Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Alveolar proteinosis (AP) is a rare disease characterized by alveolar accumulation of surfactant components, which impairs gas exchange. AP is classified into three groups: auto-immune AP defined by the presence of plasma autoantibodies anti-GM-CSF, the most frequent form (90 % of all AP); secondary AP, mainly occurring as a consequence of haematological diseases, or following on from toxic inhalation or infections, and genetic AP, which affects almost exclusively children. AP diagnosis is suspected where chest CT-scan demonstrates interstitial lung disease with a crazy paving aspect; and confirmed by bronchoalveolar lavage, which has a milky appearance and contains periodic acid Schiff positive proteinaceous alveolar deposits. The use of surgical lung biopsy to confirm AP is less frequent nowadays. In this context, positive antibodies against GM-CSF indicates an auto-immune etiology of the AP. Concerning management, whole lung lavage is the gold standard therapy. In refractory AP, new treatments are available such as subcutaneous or inhaled GM-CSF supplementation, or rituximab infusions. The clinical course is unpredictable. Spontaneous improvement or even cure can occur, and the 5-year actuarial survival is 95 %. The most frequent complications are infectious etiology.
La protéinose alvéolaire pulmonaire (PAP) est une maladie rare caractérisée par l’accumulation alvéolaire de composants du surfactant qui gêne les échanges gazeux. Les PAP sont séparées en trois groupes : les PAP auto-immunes caractérisées par la présence d’anticorps sériques anti-GM-CSF qui sont les plus fréquentes ; les PAP secondaires à une maladie sous-jacente, le plus souvent hématologique, mais aussi à l’inhalation de toxiques et à des infections ; enfin, les PAP d’origine génétique. Le diagnostic de PAP est évoqué sur le scanner thoracique avec une pneumopathie infiltrante diffuse ayant un aspect classique de crazy paving, puis confirmé par l’aspect laiteux du lavage bronchoalvéolaire, et la présence de matériel lipoprotéinacé PAS positif. La confirmation du diagnostic de PAP par biopsie pulmonaire chirurgicale est désormais rarement nécessaire. La positivité des anticorps sériques anti-GM-CSF signe le caractère auto-immun de la maladie. Le traitement de référence des PAP auto-immunes est le « grand lavage pulmonaire thérapeutique ». En cas de maladie réfractaire, d’autres traitements sont disponibles, tels que le GM-CSF en injection sous-cutanée ou en aérosol et le rituximab. L’évolution de la maladie est imprévisible. Une évolution spontanément favorable ou même une guérison spontanée peuvent survenir et la survie actuarielle à 5 ans est de 95 %. Les principales complications sont infectieuses.
ISSN: 0761-8425

hal-01085907
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01085907/file/Prot%C3%A9inose%20alv%C3%A9olaire%20pulmonaire_accepted.pdf
DOI : 10.1016/j.rmr.2014.08.009

