390 results match your criteria: "Centre d'Étude Des Pathologies Respiratoires[Affiliation]"

Nebulized aminoglycosides for ventilator-associated pneumonia: Methodological considerations and lessons from experimental studies.

J Intensive Med

January 2025

Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona - SGR 911- Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain.

Aminoglycosides are concentration-dependent antibiotics exerting a bactericidal effect when concentrations at the site of infection are equal to or greater than 5 times the minimum inhibitory concentrations (MIC). When administered intravenously, they exhibit poor lung penetration and high systemic renal and ototoxicity, imposing to restrict their administration to 5 days. Experimental studies conducted in anesthetized and mechanically ventilated sheep and pigs provide evidence that high doses of nebulized aminoglycosides induce a rapid and potent bacterial killing in the infected lung parenchyma.

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Purpose Of Review: The objective of this review is to examine the available evidence concerning feeding interruptions before extubation and other medical procedures in ICUs. We will analyze the physiological mechanisms involved, the potential risks associated with feeding interruptions, as well as the results of recent clinical studies. Additionally, we will explore current practices and recommendations from major professional societies, as well as recent innovations aimed at minimizing feeding interruptions.

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Introduction: With the worldwide growing burden of respiratory tract infections (RTIs), innovative therapeutic approaches are in high demand. Inhaled antibodies (Abs) represent a promising avenue, offering targeted treatment options with potentially better therapeutic index compared to traditional delivery methods.

Areas Covered: This comprehensive review summarizes the challenges faced in delivering Abs by (intranasal and pulmonary) inhalation.

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[Antibioprophylaxis failure with BCG therapy for bladder neoplasia].

Rev Mal Respir

December 2024

Service de pneumologie et explorations fonctionnelles respiratoires, CHRU de Tours, Tours, France; UMR 1100, université François-Rabelais, Tours, France; Inserm, centre d'étude des pathologies respiratoires, UMR 1100/EA6305, Tours, France. Electronic address:

Introduction: BCG therapy is the standard treatment for bladder tumors that do not infiltrate smooth muscle. Fluoroquinolones for antibiotic prophylaxis are recommended to lessen the risk of BCG infection (BCGitis) with respiratory involvement.

Case Report: This study describes five cases of BCGitis in males, with a median age of 71years [range: 66-77years] having undergone ofloxacin prophylaxis during their BCG therapy for a non-invasive bladder tumor (grade pT1a).

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Advancements in immunotherapy in the perioperative setting have revolutionised the treatment of resectable nonsmall cell lung cancer (NSCLC). Here we present the methodology and results of the clinical trial CheckMate 816 demonstrating the benefit of neoadjuvant therapy with nivolumab plus chemotherapy compared with chemotherapy alone. Furthermore, this article discusses the implications for future practice in resectable NSCLC and the need for future research.

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Characterization of anatomical variations of the nasal cavity in a subset of European patients and their impact on intranasal drug delivery.

Int J Pharm

December 2024

INSERM, Centre d'Etude des Pathologies Respiratoires (CEPR), UMR 1100, 37032 Tours, France; Université de Tours, Faculté de Médecine, 37032 Tours, France; DTF-aerodrug, Faculté de Médecine, 37032 Tours, France; Department of DTFmedical, 42003 Saint Etienne, France. Electronic address:

Article Synopsis
  • Anatomical 3D-printed nasal casts are important for studying how drugs are delivered inside the nose and provide unique preclinical data not available from animal studies.
  • The study analyzed CT scans from 98 patients, revealing anatomical differences in the nasal cavity and identifying three distinct nasal geometry groups, leading to the creation of representative 3D models.
  • The research demonstrated that these anatomical variations significantly impact how well different medical devices deliver drugs, especially with nasal sprays and nebulizers, highlighting the need for diverse models to assess drug effectiveness in different populations.
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Influenza A virus (IAV) is one of the leading causes of respiratory infections. The lack of efficient anti-influenza therapeutics requires a better understanding of how IAV interacts with host cells. Alveolar macrophages are tissue-specific macrophages that play a critical role in lung innate immunity and homeostasis, yet their role during influenza infection remains unclear.

