Efficacy and tolerability of a custom-made Narval mandibular repositioning device for the treatment of obstructive sleep apnea: ORCADES study 2-year follow-up data.

Objective/background: Mandibular repositioning device (MRD) therapy is an alternative to continuous positive airway pressure (CPAP). The Orkney Complex Disease Study-ORCADES study is assessing the long-term efficacy and tolerability of MRD therapy in obstructive sleep apnoea syndrome (OSAS); two-year follow-up data are presented.

Patients/methods: OSAS patients who refused or were noncompliant with CPAP were fitted with a custom-made computer-aided design/computer-aided manufacturing (CAD/CAM) bi-block MRD (ResMed, Narval CC™); mandibular advancement was individually titrated.

Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d'Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies.

Background: The French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients.

Results: The guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology.

Bilateral hypoglossal nerve stimulation for treatment of adult obstructive sleep apnoea.

Background And Aim: Hypoglossal nerve stimulation (HNS) decreases obstructive sleep apnoea (OSA) severity genioglossus muscle activation and decreased upper airway collapsibility. This study assessed the safety and effectiveness at 6 months post-implantation of a novel device delivering bilateral HNS a small implanted electrode activated by a unit worn externally, to treat OSA: the Genio™ system.

Methods: This prospective, open-label, non-randomised, single-arm treatment study was conducted at eight centres in three countries (Australia, France and the UK).

Effect of Postextubation High-Flow Nasal Oxygen With Noninvasive Ventilation vs High-Flow Nasal Oxygen Alone on Reintubation Among Patients at High Risk of Extubation Failure: A Randomized Clinical Trial.

Importance: High-flow nasal oxygen may prevent postextubation respiratory failure in the intensive care unit (ICU). The combination of high-flow nasal oxygen with noninvasive ventilation (NIV) may be an optimal strategy of ventilation to avoid reintubation.

Objective: To determine whether high-flow nasal oxygen with prophylactic NIV applied immediately after extubation could reduce the rate of reintubation, compared with high-flow nasal oxygen alone, in patients at high risk of extubation failure in the ICU.

Intra-oral trigeminal-mediated sensations influencing taste perception: A systematic review.

Food perception is a multimodal sensation which implies cross-modal interplays. Tactile, thermal, painful and kinaesthetic stimuli arising from food intake may impact on flavour perception, especially taste perception. The influence of oral somatosensory signals on food taste perception remains unclear.

Contribution of endobronchial ultrasound elastography to the characterization of mediastinal lymphadenopathy: A single-center, prospective, observational study.

Background: Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a reliable technique providing high diagnostic yield in mediastinal lymphadenopathy. However, mediastinoscopy is sometimes necessary to eliminate false-negative results. Elastography is a recent technique that can be combined with EBUS to evaluate the elasticity and consequently the nature of a tissue.

Center effect in intubation risk in critically ill immunocompromised patients with acute hypoxemic respiratory failure.

Background: Acute respiratory failure is the leading reason for intensive care unit (ICU) admission in immunocompromised patients, and the need for invasive mechanical ventilation has become a major clinical endpoint in randomized controlled trials (RCTs). However, data are lacking on whether intubation is an objective criteria that is used unbiasedly across centers. This study explores how this outcome varies across ICUs.

Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation.

Background: Atrial fibrillation is the most frequent sustained arrhythmia. Atrial fibrillation often recurs after restoration of normal sinus rhythm. Antiarrhythmic drugs have been widely used to prevent recurrence.

[Sexual dysfunctions after traumatic brain injury: Systematic review of the literature].

Background: Sexual dysfunction (SD) is common in the general population, up to 50% in women and with no clearly defined prevalence in men but up to 30% in erectile dysfunction. Sexual dysfunctions (SD) are common after a traumatic brain injury (TBI) but remain underrated in clinical practice, yet it is a crucial aspect of the person with consequences for the relationship with the other, psychological wellbeing and quality of life.

Objective: To determine, through a systematic literature review, the epidemiology, assessment tools and treatment of SD in the TBI population.

European Respiratory Society guidelines on long-term home non-invasive ventilation for management of COPD.

Background: While the role of acute non-invasive ventilation (NIV) has been shown to improve outcome in acute life-threatening hypercapnic respiratory failure in COPD, the evidence of clinical efficacy of long-term home NIV (LTH-NIV) for management of COPD is less. This document provides evidence-based recommendations for the clinical application of LTH-NIV in chronic hypercapnic COPD patients.

Materials And Methods: The European Respiratory Society task force committee was composed of clinicians, methodologists and experts in the field of LTH-NIV.

A 2-year multicenter, observational, prospective, cohort study on extracorporeal CO removal in a large metropolis area.

