Les traitements spécifiques de l'hypertension artérielle pulmonaire permettent-ils d'améliorer la désaturation à l'effort

TOULOUSE3-BU Santé-Centrale (315552105) / SudocSudocFranceF

Allergie aux antibiotiques chez les patients atteints de mucoviscidose (revue de la littérature étude rétrospective au CRCM adulte de Midi-Pyrénées)

La mucoviscidose est la plus fréquente des maladies génétiques létales dans les populations d'origine caucasienne. L'évolution vers l'insuffisance respiratoire chronique terminale est déterminée par la colonisation bactérienne et les infections bronchiques récidivantes, en particulier à Pseudomonas aeruginosa. Les traitements antibiotiques sont souvent initiés précocement dans l'histoire de la maladie ; ils sont régulièrement nécessaires et de fortes posologies doivent être employées afin de répondre aux caractéristiques pharmacodynamiques et pharmacocinétiques propres à la mucoviscidose. L'incidence de l'allergie aux antibiotiques est plus importante dans la population de patients atteints de mucoviscidose que dans la population générale. Elle limite le choix des antibiotiques à utiliser, choix déjà restreint par les résistances bactériennes. Les raisons pour lesquelles les réactions d'hypersensibilité surviennent plus fréquemment en contexte de mucoviscidose sont peu développées dans la littérature. Parmi les 94 patients suivis au Centre de Ressources et de Compétences de la Mucoviscidose adulte du CHU de Toulouse, nous avons étudié rétrospectivement ceux qui ont bénéficié au moins une fois dans leur vie d'un traitement antibiotique intraveineux. Les 54 patients inclus cumulent 1285 cures antibiotiques dont 496 ont été retenues pour l'analyse statistique des facteurs de risque. L'allergie aux antibiotiques dans notre population est fréquente, avec une incidence de 16,7%. Elle est caractérisée par la prédominance des réactions non immédiates, par la négativité fréquente des tests cutanés et par la rareté des réactions croisées. Les bêtalactamines, et en particulier la pipéracilline, sont les antibiotiques les plus souvent impliqués. Le risque de développer une réaction d'hypersensibilité est d'autant plus élevé que le patient a bénéficié tôt dans sa vie d'une antibiothérapie intraveineuse. A l'inverse, la dénutrition pourrait réduire le risque de réaction d'hypersensibilité, probablement par l'état d'immunodépression qui l'accompagne. Des résultats intéressants sont obtenus avec les protocoles d'accoutumance, aussi bien dans la littérature que dans l'expérience du CRCM adulte de la région Midi-Pyrénées.TOULOUSE3-BU Santé-Centrale (315552105) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

4-Couv: A New Treebank for French

International audienceThe question of the type of text used as primary data in treebanks is of certain importance. First, it has an influence at the discourse level: an article is not organized in the same way as a novel or a technical document. Moreover, it also has consequences in terms of semantic interpretation: some types of texts can be easier to interpret than others. We present in this paper a new type of treebank which presents the particularity to answer to specific needs of experimental linguistic. It is made of short texts (book backcovers) that presents a strong coherence in their organization and can be rapidly interpreted. This type of text is adapted to short reading sessions, making it easy to acquire physiological data (e.g. eye movement, electroencepholagraphy). Such a resource offers reliable data when looking for correlations between computational models and human language processing

4-Couv: A New Treebank for French

International audienceThe question of the type of text used as primary data in treebanks is of certain importance. First, it has an influence at the discourse level: an article is not organized in the same way as a novel or a technical document. Moreover, it also has consequences in terms of semantic interpretation: some types of texts can be easier to interpret than others. We present in this paper a new type of treebank which presents the particularity to answer to specific needs of experimental linguistic. It is made of short texts (book backcovers) that presents a strong coherence in their organization and can be rapidly interpreted. This type of text is adapted to short reading sessions, making it easy to acquire physiological data (e.g. eye movement, electroencepholagraphy). Such a resource offers reliable data when looking for correlations between computational models and human language processing

