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Article ; Online: Longitudinal assessment of loss and gain of lung function in childhood asthma.

Mahut, Bruno / Bokov, Plamen / Beydon, Nicole / Delclaux, Christophe

The Journal of asthma : official journal of the Association for the Care of Asthma

2022 Volume 60, Issue 1, Page(s) 24–31

Abstract: Objective: The Childhood Asthma Management Program revealed that 25.7% of children with mild to moderate asthma exhibit loss of lung function. The objective was to assess the trajectories of function by means of serial FEV: Methods: A total of 295 ... ...

Abstract	Objective: The Childhood Asthma Management Program revealed that 25.7% of children with mild to moderate asthma exhibit loss of lung function. The objective was to assess the trajectories of function by means of serial FEV Methods: A total of 295 children (199 boys) who had undergone at least 10 spirometry tests from the age of 8 were selected from a single-center open cohort. The annualized rate of change (slope) for prebronchodilator FEV Results: The median (25 Conclusion: Better initial FEV
MeSH term(s)	Child ; Male ; Humans ; Asthma/diagnosis ; Lung ; Respiratory Function Tests ; Spirometry ; Forced Expiratory Volume ; Vital Capacity
Language	English
Publishing date	2022-01-03
Publishing country	England
Document type	Journal Article
ZDB-ID	603816-5
ISSN	1532-4303 ; 0277-0903
ISSN (online)	1532-4303
ISSN	0277-0903
DOI	10.1080/02770903.2021.2023176
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Article ; Online: Usefulness of alveolar nitric oxide measurement in asthma: still debated.

Mahut, Bruno / Delclaux, Christophe

The Journal of allergy and clinical immunology

2013 Volume 132, Issue 5, Page(s) 1255–1256

MeSH term(s)	Asthma/metabolism ; Asthma/prevention & control ; Exhalation ; Female ; Humans ; Male ; Nitric Oxide
Chemical Substances	Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	2013-11
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	121011-7
ISSN	1097-6825 ; 1085-8725 ; 0091-6749
ISSN (online)	1097-6825 ; 1085-8725
ISSN	0091-6749
DOI	10.1016/j.jaci.2013.07.041
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Article ; Online: Wheezing recognition algorithm using recordings of respiratory sounds at the mouth in a pediatric population.

Bokov, Plamen / Mahut, Bruno / Flaud, Patrice / Delclaux, Christophe

Computers in biology and medicine

2016 Volume 70, Page(s) 40–50

Abstract: Background: Respiratory diseases in children are a common reason for physician visits. A diagnostic difficulty arises when parents hear wheezing that is no longer present during the medical consultation. Thus, an outpatient objective tool for ... ...

Abstract	Background: Respiratory diseases in children are a common reason for physician visits. A diagnostic difficulty arises when parents hear wheezing that is no longer present during the medical consultation. Thus, an outpatient objective tool for recognition of wheezing is of clinical value. Method: We developed a wheezing recognition algorithm from recorded respiratory sounds with a Smartphone placed near the mouth. A total of 186 recordings were obtained in a pediatric emergency department, mostly in toddlers (mean age 20 months). After exclusion of recordings with artefacts and those with a single clinical operator auscultation, 95 recordings with the agreement of two operators on auscultation diagnosis (27 with wheezing and 68 without) were subjected to a two phase algorithm (signal analysis and pattern classifier using machine learning algorithms) to classify records. Results: The best performance (71.4% sensitivity and 88.9% specificity) was observed with a Support Vector Machine-based algorithm. We further tested the algorithm over a set of 39 recordings having a single operator and found a fair agreement (kappa=0.28, CI95% [0.12, 0.45]) between the algorithm and the operator. Conclusions: The main advantage of such an algorithm is its use in contact-free sound recording, thus valuable in the pediatric population.
MeSH term(s)	Adolescent ; Algorithms ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Respiratory Sounds ; Signal Processing, Computer-Assisted ; Support Vector Machine
Language	English
Publishing date	2016-03-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	127557-4
ISSN	1879-0534 ; 0010-4825
ISSN (online)	1879-0534
ISSN	0010-4825
DOI	10.1016/j.compbiomed.2016.01.002
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Article ; Online: Digital Action Plan (Web App) for Managing Asthma Exacerbations: Randomized Controlled Trial.

