Occupational exposure to respirable crystalline silica and autoimmunity: sex differences in mouse models

International audienc

The collaboration of clinical pharmacists and physicians for medication safety

International audienc

Haemodynamically proven pulmonary hypertension in a patient with GATA2 deficiency-associated pulmonary alveolar proteinosis and fibrosis

International audienceOver the past few years, genetics has significantly improved the understanding of interstitial lung diseases (ILD)..

Cancers digestifs et thromboses: Quelles nouvelles recommandations ?

National audienceVenous thromboembolism (VTE) is an important cause of morbidity and mortality among patients with cancer. Update recommendations on this topic have been proposed in 2019. For VTE prophylaxis, hospitalized patients who have active malignancy and acute medical illness or reduced mobility should be offered pharmacologic thromboprophylaxis in the absence of bleeding or other contraindications. Moreover, all patients with malignant disease undergoing major surgical intervention should be offered pharmacologic thromboprophylaxis that should be continued up to 4 weeks post-operatively for patients undergoing major open or laparoscopic abdominal or pelvic surgery in the absence of high bleeding risk or other contraindications. For treatment of patients with cancer with established VTE, long-term anticoagulation may involve low-molecular-weight heparin (LMWH), direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). VKAs are inferior but may be used if LMWH or DOACs are not accessible. There is an increase in major bleeding risk with DOACs, particularly in GI malignancies. LMWH should be use for cancer patients with acute diagnosis of VTE and high risk of bleeding, including patients with gastrointestinal cancers. DOACs are acceptable alternatives if there are no drug-drug interactions, no severe renal impairment, incorporating patient preferences.La maladie thromboembolique veineuse est une cause importante de morbi-mortalité chez les patients suivis pour un cancer et a fait l’objet de nouvelles recommandations en 2019.En prévention primaire, chez les patients suivis pour une néoplasie évolutive et hospitalisés pour un problème médical aigu et/ou avec une réduction de leur mobilité, il est recommandé de débuter une prophylaxie anti-thrombotique en l’absence de saignement ou d’autres contre-indications. De plus, il est recommandé de mettre en place un traitement prophylactique anti-thrombotique prolongé pendant quatre semaines pour tous les patients en péri-opératoire d’une chirurgie abdominale ou pelvienne en l’absence de contre-indication ou de risque élevé de saignement.En prévention secondaire, l’anticoagulation au long cours peut se faire par héparine de bas poids moléculaire (HBPM), anticoagulant oral direct (AOD) ou anti-vitamine K (AVK). Un traitement par HBPM réduit significativement le nombre de récidive thromboembolique par comparaison aux AVK sans différence en termes de complications hémorragiques. Les AOD augmentent le risque de saignement par rapport à un traitement par HBPM, en particulier au cours de cancers gastro-intestinaux et génito-urinaires. Ainsi, il convient de rester prudent quant à l’utilisation des AOD au cours du traitement des thromboses chez les patients suivis pour un cancer gastro-intestinal. Il est proposé d’utiliser les HBPM en première intention chez les patients à haut risque de saignement, incluant les patients avec une tumeur gastro-intestinale. Les AOD restent une alternative acceptable en l’absence d’interaction médicamenteuse, d’insuffisance rénale sévère et en accord avec le patient

M1/M2 polarisation state of M-CSF blood-derived macrophages in systemic sclerosis

International audienc

ILD and Mediastinal Lymph Nodes A CT-Based Biomarker Beyond Nosological and Etiological Borders?

International audienc

Association of pulmonary alveolar proteinosis and fibrosis: Patient with GATA2 deficiency

International audience[No abstract available

Transferability of Published Population Pharmacokinetic Models for Apixaban and Rivaroxaban to Subjects with Obesity Treated for Venous Thromboembolism: A Systematic Review and External Evaluations

International audienceApixaban and rivaroxaban have first-line use for many patients needing anticoagulation for venous thromboembolism (VTE). The pharmacokinetics of these drugs in non-obese subjects have been extensively studied, and, while changes in pharmacokinetics have been documented in obese patients, data remain scarce for these anticoagulants. The aim of this study was to perform an external validation of published population pharmacokinetic (PPK) models of apixaban and rivaroxaban in a cohort of obese patients with VTE. A literature search was conducted in the PubMed/MEDLINE, Scopus, and Embase databases following the PRISMA statement. External validation was performed using MonolixSuite software, using prediction-based and simulation-based diagnostics. An external validation dataset from the university hospitals of Brest and Rennes, France, included 116 apixaban pharmacokinetic samples from 69 patients and 121 rivaroxaban samples from 81 patients. Five PPK models of apixaban and 16 models of rivaroxaban were included, according to the inclusion criteria of the study. Two of the apixaban PPK models presented acceptable performances, whereas no rivaroxaban PPK model did. This study identified two published models of apixaban applicable to apixaban in obese patients with VTE. However, none of the rivaroxaban models evaluated were applicable. Dedicated studies appear necessary to elucidate rivaroxaban pharmacokinetics in this population