Idiopathic pulmonary fibrosis

peer reviewedIdiopathic pulmonary fibrosis (IPF) is one of the multiple pathologies included in the large family of diffuse interstitial parenchymal lung diseases (IPD). The latter represent a large group of about 200 different diseases, most of which are orphan diseases. Recently, some new therapeutic options have appeared that require an early and accurate diagnosis of pulmonary fibrosis

Editorial: Progressive fibrosing interstitial lung disease: from bench to bedside

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Universal electric-field-driven resistive transition in narrow-gap Mott insulators

One of today's most exciting research frontier and challenge in condensed matter physics is known as Mottronics, whose goal is to incorporate strong correlation effects into the realm of electronics. In fact, taming the Mott insulator-to-metal transition (IMT), which is driven by strong electronic correlation effects, holds the promise of a commutation speed set by a quantum transition, and with negligible power dissipation. In this context, one possible route to control the Mott transition is to electrostatically dope the systems using strong dielectrics, in FET-like devices. Another possibility is through resistive switching, that is, to induce the insulator-to-metal transition by strong electric pulsing. This action brings the correlated system far from equilibrium, rendering the exact treatment of the problem a difficult challenge. Here, we show that existing theoretical predictions of the off-equilibrium manybody problem err by orders of magnitudes, when compared to experiments that we performed on three prototypical narrow gap Mott systems V2-xCrxO3, NiS2-xSex and GaTa4Se8, and which also demonstrate a striking universality of this Mott resistive transition (MRT). We then introduce and numerically study a model based on key theoretically known physical features of the Mott phenomenon in the Hubbard model. We find that our model predictions are in very good agreement with the observed universal MRT and with a non-trivial timedelay electric pulsing experiment, which we also report. Our study demonstrates that the MRT can be associated to a dynamically directed avalanche

Pulmonary arterial hypertension (PAH ) : a new era of pulmonary arterial vasodilatators

peer reviewedPulmonary arterial hypertension (PAH) is a rare disease, characterized by a progressive increase in pulmonary arterial pressure. The therapeutic management of PAH patients has evolved significantly over the past decades following the appearance of new specific therapies, but also the performance of multiple clinical studies in an otherwise rare pathology. As a result, the care is very well codified and makes it possible to treat all patients at best. To date, we can cite four therapeutic families: endothelin receptor antagonists (ERA), drugs that interfere with the cyclic guanosine monophosphate (cGMP) pathway such as phosphodiesterase type 5 inhibitors (PDE5i) or the stimulator of soluble guanylate cyclase, prostacyclin analogues, and, finally, calcium antagonists. The therapeutic approach, formerly sequential, has proven to be insufficient in favor of an aggressive and rapidly progressive upfront therapeutic approach, making it possible to greatly improve the morbidity and mortality of patients. In this context, early management remains the most appropriate attitude and justifies recourse, from the first symptoms, to a competence center.L’hypertension artérielle pulmonaire (HTAP) est une maladie rare, caractérisée par une majoration progressive de la pression artérielle pulmonaire. La prise en charge thérapeutique des patients en HTAP a fortement évolué dans les dernières décennies suite à l’apparition de nouvelles thérapeutiques spécifiques, mais également grâce à la réalisation de multiples études cliniques dans une pathologie par ailleurs rare. De ce fait, les prises en charge sont très bien codifiées et permettent de traiter, au mieux, l’ensemble des patients. A ce jour, nous pouvons citer quatre familles thérapeutiques : les antagonistes des récepteurs à l’endothéline (ERA), les médicaments interférant avec la voie de la guanosine monophosphate cyclique (GMPc) tels que les inhibiteurs de la phosphodiestérase de type 5 (PDE5i) ou le stimulateur de la guanylate cyclase soluble, les analogues aux prostacyclines, et, enfin, les antagonistes calciques. L’approche thérapeutique, anciennement séquentielle associant progressivement plusieurs thérapeutiques, s’est avérée insuffisante au profit d’une approche thérapeutique agressive et rapidement progressive, permettant d’améliorer fortement la morbi-mortalité des patients. Dans ce contexte, une prise en charge précoce reste l’attitude la plus appropriée et justifie un recours, dès les premiers symptômes, à un centre de compétence

Idiopathic mediastinal fibrosis

peer reviewedFibrosing mediastinitis is a rare condition characterized by an excessive growth of dense fibrous tissue within the mediastinum. The etiology of the disease is most often a fungal infection and may in some cases be idiopathic. We present the case of a patient with chronic obstructive pulmonary disease (COPD) suffering from fibrosing mediastinitis of undetermined origin and in whom the diagnosis was established by histopathological analysis after mediastinoscopy

Added Value of Dual-Energy CT in COVID-19 Pneumopathy.