Éditeur(s) : HAL CCSD Publisher : Paris : Baillière [1980-. Latest Publisher : Paris : Elsevier
Résumé : National audience
Pneumocystis jiroveci (anciennement P. carinii) est un champignon opportuniste responsable de pneumopathies chez les patients immunodéprimés. Les pneumocystoses des patients non infectés par le VIH se distinguent des pneumocystoses du sida par des difficultés diagnostiques accrues, et un pronostic plus sombre. Il est donc indispensable de cibler les immunodépressions les plus à risque, qui bénéficieront d’un traitement par triméthoprime-sulfaméthoxazole à faible dose au long cours, très efficace en prophylaxie des pneumocystoses : ainsi, les vascularites des moyens et petits vaisseaux, les hémopathies lymphoïdes B (leucémie lymphoïde chronique ou aiguë, lymphome malin non hodgkinien) et les cancers solides sous corticothérapie prolongée doivent faire envisager cette prophylaxie. À l’inverse, la généralisation de la prophylaxie à l’ensemble des patients porteurs de pathologies inflammatoires sous corticothérapie n’est pas justifiée. La prise en charge des pneumocystoses des patients non infectés par le VIH suit les principes établis pour les pneumocystoses du sida. Le diagnostic de certitude repose sur la mise en évidence de kystes de P. jiroveci sur des prélèvements respiratoires, tandis que la PCR ne permet pas formellement, en 2015, de différencier colonisation et infection. Le traitement repose sur le triméthoprime-sulfaméthoxazole à fortes doses. Par contre, l’intérêt de la corticothérapie adjuvante pour les patients hypoxémiques, parfaitement documenté au cours du sida, est discuté pour les autres immunodépressions, d’autant que les patients sont en général déjà sous corticoïdes au moment du diagnostic de pneumocystose. Celle-ci est cependant préconisée par plusieurs experts et sociétés savantes, compte tenu du bénéfice démontré sur la morbi-mortalité au cours du sida. Abstract Pneumocystis jiroveci (formerly P. carinii) is an opportunistic fungus responsible for pneumonia in immunocompromised patients. Pneumocystosis in non-HIV-infected patients differs from AIDS-associated pneumocystosis in mostly two aspects: diagnosis is more difficult, and prognosis is worse. Hence, efforts should be made to target immunocompromised patients at higher risk of pneumocystosis, so that they are prescribed long-term, low-dose, trimethoprime-sulfamethoxazole, highly effective for pneumocystosis prophylaxis. Patients at highest risk include those with medium and small vessels vasculitis, lymphoproliferative B disorders (chronic or acute lymphocytic leukaemia, non-Hodgkin lymphoma), and solid cancer on long-term corticosteroids. Conversely, widespread use of prophylaxis in all patients carrier of inflammatory diseases on long-term corticosteroids is not warranted. The management of pneumocystosis in non-AIDS immunocompromised patients follows the rules established for AIDS patients. The diagnosis relies on the detection of P. jiroveci cyst on respiratory samples, while PCR does not reliably discriminate infection from colonization, in 2015. High-doses trimethoprim-sulfamethoxazole is, by far, the treatment of choice. The benefit of adjuvant corticosteroid therapy for hypoxic patients, well documented in AIDS patients, has a much lower level of evidence in non-HIV-infected patients, most of them being already on corticosteroid by the time of pneumocystosis diagnosis anyway. However, based on its striking impact on morbi-mortality in AIDS patients, adjuvant corticosteroid is recommended in hypoxic, non-HIV-infected patients with pneumocystosis by many experts and scientific societies
ISSN: 0248-8663

hal-01237080
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01237080
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01237080/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01237080/file/Pneumocystose%20chez%20les%20patients%20immunod%C3%A9prim%C3%A9s%20non%20infect%C3%A9s%20par%20le%20VIH.pdf
DOI : 10.1016/j.revmed.2015.10.002

Éditeur(s) : HAL CCSD Wiley-Blackwell
Résumé : International audience
Respiratory illnesses have been linked to children's exposures to water-damaged homes. Therefore, understanding the microbiome in water-damaged homes is critical to preventing these illnesses. Few studies have quantified bacterial contamination, especially specific species, in water-damaged homes. We collected air and dust samples in twenty-one low-mold homes and twenty-one high-mold homes. The concentrations of three bacteria/genera, Stenotrophomonas maltophilia, Streptomyces sp., and Mycobacterium sp., were measured in air and dust samples using quantitative PCR (QPCR). The concentrations of the bacteria measured in the air samples were not associated with any specific home characteristic based on multiple regression models. However, higher concentrations of S. maltophilia in the dust samples were associated with water damage, that is, with higher floor surface moisture and higher concentrations of moisture-related mold species. The concentrations of Streptomyces and Mycobacterium sp. had similar patterns and may be partially determined by human and animal occupants and outdoor sources of these bacteria.
Indoor Air

hal-00877905
https://hal.archives-ouvertes.fr/hal-00877905
DOI : 10.1111/ina.12035
PUBMED : 23397905

