Pub Date : 2025-12-27DOI: 10.1016/j.rmr.2025.12.003
F Vandenbos, F Petit, M L Durant, K Risso
Introduction: Latent tuberculosis infection (LTBI) in children under 18 years of age is a mandatorily notifiable condition for which tuberculosis preventive treatment (TPT) is recommended. However, the comprehensiveness of TPT has yet to be extensively analyzed. We report on the experience of the Alpes-Maritimes Tuberculosis Control Center.
Observation: In 2023 and 2024 in the Alpes-Maritimes department, 284 LTBIs in children under 18 years of age were detected and reported. LTBI was linked to the screening of unaccompanied minor migrants (UMMs) (256 children), to an investigation on the case of a tuberculosis patient (20 children), and to the screening of minor migrants accompanied by their parents (eight children). The median age and sex ratio (M/F) differed between the UMM group and the "case investigation" and "accompanied minors" groups, with respectively 16 years and 9.7 for the UMMs, 11 years and 0.8 for the "case investigation" group, and 12 years and 0.6 for the "accompanied minors" group (P<0.05). TPT completeness was 54% in the UMMs, and 100% in the other two groups (P<0.05).
Conclusion: TPT comprehensiveness was high among minors who were surrounded by their parents, but less satisfactory among UMMs.
{"title":"[Comprehensiveness of LTBI treatment in individuals under 18 years old].","authors":"F Vandenbos, F Petit, M L Durant, K Risso","doi":"10.1016/j.rmr.2025.12.003","DOIUrl":"https://doi.org/10.1016/j.rmr.2025.12.003","url":null,"abstract":"<p><strong>Introduction: </strong>Latent tuberculosis infection (LTBI) in children under 18 years of age is a mandatorily notifiable condition for which tuberculosis preventive treatment (TPT) is recommended. However, the comprehensiveness of TPT has yet to be extensively analyzed. We report on the experience of the Alpes-Maritimes Tuberculosis Control Center.</p><p><strong>Observation: </strong>In 2023 and 2024 in the Alpes-Maritimes department, 284 LTBIs in children under 18 years of age were detected and reported. LTBI was linked to the screening of unaccompanied minor migrants (UMMs) (256 children), to an investigation on the case of a tuberculosis patient (20 children), and to the screening of minor migrants accompanied by their parents (eight children). The median age and sex ratio (M/F) differed between the UMM group and the \"case investigation\" and \"accompanied minors\" groups, with respectively 16 years and 9.7 for the UMMs, 11 years and 0.8 for the \"case investigation\" group, and 12 years and 0.6 for the \"accompanied minors\" group (P<0.05). TPT completeness was 54% in the UMMs, and 100% in the other two groups (P<0.05).</p><p><strong>Conclusion: </strong>TPT comprehensiveness was high among minors who were surrounded by their parents, but less satisfactory among UMMs.</p>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850789","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}
Pub Date : 2025-12-26DOI: 10.1016/j.rmr.2025.11.002
S Dury, P Mulette, A Vivien, H Yucel-Farcet, E Longueville, A Boutahir, B Ravoninjatovo, A Deforge, M Griffon, F Deschamps, G Deslée, J Ancel
Introduction: The complications associated with cystic fibrosis and the daily management of the disease can have significant social, familial, and professional repercussions. The objective of this study was to assess adult patients' knowledge regarding their rights and social support options, along with their access to social care.
Materials and methods: Between May 2021 and December 2023, we conducted a prospective monocentric study at the University Hospital of Reims, including adult patients diagnosed with cystic fibrosis. A questionnaire assessing their knowledge in this area was utilized.
Results: The analysis included 61 patients (64% male; mean age: 29.2 years). In 73% of cases, patients reported being assisted by their social circle in managing administrative tasks. Information sources were diverse, and most patients had already met with a social worker. While the quality of information received was generally rated as good, one-third of the participants felt that the topic of social support was insufficiently addressed. Ten patients were unaware of their being enrolled in the long-term illness coverage program. Half of patients were receiving adult disability benefits.
Conclusion: Adult patients often rely on their social support network for the performance of administrative and social tasks. Improved information on social benefits and the organization of specifically targeted workshops are desired by patients.