Beydon, Nicole / Taillé, Camille / Corvol, Harriet / Valcke, Judith / Portal, Jean-Jacques / Plantier, Laurent / Mangiapan, Gilles / Perisson, Caroline / Aubertin, Guillaume / Hadchouel, Alice / Briend, Guillaume / Guilleminault, Laurent / Neukirch, Catherine / Cros, Pierrick / Appere de Vecchi, Corinne / Mahut, Bruno / Vicaut, Eric / Delclaux, Christophe

Journal of medical Internet research

2023 Volume 25, Page(s) e41490

Abstract: Background: A written action plan (WAP) for managing asthma exacerbations is recommended.: Objective: We aimed to compare the effect on unscheduled medical contacts (UMCs) of a digital action plan (DAP) accessed via a smartphone web app combined with ...

Abstract	Background: A written action plan (WAP) for managing asthma exacerbations is recommended. Objective: We aimed to compare the effect on unscheduled medical contacts (UMCs) of a digital action plan (DAP) accessed via a smartphone web app combined with a WAP on paper versus that of the same WAP alone. Methods: This randomized, unblinded, multicenter (offline recruitment in private offices and public hospitals), and parallel-group trial included children (aged 6-12 years) or adults (aged 18-60 years) with asthma who had experienced at least 1 severe exacerbation in the previous year. They were randomized to a WAP or DAP+WAP group in a 1:1 ratio. The DAP (fully automated) provided treatment advice according to the severity and previous pharmacotherapy of the exacerbation. The DAP was an algorithm that recorded 3 to 9 clinical descriptors. In the app, the participant first assessed the severity of their current symptoms on a 10-point scale and then entered the symptom descriptors. Before the trial, the wordings and ordering of these descriptors were validated by 50 parents of children with asthma and 50 adults with asthma; the app was not modified during the trial. Participants were interviewed at 3, 6, 9, and 12 months to record exacerbations, UMCs, and WAP and DAP use, including the subjective evaluation (availability and usefulness) of the action plans, by a research nurse. Results: Overall, 280 participants were randomized, of whom 33 (11.8%) were excluded because of the absence of follow-up data after randomization, leaving 247 (88.2%) participants (children: n=93, 37.7%; adults: n=154, 62.3%). The WAP group had 49.8% (123/247) of participants (children: n=45, 36.6%; mean age 8.3, SD 2.0 years; adults: n=78, 63.4%; mean age 36.3, SD 12.7 years), and the DAP+WAP group had 50.2% (124/247) of participants (children: n=48, 38.7%; mean age 9.0, SD 1.9 years; adults: n=76, 61.3%; mean age 34.5, SD 11.3 years). Overall, the annual severe exacerbation rate was 0.53 and not different between the 2 groups of participants. The mean number of UMCs per year was 0.31 (SD 0.62) in the WAP group and 0.37 (SD 0.82) in the DAP+WAP group (mean difference 0.06, 95% CI -0.12 to 0.24; P=.82). Use per patient with at least 1 moderate or severe exacerbation was higher for the WAP (33/65, 51% vs 15/63, 24% for the DAP; P=.002). Thus, participants were more likely to use the WAP than the DAP despite the nonsignificant difference between the action plans in the subjective evaluation. Median symptom severity of the self-evaluated exacerbation was 4 out of 10 and not significantly different from the symptom severity assessed by the app. Conclusions: The DAP was used less often than the WAP and did not decrease the number of UMCs compared with the WAP alone. Trial registration: ClinicalTrials.gov NCT02869958; https://clinicaltrials.gov/ct2/show/NCT02869958.
MeSH term(s)	Adult ; Child ; Humans ; Asthma/drug therapy ; Self Care ; Mobile Applications ; Writing ; Disease Progression ; Anti-Asthmatic Agents/therapeutic use
Chemical Substances	Anti-Asthmatic Agents
Language	English
Publishing date	2023-06-29
Publishing country	Canada
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2028830-X
ISSN	1438-8871 ; 1438-8871
ISSN (online)	1438-8871
ISSN	1438-8871
DOI	10.2196/41490
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Article ; Online: Peripheral airway/alveolar nitric oxide concentration in asthma.

Mahut, Bruno / Delclaux, Christophe

Thorax

2011 Volume 66, Issue 7, Page(s) 632–3; author reply 633

MeSH term(s)	Adult ; Asthma/metabolism ; Breath Tests/methods ; Child ; Humans ; Nitric Oxide/metabolism ; Pulmonary Alveoli/metabolism ; Pulmonary Gas Exchange/physiology
Chemical Substances	Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	2011-07
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thx.2010.147959
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Article ; Online: Overweight is not a comorbidity factor during childhood asthma: the GrowthOb study.

