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Search Results: 1 - 10 of 189888 matches for " G. Simonneau "
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Optimal management of severe pulmonary arterial hypertension
O. Sitbon,G. Simonneau
European Respiratory Review , 2011,
Abstract: Over the past decade, awareness among the medical profession of pulmonary arterial hypertension (PAH) being a treatable disease has increased. Despite this, approximately one-fifth of newly diagnosed patients are classified as being in the most severely compromised functional class (i.e. New York Health Association/World Health Organization functional class (NYHA/WHO FC) IV). The prognosis for patients in NYHA/WHO FC IV is poor, with 3-yr survival being around 40%, even with treatment. Poor prognosis coupled with severe functional impairment means it is vital that these patients receive optimal treatment. There are also subgroups of patients, who, although classified as NYHA/WHO FC III, may actually be severely haemodynamically compromised and at risk of rapid deterioration. Such subgroups include patients with PAH associated with systemic sclerosis or certain heritable mutations. These patients should be considered as being at the more severe end of the disease spectrum. In this article we will discuss the optimal management of patients with severe PAH. This includes newly emerging evidence from small-scale, open-label studies that use upfront combination therapy with intravenous epoprostenol plus oral PAH-specific drugs. We also review treatment strategies that may offer clinical benefits to patients with more severe PAH.
Management of severe pulmonary arterial hypertension
J-L. Vachiéry,G. Simonneau
European Respiratory Review , 2010,
Abstract: Pulmonary arterial hypertension (PAH) is a severe, progressive condition of the small pulmonary vessels that leads to increased pulmonary vascular resistance, right ventricular failure and death. Patients in World Health Organization functional class (WHO FC) IV are the most severely affected in terms of disease severity, symptomatic impairment, exercise capacity and haemodynamics, with a very poor prognosis and low survival rate. Recent developments in PAH-specific therapies have conferred significant prognostic improvements upon PAH patients, especially when coupled with management strategies such as goal-oriented therapy and combination treatment. Despite these important developments, the outlook for WHO FC IV PAH patients remains poor. This article examines the recommendations for WHO FC IV patients that appear in current PAH treatment guidelines and the research underpinning this guidance, and discusses possible future directions for treatment of this severely unwell patient population.
The use of combination therapy in pulmonary arterial hypertension: new developments
N. Galiè,L. Negro,G. Simonneau
European Respiratory Review , 2009,
Abstract: There is a strong clinical rationale for combination therapy in pulmonary arterial hypertension (PAH), as several pathological pathways have been implicated in its pathogenesis and no single agent has yet been shown to deliver completely satisfactory results. Registry data indicate that use of combination therapy is in fact common in existing clinical practice, even though support has been largely empirical or derived from small-scale observational studies. Data from large, adequately powered, randomised controlled trials of combination therapy in PAH are now emerging and suggest that combination therapy may be clinically beneficial. Studies of bosentan in combination with prostanoids and phosphodiesterase (PDE)-5 inhibitors show consistent evidence of improvements in exercise capacity compared with placebo. Similar improvements have been observed with PDE-5 inhibitors in combination with prostanoids. The appropriate timing of combination therapy requires further evaluation but goal-oriented therapy using combinations of oral and inhaled drugs has been shown to provide acceptable long-term results in patients with advanced PAH. Monitoring should be performed regularly and be based on repeatable, noninvasive, measurable parameters that have prognostic value.
A decade of achievement in pulmonary hypertension
M. Humbert,G. Simonneau,L.J. Rubin
European Respiratory Review , 2011,
O. Cardona,E. Simonneau
Revista mexicana de astronomía y astrofísica , 2011,
Structural Properties of Spherical Galaxies: a Semi-Analytical Approach
E. Simonneau,F. Prada
Revista mexicana de astronomía y astrofísica , 2004,
Abstract: Puesto que la distribución de luz medida sobre cualquier radio galactocéntrico de una galaxia elíptica tiene la misma forma funcional: exp[_R1=n] (perfil de Sérsic) para casi todas estas galaxias, y dado que este perfil es la integral de Abel de la densidad espacial de fuentes luminosas pL(r), parece lógico buscar el camino de derivar esta densidad a partir de la distribución de luz observada. Proponemos en este artículo un método de ordenadas discretas" que proporciona, para cualquier n > 1, una expresión explícita para esa densidad de fuentes emisoras, tal que puede evaluarse numéricamente con cualquier grado de precisión. Una vez obtenida esa densidad pL(r), se calculan fácilmente la distribución de masa M(r), el potencial o(r) y la dispersión de velocidades, tanto en el espacio o2s (r) como en el plano de observación, o2p(R).