{"title":"[Social care for adult cystic fibrosis patients in clinical practice].","authors":"S Dury, P Mulette, A Vivien, H Yucel-Farcet, E Longueville, A Boutahir, B Ravoninjatovo, A Deforge, M Griffon, F Deschamps, G Deslée, J Ancel","doi":"10.1016/j.rmr.2025.11.002","DOIUrl":"https://doi.org/10.1016/j.rmr.2025.11.002","url":null,"abstract":"<p><strong>Introduction: </strong>The complications associated with cystic fibrosis and the daily management of the disease can have significant social, familial, and professional repercussions. The objective of this study was to assess adult patients' knowledge regarding their rights and social support options, along with their access to social care.</p><p><strong>Materials and methods: </strong>Between May 2021 and December 2023, we conducted a prospective monocentric study at the University Hospital of Reims, including adult patients diagnosed with cystic fibrosis. A questionnaire assessing their knowledge in this area was utilized.</p><p><strong>Results: </strong>The analysis included 61 patients (64% male; mean age: 29.2 years). In 73% of cases, patients reported being assisted by their social circle in managing administrative tasks. Information sources were diverse, and most patients had already met with a social worker. While the quality of information received was generally rated as good, one-third of the participants felt that the topic of social support was insufficiently addressed. Ten patients were unaware of their being enrolled in the long-term illness coverage program. Half of patients were receiving adult disability benefits.</p><p><strong>Conclusion: </strong>Adult patients often rely on their social support network for the performance of administrative and social tasks. Improved information on social benefits and the organization of specifically targeted workshops are desired by patients.</p>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846580","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}
Pub Date : 2025-12-17DOI: 10.1016/j.rmr.2025.12.002
A Gerard, S Manni, K Risso, D Viard, M Vassallo, F Vandenbos
Introduction: Active tuberculosis disease (ATB) remains feared in patients treated with TNF inhibitors. For that reason, screening for latent tuberculosis infection (LTBI) is currently performed before the start of treatment. Therapeutic patient education (TPE) should consequently help reduce the risk of infection during treatment.
Observation: We report the case of a 19-year-old female patient hospitalized for disseminated tuberculosis. She had been treated for two years with adalimumab for Crohn's disease. Screening for LTBI had been performed before the initiation of anti-TNF treatment and was negative. Three months after returning from a four-month study trip to South Africa, the patient nevertheless developed disseminated tuberculosis and was repeatedly hospitalized. The disease was at once pulmonary, lymphatic, ocular, and splenic. Antituberculosis treatment consisted of quadruple therapy for two months followed by dual therapy for an additional 10 months. The patient was disabled for one year and suffered some radiological sequelae.
Conclusion: Traveling to a country with high tuberculosis endemicity is a risk factor for ATB in patients undergoing anti-TNF therapy. Antibioprophylaxis may have been considered prior to the trip.
{"title":"[Travel to South Africa by a patient on anti-TNF: Could tuberculosis have been prevented?]","authors":"A Gerard, S Manni, K Risso, D Viard, M Vassallo, F Vandenbos","doi":"10.1016/j.rmr.2025.12.002","DOIUrl":"https://doi.org/10.1016/j.rmr.2025.12.002","url":null,"abstract":"<p><strong>Introduction: </strong>Active tuberculosis disease (ATB) remains feared in patients treated with TNF inhibitors. For that reason, screening for latent tuberculosis infection (LTBI) is currently performed before the start of treatment. Therapeutic patient education (TPE) should consequently help reduce the risk of infection during treatment.</p><p><strong>Observation: </strong>We report the case of a 19-year-old female patient hospitalized for disseminated tuberculosis. She had been treated for two years with adalimumab for Crohn's disease. Screening for LTBI had been performed before the initiation of anti-TNF treatment and was negative. Three months after returning from a four-month study trip to South Africa, the patient nevertheless developed disseminated tuberculosis and was repeatedly hospitalized. The disease was at once pulmonary, lymphatic, ocular, and splenic. Antituberculosis treatment consisted of quadruple therapy for two months followed by dual therapy for an additional 10 months. The patient was disabled for one year and suffered some radiological sequelae.</p><p><strong>Conclusion: </strong>Traveling to a country with high tuberculosis endemicity is a risk factor for ATB in patients undergoing anti-TNF therapy. Antibioprophylaxis may have been considered prior to the trip.</p>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145782558","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}
Pub Date : 2025-12-16DOI: 10.1016/j.rmr.2025.12.001
H Ouksel
While the SARS-CoV-2 pandemic has left a lasting impression, the long-term effects of this virus, such as persistent symptoms or long COVID, remain unclear. However, recommendations from learned societies for improving these symptoms exist and are being applied by a number of respiratory rehabilitation centers. In this paper, we provide a summary of the specificities of long COVID care in the context of respiratory rehabilitation, particularly as regards respiratory symptoms, fatigue, cognitive disorders, and cardiovascular symptoms and, more specifically, vegetative dysautonomia. The key elements of support are Therapeutic Patient Education (TPE) and activity management and fractionated exercise (PACING). While the effects of respiratory rehabilitation are highly promising, with potential improvement in symptoms and exercise capacity, the level of evidence remains low to moderate. Structured and coordinated multidisciplinary work is of paramount importance as a means of providing for these individuals the best possible support on their road to recovery. Further studies are needed to improve the level of evidence on the effectiveness of rehabilitation in cases of long COVID.