Background: Extracorporeal carbon dioxide removal (ECCOR) is a promising technique for the management of acute respiratory failure, but with a limited level of evidence to support its use outside clinical trials and/or data collection initiatives. We report a collaborative initiative in a large metropolis.

Methods: To assess on a structural basis the rate of utilization as well as efficacy and safety parameters of 2 ECCOR devices in 10 intensive care units (ICU) during a 2-year period.

Automatic Sleep Stages Classification Combining Semantic Representation and Dynamic Expert System.

Interest in sleep has been growing in the last decades, considering its benefits for well-being, but also to diagnose sleep troubles. The gold standard to monitor sleep consists of recording the course of many physiological parameters during a whole night. The human interpretation of resulting curves is time consuming.

High-flow nasal oxygen therapy alone or with non-invasive ventilation in immunocompromised patients admitted to ICU for acute hypoxemic respiratory failure: the randomised multicentre controlled FLORALI-IM protocol.

Introduction: Non-invasive ventilation (NIV) is recommended as first-line therapy in respiratory failure of critically ill immunocompromised patients as it can decrease intubation and mortality rates as compared with standard oxygen. However, its recommendation is only conditional. Indeed, the use of NIV in this setting has been challenged recently based on results of trials finding similar outcomes with or without NIV or even deleterious effects of NIV.

Importance of Early Diagnosis and Care in Knee Dislocations Associated with Vascular Injuries.

Background: Arterial injury secondary to acute knee dislocation (KD) is a rare but devastative complication. The aim of this study is to evaluate functional sequelae and factors of poor prognosis.

Methods: A retrospective monocentric series of consecutive KD with acute ischemia by popliteal artery injury was analyzed between 2005 and 2017.

[Adolescent obstructive sleep apnoea syndrome: Characteristics and treatment].

Although the prevalence of the obstructive sleep apnoea syndrome (OSAS) is high in adolescents, studies pertaining to adolescent OSAS are less numerous than childhood studies. Cases of adolescent OSAS may consist of residual OSAS after adenotonsillectomy, but most often are de novo cases. Major pathophysiological factors are weight excess or even high-grade obesity, and the association of upper airway narrowing and tonsillar hypertrophy (pharyngeal, palatal or even lingual).

Impact of emergency physician experience on decision-making in patients with suspected community-acquired pneumonia and undergoing systematic thoracic CT scan.

Objectives: To determine whether the impact of a thoracic CT scan on community-acquired pneumonia (CAP) diagnosis and patient management varies according to emergency physician's experience (≤10 vs >10 years).

Methods: Early thoracic CT Scan for Community-Acquired Pneumonia at the Emergency Department is an interventional study conducted from November 2011 to January 2013 in four French emergency departments, and included suspected patients with CAP. We analysed changes in emergency physician CAP diagnosis classification levels before and after CT scan; and their agreement with an adjudication committee.

Physiological Validation of an Airborne Ultrasound Based Surface Motion Camera for a Contactless Characterization of Breathing Pattern in Humans.

Characterizing the breathing pattern in naturally breathing humans brings important information on respiratory mechanics, respiratory muscle, and breathing control. However, measuring breathing modifies breathing (observer effect) through the effects of instrumentation and awareness: measuring human breathing under true ecological conditions is currently impossible. This study tested the hypothesis that non-contact vibrometry using airborne ultrasound (SONAR) could measure breathing movements in a contactless and invisible manner.

Atypical Presentation of Bacteremia in Older Patients Is a Risk Factor for Death.

Background: The absence of fever in bacteremia in patients who are older is known to delay diagnosis. Our objective was to determine whether atypical presentation was associated to mortality as a result of bacteremia in this patient cohort as well as possible factors associated with this atypical presentation.

Methods: We conducted an observational prospective study in 2 French university hospitals in 2016-2017 including patients ages ≥75 years with bacteremia.

Increased prevalence of granulovacuolar degeneration in C9orf72 mutation.

Granulovacuolar degeneration (GVD) is usually found in Alzheimer's disease (AD) cases or in elderly individuals. Its severity correlates positively with the density of neurofibrillary tangles (NFTs). Mechanisms underlying GVD formation are unknown.

Pulmonary Hypertension and Exercise.

Cardiopulmonary exercise testing can be a useful tool for clinicians working with pulmonary hypertension (PH) patients. Exercise magnifies numerous cardiopulmonary decompensations, which can help inform diagnoses, assess degrees of physical impairment, evaluate exertional dyspnea, and estimate prognoses for PH patients. Supervised exercise training also holds promise in PH, because it is safe for patients and feasible and may improve key prognostic outcomes that relate to improvements in quality of life and survival.