Mahut, Bruno / Beydon, Nicole / Delclaux, Christophe

The European respiratory journal

2012 Volume 39, Issue 5, Page(s) 1120–1126

Abstract: While being overweight is a risk factor for subsequent asthma in children, the importance of body mass index (BMI) as a comorbidity factor remains debated. The aim of this study was to assess the relationships between being overweight and the ... ...

Abstract	While being overweight is a risk factor for subsequent asthma in children, the importance of body mass index (BMI) as a comorbidity factor remains debated. The aim of this study was to assess the relationships between being overweight and the characteristics of childhood asthma. The BMI, BMI z-scores and International Obesity Task Force (IOTF) grades were evaluated in asthmatic children according to atopic status, symptoms during the past 3 months, exercise breathlessness, treatment and lung function in 6-15-yr-old children with confirmed asthma. 491 asthmatic children (mean ± SD age 10.8 ± 2.6 yrs; 179 females) were prospectively enrolled. There were 78 (15.5%) overweight (IOTF grade 1) and eight (1.6%) obese (grade 2) children. The children's BMI z-scores did not differ according to atopy, exacerbation, symptom-free days or treatment. The BMI z-score correlated positively with forced vital capacity and forced expiratory volume in 1 s in females, which could be related to earlier puberty in overweight females (growth spurt with increased volumes). Compared with normal weight children, overweight and obese children had reduced lung volume ratios (functional residual capacity/total lung capacity (TLC) and residual volume/TLC), no evidence of airflow limitation and similar symptoms. In conclusion, the observed functional relationships with BMI are not specific to asthma and being overweight is not associated with significant clinical impacts on asthma during childhood.
MeSH term(s)	Adolescent ; Anti-Asthmatic Agents/therapeutic use ; Asthma/drug therapy ; Asthma/epidemiology ; Body Mass Index ; Child ; Comorbidity ; Female ; Humans ; Lung/physiopathology ; Male ; Overweight/epidemiology ; Respiratory Function Tests ; Severity of Illness Index
Chemical Substances	Anti-Asthmatic Agents
Language	English
Publishing date	2012-05
Publishing country	England
Document type	Journal Article
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/09031936.00103311
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Article ; Online: Homothety ratio of airway diameters and site of airway resistance in healthy and COPD subjects.

Bokov, Plamen / Mauroy, Benjamin / Mahut, Bruno / Delclaux, Christophe / Flaud, Patrice

Respiratory physiology & neurobiology

2014 Volume 191, Page(s) 38–43

Abstract: Our objective was to evaluate whether a decrease in the homothety ratio (h: diameter of child/parent bronchus, constant over generations) explains the shift in airway resistance toward periphery in chronic obstructive pulmonary disease (COPD). Using a ... ...

Abstract	Our objective was to evaluate whether a decrease in the homothety ratio (h: diameter of child/parent bronchus, constant over generations) explains the shift in airway resistance toward periphery in chronic obstructive pulmonary disease (COPD). Using a validated computational model of fluid motion, we determined that reduced values of h (<0.76) were associated with a shift in resistance toward periphery. The calculated luminal diameters of terminal bronchioles using normal h (0.80-0.85) or reduced h (0.70-0.75) fitted well with measured micro-CT values obtained by McDonough et al. (N. Engl. J. Med., 2011; 365:1567-75) in control and COPD patients, respectively. A semi-analytic formula of resistance using tracheal dimensions and h was developed, and using experimental data (tracheal area and h from patients [Bokov et al., Respir. Physiol. Neurobiol., 2010; 173:1-10]), we verified the agreement between measured and calculated resistance (r=0.42). In conclusion, the remodeling process of COPD may reduce h and explain the shift in resistance toward lung periphery.
MeSH term(s)	Airway Remodeling/physiology ; Airway Resistance/physiology ; Bronchioles/physiopathology ; Computer Simulation ; Humans ; Hydrodynamics ; Lung/physiopathology ; Models, Biological ; Pulmonary Disease, Chronic Obstructive/physiopathology
Language	English
Publishing date	2014-01-15
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2077867-3
ISSN	1878-1519 ; 1569-9048
ISSN (online)	1878-1519
ISSN	1569-9048
DOI	10.1016/j.resp.2013.10.015
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Article ; Online: Influence of age on the risk of severe exacerbation and asthma control in childhood.

