Revue des maladies respiratoires最新文献_第3页

[Factors associated with FEV1 evolution in cystic fibrosis patients treated by CFTR modulator tritherapy]. [CFTR调节剂三联疗法治疗囊性纤维化患者FEV1进化的相关因素]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-06-05 DOI: 10.1016/j.rmr.2026.04.003

N Belard, T Blin, A De Luca, S Marchand Adam, L Plantier, Th Flament, J Mankikian

{"title":"[Factors associated with FEV1 evolution in cystic fibrosis patients treated by CFTR modulator tritherapy].","authors":"N Belard, T Blin, A De Luca, S Marchand Adam, L Plantier, Th Flament, J Mankikian","doi":"10.1016/j.rmr.2026.04.003","DOIUrl":"https://doi.org/10.1016/j.rmr.2026.04.003","url":null,"abstract":"Introduction: Triple therapy with Elexacaftor, Tezacaftor and Ivacaftor (ETI) has transformed the management of cystic fibrosis. The aim of this study was to describe the patients under treatment who do not show improvement in FEV1.Methods: In a single-center retrospective study of 63 adults, data were collected over the 12 months before and after initiation of ETI. Patients were classified as \"improved FEV1\" (FEV1 gain≥5% at 12 months of ETI) and \"stable FEV1\" (FEV1 gain<5%).Results: The patients in our study were at least 18 years old, suffered from cystic fibrosis, and had initiated a course of treatment by elexacaftor/tezacaftor/ivacaftor (ETI) between December 2019 and December 2021. They presented with either homozygosity or heterozygosity for the Phe508del mutation, with minimal function of the CFTR gene. At 12 months of ETI, an improvement in sweat chloride (-56 [-34; -69] mmol/L), FEV1 +17 [9; 24] % pred), RV/TLC ratio (-6 [-10; -3] %), walking distance +28 [14; 82] m and BMI (+1.5 [0.7; 2.6] kg/m2) was observed. Aside from the RV/TLC ratio, the improvement was similar between the \"stable FEV1\" (7 patients) and \"improved FEV1\" (56 patients) groups.Conclusion: A benefit in terms of sweat chlorine, BMI, walking distance and exacerbations was observed in patients whose FEV1 remained stable on ETI. This observation underlines the importance of multiparametric evaluation of patients treated with CFTR modulators.","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Pulmonary expression of an asymptomatic lysosomal storage disorder]. [无症状溶酶体贮积症的肺表达]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-06-05 DOI: 10.1016/j.rmr.2026.05.005

N Provis, C Stavart, J Cousin, P-A Poncelet

引用次数: 0

[Subacute pulmonary coccidioidomycosis: A differential diagnosis of lung cancer]. [亚急性肺球虫病：肺癌的鉴别诊断]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-05-22 DOI: 10.1016/j.rmr.2026.05.002

C Le Gac, S Hamane, A Costantini, E Giroux Leprieur, P Wang

{"title":"[Subacute pulmonary coccidioidomycosis: A differential diagnosis of lung cancer].","authors":"C Le Gac, S Hamane, A Costantini, E Giroux Leprieur, P Wang","doi":"10.1016/j.rmr.2026.05.002","DOIUrl":"https://doi.org/10.1016/j.rmr.2026.05.002","url":null,"abstract":"Introduction: Coccidioidomycosis is a fungal infection endemic to the southwestern United States, particularly Arizona. Rare in Europe, it can lead to diagnostic delays insofar as its clinical and radiological features may mimic lung cancer, mycobacterial and/or bacterial diseases.Observation: We report a case of pulmonary and mediastinal coccidioidomycosis diagnosed in France following travel to an endemic area by a 68-year-old immunocompetent woman, a former smoker, who presented with a persistent cough and constitutional symptoms (fatigue, weight loss and anorexia). Chest computed tomography revealed a paramediastinal mass in the middle lobe as well as ipsilateral mediastinal lymphadenopathy. Given the patient's age, clinical deterioration, and heavy smoking history, lung cancer was initially suspected but rapidly ruled out after direct examination, reverse transcription quantitative real-time polymerase reaction (RT-qPCR), and serology had confirmed the presence of coccidioidomycosis. Due to several risk severity factors, treatment with fluconazole was promptly initiated, leading to clinical and radiological improvement.Conclusion: Rarely reported in France, pulmonary and mediastinal coccidioidomycosis can mimic the clinico-radiological presentation of bronchopulmonary cancer. Diagnosis relies on thorough travel history, careful assessment of symptoms, and mycological confirmation - often requiring repeated serological sampling.","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Relevance of the ACT score in severe asthma with obesity: A pilot study]. [严重哮喘与肥胖的ACT评分相关性：一项初步研究]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-05-22 DOI: 10.1016/j.rmr.2026.05.003

