Papers by Marie Becquemin
Revue des Maladies Respiratoires, 2007
L’insuline par voie inhalée : un modèle pour l’absorption systémique pulmonaire ?
Revue des Maladies Respiratoires, 2008
Optimisation des conditions d'aerosolisation de la pentamidine : Etudes granulometriques et isotopiques
Médecine et Maladies Infectieuses, 1990
Results Of Simple Tidal Breathing Test Correlate With Spirometry-based COPD Grading
C39. CHRONIC OBSTRUCTIVE PULMONARY DISEASE DIAGNOSIS, 2010
Tailles particulaires de la fumée produite par six différents types de cigarettes
Revue des Maladies Respiratoires, 2007
Comparison Of ECCS/ERS, NHANES III And LMS Refence Equations For FEV1, FVC And FEV1/FVC On A French Caucasian Population
A72. ADVANCES IN NON-INVASIVE PULMONARY FUNCTION TECHNOLOGY AND OUTCOMES ANALYSIS, 2011
The therapeutic efficacy of nebulised pentamidine in the prophylaxis of Pneumocystis carinii pneu... more The therapeutic efficacy of nebulised pentamidine in the prophylaxis of Pneumocystis carinii pneumonia (PCP) depends on the absolute pulmonary deposition of the drug. We studied the performance of a new nebuliser (Pentasave) by comparison both in vitro and in vivo with a standard nebuliser (Respirgard II). In vitro, deposition of pentamidine labelled with technetium-99m human serum albumin was measured indirectly by capturing inhaled particles on an absolute filter and measuring radioactivity with a gamma camera. The nebulisers were initially assessed with a pentamidine dose of 100 mg in 5 ml at 44 psi and an air flow of 10 l/rain for Respirgard II and 16 1/min for Pentasave. Nebuliser output, expressed as the percentage of the initial nebuliser radioactivity captured by the inhalation filter, was 15%+2% (mean_+SD) for Respirgard II, and significantly increased to 23%___3% for an initial version and to 33%.+2% for the final version of Pentasave. Measurements with a gamma camera in a group of ten patients with human immunodeficiency virus infection were made in vivo. The results revealed that pulmonary drug distributions are good using both Respirgard II and Pentasave. The literature reports that once-monthly pulmonary deposition of 9 mg pentamidine seems enough to produce prophylactic effects against Pneumocystis carinii. We measured pulmonary pentamidine deposition of 20.22.+4.31 mg (mean _+SD) using Respirgard lI (with 300 mg in 5 ml) and of 16.00_+7.18 mg using Pentasave (with 150 mg in 6 ml). These findings show that the therapeutic dose of pentamidine (9 mg) was widely exceeded with both nebulisers. Further investigations might demonstrate that about 200 mg and 125 mg pentamidine for Respirgard II and Pentasave, respectively, will achieve a pulmonary deposition of therapeutic dose, allowing significant savings in terms of drug and expense.
Critical care (London, England), 2006
Our objectives were to determine the causes of acute respiratory failure (ARF) in elderly patient... more Our objectives were to determine the causes of acute respiratory failure (ARF) in elderly patients and to assess the accuracy of the initial diagnosis by the emergency physician, and that of the prognosis. In this prospective observational study, patients were included if they were admitted to our emergency department, aged 65 years or more with dyspnea, and fulfilled at least one of the following criteria of ARF: respiratory rate at least 25 minute-1; arterial partial pressure of oxygen (PaO2) 70 mmHg or less, or peripheral oxygen saturation 92% or less in breathing room air; arterial partial pressure of CO2 (PaCO2) > or = 45 mmHg, with pH < or = 7.35. The final diagnoses were determined by an expert panel from the completed medical chart. A total of 514 patients (aged (mean +/- standard deviation) 80 +/- 9 years) were included. The main causes of ARF were cardiogenic pulmonary edema (43%), community-acquired pneumonia (35%), acute exacerbation of chronic respiratory disease ...
Respiratory Medicine, 2007
A survey of nebulisation practice in France was conducted under the aegis of the French respirato... more A survey of nebulisation practice in France was conducted under the aegis of the French respiratory society in 2004. Methods: Analysis of a questionnaire was obtained from 3674 physicians. Results: A total of 2439 physicians were general practitioners (GPs), 698 were chest physicians, and 537 paediatricians. The main reasons to use nebulisation are (1) for chest physicians efficacy in treating various pathologies with long-term administration (1 wk to X1 month) of approved drugs, and (2) for GP's local action properties. While chest physicians learned about nebulisation during their university training and do not ask for additional information, GPs learned by practical experience or from colleagues and ask for further information. Conclusion: This study will help to develop targeted educational programmes on nebulisation practice.