Éditeur(s) : HAL CCSD
Résumé : International audience
INTRODUCTION: Auto-immune pulmonary alveolar proteinosis is a rare disorder characterized by the accumulation of surfactant proteins in the alveoli. CASE REPORT: We report a case of a 41-year-old smoker, presenting initially with acute respiratory failure. Whole lung lavages were effective initially but only for a few weeks. GM-CSF subcutaneous injections were not effective, and then plasmapheresis were tried. CONCLUSION: This is the fifth report of the use of this treatment in auto-immune pulmonary alveolar proteinosis. Plasmapheresis was not effective in our patient.
Revue Des Maladies Respiratoires

hal-01526427
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01526427
DOI : 10.1016/j.rmr.2016.06.002
PUBMED : 27743827

Éditeur(s) : HAL CCSD
Résumé : International audience
Au cours de l'année 2014, de nouvelles données publiées dans la BPCO vont nous permettre d'améliorer la prise en charge de nos patients. Le retrait progressif des corticoïdes inhalés (CSI) sous couvert d'une double bronchodilatation en traitement de fond (étude WISDOM) n'a pas été accompagné d'une majoration des exacerbations. Une étude transversale rétrospective canadienne a montré l'intérêt tout particulier des CSI chez les patients de plus de 65 ans. Un travail soulignait l'intérêt probable de la corticothérapie systémique lors des exacerbations traitées par ventilation mécanique, invasive ou non. L'étude COLUMBUS a confirmé l'intérêt des macrolides avec une indication privilégiée de l'azithromycine au long cours chez les patients BPCO présentant des exacerbations fréquentes (≥3/an), ayant un traitement inhalé maximaliste (trithérapie) et sevrés du tabac. Le timing de la réhabilitation respiratoire a été précisé et il semblerait qu'elle ne doive pas être initiée à la phase aiguë (i.e., avant la fin de l'exacerbation chez le patient hospitalisé), ce qui ne remet pas en cause l'intérêt démontré de la réhabilitation respiratoire initiée précocement après exacerbation. Enfin, l'étude STATCOPE retire toute place aux statines dans le traitement de fond des patients atteints de BPCO post-tabagique sans comorbidité cardiovasculaire. Tous ces travaux sont détaillés dans ce manuscrit. , Abstract In 2014 new data on COPD were published that allow us to improve the management of patients. The gradual withdrawal of inhaled corticosteroids (ICS) under the cover of double bronchodilatation in baseline treatment (WISDOM study) was not accompanied by an increase in exacerbations. A Canadian retrospective cross sectional study has shown the particular role of ICS in patients over 65 years old. A study underlined the probable role of systemic corticosteroids during exacerbations treated by mechanical ventilation, invasive or not. The COLUMBUS study confirmed the role of macrolides, in particular azithromycin, in the long term treatment of patients with COPD who have frequent exacerbations (3 or more per year) despite taking maximal inhaled therapy and stopping smoking. The timing of pulmonary rehabilitation has been clarified and it seems that it should not be started in the acute phase (i.e. before the end of the exacerbation in hospitalized patients). This questions the demonstrated role of initiation of pulmonary rehabilitation soon after an exacerbation. Finally, the STATCOPE study removes any place for statins in the baseline treatment of COPD patients without cardiovascular comorbidity. All these studies are detailed in this paper.
Mission CPLF 2015. Congrès de Pneumologie de Langue Française
Denver, United States

hal-01198647
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01198647
DOI : 10.1016/S1877-1203(15)30036-7