{"title":"[Long covid pulmonary rehabilitation].","authors":"H Ouksel","doi":"10.1016/j.rmr.2025.12.001","DOIUrl":"https://doi.org/10.1016/j.rmr.2025.12.001","url":null,"abstract":"<p><p>While the SARS-CoV-2 pandemic has left a lasting impression, the long-term effects of this virus, such as persistent symptoms or long COVID, remain unclear. However, recommendations from learned societies for improving these symptoms exist and are being applied by a number of respiratory rehabilitation centers. In this paper, we provide a summary of the specificities of long COVID care in the context of respiratory rehabilitation, particularly as regards respiratory symptoms, fatigue, cognitive disorders, and cardiovascular symptoms and, more specifically, vegetative dysautonomia. The key elements of support are Therapeutic Patient Education (TPE) and activity management and fractionated exercise (PACING). While the effects of respiratory rehabilitation are highly promising, with potential improvement in symptoms and exercise capacity, the level of evidence remains low to moderate. Structured and coordinated multidisciplinary work is of paramount importance as a means of providing for these individuals the best possible support on their road to recovery. Further studies are needed to improve the level of evidence on the effectiveness of rehabilitation in cases of long COVID.</p>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775654","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}
Pub Date : 2025-12-01DOI: 10.1016/j.rmr.2025.09.002
J. Milesi , R. Naud , S. Delliaux , F. Bregeon , A. Boussuges , H. Dutau , P.A. Thomas , B. Coiffard
<div><h3>Introduction</h3><div>La prise en charge des patients atteints de BPCO avec emphysème sévère au stade d’insuffisance respiratoire chronique reste complexe. Les valves endobronchiques sont de plus en plus utilisées. La chirurgie de réduction de volume pulmonaire constitue une alternative parfois sous-utilisée. Elle nécessite une évaluation multidisciplinaire, en particulier chez les candidats à la transplantation pulmonaire.</div></div><div><h3>Observation</h3><div>Nous rapportons le cas d’un homme de 57 ans, ancien fumeur, adressé pour transplantation pulmonaire dans un contexte de BPCO avec emphysème prédominant au lobe supérieur droit et distension majeure. Il présentait une dyspnée (mMRC 3), un indice BODE à 6, un VEMS à 31 % et un VR à 329 % de la théorique. L’analyse StratX® et une concertation multidisciplinaire ont conduit à une lobectomie supérieure droite. À six mois, son VEMS était à 56 %, son VR à 191 %, avec une amélioration de la <span><math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><msub><mtext>O</mtext><mn>2</mn></msub></mrow></math></span> pic, de la pente <figure><img></figure> et de la mobilité diaphragmatique.</div></div><div><h3>Conclusion</h3><div>Ce cas souligne l’intérêt de la chirurgie de réduction de volume chez des patients sélectionnés à l’ère des techniques endoscopiques de réduction de l’emphysème, permettant une amélioration significative de la fonction respiratoire et un report possible de la transplantation pulmonaire.</div></div><div><h3>Introduction</h3><div>Management of patients with chronic obstructive pulmonary disease (COPD) and severe emphysema is complex. While endobronchial valve placement has become a widespread option, lung volume reduction surgery (LVRS) remains an important but sometimes underused alternative. Selecting the most appropriate intervention requires a multidisciplinary approach, especially for lung transplantation candidates.</div></div><div><h3>Case report</h3><div>We report the case of a 57-year-old male former smoker referred for lung transplantation due to advanced COPD with severe upper-lobe predominant emphysema and pronounced pulmonary hyperinflation. The patient had disabling dyspnea (mMRC 3), a BODE index of 6, and major pulmonary function impairment (forced expiratory volume at 1st second [FEV<sub>1</sub>] 31% predicted; residual volume 329% predicted). After multidisciplinary discussion and StratX® analysis, the patient underwent right upper lobectomy. Six months postoperatively, he had experienced significant symptomatic and functional improvement: FEV<sub>1</sub> had increased to 56% predicted, residual volume had decreased to 191%, and <span><math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><msub><mtext>O</mtext><mn>2</mn></msub></mrow></math></span> max had improved. Ventilation efficiency and gas exchange likewise improved. Diaphragmatic ultrasound demonstrated enhanced mobility and thickening.</div></div><div><h3>Conclusion</h3><div>This case highlights t
