Lung transplantation for interstitial lung disease in idiopathic inflammatory myositis: A cohort study

Connective tissue disease; Idiopathic inflammatory myopathy; Interstitial lung diseaseEnfermedad del tejido conectivo; Miopatía inflamatoria idiopática; Enfermedad pulmonar intersticialMalaltia del teixit conjuntiu; Miopatia inflamatòria idiopàtica; Malaltia pulmonar intersticialIn patients with interstitial lung disease (ILD) complicating classical or amyopathic idio-pathic inflammatory myopathy (IIM), lung transplantation outcomes might be affected by the disease and treatments. Here, our objective was to assess survival and prog-nostic factors in lung transplant recipients with IIM-ILD. We retrospectively reviewed data for 64 patients who underwent lung transplantation between 2009 and 2021 at 19 European centers. Patient survival was the primary outcome. At transplantation, the median age was 53 [46–59] years, 35 (55%) patients were male, 31 (48%) had clas-sical IIM, 25 (39%) had rapidly progressive ILD, and 21 (33%) were in a high- priority transplant allocation program. Survival rates after 1, 3, and 5 years were 78%, 73%, and 70%, respectively. During follow-up (median, 33 [7–63] months), 23% of patients developed chronic lung allograft dysfunction. Compared to amyopathic IIM, classical IIM was characterized by longer disease duration, higher-intensity immunosuppres-sion before transplantation, and significantly worse posttransplantation survival. Five (8%) patients had a clinical IIM relapse, with mild manifestations. No patient expe-rienced ILD recurrence in the allograft. Posttransplantation survival in IIM-ILD was similar to that in international all- cause- transplantation registries. The main factor as-sociated with worse survival was a history of muscle involvement (classical IIM). In lung transplant recipients with idiopathic inflammatory myopathy, survival was similar to that in all-cause transplantation and was worse in patients with muscle involvement compared to those with the amyopathic disease

Simulation of the photopolymerization gradient inside a pigmented coating

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Bronchiectasis Complicating Lung Volume Reduction Coil Treatment

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Bench Evaluation of Four Portable Oxygen Concentrators Under Different Conditions Representing Altitudes of 2438, 4200, and 8000 m

International audienceBunel, Vincent, Amr Shoukri, Frederic Choin, Serge Roblin, Cindy Smith, Thomas Similowski, Capucine Morélot-Panzini, and Jésus Gonzalez. Bench evaluation of four portable oxygen concentrators under different conditions representing altitudes of 2438, 4200, and 8000 m. High Alt Med Biol. 17:370–374, 2016.—Air travel is responsible for a reduction of the partial pressure of oxygen (O2) as a result of the decreased barometric pressure. This hypobaric hypoxia can be dangerous for passengers with respiratory diseases, requiring initiation or intensification of oxygen therapy during the flight. In-flight oxygen therapy can be provided by portable oxygen concentrators, which are less expensive and more practical than oxygen cylinders, but no study has evaluated their capacity to concentrate oxygen under simulated flight conditions. We tested four portable oxygen concentrators during a bench test study. The O2 concentrations (FO2) produced were measured under three different conditions: in room air at sea level, under hypoxia due to a reduction of the partial pressure of O2 (normobaric hypoxia, which can be performed routinely), and under hypoxia due to a reduction of atmospheric pressure (hypobaric hypoxia, using a chamber manufactured by Airbus Defence and Space). The FO2 obtained under conditions of hypobaric hypoxia (chamber) was lower than that measured in room air (0.92 [0.89–0.92] vs. 0.93 [0.92–0.94], p = 0.029), but only one portable oxygen concentrator was unable to maintain an FO2 ≥ 0.90 (0.89 [0.89–0.89]). In contrast, under conditions of normobaric hypoxia (tent) simulating an altitude of 2438 m, none of the apparatuses tested was able to achieve an FO2 greater than 0.76. (0.75 [0.75–0.76] vs. 0.93 [0.92–0.94], p = 0.029). Almost all portable oxygen concentrators were able to generate a sufficient quantity of O2 at simulated altitudes of 2438 m and can therefore be used in the aircraft cabin. Unfortunately, verification of the reliability and efficacy of these devices in a patient would require a nonroutinely available technology, and no preflight test can currently be performed by using simple techniques such as hypobaric hypoxia

Extracorporeal life support allows lung transplant in anti-MDA5+ rapidly progressive interstitial lung disease.