Discourse Structure of Backcovers: A pilot study

International audienceno abstrac

Risk factors of occult malignancy in patients with unprovoked venous thromboembolism

International audienc

Performance of 18F-fluorodesoxyglucose positron-emission tomography combined with low-dose computed tomography for cancer screening in patients with unprovoked venous thromboembolism

International audienc

Zoster after Cyclophosphamide for Systemic Lupus Erythematosus or Vasculitis: Incidence, Risk Factors, and Effect of Antiviral Prophylaxis

International audienceObjective: To assess the incidence and the risk factors for zoster in patients exposed to intravenous cyclophosphamide (CYC) for systemic vasculitis or systemic lupus erythematosus (SLE), as well as the protective effect of prophylaxis by valacyclovir (VCV).Methods: This retrospective study included all adults treated by intravenous CYC for SLE or systemic vasculitis between 2011 and 2015 at Toulouse University Hospital, France. Zoster occurrence was recorded using medical chart review, laboratory data, and patient interviews. Univariate Cox models were computed to assess the risk factors for zoster and the protective effect of prophylaxis by VCV.Results: The cohort consisted of 110 patients (81 systemic vasculitis and 29 SLE). During a mean followup of 3.4 years after CYC initiation, 10 cases of zoster occurred, leading to an overall incidence of 27.9/1000 patient-years (95% CI 15.2-50.6); it was 59.4/1000 patients (95% CI 27.5-123.6) during the year after CYC initiation. Four patients experienced persistent postherpetic neuralgia. Probable risk factors were lymphopenia < 500/µl at CYC initiation (HR 5.11, 95% CI 0.94-27.93) and female sex (HR 4.36, 95% CI 0.51-37.31). The incidence was higher in patients with SLE (HR as compared with systemic vasculitis patients = 2.68, 95% CI 0.54-13.26). None of the 19 patients exposed to VCV during the followup developed zoster.Conclusion: The incidence of zoster is high in systemic vasculitis and in patients with SLE exposed to intravenous CYC. CYC may favor postherpetic neuralgia. Prophylaxis by VCV should be considered, particularly in cases of lymphopenia < 500/µl at CYC initiation and during the year after

Additional testing following screening strategies for occult malignancy diagnosis in patients with unprovoked venous thromboembolism

International audienc

Pulmonary hypertension in lymphangioleiomyomatosis: characteristics in 20 patients.

This retrospective, multicentre study evaluated patients with lymphangioleiomyomatosis (LAM) and pre-capillary pulmonary hypertension (PH) by right heart catheterisation. It was conducted in 20 females with a mean ± SD age of 49 ± 12 yrs and a mean ± SD time interval between LAM and PH diagnoses of 9.2 ± 9.8 yrs. All, except for one patient, were receiving supplemental oxygen. 6-min walking distance was mean ± SD 340 ± 84 m. Haemodynamic characteristics were: mean pulmonary artery pressure (PAP) 32 ± 6 mmHg, cardiac index 3.5 ± 1.1 L · min(-1) · m(-2) and pulmonary vascular resistance (PVR) 376 ± 184 dyn · s · cm(-5). Mean PAP was &gt;35 mmHg in only 20% of cases. The forced expiratory volume in 1 s was 42 ± 25%, carbon monoxide transfer factor was 29 ± 13%, and arterial oxygen tension (P(a,O(2))) was 7.4 ± 1.3 kPa in room air. Mean PAP and PVR did not correlate with P(a,O(2)). In six patients who received oral pulmonary arterial hypertension (PAH) therapy, the PAP decreased from 33 ± 9 mmHg to 24 ± 10 mmHg and the PVR decreased from 481 ± 188 dyn · s · cm(-5) to 280 ± 79 dyn · s · cm(-5). The overall probability of survival was 94% at 2 yrs. Pre-capillary PH of mild haemodynamic severity may occur in patients with LAM, even with mild pulmonary function impairment. PAH therapy might improve the haemodynamics in PH associated with LAM