{"title":"Réduction chirurgicale d’emphysème : une option à ne pas oublier à l’ère des valves","authors":"J. Milesi , R. Naud , S. Delliaux , F. Bregeon , A. Boussuges , H. Dutau , P.A. Thomas , B. Coiffard","doi":"10.1016/j.rmr.2025.09.002","DOIUrl":"10.1016/j.rmr.2025.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>La prise en charge des patients atteints de BPCO avec emphysème sévère au stade d’insuffisance respiratoire chronique reste complexe. Les valves endobronchiques sont de plus en plus utilisées. La chirurgie de réduction de volume pulmonaire constitue une alternative parfois sous-utilisée. Elle nécessite une évaluation multidisciplinaire, en particulier chez les candidats à la transplantation pulmonaire.</div></div><div><h3>Observation</h3><div>Nous rapportons le cas d’un homme de 57 ans, ancien fumeur, adressé pour transplantation pulmonaire dans un contexte de BPCO avec emphysème prédominant au lobe supérieur droit et distension majeure. Il présentait une dyspnée (mMRC 3), un indice BODE à 6, un VEMS à 31 % et un VR à 329 % de la théorique. L’analyse StratX® et une concertation multidisciplinaire ont conduit à une lobectomie supérieure droite. À six mois, son VEMS était à 56 %, son VR à 191 %, avec une amélioration de la <span><math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><msub><mtext>O</mtext><mn>2</mn></msub></mrow></math></span> pic, de la pente <figure><img></figure> et de la mobilité diaphragmatique.</div></div><div><h3>Conclusion</h3><div>Ce cas souligne l’intérêt de la chirurgie de réduction de volume chez des patients sélectionnés à l’ère des techniques endoscopiques de réduction de l’emphysème, permettant une amélioration significative de la fonction respiratoire et un report possible de la transplantation pulmonaire.</div></div><div><h3>Introduction</h3><div>Management of patients with chronic obstructive pulmonary disease (COPD) and severe emphysema is complex. While endobronchial valve placement has become a widespread option, lung volume reduction surgery (LVRS) remains an important but sometimes underused alternative. Selecting the most appropriate intervention requires a multidisciplinary approach, especially for lung transplantation candidates.</div></div><div><h3>Case report</h3><div>We report the case of a 57-year-old male former smoker referred for lung transplantation due to advanced COPD with severe upper-lobe predominant emphysema and pronounced pulmonary hyperinflation. The patient had disabling dyspnea (mMRC 3), a BODE index of 6, and major pulmonary function impairment (forced expiratory volume at 1st second [FEV<sub>1</sub>] 31% predicted; residual volume 329% predicted). After multidisciplinary discussion and StratX® analysis, the patient underwent right upper lobectomy. Six months postoperatively, he had experienced significant symptomatic and functional improvement: FEV<sub>1</sub> had increased to 56% predicted, residual volume had decreased to 191%, and <span><math><mrow><mover><mtext>V</mtext><mo>˙</mo></mover><msub><mtext>O</mtext><mn>2</mn></msub></mrow></math></span> max had improved. Ventilation efficiency and gas exchange likewise improved. Diaphragmatic ultrasound demonstrated enhanced mobility and thickening.</div></div><div><h3>Conclusion</h3><div>This case highlights t","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 9","pages":"Pages 498-503"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228550","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}
Pub Date : 2025-12-01DOI: 10.1016/j.rmr.2025.10.003
P. Wachinou , A. Fiogbé , A. Bara , H. Loko , S. Ade , H. Agbedjinou , B. Guendehou , G. Agodokpessi
Introduction
L’objectif de ce travail était de décrire le profil des patients suivis pour SAHOS et d’identifier les facteurs associés à l’observance de son traitement dans un centre de référence à Cotonou.
Méthode
Il s’agissait d’une étude de cohorte rétrospective au Centre national hospitalier universitaire de pneumo-phtisiologie de Cotonou qui a inclus tous les patients suivis pour SAHOS de juillet 2014 à décembre 2024. Les données ont été collectées à partir des dossiers des patients.
Résultats
Au total, 503 patients ont été inclus. Ils étaient majoritairement de sexe masculin (64,1 %) et obèses ou en surcharge pondérale (92,3 %) avec un âge moyen de 55,1 ± 11,6 ans. L’hypertension artérielle était la principale comorbidité (73,9 %). Le SAHOS était modéré à sévère dans 88,1 % des cas. Une proportion de 70,3 % avait une observance bonne à moyenne après deux ans de suivi. La sévérité du SAHOS était le seul facteur associé à une bonne observance du traitement par pression positive continue (PPC) (ORa : 2,11, IC95 % : 1,21–3,82, p = 0,011).
Conclusion
Les patients suivis pour SAHOS à Cotonou étaient majoritairement de la cinquantaine, obèses et hypertendus. Le seul facteur associé à l’observance du traitement par PPC était le caractère sévère du SAHOS.
Introduction
The aim of this study was to describe the profile of patients followed up for obstructive sleep apnea syndrome (OSAS) and to identify factors associated with adherence to its treatment in a referral centre in Cotonou.
Method
This is a retrospective cohort study at the National teaching hospital for tuberculosis and pulmonary diseases and included all patients followed for OSAS from July 2014 to December 2024. Data were collected from patient records.