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Low phase noise self-injection-locked diode laser with a high-Q fiber resonator: model and experiment

International audienceLow phase noise and narrow linewidth lasers are achieved by implementing self-injection locking of a DFB laser on two distinct fiber Fabry-Perot resonators. More than 45 dB improvement of the laser phase or frequency noise is observed when the laser is locked. In both cases, a frequency noise floor below 1 Hz2/Hz is measured. The integrated linewidth of the best of the two lasers is computed to be in the range of 400 Hz and appears to be dominated by vibration noise close to the carrier. The results are then compared with a model based on the retro-injected power and the Q factors ratio between the DFB laser and the resonator. This straightforward model facilitates the extraction of the theoretical performance of these sources close to the carrier, a characteristic still hidden by vibration noise

Rhinoviruses: molecular diversity and clinical characteristics

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Investigating infectious outcomes in adult patients undergoing solid organ transplantation: A retrospective single-center experience, Paris, France

OBJECTIVES: This study described the demographic characteristics, clinical presentation, treatment, and outcomes of solid organ transplant recipients who were admitted to our center for infection. It also determined factors associated with a poor outcome, and compares early and late period infections. METHODS: In this retrospective observational study, conducted at a tertiary care center in France between October 2017 and March 2019, infectious outcomes of patients with solid organ transplant where studied. RESULTS: A total of 104 patients were included with 158 hospitalizations for infection. Among these 104 patients, 71 (68%) were men. The median age was 59 years old. The most common symptoms on admission were fever (66%) and chills (31%). Lower respiratory tract infections were the most common diagnosis (71/158 hospitalizations). Urinary tract infections were frequently seen in kidney transplant recipients (25/60 hospitalizations). One or more infectious agents were isolated for 113 hospitalizations (72%): 70 bacteria, 36 viruses and 10 fungi, with predominance of gram-negative bacilli (53 cases) of which 13 were multidrug-resistant. The most frequently used antibiotics were third generation cephalosporins (40 cases), followed by piperacillin-tazobactam (26 cases). We note that 25 infections (16%) occurred during the first 6 months (early post-transplant period). Patients admitted during the early post-transplant period were more often on immunosuppressive treatment with prednisone (25/25 VS 106/133) (p = 0.01), mycophenolic acid (22/25 VS 86/133) (p = 0.03), presented for an urinary tract infection (10/25 VS 25/133) (p = 0.04) or a bacterial infection (17/25 VS 53/133) (p = 0.01). Patients with later infection had more comorbidities (57/83 VS 9/21) (p = 0.03), cancer (19/83 VS 0/21) (p = 0.04) or were on treatment with everolimus (46/133 VS 0/25) (p = 0.001). During 31 hospitalizations (20%), patients presented with a serious infection requiring intensive care (n = 26; 16%) or leading to death (n = 7; 4%). Bacteremia, pulmonary and cardiac complications were the main risk factors associated with poor outcome. CONCLUSION: Infections pose a significant challenge in the care of solid organ transplant patients, particularly those with comorbidities and intensive immunosuppression. This underscores the crucial importance of continuous surveillance and epidemiologic monitoring within this patient population

Fatal Covid‐19 vasoplegic shock in a recipient few hours before double lung transplantation in high emergency

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Patient-important outcomes in lung transplantation: A systematic review

International audienceBackground: Patient-important outcomes (PIOs) have emerged in respiratory medicine, in order to place the patient at the center of research. Mortality is a debated PIO in lung transplantation (LTx). The use of PIO in this specific setting has never been studied. We aimed to systematically review the use of PIOs in LTx research. Methods: MEDLINE, Cochrane Library and Embase databases were searched to include prospective studies published in 2019, involving adult LTx recipients. We excluded articles reporting non-prognostic studies, letters, reviews, commentaries, or case reports. PIOs considered were mortality, pain, physical function, pulmonary, gastrointestinal, neuropsychological, cardiac, sleep or sexual symptoms and quality of life. This systematic review was prospectively registered in the PROSPERO register (CRD42020163425). Results: Among 1048 references retrieved, 51 were finally included in the analysis. In total, 26 (51%) studies investigated at least one PIO, as a primary outcome in 12 (23.5%) and secondary outcome in 21 (41.2%). In 15 (29.4%) studies, mortality was the most frequently reported PIO; 11 (21.5%) studies evaluated at least one PIO other than mortality, quality of life being this PIO in 6. Conclusions: PIOs were described in half of prospective articles dealing with adult LTx recipients published in 2019. Outcomes other than mortality were insufficiently considered. A core outcome set of PIOs in LTx should be developed with patient input to guide future research in LTx