Teaching point: The use of dual-energy instead of conventional single-energy computed tomography pulmonary angiogram can provide additional value concerning the diagnosis of COVID-19 and its complications, especially in the detection of small pulmonary embolism

Does Facemask Impact Diagnostic During Pulmonary Auscultation?

peer reviewedFacemasks have been widely used in hospitals, especially since the emergence of the coronavirus 2019 (COVID-19) pandemic, often severely affecting respiratory functions. Masks protect patients from contagious airborne transmission, and are thus more specifically important for chronic respiratory disease (CRD) patients. However, masks also increase air resistance and thus work of breathing, which may impact pulmonary auscultation and diagnostic acuity, the primary respiratory examination. This study is the first to assess the impact of facemasks on clinical auscultation diagnostic. Lung sounds from 29 patients were digitally recorded using an electronic stethoscope. For each patient, one recording was taken wearing a surgical mask and one without. Recorded signals were segmented in breath cycles using an autocorrelation algorithm. In total, 87 breath cycles were identified from sounds with mask, and 82 without mask. Time-frequency analysis of the signals was used to extract comparison features such as peak frequency, median frequency, band power, or spectral integration. All the features extracted in frequency content, its evolution, or power did not significantly differ between respiratory cycles with or without mask. This early stage study thus suggests minor impact on clinical diagnostic outcomes in pulmonary auscultation. However, further analysis is necessary such as on adventitious sounds characteristics differences with or without mask, to determine if facemask could lead to no discernible diagnostic outcome in clinical practice

An emerging cause of chronic fatigue and pain : post-COVID-19 condition or long COVID.

editorial reviewedSome individuals who have been infected with SARS-CoV-2 can experience long-term effects from their infection, known as post-COVID conditions, post-acute sequelae of COVID-19 or long COVID. Different underlying mechanisms can lead to long COVID, none of which are mutually exclusive. Lingering symptoms can persist years after SARS-CoV-2 infection, including fatigue, muscle weakness, tachycardia, dyspnea and various neurological symptoms. The symptomatology is partly similar to that reported by people with chronic fatigue syndrome and other unwell studied long-lasting diseases that may occur after other infections. People who have experienced more severe COVID-19 illness are at higher risk of developing long COVID, although anyone who was infected can experience post-COVID conditions. Importantly, unvaccinated individuals are more likely to develop long COVID. Here we review the current knowledge and discuss key findings regarding the epidemiology and physiopathology of long COVID. We briefly review current diagnostic and treatment options that remain so far largely insufficient.Certains individus infectés par le SARS-CoV-2 peuvent présenter des symptômes à long terme, évoluant parfois durant plusieurs années. Il est alors question d’affection post-COVID-19 ou COVID long. Les symptômes sont très polymorphes, fluctuants, et comprennent, notamment, une fatigue intense, des douleurs articulaires et musculaires, de la dyspnée, de la tachycardie, ainsi qu’une constellation de plaintes neurologiques. Cette symptomatologie est, en partie, similaire à celle du syndrome de fatigue chronique et est retrouvée également après d’autres types d’infections. Les mécanismes à l’origine du COVID long sont probablement multiples et encore mal connus. Si le COVID long peut toucher tout individu infecté par le SARS-CoV-2, certains groupes sont plus à risque, notamment les personnes non vaccinées ou les individus ayant présenté une infection sévère. Dans cet article, nous résumons les connaissances actuelles et mettons en lumière les découvertes clés quant à l’épidémiologie et aux mécanismes physiopathologiques du COVID long. Nous discutons aussi des critères diagnostiques et des options thérapeutiques qui sont, à ce jour, largement insuffisantes