Multidetector Row Computed Tomography to Assess Changes in Airways Linked to Asthma Control
Respiration, 2011
In asthma, multidetector row computed tomography (MDCT) detects abnormalities that are related to... more In asthma, multidetector row computed tomography (MDCT) detects abnormalities that are related to disease severity, including increased bronchial wall thickness. However, whether these abnormalities could be related to asthma control has not been investigated yet. Our goal was to determine which changes in airways could be linked to disease control. Twelve patients with poor asthma control were included and received a salmeterol/fluticasone propionate combination daily for 12 weeks. Patients underwent clinical, functional, and MDCT examinations before and after the treatment period. MDCT examinations were performed using a low-dose protocol at a controlled lung volume (65% TLC). Bronchial lumen (LA) and wall areas (WA) were evaluated at a segmental and subsegmental level using BronCare software. Lung density was measured at the base of the lung. Baseline and end-of-treatment data were compared using the Wilcoxon signed-rank test. After the 12-week treatment period, asthma control was achieved. Airflow obstruction and air trapping decreased as assessed by the changes in FEV(1) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01) and expiratory reserve volume (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01). Conversely, LA and WA did not vary significantly. However, a median decrease in LA of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;10% was observed in half of the patients with a wide intra- and intersubject response heterogeneity. This was concomitant with a decrease in lung density (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.02 in the anteroinferior areas). MDCT is insensitive for demonstrating any decrease in bronchial wall thickness. This is mainly due to changes in bronchial caliber which may be linked to modifications of the elastic properties of the bronchopulmonary system under treatment.
Mild Intermittent Asthma: CT Assessment of Bronchial Cross-sectional Area and Lung Attenuation at Controlled Lung Volume1
Radiology, 2002
To evaluate, with thin-section computed tomography (CT), changes in bronchial cross-sectional are... more To evaluate, with thin-section computed tomography (CT), changes in bronchial cross-sectional area and lung attenuation induced by bronchial stimulation in patients with mild intermittent asthma, at a given lung volume monitored with pneumotachography. Twelve patients with mild intermittent asthma who were nonsmokers (National Institutes of Health staging) and six nonsmoking healthy volunteers, age and sex ratio-matched, were examined by using helical thin-collimation CT at the level of basal bronchi at 65% of total lung capacity. Three sets of acquisitions were obtained: at baseline and after inhalation of methacholine and then salbutamol. Cross-sectional areas of bronchi greater than 4 mm(2) were segmented and calculated from CT images. Lung attenuation was measured in the anterior, lateral, and posterior areas of the right lung parenchyma. Gas trapping was evaluated by using thin-section CT at residual volume in six of the patients with asthma. Statistical analysis included two factors repeated-measurement analysis of variance and Mann-Whitney and Kruskal-Wallis nonparametric tests. Bronchial cross-sectional areas and lung attenuation did not vary significantly compared with baseline values following bronchial challenge in healthy volunteers or patients with asthma. However, in patients with asthma, bronchial cross-sectional areas were significantly smaller than in healthy volunteers, except after inhalation of salbutamol. Lung attenuation and anteroposterior attenuation gradient were significantly higher in patients with asthma than in healthy patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). Air-trapping scores were significantly higher after methacholine challenge. Helical thin-collimation CT at controlled lung volume and at full expiration associated with bronchial challenge may help evaluate bronchoreactivity and inflammation in mild intermittent asthma.