Mahut, Bruno / Trinquart, Ludovic / Delclaux, Christophe

The Journal of asthma : official journal of the Association for the Care of Asthma

2011 Volume 48, Issue 1, Page(s) 65–68

Abstract: Background: Asthma is a heterogeneous disease but it is a common observation that children tend to "grow out of their asthma.": Objective: The aim was to specifically assess the influence of age on the occurrence of a severe exacerbation (at least 3 ... ...

Abstract	Background: Asthma is a heterogeneous disease but it is a common observation that children tend to "grow out of their asthma." Objective: The aim was to specifically assess the influence of age on the occurrence of a severe exacerbation (at least 3 days use of systemic corticosteroid--international 2009 definition) and of the achievement of control (GINA guidelines) in children treated for asthma. Our study was controlled for amount of therapy and for season. Methods: Children under inhaled corticosteroid (ICS) were enrolled over two 2-month periods (autumn, spring). Duration of oral steroid treatment and of symptoms, dose of ICS and long-acting beta-agonist were recorded for the past 3 months. Results: Three hundred and fifty-nine children (110 girls) were included (48 [<2 years], 116 [2-6 years], 107 [6-10 years], 88 [>10 years]) during autumn (n = 175) and spring (n = 184), all treated by ICS (mean daily dose ± SD = 378 ± 250 μg). Among the 359 children, 133 (37%) experienced at least one severe exacerbation, and control was observed in 111 (31%) children. A multivariate logistic regression model demonstrated that age, season, and ICS dose are independent risk factors for exacerbation, whereas age is the only predictor of control. The odds ratio of exacerbation and control are 0.85 (95% CI, 0.78-0.92, p < .0001) and 0.85 (95% CI, 0.79-0.91, p < .0001) per year of increase in age, respectively. Conclusions: From infancy to adolescence, each year of life reduces per se the risk of a severe exacerbation by 15% and similarly increases the achievement of control in children treated for asthma.
MeSH term(s)	Age Factors ; Anti-Asthmatic Agents/administration & dosage ; Asthma/drug therapy ; Asthma/physiopathology ; Child ; Child, Preschool ; Disease Progression ; Female ; Humans ; Male ; Risk Factors
Chemical Substances	Anti-Asthmatic Agents
Language	English
Publishing date	2011-02
Publishing country	England
Document type	Journal Article
ZDB-ID	603816-5
ISSN	1532-4303 ; 0277-0903
ISSN (online)	1532-4303
ISSN	0277-0903
DOI	10.3109/02770903.2010.529225
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Article ; Online: Exhaled nitric oxide and clinical phenotypes of childhood asthma.

Mahut, Bruno / Peyrard, Séverine / Delclaux, Christophe

Respiratory research

2011 Volume 12, Page(s) 65

Abstract: Whether exhaled NO helps to identify a specific phenotype of asthmatic patients remains debated. Our aims were to evaluate whether exhaled NO (FENO(0.05)) is independently associated (1) with underlying pathophysiological characteristics of asthma such ... ...

