémi

المساهمون: Mathématiques, Informatique et STatistique pour l'Environnement et l'Agronomie (MISTEA), Institut National de la Recherche Agronomique (INRA)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Unité Médicale des Maladies Auto-Inflammatoires (Centre de Référence), Laboratoire de Genetique

المصدر: ISSN: 0277-6715.

مصطلحات موضوعية: Circular data, Radiotherapy machine data, Unsupervised clustering, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], [STAT.TH]Statistics [stat]/Statistics Theory [stat.TH]

الوصف: International audience ; An unsupervised clustering problem is studied in this paper. The originality of this problem lies in the data, which consist of the positions of five separate x-ray beams on a circle. The five x-ray beam "projectors" are positioned around each patient on a predefined circle. However, similarities exist in positioning for certain groups of patients, and we aim to describe these similarities with the goal of creating pre-adjustment settings that could help save time during x-ray positioning. We therefore performed unsupervised clustering of observed x-ray positions. Because the data for each patient consists of five angle measurements, Euclidean distances are not appropriated. Furthermore, $k$-means algorithm, usually used for minimising corresponding distortion can not be computed because centers of clusters are not calculables. We present here solutions to these problems. First, we define a suitable distance on the circle. Then, we adapt an algorithm based on simulated annealing to minimize distortion. This algorithm is shown to be theoretically convergent. Finally, simulations on simulated and real data are presented.

العلاقة: hal-00674196; https://hal.science/hal-00674196Test; https://hal.science/hal-00674196v4/documentTest; https://hal.science/hal-00674196v4/file/StatinMed.pdfTest; PRODINRA: 188829; WOS: 000316625600011

الإتاحة: https://doi.org/10.1002/sim.5589Test
https://hal.science/hal-00674196Test
https://hal.science/hal-00674196v4/documentTest
https://hal.science/hal-00674196v4/file/StatinMed.pdfTest

المؤلفون: Jaffuel, Dany, Nogue, Erika, Berdague, Philippe, Galinier, Michel, Fournier, Pauline, Dupuis, Marion, Georger, Frédéric, Cadars, Marie‐Pierre, Ricci, Jean‐Etienne, Plouvier, Nathalie, Picard, François, Puel, Vincent, Mallet, Jean‐Pierre, Suehs, Carey M., Molinari, Nicolas, Bourdin, Arnaud, Roubille, François

المصدر: ESC Heart Failure; Aug2021, Vol. 8 Issue 4, p2513-2526, 14p

مصطلحات موضوعية: ENTRESTO, HEART failure patients, SLEEP apnea syndromes

مستخلص: Aims: Optimizing medical cardiac treatment for sleep apnoea (SA) in patients with chronic heart failure and reduced ejection fraction (HFrEF) is an expert Grade C recommendation based on six studies encompassing a total of 67 patients only. Whether sacubitril–valsartan (SV), a cornerstone of HFrEF medical treatment, impacts SA is unknown and requires evaluation. Methods and results: The ENTRESTO‐SAS trial is a six‐centre, prospective, open‐label real‐life cohort study (NCT02916160). Ambulatory patients eligible for SV (i.e. HFrEF adults who remain symptomatic despite optimal treatment) were evaluated before and after 3 months of SV (including nocturnal ventilatory polygraphy); 118 patients were final analysed [median age was 66 (IQ25–75: 56–73) years, 81.4% male, 36.5% New York Heart Association III–IV, N‐terminal pro‐B‐type natriuretic peptide level of 1564 (701–3376) ng/L, left ventricular ejection fraction of 30 (25–34)%, 60.7% ischaemic HFrEF, 97.5% initially treated with angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers, 83.9% with beta‐blockers, 64.4% with mineralocorticoid receptor antagonists, and 74.6% with diuretics]. Three groups were defined according to initial central/obstructive apnoea–hypopnoea indices (AHIs): G1 (n = 49, AHIcentral ≥ 5/h and AHIobstructive < 15/h); G2 (n = 27, AHIobstructive ≥ 15/h); and G3 (n = 42, AHIcentral < 5/h and AHIobstructive < 15/h). At 3 months, the AHI (main predefined outcome) decreased significantly by −7.10/h (IQ25–75: −16.10 to 0.40; P < 0.001) in G1 + G2 without positive airway pressure treatment (45 patients, median initial AHI of 24.20 (IQ25–75: 16.40–43.50)/h). Of these, 24.4% presented an AHI decrease ≥50% and 37.78% had a final AHI < 15/h (tendency for improvement from an initial value of 20%: P = 0.0574). For G1 patients (n = 37), AHI significantly decreased from a median of 22.90 (16.00–43.50)/h to 19.20 (12.70–31.10)/h (P = 0.002). For G2 patients (n = 8), AHI decreased from a median of 30.10 (26.40–47.60)/h to 22.75 (14.60–36.90)/h (statistically non‐significant, P = 0.059). Conclusions: In this real‐life population, SV treatment for 3 months in SA patients is associated with a significant decrease in AHI. These results support the current guidelines that recommend first an optimization of the HFrEF treatment in patients with HFrEF and central SA. A potential positive airway pressure sparing effect merits further investigation. [ABSTRACT FROM AUTHOR]

