Relation onchocercose-épilepsie.

International audienc

Rôle de l'onchocercose dans la survenue d'épilepsie : étude cas-témoin conduite en République Centrafricaine.

International audienc

Association entre onchocercose et épilepsie en RCA ?

International audienc

Minimal clinically important difference of 3-minute chair rise test and the DIRECT questionnaire after pulmonary rehabilitation in COPD patients

Jonathan Lévesque,1 Anestis Antoniadis,2 Pei Zhi Li,3 Frédéric Herengt,4 Christophe Brosson,5 Jean-Marie Grosbois,6 Alain Bernady,7 Anthony Bender,8,9 Murielle Favre,10 Antoine Guerder,11 Pascale Surpas,12 Thomas Similowski,11,13 Bernard Aguilaniu141Department of Medicine, Pneumology Service, Hôpital Maisonneuve-Rosemont, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada; 2Laboratoire Jean Kuntzmann UMR5224, Statistics Department, Université Grenoble-Alpes, Grenoble, France; 3Montreal Chest Institute, McGill University Health Center Research Institute, McGill University, Montreal, Quebec, Canada; 4Centre de Réadaptation Cardio-Respiratoire-Dieulefit Santé, Dieulefit, France; 5Private Physiotherapist, Cours Liberation, Grenoble, France; 6Pneumology Service, Centre Hospitalier de Béthune, Béthune, France; 7Toki-Eder Centre Médical Cardio-Respiratoire, Cambo-les-Bains, France; 8Private Physiotherapist, Boulevard de Metz Mont-Saint-Martin, France; 9LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg; 10Centre de Pneumologie Henri Bazire, Saint-Julien-de-Ratz, France; 11AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie, Médecine Intensive et Réanimation, Département R3S, Paris, France; 12Centre Médical de Bayère, Charnay, France; 13Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France; 14Faculty of Medicine, Université Grenoble-Alpes, Grenoble, FranceBackground: The 3-minute chair rise test (3-minute CRT) and the Disability Related to COPD Tool (DIRECT) are two reproducible and valid short tests that can assess the benefit of pulmonary rehabilitation (PR) in terms of functional capacity and dyspnea in everyday activities.Methods: We determined the minimal clinically important difference (MCID) of the DIRECT questionnaire and 3-minute CRT using distribution methods and anchor encroaches with a panel of eight standard tests in a cohort of 116 COPD patients who completed a PR program in real-life settings.Results: The estimated MCID for the 3-minute CRT and DIRECT scores was five repetitions and two units, respectively, using separate and combined independent anchors. The all-patient (body mass index-obstruction-dyspnea-exercise [BODE] scores 0–7), BODE 0–2 (n=42), and BODE 3–4 (n=50) groups showed improvements greater than the MCID in most tests and questionnaires used. In contrast, the BODE 5–7 group (n=24) showed improvements greater than MCID in only the 3-minute CRT, 6-minute walk test, endurance exercise test, and DIRECT questionnaire.Discussion and conclusion: This study demonstrates that the short and simple DIRECT questionnaire and 3-minute CRT are responsive to capture the beneficial effects of a PR program in COPD patients, including those with severe disease.Trial registration number: NCT03286660. Keywords: MCID, chair tests, tools, COPD, pulmonary rehabilitation, outcomes assessmen

Detection of allergen-induced basophil activation by expression of CD63 antigen using a tricolour flow cytometric method

In the field of allergy diagnosis, most in vitro functional tests are focused on basophils. Nevertheless, the very small number of circulating basophils limits these experiments and their clinical benefit remains controversial. As flow cytometry is a valuable tool for identifying cell populations, even at low concentrations, we developed a tricolour flow cytometric method for the study of allergen-induced basophil activation. Identification of cells was based both on CD45 expression and on the presence of IgE on the cell surface, since basophils express high-affinity receptors for IgE (FcεRI). Cell activation upon allergen challenge was assessed by the expression of CD63 antigen on the plasma membrane. Basophil isolation and activation (with the chemotactic peptide formyl-methionyl-leucyl-phenylalanine) were validated in 32 non-allergic patients. In 12 allergic patients, basophil stimulation by a relevant allergen was in most cases positive (10/12). Furthermore a concentration-dependent hook effect was observed. Of the allergic and non-allergic patients, none showed non-specific activation with an irrelevant allergen (specificity 100%). Overall, our preliminary results, even in a small population, suggest that this is a reliable and valuable method for the diagnosis of allergies complementing specific allergen IgE and skin test results. Obviously, additional clinical studies are needed to validate these first results

Limoges epilepsy protocol: research tool in tropical countries.

International audienc

BMC Pulm Med

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality around the world. The aim of our study was to determine the association between specific comorbidities and COPD severity. METHODS: Pulmonologists included patients with COPD using a web-site questionnaire. Diagnosis of COPD was made using spirometry post-bronchodilator FEV1/FVC < 70%. The questionnaire included the following domains: demographic criteria, clinical symptoms, functional tests, comorbidities and therapeutic management. COPD severity was classified according to GOLD 2011. First we performed a principal component analysis and a non-hierarchical cluster analysis to describe the cluster of comorbidities. RESULTS: One thousand, five hundred and eighty-four patients were included in the cohort during the first 2 years. The distribution of COPD severity was: 27.4% in group A, 24.7% in group B, 11.2% in group C, and 36.6% in group D. The mean age was 66.5 (sd: 11), with 35% of women. Management of COPD differed according to the comorbidities, with the same level of severity. Only 28.4% of patients had no comorbidities associated with COPD. The proportion of patients with two comorbidities was significantly higher (p < 0.001) in GOLD B (50.4%) and D patients (53.1%) than in GOLD A (35.4%) and GOLD C ones (34.3%). The cluster analysis showed five phenotypes of comorbidities: cluster 1 included cardiac profile; cluster 2 included less comorbidities; cluster 3 included metabolic syndrome, apnea and anxiety-depression; cluster 4 included denutrition and osteoporosis and cluster 5 included bronchiectasis. The clusters were mostly significantly associated with symptomatic patients i.e. GOLD B and GOLD D. CONCLUSIONS: This study in a large real-life cohort shows that multimorbidity is common in patients with COPD