Comparison of jet and ultrasonic nebulizers for alveolar targeting of methylprednisolone
Nuclear Medicine Communications, 1995
The secondary systemic effects of oral corticosteroid therapy in chronic lung disease indicate th... more The secondary systemic effects of oral corticosteroid therapy in chronic lung disease indicate the possible benefits of local therapy. The aim of this study was to show if alveolar targeting of a corticosteroid, methylprednisolone (MP), is possible, and to determine which type of nebulizer allows the most selective deposition into the alveoli. A jet nebulizer (Respirgard II) with 2 ml volume fill (R2), and an ultrasonic nebulizer (Ultraneb 99) with 4 ml volume fill (U4), were compared using a 40-mg dose of MP labelled 99Tcm human serum albumin. Particle size and MP-to-albumin binding were measured in the aerosol cloud. Each nebulizer was used in random order in five healthy volunteers. A dynamic posterior scan of 68 images of 15 s each was performed with a Gammatome II gamma camera during inhalation. Peripheral and central regions of interest were automatically defined with reproducible methods, and the peripheral-to-central ratio was used as a penetration index. Stomach and oropharynx activities were estimated on static anterior and static left lateral views, respectively, at the end of the examination. The mass median aerodynamic diameter (MMAD) was lower for R2 when unlabelled MP was used. The MMAD of MP+HSA was compatible with alveolar targeting. In the aerosol cloud, MP-albumin binding was 75% for R2 and 79% for U4. Peripheral and central activities at equilibrium (13-16 min) were higher with U4, but the penetration index was significantly higher with R2. Moreover, the stomach and oropharynx activities were significantly lower with R2.(ABSTRACT TRUNCATED AT 250 WORDS)
Validation of Laser Diffraction Method as a Substitute for Cascade Impaction in the European Project for a Nebulizer Standard
Journal of Aerosol Medicine, 2001
The project for a European standard testing procedure to characterize nebulizers in terms of part... more The project for a European standard testing procedure to characterize nebulizers in terms of particle size distribution has been based on using the Andersen-Marple personal cascade impactor model 298 (A-MPCI) with a sodium fluoride reference solution. In the present study methods based on laser diffraction (Mastersizer-X) and time-of-flight (TOF)(APS) and another cascade impactor (GS1-CI) were compared with the A-MPCI. Two types of nebulizer (Pari LC+ and Microneb) were tested with all apparatuses, and a third type of nebulizer (NL9) was tested with the A-MPCI and Mastersizer-X. Nebulizers were charged with a solution of sodium fluoride in conditions reproducing the European Committee for Normalization (CEN) protocol. There was no difference between the Mastersizer-X and the A-MPCI or between the GS1-CI and the A-MPCI in terms of mass median aerodynamic diameter (MMAD). Comparison between the APS and the A-MPCI showed a significant difference with the Microneb. The geometric standard deviations (GSD) obtained with the A-MPCI were on average 10% greater than GSD obtained with the other apparatuses, but the differences were not statistically significant. We conclude that laser diffraction can be used for particle size distribution in the context of the European standard, and that the Mastersizer-X is particularly interesting for industrial practice in view of its simplicity and robustness.
Experimental measurements of particle retention efficiency of filters used to prevent contamination in respiratory devices
Intensive Care Medicine, 1998
Various types of filters have been designed to prevent cross contamination of ventilation and res... more Various types of filters have been designed to prevent cross contamination of ventilation and respiratory devices. The aim of this study was to experimentally measure the retention efficiency of four simple filters (antibacterial and antiviral and seven combined filters (antibacterial and antiviral plus heat and water exchangers). The respiratory function testing (EFR) central department of a university teaching hospital. The same aerosol test with a wide range of particle sizes (0.15 to 15 micrometers) was used to compare the retention efficiency of each filter used in various conditions. The particle sizes and the concentration of the aerosol were measured by a laser velocimeter. For all the filters studied, the retention efficiency was found to be higher than 99%. However some of them let large particles let through. These data, performed in vitro, should be assessed also by further clinical studies.
