Emeline Cailliau

Objective: This retrospective study in individuals with chronic respiratory diseases (CRDs) compared changes in quality of life, anxiety and depressive symptoms, and exercise capacity after a home pulmonary rehabilitation (PR) programme, based on the care manager’s professional background. Methods: PR team was composed of nurses (Gr1, n = 989 patients), physiotherapists (Gr2, n = 466), one dietician and one sociomedical beautician (Gr3, n = 794) and one respiratory physician (Gr4, n = 201) who supervised one home session per week during 8 weeks. Quality of life, anxiety and depressive symptoms, dyspnea and exercise capacity were assessed at the beginning and end of PR, and at 12 months after the end of PR. Results: 2450 participants were included (females: 41.6%, age: 64.1 ± 13.0 years, FEV ₁ : 50.7 ± 25.2% of predicted, people with COPD: 51%, with ILD: 23%, with asthma: 10%). Gr 1, Gr 3 and Gr 4 improved all the assessments at short- and long-term (p < 0.01). Improvement in the Visual Simplified Respiratory Questionnaire in Gr2 was not maintained at long-term. According to the linear mixed models, changes over time were not statistically different between groups. Conclusion: A personalised PR programme delivered by one care manager, led to similar short-term benefits regardless of the care manager’s initial professional background.

Auditory–verbal hallucinations (AVHs) are among the most disabling symptoms of schizophrenia and often persist despite the use of adequate antipsychotic treatment. Conventional low-frequency repetitive transcranial magnetic stimulation (rTMS) targeting the T3P3 scalp site has demonstrated limited efficacy, likely due to interindividual variability in AVH-related brain networks. In this multicenter, randomized, double-blind phase 3 trial, 70 patients with drug-resistant AVHs received active 1-Hz rTMS targeted either with an individualized fMRI-based symptom-capture procedure or by using conventional T3P3 localization. fMRI-guided rTMS yielded a greater reduction in Auditory Hallucination Rating Scale (AHRS) scores at one month (mean difference, −5.43; 95% CI, −8.92 to −1.94), and the effects were sustained at three and six months. The number-needed-to-treat for neuroguided rTMS was 3.5. Clinical response was associated with greater E-field overlap with AVH-related networks. These findings demonstrate that fMRI-guided neuronavigation increases rTMS efficacy, thus supporting its use to optimize the treatment of drug-resistant AVHs in schizophrenia.

Context: Noninvasive measurement of bone marrow adipose tissue using magnetic resonance imaging and proton density fat fraction (PDFF) may enhance clinical fractures prediction in postmenopausal women. Objective: This study aimed to assess the association between PDFF measurements and clinical fracture incidence. Methods: A longitudinal study was conducted. Postmenopausal women with recent osteoporotic fractures (<12 months) and with osteoarthritis without fractures were included. Lumbar spine and proximal femur PDFFs were measured at baseline using water-fat imaging (WFI) and dual-energy x-ray absorptiometry scans. Clinical fractures were recorded during follow-up. Results: Among 195 participants (mean age 67.4 ± 10.0 years, body mass index 27.2 ± 5.9 kg/m²), the PDFF (WFI-based) was higher at the proximal femur, particularly at the femoral head (90.0% ± 4.9%), compared to the lumbar spine (57.8% ± 9.6%). Over a mean follow-up period of 37.2 ± 11.6 months, 7 participants died, 29 (14.9%) experienced incident clinical fractures, and 1 was lost to follow-up. The lack of an association between WFI-based PDFFs and the incidence of clinical fractures was demonstrated regardless of the region of measurement (hazard ratio [HR] = 0.95 [95% CI 0.67-1.35], P = 0.77 at the lumbar spine, HR = 1.07 [95% CI 0.71-1.63], P = 0.74 at the femoral neck). Stepwise regression analysis did not alter these findings, and the variable “recent osteoporotic fractures” was found to be significantly associated with incident clinical fractures. Conclusion: This study found no evidence of a relationship between PDFF and clinical fracture incidence in postmenopausal women. Further studies are necessary involving larger cohorts and longer follow-up periods.