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المؤلفون: Tanno, Luciana Kase, Chalmers, Robert, Jacob, Robert, Kostanjsek, Nenad, Bierrenbach, Ana Luiza, Martin, Bryan, Molinari, Nicolas, Annesi‐Maesano, Isabella, Papadopoulos, Nikolaos G., Sanchez‐Borges, Mario, Rosenwasser, Lanny J., Ansontegui, Ignacio, Ebisawa, Motohiro, Sisul, Juan Carlos, Jares, Edgardo, Gomez, Maximiliano, Agache, Ioana, Muraro, Antonella, Wong, Gary W. K., Thien, Francis

المصدر: Allergy; Sep2020, Vol. 75 Issue 9, p2206-2218, 13p

مصطلحات موضوعية: NOSOLOGY, WORLD health, ALLERGIES, DEFINITIONS, BUILDING permits

الشركة/الكيان: WORLD Health Organization

مستخلص: The International Classification of Diseases (ICD) provides a common language for use worldwide as a diagnostic and classification tool for epidemiology, clinical purposes and health management. Since its first edition, the ICD has maintained a framework distributing conditions according to topography, with the result that some complex conditions, such as allergies and hypersensitivity disorders (A/H) including anaphylaxis, have been poorly represented. The change in hierarchy in ICD‐11 permitted the construction of the pioneer section addressed to A/H, which may result in more accurate mortality and morbidity statistics, including more accurate accounting for mortality due to anaphylaxis, strengthen classification, terminology and definitions. The ICD‐11 was presented and adopted by the 72nd World Health Assembly in May 2019, and the implementation is ongoing worldwide. We here present the outcomes from an online survey undertaken to reach out the allergy community worldwide in order to peer review the terminology, classification and definitions of A/H introduced into ICD‐11 and to support their global implementation. Data are presented here for 406 respondents from 74 countries. All of the subsections of the new A/H section of the ICD‐11 had been considered with good accuracy by the majority of respondents. We believe that, in addition to help during the implementation phase, all the comments provided will help to improve the A/H classification and to increase awareness by different disciplines of what actions are needed to ensure more accurate epidemiological data and better clinical management of A/H patients. [ABSTRACT FROM AUTHOR]

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المؤلفون: Nohra, Dunya^1,2 (AUTHOR), Molinari, Nicolas³ (AUTHOR), Demoly, Pascal^1,2 (AUTHOR), Chiriac, Anca‐Mirela^1,2 (AUTHOR) a-chiriac@chu-montpellier.fr

المصدر: Allergy. Jun2020, Vol. 75 Issue 6, p1423-1434. 12p. 1 Diagram, 3 Charts, 3 Graphs.