Éditeur(s) : HAL CCSD BMJ Publishing Group
Résumé : International audience
OBJECTIVES: Social position and social mobility are associated with cancer incidence and mortality, yet little is known about their association with mediating factors such as occupational exposures to carcinogens. Our aim was to assess the association between the type of professional trajectory and multiple occupational exposure profiles. METHOD: Data were extracted from the Giscop93 study (n = 1 009), which is a cohort of cancer patients with (mainly) respiratory tumours. Job histories were reconstructed through interview, then a multi-disciplinary expert group examined the probability of occupational exposure to a list of 54 potentially carcinogenic agents. The typology of professional trajectories was built based on employment stability, employment continuity, job qualification trend, and multiple skills through Multiple Correspondence Analysis followed by Ascending Hierarchical Classification. Association with multiple-exposure profiles was then assessed through multiple logistic regression. RESULTS: Men and women differed in terms of predominant job category over the lifecourse (68,2% of blue-collar-workers among men, 57,3% of employees among women, p extless 0.0001). Professional trajectories were grouped in four classes as "stable qualified, employee" (21,3%), "stable manual, independent blue-collar-worker" (24,4%), "stable tiring, no gain in qualification" (30,5%), and "very unstable, precarious" (23,8%). Among men, the last two categories were associated with exposure to at least five different occupational carcinogens (ORstable_tiring/stable_qualified=2,0 [1,3;3,1], ORvery_unstable/stable_qualified=2,6 [1,6;4,2]). No such association was found among women. CONCLUSIONS: The association found between the type of professional trajectory and multiple occupational exposures among men should be replicated among people not suffering cancer. Forthcoming analysis will investigate the gendered differences observed.
ISSN: 1351-0711

hal-01063899
https://hal.archives-ouvertes.fr/hal-01063899
DOI : 10.1136/oemed-2014-102362.266

Éditeur(s) : HAL CCSD BMJ Publishing Group
Résumé : International audience
OBJECTIVE: To investigate the role of occupational exposure to chlorinated solvents in lung cancer aetiology. METHODS: ICARE (Investigation of occupational and environmental CAuses of REspiratory cancers) is a French, multicentre, population-based, case-control study. Information on the lifelong work history of 2926 cases and 3555 controls was collected using standardised questionnaires. Occupational exposures were assessed using job-exposure matrices for five chlorinated solvents. Solvents were studied separately and in combinations. ORs were computed using unconditional logistic regression models adjusted for classic risk factors, including a history of cigarette smoking and exposure to asbestos. Adjustment for socioeconomic status (SES) was also made. RESULTS: After adjustment for exposure to asbestos, we observed a positive, statistically significant association with lung cancer for men and women exposed to a combination of perchloroethylene (PCE), trichloroethylene and dichloromethane (DCM). Further adjustment for SES slightly decreased this association. In contrast, no statistically significant associations were found for other solvent combinations. CONCLUSIONS: These results suggest that exposure to PCE may constitute a risk factor for lung cancer, especially among women, who seem to have a higher prevalence of exposure than men.
ISSN: 1351-0711

hal-01063908
https://hal.archives-ouvertes.fr/hal-01063908
DOI : 10.1136/oemed-2014-102182
PUBMED : 25015929

Éditeur(s) : HAL CCSD American Thoracic Society
Résumé : International audience
ISSN: 1073-449X

hal-00873182
https://hal.archives-ouvertes.fr/hal-00873182
DOI : 10.1164/ajrccm.186.9.930
PUBMED : 23118088

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
The underlying cause of morbidity in cystic fibrosis (CF) is the decline in lung function, which results in part from chronic inflammation. Inflammation and infection occur early in infancy in CF and the role of innate immune defense in CF has been highlighted in the last years. Once thought simply to be consumers of bacteria, macrophages have emerged as highly sensitive immune cells that are located at the balance point between inflammation and resolution of this inflammation in CF pathophysiology. In order to assess the potential role of macrophage in CF, we review the evidence that: (1) CF macrophage has a dysregulated inflammatory phenotype; (2) CF macrophage presents altered phagocytosis capacity and bacterial killing; and (3) lipid disorders in CF macrophage affect its function. These alterations of macrophage weaken innate defense of CF patients and may be involved in CF disease progression and lung damage.
ISSN: 1569-1993

hal-01560280
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560280
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560280/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01560280/file/Chouly-The%20impact%20of%20impaired%20macrophage%20functions.pdf
DOI : 10.1016/j.jcf.2016.10.011

