Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Background: Two antifibrotic drugs, pirfenidone and nintedanib, are approved by the European Medicines Agency and the US Food and Drug Administration for the treatment of idiopathic pulmonary fibrosis (IPF). In this analysis, treatment patterns of European patients with IPF were investigated to understand antifibrotic prescribing and identify unmet needs in IPF treatment practice. Methods: Between February and March 2016, respiratory physicians from France, Germany, Italy, Spain, and the UK participated in an online questionnaire designed to collect information on IPF treatment patterns in patients under their care. Patients were categorized as treated (received approved antifibrotics) or untreated (did not receive approved antifibrotics, but may have received other unapproved therapies). Classification of IPF diagnosis (confirmed/suspected) and severity ('mild'/'moderate'/'severe') for each patient was based on the individual physician's report. Patients' perspectives were not recorded in this study. Results: In total, 290 physicians responded to the questionnaire. Overall, 54% of patients with IPF did not receive treatment with an approved antifibrotic. More patients had a confirmed IPF diagnosis in the treated (84%) versus the untreated (51%) population. Of patients with a confirmed diagnosis, 40% did not receive treatment. The treated population was younger than the untreated population (67 vs 70 years, respectively; p = 0.01), with more frequent multidisciplinary team evaluation (83% vs 57%, respectively; p = 0.01). A higher proportion of untreated patients had forced vital capacity > 80% at diagnosis versus treated patients. Of patients with 'mild' IPF, 71% did not receive an approved antifibrotic versus 41% and 60% of patients with 'moderate' and 'severe' IPF, respectively. Conclusions: Despite the availability of antifibrotic therapies, many European patients with confirmed IPF do not receive approved antifibrotic treatment. Importantly, there appears to be a reluctance to treat patients with 'mild' or 'stable' disease, and instead adopt a 'watch and wait' approach. More education is required to address diagnostic uncertainty, poor understanding of IPF and its treatments, and issues of treatment access. There is a need to increase physician awareness of the benefits associated with antifibrotic treatment across the spectrum of IPF severity.
ISSN: 1471-2466

hal-01616061
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01616061
DOI : 10.1186/s12890-017-0468-5
PUBMED : 28915874

Éditeur(s) : HAL CCSD Lippincott, Williams & Wilkins
Résumé : International audience
Among 103 patients with multidrug-resistant HIV who initiated raltegravir, etravirine, and darunavir/ritonavir-containing regimen in the ANRS 139 TRIO trial, 100 participated in extended follow-up and continued study treatment until week 96. Among them, 87 (87%) received an optimized background therapy including either nucleoside reverse transcriptase inhibitors or enfuvirtide, they were 78 (78%) at week 96. At week 96, 88% achieved durable virologic response (<50 copies/mL). CD4 response was maintained (median change of +150 cells/mm(3)). No major toxicity was reported. This triple drug combination showed sustained efficacy and thus should be strongly considered for patients with multiclass-resistant virus.
ISSN: 1525-4135

hal-00875207
https://hal.archives-ouvertes.fr/hal-00875207
DOI : 10.1097/QAI.0b013e31824bb720
PUBMED : 22293546

Éditeur(s) : Amer Geophysical Union
Résumé : Bolide impacts and large-scale volcanic eruptions have been proposed as possible causes of the massive extinction of life that has occurred episodically in Earth's history. In spite of the catastrophic disruption of the local environment that accompanies bolide impacts and volcanic eruptions, it has been difficult to explain why these events sometimes lead to global extinction of species. We propose that, in some cases, the missing link may be provided by hypercanes, runaway hurricanes that are capable of injecting massive amounts of water and aerosols into the middle and upper stratosphere, where they may have profound effects on atmospheric chemistry and radiative transfer. Hypercanes are theorized to occur when the sea surface temperature exceeds a critical threshold, which may occur when sea water is locally heated by bolide impact, shallow-sea volcanism, or possibly, by overturning of superheated brine pools formed by underwater volcanic activity. Simulations using a convection-resolving nonhydrostatic, axisymmetric numerical model show that hypercanes can indeed develop when the sea surface temperature is high, and that they inject large amounts of mass into the stratosphere.
Journal Of Geophysical Research-atmospheres (2169-897X) (Amer Geophysical Union), 1995-07 , Vol. 100 , N. D7 , P. 13755-13765

Droits : 1995 by the American Geophysical Union.
http://archimer.ifremer.fr/doc/00258/36966/35611.pdf
DOI:10.1029/95JD01368
http://archimer.ifremer.fr/doc/00258/36966/

Éditeur(s) : HAL CCSD Elsevier
Résumé :  
absent
Ecology and management of a neotropical rainforest: lessons drawn from Paracou, a long-term experimental research site in French Guiana

ISBN : 2-84299-455-8
hal-01189214
https://hal.archives-ouvertes.fr/hal-01189214
PRODINRA : 16123

Éditeur(s) : HAL CCSD European Geosciences Union
Résumé : International audience
The exchanges of carbon, water and energy between the atmosphere and the Amazon basin have global implications for the current and future climate. Here, the global atmospheric inversion system of the Monitoring of Atmospheric Composition and Climate (MACC) service is used to study the seasonal and interannual variations of biogenic CO 2 fluxes in Amazonia during the period 2002–2010. The system assimilated surface measurements of atmospheric CO 2 mole fractions made at more than 100 sites over the globe into an atmospheric transport model. The present study adds measurements from four surface stations located in tropical South America, a region poorly covered by CO 2 observations. The estimates of net ecosystem exchange (NEE) optimized by the inversion are compared to an independent estimate of NEE upscaled from eddy-covariance flux measurements in Amazonia. They are also qualitatively evaluated against reports on the seasonal and interannual variations of the land sink in South America from the scientific literature. We attempt at assessing the impact on NEE of the strong droughts in 2005 and 2010 (due to severe and longer-than-usual dry seasons) and the extreme rainfall conditions registered in 2009. The spatial variations of the seasonal and in-terannual variability of optimized NEE are also investigated. While the inversion supports the assumption of strong spatial heterogeneity of these variations, the results reveal critical limitations of the coarse-resolution transport model, the surface observation network in South America during the recent years and the present knowledge of modelling uncertainties in South America that prevent our inversion from capturing the seasonal patterns of fluxes across Amazonia. However, some patterns from the inversion seem consistent with the anomaly of moisture conditions in 2009.
ISSN: 1680-7316

hal-01557375
https://hal.univ-lorraine.fr/hal-01557375
https://hal.univ-lorraine.fr/hal-01557375/document
https://hal.univ-lorraine.fr/hal-01557375/file/acp-15-8423-2015.pdf
DOI : 10.5194/acp-15-8423-2015-supplement