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Introduction: First-line oxygenation strategy in patients with acute hypoxaemic respiratory failure consists in standard oxygen or high-flow nasal oxygen therapy. Clinical practice guidelines suggest the use of high-flow nasal oxygen rather than standard oxygen. However, findings remain contradictory with a low level of certainty.

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Administration of airborne pathogens in non-human primates.

Inhal Toxicol

December 2024

Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IMVA-HB/IDMIT), Université Paris-Saclay, Fontenay-aux-Roses, France.

Purpose: Airborne pathogen scan penetrate in human respiratory tract and can cause illness. The use of animal models to predict aerosol deposition and study respiratory disease pathophysiology is therefore important for research and a prerequisite to test and study the mechanism of action of treatment. NHPs are relevant animal species for inhalation studies because of their similarities with humans in terms of anatomical structure, respiratory parameters and immune system.

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Article Synopsis
  • Neutrophil subsets with regulatory properties are often seen as harmful to immune responses against tumors and infections, but new findings suggest otherwise in cases of severe viral respiratory infections (VRI).
  • A significant population of neutrophils expressing programmed death-ligand 1 (PD-L1) was identified in humans and mice with VRI, exhibiting strong regulatory functions but diminished antimicrobial capabilities.
  • Depleting these PD-L1 neutrophils or blocking their function during VRI led to worse outcomes, indicating that they play a crucial role in managing inflammation and could be potential targets for future treatments.
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Therapeutic antibodies (Ab) have revolutionized the management of multiple illnesses including respiratory tract infections (RTIs). However, anti-infectious Ab displayed several limitations including antigen restrictiveness, narrowed therapeutic windows, and limited dose in the vicinity of the target when delivered by parenteral routes. Strategies enhancing further Ab-dependent containment of infection are currently needed.

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Purpose: The aim of this study was to compare the effect of a pressure-controlled strategy allowing non-synchronised unassisted spontaneous ventilation (PC-SV) to a conventional volume assist-control strategy (ACV) on the outcome of patients with acute respiratory distress syndrome (ARDS).

Methods: Open-label randomised clinical trial in 22 intensive care units (ICU) in France. Seven hundred adults with moderate or severe ARDS (PaO/FiO < 200 mmHg) were enrolled from February 2013 to October 2018.

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Innate immune response in acute critical illness: a narrative review.

Ann Intensive Care

September 2024

Service de Médecine Intensive Réanimation, CHRU Tours, Tours, France.

Background: Activation of innate immunity is a first line of host defense during acute critical illness (ACI) that aims to contain injury and avoid tissue damages. Aberrant activation of innate immunity may also participate in the occurrence of organ failures during critical illness. This review aims to provide a narrative overview of recent advances in the field of innate immunity in critical illness, and to consider future potential therapeutic strategies.

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Article Synopsis
  • Mucormycosis, a severe fungal infection highlighted by the WHO, was studied in France from 2012 to 2022, revealing significant trends in epidemiology and mortality factors.
  • Out of 550 cases, key underlying conditions included hematological malignancies (65.1%), with pulmonary infections most common (52.4%) and substantial seasonal variations suggesting more cases in autumn.
  • The study linked the rise in PCR diagnostic methods to improved patient outcomes, highlighting that age, ICU diagnosis, and hematological malignancies increased mortality, while diagnosis after 2015 and surgical interventions decreased it.
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Transcranial doppler ultrasound for the diagnosis of large vessel occlusion in patients with acute ischemic stroke: A systematic review.

Clin Neurol Neurosurg

October 2024

Clinical Investigation Center (CIC), 1415, INSERM, Department of Interventional Neuroradiology, Tours University Hospital, Tours, France. Electronic address:

Article Synopsis
  • Transcranial Doppler (TCD) ultrasound shows potential for quickly diagnosing large vessel occlusion (LVO) in patients with suspected acute ischemic stroke (AIS).
  • A systematic review analyzed 170 studies, narrowing down to 7 that included 2260 patients, with findings showing TCD-derived biomarkers have high accuracy (85.9% to 99.2%) for diagnosing LVO.
  • TCD appears effective and cost-efficient for improving stroke management, despite some limitations in data acquisition from certain patients.
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Article Synopsis
  • * Current treatments for eumycetoma, largely relying on antifungal drugs and surgery, have low success rates and high chances of relapse.
  • * Researchers have synthesized 47 new chemical compounds that show better effectiveness and lower toxicity than existing treatments, particularly one compound that performed similarly to the standard drug itraconazole, suggesting they could be safer options for treating eumycetoma.
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Pharmacological induction of the hypoxia response pathway in Huh7 hepatoma cells limits proliferation but increases resilience under metabolic stress.