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Because earthworms sustain soil functioning and fertility, there is a need to advance the knowledge of their adaptation potential to chemicals in anthropogenic landscapes. Our hypothesis is that there is acclimation to organic chemicals (pesticides) in earthworms that durably persist under conventional farming in anthropogenic landscapes. The adaptation capability of two populations of earthworms (Aporectodea caliginosa) having a different chemical exposure history, - one originating from 20 years of organic farming (naïve population) and another from 20 years of conventional farming (pre-exposed population) - to cope with soil organic pollutant (Opus®, epoxiconazole a worldwide used fungicide) were investigated. Several complementary metabolic and energetic endpoints were followed, and cast production was assessed as a behavioural biomarker related to earthworms ecological role for the soil. Basal metabolism reflected by respiration rate was increased in both fungicide-exposed worms compared to controls. Glycogen resources were decreased in the same proportion in the two populations but more rapidly for the naïve (7 days) than for the pre-exposed population (28 days). Soluble protein and most amino-acids contents increased in the pre-exposed population only, suggesting a detoxification mechanism. Metabolomic profiles showed a cut-off between fungicide-exposed and control groups in the pre-exposed earthworms only, with an increase in most of the metabolites. Exposure to a low dose of epoxiconazole increased cast production of pre-exposed earthworms, and this resulted in an increase in pesticide disappearance. As far as we know, this is the first study which evidenced there is an acclimation to an agricultural chemical in earthworms derived from conventional farming that also relates to a change in their burrowing behaviour, and for which larger consequences for the soil ecosystem need to be addressed. This original finding is of major interest in the frame of ecosystem resilience to global changes. Whether this physiological adaptation is a general pattern of response against fungicides or other pesticides would need to be confirmed with other molecules and agricultural contexts.
Soil Biology and Biochemistry

hal-01005821
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01005821
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01005821/document
DOI : 10.1016/j.soilbio.2014.01.032

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
ISSN: 0168-1923

hal-01086595
https://hal-agroparistech.archives-ouvertes.fr/hal-01086595
DOI : 10.1016/j.agrformet.2009.06.020

Éditeur(s) : HAL CCSD Springer Verlag
Résumé : International audience
Peel splitting is a major physiological disorder affecting post-harvest banana quality. This phenomenon occurs only 3-6 days after ripening induction in specific cultivars such as cv. 925 when stored in saturating humidity conditions. In these conditions, Cavendish cultivars (Grande Naine, cv. GN) are not susceptible to splitting. Cvs. 925 and GN were thus investigated to detect possible determinants associated with splitting. Splitting intensity was tentatively found to be associated with an inverse water flux at high relative humidity (RH) through an osmotic peel to pulp water flux resulting from the higher sugar content in the pulp than in the peel. Rheological properties were measured, and although the peel resistance and elasticity in cv. 925 were surprisingly higher than in cv. GN, saturating humidity conditions (100 % RH) substantially reduced the peel resistance. However, the peel epicuticular wax in cv. 925 was clearly thinner than that in cv. GN, thus leading to limitation of peel hydration in cv. GN. Peel splitting in cv. 925 was also associated with a boost in respiration, an increase in oxidative stress markers (H2O2), resulting in an increase in cellular damage markers (MDA, PEL). Overall, our results suggest that peel splitting at high RH in cv. 925 is related to fast decrease peel water content and the induction of high oxidative stress damage.
ISSN: 0137-5881

hal-01545907
https://hal.archives-ouvertes.fr/hal-01545907
DOI : 10.1007/s11738-016-2253-0

