Publications by authors named "Bernaudin J"

Article Synopsis
  • - Platelet aggregation in the lungs may contribute to thrombocytopenia during acute pulmonary hypertension (PH) decompensation, as observed in lung transplant patients.
  • - A study involving 16 patients identified a significantly higher number of platelet aggregates in those experiencing thrombocytopenia compared to control patients without PH.
  • - Scanning electron microscopy revealed that the capillaries in the lungs of patients with acute PH decompensation were filled with these platelet aggregates, indicating a potential mechanism for the condition.
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In this review, the infectious complications observed in sarcoidosis are considered from a practical point of view to help the clinician not to overlook them in a difficult context, as pulmonary sarcoidosis makes the recognition of superinfections more difficult. An increased incidence of community-acquired pneumonia and of opportunistic pneumonia has been reported, especially in immunosuppressed patients. Pulmonary destructive lesions of advanced sarcoidosis increase the incidence of chronic pulmonary aspergillosis and infection by other agents.

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Article Synopsis
  • - Fibrotic pulmonary sarcoidosis (fPS) impacts about 20% of patients and is associated with significant health risks and variable prognosis based on factors like fibrosis extent and functional impairment severity.
  • - The condition is also affected by complications such as acute exacerbations and infections, but its natural progression, particularly the risk of ongoing fibrosis, remains unclear.
  • - Managing fPS is complex and may involve anti-inflammatory treatments, rehabilitation, and, in certain cases, antifibrotic therapy or lung transplantation.
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Background: Computational advances in artificial intelligence have led to the recent emergence of U-Net convolutional neural networks (CNNs) applied to medical imaging. Our objectives were to assess the progression of fibrotic interstitial lung disease (ILD) using routine CT scans processed by a U-Net CNN developed by our research team, and to identify a progression threshold indicative of poor prognosis.

Methods: CT scans and clinical history of 32 patients with idiopathic fibrotic ILDs were retrospectively reviewed.

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The pathophysiology of high-altitude pulmonary edema is currently attributed to exacerbated heterogeneous hypoxic pulmonary vasoconstriction. However, although other cellular mechanisms have been hypothesized, they are still poorly understood. In this review, we focused on cells of the pulmonary acinus, the distal unit for gas exchange, known to be responders to acute hypoxia, notably through many humoral or tissue factors that connect this intercellular network constituting the alveolo-capillary barrier.

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Article Synopsis
  • * A study using a mouse model of pulmonary fibrosis revealed that the condition leads to increased minute ventilation but causes lower lung compliance and oxygen desaturation, correlating with the severity of lung damage.
  • * The research also found that pulmonary fibrosis affects neural activity in key brain regions responsible for regulating breathing, indicating that the disease modifies both lung structure and the central nervous system's control of respiration.
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Article Synopsis
  • Diagnosing pulmonary sarcoidosis is complex due to the lack of specific diagnostic criteria and symptoms that resemble other diseases, making it essential for non-sarcoidosis specialists to have effective differential diagnosis strategies.
  • To determine the right diagnosis, a thorough assessment of epidemiological factors, clinical history, and physical examinations, especially chest CT scans, is crucial in identifying which diseases to prioritize for further testing.
  • The review highlights the importance of ruling out various alternative granulomatous diseases and conditions through appropriate investigations before confirming a diagnosis of sarcoidosis.
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Interstitial lung diseases, such as idiopathic pulmonary fibrosis (IPF) or post-COVID-19 pulmonary fibrosis, are progressive and severe diseases characterized by an irreversible scarring of interstitial tissues that affects lung function. Despite many efforts, these diseases remain poorly understood and poorly treated. In this paper, we propose an automated method for the estimation of personalized regional lung compliances based on a poromechanical model of the lung.

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Rationale: idiopathic pulmonary fibrosis (IPF) is the most severe form of fibrosing interstitial lung disease, characterized by progressive respiratory failure leading to death. IPF's natural history is heterogeneous, and its progression unpredictable. Most patients develop a progressive decline of respiratory function over years; some remain stable, but others present a fast-respiratory deterioration without identifiable cause, classified as acute exacerbation (AE).

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Pulmonary function is tightly linked to the lung mechanical behavior, especially large deformation during breathing. Interstitial lung diseases, such as idiopathic pulmonary fibrosis (IPF), have an impact on the pulmonary mechanics and consequently alter lung function. However, IPF remains poorly understood, poorly diagnosed, and poorly treated.

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Article Synopsis
  • High prevalence of obstructive sleep apnea (OSA) is linked to worsening idiopathic pulmonary fibrosis (IPF), and intermittent hypoxia (IH) from OSA appears to worsen lung fibrosis.
  • A study used C57BL/6J mice to assess how IH affects lung fibrosis induced by Bleomycin (BLM), either by pre-exposing the mice to IH or exposing them simultaneously with BLM.
  • Results indicated that prior exposure to IH led to significant weight loss, increased lung injury, and higher levels of pro-fibrotic markers, with notable increases in ER stress markers, highlighting the detrimental impact of IH on lung fibrosis progression.
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Background: Macrophages are pivotal cells in sarcoidosis. Monocytes-derived (MD) macrophages have recently been demonstrated to play a major role especially in pulmonary sarcoidosis. From inflammatory tissues to granulomas, they may be exposed to low oxygen tension environments.

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Extrapulmonary sarcoidosis occurs in 30-50% of cases of sarcoidosis, most often in association with pulmonary involvement, and virtually any organ can be involved. Its incidence depends according to the organs considered, clinical phenotype, and history of sarcoidosis, but also on epidemiological factors like age, sex, geographic ancestry, and socio-professional factors. The presentation, symptomatology, organ dysfunction, severity, and lethal risk vary from and to patient even at the level of the same organ.

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Article Synopsis
  • - The study investigates the impact of low income on patients with idiopathic pulmonary fibrosis (IPF), a chronic respiratory disease, hypothesizing that lower income worsens patient prognosis.
  • - Researchers analyzed data from the French COFI cohort, categorizing patients into "low income" and "higher income" groups based on their annual income, and compared survival rates using statistical models.
  • - Results showed that low-income patients had significantly worse progression-free survival and overall survival rates, alongside a higher likelihood of having non-European origin and occupational exposures, underscoring the adverse effects of low income on IPF outcomes.
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Study Question: In patients with sarcoidosis, past and ongoing immunosuppressive regimens, recurrent disease in the transplant and extrapulmonary involvement may affect outcomes of lung transplantation. We asked whether sarcoidosis lung phenotypes can be differentiated and, if so, how they relate to outcomes in patients with pulmonary sarcoidosis treated by lung transplantation.

Patients And Methods: We retrospectively reviewed data from 112 patients who met international diagnostic criteria for sarcoidosis and underwent lung or heart-lung transplantation between 2006 and 2019 at 16 European centres.

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Article Synopsis
  • The authors of the "Management of Sarcoidosis: Challenges and Solutions" Special Issue are acknowledged for their valuable contributions.
  • The editorial staff is also thanked for their role in bringing the issue to completion.
  • Overall, the text expresses gratitude towards both the authors and editorial team for their efforts in this publication.
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(1) Background: Pediatric sarcoidosis is a rare and mostly severe disease. Very few pediatric series with a prolonged follow-up are reported. We aimed to evaluate the evolution of pediatric sarcoidosis in adulthood.

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