This study aimed to evaluate the correlation between BMAT and bone quality, describe the long-term effects of ovariectomy on bone, and investigate BMAT's spatial distribution. Fifteen-months-old female Sprague‒Dawley rats were studied, comparing ovariectomized (OVX, n = 22) and sham-operated (SHAM, n = 11) groups at 6 months. Tibias were analyzed for bone microarchitecture, BMAT (microcomputed tomography), mineral parameters (quantitative backscattered electron imaging), and bone composition (Raman microspectroscopy). The OVX tibias showed severe trabecular bone loss (lower bone volume/total volume, p < 0.001) with increased BMAT (higher adipose volume per marrow volume, p < 0.001), decreased mineral content (lower calcium concentration, p < 0.001), and altered organic components (lower mineral/matrix ratio in new bone, p = 0.03 trabecular surface, p < 0.001 trabecular core). When the data are pooled over both groups (SHAM and OVX), the adipose volume/marrow volume ratio was negatively correlated with bone volume/total volume (r = − 0.79, p < 0.001) and mineral/matrix ratio (r = − 0.37, p = 0.04 trabecular surface; r = − 0.65, p < 0.001 trabecular core) and positively correlated with crystallinity (r = 0.55, p = 0.001 trabecular surface; r = 0.49, p = 0.006 trabecular core). The mineral/matrix ratio of trabecular surface new bone was strongly negatively correlated with the adipose compartment nearest to the bone surface. These findings suggest mechanisms underlying BMAT's role in bone resorption.

Objectives: The aim of this study was to determine the association between various histological patterns and prognosis in patients with SSc and histologically proven muscle involvement. Methods: A multicentre retrospective study was conducted of a cohort of scleroderma patients who had undergone muscle biopsy. The biopsies were reviewed in a coordinated manner to classify patients based on the histological findings. Three different patterns were observed: fibrosing myopathy (FMy), inflammatory myopathy (IMy), and immune-mediated necrotizing myopathy (IMNMy). Rates of survival, muscle relapse, and cardiac and pulmonary events were compared between these three groups. Results: Among the 71 scleroderma patients with muscle biopsy specimens available for review, 33 (46.5%) were classified in the FMy group, 18 (25.5%) in the IMy group and 20 (28%) in the NMy group. The median follow-up time was 6.4 years (interquartile range, 2.2–10.9 years), and 21 patients died during follow-up, primarily from heart disease and infections. The 10-year survival rate after the first non-RP symptom was 80%, and the cumulative incidence of muscle relapse was 25%. Neither factor differed significantly between the three groups. The risk of pulmonary events was lowest in the IMy group, significantly lower than in the FMy group (hazard ratio, 0.17; 95% CI, 0.04–0.67) and non-significantly lower than in the IMNMy group (hazard ratio, 0.28; 95% CI, 0.06–1.24). The risk of cardiac events did not differ significantly between the three groups. Conclusion: The mortality rate in scleroderma patients with muscle involvement was not associated with their histological patterns.

Mycosis fungoides (MF) is the most prevalent primary cutaneous T-cell lymphoma, with an indolent or aggressive course and poor survival. The pathogenesis of MF remains unclear, and prognostic factors in the early stages are not well established. Here, we characterized the most recurrent genomic alterations using whole-exome sequencing of 67 samples from 48 patients from Lille University Hospital (France), including 18 sequential samples drawn across stages of the malignancy. Genomic data were analyzed on the Broad Institute’s Terra bioinformatics platform. We found that gain7q, gain10p15.1 (IL2RA and IL15RA), del10p11.22 (ZEB1), or mutations in JUNB and TET2 are associated with high-risk disease stages. Furthermore, gain7q, gain10p15.1 (IL2RA and IL15RA), del10p11.22 (ZEB1), and del6q16.3 (TNFAIP3) are coupled with shorter survival. Del6q16.3 (TNFAIP3) was a risk factor for progression in patients at low risk. By analyzing the clonal heterogeneity and the clonal evolution of the cohort, we defined different phylogenetic pathways of the disease with acquisition of JUNB, gain10p15.1 (IL2RA and IL15RA), or del12p13.1 (CDKN1B) at progression. These results establish the genomics and clonality of MF and identify potential patients at risk of progression, independent of their clinical stage.