Results
A total of 503 patients were included. They were predominantly male (64.1%) and overweight/obese (92.3%) with a mean age of 55.1 ± 11.6 years. Hypertension was the main comorbidity (73.9%). OSAS was moderate to severe in 88.10% of the patients. Compliance was good to average in 70.30% of cases. The severity of OSAS was the only factor associated with good compliance with continuous positive airway pressure (CPAP) treatment (ORa: 2.11, IC95%: 1.21–3.82, P = 0.011).
Conclusion
The majority of patients treated for OSAS in Cotonou were in their fifties, obese and hypertensive. The only factor associated with compliance with CPAP treatment was the severity of the OSAS.
{"title":"Syndrome d’apnées du sommeil : Profils cliniques, polygraphiques et évolutifs à Cotonou","authors":"P. Wachinou , A. Fiogbé , A. Bara , H. Loko , S. Ade , H. Agbedjinou , B. Guendehou , G. Agodokpessi","doi":"10.1016/j.rmr.2025.10.003","DOIUrl":"10.1016/j.rmr.2025.10.003","url":null,"abstract":"<div><h3>Introduction</h3><div>L’objectif de ce travail était de décrire le profil des patients suivis pour SAHOS et d’identifier les facteurs associés à l’observance de son traitement dans un centre de référence à Cotonou.</div></div><div><h3>Méthode</h3><div>Il s’agissait d’une étude de cohorte rétrospective au Centre national hospitalier universitaire de pneumo-phtisiologie de Cotonou qui a inclus tous les patients suivis pour SAHOS de juillet 2014 à décembre 2024. Les données ont été collectées à partir des dossiers des patients.</div></div><div><h3>Résultats</h3><div>Au total, 503 patients ont été inclus. Ils étaient majoritairement de sexe masculin (64,1 %) et obèses ou en surcharge pondérale (92,3 %) avec un âge moyen de 55,1<!--> <!-->±<!--> <!-->11,6 ans. L’hypertension artérielle était la principale comorbidité (73,9 %). Le SAHOS était modéré à sévère dans 88,1 % des cas. Une proportion de 70,3 % avait une observance bonne à moyenne après deux ans de suivi. La sévérité du SAHOS était le seul facteur associé à une bonne observance du traitement par pression positive continue (PPC) (ORa : 2,11, IC95 % : 1,21–3,82, <em>p</em> <!-->=<!--> <!-->0,011).</div></div><div><h3>Conclusion</h3><div>Les patients suivis pour SAHOS à Cotonou étaient majoritairement de la cinquantaine, obèses et hypertendus. Le seul facteur associé à l’observance du traitement par PPC était le caractère sévère du SAHOS.</div></div><div><h3>Introduction</h3><div>The aim of this study was to describe the profile of patients followed up for obstructive sleep apnea syndrome (OSAS) and to identify factors associated with adherence to its treatment in a referral centre in Cotonou.</div></div><div><h3>Method</h3><div>This is a retrospective cohort study at the National teaching hospital for tuberculosis and pulmonary diseases and included all patients followed for OSAS from July 2014 to December 2024. Data were collected from patient records.</div></div><div><h3>Results</h3><div>A total of 503 patients were included. They were predominantly male (64.1%) and overweight/obese (92.3%) with a mean age of 55.1<!--> <!-->±<!--> <!-->11.6 years. Hypertension was the main comorbidity (73.9%). OSAS was moderate to severe in 88.10% of the patients. Compliance was good to average in 70.30% of cases. The severity of OSAS was the only factor associated with good compliance with continuous positive airway pressure (CPAP) treatment (ORa: 2.11, IC95%: 1.21–3.82, <em>P</em> <!-->=<!--> <!-->0.011).</div></div><div><h3>Conclusion</h3><div>The majority of patients treated for OSAS in Cotonou were in their fifties, obese and hypertensive. The only factor associated with compliance with CPAP treatment was the severity of the OSAS.</div></div>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 9","pages":"Pages 441-453"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477280","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}
Pub Date : 2025-12-01DOI: 10.1016/j.rmr.2025.10.001
I. Elhani, A. Bourgarit
<div><h3>Introduction</h3><div>Le TNF-α, une cytokine clé de l’inflammation et de la formation des granulomes, joue un rôle central dans plusieurs pathologies pulmonaires, telles que la sarcoïdose, la tuberculose et le syndrome de détresse respiratoire aiguë. Les biothérapies anti-TNF-α, bien que largement utilisées pour traiter des maladies inflammatoires chroniques, ont des indications limitées en pneumologie.</div></div><div><h3>État des connaissances</h3><div>L’efficacité des anti-TNF-α en traitement des pathologies pulmonaire est décevante dans les essais thérapeutiques et ils ne sont actuellement pas recommandés en première intention. La possibilité d’une immunisation contre le traitement peut être prévenue par l’adjonction d’un autre immunosuppresseur, en particulier le Méthotrexate. Les anti-TNF-α sont associés à un surrisque d’infection tuberculeuse, mais leur arrêt chez un patient atteint de tuberculose peut entraîner une aggravation paradoxale de l’infection, et la balance bénéfice-risque de la reprise de ces traitements doit être discutée. La survenue d’une granulomatose chez un patient traité par anti-TNF-α doit faire évoquer une granulomatose médicamenteuse et discuter la poursuite du traitement.</div></div><div><h3>Perspectives</h3><div>Le développement de molécules ciblant le récepteur TNFR1 pourrait améliorer l’efficacité tout en réduisant les effets indésirables. Les critères d’arrêt ou de poursuite des anti-TNF-α dans les réactions paradoxales ou les granulomatoses induites doivent être clarifiés. L’adjonction systématique de méthotrexate pour prévenir l’immunisation doit être définie.