Publications by authors named "J C Lemarie"
Article Synopsis
- Severe thrombotic antiphospholipid syndrome (APS) significantly affects critical organs and has not been thoroughly studied in ICU patients, particularly regarding hematological issues.
- A retrospective study in France tracked 134 APS patients in ICUs, revealing high rates of anemia (95%) and thrombocytopenia (93%), with low platelet counts linked to increased mortality.
- The findings highlight the importance of understanding the causes of thrombocytopenia in APS patients, as conditions like thrombotic microangiopathy (TMA), heparin-induced thrombocytopenia (HIT), and disseminated intravascular coagulation (DIC) are prevalent in this population.
Article Synopsis
- Post-intensive care syndrome (PICS) is a recognized issue that affects patients after their time in the ICU, involving ongoing physical, cognitive, and mental health problems.
- A survey sent to French ICUs revealed that only 28.6% provide follow-up visits, typically 3 to 6 months after discharge, with about 5% of patients attending these visits annually.
- Many ICUs identify barriers like staff shortages and low prioritization of PICS screening, yet nearly half of those not currently offering follow-ups expressed interest in starting within a year.
Background: Ventilator-associated pneumonia (VAP) is the leading nosocomial infection in critical care and is associated with adverse outcomes. When VAP is suspected, starting antibiotic therapy (AT) immediately after pulmonary sampling may expose uninfected patients to unnecessary treatment, whereas waiting for bacteriological confirmation may delay AT in infected patients. As no robust data exist to choose between these strategies, the decision must balance the pre-test diagnostic probability, clinical severity, and risk of antimicrobial resistance.
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- Ventilator associated pneumonia (VAP) caused by wild-type AmpC-producing Enterobacterales is common in ICU patients, and the study explores the effectiveness of different antimicrobial therapies (AMT), specifically piperacillin ± tazobactam (PTZ) and third-generation cephalosporins (3GCs).
- In a study involving 274 ICU patients, no significant differences in treatment success at day 7 were found between the groups receiving PTZ, 3GCs, or other control treatments, with all groups showing success rates around 68-74%.
- However, patients treated with 3GCs had a higher likelihood of pneumonia recurrence by day 28 compared to those on PTZ
Performance of DETECT Pulmonary Arterial Hypertension Algorithm According to the Hemodynamic Definition of Pulmonary Arterial Hypertension in the 2022 European Society of Cardiology and the European Respiratory Society Guidelines.
Oliver Distler Diana Bonderman J Gerry Coghlan Christopher P Denton Ekkehard Grünig Jean-Christophe Lemarie
Arthritis Rheumatol
May 2024
Article Synopsis
- The DETECT algorithm is used to screen for pulmonary arterial hypertension (PAH) in patients with systemic sclerosis (SSc) using noninvasive data and guiding referrals for further testing.
- A recent analysis showed that the performance of DETECT in identifying PAH risk using the updated 2022 ESC/ERS definitions was slightly less sensitive (88.2%) compared to the previous 2014 definitions (95.8%), but its specificity improved.
- Despite the changes in PAH definitions, DETECT remains a valid tool for screening PAH in SSc patients, confirming its ongoing relevance in clinical practice.