A Tran, S Dury, G Deslee, C Estellat, C Taille, J-M Perotin

{"title":"[Relevance of the ACT score in severe asthma with obesity: A pilot study].","authors":"A Tran, S Dury, G Deslee, C Estellat, C Taille, J-M Perotin","doi":"10.1016/j.rmr.2026.05.003","DOIUrl":"https://doi.org/10.1016/j.rmr.2026.05.003","url":null,"abstract":"Introduction: The Asthma Control Test (ACT) is an easy-to-use tool assessing the level of asthma control. However, interpretation in a population of severe asthma patients with obesity may be partially biased due to symptoms directly associated with obesity.Methods: The RAMSES study is a nationwide cohort of severe asthma patients. In this pilot study, we considered a subgroup of patients recruited in our center, compared the ACT scores of obese and non-obese severe asthma patients, and analysed associations between ACT scores and phenotypic features.Results: Forty non-obese and 25 obese severe asthmatics were included in the study. The ACT score did not differ between the two groups, nor was it correlated with body mass index. Unlike the non-obese group, the ACT score in the obese group was not associated with number of exacerbations (P=0.158), number of hospitalizations (P=0.840), or the HADS anxiety (P=0.105) and depression (P=0.056) scores.Conclusion: Our results suggest that the ACT score may not fully reflect asthma control in the obese severe asthma population. They rather tend to indicate a distinct severe asthma and obesity phenotype, in which a low ACT score would not be associated with number of exacerbations or psychological burden, thereby highlighting the primordiality of comprehensive assessment and multidisciplinary management.","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Above and beyond BMI: Deciphering the lung cancer paradox]. [超越BMI：解读肺癌悖论]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-05-21 DOI: 10.1016/j.rmr.2026.05.004

L Gherzi, C Di Giovannantonio, M Prieto, M Alifano

{"title":"[Above and beyond BMI: Deciphering the lung cancer paradox].","authors":"L Gherzi, C Di Giovannantonio, M Prieto, M Alifano","doi":"10.1016/j.rmr.2026.05.004","DOIUrl":"https://doi.org/10.1016/j.rmr.2026.05.004","url":null,"abstract":"Introduction: Non-small cell lung cancer (NSCLC) remains a leading cause of cancer-related death. In addition to tumor stage, host-related factors play a critical role in determining outcomes.State of knowledge: Data from the French Epithor database and institutional cohorts have consistently highlighted a \"lung cancer paradox\": while underweight is associated with increased mortality, overweight and obesity seem to confer a survival advantage. Morphometric studies have confirmed that skeletal muscle mass, which is assessed in terms of psoas or total muscle area, is an independent predictor of prognosis. On a parallel track, simple biomarkers such as preoperative C-reactive protein (CRP) and prealbumin have demonstrated strong prognostic value, as they are closely linked to systemic inflammation and intratumoral immune infiltration. More recently, patient height and height-normalized weight (sH and sHNW) have emerged as novel independent prognostic factors, once again underscoring the relevance of morphomic measures other than BMI.Perspectives: Integration of simple and reproducible anthropometric indices (BMI, height, sHNW), body composition, and biological markers (CRP, prealbumin) provides a more comprehensive framework for risk stratification. This enriched approach may help to optimize perioperative management, identify high-risk patients, and refine indications for adjuvant or immune-based therapies in cases of resectable NSCLC.Conclusions: Although BMI alone is only a crude measure, when interpreted within an integrative model it retains prognostic significance. The combining of nutritional, inflammatory, and morphometric parameters yields a robust overall representation of patient status, paving the way toward personalized prognostic assessment and improved therapeutic decision-making.","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Automated analysis of mandibular movements for the screening of obstructive sleep apnea]. [下颌运动自动分析筛查阻塞性睡眠呼吸暂停]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-05-21 DOI: 10.1016/j.rmr.2026.05.001