</div></div><div><h3>Conclusion</h3><div>Bien que les anti-TNF-α aient transformé le traitement de maladies inflammatoires, leur place en pneumologie reste marginale. Le développement de thérapies plus ciblées pourrait élargir leur utilisation tout en minimisant les effets secondaires.</div></div><div><h3>Introduction</h3><div>As a key cytokine in inflammation and granuloma formation TNF-α plays a central role in several pulmonary diseases, including sarcoidosis, tuberculosis and the acute respiratory distress syndrome. Although widely used in treatment of chronic inflammatory diseases, anti-TNF-α biotherapies have few indications in pulmonology.</div></div><div><h3>State of the art</h3><div>In therapeutic trials, the efficacy of anti-TNF-α drugs in treating lung diseases has yet to be proven, and they are not currently recommended as first-line treatments. Possible immunization against the treatment could be counteracted by the addition of another immunosuppressant, particularly methotrexate. While anti-TNF-α drugs are associated with an increased risk of tuberculosis, discontinuing their administration in patients with tuberculosis could lead to paradoxical worsening, and the benefit-risk balance of resuming these treatments calls for debate. Lastly, occurrence of granulomatosis in a patient receiving anti-TNF-α therapy should raise the possibil
{"title":"Anti-TNF-a : indications et toxicité en pneumologie","authors":"I. Elhani, A. Bourgarit","doi":"10.1016/j.rmr.2025.10.001","DOIUrl":"10.1016/j.rmr.2025.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Le TNF-α, une cytokine clé de l’inflammation et de la formation des granulomes, joue un rôle central dans plusieurs pathologies pulmonaires, telles que la sarcoïdose, la tuberculose et le syndrome de détresse respiratoire aiguë. Les biothérapies anti-TNF-α, bien que largement utilisées pour traiter des maladies inflammatoires chroniques, ont des indications limitées en pneumologie.</div></div><div><h3>État des connaissances</h3><div>L’efficacité des anti-TNF-α en traitement des pathologies pulmonaire est décevante dans les essais thérapeutiques et ils ne sont actuellement pas recommandés en première intention. La possibilité d’une immunisation contre le traitement peut être prévenue par l’adjonction d’un autre immunosuppresseur, en particulier le Méthotrexate. Les anti-TNF-α sont associés à un surrisque d’infection tuberculeuse, mais leur arrêt chez un patient atteint de tuberculose peut entraîner une aggravation paradoxale de l’infection, et la balance bénéfice-risque de la reprise de ces traitements doit être discutée. La survenue d’une granulomatose chez un patient traité par anti-TNF-α doit faire évoquer une granulomatose médicamenteuse et discuter la poursuite du traitement.</div></div><div><h3>Perspectives</h3><div>Le développement de molécules ciblant le récepteur TNFR1 pourrait améliorer l’efficacité tout en réduisant les effets indésirables. Les critères d’arrêt ou de poursuite des anti-TNF-α dans les réactions paradoxales ou les granulomatoses induites doivent être clarifiés. L’adjonction systématique de méthotrexate pour prévenir l’immunisation doit être définie.</div></div><div><h3>Conclusion</h3><div>Bien que les anti-TNF-α aient transformé le traitement de maladies inflammatoires, leur place en pneumologie reste marginale. Le développement de thérapies plus ciblées pourrait élargir leur utilisation tout en minimisant les effets secondaires.</div></div><div><h3>Introduction</h3><div>As a key cytokine in inflammation and granuloma formation TNF-α plays a central role in several pulmonary diseases, including sarcoidosis, tuberculosis and the acute respiratory distress syndrome. Although widely used in treatment of chronic inflammatory diseases, anti-TNF-α biotherapies have few indications in pulmonology.</div></div><div><h3>State of the art</h3><div>In therapeutic trials, the efficacy of anti-TNF-α drugs in treating lung diseases has yet to be proven, and they are not currently recommended as first-line treatments. Possible immunization against the treatment could be counteracted by the addition of another immunosuppressant, particularly methotrexate. While anti-TNF-α drugs are associated with an increased risk of tuberculosis, discontinuing their administration in patients with tuberculosis could lead to paradoxical worsening, and the benefit-risk balance of resuming these treatments calls for debate. Lastly, occurrence of granulomatosis in a patient receiving anti-TNF-α therapy should raise the possibil","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 9","pages":"Pages 481-491"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145638216","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}
Pub Date : 2025-12-01DOI: 10.1016/j.rmr.2025.09.003
R. Didier, J.-C. Eicher
L’insuffisance cardiaque est une maladie chronique qui affecte environ 2 % de la population. Il est aujourd’hui établi qu’il s’agit d’une cause importante de morbi-mortalité pendant la gestation. Les modifications hémodynamiques pendant la grossesse peuvent démasquer, aggraver voire générer une insuffisance cardiaque. La cardiomyopathie du péri-partum (CPP), qui est un diagnostic d’exclusion, représente la principale cause d’insuffisance cardiaque de novo chez la femme parturiente. Les diagnostics différentiels sont nombreux et incluent la cardiopathie de stress « Takotsubo » ou encore la décompensation d’une cardiopathie préexistante (hypertrophique, dilatée, restrictive, arythmogène, ischémique, valvulaire). L’identification de la cause de l’insuffisance cardiaque est indispensable pour adapter le traitement ainsi que le suivi. Après quelques rappels de physiologie, nous aborderons successivement les différents phénotypes cliniques d’insuffisance cardiaque aiguë du péri partum avant d’aborder la prise en charge.