Abstract	Whether exhaled NO helps to identify a specific phenotype of asthmatic patients remains debated. Our aims were to evaluate whether exhaled NO (FENO(0.05)) is independently associated (1) with underlying pathophysiological characteristics of asthma such as airway tone (bronchodilator response) and airway inflammation (inhaled corticosteroid [ICS]-dependant inflammation), and (2) with clinical phenotypes of asthma.We performed multivariate (exhaled NO as dependent variable) and k-means cluster analyses in a population of 169 asthmatic children (age ± SD: 10.5 ± 2.6 years) recruited in a monocenter cohort that was characterized in a cross-sectional design using 28 parameters describing potentially different asthma domains: atopy, environment (tobacco), control, exacerbations, treatment (inhaled corticosteroid and long-acting bronchodilator agonist), and lung function (airway architecture and tone). Two subject-related characteristics (height and atopy) and two disease-related characteristics (bronchodilator response and ICS dose > 200 μg/d) explained 36% of exhaled NO variance. Nine domains were isolated using principal component analysis. Four clusters were further identified: cluster 1 (47%): boys, unexposed to tobacco, with well-controlled asthma; cluster 2 (26%): girls, unexposed to tobacco, with well-controlled asthma; cluster 3 (6%): girls or boys, unexposed to tobacco, with uncontrolled asthma associated with increased airway tone, and cluster 4 (21%): girls or boys, exposed to parental smoking, with small airway to lung size ratio and uncontrolled asthma. FENO(0.05) was not different in these four clusters.In conclusion, FENO(0.05) is independently linked to two pathophysiological characteristics of asthma (ICS-dependant inflammation and bronchomotor tone) but does not help to identify a clinically relevant phenotype of asthmatic children.
MeSH term(s)	Administration, Inhalation ; Adolescent ; Adrenal Cortex Hormones/administration & dosage ; Adrenergic beta-Agonists/administration & dosage ; Asthma/diagnosis ; Asthma/drug therapy ; Asthma/metabolism ; Asthma/physiopathology ; Biomarkers/metabolism ; Breath Tests ; Bronchial Provocation Tests ; Bronchodilator Agents/administration & dosage ; Child ; Cluster Analysis ; Cross-Sectional Studies ; Exhalation ; Female ; Forced Expiratory Flow Rates ; Forced Expiratory Volume ; Humans ; Linear Models ; Lung/drug effects ; Lung/metabolism ; Lung/physiopathology ; Male ; Nitric Oxide/metabolism ; Paris ; Plethysmography ; Predictive Value of Tests ; Principal Component Analysis ; Residual Volume ; Risk Assessment ; Risk Factors ; Spirometry ; Total Lung Capacity ; Vital Capacity
Chemical Substances	Adrenal Cortex Hormones ; Adrenergic beta-Agonists ; Biomarkers ; Bronchodilator Agents ; Nitric Oxide (31C4KY9ESH)
Language	English
Publishing date	2011-05-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2041675-1
ISSN	1465-993X ; 1465-993X
ISSN (online)	1465-993X
ISSN	1465-993X
DOI	10.1186/1465-9921-12-65
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Article ; Online: Abnormalities of plethysmographic lung volumes in asthmatic children.

Mahut, Bruno / Bokov, Plamen / Delclaux, Christophe

Respiratory medicine

2010 Volume 104, Issue 7, Page(s) 966–971

Abstract: Background: While lung hyperinflation is frequent in asthma, measurement of lung volumes is not recommended in current guidelines. The aim of this descriptive functional study was to assess whether systematic measurement of volumes by plethysmography ... ...

Abstract	Background: While lung hyperinflation is frequent in asthma, measurement of lung volumes is not recommended in current guidelines. The aim of this descriptive functional study was to assess whether systematic measurement of volumes by plethysmography may detect isolated hyperinflation with normal expiratory flows. Methods and patients: One hundred sixty asthmatic children (mean age + or - SD: 10.8 + or - 2.7 years; 50 girls) receiving inhaled corticosteroid underwent lung function tests before and after bronchodilation (BD). To avoid the problem of dysanaptic lung growth on predicted values in childhood, airflow limitation and hyperinflation were defined by ratios (FEV(1,%pred)/FVC(%pred) for the former, RV/TLC for the latter) and values below and above the 5th or 95th percentiles of reference values, were chosen as cut-off values. Results: Different functional phenotypes were evidenced, mainly normal lung function (142/160 [89%] after BD), but also isolated airflow limitation (35/160 [22%] before and 7/160 [4%] after BD) and isolated hyperinflation (17/160 [11%] before and 11/160 [7%] after BD), while the combination of both impairments before BD (13/160 [8%]) was never observed after BD. There was no statistical relationship between airflow limitation and hyperinflation, either before or after BD. Indices of spirometry (FEV(1), FEF(50%)) were unable to predict isolated hyperinflation that corresponds to small airway obstructive syndrome. Conclusion: Isolated hyperinflation is not infrequent in asthmatic children (7-11%) and small airway obstruction is not detected by forced expiratory flows.
MeSH term(s)	Adolescent ; Airway Obstruction/diagnosis ; Airway Obstruction/physiopathology ; Asthma/diagnosis ; Asthma/physiopathology ; Child ; Female ; Humans ; Male ; Plethysmography/methods ; Practice Guidelines as Topic ; Reference Values ; Spirometry/methods ; Total Lung Capacity
Language	English
Publishing date	2010-07
Publishing country	England
Document type	Journal Article
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2010.01.015
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