Cell Mol Life Sci

July 2024

CIRI, Centre International de Recherche en Infectiologie, Team Viral Infection, Metabolism and Immunity, Univ Lyon, Inserm, U1111, CNRS, UMR5308, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, 69007, Lyon, France.

The hypoxia response pathway enables adaptation to oxygen deprivation. It is mediated by hypoxia-inducible factors (HIF), which promote metabolic reprogramming, erythropoiesis, angiogenesis and tissue remodeling. This led to the successful development of HIF-inducing drugs for treating anemia and some of these molecules are now in clinic.

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Cysteine cathepsins constitute the largest cathepsin family, with 11 proteases in human that are present primarily within acidic endosomal and lysosomal compartments. They are involved in the turnover of intracellular and extracellular proteins. They are synthesized as inactive procathepsins that are converted to mature active forms.

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Aerosolized Antibiotic Therapy in Mechanically Ventilated Patients.

Am J Respir Crit Care Med

September 2024

Division of Respiratory Care, Department of Cardiopulmonary Sciences, Rush University, Chicago, Illinois.

Delivering antibiotics directly to the respiratory tract through inhalation to address lung infections has garnered clinical and scientific interest for decades, given the potential favorable pharmacokinetic profile of this administration route. Among critically ill patients, the burden of healthcare-associated pulmonary infections particularly drove continued interest in delivering inhaled antibiotics to intubated patients. We present a concise overview of the existing rationale and evidence and provide guidance for implementing inhaled antibiotics among ventilated critically ill patients, emphasizing insights from recent literature.

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Inadequate intensive care physician supply in France: a point-prevalence prospective study.

Ann Intensive Care

June 2024

Service de Réanimation Médico-Chirurgicale, CH Le Mans, Le Mans, France.

Background: The COVID-19 pandemic has highlighted the importance of intensive care units (ICUs) and their organization in healthcare systems. However, ICU capacity and availability are ongoing concerns beyond the pandemic, particularly due to an aging population and increasing complexity of care. This study aimed to assess the current and future shortage of ICU physicians in France, ten years after a previous evaluation.

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Population pharmacokinetics of mycophenolate in patients treated for interstitial lung disease (EVER-ILD study).

Fundam Clin Pharmacol

October 2024

CHRU de Tours, Service de Pneumologie et d'Explorations Fonctionnelles Respiratoires, Tours, France.

Article Synopsis
  • Mycophenolate mofetil (MMF) is used to treat interstitial lung disease (ILD), but its pharmacokinetics in this context weren't previously known. This study aimed to describe the variability of MPA pharmacokinetics in ILD patients using population modeling.
  • MPA levels were measured in 27 ILD patients over an 8-hour period after administering 1000 mg MMF twice daily, and the best fit for its pharmacokinetics was a two-compartment model influenced by factors like body weight and renal function.
  • This research represents the first exploration of MPA pharmacokinetics in ILD and suggests that MPA behaves similarly to other applications, warranting further investigation.
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Neutrophils can be beneficial or deleterious during tuberculosis (TB). Based on the expression of MHC-II and programmed death ligand 1 (PD-L1), we distinguished two functionally and transcriptionally distinct neutrophil subsets in the lungs of mice infected with mycobacteria. Inflammatory [MHC-II, PD-L1] neutrophils produced inflammasome-dependent IL-1β in the lungs in response to virulent mycobacteria and "accelerated" deleterious inflammation, which was highly exacerbated in IFN-γR mice.

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High-resolution computed tomography (HRCT) may lack sensitivity for the early detection of interstitial lung disease associated with systemic sclerosis (SSc-ILD). Lung ultrasound is an emerging technique for the diagnosis of SSc-ILD. This cross-sectional study aimed to describe the prevalence of ultrasound interstitial syndrome in SSc patients with normal HRCT and pulmonary function tests (PFT).

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