F Nassurally, C Palpacuer, A Leclercq, C Iamandi, B Renaud-Picard, F Fall-Mostaine, D Debieuvre, Rahli Mohamed, L Meyer, L Kessler, R Kessler

{"title":"[Automated analysis of mandibular movements for the screening of obstructive sleep apnea].","authors":"F Nassurally, C Palpacuer, A Leclercq, C Iamandi, B Renaud-Picard, F Fall-Mostaine, D Debieuvre, Rahli Mohamed, L Meyer, L Kessler, R Kessler","doi":"10.1016/j.rmr.2026.05.001","DOIUrl":"https://doi.org/10.1016/j.rmr.2026.05.001","url":null,"abstract":"Introduction: Obstructive sleep apnea syndrome (OSAS) is a highly prevalent condition, particularly among at-risk populations such as patients with obesity, diabetes, or chronic respiratory disease. There is a growing need for simplified, automated diagnostic approaches that can be implemented outside specialized sleep laboratories.Methods: We conducted a prospective, interventional study in two hospital centers in Alsace (France), comparing an automated mandibular movement analysis device (Sunrise®) with standard ventilatory polygraphy (VP). Agreement between the two methods for determining the apnea-hypopnea index (AHI) was assessed using Bland-Altman analysis.Results: Thirty-seven patients were enrolled, from whom 29 pairs of recordings (78%) were suitable for analysis. Seven Sunrise® failures and one ventilatory polygraphy failure, were due mainly to sensor malfunctions or connectivity issues. In comparison with VP, Sunrise® tended to overestimate AHI, with a mean difference of +4.76 events/h. The limits of agreement ranged from -15.4 to +24.9 events/h, indicating moderate variability between the methods.Conclusions: The Sunrise® device demonstrates feasibility for use in non-expert clinical settings and shows reasonable agreement with ventilatory polygraphy, supporting its potential as a simplified screening tool for OSAS. However, these results should be interpreted cautiously, especially for high AHI, and technical limitations must be addressed in future \"real world\" studies.","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Management of primary spontaneous pneumothorax in France: An overview of practices in 2024]. 【法国原发性自发性气胸的治疗：2024年实践综述】。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-05-12 DOI: 10.1016/j.rmr.2026.04.001

S Jouneau, T Debec, P Chauvin, F Balusson, E Bajeux

{"title":"[Management of primary spontaneous pneumothorax in France: An overview of practices in 2024].","authors":"S Jouneau, T Debec, P Chauvin, F Balusson, E Bajeux","doi":"10.1016/j.rmr.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.rmr.2026.04.001","url":null,"abstract":"Introduction: French guidelines on the management of primary spontaneous pneumothorax (PSP) were first communicated in 2022 and subsequently published in 2023. They emphatically promoted outpatient management. We aimed to assess current therapeutic management of PSP following the release of these guidelines.Methods: A nationwide online survey was conducted to evaluate therapeutic management strategies for large PSP without signs of severity. A standardized questionnaire was sent via the French Society of Respiratory Diseases (SPLF) and the French Federation of Pulmonology (FFP). One response per center was requested.Results: All in all, 98 responses were collected from physicians (91 pulmonologists) representing 81 healthcare facilities, including 33 (40.7 %) general hospitals and 29 university hospitals (35.8 %). The majority of centers managed PSP through hospitalization (71.6 %), primarily via chest tube drainage (64.2 %), most often using small-bore chest tubes (≤14 French, in 76 % of cases). Outpatient management was practiced in 27.2 % of facilities, mainly using chest drainage with a one-way mini-valve (21 %). Analgesic prescriptions and sick leave duration significantly varied.Conclusion: Following publication of the French guidelines, PSP management has remained predominantly hospital-based, although small-bore chest tubes are commonly used. Outpatient care remains underdeveloped and should be encouraged. Any future update of these guidelines would need to provide more detailed recommendations on analgesia and sick leave.","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[A rare cause of mediastino-pulmonary granulomatosis associated with Whipple's disease]. [一种与惠普尔病相关的纵隔-肺肉芽肿病的罕见病因]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-05-12 DOI: 10.1016/j.rmr.2026.04.005

M Pinto, R Nguyen Van, D Marquette

引用次数: 0

[Efficacy and safety of intrapleural fibrinolysis in pleural infection. Real-life study over 10 years in a university hospital]. 胸膜内纤溶治疗胸膜感染的疗效和安全性。在一所大学医院进行了10年的真实研究]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-05-11 DOI: 10.1016/j.rmr.2026.04.004