Intensive Care Medicine, 1998
European Journal of Nuclear Medicine, 1994
The therapeutic efficacy of nebulised pentamidine in the prophylaxis of Pneumocystis carinii pneu... more The therapeutic efficacy of nebulised pentamidine in the prophylaxis of Pneumocystis carinii pneumonia (PCP) depends on the absolute pulmonary deposition of the drug. We studied the performance of a new nebuliser (Pentasave) by comparison both in vitro and in vivo with a standard nebuliser (Respirgard II). In vitro, deposition of pentamidine labelled with technetium-99m human serum albumin was measured indirectly by capturing inhaled particles on an absolute filter and measuring radioactivity with a gamma camera. The nebulisers were initially assessed with a pentamidine dose of 100 mg in 5 ml at 44 psi and an air flow of 10 l/rain for Respirgard II and 16 1/min for Pentasave. Nebuliser output, expressed as the percentage of the initial nebuliser radioactivity captured by the inhalation filter, was 15%+2% (mean_+SD) for Respirgard II, and significantly increased to 23%___3% for an initial version and to 33%.+2% for the final version of Pentasave. Measurements with a gamma camera in a group of ten patients with human immunodeficiency virus infection were made in vivo. The results revealed that pulmonary drug distributions are good using both Respirgard II and Pentasave. The literature reports that once-monthly pulmonary deposition of 9 mg pentamidine seems enough to produce prophylactic effects against Pneumocystis carinii. We measured pulmonary pentamidine deposition of 20.22.+4.31 mg (mean _+SD) using Respirgard lI (with 300 mg in 5 ml) and of 16.00_+7.18 mg using Pentasave (with 150 mg in 6 ml). These findings show that the therapeutic dose of pentamidine (9 mg) was widely exceeded with both nebulisers. Further investigations might demonstrate that about 200 mg and 125 mg pentamidine for Respirgard II and Pentasave, respectively, will achieve a pulmonary deposition of therapeutic dose, allowing significant savings in terms of drug and expense.
A Method to Derive Lower Limit of Normal for the FEV<sub>1</sub>/Forced Expiratory Volume at 6 s of Exhalation Ratio From FEV<sub>1</sub>/FVC Data
CHEST Journal, 2009
The FEV(1)/forced expiratory volume at 6 s of exhalation (FEV(6)) ratio has been suggested as a s... more The FEV(1)/forced expiratory volume at 6 s of exhalation (FEV(6)) ratio has been suggested as a surrogate for the FEV(1)/FVC ratio to detect airway obstruction. Current guidelines require that lower limit of normal (LLN) values be implemented to detect an abnormality. In most populations, LLN equations are available for the FEV(1)/FVC ratio but not for the FEV(1)/FEV(6) ratio. We propose a simplified statistical method to approximate reasonably the FEV(1)/FEV(6) LLN in a population for which FEV(1)/FVC LLN values are already available. Spirometric data were collected from 8,273 European patients aged 20 to 85 years. We computed by receiver operator characteristics analysis the best-fit cutoff FEV(1)/FEV(6) ratio distributions in function of age and sex for obstruction as diagnosed from FEV(1)/FVC LLN values obtained from the relevant reference equations for subjects aged 20 to 70 and 65 to 85 years. We compared the diagnosis of obstruction obtained from these surrogate equations against the reference diagnosis made by FEV(1)/FVC LLN. Misdiagnoses from the surrogate equations (FEV(1)/FEV(6) = 75.58 - 0.11 x age for men, and 77.70 - 0.09 x age for women aged 20 to 70 years) were all within 2.3 +/- 2.0% of the reference LLN. Similar results were found in the group aged 65 to 85 years. The study confirms the feasibility of computing a surrogate LLN equation for the FEV(1)/FEV(6) ratio in a population for which the accepted FEV(1)/FVC LLN already exists. Surrogate equations for FEV(1)/FEV(6) ratio may extend its use for screening and case finding when simplified spirometry is needed.
Changes in Pulmonary Blood Flow Distribution Following Hyperoxia in ATS Stage 1 to 3 COPD Patients
CHEST Journal, 2004
... Page 2. ETHNICITY AS A PREDICTOR OF THE SEVERITY OF CORO-NARY ARTERY DISEASE [CAD] IN A CITY ... more ... Page 2. ETHNICITY AS A PREDICTOR OF THE SEVERITY OF CORO-NARY ARTERY DISEASE [CAD] IN A CITY HOSPITAL WITH A SIZEABLE ASIAN IMMIGRANT POPULATION Vijay A. Rupanagudi, MBBS, MD*; Patel Umang, MD; Tejwant Dhillon, MD; Sanjay Shetty, MD; S ...
BMC Cardiovascular Disorders, 2007
Background: Cardiac asthma is common, but has been poorly investigated. The objective was to comp... more Background: Cardiac asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of cardiac asthma with that of classical congestive heart failure (CHF) in elderly patients.
Allergy, 2010
O, Denjean A, de Blic J, Delclaux C. Multicentre trial evaluating alveolar NO fraction as a marke... more O, Denjean A, de Blic J, Delclaux C. Multicentre trial evaluating alveolar NO fraction as a marker of asthma control and severity. Allergy 2010; 65: 636-644.
Uploads
Papers by Marie Becquemin