Heart failure is a chronic disease affecting approximately 2 % of the population. It is currently known to be a major cause of gestational morbi-mortality. Hemodynamic modifications during pregnancy can reveal, aggravate, or even generate heart failure. Peripartum cardiomyopathy (PPCM), a diagnosis of exclusion, is the main cause of de novo heart failure in parturient women. Differential diagnoses are numerous and include stress cardiomyopathy (“takotsubo” syndrome) and decompensation of preexisting cardiopathy (hypertrophic, dilated, restrictive arrhythmogenic, ischemic, valvular…). Identification of the cause of heart failure is mandatory in view of adapting treatment and follow-up. After several physiological reminders, we will successively consider the different clinical phenotypes of acute peripartum cardiomyopathy, and then provide indications on treatment and management.
{"title":"Insuffisance cardiaque et grossesse","authors":"R. Didier, J.-C. Eicher","doi":"10.1016/j.rmr.2025.09.003","DOIUrl":"10.1016/j.rmr.2025.09.003","url":null,"abstract":"<div><div>L’insuffisance cardiaque est une maladie chronique qui affecte environ 2 % de la population. Il est aujourd’hui établi qu’il s’agit d’une cause importante de morbi-mortalité pendant la gestation. Les modifications hémodynamiques pendant la grossesse peuvent démasquer, aggraver voire générer une insuffisance cardiaque. La cardiomyopathie du péri-partum (CPP), qui est un diagnostic d’exclusion, représente la principale cause d’insuffisance cardiaque de novo chez la femme parturiente. Les diagnostics différentiels sont nombreux et incluent la cardiopathie de stress « Takotsubo » ou encore la décompensation d’une cardiopathie préexistante (hypertrophique, dilatée, restrictive, arythmogène, ischémique, valvulaire). L’identification de la cause de l’insuffisance cardiaque est indispensable pour adapter le traitement ainsi que le suivi. Après quelques rappels de physiologie, nous aborderons successivement les différents phénotypes cliniques d’insuffisance cardiaque aiguë du péri partum avant d’aborder la prise en charge.</div></div><div><div>Heart failure is a chronic disease affecting approximately 2 % of the population. It is currently known to be a major cause of gestational morbi-mortality. Hemodynamic modifications during pregnancy can reveal, aggravate, or even generate heart failure. Peripartum cardiomyopathy (PPCM), a diagnosis of exclusion, is the main cause of <em>de novo</em> heart failure in parturient women. Differential diagnoses are numerous and include stress cardiomyopathy (“takotsubo” syndrome) and decompensation of preexisting cardiopathy (hypertrophic, dilated, restrictive arrhythmogenic, ischemic, valvular…). Identification of the cause of heart failure is mandatory in view of adapting treatment and follow-up. After several physiological reminders, we will successively consider the different clinical phenotypes of acute peripartum cardiomyopathy, and then provide indications on treatment and management.</div></div>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 9","pages":"Pages 463-471"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303124","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}
Pub Date : 2025-12-01DOI: 10.1016/j.rmr.2025.08.002
I. Kambutse , M. Ranty , P.-Y. Le Roux , F. Couturaud , C. Tromeur
La dyspnée au cours de la grossesse peut être due à de nombreuses pathologies cardio-pulmonaires (pleurésie, pneumonie, embolie pulmonaire, œdème aigu pulmonaire, asthme). L’exploration de la dyspnée au cours de la grossesse nécessite l’utilisation d’imageries thoraciques disponibles en pratique courante. Compte tenu du risque d'exposition aux rayonnements ionisants, les pratiques restent hétérogènes. Le risque de malformations fœtales survient lorsque le niveau de radiation est supérieur à 100 mGy. Le choix de l’imagerie thoracique chez la femme enceinte nécessite aussi de prendre en compte le niveau de rayonnements ionisants absorbés par la patiente et le risque de cancer radio-induit. Afin de limiter le nombre d’examens potentiellement irradiants, l’utilisation en première intention d’imageries thoraciques non irradiantes et d’approches diagnostiques bien définies est indispensable ainsi que l’utilisation de protocoles d’imagerie adaptés à la physiologie de la femme enceinte. Dans tous les cas, l’utilisation d'examens d’imagerie thoracique avec radiations ionisantes n’est pas contre-indiquée au cours de la grossesse, mais doit être clairement justifiée en tenant compte de la balance bénéfice-risque et basée sur le principe de prudence concernant le risque de malformations fœtales et de cancer radio-induit maternel.