مصطلحات موضوعية: *ANTI-inflammatory agents, *CLINICAL drug trials, *DRUG side effects, *ASPIRIN, *PHARMACOLOGY

مصطلحات جغرافية: MONTPELLIER (France)

الشركة/الكيان: UNIVERSITY of Colorado Hospital

مستخلص: Introduction: Hypersensitivity to nonsteroidal anti‐inflammatory drugs (NSAIDs) is of great concern because they are frequently encountered in daily clinical practice. Drug provocation tests (DPTs) are particularly needed for NSAIDs. Methods: The aim of this retrospective study was to detect eliciting dose thresholds during NSAIDs DPT in order to suggest optimal step doses, using the survival analysis method. Our secondary objective was to describe subgroups at higher risk during DPT and evaluate the safety of our 30 minutes incremental 1‐day protocol. The study comprised all the patients attended the Allergy of the University Hospital of Montpellier (France), between 1997 and 2017 for a suspicion of drug hypersensitivity reaction to NSAIDs. Results: Throughout the study period, 311 positive DPT were analyzed (accounting for 285 hypersensitive patients). We identified eliciting thresholds (dose and time), and we suggest the following steps for future DPT: for the rapid absorption group (acetylsalicylic acid, ibuprofen, ketoprofen, and tiaprofenic acid), every 30 minutes: 20%‐30%‐50% of daily therapeutic dose, for the moderate absorption group, every 30 minutes: for diclofenac 5%‐15%‐30%‐50%, and for celecoxib, 20%‐80%. For the slow absorption group, piroxicam, 25%‐75%, was separated by a 3‐hours interval. A surveillance period of 3 hours after the last dose is mandatory for patients. Conclusion: Drug provocation test protocols for NSAID are empirical, driven by the knowledge on patterns of DHR, cross‐reactivity between NSAID and pharmacological effects of these all drugs. This is the second experience in improving DPT protocols, after BL (B‐lactam) antibiotics. [ABSTRACT FROM AUTHOR]

المؤلفون: Bourdin, Arnaud, Husereau, Don, Molinari, Nicolas, Golam, Sarowar, Siddiqui, Mohd Kashif, Lindner, Leandro, Xu, Xiao

المصدر: Clinical & Experimental Allergy; Apr2020, Vol. 50 Issue 4, p442-452, 11p, 5 Charts, 2 Graphs

مصطلحات موضوعية: META-analysis, ASTHMA, TREATMENT effectiveness, ODDS ratio, CLINICAL trials

مستخلص: Background: Oral corticosteroid (OCS) treatment for severe asthma is associated with substantial disease burden. Thus, OCS dosage reduction is desirable. Relative efficacy of biologics in reducing OCS treatment for severe, uncontrolled asthma is not fully characterized. Objective: We performed a matching‐adjusted indirect comparison (MAIC) to assess the relative effects on OCS treatment reduction of three biologic asthma treatments. Methods: In MAIC of benralizumab vs. mepolizumab and vs. dupilumab, patient‐level data from the Phase III benralizumab OCS‐sparing trial, ZONDA, were weighted to match treatment effect–modifying patient characteristics in comparator trials. Results: After matching adjustment, mean difference between benralizumab and mepolizumab for OCS reduction was 6.08% (95% CI −22.22‐34.38; P =.67) by week 24, and odds ratio of OCS elimination was 2.32 (95% CI 0.48‐11.15; P =.29). A trend in annual asthma exacerbation rate reduction favouring benralizumab over mepolizumab was observed, although it was not statistically significant (rate ratio [RR] = 0.56 [95% CI 0.28‐1.13; P =.11]). Mean difference between benralizumab and dupilumab for OCS reduction was −0.71% (95% CI −20.56‐19.15; P =.94), and odds ratio of OCS elimination was 2.26 (95% CI 0.52‐9.84; P =.28). A non‐significant trend in annual asthma exacerbation rate reduction favouring benralizumab over dupilumab was observed (RR = 0.50 [95% CI 0.20‐1.28; P =.15]). Effective sample size was 49% (72 vs. 148) and 25% (36 vs. 142) of original sample size for MAIC of benralizumab vs. mepolizumab and benralizumab vs. dupilumab, respectively. Conclusions and Clinical Relevance: Following patient baseline characteristics matching across clinical trials, benralizumab demonstrated efficacy comparable to mepolizumab and dupilumab for OCS dosage reduction, OCS elimination, and annual exacerbation rate reduction. Comparatively low effective sample sizes indicated substantial differences for patient populations between ZONDA and mepolizumab and dupilumab trials. [ABSTRACT FROM AUTHOR]

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