Structural properties of spherical galaxies obeying the Sersic R^1/n law: a semi-analytical approach
E. Simonneau,F. Prada
Physics , 1999,
Abstract: By considering that the distribution of measured light along any galactocentric radius of an elliptical galaxy can be well represented by a R^{1/n} Sersic law, we propose in this paper a ``discrete ordenate'' method, which, for any value of n, allows an explicit expression for the luminous density, rho(r), to be found that can be numerically evaluated to any required precision. Once we have this semi-analytical expression for the spatial density, rho(r), the mass distribution, M(r), the potential, phi(r), and the velocity dispersions, sigma_s^2(r), in the space and in the observational plane, sigma_p^2(R), can be computed in a straightforward manner.
Absence of influence of gender and BMPR2 mutation type on clinical phenotypes of pulmonary arterial hypertension
Barbara Girerd, David Montani, Mélanie Eyries, Azzedine Yaici, Benjamin Sztrymf, Florence Coulet, Olivier Sitbon, Gérald Simonneau, Florent Soubrier, Marc Humbert
Respiratory Research , 2010, DOI: 10.1186/1465-9921-11-73
Abstract: We reviewed data from all patients with PAH considered as idiopathic and patients with a family history of PAH, who underwent genetic counselling in the French PAH network between January, 1st 2004 and April, 1st 2010. We compared clinical, functional, and hemodynamic characteristics between carriers and non-carriers of a BMPR2 mutation, according to gender or BMPR2 mutation type.PAH patients carrying a BMPR2 mutation (n = 115) were significantly younger at diagnosis than non-carriers (n = 267) (35.8 ± 15.4 and 47.5 ± 16.2 respectively, p < 0.0001). The presence of a BMPR2 mutation was associated with a younger age at diagnosis in females (36.4 ± 14.9 in BMPR2 mutation carriers and 47.4 ± 15.8 in non-carriers, p < 0.0001), and males (34.6 ± 16.8 in BMPR2 mutation carriers and 47.8 ± 17.1 in non-carriers, p < 0.0001). BMPR2 mutation carriers had a more severe hemodynamic compromise at diagnosis, but this was not influenced by gender. No differences in survival and time to death or lung transplantation were found in male and female PAH patients carrying a BMPR2 mutation. No differences were observed in clinical outcomes according to the type of BMPR2 mutations (missense, truncating, large rearrangement or splice defect).When compared to non-carriers, BMPR2 mutation carriers from the French PAH network are younger at diagnosis and present with a more severe hemodynamic compromise, irrespective of gender. Moreover, BMPR2 mutation type had no influence on clinical phenotypes in our patient population.Pulmonary arterial hypertension (PAH) is a severe disease affecting small pulmonary arteries, with a progressive remodeling leading to elevated pulmonary vascular resistance and right ventricular failure [1-3]. PAH can be idiopathic, heritable or associated with drug or toxin exposure or other conditions such as connective tissue diseases, human immunodeficiency virus infection, congenital heart diseases, and portal hypertension [1,2]. Germline mutations in the bone morphoge
Analytic partition function for plasmas
O. Cardona,E. Simonneau,L. Crivellari
Revista mexicana de física , 2005,
Abstract: The partition function for atoms in a gas with partial ionization is obtained by assuming that the internal and atomic linear energy densities are equal, and considering that the kinetic energy per degree of freedom is sufficient to ionize the upper levels of the atoms, and, at the same time, approximating the sum by an integral, which we solve using the mean value theorem for integrals. The resulting function reproduces the behavior of the partition function in the region of validity of perfect gases; it is also analytic and compact.
An improved version of the Implicit Integral Method to solving radiative transfer problems
E. Simonneau,O. Cardona,L. Crivellari
Physics , 2011, DOI: 10.1007/s10511-012-9220-2
Abstract: Radiative transfer (RT) problems in which the source function includes a scattering-like integral are typical two-points boundary problems. Their solution via differential equations implies to make hypotheses on the solution itself, namely the specific intensity I(tau;n) of the radiation field. On the contrary, integral methods require to make hypotheses on the source function S(tau). It looks of course more reasonable to make hypotheses on the latter because one can expect that the run of S(tau) with depth be smoother than that of I(tau;n). In previous works we assumed a piece-wise parabolic approximation for the source function, which warrants the continuity of S(tau) and its first derivative at each depth point. Here we impose the continuity of the second derivative S"(tau). In other words, we adopt a cubic spline representation to the source function, which highly stabilize the numerical processes.
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