Éditeur(s) : HAL CCSD Wiley
Résumé : 1. Resource control over abundance, structure and functional diversity of soil microbial communities is a key determinant of soil processes and related ecosystem functioning. Copiotrophic organisms tend to be found in environments which are rich in nutrients, particularly carbon, in contrast to oligotrophs, which survive in much lower carbon concentrations. We hypothesized that microbial biomass, activity and community structure in nutrient-poor soils of an Amazonian rain forest are limited by multiple elements in interaction. We tested this hypothesis with a fertilization experiment by adding C (as cellulose), N (as urea) and P (as phosphate) in all possible combinations to a total of 40 plots of an undisturbed tropical forest in French Guiana. After 2years of fertilization, we measured a 47% higher biomass, a 21% increase in substrate-induced respiration rate and a 5-fold higher rate of decomposition of cellulose paper discs of soil microbial communities that grew in P-fertilized plots compared to plots without P fertilization. These responses were amplified with a simultaneous C fertilization suggesting P and C colimitation of soil micro-organisms at our study site. Moreover, P fertilization modified microbial community structure (PLFAs) to a more copiotrophic bacterial community indicated by a significant decrease in the Gram-positive:Gram-negative ratio. The Fungi:Bacteria ratio increased in N fertilized plots, suggesting that fungi are relatively more limited by N than bacteria. Changes in microbial community structure did not affect rates of general processes such as glucose mineralization and cellulose paper decomposition. In contrast, community level physiological profiles under P fertilization combined with either C or N fertilization or both differed strongly from all other treatments, indicating functionally different microbial communities. While P appears to be the most critical from the three major elements we manipulated, the strongest effects were observed in combination with either supplementary C or N addition in support of multiple element control on soil microbial functioning and community structure. We conclude that the soil microbial community in the studied tropical rain forest and the processes it drives is finely tuned by the relative availability in C, N and P. Any shifts in the relative abundance of these key elements may affect spatial and temporal heterogeneity in microbial community structure, their associated functions and the dynamics of C and nutrients in tropical ecosystems.
ISSN: 0269-8463

hal-01204229
https://hal.archives-ouvertes.fr/hal-01204229
DOI : 10.1111/1365-2435.12329
PRODINRA : 311389

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Parapneumonic pleural effusions represent the main cause of pleural infections. Their incidence is constantly increasing. Although by definition they are considered to be a “parapneumonic” phenomenon, the microbial epidemiology of these effusions differs from pneumonia with a higher prevalence of anaerobic bacteria. The first thoracentesis is the most important diagnostic stage because it allows for a distinction between complicated and non-complicated parapneumonic effusions. Only complicated parapneumonic effusions need to be drained. Therapeutic evacuation modalities include repeated therapeutic thoracentesis, chest tube drainage or thoracic surgery. The choice of the first-line evacuation treatment is still controversial and there are few prospective controlled studies. The effectiveness of fibrinolytic agents is not established except when they are combined with DNase. Antibiotics are mandatory; they should be initiated as quickly as possible and should be active against anaerobic bacteria except for in the context of pneumococcal infections. There are few data on the use of chest physiotherapy, which remains widely used. Mortality is still high and is influenced by underlying comorbidities.
Les épanchements pleuraux parapneumoniques représentent la principale étiologie des pleurésies infectieuses. Leur incidence est en constante augmentation. Bien qu’ils soient qualifiés de « parapneumoniques », l’épidémiologie microbienne est différente de celle des pneumonies avec notamment une plus grande fréquence des germes anaérobies. La ponction pleurale exploratrice représente l’étape diagnostique centrale qui permet de distinguer les épanchements parapneumoniques compliqués et non compliqués. Seuls les épanchements parapneumoniques compliqués doivent faire l’objet d’un traitement évacuateur reposant sur la mise en œuvre de ponctions pleurales répétées (PPR), d’un drainage thoracique ou d’une prise en charge chirurgicale. Le choix de la technique évacuatrice première reste débattu car il existe peu d’études prospectives comparatives. L’utilisation d’agents fibrinolytiques n’a pas fait la preuve de son efficacité sauf lorsqu’ils sont utilisés en association à la DNAse. L’antibiothérapie doit être systématique, précoce et couvrir les germes anaérobies, sauf en cas d’infection à pneumocoque. Il existe peu de données sur la place de la kinésithérapie qui reste largement utilisée. La mortalité est élevée et directement influencée par les comorbidités sous-jacentes.
ISSN: 0761-8425

hal-01117905
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117905
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117905/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01117905/file/Les%20%C3%A9panchements%20pleuraux%20parapneumoniques_accepted.pdf
DOI : 10.1016/j.rmr.2014.12.001