Dyspnea during pregnancy may be due to cardiopulmonary disease (pleural effusion, pneumonia, pulmonary embolism, acute pulmonary oedema, asthma). Investigation requires thoracic imaging which is available in current practice. Given the risk of fetal malformation when radiation level exceeds 100mGy, clinical practices are heterogeneous. The choice of thoracic imaging for pregnant women also needs to take into account the level of ionizing radiation absorbed by the mother and the risk of radiation-induced cancer. In order to limit the number of potentially irradiating tests, it is essential to use non-irradiating thoracic imaging, to implement well-defined diagnostic strategies as first-line approaches and, more particularly, to apply imaging protocols adapted to the physiology of the pregnant patient. While thoracic imaging with ionizing radiation during pregnancy is not contraindicated, it must be clearly justified, and given the risks of fetal malformations and maternal cancer induced by radiations, it behooves clinicians to take into full account the benefit-risk balance and, as a rule, to apply the precautionary principle.
{"title":"Quels examens d’imagerie pour explorer une dyspnée chez la femme enceinte ?","authors":"I. Kambutse , M. Ranty , P.-Y. Le Roux , F. Couturaud , C. Tromeur","doi":"10.1016/j.rmr.2025.08.002","DOIUrl":"10.1016/j.rmr.2025.08.002","url":null,"abstract":"<div><div>La dyspnée au cours de la grossesse peut être due à de nombreuses pathologies cardio-pulmonaires (pleurésie, pneumonie, embolie pulmonaire, œdème aigu pulmonaire, asthme). L’exploration de la dyspnée au cours de la grossesse nécessite l’utilisation d’imageries thoraciques disponibles en pratique courante. Compte tenu du risque d'exposition aux rayonnements ionisants, les pratiques restent hétérogènes. Le risque de malformations fœtales survient lorsque le niveau de radiation est supérieur à 100<!--> <!-->mGy. Le choix de l’imagerie thoracique chez la femme enceinte nécessite aussi de prendre en compte le niveau de rayonnements ionisants absorbés par la patiente et le risque de cancer radio-induit. Afin de limiter le nombre d’examens potentiellement irradiants, l’utilisation en première intention d’imageries thoraciques non irradiantes et d’approches diagnostiques bien définies est indispensable ainsi que l’utilisation de protocoles d’imagerie adaptés à la physiologie de la femme enceinte. Dans tous les cas, l’utilisation d'examens d’imagerie thoracique avec radiations ionisantes n’est pas contre-indiquée au cours de la grossesse, mais doit être clairement justifiée en tenant compte de la balance bénéfice-risque et basée sur le principe de prudence concernant le risque de malformations fœtales et de cancer radio-induit maternel.</div></div><div><div>Dyspnea during pregnancy may be due to cardiopulmonary disease (pleural effusion, pneumonia, pulmonary embolism, acute pulmonary oedema, asthma). Investigation requires thoracic imaging which is available in current practice. Given the risk of fetal malformation when radiation level exceeds 100mGy, clinical practices are heterogeneous. The choice of thoracic imaging for pregnant women also needs to take into account the level of ionizing radiation absorbed by the mother and the risk of radiation-induced cancer. In order to limit the number of potentially irradiating tests, it is essential to use non-irradiating thoracic imaging, to implement well-defined diagnostic strategies as first-line approaches and, more particularly, to apply imaging protocols adapted to the physiology of the pregnant patient. While thoracic imaging with ionizing radiation during pregnancy is not contraindicated, it must be clearly justified, and given the risks of fetal malformations and maternal cancer induced by radiations, it behooves clinicians to take into full account the benefit-risk balance and, as a rule, to apply the precautionary principle.</div></div>","PeriodicalId":21548,"journal":{"name":"Revue des maladies respiratoires","volume":"42 9","pages":"Pages 472-480"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125807","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号