Éditeur(s) : HAL CCSD John Libbey Eurotext
Résumé : International audience
ISSN: 1635-0421

hal-01118630
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118630
DOI : 10.1684/ers.2012.0511

Éditeur(s) : HAL CCSD Oxford University Press (OUP)
Résumé : International audience
OBJECTIVES: Tracheobronchial stenosis (TBS) is noted in 12-23% of patients with granulomatosis with polyangiitis (GPA), and includes subglottic stenosis and bronchial stenosis. We aimed to analyse the endoscopic management of TBS in GPA and to identify factors associated with the efficacy of endoscopic interventions. METHODS: We conducted a French nationwide retrospective study that included 47 patients with GPA-related TBS. RESULTS: Compared with patients without TBS, those with TBS were younger, more frequently female and had less frequent kidney, ocular and gastrointestinal involvement and mononeuritis multiplex. Endoscopic procedures included 137 tracheal and 50 bronchial interventions, mainly endoscopic dilatation, local steroid injection and conservative laser surgery, and less frequently stenting. After the first endoscopic procedure, the cumulative incidence of endoscopic treatment failure was 49% at 1 year, 70% at 2 years and 80% at 5 years. Factors significantly associated with a higher cumulative incidence of treatment failure were a shorter time from GPA diagnosis to endoscopic procedure [hazard ratio (HR) 1.08 (95% CI 1.01, 1.14); P = 0.01] and a bronchial stenosis [HR 1.96 (95% CI 1.28, 3.00); P = 0.002]. A prednisone dose ≥30 mg/day at the time of the procedure was associated with a lower cumulative incidence of treatment failure [HR 0.53 (95% CI 0.31, 0.89); P = 0.02]. CONCLUSION: TBS represents severe and refractory manifestations with a high rate of restenosis. High-dose systemic CSs at the time of the procedure and increased time from GPA diagnosis to bronchoscopic intervention are associated with a better event-free survival. In contrast, bronchial stenoses are associated with a higher rate of restenosis than subglottic stenosis.
ISSN: 1462-0324

hal-01155105
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01155105
DOI : 10.1093/rheumatology/kev129
PUBMED : 26001634

Éditeur(s) : HAL CCSD Intech
Résumé : International audience
The socio-economic status (SES) of populations has an influence on the incidence or mortality rates of numerous health outcomes, among which respiratory diseases (Prescott et al., 2003; Ellison-Loschmann et al., 2007). Considering asthma, the possible contribution of SES to overall prevalence –regardless of asthma severity-, remains controversial in industrialized countries. Several studies indicate that allergic asthma is more prevalent in more well-off populations whereas the non-allergic forms of asthma are more common in the deprived ones (Cesaroni et al., 2003; Blanc et al., 2006). On the other hand, severe asthma whatever its etiology appears to be more frequent in the latter populations, as compared to the more affluent (Basagana et al., 2004). Risk factors for exacerbations (e.g., passive smoking (Wright Subramanian, 2007), psychosocial stress (Gold & Wright, 2005), cockroach allergens (Kitch et al., 2000), and suboptimal compliance with anti-inflammatory medication (Gottlieb et al., 1995)) are generally more common among people with asthma and low SES than their better-off counterparts. These observations support the hypothesis that some factors more present in deprived populations contribute to asthma exacerbation (Mielck et al., 1996).
Air Pollution

Droits : http://creativecommons.org/licenses/by-nc-nd/
ISBN : 978-953-307-143-5
hal-01118620
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118620
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118620/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118620/file/Ambient%20aire-%20chapter.pdf