Éditeur(s) : HAL CCSD Wiley
Résumé : The intensification of the hydrological cycle, with an observed and modeled increase in drought incidence and severity, underscores the need to quantify drought effects on carbon cycling and the terrestrial sink. FLUXNET, a global network of eddy covariance towers, provides dense data streams of meteorological data, and through flux partitioning and gap filling algorithms, estimates of net ecosystem productivity (FNEP), gross ecosystem productivity (P), and ecosystem respiration (R). We analyzed the functional relationship of these three carbon fluxes relative to evaporative fraction (EF), an index of drought and site water status, using monthly data records from 238 micrometeorological tower sites distributed globally across 11 biomes. The analysis was based on relative anomalies of both EF and carbon fluxes and focused on drought episodes by biome and climatic season. Globally P was ≈50% more sensitive to a drought event than R. Network-wide drought-induced decreases in carbon flux averaged −16.6 and −9.3 g C m−2 month−1 for P and R, i.e., drought events induced a net decline in the terrestrial sink. However, in evergreen forests and wetlands drought was coincident with an increase in P or R during parts of the growing season. The most robust relationships between carbon flux and EF occurred during climatic spring for FNEP and in climatic summer for P and R. Upscaling flux sensitivities to a global map showed that spatial patterns for all three carbon fluxes were linked to the distribution of croplands. Agricultural areas exhibited the highest sensitivity whereas the tropical region had minimal sensitivity to drought. Combining gridded flux sensitivities with their uncertainties and the spatial grid of FLUXNET revealed that a more robust quantification of carbon flux response to drought requires additional towers in all biomes of Africa and Asia as well as in the cropland, shrubland, savannah, and wetland biomes globally.
ISSN: 1354-1013

hal-01032076
https://hal.archives-ouvertes.fr/hal-01032076
DOI : 10.1111/j.1365-2486.2009.01991.x

Éditeur(s) : HAL CCSD
Résumé : International audience
INTRODUCTION: There are no French guidelines for the management of complicated parapneumonic effusions. A national observational study was carried out to assess the main features of current clinical practice for this condition. MATERIAL AND METHODS: A questionnaire was sent by email to the 1500 members of the Société de Pneumologie de Langue Française (SPLF) between 15th November and 15th December 2012. RESULTS: There were 92 responders, i.e. a response rate of 6%. Of these, 87 physicians mentioned that they were involved in the management of patients with complicated parapneumonic effusions with a median number of cases of 10 per year (IQR: 5-20). Chest tube drainage was the main approach used for pleural fluid aspiration (n=51/87), followed by repeated thoracentesis (n=29/87) and early surgery (1/87). Five physicians answered both chest tube drainage or repeated thoracentesis and one physician either chest tube drainage or early surgery. Pleural fibrinolytics were never used by 20% of physicians, only in case of loculations by 70% and by 10% of respondents in all cases. Only 3 physicians combined fibrinolytics with DNAse. A double antibiotic dose was used by one third of physicians. All the physicians used respiratory physiotherapy during hospitalization and to aid recovery. Follow-up practices were heterogeneous. CONCLUSIONS: The management of complicated parapneumonic effusions varies significantly in France. National guidelines may be helpful to define best practice and aid in its implementation.
Revue Des Maladies Respiratoires

hal-01146851
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01146851
DOI : 10.1016/j.rmr.2015.01.001
PUBMED : 25725981