V Roy, V Bironneau, L Guerin, P Dufay, M Charron, D Luque-Paz, S Jouneau, C Jayle, F Caron, J-C Meurice, E-M Jutant

{"title":"[Efficacy and safety of intrapleural fibrinolysis in pleural infection. Real-life study over 10 years in a university hospital].","authors":"V Roy, V Bironneau, L Guerin, P Dufay, M Charron, D Luque-Paz, S Jouneau, C Jayle, F Caron, J-C Meurice, E-M Jutant","doi":"10.1016/j.rmr.2026.04.004","DOIUrl":"https://doi.org/10.1016/j.rmr.2026.04.004","url":null,"abstract":"Introduction: Intrapleural fibrinolysis has proved effective in reducing the length of hospital stay and the need for surgery in pleural infection. However, it carries risks, and its use in France remains unsystematic. The aim of this study was to assess the efficacy and safety of pleural infection drainage with or without intrapleural fibrinolysis.Method: A single-center retrospective non-interventional study at Poitiers University Hospital (2012-2022) including patients drained for complicated pleural infection or at risk of complication and divided into two groups according to whether intrapleural fibrinolysis was or was not performed.Results: Out of 85 patients drained for pleural infection, 23 (27 %) received fibrinolysis. The two groups (with or without fibrinolysis) were similar in terms of initial characteristics. The duration of oxygen therapy and fever did not differ. However, the fibrinolysis group had more iatrogenic bleeding (26 % versus 5 %, P=0.01) and a longer hospital stay (18days versus 14days, P=0.03). Survival at one month and one year was comparable, but residual effusion was more frequent in the group without fibrinolysis.Conclusion: Intrapleural fibrinolysis remains a therapeutic option requiring regular reassessment due to difficult-to-prove benefits and marked risks in real-world practice.","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Resistance to immunotherapy in non-small cell lung cancer: State of the art]. [非小细胞肺癌免疫治疗的耐药性：最新进展]。

IF 0.5 4区医学

Revue des maladies respiratoires Pub Date : 2026-05-08 DOI: 10.1016/j.rmr.2026.04.002

J Ancel, M Dewolf, B Nawrocki-Raby, A Durlach, V Dalstein, A Cortot, V Dormoy, C Gilles, M Polette, G Deslée

{"title":"[Resistance to immunotherapy in non-small cell lung cancer: State of the art].","authors":"J Ancel, M Dewolf, B Nawrocki-Raby, A Durlach, V Dalstein, A Cortot, V Dormoy, C Gilles, M Polette, G Deslée","doi":"10.1016/j.rmr.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.rmr.2026.04.002","url":null,"abstract":"Introduction: Non-small cell lung cancer (NSCLC) remains one of the leading causes of cancer-related mortality worldwide. Immunotherapy has significantly reshaped its treatment, leading to improved survival in a subset of patients. However, failed initial response or acquired resistance may limit the long-term benefits of immunotherapy.State of the art: Resistance to immunotherapy arises from complex and multifactorial mechanisms. They include intrinsic tumor cell alterations - such as STK11 and KEAP1 mutations, antigen presentation defects, and impaired IFNγ signaling - as well as extrinsic factors related to the tumor microenvironment, including hypoxia, immunosuppressive cell infiltration, and T-cell exclusion. In response, several combination strategies have been explored: immunotherapy with chemotherapy, anti-angiogenic agents, alternative immune checkpoint inhibitors (e.g., CTLA-4, TIGIT, LAG-3), or innate immune modulators (e.g., STING, RIG-I), with encouraging early results.Perspectives: Despite recent progress, current approaches remain primarily focused on the tumor and its microenvironment, often overlooking host-related factors - such as age, comorbidities, dysbiosis, and chronic inflammation - that can significantly impact immune responsiveness. More refined patient stratification, incorporating tumor, immune, and host-derived immune and non-immune biomarkers, is essential to better tailor treatments and improve outcomes.Conclusions: The future of immunotherapy in NSCLC will likely be premised on a holistic understanding of tumor biology, immune dynamics, and host characteristics. Such an integrated approach is key to overcoming current limitations, enabling personalized strategies, and broadening the clinical benefit of immunotherapy to a wider patient population.","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0