La toxoplasmose. Enzootie porcine. Enzootie aviaire

Sergent G., Bequignon R. La toxoplasmose. Enzootie porcine. Enzootie aviaire. In: Bulletin de l'Académie Vétérinaire de France tome 114 n°7, 1961. pp. 283-293

Formes cliniques de la toxoplasmose chez les Carnivores domestiques

Groulade Paul, Sergent G., Bequignon R. Formes cliniques de la toxoplasmose chez les Carnivores domestiques. In: Bulletin de l'Académie Vétérinaire de France tome 109 n°1, 1956. pp. 49-57

Supportive care in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis : an international, multidisciplinary Delphi-based consensus

Background Supportive care is the cornerstone of management of adult and paediatric Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). However, consensus on the modalities of supportive care is lacking. Objectives Our aim in this international multicentric Delphi exercise was to establish a multidisciplinary expert consensus to standardize recommendations regarding supportive care in the acute phase of SJS/TEN. Methods Participants were sent a survey via the online tool SurveyMonkey, consisting of 103 statements organized into 11 topics: multidisciplinary team composition, suspect drug management, infection prevention, fluid resuscitation and prevention of hypothermia, nutritional support, pain and psychological distress management, management of acute respiratory failure, local skincare, ophthalmological management, management of other mucosa, and additional measures. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). The results were analysed according to the RAND/UCLA Appropriateness Method. Results Forty-five participants from 13 countries (on three continents) participated. After the first round, a consensus was obtained for 82.5% of the 103 initially proposed statements. After the second round, a final consensus was obtained for 102 statements. Conclusions We have reached an international Delphi-based consensus on best supportive care practice for SJS/TEN. Our expert consensus should help guide physicians in treating patients with SJS/TEN and thereby improve short-term prognosis and the risk of sequelae.Peer reviewe

Guidelines of the French Society of Otorhinolaryngology (SFORL). Managing epistaxis under coagulation disorder due to antithrombotic therapy

International audienceOBJECTIVE:The authors present the guidelines of the French Society of Otorhinolaryngology concerning the management of epistaxis during antithrombotic therapy.METHODS:A review of the literature was performed by a multidisciplinary work group. Guidelines were drafted, then re-edited by a reading group independent of the work group to produce the final text. The proposed recommendations were graded A, B, C or expert opinion, on decreasing levels of evidence.RESULTS:Before any decision to modify antithrombotic treatment, it is recommended to screen for overdose and assess the risk of thrombosis. In stented patients, dual antiplatelet therapy must be maintained during the month following stenting and, if possible, for 3 months. In epistaxis with antivitamin K (AVK) overdose controlled by packing, corrective measures are based on the International Normalized Ratio (INR). In uncontrolled epistaxis, it is recommended to stop AVK, administer antidotes and regularly monitor INR. In case of intravascular embolization, it is not recommended to alter anticoagulant treatment

Benralizumab improves symptoms of patients with severe, eosinophilic asthma with a diagnosis of nasal polyposis

BackgroundClinically meaningful improvement in the Sino‐Nasal Outcome Test‐22 (SNOT‐22) was observed in patients with severe, eosinophilic asthma, and nasal polyposis (NP) treated with benralizumab in the ANDHI trial. A post hoc assessment of the effects of benralizumab on SNOT‐22 response and asthma efficacy measures in these patients was conducted for further characterization of the efficacy and safety of benralizumab for patients with severe asthma and NP.MethodsAdults with severe, eosinophilic asthma who had experienced ≥2 prior‐year exacerbations despite high‐dosage inhaled corticosteroid plus additional controller[s] were randomized to 24 weeks of benralizumab or placebo. Patients with physician‐diagnosed chronic rhinosinusitis with NP of any severity ongoing at baseline who consented to participate were included in the current ANDHI NP substudy population. Effect on NP symptoms was assessed by the SNOT‐22, with an improvement of at least 8.9 defined as clinically significant (responder). Effects on chronic asthma outcomes were assessed by means of annualized asthma exacerbation rate (AER), St. George’s Respiratory Questionnaire (SGRQ) total score, forced expiratory volume in one second (FEV1), and Asthma Control Questionnaire‐6 (ACQ‐6). All p‐values were nominal.ResultsOf the ANDHI population (n = 656), 23% (n = 153) participated in the NP substudy (n = 96 benralizumab; n = 57 placebo). Patients were 50% female, with mean age of 53 years, had prior‐year AER = 3.3; mean pre‐bronchodilator FEV1 = 55% predicted; and median blood eosinophil count ​= 510 cells/µl. For patients with high baseline SNOT‐22 scores (>30), benralizumab treatment improved symptoms of NP as measured by SNOT‐22 from baseline to Week 24 compared with placebo (Week 24: −10.44 [p = .0176]). Percentage of responders to SNOT‐22 was greater for benralizumab vs. placebo (71.3% vs. 45.5%; p = .0036), and effect was enhanced for patients with high baseline SNOT‐22 scores (>30). A 69% reduction vs. placebo in annualized AER (0.77 vs. 2.47; p < .0001) and greater clinically meaningful improvements from baseline in SGRQ total score (−16.7), FEV1 (+0.32 L), and ACQ‐6 (–0.88) were observed (p < .0001). Benralizumab was well‐tolerated. Frequency of adverse events (AEs) was similar for benralizumab (76.0%) and placebo (73.7%) groups. Most common AEs (frequency ≥5%) reported at a greater frequency in benralizumab vs. placebo included headache, sinusitis, pyrexia, and influenza.ConclusionsThese substudy data from ANDHI demonstrated the efficacy profile of benralizumab for patients with severe, eosinophilic asthma and NP, with improvement in SNOT‐22 and asthma outcomes.The combination of asthma and nasal polyposis provides significant treatment challenges and substantial disease burden, including a greater number of asthma exacerbations annually, which negatively impacts quality of life. Clinically meaningful improvement in the SNOT‐22 was observed early and maintained over time for patients with severe, eosinophilic asthma and nasal polyposis treated with benralizumab in the ANDHI trial. This ANDHI substudy demonstrated that benralizumab is safe and efficacious for patients with severe, eosinophilic asthma and nasal polyposis, with improvement in SNOT‐22 total scores and asthma outcomes. Abbreviation: ACQ‐6, Asthma Control Questionnaire‐6; AER, asthma exacerbation rate; CRSwNP, chronic rhinosinusitis with nasal polyposis; FEV1, forced expiratory volume in 1 second; SGRQ, St. George’s Respiratory Questionnaire; SNOT‐22, Sino‐Nasal Outcome TestPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/171162/1/all14902_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/171162/2/all14902.pd