Éditeur(s) : HAL CCSD American Society for Microbiology
Résumé : International audience
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening infection in immunocompromised patients. Quantitative real-time PCR (qPCR) is more sensitive than microscopic examination for the detection of P. jirovecii but also detects colonized patients. Hence, its positive predictive value (PPV) needs evaluation. In this 4-year prospective observational study, all immunocompromised patients with acute respiratory symptoms who were investigated for PCP were included, totaling 659 patients (814 bronchoalveolar lavage fluid samples). Patients with negative microscopy but positive qPCR were classified through medical chart review as having retained PCP, possible PCP, or colonization, and their clinical outcomes were compared to those of patients with microscopically proven PCP. Overall, 119 patients were included for analysis, of whom 35, 41, and 43 were classified as having retained PCP, possible PCP, and colonization, respectively. The 35 patients with retained PCP had clinical findings similar to those with microscopically proven PCP but lower fungal loads (P extless 0.001) and were mainly non-HIV-infected patients (P extless 0.05). Although the mean amplification threshold was higher in colonized patients, it was not possible to determine a discriminant qPCR cutoff. The PPV of qPCR in patients with negative microscopy were 29.4% and 63.8% when considering retained PCP and retained plus possible PCP, respectively. Patients with possible PCP had a higher mortality rate than patients with retained PCP or colonization (63% versus 3% and 16%, respectively); patients who died had not received co-trimoxazole. In conclusion, qPCR is a useful tool to diagnose PCP in non-HIV patients, and treatment might be better targeted through a multicomponent algorithm including both clinical/radiological parameters and qPCR results.
ISSN: 0095-1137

hal-01063906
https://hal.archives-ouvertes.fr/hal-01063906
DOI : 10.1128/JCM.01480-14
PUBMED : 25009050

Éditeur(s) : HAL CCSD INRA
Résumé : Afin de mesurer en continu la respiration du sol, deux laboratoires de l'INRA ont développé deux systèmes automatiques basés sur des designs et automatismes très similaires. Le choix de la mesure des échanges gazeux s'est porté sur les deux principes bien connus des méthodes dynamiques, à savoir, le système ouvert ou fermé (Field et al. 1989). Ces deux méthodes présentent chacune leurs avantages et leurs inconvénients et chaque équipe a fait ses choix en fonction du matériel disponible, des conditions environnementales de mesure, des budgets ou des techniques maîtrisées. La prise en compte poussée (calculs préalables, vérification a postériori) des problèmes potentiels de mesure rapportés dans la littérature a conduit à réaliser deux systèmes correctement dimensionnés.
ISSN: 0762-7339

hal-01032041
https://hal.archives-ouvertes.fr/hal-01032041

Éditeur(s) : HAL CCSD Wiley
Résumé : International audience
Leaf dark respiration (R-dark) represents an important component controlling the carbon balance in tropical forests. Here, we test how nitrogen (N) and phosphorus (P) affect R-dark and its relationship with photosynthesis using three widely separated tropical forests which differ in soil fertility.R-dark was measured on 431 rainforest canopy trees, from 182 species, in French Guiana, Peru and Australia. The variation in R-dark was examined in relation to leaf N and P content, leaf structure and maximum photosynthetic rates at ambient and saturating atmospheric CO2 concentration.We found that the site with the lowest fertility (French Guiana) exhibited greater rates of R-dark per unit leaf N, P and photosynthesis. The data from Australia, for which there were no phylogenetic overlaps with the samples from the South American sites, yielded the most distinct relationships of R-dark with the measured leaf traits.Our data indicate that no single universal scaling relationship accounts for variation in R-dark across this large biogeographical space. Variability between sites in the absolute rates of R-dark and the R-dark : photosynthesis ratio were driven by variations in N- and P-use efficiency, which were related to both taxonomic and environmental variability.
ISSN: 0028-646X

hal-01559483
https://hal.univ-lorraine.fr/hal-01559483
DOI : 10.1111/nph.13992

Éditeur(s) : HAL CCSD
Résumé :  
absent
ATBC 2008. The Annual Meeting of the Association for Tropical Biology and Conservation
Paramaribo, Suriname

hal-01032189
https://hal.archives-ouvertes.fr/hal-01032189